Quantification and characterization of additives, plasticizers, and small microplastics (5-100 µm) in highway stormwater runoff.

Highway stormwater (HSW) runoff is a significant pathway for transferring microplastics from land-based sources to the other surrounding environmental compartments. Small microplastics (SMPs, 5-100 µm), additives, plasticizers, natural, and nonplastic synthetic fibers, together with other components of micro-litter (APFs), were assessed in HSW samples via Micro-FTIR; oleo-extraction and purification procedures previously developed were optimized to accomplish this goal. The distribution of SMPs and APFs observed in distinct HSW runoff varied significantly since rainfall events may play a crucial role in the concentration and distribution of these pollutants. The SMPs' abundance varied from 11932 ± 151 to 18966 ± 191 SMPs/L. The dominating polymers were vinyl ester (VE), polyamide 6 (PA6), fluorocarbon, and polyester (PES). The APFs' concentrations ranged from 12825 ± 157 to 96425 ± 430 APFs/L. Most APFs originated from vehicle and tire wear (e.g., Dioctyl adipate or 5-Methyl-1H-benzotriazole). Other sources of these pollutants might be pipes, highway signs, packaging from garbage debris, road marking paints, atmospheric deposition, and other inputs. Assessing SMPs in HSW runoff can help evaluating the potential threat they may represent to receiving water bodies and air compartments. Besides, APFs in HSW runoff may be efficient proxies of macro- and microplastic pollution.

Evaluación de la oferta de alimentos libres de gluten en locales de comida elaborada en la Ciudad Autónoma de Buenos Aires.

Celiac disease is an autoimmune enteropathy. The only known treatment consists of a permanent adherence to a strict gluten-free diet, which represents an important challenge for patients. Objective. To describe the gluten-free processed food offer in food locals from 3 neighborhoods representative of high, middle and low economic status in Buenos Aires, Argentina. METHODS: Cross-sectional study. Specially trained monitors performed a standardized direct assessment of food locals. Whenever direct observation was not possible, we interviewed the personnel as an indirect assessment. We classified dish offer in different categories, and evaluated the processes of food elaboration, storage and distribution. RESULTS: We included 112 food locals. Results for neighborhoods representative of high, middle and low economic status were, respectively: no gluten free dish available in 27.5% (45/62), 27.0% (27/37) and 30.8% (9/13), (p = 0.96); adequate elaboration in 17.7%, 13.5% and 7.7%, (p = 0.61); appropriate food storage in 12.9% (8), 13.5% (5) and 7.7% (1); (p = 0.85); adequate distribution in 8.1%, 8.1% and 0% (0), (p = 0.56). Conclusion. In 1 out of 4 food locals there was not even one gluten free dish. In addition, there was a lack of compliance with safety measures to avoid gluten cross-contamination.

Characteristics and quantification of small microplastics (<100 µm) in seasonal svalbard snow on glaciers and lands.

Small microplastics (SMPs < 100 µm) can easily be transported over long distances far from their sources through the atmospheric pathways and reach even remote regions, including the Arctic. However, these sizes of MPs are mostly overlooked due to different analytical challenges; besides, their pathways through atmospheric depositions, such as snow depositions, are mostly unknown. The spatial variability in bulk snow samples was investigated for the first time in distinct sites (e.g., glaciers) near Ny Ålesund, the world-known northernmost permanent research settlement in the Svalbard Islands, to better comprehend the presence of SMP pollution in snow. Seasonal snow deposited over the tundra and the summits of different glaciers were also sampled. A sampling procedure was designed to obtain representative samples while minimizing plastic contamination, thanks to rigorous quality assurance and quality control protocol. SMPs' weight (µg SMP L-1) and deposition load (mg SMPs m-2) result from being lower in the remote glaciers, where they may be subject to long-range transport. The SMPs' minimum length was 20 µm, with the majority less than 100 µm. Regarding their size distribution, there was an increase in the size length deriving from the local input of the human presence near the scientific settlement. The presence of some polymers might be site-specific in relation to the pathways that affect their distribution at the sites studied. Also, from the snow surface layer collected at the same sites to evaluate the variability of SMPs during specific atmospheric deposition events, the results confirmed their higher weight and load in surface snow near the scientific settlement compared to the glaciers. The results will enhance the limited knowledge of the SMPs in polar atmospheric compartments and deposition processes.

Quantification and Chemical Characterization of Plastic Additives and Small Microplastics (<100 µm) in Highway Road Dust.

