Tooth loss in breast cancer patients: A comparison between tamoxifen-treated and non-treated patients.

BACKGROUND: Tooth loss (TL) affects quality of life and general health. The literature suggesting that tamoxifen treatment in patients with breast cancer (BC) could be associated with alterations in oral health, increasing the risk of TL, is still scarce. This work aimed to determine the relationship between TL and tamoxifen consumption in patients with BC. MATERIAL AND METHODS: This cross-sectional observational study was carried out from July to September 2023 in the medical oncology services of the "Virgen de la Puerta" - ESSALUD High Complexity Hospital and "Dr. Luis Pinillos Ganoza" - IREN Norte - Regional Institute of Neoplastic Diseases, in Trujillo - Peru. Overall, 200 adult patients diagnosed with BC were evaluated, of which 100 consumed tamoxifen and 100 did not. Inter- and intra-rater reliability was determined with respect to TL, resulting in intra-class correlation values RHO = 0.971 and interclass RHO = 0.938. The oncologist of the corresponding service performed BC diagnosis and stage. Poisson regression was used to analyze results with a significance level of p<0.05. RESULTS: No relationship was found between TL and tamoxifen consumption in patients with breast cancer (p= 0.221); however, greater TL was observed in women who consumed tamoxifen for more than one year compared to those who did not use it (p=0.025) and in older adult women compared to young women (p=0.030). CONCLUSIONS: There is a relationship between TL and time of use of tamoxifen in patients with BC, concluding that patients who consumed tamoxifen for more than one year had greater TL than those who did not. Furthermore, no relationship was found between TL and cancer stages, but there was greater TL in older adult patients and also in those who consumed tamoxifen and did not receive chemotherapy or radiotherapy.

Riesgo de refractura según el FRAX score en pacientes mayores de 50 años que sufren una fractura por un mecanismo de bajo impacto / Risk of refracture according to the FRAX score in patients older than 50 years who suffer a fracture by a low-impact mechanism

Resumen: Introducción: a medida que se invierte la pirámide poblacional vamos a ver más pacientes que sufren fracturas por mecanismos de bajo impacto y no todos los hospitales cuentan con un densitómetro para hacer el diagnóstico definitivo. Sin embargo, se cuenta con herramientas clínicas que nos apoyan para iniciar con un tratamiento oportuno. Objetivo: reconocer el riesgo de refractura que existe en pacientes mayores de 50 años dentro de nuestra población. Material y métodos: se incluyeron a pacientes > 50 años que sufrieron de una fractura de bajo impacto en el Hospital Ángeles Mocel. Usando el FRAX score México para medir el riesgo de sufrir una fractura. Se dividió la muestra en dos grupos, utilizando una p < 0.05 para considerar estadísticamente significativa con un IC de 95%. Resultados: se incluyeron 69 pacientes, 47.8% ya habían sufrido de alguna fractura previa, 10% de ellos tienen tratamiento para la osteopenia. El riesgo de sufrir una fractura mayor osteoporótica en 10 años se observó en 50.7% de los pacientes. El riesgo de sufrir una fractura de cadera en 10 años se encontró en 75% de los pacientes. A ningún paciente se le dio tratamiento, ya sea modificadores del estilo de vida o tratamiento farmacológico para osteopenia/osteoporosis a su egreso hospitalario. Conclusión: hay una deficiencia en el manejo inmediato de los cirujanos ortopedistas para prevenir en pacientes futuras refracturas de bajo impacto.

Abstract: Introduction: as the population pyramid inverts, we'll see more old patients suffering a fracture secondary to a low impact mechanism and not all hospitals have a densitometer to make a definitive diagnosis. Nevertheless, we have clinical tools that can help us to start an early treatment. Objective: to recognize the risk of re-fracture of patients older than 50 years in our population. Material and methods: we included all patients older than 50 that suffered a low impact fracture in the Ángeles Mocel Hospital. We used Mexico FRAX score tool to determine de risk of suffering a fracture. The sample was divided in two groups. Utilizing p < 0.05 and a CI of 95%. Results: 69 patients where included. 47.8% had past fractures and only 10% of those had preventive osteoporotic treatment. 50.7% of the patients have a high risk of suffering a mayor osteoporotic fracture in 10 years and 75% of suffering a hip fracture in 10 years. None of the patients received a treatment, either lifestyle modifiers or specific osteoporosis pharmacotherapy at hospital discharge. Conclusion: there is a deficiency in the early preventive management of osteoporosis in patients suffering a low impact fracture by orthopedic surgeons.

