RESUMEN
BACKGROUND: Nutritional transition has been described in various countries, each showing inherent characteristics. Furthermore, different patterns also appear within the same country. AIM: To compare the nutritional status of schoolchildren, of both sexes, living in two Argentine cities with different urban and environment characteristics, from the perspective of nutritional transition. SUBJECTS AND METHODS: The sample comprised 5355 children (6-13 years) living in Puerto Madryn (Chubut) and General Alvear (Mendoza), Argentina. Weight and height were transformed into Z-scores according to NHANES I- II; underweight, stunting and wasting defined by - 2 SD and overweight and obesity calculated according the cut-off proposed by IOTF. Prevalences of nutritional status were estimated. RESULTS: Comparison of the two cities revealed significant χ² values for the indicators of nutritional status analysed. Puerto Madryn had higher prevalences of overweight and obesity. General Alvear exhibited higher stunting and underweight values. CONCLUSIONS: The cities studied are in different stages of nutritional transition. Puerto Madryn is undergoing growing industrialization and urbanization and thus exhibits characteristics typical of an 'obesogenic' environment. General Alvear, a less complex urban centre, where some cultural patterns related to an agrarian way of life appear to have been retained, is situated at a less advanced stage.
Asunto(s)
Estatura , Peso Corporal , Estado Nutricional , Población Urbana , Adolescente , Argentina/epidemiología , Índice de Masa Corporal , Niño , Femenino , Geografía , Humanos/crecimiento & desarrollo , Masculino , Encuestas Nutricionales , Obesidad/epidemiología , Sobrepeso , Factores Socioeconómicos , Delgadez/epidemiologíaRESUMEN
The aim of this study was to analyze growth in relation to menarche in girls from two Argentinean urban populations. We performed a comparative-descriptive cross sectional study in 2474 schoolchildren between 8.0 and 16.9 years old from Santa Rosa (SR) and La Plata (LP) cities. We registered the presence of menarche and anthropometrics variables of body weight, total and sitting heights, arm circumference, triceps and subscapular skinfolds. Body mass index, subscapular/triceps index and muscle and fat arm areas were calculated. The study group was divided into 4 groups according to the city and menarche. The socio-environmental structured survey indicated significant differences between cities with these variables: tenure status, building materials and services, health care coverage, cash assistance, educational level and parents' occupation, therefore establishing a higher welfare in youngsters of SR. Menarche at a mean age of 12.7 years old was more prevalent in SR (40.6%) than in LP (33.7%) (c2 = 12.9; p < 0.01). The ANOVA indicated significant differences between cities in total and sitting heights and muscle area (p < 0.01), body weight and arm circumference (p < 0.05) which were generally held in the post hoc comparison by age in pre-menarche and post-menarche groups. The presence of a small body size at the expense of lowering in: total height, muscle area and leg length in LP youngsters, associated with a lower prevalence of menarche in this city, it would represents the adaptive cost of a lower welfare environment.
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Composición Corporal , Crecimiento/fisiología , Menarquia/fisiología , Maduración Sexual/fisiología , Adolescente , Argentina , Niño , Estudios Transversales , Femenino , Humanos , Factores Socioeconómicos , Población UrbanaRESUMEN
BACKGROUND AND OBJECTIVE: Thoracic epidural analgesia and patient-controlled analgesia (PCA) with intravenous fentanyl have both been shown to be effective in pediatric patients treated surgically for pectus excavatum using the Nuss procedure. We compare the efficacy and safety of these techniques. METHODS: Retrospective study of pediatric cases in which the Nuss procedure was used to treat pectus excavatum between October 1997 and February 2009. Weight, age, sex, and Haller index were analyzed. Pain was assessed every 8 hours on a visual analog scale of 0 to 10 or on a scale based on observation of distress (LLANTO scale). Daily use of analgesics was also recorded. The incidence of catheter-related complications or adverse events of treatment such as nausea, vomiting, and respiratory depression were also noted. RESULTS: We identified 31 patients in 2 groups: the epidural group (n=22) and the PCA group (n=9). Demographic characteristics, the incidences of complications or adverse events, and mean (SD) pain scores (epidural group, 1.8 [3.8]; PCA group, 2.1 [3.4]; P = .775) were statistically similar in the 2 groups. However, analgesic requirements and the duration of analgesic use in days differed significantly, at 2.9 (1.1) days in the epidural group and 5.9 (1.4) days in the PCA group (P =.001). CONCLUSIONS: The efficacy and safety of thoracic epidural analgesia is similar to that of PCA with intravenous fentanyl, although the use of epidural analgesia is associated with a markedly shorter duration of requirement for postoperative analgesia.
