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La situación nutricional ha evolucionado en forma diferente en los países del continente. El objetivo del estudio fue analizar los cambios del estado nutricional y algunos de sus condicionantes en América Latina en estos últimos años. Se realizó una búsqueda electrónica y manual de artículos publicados entre 1995 y 2005, seleccionándose los que abordaron la situación alimentario nutricional de países latinoamericanos. Adicionalmente, se obtuvieron datos de encuestas nacionales y reportes internacionales incluyendo fundamentalmente información a partir de 1990. Los países han evolucionado hacia diferentes estadios de transición, observándose un incremento de exceso de peso, particularmente en mujeres adultas, en que se supera el 30% y en algunos países llega al 70%. Igualmente preocupante es la situación infantil, donde cinco países superan el 6% de obesidad. Hay una tendencia a disminuir el déficit de peso, siete de nueve países presentaron una reducción de mujeres con bajo peso y el déficit de crecimiento disminuyó generalizadamente. Se observó un aumento de la disponibilidad calórica en 17 de 20 países. La población que vive bajo la línea de pobreza ha disminuido en 9 de 13 países, aunque hay algunos que superan el 60%. Los indicadores de sedentarismo han aumentado, el parque automotriz ha subido en todos los países y algo similar ocurre con televisores y computadores. La evolución del estado nutricional refleja una acción multifactorial donde destacan: aumento de la ingesta calórica, incremento de actividades sedentarias en un entorno más urbanizado promotor de tecnologías que limitan la actividad física y disminución de la inseguridad alimentaria producto del descenso de la pobreza aunque desigualdades sociales persisten.The nutrition situation has evolved in different ways in Latin-American countries. The aim of the study was to analyze the nutritional change and some conditions within Latin America in the last years. An electronic and manual search of articles published between 1995 and 2005 was made, selecting those that included the nutritional situation of Latin American countries. Additionally, data was collected from national surveys and international reports including information since 1990. The countries have evolved through different transition stages. For example, an increase of excess of weight, particularly in adult women, which exceeded 30% in some countries also reached up to 70% in others. Equally worrisome was the over 6% obesity level in children in five of the countries surveyed. There is a tendency to diminish the deficit of weight with seven of nine countries displaying a reduction of women with low weight while stunting diminished globally. An increase of the caloric availability in 17 of 20 countries was also observed. The total population that lives under the poverty line has diminished in 9 of 13 countries although some exceeded 60%. Some indicators of sedentary lifestyle have increased, the number of cars has been increasing in all countries and similar figures are recorded with respect to television and personnel computers. The evolution of the nutritional status is reflected through the action of set factors, the most important of which being the increase in caloric ingestion and sedentary activities in an urbanized environment, the promotion of the use of technologies that limit physical activity. There is also a reduction in food insecurity due to a fall in poverty levels although social inequalities still persist. more...

Cities are increasingly acknowledged as crucial when facing climate change—and the environmental crisis more in general—, offering challenges and opportunities in terms of both mitigation and adaptation. Climate change‐sensitive urban governance requires proactive, integrated, and contextualized approaches, making room for the complex, multilayered, multiscalar, and dynamic processes constituting a city. The notion of "resilience" has been acquiring growing recognition as a flexible and powerful concept to respond to these challenges. Resilience itself, however, is also a polysemic notion, often treated as little more than a catchword or a wishful aim or superimposed with other climate‐related terms, such as risk, vulnerability, or adaptation. To promote a stronger integration among different problem‐settings and epistemic communities, this paper advances six analytical distinctions aiming to provide structure and articulation to existing definitions of the concept of "resilience." Likewise, it offers an integrated analytical framework and methodological pipeline to streamline resilience analysis in the context of urban climate risk assessment. The framework is specially defined to link up with the definition of climate risk provided by the Intergovernmental Panel on Climate Change (IPCC) latest Assessment Reports and is illustrated through examples derived from the recent experience of the Chilean Climate Risk Atlas. Plain Language Summary: This paper offers an integrated terminology, analytical framework, and procedure to measure and predict a city's resilience in the face of climate threats. Based on a thorough review and discussion of the literature on the topic, the proposal is designed to articulate existing approaches, usages, and interpretations of the concept. It aims to guide scholars, practitioners, and policymakers to employ resilience as a tool for urban planning and governance. Key Points: We advance six analytical distinctions and a methodological pipeline to streamline resilience in urban climate risk assessmentOur framework promotes integrated and interdisciplinary efforts toward climate‐sensitive urban risk assessment and planningPolycentric governance is required to balance autonomy and coherence across the systems constituting urban Systems‐of‐Systems [ABSTRACT FROM AUTHOR] more...

