Quantitative mapping of the in vivo O-GalNAc glycoproteome in mouse tissues identifies GalNAc-T2 O-glycosites in metabolic disorder.

The family of GalNAc-Ts (GalNAcpolypeptide:N-Acetylgalactosaminyl transferases) catalyzes the first committed step in the synthesis of O-glycans, which is an abundant and biologically important protein modification. Abnormalities in the activity of individual GalNAc-Ts can result in congenital disorders of O-glycosylation (CDG) and influence a broad array of biological functions. How site-specific O-glycans regulate biology is unclear. Compiling in vivo O-glycosites would be an invaluable step in determining the function of site-specific O-glycans. We integrated chemical and enzymatic conditions that cleave O-glycosites, a higher-energy dissociation product ions-triggered electron-transfer/higher-energy collision dissociation mass spectrometry (MS) workflow and software to study nine mouse tissues and whole blood. We identified 2,154 O-glycosites from 595 glycoproteins. The O-glycosites and glycoproteins displayed consensus motifs and shared functions as classified by Gene Ontology terms. Limited overlap of O-glycosites was observed with protein O-GlcNAcylation and phosphorylation sites. Quantitative glycoproteomics and proteomics revealed a tissue-specific regulation of O-glycosites that the differential expression of Galnt isoenzymes in tissues partly contributes to. We examined the Galnt2-null mouse model, which phenocopies congenital disorder of glycosylation involving GALNT2 and revealed a network of glycoproteins that lack GalNAc-T2-specific O-glycans. The known direct and indirect functions of these glycoproteins appear consistent with the complex metabolic phenotypes observed in the Galnt2-null animals. Through this study and interrogation of databases and the literature, we have compiled an atlas of experimentally identified mouse O-glycosites consisting of 2,925 O-glycosites from 758 glycoproteins.

An unusual dual sugar-binding lectin domain controls the substrate specificity of a mucin-type O-glycosyltransferase.

N-acetylgalactosaminyl-transferases (GalNAc-Ts) initiate mucin-type O-glycosylation, an abundant and complex posttranslational modification that regulates host-microbe interactions, tissue development, and metabolism. GalNAc-Ts contain a lectin domain consisting of three homologous repeats (α, ß, and γ), where α and ß can potentially interact with O-GalNAc on substrates to enhance activity toward a nearby acceptor Thr/Ser. The ubiquitous isoenzyme GalNAc-T1 modulates heart development, immunity, and SARS-CoV-2 infectivity, but its substrates are largely unknown. Here, we show that both α and ß in GalNAc-T1 uniquely orchestrate the O-glycosylation of various glycopeptide substrates. The α repeat directs O-glycosylation to acceptor sites carboxyl-terminal to an existing GalNAc, while the ß repeat directs O-glycosylation to amino-terminal sites. In addition, GalNAc-T1 incorporates α and ß into various substrate binding modes to cooperatively increase the specificity toward an acceptor site located between two existing O-glycans. Our studies highlight a unique mechanism by which dual lectin repeats expand substrate specificity and provide crucial information for identifying the biological substrates of GalNAc-T1.

Impact of a Food Skills Course with a Teaching Kitchen on Dietary and Cooking Self-Efficacy and Behaviors among College Students.

College students may face barriers to eating healthy foods. Educational interventions providing practical knowledge and skills may help students to overcome financial barriers or other barriers to acquiring, preparing, and consuming healthy foods. We evaluated the association between participation in a semester-long food skills course with an interactive teaching kitchen and dietary and cooking self-efficacy and behaviors. Participants were recruited from course enrollees (intervention) and the general student population (comparison). We assessed differences in pre-post changes in the outcomes between groups using the propensity score weighting and mixed effects linear or Poisson regression. Course participation was associated with improved self-efficacy around cooking (group × time ß-coefficient [SE]: 3.25 [0.57], p < 0.0001) and fruit (6.33 [1.19], p < 0.0001), vegetable (5.43 [1.42], p = 0.0002), and whole grain (5.83 [1.40], p < 0.0001) consumption. Course participants reported smaller pre-post decreases in vegetable consumption compared to non-participants (0.35 [0.16], p = 0.03), increased cooking frequency (0.22 [0.10], p = 0.03) and a decreased frequency of skipping meals (-0.47 [0.16], p = 0.003). There were no changes associated with the intervention in the consumption of fruit or whole grains, or in eating out frequency. Participation in a semester-long, personal food skills course with a teaching kitchen may improve self-efficacy, cooking, and vegetable consumption among college students.

