Alergia a las proteínas de la leche de vaca: proceso diagnóstico. Consenso interdisciplinario de expertos / Cow's milk allergy: diagnostic process. Expert consensus

Las proteínas de la leche de vaca pueden causar alergia alimentaria. Los distintos mecanismos de acción involucrados y la variabilidad clínica según la etapa de la vida pediátrica en la que se manifieste ocasionan dificultades en su abordaje, con riesgo de sub- o sobrediagnóstico. En este proceso, intervienen profesionales de diversas áreas y es recomendable su interacción. Es por ello que el objetivo de este consenso ha sido reflejar el conocimiento actualizado desde la interdisciplina, generando recomendaciones para su correcto diagnóstico. Hemos trabajado con el método de Delphi para sumarle a la evidencia científica, la experiencia proveniente de neonatólogos, pediatras, especialistas en alergia, nutrición y gastroenterología. Pensamos que este enfoque interdisciplinario de trabajo va a resultar de utilidad práctica y promoverá una atención más integral de estos pacientes.

Cow's milk protein can cause food allergy. The different mechanisms of action involved, the clinical variability depending on the stage of pediatric life in which it manifests, leads to difficulties in its approach, with the risk of under- or over-diagnosis. Professionals from various areas intervene in this process and their interaction is recommended. That is why the objective of this consensus has been to reflect the updated knowledge in an interdisciplinary mode, generating recommendations for its correct diagnosis. We have worked with the Delphi method to add to the scientific evidence, the experience from neonatologists, pediatricians, experts in allergy, nutrition and gastroenterology. We think that this interdisciplinary approach will be of practical use and will promote more comprehensive care for these patients.

Conmemorando los cincuenta años de Leche Purita: importancia de la leche en la erradicación de la desnutrición infantil en Chile

La desnutrición ocurre cuando hay una ingesta o asimilación deficiente de la energía y los nutrientes. Si esta se produce dentro de los primeros años de vida, las consecuencias para la salud son devastadoras. El tratamiento temprano de la desnutrición es clave para reducir estas consecuencias y en este proceso la leche tiene una participación destacada. La leche es un excelente alimento debido al contenido y calidad de sus macro- y micronutrientes, lo que ha llevado a que la investigación y el uso de la leche en el tratamiento de la desnutrición hayan aumentado sostenidamente desde comienzos del siglo XX. En Chile, la desnutrición infantil fue prácticamente erradicada entre los años 1960 y 1980 debido a la aplicación exitosa de una serie de políticas públicas materno-infantiles, dentro de las cuales la Leche Purita fue fundamental. Sin embargo, la historia de la leche como parte de las políticas nutricionales en Chile comenzó mucho antes. Conmemorando los cincuenta años desde el nacimiento de Leche Purita, el objetivo de este trabajo es realizar un breve repaso acerca de la importancia histórica de la leche en las políticas nutricionales en Chile, enfatizando la contribución realizada por la Leche Purita a la erradicación de la desnutrición infantil y a la disminución de la anemia en niños.

Undernutrition occurs when there is poor intake or assimilation of energy and nutrients. If undernutrition is established within the first years of life, the health consequences are devastating. Early treatment of undernutrition is critical to reduce these consequences and milk plays an important role in this treatment. Cow's milk is an excellent food due to the content and quality of its macro- and micronutrients. This has led to a steady increase in research and the use of milk in treating undernutrition since the beginning of the 20th century. In Chile, child undernutrition was practically eradicated between the decades of 1960 and 1980 due to the successful application of maternal and child public policies, within which the product Leche Purita was fundamental. However, the history of milk as part of nutritional policies in Chile began much earlier. Commemorating fifty years since the introduction of Leche Purita, we aim to summarize the historical importance of milk in Chile's nutritional policies. We emphasize Leche Purita's role in eradicating child undernutrition and reducing anemia among children.

Breast feeding and infection control in premature newborns: an integrative review / Aleitamento materno e controle de infecções em recém-nascidos prematuros: revisão integrativa / Lactancia materna y control de infecciones en recién nacidos prematuros: revisión integrativa

Background and Objectives: investigating the relationship between breast milk use infection control in premature newborns may provide a basis for continuing exclusive breastfeeding, reducing the rates of early introduction of formula and strengthening their immune system. In view of this, the objective was to analyze the relationship between breastfeeding and infection control in premature newborns. Content: an integrative review, which included original articles, available electronically and with a temporal cut of the last five years. Searches were carried out in August 2022 in the Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scopus, Web of Science and Science Direct databases, using the descriptors Breastfeeding, Milk Human, Infection Control, Infection Control and Premature Newborn, concatenated with the search operators "AND" and "OR". The Rayyan digital tool was used to organize the study selection stages. A total of 490 studies were identified in the search, of which seven were selected. All studies were published in English between 2018 and 2022. Regarding design, three were case-control studies, one was a cohort, one was cross-sectional, and two were clinical trials. Regarding the level of evidence, studies classified as level IV predominated. Conclusion: human breast milk has the power to reduce the incidence of necrotizing enterocolitis and cytomegalovirus, reduce the worsening of inflammatory states and late-onset sepsis, prevent diseases, encourage the physical and cognitive development of premature newborns.(AU)

Justificativa e Objetivos: a investigação da relação do uso de leite materno com o controle de infecções em recém-nascidos prematuros poderá fornecer embasamento para continuidade do aleitamento materno exclusivo, diminuindo os índices de introdução precoce de fórmula e propiciando o fortalecimento de seu sistema imunológico. Diante disso, objetivou-se analisar a relação do aleitamento materno com o controle de infecções em recém-nascidos prematuros. Conteúdo: revisão integrativa, que incluiu artigos originais, disponíveis eletronicamente e com recorte temporal dos últimos cinco anos (2018 a 2022). Foram realizadas buscas no mês de agosto de 2022 nas bases de dados Medical Literature Analysis and Retrieval System Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scopus, Web of Science e Science Direct, sendo utilizado os descritores Aleitamento Materno, Leite Humano, Controle de Infecções, Controle de Infecção e Recém-Nascido Prematuro, concatenados com os operadores de pesquisa "AND" e "OR". Foi utilizada a ferramenta digital Rayyan para a organização das etapas de seleção dos estudos. Foram identificados 490 estudos na busca, dos quais sete foram selecionados. Todos os estudos foram publicados em inglês entre 2018 e 2022. Quanto ao delineamento, três eram estudos de caso controle, um era coorte, um era transversal e dois eram ensaios clínicos. Em relação ao nível de evidência, predominaram os estudos classificados em nível IV. Conclusão: o leite humano materno tem o poder de diminuir a incidência de enterocolite necrosante e citomegalovírus, reduzir o agravamento de estados inflamatórios e de sepse tardia, prevenir doenças, estimular o desenvolvimento físico e cognitivo do recém-nascido prematuro.(AU)