Asunto(s)
Analgesia Controlada por el Paciente , Analgésicos Opioides/administración & dosificación , Cardioversión Eléctrica , Fentanilo/administración & dosificación , Tórax en Embudo/cirugía , Niño , Femenino , Humanos , Infusiones Intravenosas , Masculino , Procedimientos Ortopédicos/métodos , Estudios RetrospectivosRESUMEN
During germination, orthodox seeds become gradually intolerant to desiccation, and for this reason, they are a good model for recalcitrance studies. In the present work, physiological, biochemical, and ultrastructural aspects of the desiccation tolerance were characterized during the germination process of Anadenanthera colubrina seeds. The seeds were imbibed during zero (control), 2, 8, 12 (no germinated seeds), and 18 hours (germinated seeds with 1 mm protruded radicle); then they were dried for 72 hours, rehydrated and evaluated for survivorship. Along the imbibition, cytometric and ultrastructural analysis were performed, besides the extraction of the heat-stable proteins. Posteriorly to imbibition and drying, the evaluation of ultrastructural damages was performed. Desiccation tolerance was fully lost after root protrusion. There was no increase in 4C DNA content after the loss of desiccation tolerance. Ultrastructural characteristics of cells from 1mm roots resembled those found in the recalcitrant seeds, in both hydrated and dehydrated states. The loss of desiccation tolerance coincided with the reduction of heat-stable proteins.
Asunto(s)
Desecación , Fabaceae/fisiología , Germinación , Fabaceae/genética , Fabaceae/crecimiento & desarrollo , Fabaceae/ultraestructura , Proteínas de Plantas/metabolismo , Semillas/genética , Semillas/crecimiento & desarrollo , Semillas/fisiología , Semillas/ultraestructura , Árboles/genética , Árboles/crecimiento & desarrollo , Árboles/fisiología , Árboles/ultraestructuraRESUMEN
OBJECTIVE: To document the effectiveness and safety of intrathecal baclofen administered through a tunneled catheter during a diagnostic procedure, prior to implantation of a subcutaneous pump, in children with chronic pain due to severe spasticity. METHODS: This was a retrospective study of 6 children with intense chronic pain due to spasticity caused by cerebral palsy or genetic dystonia. Increasing doses of intrathecal baclofen in continuous perfusion through a tunneled catheter were tested. RESULTS: Lumbar intrathecal catheters were tunneled for 48 to 80 hours in 5 males and 1 female aged 8 to 18 years old. Intrathecal baclofen was administered in continuous perfusion up to maximum rates that ranged between 105 and 570 microg/day. For 5 patients the score on the visual analog pain scale (0-10) changed from over 7 to 0 by the end of the test. In 2 patients, side effects of analgesia were noted, specifically sedation, bradycardia, and bradypnea. No serious complications, such as meningitis, spinal abscess, or hematoma, were reported. The families of 4 patients chose to accept implantation of a subcutaneous pump. Pump therapy remained effective and free of complications when checked 23 or 55 months after placement. CONCLUSIONS: Performing a trial of increasing doses of intrathecal baclofen therapy in continuous perfusion through a tunneled catheter facilitated selection of patients for whom chronic administration of intrathecal baclofen is effective and free of complications.
Asunto(s)
Baclofeno/uso terapéutico , Cateterismo/métodos , Infusiones Parenterales/instrumentación , Relajantes Musculares Centrales/uso terapéutico , Espasticidad Muscular/fisiopatología , Dolor/tratamiento farmacológico , Adolescente , Baclofeno/administración & dosificación , Catéteres de Permanencia , Parálisis Cerebral/complicaciones , Niño , Enfermedad Crónica , Trastornos Distónicos/complicaciones , Femenino , Estudios de Seguimiento , Humanos , Bombas de Infusión Implantables , Región Lumbosacra , Masculino , Relajantes Musculares Centrales/administración & dosificación , Espasticidad Muscular/etiología , Dolor/etiología , Registros , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
This is the first study on genetic markers in Mexican Mestizos with multiple sclerosis (MS). Patients were born in Mexico, had no family history of MS are middle-class, and have a high-level education. HLA class I, class II determinants, C2, C4, BF, GLO-1, ABO, and Rb red cell systems were analyzed and compared with results of 295 controls. Measles antibodies, glucose, IgG, total proteins, and cell count were measured in cerebrospinal fluid; anti-neuron, T-cell, and B-cell antibodies were determined in serum. MS in Mexican Mestizos was clinically similar to MS reported in high prevalence countries. DRw6, as previously found in Japanese patients, and its subtype, DRw13, were increased in patients in our study (pc = 0.0007, pc = 0.01, respectively), and the combination A3, B7, DR2, was also elevated (pc = 0.003). The polygenicity of the disease is emphasized by the excess of AB group carriers (pc = 0.01). IgG levels were high in patients with DR2 or DRw6 and 67% of the latter had anti-T cell antibodies. Severity of the disease was also related to the DR markers. It is suggested that at least two HLA-DR linked genes and the industrialized environment are important for the expression of MS in Mestizos.
