[Initial study of trap and identification of environmental pollens and fungi spores in Samborondon, Ecuador]. / Estudio inicial de captación e identificación de pólenes y hongos ambientales en Samborondón, Ecuador.

OBJETIVO: To identify and registry the most important aeroallergens trapped at the aerobiology station in the city of Samborondon, Ecuador. METHODS: Pollen grains and fungal spore counts were performed according to the standardized technique with a Hirst-type collection equipment, Burkard spore trap for seven days, following the recommendations of the National Allergy Bureau (NAB) of the American Academy of Allergy Asthma and Immunology (AAAAI). The equipment was installed on the roof of the Universidad de Especialidades Espiritu Santo (UEES), 25 m above ground level, coordinates: 2°07 ́57 ́ ́S 79°52 ́06 ́ ́W, in the city of Samborondon. The sampling period was performed from November 2022 to April 2023. RESULTS: We identified the following pollen families: Poaceae (258 grains/m3), Apocynaceae (Plumeria rubra pc) (214 grains/m3), Lamiaceae (180 grains/m3), Asteraceae Ambrosía spp.- (60 grains/m3), Chenopodiacea (27 grains/m3), Myrtaceae (17 grains/m3), Pinaceae (11 grains/m3), Betulaceae (7 grains/m3). Also identified fungical spores: Fuzariella spp./Leptosphaeria spp. (1899/m3), Cladosporium spp. (1407/m3), Nigrospora spp. (1183/m3), Dreschlera/Helmintosporum spp. (329/m3), Alternaria spp. (98/m3), Pithomyces spp. (79/m3), Curvularia spp. (48/m3), Stemphylium spp. (46/m3). CONCLUSIONS: We reported the first study of aerobiology (capture and identification of environmental pollens and fungi) in the city of Samborondon. The inhabitants of this area are exposed to different aeroallergens with a predominance of Poaceaes pollen and Fuzzariella spp./Leptosphaeria spp. spores. The identified allergens should be part of the usual allergy studies. The results of this first preliminary study should be compared with information from the forthcoming years, which will help to identify variations in the concentration of seasonal aeroallergens, annual fluctuations, and extend the traps to other parts of the city.

OBJETIVO: Identificar y registrar los aeroalérgenos más importantes captados en la estación de aerobiología en la ciudad de Samborondón, Ecuador. MÉTODOS: Los conteos de granos de polen y esporas de hongos se realizaron según la técnica estandarizada, con un equipo colector tipo Hirst, Burkard spore trap for seven days, siguiendo las recomendaciones de la National Allergy Bureau (NAB) de la American Academy Allergy Asthma and Immunology (AAAAI). El equipo se instaló en la azotea de la Universidad Espíritu Santo (UEES), en la ciudad de Samborondón, a 25 m de altura desde el nivel del suelo, 2°07´57´´S 79°52´06´´O. El periodo de captación se llevó a cabo entre noviembre de 2022 y abril de 2023. RESULTADOS: Identificamos las siguientes familias polínicas: Poaceae (258 granos/m3), Apocynaceae (Plumeria rubra pc) (214 granos/m3), Lamiaceae (180 granos/m3), Asteraceae Ambrosía spp.- (60 granos/m3), Chenopodiacea (27 granos/m3), Myrtaceae (17 granos/m3), Pinaceae (11 granos/m3), Betulaceae (7 granos/m3). Además esporas fúngicas: Fuzariella spp./Leptosphaeria spp. (1899/m3), Cladosporium spp. (1407/m3), Nigrospora spp. (1183/m3), Dreschlera/Helmintosporum spp. (329/m3), Alternaria spp. (98/m3), Pithomyces spp. (79/m3), Curvularia spp. (48/m3), Stemphylium spp. (46/m3). CONCLUSIONES: Se reporta el primer estudio de aerobiología (captación e identificación de pólenes y hongos ambientales), en la ciudad de Samborondón. Los habitantes de esta zona están expuestos a diferentes aeroalérgenos con predominancia al polen de Poaceaes y esporas de Fuzzariella spp./Leptosphaeria spp. Los alérgenos identificados deberían formar parte de los estudios alergológicos habituales. Los resultados de este primer estudio preliminar deberían ser comparados con información de los siguientes años para ayudar a identificar las variaciones de concentración de aeroalérgenos estacionales, las fluctuaciones anuales, y extender los captadores a otros puntos de la ciudad.

