High linoleic acid levels in red blood cells predict a poor response to neoadjuvant chemotherapy in human epidermal growth factor receptor type 2-positive breast cancer patients.

OBJECTIVE: Polyunsaturated fatty acids are categorized as ω-3 or ⍵-6. Previous studies demonstrate that breast cancers display a high expression of fatty acid synthase and high fatty acid levels. Our study sought to determine if changes in plasma or red blood cell membrane fatty acid levels were associated with the response to preoperative (neoadjuvant) chemotherapy in non-metastatic breast cancer patients. METHODS: Our prospective study assessed fatty acid levels in plasma and red blood cell membrane. Response to neoadjuvant chemotherapy was evaluated by the presence or absence of pathologic complete response and/or residual cancer burden. RESULTS: A total of 28 patients were included. First, patients who achieved pathologic complete response had significantly higher neutrophil-to-lymphocyte ratio versus no pathologic complete response (P = 0.003). Second, total red blood cell membrane polyunsaturated fatty acids were higher in the absence of pathologic complete response (P = 0.0028). Third, total red blood cell membrane ⍵-6 polyunsaturated fatty acids were also higher in no pathologic complete response (P < 0.01). Among ⍵-6 polyunsaturated fatty acids, red blood cell membrane linoleic acid was higher in the absence of pathologic complete response (P < 0.01). Notably, plasma polyunsaturated fatty acid, ⍵-6, and linoleic acid levels did not have significant differences. A multivariate analysis confirmed red blood cell membrane linoleic acid was associated with no pathologic complete response; this was further confirmed by receiver operating characteristic analysis (specificity = 92.3%, sensitivity = 76.9%, and area under the curve = 0.855). CONCLUSIONS: Pending further validation, red blood cell membrane linoleic acid might serve as a predictor biomarker of poorer response to neoadjuvant chemotherapy in non-metastatic human epidermal growth factor receptor type 2-positive breast cancer. Measuring fatty acids in red blood cell membrane could offer a convenient, minimally invasive strategy to identifying patients more likely to respond or those with chemoresistance.

Calorie Restriction and Time-Restricted Feeding: Effective Interventions in Overweight or Obese Patients Undergoing Radiotherapy Treatment with Curative Intent for Cancer.

This study assesses the feasibility of calorie restriction (CR) and time-restricted feeding (TRF) in overweight and obese cancer patients who realized little to no physical activity undergoing curative radiotherapy, structured as a prospective, interventional, non-randomized open-label clinical trial. Of the 27 participants initially enrolled, 21 patients with breast cancer were selected for analysis. The participants self-selected into two dietary interventions: TRF, comprising a sugar and saturated fat-free diet calibrated to individual energy needs consumed within an 8 h eating window followed by a 16 h fast, or CR, involving a 25% reduction in total caloric intake from energy expenditure distributed across 4 meals and 1 snack with 55% carbohydrates, 15% protein, and 30% fats, excluding sugars and saturated fats. The primary goal was to evaluate the feasibility of these diets in the specific patient group. The results indicate that both interventions are effective and statistically significant for weight loss and reducing one's waist circumference, with TRF showing a potentially stronger impact and better adherence. Changes in the LDL, HDL, total cholesterol, triglycerides, glucose and insulin were not statistically significant.

Educación alimentaria nutricional: Estrategias para mejorar la adherencia al plan dietoterapéutico

RESUMEN La educación alimentaria nutricional es la combinación de estrategias educativas, acompañadas de apoyos ambientales, diseñadas para facilitar la adopción voluntaria de elecciones alimentarias que conducen a un estado óptimo de salud y bienestar. La educación alimentaria nutricional tiene tres componentes: 1) motivación, 2) acción y 3) ambiente. Para elegir la técnica de educación adecuada para cada persona, se deben considerar las características psicoemocionales individuales, especialmente las motivaciones para el cambio y el tipo de personalidad, ya que ambos han mostrado ser buenos predictores de la conducta alimentaria. Dentro de los recursos educativos posibles de utilizar para realizar la educación en alimentación nutricional se encuentran indicaciones verbales, material escrito, uso de internet, dispositivos portátiles, aplicaciones de teléfonos inteligentes, e incluso la clase de cocina. La evidencia demuestra que la educación alimentaria nutricional impacta favorablemente la adherencia a las intervenciones nutricionales, lo cual a la vez se ve reflejado en efectos positivos en la salud.

