Diseases due to unhealthy environments: an updated estimate of the global burden of disease attributable to environmental determinants of health.

Background: The update of the global burden of disease attributable to the environment is presented. The study focuses on modifiable risks to show the potential health impact from environmental interventions. Methods: Systematic literature reviews on 133 diseases and injuries were performed. Comparative risk assessments were complemented by more limited epidemiological estimates, expert opinion and information on disease transmission pathways. Population attributable fractions were used to calculate global deaths and global disease burden from environmental risks. Results: Twenty-three percent (95% CI: 13-34%) of global deaths and 22% (95% CI: 13-32%) of global disability adjusted life years (DALYs) were attributable to environmental risks in 2012. Sixty-eight percent of deaths and 56% of DALYs could be estimated with comparative risk assessment methods. The global disease burden attributable to the environment is now dominated by noncommunicable diseases. Susceptible ages are children under five and adults between 50 and 75 years. Country level data are presented. Conclusions: Nearly a quarter of global disease burden could be prevented by reducing environmental risks. This analysis confirms that eliminating hazards and reducing environmental risks will greatly benefit our health, will contribute to attaining the recently agreed Sustainable Development Goals and will systematically require intersectoral collaboration to be successful.

Salivary Urease and ADS Enzymatic Activity as Endogenous Protection against Dental Caries in Children.

UNLABELLED: The aim of this cross sectional study was to evaluate the ureolytic and arginolytic activities of saliva in children and associate them with their caries status. STUDY DESIGN: 65, 8 year old children, were randomly selected. The ureolytic and arginolytic activity of non stimulated saliva was studied and associated with DMFT and dmft index. Saliva of children were sampled under fasting conditions; Children refrained from any oral hygiene procedures during the 12 hours that preceded the sample collection. Caries activity was scored and divided in 3 groups: Group A: Index zero: without lesions; Group B: Moderate Index: 1 to 3 enamel caries lesions; and Group C: High Index: more than 4 dentin caries lesions. RESULTS: DMFT scores were moderate: 0.4(±0.79) and dmft: 2.78(±2.45). Results expressed in µmol/min/mg/protein, for urease activity were statistically significant (p=0.048): Group A= 0.69 (±0.7); Group B= 0.45 (±0.43); and Group C= 0.39 (±0.55). The arginine deiminase activity was not statistically significant (p=0.16): Group A= 2.53 (±1.42), Group B= 2.31 (±1.57) and Group C= 1.97 (±2.0). CONCLUSION: Higher levels of ureolytic (statistically significant) and arginolytic activity (trend) in saliva were associated with lower DMFT/dmft scores in 8 year old children. There was a higher production of ammonia from the arginine deiminase system than the urease enzyme in saliva (p>0.05).

Climate change and nutrition: creating a climate for nutrition security.

BACKGROUND: Climate change further exacerbates the enormous existing burden of undernutrition. It affects food and nutrition security and undermines current efforts to reduce hunger and promote nutrition. Undernutrition in turn undermines climate resilience and the coping strategies of vulnerable populations. OBJECTIVES: The objectives of this paper are to identify and undertake a cross-sectoral analysis of the impacts of climate change on nutrition security and the existing mechanisms, strategies, and policies to address them. METHODS: A cross-sectoral analysis of the impacts of climate change on nutrition security and the mechanisms and policies to address them was guided by an analytical framework focused on the three 'underlying causes' of undernutrition: 1) household food access, 2) maternal and child care and feeding practices, 3) environmental health and health access. The analytical framework includes the interactions of the three underlying causes of undernutrition with climate change,vulnerability, adaptation and mitigation. RESULTS: Within broad efforts on climate change mitigation and adaptation and climate-resilient development, a combination of nutrition-sensitive adaptation and mitigation measures, climate-resilient and nutrition-sensitive agricultural development, social protection, improved maternal and child care and health, nutrition-sensitive risk reduction and management, community development measures, nutrition-smart investments, increased policy coherence, and institutional and cross-sectoral collaboration are proposed as a means to address the impacts of climate change to food and nutrition security. This paper proposes policy directions to address nutrition in the climate change agenda and recommendations for consideration by the UN Framework Convention on Climate Change (UNFCCC). CONCLUSIONS: Nutrition and health stakeholders need to be engaged in key climate change adaptation and mitigation initiatives, including science-based assessment by the Intergovernmental Panel on Climate Change (IPCC), and policies and actions formulated by the UN Framework Convention on Climate Change (UNFCCC). Improved multi-sectoral coordination and political will is required to integrate nutrition-sensitive actions into climate-resilient sustainable development efforts in the UNFCCC work and in the post 2015 development agenda. Placing human rights at the center of strategies to mitigate and adapt to the impacts of climate change and international solidarity is essential to advance sustainable development and to create a climate for nutrition security.

Septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee: retrospective case review. / Artritis séptica tras ligamentoplastia artroscópica de la rodilla: análisis retrospectivo de casos.

INTRODUCTION: Rupture of cruciate ligaments of the knee is a common injury that is repaired by arthroscopic reconstruction, which can give rise to septic arthritis. The objective of this article is to describe the clinical and microbiological aspects of this entity. METHODS: Retrospective review of cases of septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee that occurred at a single institution from 2000-2015. According to time elapsed from surgery, infections were classified as acute (< 14 days), subacute (> 14 days and<30 days), and late (> 30 days). A descriptive and comparative analysis stratified by type of infection and causative microorganism was performed. RESULTS: 3,219 patients underwent arthroscopic reconstruction of cruciate ligaments of the knee and 30 (0.9%) developed septic arthritis. Seventeen (57%) were acute infections and 12 (40%) subacute; there was one late infection. The causative microorganisms were coagulase-negative Staphylococci (n=13; 43%), Staphylococcus aureus (n=12; 40%), other grampositive cocci (n=3; 10%), and gramnegative bacilli (n=2; 7%). All patients underwent arthroscopic debridement; no grafts were removed. All patients received antibiotic therapy for a median of 23.5 days (range: 14 - 78 days); all infections were cured. No significant differences were found in any of the variables analysed among the infection type or the causative microorganism. CONCLUSIONS: Septic arthritis after arthroscopic reconstruction of cruciate ligaments of the knee is uncommon. It generally presents within 4 weeks of surgery and is caused by Staphylococci. Its treatment consists of arthroscopic debridement (without necessarily removing the graft) and antibiotic therapy.

The effects of carabid beetles (Coleoptera: Carabidae) on the arthropod fauna of wheat fields in Chile.

The role of carabid beetles in reducing populations of phytophagous insects has been an elusive subject. A field experiment was established on a commercial wheat crop (cv. Otto) with an area of 4.5 ha in Valdivia, Chile, during the spring and summer of 1996-1997. The field had been under a prairie system for two years, before wheat sowing (fertilization and a pesticide had been applied during crop development). Samples were taken at approximately monthly intervals. Carabid beetles were sampled with a grid of pitfall traps and other insects were sampled with a vacuum insect net and soil cores. The genera of the carabids found are of neotropical origin. Exclusion by polythene barriers, together with removal of carabid beetles using traps, was an effective technique for controlling carabid populations in a commercial wheat crop. A reduction in the number of carabid beetles was associated with an increase in the number of springtails and arachnids, and a decrease of agromyzid adults. Phytophagous insects, such as homopterans and lepidopterous larvae, were not affected by carabid exclusion and removal. The action of carabid beetles on the arthropod fauna can be extremely complex, due to its predatory activity at multitrophic levels.

[Scales for predicting outcome after severe trauma]. / Escalas para predicción de resultados tras traumatismo grave.

In this article we review the development of the most-used scales for severe trauma patients over the past 40 years. It is well known that anatomical scales are effective for measuring the severity of injuries and for predicting results. Physiological scales measure the dynamic component after trauma, with a great influence on the prognosis of injured patients. Metabolic scales, both lactate and base deficit, are reflections of tissue hypoperfusion states and therefore shock. The combined scales are used for prediction and comparative assessment of results. The inclusion of factors that influence the prognosis of trauma patients has led to the development of new scales. However, they lack external validation studies for their widespread use. Until these validation studies are conducted caution should be taken with the use of existing scales.

