Prehospital SALAD Airway Technique in an Adolescent with Penetrating Trauma Case Report.

We present a case of an adolescent patient with a penetrating gunshot wound to the mouth requiring endotracheal intubation via rapid sequence intubation in the prehospital setting. The team used video laryngoscopy (VL) to secure the airway; however, continuous bloody secretions increased the complexity of the procedure and required the application of the Suction-Assisted Laryngoscopy and Airway Decontamination (SALAD) method to facilitate intubation. By utilizing the SALAD procedure, the field of view on the VL camera remained unobscured, and the patient's airway remained clear, allowing for an uneventful intubation procedure. No episodes of hypoxia, hypotension, bradycardia, or obvious clinical signs of pulmonary aspiration occurred during the procedure. The patient was transported to a local Pediatric Level I trauma center, where he underwent emergent surgery to repair an esophageal laceration and was discharged to home 40 days later. This case highlights the importance of deliberate and proactive management of the contaminated airway in the prehospital setting. The SALAD technique replaces the Yankauer suction catheter with a larger bore suction catheter in conjunction with VL to perform gross decontamination of the mouth and airway before attempting intubation. This is followed by permanently placing the large bore suction catheter under constant suction in the posterior pharynx or esophagus to keep the VL camera unobscured by vomit or blood to facilitate intubation. After the intubation, the suction catheter may be removed unless ongoing suction is required. Keeping the VL camera unobscured during the procedure may improve first-pass intubation success rate.

HPLC Analysis of Polyphenols Derived from Hungarian Aszú from Tokaj Wine Region and Its Effect on Inflammation in an In Vitro Model System of Endothelial Cells.

Many studies have been published in recent years regarding the fact that moderate wine consumption, as a part of a balanced diet can have a beneficial effect on human health. The biologically active components of wine continue to be the subject of intense research today. In this study, the bioactive molecules of Hungarian aszú from the Tokaj wine region were analyzed using high-performance liquid chromatography (HPLC) and investigated in an in vitro model system of endothelial cells induced by bacterial-derived lipopolysaccharide. The HPLC measurements were performed on a reversed phased column with gradient elution. The non-cytotoxic concentration of the active substance was determined based on 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide (MTT)-, apoptosis, and necrosis assays. The antioxidant effect of the extract was determined by evaluating its ability to eliminate ROS. The expressions of the interleukin-(IL)1α, IL1-ß, IL-6, and IL-8 pro-inflammatory cytokines and nitric oxide synthase (eNOS) at the mRNA level were evaluated using a quantitative polymerase chain reaction (qPCR). We found that the lipopolysaccharides (LPS)-induced increases in the expressions of the investigated cytokines were significantly suppressed by Hungarian aszú extract, excluding IL-6. In our experimental setup, our treatment had a positive effect on the eNOS expression, which was impaired as a result of the inflammatory manipulation. In our experimental model, the Hungarian aszú extract decreased the LPS-induced increases in the expression of the investigated cytokines and eNOS at the mRNA level, which presumably had a positive effect on the endothelial dysfunction caused by inflammation due to its strong antioxidant and anti-inflammatory effects. Collectively, this research contributes to a more thorough understanding of the bioactive molecules of aszú from the Tokaj wine region.

Conocimientos y prácticas de odontología preventiva en odontólogos en México.

No disponible.

Developing creative and research skills through an open and interprofessional inquiry-based learning course.

BACKGROUND: Biomedicine needs innovative professionals. Inquiry-based learning (IBL) aims to develop higher order thinking skills, such as creativity and research. Stimulatory techniques and interprofessional education, which requires students from different fields to collaborate, also enhances creativity. In this study, the effectiveness of an interprofessional IBL course that introduces a creativity workshop based on stimulatory techniques to develop creative and research skills is examined. METHODS: 529 undergraduate human biology and medical students performed the interprofessional IBL course, 198 with the creativity workshop and 331 without. Students' perceptions of learning processes and outcomes were assessed in surveys and focus groups by the authors of this study. As well, the final learning results from both groups of students were analyzed by the teachers of the course and the researchers. RESULTS: The results show that the open IBL approach promoted the development of these skills, interprofessionality acted as a creativity enhancer and stimulatory techniques contributed to improve the learning outcomes. CONCLUSIONS: This study provides insight into how open interprofessional IBL fosters acquisition of complex skills and knowledge, pointing out the benefits and limitations of this approach in health sciences studies.

Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Mexican Schoolchildren.

Objective: To evaluate the impact of Molar Incisor Hypomineralization (MIH) in the OHRQoL in a group of 8 to 10 year-old Mexican schoolchildren. Study design: A cross-sectional study of 411 8 to 10 year-old schoolchildren selected from public schools in Naucalpan, in the State of Mexico. The presence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry (EAPD) criteria. The OHRQoL was evaluated using the Child Perceptions Questionnaire (CPQ). Poisson regression models were performed for the analysis. Results: The prevalence of MIH in the permanent dentition was 40.4%. High scores were found in the four domains of the CPQ for children with MIH compared to children without MIH (p<0.001). In the Poisson model, a greater negative impact in the four CPQ domains was found for schoolchildren with MIH: oral symptoms [RR=1.75 (CI95% 1.63-1.78)]; functional limitations [RR=2.17 (CI95% 2.01-2.35)]; emotional wellbeing [RR=1.94 (CI95% 1.80-2.08)]; and, social well-being [RR=2.62 (CI95% 2.49-2.77)]. A greater impact on the four CPQ domains were found for children with moderate/severe MIH compared to children without MIH (p<0.001). Conclusion: Children with moderate/severe MIH experienced a greater negative impact on their OHRQoL compared to children without MIH.

Molar-Incisor Hypomineralization Is Associated with the Prevalence of Thinness among Schoolchildren in Communities with Different Fluoride Levels in the Drinking Water.

Objective: To examine the association between molar-incisor hypomineralization (MIH) and the prevalence of thinness among Mexican schoolchildren in communities with different fluoride levels in the drinking water. Methods: A cross-sectional study on Mexican children (n = 488) selected from two communities presenting different concentrations of fluoride in the drinking water (1.0-1.40 ppm/F). The World Health Organization (WHO) growth standards were used to calculate BMI-for-age z-scores, with BMI z-score cutoff points of <-2.0, >+1.0, >+2.0 recommended for defining thinness, being overweight, and obesity. The presence and severity of MIH were evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria. Multiple logistic regression analyses were used to assess the association, adjusting for confounders. Results: The proportion of children presenting thinness, being overweight, and obesity was 8.2%, 23.6%, and 28.7%, respectively, while 21.5% of the schoolchildren had MIH, classified, by severity, as 9.6% mild, 6.4% moderate, and 5.5% severe. Of those schoolchildren presenting thinness, 16.2% had MIH, and only 6.0% did not (p < 0.001). Finally, schoolchildren presenting thinness were more likely to present MIH (OR = 2.76 (CI 95% 1.33-5.73); p=0.006) than children with a normal BMI. Conclusion: The present study found a relationship between thinness and the presence of MIH in schoolchildren, indicating the need for strategies and interventions aimed at preventing and controlling micronutrient deficiencies in the child population.

Quantifying Decay Due to Wet Atmospheric Deposition on Basalt.

The study of building materials is important for a better conservation of built heritage. Worldwide, volcanic stones (including basalt, andesite and dacite) are among the least studied building materials. In this research, the decay of a red basalt due to wet atmospheric deposition was studied. Red basalt was exposed to artificial rain solutions, prepared from rain samples collected weekly from 2014-2019. In this research, the decay of stone-built heritage was indirectly studied emulating wet atmospheric accelerated weathering under three different volume weighted mean (VWM) compositions: global, acid and no-acid categories. Lixiviates were analyzed to better understand the deterioration mechanisms taking place inside the material. Decay was quantified as mass difference, water absorption capacity (WAC) and open porosity (OP) changes. Results show that the methodology used is suitable to research the decay of built heritage. The studied basalt is indeed prone to decay by wet atmospheric deposition. The main decay mechanisms are the washing of insoluble compounds, dissolution of minerals, salt crystallization and cation exchange. WAC and OP showed promising results of their appropriateness as monitoring variables of decay in situ. Acid conditions produce the most severe decay, but Ph effect is not as important as precipitation volume. Non-linear equations relating volume of precipitation with mass difference in red basalt are presented.

