Prevalencia de parasitismo intestinal en niños de la comunidad indígena U'wa en Boyacá, Colombia / Intestinal parasitism prevalence in indigenous U'wa children in Boyacá, Colombia

Resumen Objetivo: Determinar la prevalencia de parasitismo intestinal en niños menores de 15 años de la comunidad indígena U'wa, del municipio de Güicán, Boyacá. Metodología: Estudio descriptivo de corte transversal en 125 niños menores de 15 años, pertenecientes a la comunidad indígena U'wa del municipio de Güicán. Se evaluó la presencia de parásitos intestinales a partir de dos exámenes coprológicos directos. El procesamiento y análisis estadístico se realizó con el programa SPSS versión 22. Resultados: La prevalencia de parásitos fue del 72% IC 95%. Los parásitos más frecuentes fueron Blastocystis spp. 43.3%; Entamoeba histolytica/dispar 35.5%; Ascaris lumbricoides 12.2% y Giardia intestinalis con 11.1%. Los parásitos no patógenos hallados fueron Entamoeba coli 30%; Endolimax nana 24.4% y Iodamoeba butschlii 5.5%. El poliparasitismo fue de 50% y se asoció con ser menor de 7 años de edad y tener más de 4 manifestaciones clínicas. Conclusiones: Las comunidades indígenas se consideran una población vulnerable puesto que no cuentan con los servicios básicos de sanidad, tienen alta prevalencia de enfermedades infecciosas que pueden generar algunas complicaciones, especialmente en los menores de 15 años . Con este estudio se conoció la dinámica de las infecciones parasitarias en la comunidad indígena U'wa que tienen implicaciones en la salud pública y en el marco del contexto salud-enfermedad, con el fin de realizar intervenciones de manera integral en busca de mejorar el estado de salud.

Abstract Objective: To determine the prevalence of intestinal parasitism in children under 15 years of age belonging to the U'wa indigenous community in the municipality of Guican, Boyacá. Methodology: This is a descriptive cross-sectional study conducted with 125 children under the age of 15, who belong to the Uwa indigenous community of the Güican municipality. The presence of intestinal parasites was evaluated through the implementation of two direct stool tests. Statistical analysis and processing were performed with the SPSS version 22 program. Results: The prevalence of parasites was 72% 95% CI (% -%). The most frequent parasites were Blastocystis spp (43.3%), Entamoeba histolytica / dispar (35.5%), Ascaris lumbricoides (12.2%), and Giardia intestinalis (11.1%). The non-pathogenic parasites found were Entamoeba coli (30%), Endolimax nana (24.4%), and Iodamoeba bütschlii (5.5%). Polyparasitism was 50%, which was associated with being less than 7 years old and having more than 4 clinical manifestations. Conclusions: Indigenous communities are considered a vulnerable population since they do not have basic health services and they present a high prevalence of infectious diseases, especially in children under 15 years of age, which can generate some complications. This study revealed the dynamics of parasitic infections in this indigenous community, which have implications for public health and in the context of the health-disease, to carry out interventions in a comprehensive way in order to improve health status.

Intoxicación accidental por ácido acético glacial en niños / Accidental glacial acetic acid intoxication in children

Introducción: el ácido acético en bajas concentraciones se utiliza como vinagre para los alimentos, al que le da el sabor amargo y olor característico. También es un reactivo importante para la producción de otros compuestos orgánicos. Cuando está concentrado tiene usos industriales, como es el ácido acético glacial (99%) el cual se ingirió en forma accidental en este caso. Presentación del caso: paciente de 8 años de edad quien tras posterior trauma cráneo encefálico leve es manejado en casa con ácido acético glacial que ingirió accidentalmente con posterior odinofagia, emesis e intolerancia a la vía oral. Hubo lesiones iniciales en faringe y amígdalas manejadas con el respectivo antibiótico. Al no haber mejoría consulta de nuevo por aumento del compromiso faríngeo, evidenciándose quemadura y lesión esofágica por cáusticos con estenosis. El seguimiento a los 6 meses, después de realizar dilataciones por medio de esofagoduodenoscopia, el paciente tuvo buena evolución clínica.

Introduction: low concentrations of acetic acid are commonly used as table top condiment giving a bitter taste featuring a characteristic smell. It is also an important reactive to make other organic compounds. Case report: at high concentrations it has industrial uses, such as 99% glacial acetic acid which was ingested by an 8-year-old patient in this case. Patient was managed at home after a mild head trauma with glacial acetic acid which he ingested accidentally presenting with pain anddifficulty in swallowing and emesis. The initial pharyngeal and tonsil lesions were managed with the respective antibiotic therapy. He consults again for not presenting improvement and increase of the pharyngeal compromise, evidencing an esophageal burn and a corrosive injury with stenosis. At 6-month follow-up, after undergoing dilations through esophago-gastroduedenoscopy, patient presented good clinical progression.

