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Diabetes mellitus is a chronic metabolic disease characterized by high blood glucose levels, often leading to dietary restrictions. Therefore, the objective focuses on evaluating the variability of glucose levels before and after the consumption of desserts sweetened with Stevia, in addition to their organoleptic acceptance. This study adopted a mixed and cross-sectional, non-experimental approach. The quantitative part used a glucometer to measure glucose levels, while the qualitative part used a five-point hedonic scale to evaluate organoleptic attributes such as color, aroma, flavor and texture. An analysis of variance (ANOVA), an Anderson-Darling (AD) normality test and a Tukey comparative method of means were performed. Obtaining that the analyzes revealed that there is no significant variation in glucose levels after consuming three different desserts in 55 (21 + 34) participants. Organoleptic acceptability was high, with an average score of 4.6/5. Concluding that the use of Stevia in a proportion of 8% compared to sucrose is viable in manufactured products, without significantly affecting glucose levels in people with diabetes., La diabetes mellitus es una enfermedad metabólica crónica caracterizada por altos niveles de glucosa en la sangre, a menudo llevando a restricciones alimenticias. Por lo tanto, el objetivo se centra en evaluar la variabilidad de los niveles de glucosa antes y después del consumo de postres endulzados con Stevia, además de su aceptación organoléptica. Este estudio adoptó un enfoque mixto y transversal, no experimental. La parte cuantitativa utilizó un glucómetro para medir los niveles de glucosa, mientras que la parte cualitativa empleó una escala hedónica de cinco puntos para evaluar atributos organolépticos como color, aroma, sabor y textura. Se realizó un análisis de varianza (ANOVA), una prueba de normalidad Anderson-Darling (AD) y un método comparativo de medias de Tukey. Obteniendo que los análisis revelaron que no hay una variación significativa en los niveles de glucosa después de consumir tres distintos postres en 55 (21 + 34) participantes. La aceptabilidad organoléptica fue alta, con una puntuación media de 4.6/5. Concluyendo en el uso de Stevia en proporción del 8% en comparación con la sacarosa es viable en productos elaborados, sin afectar significativamente los niveles de glucosa en personas con diabetes.

Prologue The cutting edge of Health Sciences research is defined not only by its ability to respond to current challenges, but also by its audacity in entering complex and not yet fully understood areas. "Contemporary Research from a Multidisciplinary Vision. Book 6. Health Sciences" continues this tradition of excellence and exploration, consolidating itself as a pillar of advanced knowledge. This volume is committed to illuminating pragmatic solutions to persistent problems in the field of health and advancing the understanding of critical issues. The result of exceptional collaboration between prominent authors and the Latin American Editorial Network for Contemporary Research, this book transcends the boundaries of conventional knowledge. It reaffirms the commitment to academic excellence and innovation, reflecting the unwavering dedication to the highest scientific standards. The Network has played a crucial role in the conception, development and publication of this work, ensuring that each contribution stands out for its quality and originality. This volume is distinguished by its commitment to the democratization of knowledge. Following the tradition of the series, all chapters are available for free download under a Creative Commons license, thus facilitating universal access to the latest advances in Health Sciences. This effort is possible thanks to the platform of the Latin American Editorial Network for Contemporary Research, which serves as an invaluable resource for researchers, health professionals and the general public interested in the subject. Each chapter has been subjected to a rigorous editorial process, including an exhaustive anti-plagiarism check and a review by external blind peers. This guarantees not only the quality and originality of the information presented, but also the reliability of the conclusions. The topics addressed in this book, from neurogenic dehydration and diabetes insipidus to the effectiveness of the HPV vaccine i, Prólogo La vanguardia de la investigación en Ciencias de la Salud se define no solo por su capacidad para responder a los desafíos actuales, sino también por su audacia al adentrarse en áreas complejas y aún no completamente entendidas. "Investigación Contemporánea desde una Visión Multidisciplinar. Libro 6. Ciencias de la Salud" sigue esta tradición de excelencia y exploración, consolidándose como un pilar de conocimiento avanzado. Este volumen se compromete a iluminar soluciones pragmáticas a problemas persistentes en el campo de la salud y avanzar en la comprensión de temáticas críticas. Fruto de la colaboración excepcional entre destacados autores y la Red Editorial Latinoamericana de Investigación Contemporánea, este libro trasciende las fronteras del conocimiento convencional. Reafirma el compromiso con la excelencia académica y la innovación, reflejando la dedicación inquebrantable a los más altos estándares científicos. La Red ha desempeñado un papel crucial en la concepción, desarrollo y publicación de esta obra, asegurando que cada contribución destaque por su calidad y originalidad. Este volumen se distingue por su compromiso con la democratización del conocimiento. Siguiendo la tradición de la serie, todos los capítulos están disponibles para su descarga gratuita bajo licencia Creative Commons, facilitando así el acceso universal a los últimos avances en las Ciencias de la Salud. Este esfuerzo es posible gracias a la plataforma de la Red Editorial Latinoamericana de Investigación Contemporánea, que sirve como un recurso invaluable para investigadores, profesionales de la salud y el público general interesado en la materia. Cada capítulo ha sido sometido a un riguroso proceso editorial, incluyendo un exhaustivo control antiplagio y una revisión por pares ciegos externos. Esto garantiza no solo la calidad y originalidad de la información presentada, sino también la fiabilidad de las conclusiones. Los temas abordados en este libro, desde la deshidratación n

