Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

ABSTRACT Monitoring systems are essential to measure and evaluate food-nutritional security, since they can provide accurate, updated and reliable information to design effective policies and programs around the most vulnerable population groups, based on the risks they face and the capacity response from individuals and households. Taking into account the priority of the problem in the management of governments at the national, provincial and municipal levels in Cuba, the objective of the present investigation is to determine the components of a monitoring system of food-nutritional vulnerability for the province of Villa Clara. The study is based on the perspective of dialectical materialism and several of the inherent methods such as the logical-historical and the analytical-synthetic; At the empirical level, documentary analysis was used. The proposed components are conceived in correspondence with the cycle of public policies and adapted to the conditions and characteristics of the territory.

RESUMEN Los sistemas de monitoreo resultan fundamentales para medir y evaluar la seguridad alimentario-nutricional, pues pueden proporcionar información precisa, actualizada y confiable para diseñar políticas y programas efectivos en torno a grupos poblacionales más vulnerables, sobre la base de los riesgos que enfrentan y la capacidad de respuesta de personas y hogares. Teniendo en cuenta la prioridad de la problemática en la gestión de los gobiernos a escala nacional, provincial y municipal en Cuba, constituye objetivo de la presente investigación: determinar los componentes de un sistema de monitoreo de la vulnerabilidad alimentario-nutricional para la provincia de Villa Clara. El estudio se basa en la perspectiva del materialismo dialéctico y varios de los métodos consustanciales como el lógico-histórico y el analítico-sintético; del nivel empírico se empleó el análisis documental. Los componentes propuestos se conciben en correspondencia con el ciclo de políticas públicas, y adaptado a las condiciones y características del territorio.

ABSTRACT Cuba faces a complex situation related to the warranty of the pillars of food and nutrition security; due to the international economic crisis, the irrational use of natural resources and the impact of climate change; a situation that gets worse due to the lack of financial resources and the effects of the coronavirus pandemic. In this scene, the Cuban State and Government´s bet to approve the Plan of Food Sovereignty and Nutrition Education and its consequent legal instrumentation, the Law of Food Sovereignty and Food and Nutrition Security. The present article contains the construction process of these legal regulations, the novel methodologies used for their elaboration, and the systematization of good practices and lessons learned in this legislative process.

RESUMEN Cuba enfrenta un contexto complejo para garantizar los pilares de la seguridad alimentaria y nutricional; producto de la crisis económica internacional, la utilización irracional de los recursos naturales y el impacto del cambio climático, la cual se acentúa con la carencia de recursos financieros y los efectos de la pandemia del coronavirus. Ante este escenario, el Estado y Gobierno cubanos apostaron por aprobar un Plan de Soberanía Alimentaria y Educación Nutricional y su instrumentación jurídica, la Ley Soberanía Alimentaria y Seguridad Alimentaria y Nutricional y su Reglamento. El presente artículo aborda el proceso de construcción de estas normas legales, las metodologías novedosas utilizadas para su elaboración, con una sistematización de las buenas prácticas y lecciones aprendidas en este proceso legislativo.

ABSTRACT This collaborative study between the University of Granma (UDG) in Cuba and the Technical University of Madrid (UPM) in Spain aimed to enhance sustainable rabbit meat production in vulnerable rural communities in eastern Cuba to contribute to food sovereignty. In partnership with the Agroindustrial Grains Company Fernando Echenique in Granma, a feed system based on staggered planting of proteinaceous plants and energy crops has been developed as an alternative to more expensive conventional feeds. Additionally, improvements have been made in reproductive management, and a genetic improvement program for animals has been implemented. The nutritional value and in vitro digestibility of these raw materials have been analyzed at UPM. Seminars addressing topics such as reproduction, nutrition, and genetic improvement in rabbit farming have also been conducted. This work presents the results obtained until June 2023, highlighting the achieved social, economic, and environmental benefits.

RESUMEN Este estudio entre la Universidad de Granma (UDG) en Cuba y la Universidad Politécnica de Madrid (UPM) en España pretendió aumentar la producción sostenible de carne de conejo en comunidades rurales vulnerables del oriente de Cuba, con el fin de contribuir a la soberanía alimentaria. Con la Empresa Agroindustrial de Granos Fernando Echenique de Granma, se ha desarrollado un sistema de alimentación basado en plantas proteicas escalonadas y cultivos energéticos en lugar de piensos convencionales más costosos. Además, se han realizado mejoras en el manejo reproductivo y en un programa de mejora genética de los animales. Se ha analizado el valor nutricional de estas materias primas y su digestibilidad in vitro en la UPM. También se han realizado seminarios abordando temas como la reproducción, nutrición y mejora genética en la cunicultura. Este trabajo presenta los resultados obtenidos hasta junio de 2023, destacando los beneficios sociales, económicos y medioambientales logrados.