Relationships between dental fluorosis and fluoride concentrations in bottled water and groundwater in low-income children in Mexico.

Introduction: The aim of the current study was to investigate associations between dental fluorosis in children living in low socioeconomic areas in Mexico, and fluoride concentrations in tap water, fluoride concentrations and in bottled water, and body mass index (BMI). Methods: A cross-sectional study involving 585 schoolchildren aged 8-12 years was conducted in communities in a southern state of Mexico with >0.7 parts per million (ppm) fluoride in the groundwater. The Thylstrup and Fejerskov index (TFI) was used to evaluate dental fluorosis, and the World Health Organization growth standards were used to calculate age-adjusted and sex-adjusted BMI Z-scores. A BMI Z-score ≤ -1 SD was used as the cut-off point for thinness, and multiple logistic regression models for dental fluorosis (TFI ≥ 4) were constructed. Results: The mean fluoride concentration in tap water was 1.39 ppm (SD 0.66), and the mean fluoride concentration in bottled water was 0.32 ppm (SD 0.23). Eighty-four children (14.39%) had a BMI Z-score ≤ -1 SD. More than half (56.1%) of the children presented with dental fluorosis in TFI categories ≥ 4. Children living in areas with higher fluoride concentrations in the tap water [odds ratio (OR) 1.57, p = 0.002] and bottled water (OR 3.03, p < .001) were more likely to have dental fluorosis in the severe categories (TFI ≥ 4). BMI Z-score was associated with the probability of dental fluorosis (TFI ≥ 4; OR 2.11, p < 0.001), and the effect size was 29.3%. Discussion: A low BMI Z-score was associated with a higher prevalence of dental fluorosis in the severe category. Awareness of the fluoride concentrations in bottled water may help prevent dental fluorosis, particularly in children exposed to several high fluoride content sources. Children with a low BMI may be more vulnerable to dental fluorosis.

Association Between Self-Reported Health and Education with Past-year Dental Visits among Older Mexican Adults: Results of the Mexican Health and Aging Study 2018.

PURPOSE: To explore the relationship between of self-reported health (SRH) and educational attainment with pastyear dental visits in older adults in México. MATERIALS AND METHODS: For this cross-sectional study, data were derived from the Mexican Health and Aging Study 2018 (MHAS-2018), which used a nationally-representative sample of older adults (50 years or older) in Mexico (n = 14,085). Variables taken from the MHAS questionnaire included residence (rural/urban), years of education, SRH, multimorbidity, pain severity, and past-year dental visits. A logistic regression model was used to identify the association between the variables and past-year dental visits. RESULTS: While the percentage of past-year dental visits reported was 39.8%, this number declined with age [OR=0.76, p < 0.001], with older adults living in rural areas 34% less likely to report past-year dental visits than older adults living in urban areas. Older adults with no formal education were 73% less likely (OR=0.27; p < 0.001) to report past-year dental visits than older adults ≥10 years education. Older adults with poor SRH were 32% less likely (OR=0.68; p < 0.001) to report past-year dental visits than older adults with good/very good/excellent SRH. Sex, degree of multimorbidity, and pain level ([OR=1.37; p < 0.001] [OR=1.37; p < 0.001] and [OR=1.17; p < 0.001]) were all found to be positively associated with past-year dental visits in the study population. CONCLUSION: The present study highlights the association between poor SRH, a low level of educational attainment, and less frequent past-year dental visits, as well as the finding that past-year dental visits declined with age in the older adults sampled.