Chronic disease burden among Latino farmworkers in California.

Farmworkers are an essential workforce to maintain California's extensive agricultural production. However, this mostly Latino, immigrant population is affected by high poverty rates and food insecurity, which increases their risk of chronic diseases. We analyzed clinical and interview data from three studies of Latino farmworkers in California: (1) the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study, (2) the PASOS SALUDABLES pilot intervention (PASOS Pilot), and (3) the PASOS Study, a cluster-randomized, controlled trial (PASOS RCT). We aimed to determine the prevalence of diet-related chronic health outcomes (obesity, elevated waist circumference, high blood pressure, and high total cholesterol) and identify sociodemographic and socioeconomic factors associated with these conditions in this population. A total of 1,300 participants were included in this study (452 from MICASA, 248 from PASOS Pilot, and 600 from PASOS RCT). Obesity prevalence ranged from 29.2 to 54.5% across samples; elevated waist circumference was observed in 29.4-54.0% of participants; high blood pressure was detected in 42.0-45.5% of participants; 23.7-25.8% of participants had high total cholesterol. Age was positively associated with each health outcome, although not for each sample; each additional year in age increased odds by 3-9%, depending on the outcome and sample. Females were at higher risk of obesity (one sample) and elevated waist circumference, but at lower risk of high blood pressure and high total cholesterol. Single, divorced or widowed participants (vs. married/living together) had 35 and 47% reduced odds of obesity and elevated waist circumference, respectively. Each additional year living in the US was associated with 3-6% increased odds of obesity, depending on the sample. Higher household income was associated with a reduction in odds of high total cholesterol up to 76% (one sample). These findings highlight the increased risk of chronic health conditions in Latino farmworkers, in particular for obesity, and among farmworkers who may lack access to health care, which represents a large proportion of this population. Differences in chronic health risks by sex suggest that clinical and public health responses might need to be sex-specific. Expansion of eligibility for supplemental nutrition programs for this low-income population could reduce their disease burden.

Salud bucal en pacientes en estado crítico / Critical patient oral health

Fundamento: La salud bucal y sus cuidados son importantes en la atención sanitaria de pacientes en estado crítico. Objetivo: Proporcionar una visión general de los vínculos entre la salud bucal y los resultados adversos en la evolución de los pacientes en estado crítico. Metodología: Esta revisión narrativa se realizó en Google Académico, PubMed/Medline y SciELO, con los descriptores salud bucal, cuidados críticos, respiración artificial y neumonía asociada al ventilador, consultados en el DeCS. Se seleccionaron artículos a texto completo en español e inglés de revistas arbitradas por pares y de los últimos 5 años. Resultados: La disbiosis y la mala higiene bucales propician la aparición y desarrollo de enfermedades bucales que, a su vez, favorecen la incidencia de enfermedades respiratorias bajas como la neumonía asociada al ventilador en pacientes en estado crítico. Dentro de los factores vinculantes están la aspiración de secreciones bucales con bacterias patógenas que colonizan el tracto respiratorio inferior y los trastornos nutricionales que reducen el sistema defensivo. Aunque existen algunas discrepancias, la mayoría de los estudios apoyan las medidas de cuidado bucal en los pacientes en estado crítico. Conclusiones: La salud y cuidados bucales son claves para un desenlace clínico más favorable en los pacientes en estado crítico.

Background: Oral health and oral health care are important in the health care of critically ill patients. Objective: To provide an overview of the relationship between oral health and adverse outcomes in critically ill patients. Methodology: This narrative revision was conducted in Google Scholar, PubMed/Medline and SciELO, with the descriptors oral health, critical care, artificial respiration and ventilator-associated pneumonia consulted in the DeCS. Full-text articles in Spanish and English from peer-reviewed journals and from the last 5 years were selected. Results: Dysbiosis and poor oral hygiene promote the incidence and development of oral diseases, which in turn promote the incidence of lower respiratory system diseases such as ventilator-associated pneumonia in critically ill patients. Among the factors involved are aspiration of oral secretions with pathogenic bacteria that colonize the lower respiratory tract, and nutritional deficiencies that compromise the immune system. Although there are some discrepancies, most studies support oral care practices in critically ill patients. Conclusions: The health and care of the oral cavity is the key to a more favorable outcome for critically ill patients.

