Dietary supplementation with integral chia and flax flours ameliorates systemic inflammation / La suplementación dietaria con harinas integrales de chia y lino tiene efectos antiinflamatorios sistémicos

Abstract Introduction : Chia and flax seeds are rich in alpha-linolenic acid (ALA), which is bioconverted into the active derivatives eicosapentaenoic (EPA) and doco sahexaenoic (DHA) having multiple beneficial effects. However, there is limited knowledge about the anti-inflammatory effects of chia and flax integral flours diets rich in ALA. Objective : The study aimed to evaluate the anti-inflammatory effect of dietary supplementation with integral chia and flax flours in a murine model of LPS-induced systemic inflammation. Methods : Balb/c mice were distributed into three groups: diet A (control), diet B (supplemented with inte gral chia flour), and diet C (supplemented with integral flax flour). Nutritional, hematological, and biochemical determinations were performed. ALA, EPA, and DHA were assessed by GC-MS in the liver, brain, cardiac and skeletal muscles. NF-kB immunoassays were per formed in kidney, liver, and peritoneal macrophages, respectively. The phagocytic capacity was determined in peritoneal macrophages and the expression of the pro- and anti-inflammatory cytokines was assessed by RT-qPCR in the kidney, liver, and spleen. Results : Diets B and C exhibited optimal nutritional adequacy and caused increased levels of ALA, EPA, and DHA in critical tissues compared to the control. The phagocytic capacity of murine peritoneal macrophages (p< 0.01) and IL-10 transcription increased, whereas the expression of NF-κB, IL-1β, IL-6, and TNF-α decreased in animals fed both experimental diets. Conclusions : This work contributes to the current knowledge of the anti-inflammatory effects of chia and flax integral flours rich in ALA and reinforces the health advantages of their consumption.

Resumen Introducción : Las semillas de chía y lino son ricas en ácido alfa-linolénico (ALA), sus derivados activos eico sapentaenoico (EPA) y docosahexaenoico (DHA) ejercen probados efectos beneficiosos. Existe un conocimiento limitado sobre los efectos protectores de ambas semillas bajo la forma de harinas integrales, siendo de particular interés el efecto antiinflamatorio. Objetivo : El objetivo de este trabajo fue evaluar el efecto antiinflamatorio de la suplementación dietaria con harinas integrales de semillas de chía y lino en un modelo murino de inflamación sistémica inducido por LPS. Métodos : Ratones de la cepa Balb/c fueron distribui dos en tres grupos: dieta A (control), dieta B (suplemen tada con harina integral de chía) y dieta C (suplementa da con harina integral de lino). Se efecturaron determi naciones nutricionales, hematológicas y bioquímicas. El contenido de ALA, EPA y DHA en hígado, cerebro, corazón y músculo esquelético se determinó por cromatografía GC-MS. Se realizó la inmunodetección de NF-kB en macrófagos peritoneales, riñón e hígado. Se determinó la capacidad fagocítica de macrófagos peritoneales y se evaluó la expresión de citoquinas pro y antiinflamatorias por RT-qPCR en riñón, hígado y bazo. Resultados : Las dietas B y C mostraron una adecua ción nutricional óptima y generaron niveles elevados de ALA, EPA y DHA en tejidos críticos. La capacidad fagocítica de los macrófagos peritoneales (p< 0.01) y la transcripción de IL-10 aumentó, mientras que la expre sión de NF-κB, IL-1β, IL-6 y TNF-α disminuyó en animales de los grupos B y C. Conclusiones : Este trabajo contribuye al conocimien to actual de los efectos antiinflamatorios de ambas hari nas integrales y refuerza los beneficios de su consumo.

