Neurodevelopmental assessment of normocephalic children born to Zika virus exposed and unexposed pregnant people.

BACKGROUND: Studies examining the association between in utero Zika virus (ZIKV) exposure and child neurodevelopmental outcomes have produced varied results. METHODS: We aimed to assess neurodevelopmental outcomes among normocephalic children born from pregnant people enrolled in the Zika in Pregnancy in Honduras (ZIPH) cohort study, July-December 2016. Enrollment occurred during the first prenatal visit. Exposure was defined as prenatal ZIKV IgM and/or ZIKV RNA result at enrollment. Normocephalic children, >6 months old, were selected for longitudinal follow-up using the Bayley Scales of Infant and Toddler Development (BSID-III) and the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE-2). RESULTS: One hundred fifty-two children were assessed; after exclusion, 60 were exposed and 72 were unexposed to ZIKV during pregnancy. Twenty children in the exposed group and 21 children in the unexposed group had a composite score <85 in any of the BSID-III domains. Although exposed children had lower cognitive and language scores, differences were not statistically significant. For ASQ:SE-2 assessment, there were not statistically significant differences between groups. CONCLUSIONS: This study found no statistically significant differences in the neurodevelopment of normocephalic children between in utero ZIKV exposed and unexposed. Nevertheless, long-term monitoring of children with in utero ZIKV exposure is warranted. IMPACT: This study found no statistically significant differences in the neurodevelopment in normocephalic children with in utero Zika virus exposure compared to unexposed children, although the exposed group showed lower cognitive and language scores that persisted after adjustment by maternal age and education and after excluding children born preterm and low birth weight from the analysis. Children with prenatal Zika virus exposure, including those normocephalic and have no evidence of abnormalities at birth, should be monitored for neurodevelopmental delays. Follow-up is important to be able to detect developmental abnormalities that might not be detected earlier in life.

Evaluación de resultados de una encuesta de satisfacción del proceso editorial, Revista Médica Hondureña, 2016-2020 / Evaluation of results of a satisfaction survey of the editorial process, Revista Médica Hondureña, 2016-2020

Antecedentes: En el proceso editorial participan autores, editores, revisores pares y lectores, quienes contribuyen a la calidad de las publicaciones biomédicas. Objetivo: Evaluar los resultados de una encuesta de satisfacción dirigida a autores y revisores pares que participaron en el proceso editorial de la Revista Médica Hondureña (RMH), periodo 2016- 2020. Metodología: Análisis retrospectivo de los formularios completados en línea por autores y revisores pares, invitados a participar voluntariamente por correo electrónico durante diciembre 2020-julio 2021. La encuesta incluyó 16 preguntas que registraron características del proceso editorial y sugerencias de mejora. La satisfacción se clasificó en 5 categorías, de muy satisfecho a muy insatisfecho. Los resultados se presentan como frecuencias y porcentajes de las variables estudiadas. Resultados: Se analizaron 53 encuestas, completadas por 88.7% (47) autores y 11.3% (6) revisores pares. El 94.3% (50) describió como claras las instrucciones para autores, 77.4% (41) indicó haber recibido respuesta oportuna, 71.7% (38) recibió asesoría personalizada, 90.5% (48) describió como muy probable/probable su disposición a enviar artículos o colaborar como revisor par; algunas limitantes para participar fueron falta de tiempo e inexperiencia. El 69.8% (37) expresó estar muy satisfecho/satisfecho en comparación a 17.0% (9) que expresó insatisfacción con el proceso editorial. Discusión: En esta muestra limitada de usuarios, más de 2/3 expresó una percepción positiva y satisfacción con el proceso editorial. Es necesario impulsar la mejora continua de la RMH y promover el fortalecimiento del ecosistema de la investigación en el gremio médico y colaboradores en Honduras...(AU)

Microcephaly Outcomes among Zika Virus-Infected Pregnant Women in Honduras.

The impact of Zika virus (ZIKV) infection on pregnancies shows regional variation emphasizing the importance of studies in different geographical areas. We conducted a prospective study in Tegucigalpa, Honduras, recruiting 668 pregnant women between July 20, 2016, and December 31, 2016. We performed Trioplex real-time reverse transcriptase-PCR (rRT-PCR) in 357 serum samples taken at the first prenatal visit. The presence of ZIKV was confirmed in seven pregnancies (7/357, 2.0%). Nine babies (1.6%) had microcephaly (head circumference more than two SDs below the mean), including two (0.3%) with severe microcephaly (head circumference [HC] more than three SDs below the mean). The mothers of both babies with severe microcephaly had evidence of ZIKV infection. A positive ZIKV Trioplex rRT-PCR was associated with a 33.3% (95% CI: 4.3-77.7%) risk of HC more than three SDs below the mean.

