Prevalence of high neonatal thyroid stimulating hormone levels as an indicator of iodine deficiency in the province of La Pampa: An epidemiological analysis. / Prevalencia de hipertirotropinemia neonatal como indicador de deficiencia de yodo en la provincia de La Pampa: un análisis epidemiológico.

Introduction. Iodine plays a key role in human metabolism, growth, and development. During pregnancy and childhood, the demand for this micronutrient increases notably. Increased neonatal thyroid stimulating hormone (nTSH) levels, defined as nTSH ≥ 5 mIU/L, are a marker of iodine deficiency in a population if its prevalence is higher than 3%. Objective. To establish the prevalence of nTSH ≥ 5 in La Pampa in the 2021-2022 period, analyze its correlation with different variables, and compare it with data from a historical cohort. Population and methods. Cross-sectional, descriptive-analytical study in a population of newborn infants born in the 5 health regions of the province of La Pampa in 2021 and 2022. Results. Of the 5778 assessed newborn infants, 9.6% had nTSH levels ≥ 5 mIU/L. It was reported that 70.4% of these measurements were done after the third day of life. No significant differences were observed in the frequency of high nTSH levels by year of birth, birth weight, or days until sample collection. A higher prevalence was observed among male infants (10.6% versus 8.5%; p = 0.007) and term infants (9.8% versus 6.6%; p = 0.02). The prevalence of high TSH levels was superior to that observed in the 2001-2002 cohort. Conclusions. The prevalence of high nTSH levels in La Pampa during 2021 and 2022 was 9.6%, suggesting the presence of mild iodine deficiency in the population of this province, higher that what had been reported 2 decades ago.

Introducción. El yodo desempeña un rol fundamental en el metabolismo, el crecimiento y el desarrollo humano. Durante el embarazo y la infancia, la demanda de este micronutriente aumenta considerablemente. La tirotropinemia neonatal (TSHn) aumentada, definida como TSHn ≥5 mUI/l, es un marcador que señala la deficiencia de yodo en una población cuando su prevalencia supera el 3 %. Objetivo. Determinar la prevalencia de TSHn ≥ 5 en La Pampa durante el período 2021-2022, analizar su correlación con diferentes variables y compararla con datos de una cohorte histórica. Población y métodos. Estudio transversal, de diseño descriptivo-analítico, sobre una población de neonatos nacidos en las cinco zonas sanitarias de la provincia de La Pampa durante los años 2021 y 2022. Resultados. De los 5778 neonatos evaluados, el 9,6 % presentó niveles de TSHn ≥5 mUI/l. El 70,4 % de estas mediciones fueron realizadas después del tercer día de vida. No se observaron diferencias significativas en la frecuencia de niveles elevados de TSHn según el año de nacimiento, peso al nacer o días hasta la extracción. Se registró una mayor prevalencia en el sexo masculino (10,6 % versus 8,5 %; p = 0,007) y entre los neonatos nacidos a término (9,8 % versus 6,6 %; p = 0,02). La prevalencia de hipertirotropinemia fue superior a la observada en una cohorte de 2001-2002. Conclusiones. La prevalencia de hipertirotropinemia neonatal en La Pampa durante los años 2021 y 2022 fue del 9,6 %, lo que indica un estado de deficiencia leve de yodo en la provincia, superior al reportado hace dos décadas.

Vertical Immobilization Method for Time-Lapse Microscopy Analysis in Filamentous Cyanobacteria.

A main event in bacterial cell division is the septation process, where the protein FtsZ is the key element. FtsZ polymerizes forming a ring-like structure (Z-ring) in the middle of the cell that serves as a scaffold for other division proteins. Super-resolution microscopy in bacterial models Escherichia coli and Bacillus subtilis showed that the Z-ring is discontinuous, while live cell imaging studies demonstrated that FtsZ moves along the ring by a mechanism known as treadmilling. To study the dynamics of FtsZ in vivo, a special cell placement in a vertical position is necessary for imaging the complete structure of the ring in the XY plane. In the case of FtsZ imaging in multicellular cyanobacteria, such as Anabaena sp. PCC7120, maintaining the filaments in a vertical position is challenging because of the size of the cells and the filaments' length. In this article, we describe a method that allows the vertical immobilization of Anabaena sp. PCC 7120 filaments using low melting point agarose and syringes, to record the Z-ring in a mutant that expresses a FtsZ-sfGFP fusion protein. This method is a rapid and inexpensive way to register protein dynamics at the division site using confocal microscopy.

