Porous silicon opto-acoustic detector for ternary gas mixture.

The use of porous phoxonic crystals with coupled optical and acoustic response has been proposed as a sensing device. Due to the porous nature of the crystal, each layer of the structure can be connected to the environment. As the optical and acoustic performances of the phoxonic crystal change when a gas permeates the pores due to modifications of the effective refractive index and density of the system, it results that these structures are suitable platforms for the detection of gases. The sensor designed following these premises can detect the composition of ternary gas mixtures through optical measurements, while an acoustic wave induces a structural oscillation. The amplified acoustic wave produces a mechanical deformation of the crystal layers that is maximized in the center a resonant microcavity. Therefore, under such experimental conditions, the sensitivity of the optical response is not only due to the optical property changes caused by the gas mixture in contact with the porous structure but also to changes in the mechanical deformations due to modifications of the acoustic properties. In this work, we discuss the device theoretical behavior as a multiparameter sensor that distinguishes the components and concentrations of a ternary gas mixture through the transfer matrix method. For a prototype combination of CO2-Air-CH4 mixture, the estimated resolution of the proposed device fabricated in porous silicon can be has high as 0.05% (500 ppm) in the concentration of each individual species.

Moringa oleifera Improves MAFLD by Inducing Epigenetic Modifications.

BACKGROUND AND AIMS: Metabolic Associated Fatty Liver Disease (MAFLD) encompasses a spectrum of diseases from simple steatosis to nonalcoholic steatohepatitis (NASH). Here, we investigated the hepatoprotective role of Moringa oleifera aqueous extract on hepatic miRNAs, genes and protein expression, as well as histological and biochemical parameters in an experimental model of NASH. METHODS: Male C57BL/6J mice were fed with a high fat diet (HFD, 60% lipids, 42 gr/L sugar in water) for 16 weeks. Moringa extract was administered via gavage during the final 8 weeks. Insulin Tolerance Test (ITT) and HOMA-IR were calculated. Serum levels of insulin, resistin, leptin and PAI-1 and hepatic expression of miR-21a-5p, miR-103-3p, miR-122-5p, miR-34a-5p and SIRT1, AMPKα and SREBP1c protein were evaluated. Alpha-SMA immunohistochemistry and hematoxylin-eosin, Masson's trichrome and sirius red staining were made. Hepatic transcriptome was analyzed using microarrays. RESULTS: Animals treated with Moringa extract improved ITT and decreased SREBP1c hepatic protein, while SIRT1 increased. Hepatic expression of miR-21a-5p, miR-103-3p and miR-122-5p, miR34a-5p was downregulated. Hepatic histologic analysis showed in Moringa group (HF + MO) a significant decrease in inflammatory nodules, macro steatosis, fibrosis, collagen and αSMA reactivity. Analysis of hepatic transcriptome showed down expression of mRNAs implicated in DNA response to damage, endoplasmic reticulum stress, lipid biosynthesis and insulin resistance. Moringa reduced insulin resistance, de novo lipogenesis, hepatic inflammation and ER stress. CONCLUSIONS: Moringa prevented progression of liver damage in a model of NASH and improved biochemical, histological and hepatic expression of genes and miRNAs implicated in MAFLD/NASH development.

Assessment of Noninvasive Markers of Steatosis and Liver Fibrosis in Human Immunodeficiency Virus-Monoinfected Patients on Stable Antiretroviral Regimens.

Background: Nonalcoholic fatty liver disease (NAFLD) is a major nonacquired immune deficiency syndrome-defining condition for persons with human immunodeficiency virus (PWH). We aimed to validate noninvasive tests for the diagnosis of NAFLD in PWH. Methods: This is a cross-sectional study of PWH on stable antiretroviral therapy with persistently elevated transaminases and no known liver disease. The area under the receiver operating characteristic curve (AUROC) was calculated to compare the diagnostic accuracy of liver biopsy with abdominal ultrasound, transient elastography (TE) (including controlled attenuation parameter [CAP]), and noninvasive markers of steatosis (triglyceride and glucose index [TyG], hepatic steatosis index [HSI], fatty liver index [FLI]) and fibrosis ([FIB]-4, aminotransferase-to-platelet ratio index [APRI], NAFLD fibrosis score). We developed a diagnostic algorithm with serial combinations of markers. Results: Of 146 patients with increased transaminase levels, 69 underwent liver biopsy (90% steatosis, 61% steatohepatitis, and 4% F ≥3). The AUROC for steatosis was as follows: ultrasound, 0.90 (0.75-1); CAP, 0.94 (0.88-1); FLI, 0.81 (0.58-1); HSI, 0.74 (0.62-0.87); and TyG, 0.75 (0.49-1). For liver fibrosis ≥F3, the AUROC for TE, APRI, FIB-4, and NAFLD fibrosis score was 0.92 (0.82-1), 0.96 (0.90-1), 0.97 (0.93-1), and 0.85 (0.68-1). Optimal diagnostic performance for liver steatosis was for 2 noninvasive combined models of tests with TyG and FLI/HSI as the first tests and ultrasound or CAP as the second tests: AUROC = 0.99 (0.97-1, P < .001) and 0.92 (0.77-1, P < .001). Conclusions: Ultrasound and CAP performed best in diagnosing liver steatosis, and FLI, TyG, and HSI performed well. We propose an easy-to-implement algorithm with TyG or FLI as the first test and ultrasound or CAP as the second test to accurately diagnose or exclude NAFLD.

Incidence of electrocardiographic alterations in the preoperative period of non-cardiac surgery.

