Impact of tumor stage and neoadjuvant chemotherapy in fluorescence-guided lymphadenectomy during laparoscopic gastrectomy for gastric cancer: A propensity score-matched study in a western center.

BACKGROUND: The use of indocyanine green fluorescence has been shown to be a safe and effective method for improving lymph node retrieval in patients with gastric cancer. However, previous studies have focused on early-stage tumors and/or the Asian population and excluded patients who received neoadjuvant treatment. METHODS: In this study, 142 patients with gastric adenocarcinoma underwent laparoscopic gastrectomy at a Spanish hospital between January 2017 and December 2022. Of these, 42 patients received preoperative indocyanine green injection to guide lymphadenectomy. Their outcomes were compared to a retrospective cohort of 42 patients after 1:1 propensity score matching. RESULTS: The feasibility of indocyanine green lymphatic mapping was 95.5%. No complications associated with indocyanine green injection were observed. The indocyanine green group had a significantly higher number of retrieved lymph nodes than the non-indocyanine green group (32.67 vs 25.14; P = .013). This statistically significant difference was maintained across subgroups of neoadjuvant treatment, non-obese patients, pT0 to 2 stage, and pN0 stage. In 47.6% of patients from the indocyanine green group, lymphadenectomy was extended outside the standard D2 dissection area based on indocyanine green uptake, but none of the retrieved lymph nodes were metastatic. There were no differences in postoperative complications and length of hospital stay between the 2 groups. CONCLUSION: Indocyanine green-guided lymphadenectomy is safe and feasible and increases the number of retrieved lymph nodes compared to conventional lymphatic dissection, as well as in patients receiving neoadjuvant chemotherapy. The use of indocyanine green should be routine if available for guiding lymph node dissection in gastric cancer, regardless of tumor stage or previous neoadjuvant treatment. However, further studies are needed to determine the impact of this technique on disease-free and overall survival.

Global modeling of lake-water indirect photochemistry based on the equivalent monochromatic wavelength approximation: The case of the triplet states of chromophoric dissolved organic matter.

Chromophoric dissolved organic matter (CDOM) plays key role as photosensitizer in sunlit surface-water environments, and it is deeply involved in the photodegradation of contaminants. It has recently been shown that sunlight absorption by CDOM can be conveniently approximated based on its monochromatic absorption at 560 nm. Here we show that such an approximation allows for the assessment of CDOM photoreactions on a wide global scale and, particularly, in the latitude belt between 60°S and 60°N. Global lake databases are currently incomplete as far as water chemistry is concerned, but estimates of the content of organic matter are available. With such data it is possible to assess global steady-state concentrations of CDOM triplet states (3CDOM*), which are predicted to reach particularly high values at Nordic latitudes during summer, due to a combination of high sunlight irradiance and elevated content of organic matter. For the first time to our knowledge, we are able to model an indirect photochemistry process in inland waters around the globe. Implications are discussed for the phototransformation of a contaminant that is mainly degraded by reaction with 3CDOM* (clofibric acid, lipid regulator metabolite), and for the formation of known products on a wide geographic scale.

A systematic review of gender-responsive and integrated substance use disorder treatment programs for women with co-occurring disorders.

Background: Integrated and gender-responsive interventions, designed to target co-occurring substance use and psychiatric disorders in women, may be effective in addressing gender-specific challenges.Objectives: This systematic review aims to identify integrated gender-responsive substance use disorder treatments for women, summarize evaluations of these treatments, and address gaps in the literature.Methods: We searched PsycINFO, PubMed, and MEDLINE on September 24, 2021, and March 10, 2022. Included articles were randomized-controlled trials, secondary analyses of naturalistic studies, or open-label studies of integrated and gender-responsive treatments from any year that assessed both substance use and mental health/trauma outcomes.Results: We identified N = 24 studies (participants = 3,396; 100% women) examining Seeking Safety, Helping Women Recover and Beyond Trauma, A Woman's Path to Recovery, Modified Trauma Recovery and Empowerment Model (TREM), Breaking the Cycle, VOICES, Understanding and Overcoming Substance Misuse, Women's Recovery Group, Female Specific Cognitive Behavioral Therapy, and Moment by Moment in Women's Recovery. Across treatments there were significant improvements over time; Seeking Safety, Helping Women Recover, and TREM were associated with significantly better substance use and mental health outcomes relative to the comparison groups.Conclusions: Integrated gender-responsive treatments are a promising approach to treating women with co-occurring substance use and mental health concerns, and broad clinical implementation stands to benefit women. However, there remains a lack of studies evaluating substance use treatments in women with severe mental illness (e.g., psychotic-spectrum disorders) who differ in their needs and capacity.

