Abstract In recent years, resistant starch (RS) and slowly digestible starch (SDS) have been linked to the prevention of chronic noncommunicable diseases, such as obesity and its complications. Southern Mexico has an important role in the tuber crop production of M. esculenta and I. batatas, which contain considerable amounts of starch. The aim of this study was to evaluate the morphological and physicochemical changes of M. esculenta and I. batatas after pyrodextrinization, including the production of RS and SDS. The factors used in this study were the starch/acid ratio (2.2 HCl) (80:1 and 160:1 p/v); temperature (90 °C and 110 °C) and reaction time (1 and 3 h). The highest production of RS in M. esculenta was obtained with the highest starch/acid ratio and temperature, and the lowest reaction time. For pyrodextrins, loss of crystallinity and an increase in swelling power and water absorption capacity were observed. The highest production of RS in I. batatas was obtained with the highest starch/acid ratio and reaction time, and the lowest temperature. Crystallinity and enthalpy of gelatinization decreased in modified starches. The solubility, swelling power and water absorption capacity increased in both sources.

Abstract: Introduction: information on epidemiological aspects is important for decision-making. The aim of this study was to describe the demographic and clinical characteristics of pediatric patients with COVID-19 who were cared for in the state of Chiapas, Mexico, during the first year of the pandemic. Material and methods: the information from the Open Data of the General Directorate of Epidemiology of the Ministry of Health of Mexico, of the cases of COVID-19 registered from 2020 to April 22, 2021, was analyzed. Results: during the study period, 1,153 Mexican pediatric patients were treated. The distribution by sex was similar, corresponding to 50.7% (n = 584) of male patients. By age, the majority were patients younger than two years, and between 12 and 18 years. Seventy-one patients (6.2%) had pneumonia, and 2.2% (n = 25) required intubation. Nineteen patients (1.6%) died. Conclusion: the data from this study showed that pediatric patients with COVID-19 treated in Chiapas had similar characteristics to those described in other parts of the world.

Resumen: Introducción: la información sobre aspectos epidemiológicos es importante para la toma de decisiones. El objetivo de este estudio fue describir las características demográficas y clínicas de los pacientes pediátricos con COVID-19 que fueron atendidos en el estado de Chiapas, México, durante el primer año de la pandemia. Material y métodos: se analizó la información de los Datos Abiertos de la Dirección General de Epidemiología de la Secretaría de Salud de México, de los casos de COVID-19 registrados del 2020 hasta el 22 de abril de 2021. Resultados: en el periodo de estudio se atendieron 1,153 pacientes pediátricos mexicanos. La distribución por sexo fue similar, correspondiendo a 50.7% (n = 584) a pacientes masculinos. Por edad, la mayoría fueron pacientes menores de dos años, así como de entre 12 y 18 años. Del total, tuvo neumonía el 6.2% (n = 71) y requirió intubación el 2.2% (n = 25). Fallecieron 19 pacientes (1.6%). Conclusión: los datos de este estudio mostraron que los pacientes pediátricos con COVID-19 atendidos en Chiapas, tuvieron un comportamiento similar a lo descrito en otras partes del mundo.

Abstract Objective: To assess the usefulness of a saline mouth rinse (SMR) as a diagnostic tool for the detection of SARS-CoV-2 in outpatients. Method: This was a prospective study carried out at the Hospital Regional de Alta Especialidad “Dr. Juan Graham Casasús”, 34 SMR/SNP (saline mouth rinse/sample (clinical) of nasopharyngeal) randomized paired samples were selected and collected in the outpatient clinic. The samples were analyzed by real-time reverse transcription polymerase chain reaction (RT-PCR) and the concordance between SMRs and SNP samples and the sensitivity and specificity of SMR were calculated. Results: Out of the 34 SMR/SNP paired samples, 14 samples were positive for SARS- CoV-2; 4 SMR samples and 10 SNP samples. We found 3 positive concordant results in the SMRs/SNP paired samples, the mean CT for each gene (RdRp, N, E) did not show a significant difference between the samples. Eight discrepancies were observed between the two types of samples (7 individuals were positive by SNP and 1 for SMR). The concordance observed between SMR and SNP was acceptable (kappa coefficient 0.31). The sensitivity of EBSS was 30% with a specificity of 95.8%. Conclusions: The SMR sensitivity is not comparable with SNP sensitivity for SARS- CoV-2 detection, but our data suggest SMR as a non-invasive tool that allows self- collection, and it does not require health trained personnel for its collection. Also, this sample could be an alternative to the lack of swabs and/or viral transportation media. Additionally, SMR may be of benefit in remote and vulnerable populations, and/or to facilitate the screening of SARS-CoV-2 in a large number of individuals.