BACKGROUND: The electrocardiogram is the most widely used test to assess cardiovascular risk during the preoperative period. The objective of the present study is to evaluate the incidence of electrocardiographic alterations in the general population scheduled for non-cardiac surgery and to determine if the age greater than or equal to 65 years or the revised cardiac risk index ≥1 represent a risk factor for presenting these alterations. MATERIAL AND METHODS: Over a period of one month, all preoperative electrocardiograms (ECG) from the anesthesia clinic were analyzed. Various epidemiological data were collected and the revised cardiac risk index was calculated. Major alterations were defined as those requiring Cardiology follow-up. RESULTS: 476 patients were recruited, of whom 40.8% were ≥65 years, 32.6% had HTN, 14.4% DM and 27.9% dyslipidemia. 16.16% of the patients had a Lee Index ≥1. Of the entire sample, 80.5% had a normal ECG, 6.5% minor alterations and 13.0% major alterations. In the multivariate analysis, age ≥65 years and the presence of HTN were shown as independent risk factors for presenting alterations in the total and major ECG. The Lee index ≥1 was not associated with an increased risk of electrocardiographic abnormalities. CONCLUSIONS: Patients ≥65 years old and those with HTN are at greater risk of presenting major electrocardiographic abnormalities, so we recommend including the ECG as a routine diagnostic test in the preoperative period of non-cardiac surgery.

Incidence of electrocardiographic alterations in the preoperative period of non-cardiac surgery. / Incidencia de alteraciones electrocardiográficas en el preoperatorio de cirugía no cardiaca.

BACKGROUND: The electrocardiogram is the most widely used test to assess cardiovascular risk during the preoperative period. The objective of the present study is to evaluate the incidence of electrocardiographic alterations in the general population scheduled for non-cardiac surgery and to determine if the age greater than or equal to 65 years or the revised cardiac risk index ≥ 1 represent a risk factor for presenting these alterations. MATERIAL AND METHODS: Over a period of one month, all preoperative electrocardiograms (ECG) from the anesthesia clinic were analyzed. Various epidemiological data were collected and the revised cardiac risk index was calculated. Major alterations were defined as those requiring Cardiology follow-up. RESULTS: 476 patients were recruited, of whom 40.8% were ≥ 65 years, 32.6% had HTN, 14.4% DM and 27.9% dyslipidemia. 16.16% of the patients had a Lee Index ≥ 1. Of the entire sample, 80.5% had a normal ECG, 6.5% minor alterations and 13.0% major alterations. In the multivariate analysis, age ≥ 65 years and the presence of HTN were shown as independent risk factors for presenting alterations in the total and major ECG. The Lee index ≥ 1 was not associated with an increased risk of electrocardiographic abnormalities. CONCLUSIONS: Patients ≥ 65 years old and those with HTN are at greater risk of presenting major electrocardiographic abnormalities, so we recommend including the ECG as a routine diagnostic test in the preoperative period of non-cardiac surgery.

Contribución del panel de miositis en el estudio de pacientes con enfermedades pulmonares intersticiales y sospecha de enfermedad del tejido conectivo / Contribution of myositis panel in the study of patients with interstitial lung disease and suspicion of connective tissue disease

INTRODUCCIÓN: La manifestación extramuscular de las miopatías inflamatorias idiopáticas (MII) es la enfermedad pulmonar intersticial (EPI) y el diagnóstico se basa en autoanticuerpos séricos. Los nuevos anticuerpos específicos y asociados a MII han ayudado a identificar nuevas entidades clínicas en el espectro de MII. El objetivo de este estudio es evaluar la contribución diagnóstica de un panel de anticuerpos de miositis (PM) en una cohorte de pacientes chilenos con EPI sin una enfermedad del tejido conectivo (ETC) definitiva. MATERIALES Y MÉTODOS: A partir de enero de 2017 se realizó un panel de miositis a 111 pacientes consecutivos con EPI y sospecha de ETC, pero sin un diagnóstico definitivo a través de otra herramienta diagnóstica, en el programa de Pulmón-Reumatológico del Instituto Nacional del Tórax, Santiago, Chile. Se compararon las características basales clínicas y serológicas de los pacientes que se asociaban más frecuentemente a la probabilidad de tener un panel positivo. RESULTADOS: El PM fue positivo en 56 de 111 pacientes. El síndrome antisintetasa (SAS) fue el diagnóstico más frecuente. Los anticuerpos más frecuentes fueron Ro-52, PM / Scl-75 y Ku. Las variables más frecuentes en el grupo PM(+) fueron la presencia del Raynaud, miositis, manos de mecánico, los anticuerpos Ro y La positivos, la presencia de un patrón combinado de neumonía intersticial inespecífica y neumonía organizada en la tomografía computarizada de tórax. CONCLUSIONES: la incorporación del PM nos ha ayudado a mejorar nuestra precisión diagnóstica en pacientes con EPI / ETC. Presentamos elementos clínicos y serológicos que perfeccionan el rendimiento de la prueba.