Probiotics, Their Extracellular Vesicles and Infectious Diseases.

Probiotics have been shown to be effective against infectious diseases in clinical trials, with either intestinal or extraintestinal health benefits. Even though probiotic effects are strain-specific, some "widespread effects" include: pathogen inhibition, enhancement of barrier integrity and regulation of immune responses. The mechanisms involved in the health benefits of probiotics are not completely understood, but these effects can be mediated, at least in part, by probiotic-derived extracellular vesicles (EVs). However, to date, there are no clinical trials examining probiotic-derived EVs health benefits against infectious diseases. There is still a long way to go to bridge the gap between basic research and clinical practice. This review attempts to summarize the current knowledge about EVs released by probiotic bacteria to understand their possible role in the prevention and/or treatment of infectious diseases. A better understanding of the mechanisms whereby EVs package their cargo and the process involved in communication with host cells (inter-kingdom communication), would allow further advances in this field. In addition, we comment on the potential use and missing knowledge of EVs as therapeutic agents (postbiotics) against infectious diseases. Future research on probiotic-derived EVs is needed to open new avenues for the encapsulation of bioactives inside EVs from GRAS (Generally Regarded as Safe) bacteria. This could be a scientific novelty with applications in functional foods and pharmaceutical industries.

[Risk of refracture according to the FRAX score in patients older than 50 years who suffer a fracture by a low-impact mechanism]. / Riesgo de refractura según el FRAX score en pacientes mayores de 50 años que sufren una fractura por un mecanismo de bajo impacto.

INTRODUCTION: as the population pyramid inverts, we'll see more old patients suffering a fracture secondary to a low impact mechanism and not all hospitals have a densitometer to make a definitive diagnosis. Nevertheless, we have clinical tools that can help us to start an early treatment. OBJECTIVE: to recognize the risk of re-fracture of patients older than 50 years in our population. MATERIAL AND METHODS: we included all patients older than 50 that suffered a low impact fracture in the Ángeles Mocel Hospital. We used Mexico FRAX score tool to determine de risk of suffering a fracture. The sample was divided in two groups. Utilizing p < 0.05 and a CI of 95%. RESULTS: 69 patients where included. 47.8% had past fractures and only 10% of those had preventive osteoporotic treatment. 50.7% of the patients have a high risk of suffering a mayor osteoporotic fracture in 10 years and 75% of suffering a hip fracture in 10 years. None of the patients received a treatment, either lifestyle modifiers or specific osteoporosis pharmacotherapy at hospital discharge. CONCLUSION: there is a deficiency in the early preventive management of osteoporosis in patients suffering a low impact fracture by orthopedic surgeons.

INTRODUCCIÓN: a medida que se invierte la pirámide poblacional vamos a ver más pacientes que sufren fracturas por mecanismos de bajo impacto y no todos los hospitales cuentan con un densitómetro para hacer el diagnóstico definitivo. Sin embargo, se cuenta con herramientas clínicas que nos apoyan para iniciar con un tratamiento oportuno. OBJETIVO: reconocer el riesgo de refractura que existe en pacientes mayores de 50 años dentro de nuestra población. MATERIAL Y MÉTODOS: se incluyeron a pacientes > 50 años que sufrieron de una fractura de bajo impacto en el Hospital Ángeles Mocel. Usando el FRAX score México para medir el riesgo de sufrir una fractura. Se dividió la muestra en dos grupos, utilizando una p < 0.05 para considerar estadísticamente significativa con un IC de 95%. RESULTADOS: se incluyeron 69 pacientes, 47.8% ya habían sufrido de alguna fractura previa, 10% de ellos tienen tratamiento para la osteopenia. El riesgo de sufrir una fractura mayor osteoporótica en 10 años se observó en 50.7% de los pacientes. El riesgo de sufrir una fractura de cadera en 10 años se encontró en 75% de los pacientes. A ningún paciente se le dio tratamiento, ya sea modificadores del estilo de vida o tratamiento farmacológico para osteopenia/osteoporosis a su egreso hospitalario. CONCLUSIÓN: hay una deficiencia en el manejo inmediato de los cirujanos ortopedistas para prevenir en pacientes futuras refracturas de bajo impacto.

