Unraveling the effect of the inflammatory microenvironment in spermatogenesis progression.

Experimental autoimmune orchitis (EAO) is a chronic inflammatory disorder that causes progressive spermatogenic impairment. EAO is characterized by high intratesticular levels of nitric oxide (NO) and tumor necrosis factor alpha (TNFα) causing germ cell apoptosis and Sertoli cell dysfunction. However, the impact of this inflammatory milieu on the spermatogenic wave is unknown. Therefore, we studied the effect of inflammation on spermatogonia and preleptotene spermatocyte cell cycle progression in an EAO context and through the intratesticular DETA-NO and TNFα injection in the normal rat testes. In EAO, premeiotic germ cell proliferation is limited as a consequence of the undifferentiated spermatogonia (CD9+) cell cycle arrest in G2/M and the reduced number of differentiated spermatogonia (c-kit+) and preleptotene spermatocytes that enter in the meiotic S-phase. Although inflammation disrupts spermatogenesis in EAO, it is maintained in some seminiferous tubules at XIV and VII-VIII stages of the epithelial cell cycle, thereby guaranteeing sperm production. We found that DETA-NO (2 mM) injected in normal testes arrests spermatogonia and preleptotene spermatocyte cell cycle; this effect reduces the number of proliferative spermatogonia and the number of preleptotene spermatocytes in meiosis S-phase (36 h after). The temporal inhibition of spermatogonia clonal amplification delayed progression of the spermatogenic wave (5 days after) finally altering spermatogenesis. TNFα (0.5 and 1 µg) exposure did not affect premeiotic germ cell cycle or spermatogenic wave. Our results show that in EAO the inflammatory microenvironment altered spermatogenesis kinetics through premeiotic germ cell cycle arrest and that NO is a sufficient factor contributing to this phenomenon.

Effectiveness of 2-Dose BNT162b2 (Pfizer BioNTech) mRNA Vaccine in Preventing SARS-CoV-2 Infection Among Children Aged 5-11 Years and Adolescents Aged 12-15 Years - PROTECT Cohort, July 2021-February 2022.

The BNT162b2 (Pfizer-BioNTech) mRNA COVID-19 vaccine was recommended by CDC's Advisory Committee on Immunization Practices for persons aged 12-15 years (referred to as adolescents in this report) on May 12, 2021, and for children aged 5-11 years on November 2, 2021 (1-4). Real-world data on vaccine effectiveness (VE) in these age groups are needed, especially because when the B.1.1.529 (Omicron) variant became predominant in the United States in December 2021, early investigations of VE demonstrated a decline in protection against symptomatic infection for adolescents aged 12-15 years and adults* (5). The PROTECT† prospective cohort of 1,364 children and adolescents aged 5-15 years was tested weekly for SARS-CoV-2, irrespective of symptoms, and upon COVID-19-associated illness during July 25, 2021-February 12, 2022. Among unvaccinated participants (i.e., those who had received no COVID-19 vaccine doses) with any laboratory-confirmed SARS-CoV-2 infection, those with B.1.617.2 (Delta) variant infections were more likely to report COVID-19 symptoms (66%) than were those with Omicron infections (49%). Among fully vaccinated children aged 5-11 years, VE against any symptomatic and asymptomatic Omicron infection 14-82 days (the longest interval after dose 2 in this age group) after receipt of dose 2 of the Pfizer-BioNTech vaccine was 31% (95% CI = 9%-48%), adjusted for sociodemographic characteristics, health information, frequency of social contact, mask use, location, and local virus circulation. Among adolescents aged 12-15 years, adjusted VE 14-149 days after dose 2 was 87% (95% CI = 49%-97%) against symptomatic and asymptomatic Delta infection and 59% (95% CI = 22%-79%) against Omicron infection. Fully vaccinated participants with Omicron infection spent an average of one half day less sick in bed than did unvaccinated participants with Omicron infection. All eligible children and adolescents should remain up to date with recommended COVID-19 vaccinations.