ABSTRACT Food and nutrition education is the combination of educational strategies, accompanied by environmental supports designed to facilitate voluntary adoption of food choices conducive of health and well-being. It has a motivational phase, an action phase, and an environmental component. To choose the right educational technique for each patient, their individual psychoemotional characteristics must be considered; especially what their motivations for change are, as well as their personality type, because both are good predictors of food behavior. Among the resources that can be used to perform nutrition education are verbal indications, written material, the internet, mobile devices, smartphone applications, and even the kitchen as a place for education. Evidence shows that nutrition education has a favorable impact on diet adherence in different conditions that have an important nutritional component, such as celiac disease, inflammatory bowel disease, diabetes and obesity, which at the same time produces positive health outcomes.

Profesionalismo en el nutricionista: ¿Qué es y cómo incorporarlo en la formación de pregrado?

RESUMEN El profesionalismo es un pilar fundamental en la formación y ejercicio profesional de un nutricionista que implícitamente se ha incluido y desarrollado en los estándares de práctica. Recientemente se ha intentado establecer una terminología común para su definición, esta se basa en cuatro aspectos centrales: a) atributos personales como empatía, autoconciencia e inteligencia emocional, b) comunicación interpersonal, tanto con pares, otros profesionales de la salud y usuarios, c) actuar centrado en la práctica, que considera el entorno laboral en cuanto a las leyes y normativas que rigen el actuar profesional y 4) compromiso con el aprendizaje permanente, como el proceso de reflexión y autoevaluación del propio trabajo. Para garantizar un actuar profesional, la enseñanza del profesionalismo debe ser considerada de manera formal en el plan curricular, implementando distintas técnicas educativas y evaluaciones correspondientes que permitan la adquisición de conocimientos y habilidades necesarias. En el proceso formativo cobra especial relevancia el contexto y ambiente en el que se desempeñan los estudiantes para un óptimo uso de recursos.

ABSTRACT Professionalism is a fundamental aspect in the training and professional practice of a dietitian that has been implicitly included and developed in standards of practice. However, recently, an attempt to establish a common terminology for its definition has been made. The concept of professionalism is based on four central aspects: a) personal attributes such as empathy, self-awareness and emotional intelligence, b) interpersonal communication, both with peers, other health professionals and users, c) approach to practice, which considers the laws and regulations that govern professional actions, and 4) commitment to lifelong learning, such as the process of reflection and self-evaluation. To guarantee professionalism in dietitians, the teaching of professionalism must be considered formally in the plan of study, implementing different educational techniques and corresponding evaluations that guarantee the acquisition of necessary knowledge and skills. In the training process, the context and environment in which students work is especially relevant for an optimal use of resources.

Factores que limitan la adherencia a la dieta y la calidad de vida en enfermos celiacos chilenos durante COVID-19 / Factors that limit adherence to diet and quality of life in Chilean celiac patients during COVID-19

La enfermedad por coronavirus (COVID-19) es altamente contagiosa y las medidas de confinamiento dinámico han demostrado que reducen significativamente el número de contagios, sin embargo, pueden alterar la disponibilidad de alimentos afectando la adherencia a la dieta libre de gluten (DLG) y la calidad de vida (CV) en la enfermedad celiaca (EC). El objetivo de este estudio fue evaluar los factores que limitan, la adherencia a la dieta libre de gluten y la calidad de vida en personas con enfermedad celiaca en periodo de pandemia por COVID-19. Métodos Se aplicaron encuestas on-line respecto a adherencia a la DLG, CV y acerca de los factores que han generado dificultad para llevar una DLG en este escenario. Resultados Se analizaron 216 encuestas de enfermos celiacos, mayores de 15 años, de los cuales un 91% eran mujeres con un promedio de edad de 36 + 10,7 años y con 5,8 + 6,0 años de enfermedad. El 56,48% tenía una excelente adherencia a la DLG y un 43,52% una buena CV. El costo elevado de los alimentos sin gluten fue la pregunta con mayor porcentaje de respuesta, asociándose con regular y mala adherencia a la DLG (valor p=0,001) y con pobre CV (valor p=0,023). Conclusión En periodo de pandemia por COVID-19, el costo de los alimentos se asocia con adherencia regular y mala a la DLG y con pobre CV(AU)

