ECLAMC Study: Prevalence patterns of hypospadias in South America: Multi-national analysis over a 24-year period.

OBJECTIVE: To evaluate prevalence trends of hypospadias in South-America it is essential to perform multicenter and multinational studies with the same methodology. Herein we present systematic data as part of an international multicenter initiative evaluating congenital malformations in South America over a 24-year period. MATERIALS AND METHODS: A nested case-control study was conducted using the Latin American Collaborative Study of Congenital Malformations (ECLAMC), between January 1989 and December 2012. Cases were stratified as isolated (IH) and non-isolated hypospadias (NIH). Global prevalence was calculated and discriminated by country. Associations between birth weight and gestational age, and NIH distribution by associated abnormality and severity of hypospadias, were analyzed. RESULTS: A total of 159 hospitals from six countries participated, reporting surveillance on 4.020.384 newborns. A total of 4.537 hypospadias cases were detected, with a global prevalence of 11.3/10.000 newborns. Trend analyses showed in Chile, Brazil and Uruguay a statistically significant increase in prevalence. Analysis of severity and associated anomalies did not to find an association for distal cases, but did for proximal (RR=1.64 [95% CI=1.33-2.03]). CONCLUSION: This is one of only a few Latin American multicenter studies reporting on the epidemiology of hypospadias in South America in the last two decades. Our data adds to evidence suggesting an increase in some countries in the region at different times. There were also variations in prevalence according to severity. This study adds to literature describing associated anomalies at a hospital-based level.

Correction: cagA gene EPIYA motif genetic characterization from Colombian Helicobacter pylori isolates: Standardization of a molecular test for rapid clinical laboratory detection.

[This corrects the article DOI: 10.1371/journal.pone.0227275.].

cagA gene EPIYA motif genetic characterization from Colombian Helicobacter pylori isolates: Standardization of a molecular test for rapid clinical laboratory detection.

The aim of this work was to determine current cagA gene EPIYA motifs present in Colombian Helicobacter pylori isolates using a fast and reliable molecular test. DNA from eighty-five Helicobacter pylori-cagA positive strains were analyzed. Strains were obtained from patients diagnosed with functional dyspepsia at Clínica Fundadores in Bogotá. The 3' region of the cagA gene was amplified through conventional Polymerase Chain Reaction (PCR). Obtained amplicons were sequenced using the Sanger method and analyzed with bioinformatics tools. Additionally, a significant Spearman correlation coefficient was determined between the patients' age and the number of EPIYA-C repeats; with p values < 0.05 considered significant. Estimates were obtained using a 95% CI. The 3´ variable region of the cagA gene was amplified and PCR products of the following sizes corresponded to the following EPIYA motifs: 400 bp: EPIYA AB, 500 bp: EPIYA ABC, 600 bp: EPIYA ABCC and 700 bp: ABCCC. A single PCR band was observed for 58 out of 85 Helicobacter pylori isolates, with an EPIYA distribution motif as follows: 7/85 AB (8.2%), 34/85 ABC (40%), 26/85 ABCC (30.6%) and 18/85 ABCCC (21.2%). However, in 27 out of 85 Helicobacter pylori isolates, two or more bands were observed, where the most predominant cagA genotype were ABC-ABCC (26%, 7/27) and ABCC-ABCCC (22.2%, 6/27). A direct proportionality between the number of EPIYA-C repeats and an increase in the patients' age was observed, finding a greater number of EPIYA ABCC and ABCCC repeats in the population over 50 years old. All isolates were of the Western cagA type and 51.8% of them were found to have multiple EPIYA-C repeats. These standardized molecular test allowed to identify the number of EPIYA C motifs based on band size.

Mammaglobin peptide as a novel biomarker for breast cancer detection.

