Reduction of small dense LDL and Il-6 after intervention with Plantago psyllium in adolescents with obesity: a parallel, double blind, randomized clinical trial.

Obesity can lead children and adolescents to an increased cardiovascular disease (CVD) risk. A diet supplemented with Plantago psyllium has been shown to be effective in reducing LDL-C and IL-6 in adolescents. However, there are no studies that have explored small-dense LDL (sdLDL) or HDL subclasses. The aim of this study was to evaluate the impact of a fiber dietary intervention on LDL and HDL subclasses in adolescents with obesity. In this parallel, double blind, randomized clinical trial, the participants were assigned to Plantago psyllium or placebo (10g/day for 7 weeks). We randomized 113 participants, and evaluated and analyzed 100 adolescents (50 in each group), 15 to 19 years with a body mass index of 29-34. We measured biochemical markers LDL and HDL subclasses using the Lipoprint system (Quantimetrix) and IL-6 by ELISA. Post-treatment there was a decrease in sdLDL between the groups 2.0 (0-5.0) vs 1 (0-3.0) mg/dl (p = 0.004), IL-6 median 3.32 (1.24-5.96) vs 1.76 (0.54-3.28) pg/ml, p <0.0001. There were no differences in HDL subclasses and no adverse effects were reported in either group.Conclusions: Small dense LDL and IL-6 reduced in adolescents with obesity when consuming Plantago psyllium. This may be an early good strategy for the reduction of cardiovascular disease risk in this vulnerable population.Trial registration: ISRCTN # 14180431. Date assigned 24/08/2020 What is Known: • Supplementing the diet with Plantago psyllium lowers LDL-C levels. What is New: • First evidence that soluble fiber supplementation like Plantago psyllium decreases small dense LDL particles in association with lowered IL-6, reducing the risk of cardiovascular disease in obese adolescents.

Higher prolactin and vasoinhibin serum levels associated with incidence and progression of retinopathy of prematurity.

BACKGROUND: Retinopathy of prematurity (ROP) is a potentially blinding, retinal neovascular disease. Systemic prolactin accesses the retina to regulate blood vessels. Prolactin is proangiogenic and can be cleaved to antiangiogenic vasoinhibins. We investigated whether circulating prolactin and vasoinhibins associate with incidence and progression of ROP. METHODS: A prospective, longitudinal, case-control study covering postnatal weeks 1 to 9 measured serum prolactin, vasoinhibins, and vascular endothelial growth factor (VEGF) weekly in 90 premature infants diagnosed as ROP or control. RESULTS: Prolactin levels were higher in ROP than in control patients before (106.2 ± 11.3 (SEM) vs. 64.7 ± 4.9 ng/ml, postnatal week 1) and during (120.6 ± 10 vs. 84.7 ± 7.5ng/ml, postnatal week 5) ROP diagnosis. Prolactin, but not gestational age, birth weight, Apgar score, sepsis, or ventilation time, correlated with ROP. The relative risk (RR) of developing ROP increased if Prolactin (PRL) levels were higher than thresholds of 80 ng/ml (RR = 1.55, 95% CI: 1.06-2.28), 100 ng/ml (RR = 1.63, 95% CI: 1.14-2.34), or 120 ng/ml (RR = 1.95, 95% CI: 1.41-2.68). Vasoinhibin levels were 39.7% higher (95% CI: 4.5-77.5) in the circulation of ROP than in control patients at postnatal week 1 and similar thereafter, whereas VEGF serum levels were always similar. CONCLUSION: High serum prolactin and vasoinhibin levels predict and may impact ROP progression.

[Risk factors associated with the development of early neurological complications in purulent meningitis in a pediatric population]. / Factores de riesgo asociados al desarrollo de complicaciones neurológicas tempranas en meningitis purulenta.