RESUMEN Introducción: el tratamiento nutricional está afectado por la conducta de los sujetos para generar adherencia. Objetivo: determinar factores que influyen en la no adherencia al tratamiento nutricional en pacientes hipertensos que acuden al Hospital Regional de Coronel Oviedo, 2021. Metodología: estudio descriptivo transversal. La población estuvo comprendida por pacientes registrados en el Programa de hipertensión arterial/Departamento cardiovascular del Hospital Regional de Coronel Oviedo. Se estudiaron los datos sociodemográficos, los factores de tratamiento nutricional y el grado de adherencia al tratamiento nutricional. Resultados: participaron del estudio 206 sujetos, el 53,4 % poseía 55 años o menos y el 81,1 % fue del sexo femenino. Se pudo hallar que solo el 3,8 % de los pacientes se adhieren al tratamiento. La no adherencia al factor conocimiento estuvo relacionado con el bajo nivel educativo (p=0,032), al factor equipo de salud con provenir del área rural y tener un bajo nivel educativo (p=0,006, p=0,002), al factor paciente con provenir del área rural (p=0.002), ser de bajo nivel educativo (p=0,008) y poseer obesidad grado II y III (p=0,036). La no adherencia global estuvo relacionada a estar casado (p=0.001) y realizar trabajos domésticos (p=0,009). Conclusiones: la adherencia al tratamiento es baja en la población de estudio.

ABSTRACT Introduction: nutritional treatment is affected by the behavior of the subjects to generate adherence. This study was carried out to determine factors that influence non-adherence to nutritional treatment in hypertensive patients who attend the Coronel Oviedo Regional Hospital, 2021. Methodology: this was a cross-sectional descriptive observational study. The population was comprised of patients registered in the hypertension department of the Coronel Oviedo Regional Hospital. Sociodemographic data, nutritional treatment factors and the degree of adherence to nutritional treatment were studied. Results: 206 subjects participated in the study, 53.4 % were 55 years old or younger and 81.1 % were female. We found that only 3.8 % of patients adhere to treatment. Non-adherence due to the knowledge factor was related to low educational level (p=0.032), to the health team factor with coming from a rural area and having a low educational level (p=0.006, p=0.002), to the patient factor with coming from a rural area (p=0.002), to have a low educational level (p=0.008) and to have obesity grade II and III (p=0.036). Global non-adherence was related to being married (p=0.001) and doing housework (p=0.009). Conclusions: adherence to treatment is low in the study population.

RESUMEN Introducción: El labio y paladar hendido (LPH) son una alteración cráneo facial de etiología multifactorial. La alimentación de los niños con LPH puede llegar a ser deficiente, comprometiendo el crecimiento y el desarrollo. Objetivo: Determinar la evolución del estado nutricional pre y post quirúrgico y las prácticas alimentarias en lactantes de 6 a 24 meses de edad, con labio y/o paladar hendido que acudieron a la Clínica de la Fundación Operación Sonrisa durante el periodo de setiembre 2020 a mayo del 2021. Materiales y métodos: Estudio observacional, prospectivo con componente analítico. Se incluyó a 50 niños con diagnóstico de LPH de 6 a 24 meses de edad. Se evaluó el estado nutricional según estándares del MSP y BS. Resultados: Fueron evaluados 50 lactantes de 6 a 24 meses, el 60 % entre 6 -11 meses, el 64 % fueron varones, el 54 % provenía del interior del país y fueron sometidos a cierre primario de labios el 86 % y el 12 % a reconstrucción de paladar hendido. El 88 % de los niños recibieron lactancia materna. El estado nutricional pre quirúrgico fue adecuado (94 %) por indicador peso para la edad. Post quirúrgico hubo una diferencia significativa de 0,927Kg para el peso para la talla (p< 0,001), lo mismo para el peso para la edad(p<0,001). Para la talla para la edad se encontró una diferencia de 0,8cm(p=ns). Conclusiones: El estado nutricional de los niños con labio o paladar hendido, mejora a los 4 meses post cirugía reconstructiva para los indicadores peso para la edad y peso para la talla.