Electroacupuncture efficacy in diabetic polyneuropathy: Study protocol for a double-blinded randomized controlled multicenter clinical trial.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most common complication of type 2 diabetes mellitus (T2DM); its diagnosis and treatment are based on symptomatic improvement. However, as pharmacological therapy causes multiple adverse effects, the implementation of acupunctural techniques, such as electroacupuncture (EA) has been suggested as an alternative treatment. Nonetheless, there is a lack of scientific evidence, and its mechanisms are still unclear. We present the design and methodology of a new clinical randomized trial, that investigates the effectiveness of EA for the treatment of DPN. METHODS: This study is a four-armed, randomized, controlled, multicenter clinical trial (20-week intervention period, plus 12 weeks of follow-up after concluding intervention). A total of 48 T2DM patients with clinical signs and symptoms of DPN; and electrophysiological signs in the Nerve Conduction Study (NCS); will be treated by acupuncture specialists in outpatient units in Mexico City. Patients will be randomized in a 1:1 ratio to one of the following four groups: (a) short fibre DPN with EA, (b) short fibre DPN with sham EA, (c) axonal DPN with EA and (d) axonal DPN with sham EA treatment. The intervention will consist of 32 sessions, 20 min each, per patient over two cycles of intervention of 8 weeks each and a mid-term rest period of 4 weeks. The primary outcome will be NCS parameters, and secondary outcomes will include DPN-related symptoms and pain by Michigan Neuropathy Screening Instrument (MNSI), Michigan Diabetic Neuropathy Score (MDNS), Dolour Neuropatique Score (DN-4), Semmes-Westein monofilament, Numerical Rating Scale (NRS) for pain assessment, and the 36-item Short Form Health Survey (SF-36). To measure quality of life and improve oxidative stress, the inflammatory response; and genetic expression; will be analysed at the beginning and at the end of treatment. DISCUSSION: This study will be conducted to compare the efficacy of EA versus sham EA combined with conventional diabetic and neuropathic treatments if needed. EA may improve NCS, neuropathic pain and symptoms, oxidative stress, inflammatory response, and genetic expression, and it could be considered a potential coadjutant treatment for the management of DPN with a possible remyelinating effect. TRIAL REGISTRATION: ClinicalTrials.gov. NCT05521737 Registered on 30 August 2022. International Clinical Trials Registry Platform (ICTRP) ISRCTN97391213 Registered on 26 September 2022 [2b].

Pseudomonas putida configures Arabidopsis root architecture through modulating the sensing systems for phosphate and iron acquisition.

Iron (Fe) and phosphate (Pi) are two essential nutrients that are poorly available in the soil and should be supplemented either as fertilizers or organic amendments to sustain crop production. Currently, determining how rhizosphere bacteria contribute to plant mineral nutrient acquisition is an area of growing interest regarding its potential application in agriculture. The aim of this study was to investigate the influence of root colonization by Pseudomonas putida for Arabidopsis growth through Fe and Pi nutritional signaling. We found that root colonization by the bacterium inhibits primary root elongation and promotes the formation of lateral roots. These effects could be related to higher expression of two Pi starvation-induced genes and AtPT1, the major Pi transporter in root tips. In addition, P. putida influenced the accumulation of Fe in the root and the expression of different elements of the Fe uptake pathway. The loss of function of the protein ligase BRUTUS (BTS), and the bHLH transcription factors POPEYE (PYE) and IAA-LEUCINE RESISTANT3 (ILR3) compromised the root branching stimulation triggered by bacterial inoculation while the leaf chlorosis in the fit1 and irt1-1 mutant plants grown under standard conditions could be bypassed by P. putida inoculation. The WT and both mutant lines showed similar Fe accumulation in roots. P. putida repressed the expression of the IRON-REGULATED TRANSPORTER 1 (IRT1) gene suggesting that the bacterium promotes an alternative Fe uptake mechanism. These results open the door for the use of P. putida to enhance nutrient uptake and optimize fertilizer usage by plants.

A meta-analysis of essential oils as a dietary additive for weaned piglets: Growth performance, antioxidant status, immune response, and intestinal morphology.

This study aimed to evaluate the effects of dietary supplementation with EOS on growth performance, blood serum antioxidant status, immune response, and intestinal morphology of weaned piglets using a meta-analytical approach. The database included 31 studies from which the response variables of interest were obtained. All data were analyzed using a random effects model, and results were expressed as weighted mean differences between treatments supplemented with and without EOS. EOS supplementation increased (P < 0.001) average daily feed intake, average daily gain, and final body weight and decreased (P < 0.001) feed conversion ratio and diarrhea incidence. Lower (P = 0.001) serum malondialdehyde content and higher (P < 0.05) serum concentrations of superoxide dismutase, catalase, glutathione peroxidase, and total antioxidant capacity were observed in response to the dietary inclusion of EOS. EOS supplementation increased (P < 0.001) the serum concentration of immunoglobulins A, G, and M and decreased (P < 0.05) the serum concentration of tumor necrosis factor-α, interleukin-1ß, and interleukin-6. Greater (P ≤ 0.001) villus height (VH) was observed in the jejunum and ileum in response to the dietary inclusion of EOS. However, EOS supplementation did not affect (P > 0.05) crypt depth (CD) and decreased (P < 0.001) the VH/CD ratio in the duodenum, jejunum, and ileum. In conclusion, essential oils can be used as a dietary additive to improve growth performance and reduce the incidence of diarrhea in weaned piglets and, at the same time, improve the antioxidant status in blood serum, immune response, and intestinal morphology.