OBJECTIVE: To determine the risk factors associated with the development of early neurological complications in purulent meningitis in a pediatric population. METHODS: This was a case-control study including 78 children aged one month to 16 years with purulent meningitis divided into two groups: cases, with early neurological complications (defined as those presenting < 72 hours from initiation of clinical manifestation), and controls, without early neurological complications. Clinical, serum laboratory, and cerebrospinal fluid (CSF). RESULTS: Seventy-eight patients were included: cases, n = 33, and controls, n = 45. Masculine gender, 19 (57%) vs. feminine gender, 28 (62%) (p = 0.679). Median age in months, 36 months (range, 1-180) vs. 12 months (range, 1-168) (p = 0.377). Factors associated with neurological complications: convulsive crises on admission, p = 0.038, OR, 2.65 (range, 1.04-6.74); meningeal signs, p = 0.032, OR, 2.73 (range, 1.07-6.96); alteration of the alert state, p = 0.003, OR, 13.0 (range, 1.64-105.3); orotracheal intubation, p = 0.000, OR, 14.47 (range, 4.76-44.01); neurological deterioration, p = 0.000, OR, 9.60 (range, 3.02-30.46); turbid CSF, p = 0.003, OR, 4.20 (range, 1.57-11.20); hypoglycorrhachia, < 30 mg/dl, p = 0.001, OR, 9.2 (range, 3.24-26.06); and positive CSF culture, p = 0.001, OR, 16.5 (range, 1.97-138.1). CONCLUSIONS: The factors associated with early neurological complications included convulsive crises on admission, meningeal signs, alteration of the alert state, need for orotracheal intubation, turbid CSF, hypoglycorrhachia, and positive CSF culture.

[Depressive disorder in Mexican pediatric patients with systemic lupus erythematosus (SLE)]. / Trastorno depresivo en pacientes pediátricos mexicanos con lupus eritematoso sistémico (LES).

OBJECTIVE: To identify the prevalence of depression in Mexican pediatric patients with systemic lupus erythematosus. MATERIALS AND METHODS: Analytical transversal study including patients aged 7-16 years with a diagnosis of systemic lupus erythematosus seen at the Pediatric Rheumatology Consultation Service. The disease was classified by means of the MEX-SLEDAI questionnaire. Descriptive statistics with central tendency and dispersion and comparative measurements with chi-squared and Mann-Whitney U tests. Logistic regression and association with odds ratios. SPSS v.21.0 statistical software package. RESULTS: We evaluated 45 patients who presented depression, n=9 (20%), including eight females (89%) and one male (11%), median age 13 years (range, 7-16) in children with depression vs. 13 years (range, 9-14) p=0.941, depression more frequent in schoolchildren. Habitual residence, disease evolution time, and duration of the immunosuppressor did not show a significant difference between both groups. Divorced parents p=0.037. Neuropsychiatric manifestations of lupus presented in 2.2% of all patients and in 100% of patients with depression. Disease activity index (MEX-SLEDAI) did not demonstrate a relationship with the presence of depression. CONCLUSION: Prevalences in pediatric populations are less that that reported in adults, association with disease activity, evolution time, and immunosuppressor use and duration not found.

[Level of knowledge of and capability for application of isolation precautions in a tertiary-level pediatric hospital]. / Grado de conocimiento y aptitud para la aplicación de las precauciones de aislamiento en un hospital pediátrico de tercer nivel.

OBJECTIVE: To assess the level of knowledge of and capability for application of isolation precautions. MATERIALS AND METHODS: A cross-sectional study was conducted at a tertiary-level pediatric hospital, and a questionnaire including structured questions and clinical scenarios was applied to healthcare personnel. Descriptive and inferential statistics were performed with the chi-squared test and odds ratios were obtained. RESULTS: A total of 131 healthcare workers participated in the study, including 34 (26%) attending physicians, 47 (36%) medical residents, 48 (37%) nurses, and 2 (1%) physicians who were heads of the department. According to our definition, 99 (75%) had poor, 22 (17%) had fair, and 10 (8%), good knowledge. With regard to the capability for application of isolation precautions, 66 (51%), 33 (25%), and 32 (24%) possessed poor, fair, and good levels, respectively. Association with poor knowledge was exhibited as follows: physicians, OR: 0.17 (0.005-0.54), p = 0.001; undergraduate degree in medicine, OR: 0.37 (0.16-0.83), p = 0.01; seniority < 5 years, OR: 0.35 (0.14-0.86), p = 0.019, and training during previous year, OR: 0.09 (0.03-0.24), p = 0.005, while association with poor capability was the following; physician, OR: 0.25 (0.12-0.55), p = 0.005; undergraduate degree in medicine, OR: 0.38 (0.18-0.80), p = 0.009; seniority < 5 years, OR: 0.90 (0.45-1.81), p = 0.78, and training during previous year, OR: 0.23 (0.10-0.51), p = 0.005. CONCLUSIONS: Being a physician, having an undergraduate degree in medicine, < 5 years working at the hospital, and having received training in the previous year were positively associated with knowledge and application of isolation precautions.