La situación nutricional ha evolucionado en forma diferente en los países del continente. El objetivo del estudio fue analizar los cambios del estado nutricional y algunos de sus condicionantes en América Latina en estos últimos años. Se realizó una búsqueda electrónica y manual de artículos publicados entre 1995 y 2005, seleccionándose los que abordaron la situación alimentario nutricional de países latinoamericanos. Adicionalmente, se obtuvieron datos de encuestas nacionales y reportes internacionales incluyendo fundamentalmente información a partir de 1990. Los países han evolucionado hacia diferentes estadios de transición, observándose un incremento de exceso de peso, particularmente en mujeres adultas, en que se supera el 30% y en algunos países llega al 70%. Igualmente preocupante es la situación infantil, donde cinco países superan el 6% de obesidad. Hay una tendencia a disminuir el déficit de peso, siete de nueve países presentaron una reducción de mujeres con bajo peso y el déficit de crecimiento disminuyó generalizadamente. Se observó un aumento de la disponibilidad calórica en 17 de 20 países. La población que vive bajo la línea de pobreza ha disminuido en 9 de 13 países, aunque hay algunos que superan el 60%. Los indicadores de sedentarismo han aumentado, el parque automotriz ha subido en todos los países y algo similar ocurre con televisores y computadores. La evolución del estado nutricional refleja una acción multifactorial donde destacan: aumento de la ingesta calórica, incremento de actividades sedentarias en un entorno más urbanizado promotor de tecnologías que limitan la actividad física y disminución de la inseguridad alimentaria producto del descenso de la pobreza aunque desigualdades sociales persisten. more...

Introduction: Glucocorticoids are widely used in the treatment of immune-mediated diseases. Despite their widespread use, details on dosing, effectiveness and adverse effects are yet to be determined. Objective: To know the current use of methylprednisolone (MTP) in the management of immune-mediated conditions, evaluating the relationship among doses, therapeutic response and adverse effects. Methodology: A multicenter retrospective cohort study was designed, including patients who received intravenous pulses of MTP between 1 January 2013 and 12 December 2015 in three different hospitals in Uruguay. The patients included received MTP to treat systemic autoimmune diseases (SADs), hematological, nephrological and neurologic diseases and others. The following variables were analyzed: age, gender, MTP cumulative dose, duration of treatment, clinical response (complete, partial and no response) and adverse effects. Results: In total, 164 cases were identified, of which 118 (72%) were female. The median age was 48.4 (SD: 18) years. The indications for MTP included: neuroimmune- mediated 92 (56.1%), SADs 29 (17.5%), hematological 15 (9.1%), nephrological 12 (7.3%) and others 16 (9.9%). The median dose to achieve complete response was 3.2 g (SD: 1.5); the median dose to accomplish a partial response was 3.5 g (SD: 1.25); the median dose for non-responders was 3.3 g (SD 1.2) (p>0.05). The median dose in those patients with adverse effects was 3.4 g (SD 1.5) and the median dose for those who did not experience adverse effects was 3.3 g (SD: 1.3) (p>0.05). The most frequent adverse effects were infectious (22/164, 13.4%). Diabetics were found to have the highest incidence of adverse effects (13/16, 81%) in comparison to non-diabetics, p<0.05. Discussion: Our study suggests a wide range of doses and duration of treatments with MTP. No major associations were found between clinical response and the use of high MTP doses, but the latter was associated with a large proportion of severe infections. No severe infections were identified with MTP doses lower than 1.5 g. The diabetic population is known to be at risk of experiencing varied adverse effects to MTP. These observations reinforce the need for protocolized use of MTP in order to achieve a better relationship among doses, effectiveness and safety profile. [ABSTRACT FROM AUTHOR] more...