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Antígenos de Histocompatibilidad Clase II/genética , Esclerosis Múltiple/genética , Sistema del Grupo Sanguíneo ABO/genética , Adulto , Autoanticuerpos/inmunología , Linfocitos B/inmunología , Femenino , Marcadores Genéticos , Genotipo , Antígenos HLA/genética , Antígenos HLA/inmunología , Antígenos HLA-DR/genética , Antígenos HLA-DR/inmunología , Antígenos de Histocompatibilidad Clase II/inmunología , Humanos , Inmunoglobulina G/análisis , Masculino , México , Esclerosis Múltiple/inmunología , Sistema del Grupo Sanguíneo Rh-Hr/genética , Linfocitos T/inmunologíaRESUMEN
We report a casual finding of a sphenoethmoidal meningoencephaloventriculocele in an adult patient that the tomography finding was misinterpreted as an expansive neoplastic lesion with malignant features. We alert for the rare site of localization of this malformative pathology.
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Encefalocele/diagnóstico , Meningocele/diagnóstico , Seno Esfenoidal , Adulto , Humanos , Espectroscopía de Resonancia Magnética , Masculino , Tomografía Computarizada por Rayos XRESUMEN
The authors present their experience with the follow-up of 60 cases of Crohn's disease, from 1970 until 1998, in the city of Juiz de Fora, Minas Gerais state, a county of the Southeast region of Brazil, and analyse the epidemiology of disease to improve the understanding of its behaviour in the country. The incidence rates increased greatly in the last 28 years. In the group studied 53.3% were men, 90% white, 71.7% non-smokers, 93.3% non-alcoholics, and all, but two, lived in urban area; 58.3% had their symptoms started at the age between 11 and 30 years and 30% were in the second decade of life. Relatives with Crohn's disease were seen in 6.7%, and the most common symptoms observed at the beginning of disease were: abdominal pain (78.3%), diarrhea (68.3%), weight loss (26.7%) and small bowel obstruction or localized peritonitis (15%). The ileum was involved in 90% and five cases (8.3%) with lesions restricted to the colon were observed. Two patients died because they were non-responders despite any therapy schedule and had sepsis after surgery. The effect of several substances used in the treatment is described, being prednisone the most effective in controlling the active disease. Other drugs as aminosalicilates, metronidazol and immunomodulators are also considered to avoid the side-effects of long-term use of steroides. Comments are made about the clinical evolution, surgeries and response to many treatments adopted. The authors conclude that Crohn's disease is increasing its incidence rate in Brazil and probably in South America formerly considered as a region of low frequency.
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Enfermedad de Crohn/epidemiología , Adulto , Edad de Inicio , Brasil , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/fisiopatología , Femenino , Humanos , Incidencia , MasculinoRESUMEN
AIMS: To study the possible pharmacodynamic differences in children under anesthesia based on remifentanil. METHODS: This multicenter observational study enrolled 275 patients scheduled for minor pediatric surgery (herniorrhaphy, prepuceplasty, and plastic surgery). The children were grouped by age: 1-3 years, 4-7 years, 8-12 years. Premedication was with midazolam, induction with sevoflurane or propofol, and maintenance with sevoflurane 0.5%-0.8%, N2O/O2 30%/70%, and remifentanil 0.25 microg/kg/min. Postoperative analgesia (metamizol, morphine or regional block) was administered at least 30 minutes before the end of surgery. RESULTS: No differences were found between age groups with regard to remifentanil requirements, end tidal concentrations of sevoflurane, or mean times until spontaneous ventilation or extubation. Nor were there differences in the percentages of complications (5.4%), of which 4 were cases of intense postoperative muscular rigidity, or in the incidence of nausea-vomiting (3.4%). The quality of recovery from anesthesia (Aldrete test) was better in the 8-12-year-old group (P < 0.05), however, while agitation (Postoperative Agitation Score) and pain (visual analog scale or observational scales) were greater in the group of 1-3-year-olds (P < 0.05). The evaluation of the technique by participating caregivers was excellent for 20%, very good for 41%, good for 29%, adequate for 8% and poor for 2% of the cases.