Measurement of Head Circumference: Implications for Microcephaly Surveillance in Zika-Affected Areas.

Worldwide recognition of the Zika virus outbreak in the Americas was triggered by an unexplained increase in the frequency of microcephaly. While severe microcephaly is readily identifiable at birth, diagnosing less severe cases requires comparison of head circumference (HC) measurement to a growth chart. We examine measured values of HC and digit preference in those values, and, by extension, the prevalence of microcephaly at birth in two data sources: a research study in Honduras and routine surveillance data in Uruguay. The Zika in Pregnancy in Honduras study enrolled pregnant women prenatally and followed them until delivery. Head circumference was measured with insertion tapes (SECA 212), and instructions including consistent placement of the tape and a request to record HC to the millimeter were posted where newborns were examined. Three indicators of microcephaly were calculated: (1) HC more than 2 standard deviations (SD) below the mean, (2) HC more than 3 SD below the mean (referred to as "severe microcephaly") and (3) HC less than the 3rd percentile for sex and gestational age, using the INTERGROWTH-21st growth standards. We compared these results from those from a previous analysis of surveillance HC data from the Uruguay Perinatal Information System (Sistema Informático Perinatal (SIP). Valid data on HC were available on 579 infants, 578 with gestational age data. Nine babies (1.56%, 95% CI 0.71-2.93) had HC < 2SD, including two (0.35%, 95% CI 0.04-1.24) with HC < 3SD, and 11 (1.9%, 95% CI, 0.79-3.02) were below the 3rd percentile. The distribution of HC showed strong digit preference: 72% of measures were to the whole centimeter (cm) and 19% to the half-cm. Training and use of insertion tapes had little effect on digit preference, nor were overall HC curves sufficient to detect an increase in microcephaly during the Zika epidemic in Honduras. When microcephaly prevalence needs to be carefully analyzed, such as during the Zika epidemic, researchers may need to interpret HC data with caution.

TLR4 Expression by Liver Resident Cells Mediates the Development of Glucose Intolerance and Insulin Resistance in Experimental Periodontitis.

BACKGROUND: Results from epidemiological studies indicate a close association between periodontitis and type 2 diabetes mellitus. However, the mechanism linking periodontitis to glucose intolerance (GI) and insulin resistance (IR) is unknown. We therefore tested the hypothesis that periodontitis induces the development of GI/IR through a liver Toll-like receptor 4 (TLR4) dependent mechanism. METHODS: TLR4 chimeric mice were developed by bone marrow transplantation using green fluorescent protein expressing TLR4WT mouse (GFPWT) as donor and TLR4 WT or TLR4-/- as recipient mice (GFPWT:WT and GFPWT:KO chimeras respectively). These chimeras were subjected to experimental chronic periodontitis induced by repeated applications of LPS to the gingival sulci for 18 weeks. The levels of GI/IR were monitored and plasma cytokines and LPS were determined at 18 weeks when differences in glucose tolerance were most apparent. Cytokine gene expression was measured in liver tissue by qPCR. RESULTS: Alveolar bone loss was significantly greater in GFPWT:WT chimeras treated with LPS compared with chimeras treated with PBS or GFPWT:KO chimeras. However, the degree of gingival inflammation was similar between GFPWT:WT and GFPWT:KO mice with LPS application. Severe GI/IR occurred in GFPWT:WT chimeras but not in the GFPWT:KO chimeras that were subjected to 18 weeks of LPS. Serum LPS was detected only in animals to which LPS was applied and the level was similar in GFPWT:WT and GFPWT:KO mice at the 18 week time point. Surprisingly, there was no significant difference in the plasma levels of IL1ß, IL6 and TNFα at 18 weeks in spite of the severe GI/IR in the GFPWT:WT chimeras with LPS application. Also, no difference in the expression of TNFα or IL6 mRNA was detected in the liver of GFPWT:WT vs GFPWT:KO mice. In contrast, liver IL1ß expression was significantly greater in GFPWT:WT chimeras compared to GFPWT:KO chimeras treated with LPS. CONCLUSION: We observed that GFPWT:WT, but not GFPWT:KO chimeras, treated with LPS developed GI/IR despite similar degrees of gingival inflammation, circulating cytokine levels, and LPS concentrations. We conclude that LPS from periodontitis sites has a pivotal role in triggering the development of GI/IR through a mechanism that involves TLR4 expression by resident macrophages/Kupffer cells in the liver.