Moyamoya disease in Mexico: our experience.

INTRODUCTION: Moyamoya disease (MD) is a progressive, occlusive disease of the arteries of the anterior cerebral circulation that may cause ischaemia or haemorrhage. Patient management aims to prevent new cerebrovascular events through surgical revascularisation and/or pharmacological treatment. MATERIALS AND METHODS: We studied a series of 17 patients with MD (n = 14) or moyamoya syndrome (MS; n = 3), who were evaluated between January 1989 and December 2016; 11 patients were women and 6 were men. Thirteen patients had definitive MD (76%), one had unilateral MD (5.2%), and 3 had MS (18%). The condition manifested as intraparenchymal haemorrhage (in 35.2% of patients), brain ischaemia (29.4%), subarachnoid haemorrhage (17.6%), seizures (11.7%), and headache with no associated haemorrhage (1 patient). RESULTS: Ten patients (58.8%) underwent revascularisation and 7 (41.2%) received pharmacological treatment. All patients were evaluated with the modified Rankin Scale (mRs) at admission and at the last consultation; mRs scores were significantly lower in the group undergoing surgery (P <  .04). During follow-up, none of the patients undergoing revascularisation experienced recurrences, whereas 2 patients receiving pharmacological treatment did experience a new vascular event (one ischaemic and one haemorrhagic) (P <  .05). No significant differences were observed between the treatment outcomes of different revascularisation techniques. CONCLUSIONS: Although our population has different demographic characteristics from those of other non-Asian populations, ours is the largest published series of Hispanic individuals with MD. Our results support the use of revascularisation procedures to improve these patients' neurological status and to prevent new cerebrovascular events.

Dexamethasone-induced intrauterine growth restriction modulates expression of placental vascular growth factors and fetal and placental growth.

Prenatal exposure to glucocorticoids (GC) is a central topic of interest in medicine since GCs are essential for the maturation of fetal organs and intrauterine growth. Synthetic glucocorticoids, which are used in obstetric practice, exert beneficial effects on the fetus, but have also been reported to lead to intrauterine growth retardation (IUGR). In this study, a model of growth restriction in mice was established through maternal administration of dexamethasone during late gestation. We hypothesised that GC overexposure may adversely affect placental angiogenesis and fetal and placental growth. Female BALB/c mice were randomly assigned to control or dexamethasone treatment, either left to give birth or euthanised on days 15, 16, 17 and 18 of gestation followed by collection of maternal and fetal tissue. The IUGR rate increased to 100% in the dexamethasone group (8 mg/kg body weight on gestational days 14 and 15) and pups had clinical features of symmetrical IUGR at birth. Dexamethasone administration significantly decreased maternal body weight gain and serum corticosterone levels. Moreover, prenatal dexamethasone treatment not only induced fetal growth retardation but also decreased placental weight. In IUGR placentas, VEGFA protein levels and mRNA expression of VEGF receptors were reduced and NOS activity was lower. Maternal dexamethasone administration also reduced placental expression of the GC receptor, αGR. We demonstrated that maternal dexamethasone administration causes fetal and placental growth restriction. Furthermore, we propose that the growth retardation induced by prenatal GC overexposure may be caused, at least partially, by an altered placental angiogenic profile.

A rural-urban latitudinal study of the distributions of Culex quinquefasciatus and Culex pipiens bioforms in their southernmost sympatric fringe.