Justificación y Objetivos: investigar la relación entre el uso de la leche materna y el control de infecciones en los recién nacidos prematuros puede brindar una base para continuar con la lactancia materna exclusiva, reducir las tasas de introducción temprana de fórmula y fortalecer su sistema inmunológico. Ante ello, el objetivo fue analizar la relación entre la lactancia materna y el control de infecciones en recién nacidos prematuros. Contenido: revisión integradora, que incluyó artículos originales, disponibles electrónicamente y con un corte temporal de los últimos cinco años. Las búsquedas se realizaron en agosto de 2022 en las bases de datos Medical Literature Analysis and Retrievel System Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Web of Science y Science Direct, utilizando los descriptores Lactancia Materna, Leche Humana, Control de Infecciones, Control de Infecciones y Recién Nacido Prematuro, concatenado con los operadores de búsqueda "AND" y "OR". Se utilizó la herramienta digital Rayyan para organizar las etapas de selección de estudios. En la búsqueda se identificaron 490 estudios, de los cuales se seleccionaron siete. Todos los estudios fueron publicados en inglés entre 2018 y 2022. En cuanto al diseño, tres fueron estudios de casos y controles, uno fue de cohorte, uno fue transversal y dos fueron ensayos clínicos. En cuanto al nivel de evidencia predominaron los estudios clasificados como nivel IV. Conclusión: la leche materna humana tiene el poder de reducir la incidencia de enterocolitis necrotizante y citomegalovirus, reducir el agravamiento de estados inflamatorios y sepsis tardía, prevenir enfermedades, estimular el desarrollo físico y cognitivo de los recién nacidos prematuros.(AU)

Comparison of the short-term outcomes in very/extremely low birth weight infants supplemented with fortified donor human milk or preterm formula / 中华围产医学杂志

Objective:To compare the short-term outcomes of very low birth weight (VLBW) and extremely low birth weight (ELBW) infants supplementarily fed with fortified donor human milk (DHM) or preterm formula (PF) when the mother's own milk (MOM) is insufficient.Methods:This retrospective cohort study included 91 VLBW or ELBW preterm infants with birth weight<1 500 g who were hospitalized in Peking Union Medical College Hospital from October 1, 2017, to September 30, 2020. Based on the supplemental feeding method when MOM was insufficient, these infants were divided into the DHM group ( n=51) and PF group ( n=40). Mann-Whitney U, t-test, Chi-square test, or Fisher's exact test were used to compare the short-term clinical outcomes during hospitalization between the two groups. Results:(1) There were no statistically significant differences between the 91 preterm infants in the DHM group and PF group in their gestational age, birth weight, sex ratio, birth mode, mothers' age at delivery, or the proportion of infants of small gestational age (all P>0.05). (2) The feeding volume in the DHM group was significantly greater than that in the PF group on the 14th day after birth [(108.2±53.1) vs. (81.0±47.8) ml/(kg·d), t=0.78, P=0.020]. Moreover, the time to achieve the feeding amounts up to 120 ml/(kg·d) and 150 ml/(kg·d) for infants in the DHM group were significantly shorter than those in the PF group [(17.5±10.2) vs. (30.0±12.0) d, t=4.38; (22.1±13.3) vs. (32.3±11.9) d, t=0.02; both P<0.05]; (3) Lower proportion of peripherally inserted central catheter (PICC) [58.8% (30/51) vs. 100% (40/40), χ 2=21.88, P<0.001] and shorter PICC duration were observed in the DHM group [10.0 (0.0-19.0) vs. 29.0 (17.0-40.5) d, Z=5.56, P<0.001] compared to the PF group. The times of red blood cell transfusions and the incidence of late sepsis in the DHM group were less than those in the PF group [0.0 (0.0-2.0) vs. 2.0 (1.0-3.0) times, Z=4.44, P<0.001; 23.5% (12/51) vs. 50.0% (20/40), χ 2=6.39, P=0.011]. There were no statistically significant differences observed in the incidence of bronchopulmonary dysplasia, neonatal necrotizing enterocolitis, retinopathy of prematurity, and the length of hospitalization (all P>0.05). Conclusion:When MOM is insufficient, supplementing VLBW and ELBW infants with fortified donor human milk can shorten the time to achieve enteral nutrition and reduce the use rate and time of PICC, the incidence of late-onset sepsis, and the times of red blood cell transfusion.

Effect of fermentation time on exopolysaccharide production by Weissella confusa isolated from peanut (Arachis hypogaea L.) milk

Aims@#The aim of this study was to identify an isolate B, an exopolysaccharide (EPS)-producing lactic acid bacteria and determine the fermentation time effect on EPS production. @*Methodology and results@#Isolate B, an EPS producer, was isolated from peanut milk containing commercial sugar, which was fermented spontaneously for 24 h. Isolate B was identified biochemically using API 50 CH and molecularly based on 16S rDNA. The effect of fermentation time on EPS production by isolate B with variations of the fermentation time were 12, 24, 36, 48 and 60 h. Isolate B was able to produce EPS qualitatively by producing mucoid colonies on solid media containing sucrose. The identification revealed that this isolate was Weissella confusa both biochemically using API 50 CH and molecularly based on 16S rDNA sequence homology-based method. The fermentation time significantly affected EPS production (P<0.05). Isolate B (W. confusa) produced the highest EPS (10.41 g/L) at 36 h with a cell viability of 6.5 × 108 CFU/mL. Furthermore, the FTIR results of EPS showed absorption bands characteristic of carbohydrates, including O-H, C-H, C=O, C-O-C and α-1,6 glycosidic groups. The EPS in this study was most likely a dextran type.@*Conclusion, significance and impact of study@#The yield of EPS production was influenced by fermentation time. Results suggest that W. confusa isolated from peanut milk had a good ability for EPS production. Therefore, it can be considered further to apply this strain for the production of EPS. However, further research is required.