INTRODUCTION: The most common extramuscular manifestation of the idiopathic inflammatory myopathies (IIM) is interstitial lung disease (ILD) and the diagnosis is based on serum autoantibodies. The new specific and associated antibodies to IIM have helped to identify new clinical entities in the spectrum of IIM. The objective of this study is to evaluate the diagnostic contribution of a myositis antibodies panel (MP) in a cohort of Chilean patients with ILD without a definitive connective tissue disease (CTD). MATERIALS AND METHODS: Starting on January 2017 we performed a MP to 111 consecutive patients with ILD and suspected CTD but without a definitive diagnosis through another diagnostic tools in the Lung-Rheumatological Program at the "Instituto Nacional del Tórax", Santiago, Chile. The clinical and serological baseline characteristics of the patients that were most frequently associated with the probability of having a positive panel were compared. RESULTS: The MP was positive in 56 of 111 patients. Anti synthetase syndrome (ASS) was the most prevalent diagnosis. The most frequent antibodies were Ro-52, PM/Scl-75 and Ku. The most frequent variables in the positive MP group were the presence of Raynaud's phenomenon, myositis, mechanic's hands, positive Ro and La antibodies and the presence of combined pattern of nonspecific interstitial pneumonia and organizing pneumonia in chest computed tomography scan. CONCLUSIONS: The incorporation of the MP has helped us to improve our diagnostic precision of patients with CTD/ILD. We present clinical and serological elements that refine the performance of the test.

Seroepidemiological evidence for Taenia solium taeniasis/cysticercosis in three Venezuelan rural communities.

Taenia solium is the most common parasite infection of the brain, causing neurocysticercosis and typically found in rural communities with free-ranging pigs. Identification of transmission in rural areas is essential for its control. Risk factors and transmission of the parasite were evaluated in three rural Venezuelan communities (Valle del Rio and Potrero Largo, Cojedes state; and Palmarito, Portuguesa state) by a questionnaire (112 households) and coprological (492 samples) and serological (433 human and 230 porcine sera) analysis, respectively. Typical risk factors were found in all three communities: free-foraging pig husbandry, deficient sanitary conditions, high open defecation and ignorance of the parasite life cycle. Coprological examinations revealed a high level of soil-transmitted parasites. Importantly, two T. solium adult worm carriers were identified in each of the three communities. Anti-metacestode antibodies and the HP10 secreted metacestode glycoprotein were detected at significant levels in human and porcine sera in Valle del Rio, Potrero Largo and Palmarito. In conclusion, these communities may be considered to be endemic for taeniasis/cysticercosis, and the instigation of an appropriate control programme is recommended.

Healthcare-associated pneumonia: a prospective study in Spain.

OBJECTIVE: The aim of the study was to describe the epidemiological characteristics and factors related to outcome in Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA) healthcare-associated pneumonia (HCAP). METHODS: A 3-year prospective observational epidemiological case study of HCAP was conducted in seven Spanish hospitals. Microbiological and patient characteristics and outcomes were collected and classified by causative pathogen into 4 categories: "S. pneumoniae", "MRSA", "Others" and "Unknown". Patients were followed up 30 days after discharge. RESULTS: A total of 258 (84.6%) patients were enrolled (170 were men [65.9%]). Mean age was 72.4 years ± 15 years (95% CI [70.54-74.25]). The etiology of pneumonia was identified in 73 cases (28.3%): S. pneumoniae in 35 patients (13.6%), MRSA in 8 (3.1%), and other microorganisms in 30 patients (11.6%). Significant differences in rates of chronic obstructive pulmonary disease (p < 0.05), previous antibiotic treatment (p<0.05), other chronic respiratory diseases, inhaled corticosteroids (p <0.01), and lymphoma (p < 0.05) were observed among the four groups. Patients with MRSA pneumonia had received more previous antibiotic treatment (87.5%). Thirty-three (12.8%) patients died during hospitalisation; death in 27 (81.2%) was related to pneumonia. CONCLUSIONS: The etiology of HCAP was identified in only one quarter of patients, with S. pneumoniae being the most prevalent microorganism. Patients with chronic respiratory diseases more frequently presented HCAP due to MRSA than to S. pneumoniae. Death at hospital discharge was related in most cases to pneumonia.

Evaluation of a workshop to teach a new surgical technique in abdominal wall reconstruction.

PURPOSE: Assess the utility of a hands-on workshop on abdominal wall reconstruction for teaching the posterior components separation (PCS) with transversus abdominis release. METHODS: Our department has been organizing a training course on abdominal wall reconstruction for the last 6 years. It is a 2-day-long course and 10-12 surgeons with experience in abdominal wall surgery attend to every course. The first day is dedicated to theoretical lectures and two simultaneous live surgeries, and the second day there is a cadaver dissection. Feedback from the trainees was collected at the end of the workshop. A survey was sent to all the surgeons who had completed the course at least a year ago, to inquire how the course had improved their surgical practice. RESULTS: From 2013 to April 2017, we have made 15 editions of the course. A total of 192 surgeons from Europe, South Africa and Middle East attended. All the surgeons answered the survey that was carried out at the end of the course. It showed a very high level of satisfaction in more than 98% of the cases. The second survey was answered by 79 surgeons (41.15%). 96% of the surgeons had modified, after attending the course, their way of dealing with complex abdominal wall problems. Only 29% of the surgeons had made a TAR before attending the course, while 86% are performing it after attending the course and 60% do it on a regular basis. In fact, 43% of surgeons have performed more than five posterior component separations in the last year. CONCLUSIONS: A workshop of abdominal wall surgery that combines live surgery, theoretical content and a cadaver lab can be a very useful tool to expand the use of new surgical techniques.

The microstructure of laminin-111 compensates for dystroglycan loss in mammary epithelial cells in downstream expression of milk proteins.

