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BACKGROUND: Gluten intolerance is a systemic process of autoimmune nature; it develops in genetically predisposed subjects with gluten ingestion. The only treatment for celiac disease (CD) is a lifelong strict gluten-free diet (GFD). This study was designed to evaluate adherence to a GFD, risk of an eating disorder, and nutritional status in adult CD patients undergoing different interventions. METHODS: A total of 28 Spanish women, aged 40 years or more, took part in a randomized controlled trial. Each group received a different intervention: group 1, gluten-free nutrition plan + exercise (GFD + E); group 2, gluten-free nutrition plan (GFD); group 3, celiac controls (NO-GFD); and group 4, non-celiac controls (CONTROL). The training was prescribed by a sport scientist. It was based on resistance training with elastic bands; beforehand a warm-up was performed and the resistance was increased progressively. The variables studied were adherence to the GFD, risk of eating disorders, blood values, and body composition. RESULTS: Celiac women with personalized nutritional planning presented greater adherence to a gluten-free diet (p < 0.001). Regarding leukocytes, significant differences were observed between the GFD and control groups (p = 0.004). Perimeters and folds did not decrease significantly. CONCLUSION: Women with celiac disease who follow an adapted and personalized diet have a better adherence to a GFD compared to those who follow a non-professional diet, and therefore have a better immune system status (blood leukocytes).

Earthquakes trigger widespread landsliding in tectonically active landscapes. The effects of strong ground shaking on hillslope stability persist into the post-seismic stage; rates of landsliding remain elevated in the years following an earthquake. The mechanisms that control the spatial pattern and rate of ongoing landsliding are poorly constrained, hindering our ability to reliably forecast how landscapes and landslide hazard evolve. To address this, we undertook a detailed geotechnical investigation in which we subjected representative rock samples to dynamic loading, simulating the effects of earthquake ground shaking on hillslopes of different configuration. Our results indicate that post-seismic hillslope strength is not an intrinsic rock property; rather, it responds to the amplitude of imposed dynamic loads and the degree of pre-existing shear surface formation within the rock. This path-dependent behavior results from differences in the character of fractures generated by dynamic loads of different amplitude, and the ways in which apertures are mobilized or degraded in subsequent (post-seismic) shearing. Sensitivity to dynamic loading amplitude is greater in shallow landslides in which shear surfaces are yet to fully form; such hillslopes can be strengthened or weakened by earthquake events, depending on their characteristics. In contrast, deeper landslides on steeper hillslopes in which shear surfaces have largely developed are less likely to display differences in behavior in response to dynamic loading because strain accumulation along pre-existing fractures is dominant. Our results demonstrate the need to consider path-dependent hillslope stability in numerical models used to forecast how landscapes respond to earthquakes and how post-seismic hazard evolves.

The COVID-19 pandemic has become one of the most important threats to global health. Midwives are at the core of the response to the pandemic. Women still need midwifery support and care. The work of midwives is acknowledged as emotionally demanding, and their welfare may be compromised by a range of workplace and personal stress factors.

Objectives To develop and validate a prediction rule to identify well-appearing febrile infants aged = 0.6 ng/mL) and C reactive protein (>= 20 mg/L) as risk factors. The absence of any risk factor had a sensitivity of 96.0% (95% CI 80.5% to 99.3%), a negative predictive value of 99.4% (95% CI 96.4% to 99.9%) and a specificity of 32.9% (95% CI 28.8% to 37.3%) for ruling out an IBI. Applying it in the 449 infants of the validation set (IBI rate 4.9%), sensitivity, negative predictive value and specificity were 100% (95% CI 87.1% to 100%), 100% (95% CI 97.3% to 100%) and 29.7% (95% CI 25.8% to 33.8%), respectively. Conclusion This prediction rule accurately identified well-appearing febrile infants aged

Celiac disease (CD) is an autoimmune disease characterized by gluten-induced intestinal inflammation. Dietary restrictions and symptoms may have a significant impact on the patient's quality of life, body composition (BC), and strength. This study was designed to assess the impact of an isocaloric gluten free diet and resistance exercise in women. A total of 28 Spanish women, aged 40 years old or more, took part in a randomized controlled trial. Each group received a different intervention: group 1, gluten-free nutrition plan + exercise (GFD + E); group 2, gluten-free nutrition plan (GFD); group 3, celiac controls (NO-GFD); and group 4, non-celiac controls (CONTROL). The variables studied were quality of life, BC and isometric hand strength. After 12 weeks of intervention, celiac women that followed a gluten-free diet and exercise showed higher scores on the psychological health scale than celiac women without intervention. The women in group 1 were the only ones who presented improvements in BC variables; fat mass, BMI, and fat-free mass. Negative correlations were found between the perception of quality of life and age, however a positive correlation between quality of life and isometric strength test results was found. In addition to a gluten-free diet, resistance training is essential to improve BC, strength, and gastrointestinal symptoms.