Cyclical pattern of non-nutritive sucking in normal and high-risk neonates.

This study determined patterns of suction cycles by recording sucking pressure in full-term infants, normal pre-term infants and newborns with pathology (hypoxia at birth). Associations between these patterns and some clinical parameters were established in order to evaluate feeding capacity for the purpose of guiding specific stimulation and aiding hospital discharge in better health conditions. Seventy-five infants of both sexes were assessed after informed consent, grouped by their status at birth. Body weight and Apgar score were determined. Sucking pressure was evaluated with an ad-hoc device. Maximum and minimum pressure scores and the number of suction cycles were measured. Data were analyzed statistically at a significance level of p < 0.05. Maximum sucking pressure values varied between study groups. Full-term infants showed the highest pressure values and number of suction cycles. In pre-term infants, lower pressure values and fewer suction cycles were observed. Those with hypoxia showed great variability in both parameters. This study found a cyclical pattern of non-nutritive sucking in normal and high-risk newborns. Normal and preterm infants showed a significant direct correlation between suction cycles and Apgar scores at 5 minutes, but the infants with pathology due to hypoxia group did not show the same association. These findings are an important tool that will contribute to improving newborn maternal nutrition and optimizing the quality of life for high-risk newborns in our environment.

The First Italian Telemedicine Program for Non-Critical COVID-19 Patients: Experience from Lodi (Italy).

Italy was the first Western country to face a massive SARS-CoV-2 outbreak. The limited information initially available on the natural course of the disease required caution in the discharge of patients accessing health facilities. This resulted in overcrowded health facilities and emergency services. In this context, improvements of other forms of hospital care assistance were needed. This study shows the results of the first Italian remote monitoring program for COVID-19 patients. The program was implemented by the Azienda Socio Sanitaria (ASST) Lodi (Italy) by using the innovative Zcare software®. Data generated during patient recruitment, monitoring, and discharge were extracted from the Zcare software and statistically analysed. Data refer to a sample of 1196 patients enrolled in the remote monitoring program in 2020. Patients reported symptoms mainly during the first week. The most frequently reported symptoms were general fatigue, cough, and loss of taste and smell (dysosmia). More than 80% of patients reported a saturation level below 96% at least once, and more than 70% had a temperature above 37 °C. Active monitoring of reported symptoms provided valuable insights into the disease's natural history during its less severe acute phase. Only 109 individuals visited the emergency department at least once in the first 100 days of monitoring. Of these, 101 had COVID-19 infection, 69 of whom were hospitalized following a first clinical assessment at the emergency department. The ASST Lodi's telemedicine strategy for COVID patients appears to be a viable alternative to hospitalization. This strategy enables the provision of proper care while making resources available for more critically ill patients, and enhances the availability of resources available for more critically ill patients.

Pediatric Research Observing Trends and Exposures in COVID-19 Timelines (PROTECT): Protocol for a Multisite Longitudinal Cohort Study.

