Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach.

BACKGROUND & AIMS: The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation in support of the etiologic criterion for inflammation. METHODS: A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified-Delphi review. A multi-round review and revision process served to develop seven guidance statements. RESULTS: The final round of review was highly favorable with 99 % overall "agree" or "strongly agree" responses. The presence of acute or chronic disease, infection or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. Interpretation of CRP requires that consideration be given to the method, reference values, and units (mg/dL or mg/L) for the clinical laboratory that is being used. CONCLUSION: Confirmation of inflammation should be guided by clinical judgement based upon underlying diagnosis or condition, clinical signs, or CRP.

Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach.

BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation, and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation. METHODS: A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified Delphi review. A multiround review and revision process served to develop seven guidance statements. RESULTS: The final round of review was highly favorable, with 99% overall "agree" or "strongly agree" responses. The presence of acute or chronic disease, infection, or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. Interpretation of CRP requires that consideration be given to the method, reference values, and units (milligrams per deciliter or milligram per liter) for the clinical laboratory that is being used. CONCLUSION: Confirmation of inflammation should be guided by clinical judgment based on underlying diagnosis or condition, clinical signs, or CRP.

SpheroidJ: An Open-Source Set of Tools for Spheroid Segmentation.

BACKGROUND AND OBJECTIVES: Spheroids are the most widely used 3D models for studying the effects of different micro-environmental characteristics on tumour behaviour, and for testing different preclinical and clinical treatments. In order to speed up the study of spheroids, imaging methods that automatically segment and measure spheroids are instrumental; and, several approaches for automatic segmentation of spheroid images exist in the literature. However, those methods fail to generalise to a diversity of experimental conditions. The aim of this work is the development of a set of tools for spheroid segmentation that works in a diversity of settings. METHODS: In this work, we have tackled the spheroid segmentation task by first developing a generic segmentation algorithm that can be easily adapted to different scenarios. This generic algorithm has been employed to reduce the burden of annotating a dataset of images that, in turn, has been employed to train several deep learning architectures for semantic segmentation. Both our generic algorithm and the constructed deep learning models have been tested with several datasets of spheroid images where the spheroids were grown under several experimental conditions, and the images acquired using different equipment. RESULTS: The developed generic algorithm can be particularised to different scenarios; however, those particular algorithms fail to generalise to different conditions. By contrast, the best deep learning model, constructed using the HRNet-Seg architecture, generalises properly to a diversity of scenarios. In order to facilitate the dissemination and use of our algorithms and models, we present SpheroidJ, a set of open-source tools for spheroid segmentation. CONCLUSIONS: In this work, we have developed an algorithm and trained several models for spheroid segmentation that can be employed with images acquired under different conditions. Thanks to this work, the analysis of spheroids acquired under different conditions will be more reliable and comparable; and, the developed tools will help to advance our understanding of tumour behaviour.

Greener synthesis of chemical compounds and materials.

Modern trends in the greener synthesis and fabrication of inorganic, organic and coordination compounds, materials, nanomaterials, hybrids and nanocomposites are discussed. Green chemistry deals with synthesis procedures according to its classic 12 principles, contributing to the sustainability of chemical processes, energy savings, lesser toxicity of reagents and final products, lesser damage to the environment and human health, decreasing the risk of global overheating, and more rational use of natural resources and agricultural wastes. Greener techniques have been applied to synthesize both well-known chemical compounds by more sustainable routes and completely new materials. A range of nanosized materials and composites can be produced by greener routes, including nanoparticles of metals, non-metals, their oxides and salts, aerogels or quantum dots. At the same time, such classic materials as cement, ceramics, adsorbents, polymers, bioplastics and biocomposites can be improved or obtained by cleaner processes. Several non-contaminating physical methods, such as microwave heating, ultrasound-assisted and hydrothermal processes or ball milling, frequently in combination with the use of natural precursors, are of major importance in the greener synthesis, as well as solventless and biosynthesis techniques. Non-hazardous solvents including ionic liquids, use of plant extracts, fungi, yeasts, bacteria and viruses are also discussed in relation with materials fabrication. Availability, necessity and profitability of scaling up green processes are discussed.