Microbiological analysis is an integral part of food quality control, as well as of the management of food chain safety. Microbiological testing of foodstuffs complements the preventive approach to food safety activities based mainly on implementation and application of the concept of Hazard Analysis and Critical Control Points (HACCP). Traditional microbiological methods are powerful but lengthy and cumbersome and therefore not fully compatible with current requirements. Even more, pathogens exist that are fastidious to cultivate or uncultivable at all. Besides immunological tests, molecular methods, specifically those based on polymerase chain reaction (PCR), are available options to meet industry and enforcement needs. The clear advantage of PCR over all other rapid methods is the striking analytical principle that is based on amplification of DNA, a molecule being present in every cell prone to multiply. Just by changing primers and probes, different genomes such as bacteria, viruses or parasites can be detected. A second advantage is the ability to both detect and quantify a biotic contaminant. Some previously identified obstacles of implementation of molecular methods have already been overcome. Technical measures became available that improved robustness of molecular methods, and equipment and biochemicals became much more affordable. Unfortunately, molecular methods suffer from certain drawbacks that hamper their full integration to food safety control. Those encompass a suitable sample pre-treatment especially for a quantitative extraction of bacteria and viruses from solid foods, limited availability of appropriate controls to evaluate the effectiveness of the analytical procedure, the current inability of molecular methods to distinguish DNA from viable cells and DNA from dead or non-cultivable cells, and the slow progress of international harmonisation and standardisation, which limit full acceptance of PCR-based methods in food control. The aim of this review is to describe the context and the prospects of PCR-based methods, as well as trends in research and development aimed at solving the next decade challenges in order to achieve full integration of molecular methods in food safety control. [ABSTRACT FROM AUTHOR] more...

Objective: Real-world evidence on the adoption of different pharmacological strategies in inflammatory bowel disease (IBD) in Latin America is scarce. Herein, we describe real-world sociodemographic, clinical characteristics, and different therapeutic approaches used in patients with IBD in Argentina., Methods: RISE AR (NCT03488030) was a multicenter, non-interventional study with a cross-sectional evaluation and a 3-year retrospective chart review conducted in Argentina. Adult patients with a previous diagnosis of moderate-to-severe ulcerative colitis (UC) or Crohn's disease (CD) at least 6 months prior to enrollment were included., Results: This study included 246 patients with IBD (CD: 41%; UC: 59%), with a median age of 39.5 years (IQR 30.7-51.7) for CD and 41.9 years (33.3-55.3) for UC. Overall, 51.5% of CD patients had colonic disease involvement, while 45.5% of UC patients had extensive colitis. At enrollment, the overall use of biologics was high, especially in CD patients (CD: 73.2% vs. UC: 30.3%, p<0.001), while the use of immunosuppressants was similar (∼41%, p=1.000) for both diseases. IBD treatments ever prescribed and healthcare resources utilization during the retrospective period were (CD, UC): biologics: 79.2%, 33.8% (p<0.001); immunosuppressants: 65.3%, 58.6% (p=0.352); aminosalicylates: 62.4%, 97.9% (p<0.001); corticosteroids: 55.4%, 69.7% (p=0.031); surgery: 17.8%, 1.4% (p<0.001); and hospitalizations: 33.7%, 21.4% (p=0.039)., Conclusion: In this cohort of IBD patients, overall prescription patterns of conventional therapy were similar to reports elsewhere; however, biologic therapy use was high, especially in CD, consistent with disease behavior and possibly reflecting better access to care in referral centers. Interestingly, over half of CD patients presented colonic involvement., (Copyright © 2024 Elsevier España, S.L.U. All rights reserved.) more...