A laparoscopic-sutured gastropexy technique in dogs: mechanical and functional evaluation.

OBJECTIVE: To describe a laparoscopic-sutured gastropexy technique in dogs and evaluate the tensile strength of the adhesion and effects on gastric function. STUDY DESIGN: Experimental study. ANIMALS: Female beagle dogs (n=7). METHODS: A laparoscopic-sutured gastropexy technique was evaluated by ex vivo tensile distraction tests 10 weeks after surgery. The effect of the adhesion on gastric emptying, mucosal permeability, and systemic inflammation were evaluated by monitoring the C-reactive protein (CRP) and sucrose permeability, and by radiographic evaluation of gastric emptying 2 weeks before and 10 weeks after surgery. RESULTS: Mean (+/-SD) tensile force to disrupt adhesions was 51.1+/-16.4 N. There was no significant postoperative increase in CRP concentration or change in sucrose permeability. The area under the curve representing the postprandial decrease in gastric radiographic area increased by 11% after gastropexy. CONCLUSIONS: This laparoscopic gastropexy technique had appropriate mechanical and functional characteristics with limited morbidity. CLINICAL RELEVANCE: This laparoscopic-sutured gastropexy provides adhesion strength comparable with other gastropexy techniques tested at 10 weeks postoperatively. Only minor changes in gastric emptying were observed 10 weeks after surgery.

Kinetic analysis of 5 sugar probes in dog serum after orogastric administration.

The objective of this study was to describe the kinetics of orally administered sugar probes in serum for the assessment of gastrointestinal permeability and intestinal absorptive capacity in dogs. Eight healthy dogs received lactulose (L), rhamnose (R), methylglucose (M), xylose (X), and sucrose (S) by orogastric intubation. Baseline blood samples and subsequently timed blood samples were taken during 24 hours. Sugars were analyzed by gas chromatography-mass spectrometry (GC-MS). Statistical analysis was performed using a Friedman test with Dunn's multiple comparison post test and a Kruskal-Wallis test. Statistical significance was set at a P-value < 0.05. Sugars in serum were detected after orogastric administration. Concentrations of L and R were significantly different from the baseline from 90 to 240 and 60 to 300 min, respectively, and those of X, M, and S were different from 30 to 240 min post-dosing (P < 0.05 for all 5 probes). Maximum concentrations of L and R were obtained at 180 min, while X, M, and S reached their maximum concentrations at 90 min post-dosing. For all sugars, no statistically significant differences were found between concentrations at 90, 120, and 180 min or between the coefficients of variation (CV%) of those mean concentrations for these 3 time points. Based on these data, the collection of 2 blood samples, one taken at baseline and the other obtained between 90 and 180 minutes after dosing, might be sufficient for the determination of gastrointestinal permeability and mucosal absorptive capacity using these 5 sugar probes in canine serum.

Development and analytic validation of a gas chromatography-mass spectrometry method for the measurement of sugar probes in canine serum.

OBJECTIVE: To develop and analytically validate a gas chromatography-mass spectrometry (GC-MS) method for the quantification of lactulose, rhamnose, xylose, 3-O-methylglucose, and sucrose in canine serum. SAMPLE POPULATION: Pooled serum samples from 200 dogs. Procedures-Serum samples spiked with various sugars were analyzed by use of GC-MS. The method was analytically validated by determination of dilutional parallelism, spiking recovery, intra-assay variability, and interassay variability. RESULTS: Standard curves ranging from 0.5 to 500 mg/L for each sugar revealed a mean r(2) of 0.997. The lower detection limit was 0.03 mg/L for lactulose, rhamnose, xylose, and methylglucose and 0.12 mg/L for sucrose. The observed-to-expected ratios for dilutional parallelism had a mean +/- SD of 105.6 +/- 25.4% at dilutions of 1:2, 1:4, and 1:8. Analytic recoveries for the GC-MS assays of sugars ranged from 92.1% to 124.7% (mean +/- SD, 106.2 +/- 13.0%). Intra-assay coefficients of variation ranged from 6.8% to 12.9% for lactulose, 7.1% to 12.8% for rhamnose, 7.2% to 11.2% for xylose, 8.9% to 11.5% for methylglucose, and 8.9% to 12.0% for sucrose. Interassay coefficients of variation ranged from 7.0% to 11.5% for lactulose, 6.4% to 9.4% for rhamnose, 6.8% to 13.2% for xylose, 7.0% to 15.9% for methylglucose, and 5.5% to 9.4% for sucrose. CONCLUSIONS AND CLINICAL RELEVANCE: The GC-MS method described here was accurate, precise, and reproducible for the simultaneous measurement of sugar probes in canine serum.

