Functional properties and sensory profile of coffee prepared by different brewing methods.

Coffee is one of the main sources of antioxidants in the diet of many countries. The purpose of this research was to assess the effect of different brewing methods, particle size, and coffee quality on the total phenolic content, antioxidant capacity (AC), and sensory profile of the beverage. The brewing methods yielded differences in taste with higher bitterness in immersion methods. However, the main factors that influenced coffee extraction and taste were particle size and coffee type. A finer particle size allowed for greater phenolic and caffeine (CA) extraction (2.82 mg GA/mL; 1.01 mg CA/mL), resulting in higher bitterness and astringency. Additionally, the type of coffee resulted in a higher CA content in commercial coffee (Specialty: 0.72 ± 0.10 mg CA/mL; Commercial: 1.13 ± 0.14 mg CA/mL). The results showed that using a ratio of 1:20 and 1:15 for commercial and specialty coffee, respectively, yielded differences in AC using the DPPH method (Specialty: 11.54 ± 1.12 µmol/mL; Commercial: 10.20 ± 1.88 µmol/mL) but not with the ABTS method (Specialty: 10.38 ± 1.23 µmol/mL; Commercial: 10.37 ± 1.13 µmol/mL). Similarly to the ABTS method, no differences in the total phenol content of the coffee cup were observed (Specialty: 2.52 ± 0.40 mg/mL; Commercial: 2.43 ± 0.28 mg/mL). Thus, the findings suggest that specialty coffee offers consumers a more balanced cup with less CA content. This allows for more coffee consumption without an excessive intake of CA. However, consumers can adjust the functionality, sensory profile, and CA content of a coffee cup by modifying the particle size and the brewing method used.

Comparison of the Chemical Composition of Six Canihua (Chenopodium pallidicaule) Cultivars Associated with Growth Habits and after Dehulling.

The canihua (Chenopodium pallidicaule) is a native Andean crop that stands out for its high content of protein, fiber, and minerals and that has a good fatty acid profile. We studied six canihuas cultivars, which were compared according to their proximate, mineral, and fatty acid composition. Based on the form of stems, termed growth habit, they belonged to two groups: decumbent (Lasta Rosada, Illimani, Kullaca, and Cañawiri) and ascending (Saigua L24 and Saigua L25). Dehulling is an important process applied to this grain. However, there is no information about how it affects the chemical composition of the canihua. Dehulling resulted in two levels, whole and dehulled canihua. The highest protein and ash contents were in whole Saigua L25 (19.6 and 5.12 g/100 g, respectively), and the highest fat content was found in dehulled Saigua L25, while the whole grains of Saigua L24 presented the highest fiber content (12.5 g/100 g). Dehulling mainly affected the macro-minerals content, while micro-minerals were only slightly linked to the dehulling. The growth habit influenced the C18:1 and C18:3 contents. In conclusion, the canihua had a nutritional composition influenced by each variety, strongly influenced by dehulling, and to a lesser extent by growth habit.

Situación epidemiológica por Covid-19 en Bolivia ante el fin de la emergencia sanitaria internacional

En mayo 2023, la OMS levanta la declaratoria de emergencia sanitaria internacional por Covid-19, pero Bolivia continúa manteniendo la declaratoria de emergencia sanitaria nacional. Objetivo: describir la situación epidemiológica por Covid-19 en Bolivia en comparación a los países sudamericanos. Metodología: Estudio observacional de tipo ecológico; con datos agregados a nivel departamental y nacional, provenientes de los reportes del Ministerio de Salud de Bolivia y la OMS. Se reportan frecuencias absolutas, porcentajes y tasas de incidencia, mortalidad, letalidad y las coberturas de vacunación, desagregadas por países, departamentos. Resultados: A nivel sudamericano, Bolivia ocupa el 6to lugar en el número de casos confirmados (n=1,198,404); 7mo en número de fallecidos (n=22,383), 5to en letalidad (1,9%), y penúltimo en cobertura de vacunación (52,08%). En Bolivia; se observa una tendencia decreciente de casos entre la primera (n=144,592) y 6ta ola (n=88,859); Santa Cruz reportó más casos (n=4037.908) y Pando el más bajo (n=15,081). La tasa de incidencia fue más alta en Tarija y más baja en Potosí. La tasa de Letalidad fue mayor en la primera ola (6,20%) y más baja en la sexta ola (0,20%). La cobertura de vacunación con al menos una dosis fue mayor en Tarija (75,10%), y la más bajas en Beni (57,10%). Conclusión: Bolivia presenta un descenso significativo en el número total de casos nuevos reportados, con disminución de la tasa de mortalidad y letalidad; sin embargo, las coberturas de vacunación en esquema completo y dosis de refuerzo siguen siendo una de las más bajas a nivel sudamericano.

In May 2023, the WHO lifts the declaration of an international health emergency due to Covid-19, but Bolivia continues to maintain the declaration of a national health emergency. Objective: describe the epidemiological situation by Covid-19 in Bolivia compared to South American countries. Methodology: Observational study of ecological type was conducted; with aggregated data at the departmental and national level, from the reports of the Bolivian Ministry of Health and the WHO. Absolute frequencies, percentages, and rates of incidence, mortality, lethality, and vaccination coverage are reported, broken down by country and department. Results: In the South American context, Bolivia ranks 6th in the number of cumulative confirmed cases (n=1,198,404); 7th in the number of deaths (n=22,383), 5th in lethality (1.9%), and 9th in vaccination coverage (52.08%) from ten countries. A decreasing trend is observed in Bolivia, between the first epidemic wave (n=144,592) to the 6th wave (n=88,859); Santa Cruz reported the most cases (n=4037,908) and Pando the lowest (n=15,081). The incidence rate was highest in Tarija and lowest in Potosí. The fatality rate was higher in the first wave (6.20%) and lower in the sixth wave (0.20%). Vaccination coverage with at least one dose was higher in Tarija (75.10%), and the lowest in Beni (57.10%). Conclusion: Bolivia presents a significant decrease in the total number of new cases reported, with a decrease in the mortality and lethality rate; however, full-schedule vaccination coverage and booster doses continue to be one of the lowest in South America.