Among the different types of tests used for cancer diagnosis, molecular tests have been increrasingly incorporated because of their ability to detect either expression or functional changes in the molecules associated with the disease. Mammaglobin is a protein found in mammary tissue and can be detected in serum. This protein has been proposed as a biomarker to diagnose breast cancer, given that patients exhibit an increased amount of the protein in serum and tumor tissue, in comparison to healthy individuals. The ELISA test was used in the present study to detect mammaglobin in blood samples from 51 breast cancer patients and 51 control individuals. Antibodies against mamaglobin were generated in rabbits by using the following synthetic peptides: A (amino acids 13 to 21), B (amino acids 31 to 39), C (amino acids 56 to 64) and a D peptide, corresponding to the protein isoform without three amino acids (59, 60 and 61 amino acids) from peptide C. All peptides were immunogenic and allowed generation of antibodies that were able to discriminate patients from controls. The best results were obtained for antiserum B, achieving the best sensitivity (86.3%) and specificity (96%).

Association between maternal prenatal vitamin use and congenital abnormalities of the genitourinary tract in a developing country.

OBJECTIVE: To determine the association between prenatal multivitamin supplementation and congenital genitourinary tract anomalies in a group of Colombian newborn babies included in the Latin-American surveillance program (ECLAMC). STUDY DESIGN: We included all neonates born between January 2004 and August 2007 registered in the ECLAMC database. Maternal prenatal multivitamin use was assessed for 122 newborns with congenital genitourinary tract anomalies and then compared to 271 non-malformed controls. RESULTS: 46,850 births were registered and 122 (26/10,000) of them were identified to have a genitourinary tract anomaly. Prenatal multivitamin supplementation during the first, second, and third trimesters of pregnancy was associated with a reduction in the risk of these anomalies: OR 0.16 (0.08-0.31), OR 0.31 (0.19-0.52), and OR 0.38 (0.23-0.63) respectively. CONCLUSIONS: Maternal prenatal multivitamins may reduce the risk of congenital genitourinary tract anomalies, not only during the first 8 weeks of gestation but also later in pregnancy, in developing countries.

ECLAMC Study: prevalence patterns of hypospadias in South America: multi-national analysis over a 24-year period

ABSTRACT Objective To evaluate prevalence trends of hypospadias in South-America it is essential to perform multicenter and multinational studies with the same methodology. Herein we present systematic data as part of an international multicenter initiative evaluating congenital malformations in South America over a 24-year period. Materials and Methods A nested case-control study was conducted using the Latin American Collaborative Study of Congenital Malformations (ECLAMC), between January 1989 and December 2012. Cases were stratified as isolated (IH) and non-isolated hypospadias (NIH). Global prevalence was calculated and discriminated by country. Associations between birth weight and gestational age, and NIH distribution by associated abnormality and severity of hypospadias, were analyzed. Results A total of 159 hospitals from six countries participated, reporting surveillance on 4.020.384 newborns. A total of 4.537 hypospadias cases were detected, with a global prevalence of 11.3/10.000 newborns. Trend analyses showed in Chile, Brazil and Uruguay a statistically significant increase in prevalence. Analysis of severity and associated anomalies did not to find an association for distal cases, but did for proximal (RR=1.64 [95% CI=1.33-2.03]). Conclusion This is one of only a few Latin American multicenter studies reporting on the epidemiology of hypospadias in South America in the last two decades. Our data adds to evidence suggesting an increase in some countries in the region at different times. There were also variations in prevalence according to severity. This study adds to literature describing associated anomalies at a hospital-based level.

