Comparative Effectiveness in terms of Understanding of Nutri-Score and NutrInform in Spain

Background

Interpretive Front-of-Pack Labels (FoPLs) are supported by WHO as a key policy tool to promote healthy diets. At present, various FoPLs formats co-exist in the European Union (EU). However, as part of the Farm to Fork strategy, the European Commission stated it would adopt a single mandatory FoPL in 2022. The aim of this study was to analyze Spanish consumers reactions to Nutri-Score and NutrInform, two FoPLs that are currently the subject of debate in EU, testing preference through subjective understanding and perception but also performance through objective understanding of the FoPLs.

Methods

The experimental study was conducted in 2021 on a representative sample of 1026 Spanish adults (50% women, mean age±SD = 46±14 years), through an online randomized questionnaire where participants were exposed to Nutri-Score or NutrInform. Performance of and preference for these two FoPLs were assessed in three food categories (Breakfast Products, Breakfast Cereals and Added Fats). Performance was tested using multivariate logistic regression while preference using principal component analysis and t-tests.

Results

In terms of objective understanding, Nutri-Score was significantly associated with an increase in consumers’ ability to identify healthier food products across all food categories compared to NutrInform (OR = 19.1 [14.2-25.7], p < 0.0001). On the preference dimension, Nutri-Score was perceived as significantly easier to use and was more liked than NutrInform (standardized PCA dimension resp. 0.32±1.58 vs. -0.29±1.66, p < 0.0001 and 0.080±1.18 vs. -0.072±1.17, p = 0.039) and participants found Nutri-Score more helpful to discriminate the nutritional quality of Breakfast Products and Breakfast Cereals (resp. 1.32±1.00 vs. 1.14±1.02, p < 0.01 and 1.33±1.00 vs. 1.00±1.03, p < 0.0001).

Conclusions

Results of this study provide new evidence to support Nutri-Score in comparison with the NutrInform battery, on both performance and preference aspects.

Key messages

• Nutri-Score better helps participants identify healthier food products than NutrInform.

• European Commission should consider results of this study in its decision on a harmonized Front-of-Pack Label.

Associations of presidential voting preference and gubernatorial control with county-level COVID-19 case and death rates in the continental United States

OBJECTIVE

To investigate the associations of state gubernatorial party control and 2016 county-level presidential election preference on COVID-19 case and death rates in the United States.

STUDY DESIGN

This was a secondary analysis of publicly available data.

METHODS

Data including county-level COVID-19 case and death counts through February 9, 2021, 2020 gubernatorial data, and county-level US Census Bureau data, Broadstreet area deprivation index, and 2016 presidential voting tallies were included. Negative binomial regression estimated the adjusted impact of each variable on COVID-19 case and death rates.

RESULTS

A total of 3102 counties in the 48 continental United States plus Washington DC were included. County-level case and death rates were higher (12% and 22%, respectively) in Republican vs Democrat controlled states. Case and death rates were higher in counties voting Republican vs Democrat in 2016 and were modified by counties with median ages ≥ 50 years (54% increase in case rate and 91% increase in death rate).

CONCLUSIONS

These data further support the need for prevention efforts to focus on public health while extricating guidance and prevention from political agendas.

Evaluation of intrinsic image algorithms to detect the shadows cast by static objects outdoors

In some automatic scene analysis applications, the presence of shadows becomes a nuisance that is necessary to deal with. As a consequence, a preliminary stage in many computer vision algorithms is to attenuate their effect. In this paper, we focus our attention on the detection of shadows cast by static objects outdoors, as the scene is viewed for extended periods of time (days, weeks) from a fixed camera and considering daylight intervals where the main source of light is the sun. In this context, we report two contributions. First, we introduce the use of synthetic images for which ground truth can be generated automatically, avoiding the tedious effort of manual annotation. Secondly, we report a novel application of the intrinsic image concept to the automatic detection of shadows cast by static objects in outdoors. We make both a quantitative and a qualitative evaluation of several algorithms based on this image representation. For the quantitative evaluation, we used the synthetic data set, while for the qualitative evaluation we used both data sets. Our experimental results show that the evaluated methods can partially solve the problem of shadow detection.

