Evidence of Food Safety in Relation to Cry Proteins in Genetically Modified Foods / Evidencias sobre seguridad alimentaria con relación a Cry proteínas en alimentos transgénicos

Abstract Developments in applying biotechnology to crops have generated strong ethical and social debates about its use. This study was aimed at reviewing epidemiological evidence regarding the consumption of genetically modified foods and the possible effects on human health, particularly certain insect-resistant crops in which isolated Bacillum thurigiensis Cry protein has been introduced. An in-depth review of databases was conducted for 2007-2019. Articles not referring to human health were excluded. In total, 1,350 were obtained and 118 were reviewed. As a result, it can be concluded that most studies have focused on chemical composition and in vitro or laboratory animal trials. Furthermore, the guiding principle of substantial equivalency, generally used today to evaluate potential health effects, should not replace rigorously evaluating products with nutritional, immunological, and toxicological trials. Lastly, this review demonstrates a lack of epidemiological evidence, and therefore, the safety of these foods cannot be conclusively determined based on evidence.

Resumen El desarrollo de la biotecnología aplicada a los cultivos ha generado fuertes debates éticos y sociales sobre su uso. El presente estudio tuvo por objetivo revisar las evidencias epidemiológicas existentes relacionando el consumo de alimentos genéticamente modificados, en particular aquellos provenientes de cultivos con resistencia a algunos insectos plagas en los que se han introducido proteínas Cry aisladas de Bacillum thurigiensis con probables daños o trastornos en la salud de las personas. Se realizó una revisión en profundidad en el periodo 2007 a 2019, en bases de datos. Se excluyeron aquellos artículos que no hacían referencia a salud humana. Se obtuvieron 1 350 y finalmente se revisaron 118. La revisión permitió concluir que la mayoría de los estudios existentes se centran en información respecto a la composición química y ensayos in vitro o en laboratorio con animales. Igualmente, que el principio rector de equivalencia sustancial hoy utilizado en forma generalizada para la evaluación de potenciales efectos en salud, no debería sustituir la necesidad de una evaluación rigurosa de los productos incluyendo ensayos nutricionales, inmunológicos y toxicológicos. Por último se comprueba también que la evidencia epidemiológica incluida es insuficiente por lo que lo que no es posible concluir a partir de ella, sobre la inocuidad de estos alimentos.

Environmental health compromised by a new epidemic. The case of Uruguay, COVID-19 / La salud ambiental comprometida por una nueva epidemia. El caso de Uruguay, COVID-19

Abstract Uruguay is in South America. It has 3,286,314 inhabitants, 1.6% of which lacks comprehensive health insurance. Detected cases of COVID-19 represent 0.022% of the population, 2.6% of which has resulted in death. Mortality from COVID-19 is 0.6% per 100,000 inhabitants, and health workers represent 14% of detected cases. The country is slowly coming out of intensified social distancing. This article reports on accumulated, recovered, and active cases. The authors also frame the causes of this zoonosis in terms of an environmental health problem, and thus a global health problem, requiring a "one health" approach. Human activity has changed natural habitats as a result of extraction activities, increased urbanization, growing populations, different cultural practices, and socioeconomic conditions. This contributes to the emergence of zoonoses, particularly RNA viruses. If the cause of this phenomenon is not addressed, we will continue facing increasing challenges.

Resumen Uruguay se ubica en Sudamérica con una población de 3.286.314 habitantes. El 1,6% no tiene seguro integral de salud. Los casos detectados de COVID 19 representan el 0,022 % de la población. Las muertes con relación a los casos detectados representan el 2,6%. La mortalidad por COVID-19 es de 0,6 por cien mil habitantes. El 14 % de los detectados corresponden a personal de salud. Paulatinamente el país está saliendo del aislamiento social. En el artículo se muestran los casos acumulados, recuperados y activos. Los autores enmarcan las causas de esta zoonosis en un problema de Salud Ambiental y por lo tanto Global, dentro del enfoque "una sola salud". El hombre ha ocupado los suelos de forma extractiva, con urbanización creciente, creciente número de población, diferentes prácticas culturales y condiciones socio-económicas, que han modificado los hábitat naturales. Esto favorece la aparición de zoonosis emergentes y en particular virus con genoma RNA. Si no se atiende a la causalidad del fenómeno, seguiremos asistiendo a desafíos cada vez mayores.

