Actividad física intergeneracional y bienestar en la infancia / Intergenerational physical activities and well-being in childhood

El objetivo de este trabajo fue examinar si la práctica de la actividad física de ocio compartida entre abuelos y nietos se asocia con un mayor bienestar psicológico y físico en la infancia. Participaron en esta investigación 1080 niños y niñas de entre 6 y 12 años, 53,61% mujeres y 46,38% hombres, de la zona norte de España. Un 32,4% de niños practicaban actividad física de ocio con sus abuelos y opinaron que el ocio compartido con sus mayores les aportaba bienestar psicológico y físico. La práctica de actividad física compartida entre abuelos y nietos se asoció positivamente con un mayor bienestar físico y psicológico de los nietos. Las políticas de intervención social y familiar deben dirigirse a favorecer entornos de práctica de actividad física familiar intergeneracional por su contribución a la adherencia físico-deportiva de los menores y al incremento de su bienestar físico y psicológico. (AU)

The objective of this work was to examine whether the practice of physical activity shared by grandparents and grandchildren is associated with increased psychological and physical well-being in childhood. In this research, participants were 1080 children aged 6 to 12 (53.61% female and 46.38% male) from northern Spain. Concerning leisure, 32.4% of the children practiced physical leisure activity with their grandparents and considered that sharing leisure with their grandparents contributed to their psychological and physical well-being. The practice of physical activity shared by grandparents and grandchildren was positively associated with the grandchildren’s greater perception of physical and psychological well-being. Social and family intervention policies should be aimed at fostering intergenerational settings for family physical activity because of their contribution to children's physical-sports adherence and to the increase in children’s physical and psychological well-being. (AU)

Tricotilomanía: investigando una patología desapercibida / Trichotillomania: searching an unnoticed pathology

La tricotilomanía es un trastorno psíquico primario, que ocasiona una alopecia no cicatrizal autoprovocada y se ubica en el grupo de los trastornos obsesivo-compulsivos. La tricotilomanía se puede clasificar dentro de las llamadas dermatitis "artefactas". Suele ser más frecuente de lo que se pensaba; es motivo actual de investigación por la co-morbilidad asociada a otras patologías psicogénicas. A pesar de ser observada más comúnmente en niños y adolescentes, esta conducta anormal, repetida y estereotipada de manipular, traccionar y arrancar los pelos de alguna zona pilosa del cuerpo puede ocurrir a cualquier edad. Es importante el diagnóstico oportuno para evitar complicaciones médicas y psiquiátricas posteriores. La terapia psicológica y el empleo de psicofármacos para el control de este padecimiento, representan un verdadero reto terapéutico.(AU)

Trichotillomania is a self-induced nonscarring alopecia classified as an impulsive control disorder but with features of both obsessive-compulsive disorder and addictive disorders, that has recently received research attention. It appears to be more common than previously believed. Although most frequent in children, this repetitive hair pulling out of ones own hair can occur at any age. Psychogenic excoriations, nail-biting and other abnormal behaviors can be associated. It is important that the diagnosis is early and exact avoiding medical and psychiatric complications. Therapy for trichotillomania can be challenging.(AU)

Haga su diagnóstico / Do your diagnostic

Presentamos el caso de un niño con numerosas placas tumorales discrómicas bien definidas, algunas atróficas, otras levantadas, cubiertas por formaciones escamo-costrosas, indoloras, localizadas en extremidad inferior derecha, de curso lentamente progresivo. No se encuentran otros hallazgos clínicos acompañantes de importancia. El diagnóstico de certeza se efectúo mediante estudio de imagen e histopatológico; el tratamiento consistió en extirpación quirúrgica a intervalos irregulares.(AU)

An eleven-year old child with multiple depressed and raised skin pigmented tumors and plaques, with adherent desquamation and crusts on their skin suface was located in his right lower extremity. There are not any other clinical manifestation of interest. Diagnostic approach was based on radiological and pathology examinations. Surgical treatment was the suitable option.(AU)

