Polimorfismo de proteína 5, 10-metilentetrahidrofolatoreductasa en población venezolana / Polymorphisms proteína 5, 10-metilentetrahidrofolatoreductasa in venezuelan people

El folato es un miembro del grupo de la vitamina B y está relacionado con enfermedades crónicas como anemia megaloblástica, enfermedad cardiovascular, cáncer, disfunción cognitiva y riesgo de defectos del tubo neural. La proteína 5,10-metilentetrahidrofolato reductasa (MTHFR) juega un papel clave en el metabolismo del folato mediante la síntesis de nucleótidos y reacciones de metilación. El gen MTHFR se encuentra en el cromosoma 1 (1p36.3), y se han descrito dos alelos comunes, el alelo C677T (termolábil) y el alelo A1298C.El objetivo de este estudio es evaluar la distribución de los polimorfismos genéticos en MTHFR C677T y A1298C en la población venezolana. METODOS: estudio de tipo transversal, descriptivo, experimental y correlacional Las muestras de sangre se colectaron en 314 donantes no emparentados y sanos de la población. Los polimorfismos de un solo nucleótido(SNP) MTHFR 677C>T y 1298A>C se analizaron mediante polimorfismo de longitud de fragmento de restricción de reacción en cadena de polimerasa (PCR-RFLP). El desequilibrio de ligamiento (LD) entre pares de SNP se calculó mediante la prueba X. usando Prism 5 (GraphPad software, Inc). RESULTADOS: Encontramos mayor frecuencia genotípica de heterocigotos para el polimorfismo MTHFR C677T en la población general venezolana, con excepción del grupo caucásico. El polimorfismo MTHFR A1298C en el 70%de la población de estudio es homocigoto de tipo salvaje, encontrándose una baja frecuencia de homocigoto mutado. CONCLUSIONES: Se encontraron diferencias significativas entre grupos étnicos, destacando la importancia del genotipado racial de estos polimorfismos en la población venezolana(AU)

Folate is a member of the vitamin B and it has also been indicated that may be related to chronic diseases such as megaloblastic anemia, cardiovascular disease, cognitive dysfunction and risk of neural tube. Methylenetetrahydro folatereductase (MTHFR) is a key enzyme of folate pathway by nucleotide synthesis and methylation reactions. Several polymorphisms were reported in MTHFR gene but C677Tand A1298 polymorphism are most studied and these have been reported to be risk factor for several diseases/disorders. The present study was designed to determine the frequency of MTHFR polymorphisms in Venezuelan healthy population. METHODS: The blood samples were collected from 314 unrelated and healthy donors from population. Both the MTHFR 677C>T and 1298A>C single nucleotide polymorphisms (SNPs) were analyzed by Polymerase chainreaction-restriction fragment length polymorphism (PCR-RFLP). Linkage disequilibrium (LD) between pair of SNPs was calculated through the .. test using Prism 5 (GraphPad sftoware, Inc). RESULTS: We find higher genotypic frequency of heterozygotes for the MTHFR C677T polymorphism in the Venezuelan general population, with the exception of the Caucasian group. MTHFR A1298C polymorphism in 70%of the study population is homozygous wild type, finding alow frequency of homozygous mutated. CONCLUSIONS: Significant differences between ethnic groups were found,highlighting the importance of racial genotyping of these polymorphisms in the Venezuelan population(AU)

Relationship between vitamin B12 levels and insulin resistance in postmenopausal women from Colombia Caribbean / Relação entre níveis de vitamina B12 e resistência à insulina em mulheres na pós-menopausa da Colômbia Caribe

Introduction: The high prevalence of low vitamin B12 serum levels has been recognized as a public health problem in Latin America; however, the current magnitude of this deficiency in Colombia is uncertain. Low levels of vitamin B12 can induce clinical and subclinical hematological and neurological disorders. Epidemiological studies have demonstrated a relationship between vitamin B12 deficiency and cardiovascular diseases (CVDs). However, the role of vitamin B12 in insulin resistance has been poorly studied. Objective: This study aimed to evaluate the relationship between vitamin B12 serum levels and biochemical and anthropometric markers related to CVDs and insulin resistance in postmenopausal women from Colombia Caribbean. Methods: Correlational, descriptive study. By convenience sampling, 182 postmenopausal women from the medical consultation service of a health institution were linked. Serum vitamin B12 levels, anthropometric variables (body mass index, abdominal perimeter), and biochemical variables (glycemia, insulin, lipid profile, HOMA IR) were evaluated. Results: The average value of the vitamin B12 serum level was 312.5 ± 122.5 pg/mL (230.6 ± 90.4 pmol/L); 46.7% of the women had less than adequate levels of 300 pg/mL (> 221 pmol/L), and 9. 9% were deficient, with levels of less than 200 pg/mL (148 pmol/L). The women with metabolic syndrome were 63.7%, and according to HOMA IR, 52.7 % had insulin resistance. A significant inverse relationship was shown between serum vitamin B12 levels with basal glycemic (P =0.002) and HOMA-IR (P =0.040). Conclusions: A significant inverse relationship between vitamin B12 levels and basal glycemia and HOMA-IR was observed. These findings highlight vitamin B12 deficiency in postmenopausal women and suggest nutritional supplementation.Keywords: Vitamin B12, Insulin resistance, Diet, Postmenopause, Cardiovascular diseases (AU).