Medical oncology workload, workforce census, and needs in Spain: two nationwide studies by the Spanish Society of medical oncology.

PURPOSE: Growing complexity and demand for cancer care entail increased challenges for Medical Oncology (MO). The Spanish Society of Medical Oncology (SEOM) has promoted studies to provide updated data to estimate the need for medical oncologists in 2040 and to analyse current professional standing of young medical oncologists. METHODS: Two national, online surveys were conducted. The first (2021) targeted 146 Heads of MO Departments, and the second (2022), 775 young medical oncologists who had completed their MO residency between 2014 and 2021. Participants were contacted individually, and data were processed anonymously. RESULTS: Participation rates reached 78.8% and 48.8%, respectively. The updated data suggest that 87-110 new medical oncologist full-time equivalents (FTEs) should be recruited each year to achieve an optimal ratio of 110-130 new cases per medical oncologist FTE by 2040. The professional standing analysis reveals that 9.1% of medical oncologists trained in Spain do not work in clinical care in the country, with tremendous employment instability (only 15.2% have a permanent contract). A high percentage of young medical oncologists have contemplated career paths other than clinical care (64.5%) or working in other countries (51.7%). CONCLUSIONS: Optimal ratios of medical oncologists must be achieved to tackle the evolution of MO workloads and challenges in comprehensive cancer care. However, the incorporation and permanence of medical oncologists in the national healthcare system in Spain could be compromised by their current sub-optimal professional standing.

Northwest African Neolithic initiated by migrants from Iberia and Levant.

In northwestern Africa, lifestyle transitioned from foraging to food production around 7,400 years ago but what sparked that change remains unclear. Archaeological data support conflicting views: (1) that migrant European Neolithic farmers brought the new way of life to North Africa1-3 or (2) that local hunter-gatherers adopted technological innovations4,5. The latter view is also supported by archaeogenetic data6. Here we fill key chronological and archaeogenetic gaps for the Maghreb, from Epipalaeolithic to Middle Neolithic, by sequencing the genomes of nine individuals (to between 45.8- and 0.2-fold genome coverage). Notably, we trace 8,000 years of population continuity and isolation from the Upper Palaeolithic, via the Epipaleolithic, to some Maghrebi Neolithic farming groups. However, remains from the earliest Neolithic contexts showed mostly European Neolithic ancestry. We suggest that farming was introduced by European migrants and was then rapidly adopted by local groups. During the Middle Neolithic a new ancestry from the Levant appears in the Maghreb, coinciding with the arrival of pastoralism in the region, and all three ancestries blend together during the Late Neolithic. Our results show ancestry shifts in the Neolithization of northwestern Africa that probably mirrored a heterogeneous economic and cultural landscape, in a more multifaceted process than observed in other regions.

Thiosulfinate-Enriched Allium sativum Extract Exhibits Differential Effects between Healthy and Sepsis Patients: The Implication of HIF-1α.

Garlic (Allium sativum) has historically been associated with antioxidant, immunomodulatory, and microbiocidal properties, mainly due to its richness in thiosulfates and sulfur-containing phytoconstituents. Sepsis patients could benefit from these properties because it involves both inflammatory and refractory processes. We evaluated the effects of thiosulfinate-enriched Allium sativum extract (TASE) on the immune response to bacterial lipopolysaccharide (LPS) by monocytes from healthy volunteers (HVs) and patients with sepsis. We also explored the TASE effects in HIF-1α, described as the key transcription factor leading to endotoxin tolerance in sepsis monocytes through IRAK-M expression. Our results showed TASE reduced the LPS-triggered reactive oxygen species (ROS) production in monocytes from both patients with sepsis and HVs. Moreover, this extract significantly reduced tumor necrosis factor (TNF)-α, interleukin-1ß, and interleukin-6 production in LPS-stimulated monocytes from HVs. However, TASE enhanced the inflammatory response in monocytes from patients with sepsis along with increased expression of human leukocyte antigen-DR. Curiously, these dual effects of TASE on immune response were also found when the HV cohort was divided into low- and high-LPS responders. Although TASE enhanced TNFα production in the LPS-low responders, it decreased the inflammatory response in the LPS-high responders. Furthermore, TASE decreased the HIF-1α pathway-associated genes IRAK-M, VEGFA and PD-L1 in sepsis cells, suggesting HIF-1α inhibition by TASE leads to higher cytokine production in these cells as a consequence of IRAK-M downregulation. The suppression of this pathway by TASE was confirmed in vitro with the prolyl hydroxylase inhibitor dimethyloxalylglycine. Our data revealed TASE's dual effect on monocyte response according to status/phenotype and suggested the HIF-1α suppression as the possible underlying mechanism.