BSA-capped gold nanoclusters are promising theragnostic systems that can be excited to render both fluorescence emission and reactive oxygen species. Although their synthesis and photoluminescence properties are already well described, more accurate information about their use as photosensitizers is required in order to advance towards health applications. In this work, we have obtained BSA-capped gold nanoclusters and characterized their photophysics by different techniques. Singlet oxygen production was detected upon irradiation, which was enough to produce toxicity on two cell lines. Remarkably, an internal energy transfer, probably due to the presence of smaller nanoclusters and the contribution of oxidized residues of BSA in the system, caused fluorescence emission near 640 nm after excitation in the UV range. Additionally, the system was capable of penetrating human skin beyond the stratum corneum, which enhances the potential of these nanoclusters as bifunctional photodynamic therapy effectors and biomarkers with application in a diversity of skin diseases. In the absence of radiation, BSA-capped gold nanoclusters did not cause toxicity in vitro, while their toxic effect on an in vivo model as zebrafish was determined.

Radiopharmaceutical compounds, considered a special group of medicines, can be prepared outside the marketing authorisation track. Small-scale preparations at non-commercial sites thereby represent an important segment, however a lack of harmonisation in the regulation leads to extreme differences in the application and availability of radiopharmaceuticals across Europe. A number of guidelines and guidance documents have been issued by European Association of Nuclear Medicine (EAMN), Pharmaceutical inspection convention (PICs), European Directorate for the Quality of Medicines & HealthCare (EDQM) to achieve a good radiopharmacy practice for small-scale preparation. Nevertheless, in the case of non-licensed radiopharmaceuticals their consideration as magistral formulas, in some countries, makes it possible to waive regulatory inspections aimed to ensure those good practices enforcement. Moreover, special attention should be put on the quality assurance process for non-licensed starting materials, given that the final radiopharmaceuticals quality chiefly depends on it. This paper (chapter) will provide an insight into the quality standards applicable to starting materials, such as supplier qualification control, starting material re-test period, etc. in order to raise for discussion about how best to achieve a proven quality, efficacy, and safety for our radiopharmaceuticals (licensed or non-licensed).

Objetivo: Determinar los parámetros bioquímicos enzimáticos (Transaminasa Glutámico Pirúvica (ALT), Transaminasa Glutámico Oxalacetico (AST), Fosfatasa Alcalina (ALP), Gamma Glutamiltransferasa (y-GT), y Lactato Deshidrogenasa (LDH)) en niños con Leucemia Linfoblástica Aguda (LLA) antes del tratamiento antineoplásico. Material y Métodos: Estudio prospectivo experimental, observacional, de corte transversal, en 30 niños con LLA entre 2 y 15 años, en diversos Centros Neoplásicos de Lima. La colecta sanguínea se realizó en tubos BD Vacutainer® de tapa color rojo, procesados en el analizador semiautomatizado BIOTEC® EMP-168, con reactivos enzimáticos de Wiener Lab Group bajo el método modificado de Szaaz y UV-Optimizado por IFCC, SSCC y SFBC. Por último, se realizó la codificación y tabulación de datos. Resultados: El 60% correspondió a niños y el 46,7% corresponde a las edades entre 2 a 6 años. Los niveles séricos de AST estuvieron incrementados en el 33,3% en niños y el 50% en niñas. Los valores séricos de ALT estuvieron incrementados en el 33,3% de niños y en el 41,7% de niñas; solamente el 25% de niñas presentaron valores incrementados de y-GT; la ALP estuvo acrecentada en el 44,4% de niños y en el 66,7% de niñas. Por otro lado los niveles de LDH estuvieron acrecentados en el 55,6% de niños y en el 41,7% de niñas. Conclusión: Las pruebas enzimáticas LDH, AST, ALT y ALP se encuentran aumentados en niños con LLA con respecto a los valores normales, debido al síndrome de lisis tumoral caracterizada por alteraciones electrolíticas, y como consecuencia de la destrucción masiva de células tumorales y la liberación rápida de grandes cantidades de elementos intracelulares. Objective: To determine the enzymatic biochemical parameters (glutamic pyruvic transaminase (ALT), glutamic oxaloacetic transaminase (AST), alkaline phosphatase (ALP), gamma glutamyltransferase (y-GT), and lactate dehydrogenase (LDH)) in children with acute lymphoblastic leukemia (ALL) before cancer treatment. Material and Methods: A prospective experimental, observational, cross-sectional study was conducted in 30 children between 2 and 15 years old, from several Neoplastic Centers in Lima. Blood collection was performed in BD red cap Vacutainer tubes, processed in the semi-automated analyzer BIOTEC® EMP-168, with Wiener Lab Group enzyme reagents under the modified method Szaaz and UV-Optimized by IFCC, SSCC and SFBC. Finally, coding and tabulation was performed. Results: 60% were boys and 46.7% are between the ages of 2-6 years. Serum levels of AST were increased by 33.3% in boys and 50% in girls. Serum ALT values were increased in 33.3% of boys and 41.7% of girls; only 25% of girls showed increased levels of y-GT values; ALP was increased in 44.4% of boys and 66.7% of girls. Moreover LDH levels were increased in 55.6% of boys and 41.7% of girls. Conclusion: The enzymatic tests LDH, AST, ALT and ALP are increased in children with ALL compared to normal values due to tumor lysis syndrome characterized by electrolyte abnormalities, and as a result of the massive destruction of tumor cells and rapid release of large amounts of intracellular elements.