Introdução: A alta prevalência de baixos níveis séricos de vitamina B12 foi reconhecida como um problema de saúde pública na América Latina, mas a magnitude atual dessa deficiência na Colômbia é incerta. Baixos níveis de vitamina B12 podem induzir distúrbios hematológicos e neurológicos clínicos e subclínicos. Na verdade, estudos epidemiológicos demonstram uma relação entre deficiência de vitamina B12 e doenças cardiovasculares (DCVs). No entanto, o papel da vitamina B12 na resistência à insulina tem sido pouco estudado. Objetivo: O objetivo deste estudo foi avaliar a relação entre os níveis séricos de vitamina B12 e marcadores bioquímicos e antropométricos relacionados com doenças cardiovasculares e resistência à insulina em mulheres pós-menopáusicas da Colômbia Caribe. Métodos: Estudo correlacional, descritivo. Por amostragem de conveniência, foram vinculadas 182 mulheres na pós-menopausa do serviço de consulta médica de uma instituição de saúde. Níveis séricos de vitamina B12, variáveis antropométricas (índice de massa corporal, perímetro abdominal) e variáveis bioquímicas (glicemia, insulina, perfil lipídico, HOMA IR) foram avaliadas. Resultados: O valor médio do nível sérico de vitamina B12 foi de 312,5 ± 122,5 pg/mL (230,6 ± 90,4 pmol/L); 46,7% das mulheres tinham níveis abaixo do adequado de 300 pg/mL (> 221 pmol/L), e 9,9% eram deficientes, com níveis abaixo de 200 pg/mL (148 pmol/L).As mulheres com síndrome metabólica foram 63,7% e, segundo o HOMA IR, 52,7% apresentavam resistência à insulina. Uma relação inversa significativa entre os níveis séricos de vitamina B12 com glicemia basal (P = 0,002) e HOMA-IR (P = 0,040) foi mostrada. Conclusões: Foi observada uma relação inversa significativa entre os níveis de vitamina B12 e glicemia basal e HOMA-IR. Esses achados destacam a deficiência de vitamina B12 em mulheres na pós-menopausa e sugerem suplementação nutricional (AU).

Pharmacopuncture with a low dosage of B complex vitamins in the Da Zhui acupoint (Governing Vessel 14) for controlling gastrointestinal parasitism in periparturient ewes / Farmacopuntura com dose baixa de vitaminas do complexo B no acuponto Da Zhui (Vaso Governador 14) para o controle da parasitose gastrintestinal em ovelhas no periparto

Gastrointestinal parasites are a significant challenge in sheep farming, and periparturient ewes are one of the most susceptible categories in sheep flocks. This study aimed to verify whether the injection of B vitamins at the acupuncture point governing vessel 14 (GV14) can influence the parasitic load or host-parasite interaction in naturally infected ewes during the peripartum period. Four weeks before parturition, 25 ewes were divided into five treatment groups: (1) Dose Control: 0.2 mL of B complex via IM; (2) Drug Control: 2 mL Complex B via IM; (3) Acupoint Control: 0.2 mL of Water at GV14 point; (4) Control; (5) Test group: 0.2 mL of B complex at the GV14 point. Treatments were performed at weeks -3, -1, 2, 4, and 6 about the parturition time. Fecal samples to estimate the parasitic load by fecal egg counts (FEC) and total blood samples for hemogram examination were performed seven days after the treatment, coinciding with weeks -2, 3, 5, and 7 about the parturition time. The number of peripheral eosinophils was higher in group 3 than in group 1 (p <0.05). Although groups 3 and 5 had lower mean values of FEC and higher hematological values at the time of weaning, these differences were not statistically significant (p> 0.05) according to the F test. However, all animals in groups 3 and 5 maintained low parasitism levels until the end of the experiment. Further studies should be performed with larger sample sizes and minor changes to the experimental protocol to elucidate the role of GV14 acupoint stimulation in the host-parasite relationship.(AU)

A parasitose gastrointestinal é o principal desafio sanitário para a criação de ovinos a pasto, e as ovelhas no periparto são uma das categorias mais susceptíveis a esta infeção no rebanho. O objetivo deste trabalho foi verificar se a injeção de vitaminas do complexo B no acuponto Vaso Governador 14 (VG14) poderia influenciar a carga parasitária ou modular a interação hospedeiro-parasito em ovelhas naturalmente infectadas no período de periparto. Quatro semanas antes da data prevista para o parto, 25 ovelhas foram divididas em cinco grupos de tratamento (1) Controle da dose: 0,2 mL de vitaminas do complexo B via IM; (2) Controle do fármaco: 2mL complexo B via IM; (3) Controle do Ponto: 0,2 mL de água destilada no ponto VG14; (4) Controle sem tratamento; (5) Grupo teste: 0,2 mL de complexo B no pontoVG14. Estes tratamentos foram realizados nas semanas -3; -1; 2; 4 e 6 em relação à data do parto. Amostras de fezes para contagem de ovos por grama de fezes (OPG), assim como amostras de sangue para realizar o hemograma, foram obtidas dos animais sete dias após os tratamentos, coincidindo com as semanas -2, 3, 5 e 7 do parto. O número de eosinófilos periféricos foi superior no grupo 3 se comparado ao grupo 1 (p <0,05). Os animais dos grupos 3 e 5 tiveram menores valores de OPG e maior hematócrito, mas estas diferenças não foram consideradas significativas pelo teste F (p> 0,05). No entanto, todas as ovelhas dos grupos 3 e 5 se mantiveram com níveis baixos de parasitismo durante todo o experimento. Sugere-se que novos estudos sejam realizados com algumas modificações deste protocolo a fim de aprofundar o conhecimento do potencial imunomodulador do acuponto VG14.(AU)