Mosquitoes grouped in the complex Culex pipiens L. (Diptera: Culicidae) are important vectors of medical and veterinary diseases. In the South American sympatric region, Cx. pipiens and Culex quinquefasciatus Say coexist and potentially hybridize. To identify key drivers of their geographical distribution, mosquito immatures were collected from flower vases of eight urban/rural cemetery pairs within a 5° latitudinal transect along Buenos Aires Province, Argentina. The specimens were identified by molecular methods and their relative proportion modelled as a function of environmental variables. At the beginning of the warm season, northern and southern cemeteries presented exclusively Cx. quinquefasciatus and Cx. pipiens, respectively, with different proportions of both at mid latitudes. By the end of the summer, Cx. quinquefasciatus was present throughout the study area, exclusively in 11 of the 16 cemeteries both rural and urban, whereas Cx. pipiens was predominant only in the southernmost pair. Mean annual temperature, photoperiod variability and time of the season were key drivers of their distributions. All specimens of Cx. pipiens were identified as form molestus and no hybrids were recognized. The reported distribution patterns and the potential absence of Cx. pipiens f. pipiens and hybrids are discussed, along with their implications in disease transmission.

Influence of Pine Bark Tannin on Bacterial Pathogens Growth and Nitrogen Compounds on Changes in Composted Poultry Litter

To study the antimicrobial and uric acid-preserving activity of pine bark tannin on poultry litter composting, antibiotic-free wood chip-based poultry litter was distributed (11 g) to 50-mL conical centrifuge tubes and immediately amended with 1.3 mL0.4 M sodium phosphate buffer (control) or with 1.3 mL condensed tannins from pine bark (Pinus palustris; 9 % tannin wt/vol in water). All tubes (n = 3 tubes/treatment) were inoculated with a novobiocin and naladixic acid-resistant Salmo-nella typhimurium (STNN) to achieve 3.0 log10 CFU/g and incubated at 37oC for 3 days to simulate an initial compost period. Wildtype E. coli and the challenge STNN strain as well as concentrations of ammonia, uric acid and urea were measured on days 0 and 3. Pine bark tannin treatment decreased (p 0.01) STNN populations in the litter by 0.6 log units compared to the controls. Wildtype E. coli populations were unaffected by tannin treatment (p>0.05). Ammonia accumulation decreased (p 0.01) 23% in tannin-treated litter compared to the control (2.8 ± 0.1 µmol/g). Conversely, the residual uric acid concentration was 1.6-fold higher (p=0.02) in litter treated with the pine bark tannin than in the control litter. Urea concentrations were unaffected by tannin treatment (p>0.05). Results suggest that pine bark tannin treatment may preserve uric acid and reduce ammonia volatilization in composted litter while aiding Salmonella control.(AU)

Influence of Pine Bark Tannin on Bacterial Pathogens Growth and Nitrogen Compounds on Changes in Composted Poultry Litter

To study the antimicrobial and uric acid-preserving activity of pine bark tannin on poultry litter composting, antibiotic-free wood chip-based poultry litter was distributed (11 g) to 50-mL conical centrifuge tubes and immediately amended with 1.3 mL0.4 M sodium phosphate buffer (control) or with 1.3 mL condensed tannins from pine bark (Pinus palustris; 9 % tannin wt/vol in water). All tubes (n = 3 tubes/treatment) were inoculated with a novobiocin and naladixic acid-resistant Salmo-nella typhimurium (STNN) to achieve 3.0 log10 CFU/g and incubated at 37oC for 3 days to simulate an initial compost period. Wildtype E. coli and the challenge STNN strain as well as concentrations of ammonia, uric acid and urea were measured on days 0 and 3. Pine bark tannin treatment decreased (p 0.01) STNN populations in the litter by 0.6 log units compared to the controls. Wildtype E. coli populations were unaffected by tannin treatment (p>0.05). Ammonia accumulation decreased (p 0.01) 23% in tannin-treated litter compared to the control (2.8 ± 0.1 µmol/g). Conversely, the residual uric acid concentration was 1.6-fold higher (p=0.02) in litter treated with the pine bark tannin than in the control litter. Urea concentrations were unaffected by tannin treatment (p>0.05). Results suggest that pine bark tannin treatment may preserve uric acid and reduce ammonia volatilization in composted litter while aiding Salmonella control.

