What are the digestion and absorption models used to reproduce gastrointestinal protein processes?: A protocol for systematic review.

BACKGROUND: Animal, cell, and in vitro studies have been applied to simulate the human gastrointestinal tract (GIT) and evaluate the behavior of biomolecules. Understanding the peptides and/or proteins stability when exposed to these physiological conditions of the GIT can assist in the application of these molecules in the treatment of diseases such as obesity. This study describes a protocol of systematic reviews to analyze the methodologies that mimic the digestive and absorptive processes of peptides and/or proteins. METHODS: The protocol follows the guidelines described by Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Protocols (PRISMA-P). The search strategies will be applied in the electronic databases PubMed, ScienceDirect, Scopus, Web of Science, Evidence portal, Virtual Health Library, and EMBASE. The intervention group will be formed by in vivo, in cells, and in vitro (gastrointestinal simulating fluids) studies of digestion and absorption of peptides and/or proteins presenting a schedule, duration, frequency, dosages administered, concentration, and temperature, and the control group consisting in studies without peptides and/or proteins. The selection of studies, data extraction, and assessment of the risk of bias will be carried out independently by 2 reviewers. For animal studies, the risk of bias will be assessed by the instrument of the Systematic Review Center for Experimentation with Laboratory Animals (SYRCLE) and the Office of Health Assessment and Translation (OHAT) tool will be used to assess the risk of bias in cell studies. RESULTS: This protocol contemplates the development of 2 systematic reviews and will assist the scientific community in identifying methods related to the digestive and absorptive processes of peptides and/or proteins. CONCLUSION: Both systematic reviews resulting from this protocol will provide subsidies for the construction of research related to the clinical application of bioactive peptides and/or proteins. In this context, they will make it possible to understand the gastrointestinal processes during administering these molecules, as the gastrointestinal environment can affect its functionality. Therefore, validating the effectiveness of these protocols is important, as it mimics in vitro biological conditions, reducing the use of animals, being consistent with the reduction, refine and replace program.

Neonatal supraventricular extrasystole as early clinical debut of cardiac rhabdomyoma.

We are reporting the case of a newborn with a diagnosis of frequent supraventricular extrasystoles, up to 25% of beats at Holter monitoring, and partial response to beta-blockers. Initial echocardiographic studies were normal until the identification of a right atrial mass at 4 months of life. Given the progressive growth of the mass and the suspicion of myxoma or thrombus in the magnetic resonance study, surgical resection of the tumor was performed. The surgical specimen was histologically diagnostic of rhabdomyoma. Currently, the patient remains asymptomatic after a 6-year follow-up period. A single rhabdomyoma is described, located in an atypical situation, near the crista terminalis, and diagnosed from frequent extrasystoles which appeared before the echocardiographic resolution was able to identify it. Magnetic resonance showed nondiagnostic tissue enhancement characteristics.

Ingesta de fruita dels nens i nenes en edat escolar / Ingesta de fruta de los niños y niñas en edad escolar / Fruit intake by school-age children

Fonament: el consum de fruita recomanat en l'edat escolarés de dues a tres racions al dia. Objectiu: conèixer el consum de fruita dels pacients de 3 a14 anys visitats en la nostra consulta d'atenció primària. Investigar alguns factors que podrien influir en la seva ingesta. Mètode: estudi observacional transversal mitjançant enquesta única sobre el consum de fruita de l'infant. Descripció de freqüències relatives (%) o mitjanes (DE) de lesvariables següents: edat, nombre de racions i tipus de fruitaque van menjar el dia anterior a la visita, en els momentssegüents: esmorzar (casa i escola), dinar (casa i/o escola), berenar, sopar i altres. Analitzar la relació entre el nombrede racions de fruita que menja un infant segons l'edat, lapoblació on viu i el nivell d'estudis dels pares. Resultats: s'analitza la ingesta de fruita durant el curs esco-lar 2011-12 de 778 infants entre 3 i 14 anys (mitjana 7,27anys). La majoria consumeixen entre una i dues racions aldia (1,89 racions/dia) amb les excepcions dels infants de 10 anys (2,2) i els de 14 anys (1,7). Els infants que viuenfora de la província de Barcelona i els fills de mares universitàries són els que van menjar més fruita. Les tres fruitesmés consumides van ser el plàtan, la poma i la pera. Conclusions: la majoria d'infants enquestats mengenmenys de 2 racions de fruita al dia (1,89 racions/dia), perla qual cosa hem de continuar fomentant-ne el consumdiari, així com aconseguir diversificar-ne els tipus