Alergia a frutos do mar: principais desafios na alimentação e soluções desenvolvidas por alunos do curso de nutrição e gastronomia / Seafood allergy: main challenges in their diet and solutions developed by students of the nutrition and gastronomy course

A alergia alimentar caracteriza-se por uma reação adversa a um determinado alimento, envolvendo um mecanismo imunológico. Uma das alergias mais comuns encontradas atualmente é a alergia a frutos do mar, a qual se baseia em uma hipersensibilidade a animais desse grupo. O objetivo desta pesquisa é identificar os desafios expostos na alimentação de alérgicos a frutos do mar e formular soluções para essa população baseadas em alimentos nutricionalmente substitutos. Sendo realizado em três etapas: investigação inicial, construção de conceitos e planejamento de uma ação com orientações nutricionais. De acordo com as dificuldades encontradas na alimentação dessa parcela populacional, realizaram-se diferentes preparações, com nutrientes como ômega-3, proteínas, vitaminas do complexo B, zinco, ferro, potássio, magnésio, iodo e selênio, os quais também são encontrados nos frutos do mar, a fim de evitar possíveis contaminações cruzadas e garantir seu aporte nutricional em alimentos substitutos. Foi possível concluir que os alérgicos aos frutos do mar não apresentam uma interferência significativa em sua qualidade de vida, tendo um impacto nutricional pequeno, visto que por meio da alimentação existem outras fontes, necessitando somente de alguns cuidados no dia a dia em virtude das consequências de uma possível contaminação.

Food allergy is characterized by an adverse reaction to a given food, involving an immunological mechanism. One of the most common allergies currently found is seafood allergy, which is based on hypersensitivity to animals in this group. The objective of this research is to identify the challenges exposed in the feeding of seafood allergies and formulate solutions for this population based on nutritionally substitute foods. Being carried out in 3 stages, initial investigation, construction of concepts and planning of an action with nutritional guidance. According to the difficulties encountered in feeding this portion of the population, different preparations were carried out, with nutrients such as: ômega-3, proteins, B vitamins, zinc, iron, potassium, magnesium, iodine and selenium. Which are also found in seafood. In order to avoid possible cross-contamination and ensure their nutritional intake in substitute foods. It was possible to conclude that seafood allergies do not present a significant interference in their quality of life, having a small nutritional impact, since through food there are other sources, requiring only some care on a daily basis due to the consequences of possible contamination.

El rol de los suplementos vitamínicos en pacientes con depresión / The role of vitamin supplements in patients with depression

La depresión es un trastorno del estado de ánimo que se caracteriza por la existencia de un sentimiento de tristeza lo suficientemente intenso como para interferir en el desarrollo de las actividades habituales. A partir de un caso clínico real, en el que una paciente con depresión solicita a su médico de cabecera sumar un suplemento de vitaminas a su plan terapéutico, revisamos la evidencia disponible sobre el uso de estos micronutrientes para el tratamiento de la depresión, y encontramos que no existen pruebas robustas que avalen la suplementación vitamínica en pacientes con este problema de salud. (AU)

Depression is a mood disorder characterised by the existence of a feeling of sadness intense enough to interfere with the performance of normal activities. Based on a real clinical case, in which a patient with depression asked her family doctor to add a vitamin supplement to her therapeutic plan, we reviewed the available evidence on the use of these micronutrients for the treatment of depression and found that there is no robust evidence to support vitamin supplementation in patients with this health problem. (AU)

Analysis of the current status and related factors of oral nutritional supplements intake among 18-79 years old in Beijing in 2017 / 中华流行病学杂志

Objective: To understand the current status of taking nutrient supplements for residents aged 18 to 79 years old in Beijing and its related factors. Methods: Data were gathered from the 2017 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified cluster sampling method was used, and participants aged 18-79 were sampled from 16 districts. The questionnaire included chronic diseases and related risk factors, health knowledge, and oral nutritional supplements within 12 months. Multivariate logistic regression models were established to analyze associated factors that affect the intake of nutrient supplements. Results: The weighted prevalence of supplements use was 13.1% among 12 696 subjects within the past 12 months. The proportions of multivitamins (4.7%), B vitamins (4.5%), and folic acid (3.2%) were higher. The prevalence of supplement use of young people (18-39 years old) and the elderly (60-79 years old) was higher than middle-aged people (40-59 years old) (χ2=54.09, P<0.001). Except for the age group of 70-79 years old, the consumption rate of women was significantly higher than that of men (P<0.05). After adjusting age and sex, among patients with hypertension, diabetes, or dyslipidemia, the control rates of blood pressure, glucose and lipids of patients who take nutrient supplements were higher than those who do not (P<0.05). And participants who took nutrient supplements had a more heightened awareness rate of health knowledge, such as the hazards of smoking and second-hand smoke, and recommended amount of salt per day (P<0.001). The multi-factor logistic analysis found that nutrient supplement-related factors include women, old age, higher education level, living in urban, insufficient physical activity, sleeping problems, active physical examination, blood pressure control among patients, and health knowledge (P<0.05). Conclusions: The factors of nutrient supplements use were related to sex, age, education level, health status, and health literacy. We should pay attention to key populations and guide them to establish the correct concept of taking nutrient supplements.