Review: Harvesting therapeutically important bioactive compounds from possible poisonous Clitocybe species

@#From ancient times, humans have used mushrooms in different forms. Mushrooms have found their way into multiple cuisines, medicines, and other vital aspects of our lives. We have discovered and worked on different species of mushrooms. Some species of Clitocybe have not found their way into the research as they are poisonous. Many species of Clitocybe have not been studied for their therapeutically critical bioactive compounds. In this review, we have focused on the benefits of the compounds extracted from different species of Clitocybe. The compounds present in Clitocybehave been confirmed to have a wide range of beneficial effects, including antitumor, bacteriostatic, antifungal, antiviral, anti-inflammatory, antioxidant, antiaging, antidiabetic, hypoglycemic, immune stimulant, antiproliferative, neuroprotective, cardioprotective and chemopreventive properties. It has also found its way into the food industry with notable characteristics such as milk-coagulant, flavorings agent, organic food preservative, and yeast culture. There are studies confirming the use of compounds extracted from different species of Clitocybe as biological pest control.

Dynamic changes of platelet-related indicators in infants with cow′s milk protein allergy / 中国儿童保健杂志

【Objective】 To dynamically monitor and analyze the changes of platelets and related indicators in infants with cow′s milk protein allergy (CMPA) during clinical treatment, in order to provide clues for further diagnosis and treatment of CMPA. 【Methods】 From August to November in 2022, 59 children aged from 1 month to 3 years old with CMPA in the pediatric outpatient clinic were selected as the CMPA group, and 29 healthy children who took physical examination were selected as the control group. The differences in platelet related indicators from a routine blood test were compared between the two groups, and their diagnostic value for CMPA was analyzed by receiver operating characteristic (ROC) curves. 【Results】 The mean platelet count (PLT) and plateletcrit (PCT) at baseline in the CMPA group were (374.68±113.21)×109/L and 0.37±0.10, significantly higher than those in control group[(271.07±40.32)×109/L, 0.26±0.05] (t=6.27, 6.43, P<0.001). In the CMPA group, after treatment, the mean PLT level was (316.39±94.68)×109/L, and the mean PCT level was 0.31±0.10, indicating a statistically significant decrease in PLT and PCT levels after treatment compared to baseline (t=4.32,4.75,P<0.05). The diagnostic performance, indicated by the area under the curve (AUC), for PLT and PCT in diagnosing CMPA was 0.811 and 0.823, respectively. The cutoff values for PLT and PCT were determined to be 304.5×109/L and 0.305, respectively. 【Conclusion】 The PLT and PCT levels in children with CMPA are found to be higher than those in healthy controls, suggesting their potential diagnostic value in the diagnosis of CMPA.

Differences in exosome miRNAs in human breast milk between preterm and full-term infants / 中国儿童保健杂志

【Objective】 To evaluate the differential miRNA expression of breast milk exosome in premature and full-term groups, and to analyze the regulatory pathways by bioinformatics, so as to provide guidance and scientific basis for the growth and development of premature infants and the prevention and treatment of related diseases. 【Methods】 From August 2020 to June 2021, breast milk samples from 13 premature (premate group) and 9 full-term infants(full-term group) in the Department of Child Health Care of the Second Affiliated Hospital of Nanjing Medical University were collected to extract exosomes. The miRNAs of two groups of breast milk exosomes were sequenced by high-throughput sequencing. According to the sequencing results, miRNA expression profiles of milk exosome were analyzed. Biological function software was used to carry out GO and KEGG pathway analysis of differential miRNA. 【Results】 The expression of miRNA in human milk exosomes was rich, especially hsa-miR-148a-3p,hsa-let-7b-5p, hsa-let-7g-5p, hsa-miR-22-3p, hsa-miR-99a-5p, hsa-miR-200, hsa-miR-146b-5p and hsa-miR-26a-5p were relatively high expressed in preterm group and full-term group. Differential expression analysis showed that compared with full-term infant breast milk, 7 miRNAs were up-regulated(log2|fold change|=2.803, 2.714, 1.632, 2.360, 1.350, 3.387, 2.137, respectively), and 5 miRNAs were down-regulated(log2|fold change|=-2.553, -2.197, -2.771, -1.395, -1.136, respectively)(|fold change>2|, P<0.05) in breast milk for preterm infants. In these differential expressed miRNAs, down-regulated miR-29b(P=0.001) and up-regulated miR-133a-3p(P=0.004) were associated with inflammation, and up-regulated miR-126-5p(P=0.021) and miR-126-3p(P=0.041) were associated with lipid metabolism. The fatty acid biosynthesis pathway was obviously enriched in preterm group. MiR-7-5p, miR-29b-3p and miR-100-5p played a role in the fatty acid synthesis pathway. 【Conclusions】 Exosomal miRNAs are rich in breast milk, and have significant differences between preterm and full-term infants′ mothers. The differentially expressed miRNA in preterm infants treast milk may be related to inflammation and promote the growth and development of preterm infants through the fatty acid biosynthesis pathway.

Research progress in the effects of the main active ingredients of breast milk on the intestinal and immune functions of infants / 中国儿童保健杂志

Gut microbiome plays an important role in maintaining lifelong health. Infancy is a critical period for the establishment of gut microbiota, which is influenced by many factors, including delivery methods, antibiotics, and feeding mode. Human milk contains a variety of bioactive factors, such as human milk oligosaccharide, secretory immunoglobulin, and human milk microbiota, which play important roles in the establishment and stability of newborn microbiota. This article presents the latest research progress on the effects of the aforementioned bioactive factors in breast milk on the colonization and development of infant microbiota, and explains how these substances affect immune function through intestinal bacteria.

Simultaneous determination of bepotastine and hydroxychloroquine concentrations in human breast milk by LC-MS/MS / 中国药房

OBJECTIVE To establish a liquid chromatography-tandem mass spectrometry （LC-MS/MS） method for the simultaneous determination of bepotastine and hydroxychloroquine concentrations in human breast milk and apply it in clinical practice. METHODS The milk samples （50 μL） were precipitated with 200 μL methanol containing the internal standard （100 ng/mL chloroquine）， and the supernatant was taken for analysis after vortexing and centrifugation. The separation was performed on a Waters ACQUITY UPLC HSS T3 column with mobile phase consisted of 0.1% formic acid-10 mmol/L ammonium acetate solution （phase A） and methanol （phase B） at gradient elution of 0.35 mL/min. The injection volume was 2 μL， and the analysis time was 4 min. The detection of the analytes was performed by electrospray ionization in positive mode by multiple reaction monitoring with the transition of m/z 388.9→201.9 （bepotastine）， m/z 336.3→247.1 （hydroxychloroquine）， and m/z 320.2→247.2 （chloroquine）. The established LC-MS/MS method was researched in methodology and used to determine the drug concentrations in the breast milk of 1 case of lactating patient. RESULTS The linear range of bepotastine was 2-200 ng/mL（ r＝0.999）， and hydroxychloroquine was 50-1 000 ng/mL （r＝0.998）. The intra-assay and inter-assay precisions were both ≤15%， and the accuracy， extraction recovery， matrix effect， and stability all met the acceptance criteria for bioanalytical method validation. The concentration result of bepotastine and hydroxychloroquine in the breast milk of the lactating patient showed， after 2 h and 14 h， the concentrations of bepotastine in the breast milk of the patient were 34.95 ng/mL and 5.72 ng/mL； those of hydroxychloroquine were 211.92 ng/mL and 104.18 ng/mL， respectively. The relative infant doses were 1.83% and 0.56%， respectively. CONCLUSIONS The established method is simple， rapid， and sensitive. It is suitable for simultaneous determination of bepotastine and hydroxychloroquine concentrations in human milk and can provide reference for safe drug use during lactation.