Persistence of airborne tree pollen from the Cupressaceae family during the last decade in the city of Bahia Blanca.

Airborne pollen is a major contributor to allergic respiratory diseases. However, the literature on patterns and seasonality of specific pollen types mainly comes from northern hemisphere and developed regions, limiting our ability to extrapolate these findings to other geographical locations. With this research letter, our aim is to contribute to the current knowledge of aerobiology by analyzing the decade-long patterns of airborne tree pollen in the city of Bahia Blanca, Argentina. In general, we found late winter to early spring as the period with the highest Cupressaceae pollen counts. In 2020, the average pollen count during July through September was 78.81 (SD 79.70), the highest recorded during the last 10 years. These months had varying pollen concentrations from moderate (15-89 grains/m3 of air) to high (90-1499 grains/m3 of air). Regardless of such variation, August had consistently been the month with the highest peak concentrations from 2010 to 2020 (61.2, SD 57.3), followed by September (27.1, SD 20.3). We did not find any month with very high (˃1500 grains/m3 of air) peak concentration. Further studies need to be done to expand our knowledge on aerobiology to characterize specific pollen sub-types and determine the exact allergenic potential of airborne pollen in different regions.

Costo de atención de recién nacidos con peso 1500 gramos en el Hospital Penna, Bahía Blanca, Argentina / Costs for the health care of newborns weighing up to 1500 g at Penna Hospital, Bahía Blanca, Argentina

INTRODUCCIÓN: Los sistemas de costos por servicio hospitalario permiten evaluar la eficiencia en la utilización de recursos y son la base para realizar estudios comparativos entre grupos de pacientes con características diferenciales. La internación en Neonatología de niños de bajo peso al nacer presenta especial interés por su complejidad y alto costo. El objetivo fue estimar los costos directos del día de internación en el Servicio de Neonatología del Hospital Interzonal Dr. José Penna de pacientes con peso al ingreso menor o igual a 1500 g en 2019. MÉTODOS: Se realizó un estudio retrospectivo, para el cual se relevaron datos del Servicio de Neonatología y de las áreas de compras y personal del Hospital. Se estimó el costo promedio por día de internación y por egreso del total del Servicio y de los recién nacidos con peso de hasta 1500 g. RESULTADOS: El estudio se realizó sobre 489 egresos. El costo directo promedio por día de internación fue de $17.755. Para el grupo de peso ≤ 1500 g, el promedio de días de internación fue de 55,9 y el costo promedio por egreso, de $992.191; para ≤ 1000 g, de 80,6 y $1.430.229, respectivamente. Se evidenció un fuerte impacto del bajo peso al nacer: el 8% de los egresos con vida de Neonatología genera el 33% de los costos del proceso de internación neonatal. DISCUSIÓN: Es importante realizar estudios de costos por servicio hospitalario, en especial por grupos de casos, a fin de generar información útil para la toma de decisiones.

Sensitization to subtropical grass pollens in patients with seasonal allergic rhinitis from Bahia Blanca, Argentina.