Coronavirus disease (COVID-19) is highly contagious and dynamic confinement measures have shown to significantly reduce the number of infections, however, they can alter the availability of food, affecting adherence to a gluten-free diet (GFD) and quality of life (QoL) in celiac disease (CD). The objective of this study was to evaluate the limiting factors, adherence to a gluten-free diet and quality of life in people with celiac disease in a COVID-19 pandemic period. Methods. On-line surveys were applied regarding adherence to the GFD, CV, and factors that have generated difficulty in carrying out a GFD in this setting. Results. 216 surveys of celiac patients over 15 years of age were analyzed, of which 91% were women with an average age of 36 + 10.7 years and with 5.8 + 6.0 years of the disease. 56.48% had excellent adherence to the GFD and 43.52% had a good QoL. The high cost of gluten-free foods was the question with the highest response percentage, associated with regular and poor adherence to the GFD (p-value = 0.001) and with poor QoL (p-value = 0.023). Conclusion. In a COVID-19 pandemic period, the cost of food is associated with regular and poor adherence to the GFD and with poor QoL(AU)

Adherence to a gluten-free diet and quality of life in Chilean celiac patients.

INTRODUCTION: a gluten-free diet (GFD) is the treatment for celiac disease (CD), with adherence oscillating between 42 % and 91 %. The purpose of this study was to assess adherence to GFD and its relation to quality of life in Chilean celiac patients. METHODS: three surveys were performed on-line: sociodemographic-health status, adherence to GFD and quality of life. RESULTS: forty-eight per cent of respondents reported an excellent adherence to GFD and 49 % a good quality of life. CONCLUSIONS: adherence to GFD is low among Chilean celiac patients.

Microbiota, hábitos alimentarios y dieta en enfermedad inflamatoria intestinal / Microbiota, dietary habits and diet in inflammatory bowel disease

RESUMEN La enfermedad de Crohn y Colitis Ulcerosa corresponden a Enfermedades Inflamatorias Intestinales (EII). En la actualidad aún no se ha establecido la cura de estas enfermedades; sin embargo, se han desarrollado diversas terapias dirigidas a disminuir la inflamación de la mucosa (5 aminosalicílicos) y a disminuir la respuesta del sistema inmune (ejemplo: inmunomoduladores y tratamientos biológicos). Otro pilar de manejo de los pacientes con EII es la nutrición, esta es fundamental en el tratamiento por su capacidad de disminuir síntomas gastrointestinales. La alimentación tiene un impacto en la microbiota intestinal (MI), al asociarse la dieta occidental a un cambio en la biodiversidad de la microbiota. En este sentido, la MI podría tener un rol en la patogenia de la enfermedad, al existir una disminución de la biodiversidad y un aumento de bacterias que podrían favorecer la inflamación y generar una disminución en la producción de ácidos grasos de cadena corta. En EII, los hábitos alimentarios tienden a ser restrictivos y el estado nutricional se caracteriza por desnutrición, pérdida de masa muscular, sarcopenia, déficit de vitamina D y hierro. Por ello en periodos de remisión no se debe restringir la alimentación. En periodos de crisis, las dietas de exclusión de alimentos disminuyen los síntomas y, nutrientes específicos como las antocianinas y ácidos grasos w-3 podrían tener un efecto en la inflamación.

ABSTRACT Crohn's disease and Ulcerative Colitis correspond to Inflammatory Bowel Diseases (IBD). At present, its cure is not known, however nutrition is a fundamental pillar in treatment due to its ability to reduce gastrointestinal symptoms. Food has an impact on intestinal microbiota (IM), as the Western Diet is associated with a change in microbiota biodiversity. In this sense, IM could have a role in the pathogenesis of the disease, since there is a decrease in biodiversity and an increase in bacteria that could favor inflammation and generate a decrease in the production of short-chain fatty acids. In IBD, eating habits tend to be restrictive and nutritional status is characterized by malnutrition, loss of muscle mass, sarcopenia, and vitamin D and iron deficiency. Therefore, during periods of remission, feeding should not be restricted. In periods of crisis, exclusion diets decrease specific symptoms and nutrients such as anthocyanins and w-3 fatty acids could have an effect on inflammation.

Atención clínico nutricional: ¿cómo estructurar el trabajo del nutricionista? / Nutritional clinical care: how to structure the work of the nutritionist?

RESUMEN El trabajo del nutricionista clínico implica realizar una evaluación y diagnóstico nutricional basados en el pensamiento crítico y razonamiento clínico, para una atención nutricional adecuada, y tomar una decisión de intervención basada en la evidencia científica disponible. Luego, se debe monitorizar los resultados de la intervención, para generar un impacto a corto y largo plazo en las patologías que requieren tratamiento nutricional. Para lograr esto, es necesario implementar en los programas curriculares del pregrado un proceso estructurado de enseñanza que siga una secuencia lógica dependiente del nivel de formación, para adquirir habilidades del trabajo clínico en nutrición. El siguiente ensayo tiene por objetivo realizar un análisis de la literatura con respecto a la adquisición de habilidades del pensamiento crítico y razonamiento clínico, junto con conocer los modelos de atención nutricional para generar una propuesta de atención nutricional para aplicar en la práctica clínica.