Complicaciones pospancreatoduodenectomía de tumores periampulares en una unidad de cirugía hepatopancreatobiliar / Post pancreaticoduodenectomy complications of periampullary tumors in a hepatopancreatobiliary surgery unit

Resumen Introducción: Los tumores periampulares se definen como lesiones ubicadas en un radio de 2 cm alrededor de la ampolla de Vater, constituidos por 4 tipos de neoplasias con una alta tasa de malignidad que pueden originarse en páncreas, ampolla, vía biliar distal o duodeno. El manejo quirúrgico a través de la pancreatoduodenectomía sigue siendo la mejor elección en términos de resección curativa. Objetivo: Caracterizar los tumores peri-ampulares tratados en nuestra institución y que fueron llevados a pancreatoduodenectomía, asociando la relación entre tipo de tumor y complicaciones posoperatorias. Material y Método: Estudio transversal, retrospectivo y observacional con seguimiento a 45 pacientes sometidos a pancreatoduodenectomía en el Hospital Internacional de Colombia - Fundación Cardiovascular entre enero de 2011 y marzo de 2020 con diagnostico histopatológico de tumor peri-ampular. Resultados: Se realizaron 75 pancreatoduodenectomía de las cuales 45 pacientes presentaron tumor peri-ampular, siendo de origen pancreático en un 44%, seguido de ampolla 40%, vía biliar distal 8,8% y duodenal 6,6%. Las complicaciones posoperatorias más frecuentes fueron fístula pancreática y vaciamiento gástrico retardado. Falleció 1 paciente. Conclusión: La pancreatoduodenectomía es un procedimiento con alta morbilidad. Gracias al avance tecnológico, el diagnóstico de patología peri ampular es cada vez más exacto. El tipo de tumor peri-ampular puede influir no solo en su pronóstico, sino también en su morbilidad posquirúrgica.

Introduction: Periampullary tumors are defined as lesions that are located in a radius of 2 centimeters around the ampulla of Vater, constituted by 4 types of neoplasms with a high rate of malignancy originated in the pancreas, ampulla, distal bile duct or duodenum. Surgical management through the pancreatoduodenectomy remains the best choice in terms of curative resection. Objetive: To characterize periampullary tumors treated in our institution with pancreatoduodenectomy, associating the relationship between tumor type and postoperative complications. Material and Method: Cross-sectional, retrospective, observational study with a follow-up of 45 patients underwent pancreatoduodenectomy in the Hospital Internacional de Colombia - Fundación Cardiovascular between January 2011 and March 2020 with histopathological diagnosis of periampullary tumor. Results: Were performed 75 pancreatoduodenectomies, 45 patients presented with Periampullary tumor, 44% being of pancreatic origin, followed by ampulla 40%, distal bile duct 8.8% and duodenal 6.6%. Most frequent postoperative complications were pancreatic fistula and delayed gastric emptying. Mortality was of 1 patient. Conclusión: Pancreatoduodenectomy is a procedure with a high morbidity rate. Thanks to technological advances, the diagnosis of periampullary pathology is increasingly accurate. The type of periampullary tumor may influence not only in its prognosis, but also in its post-surgical morbidity.

Pathogenesis of Rift Valley fever virus in mosquitoes--tracheal conduits & the basal lamina as an extra-cellular barrier.

Knowledge of the fate of an arbovirus in a mosquito is fundamental to understanding the mosquito's competence to transmit the virus. When a competent mosquito ingests viremic vertebrate blood, virus infects midgut epithelial cells and replicates, then disseminates to other tissues, including salivary glands and/or ovaries. The virus is then transmitted to the next vertebrate host horizontally via bite and/or vertically to the mosquito's offspring. Not all mosquitoes that ingest virus become infected or, if infected, transmit virus. Several "barriers" to arbovirus passage, and ultimately transmission, have been identified in incompetent or partially competent mosquitoes, including, among others, gut escape barriers and salivary gland infection barriers. The extra-cellular basal lamina around the midgut epithelium and the basal lamina that surrounds the salivary glands may act as such barriers. Midgut basal lamina pore sizes are significantly smaller than arboviruses and ultrastructural evidence suggests that midgut tracheae and tracheoles may provide a means for viruses to circumvent this barrier. Further, immunocytochemical evidence indicates the existence of a salivary gland infection barrier in Anopheles stephensi. The basal lamina may prevent access to mosquito cell surface virus receptors and help explain why anopheline mosquitoes are relatively incompetent arbovirus transmitters when compared to culicines.