Review of third-wave therapies for substance use disorders in people of color and collectivist cultures: Current evidence and future directions.

OBJECTIVE: In people of color (POC) and from collectivist cultures, third-wave therapies utilizing mindfulness may be a more sensitive approach to substance use disorder (SUD) treatment, than cognitive behavioral therapy (CBT). This systematic review examined this hypothesis. METHOD: We searched PsycINFO, Pubmed, and MEDLINE on December 23, 2021. Articles were included if they compared efficacy of third-wave therapies to therapies with only CBT elements and reported treatment outcomes for POC/people from collectivist cultures. RESULTS: We included eleven studies conducted in the United States (n = 5), Spain (n = 2), Brazil (n = 2), Hong Kong (n = 1), and Iran (n = 1). Third-wave therapies included mindfulness-based relapse prevention (n = 4), acceptance and commitment therapy (n = 3), yoga and breathing strategies (n = 2), and mindfulness/emotion regulation training (n = 2). The substance use outcomes measured included nicotine use (n = 6), opioid use (n = 1), and general SUDs (n = 4) using biological measures (n = 7), Timeline Followback (n = 4), and the Addiction Severity Index (ASI; n = 2) to measure substance use. Overall, eight studies reported greater improvements in the third-wave therapy group relative to the CBT group in POC, on at least one substance use outcome. CONCLUSIONS: Findings suggest that relative to CBT, third-wave therapies are a promising modality in the treatment SUDs in POC and people and from collectivist cultures. However, studies are relatively sparse and carry a number of methodological problems. As such, there remains a need for further research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Solar water disinfection in large-volume containers: from the laboratory to the field. A case study in Tigray, Ethiopia.

The lack of safe drinking water affects communities in low-to-medium-income countries most. This barrier can be overcome by using sustainable point-of-use water treatments. Solar energy has been used to disinfect water for decades, and several efforts have been made to optimise the standard procedure of solar water disinfection (SODIS process). However, the Health Impact Assessment of implementing advanced technologies in the field is also a critical step in evaluating the success of the optimisation. This work reports a sustainable scaling-up of SODIS from standard 2 L bottles to 25 L transparent jerrycans (TJC) and a 12-month field implementation in four sites of Tigray in Ethiopia, where 80.5% of the population lives without reliable access to safe drinking water and whose initial baseline average rate of diarrhoeal disease in children under 5 years was 13.5%. The UVA dose required for 3-log reduction of E. coli was always lower than the minimum UVA daily dose received in Tigray (9411 ± 55 Wh/m2). Results confirmed a similar decrease in cases of diarrhoea in children in the implementation (25 L PET TJC) and control (2 L PET bottles) groups, supporting the feasibility of increasing the volume of the SODIS water containers to produce safer drinking water with a sustainable and user-friendly process.

A model to predict the kinetics of direct (endogenous) virus inactivation by sunlight at different latitudes and seasons, based on the equivalent monochromatic wavelength approach.