Background: The COVID-19 pandemic brought an increased incidence of disease and mortality in the world at large, making it a particularly salient and stressful life event. For those individuals residing in Latin America, the pandemic was met with fragmented healthcare systems, economic downturn, and sociopolitical crisis which puts autistic individuals at risk for more detrimental outcomes. Behavioral and emotional challenges experienced by autistic individuals at the beginning of the pandemic could later develop into more severe symptomatology as the pandemic progresses. The present study aimed to explore changes in dysregulated (overt and internalizing) behaviors and preoccupation with getting sick during the COVID-19 pandemic among autistic children in 7 Latin American countries., Method: Sample consisted of 1,743 caregivers, residing in: Argentina ( n  = 677, 38.8%) Brazil ( n = 156, 9%), Chile ( n = 251, 14.4%), Dominican Republic ( n  = 171, 9.8%), Mexico ( n = 126, 7.2%), Uruguay ( n = 259, 14.9%) and Venezuela ( n  = 103, 5.9%). The majority of caregivers who completed the questionnaire were mothers (85.1%), and most had a male autistic child (81.6%). A series of independent sample t -tests were conducted to assess country differences in dysregulated behaviors and preoccupation with getting sick. Linear regressions were conducted to identify which demographic characteristics and micro-level contextual factors predicted dysregulated overt behaviors and psychological changes., Results: Contextual factors, such as country of residence, were related to preoccupation with getting sick and dysregulated behavior. Particularly, residing in Mexico and Brazil were related to changes in preoccupation with getting sick and mental health concerns. Coexistence predicted dysregulated internalizing behaviors, while being older significantly predicted preoccupation with getting sick. Increased screen time only predicted anxiety., Conclusion: Our findings highlight differences and predictions of behavioral challenges and psychological changes based on certain contextual factors and individual characteristics while experiencing severe life stressors such as a worldwide pandemic. This knowledge could help inform policies and decrees aimed at protecting those most vulnerable due to their increased difficulty adapting to change., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Montenegro, Ramírez, Hernandez Rodriguez, Villalobos, Garrido, Amigo, Valdez, Barrios, Cukier, Rattazzi, Rosoli, García, Paula, Liz and Montiel-Nava.) more...

Food allergens and intolerances have been diagnosed by doctors for decades, but have received heightened attention in the last two decades because diagnosis and awareness have increased. Consequently, regulators in many jurisdictions have addressed this topic by introducing labeling requirements for substances causing allergies and intolerance reactions in affected individuals. Mandatory labeling of food allergens allows persons suffering from these to make informed choices. However, regulations in some geographic areas have resulted in significant problems for manufacturers as well as consumers. This has been mainly due to frequent changes and amendments, and it has been difficult for all stakeholders to follow and understand the status quo of legislation. The present paper describes the development of European directives and regulations for the labeling of food allergens and intolerances to substances like gluten over the past decades and provides an outlook of what can reasonably be expected to change in the coming years. It also identifies existing gaps, like a lack of threshold levels for adventitious contamination and consequently a proliferation of precautionary allergen labeling, which neither benefits the consumer nor the food industry in its current form. more...

Until recently, analytical tests for food were performed primarily in laboratories, but technical developments now enable consumers to use devices to test their food at home or when dining out. Current consumer devices for food can determine nutritional values, freshness, and, most recently, the presence of food allergens and substances that cause food intolerances. The demand for such products is driven by an increase in the incidence of food allergies, as well as consumer desire for more information about what is in their food. The number and complexity of food matrixes creates an important need for properly validated testing devices with comprehensive user instructions (definitions of technical terms can be found in ISO 5725-1:1994 and the International Vocabulary of Metrology). This is especially important with food allergen determinations that can have life-threatening consequences. Stakeholders-including food regulators, food producers, and food testing kit and equipment manufacturers, as well as representatives from consumer advocacy groups-have worked to outline voluntary guidelines for consumer food allergen- and gluten-testing devices. These guidelines cover areas such as kit validation, user sampling instructions, kit performance, and interpretation of results. The recommendations are based on (1) current known technologies, (2) analytical expertise, and (3) standardized AOAC INTERNATIONAL allergen community guidance and best practices on the analysis of food allergens and gluten. The present guidance document is the first in a series of papers intended to provide general guidelines applicable to consumer devices for all food analytes. Future publications will give specific guidance and validation protocols for devices designed to detect individual allergens and gluten, as statistical analysis and review of any validation data, preferably from an independent third party, are necessary to establish a device's fitness-for-purpose. Following the recommendations of these guidance documents will help ensure that consumers are equipped with sufficient information to make an informed decision based on an analytical result from a consumer device. However, the present guidance document emphasizes that consumer devices should not be used in isolation to make a determination as to whether a food is safe to eat. As advances are made in science and technology, these recommendations will be reevaluated and revised as appropriate. more...