Association between sociodemographic factors and noncavitated and cavitated caries lesions in 8- to 12-year-old Mexican schoolchildren.

ABSTRACT: The aim of this study was to evaluate the association between sociodemographic factors and noncavitated and cavitated caries lesions in Mexican schoolchildren.This cross-sectional study was conducted in 2020 on 8-to-12-year-old schoolchildren of different socioeconomic status (SES). The caries was evaluated using ICDAS II, SES was evaluated using three categories---a high, middle, or low-income level---of the CONAPO. Multinomial logistic regression analyses were performed in order to ascertain the associations between socioeconomic factors and noncavitated and cavitated caries lesions.The prevalence of noncavitated lesions was 38.0% and cavitated lesions was 43.4% in permanent dentition. In all the samples, 50.6% of schoolchildren had poor oral hygiene. About 52.5% of the mothers and 64.7% of the fathers had less than 9 years of education. Schoolchildren with a low-income level have more cavitated lesions (ICDAS II 4-6) than schoolchildren with high-income level (56.3% vs 15.8%, P = .009). The multinomial logistic regression models showed that mother's level of education <9 years and low-income level were significantly associated with cavitated caries lesions (ICDAS II 4-6), [odds ratio = 1.79 (1.17 - 2.75); P = .007], [OR = 2.21 (1.23 - 3.97); P = .008], respectively. The socioeconomic level was not associated with noncavitated caries lesions (ICDAS II 1-3).An association was found between the presence of cavitated caries lesions and the subject's mother's level of education and a low-income level. Socioeconomic factors were found to be associated with inequalities in caries distribution in the age group studied.

Infecciones fúngicas invasivas en niños hospitalizados en un centro de referencia de Uruguay / Invasive fungal infections in children hospitalized at a pediatric reference hospital in Uruguay / Infecções fúngicas invasivas em crianças internadas em um centro hospitalar de referência no Uruguai

Introducción: las infecciones fúngicas invasivas (IFI) son un problema de salud en creciente aumento. Objetivo: describir las características epidemiológicas, microbiológicas y clínicas de los menores de 15 años con IFI hospitalizados en el Hospital Pediátrico, Centro Hospitalario Pereira Rossell entre 2010- 2019. Metodología: estudio retrospectivo, mediante revisión de historias clínicas. Variables: edad, sexo, comorbilidades, factores de riesgo, clínica, patógenos, tratamiento y evolución. Resultados: se registraron 26 casos de IFI en 23 niños. La mediana de edad fue 8 años, de sexo femenino 17, con comorbilidades 17: infección por VIH 5, enfermedad hematooncológica 4. Todos presentaban factores de riesgo para IFI. Las manifestaciones clínicas de sospecha fueron: fiebre en 19, síntomas neurológicos 11, respiratorios 9, gastrointestinales 6, urinarios 2, sepsis/shock en 3. Los agentes identificados fueron: Candida spp en 14, Cryptococcus neoformans complex 8 y Aspergillus fumigatus complex 4. Tratamiento: se indicó fluconazol en 15, asociado a anfotericina B 11. Todas las infecciones por candida fueron sensibles a los azoles. Fallecieron 7 niños, la mediana de edad fue 1 año. En 4 se identificó Candida spp, Aspergillus fumigatus complex 2 y Cryptococcus neoformans complex 1. Conclusiones: las IFI son poco frecuentes, afectan en su mayoría a niños inmunocomprometidos asociando elevada mortalidad. El diagnóstico requiere alto índice de sospecha. Candida spp y Cryptococcus spp fueron los agentes más involucrados. El inicio precoz del tratamiento acorde a la susceptibilidad disponible se asocia a menor mortalidad.