Sunlight plays an important role in the inactivation of pathogenic microorganisms such as bacteria and viruses in water. Here we present a model that is able to predict the kinetics of direct virus inactivation (i.e. inactivation triggered by sunlight absorption by the virion, without the role played by photochemically produced reactive intermediates generated by water-dissolved photosensitizers) on a global scale (from 60 °S to 60 °N latitude) and for the different months of the year. The model is based on the equivalent monochromatic wavelength (EMW) approach that was introduced recently, and which largely simplifies complex polychromatic calculations by approximating them with a monochromatic equation at the proper wavelength, the EMW. The EMW equation was initially established for mid-July conditions at a mid-latitude, and was then extended to different seasons and to the latitude belt where the day-night cycle is always observed throughout the year. By so doing, the first-order rate constant of direct virus photoinactivation can be predicted on a global scale, with the use of a relatively simple equation plus tables of pre-calculated input data, as a function of latitude, month, and key water parameters. The model was here applied to the virus organism phiX174, a somatic phage that is often used as proxy for pathogenic viruses undergoing fast direct inactivation, and for which a wide array of published inactivation data is available. Model predictions are validated by comparison with field data of inactivation of somatic phages by sunlight.

Solar Water Disinfection to Produce Safe Drinking Water: A Review of Parameters, Enhancements, and Modelling Approaches to Make SODIS Faster and Safer.

Solar water disinfection (SODIS) is one the cheapest and most suitable treatments to produce safe drinking water at the household level in resource-poor settings. This review introduces the main parameters that influence the SODIS process and how new enhancements and modelling approaches can overcome some of the current drawbacks that limit its widespread adoption. Increasing the container volume can decrease the recontamination risk caused by handling several 2 L bottles. Using container materials other than polyethylene terephthalate (PET) significantly increases the efficiency of inactivation of viruses and protozoa. In addition, an overestimation of the solar exposure time is usually recommended since the process success is often influenced by many factors beyond the control of the SODIS-user. The development of accurate kinetic models is crucial for ensuring the production of safe drinking water. This work attempts to review the relevant knowledge about the impact of the SODIS variables and the techniques used to develop kinetic models described in the literature. In addition to the type and concentration of pathogens in the untreated water, an ideal kinetic model should consider all critical factors affecting the efficiency of the process, such as intensity, spectral distribution of the solar radiation, container-wall transmission spectra, ageing of the SODIS reactor material, and chemical composition of the water, since the substances in the water can play a critical role as radiation attenuators and/or sensitisers triggering the inactivation process.

Myelodysplastic syndromes with 20q deletion: incidence, prognostic value and impact on response to azacitidine of ASXL1 chromosomal deletion and genetic mutations.

In myelodysplastic syndromes (MDS), the 20q deletion [del(20q)] may cause deletion of the ASXL1 gene. We studied 153 patients with MDS and del(20q) to assess the incidence, prognostic value and impact on response to azacitidine (AZA) of ASXL1 chromosomal alterations and genetic mutations. Additionally, in vitro assay of the response to AZA in HAP1 (HAP1WT ) and HAP1 ASXL1 knockout (HAP1KN ) cells was performed. ASXL1 chromosomal alterations were detected in 44 patients (28·5%): 34 patients (22%) with a gene deletion (ASXL1DEL ) and 10 patients (6·5%) with additional gene copies. ASXL1DEL was associated with a lower platelet count. The most frequently mutated genes were U2AF1 (16%), ASXL1 (14%), SF3B1 (11%), TP53 (7%) and SRSF2 (6%). ASXL1 alteration due to chromosomal deletion or genetic mutation (ASXL1DEL /ASXL1MUT ) was linked by multivariable analysis with shorter overall survival [hazard ratio, (HR) 1·84; 95% confidence interval, (CI): 1·11-3·04; P = 0·018] and a higher rate for acute myeloid leukaemia progression (HR 2·47; 95% CI: 1·07-5·70, P = 0·034). ASXL1DEL /ASXL1MUT patients were correlated by univariable analysis with a worse response to AZA. HAP1KN cells showed more resistance to AZA compared to HAP1WT cells. In conclusion, ASXL1 alteration exerts a negative impact on MDS with del(20q) and could become useful for prognostic risk stratification and treatment decisions.