The purpose of this research work was to generate information about the most representative wraps of the Ecuadorian highlands, since it has been determined that some traditional recipes are being lost, and others do not have a regulated record of production processes. The research was documentary and experimental, based initially on information obtained from a bibliographic analysis and later validated throughout interviews with experts, which lead to the development of six previously selected wrap recipes. These recipes start by knowing the historical context of each wrapper, followed by technical evaluations to record the processes; information that has been collected in a technical file. As part of the validation, an experimental application of three of these wraps was carried out, in addition to spread this information through publications in the official pages of the Ministry of Tourism Zone 6. The results show the importance of the promotion of contents to promote cultural and gastronomic tourism, contributing to the tourism and educational sector, as well as to small enterprises. In this way, through the social network Twitter of the Ministry of Tourism Zone 6, all the recipes were disseminated; likewise, a private enterprise tested three of the six recipes for wraps, whose results demonstrated on the one hand the validity of the recipe data sheet and on the other hand, the need for more support for the rescue of intangible heritage aspects. Keywords: traditional gastronomy of Ecuador, wrapped, gastronomic tourism promotion

Guillain-Barré syndrome (GBS) is a general term that describes several heterogeneous clinical and electrophysiological disorders that share the common characteristic of presenting acute-onset regional or generalized flaccid paralysis with or without sensory loss. Clinically, GBS may have generalized weakness or there may be restricted involvement and rare central nervous system involvement in the form of Bickerstaff brainstem encephalitis. Electrophysiologically, there may be demyelinating or axonal features, which may determine the prognosis in an individual patient. Knowledge of GBS variants is important to differentiate the presence of this clinical condition from other mimics. Nerve conduction studies and antiganglioside antibodies may be useful to better classify various variants of GBS. Although current treatment guidelines are similar for various subtypes, new treatment strategies are being developed depending on the pathophysiology of GBS variants., El síndrome de Guillain-Barré (SGB) es un término general que describe varios trastornos clínicos y electrofisiológicos heterogéneos que comparten la característica común de presentar parálisis flácida regional o generalizada de inicio agudo con o sin pérdida sensorial. Clínicamente, el SGB puede tener debilidad generalizada o puede haber afectación restringida y rara afectación del sistema nervioso central en forma de encefalitis del tronco encefálico de Bickerstaff. Electrofisiológicamente, puede haber características desmielinizantes o axonales, que pueden determinar el pronóstico en un paciente individual. El conocimiento de las variantes de SGB es importante para diferenciar la presencia de este cuadro clínico con respecto de otros imitadores. Los estudios de conducción nerviosa y los anticuerpos antigangliósidos pueden ser útiles para clasificar mejor varias variantes del SGB. Aunque las pautas de tratamiento actuales son similares para varios subtipos, se están desarrollando nuevas estrategias de tratamiento dependiendo de la fisiopatología de las variantes del SGB.