Guidelines on the treatment of chronic coinfection by Trypanosoma cruzi and HIV outside endemic areas

As a result of population migration, Chagas disease is no longer limited to the North and South American continents. In HIV-infected patients, chronic infection by Trypanosoma cruzi behaves as an opportunistic infection in severely immunosuppressed patients and is responsible for high morbidity and mortality. Unlike other opportunistic infections, information on the natural history, diagnosis, treatment, and prevention of Chagas disease is scarce. Spain has the highest number of cases of Chagas disease outside the North and South American continents, and coinfection with HIV is increasingly prevalent. In this article, the Spanish Society for Tropical Medicine and International Health (Sociedad Española de Medicina Tropical y Salud Internacional) reviews the current situation of coinfection with HIV and T. cruzi infection and provides guidelines on the diagnosis, treatment, and prevention in areas where Chagas disease is not endemic. It also identifies areas of uncertainty where additional research is necessary.

[Chagas screening in pregnant Latin-American women. Experience in Poniente Almeriense (Almeria, Spain)]

INTRODUCTION

The transmission of Chagas disease is a public health problem in non-endemic countries.

METHODS

Chagas screening was performed by two serological tests in pregnant women from endemic areas for 4 years.

RESULTS

We studied 261 pregnant women from 13 Latin American countries, making a confirmatory diagnosis (two positive tests) in 4 cases. There was no case of vertical transmission.

CONCLUSION

Although Chagas disease has a low prevalence in the province of Almeria, the screening is necessary for the detection and treatment of infants with the disease.

[Hepatitis B virus (HBV) infection in Sub-Saharan immigrants in Almería (Spain)]

INTRODUCTION

There is scant information available in Spain regarding virological markers and clinical status in Sub-Saharan patients infected with HVB.

METHODS

A cross-sectional and retrospective study of virological markers and clinical status of HBV infection in 510 adult patients from Sub-Saharan Africa, not co-infected with HIV, most of them from West Africa countries.

RESULTS

A total of 90.8% of patients had markers of HBV infection and 137 (26.9%) were HBsAg positive. Among patients with HBsAg positive, 55.9% were chronic inactive carriers. The predominant genotype was E.

CONCLUSIONS

The study shows a high prevalence of both markers of HBV infection and of chronic hepatitis B in immigrants from Sub-Saharan Africa.

[Education on nutrition: from the university to specialized care]

The 7th Abbott-SENPE Forum is structured facing the new regulations of the European Space of High Education regarding the studies on Nutrition in the different degrees (Medicine, Pharmacology, Nutrition, Nursing) and post-doctoral education. A multi-professional and multidisciplinary discussion on the current situation of university education on nutrition, and its capabilities and limitations, is carried out. The value of the role of continuous medical education, the inhouse training programme, masters, and of scientific societies is also assessed. It is concluded that there is a need to urge academic authorities, the National Commission of Medical Specialties, the persons in charge of continuous medical education, and scientific societies of the importance of the studies relating to nutrition, feeding, and dietetics at both pre-graduate and post-graduate educational levels, and to implement and develop these studies in their areas of influence.

Energy cost of fever in children on total parenteral nutrition

The aim of the study was to measure the changes in energy expenditure (EE) and respiratory quotient (RQ) induced by fever in children receiving total parenteral nutrition (TPN). Ten children aged 1-16 years (weight for height: 104.5 +/- 13%) were included. They underwent two EE recordings of 3 h duration using indirect calorimetry, during a febrile (38.9 +/- 0.5 degrees C) and afebrile conditions, after parameters (nutritional intake, ambient temperature) being equal. The EE, (febrile phase) was significantly higher than the EE(2) (afebrile) (2.13 +/- 0.48 vs 1.78 +/- 0.42 kcal/kg/h; P < 0.01). Increase in EE was significantly correlated with body temperature (r = 0.92, P < 0.001). The slope of the regression line indicates an increase of 16.2% in EE per degree of fever. By dividing the individual increase in EE by the individual increase in temperature, the energy expenditure during fever is 11.3% per unit rise ( degrees C). During the febrile phase urinary nitrogen excretion was significantly higher (280 +/- 90 vs 210 +/- 70 mg/kg fat free mass/day, P < 0.02). The RQ during the febrile phase (0.90 +/- 0.13) did not differ significantly from mean RQ during the afebrile phase (0.95 +/- 0.07). Fever due to infection or inflammatory process is partly responsible for an hypermetabolic state including increased EE.