Summary: Introduction: invasive fungal infections (IFI) are an increasing health problem. Objective: describe the epidemiological, microbiological and clinical characteristics of children under 15 years of age with IFI hospitalized at the Pereira Rossell Hospital Center between 2010-2019. Methodology: retrospective study, review of medical records. Variables: age, sex, comorbidities, risk factors, symptoms, pathogens, treatment and evolution. Results: 26 cases of IFI were recorded involving 23 children. Median age 8 years, female 17, comorbidities 17, HIV infection 5, hematological-oncological disease 4. All with risk factors. Suspicion symptoms: fever 19, neurological symptoms 11, respiratory 9, gastrointestinal 6, urinary 2, sepsis / shock 3. Identified agents: Candida spp 14, Cryptococcus neoformans complex 8 and Aspergillus fumigatus complex 4. Treatment: fluconazole 15, associated with amphotericin B 11. All candida infections were sensitive to azoles. 7 died, median age 1 year. In 4, Candida spp was isolated, Aspergillus fumigatus complex in 2 and Cryptococcus neoformans complex in 1. Conclusions: IFI are rare, mostly affecting immunocompromised children, associated with high mortality. The diagnosis requires a high index of suspicion. Candida spp and Cryptococcus spp were the most involved agents. Early treatment according to available susceptibility is associated with lower mortality.

Introdução: as infecções fúngicas invasivas (IFI) são um problema de saúde crescente. Objetivo: descrever as características epidemiológicas, microbiológicas e clínicas de crianças menores de 15 anos com IFI internadas no Centro Hospitalar Pereira Rossell entre 2010 e 2019. Metodologia: estudo retrospectivo, revisão de prontuários. Variáveis: idade, sexo, comorbidades, fatores de risco, sintomas, patógenos, tratamento e evolução. Resultados: foram registrados 26 casos de IFI em 23 crianças. Idade mediana 8 anos, sexo feminino 17, comorbidades 17, infecção por HIV 5, doença hemato-oncológica 4. Todos com fatores de risco. Suspeita clínica: febre 19, sintomas neurológicos 11, respiratórios 9, gastrointestinais 6, urinários 2, sepse/choque 3. Agentes identificados: Candida spp 14, Cryptococcus neoformans complexo 8 e Aspergillus fumigatus complexo 4. Tratamento: fluconazol 15, associado à anfotericina B 11. Todas as infecções por cândida foram sensíveis aos azóis. 7 morreram, idade média de 1 ano. Em 4 das crianças Cândida spp foi isolada, Aspergillus fumigatus complexo em 2 e Cryptococcus neoformans complexo em 1. Conclusões: IFIs são raras, afetando principalmente crianças imunocomprometidas, associadas a alta mortalidade. O diagnóstico requer alto índice de suspeita. Cândida spp e Cryptococcus spp são os agentes mais envolvidos. O tratamento precoce de acordo com a suscetibilidade disponível está associado a menor mortalidade.

Inteligencias múltiples como estrategia para la Educación Física: una intervención didáctica durante la pandemia

El objetivo de esta investigación es conocer cómo afecta la aplicación de las inteligencias múltiples, a modo de estrategia de enseñanza, en el desarrollo de las capacidades cognitivo-motrices y las actitudes socioafectivas en la asignatura de Educación Física durante la pandemia. El enfoque de este estudio fue cuantitativo- cualitativo, con un diseño experimental. Para esto, se propuso un taller de capacitación sobre inteligencias múltiples y se le aplicó, como estrategia de aprendizaje, a un docente de Educación Física de séptimo grado en una institución privada de la ciudad de Quito, implementando este conocimiento en las clases del paralelo A como grupo experimental. En la evaluación, se observó que existe un mejor nivel de aprendizaje en este grupo experimental, en comparación con el grupo de control. Como conclusión, se debe señalar que los docentes de Educación Física deben incluir las inteligencias múltiples como una estrategia de aprendizaje en las planificaciones y evaluaciones debido a la mejora en los procesos educativos. Esta propuesta permite el trabajo cooperativo, la integración y la inclusión, además, esto favorece el ritmo y la forma de aprender de los estudiantes a través de la ejecución de actividades de tipo cognitivas, sociales, afectivas y motrices. Estas inteligencias mejoran el aprendizaje y generan en los estudiantes la autonomía de la actividad física para la vida, en la práctica.