Cravings, sugar and fat consumption as determinant factors of obesity in young adults in Juarez City.

INTRODUCTION: obesity is a global health epidemic and understanding its causes is essential for successful treatment and prevention. Cravings have been associated with the excessive consumption of sugars and fats, and addictive eating behavior. OBJECTIVE: to determine the strength of the relationship between cravings, the consumption of sugar and fat, and its impact on body composition as determined via body mass index (BMI), body fat percentage (BFP) and waist circumference (WC) in a sample of Mexicans who reside close to the México-U.S. border. METHODS: the sample was comprised of 159 young adults with a mean age of 27.96 ± 6.19, 45.9% of which were male, and all residents of Ciudad Juarez, Mexico. Cravings were measured using Trait and State Food Cravings Questionnaires. The consumption of sugars and fats was determined via a 24-hour recall of foods consumed and a food consumption frequency questionnaire. RESULTS: it was demonstrated that BMI and BFP were positively associated with responses to the craving questionnaires and WC with fat consumption. Additionally, higher fat consumption was positively associated with higher rates of obesity. CONCLUSIONS: the results demonstrate the need to identify the presence of cravings and integrate such measures for effective prevention and treatment of obesity.

Cravings, sugar and fat consumption as determinant factors of obesity in young adults in juarez city / Craving, ingesta de azúcares y grasas como determinantes de la obesidad en adultos jóvenes de Ciudad Juárez

Introduction: obesity is a global health epidemic and understanding its causes is essential for successful treatment and prevention. Cravings have been associated with the excessive consumption of sugars and fats, and addictive eating behavior. Objective: to determine the strength of the relationship between cravings, the consumption of sugar and fat, and its impact on body composition as determined via body mass index (BMI), body fat percentage (BFP) and waist circumference (WC) in a sample of Mexicans who reside close to the México-U.S. border. Methods: the sample was comprised of 159 young adults with a mean age of 27.96 ± 6.19, 45.9% of which were male, and all residents of Ciudad Juarez, Mexico. Cravings were measured using Trait and State Food Cravings Questionnaires. The consumption of sugars and fats was determined via a 24-hour recall of foods consumed and a food consumption frequency questionnaire. Results: it was demonstrated that BMI and BFP were positively associated with responses to the craving questionnaires and WC with fat consumption. Additionally, higher fat consumption was positively associated with higher rates of obesity. Conclusions: the results demonstrate the need to identify the presence of cravings and integrate such measures for effective prevention and treatment of obesity

Introducción: la obesidad es una enfermedad heterogénea, por lo que reconocer su origen es esencial para el tratamiento. El craving ha sido relacionado con el consumo excesivo de azúcares y grasas y conductas alimentarias adictivas. Objetivo: investigar la relación entre el craving y la ingesta de azucares y grasas, así como su impacto sobre la composición corporal, determinada por el índice de masa corporal (IMC), el porcentaje de grasa corporal (PGC) y la circunferencia de la cintura (CC). Método: la muestra estuvo constituida por 159 adultos jóvenes, hombres (45.9%) y mujeres (54.1%), residentes de Ciudad Juárez, cuya media de edad fue de 27.96 ± 6.19. Se utilizó el Food Cravings Questionnaires Trait y State para determinar la presencia de craving. Para el análisis de la dieta se utilizaron recordatorio de 24 horas y cuestionario de frecuencia de consumo de alimentos. Resultados: los resultados mostraron que el IMC y el PGC se relacionan con conductas de craving y la CC, con el consumo de grasa. Además, el consumo de grasa se mostró como un factor de riesgo para la obesidad. Conclusiones: se sugiere la necesidad de determinar la presencia de craving y el consumo de grasas para prevenir o tratar eficazmente la obesidad

Less-Common Nanostructures: Nanobuds: A Micro-Review.