[Evaluation of the results of percutaneous closure by means of the Amplatzer device in pediatric patients with intra-auricular communication (IAC)]. / Evaluación de los resultados del cierre percutáneo mediante el dispositivo Amplatzer en pacientes pediátricos con comunicación interauricular (CIA).

OBJECTIVE: To describe the results of percutaneous closure by means of the Amplatzer Septal Occluder (ASO) device in pediatric patients with intra-auricular communication (IAC). MATERIALS AND METHODS: Descriptive transversal study in patients submitted to percutaneous closure of IAC from March 2005 to March 2013. Patients aged <16 years, weight>6 kg, IAC type ostium segundum, and patent foramen ovale, with border separations borders>5 mm, and absence of coexisting pathology were included in the study. We excluded from the study children with severe pulmonary blood pressure/arterial hypertension. Descriptive statistics with the SPSS v. 20.0 statistical software package. RESULTS: We included in the study 28 patients, feminine gender (n=19, 68%), median age=8 years (range, 4-14), weight 30.7 kg (range, 15-69). New York Heart Association (NYHA) functional class I (n=21, 75%), II (n=7, 25%). Median IAC size, 15.50 mm (range, 5-25), and a median ASO size of 17.54 mm (range, 8-28). After ASO placement, 100% presented NYHA I at one month, cardiac murmur (n=2, 7.1%), cessation of cardiac murmur at month 6 (n=28, 100%), without evidence of arrhythmias at one month 100%, residual short circuit at 24 hours (n=4, 14%), complete occlusion at month 6 (n=28, 100%), normalization size of VD, and cessation of tricuspid insufficiency 100% at one year. Complications included minimal bleeding during the procedure (n=2, 7%), transitory cephalea (n=5, 18%), and dysautonomia (n=1, 4%). CONCLUSION: Percutaneous closure of IAC of children fitted with the ASO device is safe and exhibits good results.

[Risk factors associated with bacterial growth in derivative systems from cerebrospinal liquid in pediatric patients]. / Factores de riesgo asociados a crecimiento bacteriano en sistemas derivativos de líquido cefalorraquídeo en pacientes pediátricos.

OBJECTIVE: To determine risk factors associated with bacterial growth in systems derived from cerebrospinal fluid in pediatric patients. METHODS: Case and controls study from January to December 2012, in patients aged <16 years who were carriers of hydrocephalus and who required placement or replacement of derivative system. Cases were considered as children with cultures with bacterial growth and controls with negative bacterial growth. Inferential statistics with Chi-squared and Mann-Whitney U tests. Association of risk with odds ratio. RESULTS: We reviewed 746 registries, cases n=99 (13%) and controls n=647 (87%). Masculine gender 58 (57%) vs. feminine gender 297 (46%) (p=0.530). Age of cases: median, five months and controls, one year (p=0.02). Median weight, 7 vs. 10 kg (p=0.634). Surgical interventions: median n=2 (range, 1-8) vs. n=1 (range, 1-7). Infection rate, 13.2%. Main etiology ductal stenosis, n=29 (29%) vs. n=50 (23%) (p=0.530). Non-communicating, n=50 (51%) vs. 396 (61%) (p=0.456). Predominant microorganisms: enterobacteria, pseudomonas, and enterococcus. Non-use of iodized dressing OR=2.6 (range, 1.8-4.3), use of connector OR=6.8 (range, 1.9-24.0), System replacement OR=2.0 (range, 1.3-3.1), assistant without surgical facemask OR=9.7 (range, 2.3-42.0). CONCLUSIONS: Being a breastfeeding infant, of low weight, non-application of iodized dressing, use of connector, previous derivation, and lack of adherence to aseptic technique were all factors associated with ependymitis.

[Depression in school children and adolescents carriers of acute leukemia during the treatment phase]. / Depresión en escolares y adolescentes portadores de leucemia aguda en fase de tratamiento.