Simultaneous determination of bepotastine and hydroxychloroquine concentrations in human breast milk by LC-MS/MS / 中国药房

OBJECTIVE To establish a liquid chromatography-tandem mass spectrometry （LC-MS/MS） method for the simultaneous determination of bepotastine and hydroxychloroquine concentrations in human breast milk and apply it in clinical practice. METHODS The milk samples （50 μL） were precipitated with 200 μL methanol containing the internal standard （100 ng/mL chloroquine）， and the supernatant was taken for analysis after vortexing and centrifugation. The separation was performed on a Waters ACQUITY UPLC HSS T3 column with mobile phase consisted of 0.1% formic acid-10 mmol/L ammonium acetate solution （phase A） and methanol （phase B） at gradient elution of 0.35 mL/min. The injection volume was 2 μL， and the analysis time was 4 min. The detection of the analytes was performed by electrospray ionization in positive mode by multiple reaction monitoring with the transition of m/z 388.9→201.9 （bepotastine）， m/z 336.3→247.1 （hydroxychloroquine）， and m/z 320.2→247.2 （chloroquine）. The established LC-MS/MS method was researched in methodology and used to determine the drug concentrations in the breast milk of 1 case of lactating patient. RESULTS The linear range of bepotastine was 2-200 ng/mL（ r＝0.999）， and hydroxychloroquine was 50-1 000 ng/mL （r＝0.998）. The intra-assay and inter-assay precisions were both ≤15%， and the accuracy， extraction recovery， matrix effect， and stability all met the acceptance criteria for bioanalytical method validation. The concentration result of bepotastine and hydroxychloroquine in the breast milk of the lactating patient showed， after 2 h and 14 h， the concentrations of bepotastine in the breast milk of the patient were 34.95 ng/mL and 5.72 ng/mL； those of hydroxychloroquine were 211.92 ng/mL and 104.18 ng/mL， respectively. The relative infant doses were 1.83% and 0.56%， respectively. CONCLUSIONS The established method is simple， rapid， and sensitive. It is suitable for simultaneous determination of bepotastine and hydroxychloroquine concentrations in human milk and can provide reference for safe drug use during lactation.

Association of pregnancy factors with cow's milk protein allergy in infants / 北京大学学报(医学版)

Objective:To preliminarily explore the association of pregnancy factors with cow's milk protein allergy in infants.Methods:This study was based on data from a subcohort of a study called ge-netic susceptibility to cow's milk allergy in Chinese children,including infants born in Peking University People's Hospital between March 1,2020,and December 31,2020.The infants were divided into a cow's milk protein allergy(CMPA)group and a control group according to whether they had developed cow's milk protein allergy at the age of 1 year.We retrospectively collected the clinical data of infants and their mothers before and during pregnancy,and analyzed the association of multiple factors during pregnancy with cow's milk protein allergy in infants.Results:A total of 278 infants were enrolled in this study,including 52 infants with CMPA and 226 infants without CMPA.Among them,there were 143 boys and 135 girls.The proportion of male infants in the CMPA group(69.2％)was higher than that in the control group(47.3％),and the difference was statistically significant(P=0.004).There were no significant differences in the distribution of birth weight,gestational age at birth,low-birth-weight in-fants,premature,umbilical cord entangle neck,and neonatal asphyxia between the CMPA group and the control group(P＞0.05).The proportion of mothers complicated with autoimmune diseases,anemia or antibiotics exposure during pregnancy in the CMPA group was higher than that in the control group,and there were statistical differences between the two groups(P＜0.05).There was no significant difference in the distribution of other pregnancy complications between the two groups(P＞0.05),such as eclamp-sia/preeclampsia,chronic hypertension/gestational hypertension,diabetes/gestational diabetes,thyroid diseases,and so on.There was no significant difference in the overall distribution of some blood routine indexes during pregnancy between the CMPA group and the control group(P＞0.05).Multivariate Lo-gistic regression analysis showed that male infant,mothers complicated with autoimmune diseases or ane-mia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.Conclusion:Male infant,mothers complicated with autoimmune diseases or anemia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.

Comprehensive Analysis of Proteins and Their Phosphorylation in Milk-derived Exosomes From Different Species / 生物化学与生物物理进展

ObjectiveExosomes are microvesicles which could be secreted by all cell types with diameters between 30 and 150 nm. It was widely distributed in body fluids including blood, urine, and breast milk. Exosomes are considered as potential biomarkers and drug carriers by reason of containing nucleic acids, lipids, proteins and other bioactive molecules. Milk-derived exosomes have been widely used as drug delivery carriers to treat targeted diseases with a lower cost, higher biocompatibility and lower immunogenicity. Until now, there is no research about the milk-derived exosomes phosphorylation to reveal the difference of protein phosphorylation in different species of milk. To investigate the pathways and proteins with specific functions, phosphorylated proteomic analysis of milk-derived exosomes from different species is performed, and provide new ideas for exploring diversified treatments of disease. MethodsWhey and exosomes derived from bovine, porcine and caprine milk were performed for proteomics and phosphoproteomics analysis. The relationship between milk exosome proteins from different species and signaling pathways were analyzed using bioinformatics tools. ResultsA total of 4 191 global proteins, 1 640 phosphoproteins and 4 064 phosphosites were identified from 3 species of milk-derived exosomes, and the exosome proteins and phosphoproteins from different species were significantly higher than those of whey. Meanwhile, some special pathways were enriched like Fcγ-mediated phagocytosis from bovine exosomes, pathways related with neural and immune system from caprine exosomes, positive and negative regulation of multiple activities from porcine exosomes. ConclusionIn this study, the proteomic and phosphoproteomic analyses of exosomes and whey from bovine, porcine and caprine milk were carried out to reveal the difference of composition and related signaling pathways of milk exosome from different species. These results provided powerful support for the application of exosomes from different milk sources in the field of disease treatment.