Laminin-111 (Ln-1), an extracellular matrix (ECM) glycoprotein found in the basement membrane of mammary gland epithelia, is essential for lactation. In mammary epithelial cells (MECs), dystroglycan (Dg) is believed to be necessary for polymerization of laminin-111 into networks., thus we asked whether correct polymerization could compensate for Dg loss. Artificially polymerized laminin-111 and the laminin-glycoprotein mix Matrigel, both formed branching, spread networks with fractal dimensions from 1.7 to 1.8, whereas laminin-111 in neutral buffers formed small aggregates without fractal properties (a fractal dimension of 2). In Dg knockout cells, either polymerized laminin-111 or Matrigel readily attached to the cell surface, whereas aggregated laminin-111 did not. In contrast, polymerized and aggregated laminin-111 bound similarly to Dg knock-ins. Both polymerized laminin-111 and Matrigel promoted cell rounding, clustering, formation of tight junctions, and expression of milk proteins, whereas aggregated Ln-1 did not attach to cells or promote functional differentiation. These findings support that the microstructure of Ln-1 networks in the basement membrane regulates mammary epithelial cell function.

ΔNp73 status in peritoneal and ovarian dissemination of appendicular adenocarcinoids (goblet cells).

INTRODUCTION: Goblet cell carcinoma (GCC) is an appendicular neoplasia representing less than 5% of all appendicular tumors, found in 0.3-0.9% of the appendectomies, 35-58% of all appendicular neoplasms, and less than 14% of malign appendix tumors. The most frequent clinical presentation is abdominal pain associated with a picture of acute appendicitis. MATERIALS AND METHODS: We present 3 clinical cases of appendix GCC, 2 subjected to cytoreductory surgery plus intraperitoneal hyperthermic chemotherapy and a third, who is currently receiving neoadjuvant treatment with a good response to chemotherapy and who will be offered the same treatment as the first two patients. Given the unpredictable behavior of these tumors, the use of molecular markers could help us to predict their behavior and prognosis. In this context, the TP73 gene would make an interesting putative marker. ∆Np73 has been described as overexpressed in a great variety of tumor types including colon cancer and this up-regulation is associated with a poor prognosis. To evidence its role in this malignancy, we evaluate here the status of ∆Np73 in the primary tumor and normal counterpart tissues, in the metastatic implants and in healthy areas of the peritoneum from the appendicular GCC patients. In addition, we checked the expression levels of this p73 variant in the tumor and normal tissue of 26 patients with colon cancer. RESULTS: Remarkably, 2 patients showed significant ∆Np73 down-regulation in both the primary tumor and the implants. Case 1 presented a fourfold decrease of levels in the primary tumor and 20-fold decrease in the implants. Case 2 showed a seven- and fourfold down-regulation in the primary tumor and implants, respectively. However, Case 3 showed an up-regulation of 53- and threefold in the primary tumor and implants, respectively. CONCLUSION: Goblet cell carcinoma of the appendix is very rate. It tends to seed throughout the peritoneum, making aggressive surgical cytoreduction and chemotherapy viable treatment options. Investigation into the molecular basis of these tumors may improve the diagnosis, prognosis and therapeutic decisions regarding these patients. ∆Np73 seems a good candidate for further analysis in longer series.

Liver Transplantation Results by Donor Age.

OBJECTIVE: The objective of this study was to compare liver transplantation outcomes as a function of donor age. MATERIAL AND METHODS: We performed 212 liver transplantations between 2008 and 2014. We described a prospective cohort study and grouped the patients by liver donor age. We compared quantitative and categorical variables using statistical analysis. RESULTS: No statistically significant differences were found among any graft age groups in gender (always more males), time on waiting list, age, height, Child Pugh Turcotte (CHILD) score, Model for End-stage Liver Disease (MELD) score, need for intraoperative blood products, or intensive care unit stay. The most frequent etiology of liver failure was alcohol. A brain-dead donor was the most frequent type in all groups. The whole graft was used except in 4 cases. No statistically significant differences were found among groups in the surgical technique, postreperfusion syndrome, arterial complications, biliary complications, venous complications, acute rejection, and retransplantation. The 3-year patient survival rate was 64% in the <60-year graft age group, 48% in the 60- to 69-year group, 64% in the 70- to 79-year group, and 40% in the ≥80-year group (P = .264). The 3-year graft survival rate was 62% in the <60-year graft age group, 47% in the 60- to 69-year group, 65% in the 70- to 79-year group, and 40% in the ≥80-year group (P = .295). CONCLUSIONS: Given the need to increase the pool of liver donors, older donors should be considered as a source for liver transplantation, although careful selection is required.

Influence of Obesity on Liver Transplantation Outcomes.

OBJECTIVE: The aim of this work was to determine the impact of obesity on the morbidity and mortality of liver transplantation (LT) recipients. METHODS: A single-center, observational-cohort, retrospective study was conducted in patients undergoing LT from January 2008 to December 2014 to compare complications and survival between those with body mass index (BMI) <35 kg/m2 and those with BMI ≥35 kg/m2. RESULTS: The study included 170 patients: 162 (95.3%) with BMI <35 kg/m2 and 8 (4.7%) with BMI ≥35 kg/m2. The groups significantly differed in overall mortality and graft survival: The risk of death was 3.54-fold higher (95% confidence interval, 1.39-9.03) and the mean graft survival was shorter (61 vs 21 mo; P = .001) in the group with BMI ≥35 kg/m2. The groups did not significantly differ in rates of biliary complications, arterial and portal vein thrombosis, retransplantation or reintervention, intraoperative requirement for blood products, length of intensive care unit stay, or post-reperfusion syndrome or rejection rates. CONCLUSIONS: Although no significant differences were found between these groups in post-transplantation complications, BMI ≥35 kg/m2 emerged as a mortality risk factor in these patients.