Objetivo: Determinar la seroprevalencia de marcadores infecciosos causantes de pérdidas de hemodonaciones en el Servicio de Banco de Sangre del Hospital Nacional Docente Madre-Niño San Bartolomé de enero 2008 a diciembre del 2013. Material y Métodos: Estudio retrospectivo, de corte transversal, descriptivo. El criterio de inclusión fue hemodonaciones completas sin complicaciones que cumplían con los criterios de calidad y normatividad del PRONAHEBAS. El análisis de datos se realizó en tres procesos básicos: codificación, tabulación y construcción de tablas y gráficos. La técnica utilizada para la verificación estadística de los resultados fue mediante el analizador estadístico SPSS versión 20.0. Resultados: Los hallazgos fueron: 4.63% para HBcAb, 1.78% para sífilis, 1.21% para HTLV I-II, y 5.31% para otros marcadores serológicos de un total de 11399 donaciones completas. La prevalencia general fue de 9.36% para todos los marcadores, lo cual ocasiono una pérdida de 1016 donaciones; 457.2 Litros de sangre y 61,893.28 USD perdidos. Las asociaciones entre marcadores infecciosos más frecuentes fueron: HBcAb con sífilis y HBsAg y los tres componentes que explican la varianza fueron asociados por cronicidad y epidemias concentradas en poblaciones, por exposición ocupacional y por relación subrogante. Conclusión: La prevalencia hallada demostró la mala calidad de donantes de sangre y el gran impacto económico por hemoderivados desechados muestran las limitaciones en la cadena de donación. Por lo que es conveniente continuar con las campañas de educación sanitaria, las buenas prácticas en medicina transfusional y la selección de donantes de sangre para prevenir las infecciones transmisibles por transfusión, aumentar el suministro de sangre sin poner en riesgo al receptor y sin nuevas donaciones, asimismo reducir el costo económico perdido por donación. Objective: To determine the seroprevalence of infectious markers causing loss of blood donations in the Blood Bank Service in Hospital Nacional Docente Madre Niño San Bartolome January 2008 to December 2013. Material and Methods: A retrospective, cross-sectional, descriptive study was conducted. Inclusion criteria were donations of whole blood without complications that meet the quality criteria and standards of PRONAHEBAS. Data analysis was conducted in three basic processes: coding, tabulation and construction of tables and graphs. The technique used for the statistical verification of the results was by SPSS version 20.0 statistical analyzer. Results: The findings were 4.63% for HBcAb, 1.78% for syphilis, 1.21% for antibodies to HTLV I-II, and 5.31% for other serological markers of a total of 11399 complete donations. The overall prevalence was 9.36% for all markers which caused a loss of 1016 donations, 457.2 liters of blood, and 61893.28 USD lost. Similarly, frequent associations between infectious markers were HBcAb that of syphilis and HBsAg, and the three components explaining the variance were associated with chronicity and concentrated epidemics in populations, occupational exposure and surrogate relationship. Conclusion: The prevalence found shows the poor quality of blood donors and the high economic impact of discarded blood show the limitations of the donation chain. So it is appropriate to continue sanitary education campaigns, best practices in transfusion medicine and selection of blood donors to prevent transfusion-transmissible infections, increase the blood supply without compromising the receiver without new donations also reduce the economic cost lost by donation.