Oximetría de pulso y toma de decisión

Introducción: La enfermad producida por el COVID-19 constituye un problema sanitario mundial. La identificación precoz de las manifestaciones clínicas y del compromiso respiratorio resulta vital para minimizar las complicaciones de la enfermedad; en este sentido, la utilización del oxímetro de pulso constituye una alternativa interesante. Objetivo: Describir las ventajas aportadas por la utilización del oxímetro de pulso en la toma de decisión de pacientes para acudir oportunamente a solicitar atención médica. Métodos: Investigación básica, diseño descriptivo y retrospectivo. Universo constituido por 348 pacientes con diagnóstico de COVID-19 y la muestra por 184 casos. Se determinó frecuencia de complicaciones e influencia del uso de oxímetro de pulso en la toma de decisiones. Se utilizó prueba no paramétrica de Odd Ratio y Fisher exacta para identificar rango de ocurrencia. Resultados: promedio de edad de 54,47 años con predominio de pacientes femeninas (60,33 %) y con comorbilidades asociadas (66,85 %). El 25,00 % de los pacientes presentó afectación respiratoria como complicación de la OVID-19. El 47,83 % de los pacientes con complicaciones uso oxímetro de pulso, aunque solo el 27,27 % acudió tempranamente a consulta, pero si en el 90,91 % la decisión de asistir a servicio de urgencia estuvo influenciada por el uso del oxímetro de punto y sus resultados. Conclusiones: La oximetría de pulso ayudó a los pacientes a tomar la decisión de acudir en busca de atención médica. Puede considerarse el monitoreo de la saturación de oxígeno como una acción positiva en torno a la sospecha clínica de afección respiratoria severa.

Introduction: The disease caused by COVID-19 constitutes a global health problem. The early identification of clinical manifestations and respiratory compromise is vital to minimize the complications of the disease; in this sense, the use of the pulse oximeter constitutes an interesting alternative. Objective: To describe the advantages provided by the use of the pulse oximeter in the decision-making of patients to go in a timely manner to request medical attention. Methods: Basic research, descriptive and retrospective design. Universe made up of 348 patients diagnosed with COVID-19 and the sample of 184 cases. The frequency of complications and the influence of the use of pulse oximeter in decision making were determined. Non-parametric Odd Ratio and Fisher's exact tests were used to identify the range of occurrence. Results: average age of 54.47 years with a predominance of female patients (60.33 %) and with associated comorbidities (66.85 %). 25.00 % of the patients presented respiratory involvement as a complication of OVID-19. 47.83 % of the patients with complications used a pulse oximeter, although only 27.27 % attended the consultation early, but in 90.91 % the decision to attend the emergency service was influenced by the use of the oximeter point and its results. Conclusions: Pulse oximetry helped patients make the decision to seek medical attention. Oxygen saturation monitoring can be considered as a positive action around the clinical suspicion of severe respiratory disease.

Papel de la atención psicopedagógica en el sistema educativo / Role of psychopedagogical care in the educational system

La educación es un proceso complejo en cualquiera de los niveles educativos. Los educandos pueden sentir distintas sensaciones como miedo, inseguridad, alegría, temor y ansiedad que condicionan la actitud y predisposición al régimen educativo. La adaptación al proceso se hace diferente en cada estudiante y depende de la capacidad propia de vencer, controlar o modificar los sentimientos que se generan. En ocasiones, es necesario la orientación profesional, como alternativa orientadora, para lograr una mejor adaptación de los estudiantes al medio que los rodea y que no se afecte su rendimiento académico ni su comportamiento social. La atención psicopedagógica se considera una herramienta metodológica de apoyo al sistema educativo, cuya importancia no es dimensionada correctamente en muchas ocasiones(AU)

Education is a complex process at any educational level. Learners can feel different sensations such as fear, insecurity, happiness, fear and anxiety that condition the attitude and predisposition to the educational system. Adaptation to the process is different for each student and depends on their own ability to overcome, control or modify the feelings that are generated. Sometimes professional guidance is necessary, as a guidance alternative, to achieve a better adaptation of students to the environment that surrounds them and that neither their academic performance nor their social behavior is affected. Psychopedagogical attention is considered a methodological tool to support the educational system, whose importance is not correctly dimensioned on many occasions(AU)