Guía de actuación y abordaje frente a intoxicación por dióxido de cloro/clorito de sodio, a partir de la experiencia de los CIAT de América Latina / Guidelines for action and approach to chlorine dioxide/sodium chlorite poisoning based on the experience of the CIATs in Latin America

Resumen El 11 de marzo de 2020, la Organización Mundial de la Salud, declaró la pandemia a nivel mundial por la COVID-19. Ante este escenario, los centros de información y asesoramiento toxicológico (CIAT) de América Latina comenzaron a recibir consultas por exposición/intoxicación a dióxido de cloro/clorito de sodio y sus compuestos relacionados, por desvío de uso, destinado a la prevención y/o tratamiento de la COVID-19 sin aval científico alguno ni contar con registro sanitario para ese fin. A través de la Red de Toxicología de América Latina y el Caribe (RETOXLAC), se comprobó que no eran hechos aislados, sino que se estaba produ ciendo el mismo fenómeno en toda la región y que existían antecedentes de intoxicaciones con dichos productos y alertas desde hace más de una década, con indicaciones no aprobadas, para el tratamiento de distintas patologías como SIDA, cáncer, esclerosis lateral amiotrófica ELA, malaria, autismo, entre otras, sin evidencia. Ante esta realidad, los CIAT presentan una revisión de los signos y síntomas observados según la vía de ingreso, basados en la comunicación de riesgo en salud; proponiéndose pruebas de apoyo al diagnóstico, algoritmo de tratamiento para las intoxicaciones y modelo de ficha clínica para la vigilancia epidemiológica de los casos atendidos. Recomendamos a las autoridades y organismos responsables, reforzar las acciones tendientes a la vigilancia, control y prevención de este tipo de intoxicaciones, producto del mal uso de un desinfectante no autorizado para fines terapéuticos/médicos.

Abstract On March 11th, 2020, the World Health Organization declared a global pandemic due to COVID-19. Faced with this sce- nario, the Poison Control Centers (CIATs for its initials in spanish) in Latin America began to receive consultations for exposure/poi- soning to chlorine dioxide/sodium chlorite and its related compounds for their use aimed to prevent or treat COVID-19 without any scientific endorsement or having a sanitary registry for that purpose. It was found through the Toxicology Network of Latin America and the Caribbean (RETOXLAC) that they were not isolated events but rather that the same phenomenon was occurring throughout the region and that there has been a history of poisoning and alerts with these products for more than a decade with unapproved indications for the treatment of different pathologies such as AIDS, cancer, amyotrophic lateral sclerosis (ALS), malaria, autism, among others, without evidence. In the light of this situation, the CIATs present a review of the signs and symptoms observed ac- cording to the route of exposure based on health risk communication; proposing tests to support the diagnosis, an algorithm for poisoning treatment, and a model of a clinical record for the epidemiological surveillance of the assisted cases. We recommend to the authorities and responsible organisms reinforce the actions aimed at surveillance, control, and prevention of this type of poisoning due to the misuse of an unauthorized disinfectant for therapeutic or medical purposes.

Post-operative small pelvic field radiation therapy in patients with intermediate risk early stage cervix cancer: a safe and efficient treatment modality.

BACKGROUND: The treatment of early stage cervical cancer has different therapeutic options. Adjuvant external beam radiotherapy for surgically treated intermediate risk cervical cancer patients has shown acceptable oncological outcomes with a low incidence of toxicity. The aim of this study was to analyze the oncological outcomes and safety of adjuvant small pelvic field radiotherapy in surgically treated stage IB1-2 cervical cancer patients who met the Sedlis intermediate-risk criteria. MATERIALS AND METHODS: A retrospective cohort study was carried out with 28 patients treated from 2007 to November 2019 with biopsy proven intermediate risk stage IB1-2 cervical cancer previously treated with radical hysterectomy and bilateral lymphadenectomy who received adjuvant small pelvic field radiotherapy. The primary endpoints were local and distant control and overall survival. Secondary endpoints were acute and late gastrointestinal and genitourinary toxicity. Survival curves were analyzed using the Kaplan-Meier method. RESULTS: After a median follow up period of 41.5 (27.5-80.5) months, adjuvant small pelvic field radiotherapy showed a 100% overall survival rate, 81.82% disease free survival and 86.36% local recurrence-free survival with no incidence of grade 3 or 4 acute or late toxicity. Three patients suffered from relapse, 1 in the vaginal cuff, 1 in the retrovesical area and 1 patient in the retroperitoneal area. CONCLUSIONS: Adjuvant small pelvic field radiotherapy is an efficient and safe treatment option that offers excellent oncological outcomes to surgically treated intermediate-risk stage IB1-2 cervical cancer patients with an excellent toxicity profile.

Historia metabólica de pacientes con antecedentes de diabetes gestacional. Seguimiento durante seis años (2013-2019) / Metabolic record of patients with history of gestational diabetes. Follow-up of patients for six years (2013-2019)

Introducción: en la provincia de La Pampa no hay registro del número de pacientes con diabetes gestacional (DG) que vuelve a control metabólico posparto, cuando se conoce el riesgo que evolucione a diabetes mellitus tipo 2 (DM2). Objetivos: analizar en el Hospital Público Interzonal (Dr. Lucio Molas) el porcentaje de mujeres con DG que volvió a control metabólico posparto y desarrolló DM2 durante seis años de seguimiento. Materiales y métodos: estudio descriptivo ambispectivo en 44 pacientes con DG diagnosticada en 2013 con seguimiento hasta el 31/12/2019. Se analizaron antecedentes previos de DG y familiares de diabetes (AFD), edad, semana de gestación del diagnóstico con glucemia/prueba de tolerancia oral a la glucosa (PTOG), índice de masa corporal (IMC), presión arterial, vía del parto, peso del recién nacido, HbA1c. Resultados: en 2013 se efectuaron 1.238 partos, 44 pacientes (3,7%) tenían DG diagnosticada, 68% mediante PTOG. Presentaban 43% AFD, 38,6% sobrepeso, 20,45% obesidad, 68,2% cesáreas y 11,4% recién nacidos con alto peso. En seis años de seguimiento, 54,5% de estas pacientes realizó control metabólico; este grupo, a diferencia del grupo sin control, presentó mayor IMC al inicio del embarazo (t:2,103; p<0,02), glucemia basal (t:10,59; p<0,001), presión arterial sistólica (t:2,629; p<0,01), diastólica (t:1,965; p<0,05) y macrosomía fetal (4 vs 1). El 33,3 % manifestó DM2 predominantemente a partir de tres años del posparto. Conclusiones: el 54,5% de las pacientes con DG concurrió a control metabólico posparto tardíamente, y el 33,3% evolucionó a DM2; incluso estas pacientes presentaron mayor número de factores de riesgo obstétricos y cardiometabólicos que el grupo sin control al inicio del embarazo.