Partial purification of linoleic acid isomerase enzyme from Lactobacillus paracasei bacteria isolated from milk / Purificação parcial da enzima isomerase do ácido linoleico da bactéria Lactobacillus paracasei isolada do leite

Conjugated Linoleic Acid (CLA) has attracted the attention of many researchers, especially that of microbial origin due to its biological importance to the consumer. The current study aims to extract LA Isomerase enzyme from Lactobacillus paracasei bacteria from milk and to use the enzyme in the production of CLA. Selective media, including MRS and MRS-Dagatose, were used in isolating local strains. The selected bacterial isolates were tested for their ability to produce LA-Isomerase enzyme. The isolate with high enzymatic activity was selected. After extraction and partial purification of the enzyme, the optimal conditions for the production of conjugated fatty acid were studied, and the reaction products were diagnosed using GC-MS technology. It was found that 11 isolates have the ability to produce CLA at different concentrations, H1 isolate showed the highest production of conjugated fatty acid at a concentration of 120.45 g.ml-1, this isolate was selected as the source for enzyme extraction. The enzymatic activity of the crude extract and partially purified with ammonium sulfate was estimated using color methods at wavelength of 233 nm. The effect of the optimum conditions (pH, temperature, linoleic acid concentration and enzyme concentration) on the CLA product was studied using the partially purified LA Isomerase enzyme, the optimum conditions for production were 6.5, 45 °C, 100 µg.ml-1 and 0.7 ml, respectively. The GC-MS technique showed the presence of a number of reaction products that are isomers of conjugated linoleic acid (C9T11, T9T12, T10C12) with different concentrations.

O Ácido Linoleico Conjugado (CLA) tem chamado a atenção de diversos pesquisadores, principalmente aquele de origem microbiana, devido à sua importância biológica para o consumidor. O presente estudo visa extrair a enzima LA Isomerase da bactéria Lactobacillus paracasei do leite e usar essa enzima na produção de CLA. Meios seletivos, incluindo MRS e MRS-Dagatose, foram usados no isolamento de cepas locais. Os isolados bacterianos selecionados foram testados quanto à sua capacidade de produzir a enzima LA-Isomerase. Foi selecionado o isolado com alta atividade enzimática. Após a extração e purificação parcial da enzima, as condições ideais para a produção de ácido graxo conjugado foram estudadas e os produtos da reação foram identificados usando a tecnologia GC-MS. Verificou-se que 11 isolados possuem capacidade de produzir CLA em diferentes concentrações. O isolado H1 apresentou a maior produção de ácido graxo conjugado, na concentração de 120,45 g.ml-1, e este isolado foi selecionado como fonte para extração enzimática. A atividade enzimática do extrato bruto e parcialmente purificado com sulfato de amônio foi estimada por métodos de coloração em comprimento de onda de 233 nm. O efeito das condições ótimas (pH, temperatura, concentração de ácido linoleico e concentração de enzima) no produto CLA foi estudado usando a enzima LA Isomerase parcialmente purificada e as condições ótimas para produção foram 6,5, 45 °C, 100 µg.ml-1 e 0,7 mL, respectivamente. A técnica de GC-MS mostrou a presença de uma série de produtos de reação que são isômeros do ácido linoleico conjugado (C9T11, T9T12, T10C12) com diferentes concentrações.

Desafios para o suporte à amamentação em homens transgêneros sob à luz da interseccionalidade / Intersectionality and challenges in support for chest-feeding transgender men

Resumo O objetivo deste artigo é apreender os desafios nas vivências dos usuários e profissionais de Banco de Leite Humano no atendimento a homens transgêneros no contexto da amamentação sob à luz da Interseccionalidade. Estudo qualitativo descritivo-exploratório a partir de entrevistas realizadas com seis profissionais do Banco de Leite Humano, que atenderam previamente homens trans no contexto de amamentação, e dois homens trans bissexuais, que amamentaram ao peito. Os dados foram tratados pela Análise Temática com auxílio do software Atlas.ti versão 9.0. Observam-se lacunas nas esferas educacionais, institucionais e na gestão, associadas a questões pessoais e sociais, que reproduzem um modelo pré-concebido normativo, desconsiderando as singularidades requeridas no atendimento à população trans no contexto da amamentação. A cisheteronormatividade e a supremacia do profissional operam em âmbitos pessoais, sociais e institucionais para a segregação de homens transgêneros nos serviços de suporte à amamentação. A análise interseccional destes desafios permite uma visão global dos fatores de segregação e a implementação de políticas públicas promotoras da justiça social.

Abstract This article tried, from an intersectional standpoint, to grasp the challenges experienced by health professionals and service users of human milk banks in provision of care for transgender men chestfeeding. This exploratory, descriptive qualitative study drew on interviews of six human milk bank staff, who had previously assisted trans men in relation to chestfeeding and two bisexual trans men, who chestfed. The data was treated by thematic analysis, supported by Atlas.ti software, version 9.0. Lacunas in the educational, institutional and management spheres, associated with personal and social issues, reproduce a pre-conceived normative model and disregard the special demands of providing chestfeeding care for the trans population. Cisheteronormativity and "professional supremacy" operate in personal, social and institutional respects to segregate transgender men in lactation support services. Intersectional analysis of these challenges affords an overall view of segregative factors and enables public policies to be introduced to promote social justice.

Caracterización clínica y epidemiológica de pacientes con alergia a las proteínas de la leche de vaca

La alergia a las proteínas de la leche de vaca aparece en los primeros meses de vida y es la alergia alimentaria más frecuente en el lactante y el niño pequeño. Esta investigación tiene como objetivo caracterizar clínica y epidemiológicamente a pacientes con alergia a las proteínas de la leche de vaca. Se realizó un estudio longitudinal, descriptivo, retrospectivo en el hospital infantil Hermanos Cordové del municipio Manzanillo en Granma, Cuba. La población estuvo constituida por los 10 infantes egresados de la institución durante el período 2017-2021. Se estudiaron las variables: edad, sexo, estadía, tiempo de evolución de la enfermedad, lactancia, factores de riesgo, evaluación nutricional. Entre los principales resultados se obtuvieron que predominó el sexo femenino y las edades de uno a seis meses (60 %). El 50 % de niños estaban desnutridos. El 70 % de los pacientes presentaron diarreas como principal síntoma, seguido por las lesiones de piel (60 %). Solo el 20 % recibieron lactancia materna exclusiva hasta los 6 meses de edad. El parto por cesárea fue el factor de riesgo más predominante (50 %). Se concluye que el sexo femenino y las edades de uno a seis meses fueron las más sobresalientes. La diarrea y las lesiones de piel fueron las manifestaciones clínicas más frecuentes de los pacientes con alergia a las proteínas de la leche de vaca. Los lactantes desnutridos, con lactancia artificial y antecedentes de parto por cesárea tienen mayores probabilidades de padecer esta enfermedad.