Acerca del trabajo en grupos o equipos / The work in groups or teams

Se definen, caracterizan y comparan los grupos y equipos de trabajo. Se señalan las características y funciones que convierten gradual y paulatinamente un grupo en un equipo de trabajo. Se señalan las ventajas y desventajas de cada uno de ellos, tanto para los individuos como para las organizaciones. Se analizan algunas variables estructurales, las normas para la formación de los equipos, las características esenciales y las funciones que desempeñan sus miembros. Se anexa una lista con las características fundamentales, funciones, fortalezas y debilidades de los diferentes papeles que desempeñan los miembros en el equipo de trabajo, así como dos herramientas para su medición

Publicaciones electrónicas. Experiencias de una entidad del sector de la salud

La revolución que representa el proceso de publicación electrónica ha despertado una polémica en torno a las ventajas y desventajas de éstas con respecto a las publicaciones en papel. Aspectos tales como la posible ausencia de arbitraje de los trabajos científicos, la paternidad incierta de algunos de ellos, las tergiversaciones o malinterpretaciones posibles de la información electrónica, la comodidad y facilidad real de los lectores para consultar la información, entre muchos otros, se contraponen a ventajas que radican en las potencialidades de las publicaciones electrónicas para compartir y expandir rápidamente información actualizada a amplios mercados y las amplias posibilidades de hipermedia que muchas de ellas ofrecen. Estas cuestiones también se analizan brevemente desde la óptica de la Unidad de Análisis y Tendencias en Salud, entidad del Ministerio de Salud Pública de Cuba, que ha comenzado ha insertarse en el entorno de la publicación electrónica.

The revolution that represents the process of electronic publishing has arose a controversy regarding its advantages and disadvantages compared to printed publications. Issues such as the possible absence of scientific paper screening, the uncertain paternity of some of them, the likely misinterpretations or distortion of the electronic information, the actual convinience and easiness of readers to consult the information, among others, are opposed to the advantages that reside on the potentialities of electronic publishing to quickly share and spread updated information towards wide markets and the broad possiblities of hypermedia that offer a lot of them. These ideas are briefly analized from the point of view of the Analysis and Trends Unit in Health, entity belonging to the Ministry of Public Health which has begun to insert itself in the environment of electronic publishing.

Prevalencia de anemia nutricional de mujeres en edad fertil de un área de salud / Prevalence of the anemia nutritional of the women in age fertility in the health area

Se estudiaron 79 mujeres en edad fértil con el objeto de conocer la prevalencia de anemia nutricional. Las anémicas recibieron tratamiento de acuerdo con la carencia encontrada. La causa fundamental de la anemia fue la deficiencia de hierro. Se halló correlación significativa de la ferritina sérica y del índice de saturación, con las características demográfico-sociales; y de la hemoglobina y la protoporfirina eritrocitaria libre, con los días de duración de la menstruación. El promedio de estos últimos fue significativamente más alto en las mujeres anémicas. El grupo tratado incrementó significativamente las cifras de hemoglobina e índice de saturación y disminuyó la protoporfirina eritrocitaria libre

Repercusión de la anemia ligera por deficiencia de hierro sobre el desarrollo psicomoto en niños de 6 a 19 meses de edad / Repercusion of mild anemia due to iron deficiency upon psychomotor development in children 6-19 months of age