ABSTRACT Introduction: Cleft lip and palate (CLP) is a craniofacial alteration of multifactorial etiology. The diet of children with CLP can become deficient, compromising growth and development. Objective: To determine the evolution of the pre- and post-surgical nutritional status and feeding practices in infants between 6 and 24 months of age, with cleft lip and/or palate who attended the “Operation Smile” Foundation Clinic from September 2020 to May 2021. Materials and methods: This was an observational and prospective study with an analytical component. 50 children with a diagnosis of CLP from 6 to 24 months of age were included. Nutritional status was evaluated according to National Health Ministry standards. Results: 50 infants from 6 to 24 months were evaluated, 60% were between 6 -11 months, 64% were males, 54% came from the rural areas. 86% underwent primary lip closure and 12% cleft palate reconstruction. 88% of the children were breastfed. The pre-surgical nutritional status was adequate (94%) by weight for age indicator. Post surgery there was a significant difference of 0.927 kg for weight for height (p < 0.001), the same for weight for age (p < 0.001). For height for age, a difference of 0.8 cm was found (p=ns). Conclusions: The nutritional status of children with cleft lip or palate improves 4 months after reconstructive surgery for the indicators weight for age and weight for height.

RESUMEN Introducción: Las infecciones de sitio quirúrgico están asociadas con infecciones relacionadas a la asistencia sanitaria (IRAS), causadas por bacterias que ingresan a través de las incisiones efectuadas durante un procedimiento quirúrgico. Objetivo: Describir la frecuencia y características de las infecciones de sitio quirúrgico en las cirugías de urgencias en pacientes pediátricos hospitalizados en el Hospital General Pediátrico. Materiales y Métodos: Estudio observacional descriptivo, retrospectivo, de corte transversal. Población: Pacientes de 0 a 18 años sometidos a intervención quirúrgica abdominal de urgencia. Variables estudiadas: Edad, Sexo, Procedencia, Comorbilidad, reingreso hospitalario, tiempo trascurrido entre la intervención quirúrgica y la aparición de la infección en sitio quirúrgico. Datos obtenidos del análisis de fichas clínicas y la base de datos del HIS en el paquete estadístico SPSv23 (IBM SPSS, DEMO) utilizando estadística descriptiva. Resultados: Fueron incluidas 440 fichas de pacientes, la mediana de edad fue de 10 años, el 60,5% fueron del sexo masculino y el 71,4% procedían del Departamento Central. Se observó que el diagnóstico más frecuente fue peritonitis de origen apendicular 53,2%. El estado nutricional de la población en estudio fue normal en 93,2%, y fueron reingresos el 3% de los pacientes intervenidos. Presentaron infección de sitio quirúrgico el 4,8%, de los cuales 11/21 fueron absceso de pared. En cuanto al tiempo trascurrido entre la cirugía y la aparición de la infección la mediana fue de 14 días. Conclusión: La frecuencia de infección del sitio quirúrgico encontrada en este estudio fue del 4,8%. La patología quirúrgica con mayor porcentaje fue la peritonitis y el tipo de infección absceso de pared. La mayoría de los pacientes eran escolares con buen estado nutricional.

ABSTRACT Introduction: Surgical-site infections are associated with healthcare-associated infections (HAIs), caused by bacteria that enter through the incisions made during a surgical procedure. Objective: To describe the frequency and characteristics of surgical site infections in emergency surgeries in pediatric patients hospitalized at a Pediatric General Hospital. Materials and Methods: This was a descriptive, retrospective and cross-sectional observational study. Population: Patients aged 0 to 18 years undergoing emergency abdominal surgery. Variables studied: Age, Sex, Origin, Comorbidity, hospital readmission, time elapsed between the surgical intervention and the appearance of the surgical site infection. Data obtained from the analysis of clinical records and the electronic health record database in the SPSv23 statistical package (IBM SPSS, DEMO) using descriptive statistics. Results: 440 patient records were included, the median age was 10 years, 60.5% were male and 71.4% came from the Central Department. It was observed that the most frequent diagnosis was peritonitis of appendiceal origin 53.2%. The nutritional status of the study population was normal in 93.2%, and 3% of the operated patients were readmitted. 4.8% had surgical site infection, of which 11/21 were wall abscesses. Regarding the time elapsed between surgery and the appearance of the infection, the median was 14 days. Conclusion: The frequency of surgical-site infection found in this study was 4.8%. The surgical pathology with the highest percentage was peritonitis and the wall abscess type of infection. Most of the patients were schoolchildren with good nutritional status.