Taurine and cholestasis associated to TPN. Experimental study in rabbit model

Taurine seems to be essential in the newborn for bile acid (BA) tauroconjugation, and its deficiency has been implicated in total parenteral nutrition-associated cholestasis (TPN-AC). Our purpose was to study the relationship between taurine (Ta) and TPN-AC in rabbits, which have a similar biliary metabolism to that of humans. We used 40 young rabbits, fed for 10 days according to the following four groups: GA [10] given TPN, with amino acid solution (AA) but without taurine (Ta) or its AA-precursors (methionine, cysteine, and serine); GB [10] the same but only without taurine; GC [10] the same but with taurine and its precursors; and GD [10] the control group with oral nutrition and saline infusion. Complete blood and bile analytical data were obtained and analyzed, including plasma AA and BA. Liver samples were studied under optical and electron microscopy. Serum: In GC there was a 20% increase in the AA-precursors, but paradoxically it was greater in GA. Bile: In GC there was 30% more excretion of total and free BA compared with less than 20% in GA and GB. Regarding toxic BA, there was a 15% decline in GLC3S excretion, but more than 20% in LCA excretion, than in GA and GB. Moreover, in GC the glyco-/tauro-conjugate ratio was worse than in the other groups. Histomorphology: While in GA and GB liver steatosis was diffuse (microsteatohepatitis type), in GC there was macrosteatosis with mitochondria-surrounded lipid droplets. In GA and GB, the canaliculi appeared dilated, with abundant bile plugs and loss of microvilli. There are signs that taurine may protect against TPN-AC. The mechanism does not seem to be BA tauroconjugation, but probably taurine's antioxidant, membrane stabilization (with Ca2+ and HCO3-), and/or osmotic effects.

Performance of a new nebulizer system for simultaneous determination of Sb, Sn (hydride generation), V, and Zn by ICP–OES

A new nebulizer system is described that extends the analytical capability of the inductively coupled plasma technique to include the simultaneous determination of two elements Sb and Sn (hydride-forming), with two conventional elements, V and Zn. The main advantage of this system is its simultaneous determination of elements that form volatile hydrides and elements that do not, without any instrumental changes. Optimization of reaction and instrumental conditions was performed to characterize the new system. The performance of the new nebulizer system was evaluated by studying the effect of some transition metals (Ni, Cu, Co, and Fe, 1-1000 mg L(-1)) on the Sb, Sn, V, and Zn emission signals (1 mg L(-1)). Interferences from transition metal ions were found to be insignificant for determination of the four elements in presence of L: -cysteine. Long-term and short-term stability was also evaluated. The precision, expressed as RSD for 15 replicate measurements was 0.7% for Sb, 1.7% for Sn, 2.5% for V, and 2.3% for Zn at 200 microg L(-1) of each analyte. The detection limits obtained were 0.52, 1.3, 3.2, and 4.7 microg L(-1) for Sb, Sn, V, and Zn, respectively. Spike and recovery experiments were performed on the NIST 1643c trace metals in water standard reference material and results were in agreement with the certified values.

Inpatient intervention in an indigent, minority population with uncontrolled diabetes

OBJECTIVE

To study whether a program of brief, intensive, inpatient intervention could improve glycemic control in an indigent, minority population with uncontrolled diabetes unresponsive to outpatient treatment.

METHODS

Patients with uncontrolled diabetes unresponsive to treatment in our outpatient Diabetes Clinic were admitted to our inpatient Diabetes Unit, where their care was directed by the Diabetes Team (an attending diabetologist, an endocrinology fellow, two nurses, and two nutritionists). Of 108 patients admitted, data were available for 96. Patients from minority populations constituted 91.7% of the group. All patients were indigent. The mean duration of stay was 4.3 days. After dismissal, patients underwent follow-up again in our Diabetes Clinic. During the 540-day follow-up period, 25 patients were electively readmitted when satisfactory improvement in glycemic control was not achieved. Hemoglobin A1c levels were averaged and plotted for the group at defined time points up to 360 days before admission and up to 540 days after admission.

RESULTS

During the year before admission, hemoglobin A1c increased slowly from 10.1 +/- 0.3% (mean +/- standard error) at day -360 to 10.3 +/- 0.2% at day -210 (F5 = 29; P<0.01) and then rapidly to 11.4 +/- 0.2% at admission (F7 = 1,541; P<0.001). After admission, hemoglobin A1c declined rapidly to 9.5 +/- 0.2% at day 90 (F4 = 121; P<0.005), plateaued at that level until day 240, and then declined again slowly to 9.0 +/- 0.3% at day 540, the end of the follow-up period (F10 = 70; P<0.01). All hemoglobin A1c levels 30 days or more after admission were significantly lower than the mean level at admission (P<0.05 at day 30 and P<0.001 from day 45 to day 540).