[Modeling a clinical process for differentiated thyroid cancer health care in Hospital Base Valdivia, Chile]. / Modelamiento del proceso clínico para manejo de usuarios con cáncer tiroideo diferenciado en el Hospital Base Valdivia, Chile.

OBJECTIVE: To design a clinical process model in the management of differentiated thyroid cancer in order to improve accessibility to this treatment. MATERIAL AND METHODS: Based on modified Participatory Action Research, a model design process was conducted using a literature review and meetings with organisations committed to the redesigning process, and to agree an improved and feasible process. RESULTS: The process map was constructed by participatory action including, characterisation of the value chain, fault detection in the flow of the process, relevant documents and process for proposing modifications and approvals necessary for this purpose. Links were established between the main process and the support and strategic processes. The participatory model helped to cut the waiting times for diagnosis and treatment of this disease from 12 to 4 months. CONCLUSIONS: For each unit to be able to fully visualise the map of the process and understand their contribution as a set of integrated contributions and not fragmented, helps in the comprehensive management of patients and operation processes based on the hierarchical and dominant organisational model in Chilean hospitals. To analyse and remodel clinical processes by participatory action helps to limit failures in the fluidity of care of the patients, by presenting each participating unit with a general view of the process, the problems, and the possible solutions. Furthermore, this approach helps to clarify the process in order to make it more efficient, to harmonise relationships, and to improve coordination in order to optimise patient care.

1º Congreso AADYND: Categoría Premio Congreso / Gasto energético y hemodiálisis crónica / Valoración nutricional cualitativa de los menús y diseño de la carta de restaurantes / Ferias Municipales: Viabilidad como canal de comercialización / Prueba piloto para conocer aceptabilidad, preferencia y saciedad de colaciones dulces con baja densidad energética y alto aporte proteico en mujeres perimenopáusicas / Rol de la infección por Helicobacter pylori en la regulación hormonal del apetito y el índice de masa corporal / Incursionando nuevas áreas de trabajo: "El licenciado en nutrición en una unidad de cuidados intensivos neonatales" / Diseño y proyección de audiovisuales animados como estrategia comunicativa / Proceso de mejora de las bases y condiciones para la concesión del servicio de confitería de la Facultad de Ciencias de la Salud (FCS). Universidad Nacional de Salta (UNSa) / Consumo de frutas en estudiantes universitarios

Introducción: Existen controversias sobre el comportamiento del gasto energético en reposo (GER) en pacientes en hemodiálisis (HD), algunos autores señalan que la HD aumenta el GER, mientras que otros no hallaron diferencias significativas. Objetivos: Determinar si el GER en pacientes en HD es superior al de individuos que no dializan. Determinar si el GER en pacientes en HD es mayor durante el momento de diálisis en comparación al momento que no dializan. Materiales y método: Para el objetivo 1, diseño comparativo a muestras independientes, observacional, prospectivo, transversal; para el objetivo 2, comparativo a muestras relacionadas, observacional, prospectivo, longitudinal. La muestra quedó conformada por 30 individuos en HD crónica y 30 controles apareados por edad, sexo, actividad física y estado nutricional. Se midió el GER utilizando un calorímetro indirecto móvil. Para el análisis estadístico se aplicaron test de diferencias (p < 0,05). Resultados: El GER de los individuos en HD no fue significativamente mayor al del grupo control (test de medias 56,8kcal, IC -76,6/190,2, p=0,1955; test de medianas 49,9kcal, IC -84,9/189,9, p=0,2142; test de signos 56,6%, IC 37,4/74,5, p=0,292). En los individuos en HD, el GER aumentó significativamente durante la sesión (test de medias 173kcal, IC -83,6/262,4, p=0,00022; test de medianas 170kcal, IC 85/255, p=0,00024; test de signos 83,33%, IC 65,3/94,3, p=0,00016). Al subdividir este grupo según presencia o ausencia de diabetes, se mantuvo el incremento del GER durante la diálisis. (test de medias 210kcal, IC 75,1/344,9, p 0,0044; test de medianas 212,5kcal, IC 65/340, p 0,0028; test de signos 85,71%, IC 42,1/99,6, p 0,06). Conclusiones: El GER de pacientes en HD no está incrementado con respecto a individuos sanos. En el paciente en HD crónica el GER aumenta durante el procedimiento dialítico en comparación al día que no asiste a diálisis.

Introducción: La carta de menú del restaurante, aparece como el elemento de comunicación más fuerte y a veces el único que se establece entre el restaurante y el consumidor. La tendencia creciente de comer fuera de casa convierte a los restaurantes en establecimientos cruciales para la promoción de un patrón alimentario saludable para toda la población. Una oferta alimentaria variada y equilibrada desde el punto de vista nutricional es el camino adecuado para mejorar la calidad de los menús, y con ello llevar mensajes nutricionales para mejorar la salud poblacional. Objetivos: Analizar el valor nutricional cualitativo de los menús y el diseño de la carta en los restaurantes de la ciudad de Mar del Plata en el año 2014. Materiales y método: La selección de restaurantes se llevó a cabo al azar por estratificación en zonas geográficas. Se realizó un análisis de valoración nutricional cualitativa de los menús con los datos recolectados. Simultáneamente, se analizó el diseño de las cartas de menús a través de una grilla de observación planteada específicamente para tal fin. Es un estudio descriptivo; no experimental y de tipo transversal. Resultados: Del menú se analizó un total de 258 entradas, 1186 platos principales, 137 guarniciones y 198 postres. La mayoría de las entradas y los platos principales ofrecidos están compuestos por proteínas animales, representado el 84% y el 70%, respectivamente. El promedio por restaurante es de 28 platos principales con papas fritas de guarnición. El diseño de la carta en su mayoría es sencillo y claro, sin elementos de comunicación visual llamativos. Conclusiones: Los menús analizados presentan un desequilibrio en su valor nutricional, con un exceso en proteína animal y poca oferta de platos con carbohidratos bajos.