ABSTRACT The consumption of fresh fruits has increased nowadays due to the lifestyle of the consumers. Maintaining the quality and nutritional value of cut fruits during storage is difficult compared to whole fruits. Deterioration of internal and external quality usually occurs in freshly harvested fruits. It is necessary to use different techniques to maintain the quality and increase the shelf life of the freshly cut product. This research studied the effect of treating apple slices with cold plasma once and with filtered water again on quality characteristics (hardness, moisture content, sugar content, carbohydrate content, and color) after being stored for five days. The best treatment was determined using two different pressures of the plasma jet (1 and 5 atm) and two different immersion times (3 and 6 minutes). It was verified the superiority of cold plasma treatment at 5 atm and 3 minutes immersion time in all studied traits, while treatment with filtered water and 6 minutes immersion time was superior concerning the moisture content of apple slices. There is an inverse relationship between L* and a direct relationship between the a* and b* values with the storage time. Therefore, the use of cold plasma treatment is promising in storing cut fruits, extending their shelf life, and improving their quality and safety, which provides fresh fruits.

RESUMO O consumo de frutas frescas tem aumentado atualmente devido ao estilo de vida dos consumidores. Manter a qualidade e o valor nutricional dos frutos cortados durante o armazenamento é difícil em comparação com os frutos inteiros. A deterioração da qualidade interna e externa geralmente ocorre em frutas recém-colhidas. Para manter a qualidade e aumentar a vida útil do produto recém-cortado, é necessário utilizar diferentes técnicas. Nesta pesquisa, foi estudado o efeito do tratamento de fatias de maçã com plasma frio uma vez e com água filtrada novamente nas características de qualidade (como dureza, teor de umidade, teor de umidade, teor de carboidratos e cor) após armazenamento por 5 dias. O melhor tratamento foi determinado utilizando duas pressões diferentes do jato de plasma (1 e 5 atm) e dois tempos de imersão diferentes (3 e 6 min). Verificou-se superioridade do tratamento com plasma frio a 5 atm e tempo de imersão de 3 min em todas as características estudadas, enquanto o tratamento com água filtrada no tempo de imersão de 6 min foi superior no teor de umidade das fatias de maçã. Existe uma relação inversa entre o valor da cor L* e uma relação direta entre o valor de a* e b* com o tempo de armazenamento. Portanto, o uso do tratamento com plasma frio é promissor no armazenamento de frutas cortadas, prolongando sua vida útil e melhorando sua qualidade e segurança, o que proporciona frutas frescas.

Abstract Background: Malnutrition is more common in diabetic patients, and this can influence the severity of the diabetic foot due to impaired healing. Objective: To describe the characteristics of hospitalized patients due to diabetic foot, their nutritional status, their stage, and look for correlations between them. Method: Retrospective and analytical study of the Dr. Carlos Macgregor Sánchez Navarro Regional General Hospital from April to July 2023. Sample of 23 patients with diabetic foot with medical records and complete procedures. Demographic, clinical and laboratory data were collected and evaluated with the CONUT and WIFI scales. Results: Average of 61.5 years and an average duration of diabetes of 9.1 years, advanced lesions in the foot, with absent pulses, deformities and claudication. All with anemia and suboptimal glycemic control. Protein ratio suggests inflammation, metabolic stress and malnutrition. WIFI and CONUT scales: advanced injuries and malnutrition. No statistically significant association was found between nutritional status and injury severity. Conclusions: In older patients with long-term diabetes, the diabetic foot is complex. Optimal glucose control and multidisciplinary care are essential. Nutritional status should be evaluated and improved for better clinical outcomes and quality of life.