Caracterización de la población con anemia en el embarazo y su asociación con la morbimortalidad perinatal / Characterization of pregnant population with anemia and asociation with perinatal morbimortality

Resumen Introducción: la anemia es el trastorno nutricional más frecuente en el mundo y en el embarazo constituye un riesgo para la madre, el feto o recién nacido, desencadenando complicaciones como IVU, aborto, RCIU, parto prematuro, preeclampsia, bajo peso al nacer, RPM, etc. Objetivo: Determinar los efectos de la anemia en el embarazo y el desenlace perinatal de las pacientes atendidas en el Hospital Universitario Hernando Moncaleano de Neiva en el periodo de junio de 2012 a junio de 2016. Metodología: Se realizó un estudio observacional, descriptivo, retrospectivo, en gestantes atendidas en consulta de alto riesgo obstétrico durante el periodo e institución mencionados, con cruce de variables para determinar la relación entre la gravedad de la anemia y sus complicaciones mediante el cálculo del Chi-cuadrado Resultados: De 1.493 pacientes, 101 mujeres embarazadas entre los 16 a 34 años fueron incluidas en el estudio. La prevalencia de anemia fue de 32.01% y las complicaciones identificadas fueron: Infección de vías urinarias (8,91%), restricción de crecimiento intrauterino (7,9%), bajo peso al nacer (6,9%), preeclampsia (4,95%), parto prematuro (3,96%), ruptura prematura de membranas (3,03%) y un solo caso de aborto. El 10,89% de los recién nacidos requirieron hospitalización, de los cuales 2 presentaron hipoglicemia y 5 ictericia neonatal. Conclusiones: La anemia es una patología subdiagnosticada que afecta a mujeres entre los 16 y 30 años cuyas complicaciones como bajo peso al nacer, restricción de crecimiento intrauterino e ictericia neonatal resultan dependientes de la gravedad de la anemia.

Abstract Introduction: Anemia is the most frequent nutritional disorder in the world and in pregnancy it is a risk for the mother, the fetus or newborn, triggering complications such as IVU, abortion, IUGR, preterm birth, preeclampsia, low birth weight, RPM, etc. Objective: To determine the effects of anemia on pregnancy and the perinatal outcome of the patients treated at the Hernando Moncaleano Hospital in Neiva from June 2012 to June 2016. Methodology: An observational, descriptive, retrospective study, In pregnant women attended at a high obstetrical risk visit during the period and institution mentioned, with cross-variables to determine the relationship between the severity of the anemia and its complications by the Chi-square calculation Results: Of 1,493 patients, 101 pregnant women Between the ages of 16 and 34 were included in the study. The prevalence of anemia was 32.01% and the complications identified were: Urinary tract infection (8.91%), intrauterine growth restriction (7.9%), low birth weight (6.9%), preeclampsia, 95%), preterm delivery (3.96%), premature rupture of membranes (3.03%) and a single case of abortion. 10.89% of the newborns required hospitalization, of which 2 had hypoglycemia and 5 neonatal jaundice. Conclusions: Anemia is an underdiagnosed pathology that affects women between 16 and 30 whose complications such as low birth weight, intrauterine growth restriction and neonatal jaundice are dependent on the severity of the anemia.

Moyamoya disease in Mexico: Our experience. / Enfermedad moyamoya en México. Experiencia institucional.

INTRODUCTION: Moyamoya disease (MD) is a progressive, occlusive disease of the arteries of the anterior cerebral circulation that may cause ischaemia or haemorrhage. Patient management aims to prevent new cerebrovascular events through surgical revascularisation and/or pharmacological treatment. METHODS: We studied a series of 17 patients with MD (n = 14) or moyamoya syndrome (n = 3), who were evaluated between January 1989 and December 2016; 11 patients were women and 6 were men. Thirteen patients had definitive MD (76%), one had unilateral MD (5.2%), and 3 had moyamoya syndrome (18%). The condition manifested as intraparenchymal haemorrhage (in 35.2% of patients), brain ischaemia (29.4%), subarachnoid haemorrhage (17.6%), seizures (11.7%), and headache with no associated haemorrhage (one patient). RESULTS: Ten patients (58.8%) underwent revascularisation and 7 (41.2%) received pharmacological treatment. All patients were evaluated with the modified Rankin Scale (mRs) at admission and at the last consultation; mRs scores were significantly lower in the group undergoing surgery (P < .04). During follow-up, none of the patients undergoing revascularisation experienced recurrences, whereas 2 patients receiving pharmacological treatment did experience a new vascular event (one ischaemic and one haemorrhagic) (P < .05). No significant differences were observed between the treatment outcomes of different revascularisation techniques. CONCLUSIONS: Although our population has different demographic characteristics from those of other non-Asian populations, ours is the largest published series of Hispanic individuals with MD. Our results support the use of revascularisation procedures to improve these patients' neurological status and to prevent new cerebrovascular events.