Reflections on TRP and TP/GFR in the definition of renal phosphate loss: conceptual review.

BACKGROUND: Fractional tubular reabsorption of phosphate (TRP) has been used for over 60 years to establish the existence of renal phosphate loss. It is a parameter of corrected volume per decilitre of glomerular filtration rate (GFR). Later, a mass parameter per dl GFR called TP/GFR (tubular PO4 reabsorption per dl GFR) was devised which some authors have sought to substitute for TRP. The aim of the present work is to attempt to demonstrate that TRP and TP/GFR are similar parameters and, in certain aspects, TRP is more effective for diagnosis. METHODS: Data were gathered on the metabolism of phosphate corresponding to a group of healthy children without hypophosphatemia (n = 47), a group of patients with idiopathic hypercalciuria (n = 27), and ten patients diagnosed with X-linked hypophosphatemia (XLH). The TRP, the TP/GFR, and the percent tubular reabsorption of phosphate were calculated. RESULTS: All the patients with XLH presented TRP values lower than 95 ml/dl GFR and of TP/GFR equal to or lower than 2.8 mg/dl GFR. In the total sample, a direct correlation was observed between TRP and TP/GFR (r = 0.65; p = 0.01). The TRP and the percent tubular reabsorption of phosphate values were the same in the three groups (r = 1; p = 0.01). CONCLUSIONS: TRP and TP/GFR are similar parameters. TRP is more effective than TP/GFR given that in renal hypophosphatemia it is always below 95% and above 95% in reduced phosphatemia and normal kidney proximal tubular function. There is no solid reason for using TP/GFR rather than TRP. A higher resolution version of the Graphical abstract is available as Supplementary information.

[Guidelines on atopic dermatitis for Mexico (GUIDAMEX): using the ADAPTE methodology]. / Guía de dermatitis atópica para México (GUIDAMEX): lineamientos usando metodología ADAPTE.

With the advancement of knowledge in relation to the physiopathogenesis of atopic dermatitis (AD), several new therapeutic forms have been developed. There are also new guidelines for self-care. On the other hand, there is still an underdiagnosis of AD in Mexico. Thus, the need was seen to develop a national guide, with a broad base among the different medical groups that care for patients with AD. The Atopic Dermatitis Guidelines for Mexico (GUIDAMEX) was developed with the ADAPTE methodology, with the endorsement and participation of ten national medical societies, from physicians in Primary Healthcare to allergists and dermatologists. Throughout the manuscript, key clinical questions are answered that lead to recommendations and suggestions for the diagnosis of AD (including differential diagnosis with immunodeficiency syndromes), the recognition of comorbidities and complications, non-pharmacological treatment including therapeutic education, treatment of flares and maintenance therapy. The latter encompasses general measures to avoid triggering factors, first-line treatment focussed on repair of the skin barrier, second-line treatment (topical proactive therapy), and third-line phototherapy or systemic treatment, including dupilumab and JAK inhibitors.

Con el avance de los conocimientos en relación con la fisiopatogenia de la dermatitis atópica (DA) se han desarrollado varias formas terapéuticas nuevas. Asimismo, existen nuevos lineamientos para el autocuidado. Por otro lado, aún existe un subdiagnóstico de la DA en México. Así, se vio la necesidad de desarrollar una guía nacional, con base amplia entre las diferentes agrupaciones médicos que atienden pacientes con DA. Se desarrolló la Guía de DA para México (GUIDAMEX) con la metodología ADAPTE, con el aval y la participación de diez sociedades médicas nacionales, desde médicos del primer contacto hasta alergólogos y dermatólogos. A lo largo del escrito se contestan preguntas clínicas clave que llevan a recomendaciones y sugerencias para el diagnóstico de la DA (incluyendo diagnóstico diferencial con síndromes de inmunodeficiencia), el reconocer de las comorbilidades y complicaciones, las medidas generales (tratamiento no farmacológico) incluyendo la educación terapéutica, el tratamiento de los brotes y el tratamiento de mantenimiento. Este último abarca las medidas generales de evitar agravantes, el tratamiento de primera línea reparador de la barrera cutánea, de segunda línea (manejo proactivo tópico), hasta la fototerapia y el tratamiento sistémico de la tercera línea, incluyendo dupilumab y los inhibidores de la cinasa de Jano.