BACKGROUND: Grass pollinosis is an important contributor to allergic diseases, with varying patterns and frequency of allergens according to the geographical location studied. Our study aims to provide a better understanding of subtropical grass pollinosis in Argentinian patients with seasonal allergic rhinitis. METHODS: We conducted a retrospective cross-sectional study involving 894 patients with seasonal allergic rhinitis from Bahía Blanca, Argentina. Skin prick tests were performed to selected pollen species belonging to three subfamilies of the Poaceae genera. Frequency of sensitization to specific grass pollen extracts, cross-reactivity of allergens assessed by skin prick test, and possible associations between allergen extracts and asthma or allergic conjunctivitis were analyzed. RESULTS: Sensitization to the Pooideae subfamily was the most frequent, encompassing 86.8% (CI: 84.4%-88.9%) of the studied population. Positive reactions to allergen extracts from the Chloridoideae and the Panicoideae subfamilies showed smaller papule size than allergen extracts from the Pooideae subfamily (χ2(5) = 83.75, p < 0.001). Patients with a positive skin prick test (SPT) to a specific extract were more likely to present some degree of cross-reactivity to the remaining pollens when compared to patients with negative SPT to the same specific extract. Even though the proportion of patients presenting with asthma (46.9%) was higher than those with conjunctivitis (22.6%), there was only a statistically significant association between sensitization to Festuca arundinacea (φ = 0.089, p = .009), Phalaris arundinacea (φ = 0.074, p = .032) and Paspalum notatum (φ = 0.070, p = .038) and the presence of conjunctivitis. CONCLUSIONS: Our results suggest a high frequency of sensitization to grass pollen extracts from the Poaceae family among patients with seasonal allergic rhinitis. Overall, sensitization to the Pooidae subfamily was the most common, where Phalaris arundinacea presented the highest frequency.

Periodontal health status and lung function in two Norwegian cohorts.

RATIONALE AND OBJECTIVES: The oral cavity is united with the airways, and thus poor oral health may affect respiratory health. However, data on the interaction of periodontal and respiratory health is limited. We aimed to evaluate whether periodontal health status, assessed by the Community Periodontal Index (CPI), was related to lung function among young and middle-aged adults in two Norwegian cohorts. METHODS: Periodontal health status and lung function were measured among 656 participants in the Norwegian part of the European Community Respiratory Health Survey (ECHRS III) and the RHINESSA offspring study. Each participant was given a CPI-index from 0 to 4 where higher values reflect poorer periodontal status. The association between CPI and lung function was estimated with linear regression adjusting for age, gender, smoking, body mass index, exercise, education, use of antibiotics, inhaled medication and corrected for clustering within families. MAIN RESULTS: Participants with CPI 3-4 had significantly lower FEV1/FVC ratio compared to participants with CPI 0, b (95% CI) = -0.032 (-0.055, -0.009). Poorer periodontal health was associated with a significant decrease in the FEV1/FVC ratio with an adjusted regression coefficient for linear trend b (95% CI) = -0.009 (-0.015, -0.004) per unit increase in CPI. This negative association remained when excluding asthmatics and smokers (-0.014 (-0.022, -0,006)). CONCLUSIONS: Poorer periodontal health was associated with increasing airways obstruction in a relatively young, healthy population. The oral cavity is united with the airways and our findings indicate an opportunity to influence respiratory health by improving oral health.

The Association of Gum Bleeding with Respiratory Health in a Population Based Study from Northern Europe.

BACKGROUND: There is little knowledge about how oral and respiratory health is interrelated even though the mucosa of the oral cavity and airways constitutes a continuum and the exposures to these are partly similar. AIMS: To investigate whether gum bleeding is related to asthma, respiratory symptoms and self-reported COPD. METHODS: A postal questionnaire including questions about respiratory and oral health was sent to general population samples in seven Northern European centres. In 13,409 responders, gum bleeding when brushing teeth was reported always/often by 4% and sometimes by 20%. Logistic regressions accounted for age, smoking, educational level, centre and gender. Effects of BMI, cardio-metabolic diseases, early life factors, gastro-oesophageal reflux, dental hygiene, nasal congestion, and asthma medication were addressed. RESULTS: Gum bleeding always/often was significantly associated with ≥ 3 asthma symptoms (OR 2.58, 95% CI 2.10-3.18), asthma (1.62 [1.23-2.14]) and self-reported COPD (2.02 [1.28-3.18]). There was a dose-response relationship between respiratory outcomes and gum bleeding frequency (≥ 3 symptoms: gum bleeding sometimes 1.42 [1.25-1.60], often/always 2.58 [2.10-3.18]), and there was no heterogeneity between centres (p(heterogeneity) = 0.49). None of the investigated risk factors explained the associations. The observed associations were significantly stronger among current smokers (p(interaction) = 0.004). CONCLUSIONS: A consistent link between gum bleeding and obstructive airways disease was observed, not explained by common risk factors or metabolic factors. We speculate that oral pathogens might have unfavourable impact on the airways, and that the direct continuity of the mucosa of the oral cavity and the airways reflects a pathway that might provide novel opportunities for interventions.