Variabilidad de la dieta de las mujeres jóvenes universitarias, su influencia sobre los criterios de evaluación dietética / Diet variability in university young women: the influence on dietary evaluation criteria

No existen muchos artículos sobre la variabilidad de la dieta, la recolección de información durante múltiples días es complicada. La validez de los esquemas de evaluación dietética basados en los registros o recordatorios de 24 horas depende de esa variabilidad. Se evaluó, durante 28 días, la ingesta diaria de 43 estudiantes universitarias mediante un diario de consumo; la calidad de los datos se aseguró mediante entrenamiento y controles semanales. El principal hallazgo fue la presencia de heterocedasticidad entre las varianzas de las ingestas de energía y los diferentes nutrientes analizados: siendo incorrectos, para este grupo poblacional, los esquemas de recolección de información del consumo aplicados usualmente en la práctica clínica y la investigación epidemiológica. Estos esquemas consisten en la evaluación del consumo de un individuo dentro de un rango de 1 a 7 días, siendo 2 o 3 días el procedimiento más popular. Los resultados obtenidos mostraron que estos esquemas no corresponden con los patrones de variabilidad. Se propuso considerar una distribución de probabilidades para representar el comportamiento de la variabilidad en esa población. Las diferencias en la variabilidad de la ingesta tuvieron un importante efecto sobre el número de días necesarios para estimar los patrones de consumo individual.

There are no many publications analyzing daily diet variability, because of data collection in multiple days is very difficult, and validity of dietary data collection methods such as 24 hours recalls or food questionnaires depend on this variability. Daily food intake of 43 students from the university was evaluated during 28 days, using a self report food consumption diary. Participants were trained in data collection and weekly controls were done to verify the accuracy of data. A strong heterogeneity between variances in energy and nutrients intake was found; this means that the data collection methods applied in clinical practice and research are incorrect. These methods are using to collect data in a range of 1 to 7 days, but the most common is to get dietary information in 2-3 days. The outcomes of this study showed that this food collecting data model doesn’t match with population’s food variability patterns. Therefore it is necessary to consider a probability distribution in order to represents the population’s food habits variability. Differences in variability had an important effect on the number of days that are needed to estimate individual consumption patterns.

Recuperación nutricional de recién nacidos de muy bajo peso durante el primer año de vida / Nutritional recovery of very low birthweight newborns during their first year of life

Los recién nacidos de muy bajo peso al nacer tienen un doble reto en su crecimiento durante el primer año de vida, porque tienen escasas reservas energéticas, disminución de la capacidad para tolerar grandes ingestas, y elevadas necesidades de energía y macronutrientes para asegurar un crecimiento acelerado. El objetivo de este trabajo fue caracterizar el crecimiento durante el primer año de vida de recién nacidos de muy bajo peso y un grupo control de término. Para ello se realizó un estudio de cohorte en 25 recién nacidos con peso al nacer menor de 1 800 g y 34 semanas de edad gestacional, nacidos en el Hospital Ginecoobstétrico Ramón González Coro, en Ciudad de La Habana, desde enero de 2000 hasta enero de 2001 y en 25 recién nacidos de buen peso a término como grupo control. Se evaluaron aspectos del desarrollo nutricional perinatal y antropométrico, mediante la utilización de la evolución del peso, talla, circunferencia cefálica y circunferencia del brazo, durante el primer año de vida. Se encontró que el crecimiento longitudinal fue bueno en recién nacidos de muy bajo peso, aunque no lograron los canales de crecimiento de lactantes de término al cumplir el año de edad. El peso para la edad fue el indicador que demoró más la recuperación.

Diagnóstico de la anemia por deficiencia de hierro en niños de 6 a 24 meses y de 6 a 12 años de edad de las provincias orientales de Cuba / Iron deficiency anemia in children from 6 to 24 months and 6 to 12 years of age in eastern Cuba