CONCLUSION

Brief, intensive, inpatient intervention in an indigent, minority population with uncontrolled diabetes unresponsive to outpatient treatment produced and sustained a significant improvement in glycemic control. This mode of treatment is a practical approach to achieving the improvement in glycemic control that the Diabetes Control and Complications Trial demonstrated to be effective in delaying the onset and slowing the progression of diabetic retinopathy, nephropathy, and neuropathy.

[Ring chromosome 20: a distinctive syndrome identifiable by electroclinical diagnosis]

The ring chromosome 20 syndrome is characterized by treatment resistant non-convulsive status epilepticus, and slow waves intercalated by spikes/spike waves predominantly in the front-temporal regions. Here, we describe the case of an 18 year old patient, whose seizures began at the age of 10, these being resistant to treatment. Neurologic examination and cranial MRI were normal. Interictal EEG showed normal background activity with burst of 2-20 seconds with bilateral spike wave. Ictal EEG showed continuous paroxysmal activity with generalized spike waves discharges and slow delta waves, coinciding with nonconvulsive status epilepticus. After 1 mg of intravenous clonazepam, both clinical semiology and EEG abnormalities disappeared. A cytogenetic study showed ring chromosome 20 in 35 % of metaphases. The epilepsy associated with ring chromosome 20 constitutes a syndrome with its distinctive electroclinical characteristics.

Groundwater chemistry of the Okélobondo uraninite deposit area (Oklo, Gabon): two-dimensional reactive transport modelling

The stability of uranium-bearing minerals in natural environments is of interest to evaluate the feasibility of radioactive waste repositories. The uraninite bodies, UO2(s), in the Oklo district (Gabon) are the result of a natural fission process, which took place 1970 Ma ago. These deposits can be regarded as natural analogues for spent fuel. One of the uraninite bodies, the Okélobondo deposit, is located at a depth of 300 m. Groundwater samples from boreholes located at shallow depths (100-200 m) show neutral to basic pH, anoxic conditions (Eh = 0.10 to -0.05 V) and are saturated with respect to uraninite. In contrast, deeper samples collected in the vicinity of the ore body are oxidising (Eh = 0.32-0.47 V), slightly basic (pH = 7.0-8.5) and undersaturated with respect to uraninite. These oxidising conditions at depth, if present under repository conditions, may affect the stability of uranium oxide. In order to improve our understanding of the observed site geochemistry, the available information on the lithology and groundwater flow was integrated in a reactive transport model. The chemical composition and the pH-Eh values of the water sampled above and in the western side of the Okélobondo deposit can be explained by the interaction of meteoric recharge with pelites, dolomites and sandstones. The dissolution of Fe(II)-silicates and the oxidation of the Fe(II)-aqueous species maintained the pH-Eh distribution along the Fe(2+)-Fe(OH)3(am) equilibrium, with the result that uraninite does not dissolve. This may explain the lower uranium content in the water samples from pelites and dolomites above the Okélobondo deposit. The high Mn/Fe ratio and the high pH-Eh values of the water sampled at depth, close to the Okélobondo deposit, suggest a control by the Mn(2+)-MnOOH(s) equilibrium. This control is attributed to the dissolution of a large rhodochrosite, MnCO3(s), and manganite, MnOOH(s) deposit in the recharge area on the eastern side.

[Current census rates in inpatients hospitalized in the Hospital de Poniente in Almería [Spain]]

OBJECTIVE

To study the current census rate of patients admitted to an internal medicine service.

METHOD

We studied all patients admitted to the internal medicine service from January 1 to August 31, 2000 whose addresses were registered in four local authorities of our hospital district. We made exhaustive searches to ascertain whether these patients were included in the register in September 2000.

RESULTS

We analyzed 1,095 admissions from a total of 1,759 up to August 31, 2000. Twenty-four percent corresponded to patients who were not registered. Fifty-eight percent of those not registered were aged more than 70 years. Twenty-seven percent of patients aged less than 40 years, most of whom were immigrants, were also unregistered.

CONCLUSIONS

Twenty-four percent of the admissions to the internal medicine service that were studied corresponded to patients who were not registered with their respective local authorities. A possible explanation is the large immigrant population and the lack of registration among the elderly.