Vitamin C deficiency in critically ill COVID-19 patients admitted to intensive care unit.

Objectives: To determine vitamin C plasma kinetics, through the measurement of vitamin C plasma concentrations, in critically ill Coronavirus infectious disease 2019 (COVID-19) patients, identifying eventually the onset of vitamin C deficiency. Design: Prospective, observational, single-center study. Setting: Intensive Care Unit (ICU), Vall d'Hebron University Hospital, Barcelona. Study period from November 12th, 2020, to February 24th, 2021. Patients: Patients who had a severe hypoxemic acute respiratory failure due to COVID-19 were included. Interventions: Plasma vitamin C concentrations were measured on days 1, 5, and 10 of ICU admission. There were no vitamin C enteral nor parenteral supplementation. The supportive treatment was performed following the standard of care or acute respiratory distress syndrome (ARDS) patients. Measurement: Plasma vitamin C concentrations were analyzed using an ultra-performance liquid chromatography (UPLC) system with a photodiode array detector (wavelength set to 245 nm). We categorized plasmatic levels of vitamin C as follows: undetectable: < 1,5 mg/L, deficiency: <2 mg/L. Low plasma concentrations: 2-5 mg/L; (normal plasma concentration: > 5 mg/L). Main results: Forty-three patients were included (65% men; mean age 62 ± 10 years). The median Sequential Organ Failure Assessment (SOFA) score was 3 (1-4), and the Acute Physiology and Chronic Health disease Classification System (APACHE II) score was 13 (10-22). Five patients had shock. Bacterial coinfection was documented in 7 patients (16%). Initially all patients required high-flow oxygen therapy, and 23 (53%) further needed invasive mechanical ventilation during 21 (± 10) days. The worst PaO2/FIO2 registered was 93 (± 29). ICU and hospital survival were 77 and 74%, respectively. Low or undetectable levels remained constant throughout the study period in the vast majority of patients. Conclusion: This observational study showed vitamin C plasma levels were undetectable on ICU admission in 86% of patients with acute respiratory failure due to COVID-19 pneumonia requiring respiratory support. This finding remained consistent throughout the study period.

Black Garlic and Thiosulfinate-Enriched Extracts as Adjuvants to Ceftriaxone Treatment in a Rat Peritonitis Model of Sepsis.

To date, there have been no new drugs or adjuvants able to decrease both morbidity and mortality in the context of sepsis and septic shock. Our objective was to evaluate the use of thiosulfinate-enriched Allium sativum and black garlic extracts as adjuvants in the management of sepsis. An experimental in vivo study was carried out with male Sprague-Dawley® rats. Animals were randomized in four treatment groups: antibiotic (ceftriaxone) treatment (group I), ceftriaxone plus thiosulfinate-enriched extract (TASE, group II), ceftriaxone plus thiosulfinate-enriched extract and black garlic extracts (TASE + BGE, group III), and ceftriaxone plus black garlic extract (BGE, group IV). All animals were housed and inoculated with 1 × 1010 CFU/15 mL of intraperitoneal Escherichia coli ATCC 25922. Subsequently, they received a daily treatment according to each group for 7 days. Clinical, analytical, microbiological, and histopathological parameters were evaluated. Statistically significant clinical improvement was observed in rats receiving garlic extracts in weight (groups II and III), ocular secretions, and piloerection (group IV). Moreover, less liver edema, vacuolization, and inflammation were observed in groups receiving adjuvant support (groups II, III, and IV). When comparing interleukins 24 h after bacteria inoculum, we found statistically significant differences in TNF-alpha levels in groups receiving BGE (groups III and IV, p ≤ 0.05). Blood and peritoneal liquid cultures were also analyzed, and we detected a certain level of Enterococcus faecalis in peritoneal cultures from all treatment groups and less bacteria presence in blood cultures in rats receiving garlic extracts (groups II, III, and IV). In conclusion, TASE and BGE could be promising nutraceutical or medicinal agents as coadjuvants in the treatment of sepsis because of its effects in modulating the inflammatory response.