Tricotilomanía: investigando una patología desapercibida / Trichotillomania: searching an unnoticed pathology

La tricotilomanía es un trastorno psíquico primario, que ocasiona una alopecia no cicatrizal autoprovocada y se ubica en el grupo de los trastornos obsesivo-compulsivos. La tricotilomanía se puede clasificar dentro de las llamadas dermatitis "artefactas". Suele ser más frecuente de lo que se pensaba; es motivo actual de investigación por la co-morbilidad asociada a otras patologías psicogénicas. A pesar de ser observada más comúnmente en niños y adolescentes, esta conducta anormal, repetida y estereotipada de manipular, traccionar y arrancar los pelos de alguna zona pilosa del cuerpo puede ocurrir a cualquier edad. Es importante el diagnóstico oportuno para evitar complicaciones médicas y psiquiátricas posteriores. La terapia psicológica y el empleo de psicofármacos para el control de este padecimiento, representan un verdadero reto terapéutico.

Trichotillomania is a self-induced nonscarring alopecia classified as an impulsive control disorder but with features of both obsessive-compulsive disorder and addictive disorders, that has recently received research attention. It appears to be more common than previously believed. Although most frequent in children, this repetitive hair pulling out of one's own hair can occur at any age. Psychogenic excoriations, nail-biting and other abnormal behaviors can be associated. It is important that the diagnosis is early and exact avoiding medical and psychiatric complications. Therapy for trichotillomania can be challenging.

Haga su diagnóstico / Do your diagnostic

Presentamos el caso de un niño con numerosas placas tumorales discrómicas bien definidas, algunas atróficas, otras levantadas, cubiertas por formaciones escamo-costrosas, indoloras, localizadas en extremidad inferior derecha, de curso lentamente progresivo. No se encuentran otros hallazgos clínicos acompañantes de importancia. El diagnóstico de certeza se efectúo mediante estudio de imagen e histopatológico; el tratamiento consistió en extirpación quirúrgica a intervalos irregulares.

An eleven-year old child with multiple depressed and raised skin pigmented tumors and plaques, with adherent desquamation and crusts on their skin suface was located in his right lower extremity. There are not any other clinical manifestation of interest. Diagnostic approach was based on radiological and pathology examinations. Surgical treatment was the suitable option.

Tumor extragonadal de células germinales en mediastino: aportación de un caso / Extragonadal germ cell tumor in mediastinum: case report

Los tumores de células germinales de origen extragonadal son descritos infrecuentemente en la literatura, siendo menos de 1.000 casos. Los sitios de origen por orden de frecuencia son mediastino, retroperitoneo, región sacro coccígea y glándula pineal. Este caso es de un germinoma primario en mediastino en un paciente de 27 años de edad. En los estudios de imagen se demostró una masa mediastinal, se tomo una biopsia para llegar al diagnóstico. Marcadores tumorales normales, el ultrasonido testicular reportó la presencia de microlitiasis bilateral. El paciente fue tratado con poliquimioterapia y resección de masa residual. La evolución fue satisfactoria con respuesta completa (AU)

The Germ Cell tumors of extragonadal origin are infrequent cases being described in literature less than 1000 cases. The frequent origin sites are mediastinum, retroperitoneum, sacrococcygeal region, and the pineal gland. There was a primary case of germinoma in mediastinum in a 27 years patient. In the image studies a mediastinal mass was demonstrated, a biopsy was taken arriving at the diagnosis. Normal tumor markers, testicular ultrasonography reported the presence of bilateral microlitiasis. It was treating with polychemotherapy and later residual mass was dried. The evolution was satisfactory with complete answer (AU)

In vitro and in vivo killing of ocular Demodex by tea tree oil.