[Parenteral nutrition at home: NADYA register for the year 2000]

AIM

We analyze the registered data of home parenteral nutrition (HPN) in our country during the year 2000.

METHOD

The data were collected through a previously designed questionnaire. Apart from epidemiological information, the form includes the disease to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, and progress. All data were processed and analysed by the co-ordinating team.

RESULTS

Fourteen hospitals participated, and 67 patients were enrolled. Middle age was 5 +/- 4 years for patients < 14 years old, and 48 +/- 15 years for those > or = 14 years old. The more prevalent diagnosis were: ischemic bowel (28.4%), neoplasm (16.4%), radiation enteritis (13.4%), motility disorders (7.5%), Crohn's disease (2.9%), and other. The mean time on HPN was 7.5 +/- 4.4 months. Tunelized catheter was the preferential route (77.6%), followed by the implantated one (20.9%). The intermittent method (nocturnal) was preferential (91.0%). Patients receive the formula from hospital pharmacy more frequently than from Nutriservice (71.5% versus 19.4%). The complications related to nutrition (0.32/100 days of HPN) included the infections (0.12 catheter sepsis/100 d of HPN), metabolic (0.06/100 d of HPN), mechanic (0.03/100 d of HPN) and electrolitic disorders (0.03/100 d of HPN). The readmission rate, for nutritional problems, was 0.3 hospitalizations/100 d of HPN. At the end of the year, 61.2% of the patients remained in the HPN program, 37.3% abandoned the treatment (due to death (40%), to progress to oral feeding (48%), and to progress to enteral nutrition (4%); and 1.5% of the patients were not follow up.

CONCLUSIONS

This review illustrates that there is an increment in the registration of HPN patients in our country (1997: 0.7 patients/10(6) habitants, 2000: 1.9 patients/10(6) habitants), that vascular pathology is the more frequent diagnoses in HPN patients, and the rate of readmission and complications and the behaviour is similar to other series making this as a safe treatment in our place.

[Enteral nutrition at home: National register for the year 2000]

GOAL

Once again, the NADYA-SENPE Working Group analysed the registered data of Home Enteral Nutrition (HEN) in our country, during the year 2000.

MATERIAL AND METHODS

The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, patient's quality of life and progress. All data were processed and analysed by the co-ordinating team.

RESULTS

Twenty two hospital participated and 2,986 patients, aged 65.1 +/- 19.7 years, were enrolled. Of these patients, 41.2% were diagnosed with neurological diseases and 33.3% with cancer. The mean time on HEN was 6.3 +/- 4.4 months. Oral nutrition was the preferential route (50.8%), followed by nasoenteral tube (30.5%), and in 17.4% ostomy tubes were placed. Polymeric was the formula composition mainly used (83.2%). Patients were followed (70.1%) by the hospital reference Nutritional Support Unit. The complications related to nutrition included the gastrointestinal (0.25 complications/patient), the mechanical one (0.19 complications/patient), and the metabolic (0.007 complications/patient). Feeding tube need to be replaced 0.3 times/patient/year. The readmission rate, for nutritional problems, was observed in 0.03 patients. At the end of the year, 54.9% of the patients were in the HEN program, and in 30.3% HEN was finish due to different reasons. In 21.9% of the patients no, o light, discapacity degree was found.

CONCLUSIONS

Related to previous years, there is an increment in the number of enrolled patients. Neurological diseases and cancer were the more frequent diagnoses in HEN patients. Oral access was the higher feeding route due, probably, to the high prevalence of cancer patients. In spite of the elevated prevalence of neurological diseases, a few number of patients were feed with ostomy tube. Finally, due to the few readmission rate and complications, HEN is a safe treatment in our country.

[Left paramesocolic hernia with retroperitoneal incarceration of jejunum]

We present a case left paramesocolic hernia and review the literature. The patients was a 14 years old male and had suffered periods of relapses into abdominal pain from the age of three. When for years old he was operated on using the Nisses technique. Also a laparoscopy had already been performed on this same patient when he was 13 years old, without discovering any pathological conditions. In a new upper gastrointestinal serie, realized one year later, a retroperitoneal incarceration and a paraduodenal loop of jejunum was observed, which obstructed, partially the second part of the duodenum. We have not found the anatomical characteristics of this case in any previous report. In the ample literature pressured, it was confirmed that almost all the clinical cases, previously published had suffered a relapse abdominal pain crisis, diagnosed in advanced states and in/or emergency situations. This produces a mortality rate higher than 20% and or irreparable digestive damage. In cases involving paraduodenal hernias, there exists a low rate of diagnostic suspicion. These delays and diagnostic errors cause irreparable damage. In those patients who suffer relapses into abdominal pain syndrome, one should always include the differential diagnosis of PMH, applying a complete gastrointestinal serie or a CT-Scan with contrast.