The Isolation of Specialty Compounds from Amphidinium carterae Biomass by Two-Step Solid-Phase and Liquid-Liquid Extraction.

The two main methods for partitioning crude methanolic extract from Amphidinium carterae biomass were compared. The objective was to obtain three enriched fractions containing amphidinols (APDs), carotenoids, and fatty acids. Since the most valuable bioproducts are APDs, their recovery was the principal goal. The first method consisted of a solid-phase extraction (SPE) in reverse phase that, for the first time, was optimized to fractionate organic methanolic extracts from Amphidinium carterae biomass using reverse-phase C18 as the adsorbent. The second method consisted of a two-step liquid-liquid extraction coupled with SPE and, alternatively, with solvent partitioning. The SPE method allowed the recovery of the biologically-active fraction (containing the APDs) by eluting with methanol (MeOH): water (H2O) (80:20 v/v). Alternatively, an APD purification strategy using solvent partitioning proved to be a better approach for providing APDs in a clear-cut way. When using n-butanol, APDs were obtained at a 70% concentration (w/w), whereas for the SPE method, the most concentrated fraction was only 18% (w/w). For the other fractions (carotenoids and fatty acids), a two-step liquid-liquid extraction (LLE) method coupled with the solvent partitioning method presented the best results.

Physiological Response of Atlantic Salmon (Salmo salar) to Long-Term Exposure to an Anesthetic Obtained from Heterosigma akashiwo.

Despite the invaluable role of anesthetics as a tool for ensuring animal welfare in stressful situations, there is currently a lack of anesthetic drugs that meet the requirements of intensive aquaculture. In response to the growing interest in anesthetic substances of natural origin, this study evaluated the physiological and health impact of an anesthetic based on an extract of the microalga Heterosigma akashiwo on juvenile salmon (Salmo salar) exposed for a period of 72 h. To simulate a condition closer to reality where fish are subjected to stimuli (e.g., transport), the animals were exposed to 50 mg L-1 of algal extract and to physical stress. Functional, physiological, and histological parameters were evaluated in blood and tissues at different sampling periods (0, 24, and 72 h). There was no mortality and the induction and recovery times observed were within the established criteria for anesthetic efficacy. The anesthetic extract did not induce any side effects, such as stress or metabolic damage, indicating that this extract is a viable option for supporting fish welfare during deleterious events. This study provides information to support that the anesthetic extract tested, derived from H. akashiwo, is a promising candidate drug for operations requiring sedation (e.g., Salmonid transport).

Integra Dermal Regeneration Template in reconstructive surgery for cutaneous tumours: a two-year retrospective review.

OBJECTIVE: Integra Dermal Regeneration Template (IDRT) (Integra LifeSciences, US) is a bioengineered dermal matrix that has been widely used in burn reconstruction since its first description. However, little is reported on its use in oncologic dermatological defects. Our objective was to evaluate reconstruction using IDRT on cutaneous tumour defects. METHOD: We conducted a two-year retrospective review of patients with skin tumours who had an excision surgery, followed by reconstruction with IDRT, as a mid-step towards a final autograft procedure: a split-thickness skin graft. The records of all patients at a single academic institution were queried from the electronic medical record using data obtained from the operating surgeon. RESULTS: We identified 13 patients with different tumour types and locations. The mean defect size was 105.92cm². The matrix take rate was 92.3% and average postoperative day for definite autograft was 20 days. Patients were followed for a period of up to 12 months. Of the patients, one had exposed bone without periosteum; another patient showed recurrence six months after matrix placement, requiring a new second two-stage IDRT-autograft procedure before radiation therapy. Patients reported complete satisfaction with the cosmetic, functional and oncological results. No cases of infection were encountered. CONCLUSION: IDRT is a valid option for the reconstruction of oncologic surgical defects of the skin and can be used in different anatomical locations. Specifically, it is an alternative to the reconstructive ladder when grafts and local flaps are not possible in those patients, and an option for patients who will eventually need adjuvant radiotherapy.

Maternal supply of a source of omega-3 fatty acids and methionine during late gestation on the offspring's growth, metabolism, carcass characteristic, and liver's mRNA expression in sheep.