Fundamentos: Se realizó un estudio transversal en elsegundo semestre del año 2002 con el objetivo de estimarla prevalencia de anemia por deficiencia de hierro enniños de 6 a 24 meses y de 6 a 12 años de edad residentesen las provincias orientales de Cuba.Métodos: La muestra estuvo compuesta por 1708 niños.La concentración de hemoglobina se determinó porel método de la cianometahemoglobina, la ferritina séricapor enzimoinmunoensayo y el retinol sérico por el métodoespectrofotométrico de inactivación ultravioleta deBessey.Resultados: La prevalencia de anemia en los niñoshasta 2 años de edad fue del 29,1%. Fue más frecuentela anemia en niños de 6 a 12 meses de edad. Segúnlas concentraciones de ferritina sérica la prevalenciade deficiencia de hierro fue del 38,6 %. Para los niñosde 6 a 12 años de edad la prevalencia de anemia fuedel 14,6%. Los niveles de vitamina A hallados no estuvieronasociados a la anemia encontrada en niñosde 6 a 12 años de edad. Para este grupo, el consumode alimentos portadores importantes de hierro hem espoco frecuente y bastante similar entre las provincias.El consumo de portadores de hierro no hem es superiory muy diferente entre las provincias. Se encontróuna disminución de la prevalencia de anemia en niñosde 6 a 24 meses de edad al compararlos con los resultadosde finales de 1999 en una muestra derepresentatividad nacional.Conclusiones: Para combatir con efectividad estas deficienciasse hace necesario incrementar la fortificación dealimentos dirigidos a estos grupos de edades, actividadesde educación nutricional, así como mejorar los patronesde ingestión de alimentos ricos en hierro

Study Objective: Prevalence of iron deficiency anemia inchildren aged 6-24 months and 6-12 years in easternprovinces of Cuba was estimated by a cross-sectionalstudy carried out in the second semester of 2002.Desing: The sample included 1708 children. Hemoglobinconcentration was determined by cyanomethemoglobinmethod, serum ferritin by enzymoimmunoassay andserum retinol by Bessey ultraviolet inactivationspectrophotometric method.Results: Prevalence of anemia in children aged 6-24months was 29,1 %. Anemia was more frequent inchildren 6-12 months of age. According to serum ferritinvalues, iron deficiency was 38,6 %. Prevalence of anemiawas 14,6 % for children 6-12 years of age. Serumvitamin A values were not associated to anemia inchildren 6 to 12 years of age. Intake of foods rich in hemeiron was infrequent; conversely, intake of non heme ironwas much higher. Prevalence of anemia in children 6-24months of age was lower in this study in comparison withthe result found in a nation-wide representative sample in1999.Conclusions: In order to combat iron deficiency it isnecessary to increase the fortification of foods targeted tothese age groups as well as implement nutrition education,food diversification and other actions aimed at improvingiron dietary patterns, all of them included in the NationalProgram for the Prevention and Control of Anemia andIron Deficiency in Cuba

Evaluación del estado nutricional de vitamina E y lípidos en escolares cubanos de 6 a 11 años / Vitamin E and lipid nutritional status assessment in 6-11 year old Cuban school children

Fundamentos: En Cuba las primeras causas de muerteen la población están encabezadas por las enfermedadesdel corazón. Se considera que diversos factores ya en laniñez y la adolescencia podrían estar relacionados con eldesarrollo de estas enfermedades. El objetivo de este trabajofue analizar las concentraciones de α tocoferol ylípidos séricos así como los factores que las afectan y lasfuentes alimentarias de grasa y vitamina E en escolarescubanos.Métodos: El estudio se realizó en el primer semestre de2003 en una muestra de 1225 escolares de primero asexto grado de 7 provincias (edades de 6 a 11 años)para la determinación de vitamina A. De esta muestrainicial se tomó una submuestra de 710 escolares para ladeterminación de α tocoferol (αTF), colesterol (CT),triglicéridos (TG), HDL-colesterol (HDL-C), lípidos totalesy cálculo de αTF con las fracciones de lípidos. Losniveles plasmáticos de αTF se midieron por el método deHPLC y para el lipidograma se utilizaron técnicascolorimétricas. Se realizó una encuesta dietética dondese recogió la frecuencia de consumo en los seis mesesanteriores a la toma de la muestra de los 8 alimentosprincipales fuentes de grasas.Resultados: La media de los valores de αTF se encuentradentro de valores deficientes. El 55,6% de los escolaresde la zona occidental y el 42% de los de la zona centraltienen valores deficientes. El resultado del lipidogramaindica valores superiores de TG y HDL-C en la regióncentral con diferencias estadísticamente significativas. Lasvariables que explican los resultados de αTF son lasmayores concentraciones de CT y la región de procedencia;los escolares que viven en la región central tienenmayores concentraciones de αTF con respecto a los queviven en la región occidental. La ingestión de hidratos decarbono es superior al 70% de la ingestión calórica totaly la de grasa inferior al 20%.Conclusión: Diversos estudios sugieren que los predictoresbioquímicos de ateroesclerosis, como son las bajas concentracionesde HDL-C, pueden ser ya en la infancia tempranay la niñez muy buenos predictores de valores futuros,y el αTF es un factor adicional al que debe prestárseleuna atención especial en la nutrición en la infancia