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Analgesia , Analgésicos Opioides , Anestesia/métodos , Dolor Postoperatorio/prevención & control , Piperidinas , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Estudios Prospectivos , RemifentaniloRESUMEN
Abstract During germination, orthodox seeds become gradually intolerant to desiccation, and for this reason, they are a good model for recalcitrance studies. In the present work, physiological, biochemical, and ultrastructural aspects of the desiccation tolerance were characterized during the germination process of Anadenanthera colubrina seeds. The seeds were imbibed during zero (control), 2, 8, 12 (no germinated seeds), and 18 hours (germinated seeds with 1 mm protruded radicle); then they were dried for 72 hours, rehydrated and evaluated for survivorship. Along the imbibition, cytometric and ultrastructural analysis were performed, besides the extraction of the heat-stable proteins. Posteriorly to imbibition and drying, the evaluation of ultrastructural damages was performed. Desiccation tolerance was fully lost after root protrusion. There was no increase in 4C DNA content after the loss of desiccation tolerance. Ultrastructural characteristics of cells from 1mm roots resembled those found in the recalcitrant seeds, in both hydrated and dehydrated states. The loss of desiccation tolerance coincided with the reduction of heat-stable proteins.
Resumo Durante a germinação, sementes ortodoxas tornam-se gradualmente intolerantes à dessecação, e por isso podem ser utilizadas como modelo para o estudo da recalcitrância. No presente trabalho realizou-se uma caracterização dos aspectos fisiológicos, bioquímicos e ultraestruturais da perda da tolerância à dessecação de sementes de Anadenanthera colubrina em processo germinativo. Para isso as sementes foram embebidas durante 0 (controle), 2,8,12 e aproximadamente 18 horas (sementes germinadas com 1 mm de radícula), secas por 72 horas, reidratadas e a sobrevivência avaliada. Ao longo da embebição foram realizadas análises citométricas, ultraestruturais e extração de proteínas resistentes ao calor e após embebição e secagem foram avaliados danos ultraestruturais. A tolerância à dessecação foi totalmente perdida após a protrusão radicular. Não houve aumento do conteúdo de DNA 4C quando a tolerância à dessecação foi perdida. Características ultraestruturais de células de radículas de 1 mm assemelharam-se às encontradas em sementes recalcitrantes tanto no estado hidratado quanto desidratado. A perda da tolerância à dessecação coincidiu com a redução do conteúdo de proteínas resistentes ao calor.
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Germinación , Desecación , Fabaceae/fisiología , Proteínas de Plantas/metabolismo , Semillas/crecimiento & desarrollo , Semillas/fisiología , Semillas/genética , Semillas/ultraestructura , Árboles/crecimiento & desarrollo , Árboles/fisiología , Árboles/genética , Árboles/ultraestructura , Fabaceae/crecimiento & desarrollo , Fabaceae/genética , Fabaceae/ultraestructuraAsunto(s)
Antígenos HLA-D/genética , Antígenos HLA-DR/genética , Lepra/genética , Adulto , Femenino , Antígeno HLA-DR3 , Humanos , Masculino , México , Persona de Mediana EdadRESUMEN
PURPOSE: To determine vision quality when testing two acrylic intraocular lenses (IOLs), AcrysofIQ and AcrysofSingle-Piece, after routine cataract extraction and IOL implantation.SettingStorm Eye Institute and Magill Research Center for Vision Correction, Medical University of South Carolina, Charleston, SC, USA. METHODS: Prospective, randomized, double-masked study that included 53 eyes of 27 patients who underwent bilateral cataract extraction and IOL implantation. Patients were randomly divided into two groups depending on the type of IOL implanted: AcrysofIQ or AcrysofSingle-Piece. Preoperative, 1- and 3-month postoperative evaluations included ETDRS visual acuity, photopic contrast sensitivity, pupil size, wavefront testing, and a subjective questionnaire. Comparisons between the two groups and comparisons to baseline were made at each visit. P<0.05 was considered statistically significant. RESULTS: Preoperative, statistically significant differences were evident in response to the subjective questionnaire (near activities, driving dimensions, and overall score) between the two groups. Postoperatively there was a greater increase in contrast sensitivity at 1 and 3 months in the AcrysofIQ group when compared to baseline. Patients with AcrysofIQ IOL had a significant reduction in total high-order aberrations (HOA) and spherical aberration (SA) when compared to those patients with AcrysofSingle-Piece at 1 and 3 months and to baseline. Postoperative patient satisfaction showed no difference among the groups. CONCLUSION: The use of a new aspheric acrylic IOL may improve the quality of vision as a result of the reduction of total HOA and SA.