UNLABELLED: Objective: To describe depression levels in school aged children and adolescents with acute leukemia during the treatment. MATERIALS AND METHODS: This transversal descriptive study took place during January to September 2012 and included school aged children and adolescents, carriers of acute leukemia, in treatment at a high-ranking specialty hospital. A modified Kovacs questionnaire (C O/) was applied. They were grouped according to presence or absence of depression. Inferential statistics with x2 and Statistical package SPSS 20.0 were used. RESULTS: Forty-six patients were included in the study: with depression n = 43 (94%), without depression n=3 (6%), males n= 32 (70%) and females n=14 (30%), average age 8 years old (7-15). Acute lymphoblast leukemia was the most frequent n=42 patients (91 %). Depression was found in 42 patients (91 "'o), with nine presenting a minor level (21 "'o), 11 a moderate level (26 "/o), and 23 a severe level (53 "/o). Mostly during the consolidation phase, 30 patients (70"/o) patients with no relapses showed a higher incidence of depression, 23 (54 "/o) vs. with relapses 20 (47"/o) (p = 0.870); the majority had no family history of depression 41 (95 "/o) vs. 2 (5"/o) (p = 0.017). CONCLUSIONS: We found a high percentage of severe level depression, which affected mostly male patients, suffering a relapse during the consolidation treatment phase.

[Early complications with colon esophageal substitution for children via retrosternal]. / Complicaciones tempranas de la sustitución esofágica con colon por vía retroesternal en niños.

OBJECTIVE: To describe the early complications of esophageal replacement with colon in children. METHODS: Descriptive cross-sectional study from 2005 to 2011 in pediatric patients diagnosed with alkali intake, esophageal atresia or esophageal injury traumatic esophageal replacement handled via retrosternal colon. Descriptive statistical analysis using SPSS 20.0. RESULTS: We included 19 esophageal replacements, age seven (4-15), 13 (68%) male and six (31%) female. Initial diagnosis of ingestion of caustic 13 patients (68%) and type III esophageal atresia six cases (32%). Of the six esophageal atresia, four(66%) had dehiscence plasty, one (17%) long-gap atresia and type 1 (17%) esophageal perforation by dilatation. The segment of transverse colon was used in eight (42%), transverse/descending seven (36%), ascending/transverse three (15%), and descending colon one (5%). Early complications were pneumothorax one patient (5%), pneumonia three (15%), sepsis three (15%), intestinal obstruction due to adhesions two (10%), intussusception one (5%), cervical fistula three (15%). One death from sepsis (5%) at four days after surgery. DISCUSSION: Esophageal replacement with colon is a good alternative for esophageal replacement; the most frequent early complications were cervical fistula, pneumonia, and sepsis.

[Comparison of participative educative strategy versus traditional educative strategy in health personnel]. / Comparación de la estrategia educativa participativa con la tradicional en el desarrollo de aptitud clínica en reanimación neonatal en personal de salud.

OBJECTIVE: To compare the clinical aptitude in neonatal resuscitation with participative educative strategy versus traditional educative strategy in health personnel. MATERIAL AND METHODS: Quasi-experimental study design including physicians and nurses distributed in two groups: (i) participative educative strategies n=156, and (ii) traditional n=158, were imparted in 12 sessions. Evaluation of clinical aptitude evaluated with validated questionnaire. Descriptive and interferential statistical inter- and intragroup. RESULTS: Clinical aptitude median score before/after: participative educative strategy 25.0/36.5 (p=0.000) and traditional 24.5/31.0 (p=0.000); differences between intergroup p=0.040. Changes to higher category according to the score before/after in participative 114 (73%) vs. traditional 65 (41%); p=0.010. There were no significant differences in the intergroup results in the category of evaluation of clinical aptitude, but there were differences in the intragroup when we evaluated median before and after with both strategies. CONCLUSIONS: Increase of clinical aptitude in neonatal resuscitation in health personnel,with both educative strategies being higher with participative strategy.

[Evaluation of the diagnostic utility scale of NOSEP-1 and NOSEP-1 modified in suspected nosocomial sepsis in preterm infants].