Evaluation of select variables in the ion chromatographic determination of F-, Cl-, Br-, NO(-)3, SO(-2)4, and PO(-3)4 in serum samples

A full experimental design at two levels is applied for the estimation of the significance of select factors that may influence the ion chromatography (IC) determination of F-, Cl-, Br-, NO(-)3, SO(-2)4, and PO(-3)4 in serum samples. The factors studied are various sample deproteinization procedures, eluent composition, and flow rates. Deproteinization using either acetonitrile-NaOH or ultrafiltration can be used in order to obtain a significant protein removal before IC analysis; however, the former is recommended because it is less time-consuming and cheaper. Better resolution is obtained when a sodium hydroxide solution is used as the eluent. There is no influence of the sample's deproteinization procedures on the chromatographic resolution.

[Home enteral nutrition. Annual report 1999. NADYA-SENPE Group]

GOAL

During 1999, as in previous years, the NADYA-SENPE Group has maintained an annual register of patients with Artificial Nutrition at Home in order to keep up to date our available knowledge of this therapy. The present paper analyzes the results of the sixth National Register of patients under treatment with Enteral Nutrition at Home corresponding to 1999, produced with the co-operation of twenty-three centres in the Spanish national health network.

MATERIAL AND METHODS

The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication that led to the prescription of nutrition, nutritional treatment, access path, complications and admissions to hospital, follow-up of the treatment, patients' quality of life and progress. All of the data are processed by the co-ordinating team. The Nutrition Unit at La Paz Teaching Hospital in Madrid has acted as the group co-ordinator.

RESULTS

During 1999, a total of 2,262 patients at the twenty-three collaborating centres followed treatment with Home Enteral Nutrition (NED in its Spanish acronym). The mean age was 63.6 (19.67 years (males: 57.6%; females: 42.3%). The mean time with nutritional treatment is 5.89 (4.25 months. The neurological alterations (37.5%) and neoplasias (36.8%) were the most frequent indications for NED. Most patients used oral administration (50.7%), the use of artificial routes is less frequent, with 5NG being used on 27.9% and PEG on 12.7%. The polymeric formulas are the ones most commonly used (87.7%). The number of complications recorded amounted to 1,403 episodes, representing 0.62 complications per patient per year, of which 40.8% were gastro-intestinal (0.26 complications per patient per year) and 18.7% were mechanical complications, with only 9 recorded cases of bronchoaspiration. It was necessary to admit patients to hospital on 836 occasions (0.38 admissions per patient), albeit generally for causes not associated with nutrition (86.1%). At year-end, 51.4% of patients continued to receive nutritional support.

CONCLUSIONS

Enteral nutrition at home is a safe technique whose use is growing in Spain. It requires the existence of appropriately equipped nutrition teams as well as the collaboration of the Primary Health Care services and the suitable training of patients and relatives. It is essential to progress more deeply into the development and application of clinical routes that provide a clear and concise methodology covering all nutrition-related aspects. In itself, nutrition is a therapeutic alternative regardless of whether access is obtained through a natural or an artificial route. It is necessary for the persons responsible for health-care administration to realize that the appropriate nutrition of patients leads to an improvement in their general health, a shorter course for their illness and, therefore, a reduction in costs.

Novel azo derivatives as prodrugs of 5-aminosalicylic acid and amino derivatives with potent platelet activating factor antagonist activity