Resumen Objetivo: Evaluar la utilidad de un enjuague bucal con solución salina (EBSS) como muestra diagnóstica para la detección de SARS-CoV-2 en pacientes ambulatorios. Material y métodos: Este fue un estudio prospectivo realizado en el Hospital Regional de Alta Especialidad “Dr. Juan Graham Casasús”, se seleccionaron 34 muestras aleatorias pareadas EBSS/MNF (enjuague bucal con solución salina/muestra (clínica) de la nasofaringe) que se recolectaron durante la visita al centro de evaluación ambulatoria de dicho hospital. Las muestras se analizaron mediante la reacción en cadena de la polimerasa con transcripción inversa en tiempo real (RT-PCR) y se calculó la concordancia entre EBSS y MNF, la sensibilidad y especificidad del EBSS. Resultados: De las 34 muestras pareadas EBSS/MNF, 14 fueron positivas para SARS- CoV-2; 4 muestras de EBSS y 10 muestras de MNF. Los resultados concordantemente positivos en las muestras pareadas EBSS/MNF fueron 3 y las medias de CT de cada gen (RdRp, N, E) no mostraron diferencia significativa entre las muestras. Se observaron 8 discordancias entre los dos tipos de muestras (7 individuos dieron positivo por MNF y 1 por EBSS). La concordancia observada entre EBSS y MNF fue aceptable (coeficiente kappa 0.31). La sensibilidad de EBSS fue de 30% con una especificidad del 95.8%. Conclusiones: La sensibilidad de EBSS no es comparable con la sensibilidad de MNF para la detección de SARS-CoV-2, pero nuestros datos sugieren al EBSS como una herramienta no invasiva, permite la autocolección y no requiere personal de salud capacitado para su muestreo: asimismo, esta muestra podría ser alternativa ante la escasez de hisopos y medios de transporte viral. Además, el EBSS puede tener beneficio para poblaciones remotas, vulnerables o facilitar las pruebas a un gran número de individuos.

Abstract Objective: To analyze the composition of formulations of probiotics sold in establishments in the State of Tabasco or that can be purchased online. Materials and methods: A descriptive study in which formulations of probiotics sold in 21 establishments in the city of Villahermosa were identified and compared with 30 probiotic supplements sold online. Product information was organized in a database and analyzed according to the dosage form, probiotic genera, species/subspecies contained and their classification as probiotics or synbiotics and as drugs or supplements. Results: Thirty-one local products and 30 online products formulated with probiotics in 6 different dosage forms were analyzed. Only five local products and no online products are certified by COFEPRIS as drugs. Forty-eight percent of the formulations are monostrain and the rest are multistrain. Seventy-two percent of the formulations are probiotics and the rest are synbiotics. Among the 61 products analyzed, 46 species belonging to 13 different genera were identified, and 39% were common to local and online products. Many of products contain species of the Lactobacillus and Bifidobacterium genera. The genus Bacillus was the only genus that was never combined with other genera in the formulations analyzed in this study. Conclusions: The population of the state of Tabasco can find at least 31 formulations of probiotics in local establishments. The variety increases if we consider the dietary supplements available for sale online. Multistrain supplements are particularly abundant in online retailers. The products certified by COFEPRIS ensure that the benefits of the formulation are supported by clinical trials in humans and are manufactured following good manufacturing practices.

Resumen Objetivo: Analizar la composición de formulaciones de probióticos que se venden en establecimientos del Estado de Tabasco o que se pueden comprar en línea. Materiales y métodos: Estudio descriptivo en el que se identificaron formulaciones de probióticos comercializados en 21 establecimientos de la ciudad de Villahermosa y se compararon con 30 suplementos probióticos comercializados en línea. La información del producto se organizó en una base de datos y se analizó de acuerdo con la forma de dosificación, los géneros y especies / subespecies de probióticos presentes y su clasificación como probióticos o simbióticos y como medicamentos o suplementos. Resultados: Se analizaron 31 productos locales y 30 productos de venta en línea formulados con probióticos en 6 formas de dosificación diferentes. Solo cinco productos locales y ningún producto en línea están certificados por COFEPRIS como medicamentos. El 48% de las formulaciones son monocepa y el resto son multicepa. El 72% de las formulaciones son probióticos y el resto son simbióticos. Entre los 61 productos analizados, se identificaron 46 especies pertenecientes a 13 géneros diferentes y el 39% fueron comunes a productos locales y de venta en línea. Muchos de los productos contienen especies de los géneros Lactobacillus y Bifidobacterium. El género Bacillus fue el único que nunca se combinó con otros géneros en las formulaciones analizadas en este estudio. Conclusiones: La población del estado de Tabasco puede encontrar al menos 31 formulaciones de probióticos en establecimientos locales. La variedad aumenta si tenemos en cuenta los suplementos dietéticos disponibles de venta en línea. Los suplementos multicepa son particularmente abundantes en los productos en línea. Los productos certificados por COFEPRIS aseguran que los beneficios de la formulación están respaldados por ensayos clínicos en humanos y se fabrican siguiendo buenas prácticas de fabricación.