Evaluation of roasting and storage conditions as a strategy to improve the sensory characteristics and shelf life of coffee.

Coffee is one of the most consumed products worldwide. Among the varieties of this product, specialty coffee is a type of coffee that has been growing in the world market. This paper aims to assess the effects that the conditions derived from coffee roasting at different altitude levels have on the quality of the product. It was discovered that processing coffee at a higher altitude level yielded a smaller increase in bitterness. This led to a better Specialty Coffee Association (SCA) score in cupping and, consequently, to better preservation of the coffee quality. The storage time affected the aroma by associating roaster aromas with older coffees. Although the assessed origins had the same NIR spectra, differences in peak intensity lead to variations in the flavor and aroma of the coffee. Furthermore, although green beans prolong quality allowing a SCA score of 84.73 ± 2.81 after 4 months of storage, roasted coffee at higher altitudes could also maintain the quality between production and consumption (SCA score of 80.22 ± 0.91 after 2 months). Finally, this research found that the instrumental equipment helped to find minor changes in the sensorial profile, and with these changes correlated with the sensorial panel, the best conditions to preserve coffee quality were found.

A simple parasitological technique to increase detection of Strongyloides stercoralis in Bolivian primary health care system.

BACKGROUND: Strongyloides stercoralis is widespread; however, there is limited information on its prevalence owing to laboratory underestimation and low clinical manifestations. The Baermann method and agar culture stand out among the parasitological techniques. Strongyloides stercoralis is present in Bolivia, but its prevalence in children remains unknown. The objective of this study was to estimate the applicability of simple parasitological techniques to increase the detection of this parasite in children living in the tropics. METHODS: This cross-sectional study was conducted in a tropical village in Cochabamba, Bolivia. Participants were 304 children aged 5 - 12 years who provided stool samples for different parasitological analyses (direct examination, Ritchie, Baermann, and Dancescu techniques), and their parents provided informed consent. RESULTS: Up to 64.8% of pathogenic parasites were detected using the modified Ritchie method. The Baermann technique identified 17.8% of Strongyloides stercoralis cases, and a high sensitivity with respect to the Baermann technique was only for the Dancescu technique (75.9%) that is also specific for Strongyloides stercoralis, followed by 66.7% for the modified Ritchie technique, which is used in second-line care. DISCUSSION: The Baermann technique is the best parasitological option for improving Strongyloides stercoralis diagnosis in the first-line care of the Primary Health Care System. A particular cycle of reinfection, combined with the environment and some other risk factors are related with persistence. Control is difficult without a proper diagnosis, and the Baermann technique is an approach to the solution. We conclude that with a high suspicion of the presence of Strongyloides stercoralis, the use of the Baermann technique is strongly recommended as support for direct examination in primary health care systems especially in tropical areas.

Hongos formadores de micorrizas aislados a partir de raíces de la orquídea Rodriguezia granadensis (LINDL.) RCHB. F / Mycorrhizal forming fungi isolated from roots of the orchid Rodriguezia granadensis (LINDL.) RCHB. F

RESUMEN Rodriguezia granadensis (Lindl.) Rchb. f. es una orquídea epífita que crece sobre árboles, en zonas poco intervenidas. Para la germinación de sus semillas y en los estadios iniciales de su desarrollo forma relaciones simbióticas con hongos micorrícicos, los cuales, brindan los nutrientes que necesita. En el municipio de Fusagasugá esta especie crece en condiciones naturales y debido a la belleza de sus flores es promisoria para su producción comercial, pero hay poca información sobre los microorganismos asociados a esta planta; por lo tanto, el presente trabajo tuvo como propósito identificar, a nivel de género, los hongos asociados a las raíces de R. granadensis, en el agroecosistema Hacienda Betania. Se tomaron muestras de raíz, anotando el forofito donde se encontraban las plantas. En laboratorio, se dividieron en tres extremos: proximal, medio y distal y se realizaron cortes transversales, para identificar enrollamientos hifales. Adicionalmente, se sembraron explantes en agar papa dextrosa, agar Sabouraud y medio de Ko y Hora. Se identificó al género Rhizoctonia, con una frecuencia del 95 %. Se encontró que el 70 % de las plantas muestreadas crecían sobre árboles de guayabo y el 30 % sobre cítricos. Los resultados indican que R. granadensis pueden tener interacciones con hongos del género Rhizoctonia.

ABSTRACT Rodriguezia granadensis (Lindl.) Rchb. f. is an epiphytic orchid that grows on trees in areas with little intervention. For seed germination and the initial stages of development, it forms symbiotic relationships with mycorrhizal fungi, which provide the necessary nutrients. In the municipality of Fusagasugá, this species grows in natural conditions and, due to the beauty of its flowers is a promissory specie to commercial production, but there is little information about the microorganisms associated with this plant; therefore, the purpose of this work was to identify, at the genus level, the fungi associated with the roots of R. granadensis in Betania farm. Root samples were taken, noting the phorophyte where the plants grew. In the laboratory, they were divided into three sections: proximal, middle, and distal, and made cross-sections to identify hyphal curls. Additionally, explants were put in potato dextrose agar, Sabouraud agar, and Ko and Hora media. The genus Rhizoctonia was identified, with a frequency of 95 %. It was found that 70 % of the sampled plants grew on guava trees and 30 % on citrus. The results indicate that R. granadensis may have interactions with fungi of Rhizoctonia genus.