Road dust is one of the environment's most important microplastic and plastic additive sources. Traffic vehicles and the wear of tires can release these emerging contaminants, which can be resuspended in the air and washed off by stormwater runoff. In this study, a concurrent quantification and chemical characterization of additives, plasticizers, natural and non-plastic synthetic fibers (APFs), and small microplastics (SMPs, <100 µm) in samples of highway road dust (HWRD) was performed. The sampling procedure was optimized, as well as pretreatment (extraction, purification, and filtration) and analysis via micro-FTIR. The average length of the SMPs was 88 µm, while the average width was 50 µm. The highest abundance of SMPs was detected in HWRD 7 (802 ± 39 SMPs/g). Among the polymers characterized and quantified, vinyl ester and polytetrafluoroethylene were predominant. APFs' average particle length was 80 µm and their width was 45 µm, confirming that both of these emerging pollutants are less than 100 µm in size. Their maximum concentration was in RD7, with 1044 ± 45 APFs/g. Lubricants and plasticizers are the two most abundant categories, followed by vulcanizing agents, accelerators, and pre-vulcanizing retarders derived mainly from tires. A potential relationship between APFs and SMPs in the different seasons was observed, as their concentration was lower in summer for both and higher in winter 2022. These results will be significant in investigating the load of these pollutants from highways, which is urgently necessary for more accurate inclusion in emission inventories, receptor modeling, and health protection programs by policymakers, especially in air and water pollution policies, to prevent risks to human health.

Identification and quantification of tire wear particles by employing different cross-validation techniques: FTIR-ATR Micro-FTIR, Pyr-GC/MS, and SEM.

Tire wear particles (TWPs) are one of the environment's most important emission sources of microplastics. In this work, chemical identification of these particles was carried out in highway stormwater runoff through cross-validation techniques for the first time. Optimization of a pre-treatment method (i.e., extraction and purification) was provided to extract TWPs, avoiding their degradation and denaturation, to prevent getting low recognizable identification and consequently underestimates in the quantification. Specific markers were used for TWPs identification comparing real stormwater samples and reference materials via FTIR-ATR, Micro-FTIR, and Pyrolysis-gas-chromatography-mass spectrometry (Pyr-GC/MS). Quantification of TWPs was carried out via Micro-FTIR (microscopic counting); the abundance ranged from 220,371 ± 651 TWPs/L to 358,915 ± 831 TWPs/L, while the higher mass was 39,6 ± 9 mg TWPs/L and the lowest 31,0 ± 8 mg TWPs/L. Most of the TWPs analyzed were less than 100 µm in size. The sizes were also confirmed using a scanning electron microscope (SEM), including the presence of potential nano TWPs in the samples. Elemental analysis via SEM supported that a complex mixture of heterogeneous composition characterizes these particles by agglomerating organic and inorganic particles that could derive from brake and road wear, road pavement, road dust, asphalts, and construction road work. Due to the analytical lack of knowledge about TWPs chemical identification and quantification in scientific literature, this study significantly contributes to providing a novel pre-treatment and analytical methodology for these emerging contaminants in highway stormwater runoff. The results of this study highlight the uttermost necessity to employ cross-validation techniques, i.e., FTIR-ATR, Micro-FTIR, Pyr-GC/MS, and SEM for the TWPs identification and quantification in the real environmental samples.

Microplastics in inland and offshore sediments in the Apulo-Lucanian region (Southern Italy).

Inland and offshore sediments from Southern Italy were studied in order to evaluate the occurrence and nature of microplastics (MPs). Inland sediments were collected in the Bradano and Basento rivers (Apulo-Lucanian region, Southern Italy), while offshore sediments were collected on the continental shelf near Bari (Adriatic Sea) and Metaponto (Ionian Sea). MPs were detected and characterized using optical microscopy, micro-Fourier-Transform Infrared spectroscopy (µ-FTIR) and micro-Raman analyses. The number of MPs present varied between 144 and 1246 kg-1 of dry sediment (468.8 ± 410,7 MPs kg-1) with a predominance of black fibers; no correlation emerged between MPs and sediment grain size. In river sediments, the occurrence of MPs is associated with local pollution, whereas the offshore occurrence of MPs depends on seasonal river flow and submarine canyons. Compositional analyses suggest that the main source of MPs in the studied sediments is sewage discharge from residential areas.