Seguridad alimentaria en madres indígenas colombianas y su relación con los conocimientos, actitudes y prácticas en la primera infancia / Food security in Colombian indigenous mothers and its relationship with knowledge, attitudes and practices in early childhood

FUNDAMENTOS: La seguridad alimentaria (SA) es un determinante del estado nutricional, subsistiendo en comunidades indígenas mayormente vulnerables. Existen cambiosgeneracionales que han modificado los conocimientos, actitudes y prácticas utilizadas por las madres en el momento de la preparación y suministrode la alimentación infantil. El objetivo fue determinar la seguridad-alimentaria en madres indígenas colombianas ysu relación con los conocimientos, actitudes y prácticas en familias con menores de edad en un cabildo indígena Nasa del norte del Cauca, Colombia. MÉTODOS:Estudio observacional de corte transversal.Los datos se recogieron mediante entrevista individual a las 104 madres indígenas Nasa por medio del manual de Conocimientos, Actitudes y Prácticas (CAP) posteriormente se midió la seguridad alimentaria en los hogares con la Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA). RESULTADOS: La SA en los hogares fue 39,4%. En las prácticas la lactancia materna exclusiva fue del 11,9%. El 70% de las madres indígenas iniciaron la alimentación complementaria a los 6 meses. En general, las madres presentan actitudes positivas y favorables en relación con la alimentación de sushijos. Se relacionó la SA con la edad de la madre y el conocimiento de la lactancia materna. CONCLUSIONES: Las madres indígenas y sus familias están expuestas a inseguridad alimentaria. Los conocimientos y las prácticas impactan la SA de las comunidades. Es importante fortalecer la educación y acompañar las familias indígenas

BACKGROUND: Food security (FS) is a determinant of nutritional status, with the existence of indigenous communities who are more food vulnerable. There are generational changes that have modified the knowledge, attitudes and practices used by mothers at the time of preparation and supply of children's food. METHODS: Cross-sectional observational study, food safety was measured with the Latin American and Caribbean Food Security Scale (ELCSA) and the Knowledge, Attitudes and Practices (CAP) manual was applie. RESULTS: The SA in households was 39.4%. In practices, breastfeeding was 11.9%, beginning of complementary feeding at 6 months of 70%. The SA was related to the mother's age and the knowledge of breastfeeding, the relationship with attitudes was not found. CONCLUSIONS: Indigenous mothers and their families are exposed to food insecurity (AI). The knowledge and practices impact the SA of these communities. It is important to strengthen education and accompany indigenous families

Kinetic modeling of the synergistic thermal and spectral actions on the inactivation of Cryptosporidium parvum in water by sunlight.

Water contamination with the enteroprotozoan parasite Cryptosporidium is a current challenge worldwide. Solar water disinfection (SODIS) has been proved as a potential alternative for its inactivation, especially at household level in low-income environments. This work presents the first comprehensive kinetic model for the inactivation of Cryptosporidium parvum oocysts by sunlight that, based on the mechanism of the process, is able to describe not only the individual thermal and spectral actions but also their synergy. Model predictions are capable of estimating the required solar exposure to achieve the desired level of disinfection under variable solar spectral irradiance and environmental temperature conditions for different locations worldwide. The thermal contribution can be successfully described by a modified Arrhenius equation while photoinactivation is based on a series-event mechanistic model. The wavelength-dependent spectral effect is modeled by means of the estimation of the C. parvum extinction coefficients and the determination of the quantum yield of the inactivation process. Model predictions show a 3.7% error with respect to experimental results carried out under a wide range of temperature (30 to 45 °C) and UV irradiance (0 to 50 W·m-2). Furthermore, the model was validated in three scenarios in which the spectral distribution radiation was modified using different plastic materials common in SODIS devices, ensuring accurate forecasting of inactivation rates for real conditions.

Kinetic modeling of the synergistic thermal and spectral actions on the inactivation of viruses in water by sunlight.

Sunlight can be an effective tool for inactivating pathogens in water disinfection processes. In clear water, photoinactivation of viruses is driven by the absorption of UVB radiation and it is more efficient at shorter wavelengths. Moreover, the temperature can significantly improve the efficiency of the process. To date, no kinetic model has been reported that describes the simultaneous thermal and spectral effects that occur during the solar inactivation of viruses. This work presents a novel comprehensive kinetic model for the solar inactivation of MS2 coliphage as a function of the water temperature, irradiance, and spectral distribution of the incident radiation. The model is based on a combination of the modified Arrhenius equation, a wavelength-dependent first-order inactivation model with the quantum yield, and thermal parameters estimated from laboratory data. Model predictions have a 9% error with respect to experiments in the temperature range from 30 to 50 °C and UV irradiance range from 15 to 50 W/m2. Moreover, the model was validated in three scenarios using different plastic materials that modify the spectral range of the radiation reaching the water, confirming an accurate prediction of inactivation rates for real solar disinfection systems worldwide using containers made of any material.