ABSTRACT The activities of a clinical dietitian involve nutritional assessment and diagnosis based on critical thinking and clinical reasoning. The objective is to offer proper nutritional care and deciding on interventions based on available scientific evidence. The results of the intervention should be monitored to generate short- and long-term impact on the pathologies that require nutritional treatment. To achieve this goal, it is necessary to implement a structured teaching process in the undergraduate program that follows a logical sequence depending on the level of training. The following essay aims to conduct an analysis of the literature regarding the acquisition of critical thinking skills and clinical reasoning, together with knowing the models of nutritional care to generate a nutritional care proposal for application in clinical practice.

Esofagitis eosinofílica: diagnóstico y manejo / Diagnosis and management of eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease, induced by food allergens, clinically characterized by symptoms of esophageal dysfunction. Pathologically there is a predominant eosinophilic inflammation. This disease is relatively new, and its definitions have evolved over time. Its prevalence and incidence are increasing and causes clinical problems both in children and adults. Its symptoms include food impaction, dysphagia, symptoms that resemble gastroesophageal reflux, abdominal pain, and vomiting. It can also have extra-digestive symptoms such as rhinosinusitis, chronic cough, recurrent croup and hoarseness. EoE can be associated with other atopic conditions, such as asthma, eczema and food allergies. The diagnosis is made by the analysis of endoscopic biopsies (> 15 eosinophils per high power field). Proton pump inhibitors (PPIs) are currently accepted as a treatment for EoE. The clinical and pathological improvement with the use PPIs ceased to be a criterion to define Esophageal eosinophilia responsive to PPIs as a differential diagnosis, since this condition is currently considered within the EoE spectrum. There are three main treatment approaches for EoE: diet, drugs and dilation. Its diagnosis and early treatment are key to avoid or delay its complications, such as stenosis and severe esophageal dysfunction.

Phytochemicals and Traditional Use of Two Southernmost Chilean Berry Fruits: Murta (Ugni molinae Turcz) and Calafate (Berberis buxifolia Lam.).

Murta and calafate have been traditionally used by indigenous and rural peoples of Chile. Research on murta and calafate has gained interest due to their attractive sensory properties as well as a global trend in finding new fruits with potential health benefits. The objective of this review was to summarize the potential use of murta and calafate as sources of nutraceuticals regarding both the traditional and the up-to-date scientific knowledge. A search of historical documents recorded in the Digital National Library as well as scientific articles in the Web of Science database were performed using combinations of keywords with the botanical nomenclature. Peer-reviewed scientific articles did meet the inclusion criteria (n = 38) were classified in phytochemicals (21 papers) and biological activity (17 papers). Murta and calafate are high oxygen radical absorbance capacity (ORAC)-value fruits and promising sources of natural antioxidants, antimicrobial, and vasodilator compounds with nutraceutical potential. The bioactivity of anthocyanin metabolites in murta and calafate must continue to be studied in order to achieve adequate information on the biological activity and health-promoting effects derived for the consumption of murta and calafate fruit.

[Diagnosis and management of eosinophilic esophagitis]. / Esofagitis eosinofílica: diagnóstico y manejo.

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease, induced by food allergens, clinically characterized by symptoms of esophageal dysfunction. Pathologically there is a predominant eosinophilic inflammation. This disease is relatively new, and its definitions have evolved over time. Its prevalence and incidence are increasing and causes clinical problems both in children and adults. Its symptoms include food impaction, dysphagia, symptoms that resemble gastroesophageal reflux, abdominal pain, and vomiting. It can also have extra-digestive symptoms such as rhinosinusitis, chronic cough, recurrent croup and hoarseness. EoE can be associated with other atopic conditions, such as asthma, eczema and food allergies. The diagnosis is made by the analysis of endoscopic biopsies (> 15 eosinophils per high power field). Proton pump inhibitors (PPIs) are currently accepted as a treatment for EoE. The clinical and pathological improvement with the use PPIs ceased to be a criterion to define Esophageal eosinophilia responsive to PPIs as a differential diagnosis, since this condition is currently considered within the EoE spectrum. There are three main treatment approaches for EoE: diet, drugs and dilation. Its diagnosis and early treatment are key to avoid or delay its complications, such as stenosis and severe esophageal dysfunction.