Allergy to cow's milk proteins, appears in the first months of life and is the most common food allergy in infants and young children. This research aims to characterize clinically and epidemiologically patients with allergy to cow's milk proteins. A longitudinal, descriptive, retrospective study was conducted at the Hermanos Cordové Children's Hospital in the municipality of Manzanillo in Granma, Cuba. The population consisted of the 10 children who graduated from the institution during the period 2017-2021. The following variables were studied: age, sex, length of stay, duration of disease progression, breastfeeding, risk factors, nutritional assessment. Among the main results, it was found that the female sex and the ages of one to six months predominated (60 %). The 50 % of children were malnourished. 70 % of patients had diarrhea as the main symptom, followed by skin lesions (60 %). Only 20 % were exclusively breastfed up to 6 months of age. Caesarean section was the most prevalent risk factor (50 %). It is concluded that the female sex and the ages of one to six months were the most outstanding. Diarrhea and skin lesions were the most common clinical manifestations in patients with cow's milk protein allergy. Malnourished infants, breastfed infants and a history of cesarean delivery are more likely to have this disease.

A alergia à proteína do leite de vaca aparece nos primeiros meses de vida e é a alergia alimentar mais comum em lactentes e crianças pequenas. Esta pesquisa tem como objetivo caracterizar clínica e epidemiologicamente pacientes com alergia à proteína do leite de vaca. Foi realizado um estudo longitudinal, descritivo e retrospectivo no Hospital Infantil Hermanos Cordové, no município de Manzanillo, em Granma, Cuba. A população foi composta por 10 crianças que se formaram na instituição no período de 2017 a 2021. As seguintes variáveis foram estudadas: idade, sexo, tempo de internação, tempo de evolução da doença, aleitamento materno, fatores de risco, avaliação nutricional. Dentre os principais resultados, predominaram o sexo feminino e a faixa etária de um a seis meses (60%). 50% das crianças estavam desnutridas. A diarreia foi o principal sintoma de 70% dos pacientes, seguida pelas lesões cutâneas (60%). Apenas 20% foram amamentados exclusivamente até os 6 meses de idade. O parto cesáreo foi o fator de risco mais prevalente (50%). Conclui-se que o sexo feminino e a idade de um a seis meses foram os que mais se destacaram. Diarreia e lesões cutâneas foram as manifestações clínicas mais frequentes dos pacientes com alergia à proteína do leite de vaca. Lactentes desnutridos, lactentes com alimentação com fórmula e história de parto cesáreo são mais propensos a sofrer dessa doença.

Outcomes and factors associated with tolerance in infants with non-IgE-mediated cow's milk allergy with gastrointestinal manifestations

Abstract Objectives To evaluate outcomes of oral food challenge (OFC) test to assess tolerance in infants with non-IgE-mediated cow's milk allergy (CMA) with gastrointestinal manifestations and explore clinical data predictive of these outcomes. Methods Single-center retrospective study including infants (age < 12 months) who were referred for CMA between 2000 and 2018 and underwent OFC on follow-up. A univariate logistic regression test was performed to evaluate variables associated with the outcomes of the follow-up OFC test. Results Eighty-two patients were included, 50% were male. Eighteen patients had a positive OFC test (22%). Most patients had presented with hematochezia (77%). The median age of symptom onset was 30 days. Two-thirds of the patients were on appropriate infant formula (extensively hydrolyzed or amino acid-based formula), exclusively or in association with breastfeeding. The median time on an elimination diet before the OFC test was 8 months (Q1 6 - Q3 11 months). All cases with positive follow-up OFC tests (n= 18) had been exposed to cow's milk-based formula before the first clinical manifestation of CMA. Five out of eight cases with Food Protein-Induced Enterocolitis Syndrome (FPIES) had positive OFC tests. Exposure to cow's milk-based formula before diagnosis, a history of other food allergies, hematochezia and diarrhea were predictors of a positive OFC test. Conclusions In infants with non-IgE-mediated CMPA with gastrointestinal manifestations, the use of cow's milk-based formula, a history of other food allergies, and hematochezia and diarrhea upon initial presentation were associated factors for the later achievement of tolerance.

Relação entre desmame precoce e alergias alimentares / Relationship between early weaning and food allergies / Relación entre el destete precoz y las alergias alimentarias

Objetivo: Analisar a relação entre o desmame precoce e o desenvolvimento de alergias alimentares por meio de uma revisão integrativa. Método:Revisão integrativa da literatura realizada através das bases de dados Pubmed, Mesh e Scielo.Resultados:Através da busca pelos descritores determinados, foram selecionados 25 estudos científicos que atenderam aos critérios de inclusão. Devido sua grande composição, o leite humano é responsável pela promoção do crescimento das bactérias com efeito bifidogênico, estando em quantidades superiores nos lactentes em AME. Conclusão: Apesar de alguns dos estudos não mostrarem resultados significativos em relação ao leite materno ser um fator protetor contra as alergias alimentares, nenhum deles deixoude incentivar o AM ou mostrar os seus benefícios já cientificamente comprovados.

Objective: To analyze the relationship between early weaning and the development of food allergies through an integrative review. Method: Integrative literature review performed through the Pubmed, Mesh and Scielo databases. Results: Through the search for the descriptors determined, 25 scientific studies that met the inclusion criteria were selected. Due to its large composition, human milk is responsible for promoting the growth of bacteria with bifidogenic effect, being in higher amounts in infants in EBF. Conclusion: Although some of the studies did not show significant results regarding breast milk being a protective factor against food allergies, none of them failed to encourage BF or show its scientifically proven benefits.

Objetivo: Analizar la relación entre el destete precoz y el desarrollo de alergias alimentarias a través de una revisión integradora. Metodo:Revisión integradora de la literatura realizada a través de las bases de datos Pubmed, Mesh y Scielo. Resultados: A través de la búsqueda de los descriptores determinados, se seleccionaron 25 estudios científicos que cumplieron con los criterios de inclusión. Debido a su gran composición, la leche humana es responsable de promover el crecimiento de bacterias con efecto bifidogénico, estando en mayores cantidades en bebés en LME. Conclusión:Aunque algunos de los estudios no mostraron resultados significativos con respecto a que la leche materna sea un factor protector contra las alergias alimentarias, ninguno de ellos falló en fomentar la BF o mostrar sus beneficios científicamente probados.