Adipose tissue as a source of growth factors to promote wound healing: a human study of skin graft donor sites.

OBJECTIVE: In the microenvironment of wound sites, naturally occurring growth factors are crucial for cell migration, opsonisation, chemotaxis, differentiation and angiogenesis. Exogenous growth factors, such as platelet-rich plasma (PRP) and adipose tissue, also improve healing. METHOD: In the present within-subject study, we described the effects of PRP and adipose tissue extract (ATE) on skin graft donor site wound healing in patients requiring split-thickness skin grafts. Each patient, having at least two donor sites, received both control (no growth factor) and experimental (PRP or ATE) treatments. Wounds were evaluated on days 5, 7, 10, 15, 30 and 60. Digital photography and spectral images were used to analyse haemoglobin and melanin content, and re-epithelialisation area. Pain was assessed by visual analogue scale. Scar characteristics were scored on days 30 and 60. Biomaterial samples were analysed for growth factor and protein content. RESULTS: The study included 24 patients (18 male and six female; mean age: 59.1 years). PRP was topically applied to wounds in 11 patients (13 donor sites) and ATE in 13 patients (15 sites). ATE-treated donor sites exhibited significantly accelerated wound re-epithelialisation on days 5 and 7 compared with control sites (p=0.003 and 0.04, respectively). PRP accelerated healing on day 7 compared with control sites (p=0.001). Additionally, the application of ATE improved scar quality on days 30 and 60 (p=0.0005 and 0.02, respectively). Pain scores did not differ significantly between treatments. CONCLUSION: In this study, both growth factor sources stimulated wound healing. ATE is an alternative source of growth factors that promote early wound healing and improve scar quality.

Significados e interpretaciones del trabajo infantil en contexto rural y urbano / Meanings and interpretations of child labor in rural and urban contexts / Significados e interpretações do trabalho infantil em contextos rurais e urbanos

Resumen (analítico) El artículo propicia la comprensión del problema del trabajo infantil rural y urbano desde perspectiva interpretativa, a partir de los significados y las conceptualizaciones de las acciones de la práctica del trabajo, propias de niños y niñas en una zona rural del municipio de Tello y en la ciudad de Neiva en el departamento del Huila, Colombia. El enfoque metodológico empleado es una aproximación a la teoría fundamentada, configurada a partir de tres substanciales categorías: el capital social, el reconocimiento y el enfoque de capacidades. Se producen hallazgos respecto a la diferenciación sobre la lectura que los niños y niñas construyen sobre el significado de trabajo infantil remunerado, doméstico y relacionado con la dinámica y los vínculos que se tejen en el hogar y el entorno escuela.

Abstract (analytical) The paper seeks to understand the problem of rural and urban child labor using an interpretive perspective based on the meanings and conceptualizations of child labour in in the rural municipality of Tello and the city of Neiva, both located in the department of Huila, Colombia. The methodological approach used is an approximation of grounded theory that is configured with three categories: social capital; recognition; and the capabilities approach. The authors identify differentiations in the meanings constructed by children regarding the meaning of paid child labor, domestic work and the dynamics and links that form part of their home and school environments.

Resumo (analítico) Este artigo promove a compreensão da problemática do trabalho infantil rural e urbano em uma perspectiva interpretativa, a partir dos significados e conceituações das ações da prática laboral, típicas de meninos e meninas de uma zona rural do município de Tello e na cidade de Neiva no departamento de Huila, Colômbia. A abordagem metodológica empregada é uma aproximação à teoria fundamentada, configurada a partir de três categorias substanciais: capital social, reconhecimento e abordagem das capacidades. São produzidos resultados sobre a diferenciação na leitura que meninos e meninas constroem sobre o significado de trabalho infantil remunerado, trabalho doméstico e em relação às dinâmicas e vínculos que se tecem no ambiente doméstico e escolar.

A case of pemphigus herpetiformis with excellent response to mycophenolate mofetil.

Pemphigus herpetiformis (PH) is a rare and unique clinical form of pemphigus foliaceus and pemphigus vulgaris. Patients show autoantibodies against desmoglein 1 and less frequently against desmoglein 3 and desmocollins. We report a 24-year-old woman with a 3-year history of recurrent intensely pruritic erythematous papules and annular plaques localized on the trunk and extremities. In recent months she developed small vesicles around the annular lesions. The histological features showed eosinophilic spongiosis, and direct immunofluorescence demonstrated typical staining of the epidermal intercellular spaces characteristic for pemphigus. There was no mucosal involvement, and hence a diagnosis of PH was established. This patient was unresponsive to dapsone and methotrexate, but she finally experienced remission with prednisone and mycophenolate mofetil.

Geographic differences in the distribution of parasitic infections in children of Bolivia.

BACKGROUND: A high percentage of the population in Latin America lives with intestinal parasitic infections, a neglected tropical disease frequently not treated. Intestinal parasitism is associated with other disorders, but information about the epidemiological situation in countries like Bolivia is scarce. Environmental conditions play a role in the prevalence of certain parasites. The main objective was to know the current situation of parasitic infections among children under 12 years old from different geographical areas of Cochabamba - Bolivia. METHODS: We analysed the laboratory reports of four second-line hospitals in different areas and the Tertiary Care Hospital. Results of stool examinations performed between 2011 and 2015 in children under 12 years of age were collected. RESULTS: We gathered the results of 23,221 examinations. The 89% of children were less than five years old. Pathogenic parasites were found in 31%. Entamoeba histolytica and Giardia lamblia were the two most prevalent parasites in all areas. Helminths were 19% of positive samples and Ascaris lumbricoides was the most prevalent. Parasitic infections are more frequent in tropical areas where helminths are highly concentrated. Pre-school age children (OR: 5.296; 95% CI: 4.81-5.83) and semi-tropical area (OR: 3.26; 95% CI: 2.90-3.66) were strongly associated to the presence of pathogenic parasites. CONCLUSIONS: Parasitic infections in children are still very prevalent in Bolivia. Protozoan infections are a major problem, while the prevalence of helminths seems to be decreasing. The most vulnerable population is still concentrated in semi-tropical and tropical areas, where the risk of parasitic infection is probably increased due to poor environmental conditions. Our results could allow reconsideration of more effective parasitic disease control policies, taking into account regional characteristics.