Impact on Longevity of Genetic Cardiovascular Risk and Lifestyle including Red Meat Consumption.

BACKGROUND: Cardiovascular risk (CVR) underlies aging process and longevity. Previous work points to genetic and environmental factors associated with this risk. OBJECTIVES: The aim of this research is to look for any CVR gene-gene and gene-multifactorial/lifestyle interactions that may impact health and disease and underlie exceptional longevity. METHODS: A case-control study involving 521 both gender individuals, 253 centenarians (100.26 ± 1.98 years), and 268 controls (67.51 ± 3.25 years), low (LCR, n = 107) and high (HCR, n = 161) CVR. Hypertension, diabetes, obesity (BMI, kg·m-2), and impaired kidney function were defined according to standard criteria. CVR was calculated using Q risk®. DNA was genotyping (ACE-rs4646994, AGT-rs4762, AGR1-rs5182, GRK4-rs2960306, GRK4-rs1024323, NOS3-rs1799983, and SLC12A3-rs13306673) through iPlex-MassARRAY®, read by MALDI-TOF mass spectrometry, and analyzed by EARTDECODE®. RESULTS: Antilongevity factors consisted (OR 95% CI, p < 0.05) BMI 1.558 (1.445-1.680), hypertension 2.358 (1.565-3.553), smoking habits 4.528 (2.579-7.949), diabetes 5.553 (2.889-10.675), hypercholesterolemia 1.016 (1.010-1.022), and regular consumption of red meat 22.363 (13.987-35.755). Genetic aspects particularly for HCR individuals ACE II (OR: 3.96 (1.83-8.56), p < 0.0001) and NOS3 TT (OR: 3.11 (1.70-5.70), p < 0.0001) genotypes were also risk associate. Obesity, smoking, hypercholesterolemia, and frequent consumption of red meat have an additive action to hypertension in the longevity process. There was a synergistic interaction between the endothelial NOS3 genotypes and the severity of arterial hypertension. An epistatic interaction between functional genetic variants of GRK4 and angiotensinogen was also observed. CONCLUSIONS: Cardiovascular risk-related genetic and multifactorial or predominantly lifestyle aspects and its interactions might influence the aging process and contribute to exceptional longevity in Portuguese centenarians. Besides lifestyle, the activity of nitrite oxide synthase may be one of the main physiologic regulators of cardiovascular protection in the path of longevity.

Material selection and prediction of solar irradiance in plastic devices for application of solar water disinfection (SODIS) to inactivate viruses, bacteria and protozoa.

Solar water disinfection (SODIS) is a simple, inexpensive and sustainable Household Water Treatment (HWT) that is appropriate for low-income countries or emergency situations. Usually, SODIS involves solar exposure of water contained in transparent polyethylene terephthalate (PET) bottles for a minimum of 6 h. Sunlight, especially UVB radiation, has been demonstrated to photoinactivate bacteria, viruses and protozoa. In this work, an in-depth study of the optical and mechanical properties, weathering and production prices of polymeric materials has been carried out to identify potential candidate materials for manufacturing SODIS devices. Three materials were ruled out (polystyrene (PS), polyvinyl chloride (PVC) and polyethylene (PE)) and four materials were initially selected for study: polymethylmethacrylate (PMMA), polypropylene (PP), polycarbonate (PC) and polyethylene terephthalate (PET). These plastics transmit sufficient solar radiation to kill waterborne pathogens with production costs compensated by their durability under solar exposure. A predictive model has been developed to quantitatively estimate the radiation available for SODIS inside the device as a function of the material and thickness. This tool has two applications: to evaluate design parameters such as thickness, and to estimate experimental requirements such as solar exposure time. In this work, this model evaluated scenarios involving different plastic materials, device thicknesses, and pathogens (Escherichia coli bacterium, MS2 virus and Cryptosporidium parvum protozoon). The developed Solar UV Calculator model is freely available and can be also applied to other customized materials and conditions.