Introducción. El consumo de fruta recomendado en la edad escolar es de dos a tres raciones al día. Objetivo. Conocer el consumo de fruta de los pacientes de 3 a 14 años visitados en nuestra consulta de atención primaria. Investigar algunos factores que podrían influir en su consumo. Mètode. Estudio observacional transversal mediante una encuesta única sobre el consumo de fruta del niño el día anterior a la visita. Descripción de frecuencias relativas (%) o medias (DE) de las siguientes variables: edad, número de raciones y tipo de fruta que comieron el día anterior de la visita en los siguientes momentos: desayuno (casa y colegio), comida (casa y/o colegio), merienda, cena y en otros momentos del día. Analizar la relación entre el número de raciones de fruta que come un niño en función de su edad, la población donde vive y el nivel de estudios de los padres. Resultados. Se analiza la ingestión de fruta durante el curso escolar 2011-2012 de 778 niños entre 3 y 14 años (mediana 7,27 años). La mayoría de niños consumieron entre una y dos raciones al día (1,89 raciones/día) con la excepción de los niños de 10 años (2,2) y los de 14 años (1,7). Los niños que viven fuera de la provincia de Barcelona y los hijos de madres universitarias fueron los que comieron más fruta. Las tres frutas preferentes son el plátano, la manzana y la pera. Conclusiones. El consumo de fruta recomendado en la edad escolar es de dos a tres raciones al día. La mayoría de niños encuestados comen menos (1,89 raciones/día), por lo que tenemos que seguir fomentando el consumo de fruta en diferentes momentos del día, así como conseguir diversificar los tipos de fruta (AU)

Background. The recommended daily intake of fruit for school-age children is two to three servings. Objective. To describe the fruit intake by children between 3 and 14 years of age attending our primary clinic and to determine factors that could influence it. Methods. Cross-sectional study, using a single survey on fruit consumption the day before the visit. The following variables were collected: age, type and number of servings of fruit taken the day before the visit, at the following times: breakfast (home and school), lunch (home or school), snack, dinner, and other times in the day. We analyzed the relationship between the number of servings of fruit the children ate and the age, the area where they reside, and the educational level of their parents. Results. During the 2011-2012 school year a total of 778 children between 3 and 14 years (mean 7.27 years) were included in this study. Most children had one or two servings per day (median 1.89 servings/day); the highest intake was among 10-year-old children (2.2 servings/day) and the lowest was among 14-year-old adolescents (1.7 servings/day). Children residing outside the province of Barcelona and children whose mothers have a University degree ate more fruit servings. The three most commonly consumed fruits were bananas, apples, and pears. Conclusions. The children surveyed ate fewer than the 2-3 servings of fruit per day recommended in school-age children. The consumption of fruit at different times of the day and the diversification of the fruit offered should be encouraged (AU)

Activating community health center patients in developing question-formulation skills: a qualitative study.

The authors developed and delivered a brief patient activation intervention (PAI) that sought to facilitate physician-patient communication. The intervention was designed to assist low-income, racial/ethnic minority users of community health centers in building skills and confidence asking questions. The PAI takes 8 to 10 minutes to deliver and consists of five steps that can be carried out by individuals with minimal formal medical training. A total of 252 patients waiting to see their physician participated in the intervention and completed the follow-up semistructured interview after their health care visit. The authors describe the intervention and the results of their qualitative evaluation of patient's responses. Overall, the PAI was valued by patients, appeared to add to patients' satisfaction with the health care they received, and was feasible to implement in the primary care setting. Furthermore, findings from this study provide indirect insight regarding factors that influence minority patient's question-asking behavior that include patient's attitudes, social factors, and patient's self-efficacy in question formulation.