Embarazo y nuevo coronavirus: experiencia global reportada / Pregnancy and novel coronavirus: worldwide reported experience

INTRODUCCIÓN: La Organización Mundial de La Salud ha reportado recientemente que el nuevo foco de la pandemia global de la enfermedad Covid-19 es el continente americano. OBJETIVO: Realizar una revisión de la literatura sobre la experiencia internacional de la pandemia Covid 19 y embarazo. MÉTODO: Se realiza una búsqueda de la base de datos PubMed para las palabras clave Pregnancy / Pregnant / Novel Coronavirus / SARS-CoV-2 / Covid-19, desde el 1 de noviembre 2019 hasta el 21 de mayo 2020. RESULTADOS: Un total de 365 artículos fueron inicialmente seleccionados de acuerdo con la estrategia de búsqueda diseñada. El total de artículos revisados de acuerdo con los criterios fueron 42. Las series clínicas seleccionadas acumularon un total de 1098 embarazadas y enfermedad de Covid-19. Las co-morbilidades mas frecuentes fueron hipertensión arterial, diabetes mellitus, obesidad y asma. La mortalidad en relación con el total de pacientes fue de un 1,2 % y la transmisión al recién nacido de 1,7% (15 de 875). CONCLUSIÓN: La información obtenida permite inferir que la presentación clínica de la enfermedad es a lo menos equivalente a la de mujeres de la misma edad no embarazadas. Dada la severidad de la enfermedad por SARS-CoV-2 reportada, las lecciones aprendidas deben ser rápidamente asimiladas y utilizadas en el contexto de la situación nacional epidémica.

INTRODUCTION: The World Health Organization has recently reported that the new focus of the global pandemic of Covid-19 disease is the American continent. OBJECTIVE: To conduct a literature review on the international experience of the Covid 19 pandemic and pregnancy. METHOD: A PubMed database search is performed for the keywords Pregnancy / Pregnant / Novel Coronavirus / SARS-CoV-2 / Covid-19, from November 1, 2019 to May 21, 2020. RESULTS: A total of 365 articles were initially selected according to the designed search strategy. The total of articles reviewed according to the criteria was 42. The selected clinical series accumulated a total of 1098 pregnant women and Covid-19 disease. The most frequent comorbidities were hypertension, diabetes mellitus, obesity, and asthma. Mortality in relation to the total number of patients was 1.2% and transmission to the newborn was 1.7% (15 of 875). CONCLUSION: The information obtained allows us to infer that the clinical presentation of the disease is at least equivalent to that of non-pregnant women of the same age. Given the severity of the reported SARS-CoV-2 disease, the lessons learned must be quickly assimilated and used in the context of the national epidemic situation.

Telomeric association in women with breast and uterine cervix cancer.

This study compares the frequency of telomeric associations in the peripheral blood of women suffering breast and cervix uterine cancer with a healthy control group. Two kinds of cultures were developed for each individual: with and without aphidicolin. In the normal cultures, the number of telomeric associations observed was 95.5 times higher in individuals affected by breast cancer and 41.3 times higher in those affected by cervix uterine cancer when compared to the control group (p < 0.001). In the cultures with aphidicolin, higher numbers of altered metaphases were observed in both groups as compared to the control groups (p < 0.001). Statistically significant differences (p < 0.001) could also be observed when comparing telomeric associations between the two types of cancer in both cultures. When we compared individuals affected by breast cancer in both types of cultures statistical differences were found (p < 0.05), and similar results were found in individuals affected by uterine cervix cancer (p < 0.001). The findings suggest that telomeric associations may be reflecting chromosome instability observed in cancer and that this instability behaves differently for various types of cancer.