Sobrepeso y obesidad en la enfermedad celiaca activa: posibles mecanismos fisiopatológicos / Overweight and obesity in active celiac disease: possible pathophysiological mechanisms

RESUMEN La enfermedad celiaca (EC) es una enteropatía crónica del intestino delgado, mediado por una respuesta inmune, gatillada por la exposición al gluten en individuos genéticamente susceptibles. La presentación clínica de la EC es variada y conduce a mala absorción. El estado nutricional en el momento del diagnóstico de la EC depende del tiempo en que la enfermedad ha estado activa, la extensión de la inflamación intestinal, grado de mala absorción e ingesta alimentaria. Sin embargo, en los últimos años se ha observado un cambio epidemiológico del estado nutricional en los pacientes celiacos al momento del diagnóstico. La presente revisión tuvo por objetivo realizar un análisis descriptivo de la presencia de obesidad en pacientes celiacos y de los posibles mecanismos fisiopatológicos que la explicarían.

ABSTRACT Celiac disease (CD) is a chronic enteropathy of the small intestinal, mediated by an immune response triggered by exposure to dietary gluten in genetically predisposed individuals. The clinical presentation of CD is varied and leads to malabsorption. Nutritional status at the time of diagnosis of CD depends on the time in which the disease has been active, the extent of intestinal inflammation, degree of malabsorption, and dietary intake. However, in recent years an epidemiological change of nutritional status has been observed in celiac patients at the time of diagnosis. The objective of this review was to perform a descriptive analysis of the presence of obesity in celiac patients and the possible physiopathological mechanisms that would explain it.

Exceso de peso y síntomas gastrointestinales en pacientes celiacos chilenos al momento del diagnóstico / Excess weight and gastrointestinal symptoms in Chilean celiac patients at the time of diagnosis

Introducción: la enfermedad celiaca es una patología inmune que genera alteraciones histológicas en el intestino delgado y síntomas digestivos o extradigestivos. La lesión intestinal produce pobre absorción y deteriora el peso o dificulta una ganancia óptima de peso. Sin embargo, la presencia de sobrepeso y obesidad se puede encontrar en estos pacientes, a pesar de la lesión histológica. El objetivo de este estudio fue determinar la prevalencia de exceso de peso en pacientes celiacos (adultos) recién diagnosticados. Métodos: estudio observacional retrospectivo de pacientes con diagnóstico reciente de enfermedad celiaca según la clasificación estándar propuesta por Marsh. Se evaluó el estado nutricional en base al índice de masa corporal (IMC) clasificado por criterio de la Organización Mundial de la Salud (OMS). La presentación clínica se clasificó en típica y atípica. Adicionalmente, se evaluó si existían diferencias en la presencia de síntomas gastrointestinales según estado nutricional. Resultados: se revisaron 135 historias clínicas de pacientes celiacos adultos (mujeres = 123; hombres = 12). El promedio de peso e IMC fue de 61,1 kg y 23,7 kg/m2, respectivamente. La presentación clínica típica fue de 59,2% y la atípica, de 40,8%. Del total de pacientes, el 71,8% presentó IMC de bajo peso y normal y el 28,1%, IMC de sobrepeso y obesidad. No se encontraron diferencias en la presencia de síntomas gastrointestinales según estado nutricional. Conclusiones: es necesario realizar estudios que evalúen en conjunto la ingesta energética y la absorción intestinal de estos pacientes de manera que se pueda explicar la alta presencia de exceso de peso

Introduction: celiac disease is an immune condition that results in histologic changes in the small bowel and produces both digestive and extra-digestive symptoms. Intestinal damage results in malabsorption and impaired weight or impaired optimal weight gain. However, these patients may be overweight or obese in spite of histologic damage. The aim of this study was to determine the prevalence of excess weight in newly diagnosed (adult) celiac patients. Methods: this was a retrospective observational study of patients recently diagnosed with celiac disease according to the standard Marsh classification. Nutritional status was assessed based on body mass index (BMI), as categorized by the World Health Organization (WHO). Clinical presentation was classified as typical or atypical. Potential differences in gastrointestinal symptoms according to nutritional status were also assessed. Results: a total of 135 medical records of adult celiac patients (women = 123; men = 12) were reviewed. The average weight and BMI were 61.1 kg and 23.7 kg/m2, respectively. The proportion of typical clinical presentations was 59.2% and of atypical presentations 40.8%. A total of 71.8% of patients had a BMI indicating low or normal weight and 28.1% had a BMI indicative of being overweight or obese. No differences with regard to the presence of gastrointestinal symptoms were found according to nutritional status. Conclusions: further studies are needed to jointly assess energy intake and intestinal absorption in these patients, in order to explain the high rate of excess weight

Excess weight and gastrointestinal symptoms in Chilean celiac patients at the time of diagnosis.