Introduction: there is no register of the number of women with gestational diabetes (GD) that have undergone metabolic post-partum control in the province of La Pampa, even though it is well-known the increased associated risk of becoming a diabetes type 2 patient (T2DM). Objectives: to analyze at the Interzonal Public Hospital (Dr. Lucio Molas) the percentage of women with GD who returned to postpartum metabolic control and developed T2DM during six years of follow-up. Materials and methods: descriptive ambispective study in 44 patients with GD diagnosed in 2013 with follow-up until 31 December 2019. Different characteristics were analyzed in all participants: previous history of GD and family members of diabetes (FHD), age, gestational week of the diagnosis with fasting glucose or oral glucose tolerance test (OGTT), body mass index (BMI), blood pressure, delivery route, newborn weight, glycated hemoglobin (HbA1C). Results: a number of 1,238 of deliveries were performed in 2013, 44 women (3.7%) developed GD diagnosed by OGTT (68%), 43% presented FHD, 38.6% overweight, 20.45% obesity. Among the totality of deliveries 68.2% were by caesarea and 11.4% high birth weight newborns. In six years of follow-up, 54.5% of these patients underwent metabolic control, presenting this group, unlike the group without control, higher BMI at the beginning of pregnancy (t:2.103; p<0.02), fasting blood glucose (t:10 .59; p<0.001), systolic blood pressure (t:2.629; p<0.01), diastolic blood pressure (t; 1.965; p<0.05) and fetal macrosomia (4 vs 1). 33.3% developed T2DM predominantly from at three years postpartum. Conclusions: the present study reported that 54.5% of women with GD performed a late metabolic postpartum control evolving 33.3% developed T2DM presenting higher obstetric and cardiometabolic risk factors than the group without control at the beginning of pregnancy.

Consultas odontológicas de mujeres consumidoras de cannabis y/o cocaína versus no consumidoras. Estudio de cohorte retrospectivo durante 4 años en Argentina

Resumen Introducción: El consumo de cannabis y de cocaína constituye un problema global que afecta la salud bucal. La mayoría de las investigaciones se han realizado en hombres, en programas de rehabilitación. Objetivo: describir y comparar consultas y diagnósticos odontológicos de mujeres consumidoras y no consumidoras de cocaína y/o cannabis, por un período de 4 años. Métodos: estudio de cohorte retrospectivo. Grupos comparados de mujeres consumidoras y no consumidoras de cannabis y/o cocaína, seleccionadas en el posparto en un hospital público. Resultados: la edad promedio en ambos grupos fue de 22 años, sin diferencias en nivel educativo. Las mujeres del grupo de consumidoras (n=29) fueron mayormente policonsumidoras, realizaron más consultas odontológicas de emergencias (p=0,0002), y presentaron más gingivitis y periodontitis (p=0,0001) que las no consumidoras (n=58). Conclusiones: las mujeres consumidoras de cannabis y/o cocaína realizaron más consultas por emergencias, y presentaron con mayor frecuencia diagnóstico de gingivitis y periodontitis que las no consumidoras.

Resumo Introdução: O uso de cannabis e cocaína é um problema global que afeta a saúde bucal. A maior parte da pesquisa foi feita em homens, em programas de reabilitação. Objetivo: descrever e comparar consultas e diagnósticos odontológicos de mulheres que consumiram e não consumiram cocaína e/ou maconha, durante 4 anos. Métodos: estudo de coorte retrospectivo. Grupos comparados de mulheres que usam e não usam cannabis e/ou cocaína, selecionados no período pós-parto em um hospital público. Resultados: a média de idade em ambos os grupos foi de 22 anos, sem diferenças de escolaridade. As mulheres do grupo das consumidoras (n= 29) eram, em sua maioria, policonsumidoras, realizavam mais consultas odontológicas de urgência (p= 0,0002) e apresentavam mais gengivite e periodontite (p= 0,0001) do que as não usuárias (n= 58). Conclusões: mulheres usuárias de cannabis e/ou cocaína realizaram mais consultas de urgência e tiveram diagnóstico de gengivite e periodontite mais frequentes do que as não usuárias.