Occurrence and Characterization of Small Microplastics (<100 µm), Additives, and Plasticizers in Larvae of Simuliidae

This study is the first to investigate the ingestion of microplastics (MPs), plasticizers, additives, and particles of micro-litter < 100 µm by larvae of Simuliidae (Diptera) in rivers. Blackflies belong to a small cosmopolitan insect family whose larvae are present alongside river courses, often with a torrential regime, up to their mouths. Specimens of two species of blackfly larvae, Simulium equinum and Simulium ornatum, were collected in two rivers in Central Italy, the Mignone and the Treja. Small microplastics (SMPs, <100 µm), plasticizers, additives, and other micro-litter components, e.g., natural and non-plastic synthetic fibers (APFs) ingested by blackfly larvae were, for the first time, quantified and concurrently identified via MicroFTIR. The pretreatment allowed for simultaneous extraction of the ingested SMPs and APFs. Strong acids or strong oxidizing reagents and the application of temperatures well above the glass transition temperature of polyamide 6 and 6.6 (55−60 °C) were not employed to avoid further denaturation/degradation of polymers and underestimating the quantification. Reagent and procedural blanks did not show any SMPs or APFs. The method's yield was >90%. Differences in the abundances of the SMPs and APFs ingested by the two species under exam were statistically significant. Additives and plasticizers can be specific to a particular polymer; thus, these compounds can be proxies for the presence of plastic polymers in the environment.

A novel method for purification, quantitative analysis and characterization of microplastic fibers using Micro-FTIR.

Microplastics pose a worldwide risk for the environment. Microplastic fibers, which are released during the household washing of synthetic fabrics, are a substantial percentage of microplastics in rivers and in oceans. A novel quantification and simultaneous identification of fiber polymers via Micro-FTIR (Fourier Transform Infrared Spectroscopy) was developed. Washing simulations with commercially available household products were performed and effluents were filtered either on GF/F filters (0.7 µm) or on Anodisc filter (0.2 µm), to gather even the smallest fibers. Furthermore, a novel purification procedure of effluents was developed. Subsequently, filters were analyzed also with the scanning electronic microscope (SEM) to confirm the width and length of fibers. This novel method is robust and replicable and it allows better quantification of fibers released and identification of fiber polymers with optimal matches (averagely 80%).

Dr. León Cuervo Rubio y la penicilina en Pinar del Río / Dr. León Cuervo Rubio and Penicillin in Pinar del Río

RESUMEN Introducción: a los 23 años de haberse graduado de médico cirujano, el Dr. León Cuervo Rubio conoce de una noticia que cambiaría el rumbo de la medicina; el descubrimiento de la penicilina por Alexander Fleming Morton, en Londres. La revisión de un artículo en un periódico pinareño de julio de 1944 que da a conocer la noticia de la aplicación de la penicilina en Pinar del Río en la colonia española, motivó la realización de esta investigación, por estar implicado el Dr. León Cuervo Rubio en el hecho. Objetivo: realizar la búsqueda de las fuentes documentales que avalen el inicio del uso de la penicilina en la provincia de Pinar del Río. Métodos: investigación cualitativa, histórica, testimonial y situacional que permitió encontrar los detalles que sacaron a la luz este hecho histórico de la provincia. Desarrollo: se realizó una síntesis de la vida y obra de Alexander Fleming, la presentación de los documentos encontrados sobre el tema del uso de la penicilina en Cuba, un recuento de la visita de Fleming a Cuba y los reconocimientos que se le otorgaron y finalmente el lugar que le corresponde al Dr. León Cuervo Rubio en esta historia. Conclusiones: la revisión documental realizada lleva a asignar al Dr. León Cuervo Rubio como el primero en usar la penicilina en Pinar del Río y no descarta en Cuba, por lo que sería competente profundizar investigaciones que pudieran complementar las realizadas, pues no aparecieron su uso en otros hospitales.