BACKGROUND: Synthesis, properties, structural peculiarities, and applications of nanobuds and related nanostructures are discussed. In addition, few relevant patents to the topic have been reviewed and cited. According to observed properties and those predicted by DFT calculations, the nanobuds are semiconducting and stable in normal conditions, can accept adatoms and molecules. They contain a relatively chemically inert carbon nanotubes and more active fullerene species and can be compatible with a variety of other materials, in particular polymers. In addition to nanobuds for SWCNTs, the nanobuds with graphene, small fullerenes or metal nanobud-like structures are also known. METHOD: We have undertaken an extensive search of bibliographic databases for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The characteristics of screened papers were described and critically compared. RESULTS: Thirty-six papers were included in the review, mainly from high-impact international journals. The published articles correspond to the range 2006-2016; the term "nanobuds" appeared in 2006 after their discovery. The reports included approaches of the synthesis of carbon nanobuds, their formation mechanism, in situ engineering, different modes of attachment of fullerene on carbon nanotubes, DFT and MD calculations, nanobuds containing small fullerenes and graphene nanobuds, information about related noble metal nanobuds, and applications of carbon nanobuds. CONCLUSION: The findings of this review confirm the importance of novel less-common nanostructures on the basis of carbon for fundamental science, their unusual properties and current and possible applications.

Perfiles psicopatológicos de obesos y desnutridos medidos con el CBCL/6-18 / Psychopathological profiles of obese children and malnourished measures Obesity; in CBCL/6-18

Los objetivos de este trabajo fueron definir los trastornos psicopatológicos más comunes asociados a la obesidad y a la desnutrición, así como establecer el grupo de referencia normativo al cual pertenece México en la escala Child Behavior Checklist 6-18 (CBCL/6-18). Este fue un estudio transversal de diseño cuasiexperiemental. Se utilizó la información de 125 niños de escuelas públicas de Ciudad Juárez, Chihuahua, México, en estados de desnutrición, obesidad y normopeso, obtenida mediante las 113 preguntas relacionadas con el comportamiento de niños, que contiene el CBCL 6-18. Por medio de análisis de varianzas se estudiaron las posibles diferencias entre los grupos. Encontramos que nuestra muestra mexicana, pertenece al grupo normativo de referencia tres; las diferencias más significativas se encuentran en el grupo de obesos en la escala de problemas internalizados específicamente en ansiedad/depresión, y en el total de problemas.

This paper sought to define the most common psychopathological disorders associated with obese and malnourished children, and establish the normative group to which Mexico belongs in the Child Behavior Checklist 6-18(CBCL/6-18). This was a cross-sectional study of cuasiexperimental design. CBCL/6-18 data from 125 children from public school in Ciudad Juárez, Chihuahua, México were categorized into obese, malnourished and normal nutrition states. The 113 questions related to the behavior of children of the CBCL 6-18 through variance analysis were used to explore the possible differences between groups. Our Mexican children sample belongs to the normative group three. We found that the major differences were in internalized problems, specifically in anxiety/depression, and on Total Problems with the obese group.

Variantes genotípicas del SNP -19 del gen de la CAPN 10 y su relación con la diabetes mellitus tipo 2 en una población de Ciudad Juárez, México / SNP-19 Genotypic variants of CAPN 10 gene and its relation to diabetes mellitus type 2 in a population of ciudad juarez, México

Introducción: La diabetes mellitus (DM) tipo 2 es una patología común de origen multifactorial cuyas bases genéticas exactas se desconocen aún; diversos estudios sugieren que los polimorfismos de nucleótido único (SNPs) en el gen CAPN10 (Locus 2q37.3) podrían participar en su desarrollo, incluyendo el polimorfismo de inserción/ deleción SNP-19 (2R→3R). Objetivo: Determinar la relación entre el polimorfismo SNP-19 y la presencia de DM tipo 2 en una población de Ciudad Juárez. Métodos: Se seleccionaron 107 individuos: 43 diabéticos tipo 2 (casos) y 64 no diabéticos sin antecedentes heredo-familiares de DM tipo 2 en primer grado (control). Se realizó estudio antropométrico y perfil bioquímico de lípidos, lipoproteínas y glucosa sérica. Se extrajo ADN de linfocitos de sangre periférica y se amplificó mediante la técnica de reacción en cadena de la polimerasa (PCR). Se analizaron los genotipos del polimorfismo SNP-19 del gen CAPN10 por análisis electroforético en geles de agarosa. Se calcularon las frecuencias genotípicas y alélicas y se realizaronpruebas de equilibrio de Hardy-Weinberg (GenAlEx 6.4). Resultados: El análisis mediante la prueba X² identificó diferencias en los genotipos entre casos y control, con una mayor frecuencia del genotipo homocigoto 3R del SNP-19 en el grupo de casos (0.418) respecto al grupocontrol (0.265). El genotipo 2R/3R presentó relación con valores elevados de peso, índice de masa corporal y perímetros de cintura y cadera; pero solo en el grupo de diabéticos (P=< 0.05). Conclusión: Los resultados de esta investigación sugieren la participación del SNP-19 del gen CAPN10 en el desarrollo de DM tipo 2 en la población estudiada (AU)