Abstract Introduction: resistant starch (RS) is not completely digested in the human intestine but is fermented in the colon; intestinal pH decreases as short-chain fatty acids are produced. This is beneficial for health, and for preventing and treating rectal colon cancer. Pyrodextrinization and enzymatic hydrolysis are modifications to native starch (NS) that may increase the amount of RS. Objective: the objective of this project was to evaluate the effects of M. cavendishAAA native and both chemically and enzymatically modified starches on tumor markers in rats. Methods: modifications (chemical and enzymatic) were made to M. cavendishAAA NS, and were evaluated in rats with 1,2-DMH. Male Sprague Dawley rats (25) were used, divided into five experimental groups: PC, NC, NS, PI, and ERM. During 4 weeks they received the experimental diet assigned to each group. The PC, NS, PI and ERM groups received 2 weekly s.c. (subcutaneous) injections of 1,2-DMH (40 mg/kg) (third and fourth week). In feces, pH, β-glucuronidase enzyme, and short-chain fatty acids were evaluated, and a histopathological study was performed of the intestine to detect microscopic lesions. Results: the activity of β-glucuronidase decreased (p < 0.05) for NS, PI and ERM vs. PC. The highest proportion of butyric acid was observed in the NS (p < 0.05) vs. NC group. Sixty percent of enteritides were severe in grade in the PC group, and 40 % in the experimental groups. Conclusions: native starch granules resisted pyrodextrinization, but treatment with α-amylase broke the structure of the pyrodextrin granule. According to the treatments given to the rats, as the amount of RS present in the diet increases (NS), the neoplastic cells do not advance beyond the basement membrane, suggesting a possible cell-protective or anticancer effect.

Resumen Introducción: el almidón resistente (AR) no se digiere completamente en el intestino humano sino que se fermenta en colon; disminuye el pH intestinal, ya que se producen ácidos grasos de cadena corta, interviniendo de manera benéfica en el tratamiento preventivo y curativo del cáncer de colon rectal. La pirodextrinización y la hidrólisis enzimática son modificaciones al almidón nativo (AN) que pueden incrementar la cantidad de AR. Objetivo: el objetivo de este proyecto fue evaluar los efectos del almidón nativo de M. cavendishAAA y de los almidones modificados química y enzimáticamente sobre diversos marcadores tumorales en ratas. Métodos: se realizaron modificaciones (química y enzimática) del AN del banano M. cavendishAAA y se evaluaron en ratas tratadas con 1,2-DMH. Se utilizaron 25 ratas Sprague Dawley machos divididas en cinco grupos experimentales: CP, CN, AN, PI y MER. Durante 4 semanas recibieron la dieta experimental asignada a cada grupo. Los grupos CP, AN, PI y MER recibieron 2 inyecciones s.c. (subcutáneas) semanales de 1,2-DMH (40 mg/kg) (semanas 3 y 4). En las heces se evaluaron el pH, la enzima β-glucuronidasa y los ácidos grasos de cadena corta, y se realizó un estudio histopatológico del ciego y el colon para detectar lesiones microscópicas. Resultados: la actividad de β-glucuronidasa disminuyó (p < 0,05) para los grupos AN, PI y MER en comparación con el CP. La mayor proporción de ácido butírico se observó en el AN (p < 0,05) frente al CN. El 60 % de las enteritis fueron de grado severo en el CP, mientras que en los grupos experimentales fueron de 40 %. Conclusiones: los gránulos de almidón nativo resistieron la pirodextrinización pero el tratamiento con α-amilasa rompió la estructura del gránulo de pirodextrina. De acuerdo a los tratamientos suministrados a las ratas, conforme mayor es la cantidad de AR presente en la dieta (AN), las células neoplásicas no avanzan más allá de la membrana basal, sugiriendo un posible efecto protector o anticancerígeno celular.

Abstract Background: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. Main body: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. Conclusions: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.