ABSTRACT Introduction: 23 years after graduating as a surgeon, Dr. León Cuervo Rubio learned about a news that would change the course of medicine; the discovery of Penicillin by Alexander Fleming Morton, in London. The review of an article in a newspaper from Pinar del Rio in July 1944, which gives the news of the application of Penicillin in Pinar del Rio in the Spanish Colony, motivated the realization of this research, because Dr. Leon Cuervo Rubio was involved in the fact. Objective: to search for documentary sources that support the beginning of the use of Penicillin in the province of Pinar del Río. Methods: qualitative, historical, testimonial and situational research that allowed finding the details that brought to light this historical fact of the province. Development: a synthesis of Alexander Fleming's life and work was carried out; continuing with the presentation of the documents found on the subject of the use of Penicillin in Cuba; an account of Fleming's visit to Cuba and the recognitions that were granted to him and finally the place that corresponds to Dr. León Cuervo Rubio in this history. Conclusions: the documentary review carried out leads to assign Dr. León Cuervo Rubio as the first one in using Penicillin in Pinar del Río and does not rule out in Cuba, leaving open the need to deepen investigations that could complement those carried out, since its use in other hospitals did not appear.

Tratamiento homeopático de los condilomas acuminados en niños en hospital pediátrico pinareño / Homeopathic treatment of condyloma acuminata in children Pediatric pinareño

RESUMEN Introducción: se ha identificado un incremento de pacientes pediátricos con condilomas acuminados. Objetivo: evaluar la efectividad de los medicamentos homeopáticos en el tratamiento de los condilomas acuminados en niños de un mes a 18 años, en hospital pediátrico pinareño entre los años 2014 y 2015. Métodos: se realizó un estudio descriptivo longitudinal y prospectivo a un universo muestral de 33 niños, remitidos por el Dermatólogo a la consulta de Medicina Bioenergética y Natural del Hospital Pediátrico Provincial Docente Pepe Portilla de Pinar del Río, Cuba, durante los años 2014-2015, seguidos de forma evolutiva hasta el 2018. Se les aplicaron medicamentos homeopáticos seleccionados de forma tópica y sistémica. Resultados: no existió predominio de sexo, la edad más representada fue de 13-18 años, y la localización más frecuente fue genital con morfología clínica predominante coliflor, el modo de transmisión más frecuente fue por contacto sexual. En cuatro pacientes se corroboró abuso sexual, en el resto de los casos por hetero inoculación. La evolución fue satisfactoria con la aparición de lesiones en el tercer año de su seguimiento. Conclusiones: las verrugas ano genitales son un reto para el pediatra y el dermatólogo pedíatra, sobre todo sus mecanismos de transmisión. Los medicamentos homeopáticos resultaron eficaces en el tratamiento de los condilomas acuminados en niños.

ABSTRACT Introduction: an increase in pediatric patients with condyloma acuminata has been identified. Objective: to assess the effectiveness of homeopathic medicines in the treatment of condyloma acuminata in children from 1 month to 18 years at Pepe Portilla Pediatric Provincial Teaching Hospital in Pinar del Río between the years 2014 and 2015. Methods: a longitudinal and prospective descriptive study was carried out on a sampling target group of 33 children, referred by the Dermatologist to the Bioenergetic and Natural Medicine consultation at Pepe Portilla Pediatric Provincial Teaching Hospital in Pinar del Río, Cuba, during the years 2014-2015, performing a follow-up until 2018. Topical and systemic homeopathic medicines were chosen to apply to them. Results: there was no predominance of gender, the age most represented was 13-18 years, and the most frequent location was genital regions, predominantly cauliflower clinical morphology, the most frequent type of transmission was by sexual contact. In four patients sexual abuse was corroborated, in the rest of the cases by hetero inoculation, the evolution was satisfactory with the appearance of lesions in the third year of their follow-up. Conclusions: genital-anal warts are a challenge for the pediatricians and pediatric dermatologists; basically because of their mechanisms of transmission. Homeopathic medicines were effective in the treatment of condyloma acuminata in children.

La no-maternidad en México. El rol del género y la desigualdad socioeconómica

a no-maternidad en México se perfila como un complejo fenómeno distinto al de las sociedades industrializadas y altamente urbanizadas en las que ha sido fundamentalmente estudiada. Las desiguales condiciones en la que esta se lleva a cabo aluden a una diversidad de experiencias que requieren ser documentadas. Este estudio busca contribuir al conocimiento de la no-maternidad en México, explorando, a partir de fuentes secundarias y análisis descriptivos, sus aspectos sociales y económicos más relevantes. Los resultados ratifican que la no-maternidad ocurre bajo diferentes contextos socioeconómicos, que llegan a ser incluso antagónicos. La no unión conyugal se presenta como un aspecto importante de la nomaternidad que, al no haberse asociado con índices migratorios, muestra que en México las mujeres que no son madres tampoco son esposas, sugiriendo con ello, una doble transgresión al modelo hegemónico del ser mujer, al tiempo que revela una realidad hasta ahora poco visible de las mujeres no madres y no esposas: la de las mujeres con limitaciones físicas.