Introducción: La perimenopausia se asocia con mayor probabilidad de padecer trastornos de la alimentación, destacándose la compulsión glucídica, que lleva a consumir fundamentalmente alimentos con alto contenido de carbohidratos entre comidas. Objetivos: evaluar aceptabilidad, preferencia y saciedad de colaciones dulces de baja densidad energética (DE) y alto aporte proteico en muestra de mujeres adultas perimenopáusicas. Materiales y método: A partir de receta estándar de merengues, se desarrollaron tres variantes con disminución de DE y sacarosa (Muestra A y C se reemplazó sacarosa por azúcar light y sucralosa en diferentes proporciones; Muestra B se disminuyó sacarosa y se agregó sucralosa). Se realizó ensayo de aceptabilidad y preferencia en 75 evaluadoras no entrenadas y prueba de saciedad a 27 evaluadoras no entrenadas, utilizando encuesta autoadministrada y escala hedónica de Likert de 9 puntos. Análisis estadístico: medidas de tendencia central, ANOVA, prueba de Friedman y Software "Statgraphics Centurion XVII" para pruebas de aceptabilidad. Resultados: Se desarrollaron merengues para las tres muestras de 1 g. cada uno, con disminución del 31% en la DE y 1,03 mg. de triptófano por unidad. La muestra B (se disminuyó la sacarosa al 88,7% y se agregó sucralosa en 11,3%), fue la de mayor preferencia y aceptabilidad por sus características sensoriales. Sobre esta muestra se aplicó el test de saciedad (libre demanda), obteniendo una media de ingesta de 10 unidades (Rango: 3-15). El 22,2% de las mujeres consumió 3 a 8 merengues; 51,8% 9 a 12 merengues y 25,9% más de 12 merengues. Se pudo observar que las mujeres estaban plenamente saciadas a los primeros 30 minutos, manifestando que a los 120 minutos tuvieron apetito. Conclusiones: La colación más aceptada y preferida fue la que mantuvo sacarosa y una proporción fue sustituida por edulcorante no calórico. El test de saciedad demostró que la colación seleccionada logró saciedad a corto plazo.

Introducción: Helicobacter pylori coloniza la mucosa gástrica y se asocia con el desarrollo de patologías gastrointestinales, pudiendo afectar la secreción de hormonas moduladoras del apetito. Objetivo: Evaluar la asociación entre la colonización gástrica por H. pylori, las concentraciones séricas de grelina y leptina y el índice de masa corporal (IMC) en pacientes con sintomatología digestiva. Materiales y método: Se llevó a cabo un estudio transversal que incluyó 163 pacientes dispépticos (18 - 70 años) derivados al Hospital de Gastroenterología "Dr. Carlos Bonorino Udaondo". Se realizó una encuesta sociodemográfica, recordatorio de 24 horas y se midió circunferencia de cintura (CC), peso y talla para el cálculo del IMC. La presencia de H. pylori se diagnosticó mediante 13C-Test del Aire Espirado (13C-UBT). Las concentraciones séricas de grelina y leptina se determinaron mediante enzimoinmunoensayo. Para el análisis estadístico se utilizaron los Tests de χ2, Mann-Whitney, correlación de Spearman y regresión lineal (SPSS19.0). Resultados: La prevalencia de la infección por H. pylori fue de 53,4% (IC95%;45,7-65,8%). La ingesta promedio de energía, carbohidratos, proteínas y lípidos no se asoció a la infección. Las prevalencias de sobrepeso/ obesidad y adiposidad central no difirieron significativamente entre H. pylori positivos y negativos (p=0.09 y p=0.87, respectivamente). La mediana de la concentración de grelina fue 306.5 pg/mL (RIC;230.0- 385.5) en H. pylori positivos y 358.3 pg/mL (RIC;253.8-547.8) en negativos. La infección se asoció con menores concentraciones séricas de grelina (p=0.016) aún ajustando por IMC y género (p=0.019), no habiéndose encontrado asociación entre los valores de leptina y la infección (p=0,76). Los niveles de grelina sérica se correlacionaron negativamente con el IMC (r=-0,25; p=0,0013), mientras que la correlación leptina-IMC fue positiva (r=0,56; p<0,00001) en la población total. Conclusiones: La colonización por H. pylori en pacientes con sintomatología digestiva se asoció con menores concentraciones séricas de grelina, enfatizando su rol en la regulación hormonal del apetito.