Impairment of nitric oxide-mediated relaxations in anaesthetized autoperfused streptozotocin-induced diabetic rats.

This work was designed to determine in vivo the influence of the metabolic control of streptozotocin-induced diabetic rats, measured by the levels of haemoglobin glycosylation in blood (HbA1c), on developing vascular endothelial dysfunction. For this, the vasoactive responses to basal and stimulated endothelial nitric oxide (NO) were studied using the technique of the anaesthetized autoperfused rat, analyzing the responses to acetylcholine (ACh) and N(G)-nitro-L-arginine methyl ester (L-NAME) in non-diabetic and diabetic rats with different degrees of metabolic control (four groups with HbA1c levels of 5.5-7.4%, 7.5-9.4%, 9.5-12%, and >12%, respectively). When administered over a noradrenaline-induced vasopressor tone, ACh (0.25, 0.75, 2.5, 7.5 and 25 microg kg(-1)) induced dose-dependent vasodilatatory responses in all rat groups, reducing both mean arterial pressure and perfusion pressure of the left hindlimb. These responses were similar in non-diabetic and in diabetic rats with good metabolic control (HbA1c 5.5-7.4%), while diabetic rats with levels of HbA1c higher than 7.5% showed significantly lower vasodilatatory responses to ACh. In untreated diabetic rats, the relaxant responses evoked by the NO donor sodium nitroprusside were also impaired. On the other hand, increasing doses of L-NAME (0.1 to 10 mg kg(-1)) enhanced both mean arterial pressure and left hindlimb perfusion pressure in diabetic and non-diabetic rats. As with ACh, the responses to L-NAME were significantly reduced in diabetic rats with HbA1c levels higher than 7.5%. To determine the mechanism underlying the NO-mediated endothelial dysfunction, the responses to ACh in untreated diabetic rats (HbA1c >12%) were studied in the presence of the NO substrate L-arginine, in the presence of the oxygen-derived free radical scavenger superoxide dismutase (SOD), or in the presence of both compounds. Both L-arginine and SOD produced a partial improvement of the ACh-induced vasodilatatory responses, but the effects of these agents were not additive. In this group of animals, SOD also induced a partial recovery of the L-NAME-evoked vasoconstrictions. In non-diabetic and untreated diabetic rats, the plasma levels of NO derivatives and arginine were measured. No significant differences were obtained in the amount of nitrites plus nitrates, while plasma levels of arginine were markedly reduced in the untreated diabetic animals. The results indicate that the endothelial dysfunction associated to diabetes is closely related to the level of metabolic control of the disease. Therefore, it is possible to establish a threshold for developing endothelium impairment from percentages of HbA1c higher than 7.5%. As the responses to the NO synthase blocker L-NAME were analogously impaired, it is reasonable to suggest that diabetic endothelial dysfunction is related to the interference with mechanisms linked both to stimulated and basal production of NO. We suggest that this interference is partially due to a deficit in the substrate availability for NO and to an increased generation of superoxide anions.

The effects of bakery processing on natural deoxynivalenol contamination.

The aim of this study was the evaluation of the influence of the breadmaking process on initial deoxynivalenol (DON) contamination. Samples (92) were taken from four batches of eight different types of products in a low-technology bakery. The final products, as well as the corresponding flours, doughs and fermented doughs were analyzed. Extracts were obtained with acetonitrile:water (84:16), the clean up was made with a multifunctional column and DON was quantified by thin layer chromatography by visual comparison with standards. Confirmation was made by electron capture gas chromatography. The contamination levels in flour samples ranged from 500 micrograms/kg to 2000 micrograms/kg on dry weight basis. The results showed a positive correlation between the initial contamination level and the reduction of DON after fermentation. A significant reduction was observed as a consequence of the breadmaking process.

Omeprazole, a specific gastric secretion inhibitor on oxynticopeptic cells, reduces gizzard erosion in broiler chicks fed with toxic fish meals.