he non-maternity in Mexico is emerging as a complex phenomenon different from the highly urbanized and industrialized societies in which primarily has been studied. The unequal conditions in which it takes place refer to a variety of experiences that need to be documented. This study seeks to contribute to the knowledge of non-maternity in Mexico, exploring, from secondary sources and descriptive analysis, its most important social and economic aspects. The results confirm that non-maternity occurs under different socioeconomic contexts, that become even antagonistic. Non-marital union was presented as an important aspect of non-maternity that, not having been associated with migration rates, shows that in Mexico women who are not mothers neither are wives, thereby suggesting a double transgression of the hegemonic model of womanhood, while it is revealing a reality hitherto little visible of women who are neither mothers nor wives: the women with physical limitations to work.

Tuberculosis y SIDA pediátrico: a propósito de un caso en Mozambique / Tuberculosis and pediatric AIDS: a case report in Mozambique

La Tuberculosis (TB), es una enfermedad producida por el Mycobacterium tuberculosis hominis, bacilo débilmente Gram positivo, aerobio, ácido-alcohol resistente, de aspecto curvo, inmóvil, no esporulado, constituye una de las enfermedades re - emergentes en la infancia a nivel mundial, el Síndrome de inmunodeficiencia adquirida (sida) es el factor de riesgo mayor para la progresión de la TB. a pesar de que la incidencia de ambas enfermedades es baja con relación a las estadísticas mundiales según la OMS; los estados y autoridades sanitarias ponen el mayor empeño para un control eficaz y manejo adecuado de los casos registrados. Motivados con la presencia del Internacionalismo médico cubano en diversos países fue considerado de interés transmitir una experiencia, presentando el caso de un niño de 4 años de edad, raza negra, procedente de un área rural en Nampula, Mozambique (África), donde el cuadro clínico y los complementarios confirmaron una TB pulmonar, constatando además la presencia de sida (VIH positivo y linfocitos CD4+ en < 15 %). Se aplicó la terapéutica adecuada siguiendo los protocolos establecidos en Mozambique para ambas enfermedades, que permitió una mejoría del estado clínico e hizo posible un cambio en la calidad y esperanza de vida de este.

Tuberculosis (abbreviated TB for tubercle bacillus or Tuberculosis), is a disease caused by Mycobacterium Tuberculosis Hominis, weakly Gram-positive bacillus, aerobic, acid-alcohol resistance, of curved aspect, motionless and sporeless. TB constitutes one of the re-emergent diseases in the childhood all over the world. Acquired Immunodeficiency Syndrome (AIDS) is the most important risk factor to the TB development. Despite the incidence of both diseases is low in relation to the worldwide statistics; and according to the World Health Organization (WHO), the states and sanitary authorities are making a great effort to carry out an effective control and an adequate management of the cases recorded. Encouraged by the presence of the Cuban Medical Internationalist Missions in several countries the case is presented in order to transmit experience. A 4-year-old, black boy, coming from a rural region in Mampula City, Mozambique, sub-Saharan Africa; the clinical and laboratory findings confirmed a pulmonary TB, also the presence of AIDS was verified (positive HIV and lymphocytes CD4+ in 15%). An adequate therapeutic taking into account the protocols established in Mozambique for both diseases was followed with the purpose of improving the clinical conditions of the patient, which made possible changes in the quality of life and life expectancy.

Tuberculosis y SIDA pediátrico: a propósito de un caso en Mozambique / Tuberculosis and pediatric AIDS: a case report in Mozambique

La Tuberculosis (TB), es una enfermedad producida por el Mycobacterium tuberculosis hominis, bacilo débilmente Gram positivo, aerobio, ácido-alcohol resistente, de aspecto curvo, inmóvil, no esporulado, constituye una de las enfermedades re - emergentes en la infancia a nivel mundial, el Síndrome de inmunodeficiencia adquirida (sida) es el factor de riesgo mayor para la progresión de la TB. a pesar de que la incidencia de ambas enfermedades es baja con relación a las estadísticas mundiales según la OMS; los estados y autoridades sanitarias ponen el mayor empeño para un control eficaz y manejo adecuado de los casos registrados. Motivados con la presencia del Internacionalismo médico cubano en diversos países fue considerado de interés transmitir una experiencia, presentando el caso de un niño de 4 años de edad, raza negra, procedente de un área rural en Nampula, Mozambique (África), donde el cuadro clínico y los complementarios confirmaron una TB pulmonar, constatando además la presencia de sida (VIH positivo y linfocitos CD4+ en ‹ 15 por ciento). Se aplicó la terapéutica adecuada siguiendo los protocolos establecidos en Mozambique para ambas enfermedades, que permitió una mejoría del estado clínico e hizo posible un cambio en la calidad y esperanza de vida de éste...(AU)

