Macronutrients during pregnancy and life-threatening respiratory syncytial virus infections in children.

RATIONALE: Respiratory syncytial virus (RSV) is an important cause of hospitalization and death in infants worldwide. Most RSV deaths occur in developing countries, where burden and risk factors for life-threatening illness are unclear. OBJECTIVES: We defined the burden of life-threatening (O(2) saturation [O(2) sat] ≤ 87%) and fatal RSV infection, and characterized risk factors for life-threatening disease in hospitalized children. Special emphasis was placed on studying the impact of dietary habits during pregnancy. We hypothesized that dietary preferences, differing from those of our remote ancestors, would negatively impact children's pulmonary health. For instance, a diet rich in carbohydrates is a signature of recent millennia and typical of low-income populations, heavily burdened by life-threatening RSV disease. METHODS: Prospective study in a catchment population of 56,560 children under 2 years of age during the RSV season in Argentina. All children with respiratory signs and O(2) sat less than 93% on admission were included. MEASUREMENTS AND MAIN RESULTS: Among 1,293 children with respiratory infections, 797(61.6%) were infected with RSV: 106 of these had life-threatening disease; 1.9 per 1,000 children (95% confidence interval [CI], 1.5-2.2/1,000) under 24 months. A total of 22 hospitalized children died (9 RSV(+)), 26 died at home due to acute respiratory infection (14 attributed to RSV); all were under 12 months old. The annual attributable mortality rate for RSV was 0.7 per 1,000 infants (95% CI, 0.4-1.1/1,000). Life-threatening disease was dose-dependently associated with carbohydrate ingestion during pregnancy (adjusted odds ratio from 3.29 [95% CI, 1.15-9.44] to 7.36 [95% CI, 2.41-22.5] versus the lowest quartile). CONCLUSIONS: Life-threatening and fatal RSV infections are a heavy burden on infants in the developing world. Diets rich in carbohydrates during pregnancy are associated with these severe outcomes.

Design, characterization, and in vitro evaluation of antifungal polymeric films.

The objective of the present paper was the development and the full characterization of antifungal films. Econazole nitrate (ECN) was loaded in a polymeric matrix formed by chitosan (CH) and carbopol 971NF (CB). Polyethylene glycol 400 and sorbitol were used as plasticizing agents. The mechanical properties of films were poorer when the drug was loaded, probably because crystals of ENC produces network outages and therefore reduces the polymeric interactions between the polymers. Polymers-ECN and CH-CB interactions were analyzed by Fourier-transform infrared spectroscopy (FTIR), thermal gravimetry analysis, and differential thermal analysis (DTA-TGA). ECN did not show structure alterations when loaded into the films. In scanning electron microphotographs and atomic force microscopy analysis, films prepared with CB showed an evident wrinkle pattern probably due to the strong interactions between the polymers, which were observed by FTIR and DTA-TGA. The in vitro activity of the formulations against Candida krusei and Candida parapsilosis was twice as greater as the commercial cream, probably as a result of the antifungal combination of the drug with the CH activity. All these results suggest that these polymeric films containing ECN are potential candidates in view of alternatives dosages forms for the treatment of the yeast assayed.

Poly( N-isopropylacrylamide) Cross-Linked Gels as Intrinsic Amphiphilic Materials: Swelling Properties Used to Build Novel Interphases.

The hydrophilic nature of hydrogels allows their swelling in aqueous solutions. In that way, any substance loaded inside the gel is exposed to the aqueous media and could be released if it is soluble in water. However, only substances that are soluble in water can be loaded inside a gel, which can be swelled only in water. In this work, we studied the swelling of poly( N-isopropylacrylamide) (PNIPAM) gels in nonaqueous solvents and their solutions with water. PNIPAM gels swell strongly in highly polar solvents, but they do not swell in slightly polar solvents (e.g., toluene). However, it is possible to swell the gel in mixtures containing toluene. The observed properties of PNIPAM gels allow describing them both as solvogels or amphigels. When the loaded substance is soluble in one solvent (e.g., water) and not in another (e.g., chloroform), the substance is not released but exposed to the new media. As a proof of concept, a colorimetric pH sensor active in CHCl3 and a Cu1+ sensor in water were built. Moreover, using a ternary solution containing toluene linear polystyrene can be loaded inside the gel, making a semi-interpenetrated network. Because PNIPAM swells in water and solvents immiscible in water, a liquid/liquid interphase can be set inside a gel. A near-infrared absorbing dye (soluble in CHCl3) is loaded in only half of a thermoresponsive PNIPAM gel. Upon near-infrared irradiation, only the region where the dye is loaded heats up driving the phase transition of PNIPAM.