Introducción: La alimentación del recién nacido de pretérmino (RNPT) es un gran desafío. La administración óptima de nutrientes requiere de una infraestructura organizada y profesionales de distintas áreas que trabajen en forma conjunta. A partir de la necesidad de cumplir con estándares de calidad respecto del estado nutricional de pacientes neonatales, la Unidad de Cuidados Intensivos Neonatales (UCIN) del Hospital Universitario Austral (HUA) sugirió la incorporación de un licenciado en nutrición para colaborar en diferentes aspectos del cuidado nutricional de los mismos. Objetivos: Promover la inserción del licenciado en nutrición como parte del equipo colaborador del cuidado nutricional del neonato. Evaluar posibles herramientas que el licenciado en nutrición pudiera aportar dentro de una UCIN. Materiales y método: Se trabajó con monitoreo continuo de pacientes ingresados en la UCIN del HUA de Pilar durante el periodo de diciembre 2012 hasta la actualidad. Se diseñó una planilla para cargar datos de los pacientes que ingresan a la Unidad obtenidos de la historia clínica informatizada de la institución (Pectra Digital Gate®). Resultados: A partir de los datos recolectados se obtuvo información sobre: días de recuperación del peso de nacimiento; número de días para cubrir requerimientos propuestos; número de días que recibe NPT; aumento de peso de los últimos 7 días; monitoreo de soporte nutricional indicado y recibido; porcentaje de leche materna vs fórmula recibida. Se colaboró en el diseño de planillas de fraccionamiento de leches, protocolos de inicio de alimentación del recién nacido de bajo peso al nacer y uso de fortificadores de la leche materna; se optimizó el registro de la alimentación enteral y parenteral recibida en la historia clínica; se realizó asesoramiento de productos y búsqueda bibliográfica para la incorporación de nuevas fórmulas dentro del Vademécum de la institución. Conclusión: La existencia de protocolos básicos actualizados, cálculo de los requerimientos energéticos en función de la situación clínica y el estado nutricional, monitoreo de la alimentación enteral y parenteral, cumplimento del objetivo calórico, son algunos indicadores que pueden utilizarse como herramienta para medir la calidad de la actividad asistencial. El asesoramiento y monitoreo del cuidado nutricional del neonato son parte de las funciones que los nutricionistas pueden cumplir dentro de dichas unidades. La inclusión en la enseñanza de grado y postgrado del cuidado nutricional de este grupo es de vital importancia dentro del aprendizaje continuo del licenciado en nutrición.

Introducción: El proyecto se enmarca en el Programa de Ciudadanía Porteña, programa de asistencia alimentaria implementado por el Ministerio de Desarrollo Social de la Ciudad de Buenos Aires, basado en transferencia directa de ingresos a familias en situación de vulnerabilidad Objetivos: Realizar educación alimentaria nutricional en 3 mensajes: lactancia materna, alimentación complementaria e hidratación a usuarios del programa en salas de espera de las sedes en que realizan trámites. Materiales y método: Se diseñaron y proyectaron 3 animaciones audiovisuales de corta duración, cada una con contenidos de cada mensaje principal de los objetivos. Se entregaron 3 folletos para complementar la información del video. Se realizaron 148 encuestas directas a los beneficiarios que asistieron a las sedes del programa para evaluar la incorporación de los mensajes. Resultados: Se analizaron las encuestas por mensaje. Lactancia materna: 98% vio el video; 81,6 % recordó el tema principal; el beneficio de defensas fue el mayor con el 33%; 28% leyó el folleto; 42% opinó es bueno amamantar hasta los 2 años y más. Alimentación complementaria: 87% vio el video; 47,5% respondió como tema principal: Primeras comidas del bebé; 24% y el 17% según sede leyeron el folleto; 60% respondió como tema del folleto: Qué alimentos dar a los bebés por edades; 31% opinó en comenzar la alimentación complementaria antes de los 6 meses. Hidratación y consumo: 76% vio el video; 86% respondió correctamente el tema principal del video; 44% respondió como principal beneficio del agua saca la sed; 6% tomó el folleto. Conclusiones: Los mensajes fueron comprendidos satisfactoriamente. La implementación de la animación es un recurso práctico y moderno que facilita la incorporación de los mensajes. Su proyección repetitiva permite llegar a mayor cantidad de beneficiarios, el material gráfico tuvo menor recepción.

Introducción: El pliego de condiciones para la concesión de un servicio de confitería establece la calidad requerida. Por tal motivo es esencial especificar adecuadamente las condiciones del servicio que se espera recibir para brindar satisfacción a los usuarios y partes interesadas.Objetivos: Analizar el proceso y el pliego de bases y condiciones para la concesión del servicio de confitería de la FCS de la UNSa. Proponer mejoras para orientar las actividades futuras en relación a la compra, selección, preparación distribución y control del servicio. Materiales y Método: Se realizó una encuesta de satisfacción para conocer la calidad percibida por los usuarios de la confitería de la FCS. Se analizaron el proceso y los subprocesos de concesión del servicio, el pliego de condiciones mediante el cual se rige la actual concesión. Se aplicó el diagrama de Espina de Pescado para determinar la causa raíz el problema. Resultados: Los clientes manifestaron insatisfacción en relación a la variedad de preparaciones y la omisión de alimentos saludables como vegetales, pescados, lácteos descremados, jugos de frutas, cereales integrales. Problema raíz: pliego de condiciones incompleto y poco detallado. Conclusiones: El plan de mejoras en relación al pliego de bases y condiciones requiere tener en cuenta aspectos tales como: calidad de la materia prima, plan de menú, tipo y cantidad de comidas, ingredientes, formas de preparación, características físico químicas de las preparaciones saludables, porción estándar, presentación y tipos de vajilla.