Tuberculosis (abbreviated TB for tubercle bacillus or Tuberculosis), is a disease caused by Mycobacterium Tuberculosis Hominis, weakly Gram-positive bacillus, aerobic, acid-alcohol resistance, of curved aspect, motionless and sporeless. TB constitutes one of the re-emergent diseases in the childhood all over the world. Acquired Immunodeficiency Syndrome (AIDS) is the most important risk factor to the TB development. Despite the incidence of both diseases is low in relation to the worldwide statistics; and according to the World Health Organization (WHO), the states and sanitary authorities are making a great effort to carry out an effective control and an adequate management of the cases recorded. Encouraged by the presence of the Cuban Medical Internationalist Missions in several countries the case is presented in order to transmit experience. A 4-year-old, black boy, coming from a rural region in Mampula City, Mozambique, sub-Saharan Africa; the clinical and laboratory findings confirmed a pulmonary TB, also the presence of AIDS was verified (positive HIV and lymphocytes CD4+ in 15 per cent). An adequate therapeutic taking into account the protocols established in Mozambique for both diseases was followed with the purpose of improving the clinical conditions of the patient, which made possible changes in the quality of life and life expectancy...(AU)

Espondilo artritis anquilosante: presentación de un caso atípico / Ankylosing spondyloarthritis: an atypical case report

La espondiloartritis anquilosante es una enfermedad que tiene muy baja prevalencia en Cuba, y es muy rara en Pinar del Río, y más en la juventud. Se presenta un caso de un joven adolescente de 16 años, estudiante, blanco, que debuta con dolor plantar y espolones calcáneos. Es ingresado y estudiado y se le diagnóstica espondiloartritis anquilosante. Se expone el cuadro clínico, los complementarios y la terapéutica utilizada. Se revisa la literatura al respecto.

Ankylosing spondyloarthritis (AS) is an uncommon disease in Cuba, and very rare in Pinar del Río Province, and much more uncommon in teenagers. A white 16- year-old adolescent student begins with plantar pain and calcaneous spikes. He is admitted to be studied and Ankylosing Spondyloarthritis is diagnosed. Clinical chart, complementary exams and the therapeutics to be used are discussed. Medical Literature is reviewed.

Esquistosomiasis en la infancia: una experiencia para el internacionalismo médico cubano / Schistosomiasis in childhood: an experience to the Cuban Medical Internationalist Missions

El Esquistosoma es un parásito no endémico de Cuba, pero con una elevada frecuencia en los países de África, Asia y América Latina; de ellos, cinco especies infectan al hombre. No existen evidencias de dicho parasitismo en nuestro país. Con la presencia del internacionalismo médico cubano en las diversas tierras del mundo es que fue considerado útil transmitir la experiencia profesional en un país africano. Se presenta un caso clínico de un paciente de 7 años de edad, sexo masculino y estado nutricional adecuado, procedente de un área suburbana de la Cuidad de Nampula, Mozambique, África Subsahariana que al examen físico se constató que tenía lesiones de dermatitis en las manos y los pies, de varias semanas en evolución; acude por la aparición de edemas en miembros inferiores, dificultad para orinar y orinas oscuras. Se sospecha una posible Glomerulonefritis Difusa Aguda según la frecuencia de la entidad en nuestro medio. Después de una respuesta terapéutica escasa, un cambio en la visión epidemiológica y los resultados complementarios, se confirma una forma de presentación infantil de esquistosomiasis masiva, entidad frecuente en las regiones geográficas donde hoy en día está presente el internacionalismo médico cubano. Después de una revisión bibliográfica se consideró útil trasmitir la experiencia al médico internacionalista y se hacen algunas consideraciones al respecto...(AU)