O fim desta investigação é descobrir como a aplicação de inteligências múltiplas, como estratégia de ensino, afecta o desenvolvimento de competências cognitivo-motoras e atitudes sócio afetivas no tema da Educação Física durante a pandemia. A aproximação deste estudo foi quantitativa-qualitativa, com um desenho experimental. Para este efeito, foi proposta uma oficina de formação sobre inteligências múltiplas e aplicada como estratégia de aprendizagem para um professor de Educação Física do sétimo ano de uma instituição privada na cidade de Quito, implementando estes conhecimentos em aulas paralelas A como um grupo experimental. Na avaliação, observou-se que existe um melhor nível de aprendizagem neste grupo experimental em comparação com o grupo de controlo. Em conclusão, é de notar que os docentes de Educação Física devem incluir múltiplas inteligências como estratégia de aprendizagem no planeamento e avaliações devido à melhora dos processos educativos. Esta proposta permite o trabalho cooperativo, integração e inclusão, bem como favorecer o ritmo e a forma de aprendizagem dos estudantes através de atividades cognitivas, sociais, afetivas e motoras. Estas inteligências melhoram a aprendizagem e geram nos estudantes a auto segurança da atividade física para a vida, na prática.

The objective of this research is to know how the application of multiple intelligences, as a teaching strategy, affects the development of cognitive-motor skills and socio-affective attitudes in the subject of Physical Education during the pandemic. The approach of this study was quantitative-qualitative, with an experimental design. For this, a training workshop on multiple intelligences was proposed and applied, as a learning strategy, to a seventh grade Physical Education teacher in a private institution in the city of Quito, implementing this knowledge in parallel A classes as an experimental group. In the evaluation, it was observed that there is a better level of learning in this experimental group, compared to the control group. As a conclusion, it should be noted that Physical Education teachers should include multiple intelligences as a learning strategy in planning and evaluations due to the improvement in educational processes. This proposal allows cooperative work, integration and inclusion, in addition, it favors the rhythm and way of learning of students through the execution of cognitive, social, affective and motor activities. These intelligences improve learning and generate in students the autonomy of physical activity for life, in practice.

Evaluación de anquiloglosia y lactancia materna en lactantes de 0 a 24 meses / Evaluation of ankyloglossia and breastfeeding in 0-24-month infants / Avaliação da anquiloglossia e da amamentação em lactentes de 0 a 24 meses

Introducción. La anquiloglosia es una condición limitante que en algunos casos no interfiere en la lactancia y genera adaptaciones anatomofisiológicas del frenillo al seno materno, el cual se presenta más elástico y menos fibroso. El objetivo fue establecer si existe relación entre las alteraciones del frenillo lingual y la lactancia materna. Materiales y métodos. Investigación descriptiva correlacional de corte transversal. La población objeto de estudio fue evaluada mediante el Protocolo de evaluación del frenillo de la lengua con puntuación para bebés. Resultados. Se identificó un 29% de prevalencia en las alteraciones del frenillo lingual. La anatomofisiología del frenillo y la succión son dependientes y estadísticamente significantes. Conclusiones. La lactancia materna y la anatomofisiología del frenillo lingual alterado, conocido como anquiloglosia, guardan una fuerte relación de dependencia, ya que ante la presencia de anquiloglosia no se produce un agarre adecuado del pezón en la cavidad oral. No obstante, en algunos casos se ha comprobado que los lactantes realizan procesos de adaptación para suplir las dificultades en la movilidad lingual y alimentarse.

