Diabetic Ketoacidosis in Type 1 Diabetes Onset in Latin American Children.

OBJECTIVE: To describe the patterns of diabetic ketoacidosis (DKA) occurrence in children newly diagnosed with type 1 diabetes (T1DM) across several Latin American pediatric diabetes centers from 2018 to 2022. METHODS: A retrospective chart review included children under 18 with new-onset T1DM from 30 Latin American pediatric diabetes centers (Argentina, Chile, and Peru) between 30 December 2018 and 30 December 2022. Multiple logistic regression models examined the relationships between age, gender, medical insurance, BMI, and DKA at new-onset T1DM. As far as we know, there are no large studies in Latin American countries exploring the patterns of DKA in new-onset T1DM. RESULTS: A total of 2,026 (983 females) children, median age 9.12 (5.8 -11.7) years with new-onset-T1DM were included. Approximately 50% had no medical insurance. Mean glucose values were 467 mg/dL, pH 7.21, bicarbonate 13 mEq/L, HbA1c 11.3%, and BMI 18. The frequency of DKA was 1,229 (60.7%), out of which only 447 (36%) were severe. There was a significant decrease in the frequency of DKA as age increased: 373 (70.2%) in children under 6, 639 (61.6%) in those between 6 and 12, 217 and (47.5%) in those over 12. Children with medical insurance (58.8%) had a significantly lower frequency of DKA than those without (62.7%). The multiple logistic regression models showed that DKA was significantly and inversely associated with age [OR, 0.72 (95% CI 0.60-0.86)], BMI [OR, 0.95 (95% CI 0.92-0.99)], and medical insurance [OR, 0.75 (95% CI 0.60-0.94)] adjusted for sex. CONCLUSION: Latin American children with new-onset T1DM exhibited a substantial occurrence of DKA. Younger ages and the lack of medical insurance were significantly associated with DKA in new-onset T1DM.

Dietary intake in children and adolescents with food addiction: A systematic review.

Food addiction (FA) is characterized by behavioral changes related to the consumption of palatable foods, marked by dependence, impulsivity, and compulsion. Children and adolescents are more vulnerable to FA owing to their significant consumption of ultra-processed foods. This review aims to investigate the differences in dietary intake in pediatric populations with and without FA. We conducted a systematic literature review. PubMed, ScienceDirect, and PsycINFO databases were searched up to July 2023. Potentially eligible studies were independently checked by two researchers. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies. Of the 4868 articles identified, six studies were included. All the included studies had high methodological quality. High consumption of calories and fat was observed in children and adolescents with FA. A diet quality analysis showed that the consumption of ultra-processed foods, such as sugary drinks, sweets, and chips, was related to FA. Given these findings, we concluded that FA in childhood may be associated with higher energy consumption and, consequently, higher intake of macronutrients. Few studies have examined the relationship between FA and food intake in childhood, and more studies are required.

Manejo inicial de la hiperamonemia aguda en pediatría / Initial management of acute hyperammonemia in pediatrics

La hiperamonemia constituye una emergencia médica. No existen publicaciones que hagan referencia a la disponibilidad de recursos, insumos y conocimientos necesarios para el manejo inicial de esta por parte del pediatra en nuestro país, pero, según la experiencia de los autores, los recursos necesarios no se encuentran disponibles los 365 días del año en una gran porción de nuestro territorio. Sobre la base de este estado de situación, de una revisión bibliográfica internacional sobre el tema y de la experiencia de los autores, se elaboraron una serie de recomendaciones para el manejo pediátrico inicial de esta emergencia, que tienen como objetivo poder reducir las deficiencias, permitir una sospecha clínica adecuada que lleve a un diagnóstico y tratamiento de emergencia oportunos, con utilización racional de recursos farmacológicos (algunos de ellos de alto costo), para reducir la morbimortalidad que asocia la patología.

Hyperammonemia is a medical emergency. There are no publications regarding the availability of resources, supplies, and knowledge necessary for the initial management of hyperammonemia by pediatricians in Argentina; however, according to the authors' experience, the necessary resources are not available all year round in a large portion of our territory. Based on such state of affairs, an international bibliographic review on this topic and the authors' experience, we developed a series of recommendations for the initial pediatric management of this emergency, with the objective of reducing deficiencies, allowing adequate clinical suspicion leading to a timely diagnosis and emergency management and a rational use of pharmacological resources (some of which are costly) to reduce the morbidity and mortality associated with hyperammonemia.