Diferencias de género en la interacción entre consumo de tabaco y alcohol con la presión arterial elevada / Gender differences in the interaction between tobacco and alcohol consumption with raised blood pressure

OBJETIVO: analizar las diferencias de género en la interacción entre consumo de tabaco y alcohol con la presión arterial elevada (PAE) en Cochabamba, Bolivia. MÉTODOS: estudio transversal, con n=10704 participantes, seleccionados aleatoriamente. Se calcularon proporciones, Odds-ratios y análisis robusto de descomposición Blinder-Oaxaca. RESULTADOS: 33,5% reportó que solo bebe, 1,8% solo fuma y 9,2% ambos. La probabilidad de presentar PAE fueron mayores en aquellos que fuman (OR:2,04); beben y fuman (OR:1,73) o solo beben (OR:1,43). Los hombres presentaron prevalencias más elevadas de PAE, tabaquismo y consumo nocivo de alcohol; pero las mujeres que fuman presentaron niveles de OR más altos para el desarrollo de PAE. El nivel educativo, la edad, y el tipo de trabajo contribuyeron de manera positiva a explicar la brecha entre hombres y mujeres. CONCLUSIÓN: la probabilidad de presentar PAE fue mayor en mujeres, especialmente en aquellas que fuman, a pesar de su baja prevalencia.

OBJECTIVE: to analyze gender differences in the interaction between tobacco and alcohol consumption with high blood pressure (HBP) in Cochabamba, Bolivia. METHODS: a cross-sectional study was conducted, with n=10704 participants, randomly selected. Proportions, Odds-ratios and robust analysis of Blinder-Oaxaca decomposition were calculated. RESULTS. 33.5% of participants only drink alcohol, 1.8% only smoke and 9.2% both simultaneously. The probability of presenting HBP was higher in smokers (OR: 2.04); those who consume both simultaneously (OR: 1.73) or only drink alcohol (OR: 1.43). The men had a higher prevalence of HBP, smoking and harmful alcohol consumption; but women who smoke had higher OR levels to develop HBP. The differences in educational level, age, and type of work contributed positively to explain the gap between men and women. CONCLUSION: the probability of presenting HBP was higher in women, especially those who smoke, despite their low prevalence.

Desigualdades étnicas y de género en la prevalencia de presión arterial elevada en población general de Cochabamba: un análisis interseccional de inequidades en salud / Ethnic and gender inequalities in the prevalence of elevated blood pressure in the general population of Cochabamba: an intersectional analysis of health inequities

Las desigualdades en salud comúnmente son evaluadas en una sola dimensión de análisis y poco se conoce sobre el efecto sumativo o multiplicativo cuando se combinan 2 o más dimensiones sociales; representando un desafío para la prevención y control de la Presión Arterial Elevada (PAE). OBJETIVO: analizar los factores involucrados en las desigualdades poblacionales de la prevalencia de PAE en el espacio inter seccional de los procesos de ventaja y desventaja social por referencia étnica y de género. MÉTODOS: estudio observacional, de corte transversal con enfoque interseccional. Participaron sujetos mayores de 18 años con residencia permanente en Cochabamba (n=10595), seleccionados mediante muestreo aleatorio trietápico. Se utilizó la encuesta WHO-STEPS para recopilar información sobre PAE y factores de riesgo asociados. Se construyeron cuatro posiciones interseccionales por la combinación de género y etnicidad. La descomposición de Oaxaca-Blinder se aplicó para estimar las contribuciones de los factores explicativos de las desigualdades. RESULTADOS: la prevalencia de PAE fue mayor en los hombres-mestizos (10,76%); la disparidad por referencia de género fue más importante entre mestizos (3,74%) e indígenas (3,11%); la disparidad interseccional entre grupos extremos (3,53%) fue mayor a la disparidad entre grupos medios (3,32%). La edad, el tipo de trabajo y estilos de vida, contribuyeron más para explicar estas diferencias. CONCLUSIONES: la PAE no se distribuye según los patrones esperados de desventaja social en el espacio interseccional de etnicidad y género. Una alta ventaja social se relacionó con prevalencias más altas de PAE, así como los factores de riesgo de comportamiento asociados.

Health inequalities are commonly evaluated in a single dimension of analysis and little is known about the summative or multiplicative effect when 2 or more social dimensions are combined; representing a challenge for the prevention and control of High Blood Pressure (HBP). OBJECTIVE: analyze the factors involved in the inequalities of the prevalence of HBP in the inter-sectional space of the processes of social advantage and disadvantage by ethnic and gender reference. METHODS: observational, cross-sectional study with an intersectional approach. Subjects over 18 years of age with permanent residence in Cochabamba (n = 10,595), selected by means of three-stage random sampling, participated. The WHO-STEPS survey was used to collect information on HBP and the risk factors associated. Four intersectional positions were constructed by the combination of gender and ethnicity. The Oaxaca-Blinder decomposition was applied to estimate the contributions of the explanatory factors of the inequalities. RESULTS: the prevalence of HBP was higher in mestizos men (10.76%); the disparity by gender reference was more important between mestizos (3.74%) and indigenous people (3.11%); the intersectional disparity between extreme groups (3.53%) was greater than the disparity between middle groups (3.32%). Age, type of work, and lifestyles contributed more to explain these differences. CONCLUSIONS: the HBP is not distributed according to the expected patterns of social disadvantage in the intersectional space of ethnicity and gender. A high social advantage was related to higher prevalence of HBP, as well as associated behavioral risk factors.

