Anatomía Digital

Nutrigenetics and nutrigenomics. Advances in precision nutrition for NCDs: obesity, diabetes, and hypertension

Valeria Sophia Navas Benavides — 2026-02-06

Introduction. Traditional population-based nutrition guidelines have been effective in reducing nutritional deficiencies but show limitations when addressing individual genetic variability, particularly in the context of non-communicable chronic diseases (NCDs). Precision nutrition, grounded in nutrigenetics and nutrigenomics, offers personalized dietary interventions based on everyone’s molecular profile. Objective. To analyze advances in nutrigenetics and nutrigenomics applied to precision nutrition and their clinical impact on the prevention and management of obesity, type 2 diabetes, and hypertension. Methodology. A narrative review was conducted based on a non-systematic search of scientific databases (PubMed, SciELO, ScienceDirect), including articles published between 2018 and 2023. A total of 42 relevant studies were selected that provided evidence on gene–nutrient interactions with clinical applicability in NCDs. Results. At least 43 clinically relevant genetic variants were identified in relation to obesity, type 2 diabetes, and hypertension. Polymorphisms such as FTO (rs9939609), TCF7L2 (rs7903146), and ACE (rs1799752) modulate the response to specific dietary interventions, including high-fiber diets, sodium restriction, and increased monounsaturated fat intake. Omics technologies and next-generation sequencing have enabled the characterization of individual molecular profiles and the development of evidence-based, genetically tailored nutritional strategies. Conclusion. The integration of nutrigenetics and nutrigenomics into clinical practice enhances the effectiveness of dietary interventions for NCDs through individualized approaches. Despite current implementation challenges, scientific evidence supports the consolidation of precision nutrition as an emerging model within personalized medicine. General Area of Study: Health and Wellness. Specific area of study: Nutrition and Dietetics. Type of study: Bibliographic review.

Refeeding syndrome in the critically ill pediatric patient: a pathophysiological approach

Yanitzia Belalcazar Ortiz — 2026-02-06

Introduction. Refeeding Syndrome (RS) is a potentially life-threatening metabolic complication triggered by the reintroduction of nutrition in pediatric patients with prolonged malnutrition or fasting. It results from an abrupt shift from a catabolic to an insulin-mediated anabolic state, causing rapid intracellular shifts of phosphate, potassium, and magnesium, along with thiamine deficiency, which may lead to multi-organ dysfunction. Children are particularly vulnerable due to limited energy reserves and higher metabolic demands. Objective. To provide an integrative pathophysiological overview of refeeding syndrome in critically ill pediatric patients, emphasizing risk identification, clinical manifestations, and evidence-based strategies for safe nutritional reintroduction. Methodology. A narrative review was conducted through PubMed, SciELO and ScienceDirect, including English and Spanish articles published between 2019 and 2024, with exceptional inclusion of earlier seminal studies. Controlled MeSH/DeCS terms related to “Refeeding Syndrome,” “Pediatric Nutrition” and “Malnutrition” were used. A total of 28 studies were selected based on clinical relevance and pediatric focus. Results. RS typically occurs within 48–120 hours after restarting nutrition, most frequently presenting as hypophosphatemia with associated electrolyte derangements and potential multi-organ impairment. Incidence reaches 7% in pediatric intensive care units and nearly 47% in children with severe malnutrition. Prevention relies on early risk stratification, close biochemical monitoring (every 6–8 h initially), hypocaloric initiation (10–12.5 kcal/kg/day), anticipatory thiamine supplementation and initiative-taking electrolyte replacement. Early, gradual enteral nutrition with adequate protein support (1–3 g/kg/day) is considered optimal. Conclusion. Refeeding syndrome in pediatric critical care demands initiative-taking, gradually titrated nutritional strategies and vigilant monitoring. Early detection and micronutrient correction are key to reducing morbidity and mortality. Further pediatric-specific prospective research is needed to refine metabolic risk-adapted protocols. General Area of Study: Health and Wellness. Specific area of study: Critical Care Medicine. Type of study: Bibliographic review.

Acute metabolic response in the pediatric critical patient

Ronny Richard Mera Flores — 2026-02-06

Introduction. The acute metabolic response in critically ill pediatric patients is a complex phenomenon characterized by hypermetabolism, insulin resistance, systemic inflammation, and accelerated protein catabolism. Children have limited energy reserves and are more vulnerable to early malnutrition, worsening prognosis if nutritional and therapeutic support are not promptly provided. Objective. To provide a comprehensive analysis of pathophysiology, clinical-metabolic evaluation, nutritional implications, and therapeutic strategies associated with the acute metabolic response in critically ill pediatric patients. Methodology. A narrative review was conducted in PubMed, SciELO, and ScienceDirect, including English and Spanish articles from the last five years and older seminal studies when relevant. MeSH and DeCS descriptors related to critical illness, pediatric ICU, metabolic response, energy expenditure, nutritional support, hypermetabolism, and protein catabolism were used. After screening for pediatric focus and relevance, 34 articles were included. Results. The acute metabolic response involves proinflammatory cytokine activation, increased cortisol and catecholamines, insulin resistance, hyperglycemia, accelerated lipolysis, and marked protein catabolism with rapid muscle loss. Indirect calorimetry provides precise energy requirement estimation. Early enteral nutrition (24–48 h) reduces infections and cumulative energy deficit. Protein needs should be 1.5–2.5 g/kg/day. Emerging strategies include immunonutrition, metabolic β-blockade, microbiota modulation, and precision nutrition based on metabolic phenotype. Conclusion. Management of the acute metabolic response in critically ill pediatric patients requires early, individualized, and metabolically directed intervention. Early, monitored nutritional support is crucial to preserve lean mass and modulate inflammation. Pediatric evidence gaps remain, emphasizing the need for studies validating safe and effective strategies. General Area of Study: Health and Wellness. Specific area of study: Critical Care Medicine. Type of study: Bibliographic review.

Design of a bacterial system for the production and purification of recombinant NcGRA7 protein using Staphylococcus aureus Sortase A Activity

Janneth Fernanda Cárdenas Cordero — 2026-02-12

Introduction. Sortase A (SrtA) is a cysteine transpeptidase found in Gram-positive bacteria, where it catalyzes site-specific peptide bond cleavage and ligation. Due to these properties, SrtA widely applied as a biotechnological tool for the production and purification of recombinant proteins, allowing controlled proteolytic processing and improved purification efficiency. Objective. This study aimed to develop a bacterial system for the production and purification of recombinant proteins based on the enzymatic activity of Staphylococcus aureus Sortase A (Sa-SrtA). Methodology. A modified pET15b NT-Histidine vector (Novagen) was constructed by incorporating the coding sequence of Δ60Sa-SrtA (GenBank Acc. No.: AF162687) from S. aureus (ATCC 12598), followed by the consensus recognition motif LPET4G. The antigenic protein NcGRA7 from Neospora caninum (GenBank Acc. No.: U82229) was cloned downstream of this motif, generating the fusion construct His-tag–Δ60Sa-SrtA–LPET4G–NcGRA7. Protein expression was conducted in Escherichia coli Rosetta 2 (DE3), and purification was performed by immobilized metal affinity chromatography (IMAC) using Ni-NTA resin. Enzymatic cleavage was induced in the presence of Ca²⁺ and triglycine, enabling the release of the target protein. Results. A bacterial model was obtained for the generation of purified recombinant proteins by the enzymatic activity of Δ60Sa-SrtA. The system allowed the purification of the recombinant protein of N. caninum 4G-NcGRA7, that could be used for the generation of the diagnostic system. Conclusion. The Δ60Sa-SrtA-based system represents an effective and reliable strategy for the production and purification of recombinant proteins, with potential applications in diagnostic and biotechnological developments. General Area of Study: Biology. Specific area of study: Molecular Biology. Type of study: Original articles.

Application of I-PRF in bone and periodontal healing after apicoectomy: clinical case

Brigithe Bethzabet Figueroa Ortiz — 2026-02-25

Introduction: endodontic microsurgery is used to treat periapical pathologies when endodontic retreatment fails. In this context, injectable platelet-rich fibrin (I-PRF) is considered a complement to healing due to its ability to gradually release factors that promote bone and periodontal repair. Objective: to report, from a clinical and radiological point of view, a case of apicoectomy following the complementary application of I-PRF. Methodology: a descriptive observational study was conducted, corresponding to a case report, on a 50-year-old female patient treated at the clinic of the Catholic University of Cuenca. A deficient endodontic treatment associated with a metal-porcelain crown with leakage was identified. Apical resection, curettage of the inflammatory tissue, retrograde filling with Biodentine, and application of I-PRF obtained by low-speed centrifugation were performed; subsequently, the flap was repositioned and sutured. Results: the clinical outcome was favorable, with no pain or inflammation. Radiographic controls showed bone regeneration and functional restoration. Conclusion: the complementary use of I-PRF in apical surgery is a minimally invasive option that promotes bone and periodontal healing. Thus, the integration of autologous and bioceramic biomaterials, applied under surgical protocols. General area of study: Dentistry. Specific area of study: Endodontics. Type of article: Clinical case.

Dental autotransplantation with regenerative therapy using A-PRF (Advanced Platelet Rich Fibrin) and I PRF (Injectable Platelet Rich Fibrin)

Marco Salinas Molina — 2026-02-27

Introduction: Dental autotransplantation represents a conservative and functional therapeutic alternative to replace teeth with an unfavorable prognosis, by maintaining the vitality of the periodontium and the capacity for bone regeneration. Objectives: We present the case of a 36-year-old female patient who presented with toothalgia in piece 1.6, diagnosing a deep lesion with periodontal involvement and root fracture of the instruments during endodontic treatment, which modified her prognosis. Methodology: An experimental clinical case study was developed, of a descriptive cross-sectional nature with longitudinal follow-up, in which the clinical and radiographic evolution of a patient undergoing a dental autotransplant with regenerative therapy was evaluated using A-PRF (Advanced Platelet Rich Fibrin) and I-PRF (Injectable Platelet Rich Fibrin). Results: After a comprehensive assessment, it was decided to perform a dental autotransplant using piece 2.8 as a donor tooth, selected for its morphology and adequate root characteristics. By means of a tomographic study with CBCT and 3D digital planning, the need for a slight distal wear of the receiving alveolus was determined for a correct adaptation. During the surgery, atraumatic protocols, controlled extraoral time and regenerative biotechnology with A-PRF AND IPRF were used, applied both to the socket and to the root of the donor tooth, favoring angiogenesis, periodontal regeneration and functional integration of the graft. The procedure was successful, showing correct clinical and radiographic adaptation. Conclusions: The case demonstrates that autotransplantation, supported by regenerative therapies and digital planning, is a biologically viable alternative to conventional tooth replacement treatments. General area of study: Dentistry. Specific area of study: Endodontics. Type of article: Clinical case.