HIV Coinfection Predicts Failure of Ledipasvir/Sofosbuvir in Treatment-Naïve Noncirrhotic Patients With HCV Genotype 1.

BACKGROUND: The efficacy of licensed direct-acting antiviral (DAA) regimens is assumed to be the same for hepatitis C virus (HCV)-monoinfected patients (HCV-Mono) and HIV/HCV-coinfected patients (HCV-Co). However, the high sustained viral response (SVR) rates of DAA regimens and the small number of HIV-infected patients included in registration trials have made it difficult to identify predictors of treatment failure, including the presence of HIV. METHODS: We compared treatment outcomes for ledipasvir/sofosbuvir (LDV/SOF) against HCV G1 in treatment-naïve HCV-Mono and HCV-Co without cirrhosis in a prospective registry of individuals receiving DAAs for HCV. RESULTS: Up to September 2017, a total of 17 269 patients were registered, and 1358 patients (1055 HCV-Mono/303 HCV-Co) met the inclusion criteria. Significant differences between HCV-Mono and HCV-Co were observed for age, gender, and G1 subtype distribution. Among HCV-Co, 99.0% were receiving antiretroviral therapy. SVR rates for LDV/SOF at 8 weeks did not differ significantly between HCV-Mono and HCV-Co (96.9% vs 94.0%; P = .199). However, the SVR rate for LDV/SOF at 12 weeks was significantly higher for HCV-Mono than HCV-Co (97.2% vs 91.8%; P = .001). A multivariable logistic regression model including age, sex, liver stiffness, G1 subtype, HCV-RNA, HIV, and treatment duration showed the factors associated with treatment failure to be male sex (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.27-4.91; P = .008) and HIV infection (aOR, 2.23; 95% CI, 1.13-4.38; P = .020). CONCLUSIONS: The results of this large prospective study analyzing outcomes for LDV/SOF against HCV G1 in treatment-naïve noncirrhotic patients suggest that HIV infection is a predictor of treatment failure in patients with chronic hepatitis C.

Hypertension and longevity: role of genetic polymorphisms in renin-angiotensin-aldosterone system and endothelial nitric oxide synthase.

Hypertension (HT), a common age-related disorder, is an important risk factor for cardiovascular disease. This study aims to identify the prevalence of HT in Portuguese centenarians and evaluate whether gene polymorphisms encoding key molecules in blood pressure (BP) regulation are associated with longevity. There were recruited 253 centenarians (100.26 ± 1.98 years) and 268 control subjects (67.51 ± 3.25 years). Hypertension (ESH/ESC2013 and JNC8) and diabetes (WHO) were evaluate. Genetic polymorphisms of renin-angiotensin-aldosterone system (RAAS) and NOS3 were determined. The prevalence of HT among centenarians was 64.4% and the majority (58.9%) were controlled, differing from control group both on frequency (P < 0.001) and on their control (P < 0.001). We found that HT is a risk factor for not achieving longevity (OR 2.531, 95% CI 1.688-3.793, P < 0.001), the same for diabetes (OR 5.669 95% CI 2.966-10.835, P < 0.001), and male gender (OR 2.196, 95% CI 1.493-3.29, P < 0.001). Hypertension, adjusted for gender and diabetes, was independent risk factor anti-longevity (OR 2.007, 95% CI 1320-3.052, P = 0.001). The ACE_D and NOS3_G alleles were more frequent in centenarians compared to controls (P < 0.001, both cases). ACE_II and NOS3_TT genotypes, adjusted for BP, gender and diabetes, increased risk in 3.748 (95% CI 1.887-7.444) and 2.533 (95% CI 1.483-4.327), respectively, in relation to ACE_DD (P < 0.001) and NOS3_GG (P = 0.001), against longevity. Our findings suggest that the prevalence of hypertension was lower in Portuguese centenarians than in the elderly, reinforcing the importance of better cardiovascular risk profiles to achieve longevity even in the presence of genetic condition.