BACKGROUND: Assessing the real-world effectiveness of COVID-19 vaccines and understanding the incidence and severity of SARS-CoV-2 illness in children are essential to inform policy and guide health care professionals in advising parents and caregivers of children who test positive for SARS-CoV-2. OBJECTIVE: This report describes the objectives and methods for conducting the Pediatric Research Observing Trends and Exposures in COVID-19 Timelines (PROTECT) study. PROTECT is a longitudinal prospective pediatric cohort study designed to estimate SARS-CoV-2 incidence and COVID-19 vaccine effectiveness (VE) against infection among children aged 6 months to 17 years, as well as differences in SARS-CoV-2 infection and vaccine response between children and adolescents. METHODS: The PROTECT multisite network was initiated in July 2021, which aims to enroll approximately 2305 children across four US locations and collect data over a 2-year surveillance period. The enrollment target was based on prospective power calculations and accounts for expected attrition and nonresponse. Study sites recruit parents and legal guardians of age-eligible children participating in the existing Arizona Healthcare, Emergency Response, and Other Essential Workers Surveillance (HEROES)-Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel (RECOVER) network as well as from surrounding communities. Child demographics, medical history, COVID-19 exposure, vaccination history, and parents/legal guardians' knowledge and attitudes about COVID-19 are collected at baseline and throughout the study. Mid-turbinate nasal specimens are self-collected or collected by parents/legal guardians weekly, regardless of symptoms, for SARS-CoV-2 and influenza testing via reverse transcription-polymerase chain reaction (RT-PCR) assay, and the presence of COVID-like illness (CLI) is reported. Children who test positive for SARS-CoV-2 or influenza, or report CLI are monitored weekly by online surveys to report exposure and medical utilization until no longer ill. Children, with permission of their parents/legal guardians, may elect to contribute blood at enrollment, following SARS-CoV-2 infection, following COVID-19 vaccination, and at the end of the study period. PROTECT uses electronic medical record (EMR) linkages where available, and verifies COVID-19 and influenza vaccinations through EMR or state vaccine registries. RESULTS: Data collection began in July 2021 and is expected to continue through the spring of 2023. As of April 13, 2022, 2371 children are enrolled in PROTECT. Enrollment is ongoing at all study sites. CONCLUSIONS: As COVID-19 vaccine products are authorized for use in pediatric populations, PROTECT study data will provide real-world estimates of VE in preventing infection. In addition, this prospective cohort provides a unique opportunity to further understand SARS-CoV-2 incidence, clinical course, and key knowledge gaps that may inform public health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/37929.

Human temporomandibular joint disc: anatomy and measurements in prenatal development.

The objective of this study was to determine morphological characteristics and measurements of the temporomandibular joint (TMJ) disc in human fetuses between 16 and 20 weeks of intrauterine life, and correlate it with oral-facial neuro-muscular maturing. Scanner images were used to record the length of the disc (D) and the thickness of its anterior middle and posterior bands in TMJ anteroposterior vertical sections from human fetuses of 16, 18 and 20 weeks of intrauterine life (WIL). Mean disc length was 1.98 mm, 2.69 mm and 2.90 mm at 16, 18 and 20 WIL respectively, and measurements differed significantly between those ages. The thicknesses of the anterior, middle and posterior bands also differed significantly. The results give normal morphological data for D between 16 and 20 WIL. TMJ anatomy and measurements appear to be related and agree with the neuro-muscular maturation time at which sucking and swallowing reflexes begin before birth. It is known that these functions, as well as the neuro-muscular capacity to perform prenatal mandibular movements (opening and closing), begin at 14 to 15 weeks of prenatal development and are fully attained at about 20 weeks of development. Knowledge of this reference pattern may be of major importance to future research, for assessing jaw biomechanics and detecting alterations of TMJ and prenatal development of a vital human function - suckling in preterm infants.

Parotid sialosis: morphometrical analysis of the glandular parenchyme and stroma among diabetic and alcoholic patients.

BACKGROUND: Among the agents that cause parotid sialosis, diabetes mellitus type 2 and chronic alcoholism are included. In this study, the morphometrical modifications in the diabetic parotid sialosis were determined to compare them with the histopathological characteristics of alcoholic parotid sialosis. METHODS: Five parotid biopsy samples obtained from patients with diabetic sialosis, 12 samples from patients with alcoholic sialosis and seven from individuals without these pathologies (control group) were analyzed. A morphometrical study of parotid parenchyme and stroma, using a digital image analyzer attached to an optical microscope, was carried out. Dimensions of serous acini and striated ducts, the area occupied by the fatty tissue, and the number of ducts were recorded. Mean values were compared using the Mann-Whitney U-test (P

The inflammatory mediators TNFα and nitric oxide arrest spermatogonia GC-1 cell cycle.