Initial management of acute hyperammonemia in pediatrics. / Manejo inicial de la hiperamonemia aguda en pediatría.

Hyperammonemia is a medical emergency. There are no publications regarding the availability of resources, supplies, and knowledge necessary for the initial management of hyperammonemia by pediatricians in Argentina; however, according to the authors' experience, the necessary resources are not available all year round in a large portion of our territory. Based on such state of affairs, an international bibliographic review on this topic and the authors' experience, we developed a series of ecommendations for the initial pediatric management of this emergency, with the objective of reducing deficiencies, allowing adequate clinical suspicion leading to a timely diagnosis and emergency management and a rational use of pharmacological resources (some of which are costly) to reduce the morbidity and mortality associated with hyperammonemia.

La hiperamonemia constituye una emergencia médica. No existen publicaciones que hagan referencia a la disponibilidad de recursos, insumos y conocimientos necesarios para el manejo inicial de esta por parte del pediatra en nuestro país, pero, según la experiencia de los autores, los recursos necesarios no se encuentran disponibles los 365 días del año en una gran porción de nuestro territorio. Sobre la base de este estado de situación, de una revisión bibliográfica internacional sobre el tema y de la experiencia de los autores, se elaboraron una serie de recomendaciones para el manejo pediátrico inicial de esta emergencia, que tienen como objetivo poder reducir las deficiencias, permitir una sospecha clínica adecuada que lleve a un diagnóstico y tratamiento de emergencia oportunos, con utilización racional de recursos farmacológicos (algunos de ellos de alto costo), para reducir la morbimortalidad que asocia la patología.

Síndrome de quilomicronemia familiar: experiencia pediátrica en Argentina / Familial chylomicronemia syndrome: pediatric experience in Argentina

El síndrome de quilomicronemia familiar (SQF) es unaenfermedad autosómica recesiva rara, con una prevalencia1:200 000 - 1:1 000 000, y se caracteriza por quilomicronemiaen ayunas y niveles muy elevados de triglicéridos (> 880 mg/dl). LPL es el gen más frecuentemente afectado, luego APOC2,GPIHBP1, APOA5 y LMF1; todos ellos comprometen la función de la lipoproteinlipasa endotelial. El SQF suele presentarseen la infancia con dolor abdominal recurrente, xantomaseruptivos, retraso del crecimiento, pancreatitis y, en ocasiones,asintomático. El tratamiento convencional es la restriccióndietética de grasas. Se muestra el resultado clínico de 20 pacientes pediátricoscon SQF reclutados de 4 hospitales en Argentina.

Familial chylomicronemia syndrome (FCS) is a rare autosomalrecessive disease, prevalence 1:200,000 - 1:1,000,000, andis characterized by fasting chylomicrons and very hightriglycerides > 880 mg/dl. LPL is the most frequentlyaffected gene, then APOC2, GPIHBP1, APOA5, LMF1, all ofthem compromising the function of lipoproteinlipase. FCScommonly presents in childhood with recurrent abdominalpain, eruptive xanthomas, failure to thrive, pancreatitis, andsometimes asymptomatic. The conventional treatment isdietetic fat restriction. The clinical outcome of 20 pediatric patients with FCS recruited from 4 hospitals in Argentina is reported.

[Familial chylomicronemia syndrome: pediatric experience in Argentina]. / Síndrome de quilomicronemia familiar: experiencia pediátrica en Argentina.

Familial chylomicronemia syndrome (FCS) is a rare autosomal recessive disease, prevalence 1:200,000 - 1:1,000,000, and is characterized by fasting chylomicrons and very high triglycerides > 880 mg/dl. LPL is the most frequently affected gene, then APOC2, GPIHBP1, APOA5, LMF1, all of them compromising the function of lipoproteinlipase. FCS commonly presents in childhood with recurrent abdominal pain, eruptive xanthomas, failure to thrive, pancreatitis, and sometimes asymptomatic. The conventional treatment is dietetic fat restriction. The clinical outcome of 20 pediatric patients with FCS recruited from 4 hospitals in Argentina is reported.