Background: The main cause of mortality in Cuba is heartdisease. Several factors in childhood and adolescenceare considered as potentially influence the developmentof these diseases in adult life. The aim of this paper is toanalyze serum levels of α tocoferol and lipids as well asfactors influencing those and main food sources of fatand vitamin E in Cuban schoolchildren.Methods: The study was conducted in the first semestreof 2003 on a sample of 1225 schoolchidren attendingfirst to sixth grade in 7 provinces (age range 6 to 11years) for vitamin A assessment. In a subsample of 710schoolchildren from the initial sample serum levels of αtocoferol (αTF), cholesterol (CT), triglicerides (TG), HDLcholesterol(HDL-C), total lipids and computed ratios ofαTF and lipid fractions were assessed. Plasma levels ofαTF were determined by HPLC. Lipidogram was assessedby colorimetric techniques. Dietary intake was assessedby means of a food frequency questionnaire including the8 food items which are the main sources of fat in the dietfor the six month period prior to blood sample extraction.Results: Mean of αTF levels is in the range of defficientvalues. In the western region, 55,6% of the children haddefficient αTF levels and 42% in the central region. Resultsof lipidogram showed significant higher levels of TG andHDL-C in the central region. Variables explaining resultsof αTF levels were higher concentrations of CT and theregion of procedence. School children living in the centralregion had higher levels of αTF compared to those livingin the western region. Carbohydrate intake was above70% of total energy intake and fat intake was below 20%.Conclusion: Several studies suggest that biochemicalpredictors of atheroclerosis such as low HDL-c levels,can be in early childhood good predictors of future levels.αTF is an additional factor which should be considered inchildren nutrition

Sitios centinelas: su aplicación en la vigilancia del estado nutricional materno en Cuba / State of the art of clinical follow-up of phoenilketonuria in Cuba

Justificación y objetivos: Se presenta la aplicación de la metodología de sitios centinelas a la vigilancia del estado nutricional materno durante los años 1997 a 2001 con el objetivo de seguir la evolución de los indicadores evaluados y tomar en consideración algunas variables sociodemográficas. Métodos: La selección de los sitios se realizó mediante criterio de expertos, los sitios se ubicaron en las áreas de salud de mayor y menor índice de bajo peso al nacer de cada una de las 15 provincias del país. Se evaluó la evolución de la deficiencia energética crónica y el sobrepeso al inicio del embarazo mediante el IMC, la ganancia de peso insuficiente durante el embarazo y la evolución de la anemia en el tercer trimestre de gestación. Resultados: Se aprecia un incremento del sobrepeso al inicio del embarazo con cifras de aproximadamente 27 por ciento, tendencia a la disminución del porcentaje de embarazadas con ganancia insuficiente de peso después de una intervención en este grupo poblacional y tendencia al descenso en el porcentaje de embarazadas anémicas fundamentalmente durante el primer trimestre. Se discute el valor de la metodología en las condiciones de Cuba (AU)