The relation between gizzard erosion-black vomit (GE-BV) and gastric secretion is not completely understood. A pharmacological approach to reduce the presence of GE-BV in chicks due to fish meal in diets is also unknown. In this study the use of omeprazole, a H+/K+ ATPase inhibitor, and fish meals of different biotoxicological characteristics, showed that: 1) Omeprazole decreased total gastric acid content, GE scores and severe GE (SGE) cases, in a dose-dependent manner. This reduction was significant at levels higher than 20 mg omeprazole/Kg body weight (BW)/day (p < 0.01). The addition of 50 mg omeprazole/kg BW/day almost completely prevented the incidence of SGE cases and reduced in 50% GE score in chicks (p < 0.01). 2) A significant reduction in specific mortality, near 90%, was also seen with all toxic fish meals when omeprazole (50 mg/Kg BW/day) was added to experimental diets in comparison to control groups. However, no mortality was observed when omeprazole was added to diets containing non-toxic fish meals. 3) In chicks fed with toxic fish meals, addition of different amounts of omeprazole to diets changed the relative weight of proventriculus (p < 0.01) and gizzard (p < 0.05). Maximum effect was obtained with omeprazole concentration higher than 50 mg/Kg BW/day. 4) Omeprazole did not change feed intake in chicks fed with toxic fish meal. However, in some fish meal a reduction on weight gain was observed with the addition of omeprazole.

Research note: ability of fenthion to increase gizzard erosion in broiler chicks.

Fenthion, an irreversible cholinesterase inhibitor, was used to study the role of the cholinergic system on the development of gizzard erosion. Fenthion increases the gizzard erosion score in a dose-dependent manner and this effect became significant at levels higher than .1 ppm (p less than .05). An inverse relationship between plasma cholinesterase activity and pesticide concentration was also observed at doses higher than 1 ppm (P less than .05). These results show the necessity to evaluate organophosphate pesticide levels during the selection of fish meals in poultry.

[Measles outbreak in the province of Córdoba, Argentina, in 1998]. / Brote de sarampión en la provincia de Córdoba, Argentina, en 1998.

The World Health Organization had the global target of reducing reported measles incidence from pre-vaccination era in American countries by 1995, to later eliminate indigenous measles transmission. The countries that have given priority to measles control have substantially reduced morbidity and mortality. Despite that, measles has continued occurring in epidemic outbreaks. This paper describes and analyses the outbreak occurred in Cordoba province, Argentina, in 1998. Out of 195 serum samples analysed from suspected cases, 28 (14.4%) were confirmed as measles by laboratory diagnosis. Of them, 25.0% occurred among vaccinated persons, 39.3% among unvaccinated ones, and 35.7% in individuals without reported vaccine status. The highest measles incidence was in the group aged 20-29 years old (60.7%), followed by the pre-school age group (1-4 years old) (21.4%), the infants under one year of age (14.3%) and finally 3.5% in the group older than 30 years old. These findings suggest a change in measles epidemiology with respect to the pre-vaccine era. The ability to prevent the next epidemic outbreaks will depend on the efficacy to prevent the accumulation of susceptible individuals and the maintenance of high measles vaccine coverage levels.

[How I prevent erysipelas and its consequences and recurrences]. / Comment je préviens...un érysipèle, ses consequences et ses récidives.

Erysipelas is a serious infection of the skin. In case of delay in initiating adequate antibiotic treatment, complications, sometimes dismal, can supervene. In addition, erysipelas shows a tendancy to recurrences. The prevention of an episode of erysipelas calls for correct personal hygiene and adequate use of topical antiseptics in case of skin effraction, even when minimal. When erysipelas is established, a rapidly initiated antibiotic treatment for a prolonged period prevents streptococcal gangrene complications. Elastic contention of any leg edema from venous or lymphatic origin and prophylactic antisepsis of discrete wounds help in preventing erysipelas recurrences.

[Food consumption and intake of several nutrients in a population of the University of Luján, Argentina]. / Consumo de alimentos e ingesta de algunos nutrientes en la población de la Universidad Nacional de Luján, Argentina.