Synergistic anti-inflammatory effect of NSAIDs plus B vitamins administered pre and postoperatively in third molar surgery: randomized clinical trial / Efeito anti-inflamatório sinérgico da associação de AINEs e vitaminas do complexo B administrada no pré e pós-operatório de cirurgia de terceiros molares: ensaio clínico randomizado

Objective : The aim of the present study was to evaluate the synergistic anti-inflammatory effect of Non-steroidal anti-inflammatory drugs (NSAIDs) plus B vitamins administered pre and postoperatively in surgeries of impacted mandibular third molars. Material and Methods : Double-blind randomized clinical trial, sixty-six patients participated and were randomized into 2 groups. The control group was administered meloxicam 15 mg intramuscularly plus placebo orally and to the experimental group, meloxicam 15 mg intramuscularly plus vitamins B [B1, B6, and B12] orally; both treatments were administered preoperatively. The anti-inflammatory effect was evaluated by pain intensity, facial swelling (facial contour measurements), and mouth opening (distance between the upper and lower incisors) during the post-surgical phase. Student's t-test was performed for independent samples. Results : In all the evaluated times (1 hour, 6 hours, 12 hours, 24 hours, 2 days, and 3 days after the end of the surgery) the experimental group presented a significantly lower intensity of pain compared to the control group (p<0.05). The highest pain intensity was recorded at 6 hours (17.7 ± 9.1 mm in the experimental group and 34.5 ± 21.3 mm in the control group). Swelling and mouth opening were similar in both groups, at all times evaluated (p>0.05). Conclusion : In the present study, the administration of NSAIDs plus B vitamins (B1, B6, B12) produced lower intensity of pain compared to the administration of only NSAIDs. Nevertheless, swelling and mouth opening were similar in all evaluations for both study groups (AU)

Objetivo : O objetivo do presente estudo foi avaliar o efeito anti-inflamatório sinérgico de anti-inflamatórios não esteroidais (AINEs) com vitaminas do complexo B administrados no pré e pós-operatório de cirurgias de terceiros molares inferiores impactados. Material e Métodos: Ensaio clínico randomizado duplo-cego, 66 participantesque foram randomizados em 2 grupos. O grupo controle recebeu Meloxicam 15 mg por via intramuscular + placebo por via oral e o grupo experimental, Meloxicam 15 mg por via intramuscular + vitaminas B [B1, B6 e B12] por via oral; ambos os tratamentos foram administrados no pré-operatório. O efeito anti-inflamatório foi avaliado pela intensidade da dor, edema facial (medidas do contorno facial) e abertura da boca (distância entre os incisivos superiores e inferiores) durante a fase pós-cirúrgica. Foi aplicado o teste t de Student para amostras independentes. Resultados: Em todos os tempos avaliados (1 hora, 6 horas, 12 horas, 24 horas, 2 dias e 3 dias após o término da cirurgia) o grupo experimental apresentou uma intensidade de dor significativamente menor em relação ao grupo controle (p <0,05). A maior intensidade de dor foi registrada em 6 horas (17,7 ± 9,1 mm no grupo experimental e 34,5 ± 21,3 mm no grupo controle). Edema e abertura bucal foram semelhantes nos dois grupos, em todos os momentos avaliados (p>0,05). Conclusão: No presente estudo, a administração de AINEs com vitaminas do complexo B (B1, B6, B12) resultou em menor intensidade de dor em comparação com a administração apenas de AINEs. No entanto, o edema e a abertura da boca foram semelhantes em todas as avaliações para ambos os grupos de estudo (AU).

Comparison of sublingual and intramuscular administration of vitamin b12 for the treatment of vitamin b12 deficiency in children

Abstract Background: In most countries, contrary to some disadvantages, such as pain, relatively higher cost, and poor adherence to treatment, intramuscular (IM) route is still the primary treatment method for Vitamin B12 (VB12) deficiency. In recent years, because of these difficulties, new treatment methods are being sought for VB12 deficiency. Objectives: We aimed to compare sublingual (SL) and IM routes of VB12 administration in children with VB12 deficiency and to compare the efficacy of methylcobalamin and cyanocobalamin therapy in these children. Methods: This retrospective study comprised 129 patients with VB12 deficiency (serum Vitamin 12 level ≤ 200 pg/mL) aged 5-18 years. Based on the formulations of Vitamin 12, we divided the patients into three treatment groups as IM cyanocobalamin, SL cyanocobalamin, and SL methylcobalamin. Results: After Vitamin 12 therapy, serum Vitamin 12 levels increased significantly in all patients, and there was a statistically significant difference between the treatment groups (p < 0.05). Conclusions: SL cyanocobalamin and methylcobalamin were found as effective as IM cyanocobalamin for children with Vitamin 12 deficiency in correcting serum Vitamin 12 level and hematologic abnormalities.

Rol de la homocisteína y vitamina B en el metabolismo óseo / Role of homocysteine and vitamin B in bone metabolism

RESUMEN Se han propuesto varios estudios que sugieren que el grupo de vitaminas B posee un rol en la fisiología ósea. Se realizó una revisión bibliográfica sobre la interacción de este con la homocisteína y la relación de ambos con el metabolismo óseo y la osteoporosis. Algunos estudios han sugerido que los niveles de vitamina B, sobre todo las vitaminas B12 y B9, se han asociado a una baja densitometría ósea y a un aumentado riesgo a fractura, y que estos, a su vez, intervienen en el metabolismo de la homocisteína, por lo que su déficit puede ocasionar un estado de hiperhomocisteinemia. Publicaciones recientes proponen que la hiperhomocisteinemia se encuentra asociada a desmineralización ósea, baja calidad de masa ósea y aumento de biomarcadores de recambio óseo, dado que influye en la actividad osteoclástica y en los enlaces cruzados de colágeno. Por lo tanto, la hiperhomocisteinemia puede ser un factor que reduce la densidad y la calidad ósea. Se necesita más información para determinar el papel que tiene cada vitamina directamente en la salud ósea, o si estas solo influyen a través de las concentraciones séricas de homocisteína.