Background: Gait disorder is very prevalent in multiple sclerosis. After 15 years of disease progression, 50% of patients need assistive devices for walking., Materials & Methods: We performed a multicenter observational study, including multiple sclerosis patients with an Expanded Disability Status Scale score between 4.0 and 7.0, normal kidney function and no previous history of seizures., Results: The study sample comprised 138 patients with average age of 50.3 years median Expanded Disability Status Scale of 6.0. After treatment, a significant reduction was observed in both the Timed 25-Foot Walk test (baseline, 20.3 s; 14 days, 13.2 s; p < 0.001; 3 months, 12.1 s; p < 0.001) and the 12-Item Multiple Sclerosis Walking Scale score (baseline, 82.3; 14 days, 59.4; p < 0.001; 3 months, 57.2; p < 0.001). Adverse events were recorded in 39.9% of patients. more...

The food allergen analytical community is endeavoring to create harmonized guidelines for the validation of food allergen ELISA methodologies to help protect food-sensitive individuals and promote consumer confidence. This document provides additional guidance to existing method validation publications for quantitative food allergen ELISA methods. The gluten-specific criterion provided in this document is divided into sections for information required by the method developer about the assay and information for the implementation of the multilaboratory validation study. Many of these recommendations and guidance are built upon the widely accepted Codex Alimentarius definitions and recommendations for gluten-free foods. The information in this document can be used as the basis of a harmonized validation protocol for any ELISA method for gluten, whether proprietary or nonproprietary, that will be submitted to AOAC andlor regulatory authorities or other bodies for status recognition. Future work is planned for the implementation of this guidance document for the validation of gluten methods and the creation of gluten reference materials. more...

The determination of prolamins by ELISA and subsequent conversion of the resulting concentration to gluten content in food appears to be a comparatively simple and straightforward process with which many laboratories have years-long experience. At the end of the process, a value of gluten, expressed in mg/kg or ppm, is obtained. This value often is the basis for the decision if a product can be labeled gluten-free or not. On the basis of currently available scientific information, the accuracy of the obtained values with commonly used commercial ELISA kits has to be questioned. Although recently several multilaboratory studies have been conducted in an attempt to emphasize and ensure the accuracy of the results, data suggest that it was the precision of these assays, not the accuracy, that was confirmed because some of the underlying assumptions for calculating the gluten content lack scientific data support as well as appropriate reference materials for comparison. This paper discusses the issues of gluten determination and quantification with respect to antibody specificity, extraction procedures, reference materials, and their commutability. more...

Immunodetection of allergens in dark chocolate is complicated by interference from the chocolate components. The objectives of this study were to establish reference materials for detecting multiple allergens in dark chocolate and to determine the accuracy and precision of allergen detection by enzyme-linked immunosorbent assay (ELISA) before and after chocolate processing. Defatted peanut flour, whole egg powder, and spray-dried milk were added to melted chocolate at seven incurred levels and tempered for 4 h. Allergen concentrations were measured using commercial ELISA kits. Tempering decreased the detection of casein and β-lactoglobulin (BLG), but had no significant effect on the detection of peanut and egg. Total coefficients of variation were higher in tempered than untempered chocolate for casein and BLG, but total and analytical CVs were comparable for peanut and egg. These findings indicate that processing has a greater effect on recovery and variability of casein and BLG than peanut and egg detection in a dark chocolate matrix. more...

Among the major food allergies, peanut, egg, and milk are the most common. The immunochemical detection of food allergens depends on various factors, such as the food matrix and processing method, which can affect allergen conformation and extractability. This study aimed to (1) develop matrix-specific incurred reference materials for allergen testing, (2) determine whether multiple allergens in the same model food can be simultaneously detected, and (3) establish the effect of processing on reference material stability and allergen detection. Defatted peanut flour, whole egg powder, and spray-dried milk were added to cookie dough at seven incurred levels before baking. Allergens were measured using five commercial enzyme-linked immunosorbent assay (ELISA) kits. All kits showed decreased recovery of all allergens after baking. Analytical coefficients of variation for most kits increased with baking time, but decreased with incurred allergen level. Thus, food processing negatively affects the recovery and variability of peanut, egg, and milk detection in a sugar cookie matrix when using immunochemical methods. more...