During an inflammatory process of the testis, the network of somatic, immune, and germ cell interactions is altered leading to organ dysfunction. In testicular biopsies of infertile men, spermatogenesis impairment is associated with reduced spermatogonia proliferation, increased number of immune cells, and content of pro-inflammatory cytokines. TNFα-TNFR and nitric oxide (NO)-NO synthase systems are up-regulated in models of testicular damage and in human testis with maturation arrest. The purpose of this study was to test the hypothesis that TNFα-TNFR system and NO alter the function of spermatogonia in the inflamed testis. We studied the effect of TNFα and NO on GC-1 spermatogonia cell cycle progression and death by flow cytometry. GC-1 cells expressed TNFR1 and TNFR2 (immunofluorescence). TNFα (10 and 50 ng/ml) and DETA-Nonoate (0.5 and 2 mM), a NO releaser, increased the percentage of cells in S-phase of the cell cycle and reduced the percentage in G1, inducing also cell apoptosis. TNFα effect was not mediated by oxidative stress unlike NO, since the presence of N-acetyl-l-cysteine (2.5 and 5.0 mM) prevented NO induced cell cycle arrest and death. GC-1 spermatogonia overpass NO induced cell cycle arrest but no TNFα, since after removal of NO, spermatogonia progressed through the cell cycle. We propose TNFα and NO might contribute to impairment of spermatogenesis by preventing adequate functioning of the spermatogonia population. Our results showed that TNFα and NO impaired spermatogonia cell cycle, inducing GC-1 arrest in the S phase.

Prolactin and its receptor as therapeutic targets in glioblastoma multiforme.

Although prolactin (PRL) and its receptor (PRLR) have been detected in glioblastoma multiforme (GBM), their role in its pathogenesis remains unclear. Our aim was to explore their contribution in GBM pathogenesis. We detected PRL and PRLR in all GBM cell lines tested. PRLR activation or overexpression using plasmid transfection increased proliferation, viability, clonogenicity, chemoresistance and matrix metalloproteinase activity in GBM cells, while PRLR antagonist ∆1-9-G129R-hPRL reduced their proliferation, viability, chemoresistance and migration. Meta-analysis of transcriptomic data indicated that PRLR was expressed in all grade II-III glioma (GII-III) and GBM samples. PRL was upregulated in GBM biopsies when compared to GII-III. While in the general population tumour PRL/PRLR expression did not correlate with patient survival, biological sex-stratified analyses revealed that male patients with PRL+/PRLRHIGH GBM performed worse than PRL+/PRLRLOW GBM. In contrast, all male PRL+/PRLRHIGH GII-III patients were alive whereas only 30% of PRL+/PRLRLOW GII-III patients survived after 100 months. Our study suggests that PRLR may be involved in GBM pathogenesis and could constitute a therapeutic target for its treatment. Our findings also support the notion that sexual dimorphism should be taken into account to improve the care of GBM patients.

Morphometric analysis of the parotid gland affected by alcoholic sialosis.

BACKGROUND: In alcoholic parotid sialosis, the gland is frequently enlarged due to ductal and/or acinar hypertrophy, ductal hyperplasy and stromal fat infiltration. The aim of this study was to determine acinar and ductal dimensions, the number of striated ducts and the proportion of fat tissue in patients with and without alcoholic parotid sialosis. METHODS: Twelve parotid biopsy samples from patients with hepatic alcoholic cirrhosis and those from seven controls were used. A morphometrical study with a digital image analyser attached to an optical microscope was carried out. Direct and indirect indicators from acinar and ductal dimensions were recorded. The number of striated ducts and the proportion of fat tissue in stroma were determined. Fifteen records for each variable were taken. Mean values were compared using the Mann-Whitney U-test (P

Cross-sectional geometrical properties of distal radius and ulna in large, medium and toy breed dogs.