Variantes genéticas del SARS-CoV-2 y sus implicaciones clínicas / Genetic variants of SARS-CoV-2 and its clinical implications

El SARS-CoV-2, agente causal de la actual pandemia de la COVID-19, va sufriendo mutaciones como consecuencia de su ciclo evolutivo, lo que ha originado diferentes variantes genéticas, que han sido agrupadas en dos categorías: preocupante (alfa o británica, beta o sudafricana, gamma o brasileña y delta o india) y de interés (lamdba, mu, épsilon, eta, iota, kappa, zeta, theta); estas conllevan implicaciones clínicas en la transmisibilidad, virulencia y resistencia del SARS-CoV-2 a la inmunidad natural y adquirida, lo que representa un serio desafío para los servicios de salud en todo el mundo. En este artículo se describen dichas variantes genéticas, con énfasis en su probable impacto clínico, y además se plantea la posibilidad de que aparezcan otras, como fenómeno natural en la evolución de los virus.

The SARS-CoV-2, causal agent of the COVID-19 current pandemic, is suffering mutations as a consequence of its evolutive cycle, what has originated different genetic variants that have been grouped in two categories: worrying (alpha or British, beta or South African, gamma or Brazilian and delta or Indian) and of interest (lamdba, mu, epsilon, eta, iota, kappa, zed, theta); these categories bear clinical implications in the transmissibility, virulence and resistance from SARS-CoV-2 to the natural and acquired immunity, what represents a serious challenge in health services worldwide. These genetic variants are described in this work, with emphasis in its probable clinical impact, and the possibility that other variants could appear is also explained, as natural phenomenon in the evolution of viruses.

Una mirada hacia las unidades decuidados intermedios / A look at the intermediate care units

Introducción: Las unidades de cuidados intermedios constituyen parte de los procesos de atención progresivo. Brindan asistencia continua a pacientes potencialmente graves, además ofrecen vigilancia y tratamiento en un nivel menor que las unidades de cuidados intensivos, pero superior a las salas de hospitalización convencionales. Objetivo: Motivar a los profesionales del nivel de atención secundaria a valorar las ventajas de la unidades de cuidados intermedios y fomentar su aplicación. Métodos: Se realizó una revisión bibliográfica minuciosa de 80 artículos publicados en español e inglés sin limitación de la fechas de publicación, en las bases de datos: PubMed, Latindex y Medline. Se utilizó la palabra clave Unidades de Cuidados Intermedios. Se aplicaron métodos de síntesis de la información y análisis crítico para crear un artículo de revisión y opinión. Resultados: De los artículos revisados 28 se incluyeron en el presente trabajo. Discusión: Entre las ventajas de hacer uso de unidades de cuidados intermedios están, disminución de costos, adecuada distribución de los recursos, reducción de las transferencias a prestadores externos, elevación de la calidad asistencial y disminución de ingresos en las unidades de cuidados intensivos. Varios países latinoamericanos carecen de unidades de cuidados intermedios, incrementándose los costos hospitalarios y afectándose la atención del paciente potencialmente grave. Conclusiones: Las unidades de cuidados intermedios representan un eslabón en la actividad asistencial del paciente potencialmente grave de gran importancia, con numerosas ventajas que impactan sobre los costos y calidad en la atención hospitalaria.

Craniectomía descompresiva, una alternativa de tratamiento. Caso clínico / Decompressive craniectomy, an alternative treatment. Clinical case

Introducción: El Trauma Cráneo Encefálico Grave (TCE), continúa siendo un problema de preocupación para las autoridades sanitarias a nivel mundial. A pesar de las diferentes publicaciones existen divergencias en la toma de desición en aplicar la Craniectomía descompresiva (Cd). En el presente trabajo se describe caso clínico portador de Hematoma Epidural (HE), Hipertensión Endocraneana (HE), intervenido quirúrgicamente donde la información fue tomada de la historia clínica realizada en la Unidad de Cuidados Intensivos del Hospital Andino del Chimborazo, Riobamba, Ecuador, previa obtención del consentimiento informado. Presentación del caso: Paciente femenina de 18 años de edad que sufre Trauma craneoencefálico grave, hematoma epidural con efecto de masa y edema cerebral. Sometida a craniectomía descompresiva y tratamiento neurointensivo. Estadía en Unidad de Cuidados Intensivos de seis días, evolución favorable, ausencia de secuelas neurológicas. Conclusiones: La Craniectomía descompresiva mejora la Hipertensión endocraneana, disminuye la estadía UCI, y los días de ventilación mecánica, sin embargo los estudios actuales demuestran que esta intervención no mejora resultados finales. La Craniectomía Descompresiva primaria, en centros de escasos recursos de neuromonitoreo, puede constituir un proceder salvador. La craniectomía descompresiva está indicada en la segunda línea de tratamiento según la American Association of Neurological Surgeons.