Abstract Introduction: Cannabis and cocaine use is a global problem that affects oral health. Most of the research has been conducted on men in rehabilitation programs. Objective: to describe and compare the dental attendance and oral diagnoses of women who are cannabis and/or cocaine users and not users for four years. Methods: a retrospective cohort study. We compared two groups of women who use and do not use cannabis and/or cocaine, selected in the postpartum period in a public hospital. Results: The average age in both groups was 22, and there were no education-related differences. The consumers (n=29) were mostly multiple drug users who sought emergency dental care more often (p=0.0002) and had more gingivitis and periodontitis (p=0.0001) than non-users (n=58). Conclusions: women who used cannabis and/or cocaine sought emergency dental care more often and had a more frequent diagnosis of gingivitis and periodontitis than non-users.

Adjuvant radiochemotherapy in locally advanced gastric cancer: from evidence to daily clinical practice in a single institution.

BACKGROUND: Gastric cancer is one of the main important causes of cancer death in Chile. OBJECTIVE: To report the results of adjuvant radiochemotherapy in advanced gastric cancer. MATERIAL AND METHODS: Between 2000 and 2018, 214 subjects aged 23-85 (median, 62) years with lymph node and/or serosa involvement were treated with adjuvant chemoradiotherapy after curative resection. RESULTS: With a median follow-up of 41 months, overall 3- and 5-year survival was 54.9% and 40.85%, respectively. On multivariate analysis, the factors associated with lower survival were aged >65 years, stage group and number of lymph nodes involved. CONCLUSION: In patients with locoregionally advanced gastric cancer treated with curative intent with surgery and adjuvant radiochemotherapy, the overall 5-year survival reported from local clinical practice is similar to that reported in randomised series and supports its use as an effective treatment for this type of patients in our country.

Caracterización epidemiológica de las exposiciones a dióxido de cloro/clorito de sodio en el contexto de la pandemia COVID-19: Reporte de los centros toxicológicos de América Latina / Epidemiological characterization of exposures to chlorine dioxide/ sodium chlorite in the context of the COVID-19 pandemic: Report of Poison Control Centers in Latin America

Resumen Los centros de información y asesoramiento toxicológico CIATs de América Latina, en el contexto de la pandemia de COVID-19, recibieron una serie de llamadas para consultas y asesoramientos relacionados con el uso de dióxido de cloro/clorito de sodio, que se estaban empleando en el tratamiento o prevención de dicha enfermedad. Dentro de la legislación vigente en los países de América Latina, no se contemplan productos farmacéuticos registrados para uso en humanos, ni se tiene evidencia de registros sanitarios en Europa, Canadá o Estados Unidos para tal fin, que contengan dióxido de cloro o clorito de sodio. Esta publicación, compila la información registrada como parte de la estadística del trabajo de ocho CIATs correspondientes a igual número de países de América Latina. Se identificó sexo, edad, sintomatología, circunstancia y grado de severidad de los 56 casos de pacientes intoxicados con dióxido de cloro/clorito de sodio registrados en el período del 15 de marzo al 30 de septiembre de 2020 en estos ocho países. Los resultados obtenidos confirman que la causa más común fue por mal uso, y el lugar de ocurrencia fue el hogar o sus alrededores, siendo el mayor porcentaje adultos jóvenes comprendidos entre 30 y 49 años. Los síntomas de intoxicación más frecuentemente encontrados fueron gastrointestinales, seguidos de cardiovasculares y respiratorios. La vía de ingreso al organismo en la mayoría de los casos fue por vía oral, reportándose algunos casos por vía inhalatoria, y en el 50% de los casos se constituyeron casos de severidad moderada, severa o fatal (3 fallecimientos). Este estudio contribuye a generar información relevante para las diferentes autoridades sanitarias, los ministerios de salud, las entidades encargadas de inspección, vigilancia y control de los países en los que se comercializan estos productos de manera ilegal por medio de redes sociales y promoviéndolos para uso en humanos para prevenir o curar COVID-19.

Abstract The Poison Control Centers in Latin America, in the context of COVID-19 pandemic, received a series of calls for consultations and recommendations related to the use of chlorine dioxide/sodium chlorite, in the treatment or prevention of CO-VID-19. Under current legislation in Latin America, no pharmaceutical products are registered for use in humans that contain chlorine dioxide or sodium chlorite, nor is there evidence of sanitary registries in Europe, Canada, or the United States for this purpose. This publication compiles the information registered by eight Poison Control Centers that correspond to the same number of Latin American countries. Sex, age, symptoms, circumstance, and degree of severity of the 56 cases of patients poisoned with chlorine dioxide/ sodium chlorite registered in the period from March 15th to September 30th, 2020 were identified. The results obtained confirm that the most common cause of poisoning was unintentional misuse, all of which occurred at home or its surroundings, with the highest percentage of registered cases being young adults between 30 and 49 years old. The most frequent symptoms of intoxication were gastrointestinal, followed by cardiovascular and respiratory. The route of exposure in most cases was oral, with some cases reported by inhalation; 48.2% of the cases were of moderate, severe, or fatal (3 deaths). This study contributes to the generation of relevant information for different health authorities, ministries of health, entities in charge of inspection, surveillance, and control in countries where these products are illegally marketed through social networks and promoted for use in humans to prevent or cure COVID-19.

[Health trajectories of women who used cocaine and/or cannabis during pregnancy. Retrospective cohort study in La Pampa, Argentina]. / Trayectorias sanitarias de mujeres consumidoras de cocaína y/o cannabis durante el embarazo. Estudio de cohorte retrospectivo en La Pampa, Argentina.