Factores sociodemográficos asociados a la malnutrición del adulto mayor en Cochabamba, Bolivia / Sociodemographic factors associated with malnutrition in elderly people from Cochabamba, Bolivia

OBJETIVO: analizar los patrones sociodemográficos de la malnutrición del adulto mayor en el departamento de Cochabamba, Bolivia. MÉTODOS: se realizó un estudio observacional, de corte transversal, con sujetos mayores de 60 años con residencia permanente en Cochabamba. Ingresaron al estudio n=7985 adultos mayores, seleccionadas de manera aleatoria en 44 de 47 municipios del departamento, utilizando la metodología del mini examen nutricional para el adulto mayor sugerido por la OMS/OPS. Se recolectó información sobre factores sociodemográficos y antropométricos. Se calcularon proporciones e intervalos de confianza al 95%, se utilizó la regresión logística bivariado y multivariado para la obtención del Odds Ratio crudos y ajustados. RESULTADOS: el promedio de edad fue de 70,71±7,70 años y el 55,7% fueron mujeres. La prevalencia de desnutrición fue del 16,0%, 18,9% de sobrepeso y 20,7% de obesidad. Una mayor probabilidad de presentar desnutrición se asoció de manera significativa con el sexo femenino, los indígenas, aquellos sin seguro de salud y con los que residen en la zona andina. Por otro lado, se reporta una mayor probabilidad de presentar obesidad en mujeres, de 60 a 79 años, y con residencia en el área metropolitana o el trópico de Cochabamba. CONCLUSIÓN: la prevalencia de sobrepeso y obesidad es mayor que la prevalencia de desnutrición en los adultos mayores de Cochabamba; y los factores sociodemográficos afectan de manera diferente el riesgo de presentar desnutrición, por un lado y sobrepeso u obesidad por el otro. AU)

OBJECTIVE: to analyze the sociodemographic patterns of malnutrition in the elderly from Cochabamba, Bolivia. METHODS: a crosssectional study was conducted with elderly people over 60 years of age, and permanent residence in Cochabamba. n=7950 participants were randomly selected in 44 of 47 municipalities from Cochabamba department, using the Mini Nutritional Assessment MNA. The sociodemographic and anthropometric information were collected. Proportions and 95% confidence intervals were calculated, bivariate and multivariate logistic regression were used to calculate crude and adjusted odds ratios. RESULTS: the age average was 70.71 ± 7.70 years and 55.7% were women. The prevalence of underweight was 16.0%, 18.9% of overweight and 20.7% of obesity. A higher probability to present underweight was significantly associated with the female sex, the indigenous, those without health insurance and with residence in the Andean region. On the other hand, there is a higher probability of present obesity in women, 60 to 79 years old, and with residence in the metropolitan or tropic regions from Cochabamba. CONCLUSION: the prevalence of overweight and obesity is higher than underweight in the elderly population from Cochabamba; and sociodemographic factors affect differently the risk of underweight, on the one hand, and overweight or obesity on the other.(AU)

Desigualdades en la epidemiología nutricional infantil en Cochabamba: a diez años del programa multisectorial desnutrición cero / Inequalities in children's nutritional epidemiology from Cochabamba: ten years after of multisectoral zero malnutrition program implementation

A diez años de la promulgación del Programa Desnutrición Cero, y más de un quinquenio de la implementación de las Unidades de Nutrición Integral (UNI), no se cuenta con información epidemiológica local acerca de su repercusión a nivel poblacional. OBJETIVO: analizar las desigualdades en las prevalencias de los factores de riesgo asociados a la desnutrición infantil en municipios con y sin UNI del departamento de Cochabamba. METODOLOGÍA: se realizó un estudio ecológico de corte transversal con datos agregados por municipio, utilizando la información recabada por el estudio departamental sobre Factores de Riesgo Asociados a Malnutrición Infantil en Cochabamba (FRAMIC). Las unidades de análisis fueron los municipios con y sin UNI de Cochabamba. Se calcularon promedios de las prevalencias municipales por grupo de estudio, acompañadas de desviaciones estándar y prueba de T de student para las diferencias estadísticas. Para el análisis de desigualdades se utilizó el índice de concentración de las prevalencias acumuladas por grupo de estudio. RESULTADOS: la prevalencia de lactancia materna exclusiva fue más alta en los municipios con UNI (75%). El inicio adecuado de alimentación complementaria y la cobertura de entrega de Nutribebé fue mayor en los municipios con UNI (76% y 83%). No se encontraron diferencias estadísticamente significativas en el uso adecuado del Nutribebe y chispitas nutricionales entre municipios con y sin UNI. La reducción de la prevalencia de desnutrición crónica fue mayor en municipios con UNI. CONCLUSIÓN: no existen diferencias estadísticamente significativas en las prevalencias de desnutrición infantil entre los municipios con y sin UNI, smostrando que la presencia de las UNI's contribuyó a disminuir la brecha de desigualdad en la prevalencia de desnutrición crónica entre los grupos poblacionales estudiados.(AU)