Introduction: Serious Skull Trauma (SST), continues to be a problem of concern for health authorities worldwide. Despite the different publications there are divergences in the decision making in applying decompressive craniectomy (dc). In the present work, a clinical case of Epidural Hematoma (EH), Endocranial Hypertension (EH), surgically intervened was described, where the information was taken from the clinical history carried out in the Intensive Care Unit of the Andino del Chimborazo Hospital, Riobamba, Ecuador, after obtaining the informed consent. Presentation of the case: An 18-year-old female patient suffering from severe head trauma, epidural hematoma with mass effect and cerebral edema. Subjected to decompressive craniectomy and neurointensive treatment. Stay in the Intensive Care Unit for six days, favorable evolution, absence of neurological sequelae. Conclusions: Decompressive craniectomy improves intracranial hypertension, decreases ICU stay, and days of mechanical ventilation, however current studies show that this intervention does not improve final results. Primary Decompressive Craniectomy, in centers with scarce resources of neuromonitoring, can be a saving procedure. Decompressive craniectomy is indicated in the second line of treatment according to the American Association of Neurological Surgeons.

Meningoencefalitis por Candida krusei / Meningoencephalitis by Candida krusei

Los procesos infecciosos del sistema nervioso presentan una elevada morbilidad y mortalidad, debido a esto es necesario un diagnóstico certero y rápido por parte del equipo médico de urgencia. En este trabajo se reporta el caso de un paciente tratado en la Unidad de Cuidados Intensivos (UCI) del Hospital Andino de la ciudad de Riobamba de Ecuador. Se trata de un paciente de 46 años de edad que presenta un síndrome convulsivo de etiología infecciosa que se interpreta como una meningoencefalitis. El resultado del cultivo de líquido cefalorraquídeo señala como agente etiológico una especie de Candida poco frecuente: Candida krusei. Desde su ingreso el paciente necesitó ventilación mecánica invasiva y se le administró tratamiento antibiótico y antiviral hasta ir descantando etiologías bacterianas, virales o parasitarias. Al quinto día se aislaron más de 35 000 Unidades Formadoras de Colonias de Candida krusei, por lo que se indicó tratamiento antimicótico con Voriconazol. Se realizaron estudios de imagen, lo que incluyó tomografía axial computarizada (TAC) y resonancia magnética (RM) que mostraron edema cerebral en corteza temporal excluyéndose procesos expansivos. Paciente se retira del ventilador mecánico y es dado de alta de la UCI con afasia sensitiva y hemiparesia izquierda. Durante su estancia en la sala de medicina interna el paciente se somete a rehabilitación con evolución favorable.

Infectious processes of the nervous system produce high morbidity and mortality and because of this, it is necesary an accurate and opportune diagnosis. In this paper we report the case of a patient treated in the Intensive Care Unit (ICU) of the Hospital Andino of the city of Riobamba of Ecuador. It consist of a 46 years old patient that presents a seizure syndrome of infectious etiology that is is interpreted as meningoencephalis. Results of cerebrospinal fluid culture shows the presence of a rare specie of Candida: Candida krusei. From the first day of hospitalization the patient needed invasive mechanical ventilation, antimicrobial and antiviral treatment while a bacterial, viral or parasitic etiology was identified. On the 5th day more than 35 000 Colony Forming Units of Candida krusei were isolated, therefore an antifungal treatment with Voriconazole was indicated. Imaging studies were carried out including, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), which showed cerebral edema in the temporal cortex and that expansive processes were excluded. The patient is removed from the mechanical ventilator and was discharged form the ICU presenting sensory aphasia and left hemiparesis. During his stay in the internal medicine unit of the hospital, the patient underwent rehabilitation and showed a favorable evolution.