Resultados neonatales en recién nacidos prematuros traslados antes y despues de la implementación de un equipo de traslado. Hospital Penna. Bahia Blanca 2009-2013: informe final

Objetivos: comparar los resultados neonatales de los RN prematuros derivados al Hospital Penna de Bahía Blanca desde la Región Sanitaria I en el período 2009-2013 según hayan sido trasladados por un equipo terrestre especializado o no. Material y Métodos: estudio retrospectivo, transversal. Se incluyeron RN prematuros traslados desde la Región Sanitaria I al Hospital Penna desde julio de 2009 a julio de 2013. Resultados: Se evaluaron 48 traslados, de los cuales 22 fueron traslados por el equipo de alta complejidad. Se encontraron diferencias en las condiciones de traslado y de ingreso. En cuanto a los resultados neonatales hubieron mas hemorragias y muerte en los RN trasladados por el equipo de alta complejidad lo que podría deberse a la menor edad gestacional peso. Conclusiones: El traslado neonatal requiere de personal entrenado y capacitado para tal fin con equipamiento adecuado, protocolos y procedimientos acordes que puedan ser revisados periódicamente...

Objective: compare neonatal outcomes of preterm infants transferred to the Hospital Penna of Bahia Blanca from the Region I in the period 2009-2013 as they were moved by a specialized ground equipment or not. Methods: Retrospective, cross. Preterm infants were included transfers from the Health Region I Penna Hospital from July 2009 to July 2013. Results: We evaluated 48 transfers, of which 22 were transferred by the team of high complexity. There were differences in the conditions of transfer and income. Regarding neonatal outcomes had more brain hemorrhages and death in newborns transferred for highly complex equipment which might be due to the lower gestational age and weight. Conclusions: The neonatal transport requieres trained and skilled for this purpose with adequate equipment, protocols and procedures consistent they can be reviewed periodically...

Epidemiología de eventos adversos en el servicio de neonatología de un hospital público regional en la Argentina / Epidemiology of adverse events in the neonatal unit of a regional public hospital in Argentina

La seguridad del paciente es una de las dimensiones críticas de la calidad de la atención. Objetivos. Describir la epidemiología de eventos adversos en la unidad de cuidados intensivos neonatales del Hospital Penna, de Bahía Blanca, en el año 2006. Metodología. Estudio de corte transversal basado en la revisión de las historias clínicas neonatales en dos etapas: rastreo a través de indicadores que identifican las historias clínicas con mayor riesgo de ocurrencia de eventos adversos y confirmatoria (valoración de la existencia, tipo, categoría, prevenibilidad y consecuencias del evento adverso). Resultados. Se incluyeron 484 historias clínicas, encontrándo se 146 eventos adversos en 82 internaciones (16,9%) y un promedio de 3 eventos adversos cada 10 internaciones. Más del 90% fueron considerados prevenibles. Los eventos adversos más frecuentes fueron: infecciones intrahospitalarias, eventos relacionados con el manejo de catéteres y las extubaciones. La probabilidad de eventos adversos se asoció inversamente con el peso al nacer y la edad gestacional; directamente con la estadía hospitalaria (fue mayor a mayor estadía) y con el tipo de internación (mayor enterapia intensiva).Conclusión. La población neonatal y sobre todo el recién nacido prematuro, constituye un grupo de gran vulnerabilidad para presentar eventos adversos. La mayoría de estos eventos son potencialmente prevenibles, lo cual evidencia la necesidad de implementar intervenciones eficaces que permitan mejorar la seguridad y calidadde la atención.