Resumen Antecedentes: La desnutrición es más común en pacientes diabéticos y esto puede influir en la severidad del pie diabético debido a la alteración en la cicatrización Objetivo: Describir las características de los pacientes hospitalizados por pie diabético, su estado nutricional, su estadio y buscar correlaciones entre ellas. Método: Estudio retrospectivo y analítico del Hospital General Regional Dr. Carlos Macgregor Sánchez Navarro de abril a julio de 2023. Muestra de 23 pacientes con pie diabético con registros médicos y de los procedimientos completos. Se recopilaron datos demográficos, clínicos y laboratoriales, se evaluaron con las escalas CONUT y WIFI. Resultados: Promedio de 61.5 años y una duración promedio de diabetes de 9.1 años, lesiones avanzadas en el pie, con pulsos ausentes, deformidades y claudicación. Todos con anemia y control glucémico subóptimo. La relación proteica sugiere inflamación, estrés metabólico y desnutrición. Escalas WIFI y CONUT: lesiones avanzadas y desnutrición. No se encontró asociación estadísticamente significativa entre el estado nutricional y la gravedad de las lesiones. Conclusiones: En pacientes mayores con diabetes de larga duración, el pie diabético es complejo. Es esencial un buen control de glucosa y atención multidisciplinaria. Se debe evaluar y mejorar el estado nutricional para mejores resultados clínicos y calidad de vida.

Resumo Introdução: O síndroma de Bardet-Biedl (SBB) é uma doença multissistémica rara, de transmissão predominantemente autossómica recessiva, genética e clinicamente heterogénea. A sua prevalência na Europa varia entre 1:125.000 e 1:175.000, afetando de igual modo ambos os sexos. Este síndroma define-se por obesidade, polidactilia, anomalias genitourinárias, distrofia retiniana e dificuldades cognitivas, que se associam de forma variável e pode incluir um amplo espectro de outras manifestações menos prevalentes. O diagnóstico da SBB é clínico, sendo confirmado por análise molecular, o que permite o aconselhamento genético dos restantes membros da família e a realização do diagnóstico pré-natal. Atualmente não existe tratamento curativo, mas o diagnóstico precoce é importante para orientar o acompanhamento multidisciplinar. O médico de família, pela sua proximidade com o doente e seguimento longitudinal, poderá identificar sinais de alarme relativos ao diagnóstico e à identificação de complicações da doença, além de poder ajudar a mitigar impactos psicossociais deletérios. Descrição do caso: Utente do sexo masculino, quatro anos de idade, raça caucasiana, natural de Lisboa, primeiro filho de uma fratria de três. A gravidez foi vigiada pelo seu médico de família, tendo, por alterações na ecografia morfológica - rins poliquísticos e polidactilia - iniciado seguimento na consulta de genética médica, onde se estabeleceu o diagnóstico de SBB tipo 4. Nasceu por parto eutócico de uma gestação de termo sem outras intercorrências. Foi referenciado às consultas de pediatria, genética, nefrologia, oftalmologia, otorrinolaringologia, cirurgia pediátrica plástica e cardiologia pediátrica. Com cerca de um ano de idade foi-lhe diagnosticada miopia. Aos três anos foi submetido a desarticulação de dedos supranumerários. Presentemente mantém vigilância na consulta de saúde infantil da USF e acompanhamento nutricional, apresentando progressão estaturo-ponderal adequada. Comentário: O objetivo deste trabalho é relatar um caso de SBB e identificar o papel do médico de família na sinalização e acompanhamento da criança com doença genética rara.

Abstract Introduction: Bardet-Biedl syndrome (BBS) is a rare multisystem disorder, predominantly of autosomal recessive transmission, with genetic and clinical heterogeneity. Prevalence in Europe varies from 1:125,000 to 1:175,000, equally affecting both sexes. BBS is defined by a variable combination of obesity, polydactyly, genitourinary anomalies, retinal dystrophy, cognitive impairment, and other less prevalent manifestations. The diagnosis of BBS is clinical, confirmed by molecular analysis. This allows for genetic counseling of families and the possibility of prenatal diagnosis. Currently, there is no curative treatment for BBS, being early diagnosis is important to plan a multidisciplinary follow-up. Family physicians, owing to their closeness with the patient and longitudinal follow-up, may identify red flags leading both to early diagnosis and early detection of complications, and to detect and mitigate any psychosocial mishaps. Case description: Male, Caucasian, four years old, born in Lisbon, first of three children. The pregnancy was initially followed by the general practitioner. Due to changes in the routine morphological ultrasound - polycystic kidneys and polydactyly - a referral was made to a consultation of medical genetics, where the genetic study was carried out to establish the diagnosis of BBS type 4. He was born by eutocic delivery, at the end of a full-term gestation, without complications. He was referred to consultations in pediatrics, genetics, nephrology, ophthalmology, otorhinolaryngology, pediatric plastic surgery, and pediatric cardiology. At about one year of age, he was diagnosed with myopia. At the age of three, he underwent the first disarticulation of the supernumerary fingers and toes. The child keeps follow-up at the USF consultation and nutritional monitoring, so far showing adequate height-weight progression. Comment: The objective of this case report is to describe a case of BBS and to identify the role of the family physician in the referral and follow-up of a child with a rare genetic disorder.

