Prevalencia y factores relacionados con desnutrición en la primera infancia. Colombia año 2018 a 2020

La desnutrición como enfermedad de origen social es la expresión última de la situación de inseguridad alimentaria y nutricional de una población, al afectar principalmente a los niños. El objetivo fue analizar la prevalencia y factores relacionados con la desnutrición en la primera infancia en Colombia durante los años 2018 a 2020, mediante un estudio cuantitativo descriptivo de tipo ecológico - exploratorio, con recolección de datos retrospectivos a partir de reportes obtenidos del Sistema Integrado de Información de la Protección Social. El total de casos corresponde a 43.823 reportes, la prevalencia para los tres años fue de 1,13% principalmente en los departamentos de Guajira (n: 3.488; 3,17%) y Boyacá (n: 1.277; 1,39%), mayor número de casos presentados en el sexo masculino (n: 23.804; 54,3%), en edad entre 0 y 1 año (n: 17.099; 39,0%), pertenecientes al régimen subsidiado (n: 28.814; 65,75%) y ubicados en la cabecera municipal (n: 28.114; 64,15%). Con relación a la pertenencia étnica la mayor frecuencia se evidencia en "otras etnias" (n: 33.050; 75,42%), seguido de la etnia indígena (n: 8.348; 19,05%) y el estrato socioeconómico más representativo es el "bajo-bajo" (n: 17.620; 40,21%). Además, existe relación entre el sexo masculino y la desnutrición, comportándose como un factor de riesgo, y el vivir en centro poblado disminuye la probabilidad de presentar desnutrición. Se evidenció una frecuencia significativa de características asociadas a los determinantes sociales en salud y variables específicas relacionadas con la desnutrición.

Malnutrition as a disease of social origin is the ultimate expression of the situation of food and nutritional insecurity of a population, mainly affecting children. The objective was to analyze the prevalence and factors related to malnutrition in early childhood in Colombia during the years 2018 to 2020, through a descriptive quantitative study of an ecological-exploratory type, with retrospective data collection from reports obtained from the Integrated System of Social Protection Information. The total number of cases corresponds to 43,823 reports, the prevalence for the three years was 1.13%, mainly in the departments of Guajira (n: 3,488; 3.17%) and Boyacá (n: 1,277; 1.39%). greater number of cases presented in males (n: 23,804; 54.3%), aged between 0 and 1 year (n: 17,099; 39.0%), belonging to the subsidized regime (n: 28,814; 65.75%) and located in the municipal seat (n: 28,114; 64.15%). In relation to ethnicity, the highest frequency is evidenced in "other ethnic groups" (n: 33,050; 75.42%), followed by the indigenous ethnic group (n: 8,348; 19.05%), and the most representative socioeconomic stratum is the "low-low" (n: 17,620; 40.21%). In addition, there is a relationship between the male sex and malnutrition, behaving as a risk factor, and living in a populated center decreases the probability of presenting malnutrition. A significant frequency of characteristics associated with the social determinants of health and specific variables related to malnutrition was evidenced.

Prognostic value of venous blood analysis at the start of CPR in non-traumatic out-of-hospital cardiac arrest: association with ROSC and the neurological outcome.

BACKGROUND: The knowledge of new prognostic factors in out-of-hospital cardiac arrest (OHCA) that can be evaluated since the beginning of cardiopulmonary resuscitation (CPR) manoeuvres could be helpful in the decision-making process of prehospital care. We aim to identify metabolic variables at the start of advanced CPR at the scene that may be associated with two main outcomes of CPR (recovery of spontaneous circulation (ROSC) and neurological outcome). METHODS: Prospective observational study of all non-traumatic OHCA in patients older than 17 years assisted by emergency medical services (EMS), with doctor and nurse on board, between January 2012 and December 2017. Venous blood gases were sampled upon initially obtaining venous access to determine the initial values of pH, pCO2, HCO3-, base excess (BE), Na+, K+, Ca2+ and lactate. ROSC upon arrival at the hospital and neurological status 30 days later (Cerebral Performance Categories (CPC) scale) were recorded. RESULTS: We included 1552 patients with OHCA with blood test data in a 6-year period. ROSC was achieved in 906 cases (58.4%), and good neurological recovery at 30 days (CPC I-II) occurred in 383 cases (24.68%). In multivariate analysis, we found a significant relationship between non-recovery of spontaneous circulation (no-ROSC) and low pH levels (adjusted odds ratio (OR) 0.03 (0.002-0.59), p = 0.020), high pCO2 levels (adjusted OR 1.03 [1.01-1.05], p = 0.008) and high potassium levels (adjusted OR 2.28 [1.43-3.61], p = 0.008). Poor neurological outcomes were associated with low pH levels (adjusted OR 0.06 [0.02-0.18], p < 0.001), high pCO2 (adjusted OR 1.05 [1.03-1.08], p < 0.001), low HCO3- (adjusted OR 0.97 [0.94-0.999], p = 0.044), low BE (adjusted OR 0.96 [0.93-0.98], p < 0.001) and high potassium levels (adjusted OR 1.37 [1.16-1.60], p < 0.001). CONCLUSION: There is a significant relationship between severe alterations of venous blood-gas variables and potassium at the start of CPR of non-traumatic OHCA and low-ROSC rate and neurological prognosis.

[Incidence of acute agitation and variation in acute agitation management by emergency services]. / Incidencia y variabilidad de manejo de la agitación aguda en los servicios de emergencias médicas.

OBJECTIVES: To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. MATERIAL AND METHODS: Observational descriptive study based on aggregate data from unpublished internal EMS reports. RESULTS: Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. CONCLUSION: The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.

OBJETIVO: Evaluar la incidencia y el manejo de la agitación aguda por los servicios de emergencias médicas (SEM) en España. METODO: Estudio observacional descriptivo que utiliza datos agregados de las memorias de actividad o datos internos no publicados de los SEM. RESULTADOS: Durante el año 2013, los 7 SEM participantes recibieron 4.306.213 llamadas, de las cuales 111.599 (2,6%; 6,2 llamadas/1.000 habitantes) fueron categorizadas como psiquiátricas. Las actuaciones requeridas por motivos psiquiátricos fueron 84.933 (4,2% del total de actuaciones; 4,0 actuaciones/1.000 habitantes) y, de estas, 37.951 fueron por pacientes agitados (1,9% del total de actuaciones; 2,0 actuaciones/1.000 habitantes). Solo 3 SEM disponían de un procedimiento específico para los equipos asistenciales de atención al paciente psiquiátrico y al paciente agitado. CONCLUSIONES: El paciente agitado es un problema común en los equipos asistenciales de los SEM. Pocos de estos equipos cuentan con procedimientos específicos de actuación ante estos casos.

Influence of Aging on Microvascular Supply of the Gluteus Medius Tendon: A Cadaveric and Histologic Study.

PURPOSE: The purpose of this cadaveric study was to assess the relation between age and microvascular supply of 3 areas of the gluteus medius tendon using a previously validated CD31 immunohistochemistry staining technique. METHODS: Twenty-four fresh-frozen gluteus medius specimens were obtained through a posterolateral approach to the hip. Specimens aged 18 years or older, of either sex, and of any race were considered for this study. The average age of donors was 47.3 years (range, 18-68 years). Each sample was divided into 3 portions: musculotendinous, tendinous, and tendon-bone junction. H&E staining was used for qualitative structural analysis, and then all samples underwent staining with CD31 immunohistochemistry for quantitative assessment of vessels per square millimeter. A comparison of the microvessel density between zones according to age was performed by an analysis of variance. To evaluate the relation between microvessel supply and age, a regression model with curvilinear estimation was used. The data were fitted to a quadratic model. RESULTS: Vascular supply in transversal and longitudinal cuts regardless of the zone was, on average, 53.9 ± 32.1 vessels/mm2 and 51.1 ± 19.3 vessels/mm2, respectively. All the areas of the tendon showed a strength of relation (R) ranging from 0.41 to 0.76 between age and vascular supply. In addition, the proportion of vascular supply change explained by age (R2) was significant in most cases (ranging from 0.17 to 0.56, with P < .05). CONCLUSIONS: There is a chronological relation between aging and microvascular supply of the gluteus medius tendon, in which an initial increase occurs from 18 years of age to 30 to 40 years of age, with a progressive decrease after 50 years of age. CLINICAL RELEVANCE: The findings of our study may have implications for increased vulnerability of the gluteus medius tendon and decreased healing potential.

Code 100: a study on suicidal behavior in public places.

Every day, the emergency departments in our country receive a large number of patients that have thought about or attempted suicide. Unfortunately, these patients are very often reluctant to maintain a regular follow-up in mental health services. In this study we describe an original program to encourage assessment and treatment of suicidal patients, particularly when they receive medical treatment in public places. We summarize the application of the program and compare the results of a specific follow-up between two groups of patients: suicidal patients assessed by emergency services in public places and all other suicidal patients assessed in the emergency department of a tertiary hospital.

Etiquetado nutricional de productos artesanales elaborados por pequeñas empresas del estado Mérida- Venezuela / Nutritional labels in artisan products made by small business entreprenuers in Merida state-Venezuela

En muchos países del mundo, la información que aparece en las etiquetas de los productos alimenticios forma parte de los es - fuerzos de la educación nutricional para fomentar en los consumidores cambios positivos en la conducta alimentaría. La sociedad busca sustentar a través de sus métodos el co no ci miento aplicado con tecnología, de manera tal que pue da ob te ner de dicho proceso la información útil, completa y oportuna. El impacto de la información sustentada en la evidencia científica y tecnológica sobre la masa poblacional de un producto de consumo masivo particular, induce de forma ética a la toma de decisiones. El objetivo de la presente investigación fue realizar los análisis fi sicoquímicos previo muestreo, de los productos elaborados por 13 empresas de alimentos, en el estado Mérida, comparar los resultados con las normas Covenin, a fin de ela borar el etiquetado nutricional. Estas empresas fueron en cuestadas previamente para obtener la aceptación de las mis mas en el proyecto en estudio. La ubicación geográfica de las empresas corresponde a los municipios Libertador, San tos Marquina y Campo Elías del estado Mérida. Se de terminó el % de grasa, mediante el método de Soxhlet (Co ve nin, 3821:2003); Pro - teínas por micro Kjeldahl (Covenin, 370-1986)), humedad por el método gravimétrico de desecación en estufa (AOAC, 2000); cenizas por incineración directa en lla ma (AOAC, 2000), y carbohidratos por diferencia. De los re sultados obtenidos se concluye que de 21 productos analizados, el 80% no cumple con la norma de referencia para cada producto, y un 20% está dentro de los valores exigidos por la referencia respectiva. Estos resultados se compararon en al gunos casos con la norma Covenin y en otros por la Tabla de composición de alimentos del Institu to Na cional de Nutrición.

In many countries of the world, the nutritional facts that appear in the nutritional labels of many marketed alimentary products, is part of an educational effort to promote positive changes in the nutritional habits of consumers. Our society seeks sustainability through methods that enable the administration of knowledge applied to technology, in order to obtain useful, complete and opportune information. The impact over the population of the information based in scientific evidence induces positive decision making in an ethical manner. The objectives of the present investigation were to make physical and chemical analysis previous sample recollections of the manufactured alimentary products of 13 different businesses of the state of Merida and compared the results with the COVENIN norms, and finally, elaborate the nutritional labels. These businesses were pre viously submitted to the required rules of acceptance of the investigation. These small businesses are geographically located in the municipalities of Santos Marquina, Libertador y Campo Elias of the state of Mérida. The percentage of lipid content was determined by the method Soxhlet (COVENIN, 3821:2003); Proteins by micro Kjeldahl (COVENIN, 370:1986), humidity by the gravimetric method of desiccation in estove (AOAC, 2000); ashes by direct incineration (AOAC, 2000), y carbohydrates by difference. The results obtainned, are as follows: of the 21 products analized, 80% don’t fulfil the COVENIN parameters and 20% are in the range of values of reference. Some of these results were compared with the COVENIN norms and others with the table of composition of the Institute of National Nu - trition.