Mortality predictive indexes in non-critical inpatients.

BACKGROUND: Mortality predictive indexes have not been applied to patients in general wards out of the ICU. METHODS: Retrolective study aimed to evaluate the value of mortality prediction indexes in a cohort of 944 non-critical patients. Three indexes were evaluated according to their calibration and discriminative power: the Mortality Probability Model II (MPMII), the Simplified Acute Physiology System II (SAPS II) and the Logistic Organ Dysfunction System (LODS). The bivariate calculation of relative risk (RR) to die was performed relative to the group of patients that had an expected probability to die > 10%, calculated by an index. To evaluate the calibration, data were arranged in descending order using the chi2 goodness-of-fit model. To evaluate discrimination power, ROC curves were used. RESULTS: SAPS II, MPM II and LODS predicted significant risks at levels of P < 0.005, (RR = 6.56, 4.03 and 3.44, respectively). Regarding the calibration, the null hypothesis was accepted only by using SAPS II (P = 0.664). CONCLUSIONS: The three evaluated indexes each had a good discriminative capacity to detect non-critical inpatients with high risk to die. SAPS II was the best index to predict mortality, as determined by both the bivariate and the calibration analysis. There is no reason for not using mortality predictive indexes for non-critical inpatients.

Aceleración del movimiento ortodóntico mediante corticotomías alveolares / Orthodontic movement acceleration with alveolar corticotomies

Los dientes se mueven a través del hueso, generando tejido óseo en el lado de tensión y removiendo el mismo en el lado de presión, en respuesta a cargas terapéuticas y funcionales, proceso llamado remodelación ósea. Esta remodelación ósea depende de múltiples factores como la densidad y la consistencia de los maxilares, la edad del paciente, entre otros y en algunos casos, se ve comprometida, por defectos óseos, corticales alveolares fusionadas, dientes anquilosados o impactados, entre otros. Por todo esto, se ha propuesto el uso de corticotomías alveolares para coadyuvar el movimiento ortodóncico y se ha utilizado en pacientes de todas las edades, para ayudar a reducir notablemente el lapso de tiempo del tratamiento, y en muchos casos, lograr movimientos que antes eran prácticamente imposibles de realizar. Este artículo tiene por objeto examinar la bibliografía relativa a la corticotomía, como técnica quirúrgica que permite la aceleración del movimiento ortodóncico. El análisis de esto, permite concluir que, la corticotomía alveolar pudiese servir como coadyuvante en el movimiento de ortodoncia en algunos casos, acelerando el mismo hasta un 30 % y permitiendo el paso de los dientes a través del hueso esponjoso de manera más eficiente, y en otros casos pudiendo realizar movimientos ortodóncicos que son difíciles de lograr sin la realización de corticotomías

Teeth move through bone, causing new bone tissue at the side of tension and stirring the same on the pressure side, in response to therapeutic and functional loads, a process called bone modeling. This bone modeling depends on many factors such as density and consistency of the jaws, age of the patient, and in some cases, those factors are compromised by bone defects, collapse in cortical tables, impacted and ankylosed teeth. For all this, it has been proposed the use of alveolar corticotomies to assist orthodontic tooth movement which has been used in patients of all ages, helping significantly in the reduction of treatment time period, and also allowing movements that were previously virtually impossible. This article aims to review the literature on the corticotomy, as a surgical technique that allows accelerated orthodontic movement. The analysis allow to conclude, that the alveolar corticotomy could help in the acceleration of orthodontic movement in some cases until 30%, allowing teeth to pass through the spongy bone more efficiently, and in other cases carrying out orthodontic movements that are difficult to achieve without the realization of corticotomies

Una estrategia de intervención comunitaria en la prevención de los delitos sexuales en féminas / A strategy of community intervention to prevent sexual crimes on women

Se realizan un total de seis seminario-talleres sobre la frecuencia y características de los delitos sexuales en féminas en la provincia, en las zonas mayormente afectadas por el fenómeno (áreas de salud Raúl Sánchez y Hermanos Cruz) a los cuales asistieron 407 representantes de las comunidades elegidas y al término de cada sesión se aplicó a estos una encuesta anónima para recoger sus opiniones sobre el posible impacto del método en la preparación, para identificar situaciones relacionadas con la violencia sexual en féminas y también sobre sus posibles causas, destacándose la opinión popular de un 52,3 por ciento que los vinculan al alcoholismo y en otros porcientos, la falta de control de los padres para con los hijos, desajustes familiares e inadecuados vestuarios y horarios de salida de las jóvenes, entre otros, encontrando el método empleado, aceptación y apoyo entre los encuestados, que se consideran medianamente preparados para identificar y prevenir situaciones vulnerantes...(AU)