Cap a una alimentació ètica. Aproximació teòrico-pràctica a les dietes vegetarianes / Hacia una alimentación ética. Aproximación teórico-práctica a las dietas vegetarianas / Towards an ethical food. Theoretical and practical approaches to a vegetarian diet

Des que tenia cinc anys en Tom Watkins s'alimentava seguint exclusivament una dieta crudivegana. L'any 2008 nombroses veus es van alçar en contra de la seva mare per la manera com aquesta l'alimentava, ja que consideraven tenia conseqüències negatives per la salut del menor. L'estudi d'aquest cas ens permetrà, prenent com a referència els principis de la bioètica i la deontologia professional, discutir quines són les possibilitats de les que disposem per abordar conflictes com aquest. Debatrem les característiques del model alimentari actual, i veurem com d'allunyat n'està de poder-se considerar saludable i respectuós tant amb el medi ambient com amb els animals. I finalment ens preguntarem sobre quin ha de ser el paper del dietista-nutricionista a l'hora de tractar qüestions com aquestes

Desde que tenía cinco años, Tom Watkins se alimentaba siguiendo exclusivamente una dieta crudivegana. El año 2008, numerosas voces se alzaron en contra de su madre por la manera en que lo alimentaba, ya que consideraban que tenía consecuencias negativas para la salud del menor. El estudio de este caso nos permitirá, tomando como referencia los principios de la bioética y la deontología profesional, discutir cuáles son las posibilidades de las que disponemos para abordar conflictos como este. Debatiremos las características del modelo alimentario actual y veremos cuán alejado está de poder considerarlo saludable y respetuoso tanto con el medio ambiente como con los animales. Finalmente nos preguntaremos cuál debe ser el papel del dietista-nutricionista a la hora de tratar cuestiones como éstas

Since he was five years old, Tom Watkins was exclusively fed following a raw vegan diet. In 2008, many people started criticizing his mother for the way she was feeding her son, as they considered this diet had negative consequences for the minor's health. Analysing this case will allow us, taking as a point of reference the principles of bioethics and professional ethics, to discuss the available possibilities to tackle such conflicts. We will also discuss the characteristics of the current food model and we will see how distant it is from being healthy and respectful with the environment and the other animals. Finally, we will analyse the role of the dietician-nutritionists in dealing with this type of issues

Mountain Cycling Ultramarathon Effects on Inflammatory and Hemoglobin Responses.

PURPOSE: This study aimed to analyze the cumulative physiological burden of repetitive, strenuous exercise held during mountain cycling ultramarathon on regulatory mechanisms of hemoglobin degradation. METHODS: Fifty-five nonprofessional athletes (mean age, 44.8 ± 7.1 yr) participating in a 9-consecutive-day mountain cycling ultramarathon (TransPortugal) underwent anthropometric, hematological, and biochemical assessments before and immediately after the race. Participants were further stratified as completers (nine courses) or noncompleters and were divided according to the time they took to complete the race. The heme oxygenase-1 (HMOX1) functional genetic polymorphism and haptoglobin (HP) phenotypic variants were also analyzed. RESULTS: Total leukocytes, neutrophil count, and monocyte count increased, whereas decreases in erythrocyte counts and hemoglobin were found between pre- and postultramarathon. Circulating haptoglobin (Hp) was increased, whereas its soluble receptor (sCD163) decreased. Athletes who completed all nine courses presented with increased leukocyte, neutrophil, and erythrocyte counts, as well as hemoglobin, red cell distribution width, total bilirubin, and total cholesterol levels. High-sensitivity C-reactive protein and Hp decreased in comparison with noncompleters. HMOX1 and HP genetic polymorphisms were associated with biochemical profile, notably with Hp levels. Analysis of covariance showed a significant effect of HP phenotype in Hp circulating levels at the end of race and on the magnitude of variation from pre- to postrace. CONCLUSIONS: Present findings support a comodulatory influence of genetic- and exercise-associated factors on resulting inflammatory and hemoglobin catabolic marker Hp after highly demanding endurance exercise.