Introduction: Diabetes Mellitus (DM) type 2 is a common pathology with multifactorial etiology, which exact genetic bases remain unknown. Some studies suggest that single nucleotides polymorphisms (SNPs) in the CAPN10 gene (Locus 2q37.3) could be associated with the development of this disease, including the insertion/deletion polymorphism SNP-19 (2R→3R). Objective: The present study determined the association between the SNP-19 and the risk of developing DM type 2 in Ciudad Juarez population. Methodology: For this study 107 participants were selected: 43 diabetics type 2 (cases) and 64 non diabetics with no family history of DM type 2 in first grade (control). Anthropometric studies were realized as well as lipids, lipoproteins and serum glucose biochemical profiles. The genotypification of SNP-19 was performed using peripheral blood lymphocytes DNA, polymerase chain reactions (PCR), and electrophoretic analysis in agarose gels. Once obtained the genotypic and allelic frequencies, the Hardy-Weinberg equilibrium test (GenAlEx 6.4) was also performed. Results: Using the X² analysis it was identified the genotypic differences between cases and control with higher frequency of the homozygous genotype 3R of SNP- 19 in the cases group (0.418) compared to control group (0.265). Also, it was observed an association between genotype 2R/3R with elevated weight, body mass index, and waist and hip circumferences, but only in the diabetic group (P=< 0.05). Conclusion: The findings in this study suggest that SNP-19 in CAPN10 may participate in the development of DM type 2 in the studied population (AU)

Actividad antifúngica del aceite esencial de naranja (Citrus sinensis L.) sobre hongos postcosecha en frutos de lechosa (Carica papaya L.) / Anti-fungal activity of essential orange oil (Citrus sinensis L.) over post-harvest fungi in papaya fruits (Carica papaya L.)

Los hongos postcosecha causan pudriciones que afectan la calidad de los frutos de lechosa (Carica papaya L.). Actualmente los aceites esenciales son considerados una alternativa a los fungicidas químicos para controlar estos hongos. En este estudio se evaluó la actividad antifúngica del aceite esencial de naranja (Citrus sinensis L.) sobre los hongos Colletotrichum gloeosporioides, Penicillium indicum, Fusarium solani, Rhizopus stolonifer y Aspergillus flavus, en medio de cultivo Papa Dextrosa Agar (PDA) en un diseño completamente al azar. Los resultados mostraron que existe un efecto inhibidor del aceite esencial de naranja (AEN) en el crecimiento micelial de los hongos in vitro, superior al 80% a concentración de AE de 1%, y 100% de inhibición a concentraciones de 2,5% y 5% de AE (p<0,05). Al ser utilizado como recubrimiento de los frutos, a concentraciones de 2,5% y 5%, disminuye la presencia de lesiones en los mismos, sin diferencias significativas (p<0,05), con igual comportamiento en efectividad in vitro e in vivo. El AEN puede ser una alternativa factible, para el control natural y eficaz de hongos postcosecha, causantes de grandes pérdidas en frutas para exportación y consumo.