Resumo Se por um lado, doenças pancreáticas comuns, tais como pancreatite aguda (PA), pancreatite crónica (PC) e cancro pancreático (CP), podem ter um grande impacto na normal fisiologia pancreática e contribuir para desnutrição, por outro lado, uma abordagem nutricional adequada nos doentes com essas patologias pode influenciar significativamente o seu prognóstico. Em doentes com PA, os objetivos do suporte nutricional são a prevenção da desnutrição, a correção de um balanço negativo de nitrogénio, a redução da inflamação, e a evicção de outcomes desfavoráveis, como desenvolvimento de complicações locais ou sistémicas ou morte. A desnutrição é comum em doentes com PC, sendo frequentemente umamanifestaçãotardiadadoença, da qual resulta uma diminuição da capacidade funcional e da qualidade de vida, bem como um aumento significativo do risco de doença óssea, complicações pós-operatórias, hospitalizações e morte. A desnutrição associada ao CP é também habitual e é atualmente reconhecido que um suporte nutricional precoce pode influenciar favoravelmente a sobrevida, não só por aumentar a tolerância e resposta aos tratamentos, mas também por melhorar a qualidade de vida e diminuir as complicações pós-operatórias. O objetivo da presente revisão é salientar o papel da nutrição e propor uma abordagem nutricional sistematizada nos doentes com PA, PC e CP.

Abstract While common pancreatic diseases, such as acute pancreatitis (AP), chronic pancreatitis (CP), and pancreatic cancer (PC), may greatly impact the normal pancreatic physiology and contribute to malnutrition, the adequate nutritional approach when those conditions are present significantly influences patients’ prognosis. In patients with AP, the goals of nutritional care are to prevent malnutrition, correct a negative nitrogen balance, reduce inflammation, and improve outcomes such as local and systemic complications and mortality. Malnutrition in patients with CP is common but often a late manifestation of the disease, leading to decreased functional capacity and quality of life and increased risk of developing significant osteopathy, postoperative complications, hospitalization, and mortality. Cancer-related malnutrition is common in patients with PC, and it is now well recognized that early nutritional support can favorably impact survival, not only by increasing tolerance and response to disease treatments but also by improving quality of life and decreasing postoperative complications. The aim of this review was to emphasize the role of nutrition and to propose a systematic nutritional approach in patients with AP, CP, and PC.

Food and Nutrition Security (SAN) is the realization of everyone's right to access food in sufficient quantities, quality and regularly, without compromising access to other needs. In view of the increase in food and nutrition insecurity, observed in recent years in Brazil and in the world, concomitant with the disruption of programs and public policies combined with the incentive to promote the right to Food and Nutritional Security (SAN) in Brazil (2019-2022) , and the pandemic context that aggravated this problem, we are currently experiencing alarming levels of Food and Nutrition Insecurity (INSAN), including the serious one that is characterized by hunger, which preferentially affects a certain social class and region in Brazil, North and Northeast. The present study analyzed the food and nutritional security profile of families residing in the rural community of Sítio Laguinha, around a wind farm in the municipality of Caetés, in Pernambuco. This study can be characterized as a mixed descriptive study with a quantitative and qualitative approach, in order to identify the prevalence of food (in)security and the associated factors. A semi-structured questionnaire was used to obtain information on socioeconomic conditions and food consumption in the rural community of Laguinha, as well as the Brazilian Food Insecurity Scale (EBIA) to assess the situation of Food and Nutritional Security. Among the factors associated with the community, the vulnerabilities to which this community is exposed stand out, such as the location in a rural area that is difficult to move around, around a wind farm that brings with it impacts and the pandemic context. The results obtained showed a high prevalence of food and nutritional insecurity (88.4%) at all levels, mild, moderate and severe. Among the factors that may be associated with and aggravate the INSAN situation, we can mention the impact of the wind farm and the pandemic, with all associated socioeconomic impacts. The results obtained in this work bring relevant data about the situation of an invisible community that needs assistance to achieve food and nutritional security, a right established in our constitution. In addition, these data can serve as a basis for the implementation of public policies aimed at the community