Phase Ib Trial of Copanlisib, A Phosphoinositide-3 Kinase (PI3K) Inhibitor, with Trastuzumab in Advanced Pre-Treated HER2-Positive Breast Cancer "PantHER".

BACKGROUND: Activation of the phosphoinositide-3 kinase (PI3K) pathway is a resistance mechanism to anti-human epidermal growth factor receptor 2 (HER2) therapy. This phase Ib trial was conducted to determine the maximum tolerated dose (MTD) of copanlisib, an intravenous (IV) pan-class I PI3K inhibitor, combined with trastuzumab. METHODS: Patients with advanced HER2-positive breast cancer and disease progression following at least one prior line of HER2 therapy in the metastatic setting were treated with copanlisib (45 or 60 mg) IV on days 1, 8 and 15 of a 28-day cycle with a fixed dose of trastuzumab 2 mg/kg weekly. RESULTS: Twelve patients were enrolled. The MTD was determined as copanlisib 60 mg plus trastuzumab 2 mg/kg weekly. The most common adverse events of any grade occurring in more than two patients were hyperglycaemia (58%), fatigue (58%), nausea (58%) and hypertension (50%). Stable disease was confirmed at 16 weeks in six participants (50%). PIK3CA mutations were detected in archival tumour of six participants (50%). PIK3CA hotspot mutations, were detectable in pre- and on-treatment plasma of all participants. Pre- and post-treatment tumour biopsies for two patients identified temporal genomic heterogeneity, somatic mutations in the TRRAP gene, which encodes a PI3K-like protein kinase, and emergent somatic mutations related to protein kinase signalling. CONCLUSION: Copanlisib and trastuzumab can be safely administered with fair overall tolerability. Preliminary evidence of tumour stability was observed in patients with heavily pre-treated, metastatic HER2 positive breast cancer. Several potential biomarkers were identified for further study in the current phase 2 clinical trial. NCT: 02705859.

Pilot study of bevacizumab in combination with docetaxel and cyclophosphamide as adjuvant treatment for patients with early stage HER-2 negative breast cancer, including analysis of candidate circulating markers of cardiac toxicity: ICORG 08-10 trial.

BACKGROUND: Combining bevacizumab and chemotherapy produced superior response rates compared with chemotherapy alone in metastatic breast cancer. As bevacizumab may cause hypertension (HTN) and increase the risk of cardiac failure, we performed a pilot study to evaluate the feasibility and toxicity of a non-anthracycline-containing combination of docetaxel with cyclophosphamide and bevacizumab in early stage breast cancer patients. METHODS: Treatment consisted of four 3-weekly cycles of docetaxel and cyclophosphamide (75/600 mg/m2). Bevacizumab was administered 15 mg/kg intravenously on day 1, and then every 3 weeks to a total of 18 cycles of treatment. Serum biomarker concentrations of vascular endothelial growth factor (VEGF), cardiac troponin-I (cTnI), myeloperoxidase (MPO), and placental growth factor (PlGF) were quantified using enzyme-linked immunosorbent assay (ELISA) in 62 patients at baseline and whilst on treatment to determine their utility as biomarkers of cardiotoxicity, indicated by left ventricular ejection fraction (LVEF). RESULTS: A total of 106 patients were accrued in nine sites. Median follow up was 65 months (1-72 months). Seventeen protocol-defined relapse events were observed, accounting for an overall disease-free survival (DFS) rate of 84%. The DFS rates for hormone receptor positive (HR+) and triple-negative (TN) patients were 95% versus 43%, respectively. The median time to relapse was 25 (12-54) months in TN patients versus 38 (22-71) months in HR+ patients. There have been 13 deaths related to breast cancer . The overall survival (OS) rate was 88%. The 5-year OS rate in HR+ versus TN was 95% versus 57%. None of the measured biomarkers predicted the development of cardiotoxicity. CONCLUSIONS: We observed a low relapse rate in node-positive, HR+ patients; however, results in TN breast cancer were less encouraging. Given the negative results of three large phase III trials, it is unlikely that this approach will be investigated further. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00911716.

Frecuencia de colonización de Staphylococcus Aureus Meticilino - Resistente, de Enterobacterias y de Candida spp. en estetoscopios y teléfonos móviles en una Unidad de Cuidados Intensivos Neonatal / Frequency of colonization of methicillin-resistant Staphylococcus Aureus, Enterobacteria and Candida Spp. in stethoscopes and cellular phones, inside a Neonatal Intensive Care Unit

Resultados: se encontró un 80% de los estetoscopios contaminados, con una mediana de colonización de 2.58 Unidades Formadoras de Colonias (UFC)/cm2 y un 100% de los teléfonos móviles contaminados con una mediana de 0.401 UFC/cm2. En estetoscopios se aislaron SAMR (n=3) y Enterobacterias resistentes a cefalosporinas de tercera generación (n=2). En teléfonos móviles se aislaron SAMR(n=1), Candida spp (n=1) y Enterobacterias (n=5). La encuesta permitió establecer una tendencia de hábitos de higiene inapropiados sobre el uso de los fómites. Conclusiones: el hallazgo de bacterias resistentes en estos fómites los convierte en fuentes potenciales de transmisión cruzada y de brotes de infección intrahospitalaria. Estos resultados deben orientar el desarrollo de protocolos para el uso racional de dispositivos médicos y tecnología portátil dentro de ambientes hospitalarios.