The objective of the present experiment was to evaluate the effect of maternal supplementation with fatty acids (FAs) and methionine (Met) during late gestation on offspring growth, energy metabolism, plasma resolvin (RvD1) concentration, carcass characteristics, and hepatic mRNA expression. Ewes (5 pens/treatment; 3 ewes/pen) blocked by body weight (BW) were assigned to one of four treatments from day 100 of gestation until lambing. The treatments were: basal diet (NS) without FAs or Met supplementation; FA supplementation (FS; 1.01 % of Ca salts, containing n-3 FA); Met supplementation (MS; 0.1 % of rumen-protected methionine); and FS and MS (FS-MS). At birth (day 0), ewes and lambs were placed in a common pen. On day 60, lambs were weaned, sorted by sex, blocked by BW, and placed on a common finishing diet for 54 d (FP). A lamb per pen was used for a glucose tolerance test (GTT) after the FP. Carcass characteristics were recorded on day 56. Lamb data were analyzed as a randomized complete block design with a 2 × 2 × 2 factorial arrangement, with repeated measurements when needed (SAS 9.4). At weaning, lambs born to MS- or FS-fed ewes were heavier than lambs born from FS-MS ewes (FS × MS × Time; P = 0.02). A marginal significant FS × MS interaction (P = 0.09) was also observed on RvD1; lambs born to ewes in the NS and FS-MS treatments showed a lower RvD1 plasma concentration when compared with lambs born to FS- or MS-fed ewes. Lambs born to dams fed FA showed an increase (P = 0.05) in liver COX-2 mRNA relative expression. Lambs born to ewes supplemented with Met showed an increase (P = 0.03) in liver FABP4 mRNA expression. An FS × MS × Time interaction (P = 0.07) was observed in plasma glucose during the GTT; lambs born from FS-fed ewes showed lower plasma glucose concentration than lambs born to Met-supplemented ewes at 2 min after bolus administration. During the GTT, a marginal significant effect (P = 0.06) was observed for the lamb average insulin concentration due to maternal Met supplementation during late gestation, where these lambs had the lowest plasma concentration. Contrary to our hypothesis, the interaction of FA and Met supplementation during late gestation did not show a greater positive effect on offspring postnatal growth and metabolism. However, the individual supplementation of each nutrient has an effect on offspring development with a concomitant change in markers involved in the inflammatory response and energy metabolism.

Late gestation supplementation of omega-3 fatty acids (FAs) or methionine (Met) alters the offspring's development. However, the effect of both nutrients on the physiology and growth of the progeny has not been explored. The experiment's objective was to evaluate the effect of dam supplementation with a Met and the omega-3 FAs, such as eicosapentaenoic and docosahexaenoic acids, during late gestation on growth, energy metabolism, and inflammatory response markers of the lamb. Ewes received one of the four following treatments: basal diet without FA or Met, FA supplementation, Met supplementation, or FA and Met supplementation. Supplementation of omega-3 FAs and Met did not show a greater effect on postnatal growth and metabolism of the offspring compared with the supplementation of each nutrient individually. However, individual supplementation influences offspring development with a concomitant change in markers involved in the inflammatory response and energy metabolism. Results of the present experiment suggest that offspring born to mothers that were fed FAs or Met on late gestation could have the ability to better cope with inflammatory processes, which could improve their long-term growth performance. Moreover, maternal supplementation of Met during late gestation could modulate offspring's glucose­insulin system, which may also affect offspring's growth.

La salud pública en contextos pluriculturales. Avances y retrocesos / Public health in pluricultural contexts. Advances and setbacks

La cultura constituye un complejo dinámico de conocimientos, creencias, conductas aprendidas y transmitidas por generaciones, a través del lenguaje y la vida cotidiana. El concepto de cultura se relaciona con el proceso salud-enfermedad puesto que el bienestar social, espiritual, psicológico y biológico de individuos y comunidades es expresión del medio ambiente, estilo de vida, vivienda, alimentación, educación y acceso adecuado a bienes y servicios. En el campo de salud se identifican la medicina tradicional desarrollada por pueblos indígenas; la medicina popular basada en creencias de la familia y la comunidad y la medicina profesional, basada en el estudio científico. La medicina indígena se caracteriza por la atención holística del sujeto, asequibilidad y acceso en poblaciones donde los sistemas de salud oficiales no tienen presencia, no obstante, presenta bajo reconocimiento por parte de los gobiernos. Con el presente estudio se pretende reflexionar acerca de la importancia de fomentar la interculturalidad en salud con base en las necesidades, organización y visión del mundo de los pueblos indígenas a partir del enfoque intercultural. Se expone una panorámica que aborda con mirada actual, las particularidades de la interculturalidad y la multiculturalidad en el contexto pluricultural, que contribuye a un mejor entendimiento de la necesidad de redimensionamiento de los sistemas de salud a partir de los elementos que aporta el enfoque intercultural como modelo de franca concepción humanista, en contraposición con el modelo hegemónico de salud actual, que favorece las desigualdades en salud(AU)