A Segurança Alimentar e Nutricional (SAN) é a realização do direito de todos ao acesso a alimentos em quantidade suficiente, qualidade e regularmente, sem comprometer o acesso a outras necessidades. Diante do aumento da insegurança alimentar e nutricional, observada nos últimos anos no Brasil e no mundo, concomitante com a desestruturação de programas e políticas públicas aliadas ao incentivo à promoção do direito à Segurança Alimentar e Nutricional (SAN) no Brasil (2019-2022), e o contexto pandêmico que agravou esse problema, atualmente vivenciamos índices alarmantes de Insegurança Alimentar e Nutricional (INSAN), incluindo a insegurança grave que se caracteriza pela fome, que afeta preferencialmente uma determinada classe social e região no Brasil, Norte e Nordeste. O presente estudo analisou o perfil da segurança alimentar e nutricional de famílias residentes na comunidade rural do Sítio Laguinha, em torno de um parque eólico no município de Caetés, em Pernambuco. Esse estudo pode ser caracterizado como descritivo misto com abordagem quantitativa e qualitativa, a fim de identificar a prevalência da (in)segurança alimentar e os fatores que a ela se associam. Foram utilizados um questionário semiestruturado para obtenção de informações sobre condições socioeconômicas e de consumo alimentar da comunidade rural de Laguinha bem como a Escala Brasileira de Insegurança Alimentar (EBIA) para avaliar a situação de Segurança Alimentar e Nutricional. Dentre os fatores associados à comunidade destaca-se as vulnerabilidades às quais essa comunidade está exposta, como a localização em uma área rural de difícil deslocamento, em torno de um parque eólico que traz consigo impactos e o contexto pandêmico. Os resultados obtidos mostraram alta prevalência de insegurança alimentar e nutricional (88,4%) em todos os níveis, leve, moderada e grave. Dentre os fatores que podem estar associados e agravar a situação de INSAN podemos citar o impacto do parque eólico e a pandemia, com todos impactos socioeconômicos associados. Os resultados obtidos neste trabalho trazem dados relevantes sobre a situação de uma comunidade invisibilizada e que necessita de assistência para alcançar a segurança alimentar e nutricional, um direito estabelecido na nossa constituição. Além disso, esses dados podem servir de base para implementação de políticas públicas voltadas à comunidade.

ABSTRACT Municipal biowaste has a high potential for agricultural use. However, it requires an additional amendment to increase the nutritional content used during the composting process. The purpose of this study was to investigate the selection of compost-enhancing amendments from municipal biowaste using bibliometric and multicriteria analysis. The municipality of Yopal (Casanare, Colombia) was chosen as a case study. Using a search equation in the Scopus and Web of Science databases over five years (2018-2022), 53 publications were discovered, from which 25 were chosen for a full review to identify alternatives for amendment. Ashes, rice husks, sawdust, sugarcane bagasse, tree pruning waste, and alfalfa hay were assessed as amendment substitutes. Criteria such as financial cost, accessibility to acquire the amendment, nitrogen, phosphorus, and carbon contribution were used in the analysis of hierarchical processes. Tree pruning waste was the best option based on the criteria chosen because it is easily accessible and contributes with carbon and nitrogen (C/N: 13) to composting. Factors such as cost and affordability influence the physical and chemical characteristics that an amendment brings to the composting of municipal biowaste.

RESUMO Os biorresíduos municipais têm um elevado potencial para utilização agrícola. No entanto, requer uma alteração adicional para aumentar o conteúdo nutricional utilizado durante o processo de compostagem. O objetivo deste estudo foi investigar a seleção de aditivos melhoradores de compostagem a partir de resíduos biológicos municipais, utilizando análise bibliométrica e multicritério. O município de Yopal (Casanare, Colômbia) foi escolhido como estudo de caso. Utilizando uma equação de busca nas bases de dados Scopus e Web of Science ao longo de cinco anos (2018-2022), foram descobertas 53 publicações, das quais 25 foram escolhidas para uma revisão completa para identificar alternativas de alteração. Cinzas, cascas de arroz, serragem, bagaço de cana-de-açúcar, podas de árvores e feno de alfafa foram testados como substitutos de emendas. Critérios como custo financeiro, acessibilidade para aquisição do aditivo, aporte de nitrogênio, fósforo e carbono foram utilizados na análise dos processos hierárquicos. A poda de árvores foi a melhor opção pelos critérios escolhidos por ser de fácil acesso e contribuir com carbono e nitrogênio (C/N: 13) para a compostagem. Fatores como custo e acessibilidade influenciam as características físicas e químicas que uma alteração traz para a compostagem de biorresíduos municipais.