Results: 80% of the stethoscopes (n=40) were found contaminated with a median count of 2,58 CFU/cm2 meanwhile 100% of cellular phones where found contaminated with a median count of 0,401 CFU/cm2. MRSA (n=3) and third generation cephalosporin-resistant Enterobacteriaceae (n=2) were isolated from stethoscopes, whereas in cellular phones MRSA (n=1), Candida (n=1) and third generation cephalosporin-sensitive Enterobacteriaceae (n=5) where found. Survey results indicated a trend towards inappropriate hygiene habits with fomites; however no statistical correlation could be established between these habits and colonization. Conclusion: The finding of nosocomial pathogens in these fomites transforms them in potential sources of crosscontamination and hospital-acquired infections outbreaks. Present results must steer development of protocols for rational use of medical devices and portable technology gadgets within hospital controlled environments.

Educación integral en sexualidad y anticoncepción para los/las jóvenes / Comprehensive sexual and contraceptive education for young people

El número de embarazos en jóvenes sigue aumentando cada año en España, siendo preocupante en niñas menores de 15 años en las que aumentó un 76% desde el 2001 al 2005, según el Instituto Nacional de Estadística (INE). El descenso de la edad en la que los jóvenes inician las relaciones sexuales, las actitudes cada vez más liberales, el mayor número de parejas y las prácticas sexuales de riesgo, les exponen a problemas de salud tan importantes como los embarazos no deseados y las infecciones de transmisión sexual. La adolescencia constituye una etapa vital clave en el proceso de construcción de la identidad personal y sexual. La educación sexual es cada vez más necesaria en una sociedad que parece estar bien informada, y que sin embargo, tiene altas dosis de desconocimiento y de errores que pueden afectar al equilibrio emocional de las personas. Enseñar a conocer y aceptar el propio cuerpo, a buscar información o a demandar ayuda es educar para ser capaces de establecer con los demás unas relaciones más sanas y satisfactorias. Por otra parte, el aumento de los embarazos no deseados y las infecciones de transmisión sexual, incluido el virus de la inmunodeficiencia humana, hacen más acuciante la necesidad de esta educación. Nuestra experiencia en educación sexual para jóvenes responde a esta necesidad. Los jóvenes tienen derecho a una educación sexual efectiva. Una información de calidad y educación sexual pueden aportarles el conocimiento, las capacidades y las actitudes necesarias para la toma de decisiones informadas durante el presente y el futuro(AU)

According to the National Institute of Statistics (INE) the number of unwanted pregnancies in Spain is increasing every year. This is particularly worrying as regards unwanted in young people, particularly those under 15, which increased by 76% from 2001 to 2005.The younger age when people begin sexual relationships, the increasingly liberal attitudes, a higher number of sexual partners and high risk sexual practices, expose them to very important health problems, such as unwanted pregnancies and sexually transmitted diseases (STD). Adolescence is a vital phase in the personal and sexual identity process. Sexual Education is necessary in a society which seems to be well informed but on the other hand has a high proportion of ignorance and errors, which could seriously affect the emotional balance of people. Teaching to know and accept their own body, seek information or ask for help is an education that can help them to maintain healthier and satisfactory relationships. On the other hand, the increase in undesired pregnancies and sexually transmitted diseases, including HIV, makes this kind of education a priority. Our experience in sexual education for young people answers this need. Young people have the right to an effective sexual education. Information and comprehensive sexual education provide them with the knowledge, skills and attitudes necessary to take decisions in the present and future(AU)

[Comprehensive sexual and contraceptive education for young people]. / Educación integral en sexualidad y anticoncepción para los/las jóvenes.

According to the National Institute of Statistics (INE) the number of unwanted pregnancies in Spain is increasing every year. This is particularly worrying as regards unwanted in young people, particularly those under 15, which increased by 76% from 2001 to 2005. The younger age when people begin sexual relationships, the increasingly liberal attitudes, a higher number of sexual partners and high risk sexual practices, expose them to very important health problems, such as unwanted pregnancies and sexually transmitted diseases (STD). Adolescence is a vital phase in the personal and sexual identity process. Sexual Education is necessary in a society which seems to be well informed but on the other hand has a high proportion of ignorance and errors, which could seriously affect the emotional balance of people. Teaching to know and accept their own body, seek information or ask for help is an education that can help them to maintain healthier and satisfactory relationships. On the other hand, the increase in undesired pregnancies and sexually transmitted diseases, including HIV, makes this kind of education a priority. Our experience in sexual education for young people answers this need. Young people have the right to an effective sexual education. Information and comprehensive sexual education provide them with the knowledge, skills and attitudes necessary to take decisions in the present and future.