INTRODUCTION: celiac disease is an immune condition that results in histologic changes in the small bowel and produces both digestive and extra-digestive symptoms. Intestinal damage results in malabsorption and impaired weight or impaired optimal weight gain. However, these patients may be overweight or obese in spite of histologic damage. The aim of this study was to determine the prevalence of excess weight in newly diagnosed (adult) celiac patients. METHODS: this was a retrospective observational study of patients recently diagnosed with celiac disease according to the standard Marsh classification. Nutritional status was assessed based on body mass index (BMI), as categorized by the World Health Organization (WHO). Clinical presentation was classified as typical or atypical. Potential differences in gastrointestinal symptoms according to nutritional status were also assessed. RESULTS: a total of 135 medical records of adult celiac patients (women = 123; men = 12) were reviewed. The average weight and BMI were 61.1 kg and 23.7 kg/m2, respectively. The proportion of typical clinical presentations was 59.2% and of atypical presentations 40.8%. A total of 71.8% of patients had a BMI indicating low or normal weight and 28.1% had a BMI indicative of being overweight or obese. No differences with regard to the presence of gastrointestinal symptoms were found according to nutritional status. CONCLUSIONS: further studies are needed to jointly assess energy intake and intestinal absorption in these patients, in order to explain the high rate of excess weight.

[Overweight and obesity in celiac disease: expression of the interleukin profile Th17]. / Sobrepeso y obesidad en enfermedad celiaca: expresión del perfil de interleuquinas Th17.

INTRODUCTION: the histological alteration in the small intestine of the celiac patients produces a poor absorption that deteriorates or hinder an optimal weight gain. This can be the result of an increase expression of the Th17 gluten-specific interleukins. OBJECTIVE: the aim of this study was to compare the expression of Th17 interleukins in celiac patients with normal and overweight/obese nutritional status. METHODS: a total of 22 patients with newly diagnosed celiac disease were eligible: 15 patients with normal weight and seven overweight/obese. Small intestine biopsies were taken for the evaluation of the expression of interleukins through real-time PCR. RESULTS: expression levels of Th17 interleukins showed a tendency to be higher in intestinal biopsies of overweight/obese patients compared to normal weight celiac subjects; however, this difference was not statistical significant. CONCLUSION: body weight excess in celiac patients is not influenced by the expression levels of Th17 interleukins.

Introducción: la alteración histológica en el intestino delgado de los enfermos celiacos produce una pobre absorción que deteriora o dificulta una ganancia óptima de peso. Esto puede ser el resultado de un aumento de la expresión de las interleuquinas Th17 gluten-específicas. Objetivo: el objetivo de este estudio fue comparar la expresión de las interleuquinas Th17 en pacientes celiacos con peso normal y sobrepeso/ obesidad. Métodos: se estudiaron 22 pacientes con reciente diagnóstico de enfermedad celiaca: 15 con peso normal y siete con sobrepeso/obesidad. Se tomaron biopsias de intestino delgado para la evaluación de la expresión de las interleuquinas a través de PCR a tiempo-real.Resultados: los niveles de expresión de las interleuquinas Th17 mostraron una tendencia a ser más altos en las biopsias de intestino de pacientes con sobrepeso/obesidad en comparación a los celiacos con peso normal, sin embargo, esta diferencia no fue significativa. Conclusión: el exceso de peso en pacientes celiacos no es influenciado por los niveles de expresión de interleuquinas Th17.

Sobrepeso y obesidad en enfermedad celiaca: expresión del perfil de interleuquinas th17 / Overweight and obesity in celiac disease: expression of the interleukin profi le Th17

Introducción: la alteración histológica en el intestino delgado de los enfermos celiacos produce una pobre absorción que deteriora o dificulta una ganancia óptima de peso. Esto puede ser el resultado de un aumento de la expresión de las interleuquinas Th17 gluten-específicas. Objetivo: el objetivo de este estudio fue comparar la expresión de las interleuquinas Th17 en pacientes celiacos con peso normal y sobrepeso/ obesidad. Métodos: se estudiaron 22 pacientes con reciente diagnóstico de enfermedad celiaca: 15 con peso normal y siete con sobrepeso/obesidad. Se tomaron biopsias de intestino delgado para la evaluación de la expresión de las interleuquinas a través de PCR a tiempo-real. Resultados: los niveles de expresión de las interleuquinas Th17 mostraron una tendencia a ser más altos en las biopsias de intestino de pacientes con sobrepeso/obesidad en comparación a los celiacos con peso normal, sin embargo, esta diferencia no fue significativa. Conclusión: el exceso de peso en pacientes celiacos no es influenciado por los niveles de expresión de interleuquinas Th17