Fractures of the distal radius and the ulna are the third most common fractures in dogs. Toy and miniature breeds have a propensity to develop antebrachial fractures after falling or jumping. Most affect the distal third of both bones involving between 15% and 37% of the radial length. Larger dogs, instead, typically sustain hyperextension injuries to the carpus. The causative mechanisms for this fracture prevalence in toy dogs are unknown. Breed-related changes in bone geometry and/or mineral density have been suggested as possible etiologic factors. In a multifactorial study, the main etiological factors potentially responsible for determining susceptibility to fractures in toy breeds are considered. The aim of this first study is to evaluate the geometric bone features in different dog sizes. The cortical bone cross-sectional properties along the length of the right radius and the ulna of 28 dogs from three different size categories have been quantified by computerized tomographic scanning. Geometrical cross-sectional parameters were measured and normalized to radial length to allow intergroup comparisons. Discriminant analysis was used to classify the observations into different groups. Through statistical analysis of the normalized values, significant differences in cross-sectional properties of different bone sizes were found. The results suggest that, when proportionally loaded, the antibrachii of toy breed dogs are more susceptible to fracture than those of large breed dogs due to morphological differences.

The role of imaging in the choice of correct treatment of unstable thoraco-lumbar fractures.

The concept of unstable burst fracture has been discussed since over 50 years and this injury has received much attention in the literature as regards its radiological diagnosis and clinical treatment. The purpose of this article is to review the way we use imaging to diagnose the injury and to guide treatment.

Structural and functional salivary disorders in type 2 diabetic patients.

UNLABELLED: Diabetes mellitus type 2 is the most common metabolic disorder and it causes an important morbimortality. The structural modifications in the parotid gland (sialosis) had already been described in these patients and could result in variations in the salivary composition, as well as an increase in periodontal and dental pathology. OBJECTIVES: To compare the biochemical findings in the saliva and to correlate these biochemical disturbances with the morphologic findings previously described. PATIENTS AND METHODS: Clinical information were gathered about 33 patients, 17 had type 2 diabetes. Samples of whole saliva were obtained for biochemical analysis and serum samples to determine metabolic control. RESULTS: In the diabetics saliva we found urea and total proteins increased and reduced levels of microalbumina. Salivary glucose was only augmented in patients with poor metabolic control. Clinical symptoms of xerostomia were present in 76,4% and dental and periodontal disease in 100%. The parotid gland was characterised by the presence of small acini, lipid intracytoplasmic droplets, as well as adipose stroma infiltration. The acinar cytoqueratins expression was heterogeneous and very positive in the hyperplasic ducts. CONCLUSIONS: These biochemical disorders in the saliva of the type 2 diabetic patients would be related with the structural changes previously observed in parotid glands.

Morphology of the lateral pterygoid muscle associated to the mandibular condyle in the human prenatal stage.

The lateral pterygoid muscle (LPM) inserts at the condyle and the articular disc and plays a central role in mandibular movement via the Temporomandibular Articular Complex. The aim of this study was to examine the association between the morphology of LPM muscular fascicles and the degree of mineralization of the mandibular condyle in the prenatal stage employing structural, ultrastructural and microanalytical evaluation. Sixteen human fetuses at 11-37 weeks of gestation, with no apparent pathology and resulting from spontaneous abortions, were included in the study. Samples from lateral pterygoid muscle and the mandibular condyle were processed for light microscopy and electron microscopy and microanalysis. Desmin immunolabeling (dilution 1: 25 Dako) and alpha sarcomeric actin immunolabeling (dilution 1:50 Dako) employing the avidin-biotin system were used in paraffin embedded samples. Contralateral samples were examine by transmission electron microscopy. Four condyles (at 17-21 weeks of gestation) were used to measure the relative content of calcium and phosphorous employing the X-ray diffraction microanalytical technique. At 11-16 weeks of gestation, the LPM was composed of secondary myotubes associated to satellite cells and nerve fibers. At 18 weeks, the muscle exhibited multiple compact fascicles and the condyle showed a thin, external, subperiostal mineralized layer with few central bone spicules. At 20 weeks, at the site of insertion of the LPM, the bone trabeculae of the condyle contained an electrondense matrix with abundant mineralization nuclei. At 17-21 weeks of gestation no significant variations in the contents of phosphorous and calcium were observed. At 24 weeks, transmission electron calcium and microscopy studies revealed a marked increase in the functional units of the muscle fascicles. Also, at this age muscle fibers exhibited differences in the expression of desmin and alpha sarcomeric actin. At 37 weeks the muscle became multipennate in appearance, exhibiting a more complex organization than younger fetuses. Alpha sarcomeric actin labeling became light with age. This results suggest that between 16 and 22 weeks of gestation the differentiation and maturation process of the muscle fibers precedes and prevails over the development and mineralization process from mandibular condyle. The rudimentary performance of the prenatal LPM would be one of the factors that regulate the process of ossification at the level of the mandibular condyle. The rate of ossification would increase starting from 22 of gestation week.