ABSTRACT Several studies have suggested a role for B-vitamins in bone physiology. A systematic review is presented on the interaction of B-vitamins with homocysteine and the relationship of both in bone metabolism and osteoporosis. The levels of vitamin-B, particularly B12 and B9, have been associated with a low bone mineral density and an increased risk of fracture. At the same time, its deficit affects the metabolism of homocysteine, which can then result in a high serum homocysteine. Recent findings have proposed that high serum homocysteine is linked to bone demineralisation, low quality of bone mass, and an increase in bone turnover biomarkers, given the influence over the osteoclastic activity and the cross-linking of collagen molecules. Therefore, high serum homocysteine could be a factor that reduces bone density and quality. More information is needed to determine whether there is a direct role of each vitamin in bone health, or if they are just influenced by homocysteine serum concentrations.

Dietas vegetarianas en alumnos universitarios / Vegetarian diets in first year university students

INTRODUCCIÓN: Se ha observado un aumento en la popularidad de las dietas vegetarianas, en especial en la población adolescente y adulto joven. Estas dietas se presentan como saludables y balanceadas pero las recomendaciones son controversiales en cuanto a los potenciales déficit nutricionales. OBJETIVO: Identificar la frecuencia y tipos de dieta vegetariana utilizada, su motivación y fuentes de información. PACIENTES Y MÉTODO: Estudio transversal y analítico en universitarios de primer año de la Pontificia Universidad Católica de Chile (PUC). Se realizó una encuesta vía online obteniendo información demográfica y caracterización de dietas de aquellos que se consideraban vegetarianos. Las variables fueron analizadas mediante el software IDM SPSS Statistics® y en planilla Excel® de forma cuantitativa. RESULTADOS: 152 alumnos respondieron la encuesta (15,2% del total), siendo el 49,4% de estos vegetariano. El 32,4% inició este patrón alimentario entre los 12-18 años; sus motivaciones más frecuentes fueron las medio ambientalistas (91,9%) y animalistas (72,9%). El 52,9% de los vegetarianos reciben suplementación de vitamina b 12 pero solo un 15,9% reportó presentar este déficit. El 75,7% obtiene información relacionada acerca de las dietas vegetarianas a través de medios digitales. CONCLUSIÓN: Se encontró un alto porcentaje de estudiantes vegetarianos en las encuestas contestadas, lo que hace necesario que los profesionales de salud estén capacitados en esta área para asegurar una adecuada educación nutricional, suplementación si es necesario, y seguimiento.

INTRODUCTION: There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE: To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD: Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS: 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION: In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.

A importância do metilfolato na prevenção dos defeitos abertos do tubo neural / The importance of methylfolate in the prevention of open neural tube defects

A suplementação periconcepcional com vitamina B9 ou folato é considerada medida efetiva para diminuir a ocorrência e a recorrência de defeitos do tubo neural (DTNs). É recomendada para todas as mulheres que planejam gravidez ou que possam engravidar. O ácido fólico necessita passar por processos enzimáticos necessários à metabolização para a sua forma ativa L-5-metiltetrahidrofolato (L-metilfolato, 5-MTHF) envolvida nos processos biológicos e que circula no plasma. A enzima metilenotetrahidrofolato redutase (MTHFR) é de fundamental importância para fornecer 5-MTHF, forma biologicamente ativa. A presença de polimorfismo do gene da MTHF-redutase promove menor atividade enzimática e menor produção de L-metilfolato.(AU)

Folic Acid Supplementation in Chinese Peri-conceptional Population: Results from the SPCC Study / 生物医学与环境科学（英文）

Objective@#To determine the prevalence and determinants of folic acid (FA) supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.@*Methods@#This was a cross-sectional study based on the Shanghai PreConception Cohort (SPCC) study. Data on FA supplementation and socio-demographic features were collected using questionnaires. Couples visiting clinics for pre-pregnancy examination and pregnant women at < 14 gestational weeks were recruited in Shanghai, China, between March 2016 and September 2018.@*Results@#Among the pregnancy planners, 42.4% (4,710/11,099) women and 17.1% (1,377/8,045) men used FA supplements, while 93.4% (14,585/15,615) of the pregnant women used FA supplements. FA supplement use was higher in female pregnancy planners who were older ( : 1.13, 95% : 1.08-1.18), had higher education ( : 1.71, 95% : 1.53-1.92), and were residing in urban districts ( : 1.06, 95% : 1.01-1.11) of FA supplementation; female pregnancy planners with alcohol consumption ( : 0.95, 95% : 0.90-0.99) had lower odds of FA supplementation. In early pregnancy, women with higher educational level ( : 1.04, 95% : 1.03-1.06), who underwent pre-pregnancy examination ( : 1.02, 95% : 1.01-1.03) had higher odds of using an FA supplement; older aged ( : 0.99, 95% : 0.98-0.99), and multigravida ( : 0.97, 95% : 0.96-0.98) had lower odds of FA supplementation.@*Conclusion@#Although the majority of pregnant women took FA supplements, more than half of the women planning for pregnancy did not. Urgent strategies are needed to improve pre-conception FA supplementation.