Ten years after of the promulgation of Multi sectorial Zero Malnutrition Program, and more than a five-year of the Integral Nutrition Units (UNI) implementation, there is no local epidemiological information about its impact at the population level. OBJECTIVE: to analyze the inequalities in the prevalence of the risk factors associated with child malnutrition in municipalities with and without UNI from Cochabamba. METHODOLOGY: an ecological cross-sectional study with aggregated data by municipality was conducted, using the information collected by the departmental study on Risk Factors Associated with Child Malnutrition in Cochabamba (FRAMIC). The municipalities with and without UNI from Cochabamba were the analysis units. Prevalence averages of the municipal level were calculated by the study group, accompanied by standard deviations and student's T-test for statistical differences. For the analysis of inequalities, the concentration index of the accumulated prevalence per study group was used. RESULTS: the prevalence of exclusive breastfeeding was higher in municipalities with UNI (75%). The adequate complementary feeding and Nutribebe delivery coverage were higher in municipalities with UNI (76% and 83%). No statistically significant differences were found in the use of Nutribebe and iron supplement between municipalities with and without UNI. The reduction in the prevalence of chronic malnutrition was higher in municipalities with UNI. CONCLUSION: there are no statistically significant differences in the prevalence of child malnutrition among municipalities with and without UNI; showing that the presence of the UNI contributed to reducing the inequality gap in the prevalence of chronic malnutrition among the study groups.(AU)

Underpinnings of entangled ethnical and gender inequalities in obesity in Cochabamba-Bolivia: an intersectional approach.

BACKGROUND: Social inequalities in obesity have been observed not only by gender but also between ethnic groups. Evidence on combined dimensions of inequality in health, and specifically including indigenous populations, is however scarce, and presents a particularly daunting challenge for successful prevention and control of obesity in Bolivia, as well as worldwide. OBJECTIVE: The aims of this study were i) to examine intersectional inequalities in obesity and ii) to identify the factors underlying the observed intersectional inequalities. METHODS: An intersectional approach study was employed, using the information collected in a cross-sectional community-based survey. The sample consisted of youth and adults with permanent residence in Cochabamba department (N = 5758), selected through a multistage sampling technique. An adapted version of the WHO-STEPS survey was used to collect information about Abdominal obesity and risk factors associated. Four intersectional positions were constructed from gender (woman vs. men) and ethnic group (indigenous vs. mestizo). Joint and excess intersectional disparities in obesity were estimated as absolute prevalence differences between binary groups, using binomial regression models. The Oaxaca-Blinder decomposition was applied to estimate the contributions of explanatory factors underlying the observed intersectional disparities, using Oaxaca command in Stata software v15.1. RESULTS: The prevalence of abdominal obesity had a higher prevalence in mestizos (men 35.01% and women 30.71%) as compared to indigenous (men 25.38% and women 27.75%). The joint disparity was estimated at 7.26 percentage points higher prevalence in the doubly advantaged mestizo men than in the doubly disadvantaged indigenous women. The gender referent disparity showed that mestizo-women had a higher prevalence than indigenous-women. The ethnic referent disparity showed that mestizo-men had a higher prevalence than indigenous men. The behavioural risk factors were the most important to explain the observed inequalities, while differences in socioeconomic and demographic factors played a less important role. CONCLUSION: Our study illustrates that abdominal obesity is not distributed according to expected patterns of structural disadvantage in the intersectional space of ethnicity and gender in Bolivia. In the Cochabamba case, a high social advantage was related to higher rates of abdominal obesity, as well as the behavioural risk factors associated with them.

Malnutrición infantil en Cochabamba, Bolivia: la doble carga entre la desnutrición y obesidad / Infant Malnutrition in Cochabamba, Bolivia: the double burden between underweight and obesity

La presencia concomitante de talla baja y obesidad, conocida como la doble carga de la malnutrición infantil, es observada con mayor frecuencia en países de bajos y medios ingresos económicos como el nuestro. OBJETIVO: analizar la prevalencia de la desnutrición y obesidad infantil en Cochabamba, Bolivia. MÉTODOS: se realizó un estudio observacional de corte transversal, con una muestra de n=4885 niños menores de 5 años, estratificada para las 5 macrorregiones de Cochabamba, aplicando el Sistema de Vigilancia Nutricional Comunitario. Las mediciones antropométricas se ingresaron al Software WHO-Anthro v3.1.0, para el cálculo de Z-score y su categorización. Se presentan proporciones e IC-95%; Chi2 para la asociación entre variables categóricas, correlación de Pearson para la interacción entre variables cuantitativas y regresión logística multivariada para el cálculo de Odds Ratio (OR) ajustados. RESULTADOS: encontramos una prevalencia de 22,1% para DNT-Crónica; 6,0% para DNT-Global; 6,1% para DNT-Aguda; 16,4% de probable retraso de crecimiento del perímetro cefálico y 10,8% con reserva energética inadecuada. La prevalencia de sobrepeso y obesidad fue del 16,5% para el indicador peso/talla; 17,6% según el IMC/edad y 10,8% para el PMB/Edad. El 66,03% de los niños con talla baja presentaban sobrepeso u obesidad. La prevalencia de desnutrición y obesidad fue mayor en la región andina, el grupo etario más afectado por la obesidad fueron los niños de 1 a 3 años. CONCLUSIÓN: existe una asociación estadísticamente significativa entre la talla baja y la presencia de obesidad; esta doble carga de malnutrición infantil fue más prevalente en la región andina.

A concomitant presence of chronically malnourished (stunted) and obesity, is known as the double burden of childhood malnutrition, is observed more frequently in low and middle-income countries. OBJECTIVE: to analyze the prevalence of underweight and childhood obesity in Cochabamba, Bolivia. METHODS: a cross-sectional study was conducted, with a sample of n=4885 children under 5 years, stratified for the 5 macro regions from Cochabamba, applying the Community Nutritional Surveillance System. The anthropometric measurements were entered into the WHO-Anthro Software v3.1.0, to calculate the Z-score and its nutritional status categorization. Proportions and IC-95% are presented; Chi2 to associations between categorical variables, Pearson correlation for the interaction between quantitative variables, and multivariate logistic regression for adjusted Odds Ratio (OR). RESULTS: we found a prevalence of 22,1% for estunted; 6,0% for global underweight; 6,1% for acute underweight; 16,4% probable delay of growth of the cephalic perimeter and 10,8% with inadequate energy reserve. The prevalence of overweight and obesity was 16,5% for the weight/height indicator; 17,6% according to the BMI/age and 10.8% for the MUAC/age. 66,03% of stunted children were overweight or obese. The prevalence of underweight and obesity was higher in the Andean region, the age group most affected by obesity were children from 1 to 3 years. CONCLUSION: there is a statistically significant association between stunted and obesity; this double burden of child malnutrition was more prevalent in the Andean region.

