ObjectiveWe aimed to explore the range of stakeholders’ perceptions of the Balance Calories Initiative (BCI), under which the American Beverage Association pledged to decrease per capita US consumption of beverage energy by 20 % by 2025.DesignSemi-structured cross-sectional interviews were conducted in 2017.SettingParticipants were recruited from communities targeted by the BCI (Montgomery, AL; North Mississippi Delta, MS; Eastern Los Angeles, CA).ParticipantsA total of thirty-three parents and thirty-eight youths aged 10–17 years were recruited through youth-serving organizations, street intercept and snowball sampling; sixteen store/restaurant managers were recruited at businesses. Participants were asked about their awareness of the BCI. Parents and youths were asked to ‘think aloud’ as they viewed BCI messages (e.g. ‘Balance What You Eat, Drink, and Do’) and managers were asked about beverage marketing.ResultsTwelve parents and twenty-four youths had seen BCI messages; only four managers were aware of the BCI. Many parents and youths showed some misunderstanding of BCI messages (e.g. that they should drink more sugar-sweetened beverages (SSB) or they needed to equalize healthy and unhealthy beverage intake). Only one manager had communicated with beverage companies about the BCI.ConclusionsWe found mixed comprehension and low awareness of BCI messages in communities targeted by the American Beverage Association for reduced SSB consumption. Industry self-regulation attempts to reduce SSB consumption may have limited effectiveness if stakeholder input is not addressed. Public health practitioners should be aware of the need to address youths’ and parents’ misunderstandings about SSB consumption, especially in BCI-targeted communities.

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Background: Trastuzumab (T), a recombinant monoclonal antibody against HER-2 receptor, significantly improves overall (OS) and disease-free survival (DFS) in women with HER2 positive (HER2+) early breast cancer (EBC) when administered concurrent with or sequentially after adjuvant chemotherapy. Material and Methods: HERA (BIG 1-01) is an international, multicenter, phase III randomized trial involving 5102 women with HER2-positive (HER2+) EBC either nodal negative (tumor-size ≥ 1cm) or nodal positive. After completion of primary therapy, including surgery, chemotherapy and radiotherapy as indicated, patients (pts.) were randomized to T every 3 weeks for 1 yr, 2 years (yrs), or observation. Primary endpoint is DFS and secondary endpoints are OS and time to distant recurrence (TTDR). Here, we are presenting the HERA final analysis after 10 years of follow-up. Results: The clinical data cut-off for this final analysis of the HERA trial is June 2015. Data are being cleaned and final safety and efficacy analyses will be available for presentation at the meeting. Cardiac toxicity remained low and occurred mostly during the treatment phase. Citation Format: Jackisch C, Piccart MJ, Gelber RD, Procter M, Goldhirsch A, DeAzambuja E, Castro Jr G, Untch M, Smith I, Gianni L, Baselga J, Al-Sakaff N, Lauer S, Mcfadden E, Leyland-Jones B, Bell R, Dowsett M, Cameron D. HERA trial: 10 years follow up of trastuzumab after adjuvant chemotherapy in HER2 positive early breast cancer – Final analysis. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr PD5-01.

Since neonatal screening and early nutritional treatment began, it has been possible to reverse the neurological damage that phenylketonuria (PKU) causes. Scientific evidence gathered over more than 50 years on the monitoring of individuals with PKU indicates that a phenylalanine level of about 6 mg/dL (360 mmol/L) is ideal and points to the necessity of starting a long-term phenylalanine-restricted diet in which blood phenylalanine level should stay between 2 and 6 mg/dL (120-360 mmol/L). This article aims to establish the general basis for proper monitoring of people with PKU and provide a useful tool for clinicians overseeing treatment. We hope to establish similar criteria throughout Latin America and create a uniform protocol in order to have comparative monitoring results for the region.

Energy recommendations for MSUD children are according to energy expenditure; thus the use of WHO equation is a clinically and statistically feasible tool for its determination.