Gluten is a commonly used cereal derivative found in bakery products, among other items. In some susceptible individuals, however, it triggers immune responses of different kinds; there is, to a lesser extent, the wheat allergy that is immunoglobulin E (IgE)-mediated and leads to histamine release and typical allergic symptoms. In this case, other water-soluble proteins, like albumins, are also involved. On the other hand, there is, more frequently, celiac disease (CD), where the gluten causes immune reactions in the intestines of certain individuals, leading to degeneration of villi, which typically leads to malabsorption of nutrients and, consequently, malnutrition. The only currently effective health strategy for affected consumers is avoidance of gluten-containing products, based on clear labeling rules. However, despite unanimously accepted Codex definitions by all member jurisdictions, the national implementation of equivalent laws shows significant differences. In the context of CD and in support of the gluten-free statement, regulatory enforcement, as well as manufacturers' quality controls are mostly based on analytical results. However, numerous methods are available, some of which have been validated better than others, and many provide different results on identical samples. Reasons include detection of different gluten components and variability in extraction efficiency due to different buffer compositions, especially from processed foods. Last but not least, the lack of reference materials is hindering the process of generating comparable data across different ELISA kits, as well as other methods. How can such data still be used to support a gluten-free claim? New methodologies, in particular mass spectrometric analysis of gluten derived peptides, are being introduced in numerous laboratories. This methodology is not only capable of detecting gluten derived peptides but can also differentiate between and quantitate wheat, barley, rye, and oat. This paper presents analytical limitations, as well as promising new approaches in support of industry and enforcement activities to ensure compliance with the gluten-free claim under the current regulatory framework. more...

Celiac disease and wheat allergy are the most common adverse reactions triggered by cereal proteins, mainly gluten, which is one of the 14 allergenic food ingredients that must be labeled on food products in the European Union (EU). To meet the requirements of this regulation, reliable analytical methodology for proper quantification of gluten is necessary. However, validation of presently used methods (ELISA and lateral flow device) is limited partly due to the lack of reference methods and incurred reference materials. To solve this problem, the goal of our work was to develop an incurred reference material for the quantification of gluten under the auspices of EU-FP6 funded Network of Excellence MoniQA. During this work, we produced a processed model product (cookie) containing gliadin (major allergenic fraction of gluten) in a defined amount. This paper addresses the development process of this material together with the associated problems (insufficient homogeneity and low recovery) and their solutions. As a result, an incurred food matrix was produced on a laboratory-scale with a potential use as a reference material. The model product was tested by an ELISA method followed by a comparative study of commercially available ELISA kits to investigate the applicability of the product. Preliminary results of this study are also presented. more...

Food allergen labeling regulations have been implemented in several countries since 2006. Currently, experts are still discussing the introduction of thresholds or action levels, which should lead to the reduction of the widespread use of advisory statements (e.g., "may contain") for the benefit of the allergic consumer. However, the establishment of threshold requires supporting analytical methodologies to enforce and comply with the regulations. This article discusses the possibilities and limitations of existing and emerging methodologies for the purpose of enabling compliance with and enforcement of allergen action levels. more...

The sesquiterpenoid panasinsane derivatives 11 and 14-16 have been prepared from caryophyllene oxide (7). The novel rearrangement reactions of compounds 11 and 14 under TCNE-catalyzed solvolysis conditions and the reactions of compounds 15 and 16 under superacid conditions (HSO3F/Et2O, -63 degrees C) have been investigated. The ginsenol derivative 17 is obtained from compounds 11 and 14 under TCNE-catalyzed conditions. The rearrangement of compounds 15 and 16 under superacid conditions leads to the novel sesquiterpene derivatives (1S,4S,7S,10S,11S)-3,3,10,11-tetramethyltricyclo[5.3.1.0(4,10)]undecan-1,11-yl sulfate (19) and (1S,4S,5S,8S)-2,2,4,8-tetramethyl tricyclo[3.3.2.1(4,8)]undecan-11-one (20). The influence of the secondary hydroxyl group at C-5 of the panasinsane derivatives on the course of these rearrangements is discussed. more...