Introduction: the use of cocaine and cannabis during pregnancy is a growing problem, of importance for the World Public Health. Women can present a wide range of complications during pregnancy and perinatally, although knowledge about evolution thereafter is scarce. Objectives: to describe and compare health trajectories up to 4 years pospartum of user and not user women of cocaine and/or cannabis during pregnancy. Methods: retrospective cohort study with a comparison group consisting of 2 not users women for each user during pregnancy. User women were detected in Neonatology Division of a public Hospital with an urine pospartum test, between 2009 and 2013. Results: 29 women cocaine and/or cannabis users during pregnancy, and 58 not users were evaluated. In the first group, 93% women were polydrug users. Users had higher frequency of: history of violence in childhood ((p<0,001), previous (p<0,0045) and acquired (p<0,0007) disease, medical (p<0,0001) and odontological (p=0,0002) emergency consultations, hospitalizations (p<0,0001), and violent deaths in relatives, compared with non users. Conclusions: women who used cocaine and/or cocaine during pregnancy had a greater history of violence and illness, emergency medical and dental consultation, hospitalization and deaths, than non users. Injuries where the main cause of hospitalization. In the variables evaluated, the differences between consumers and non-consumers of pregnancy were significative.

Introducción: el consumo de cocaína y cannabis durante el embarazo constituye un problema en ascenso, de importancia para la Salud Pública mundial. Las mujeres consumidoras pueden presentar un amplio rango de complicaciones durante el embarazo y perinatales, pero los conocimientos sobre su evolución posterior son escasos. Objetivos: describir las trayectorias sanitarias durante 4 años de mujeres consumidoras de cocaína y/o cannabis durante el embarazo, y compararlas con mujeres no consumidoras. Métodos: estudio de cohorte retrospectivo con grupo de comparación doble. Las mujeres consumidoras fueron detectadas en el Servicio de Neonatología de un Hospital público con prueba en orina posparto positivo para cocaína y/o cannabis, entre 2009 y 2013. Resultados: se evaluaron 29 mujeres consumidoras, y 58 no consumidoras. En el primer grupo, el 93% eran policonsumidoras. Las mujeres consumidoras presentaron mayor frecuencia de: antecedente de violencia en sus infancias (p<0,001), enfermedades previas (p<0,0045) y adquiridas (p<0,0007), consultas médicas (p<0,0001) y odontológicas (p=0,0002) de emergencia, internaciones (p<0,0001) y muertes familiares violentas, comparando con no consumidoras. Conclusión: las mujeres consumidoras de cocaína y/o cannabis durante el embarazo presentaron mayores antecedentes de violencia y enfermedad, de consultas médicas y odontológicas de emergencia, de internación y muertes violentas en el grupo familiar, que las no consumidoras. Los traumatismos constituyeron la principal causa de consulta e internación. En las variables evaluadas, las diferencias entre consumidoras y no consumidoras del embarazo fueron significativas.

Alcohol consumption in adolescents: The predictive role of drinking motives.

BACKGROUND: Several studies have shown differences in the motivational processes that lead to excessive alcohol consumption among adolescents. The paper focuses on the analysis of the reasons for alcohol consumption among minors, and compare the differences according to sex, age, and level of consumption. METHOD: A representative sample (N = 2,865) of adolescents aged 12 to 18 years (mean age 14.24, dt = 1.33) was collected. The variables abuse, binge drinking and drinking motives were evaluated using a questionnaire designed ad hoc, which identified the Cooper's four categories of motives. RESULTS: The analyses (ANOVA, Pearson correlation, and logistic regression) showed that there were no differences between young men and women regarding consumption or binge drinking. Minors who abused alcohol experience consumption as pleasurable in itself, as an important source of intrinsic reinforcement. Conformity predicted the problematic consumption of alcohol among boys and a decrease in the frequency of binge drinking among girls. In addition, the larger group showed more presence of enhancement and social motives. CONCLUSIONS: This study suggests that it would not be of interest to focus prevention on the negative consequences of consumption, but rather on the training of specific skills.

Trayectorias sanitarias durante 4 años de niños expuestos prenatalmente a cocaína y/o cannabis. Estudio de cohorte retrospectivo en La Pampa, Argentina / Four-year health trajectories of children prenatally exposed to cocaine and/or cannabis. A retrospective, cohort study in La Pampa, Argentina

El consumo de cocaína y/o cannabis durante el embarazo constituye un problema en ascenso, de importancia para la salud pública mundial. Los niños expuestos pueden presentar un amplio rango de complicaciones en el período perinatal, pero los conocimientos sobre la evolución posterior son escasos.Objetivo: Describir y comparar las trayectorias sanitarias de niños expuestos y no expuestos prenatalmente a cocaína y/o cannabis durante 4 años. Métodos: Estudio de cohorte retrospectivo con grupo de comparación doble. Los niños expuestos fueron detectados en el Servicio de Neonatología de un hospital público mediante una prueba de orina, entre 2009 y 2013. Resultados: Se evaluaron 29 niños expuestos y 58 no expuestos. Las principales drogas detectadas en el grupo expuesto fueron cocaína y cannabis. La mayoría de las madres fueron policonsumidoras. En los niños del grupo expuesto, se encontraron diferencias significativas en menor frecuencia de controles de salud (p < 0,0001) y mayor frecuencia de consultas en Emergencias (p = 0,0295) e Internaciones (p = 0,007), principalmente, por cuadros respiratorios. Presentaron, además, mayor frecuencia de enfermedad pulmonar obstructiva crónica, cambios de hogar y judicialización. En ese grupo, hubo 1 niño y 2 progenitores muertos por causa violenta. No hubo ninguna muerte en el grupo no expuesto.Conclusiones: Los niños expuestos a cocaína y/o cannabis prenatalmente tuvieron menor número de controles de salud y mayor frecuencia de consultas en Emergencias e Internaciones. Presentaron, además, mayor frecuencia de enfermedad pulmonar obstructiva crónica, cambios de hogar, judicialización y muertes violentas en el grupo familiar directo.