Effect of accelerated corneal crosslinking on ocular response analyzer waveform-derived parameters in progressive keratoconus / Efeito do crosslimking corneano acelerado nos parâmetros derivados da forma de onda do analisador de resposta ocular no ceratocone progressivo

ABSTRACT Purpose: To evaluate the effect of accelerated corneal crosslinking on corneal biomechanics with an ocular response analyzer in patients with progressive keratoconus. Methods: In this retrospective study, 50 eyes of 45 patients with progressive keratoconus who underwent accelerated corneal crosslinking were evaluated with ocular response analyzer waveform parameters before and one year after corneal crosslinking. Paired two-tailed Student's t-test was performed to compare the parameters before vs. after corneal crosslinking. Results: Mean patient age was 17.6 ± 3.6 (range 9-25) years. A significant increase was observed in p1 area, p2 area, h2, and dive2 values. No significant difference in corneal hysteresis, corneal resistance factor, or other waveform-derived parameters was observed at one year postoperatively. Conclusion: For estimating the effect of accelerated corneal crosslinking on corneal biomechanics, parameters such as p1 area, p2 area, h2, and dive2 are more sensitive than corneal hysteresis and corneal resistance factor. These results may help us to find out which corneal crosslinking method is most effective for stiffening the cornea.

RESUMO Objetivo: Avaliar o efeito do cross-linking corneano acelerado na biomecânica corneana com analisador de resposta ocular em pacientes com ceratocone progressivo. Métodos: Neste estudo retrospectivo, 50 olhos de 45 pacientes com ceratocone progressivo submetidos à cross-linking corneano acelerado foram avaliados com os parâmetros da forma de onda do analisador de resposta ocular antes e um ano após o tratamento com cross-linking corneano. O teste t de Student pareado bicaudal foi realizado para comparar os parâmetros antes e depois do cross-linking corneano. Resultados: A média de idade dos pacientes foi de 17,6 ± 3,6 (variação de 9 a 25) anos. Um aumento significativo foi observado nos valores de p1area, p2area, h2 e dive2. Nenhuma diferença significativa foi encontrada na histerese da córnea, fator de resistência da córnea ou outros parâmetros derivados da forma de onda foi observada em um ano de pós-operatório. Conclusão: Para estimar o efeito do cross-linking corneano acelerado na biomecânica corneana, parâmentros como p1area, p2area, h2 e dive2 são mais sensíveis que histerese da córnea e fator de resistência corneana. Esses resultados podem nos ajudar a descobrir qual método cross-linking corneano é mais eficaz no enrijecimento da córnea.

Percepções de gestantes acerca do cuidado pré-natal na atenção primária à saúde / Percepciones de gestantes acerca del cuidado prenatal en la atención primaria a la salud / Perceptions of pregnant women about prenatal care in primary health care

Resumo OBJETIVO Compreender as percepções das gestantes acerca do cuidado recebido durante o pré-natal, no âmbito da atenção primária à saúde. MÉTODO Estudo qualitativo, baseado na Grounded Theory. A coleta de dados foi realizada de agosto a dezembro de 2016, através de entrevista semiestruturada com 12 gestantes que realizaram acompanhamento pré-natal na atenção primária do município de Florianópolis/SC/Brasil. A coleta e análise dos dados foram realizadas concomitantemente. Na análise de dados utilizou-se a codificação aberta e axial. RESULTADOS Foram elaboradas três categorias, sendo elas: O cuidado antes e durante a gestação. Participação em grupos de gestantes e, Cuidado de qualidade durante a gestação. CONCLUSÃO As percepções das gestantes acerca do cuidado recebido durante o pré-natal estão relacionadas à atenção dispensada, ao acolhimento humanizado, consideração da subjetividade da gestante e amparo nos momentos difíceis que tornam este período satisfatório.

Resumen OBJETIVO Comprender las percepciones de las gestantes acerca del cuidado recibido durante el prenatal, en el ámbito de la atención primaria a la salud. MÉTODO Estudio cualitativo, basado en la Grounded Theory. La recolección de datos fue realizada de agosto a diciembre de 2016, a través de entrevista semiestructurada con 12 gestantes en la atención primaria a la salud del municipio de Florianópolis/SC/Brasil. La recolección y análisis de los datos se realizaron concomitantemente. En el análisis de datos se utilizó la codificación abierta y axial. RESULTADOS Fueron elaboradas tres categorías, siendo ellas: El cuidado antes y durante la gestación, Participación en grupos de gestantes y, Cuidado de calidad durante la gestación. CONCLUSIÓN Las percepciones de las gestantes acerca del cuidado recibido durante el prenatal están relacionadas la atención dispensada, acogida humanizada, consideración de la subjetividad de la gestante y amparo en los momentos difíciles que hacen este período satisfactorio.

Abstract OBJECTIVE To understand the perceptions of pregnant women about the care received during prenatal care, in the field of primary health care. METHOD Qualitative study, based on Grounded Theory. Data collection was performed from August to December 2016, through a semi-structured interview with 12 pregnant women who received prenatal care in the city of Florianópolis/SC/Brazil. Data collection and analysis were performed concomitantly. Data analysis was performed using open and axial coding. RESULTS Three categories were elaborated: Care before and during gestation, Participation in groups of pregnant women, and Quality care during pregnancy. CONCLUSION The perceptions of the pregnant women about the care received during the prenatal care is related to the care given, humanized reception, consideration of the pregnant woman's subjectivity and support in the difficult moments that make this period satisfactory.