The relationship between physician and cancer patient when initiating adjuvant treatment and its association with sociodemographic and clinical variables.

PURPOSE: The aim of this study was to analyze differences in physician and patient satisfaction in shared decision-making (SDM); patients' emotional distress, and coping in subjects with resected, non-metastatic cancer. METHODS: 602 patients from 14 hospitals in Spain were surveyed. Information was collected regarding physician and patient satisfaction with SDM, participants' emotional distress and coping, as well as patient sociodemographic and clinical characteristics by means of specific, validated questionnaires. RESULTS: Overall, 11% of physicians and 19% of patients were dissatisfied with SDM; 22% of patients presented hopelessness or anxious preoccupation as coping strategies, and 56% presented emotional distress. By gender, female patients showed a higher prevalence of dissatisfaction with SDM (23 vs 14%), anxious preoccupation (26 vs 17%), and emotional distress (63 vs 44%) than males. Hopelessness was more prevalent in individuals with stage III disease than those with stages I-II (28 vs 18%). CONCLUSION: Physicians must be mindful of the importance of emotional support and individual characteristics when communicating treatment options, benefits, and adverse effects of each alternative to oncological patients.

Heterogeneous distribution of Culex pipiens, Culex quinquefasciatus and their hybrids along the urbanisation gradient.

The mosquitoes of the Culex pipiens complex, hereafter referred to as the Pipiens Assemblage, are vectors of arbovirus of worldwide concern including West Nile and St. Louis encephalitis. Given their distinct eco-physiology and vectorial capacity, accurate specimen identification and insight in the environmental drivers of their distribution are essential for the understanding of disease transmission patterns. Using a PCR-based identification protocol, we characterized the spatial distribution of Cx. pipiens, Cx. quinquefasciatus and their hybrids developing in used tyres located within the overlapping region in South America as a function of different estimators of the urbanisation gradient. Out of 84 samples collected from tyre piles of 20 sites, we identified 369 larvae which corresponded predominantly to Cx. quinquefasciatus (76.4% of immatures) all along the gradient but more frequent at the urban end. Cx. pipiens (21.4%) was more conspicuous at the low urbanised end but was also present in highly urbanised sites, whereas hybrids were collected in very low numbers (2.2%). The urbanisation estimator best associated with the heterogeneous occurrence of the Pipiens Assemblage members was the proportion of impervious surface 1km around each tyre pile, which explained 41.7% of the variability in the data, followed closely by the distance to the Capital City (38.3%). Cumulative annual precipitation, population number in a 1km radius around each pile and distance to the de la Plata River were significantly associated with the distribution of the Pipiens Assemblage at lower explanation percentages (20-23%). A thorough understanding of the ecological basis and environmental associations of the distribution of Pipiens Assemblage members will enable forecasting population trends in changing environments to develop effective control measures for mosquitoes and the diseases they transmit.

Amaranth addition to enzymatically modified wheat flour improves dough functionality, bread immunoreactivity and quality.