Cocaine and/or cannabis use during pregnancy is a growing problem of relevance for global public health. Exposed children may have a wide range of perinatal complications, but there is little knowledge on their course.Objective: To describe and compare the health trajectories of children prenatally exposed and unexposed to cocaine and/or cannabis over 4 years.Methods: Retrospective, cohort study with a double control group. Exposed children were detected through a urine test by the Department of Neonatology of a public hospital between 2009 and 2013. Results: A total of 29 exposed children and 58 unexposed children were assessed. The most common drugs detected in the exposed group were cocaine and cannabis. Most mothers were poly-drug users. The exposed group showed significant differences in relation to a lower frequency of health checkups (p < 0.0001) and a higher number of visits to the emergency department (p = 0.0295) and hospitalizations (p = 0.007), mainly due to respiratory conditions. In addition, they had a greater rate of chronic obstructive pulmonary disease, changes of home, and legal interventions. In this group, 1 child and 2 parents had a violent death. No deaths were reported in the unexposed group. Conclusions: Children prenatally exposed to cocaine and/or cannabis had a lower number of health checkups and a higher number of visits to the emergency department and hospitalizations. Besides, they showed a greater rate of chronic obstructive pulmonary disease, changes of home, legal interventions, and violent deaths in the direct family group.

Four-year health trajectories of children prenatally exposed to cocaine and/or cannabis. A retrospective, cohort study in La Pampa, Argentina. / Trayectorias sanitarias durante 4 años de niños expuestos prenatalmente a cocaína y/o cannabis. Estudio de cohorte retrospectivo en La Pampa, Argentina.

INTRODUCTION: Cocaine and/or cannabis use during pregnancy is a growing problem of relevance for global public health. Exposed children may have a wide range of perinatal complications, but there is little knowledge on their course. OBJECTIVE: To describe and compare the health trajectories of children prenatally exposed and unexposed to cocaine and/or cannabis over 4 years. METHODS: Retrospective, cohort study with a double control group. Exposed children were detected through a urine test by the Department of Neonatology of a public hospital between 2009 and 2013. RESULTS: A total of 29 exposed children and 58 unexposed children were assessed. The most common drugs detected in the exposed group were cocaine and cannabis. Most mothers were poly-drug users. The exposed group showed significant differences in relation to a lower frequency of health checkups (p < 0.0001) and a higher number of visits to the emergency department (p = 0.0295) and hospitalizations (p = 0.007), mainly due to respiratory conditions. In addition, they had a greater rate of chronic obstructive pulmonary disease, changes of home, and legal interventions. In this group, 1 child and 2 parents had a violent death. No deaths were reported in the unexposed group. CONCLUSIONS: Conclusions: Children prenatally exposed to cocaine and/or cannabis had a lower number of health checkups and a higher number of visits to the emergency department and hospitalizations. Besides, they showed a greater rate of chronic obstructive pulmonary disease, changes of home, legal interventions, and violent deaths in the direct family group.

El consumo de cocaína y/o cannabis durante el embarazo constituye un problema en ascenso, de importancia para la salud pública mundial. Los niños expuestos pueden presentar un amplio rango de complicaciones en el período perinatal, pero los conocimientos sobre la evolución posterior son escasos. Objetivo: Describir y comparar las trayectorias sanitarias de niños expuestos y no expuestos prenatalmente a cocaína y/o cannabis durante 4 años. Métodos: Estudio de cohorte retrospectivo con grupo de comparación doble. Los niños expuestos fueron detectados en el Servicio de Neonatología de un hospital público mediante una prueba de orina, entre 2009 y 2013. Resultados: Se evaluaron 29 niños expuestos y 58 no expuestos. Las principales drogas detectadas en el grupo expuesto fueron cocaína y cannabis. La mayoría de las madres fueron policonsumidoras. En los niños del grupo expuesto, se encontraron diferencias significativas en menor frecuencia de controles de salud (p < 0,0001) y mayor frecuencia de consultas en Emergencias (p = 0,0295) e Internaciones (p = 0,007), principalmente, por cuadros respiratorios. Presentaron, además, mayor frecuencia de enfermedad pulmonar obstructiva crónica, cambios de hogar y judicialización. En ese grupo, hubo 1 niño y 2 progenitores muertos por causa violenta. No hubo ninguna muerte en el grupo no expuesto. Conclusiones: Los niños expuestos a cocaína y/o cannabis prenatalmente tuvieron menor número de controles de salud y mayor frecuencia de consultas en Emergencias e Internaciones. Presentaron, además, mayor frecuencia de enfermedad pulmonar obstructiva crónica, cambios de hogar, judicialización y muertes violentas en el grupo familiar directo.