Introduction. Ankyloglossia appears as a limiting condition, in some cases it does not interfere with lactation, presenting anatomophysiological adaptations of the frenulum to the mother's breast; it is more elastic and less fibrous. The objective was to establish whether there is a relationship between lingual frenulum alterations and breastfeeding. Methods. Cross-sectional correlational descriptive research. The population under study was evaluated through the "Protocol for evaluating the frenulum of the tongue with scores for babies". Results. A 29% prevalence of alterations in the lingual frenulum was identified, the anatomophysiology of the frenulum and suction are dependent and statistically significant. Conclusions. Breastfeeding and the anatomophysiology of the altered lingual frenulum known as ankyloglossia are strongly dependent, since in the presence of ankyloglossia there is not an adequate grip of the nipple in the oral cavity; however, in some cases it has been It has been proven that infants carry out adaptation processes in order to compensate for difficulties in tongue mobility and feeding.

Introdução. A anquiloglossia é uma condição limitante que em alguns casos não interfere na lactação e gera adaptações anatomofisiológicas do frênulo à mama da mãe, que é mais elástica e menos fibrosa. O objetivo foi estabelecer se existe relação entre as alterações do frênulo lingual e a amamentação. Materiais e métodos. Pesquisa descritiva e correlacional de corte transversal. A população em estudo foi avaliada por meio do protocolo de avaliação do frênulo da língua com pontuação para bebês. Resultados. Identificou-se prevalência de 29% nas alterações do frênulo lingual. A anatomofisiologia do frênulo e da sucção são dependentes e estatisticamente significativas. Conclusões. A amamentação e a anatomofisiologia do frênulo lingual alterado, conhecido como anquiloglossia, apresentam forte relação de dependência, visto que na presença de anquiloglossia não há pega adequada do mamilo na cavidade oral. No entanto, em alguns casos, descobriu-se que os bebês realizam processos de adaptação para superar as dificuldades de mobilidade da língua e alimentação.

Ertapenem once daily versus piperacillin-tazobactam 4 times per day for treatment of complicated skin and skin-structure infections in adults: results of a prospective, randomized, double-blind multicenter study.

We conducted a prospective, randomized, double-blind trial comparing ertapenem (1 g once daily) with piperacillin-tazobactam (3.375 g every 6 h) as parenteral treatment for 540 adults with complicated skin and skin-structure infections. The most common diagnoses were skin or soft-tissue abscesses and lower-extremity infections associated with diabetes. The mean duration (+/- standard deviation) of therapy was 9.1+/-3.1 days for ertapenem and 9.8+/-3.3 days for piperacillin-tazobactam. At the assessment of primary efficacy end point, 10-21 days after treatment, 82.4% of those who received ertapenem and 84.4% of those who received piperacillin-tazobactam were cured. The difference in response rates, adjusting for the patients' assigned strata, was -2.0% (95% confidence interval, -10.2% to 6.2%), indicating that the response rates in the 2 treatment groups were equivalent. Cure rates for the 2 treatment groups were similar when compared by stratum, diagnosis, and severity of infection. The frequency and severity of drug-related adverse events were similar in the treatment groups.

Diagnostic accuracy of a point-of-care blood typing kit conducted by potential end users.

The usability of a rapid point-of-care ABO-Rh blood typing kit was determined by comparing the performance of individuals with extensive medical training/experience to those with a lesser extent. Subjects were asked to use the blood typing kit with their own blood. These outcomes were compared to that listed in the subject's medical record, stamped on their dog tag, and the result interpreted by a laboratorian. For all participants, there was ∼80% consistency between the result interpreted by the subject and that stated in their medical record. The participant's level of formal education (P ≤ 0.05) affected the accuracy of the blood typing kit. When comparing the subject's outcome to that stated in their medical record, the performance of individuals in the Medical Corps was approximately 10% and 25% higher (P < 0.05) than that observed with Hospital Corpsman or Medical Service Corps members, respectively. To remove bias that can occur when interpreting the blood type of oneself, the subjects also interpreted the result from cards prepared by the investigator. Taken together, a discrepancy between the potential diagnostic accuracy of the kit and that observed with potential end users was identified.