Consumers with gluten-related disorders require gluten-free (GF) foods to avoid an immune response. Alternative to the use of non-gluten containing grains to prepare GF bread, the gluten reactivity has been greatly reduced using a proline specific cleavage enzyme, however, the gluten functionality was lost. The aim of this study was to evaluate the effect of adding an amaranth flour blend (AFB) to enzymatically modified wheat-flour proteins on dough functionality and to evaluate the immunoreactivity and acceptability of the prepared bread. First, wheat flour (20% w/v, substrate) was hydrolyzed using 8.4 U mg-1 protein Aspergillus niger prolyl-endopeptidase (AnPEP) for 8 h at 40 °C under constant agitation. Four types of breads were prepared with the same formulation except for the type of flour (14% w.b.): wheat flour (WF), WF-AFB unmodified not incubated, WF-AFB unmodified incubated and WF-AFB modified. The protein composition and free thiols were analyzed before and after amaranth addition, and the flour and bread proteins were run using SDS-PAGE and immune-detected in blots with IgA from celiac disease patients. The immunoreactive gluten content, specific volume and bread acceptability were evaluated. The polymeric proteins and free thiol groups of WF decreased after AnPEP treatment. The electrophoretic patterns of the modified flour and bread proteins were different and the IgA-immunodetection in blots was highly reduced, particularly for the higher molecular weight subunits. The addition of AFB to the modified wheat flour prepared using AnPEP improved the dough functionality by increasing the thiol groups and allowed the preparation of a sensorially acceptable bread with only 60 mg kg-1 immunoreactive gluten.

Lactobacillus casei BL23 Produces Microvesicles Carrying Proteins That Have Been Associated with Its Probiotic Effect.

Archaea, bacteria, and eukarya secrete membrane microvesicles (MVs) as a mechanism for intercellular communication. We report the isolation and characterization of MVs from the probiotic strain Lactobacillus casei BL23. MVs were characterized using analytical high performance techniques, DLS, AFM and TEM. Similar to what has been described for other Gram-positive bacteria, MVs were on the nanometric size range (30-50 nm). MVs carried cytoplasmic components such as DNA, RNA and proteins. Using a proteomic approach (LC-MS), we identified a total of 103 proteins; 13 exclusively present in the MVs. The MVs content included cell envelope associated and secretory proteins, heat and cold shock proteins, several metabolic enzymes, proteases, structural components of the ribosome, membrane transporters, cell wall-associated hydrolases and phage related proteins. In particular, we identified proteins described as mediators of Lactobacillus' probiotic effects such as p40, p75 and the product of LCABL_31160, annotated as an adhesion protein. The presence of these proteins suggests a role for the MVs in the bacteria-gastrointestinal cells interface. The expression and further encapsulation of proteins into MVs of GRAS (Generally Recognized as Safe) bacteria could represent a scientific novelty, with applications in food, nutraceuticals and clinical therapies.

FOTROCAN Delphi consensus statement regarding the prevention and treatment of cancer-associated thrombosis in areas of uncertainty and low quality of evidence.

INTRODUCTION: Decision-making in cancer-related venous thromboembolism (VTE) is often founded on scant lines of evidence and weak recommendations. The aim of this work is to evaluate the percentage of agreement surrounding a series of statements about complex, clinically relevant, and highly uncertain aspects to formulate explicit action guidelines. MATERIALS AND METHODS: Opinions were based on a structured questionnaire with appropriate scores and were agreed upon using a Delphi method. Questions were selected based on a list of recommendations with low evidence from the Spanish Society of Oncology Clinical Guideline for Thrombosis. The questionnaire was completed in two iterations by a multidisciplinary panel of experts in thrombosis. RESULTS: Of the 123 statements analyzed, the panel concurred on 22 (17%) and another 81 (65%) were agreed on by qualified majority, including important aspects of long-term and prolonged anticoagulation, major bleeding and rethrombosis management, treatment in special situations, catheter-related thrombosis and thromboprophylaxis. Among them, the panelists agreed the incidental events should be equated to symptomatic ones, long-term and extended use of full-dose low-molecular weight heparin, and concluded that the Khorana score is not sensitive enough to uphold an effective thromboprophylaxis strategy. CONCLUSION: Though the level of consensus varied depending on the scenario presented, overall, the iterative process achieved broad agreement as to the general treatment principles of cancer-associated VTE. Clinical validation of these statements in genuine practice conditions would be useful.

Prevalence and Phylogenetic Analysis of Bartonella Species of Wild Carnivores and Their Fleas in Northwestern Mexico.