Revisão de literatura sobre os aspectos fisiológicos e nutricionais em bezerros alimentados com colostro acidificado / Literature review on physiological and nutritional aspects in calves fed acidified colostrum / Revisión de la literatura sobre aspectos fisiológicos y nutricionales en terneros alimentados con calostro acidificado

A colostragem é essencial para a saúde dos bezerros neonatos, uma vez que não há a transferência de imunidade através da placenta, ou seja, o contato inicial do organismo com anticorpos se dá através da primeira mamada, onde há transferência da imunidade passiva. Sendo assim, o objetivo do trabalho é revisar os benefícios da acidificação ou silagem do colostro para otimizar a conservação da dieta líquida em fazendas; analisar o impacto no desempenho de bezerros em comparação com o colostro tradicional refrigerado em aleitamentos convencionais. O volume ideal preconizado é, no mínimo, 10% do peso vivo do animal nas primeiras duas horas e mais 5% do peso vivo nas seis a oito horas seguintes a primeira ingestão, para que se obtenha um bom desenvolvimento durante o crescimento, caso contrário, a falta da administração do colostro nas primeiras horas de vida predispõe enfermidades, tais como pneumonia e diarreia, prejudicando assim a saúde e consequentemente o desempenho em relação a outros animais que receberam uma colostragem adequada. Problemas com a qualidade do colostro surgem devido ao armazenamento inadequado, especialmente em propriedades sem refrigeração. A falta de sistemas de congelamento resulta em administração de leite em temperatura ambiente por períodos prolongados, prejudicando assim a imunidade e nutrição dos bezerros durante a colostragem. Todavia, há alternativas para o problema tal como o fornecimento de silagem de colostro. Em alguns casos, o processo de acidificação demanda a adição de ácidos no leite, a fim de evitar o crescimento de microrganismos patogênicos. O principal aspecto positivo do leite acidificado é a manutenção em temperatura ambiente, ou seja, não há a necessidade de passar por processos de refrigeração.

Colostrum is essential for the health of newborn calves, since there is no transfer of immunity through the placenta, that is, the body's initial contact with antibodies occurs through the first feeding, where there is a transfer of passive immunity. Therefore, the objective of the work is to review the benefits of acidifying or colostrum silage to optimize the conservation of liquid diets on farms; analyze the impact on calf performance compared to traditional refrigerated colostrum in conventional sucklers. The recommended ideal volume is at least 10% of the animal's live weight in the first two hours and a further 5% of its live weight in the six to eight hours following the first ingestion, so that good development is achieved during growth, otherwise, the lack of colostrum administration in the first hours of life predisposes diseases, such as pneumonia and diarrhea, thus harming health and consequently performance in relation to other animals that received adequate colostrum. Problems with colostrum quality arise due to inadequate storage, especially in unrefrigerated properties. The lack of freezing systems results in milk being administered at room temperature for prolonged periods, thus damaging the calves immunity and nutrition during colostrum. However, there are alternatives to the problem such as the supply of colostrum silage. In some cases, the acidification process requires the addition of acids to the milk in order to prevent the growth of pathogenic microorganisms. The main positive aspect of acidified milk is that it remains at room temperature, that is, there is no need to undergo refrigeration processes.

El calostro es esencial para la salud de los terneros recién nacidos, ya que no existe transferencia de inmunidad a través de la placenta, es decir, el contacto inicial del cuerpo con los anticuerpos ocurre a través de la primera alimentación, donde existe una transferencia de inmunidad pasiva. Por lo tanto, el objetivo del trabajo es revisar los beneficios de acidificar o ensilar el calostro para optimizar la conservación de dietas líquidas en granjas; analizar el impacto en el rendimiento de los terneros en comparación con el calostro refrigerado tradicional en lechones convencionales. El volumen ideal recomendado es al menos el 10% del peso vivo del animal en las dos primeras horas y otro 5% de su peso vivo en las seis a ocho horas siguientes a la primera ingesta, para que se consiga un buen desarrollo durante el crecimiento, en caso contrario. la falta de administración de calostro en las primeras horas de vida predispone a enfermedades, como neumonía y diarrea, perjudicando la salud y consecuentemente el rendimiento en relación a otros animales que recibieron el calostro adecuado. Los problemas con la calidad del calostro surgen debido a un almacenamiento inadecuado, especialmente en propiedades no refrigeradas. La falta de sistemas de congelación provoca que la leche se administre a temperatura ambiente durante períodos prolongados, dañando así la inmunidad y la nutrición de los terneros durante el calostro. Sin embargo, existen alternativas al problema como el suministro de ensilaje de calostro. En algunos casos, el proceso de acidificación requiere la adición de ácidos a la leche para evitar el crecimiento de microorganismos patógenos. El principal aspecto positivo de la leche acidificada es que se mantiene a temperatura ambiente, es decir, no es necesario someterse a procesos de refrigeración.

Aspectos que influenciam a contagem bacteriana total e a contagem de células somáticas do leite de propriedades rurais do interior do estado de São Paulo, Brasil / Aspects that influence milk total bacterial count and somatic cell count from farms in interior of São Paulo State, Brazil / Aspectos que influyen el contaje bacteriano total y el contaje de células somáticas de la leche de propiedades rurales del interior del estado de São Paulo, Brasil