An experimental model of affinity filtration for the isolation of egg white Lysozyme using Cibacron Blue immobilized to yeast cells.

An experimental model of affinity filtration process was designed using a macroligand composed by Cibacron Blue F3GA immobilized to yeast cells. Its performance was evaluated, at bench scale, through the recovery of egg white Lysozyme. The selective and reversible binding between the Cibacron ligand molecule and the enzyme is described. The separation of Lysozyme from the protein mixture included the application of stages such as affinity adsorption, concentration, diafiltration and elution. A tangential microfiltration system with an inorganic membrane was designed. The main finding was the development of the diafiltration operation, key stage in the enzyme isolation. The macroligand particle kept its integrity along the whole process and the degree of purity of the isolated Lysozyme was significant.

Structural differences between alcoholic and diabetic parotid sialosis.

UNLABELLED: Between the sialosis' etiologic agents, we can find the chronic alcoholism and diabetes. Both nosologic entities are described using a similar histopathologic pattern. OBJECTIVES: The purpose of this work has been analyzing and comparing the histopathological differences between the diabetic and alcoholic sialosis. STUDY DESIGN: We studied 7 parotid glands samples of diabetic patients and 4 samples of normal glands obtained from surgical material were used as a control. For the comparative study, we used 12 parotid glands from chronic alcoholic patients with clinical diagnosis of cirrhosis and 6 autopsies on individuals who had died from alcoholic hepatic cirrhosis. This material was fixed in formaline, processed for embedding in paraffin, standard coloration techniques and immunotechnique for cytokeratin EA/1 y EA/3. RESULTS: In the cases of diabetics, the parotid gland was characterised by the presence of small acini, a bigger number of lipid intracytoplasmic droplets in the acinar and ductal cells, as well as an abundant adipose infiltration in the stroma when compared to the alcoholics. We observed that the cytokeratins' expression was heterogeneous at the acinar level, and very positive in the hyperplasic ducts, compared to the alcoholic and control groups. CONCLUSIONS: These qualitative valorations indicate the differences between the histopathologic pattern of sialosis with different origins.

Affinity adsorption of lysozyme on a macroligand prepared with Cibacron Blue 3GA attached to yeast cells.

The objective of this study was the development of affinity adsorbent particles with the appropriate characteristics to be applied in protein purification using the affinity ultrafiltration method. To prepare affinity macroligands Cibacron Blue 3GA, as a ligand molecule, was immobilized by covalent bonding onto yeast cell walls, the support material or matrix. The maximum attachment of the ligand to the matrix was 212 µmol/g (ligand dry weight/yeast dry weight). Lysozyme was selected as the protein model for the adsorption studies. Its adsorption onto the matrix without ligand and matrix with attached ligand were investigated batch-wise. The adsorption equilibrium isotherms appeared to follow a typical Langmuir isotherm. The maximum adsorption capacity (q(m)) of the Cell-Cibacron macroligand for lysozyme was 110 mg/ml of wet macroligand. The adsorbent was also employed for the separation of lysozyme from hen egg white. High purity lysozyme was obtained.