Background and Objectives: One of the major disadvantages of DNA-based microbial diagnostics is their inability to differentiate DNA between viable and dead microorganisms, which could be important when studying etiologically relevant pathogens. The aim of this investigation was to optimize a method forthe selective detection and quantification of only viable Aggregatibacter actino-mycetemcomitans and Porphyromonas gingivalis cells by combining quantitative real-time polymerase chain reaction (qPCR) and propidium monoazide (PMA). Material and Methods: Three different concentrations of PMA (10, 50 or 100lM)were added to suspensions of 106(CFU)/mL of viable/dead A. actinomycetem-comitans and P. gingivaliscells. After DNA isolation, qPCR was carried out using specific primers and probes for the tested bacteria. PMA was further tested with different mixtures containing varying ratios of viable and dead cells. The efficacyof PMA to detect viable/dead cells was tested by analysis of variance. Results: For these specific bacterial pathogens, 100lMPMA resulted in a signif-icant reduction of qPCR amplification with dead cells (106CFU/mL), while with viable cells no significant inhibition was detected. PMA was also effectivein detecting selectively viable cells by qPCR detection, when mixtures of varying ratios of viable and dead bacteria were used. Conclusions: This study demonstrated the efficiency of PMA for differentiating viable and dea dA. actinomycetemcomitans and P. gingivaliscells. This method of PMA-qPCR may be useful for monitoring new antimicrobial strategies and for assessing the pathogenic potential ofA. actinomycetemcomitansandP. gingi-valisin different oral conditions when using molecular diagnostic methods., Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub

Objectives: To compare biofilm formation on whole dental titanium implants with different surface micro‐topography. Methods: A multispecies in vitro biofilm model consisting of initial (Streptococcus ora‐lis and Actinomyces naeslundii), early (Veillonella parvula), secondary (Fusobacterium nucleatum) and late colonizers (Porphyromonas gingivalis and Aggregatibacter actino‐mycetemcomitans) was grown for 96 hr on sterile titanium dental implants with either minimal (Sa: 0.5–1.0 mm) or moderate‐roughness titanium surfaces (Sa: 1.1–2.0 mm). The resulting biofilms were studied with Confocal Laser Scanning Microscopy (CLSM) and Scanning Electron Microscope. Concentrations (colony‐forming units per mL [CFU/ml]) of each bacterium were measured by quantitative Polymerase Chain Reaction (qPCR) and compared by Student t tests. Results: A biofilm, located mainly at the peak and lateral areas of the implant threads, was observed on both implant surfaces, with a greater biomass and a greater live/dead ratio in moderate‐ compared to minimal‐roughness surface implants. Statistically sig ‐nificant higher values of total bacteria (mean difference = 2.61 × 107 CFU/ml; 95% confidence interval — CI [1.91 × 106; 5.02 × 107]; p = 0.036), F. Nucleatum (mean difference = 4.43 × 106 CFU/ml; 95% CI [1.06 × 106; 7.80 × 106]; p = 0.013) and A. actinomycetemcomitans (mean difference = 2.55 × 107 CFU/ml; 95% CI [1.07 × 107; 4.04 × 107]; p = 0.002), were found in the moderate‐ compared to minimal‐roughness surface dental implants. Conclusions: Implants with moderate‐roughness surfaces accumulated more bacte ‐rial biomass and significant higher number of pathogenic bacteria (F. nucleatum and A. actinomycetemcomitans), when compared to implants with minimal‐roughness sur ‐faces, within a similar biofilm structure., Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub

Background and Objectives: Differentiation of live and dead cells is an important challenge when using molecular diagnosis for microbial identification. This is particularly relevant when bacteria have been exposed to antimicrobial agents. The objective of this study was to test a method using quantitative real-time polymerase chain reaction (qPCR) combined with propidium monoazide (PMA), developed for the selective quantification of viable P. gingivalis, A. actinomycetemcomitans, F. nucleatum and total bacteria in an in vitro biofilm model after antimicrobial treatment. Material and Methods: PMA-qPCR method was tested in an in vitro biofilm model, using isopropyl alcohol as the antimicrobial agent. Matured biofilms were exposed for 1, 5, 10 and 30 min to isopropyl alcohol by immersion. Biofilms were disrupted and PMA added (final concentration of 100 lM). After DNA isolation, qPCR was carried out using specific primers and probes for the target bacteria. The differentiation of live and dead cells was tested by analysis of variance. Results: When PMA was used in the presence of viable target bacterial cells, no statistically significant inhibition of qPCR amplification was detected (p > 0.05 in all cases). Conversely, after immersion in isopropyl alcohol of the biofilm, PMA resulted in a significant total reduction of qPCR amplification of about 4 log10. P. gingivalis showed a vitality reduction in the biofilm of 3 log10, while A. actinomycetemcomitans and F. nucleatum showed a 2 log10 reduction. Conclusion: These results demonstrate the efficiency of PMA for differentiating viable and dead P. gingivalis, A. actinomycetemcomitans and F. nucleatum cells, as well as total bacteria, in an in vitro biofilm model, after being exposed to an antimicrobial agent. Hence, this PMA-qPCR method may be useful for studying the effect of antimicrobial agents aimed at oral biofilms., Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub

Background and objective Porphyromonas gingivalis is a keystone pathogen in the onset and progression of periodontitis. Its pathogenicity has been related to its presence and survival within the subgingival biofilm. The aim of the present study was to compare the genome-wide transcription activities of P. gingivalis in biofilm and in planktonic growth, using microarray technology. Material and methods P. gingivalis ATCC 33277 was incubated in multi-well culture plates at 37˚C for 96 hours under anaerobic conditions using an in vitro static model to develop both the planktonic and biofilm states (the latter over sterile ceramic calcium hydroxyapatite discs). The biofilm development was monitored by Confocal Laser Scanning Microscopy (CLSM) and Scanning Electron Microscopy (SEM). After incubation, the bacterial cells were harvested and total RNA was extracted and purified. Three biological replicates for each cell state were independently hybridized for transcriptomic comparisons. A linear model was used for determining differentially expressed genes and reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to confirm differential expression. The filtering criteria of ±2 change in gene expression and significance p-values of <0.05 were selected. Results A total of 92 out of 1,909 genes (4.8%) were differentially expressed by P. gingivalis growing in biofilm compared to planktonic. The 54 up-regulated genes in biofilm growth were mainly related to cell envelope, transport, and binding or outer membranes proteins. Thirty-eight showed decreased expression, mainly genes related to transposases or oxidative stress. Conclusion The adaptive response of P. gingivalis in biofilm growth demonstrated a differential gene expression., Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub

Objective: To investigate the effects of an orally administered probiotic on the oral microbiota. Methods: A placebo-controlled, parallel study was conducted in 40 gingivitis subjects during 8 weeks. Treatment consisted on the administration of a daily tablet, either containing Lactobacillus reuteri or placebo. Unstimulated saliva and subgingival samples were collected and analysed by culture and PCR. Clinical and microbiological outcome variables were compared between and within groups. Results: There were no significant changes between and within the groups in the clinical variables. In saliva, total anaerobic counts after 4 weeks (p = 0.021) and counts of Prevotella intermedia after 8 weeks (p = 0.030), showed reductions in the test group. In subgingival samples, significant reductions in the changes baseline to 4 weeks were observed for P. gingivalis counts (p = 0.008). With PCR, L. reuteri ATCC-PTA-5289 was more frequently detected than L. reuteri DSM-17938. Conclusions: The effect of L. reuteri administered in tablets resulted in a reduction in the number of selected periodontal pathogens in the subgingival microbiota, without an associated clinical impact., Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub

Background and Objective: There are few in vitro models available in the scientific literature for study of the structure, formation and development of the subgingival biofilm. The purpose of this study was to develop and validate an in vitro biofilm model, using representative selected bacteria from the subgingival microbiota. Material and Methods: Six standard reference strains were used to develop biofilms over sterile ceramic calcium hydroxyapatite discs coated with saliva within the wells of presterilized polystyrene tissue culture plates. The selected species represent initial (Streptococcus oralis and Actinomyces naeslundii), early (Veillonella parvula), secondary (Fusobacterium nucleatum) and late colonizers (Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans). The structure of the biofilm obtained was studied using a vital fluorescence technique in conjunction with confocal laser scanning microscopy. The biofilm bacterial kinetics were studied by terminal restriction fragment length polymorphism analysis. Results: After 12 h, initial and early colonizers were the first microorganisms detected adhering to the calcium hydroxyapatite discs. The intermediate colonizer F. nucleatum was not detected in the model until 24 h of incubation. Late colonizers A. actinomycetemcomitans and P. gingivalis could be measured inside the biofilm after 48 h. The biofilm reached its steady state between 72 and 96 h after inoculation, with bacterial vitality increasing from the hydroxyapatite surface to the central part of the biofilm. Conclusion: An in vitro biofilm model was developed and validated, demonstrating a pattern of bacterial colonization and maturation similar to the in vivo development of the subgingival biofilm., Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub