Changes in the prevalence of undernutrition, overweight and obesity in children and adolescents from Buenos Aires, Mendoza, and Misiones provinces (Argentina) over the last two decades.

OBJECTIVES: The aim of this study was to determine changes in the prevalence of undernutrition, overweight and obesity in Argentine children and adolescents over the last two decades, and analyze their relationship with family socioeconomic conditions. METHODS: We compared data in two cross-sectional studies (C) of schoolchildren (n: 4971) aged 4 to 13 years from three provinces: Buenos Aires, Mendoza and Misiones. C1 was carried out between 2005 and 2009 and C2 between 2010 and 2019. Anthropometric (body weight, height, triceps and subscapular skinfolds) and socioeconomic data of both studies were obtained in the same schools by the same investigators, using a similar methodology. The prevalence of nutritional status and the frequency of family socioeconomic conditions were calculated by province and C. Data were analyzed by chi square test, categorical principal component analysis and generalized linear model. RESULTS: The prevalence of undernutrition decreased in C2 in Buenos Aires and Misiones and remained constant in Mendoza. At the same time, the prevalence of overweight and obesity increased in the three provinces, around 13% in Buenos Aires and 9% in Mendoza and Misiones. Similarly, fat mass increased in C2. Undernutrition was associated with inadequate family socioeconomic conditions only in C1. CONCLUSIONS: This 14-year follow-up study shows a decreasing trend in the prevalence of undernutrition and an increasing trend in the prevalence of overweight, obesity, and fat mass in the child and adolescent population of Argentina. Also, a marked deterioration in family socioeconomic conditions was found, but its relationship with the changes in nutritional status remains to be elucidated.

Embarazo adolescente: Resultados perinatales en la maternidad de un hospital de la Ciudad de Corrientes / Adolescent pregnancy: Perinatal results in the maternity ward of a hospital in the City of Corrientes

El embarazo en la adolescencia constituye un grave problema de la salud pública, más aún en nuestro país donde presenta un alto porcentaje de casos, lo que involucra mayores riesgos de salud reproductiva aumentando de esta manera la morbilidad y mortalidad. El objetivo es analizar los resultados perinatales, en los recién nacidos de las gestantes adolescentes en la maternidad del Hospital "Dr José R. Vidal" de la ciudad de Corrientes. Estudio observacional, retrospectivo, analítico y transversal comprendido entre Agosto-2015 a Julio-2016. La población en estudio estuvo conformada por recién nacidos de madres adolescentes entre 10 a19 años. Las variables fueron edad materna; semanas de gestación al momento del parto; peso del recién nacido de término; puntuación de Apgar y destino del recién nacido. Del total de partos el 22,14% fueron de madres adolescentes, de los cuales 77% correspondieron a nacimientos de término de peso adecuado para la edad gestacional (PAEG) (91,02%), con puntuación de Apgar normal (79%) que ingresaron a internación junto a la madre (82%). Los nacimientos de pretérmino resultaron 22,69%, siendo el 66,66% deprimidos moderados según Apgar y el 79,24% fueron trasladados a unidad de cuidados intensivos neonatales (UCIN). La frecuencia de embarazos adolescentes fue elevada, en cuanto a los resultados perinatales se observó peso adecuado, puntuación de Apgar normal einternación conjunta con la madre predominaron ampliamente en el recién nacido de termino.

Weight and height percentiles calculated by the LMS method in Argentinean schoolchildren. A comparative references study.

BACKGROUND: The Argentinean population is characterized by ethnic, cultural and socio-economic diversity. AIM: To calculate the percentiles of weight-for-age (W/A) and height-for-age (H/A) of schoolchildren from Argentina employing the LMS method; and to compare the obtained percentiles with those of the international and national references. SUBJECTS AND METHODS: Anthropometric data of 18 698 students (8672 girls and 10 026 boys) of 3-13 years old were collected (2003-2008) from Buenos Aires, Catamarca, Chubut, Jujuy, La Pampa and Mendoza. Percentiles of W/A and H/A were obtained with the LMS method. Statistical and graphical comparisons were established with the WHO (international reference) and with that published by the Argentinean Paediatric Society (national reference). RESULTS: Differences in W/A and H/A, regarding the references, were negative and greater at the highest percentiles and in most of the age groups. On average, the differences were greater for boys than girls and for national than international references. CONCLUSION: The distribution of weight and height of schoolchildren, coming from most regions of the country, differs from those of national and international references. It should be advisable to establish a new national reference based on internationally recognized methodological criteria that adequately reflect the biological and cultural diversity of the Argentinean populations.

[Primary pneumonic plague with nosocomial transmission in La Libertad, Peru 2010]. / Peste neumónica primaria con transmisión intrahospitalaria en La Libertad, Perú 2010.

UNLABELLED: Pneumonic plague is one of the clinical forms of plague, of low frequency and high mortality, transmitted by direct inhalation of Yersinia pestis coming from an animal or from person to person. OBJECTIVE: To describe the clinical and epidemiological characteristics of the cases of primary pneumonic plague in an outbreak in the north of Peru. MATERIALS AND METHODS: The clinical records of the confirmed cases of primary pneumonic plague presenting in an outbreak occurring in La Libertad, in July 2010, were reviewed, also the search and contact investigation was performed. RESULTS: The index case was identified, as well as three additional cases, out of these, two were nosocomial infections related to the index case. The initial clinical presentation was characterized by sudden onset of fever, chills, myalgia and chest pain, which in less than 24 hours evolved to hypotension and cyanosis. The initiation of specific treatment varied from 2 to 12 days, and cases with prompt initiation of treatment had a better clinical outcome. The lethality was 50% (2/4). CONCLUSION: Nosocomial transmission of pneumonic plague in Peru is evidenced, with severe clinical manifestations and high lethality.

Peste neumónica primaria con transmisión intrahospitalaria en La Libertad, Perú 2010 / Primary pneumonic plague with nosocomial transmission in La libertad, Peru 2010

La peste neumónica es una forma clínica de peste, de baja frecuencia y alta letalidad, transmitida por la inhalación directa de Yersinia pestis proveniente de un animal o de persona a persona. Objetivo: Describir las características clínicas y epidemiológicas de los casos de un brote de peste neumónica primaria humana en el norte de Perú. Materiales y Métodos. Se revisaron las historias clínicas de los casos confirmados de peste neumónica primaria presentados en un brote ocurrido en la región de La Libertad, en el mes de julio de 2010, asimismo, se efectuó la búsqueda e investigación de contactos. Resultados: Se identificó el caso Índice y tres casos adicionales, de estos últimos, dos fueron infecciones intrahospitalarias relacionadas con el caso índice. La presentación clínica inicial se caracterizó por fiebre de inicio súbito, escalofríos, mialgias y dolor torácico y evolución en menos de 24 horas a hipotensión arterial y cianosis. El inicio del tratamiento específico varió de 2 a 12 días, observándose que los casos con inicio precoz de tratamiento tuvieron un mejor resultado clínico. La lealtad fue de 50 por ciento (2/4). Conclusión: Se evidenció la transmisión intrahospitalaria de peste neumónica en el Perú con manifestaciones graves y alta letalidad.

Pneumonic plague is one of the clinical forms of plague, of low frequency and high mortality, transmitted by direct inhalation of Yersinia pestis coming from an animal or from person to person. Objective. To describe the clinical and epidemiological characteristics of the cases of primary pneumonic plague in an outbreak in the north of Peru. Materials and methods. The clinical records of the confirmed cases of primary pneumonic plague presenting in an outbreak occurring in La Libertad, in July 2010, were reviewed, also the search and contact investigation was performed. Results. The index case was identified, as well as three additional cases, out of these, two were nosocomial infections related to the index case. The initial clinical presentation was characterized by sudden onset of fever, chills, myalgia and chest pain, which in less than 24 hours evolved to hypotension and cyanosis. The initiation of specific treatment varied from 2 to 12 days, and cases with prompt initiation of treatment had a better clinical outcome. The lethality was 50 percent (2/4). Conclusion. Nosocomial transmission of pneumonic plague in Peru is evidenced, with severe clinical manifestations and high lethality.

Sobrepeso y obesidad en escolares de Brandsen en relación a las condiciones socioambientales de residencia / Overwweight and obesity in schoolchildren from Brandsen and its relationship with socio environmental characteristics of residence

Introducción. Los factores socioambientales desempeñan un papel esencial en la etiología del sobrepeso (S) y la obesidad (O) y constituyen elllamado “entorno obesogénico”. Los objetivos del presente trabajo son: a) estimar las prevalencias de sobrepeso y obesidad en escolares de 3 a 14 años del partido de Brandsen (Provincia deBuenos Aires) y b) analizar la probabilidad de ocurrencia de sobrepeso y obesidad en relación a las condiciones socioambientales de residencia. Población y métodos. Se relevaron peso y talla de 989 escolares, de ambos sexos, de 3-14 años de edad. Se determinaron S y O según los criterios de la International Obesity Task Force. Las prevalencias fueron comparadas entre sexos y edades. Los datos socioambientales, obtenidos apartir de encuestas, fueron procesados mediante Análisis de Componentes Principales (catPCA). Se empleó un Modelo Lineal Generalizado (link logit) para las variables S y O. Resultados. El 15,8% de los escolares presentó S yel 7,2% O, encontrándose diferencias estadísticas no significativas entre sexos y edades. El primer eje del análisis catPCA, discriminó con valorespositivos los casos que presentaron las mejores condiciones socioambientales y negativos las más desfavorables. Hubo mayor probabilidad de niños obesos asociada a condiciones socioambientalesadecuadas (mayor nivel educativo depadres, mayores ingresos y mejor acceso a servicios públicos), en tanto que se observó mayor probabilidad de niños con sobrepeso asociada a ambientes menos favorecidos. Conclusiones. Se concluye que la población escolar de Brandsen presenta elevadas prevalencias de sobrepeso y obesidad. La probabilidad de presentar sobrepeso es mayor en los niñosprovenientes de hogares con condiciones socioambientalesdesfavorables. La obesidad, en cambio, lo es en aquellos hogares que reúnencondiciones socioambientales favorables.