INTRODUCTION: Nosocomial sepsis in premature neonates entertains a high rate of mortality. Diagnosis and timely treatment increase the therapeutic response. The nosocomial sepsis neonate prediction (NOSEP-1) scale has been utilized to evaluate neonatal sepsis; this scale required modifications to improve its sensitivity and specificity (NOSEP-1 modified). OBJECTIVE: To determine the diagnostic usefulness of the NOSEP-1 and NOSEP-1 modified scales when nosocomial sepsis is suspected in premature neonates. MATERIAL AND METHODS: Evaluation of the diagnostic test in premature neonates with data suggestive of sepsis. The gold standard was the hemoculture and the following diagnostic tests: nosocomial sepsis neonate prediction (NOSEP-1), with the following five items, including C-reactive protein (CRP); neutrophils; platelets; evaluation of the 24-h parenteral nutrition test, and fever, while NOSEP-1 modified substitutes fever with thermal stability and days on parenteral nutrition are reduced from 14 to 3 days. Precision, sensitivity, specificity, and positive and negative predictive values were calculated. The Fagan nomogram determined diagnostic usefulness. We employed the SSPS ver. 20 statistical software Packaged and statistical significance of p < 0.05. RESULTS: We studied 77 premature neonates, with application of the gold standard and the diagnostic test. There were 36 (47%) positive hemocultures. NOSEP-1, > 9 in sepsis 24 (67%), without sepsis 15 (36%) (p = 0.012). NOSEP-1 modified, > 9 in sepsis 35 (97%), without sepsis 35 (88%) (p = 0.113). NOSEP-1: sensitivity, 66%; specificity, 63%; positive pressure volume (PPV), 61%; negative pressure volume (NPV), 68%; positive pressure rate (RPP), 1.82, and negative pressure rate (RPN), 1.14. NOSEP-1 modified scale: sensitivity 97%; specificity 14%; positive pressure value (PPV), 50%; negative pressure value (NPV), 85%; positive probability ratio (PPR), 0.53, and negative probability ratio (NPR), 0.19. Diagnostic usefulness: NOSEP-1, 64%, and NOSEP-1 Modified, 53%. CONCLUSIONS: The NOSEP-1 and the modified NOSEP-1 scales have limited usefulness for diagnosing nosocomial sepsis in premature neonates.

[Clinical course of children of mothers with addictions into a neonatal intensive care unit in western Mexico]. / Evolución clínica de hijos de madres con adicciones internados en una unidad de terapia intensiva neonatal del Occidente de México.

BACKGROUND: Pregnancy in women addicted represents, in itself, a major risk of destruction of physical and mental health of the unborn child; urgent prevention is the same as essential to providing quality care to the mother and child knowledge. OBJECTIVE: Describe the physical and sociodemographic characteristics of neonates in intensive care units, born of mothers with addictions. MATERIALS AND METHOD: Cross-sectional, descriptive study of neonates with addict mothers, analyzing age, gender, clinical symptoms and complications. Findings for frequency-percentages with regard to qualitative variables, and medians and ranges for quantitative variables. SPSS-20.0-Windows Statistics software package. RESULTS: 618 patients admitted to the NICU, 180(29%) showing withdrawal symptoms; irritability in 117 (63%), intensive crying in 93 (51%), spontaneous Moro reflex 74 (42%), diarrhea 61 (30%), fever 61 (30%). Birth defects 124 (20%), from greater to lesser occurrence: disorders in central nervous system, digestive tract and abdominal wall, extremities, kidneys, and others. 309 (50%) weight lower than 2600g. The most frequent metabolic disorders were hypoglycemia, Metabolic Acidosis and jaundice, among others. CONCLUSIONS: Every day, we see more children born of substance-dependent mothers in the Mexico. Our study reveals high mortality rate and many complications for this group; thus, it becomes necessary to institute preventive measures among Mexican women of childbearing age in order to prevent illegal drug use and to increase treatment among pregnant addicts. Gynecologists, pediatricians and neonatologists must have extensive knowledge regarding the entire clinical-social spectrum of symptoms that may be observed in children of mothers suffering addictions.

[Comparison of perinatal clinical profiles in newborns of adolescent and non-adolescent mothers]. / Comparación del perfil clínico perinatal de recién nacidos de madres adolescentes y no adolescentes.