Culture constitutes a dynamic complex of knowledge, beliefs, behaviors learned and transmitted through generations, through language and everyday life. The concept of culture is related to the health-disease process since the social, spiritual, psychological and biological well-being of individuals and communities is an expression of the environment, lifestyle, housing, food, education and adequate access to goods and services. In the field of health, traditional medicine developed by indigenous peoples is identified; folk medicine based on family and community beliefs; and professional medicine, based on scientific study. Indigenous medicine is characterized by the holistic care of the subject, affordability and access in populations where the official health systems do not have a presence, however, it is under recognition by governments. This study aims to reflect on the importance of promoting interculturality in health based on the needs, organization and worldview of indigenous peoples from the intercultural approach. A panorama is presented that addresses with a current perspective, the particularities of interculturality and multiculturalism in the multicultural context, which contributes to a better understanding of the need to resize health systems based on the elements provided by the intercultural approach such as model of frank humanist conception, in contrast to the current hegemonic model of health, which favors inequalities in health(AU)

Effects of Dietary Calcium Propionate Supplementation on Hypothalamic Neuropeptide Messenger RNA Expression and Growth Performance in Finishing Rambouillet Lambs.

The objective of this experiment was to evaluate the effects of feeding different levels concentrations of dietary calcium propionate (CaPr) on lambs' growth performance; ruminal fermentation parameters; glucose-insulin concentration; and hypothalamic mRNA expression for neuropeptide Y (NPY), agouti-related peptide (AgRP), and proopiomelanocortin (POMC). Thirty-two individually fed lambs were randomly assigned to four treatments: (1) control diet (0 g/kg of CaPr), (2) low CaPr, (30 g/kg dry matter (DM)), (3) medium CaPr, (35 g/kg DM), and (4) high CaPr (40 g/kg DM). After 42 days of feeding, lambs were slaughtered for collecting samples of the hypothalamus. Data were analyzed as a complete randomized design, and means were separated using linear and quadratic polynomial contrast. Growth performance was not affected (p ≥ 0.11) by dietary CaPr inclusion. The ruminal concentration of total volatile fatty acids (VFA) increased linearly (p = 0.04) as dietary CaPr increased. Likewise, a linear increase in plasma insulin concentration (p = 0.03) as dietary CaPr concentration increased. The relative mRNA expression of NPY exhibited a quadratic effect (p < 0.01), but there were significant differences in the mRNA expression of AgRP and POMC (p ≥ 0.10). Dietary calcium propionate did not improve lamb growth performance in lambs feed with only forage diets. Intake was not correlated with feed intake with mRNA expression of neuropeptides.

Maternal Supply of Fatty Acids during Late Gestation on Offspring's Growth, Metabolism, and Carcass Characteristics in Sheep.

Lambs born from dams supplemented with different sources of fatty acids (FA) during late gestation have a different growth rate and plasma glucose concentration. The main objectives of this experiment were to evaluate the effect of supplementing different sources of FA during late gestation on offspring plasma metabolite concentrations, growth, and on a glucose tolerance test (GTT) during the finishing phase. Fifty-four lambs (18 pens, 3 lambs/pen) were born from ewes supplemented during late gestation with one of three treatments: (1) no FA (NF); (2) a source of monounsaturated FA (PDS, 1.01% of Ca salts); or (3) a source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (EDS, 1.01% of Ca salts containing). At birth (day 0), supplementation ceased, and all ewes and lambs were placed in a common pen. On day 60, lambs were weaned, grouped by sex, blocked by body weight (BW), and placed on a common finishing diet for 54 days (FP). One lamb per pen was used for the GTT after the FP. There was a tendency for FA × Sex × Day interaction (p = 0.08) on lamb growth during the finishing period, with PDS females being heavier than PDS males, while EDS males were heavier than EDS females at day 60. There was a tendency for FA × Sex interaction (p = 0.06) for plasma insulin concentration for the GTT. Plasma insulin concentration of wethers increased as FA unsaturation degree increased during the GTT; the opposite happened with the plasma insulin concentration of female lambs. In conclusion, FA supplementation during late gestation tended to modified growth and insulin response to a GTT; these changes differed with the degree of FA unsaturation of the supplement and lamb sex.