A series of six seminaries were performed in order to know the frequency and characteristics of sexual crimes, especially in women. The study was carried out in a population of 407 neighbors in Pinar del Río Province, belonging to a selected health area of Raúl Sánchez and Hermanos Cruz Teaching Polyclinic. At the end of each seminary an anonymous survey was applied to gathers their opinion to get a big effects of this technique to identify some sexual crimes and furthermore the main ethiology. A 52,3 poecent reported an opinion about alcoholism with approved-supported methods for the entire universe. They are mild prepared to identify and prevent vulnerable situations...(AU)

Una estrategia de intervención comunitaria en la prevención de los delitos sexuales en féminas / A strategy of community intervention to prevent sexual crimes on women

Se realizan un total de seis seminario-talleres sobre la frecuencia y características de los delitos sexuales en féminas en la provincia, en las zonas mayormente afectadas por el fenómeno (áreas de salud " Raúl Sánchez " y "Hermanos Cruz") a los cuales asistieron 407 representantes de las comunidades elegidas y al término de cada sesión se aplicó a estos una encuesta anónima para recoger sus opiniones sobre el posible impacto del método en la preparación, para identificar situaciones relacionadas con la violencia sexual en féminas y también sobre sus posibles causas, destacándose la opinión popular de un 52,3% que los vinculan al alcoholismo y en otros porcientos, la falta de control de los padres para con los hijos, desajustes familiares e inadecuados vestuarios y horarios de salida de las jóvenes, entre otros, encontrando el método empleado, aceptación y apoyo entre los encuestados, que se consideran medianamente preparados para identificar y prevenir situaciones vulnerantes.

A series of six seminaries were performed in order to know the frequency and characteristics of sexual crimes, especially in women. The study was carried out in a population of 407 neighbors in Pinar del Río Province, belonging to a selected health area of Raúl Sánchez and Hermanos Cruz Teaching Polyclinic. At the end of each seminary an anonymous survey was applied to gathers their opinion to get a big effects of this technique to identify some sexual crimes and furthermore the main ethiology. A 52.3 % reported an opinion about alcoholism with approved-supported methods for the entire universe. They are mild prepared to identify and prevent vulnerable situations.

Diagnóstico de situación y evaluación de un programa de educación comunitaria para la prevención del Síndrome Urémico Hemolítico / Situation Diagnosis and Evaluation of a Community Education Program for the Prevention of Hemolytic Uremic Syndrome

Se conocen los puntos precisos de intervención en la cadena epidemiológica para prevenir el Síndrome Urémico Hemolítico, pero las condiciones pueden variar entre distintas localidades. OBJETIVOS: Con este estudio se pretende mostrar la utilidad de un modelo de diagnóstico de situación que permite optimizar la implementación de un programa preventivo de educación comunitaria de tipo “formación de formadores” en dos municipios de la provincia de Buenos Aires, y una evaluación de procesos. MÉTODO: El diagnóstico incluyó el relevamiento de la situación socio-sanitaria, hábitos y costumbres alimentarios y detección de los problemas en la cadena de producción, comercialización y consumo de alimentos. La evaluación del proceso fue cuali-cuantitativa: número de talleres y de participantes, e indagación de fortalezas y debilidades del proceso. RESULTADOS: Los principales problemas encontrados fueron la carencia de agua potable y de manejo de las excretas en un gran porcentaje de la población y los deficientes controles bromatológicos y de mantenimiento de la cadena de frío en la provisión de carne y leche. Este diagnóstico permitió adaptar el programa a las condiciones específicas locales, elemento necesario para lograr una intervención eficaz. Se realizaron en total 26 talleres con la participación de 588 agentes. El material gráfico fue de gran utilidad para la comprensión de los contenidos docentes y todos los participantes de los talleres respondieron con gran motivación. Se logró el apoyo de las autoridades locales, lo que facilitó la ejecución del programa

The precise points of intervention in the epidemiological chain to prevent Hemolytic Uremic Syndromeare well known, although conditions may vary between different localities. OBJECTIVES: This study aims to show the usefulness of a situation diagnostic model to optimize the implementation of a preventive community education program type “training the trainers” in two municipalities in the province of Buenos Aires, and the evaluation of the process. METHODS: The diagnosis included a survey of the socio-sanitary conditions, food habits and identifying problem sin the chain of production, marketing and consumption of food. Process assessment was qualitative and quantitative: number of workshops and participants, and determination of strengths and weaknesses of the process. RESULTS: The main concerns were: lack of safe water and excreta management in a large percentage of the population, weak bromatological controls and maintenance of cold chainin providing meat and milk. This diagnosis allowed to adaptthe program to specific local conditions, which is necessary to achieve effective intervention. A total of 26 workshops involving 588 agents were carried out. The artwork was useful for the understanding of educational contents and all workshop participants responded with great motivation. The support from local authorities facilitated the implementation of the program