Objective. To compare the clinical profiles in newborns of adolescent and non-adolescent mothers. Materials and Methods. Comparative cross-sectional study. Newborns selected by cluster sampling registered in the hospital. Two groups were formed according to the mother's age: adolescent and non-adolescent. The clinical profile was evaluated with: weight, length, Apgar score, gestational age, and presence of neonatal pathology. For the comparison between proportions, we used chi-squared test and student´s t-test between the mean. Results. Of the 2,155 clinical profiles of newborns analyzed, 819 (38%) were newborns of adolescent mothers and 1,336 (62%) of non-adolescent mothers. Differences between birth weight groups 2,859 ± 459 vs. 3,265 ± 486 grams (p = 0.000), male gender 518 (63%) vs. 725 (54%) female (p = 0.000); intrauterine growth restriction in full-term newborns 62 (7.5%) vs. 66 (4.9%) (p = 0.012); prematurity 171 (21%) vs. 213 (16%) (p = 0.003). Factors that favor the alteration of clinical profiles in newborns: adolescent mother OR: 1.58 (1.99-2.99), male gender OR: 1.80 (1.50-2.17), neonatal pathology OR: 3.73 (2.50-5.30), association of low birth weight in newborns of adolescent mothers OR: 2.4 (1.72-3.42). Conclusion. We found a high frequency of observing in newborns of adolescent mothers greater risk of prematurity, intrauterine growth restriction, and neonatal pathology. No differences were seen in length and Apgar score.

[Behavior of cervical intraepithelial neoplasia in pregnant adolescents and its persistence after an obstetric event]. / Comportamiento de la neoplasia intraepitelial cervical (NIC) en la adolescente embarazada y su persistencia posterior al evento obstétrico.

OBJECTIVE: To observe the behavior of cervical intraepithelial neoplasia in pregnant adolescents and the persistence before the delivery. MATERIALS AND METHODS: A cross-sectional study including 47 pregnant adolescents with NIC-positive results diagnosed by colposcopy during pregnancy with subsequent evaluation before the delivery. Nonrandom sampling of consecutive cases. Descriptive statistics with central and dispersal measures. RESULTS: In total, 156 pregnant adolescents were studied, of which 30% (n = 47) had positive results to NIC with subsequent evaluation. Ages 18 ± 1.5 years, primiparous 77%, sexual activity initiation 15.6 ± 1.6 years old, sexual partners 1 (1-6), smoking and alcoholism 21%. At the beginning of pregnancy, 98% had NIC I results and 2% had NIC II by colposcopy. After delivery, 13% had normal results and 87% remained in NIC I. CONCLUSION: The findings suggest that in pregnant adolescents there exists a natural dysplasia history as in pregnant women. Most of the lesions are NIC I and don't modify the evolution, with some regressing after the delivery.

Description of clinical and genetic features of 122 patients included in the Spanish Pompe registry.

Pompe disease is a rare genetic disorder with an estimated prevalence of 1:60.000. The two main phenotypes are Infantile Onset Pompe Disease (IOPD) and Late Onset Pompe Disease (LOPD). There is no published data from Spain regarding the existing number of cases, regional distribution, clinical features or, access and response to the treatment. We created a registry to collect all these data from patients with Pompe in Spain. Here, we report the data of the 122 patients registered including nine IOPD and 113 LOPD patients. There was a high variability in how the diagnosis was obtained and how the follow-up was performed among different centres. Seven IOPD patients were still alive being all treated with enzymatic replacement therapy (ERT) at last visit. Ninety four of the 113 LOPD patients had muscle weakness of which 81 were receiving ERT. We observed a progressive decline in the results of muscle function tests during follow-up. Overall, the Spanish Pompe Registry is a valuable resource for understanding the demographics, patient's journey and clinical characteristics of patients in Spain. Our data supports the development of agreed guidelines to ensure that the care provided to the patients is standardized across the country.

Why Do Not All Living Kidney Donor Candidates Are Accepted for Donation? A Pediatric Center Experience.

BACKGROUND: Living donor kidney transplantation is the best type of renal replacement therapy for patients with end-stage renal disease. Living kidney donors (LKDs) undergo an extensive evaluation before donating, and many potential LKDs are declined. This study aimed to define the reasons for the decline in LKD candidates referred to our center. METHODS: We retrospectively analyzed clinical data of all potential LKDs evaluated between January 2001 and December 2021 at our institution,Western National Medical Center, Pediatric Hospital. Data were obtained by review of an electronic database. RESULTS: A total of 1332 potential LKDs were evaluated, 796 (59.7%) successfully donated; 20 (1.5%) had a complete evaluation, were accepted for donation, and were on the waiting list for intervention; 56 (4.2%) continued in the evaluation process; 200 (15%) were discharged from the program due to administrative aspects, death (donor or receptor), or cadaveric renal transplantation in order of frequency; 56 (4.2%) withdraw by personal choice; and 204 (15.3%) were rejected for donation. Donor-related reasons included medical contraindications (n = 134, 65.7%), anatomic contraindications (n = 38, 18.6%), immunologic barriers (n = 18, 8.8%), and psychological reasons (n = 11, 5.4%). CONCLUSIONS: Despite the large number of potential LKDs, a significant proportion did not proceed for donation for different reasons; in our description, it represents 40.3%. The largest proportion is because of donor-related causes, and most of the reasons result from the candidate's unnoticed chronic diseases.