AIMS: To compare the in vitro killing effect of different agents on Demodex and to report the in vivo killing effect of tea tree oil (TTO) on ocular Demodex. METHODS: Survival time of Demodex was measured under the microscope. Sampling and counting of Demodex was performed by a modified method. RESULTS: Demodex folliculorum survived for more than 150 minutes in 10% povidone-iodine, 75% alcohol, 50% baby shampoo, and 4% pilocarpine. However, the survival time was significantly shortened to within 15 minutes in 100% alcohol, 100% TTO, 100% caraway oil, or 100% dill weed oil. TTO's in vitro killing effect was dose dependent. Lid scrub with 50% TTO, but not with 50% baby shampoo, can further stimulate Demodex to move out to the skin. The Demodex count did not reach zero in any of the seven patients receiving daily lid scrub with baby shampoo for 40-350 days. In contrast, the Demodex count dropped to zero in seven of nine patients receiving TTO scrub in 4 weeks without recurrence. CONCLUSIONS: Demodex is resistant to a wide range of antiseptic solutions. Weekly lid scrub with 50% TTO and daily lid scrub with tea tree shampoo is effective in eradicating ocular Demodex.

Isolation of shiga toxin-producing Escherichia coli from a South American camelid (Lama guanicoe) with diarrhea.

Shiga toxin-producing Escherichia coli belonging to serotype O26:H11 was isolated from a 2-month-old guanaco with severe watery diarrhea. E. coli colonies carried the stx1 and eae genes, showed localized adherence to HEp-2 cells, and produced enterohemolysin. A serological response to lipopolysaccharide O26 was observed at the onset of diarrhea.

Non-O157 Shiga toxin-producing Escherichia coli isolated from diarrhoeic calves in Argentina.

Faecal samples from 76 diarrhoeic calves belonging to 36 farms located in the Pampas plain, Argentina, were examined for Shiga toxin-producing Escherichia coli (STEC). A total of 15 STEC strains were isolated from 12 (15.8%) calves which came from six different farms. All stx positive strains assayed by PCR were also positives in the Vero cell cytotoxicity test. The majority (60.0%) of the STEC strains carried the stx(1) gene. Twelve (80.0%) of the STEC isolates which belonged to serotypes O5:H- (n = 4), O26:H11 (n = 4), O26:H- (n = 1), O111:H- (n = 2), and O123:H38 (n = 1) were also enterohaemolysin (EHly) positive and carried the gene encoding for intimin (eae). All the stx positive strains were negative for the bfpA gene. Localized adherence to HEp-2 cells were observed in 83.3% of the eae+ STEC strains. STEC belonging to serotype O5:H- showed atypical biochemical properties, including urease production. Urease was also produced by two strains belonging to serotypes O153:H? and non-typeable, respectively. Resistance to three or more antibiotics was observed in 12 (80.0%) of the STEC isolates. Most of the serotypes of STEC recovered in this survey carried virulence traits that are associated with increased human and bovine pathogenicity. The present study shows that highly virulent STEC strains are being shed by diarrhoeic calves from farms located in a high incidence area of human STEC infections.

Occurrence and characteristics of CS31A antigen-producing Escherichia coli in calves with diarrhoea and septicaemia in Argentina.

CS31A is a K88-related non-fimbrial adhesin first described on Escherichia coli strains isolated from diarrhoeic and septicaemic calves. In this report, CS31A antigen was screened by immunological methods and confirmed by PCR among bovine E. coli isolates. In addition, CS31A-producing strains were characterized with respect to different fimbrial antigens, O-serogroup and other properties related to virulence. Faecal or tissue specimens of 100 diarrhoeic or septicaemic calves and 27 older cattle with different pathologies from 71 outbreaks or individual cases that occurred in Buenos Aires province, Argentina, were examined. CS31A + E. coli strains were isolated from 21 (21.0%) calves from 16 outbreaks or individual cases. No CS31A + E. coli was detected in samples from cattle more than 1 year old. Fimbriae F5, F41, F17a and F17b were not detected among the CS31A-producing strains. Three (14.3%) of the CS31A+ E. coli strains expressed the F17c fimbria. All of the 21 isolates exhibited at least one property of septicaemic strains (resistance to serum, production of aerobactin or colicins) but none of them demonstrated heat-stable enterotoxigenic activity. CS31A + E. coli isolates belonged to 10 serogroups, more commonly O8, O7, O17 and O21. The results obtained here confirm the worldwide distribution of CS31A antigen in bovine E. coli strains. However, CS31A + or CS31A + /F17c + E. coli were less frequently isolated than they were in North hemisphere countries.