Effect of obstacle position in the flow of sheep through a narrow door.

In a recent work [Phys. Rev. E 91, 022808 (2015)PLEEE81539-375510.1103/PhysRevE.91.022808] it was reported that placing an obstacle in front of a gate has a beneficial effect in the flow of sheep through it. Here, we extend such results by implementing three different obstacle positions. We have observed that the flow is improved in two cases, while it worsens in the other one; the last instance happens when the obstacle is too close to the door. In this situation, the outcomes suggest that clogging develops between the doorjamb and the obstacle, contrary to the cases when the obstacle is farther, in which case clogging always occurs at the very door. The effectiveness of the obstacle (a strategy put forward to alleviate clogging in emergency exits) is therefore quite sensitive to its location. In addition, the study of the temporal evolution of the flow rate as the test develops makes evident a steady behavior during the entire duration of the entrance. This result is at odds with recent findings in human evacuation tests where the flow rate varies over time, therefore challenging the fairness of straightforward comparisons between pedestrian behavior and animal experimental observations.

Investigación de la ingesta de sal mediante natriuresis en escolares de 6 a 13 años de La Pampa / RESEARCH IN SALT INTAKE BY NATRIURESIS IN CHILDREN AGED 6 TO 13 THE PROVINCE OF LA PAMPA

Introducción: en la provincia de La Pampa prevalece una alta ingesta de carnes y fiambres. Existe promoción en adultos para disminuir la ingesta de sal, no focalizada en niños. Objetivos: investigar en escolares de la comunidad agrícolaganadera la ingesta de sal mediante la natriuresis y determinar riesgo de hipertensión arterial. Materiales y métodos: estudio piloto, exploratorio, descriptivo en 67 niños/niñas de 6-13 años, de escuela de jornada completa, sin restricción dietética. Se determinó frecuencia de ingesta de fiambres, peso, talla e IMC, perímetro de cintura mínima (cm) y un control de presión arterial (PA). Se describen los resultados según sexo, edad y percentiles (Pc) de talla (Task Force, 2004). Se determinó natriuresis (matutina y vespertina) e ingesta de sal (método de Tanaka, et al.). Se informaron los resultados a la familia y se educó sobre los factores de riesgo cardiovasculares. Resultados: el 96% consumía frecuentemente fiambres, el 14,66% tenía un Pc de PA anormal. Las niñas mayores de 9 años tuvieron mayor peso (p:0,01) e IMC que los varones (p:0,02). Los varones menores de 9 años tenían mayores niveles de natriuresis matutina que las niñas (p:0,04). La ingesta de sal/24 h de las niñas menores de 9 años fue de 2,48±1,99 g y 3,19±0,36 g en las mayores (p:0,09), siendo de 1,82±0,56 y 3,27±1,03 g respectivamente en los niños (p:0,01). Conclusiones: hallamos un consumo elevado de sal en la población estudiada, aumentando significativamente en varones a partir de los 9 años poniéndolos en riesgo de hipertensión arterial. Se debe efectuar un programa de alimentación saludable especialmente a partir de esta edad para el control de peso en las niñas y de la ingesta de sal en los niños, informando a los médicos responsables para que efectúen el control de la presión arterial en particular.

Draft Genome Sequence of Antarctic Pseudomonas sp. Strain KG01 with Full Potential for Biotechnological Applications.

We report here the draft genome sequence of a free-living psychrotolerant, Pseudomonas sp. strain KG01, isolated from an Antarctic soil sample and displaying interesting antimicrobial and surfactant activities. The sequence is 6.3 Mb long and includes 5,648 predicted-coding sequences.

Metabolic compensation of fitness costs associated with overexpression of the multidrug efflux pump MexEF-OprN in Pseudomonas aeruginosa.

The acquisition of antibiotic resistance has been associated with a possible nonspecific, metabolic burden that is reflected in decreased fitness among resistant bacteria. We have recently demonstrated that overexpression of the MexEF-OprN multidrug efflux pump does not produce a metabolic burden when measured by classical competitions tests but rather leads to a number of changes in the organism's physiology. One of these changes is the untimely activation of the nitrate respiratory chain under aerobic conditions. MexEF-OprN is a proton/substrate antiporter. Overexpression of this element should result in a constant influx of protons, which may lead to cytoplasmic acidification. Acidification was not observed in aerobiosis, a situation in which the MexEF-overproducing mutant increases oxygen consumption. This enhanced oxygen uptake serves to eliminate intracellular proton accumulation, preventing the cytoplasmic acidification that was observed exclusively under anaerobic conditions, a situation in which the fitness of the MexEF-OprN-overproducing mutant decreases. Finally, we determined that the early activation of the nitrate respiratory chain under aerobic conditions plays a role in preventing a deleterious effect associated with the overexpression of MexEF-OprN. Our results show that metabolic rewiring may assist in overcoming the potential fitness cost associated with the acquisition of antibiotic resistance. Furthermore, the capability to metabolically compensate for this effect is habitat dependent, as demonstrated by our results under anaerobic conditions. The development of drugs that prevent metabolic compensation of fitness costs may help to reduce the persistence and dissemination of antibiotic resistance.