[Parental aptitude to prevent child sexual abuse after a participatory education intervention]. / Aptitud de padres para prevenir abuso sexual en menores después de una intervención educativa participativa.

OBJECTIVE: To evaluate the aptitude of parents regarding the educational impact of equity education for children to prevent child sexual abuse using participatory strategies. MATERIAL AND METHODS: Quasi-experimental design. Ninety-two parents with children in preschool were included in the study. The parents were given a course using participatory educational strategies for one hour daily over a period of 20 days. Prior to the course, a group of experts in child education and sexology prepared a questionnaire with 20 sentences. A Wilcoxon test was used to compare intergroup differences RESULTS: We found statistically significant differences in the parents' responses before and after the educational intervention, with a median (range) of 10(2-12)/18(6-20), p<0.01. CONCLUSIONS: A significant change in aptitude was noted when parents attended classes using a participatory strategy to learn about the impact of educational equity for the prevention of child sexual abuse. Thus, it is imperative to continue evaluating different educational strategies.

Retrospective Study of the Seroprevalence of HIV, HCV, and HBV in Blood Donors at a Blood Bank of Western Mexico.

Obtaining blood which is safe for transfusions is one of the principal challenges in the health systems of developing countries. Supply of contaminated blood increases morbidity, mortality, and the costs of patient care. In Mexico, serological screening is mandatory, but only a few of the main blood banks routinely perform a nucleic acid test (NAT). Data from 80,391 blood donations processed between August 2018 and December 2019 at the Central Blood Bank of the Western National Medical Center of the Mexican Social Security Institute (IMSS) were analyzed. All donors were screened for serological markers and NAT was performed. Reactive donors were followed-up to confirm their results. The number of reactive donors and seroprevalence rates for HIV, HCV, and HBV were 152 (18.91/10,000), 385 (47.89/10,000), and 181 (22.51/10,000), respectively; however, these rates decreased when NAT-confirmed reactive results were considered. Male donors were found to have a higher seroprevalence than females, and younger donors higher than older donors. The present study shows that HIV, HCV, and HBV seroprevalence in blood donors in Western Mexico is low. We propose that Mexico should establish future strategies, including pathogen reduction technologies (PRTs), in order to improve blood safety and reduce transfusion-transmissible infections (TTIs).

[Assessment of prenatal, perinatal, and postnatal factors for intraventricular hemorrage in premature newborns less than 33 weeks of gestational age]. / Evaluación de factores prenatales, perinatales y posnatales para hemorragia intraventricular en prematuros menores de 33 semanas de edad gestacional.

OBJECTIVE: Evaluation of risk factors for intraventricular hemorrhage in preterm less than 33 weeks gestational age (RNP). METHODS: CASE-control study. We included RNP from a tertiary care center classified by the results of transfontanellar sonography. CASE: presence of intraventricular hemorrhage. CONTROL: absence of intraventricular hemorrhage. We investigated prenatal history perinatal and postnatal. Logistic regression was used to adjust the variables associated with intraventricular hemorrhage; we calculated odds ratios (OR) with confidence intervals of 95% (95% CI). RESULTS: We analyzed the medical records of RNP 64; of these 32 were cases. The risk factors associated with intraventricular hemorrhage were: sepsis (OR: 18.45; 95% CI: 4.01-32.82; p = 0.01), respiratory distress syndrome (OR: 2.24; 95% CI: 1.07-4.95; p = 0.04), use with mechanical ventilation (OR: 3.60; 95% CI: 1.46-8.91; p = 0.01), and exogenous surfactant (OR: 2.32; 95% CI: 1.05-6.14; p = 0.03). CONCLUSIONS: The postnatal factors were associated with higher risk for intraventricular hemorrhage in RNR The transfontanellar sonography should be taken at different times to know with precision the risk factors for this pathology and try to avoid them.