This paper describes the synthesis of a series of azo compounds able to deliver 5-aminosalicylic acid (5-ASA) and a potent platelet activating factor (PAF) antagonist in a colon-specific manner for the purpose of treating ulcerative colitis. We found it possible to add an amino group on the aromatic moiety of our reported 1-[(1-acyl-4-piperidyl)methyl]-1H-2-methylimidazo[4,5-c]pyridine derivatives or on British Biotech compounds BB-882 and BB-823 maintaining a high level of activity as PAF antagonist. A selected compound UR-12715 (49c) showed an IC(50) of 8 nM in the in vitro PAF-induced aggregation assay, and an ID(50) of 29 microg/kg in the in vivo PAF-induced hypotension test in normotensive rats. Through attachment of 49c to the 5-ASA via azo functionality we obtained UR-12746 (70). Pharmacokinetics experiments with [14C]-70 allow us to reach the following conclusions, critical in the design of these new prodrugs of 5-ASA. Neither the whole molecule 70 nor the carrier 49c were absorbed after oral administration of [14C]-70 in rat as was demonstrated by the absence of plasma levels of radioactivity and the high recovery of it in feces. Effective cleavage of azo bond (84%) by microflora in the colon is achieved. These facts ensure high topical concentrations of 5-ASA and 49c in the colon. Additionally, 70 exhibited a potent anticolitic effect in the trinitrobenzenesulfonic acid-induced colitis model in the rat. This profile suggests that UR-12746 (70) provides an attractive new approach to the treatment of ulcerative colitis.

Exact T=0 partition functions for Potts antiferromagnets on sections of the simple cubic lattice

We present exact solutions for the zero-temperature partition function of the q-state Potts antiferromagnet (equivalently, the chromatic polynomial P) on tube sections of the simple cubic lattice of fixed transverse size Lx x L(y) and arbitrarily great length L(z), for sizes Lx x L(y)=2 x 3 and 2 x 4 and boundary conditions (a) (FBC(x),FBC(y),FBC(z)) and (b) (PBC(x),FBC(y),FBC(z)), where FBC (PBC) denote free (periodic) boundary conditions. In the limit of infinite length, L(z)-->infinity, we calculate the resultant ground-state degeneracy per site W (=exponent of the ground-state entropy). Generalizing q from Z+ to C, we determine the analytic structure of W and the related singular locus Beta which is the continuous accumulation set of zeros of the chromatic polynomial. For the L(z)-->infinity limit of a given family of lattice sections, W is analytic for real q down to a value q(c). We determine the values of q(c) for the lattice sections considered and address the question of the value of q(c) for a d-dimensional Cartesian lattice. Analogous results are presented for a tube of arbitrarily great length whose transverse cross section is formed from the complete bipartite graph K(m,m).

Isolation and partial characterization of three DNA polymerases from Trypanosoma cruzi

Three distinct DNA polymerase fractions (A, B and C), were isolated from Trypanosoma cruzi epimastigote forms. Fraction A is a low molecular mass enzyme corresponding to beta-like DNA polymerase of T. cruzi. Fraction B co-purified along several purification steps with fraction A, but in the last step it was clearly separated by a phosphocellulose chromatography. Fraction C was separated from fractions A and B by binding to DEAE-cellulose column, since the other two fractions were eluted in the flowthrough. This enzyme has an apparent native molecular mass of 100 kDa and showed a high preference for poly(dC)-oligo(dG) among different template-primers tested as substrate. Western-blot and biochemical analysis strongly suggest that the three DNA polymerase fractions correspond to different molecular entities. These results are in agreement with the idea that fraction C is a new DNA polymerase of T. cruzi, not described before.

DARPP-32 and CREB are present in type 2 iodothyronine deiodinase-producing tanycytes: implications for the regulation of type 2 deiodinase activity

Type 2 iodothyronine deiodinase, an enzyme involved in the conversion of thyroxin to the biologically active 3,5, 3'-triiodothyronine, is highly concentrated in a group of specialized ependymal cells, tanycytes, lining the wall and floor of the third ventricle. As this distribution is highly reminiscent of the distribution of cells containing the phosphatase inhibitor, DARPP-32, we raised the possibility that these two proteins may coexist in tanycytes and that DARPP-32 may modulate type 2 deiodinase activity by regulating the phosphorylation state of the cAMP regulatory factor, CREB. To address this question, double-labeling histochemical studies were performed for type 2 deiodinase mRNA and DARPP-32 immunoreactivity (IR), or DARPP-32- and CREB-IR in the same tissue sections. Type 2 deiodinase mRNA was found in the cell bodies of all DARPP-32-immunolabeled tanycytes. Both type 2 deiodinase mRNA and DARPP-32-IR also extended into tanycyte processes that ramified in the arcuate nucleus and median eminence, in close association with blood vessels and portal capillaries. In contrast, type 2 deiodinase mRNA was not present in the same cells that contained DARPP-32-IR in the pituitary gland. All tanycytes containing DARPP-32-IR also contained CREB-IR in their nucleus. Since type 2 deiodinase activity can be induced by substances that increase cAMP, we hypothesize that DARPP-32 may regulate the activity of type 2 deiodinase by prolonging the activation of CREB. Selectivity for the colocalization of these factors to tanycytes but not the pituitary gland, may explain the heterogeneous response of type 2 deiodinase activity in these two loci in response to specific stimuli such as fasting.