Introducción: La importancia del consumo de frutas es vital debido a sus propiedades nutritivas, por su aporte de vitaminas, minerales, fibra y agua. Las Guías Alimentarias para la Población Argentina (GAPA) recomiendan el consumo diario de 2 a 3 frutas. Objetivos: Estimar la prevalencia de consumo inadecuado de frutas y determinar la prevalencia de dicho consumo por exceso o déficit, en estudiantes. Estimar la prevalencia de los motivos por los cuales no se consumen frutas en estudiantes. Materiales y método: Diseño descriptivo, observacional y transversal. La muestra quedó conformada por 486 estudiantes universitarios y terciarios. Se midió el consumo de frutas a través de una encuesta diseñada para tal fin. El análisis estadístico se realizó mediante el paquete VCCstat V.Beta 2.0. Resultados: El 23,5% de la muestra pertenecía a alguna carrera de ciencias de la salud. El 74% (IC95% 69,9-77,9) de los estudiantes no cumplió con la recomendación diaria de las GAPA. De este porcentaje, un 96,4% (IC95% 93,8-98) no llegó a consumir al menos dos frutas diarias, mientras que solo un 3,6% (IC95% 1,9-6,1) de los encuestados superó dicha recomendación. Se encontró un 34,6% (IC95%30,3-38,9) de estudiantes con consumo nulo. Entre los motivos de este hallazgo, un 72% (IC95% 64,5-78,6) lo adjudicó a la "falta de hábito". Entre los motivos restantes se destacan "no me gusta" con el 10,7% (IC95%6,4-16,4) y "falta de practicidad" con el 9,5% (IC95%,5-15). Conclusión: La mayoría de los estudiantes consume menos cantidad de frutas que la recomendada. Debido a la falta de hábito, un gran porcentaje de estudiantes no incorpora frutas en su alimentación diaria.

Liver Transplantation Outcomes Using Grafts From Donors Older Than the Age of 80 Years.

We performed a retrospective cohort study between 2002 and 2014 to compare liver transplantation outcomes between recipients of grafts from donors older than and younger than the age of 80 years. Numerical variables were compared with the Student t test when their distribution was normal and the Mann-Whitney test when it was not, whereas categorical variables were compared with Pearson chi-squared test or Fisher test, as appropriate; P < .05 was considered significant. The study included 312 patients with organs from donors younger than 80 years of age and 17 with organs from older donors. The 2 recipient groups did not significantly differ in weight, height, gender, body mass index (BMI), CHILD or MELD score, intensive care unit (ICU) or hospital stay, need for intraoperative hemoderivatives, postreperfusion syndrome, biliary or vascular complications, ischemic cholangiopathy, number of repeat surgeries, graft rejection, retransplantation, or survival at 6 months. Although earlier studies considered livers from elderly donors to be suboptimal, our results support the proposition that octogenarian donors can be an excellent source of liver grafts.

Supine versus prone position for percutaneous nephrolithotomy.

Percutaneous nephrolithotripsy (PCNL) is today gold standard for the management of complex urinary calculi. Over its lifespan this surgery has been subjected to multiple modifications and variants: for example, the anatomical positioning of the patient is still under controversy, especially the opposition amongst the prone and supine approaches, the two most common patient positions currently used for PCNL. Our objective was to review the literature and to discuss advantages and drawbacks from either technique.

Botulinum neurotoxin type A inhibits synaptic vesicle 2 expression in breast cancer cell lines.

AIM: It is known that botulinum neurotoxin type A (BoNTA) improves some kinds of cancer (e.g. prostate) and that synaptic vesicle glycoprotein 2 (SV2) is the molecular target of this neurotoxin. Besides having potential therapeutic value, this glycoprotein has recently been proposed as a molecular marker for several types of cancer. Although the mechanisms of cancer development and the improvement found with botulinum treatment are not well understood, the formation of the botulinum-SV2 complex may influence the presence and distribution of SV2 and the function of vesicles. To date, there are no reports on the possible effect of botulinum on breast cancer of unknown causes, which have a great impact on women's health. Thus we determined the presence of SV2 in three breast cancer cell lines and the alterations found with botulinum application. MATERIALS AND METHODS: With and without adding 10 units of botulinum, SV2 protein expression was determined by optical densitometry in T47D, MDA-MB-231 and MDA-MB-453 cell lines and the distribution of SV2 was observed with immunochemistry (hematoxylin staining). RESULTS: The SV2 protein was abundant in the cancer cells herein tested, and maximally so in T47D. In all three cancer cell lines botulinum diminished SV2 expression, which was found mostly in the cell periphery. CONCLUSION: SV2 could be a molecular marker in breast cancer. Its expression and distribution is regulated by botulinum, suggesting an interesting control mechanism for SV2 expression and a possible alternative therapy. Further studies are needed in this sense.

The follicular thyroid cell line PCCL3 responds differently to laminin and to polylaminin, a polymer of laminin assembled in acidic pH.

The extracellular-matrix protein laminin forms polymers both in vivo and in vitro. Acidification of pH leads to the formation of an artificial polymer with biomimetic properties, named polylaminin (polyLM). Follicle cells in the thyroid are in close contact with laminin, but their response to this important extracellular signal is still poorly understood. PCCL3 thyroid follicular cells cultured on glass, on regular laminin (LM) or on laminin previously polymerized in acidic pH (polyLM) showed different cell morphologies and propensities to proliferate, as well as differences in the organization of their actin cytoskeleton. On polyLM, cells displayed a typical epithelial morphology and radially organized actin fibers; whereas on LM, they spread irregularly on the substrate, lost cell contacts, and developed thick actin fibers extending through the entire cytoplasm. Iodide uptake decreased similarly in response to both laminin substrates, in comparison to glass. On both the LM and polyLM substrates, the expression of the sodium iodide symporter (NIS) decreased slightly but not significantly. NIS showed dotted immunostaining at the plasma membrane in the cells cultured on glass; on polyLM, NIS was observed mainly in the perinuclear region, and more diffusely throughout the cytoplasm on the LM substrate. Additionally, polyLM specifically favored the maintenance of cell polarity in culture. These findings indicate that PCCL3 cells can discriminate between LM and polyLM and that they respond to the latter by better preserving the phenotype observed in the thyroid tissue.