Modificación de conocimientos sobre salud reproductiva en adolescentes con riesgo preconcepcional / Knowledge modification to sexually reproductive health in adolescents with pre-conception risk

Se hizo una intervención educativa en 30 adolescentes con riesgo preconcepcional, atendidas en la consulta de planificación familiar y salud reproductiva perteneciente al Policlínico Universitario Josué País García de Santiago de Cuba, desde enero hasta diciembre del 2007, a fin de modificar sus conocimientos sobre salud sexual. En la serie predominó la instrucción inadecuada en cuanto a embarazo en la adolescencia, aborto provocado, métodos anticonceptivos e infecciones sexualmente transmisibles; comportamiento que fue variado satisfactoriamente luego de la estrategia educativa, pues la mayoría de las integrantes incorporaron nuevas nociones sobre el tema o incrementaron las que poseían anteriormente al respecto.

A teaching intervention in 30 adolescents with pre-conception risk attended at the Birth Control and Reproductive Health Department from Josué País García University Polyclinic in Santiago de Cuba was carried out from January, 2007 to December, 2007, in order to modify their sexual health knowledge. Inadequate instruction about teenage pregnancy, artificial abortion, contraceptive methods, and sexually transmitted infections were predominant in the series. This behavioral pattern was successfully modified after the educational strategy, since most of the adolescents acquired new ideas about this issue or improved the ones they had already learned.

Algunas consideraciones sobre la hepatitis G / Some considerations on hepatitis G

La búsqueda de nuevos agentes capaces de producir inflamación hepática ha avanzado notablemente en los últimos años. Recientenmente se reportó el aislamiento de dos nuevos virus mediante las técnicas de Biología Molecular, los cuales han resultado ser aislados idénticos de un mismo virus, cuyas características estructurales permiten incluirlo dentro de la familia Flavivirus. Existe discrepancia en los criterios sobre si este agente es capaz o no de causar hepatitis. Se plantea como principal vía de transmisión la parenteral, aunque no se descarta la propagación sexual o tal vez de paciente a paciente. Dada la poca capacidad del virus para inducir una respuesta inmune no ha sido posible hasta ahora obtener un ensayo serológico suficientemente seguro, y hasta tanto eso no ocurra serán difíciles los estudios epidemiológicos a gran escala

Nivel de satisfacción de los pacientes que acuden a un policlínico principal de urgencias / Level of satisfaction of patients going to main emergency polyclinics

Se determinó el nivel de satisfacción de los pacientes que acudieron al policlínico principal de urgencias Pedro Borras Astorga de Pinar del Río, Cuba, durante los meses de enero a diciembre del año 2000. Se realizó un estudio longitudinal y prospectivo que demostró elevadas frecuencias de atención inmediata a los pacientes en el servicio de urgencias aunque se recogió la presencia de 14 pacientes para los cuales el tiempo de atención se retrasó entre 15 y 30 minutos, pero ninguno de los problemas de salud de ellos era una emergencia médica. Se lograron las interconsultas del clínico y del pediatra de forma rápida y existieron criterios satisfactorios de los pacientes con relación al trato recibido por médicos, enfermeras y técnicos. Se observó optimización del servicio en este sistema de salud a pesar de notificarse dificultades estructurales que atentaron contra el criterio de calidad que expresaron los pacientes que acudieron al mismo(AU)

The level of the patients' satisfaction was determined that went to the main policlínico of urgencies Pedro you Erase Astorga of Pinegrove of the River, Cuba, during the months of January to December of the year 2000. He/she was carried out a longitudinal and prospective study that demonstrated high frequencies of immediate attention to the patients in the service of urgencies although the presence of 14 patients was picked up for which the time of attention was delayed between 15 and 30 minutes, but none of the problems of health of them was a medical emergency. The interconsultas of the clinical one was achieved and of the pediatrician in a quick way and the patients' satisfactory approaches existed with relationship to the treatment received by doctors, nurses and technicians. Optimization of the service was observed in this system of health in spite of being notified structural difficulties that attempted against the approach of quality that the patients that went to the same one expressed(AU)