Encefalopatía de Wernicke secundario a hiperémesis gravídica: la importancia del diagnóstico temprano / Wernicke encephalopathy secondary to hyperemesis gravidarum: importance of early diagnosis

RESUMEN Introducción: La hiperémesis gravídica (HG) es una condición frecuente en el embarazo, que puede resultar en complicaciones potencialmente letales como la encefalopatía de Wernicke (EW), síndrome que al ser reconocido y tratado tardíamente puede traducirse en una alta morbi-mortalidad materna y fetal. Objetivo: Describir el primer caso de EW secundario a HG en Colombia y realizar una revisión de la literatura publicada sobre su diagnóstico y tratamiento. Materiales y métodos: Se describe un caso de EW secundario a HG en el que se brindó un manejo interdisciplinario. Se realizó una revisión de la literatura con los términos "encefalopatía de Wernicke", "hiperémesis gravídica" y "embarazo" incluyendo reportes de casos, series de casos, artículos de revisión, investigaciones originales o cartas al editor en inglés, español y francés, en donde se analizaron el método y tiempo del diagnóstico, pauta de tratamiento y estado funcional final. Resultados: Se incluyeron 69 publicaciones y se identificaron 89 casos. En 23 de ellos se presentó pérdida gestacional, sólo en el 12,4% de los casos se reportó el nivel de tiamina, de los cuales en el 90% se encontraba disminuido y de los casos en donde se reportó estado funcional final en el 5,9% la gestante falleció. Conclusión: La EW secundaria a HG es una complicación potencialmente letal. Debe sospecharse ante cualquier alteración neurológica e historia de emesis persistente. El diagnóstico y tratamiento oportuno interdisciplinario son fundamentales para disminuir el riesgo de secuelas que limitan la capacidad funcional con alto impacto en la calidad de vida.

ABSTRACT Introduction: Hyperemesis gravidarum (HG) is a frequent condition in pregnancy, which can result in potentially lethal complications such as Wernicke encephalopathy (WE), a syndrome that can be translated into a high maternal and fetal morbidity and mortality if it is recognized and treated late. Objective: To describe the first case of WE due to HG in Colombia and to review the published literature about its diagnosis and treatment. Materials and methods: We describe a case of WE due to HG with an interdisciplinary approach. A review of the literature was performed with the terms "Wernicke's encephalopathy", "hyperemesis gravidarum" and "pregnancy" including case reports, case series, review articles, original investigations or letters to the editor in English, Spanish and French, where the method and time of the diagnosis, treatment regimen and sequelae were analyzed. Results: Sixty-nine publications were included and 89 cases were identified. In 23 of them had a gestational loss, only in 12.4% of the cases the thiamine level was reported, in which 90% was diminished and in the cases where the final functional status was reported in 5.9% of the pregnant woman died. Conclusion: WE due to HG is a potentially lethal complication. In any neurological disturbance and history of persistent emesis it should be suspected. Timely interdisciplinary diagnosis and treatment are essential to reduce the risk of sequelae that limit functional capacity with a high impact on quality of life.

Elaboración de productos panificados a partir de premezcla de harinas aptas para celíacos enriquecidas con hierro y vitaminas del complejo B y su aceptabilidad / Preparation of bakery products from premix of flours suitable for celiac people and enriched with iron and vitamin B complex and their acceptability

La Ley 20.830/98 reglamenta el enriquecimiento de la harina, sin embargo, no contempla a la premezcla de harinas aptas para celíacos. Aproximadamente 50% de los celíacos presenta anemia, por lo es necesario elaborar productos cuyas características nutricionales, sensoriales y funcionales sean óptimas. El objetivo del trabajo fue enriquecer con hierro y vitaminas del complejo B (mix) la premezcla de harinas apta para celíacos y evaluar la aceptabilidad de dos panificados de alta demanda poblacional elaborados a partir de la premezcla. En cocinas especializadas para celíacos se elaboraron panes y palitos, cada uno en dos versiones (con mix y sin mix), se presentaron en envases individuales y etiquetados forma numérica para la degustación. Se evaluó la aceptabilidad de los panificados utilizando una escala hedónica de 9 puntos a través de un cuestionario autoadministrado. Se utilizó la prueba t de Student para la comparación de promedios obtenidos. Participaron 105 celíacos (81% mujeres), el promedio de edad fue 34,5±10,9 años Según auto-reporte el 60% cursó con anemia. La puntuación global promedio de aceptabilidad fue: pan sin mix 7,42±1,33puntos; pan con mix 8,00±1,06 puntos; palito sin mix 7,91±1,05 puntos y palito con mix 7,86±1,17 puntos. Se realizó el análisis de la premezcla apta para celíacos y se constató que la misma cumple con el aporte de micronutrientes (hierro, B1, B2, B3 y ácido fólico). En este estudio, los panes con mix tuvieron mayor aceptabilidad que aquellos sin mix. En el caso de los palitos no se observaron diferencias en la aceptabilidad entre productos (con mix vs sin mix)(AU)

Caso clínico: hipofosfatasia de la niñez. Seguimiento clínico / Clinical case: childhood hypophosphatasia. Clinical follow-up