[The diet rich in monounsaturated fat modifies in a beneficial way carbohydrate metabolism and arterial pressure]

OBJECTIVE

Two dietary regimens recommended for the reduction of coronary risk, by way of their effects on lipid profile, are the diet low in saturated fat and a diet rich in monounsaturated fats (MUFA). However the effects of these diets on carbohydrate metabolism in healthy subjects are not well known. The objective of this study was to compare the effect of both diets on various parameters of carbohydrate metabolism.

METHODS

41 healthy young males were submitted to 3 consecutive diets, each for a duration of 4 weeks. The first diet was rich in saturated fat (SAT) (38% fat, 20% saturated). The second was rich in carbohydrates following the recommendations of the NCEP-I (National Cholesterol Education Program type I) (28% fat, 47% carbohydrates). The last one was a diet rich in monounsaturated fatty acids (38% fat, 22% MUFA). At the end of each dietary period, blood pressure (BP) and blood levels of glucose, insulin and free fatty acids were determined. 29 subjects were also submitted to an oral glucose tolerance test (OGTT) at the end of each diet.

RESULTS

The SAT diet induced the highest levels of insulin after the OGTT. The consumption of the MUFA diet determined the lowest levels of fasting blood glucose (-0.60 mmol/l [13%], p < 0.0002), insulin (-9 microUl/ml [47%], p < 0.0002) and free fatty acids (-0.11 mmol/l [24%], p = 0.006), compared to the NCEP-I diet. Systolic and diastolic blood pressure were higher in the NCEP-I diet than during the other periods (SBP: +6 mmHg compare with SAT [5%], p = 0.0001; and +5 mmHg compare with MUFA [4%], p = 0.0001; DBP: +20 mmHg compare with MUFA [27%], p = 0.0001) and +6 mmHg compared with SAT [8%], p = 0.0001).

CONCLUSION

Of the diets most commonly used for the treatment and prevention of arteriosclerosis, a diet rich in monounsaturated fats is the most beneficial for the healthy population from the point of view of carbohydrate metabolism and blood pressure.

African swine fever virus dUTPase is a highly specific enzyme required for efficient replication in swine macrophages

The African swine fever virus (ASFV) gene E165R, which is homologous to dUTPases, has been characterized. A multiple alignment of dUTPases showed the conservation in ASFV dUTPase of the motifs that define this protein family. A biochemical analysis of the purified recombinant enzyme showed that the virus dUTPase is a trimeric, highly specific enzyme that requires a divalent cation for activity. The enzyme is most probably complexed with Mg(2+), the preferred cation, and has an apparent K(m) for dUTP of 1 microM. Northern and Western blotting, as well as immunofluorescence analyses, indicated that the enzyme is expressed at early and late times of infection and is localized in the cytoplasm of the infected cells. On the other hand, an ASFV dUTPase-deletion mutant (vDeltaE165R) has been obtained. Growth kinetics showed that vDeltaE165R replicates as efficiently as parental virus in Vero cells but only to 10% or less of parental virus in swine macrophages. Our results suggest that the dUTPase activity is dispensable for virus replication in dividing cells but is required for productive infection in nondividing swine macrophages, the natural host cell for the virus. The viral dUTPase may play a role in lowering the dUTP concentration in natural infections to minimize misincorporation of deoxyuridine into the viral DNA and ensure the fidelity of genome replication.

[Fournier's gangrene. Our clinical experience, etiopathogenesis and management]

We report 12 cases of Fournier's Gangrene treated over an 19-month period; at Division Urology of the Hospital Gral. de Agudos Dr. José M. Ramos Mejia. We emphatized 58.3% of the patients had an urology origin. We considered diagnostic and therapeutic issues, and bibliografic review.

[Clear cell renal carcinoma outside of the usual age group]

We report a case of a 17 year old woman with a clear cell sarcoma of kidney treated at the Division of Urology of Hospital General de Agudos Dr. José M. Ramos Mejía dependent of Government of Buenos Aires City. This report is based on the unusual age of tumor presentation and its good course and results after radiotherapy and chemotherapy, with 10 years survival after surgery.