Abstract Literature has emphasized on food environments centrality in food choices and nutritional status. Objective: identify social perceptions of fathers, mothers and guardians, professionals from educational establishments, municipal officials, and stallholders belonging to the southern area of Santiago de Chile, regarding limitations of healthy diet implementation on school environments. Method: six focus groups were carried out grouping 50 key actors linked to educational establishments using a non-probabilistic sample. A content analysis was applied through thematic coding technique seeking to reveal emerging semantic universes. Results: Nine barriers, or semantics, were identified characterizing limitations to healthy eating habits in school environments: family, school kiosks, leaving school establishments, taste, socioeconomic determinants, public policy, lack of knowledge, publicity, and availability of products without seals. Conclusions: limitations associated with domestic food environment have a significantly high representation (47,9%) and contain an individualized responsibility feature. This explanatory culture is opposed to scientific and academic evidence regarding the functioning of eating behavior, and the centrality of food environments facilitating or hindering healthy food consumption.

Resumen La literatura ha hecho hincapié en la centralidad que cumplen los entornos alimentarios en las elecciones alimentarias y en el estado nutricional de la población. Objetivo: identificar las percepciones de padres, madres y apoderados, profesionales de establecimientos educacionales, funcionarios municipales, y feriantes pertenecientes a la zona sur de Santiago de Chile, respecto a las barreras y limitaciones de la puesta en práctica de una alimentación saludable en el ambiente alimentario escolar. Método: se realizaron seis grupos focales agrupando a 50 actores claves vinculados a los establecimientos educacionales de Ciudad Sur utilizando una muestra no probabilística. Se aplicó un análisis de contenido mediante la técnica de codificación temática buscando relevar los universos semánticos emergentes. Resultados: se identificaron nueve barreras, o semánticas, que caracterizan limitantes a la realización de la alimentación saludable en los entornos escolares desde la perspectiva de los participantes: la familia, kioscos escolares, la salida de los establecimientos escolares, gusto, determinantes socioeconómicos, política pública, falta de conocimiento, publicidad y disponibilidad de productos sin sellos. Conclusiones: las limitaciones asociadas al ambiente alimentario doméstico tienen una representación significativamente alta (47,9%) y contienen un carácter de responsabilización individual en su enunciación. Esta cultura explicativa es opuesta a la evidencia científica y académica respecto al funcionamiento de la conducta alimentaria, y a la centralidad de los ambientes alimentarios respecto a la facilitación u obstaculización del consumo de alimentos saludables o adecuados.

Abstract The aim of this study was to characterize in the retail outlets the marketing strategies used in food and non-alcoholic beverages aimed at children, adolescents, and their parents or guardians (shoppers) which influence the purchase of products of high energy content and low nutritional value in Costa Rica. Data collection was carried out in 2018 with an observation guide applied at the retail outlets (RO) (n: 12) and a questionnaire aimed at parents or guardians (shoppers) (n: 72) of the child and adolescent population. The study found that the marketing strategy most frequently used in the entry, cash and exit area the retail outlets was price reduction (79,0, 87.5 and 88,0%, respectively).There is a frequent and varied use of marketing strategies in retail outlets for calorie-dense food products with an excess of critical nutrients that are relevant in public health due to their association with obesity and non-communicable diseases.

Resumen El objetivo del presente estudio fue caracterizar en los puntos de venta de Costa Rica las estrategias de mercadeo utilizadas en alimentos y bebidas no alcohólicas dirigidas a la población infantil, adolescente y a sus padres o tutores (compradores), que influyen en la compra de productos de alto contenido energético y bajo valor nutricional. La recolección de datos se realizó en el 2018 mediante una guía de observación aplicada al punto de venta (n:12) y un cuestionario dirigido a los padres o tutores (n: 72) de la población infantil y adolescente. Se encontró que la estrategia de mercadeo utilizada con mayor frecuencia en el área de entrada, caja y salida del punto de venta fue la reducción de precios (79,0; 87,5 y 88,0%, respectivamente). En los puntos de venta existe un empleo frecuente y variado de estrategias de mercadeo de productos alimenticios densamente calóricos y con un exceso de nutrientes críticos que son relevantes en salud pública por su asociación con la obesidad y enfermedades no transmisibles.