This study aimed to describe the current practices in the diagnosis and dietary management of phenylketonuria (PKU) in Latin America, as well as the main barriers to treatment. We developed a 44-item online survey aimed at health professionals. After a pilot test, the final version was sent to 25 practitioners working with inborn errors of metabolism (IEM) in 14 countries. Our results include 22 centers in 13 countries. Most countries (12/13) screened newborns for PKU. Phenylalanine (Phe) targets at different ages were very heterogeneous among centers, with greater consistency at the 0–1 year age group (14/22 sought 120–240 µmol/L) and the lowest at >12 years (10 targets reported). Most countries had only unflavored powdered amino acid substitutes (10/13) and did not have low-protein foods (8/13). Only 3/13 countries had regional databases of the Phe content of foods, and only 4/22 centers had nutrient analysis software. The perceived obstacles to treatment were: low purchasing power (62%), limited/insufficient availability of low-protein foods (60%), poor adherence, and lack of technical resources to manage the diet (50% each). We observed a heterogeneous scenario in the dietary management of PKU, and most countries experienced a lack of dietary resources for both patients and health professionals.

Introduction: Propionic acidemia is a metabolic disease produced by a deficiency of the enzyme propionylCoA carboxylase. It can lead to coma, with severe neurologic encephalopathy or present later in life with vomiting, hypotonia, and seizures. An early diagnosis with adequate treatment helps to prevent the sequelae. Among the described complications is optic neuropathy, although not commonly reported, it is very disabling. Objectives: To describe two patients with propionic acidemia and optic neuropathy. Patients and Methods: Patient 1: 16 years old, male, parents without consanguinity. He was diagnosed at 5 months of age because of hypotonia and seizures. Until the age of 9 years, he evolved satisfactorily; therefore, he stopped treatment. At 13 years, he presented bilateral optic neuropathy. Patient 2: 20 years, female, parents without consanguinity. She was diagnosed with PA at 11 months of age because of hypotonia and seizures. She evolved satisfactorily until the age of 9 years when she presented a metabolic decompensation followed by a bad metabolic control. At 18 years, she presented bilateral progressive optic neuropathy. Results: Both patients have psychometric scores with borderline IQ 84-75 (WISC-R) beside optic neuropathy. They were evaluated by an ophthalmologist and also by neuroimaging (MRI of optic pathway). Conclusions: Pathophysiology of optic neuropathy is not completely understood. There is evidence that the damage is due to an accumulation of neurotoxic compounds secondary to the metabolic block increasing the oxidative stress. We suggest an annual ophthalmologic evaluation in the longterm follow-up of organic acidurias with visual loss, in order to detect this disabling sequela at an earlier stage.

The aim of this work was to detect Escherichia coli isolates displaying resistance to oxyimino-cephalosporins, quinolones, and colistin in feces from livestock in Uruguay. During 2016-2019, fecal samples from 132 broiler and layer chicken flocks, 100 calves, and 50 pigs, were studied in Uruguay. Samples were cultured on MacConkey Agar plates supplemented with ciprofloxacin, ceftriaxone, or colistin. E. coli isolates were identified by mass spectrometry and antibiotic susceptibility testing was performed by disk diffusion agar method and colistin agar test. Antibiotic resistance genes were detected by polymerase chain reaction and sequencing. The most frequently detected resistance gene was qnrB19, recovered from 87 animals. Regarding plasmid-mediated quinolone resistance genes, qnrS1 was the second in prevalence (23 animals) followed by qnrE1, found in 6 chickens and two calves. Regarding resistance to oxyimino-cephalosporins, 8 different β-lactamase genes were detected: bla CTX−M−8 and bla CMY−2 were found in 23 and 19 animals, respectively; next, bla CTX−M−2 and bla SHV−12 in 7 animals each, followed by bla CTX−M−14 in 5, bla CTX−M−15 and bla SHV2a in 2, and bla CTX−M−55 in a single animal. Finally, the mcr-1 gene was detected only in 8 pigs from a single farm, and in a chicken. Isolates carrying bla CMY−2 and bla SHV−12 were also found in these animals, including two isolates featuring the bla CMY−2 /mcr-1 genotype. To the best of our knowledge, this is the first work in which the search for transferable resistance to highest priority critically important antibiotics for human health is carried out in chickens and pigs chains of production animals in Uruguay.