Caracterización del perfil epidemiológico del síndrome metabólico y factores de riesgo asociados. Cochabamba, Bolivia / Characterization of the epidemiological profile of the metabolic syndrome and associated risk factors. Cochabamba, Bolivia

La evaluación del perfil epidemiológico del Síndrome Metabólico en población general usando la metodología WHO-STEPS de la Organización Mundial de la Salud es incipiente o nula en muchos países Latino Americanos. OBJETIVO: caracterizar el perfil epidemiológico del Síndrome Metabólico y sus factores de riesgo asociados en población general mayor de 18 años en la ciudad de Cochabamba, Bolivia, durante la gestión II-2016. MÉTODOS: se realizó un estudio observacional, analítico de corte transversal, en población general de 18 o más años, con una muestra de n=186 sujetos ajustados por grupo etario y sexo en base a la pirámide poblacional de Cochabamba-Bolivia. Se aplicó la metodología STEPS (pasos) de la OPS/OMS para la recolección de la información centrada en datos sociodemográficos, hábitos de vida, evaluación física y laboratorial. Se calcularon proporciones e intervalos de confianza al 95% conforme lo establecido en el manual de implementación de la metodología STEP; y regresión logística multivariada para la obtención del OR ajustado para el nivel de riesgo asociados al Síndrome Metabólico. RESULTADOS: la prevalencia global de Síndrome metabólico fue de 44,1%; la prevalencia de sus factores de riesgo asociados fue: STEP-1, Tabaquismo 11,29%; consumo actual de alcohol 63,44%; bajo consumo de frutas y vegetales 76,88%; sedentarismo o bajo nivel de actividad física 75,81%. STEP-2: sobrepeso 44,62%; obesidad 24,73%; obesidad abdominal 38,7% y presión arterial elevada en 35,14%. STEP3: Glicemia alterada en ayunas 36,02%; Insulina basal alterada 36,56%; colesterol total elevado 36,02%; Triglicéridos elevados 46,77% y HDL-colesterol reducido en el 66,67%. Los niveles de OR ajustado fueron >1 y estadísticamente significativas para las medidas físicas y laboratoriales. CONCLUSIÓN: el síndrome metabólico en altamente prevalente en la población general de la ciudad de Cochabamba y se asocia a niveles elevados de IMC, presión arterial elevada y perfil laboratorial alterado.

The epidemiological profile evaluation of Metabolic Syndrome in the general population using the WHO-STEPS approach of the World Health Organization is incipient or null in many Latin American countries. OBJECTIVE: to characterize the epidemiological profile of Metabolic Syndrome and risk factors associated in the general population over 18 years of age in Cercado-Cochabamba city, from Bolivia, during the second semester of 2016. METHODS: an observational, analytical, cross-sectional study was conducted in the general population of 18 years of age or older, with a sample of n = 186 subjects adjusted by age group and sex based on the population pyramid of Cochabamba-Bolivia. WHO-STEPS approach was applied for the collection of information focused on sociodemographic data, life habits, physical and laboratory evaluation. Proportions and 95% confidence intervals were calculated as established in the STEP ́ implementation manual, and multivariate logistic regression was calculated to obtain adjusted OR for the level of risk associated with Metabolic Syndrome. RESULTS: the overall prevalence of metabolic syndrome was 44.1%; the prevalence of risk factors associated were: STEP-1, Smoking 11.29%; current alcohol consumption 63.44%; low consumption of fruits and vegetables 76.88%; sedentary lifestyle or low level of physical activity 75.81%. STEP-2: overweight 44.62%; obesity 24.73%; abdominal obesity 38.7% and high blood pressure 35.14%. STEP3: Hyperglycemia in 36.02%; basal insulin elevated 36.56%; total cholesterol 36.02%; Triglycerides elevated 46.77% and HDL-cholesterol reduced in 66.67%. CONCLUSION: metabolic syndrome is highly prevalent in the general population in Cochabamba City and is associated with high levels of BMI, high blood pressure high values of the laboratorial profile.

Factores de riesgo asociados al síndrome metabólico en conductores del transporte público en Cochabamba Bolivia / Risk factors associated with Metabolic Syndrome in car drivers of the public transport from Cochabamba Bolivia

Introducción: el Síndrome Metabólico es un desorden complejo que incrementa el riego de desarrollar Diabetes Mellitus tipo 2 y Enfermedades cardiovasculares. Objetivo: analizar la prevalencia de factores de riesgo asociados al síndrome metabólico en conductores del transporte público en Cochabamba-Bolivia. Métodos: estudio observacional, analítico de corte transversal, en una población de referencia de N=246 conductores de 6 líneas de transporte de la zona sud de Cochabamba-Bolivia; alcanzando una muestra de n=69 sujetos de estudio y aplicando la metodología STEPS de la OPS/OMS. Se utilizó Chi cuadrado (X²) para la asociación estadística con el sexo; regresión logística bi-variada y multivariada para la obtención del OR crudo y ajustado en relación a los factores de riesgo asociados al SM. Resultados: las prevalencias de los factores de riesgo asociados a Síndrome Metabólico fueron: STEP-1: Tabaquismo 20,3%; consumo actual de alcohol 63,8%; bajo consumo de frutas y vegetales 94,2%; sedentarismo o bajo nivel de actividad física 66,7%. STEP-2: sobrepeso 47,8%; obesidad 37,7%; cintura de riesgo u obesidad abdominal 37,7% y presión arterial elevada en 36,4%. STEP3: Glicemia alterada en ayunas 43,9%; Resistencia a la Insulina 47,8%; colesterol total elevado 56,1%; Triglicéridos elevados 66,7% y HDL-colesterol reducido en el 60,6%. Conclusión: el síndrome metabólico es altamente prevalente en la población de conductores del transporte público de la zona sud de la ciudad de Cochabamba (79,3%); asociado al tiempo de trabajo en el rubro, el incremento de edad, la ausencia de pareja y la situación de trabajo.