The quantal catecholamine release from mouse chromaffin cells challenged with repeated ACh pulses is regulated by the mitochondrial Na+ /Ca2+ exchanger.

KEY POINTS: Upon repeated application of short ACh pulses to C57BL6J mouse chromaffin cells, the amperometrically monitored secretory responses promptly decayed to a steady-state level of around 25% of the initial response. A subsequent K+ pulse, however, overcame such decay. These data suggest that mouse chromaffin cells have a ready release-vesicle pool that is selectively recruited by the physiological neurotransmitter ACh. The ACh-sensitive vesicle pool is refilled and maintained by the rate of Ca2+ delivery from mitochondria to the cytosol, through the mitochondrial Na+ /Ca2+ exchanger (mNCX). ITH12662, a novel blocker of the mNCX, prevented the decay of secretion elicited by ACh pulses and delayed the rate of [Ca2+ ]c clearance. This regulatory pathway may be physiologically relevant in situations of prolonged stressful conflicts where a sustained catecholamine release is regulated by mitochondrial Ca2+ circulation through the mNCX, which couples respiration and ATP synthesis to long-term stimulation of chromaffin cells by endogenously released ACh. ABSTRACT: Using caged-Ca2+ photorelease or paired depolarising pulses in voltage-clamped chromaffin cells (CCs), various pools of secretory vesicles with different readiness to undergo exocytosis have been identified. Whether these pools are present in unclamped CCs challenged with ACh, the physiological neurotransmitter at the splanchnic nerve-CC synapse, is unknown. We have explored here whether an ACh-sensitive ready-release vesicle pool (ASP) is present in C57BL6J mouse chromaffin cells (MCCs). Single cells were fast perfused with a Tyrode solution at 37°C, and challenged with 12 sequential ACh pulses (100 µm, 2 s, every 30 s) plus a K+ pulse given at the end (75 mm K+ ). After the first 2-3 ACh pulses the amperometrically monitored secretory responses promptly decayed to a steady-state level of around 25% of the initial response. The last K+ pulse, however, overcame such decay. Repeated ACh pulses to voltage-clamped cells elicited non-desensitising nicotinic currents. Also, the [Ca2+ ]c transients elicited by repeated ACh pulses that were superimposed on a stable baseline elevation did not undergo decay. The novel blocker of the mitochondrial Na+ /Ca2+ exchanger (mNCX) ITH12662 prevented the decay of secretion elicited by ACh pulses and delayed the rate of [Ca2+ ]c clearance. The experiments are compatible with the idea that C57BL6J MCCs have an ASP vesicle pool that is selectively recruited by the physiological neurotransmitter ACh and is regulated by the rate of Ca2+ delivery from mitochondria to the cytosol, through the mNCX.

Sickle cell anemia - Nitric oxide related genetic modifiers of hematological and biochemical parameters.

BACKGROUND: Sickle cell anemia (SCA) is an inherited blood disorder. SCA patients present clinical and hematologic variability that cannot be only explained by the single mutation in the beta-globin gene. Others genetic modifiers and environmental effects are important for the clinical phenotype. SCA patients present arginine deficiency that contributes to a lower nitric oxide (NO) bioactivity. OBJECTIVE: The aim of this work is to determine the association between hematological and biochemical parameters and genetic variants from eNOS gene, in pediatric SCA patients. METHODS: 26 pediatric SCA patients were genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) techniques in three important eNOS gene polymorphisms - rs2070744, rs1799983 and intron 4 VNTR. RESULTS: Results from this study show a significant statistical association between some parameters and genetic variants: an increased reticulocyte count and high serum lactate dehydrogenase levels were associated with both the rs2070744_TT and the rs1799983_GG genotypes at eNOS gene and high levels of neutrophils were associated with the eNOS4a allele at intron 4 VNTR. CONCLUSIONS: Our results reinforce the importance of NO bioactivity in SCA. We presume that NO, and its precursors might be used as therapy to improve the quality of life of SCA patients.