Asking questions: the effect of a brief intervention in community health centers on patient activation.

OBJECTIVE: To evaluate the impact of a patient activation intervention (PAI) focused on building question formulation skills that was delivered to patients in community health centers prior to their physician visit. METHODS: Level of patient activation and patient preferred role were examined using the patient activation measure (PAM) and the patient preference for control (PPC) measure. RESULTS: More of the 252 patients evaluated were at lower levels of activation (PAM levels 1 or 2) than U.S. population norms before the intervention. Paired-samples t-test revealed a statistically significant increase from pre-intervention to post-visit PAM scores. One-third of participants moved from lower levels of activation to higher levels (PAM levels 3 or 4) post-intervention. Patients preferring a more passive role had lower initial PAM scores and greater increases in their post-intervention PAM scores than did those who preferred a more active role. CONCLUSION: Patients exposed to the PAI demonstrated significant improvement on a measure of activation. The PAI may be useful in helping patients prepare for more effective encounters with their physicians. PRACTICE IMPLICATIONS: The PAI was feasible to deliver in the health center setting and may be a useful method for activating low-income, racial/ethnic minority patient populations.

Evaluation of a patient activation and empowerment intervention in mental health care.

BACKGROUND: Evidence suggests that minority populations have lower levels of attendance and retention in mental health care than non-Latino whites. Patient activation and empowerment interventions may be effective in increasing minority patients' attendance and retention. OBJECTIVES: This study developed and evaluated a patient self-reported activation and empowerment strategy in mental health care. RESEARCH DESIGN: The Right Question Project-Mental Health (RQP-MH) trainings consisted of 3 individual sessions using a pre/post test comparison group design with patients from 2 community mental health clinics. The RQP-MH intervention taught participants to identify questions that would help them consider their role, process and reasons behind a decision; and empowerment strategies to better manage their care. SUBJECTS: A total of 231 participated, completing at least the pretest interview (n = 141 intervention site, 90 comparison site). MEASURES: Four main outcomes were linked to the intervention: changes in self-reported patient activation; changes in self-reported patient empowerment; treatment attendance; and retention in treatment. RESULTS: Findings show that intervention participants were over twice as likely to be retained in treatment and over 3 times more likely than comparison participants to have scheduled at least 1 visit during the 6-month follow-up period. Similarly, intervention participants demonstrated 29% more attendance to scheduled visits than comparison patients. There was no evidence of an effect on self-reported patient empowerment, only on self-reported patient activation. CONCLUSIONS: Results demonstrate the intervention's potential to increase self-reported patient activation, retention, and attendance in mental health care for minority populations. By facilitating patient-provider communication, the RQP-MH intervention may help minorities effectively participate in mental health care.

Microorganismos aislados en septicemia neonatal / Microorganisms isolated in neonatal septicemia

Se realiza esta investigación para determinar los microorganismos aislados en neonatos con hemocultivos positivos y valorar las sintomatologías, parámetros maternos y neonatales de recién nacidos admitidos con sospechas clínicas de sepsis en la Maternidad del Instituto Dominicano de seguros Sociales, en Santo Domingo. De 70 neonatos ingresados en salas de recién nacidos, 46 casos dieron hemocultivo positivo, aislándose Klebsiella-Enterobacter en el 58.7% de ellos, E. Coli en el 13% staphylococcus auereus en el 6.5%. Entre los parámetros maternos con cultivo de sangre positivo predomino el parto prematuro, mientras que en los neonatales predominó la prematuridad. El sexo masculino también fue predominante. Se concluye, al igual que en otros estudios nacionales, que los gérmenes gram negativos son aislados más frecuentemente en los neonatos con sospechas de sepsis, y que esto es debido al pobre saneamiento ambiental y las pobres condiciones socio-econômicas prevalecientes en los países llamados en vía de desarrollo