The intrinsic resistome of bacterial pathogens.

Intrinsically resistant bacteria have emerged as a relevant health problem in the last years. Those bacterial species, several of them with an environmental origin, present naturally low-level susceptibility to several drugs. It has been proposed that intrinsic resistance is mainly the consequence of the impermeability of cellular envelopes, the activity of multidrug efflux pumps or the lack of appropriate targets for a given family of drugs. However, recently published articles indicate that the characteristic phenotype of susceptibility to antibiotics of a given bacterial species depends on the concerted activity of several elements, what has been named as intrinsic resistome. These determinants comprise not just classical resistance genes. Other elements, several of them involved in basic bacterial metabolic processes, are of relevance for the intrinsic resistance of bacterial pathogens. In the present review we analyze recent publications on the intrinsic resistomes of Escherichia coli and Pseudomonas aeruginosa. We present as well information on the role that global regulators of bacterial metabolism, as Crc from P. aeruginosa, may have on modulating bacterial susceptibility to antibiotics. Finally, we discuss the possibility of searching inhibitors of the intrinsic resistome in the aim of improving the activity of drugs currently in use for clinical practice.

RND multidrug efflux pumps: what are they good for?

Multidrug efflux pumps are chromosomally encoded genetic elements capable of mediating resistance to toxic compounds in several life forms. In bacteria, these elements are involved in intrinsic and acquired resistance to antibiotics. Unlike other well-known horizontally acquired antibiotic resistance determinants, genes encoding for multidrug efflux pumps belong to the core of bacterial genomes and thus have evolved over millions of years. The selective pressure stemming from the use of antibiotics to treat bacterial infections is relatively recent in evolutionary terms. Therefore, it is unlikely that these elements have evolved in response to antibiotics. In the last years, several studies have identified numerous functions for efflux pumps that go beyond antibiotic extrusion. In this review we present some examples of these functions that range from bacterial interactions with plant or animal hosts, to the detoxification of metabolic intermediates or the maintenance of cellular homeostasis.

Characterization of the polymyxin B resistome of Pseudomonas aeruginosa.

Multidrug resistance in Pseudomonas aeruginosa is increasingly becoming a threat for human health. Indeed, some strains are resistant to almost all currently available antibiotics, leaving very limited choices for antimicrobial therapy. In many such cases, polymyxins are the only available option, although as their utilization increases so does the isolation of resistant strains. In this study, we screened a comprehensive PA14 mutant library to identify genes involved in changes of susceptibility to polymyxin B in P. aeruginosa. Surprisingly, our screening revealed that the polymyxin B resistome of this microorganism is fairly small. Thus, only one resistant mutant and 17 different susceptibility/intrinsic resistance determinants were identified. Among the susceptible mutants, a significant number carried transposon insertions in lipopolysaccharide (LPS)-related genes. LPS analysis revealed that four of these mutants (galU, lptC, wapR, and ssg) had an altered banding profile in SDS-polyacrylamide gels and Western blots, with three of them exhibiting LPS core truncation and lack of O-antigen decoration. Further characterization of these four mutants showed that their increased susceptibility to polymyxin B was partly due to increased basal outer membrane permeability. Additionally, these mutants also lacked the aminoarabinose-substituted lipid A species observed in the wild type upon growth in low magnesium. Overall, our results emphasize the importance of LPS integrity and lipid A modification in resistance to polymyxins in P. aeruginosa, highlighting the relevance of characterizing the genes that affect biosynthesis of cell surface structures in this pathogen to follow the evolution of peptide resistance in the clinic.

Low iodine intake during pregnancy: relationship to placental development and head circumference in newborn.

INTRODUCTION: Iodine is considered to be an essential micronutrient in pregnant women. Iodine placental transport to the embryo-fetus is essential for hormone synthesis and is crucial for nervous system development. However, the relationship between iodine intake and placental weight and its potential implications for the newborn have not been studied. MATERIAL AND METHODS: Iodine intake was analyzed in 77 pregnant women based on urinary iodine excretion (UIE) levels, measured using Pinós modified method (normal value, ≥ 150 µg/L). Placental weight was measured (PW: normal, ≥500 g). In the newborn, weight, height, and head perimeter (HP) were also measured. Placental index (PI: placental weight/newborn weight) was calculated, and was considered normal if ≥0.15. RESULTS: UIE was normal in 50 pregnant women (mean ± SD, 279 µg/L ± 70.22 µg/L) and decreased in 27 (94 µg/L ± 31.49 µg/L). Newborns of mothers with low UIE had a similar weight (3357 g ± 416.30 g; n: 27) to those of mothers with normal UIE (3489 g ± 560.59 g; n: 50). Forty-four percent of mothers with low UIE had PW <500 g, and statistically lower HPs were found in newborns of mothers with low PW (PW(3)500 g: 36.05 cm ± 0.55 cm, n: 54; PW <500 g: 33.93 cm ± 15 cm, n:23, p<0.019). Similar results were found with PI, but they did not reach statistical significance (0,17 ± 0,04; p=0.066). No differences were seen in all other parameters. CONCLUSION: The study suggests the existence of a relationship between PW and HP. This finding may be related to iodine intake during pregnancy.