Contribution of dietary and newly formed arachidonic acid to human milk lipids in women eating a low-fat diet.

BACKGROUND: Polyunsaturated fatty acids in milk are derived from direct intestinal absorption, endogenous synthesis, or maternal body stores. Arachidonic acid (AA) intake is frequently low in undernourished women, but milk secretion of this fatty acid is similar to that in well-nourished women. OBJECTIVE: The objective was to evaluate the contribution of dietary and endogenously synthesized AA to its total secretion in the milk of women eating a low-fat diet. DESIGN: Ten lactating women who habitually ate a low-fat diet (17% of energy) received 2.5 mg [(13)C]linoleic acid (LA)/kg body wt orally 5 mo postpartum. LA and AA concentrations and (13)C enrichment were measured in milk samples collected before and after the tracer application. Total lipid, LA, and AA contents were determined in diet composites. Fatty acids were assessed by gas chromatography and (13)C enrichment by isotope ratio mass spectrometry. RESULTS: The cumulative 72-h recovery of [(13)C]LA in milk was 16.3 +/- 6.4% of the dose; only 0.01% of the label was found as [(13)C]AA. The calculated transfer of dietary LA and AA into milk was 32.8 +/- 18.0% and 11.8 +/- 6.6%, respectively. AA originating from conversion of dietary LA contributed only 1.1% to the total milk AA secreted. CONCLUSIONS: Little milk AA originates from conversion of LA; 70% of LA and 90% of AA secreted in milk were not derived from direct intestinal absorption. Our results suggest that maternal body stores are the major source of milk LA and AA in these women.

Elimination of bleeding associated with urinary catheterization in neonates.

Three cases of hematuria associated with urinary catheterization in infant males in this NICU over a year prompted an investigation by the health care team. The team tracked catheterizations in the unit, conducted a national survey, and did a literature review. Based on their findings, the team revised the unit policy and procedure and evaluated new products. After changes were implemented, the incidence of hematuria--originally at 20.7 percent--dropped to 5.5 percent during the first evaluation period and to zero during a second follow-up period.

[Evolution of the prevalence of bedsores in the Hospital of Navarra]. / Evolución de la prevalencia de úlceras por presión en el Hospital de Navarra.

INTRODUCTION: The rates of incidence and prevalence of patients with sores in hospital are indicators of nursing care quality. The aim of this study is to evaluate such prevalence in the last two years (1997-1998), comparing the patients with sores, the evaluation of the risk of developing sores, and the factors associated with their development. MATERIAL AND METHODS: A transversal study was made, in which the subjects under study were all of the patients hospitalised in the Hospital of Navarra on the day set for the study. The study gathers the variables of sex, age, unit of hospitalisation, date of admission and date of the study, presence and number of sores, their development in or outside the hospital, evaluation of risk on admission and evaluation of risk on the day of the study (according to the modified Braden scale). RESULTS: The prevalence of patients with sores was 8.9 per 100 patients hospitalised in 1997 and 5.1 in 1998. The difference is statistically significant with a value of p=0.025. Age, the classification of patients within those of risk, and the time of hospital stay are factors related to the development of sores. CONCLUSIONS: The factors associated with the development of sores detected in the study lead us to be more attentive in our vigilance of the patients that show them. The follow up of the prevalence and incidence of bedsores in hospitals is an instrument that makes it possible to continue improving understanding, prevention and treatment of such lesions in patients.

Nursing case management in the neonatal intensive care unit, Part 2: Developing critical pathways.