Patient safety is one of the critical dimensions of quality of care. Objective. To describe the epidemiology of adverseevent (AE) in the neonatal unit of the Hospital Penna in Bahía Blanca, in 2006.Methodology. Cross-sectional study based on a two-stage-chart-review methodology. 1st stage: screening through indicators that allow the identification of hospitalizations with higher risk of AE; 2nd stage: AE confirmation (assessment of the existence, type, category, preventability and consequences of AE). Results. 484 charts were included. Frequency of AE: 146 in 82 hospitalizations (16.9%) and an average of 3 out of 10 hospitalizations. The most frequent AE were: nosocomial infections; catheter-use related events and extubations. The probability of AE was inversely associated with weight at birth and gestational age and directlyrelated to length of stay (the longer the stay, the higher the probability). It was also positively associated with admission to the intensive care unit.Conclusion. The neonatal population, especially premature newborns, constitutes a group of high vulnerability to present AE. Most of these events are potentially preventable, whichhighlights the need of implementing effective interventions oriented to improve patient safety and quality of care.

[Epidemiology of adverse events in the neonatal unit of a regional public hospital in Argentina]. / Epidemiología de eventos adversos en el servicio de neonatología de un hospital público regional en la Argentina.

UNLABELLED: Patient safety is one of the critical dimensions of quality of care. OBJECTIVE: To describe the epidemiology of adverse event (AE) in the neonatal unit of the Hospital Penna in Bahía Blanca, in 2006. METHODOLOGY: Cross-sectional study based on a two-stage-chart-review methodology. 1st stage: screening through indicators that allow the identification of hospitalizations with higher risk of AE; 2nd stage: AE confirmation (assessment of the existence, type, category, preventability and consequences of AE). RESULTS: 484 charts were included. Frequency of AE: 146 in 82 hospitalizations (16.9%) and an average of 3 out of 10 hospitalizations. The most frequent AE were: nosocomial infections; catheter-use related events and extubations. The probability of AE was inversely associated with weight at birth and gestational age and directly related to length of stay (the longer the stay, the higher the probability). It was also positively associated with admission to the intensive care unit. CONCLUSION: The neonatal population, especially premature newborns, constitutes a group of high vulnerability to present AE. Most of these events are potentially preventable, which highlights the need of implementing effective interventions oriented to improve patient safety and quality of care.

El análisis causa-raíz como oportunidad de mejora de la seguridad en la atención perinatal: análisis de un brote de infección intra-hospitalaria / Root Cause Analysis as an Opportunity to Improve the Safety of Perinatal Care: Analysis of a Nosocomial Infection Outbreak

La seguridad del paciente es un problema grave de salud pública en todo el mundo. El análisis causal con un enfoque sistemático y participativo es una herramienta útil para mejorar la seguridad. OBJETIVOS: Aplicar un análisis causa raíz (ACR) y proponer acciones para corregir estas causas y/o minimizar el riesgo de ocurrencia de eventos similares. MÉTODOS: Análisis Causa Raíz de un evento centinela ocurrido en Unidad de Cuidados Intensivos Neonatales del Hospital Penna de Bahía Blanca, Argentina, en las siguientes etapas: 1) Identificación y selección del evento; 2) Recopilación de la información y descripción del evento; 3) Construcción del mapa de los hechos; 4) Análisis de los factores contribuyentes y estudio de las barreras (físicas, administrativas, organizacionales) que pueden prevenir daños, 5) Desarrollo de soluciones y plan de acción. RESULTADOS: Se seleccionó un brote intra-hospitalario por Staphylococcus aureus meticilino resistente, calificado como catastrófico(muerte de un neonato y de frecuencia ocasional). Con el análisis causal se identificaron los factores humanos proximales y las fallas latentes del sistema relacionadas con aspectos de la organización, la gestión de la información, el manejo del contexto y la cultura corporativa. Como principales barreras de contención se reconocieron la adecuada comunicación entre los profesionales de la salud y la sistematización de los procesos relacionados con la adherencia del personal a las normas de bioseguridad. Luego se diseñó un plan de acción destinado a fortalecer estas barreras. CONCLUSIONES: El ACR es un método factible de implementar para el equipo de salud. Su uso permitiría mejorar la seguridad de los pacientes a través de la identificación y corrección de las fallas latentes del sistema