Introduction: the histological alteration in the small intestine of the celiac patients produces a poor absorption that deteriorates or hinder an optimal weight gain. This can be the result of an increase expression of the Th17 gluten-specific interleukins. Objective: the aim of this study was to compare the expression of Th17 interleukins in celiac patients with normal and overweight/obese nutritional status. Methods: a total of 22 patients with newly diagnosed celiac disease were eligible: 15 patients with normal weight and seven overweight/obese. Small intestine biopsies were taken for the evaluation of the expression of interleukins through real-time PCR. Results: expression levels of Th17 interleukins showed a tendency to be higher in intestinal biopsies of overweight/obese patients compared to normal weight celiac subjects; however, this difference was not statistical significant. Conclusion: body weight excess in celiac patients is not influenced by the expression levels of Th17 interleukins

[Fructose consumption and its health implications; fructose malabsorption and nonalcoholic fatty liver disease]. / Consumo de fructosa y sus implicaciones para la salud; malabsorción de fructosa e hígado graso no alcohólico.

UNLABELLED: Fructose intake has increased considerably in recent years, especially in the form high fructose corn syrup, due its high sweetening power. Several studies have associated high intake of fructose to metabolic alterations, as nonalcoholic fatty liver disease and fructose malabsorption, among other pathologies. This review aims to update about the effect of high intake of fructose in the liver and intestine, mainly associated with processed foods with added fructose. METHODS: An updated literature search was conducted using databases (Pubmed, Scopus and SciELO), selecting articles published after the year 2000, resulting from the keywords "fructose intake, fructose intolerance, nonalcoholic fatty liver and fructose, fructose malabsorption" RESULTS: Of 735 articles initially retrieved, 78 met the inclusion criteria. CONCLUSIONS: Fructose consumption has increased in recent decades, especially due to increased consumption of sweetened beverages and processed foods with added fructose. High fructose intake has been associated to pathologies as NAFLD and fructose malabsorption.

La ingesta de fructosa se ha incrementado considerablemente en los últimos años, especialmente bajo la forma de jarabe de maíz alto en fructosa, debido a su gran poder edulcorante. Diversos estudios, han asociado su elevado consumo con alteraciones metabólicas, hígado graso no alcohólico y malabsorción de fructosa, entre otras patologías. Esta revisión tiene como objetivo actualizar acerca del efecto de la alta ingesta de fructosa en el hígado e intestino, asociada principalmente a alimentos procesados con fructosa agregada. Métodos: Para la búsqueda bibliográfica se utilizaron las bases de datos de Pubmed, Scopus y Scielo, seleccionando aquellos artículos publicados después del año 2000 y resultantes de las palabras claves "fructose intake, high fructose corn syrup, nonalcoholic fatty liver and fructose, fructose malabsorption, fructose intolerance/metabolism". Resultados: La búsqueda arrojó 735 publicaciones de las cuales 78 cumplieron con los criterios de inclusión. Conclusiones: El consumo de fructosa ha aumentado en las últimas décadas, especialmente a través de bebidas endulzadas y productos alimentarios con fructosa agregada. La alta ingesta de fructosa tiene un impacto a nivel intestinal y hepático, asociándose a patologías como hígado graso no alcohólico y malabsorción de fructosa.

Consumo de fructosa y sus implicaciones para la salud; malabsorción de fructosa e hígado graso no alcohólico / Fructose consumption and its health implications; fructose malabsorption and nonalcoholic fatty liver disease

La ingesta de fructosa se ha incrementado considerablemente en los últimos años, especialmente bajo la forma de jarabe de maíz alto en fructosa, debido a su gran poder edulcorante. Diversos estudios, han asociado su elevado consumo con alteraciones metabólicas, hígado graso no alcohólico y malabsorción de fructosa, entre otras patologías. Esta revisión tiene como objetivo actualizar acerca del efecto de la alta ingesta de fructosa en el hígado e intestino, asociada principalmente a alimentos procesados con fructosa agregada. Métodos: Para la búsqueda bibliográfica se utilizaron las bases de datos de Pubmed, Scopus y Scielo, seleccionando aquellos artículos publicados después del año 2000y resultantes de las palabras claves "fructose intake, highfructose corn syrup, nonalcoholic fatty liver and fructose, fructose malabsorption, fructose intolerance/metabolism". Resultados: La búsqueda arrojó 735 publicaciones de las cuales 78 cumplieron con los criterios de inclusión. Conclusiones: El consumo de fructosa ha aumentado en las últimas décadas, especialmente a través de bebidas endulzadas y productos alimentarios con fructosa agregada. La alta ingesta de fructosa tiene un impacto a nivel intestinal y hepático, asociándose a patologías como hígado graso no alcohólico y malabsorción de fructosa (AU)