Caracterización médico-legal de los delitos sexuales en Pinar del Río, 2003-2005 / Medical and legal characteristics of sex offenses in Pinar del Río, 2003-2005

Se encuestó una muestra de 399 víctimas de diferentes edades enviadas al departamento de Medicina legal de Pinar del Río en el trienio 2003 2005 por estarse instruyendo procedimiento penal a causa de algún delito realizado por intermedio de una conducta sexual impositiva que da lugar a la radicación del expediente. Se aplicó de modo directo una encuesta anónima, abierta, previamente elaborada y constitutiva de 9 preguntas, los resultados fueron tabulados por el método de los palotes y llevadas las variables a sábanas, agrupadas en tablas, arrojando la información que los municipios más afectados fueron Pinar del Río, San Cristóbal, consolación del Sur, San Juan y Sandino, siendo los grupos etáreos más vulnerantes las menores de 20 años. Las figuras delictivas que más se repiten son la violación y los abusos lascivos predominando en la relación víctima –victimario; los conocidos, vecinos , padrastros y familiares. En el modus operandi sobresalen el abuso de confianza, intimidación, violencia física y abuso de autoridad, siendo la casa de la víctima y alrededores, casa del victimario, centro de estudios o trabajo y cercanías, caminos, carreteras, lugares recreativos, los lugares mayormente escogidos por los ofensores...(AU)

This study was conducted on different ages 399 victims, where a questionnaire was assessed. They were sent to Legal Medicine Departament of Pinar del Río, during triennium 2003-2005 due to a penal processing. A crime was comsummated in relation to impositive sexual mis conduct with proceeding files an anonymous, opening and direct questionnaire with 9 questions was analyzed. The data were statistically analyzed using palotes methods. All the variables were placed in a sheep and graphic. Pinar del Río, San Cristobal, Consolación Sur, San Juan and Sandino, were more affected. Patients of 20 years old and lees were more wounded violation and lascivious abuse were more frcuently with a big important to stepfather neighbor and relatives. In the operanting modus we consider abuse of confidence, intimidation and physical violence the perfect selected place by ofender are victim home and around, hear a school or job...(AU)

Caracterización medico legal de los delitos sexuales en Pinar del Río, 2003-2005 / Medical and legal characteristics of sex offenses in Pinar del Río, 2003-2005

Se encuestó una muestra de 399 víctimas de diferentes edades enviadas al departamento de Medicina legal de Pinar del Río en el trienio 2003-2005 por estarse instruyendo procedimiento penal a causa de algún delito realizado por intermedio de una conducta sexual impositiva que da lugar a la radicación del expediente. Se aplicó de modo directo una encuesta anónima, abierta, previamente elaborada y constitutiva de 9 preguntas, los resultados fueron tabulados por el método de los palotes y llevadas las variables a sábanas, agrupadas en tablas, arrojando la información que los municipios más afectados fueron Pinar del Río, San Cristóbal, consolación del Sur, San Juan y Sandino, siendo los grupos etáreos más vulnerantes las menores de 20 años. Las figuras delictivas que más se repiten son la violación y los abusos lascivos predominando en la relación víctima - victimario; los conocidos, vecinos, padrastros y familiares. En el modus operandi sobresalen el abuso de confianza, intimidación, violencia física y abuso de autoridad, siendo la casa de la víctima y alrededores, casa del victimario, centro de estudios o trabajo y cercanías, caminos, carreteras, lugares recreativos, los lugares mayormente escogidos por los ofensores.

This study was conducted on different ages 399 victims, where a questionnaire was assessed. They were sent to Legal Medicine Departament of Pinar del Río, during triennium 2003-2005 due to a penal processing. A crime was comsummated in relation to impositive sexual mis conduct with proceeding files an anonymous, opening and direct questionnaire with 9 questions was analyzed. The data were statistically analyzed using palotes methods. All the variables were placed in a sheep and graphic. Pinar del Río, San Cristobal, Consolación Sur, San Juan and Sandino, were more affected. Patients of 20 years old and lees were more wounded violation and lascivious abuse were more frcuently with a big important to stepfather neighbor and relatives. In the operanting modus we consider abuse of confidence, intimidation and physical violence the perfect selected place by ofender are victim home and around, hear a school or job.