[Monitoring the Paraguayan epidemiological dengue surveillance system (2009-2011) using Benford's law].

INTRODUCTION: Dengue is the most widespread arbovirus worldwide. In Paraguay, it reappeared in 1988-1989, with one of the largest epidemic outbreaks occurring in 2011. OBJECTIVE: To evaluate the performance of the dengue epidemiological surveillance system in Paraguay between 2009 and 2011. MATERIALS AND METHODS: We conducted an ecological study with secondary epidemiological surveillance data. We analyzed notified cases of the disease based on the distribution expected by Benford's law. To this end, we used the first and second digits from the global records stratified by region, season, population density, indicators of housing conditions and heads of cattle. RESULTS: The epidemiological surveillance system performed better during non-epidemic periods and in the states with better housing conditions and fewer heads of cattle. CONCLUSION: Given that a difference in the performance existed, we recommended that the system remains operating at the same high alert level even during periods when fewer cases are expected. The technology used by the method proposed to monitor the notification of cases is easy to transfer to operational staff.

Monitoring the Paraguayan epidemiological dengue surveillance system (2009-2011) using Benford's law

ABSTRACT Introducción. El dengue es la principal arbovirosis en el mundo. En Paraguay reapareció en 1988-1989, y en el 2011 se produjo uno de los mayores brotes epidémicos. Objetivo. Evaluar el desempeño del sistema de vigilancia epidemiológica del dengue en Paraguay entre 2009 y 2011. Materiales y métodos. Se hizo un estudio ecológico basado en datos secundarios de la vigilancia epidemiológica. Con base en la distribución esperada según la ley de Benford, se analizaron los casos notificados de la enfermedad; para tal fin, se usaron los primeros y segundos dígitos de los registros globales y estratificados por regiones, estaciones, densidad poblacional, indicadores de las condiciones de la vivienda y número de cabezas de ganado bovino. Resultados. El sistema de vigilancia epidemiológica se desempeñó mejor durante los periodos no epidémicos, y en los departamentos donde existen mejores condiciones de vivienda y pocas cabezas de ganado bovino. Conclusión. Dadas las diferencias de desempeño, se recomendó que el sistema mantenga la alerta incluso cuando no se espere un mayor número de casos. El método propuesto para evaluar la notificación de casos es fácil de transferir al personal operativo.

RESUMEN Introduction: Dengue is the most widespread arbovirus worldwide. In Paraguay, it reappeared in 1988-1989, with one of the largest epidemic outbreaks occurring in 2011. Objective: To evaluate the performance of the dengue epidemiological surveillance system in Paraguay between 2009 and 2011. Materials and methods: We conducted an ecological study with secondary epidemiological surveillance data. We analyzed notified cases of the disease based on the distribution expected by Benford's law. To this end, we used the first and second digits from the global records stratified by region, season, population density, indicators of housing conditions and heads of cattle. Results: The epidemiological surveillance system performed better during non-epidemic periods and in the states with better housing conditions and fewer heads of cattle. Conclusion: Given that a difference in the performance existed, we recommended that the system remains operating at the same high alert level even during periods when fewer cases are expected. The technology used by the method proposed to monitor the notification of cases is easy to transfer to operational staff.

Predictive model for chloroform during disinfection of water for consumption, city of Montevideo.

The objective of this study was to predict chloroform formation resulting from the process of disinfecting water, particularly trihalomethane which is most frequently produced. A statistical model was used which included repeated measurements of water parameters used for monitoring water quality at 51 sites covering the municipal water system of Montevideo. Samples were taken considering different seasons from June 2009 to July 2011 in Montevideo. Total samples (n = 330) were analytically studied using the headspace-gas chromatography method coupled with mass spectrometry. Chloroform was the dependent variable and the covariables were pH, temperature, free chlorine, and total chlorine. A Tobit analysis with an unstructured correlation matrix was performed, and a significant interaction was found between pH and free chlorine for the prediction of chloroform formation. We concluded that parameters for the continuous control of water quality for consumption can be used to predict the levels of chloroform that may be present. Given the large measurement to variability found in the repeated measurements, the use of averages that include more than one season is not recommended to determine the degree of compliance with acceptable levels established by norms.