Fructose intake has increased considerably in recent years, especially in the form high fructose corn syrup, due its high sweetening power. Several studies have associated highintake of fructose to metabolic alterations, as nonalcoholic fatty liver disease and fructose malabsorption, among other pathologies. This review aims to update about the effect of high intake of fructose in the liver and intestine, mainly associated with processed foods with added fructose. Methods: An updated literature search was conducted using databases (Pubmed, Scopus and SciELO), selecting articles published after the year 2000, resulting fromthe keywords "fructose intake, fructose intolerance, nonalcoholic fatty liver and fructose, fructose malabsorption". Results: Of 735 articles initially retrieved, 78 met the inclusion criteria. Conclusions: Fructose consumption has increased in recent decades, especially due to increased consumption of sweetened beverages and processed foods with added fructose. High fructose intake has been associated to pathologies as NAFLD and fructose malabsorption (AU)

[Mitochondrial DNA heteroplasmy of the m.3243A>G mutation in maternally inherited diabetes and deafness]. / Heteroplasmia de la mutación del ADN mitocondrial m.3243A>G en la diabetes y sordera de herencia materna.

Maternally Inherited Diabetes and Deafness (MIDD) is caused by mutations in mitochondrial DNA (mtDNA), mainly m.3243A>G. Severity, onset and clinical phenotype of MIDD patients are partially determined by the proportion of mutant mitochondrial DNA copies in each cell and tissue (heteroplasmy). The identification of MIDD allows a corred treatment with insulin avoiding drugs that may interfere with mitochondrial electrón chain transpon. We estimated the degree of heteroplasmy of the mutation m.3243A>G from blood, saliva, hair root and a muscle biopsy using quantitative PCR (qPCR) in a femóle adult patient. For this purpose, PCR producís were inserted in a vector creating plasmids with 3243A or G. Mutant and wild-type vectors were mixed in different proportions to créate a calibration curve used to interpólate heteroplasmy percentages with qPCR threshold cycles. The proportions of m.3243A>G heteroplasmy were 62% (muscle), 14% (saliva), 6% (blood leukocytes) and 3% in hair root. Quantitative analysis of heteroplasmy showed marked variations in different tissues (highest in muscle and lowest in blood). Given the relatively high heteroplasmy found in saliva, this type of biológical sample may represent an adequate non-invasive way for assessing the presence of m.3243A>G mutations in epidemiologic studies.

Heteroplasmia de la mutación del ADN mitocondrial m.3243A>G en la diabetes y sordera de herencia materna / Mitochondrial DNA heteroplasmy of the m.3243A>G mutation in maternally inherited diabetes and deafness

Maternally Inherited Diabetes and Deafness (MIDD) is caused by mutations in mitochondrial DNA (mtDNA), mainly m.3243A>G. Severity, onset and clinical phenotype of MIDD patients are partially determined by the proportion ofmutant mitochondrial DNA copies in each cell and tissue (heteroplasmy). The identification ofMIDD allows a corred treatment with insulin avoiding drugs that may interfere with mitochondrial electrón chain transpon. We estimated the degree of heteroplasmy ofthe mutation m.3243A>G from blood, saliva, hair root and a muscle biopsy using quantitative PCR (qPCR) in a femóle adult patient. For this purpose, PCR producís were inserted in a vector creatingplasmids with 3243A or G. Mutant and wild-type vectors were mixed in different proportions to créate a calibration curve used to interpólate heteroplasmy percentages with qPCR threshold cycles. The proportions of m.3243A>G heteroplasmy were 62% (muscle), 14% (saliva), 6% (blood leukocytes) and 3% in hair root. Quantitative analysis of heteroplasmy showed marked variations in different tissues (highest in muscle and lowest in blood). Given the relatively high heteroplasmy found in saliva, this type of biológical sample may represent an adequate non-invasive way for assessing the presence of m.3243A>G mutations in epidemiologic studies.