Carlos Jiménez-Gutiérrez

El niño es un ser humano en desarrollo, NO un adulto pequeño. Así como no tiene la estatura final que alcanzará con los años, tampoco tiene la capacidad y autonomía que logrará en la edad adulta, pero ya es una persona con la dignidad, derechos y principios de los seres humanos. El Consentimiento Informado se originó en el ambiente jurídico por una demanda en tema de salud desde 1914, en tanto que el Asentimiento se empieza a considerar hasta 1977. El Consentimiento de un adulto requiere su cabal comprensión. El Asentimiento informado también, por lo que requerimos que el niño tenga competencias para ello. Se revisa el tema de desarrollo psicológico y moral con los enfoques de Piaget, Kohlberg, Erickson y Gilligan. Se analiza la aproximación de las competencias de Appelbaum y Grisso, así como los resultados de estudios que identifican cuando el niño tiene la competencia para asentir. Como conclusión se ilustran las ventajas y los retos del Asentimiento en investigación y atención clínica. En investigación en niños, siempre debe participar un pediatra e idealmente un/a psicólogo/a. El asentimiento informado en pediatría debe entenderse como un proceso continuo de toma de decisiones, centrado en una relación tripartita: Padre o Madre – Medico – Infante.

Here, 18S-rDNA sequences of Blastocystis sp., previously documented from symptomatic (cases) and asymptomatic (controls) carriers, were analyzed to determine their population structure, predict their secondary structure, and examine their interactions with ribosomal proteins (Bud23, RPS5, and RPS18). Phylogenetic and population differentiation analyses were performed using STRUCTURE software V2.3.4. Moreover, an analysis of the rRNA secondary structure and folding of each sequence was performed, and their probability of interaction with ribosomal proteins was determined. Phylogenetic and haplotype analyses sorted the sequences into genetic subtypes ST1, ST2, and ST3, while the population structure showed each cluster as a differentiated subpopulation, suggesting incipient speciation or cryptic species differentiation. Furthermore, the analysis of the secondary structure of rRNA exhibited specific arrangements for each subtype. In addition, the probability of interaction between 18S-rRNA sequences of Blastocystis from cases and controls with RPS5 and RPS18 was significant, matching the biological plausibility of the previously documented finding that control isolates had a lower generation time than isolates obtained from cases. These findings reinforce the hypothesis that ribosomal subtypes ST1–ST3 of Blastocystis represent evolutionarily distinct lineages with the potential to be recognized as future species. Furthermore, they underscore the functional relevance of 18S-rRNA sequences from clinical isolates of Blastocystis.

Background: Amino acid biomarkers have a crucial influence on our understanding of brain injury mechanisms, and their plasma concentrations may indicate neurological damage and recovery patterns. Pediatric mild traumatic brain injury (mTBI) assessment particularly benefits from such molecular indicators, as clinical presentations can be subtle and variable. However, current diagnostic and prognostic tools lack reliable biochemical markers that can track the temporal evolution of injuries and recovery. Methods: We conducted a prospective longitudinal cohort study involving 36 pediatric mTBI patients and 44 controls to characterize the temporal evolution of key amino acids and their derived indices. Blood samples were collected at 3, 6, 12, and 24 h and at 7, 14, and 28 days post-injury, with amino acids quantified using high-performance liquid chromatography. Results: Our analysis revealed significant temporal changes in glutamate, glutamine, and glycine concentrations, with glutamate peaking at day 7 before declining, while glutamine showed steady increases throughout. The GLN/GLU ratio demonstrated an early excitatory imbalance followed by astrocytic compensation, and the GLX ratio indicated progressive recovery. Conclusions: These patterns represent continuous neurochemical processes involving excitotoxicity and glial regulation, suggesting potential utility as biomarkers for mTBI diagnosis and monitoring. While further validation using larger cohorts is needed, these findings provide compelling evidence of the efficacy of using amino acid profiles to track pediatric mTBI progression and recovery.

Background The classification and nomenclature of non-alcoholic fatty liver disease (NAFLD) has been the subject of ongoing debate in the medical community. Through the introduction of metabolic dysfunction-associated fatty liver disease (MAFLD) and the later release of metabolic dysfunction-associated steatotic liver disease (MASLD), the limitations associated with NAFLD are intended to be addressed. Both terminologies incorporate the metabolic component of the disease by providing diagnostic criteria that relies on the presence of underlying metabolic risk factors. Materials and Methods An epidemiologic cross-sectional study of individuals who had undergone abdominal ultrasound and vibration-controlled transient elastography (VCTE) as part of a routine check was performed. We evaluated clinical, anthropometric, and biochemical variables to determine the metabolic profile of each subject. Results The study included a total of 500 participants, 56.8% (n = 284) males and 43.2% (n = 216) females, with a mean age of 49 ± 10 years. 59.4% (n = 297) were diagnosed with MAFLD and MASLD, 10.2% (n = 51) were diagnosed only with MASLD and 30.4% (n = 152) were not diagnosed with either MAFLD or MASLD. The differences in prevalence were mainly based on the detection of individuals with a BMI < 25 kg/m², where MASLD captures the largest number (p < 0.001). Conclusions Although MASLD has a higher capture of lean patients compared to MAFLD, patients with MAFLD and MASLD have a worse metabolic profile than those with only MASLD. Our results provide evidence that MAFLD better identifies patients likely to have a higher risk of liver fibrosis and of disease progression. Graphical abstract

Background: The importance of prebiotics consumption is increasing all over the world due to their beneficial effects on health. Production of better prebiotics from endemic plants raises possibilities to enhance nutritional effects in vulnerable population groups. Fructans derived from Agave Plant have demonstrated their safety and efficacy as prebiotics in animal models. Recently, the safety in humans of two fructans obtained from Agave tequilana (Metlin^® and Metlos^®) was demonstrated. Methods: This study aimed to demonstrate the efficacy as prebiotics of Metlin^® and Metlos^® in newborns of a randomized, double blind, controlled trial with a pilot study design. Biological samples were taken at 20 ± 7 days, and three months of age from healthy babies. Outcomes of efficacy include impact on immune response, serum ferritin, C-reactive protein, bone metabolism, and gut bacteria changes. Results: There were differences statistically significant for the groups of infants fed only with infant formula and with formula enriched with Metlin^® and Metlos^®. Conclusions: Our results support the efficacy of Metlin^® and Metlos^® as prebiotics in humans, and stand the bases to recommend their consumption. Trial Registration: ClinicalTrials.gov, NCT 01251783.