Post-harvest fungi produce rotting that affects the quality of papaya fruits (Carica papaya L.) At present, essential oils are considered an alternative to chemical anti-fungal substances for controlling these fungi. In this study we evaluated the antifungal activity of essential orange oil (Citrus sinensis L.) over Colletotrichum gloeosporioides, Penicillum indicum, Fusarium solani, Rhizopus stolonifer and Aspergillus flavus, in Potato Dextrose Agar (PDA) culture medium in a completely random design. The results showed that there is an inhibitory effect of essential orange oil (EOO) over the in vitro mycelium growth of fungi, higher than 80% at a 1% EOO concentration and 100% inhibition at 2.5% and 5% EOO concentrations (p<0.05). When used as covering over the fruits at 2.5% and 5% concentrations, it decreased the presence of lesions without significant differences (p<0.05), with similar effectiveness in vitro and in vivo. EOO can be a feasible alternative for the natural and effective control of post-harvest fungi, which cause great losses in exportation and consumption fruits.

Clinical significance of neuropsychological improvement after supplementation with omega-3 in 8-12 years old malnourished Mexican children: a randomized, double-blind, placebo and treatment clinical trial.

It has been shown that supplementation with omega-3 improves cognitive performance, especially in infants and toddlers, but it is unknown whether these results are effective in older malnourished children. The aims of this study, therefore, were to investigate the omega-3 supplementation effects in 8- to 12-year-old children and to know which neuropsychological functions improve after three months of intervention in a sample of Mexican children with mild to moderate malnutrition. This study was a randomized, double-blind, treatment and placebo study of 59 children aged 8-12 years who were individually allocated to 2 groups. The duration of the intervention lasted 3 months. Neuropsychological performance was measured at baseline and at 3 months. Results show that more than 50% of children in the treatment group had greater improvement in 11 of the 18 neuropsychological variables studied. Processing speed, visual-motor coordination, perceptual integration, attention and executive function showed improvement in more than 70% of the omega-3 supplemented children. This trial was registered at clinicaltrials.gov as NCT01199120.

[SNP-19 genotypic variants of CAPN10 gene and its relation to diabetes mellitus type 2 in a population of Ciudad Juarez, Mexico]. / Variantes genotípicas del SNP-19 del gen de la CAPN10 y su relación con la diabetes mellitus tipo 2 en una población de Ciudad Juárez, México.

INTRODUCTION: Diabetes Mellitus (DM) type 2 is a common pathology with multifactorial etiology, which exact genetic bases remain unknown. Some studies suggest that single nucleotides polymorphisms (SNPs) in the CAPN10 gene (Locus 2q37.3) could be associated with the development of this disease, including the insertion/deletion polymorphism SNP-19 (2R→3R). OBJECTIVE: The present study determined the association between the SNP-19 and the risk of developing DM type 2 in Ciudad Juarez population. METHODOLOGY: For this study 107 participants were selected: 43 diabetics type 2 (cases) and 64 non diabetics with no family history of DM type 2 in first grade (control). Anthropometric studies were realized as well as lipids, lipoproteins and serum glucose biochemical profiles. The genotypification of SNP-19 was performed using peripheral blood lymphocytes DNA, polymerase chain reactions (PCR), and electrophoretic analysis in agarose gels. Once obtained the genotypic and allelic frequencies, the Hardy-Weinberg equilibrium test (GenAlEx 6.4) was also performed. RESULTS: Using the X² analysis it was identified the genotypic differences between cases and control with higher frequency of the homozygous genotype 3R of SNP- 19 in the cases group (0.418) compared to control group (0.265). Also, it was observed an association between genotype 2R/3R with elevated weight, body mass index, and waist and hip circumferences, but only in the diabetic group (P=< 0.05). CONCLUSION: The findings in this study suggest that SNP-19 in CAPN10 may participate in the development of DM type 2 in the studied population.