La hipofosfatasia (HP) es una enfermedad congénita, causada por mutaciones con pérdida de función en el gen ALPL que codifica la isoenzima no específica de tejido de la fosfatasa alcalina (TNSALP). Su expresión clínica es muy variable, desde casos de muerte intraútero por alteración grave de la mineralización ósea, hasta casos solo con caída prematura de la dentición. Se presenta el caso clínico de un varón al que se le diagnosticó odontohipofosfatasia a los 30 meses por pérdida temprana de piezas dentarias y niveles anormalmente bajos de fosfatasa alcalina, sin signos de raquitismo ni deformidades óseas. Durante su seguimiento, hasta los 13 años, presentó síntomas compatibles con HP infantil leve, como cansancio al caminar, incoordinación en la marcha y dolor en miembros inferiores que aumentaban con la actividad física. Ante la aparición de edema bimaleolar y poca respuesta al tratamiento con calcitonina y antiinflamatorios, se descartaron patologías infecciosas o reumáticas o ambas y se diagnosticó, por biopsia de tibia y peroné, periostitis sin detección de cristales de pirofosfato. Los controles radiológicos durante su evolución mostraron ensanchamiento metafisario en muñeca, falta de remodelado de metacarpianos, hojaldrado perióstico en tibia y peroné e hipomineralización en metáfisis tibiales, con "lenguas radiolúcidas" características de HP. Como conclusión, la hipofosfatasia debe considerarse como una entidad clínica para descartar en niños que presentan pérdida temprana de dientes. La presencia de este cuadro clínico es en general suficiente para realizar el diagnóstico de HP de la niñez. (AU)

Hypophosphatasia (HP) is a congenital disease, caused by mutations with loss of function in the gene ALPL that encodes the non-specific tissue isoenzyme of alkaline phosphatase (TNSALP). Its clinical expression displays considerable variability, from cases of intrauterine death due to severe alteration of bone mineralization, to cases with only early loss of teeth. We report the case of a male, diagnosed as odontohypophosphatasia at 30 months of age due to early loss of teeth and abnormally low levels of alkaline phosphatase, without signs of rickets or bone deformities. During follow-up, up to 13 years of age, he presented symptoms consistent with mild infantile HP such as tiredness when walking, lack of gait coordination, and pain in lower limbs, especially after physical activity. Due to the appearance of bimalleolar edema and poor response to treatment with calcitonin and anti-inflammatory drugs, infectious and / or rheumatic pathologies were ruled out. Periostitis without pyrophosphate crystal detection was diagnosed by tibial and fibular biopsy. Radiological controls during follow up showed metaphyseal wrist enlargement, lack of remodeling of metacarpals, periosteal flaking in the tibia and fibula and hypomineralization in the tibial metaphysis, with "radiolucent tongues"; characteristic of HP. In conclusion, hypophosphatasia should be considered as a clinical entity in children who present early loss of teeth. The presentation of this clinical case is generally sufficient to make the diagnosis of childhood HP. (AU)

Neuropatia óptica tóxica por inalação de metanol / Optic neuropathy toxic after methanol inhalation

Resumo A intoxicação por metanol é um evento considerado raro, principalmente quando feita por via inalatória. Retratou-se neste presente estudo um relato de caso de um paciente que desenvolveu neurite óptica tóxica após exposição ao metanol e ácido acético por via inalatória em seu ambiente de trabalho. Foi descrito sobre as terapias obtidas na literatura, bem como as manifestações clínicas e o manejo a este paciente.

Abstract The methanol toxicity is considered rare event , especially when taken by inhalation . It was portrayed in the present study a case report of a patient who developed toxic optic neuritis after exposure to methanol and acetic acid by inhalation in the workplace . It was described for the therapies from the literature as well as the clinical manifestations and management in this patient.

Combined treatment with myo-inositol and luteolin selectively suppresses growth of human lung cancer A549 cells possibly by suppressing activation of PDK1 and Akt / 南方医科大学学报

OBJECTIVE@#To study the effects of myo-inositol and luteolin on human lung cancer A549 cells and explore the possible mechanisms.@*METHODS@#A549 cells were treated with different concentrations of myo-inositol and luteolin, either alone or in combination, and the cell viability was examined using MTT assay. A549 cells and human bronchial epithelial Beas-2B cells were treated for 48 h with 10 mmol/L myo-inositol and 20 μmol/L luteolin, alone or in combination, and the cell proliferation was detected using MTT assay; the colony formation and migration of the cells were examined with colony formation assay and wound healing assay, respectively. The protein expression levels in A549 cells were detected using Western blotting.@*RESULTS@#Both myo-inositol and luteolin could dose-dependently inhibit the viability of A549 cells. Treatments with 10 mmol/L myo-inositol, 20 μmol/L luteolin, and both for 48 h caused significant reduction in the cell viability (92%, 83% and 70% of the control level, respectively) and colony number (79%, 73% and 43%, respectively), and significantly lowered the wound closure rate (24.61%, 13.08% and 8.65%, respectively, as compared with 29.99% in the control group). Similar treatments with myoinositol and luteolin alone or in combination produced no significant inhibitory effect on the growth, colony formation or migration of Beas-2B cells. The expressions of p-PDK1 and p-Akt in myo-inositol-treated A549 cells and the expression of pPDK1 in luteolin-treated cells were significantly decreased ( < 0.05), and the decrements were more obvious in the combined treatment group ( < 0.05).@*CONCLUSIONS@#Luteolin combined with myo-inositol can selectively inhibit the proliferation and migration of A549 cells, and these effects are probably mediated, at least in part, by suppressing the activation of PDK1 and Akt.