Este estudo objetivou avaliar aspectos que exercem influência sobre a contagem bacteriana total (CBT) e a contagem de células somáticas (CCS) do leite e avaliar a adequação das amostras do produto à Instrução Normativa nº 76, de 26 de novembro de 2018, do Ministério da Agricultura e Pecuária do Brasil (IN 76). A pesquisa foi realizada em propriedades rurais da microrregião de Birigui, São Paulo, Brasil, e se baseou em coleta de dados, por entrevista estruturada, e coletas de leite nas propriedades. Foi realizada amostragem por conveniência, sendo escolhidos 15 produtores de cada estrato (de acordo com a produção diária de leite: pequeno - até 100 L; médio - 101 a 300 L; grande - mais de 300 L), totalizando 45 produtores de leite. Participaram da pesquisa somente propriedades com base da alimentação volumosa em sistema de pastejo ou em semiconfinamento. Para avaliar a influência de diferentes fatores sobre a contagem bacteriana total (CBT) e a contagem de células somáticas (CCS), separadamente, realizou-se regressão multivariada. Ainda, foi determinado o coeficiente de correlação entre variáveis desta pesquisa. As variáveis resposta foram transformadas em logaritmo para normalização dos dados. Foi feita comparação entre os resultados da pesquisa e os parâmetros da IN 76 para verificar o cumprimento das normas pelos produtores. Foram encontrados valores médios de 6.986.977,818.961.790,7 UFC/mL para CBT e de 608.911,1 ± 414.802,9 CS/mL para CCS. A utilização de tanque de resfriamento individual mostrou-se favorável à baixa CBT, em comparação com não uso de tanque ou uso de tanque comunitário, conforme o esperado, pois quanto mais tempo leva para resfriar o leite, maior é a proliferação de bactérias no produto. Foi verificado que o leite de produtores que realizam o California Mastitis Test (CMT) com maior frequência apresentou CCS mais elevada, o que não era esperado. As análises físico-químicas médias foram densidade 1,031 g/mL a 15°C, índice crioscópico -0,538 °H, teor de proteína 3,58%, teor de gordura 4,06%, extrato seco total 12,75%, extrato seco desengordurado 8,69%, acidez titulável 16,2 °D e estabilidade ao álcool (Alizarol 72%) 100%. Em 13,3% (6/45) das amostras foi detectada presença de antibióticos. Considerando a IN 76, o leite de somente 8,9% (4/45) dos produtores apresentou-se adequado simultaneamente para todos os parâmetros analisados (CBT, CCS, densidade, índice crioscópico, proteína, gordura, extrato seco total, extrato seco desengordurado, acidez titulável, estabilidade ao alizarol e pesquisa de antibióticos). A utilização de tanque de resfriamento individual e a realização de CMT favoreceram menor CBT e maior CCS, respectivamente.

This study aimed to evaluate aspects that exerts influence on the total bacterial count (TBC) and somatic cell count (SCC) of milk and evaluate the conformity of the samples to the Normative Instruction no. 76, from November 26, 2018, of the Brazilian Agriculture and Livestock Ministry (NI 76). The research was done in farms around Birigui micro-region, São Paulo State, Brazil, and was based on data collection obtained by structured interviews and milk collection in the farms. Convenience sampling was carried out from 15 producers of each stratum (according to daily milk production: small - up to 100 L; medium - 101 to 300 L; large - more than 300 L), totalizing 45 milk producers. Only farms with grazing or semi-feedlot system for roughage feeding base were included. To evaluate the influence of different factors on Total Bacterial Count (TBC) and Somatic Cell Count (SCC), separately, a multivariate regression was done. Moreover, the correlation coefficient among variables was determined. The response variables were transformed into logarithms for the normalization of the data. A comparison between results and NI 76 parameters was done to verify the standard compliance by producers. Mean TBC was 6.986.977,8 ± 18.961.790,7 CFU/mL and mean SCC was 608.911,1414.802,9 cells/mL. The use of individual cooler tank was favorable to lower TBC, compared with the non-use of the tank or with the use of the communitarian tank, as expected, since the longer it takes to cool the milk, the higher the proliferation of bacteria in the product. It was verified that milk from farmers that more frequently perform California Mastitis Test (CMT) showed higher SCC, which was not expected. The average physicochemical analyzes were density 1.031 g/mL at 15°C, cryoscopic index -0.538 °H, protein content 3.58%, fat content 4.06%, total dry extract 12.75%, dry extract defatted 8.69%, titratable acidity 16.2 °D and alcohol stability (Alizarol 72%) 100%. The presence of antibiotics was detected in 13.3% (6/45) of the samples. Considering NI 76, milk from only 8.9% (4/45) farmers were proper simultaneously for all the parameters analyzed (TBC, SCC, density, cryoscopic index, protein, fat, total dry extract, defatted dry extract, titratable acidity, alizarol stability and antibiotics). The use of individual cooling tank and the CMT performance support lower TBC and higher SCC respectively.

Este estudio tuvo como objetivo evaluar los aspectos que influyen en el contaje bacteriano total (CBT) y el contaje de células somáticas (CCS) de la leche y evaluar la adecuación de las muestras del producto a la Instrucción Normativa nº 76, de 26 de noviembre de 2018, del Ministerio de Agricultura y Ganadería en Brasil (IN 76). La investigación se llevó a cabo en propiedades rurales en la microrregión de Birigui, São Paulo, Brasil, y se basó en la recolección de datos, a través de entrevistas estructuradas, y colectas de leche en las propiedades. Se realizó un muestreo por conveniencia, escogiendo 15 productores de cada estrato (de acuerdo con la producción diaria de leche: pequeño - hasta 100 L; medio - 101 hasta 300 L; grande ­ más de 300 L), totalizando 45 productores de leche. Participaron de la investigación únicamente propiedades basadas en alimentación voluminosa en sistema de pastoreo o, a lo sumo, en semiconfinamiento. Para evaluar la influencia de diferentes factores sobre el contaje bacteriano total (CBT) y el contaje de células somáticas (CCS), por separado, se realizó una regresión multivariada. Asimismo, se determinó el coeficiente de correlación entre las variables de esta investigación. Las variables de respuesta se transformaron en logaritmos para la normalización de datos. Se realizó una comparación entre los resultados de la investigación y los parámetros de la IN 76 para verificar el cumplimiento de las normas por parte de los productores. Se encontraron valores medios de 6.986.977,818.961.790,7 UFC/mL para CBT y de 608.911,1 +414.802,9 CS/mL para CCS. El uso de un tanque de enfriamiento individual se ha mostrado favorable a la baja CBT, en comparación con no usar un tanque o usar un tanque comunitario, conforme lo esperado, ya que cuanto más se tarda en enfriar la leche, mayor es la proliferación de bacterias en el producto. Se verificó que la leche de los productores que realizan el California Mastitis Test (CMT) con mayor frecuencia presentó CCS más alto, lo cual no se esperaba. Los análisis fisicoquímicos promedio fueron densidad 1,031 g/mL a 15°C, índice crioscópico -0,538 °H, contenido de proteína 3,58%, contenido de grasa 4,06%, extracto seco total 12,75%, extracto seco desgrasado 8,69%, acidez titulable 16,2°D y estabilidad del alcohol (Alizarol 72%) 100%. En el 13,3% (6/45) de las muestras se detectó la presencia de antibióticos. Considerando la IN 76, la leche de solo el 8,9% (4/45) de los productores se presentó adecuado simultáneamente para todos los parámetros analizados (CBT, CCS, densidad, índice crioscópico, proteína, grasa, extracto seco total, extracto seco desgrasado, acidez titulable, estabilidad al alizarol e investigación de antibióticos). El uso de un tanque de enfriamiento individual y la realización de CMT favorecieron un CBT más bajo y un CCS más alto respectivamente.