Se evaluaron 90 niños saludables entre 6 y 19 meses de edad, con el objeto de conocer la relación de la anemia por deficiencia de hierro con el desarrollo psicomotor. Se clasificaron en deficientes según el número de indicadores de la deficiencia de hierro alterados, y se hallaron valores promedio del índice mental significativamente más bajos en el grupo deficiente. No se encontró correlación significativa del nivel socioeconómico y cultural con el índice mental ni el índice motro. Se hallaron correlaciones significativas del índice mental con la hemoglobina y del índice mental con la protoporfirina eritrocitaria libre. Se concluye que las alteraciones del índice mental halladas en el presente estudio plantean, con una elevada probabilidad, la influencia de la deficiencia de hierro, dada en una de las muestras más numerosas y con anemia con deficiencia de hierro más ligera informada hasta el presente, después de descartar la presencia de otras carencias nutricionales, así como de un grupo de factores demográficos, sociales y del estado de salud

Estudio interlaboratorio de control de calidad de las hemoglobinas en hospitales de Ciudad de La Habana / Interlaboratory study on hemoglobin quality control in hospitals in Havana City

Se realizó un estudio de control de calidad externo en 33 laboratorios de los hospitales de Ciudad de La Habana con 2 juegos de hemolisados controles de diferentes concentraciones, para la determinación del nivel dehemoglobina en las condiciones habituales de trabajo y en condiciones experimentales , con reactivo, patrón y material entregado. Se encontraron diferencias significativas en los valores de hemolisados de acuerdo con el tipo de equipo empleado, así como la estabilidad de la corriente eléctrica que éste recibe. Los resultados del nivel de destreza alcanzado por los laboratorios demuestran el carácter satisfactorio del conjunto

Estudio preliminar interlaboratorio para la estandarización de la determinación de transferrina sérica por inmunodifusión radial simple / Preliminary interlaboratory study for the standardization of serum transferrin determination by simple radial immunodifusion

En 9 laboratorios se distribuyeron 4 sueros controles con valores altos, normales y bajos de transferrina, conjuntamente con los reactivos, patrones y accesorios necesarios para su medición con una técnica de inmunodifusión radial simple que utiliza transferrina y antisuero contra la misma, producidos en nuestros laboratorios. Se evaluó el valor diagnóstico de los resultados obtenidos y se analizó el funcionamiento de estos laboratorios. Estos resultados muestran la posibilidad de generalizar esta técnica, mediante un entrenamiento del personal sin experiencia previa en su ejecición, así como la necesidad de realizar controles interlaboratorios periódicos para incrementar la calidad de los resultados de los laboratorios participantes

Valores de referencia de ferritina en hombres y mujeres / Ferritin reference of valves in males and femeles

Se desarrolló un enzimo-inmunoensayo para cuantificar ferritina sérica. La IgG antiferritina humana se adsorbió sobre las placas de polivinilcloruro y se utilizó como agente cromógeno un conjugado de IgG antiferritina-peroxidasa. El rango de valores obtenido por el ensayo fue entre 5 y 500 *g/L con una sensibilidad de 1 *g/L. Los coeficientes de variación intra y entre experimentos fueron similares a los comunicados para enzimo-inmunoensayos comerciales. El coeficiente de correlación obtenido entre los resultados con el método desarrolado y los de un radioinmunoensayo comercial fue de 0,974. Los valores promedios de ferritina en hombres y mujeres normales fueron 33 *g/L y 80 *g respectivamente

Distribución de probabilidades de las variables más importantes para el diagnóstico de las anemias nutricionales / Distribution of probabilities of the most important variables for the diagnosis of nutricional anemias

Se analizaron los resultados de los indicadores de laboratorio más importantes para el estudio de las anemias nutricionales, en 135 niños entre 6 y 19 meses de edad, con el objetivo de conocer la distribución de probabilidades de estas variables y comprobar las ventajas del empleo de los procedimientos estadísticos de acuerdo con las caracterìsticas de estas distribuciones. Se encontró que las variables hemoglobina, hematócrito, concentración de hemoglobina corpuscular media y capacidad total de unión con el hierro, admitieron la distribución normal como modelo probabilístico aceptable, mientrasque el hierro sérico, el índice de saturación de la transferrina, la protoporfirina eritrocitaria libre, la ferritina sérica, el folato sérico, el folato eritrocitario y la vitamina B12 sérica se ajustaron a una distribución logarítmica noraml. Se comprobaron las ventajas del empleo de los logaritmos de la ferritina en relación con los valores originales para detectar diferencias entre deficientes y no deficientes de hierro, así como para el cálculo del coeficiente de correlación de esta variable con la hemoglobina