The host-parasite-vector relationship of Bartonella spp. system in wild carnivores and their fleas from northwestern Mexico was investigated. Sixty-six carnivores belonging to eight species were sampled, and 285 fleas belonging to three species were collected during spring (April-May) and fall (October-November) seasons. We detected Bartonella species in 7 carnivores (10.6%) and 27 fleas (9.5%) through either blood culture or PCR. Of the 27 Bartonella-positive fleas, twenty-two were Pulex simulans, three were Pulex irritans and one was Echidnophaga gallinacea. The gltA gene and ITS region sequences alignment revealed six and eight genetic variants of Bartonella spp., respectively. These variants were clustered into Bartonella rochalimae, Bartonella vinsonii subsp. berkhoffii and another genotype, which likely represents a novel species of Bartonella spp. Although experimental infection studies are required to prove the vector role of P. simulans, our results suggest that this flea may play an important role in the Bartonella transmission. The results indicated possible host-specific relationships between Bartonella genotypes and the families of the carnivores, but further studies are needed to verify this finding. The presence of zoonotic species of Bartonella spp. in wild carnivores raises the issue of their potential risk for humans in fragmented ecosystems.

Relation between dengue and climate trends in the Northwest of Mexico.

Dengue is native to tropical areas. It has expanded into temperate and arid zones in Mexico. Due to climate change, it is urgent to study the behavior of this disease in northwestern Mexico. Incidence of dengue fever and monthly maximum and minimum temperature and rainfall were obtained for 1990-2013 for the State of Baja California Sur. The relation between monthly and seasonal climate data with dengue records was analyzed by Pearson's correlation. The analysis shows that the minimum temperature has increased and the climate factor significantly correlates with dengue. Temperature variations have decreased. In this state, incidence of dengue cases directly correlates with minimum monthly temperature. It is expected that, as minimum temperatures increase to the end of this century, it will likely lead to increasing incidence of dengue. Preventive actions are recommended.

Percepción de la vivencia del acceso oportuno al diagnóstico del VIH, en personas viviendo con VIH/SIDA: Acceso oportuno al test de VIH / Perceptions about the elisa test of people diagnosed at the aids stage

Background: The delay in the diagnosis of AIDS results in higher treatment costs. Aim: To reveal the experiences of people who were diagnosed in the AIDS stage about the access to the ELISA test. Material and Methods: In depth interviews were carried out to 15 participants from public hospitals who were in the AIDS stage at the moment of the diagnosis. The main questions asked were about the motivations to take the test, the barriers found and the help received from the health care personnel. All interviews were recorded and analyzed according to Kripperdorff. Results: The three categories that emerged were the motivations to take the test, the facilitators found and the difficulties to access to the test. The main motivation was a condition of vulnerability due to the suspicion or certainty of being infected. The main facilitator was the sensation of being accepted and not discriminated. The main difficulties were the fear of having a positive test and of being discriminated and the lack of information. Conclusions: Knowing these experiences will help to improve the early detection of HIV infections.

EPSPS variability, gene expression, and enzymatic activity in glyphosate-resistant biotypes of Digitaria insularis.

Weed resistance to herbicides is a natural phenomenon that exerts selection on individuals in a population. In Brazil, glyphosate resistance was recently detected in Digitaria insularis. The objective of this study was to elucidate mechanisms of weed resistance in this plant, including genetic variability, allelism, amino acid substitutions, gene expression, and enzymatic activity levels. Most of these have not previously been studied in this species. D. insularis DNA sequences were used to analyze genetic variability. cDNA from resistant and susceptible plants was used to identify mutations, alleles, and 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) expression, using real-time quantitative reverse transcription-polymerase chain reaction. In addition, EPSPS activity was measured. We found a decrease in genetic variability between populations related to glyphosate application. Substitutions from proline to threonine and tyrosine to cysteine led to a decrease in EPSPS affinity for the glyphosate. In addition, the EPSPS enzymatic activity was slightly higher in resistant plants, whereas EPSPS gene expression was almost identical in both biotypes, suggesting feedback regulation at different levels. To conclude, our results suggest new molecular mechanisms used by D. insularis to increase glyphosate resistance.