A dietary survey was carried out at the National University of Luján (Argentina), with the objective of evaluating: a) food consumption and energy supply of cereals; b) the adequation of the intake of protein, calcium, iron, vitamins A, B1, B2, C and niacin, regarding the Recommended Dietary Allowances (RDA). A representative sample of 827 people (16% of the total population of 1991, equally distributed in the four seasons) was assessed with a 24 hour dietary recall. Sample was composed by: males: 189, aged 18-24 ys (GIM); 189, aged 25-50 ys (G2M); females: 209, aged 18-24 ys (GIF); 240, aged 25-50 ys (G2F). The results showed that cereals, 90% deriving from wheat products, supplied 32% of the total energy intake in G1F and between 40% and 48% in the other three groups. The mean daily intake of meat ranged between 90.5 g and 128.7 in females and over 140.0 g in males. Dairy products consumption was quite low, as well as fruits and vegetables in the whole of the population. Protein intake was over 1.25 g/d in 50% of the population. Calcium intake was below the RDA in a great percentage of the population, the mean percentage of adequation being: G1F, 71%; G2F, 62%; G1M, 64%; G2M, 65%. Iron mean daily intake was quite good, ranging between 16.4 and 20.8 mg in females and between 17.5 and 19.2 mg in males. The percentage of iron supplied by meat was: G1F, 16%; G2F, 21%; G1M, 34% and G2M, 26%; therefore iron bioavailability can be considered high. Besides, "mate", which is drunk between meals, supplied between 25% and 29% of the total iron intake in females and between 12% and 56% in males. Vitamin A intake was below the RDA in 74% to 58% of the population. The mean intake of vitamin B1 was 89% of the RDA in G1M and over RDA in the other three groups. Intake and percentage of adequation of vitamin B2, vitamin C and niacin presented a great range, but the mean values were over the RDA. The overall results showed: a) a high protein intake, providing red meat between 26% and 39%; b) low consumption of dairy products, with the consequence of a low calcium and vitamin A intake; c) low consumption of fruits and vegetables, being in relation to the low intake of fibre and carotenes; d) high consumption of cereals, mainly wheat products, that must be controlled from the toxicological point of view, due to the variable presence of mycotoxins. These results are in agreement with other dietary surveys carried out in previous years and are a consequence of some characteristic feeding habits of the Argentine population. They show that nutritional education is necessary for promoting changes in the latter, with the aim of reaching a better nutritional status.

La paradoja de la inmigración: las madres haitianas y latinoamericanas en Chile / The Immigration Paradox: Haitian and Latin American Mothers in Chile

Introducción: Existe información internacional sobre las diferencias en parto prematuro y peso al nacer para madres migrantes de diferentes etnias originarias. El objetivo de este trabajo es evaluar parto prematuro y peso al nacer de madres de nacionalidad diferente, cuyos partos ocurrieron en Chile. Materiales y métodos Se utilizó la base de datos nacional del Departamento de Informática del Ministerio de Salud de Chile. Se incluyeron los recién nacidos del período Septiembre 2012 a Diciembre 2016. Se evaluaron los datos perinatales básicos, parto prematuro, bajo peso al nacer y su relación con la edad gestacional de nacidos de madres chilenas y de otras nacionalidades. Resultados En el periodo estudiado hubo 1.048490 nacimientos, de los cuales 50995 son de madres extranjeras. El porcentaje de nacidos antes de 37 semanas en madres de Bolivia, Colombia, Ecuador, Perú y Venezuela es entre un 4.8 y 7.3 %, versus 8% en madres chilenas. Los percentiles 10 para el peso al nacer entre 30 y 40 semanas para madres chilenas y Haitianas (en paréntesis) expresados en gramos: 1045 (1102), 1195 (1160), 1360 (1370), 1550 (1503), 1750 (1508), 2000 (1669), 2235 (1982), 2500 (2237), 2810 (2607), 2970 (2710), 3080 (2858). Los z-score de madres Haitianas fueron significativamente menores después de las 35 semanas. Conclusiones La paradoja de la inmigración se verifica en la experiencia nacional, con tasas de natalidad prematuras y bajo peso al nacer más favorables para las madres extranjeras en comparación con las mujeres chilenas y con sus países de origen. Las madres afro-caribeñas tuvieron nacimientos con peso menor, en edades gestacionales donde se toman decisiones frecuentes, con diferencias de hasta un 20 % entre las 35- 37 semanas.