Nursing case management is a model of care delivery that focuses on achieving optimal patient outcomes in expected time frames while containing costs. The critical pathway is a tool used to help the team achieve the goals of nursing care management. The critical pathway serves as a multidisciplinary plan of care, based on time. Few neonatal critical pathways are available in the literature. They can be easily developed through a collaborative process. This article presents the author's recommendations on how to develop critical pathways. Once developed, they can serve as an important source of communication among disciplines and as a source of information regarding patient outcomes. Critical pathways can also be used as a teaching tool. Two critical pathways are included in this article.

Nursing case management in the neonatal intensive care unit. Part 1: Pioneering new territory.

Nursing case management is a model of care delivery that focuses on achieving optimal patient outcomes in expected time frames while containing costs. This is accomplished through a multidisciplinary team approach, guided by a multidisciplinary care plan, called a critical pathway. This model of care meets the standards of regulatory agencies and is in line with health care reform activities at the federal level. It should be considered as an effective, new way to provide care in the NICU.

An outbreak of enterotoxaemia caused by Clostridium perfringens type D in goats in Patagonia.

Forty-four of a flock of 117 angora goats in the Rio Negro province of Argentina died within four days. Most of the animals died shortly after the onset of clinical signs, but in a few the clinical course lasted for several days. Post mortem the small and large intestines were filled with watery contents, blood and fibrin clots, and there were numerous ulcers on the mucosa. Small areas of malacia were observed histologically in the brain. Clostridium perfringens type D in pure culture was isolated from the kidneys and gut contents of the affected animals. Epsilon toxin was identified by the mouse seroneutralisation test in the supernatant solution from cultures of these isolates and in the intestinal contents of the affected animals. Heavy infestations with coccidia, nutritional and environmental stress, and an anthelmintic overdose were possible predisposing factors for the outbreak.

Epidemiología del SIDA y de la infección por el VIH en Costa Rica / The epidemiology of AIDS and HIV infection in Costa Rica

El presente artículo examina y describe la epidemiología del SIDA y de la infección por el VIH en Costa Rica. Entre 1983, cuando se diagnosticaron los primeros casos, y fines de agosto de 1991, se notificaron 283 casos de SIDA, lo que coloca a Costa Rica en tercer lugar entre los siete países de Centroamérica en lo que respecta a incidencia acumulativa y número acumulativo de casos. Aunque persiste un número reducido de casos de SIDA en hemofílicos y receptores de transfusiones sanguíneas, el tamizaje de la sangre y sus derivados ha aumentado enormemente la inocuidad de estas sustancias. Varios factores sugieren que Costa Rica tiene un patrón de transmisión tipo I: es decir, que el SIDA se transmite principalmente por contacto entre hombres homosexuales o bisexuales. Se observa una razón de hombres a mujeres de 11:1 en casos de SIDA notificados y de 14:1 en casos notificados de infección por el VIH. La proporción de casos por contacto sexual entre hombres es de 72 por ciento. No obstante, el creciente número de casos heterosexuales y perinatales, las altas tasas de infección en mujeres embarazadas y los patrones de bisexualidad prevalecientes son compatibles con una posible transición hacia un patrón de tipo I/II

The epidemiology of AIDS and HIV infection in Costa Rica

This articulo describes and assesses the epidemiology of AIDS and HIV infection in Costa Rica. A total of 238 AIDS cases were reported in the contry between 1983, when the first cases were diagnosed, and the end of August 1991. This placed Costa Rica third among the seven Central American countries- both in terms of cumulative AIDS incidence and the cumulative number of cases. Despite a continued small number of hemophilia and transfusion-associated AIDS cases, screening of blood and blood products has provided a high degree of safety for the blood supply. The high male:female ratios of reported AIDS cases (11:1) and HIV infections (14:1) and the high proportion of AIDS cases (72 percent) transmitted by male-to-male sexual contact give grounds for considering Costa Rica to be a Pattern I country- one where the disease is transmitted primarily among homosexual/bisexual males. However, increasing numbers of heterosexual and perinatal cases, high rates of HIV infections among pregnant women, and existing patterns of bisexuality are consistent with a possible shift toward a Pattern I/II epidemic

Published in Spanish in BOSP. Vol. 115, 1993