Schistosome is a non-endemic parasite in Cuba, but with an elevated frequency in Africa, Asia and Latin-America; of them, five species infest man. No evidences of this parasite are found in Cuba. Considering the presence of Cuban Medical Internationalist Missions in other parts of the world, it is useful to transmit the professional experience in an African country. A 7-year-old-male patient, presenting an adequate nutritional status, coming from a sub-urban district of Mampula City. Mozambique, sub-Saharan Africa, at physical examination showed dermatitis in hands and feet for several weeks in evolution. The patient attended to the clinic presenting edema in the lower limbs, difficulties to urinate and dark urines. Suspecting, a possible Acute Diffuse Glomerulonephritis according to the frequency of the disease in that environment. After a limited therapeutic response, and a change in the epidemiologic view and the laboratory results; a childhood presentation of a form of massive schistosomiasis was confirmed, a frequent entity in the geographic regions where Cuban medical missions work. Some suggestions to transmit the experience to the medical missions were made taking into consideration several aspects after a medical literature review...(AU)

Espondiloartritis anquilosante: presentación de un caso atípico / Ankylosing spondyloarthritis: an atypical case report

La espondiloartritis anquilosante es una enfermedad que tiene muy baja prevalencia en Cuba, y es muy rara en Pinar del Rio, y más en la juventud. Se presenta un caso de un joven adolescente de 16 años, estudiante, blanco, que debuta con dolor plantar y espolones calcáneos. Es ingresado y estudiado y se le diagnóstica espondiloartritis anquilosante. Se expone el cuadro clínico, los complementarios y la terapéutica utilizada. Se revisa la literatura al respecto...(AU)

Ankylosing spondyloarthritis (AS) is an uncommon disease in Cuba, and very rare in Pinar del Río Province, and much more uncommon in teenagers. A white 16- year-old adolescent student begins with plantar pain and calcaneous spikes. He is admitted to be studied and Ankylosing Spondyloarthritis is diagnosed. Clinical chart, complementary exams and the therapeutics to be used are discussed. Medical Literature is reviewed...(AU)

Schistosomiasis en la infancia. Una experiencia para el internacionalismo médico cubano / Schistosomiasis in childhood: an experience to the Cuban Medical Internationalist Missions

El Schistosoma es un parásito no endémico de Cuba, pero con una elevada frecuencia en los países de África, Asia y América Latina; de ellos, cinco especies infectan al hombre. No existen evidencias de dicho parasitismo en nuestro país. Con la presencia del internacionalismo médico cubano en las diversas tierras del mundo es que fue considerado útil transmitir la experiencia profesional en un país africano. Se presenta un caso clínico de un paciente de 7 años de edad, sexo masculino y estado nutricional adecuado, procedente de un área suburbana de la Cuidad de Nampula, Mozambique, África Subsahariana que al examen físico se constató que tenía lesiones de dermatitis en las manos y los pies, de varias semanas en evolución; acude por la aparición de edemas en miembros inferiores, dificultad para orinar y orinas oscuras. Se sospecha una posible Glomerulonefritis Difusa Aguda según la frecuencia de la entidad en nuestro medio. Después de una respuesta terapéutica escasa, un cambio en la visión epidemiológica y los resultados complementarios, se confirma una forma de presentación infantil de esquistosomiasis masiva, entidad frecuente en las regiones geográficas donde hoy en día está presente el internacionalismo médico cubano. Después de una revisión bibliográfica se consideró útil trasmitir la experiencia al médico internacionalista y se hacen algunas consideraciones al respecto.

Schistosome is a non-endemic parasite in Cuba, but with an elevated frequency in Africa, Asia and Latin-America; of them, five species infest man. No evidences of this parasite are found in Cuba. Considering the presence of Cuban Medical Internationalist Missions in other parts of the world, it is useful to transmit the professional experience in an African country. A 7-year-old-male patient, presenting an adequate nutritional status, coming from a sub-urban district of Mampula City. Mozambique, sub-Saharan Africa, at physical examination showed dermatitis in hands and feet for several weeks in evolution. The patient attended to the clinic presenting edema in the lower limbs, difficulties to urinate and dark urines. Suspecting, a possible Acute Diffuse Glomerulonephritis according to the frequency of the disease in that environment. After a limited therapeutic response, and a change in the epidemiologic view and the laboratory results; a childhood presentation of a form of massive schistosomiasis was confirmed, a frequent entity in the geographic regions where Cuban medical missions work. Some suggestions to transmit the experience to the medical missions were made taking into consideration several aspects after a medical literature review.