Introduction. Environmental factors play an important role in the etiology of overweight (S) and obesity (O), constituting the "obesogenic environment”. The objectives of the present study are: a) to estimate overweight and obesity prevalences in 3 to 14 years-old schoolchildrenfrom Brandsen (Provincia de Buenos Aires), and b) to analyze the probability of occurrence of overweight and obesity in relation to the socioenvironmentalconditions of resident. Population and methods. Weight and height were measured in 989 boys and girls aged 3 to 14 years. S and O were estimated following the criteria suggested by the International Obesity Task Force. The prevalences of S and O were compared between genders and ages. The socio-environmental information was gatheredaccording to surveys and processed by Categorical Principal Components Analysis (catPCA). Generalized Linear Model (link logit) against the variables S and O was employed. Results. S was found in 15,8% of schoolchildren and O in 7,2%. None significative statisticsdifferences between both genders and ages, were found. The first axis of the catPCA discriminated the cases that presented better socio-environmental conditions with positive values and those with more unfavorable conditions with negatives values. Higher probability of obese children was associated with better socio-environmental conditions (higher educational level of parents, higherincome and better access to public services), and higher probability of overweight children was associated with less favored environments.Conclusions. The schoolchildren population of Brandsen presents high overweight and obesity prevalences. The chance of presenting overweight is higher in children from householdswith adverse socio-environmental conditions. On the contrary, obese children are to be more found in households which have more favorablesocio-environmental conditions.

[Overweight and obesity in schoolchildren from Brandsen and its relationship with socio-environmental characteristics of residence]. / Sobrepeso y obesidad en escolares de Brandsen en relación a las condiciones socioambientales de residencia.

INTRODUCTION: Environmental factors play an important role in the etiology of overweight (S) and obesity (O), constituting the "obesogenic environment". The objectives of the present study are: a) to estimate overweight and obesity prevalences in 3 to 14 years-old schoolchildren from Brandsen (Provincia de Buenos Aires), and b) to analyze the probability of occurrence of overweight and obesity in relation to the socioenvironmental conditions of resident. POPULATION AND METHODS: Weight and height were measured in 989 boys and girls aged 3 to 14 years. S and O were estimated following the criteria suggested by the International Obesity Task Force. The prevalences of S and O were compared between genders and ages. The socio- environmental information was gathered according to surveys and processed by Categorical Principal Components Analysis (catPCA). Generalized Linear Model (link logit) against the variables S and O was employed. RESULTS: S was found in 15,8% of schoolchildren and O in 7,2%. None significative statistics differences between both genders and ages, were found. The first axis of the catPCA discriminated the cases that presented better socio-environmental conditions with positive values and those with more unfavorable conditions with negatives values. Higher probability of obese children was associated with better socio-environmental conditions (higher educational level of parents, higher income and better access to public services), and higher probability of overweight children was associated with less favored environments. CONCLUSIONS: The schoolchildren population of Brandsen presents high overweight and obesity prevalences. The chance of presenting overweight is higher in children from households with adverse socio-environmental conditions. On the contrary, obese children are to be more found in households which have more favorable socio-environmental conditions.

Socioenvironmental conditions and nutritional status in urban and rural schoolchildren.

We analyzed the nutritional status of urban and rural schoolchildren from Mendoza (Argentina), but avoided rural and urban categorization by generating subpopulations as a function of their socioenvironmental characteristics. We transformed weight and height data into z-scores using the CDC/NCHS growth charts; defined underweight, stunting, and wasting by z-scores of less than -2 SD; and calculated overweight and obesity, according to the cutoff proposed by the International Obesity Task Force. Socioenvironmental characteristics included housing, public services, parental resources, and farming practices; we processed these variables by categorical principal-component analysis. The two first axes defined four subgroups of schoolchildren: three of these were associated with urban characteristics, while the remaining subgroup was considered rural. Nutritional status differed across groups, whereas overweight was similar among the groups and obesity higher in urban middle-income children. Urban differences were manifested mainly as underweight, but rural children exhibited the greatest stunting and wasting. Thus, the negative effects of environment on nutritional status in children are not restricted to poor periurban and rural areas, though these are indeed unfavorable environments for growth: some urban families provide children with sufficient quantity and diversity of foods to expose them to obesity. By contrast, the more affluent urban families would appear to have greater possibilities for allowing their children to adopt a healthy life-style. Although the causes of differences in nutritional status between middle- and high-income urban groups are not clear, these determinants probably involve economic as well as educational influences.