Background: metabolic Syndrome is a complex disorder that increases the risk of developing Diabetes Mellitus type 2 and cardiovascular diseases. Objective: to analyze the prevalence of risk factors associated with the metabolic syndrome in drivers of public transport in Cochabamba, Bolivia. Methods: a cross-sectional study was conducted, in a reference population of N= 246 car drivers of 6 transport lines in the south zone forme Cochabamba-Bolivia; reaching a sample of n = 69 study subjects and applying the PAHO / WHO STEPS methodology. Chi-square (X²) was used for the statistical association with sex; bi-varied and multivariate logistic regression to obtain the crude and adjusted OR, in relation to the risk factors associated with the MetS. Results: the prevalences of risk factors associated with Metabolic Syndrome were: STEP-1: Smoking 20,3%; current alcohol consumption 63,8%; low consumption of fruits and vegetables 94,2%; sedentary lifestyle or low level of physical activity 66,7%. STEP-2: overweight 47.8%; obesity 37.7%; waist risk or abdominal obesity 37,7% and high blood pressure in 36,4%. STEP3: Hyperglycemia in fasting 43,9%; Insulin resistance 47,8%; high total cholesterol 56.1%; Triglycerides elevated 66,7% and HDL-cholesterol reduced 60,6%. Conclusion: the metabolic syndrome is highly prevalent in the population of drivers of public transport in the south zone from Cochabamba city (79,3%); associated with working time in driving, increase with age, in singles and the employers.

Adipose tissue extract shows potential for wound healing: in vitro proliferation and migration of cell types contributing to wound healing in the presence of adipose tissue preparation and platelet rich plasma.

Growth factors are the key elements in wound healing signaling for cell migration, differentiation and proliferation. Platelet-rich plasma (PRP), one of the most studied sources of growth factors, has demonstrated to promote wound healing in vitro and in vivo. Adipose tissue is an alternative source of growth factors. Through a simple lipoaspirate method, adipose derived growth factor-rich preparation (adipose tissue extract; ATE) can be obtained. The authors set out to compare the effects of these two growth factor sources in cell proliferation and migration (scratch) assays of keratinocyte, fibroblast, endothelial and adipose derived stem cells. Growth factors involved in wound healing were measured: keratinocyte growth factor, epidermal growth factor, insulin-like growth factor, interleukin 6, platelet-derived growth factor beta, tumor necrosis factor alfa, transforming growth factor beta and vascular endothelial growth factor. PRP showed higher growth factor concentrations, except for keratinocyte growth factor, that was present in adipose tissue in greater quantities. This was reflected in vitro, where ATE significantly induced proliferation of keratinocytes at day 6 (p < 0.001), compared to plasma and control. Similarly, ATE-treated fibroblast and adipose stem cell cultures showed accelerated migration in scratch assays. Moreover, both sources showed accelerated keratinocyte migration. Adipose tissue preparation has an inductive effect in wound healing by proliferation and migration of cells involved in wound closure. Adipose tissue preparation appears to offer the distinct advantage of containing the adequate quantities of growth factors that induce cell activation, proliferation and migration, particularly in the early phase of wound healing.

Cytokine-Rich Adipose Tissue Extract Production from Water-Assisted Lipoaspirate: Methodology for Clinical Use.

Proper functioning wound healing strategies are sparse. Adequate vascular formation to the injured area, as well as replacement of the volume loss, is fundamental in soft tissue repair. Tissue engineering strategies have been proposed for the treatment of these injury sites. Novel cell-free substance, human adipose tissue extract (ATE), has been previously shown to induce in vitro angiogenesis and adipogenesis and in vivo soft tissue formation. This study reports the translation of ATE preparation from laboratory to the operating room (OR). ATE samples for this study were derived from adipose tissue obtained with the water-jet assisted liposuction technique from 27 healthy patients. The variables studied included incubation time (15, 30, and 45 min), temperature (room temperature vs. 37°C), and filter type to determine the optimal method yielding the most consistent total protein content, as well as consistent and high expression of adipose-derived growth factors and cytokines, including: vascular endothelial growth factor, basic fibroblast growth factor, interleukin-6, adiponectin, leptin, and insulin-like growth factor. Following the optimization, samples were produced in the OR and tested for their sterility. No significant differences were observed when comparing extract incubation time points or incubation temperature. Nonetheless, when studying the different filter types used, a syringe filter with PES membrane with larger filter area showed significantly higher protein concentration (p ≤ 0.018). When studying the different growth factor concentrations, ELISA results showed less variation in cytokine concentrations in the OR samples with the optimized protocol. All of the OR samples were tested sterile. The devised protocol is an easy and reproducible OR-ready method for ATE generation. As an attractive source of growth factors, ATE is a promising alternative in the vast field of tissue engineering. Its clinical applications include volume replacement as a complement to fillers and improvement of the permanence of fat grafts and wound healing, among other bioactive functions.