Familias: aportes a la construcción de un abordaje integral de la disfunción familiar / Families: contributions to the construction of a comprehensive approach to family dysfunction

En los equipos de salud confluyen teorías, valores y prácticas en relación al diagnóstico y tratamiento de las llamadas familias disfuncionales. Este artículo busca ampliar y reflexionar sobre los conceptos de familia porque desde donde escuchemos y observemos a las familias es desde donde se construirán las distintas estrategias de abordaje de las problemáticas que aparecen en la consulta.Las familias ya no responden al ideal de “papá, mamá e hijos”. Así se presentan configuraciones familiares variadas donde la convivencia, el matrimonio y el género no serían condiciones indispensables para acompañar procesos de constitución biopsicosocial.La propuesta de abordaje integral de las familias está orientada por la noción de procesos de función-disfunción y tiene como pilares fundamentales a la inter-disciplina, la promoción de la salud, el trabajo en equipo y la formación profesional permanente. El buen manejo de entrevistas individuales y familiares constituye una competencia indispensable para el diagnóstico y tratamiento de situaciones familiares complejas. Ala vez, las intervenciones grupales y comunitarias requieren del contacto intersectorial para desarrollar actividades preventivas y de promoción de vínculos saludables. Frente a lo que ya no es, los profesionales de la salud tenemos la posibilidad de descubrir lo nuevo. La diversidad como oportunidad para reformular nuestras teorías y nuestras prácticas.

In health teams converge theories, values and practices in relation to diagnosis and treatment of so-called handling dysfunctional families.This article seeks to expand and reflect on the concepts of family because from where we listen and observe families is where the different strategies for addressing the problematic that appear in the consultation will be built.Families no longer respond to the ideal “father, mother and children”. So varied family configuration are presented where cohabitation, marriage and gender would not be necessary conditions to accompany biopsychosocial processes constitution.The proposed integrated approach to families is guided by the notion of processes function-dysfunction has as its correstone the interdisciplinary, the health promotion, teamwork and the continuing vocational training. Good management of individual and family interviews is essential for the diagnosis and treatment of complex family situations. Also, the group and community interventions require intersectoral contact to develop preventive and promotion of healthy link activities.Versus what is no longer, health professionals have the ability to discover the new. Diversity as an opportunity to reformulate our theories and our practices.

Cyclical pattern of non-nutritive sucking in normal and high-risk neonates

En este trabajo se determinaron patrones de ciclos de succión mediante registros de la presión de succión en recién nacidos a término, prematuro normal y recién nacido con patología(hipoxia al nacer). Además, se establecieron asociaciones entreestos patrones y algunos parámetros clínicos, con el propósito de valorar la capacidad de alimentación, para orientar la estimulación específica y favorecer el alta de internación en mejorescondiciones de salud. Se evaluó a 75 neonatos de ambos sexos con consentimiento firmado, agrupados según su condición al nacer. Se determinó el peso corporal y el scorede Apgar. Se obtuvieron los registros de valores máximos y mínimos de presión utilizando un aparato “ad-hoc” (de presión-succión) que permitió medir el número de ciclos de succión. Los datos fueron analizados estadísticamente con un nivel de significación p<0.05. Los valores máximos de presiónsucciónpresentaron variaciones entre los grupos analizados. Los valores más altos de presión y el mayor número de ciclos de succión se observó en nacidos a término. Los prematuros mostraron valores de presión más bajos y menor cantidad de ciclos de succión, lo que posibilitó establecer un patrón específicopara estos grupos. Los hipoxiados exhibieron una gran variabilidad en ambos parámetros. En los neonatos normales y pretérmino hubo una correlación directa y significativa entrelos ciclos de succión y los valores de Apgar a los cinco minutos. El grupo de recién nacidos con patología debido a hipoxia no mostró la misma asociación. Estos resultados constituyen unaimportante herramienta que contribuirá a mejorar la nutrición materna neonatal y optimizar la calidad de vida de los recién nacidos de alto riesgo en nuestro medio