[Identification of users using cluster analysis according to degree of satisfaction with geriatric care services]. / Identificação dos usuários segundo nível de satisfação nos módulos gerontológicos empregando a análise de conglomerados.

The aim of this study was to identify groups of users according to their degree of satisfaction with geriatric care services and determine the primary factors associated with satisfaction. This was a cross-sectional study of 181 people enrolled in 36 modules pertaining to the State Workers Social Security Institute (ISSSTE) in Mexico. Degree of satisfaction was measured according to the following three areas: general characteristics of services offered, friendliness of staff and infrastructure. A cluster analysis was performed to identify groups of users according to their level of satisfaction, and an ordinal logistic regression model was used to determine the associated factors. Fifty-three percent were satisfied with the services, 34.3% were fairly satisfied and 12.7% were dissatisfied. The main characteristics associated with a greater degree of satisfaction were being female, older and the head of household. The health system must address this growing population and ensure the development of quality care to meet their needs.

Identificação dos usuários segundo nível de satisfação nos módulos gerontológicos empregando a análise de conglomerados / Identification of users using cluster analysis according to degree of satisfaction with geriatric care services / Identificación de los pacientes según nivel de satisfacción en módulos gerontológicos empleando el análisis de conglomerados

Esta pesquisa teve como objetivos identificar os grupos de usuários segundo o grau de satisfação com a atenção recebida nos Módulos Gerontológicos e determinar os principais fatores associados. Trata-se de estudo transversal realizado com 181 usuários nos 36 módulos do Seguro Social dos Trabalhadores Públicos, no México. O nível de satisfação foi avaliado segundo três aspectos: características gerais da atenção recebida, amabilidade no trato e infraestrutura. Foi realizada uma análise de conglomerados para identificar grupos de usuários segundo o grau de satisfação e um modelo de regressão logística ordinal para identificar os fatores associados. Estiveram satisfeitos com o serviço 53% dos usuários; medianamente satisfeitos, 34,3%; e insatisfeitos, 12,7%. Os principais fatores associados com maior grau de satisfação foram: ser mulher, maior idade e ser chefe/a de família. O sistema de saúde deve dirigir sua atenção para esse grupo populacional que é crescente e incentivar o desenvolvimento de uma atenção de qualidade que contemple as suas necessidades.

The aim of this study was to identify groups of users according to their degree of satisfaction with geriatric care services and determine the primary factors associated with satisfaction. This was a cross-sectional study of 181 people enrolled in 36 modules pertaining to the State Workers Social Security Institute (ISSSTE) in Mexico. Degree of satisfaction was measured according to the following three areas: general characteristics of services offered, friendliness of staff and infrastructure. A cluster analysis was performed to identify groups of users according to their level of satisfaction, and an ordinal logistic regression model was used to determine the associated factors. Fifty-three percent were satisfied with the services, 34.3% were fairly satisfied and 12.7% were dissatisfied. The main characteristics associated with a greater degree of satisfaction were being female, older and the head of household. The health system must address this growing population and ensure the development of quality care to meet their needs.

Se objetivó identificar grupos de usuarios según grado de satisfacción con la atención recibida en Módulos Gerontológicos, y determinar los principales factores asociados. Estudio transversal, muestra de 181 pacientes de los 36 módulos del Seguro Social de Trabajadores Estatales, en México. El nivel de satisfacción fue evaluado bajo tres aspectos: características generales de la atención recibida; amabilidad en el trato e infraestructura. Se realizó análisis de conglomerados para identificar grupos de pacientes según grado de satisfacción y un modelo de regresión logística ordinal para identificar factores asociados. Resultaron satisfechos con el servicio 53% de los pacientes; medianamente satisfechos 34,3% e insatisfechos 12,7%. Los principales factores asociados a mayor grado de satisfacción fueron: ser mujer, mayor edad, ser jefe/a de familia. El sistema de salud debe dirigir su atención a este grupo poblacional creciente, e incentivar el desarrollo de una atención calificada que contemple sus necesidades.