Patient safety is a serious global public health issue.The causal analysis with a systematic and participatory approachis a useful tool for improving safety. OBJECTIVE: to perform the causal analysis of a sentinel event in order to identify improvement opportunities, propose actions aimed at increasing patient safety and promote a collaborative approach by the health team. METHODS: Root Cause Analysis (RCA) of a sentinel event occurred in the Neonatal Intensive Care Unit of Hospital Penna de Bahía Blanca, Argentina, which included the following steps: 1)identification and selection of the event; 2) information collection and description of the event; 3) construction on the map of the facts; 4) analysis of contributing factors and study of the barriers(physical, administrative, organizational) that may prevent damage, 5) Developing solutions and action plan. RESULTS: an intrahospital methicillin-resistant Staphylococcus aureus out break that affected six new borns and caused one death was selected. The causal analysis permitted the identification of proximal human factors as well as latent system failures associated with organizational factors and factors related to information management, context management and corporative culture. Appropriate communication between health professionals and systematization of processes aimed at guarantying personal adherence to bio-security norms were identified as the main barriers. Interventions oriented to strengthen these barriers were proposed. CONCLUSIONS: ACR is a feasible method to be implemented by the health team. Its use permitted patient safety improvement through the identification and correction of the latent failures of the system

Prevalencia de alergia al veneno de abeja entre los apicultores del sudoeste de la provincia de Buenos Aires / Prevalence of venom bee allergy in beekeepers of the Southwest of the Provincia de Buenos Aires

Objetivos. Relevar la prevalencia de racciones alérgicas (RA) por picaduras de abejas (Apis mellifera), así como el grado de conocimiento entre los apicultores y salas médicas en cuanto a los tratamientos y medidas de prevención. Materiales y métodos. Preguntas ak hoc en una encuesta realizada a apicultores, en 18 partidos del sudoeste bonaerense (proyecto financiado por el Consejo Federal de Inversiones). Resultados. De los 1.335 encuestados, el 97% alguna vez fue picado por una abeja, el 23% manifestó RA de diferente grado, el resto tuvo reacciones normales. Las RA son más frecuentes entre los 5 a 30 minutos posteriores a la picadura. En 8% de los que tuvieron RA necesitó ser medicado. El 94% de éstos fue medicado con algún tipo de corticoide. El 98% conoce el peligro de la picadura de abeja, y sólo el 71% respondió qué tratamiento aplicar en ese caso. Entre ellos, el 90% usaría algún tipo de corticoide (7% adrenalina y 2% antihistamínicos). Sólo el 6,6% sabe que tienen que usar adrenalina en caso de shock anafiláctico. El 1,6% de los apicultores sabe qué tratamiento se les aplicó. También representa un 1,1% del total de apicultores que debieron ser medicados en un hospital o sala. Conclusión. La actividad supone un riesgo alto de picaduras y la mayoría de los apicultores no cuentan con información suficiente para afrontar esta tarea con los conocimientos sobre prevención o tratamiento adecuados. Hay poco conocimiento en las salas asistenciales sobre el tratamiento de urgencia en un shock anafiláctico y su prevención.