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Extracción de Catarata/métodos , Sensibilidad de Contraste/fisiología , Lentes Intraoculares , Satisfacción del Paciente , Complicaciones Posoperatorias/etiología , Trastornos de la Visión/etiología , Acrilatos , Anciano , Catarata/fisiopatología , Catarata/psicología , Método Doble Ciego , Femenino , Humanos , Implantación de Lentes Intraoculares/métodos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/fisiopatología , Estudios Prospectivos , Diseño de Prótesis , Errores de Refracción/fisiopatología , Trastornos de la Visión/fisiopatologíaRESUMEN
OBJETIVOS: Tanto la analgesia epidural torácica comola analgesia intravenosa con fentanilo controlada por elpaciente se han demostrado eficaces en los pacientespediátricos operados de pectus excavatum con la técnicade Nuss. En el presente estudio se analizan la eficacia yseguridad de ambas técnicas.MÉTODOS: Se analizaron retrospectivamente pacientespediátricos operados con la técnica de Nuss de pectusexcavatum entre octubre de 1997 y febrero de 2009. Seevaluaron peso, edad, sexo e índice de Haller. El dolor sevaloró cada 8 horas del 0 al 10 con la escala analógicavisual (EVA) o con la escala observacional LLANTO.Igualmente se registró la duración del tratamiento analgésicoen días. Finalmente se recogió la incidencia decomplicaciones del catéter o efectos secundarios del tratamientocomo náuseas, vómitos y depresión respiratoria.RESULTADOS: El estudio incluyó 31 pacientes distribuidosen 2 grupos: grupo EPI (n = 22) y grupo PCA(n = 9). No se observaron diferencias estadísticamentesignificativas entre ambos grupos en las variables demográficasestudiadas, en la incidencia de complicaciones oefectos secundarios, ni en las puntuaciones medias dedolor entre ambos grupos (grupo EPI 1,8 ± 3,8 frente agrupo PCA 2,1 ± 3,4; p = 0,775), pero sí en la duraciónen días de la necesidad de tratamiento analgésico (grupoEPI 2,9 ± 1,1 frente a grupo PCA 5,9 ± 1,4; p = 0,001).CONCLUSIONES: La analgesia epidural torácica tieneun perfil de eficacia y seguridad similar al de la analgesiaintravenosa con fentanilo controlada por el paciente,aunque permite acortar de un modo muy importante eltiempo de duración de la analgesia postoperatoria(AU)
BACKGROUND AND OBJECTIVE: Thoracic epiduralanalgesia and patient-controlled analgesia (PCA)with intravenous fentanyl have both been shown tobe effective in pediatric patients treated surgicallyfor pectus excavatum using the Nuss procedure. Wecompare the efficacy and safety of thesetechniques.METHODS: Retrospective study of pediatric cases inwhich the Nuss procedure was used to treat pectusexcavatum between October 1997 and February 2009.Weight, age, sex, and Haller index were analyzed. Painwas assessed every 8 hours on a visual analog scale of 0to 10 or on a scale based on observation of distress(LLANTO scale). Daily use of analgesics was alsorecorded. The incidence of catheter-relatedcomplications or adverse events of treatment such asnausea, vomiting, and respiratory depression were alsonoted.RESULTS: We identified 31 patients in 2 groups: theepidural group (n=22) and the PCA group (n=9).Demographic characteristics, the incidences ofcomplications or adverse events, and mean (SD) painscores (epidural group, 1.8 [3.8]; PCA group, 2.1 [3.4];P=.775) were statistically similar in the 2 groups.However, analgesic requirements and the duration ofanalgesic use in days differed significantly, at 2.9 (1.1)days in the epidural group and 5.9 (1.4) days in the PCAgroup (P=.001).CONCLUSIONS: The efficacy and safety of thoracicepidural analgesia is similar to that of PCA withintravenous fentanyl, although the use of epiduralanalgesia is associated with a markedly shorter durationof requirement for postoperative analgesia(AU)