Introducción: La diabetes mellitus (DM) tipo 2 es una patología común de origen multifactorial cuyas bases genéticas exactas se desconocen aún; diversos estudios sugieren que los polimorfismos de nucleótido único (SNPs) en el gen CAPN10 (Locus 2q37.3) podrían participar en su desarrollo, incluyendo el polimorfismo de inserción/ deleción SNP-19 (2R→3R). Objetivo: Determinar la relación entre el polimorfismo SNP-19 y la presencia de DM tipo 2 en una población de Ciudad Juárez. Métodos: Se seleccionaron 107 individuos: 43 diabéticos tipo 2 (casos) y 64 no diabéticos sin antecedentes heredo-familiares de DM tipo 2 en primer grado (control). Se realizó estudio antropométrico y perfil bioquímico de lípidos, lipoproteínas y glucosa sérica. Se extrajo ADN de linfocitos de sangre periférica y se amplificó mediante la técnica de reacción en cadena de la polimerasa (PCR). Se analizaron los genotipos del polimorfismo SNP-19 del gen CAPN10 por análisis electroforético en geles de agarosa. Se calcularon las frecuencias genotípicas y alélicas y se realizaron pruebas de equilibrio de Hardy-Weinberg (GenAlEx 6.4). Resultados: El análisis mediante la prueba X² identificó diferencias en los genotipos entre casos y control, con una mayor frecuencia del genotipo homocigoto 3R del SNP-19 en el grupo de casos (0.418) respecto al grupo control (0.265). El genotipo 2R/3R presentó relación con valores elevados de peso, índice de masa corporal y perímetros de cintura y cadera; pero solo en el grupo de diabéticos (P=< 0.05). Conclusión: Los resultados de esta investigación sugieren la participación del SNP-19 del gen CAPN10 en el desarrollo de DM tipo 2 en la población estudiada.

Perfil clínico y epidemiológico de la leishmaniasis visceral americana en el estado Trujillo, Venezuela (1975-2007) / Clinical and epidemiologic profile of visceral leishmaniasis in Trujillo state, Venezuela (1975-2007)

El objetivo de este estudio fue consolidar y analizar información referente a los aspectos clínicos y epidemiológicos de pacientes con leishmaniasis visceral en el estado Trujillo, Venezuela, a través de un estudio retrospectivo que incluyó los ingresos hospitalarios durante 1975 - 2007. Ochenta y dos historias clínicas fueron seleccionadas, de las cuales 55 correspondieron a niños y adolescentes entre los 0-17 años y 27 adultos entre 18 y 60 años. El 53,7% de los pacientes fueron niños en el rango de edad de 0-5 años. Se observó predominio del sexo masculino en los adultos (P=0,002). En cuanto a los signos y síntomas se encontró diferencia significativa entre niños-adolescentes y adultos en las variables astenia (P=0,01) y pérdida de peso (P = 0,001) siendo ambas más frecuentes entre adultos. El tiempo promedio de hospitalización fue 31,17±14 días y la tasa de mortalidad de 4,9 %. Se concluye que la LVA en el estado de Trujillo, se comporta persistentemente endémica con casuística baja y esporádica y debe ser descartada en pacientes adultos con pérdida de peso y astenia que provengan de áreas endémicas.

The objective of this study was to consolidate and analyze information in reference to clinical and epidemiological aspects of patients with Visceral Leshismaniasis in Trujillo State, Venezuela through a retrospective study which included interned patients from 1975-2007. 82 clinical records were reviewed: 55 children and teenagers between 0- 17 years, and 27 adults between 18 and 60 years. 53.7% of them were children between 0 and 5 years. Among adults, the male sex was dominant (P=0. 002). In reference to the signs and symptoms, a significant difference was found between children/teenagers and adults in the variables of astenia (P=0.001) and loss of weight (P=0.001) which were more frequent among adults. The average ingression to the hospital was 31.17 ±14 days and the rate of mortality was 4.9%. In conclusion the LVA in Trujillo state is persistently endemic with a low and sporadic cases, which must be discarded in adult patients who come from endemic areas with weight loss and asthenia.

Síndrome de distrés respiratorio agudo asociado a listeriosis del embarazo / Acute respiratory distress syndrome associated with listeriosis during pregnancy

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Nutrición en pacientes con enfermedades hepáticas: (primera parte) / Nutrition in chronic liver diseases

La dieta al poder ser manipulable puede de una u otra forma comprometer la función del hígado o contribuir para mantener la misma a niveles óptimos. El objetivo del presente trabajo fue revisar los recientes avances del efecto de la nutrición sobre los aspectos clínicos en enfermedades hepáticas crónicas y el uso adecuado de medidas dietéticas haciendo énfasis en los estudios que al respecto se han realizado en México. Se incluyeron informes originales en inglés y español a través de información computada (Medline) hasta 1994, además de los informes publicados en revistas nacionales sobre el aspecto nutricio en enfermedades hepáticas