SUMMARY The immigration paradox: Haitian and Latin American mothers in Chile Introduction There is international information on the differences in preterm birth and birth weight for migrant mothers of different ethnicities. The objective is to evaluate prematurity and birth weight of mothers of different national origin, whose deliveries occurred in Chile. Materials and methods The national database of the Department of Informatics of the Ministry of Health of Chile was used. Newborns from the period of September 2012 to December 2016 were included. Basic perinatal data, preterm birth, low birth weight and their relationship with the gestational age of babies born to mothers of local origin and other nationalities were evaluated. Results 1,048,490 births, 50,995 foreign mothers were studied. The percentage of those born before 37 weeks of mothers from Bolivia, Colombia, Ecuador, Peru, and Venezuela is between 4.8 and 7.3%, compared to nationals with 8%. The 10th percentiles for birth weight from 30 to 40 weeks for Chilean and Haitian mothers (in parentheses) were (g): 1045 (1102), 1195 (1160), 1360 (1370), 1550 (1503), 1750(1508 ), 2000 (1669), 2235 (1982), 2500 (2237), 2810 (2607), 2970 (2710), 3080 (2858). The z-scores of Haitian mothers were significantly lower. Conclusions The immigration paradox is verified in the national experience, with preterm birth rates and low birth weight more favorable to foreign mothers compared to chileans Afro-Caribbean mothers had births with a lower weight, at gestational ages where relevant decisions are made, with differences of up to a 20% between 35-37 weeks.

Confiabilidad interevaluador de la prueba video head impulse test en estudiantes de primer año de la generación 2016 de la Escuela de Fonoaudiología de la Universidad de Valparaíso Casa Central / Inter-rater reliability of the video head impulse test in students from the School of Speech and Language therapist of the University of Valparaiso main campus class 2016

RESUMEN Introducción: El video head impulse test es un método rápido, no invasivo y cómodo para evaluar el reflejo vestíbulo ocular, el cual está siendo utilizado con mayor frecuencia en la evaluación de pacientes con alteraciones del equilibrio. Sin embargo, en Chile se evidencia una falta de estudios relacionados a la confiabilidad interevaluador de dicha prueba. Objetivo: Determinar el nivel de concordancia de los resultados de la eficiencia del reflejo vestíbulo ocular de los canales semicirculares horizontales, obtenidos mediante la aplicación de la prueba video head impulse test, por parte de 3 evaluadores. Material y método: Estudio cuantitativo, correlacional, no experimental transversal descriptivo, con muestreo no probabilístico, de participación voluntaria. La prueba video head impulse test fue aplicada por 3 examinadores a 30 estudiantes que cumplieron con los criterios de inclusión. Resultados: El método de Bland y Altman mostró gran concordancia en las mediciones realizadas entre los 3 examinadores. La correlación intraclase para la ganancia del canal semicircular horizontal derecho e izquierdo fue de 0,85 y 0,91 respectivamente y de 0,75 para el valor de asimetría. Conclusión: El estudio mostró una confiabilidad interevaluador adecuada de la prueba video head impulse test para la evaluación de los canales semicirculares horizontales.

ABSTRACT Introduction: The video head impulse test is a rapid, non-invasive and comfortable method for the evaluation of the vestibulo-ocular reflex that is being used more often in the evaluation of patients with balance disorders. In Chile there is a lack of studies related to the inter-rater reliability for this test. Aim: To determine the level of agreement on the results for the vestibulo-ocular reflex of the horizontal semicircular canals obtained by the execution of the video head impulse test by 3 raters. Material and method: Quantitative, correlational, non-experimental, cross-sectional descriptive study with a type of non-probability sampling with voluntary participation. The video head impulse test was applied by 3 raters to 30 students who fulfilled the inclusion criteria. Results: The Bland-Altman method demonstrated good agreement in the measurements made between the 3 raters. The inter-rater reliability for the gain of the left and right horizontal semicircular canals was 0.85 and 0.91 respectively and 0.75 for the asymmetry value. Conclusion: The study showed an adequate inter-rater reliability for the video head impulse test in the evaluation of the horizontal semicircular canals.