El síndrome de quilomicronemia familiar (SQF) es una enfermedad autosómica recesiva rara, con una prevalencia 1:200 000 - 1:1 000 000, y se caracteriza por quilomicronemia en ayunas y niveles muy elevados de triglicéridos (> 880 mg/ dl). LPL es el gen más frecuentemente afectado, luego APOC2, GPIHBP1, APOA5 y LMF1; todos ellos comprometen la función de la lipoproteinlipasa endotelial. El SQF suele presentarse en la infancia con dolor abdominal recurrente, xantomas eruptivos, retraso del crecimiento, pancreatitis y, en ocasiones, asintomático. El tratamiento convencional es la restricción dietética de grasas. Se muestra el resultado clínico de 20 pacientes pediátricos con SQF reclutados de 4 hospitales en Argentina.

Molecular diagnosis of amoebiasis.

Amoebiasis is an intestinal parasitosis caused by the protozoan Entamoeba histolytica that represents the third leading cause of mortality due to parasitosis. It is a prevalent disease in tropical climate regions with poor or absent sanitary services. Microscopy and antigen detection techniques are routinely used to diagnose amoebiasis because of their low cost and ease of application. However, these techniques do not differentiate E. histolytica infections and other potentially pathogenic species such as Entamoeba moshkovskii or Entamoeba bangladeshi. Therefore, in the last decades, molecular tests that allow correct identification of the causal agent of amoebiasis and the establishment of the prevalence of the infecting species have been developed. Techniques based on nucleic acids, such as conventional, multiplex, or real-time polymerase chain reaction (PCR), are being seriously considered in clinical laboratories, because they detect the etiologic agent directly from the sample without the need for previous prolonged culture, thus reducing diagnostic time. Also, the nested PCR test and the sequencing of ribosomal markers have allowed the identification of new parasitic species in humans, such as E. moshkovskii and E. bangladeshi, and an improved characterization of the known infecting species. The application of multiplex platforms allows the simultaneous identification of infecting species, increasing the sensitivity and specificity of these techniques. Therefore, the molecular diagnosis of amoebiasis is projected as an innovative tool in the fight against this parasitosis.

La amebiasis es una parasitosis intestinal causada por el protozoario Entamoeba histolytica y representa la tercera causa de mortalidad por parasitosis. Es una enfermedad prevalente en regiones de clima tropical con deficientes o nulos servicios sanitarios. Las técnicas de microscopía y detección de antígenos se emplean sistemáticamente para el diagnóstico de la amebiasis por su bajo costo y fácil aplicación. Sin embargo, no permiten diferenciar entre infecciones por E. histolytica y otras especies de potencial patogenicidad como Entamoeba moshkovskii o Entamoeba bangladeshi. Ante ello, en las últimas décadas se han desarrollado pruebas moleculares que permiten una correcta identificación del agente causal de la amebiasis y el establecimiento de la prevalencia de la especie infectante. Las técnicas basadas en ácidos nucleicos, como la reacción en cadena de la polimerasa (PCR) convencional, múltiple o en tiempo real, están siendo seriamente consideradas en los laboratorios clínicos, porque detectan al agente etiológico de manera directa en la muestra sin necesidad de cultivo prolongado previo, disminuyendo de esta forma el tiempo del diagnóstico. Asimismo, la PCR anidada sumada a la secuenciación de marcadores ribosomales ha permitido la identificación de nuevas especies parasitarias, como E. moshkovskii y E. bangladeshi en humanos, y una mejor caracterización de las especies infectantes ya conocidas. La aplicación de las plataformas multiplex permite la identificación simultánea de especies infectantes, aumentando la sensibilidad y la especificidad de estas técnicas. Por esto, el diagnóstico molecular de la amebiasis se proyecta como una verdadera herramienta innovadora en la lucha contra las parasitosis.

Surveillance and molecular characterization of human sapovirus in patients with acute gastroenteritis in Brazil, 2010 to 2017.

BACKGROUND: Human sapoviruses (HuSaV) are associated with acute gastroenteritis (AGE), causing sporadic cases and outbreaks in patients worldwide. In Brazil, however, there are few reports describing the prevalence of HuSaV in patients with AGE. OBJECTIVE: Describing the diversity of HuSaV in Brazil by detecting and molecularly characterizing HuSaV among patients with AGE during an 8-year period (2010-2017). STUDY DESIGN: A total of 3974 stool samples, testing negative for rotavirus (RVA), norovirus (NoV) and human adenovirus (HAdV), were selected and screened for the presence of HuSaV. Nested RT-PCR were performed for a partial region of VP1, sequenced and genetic analyzed for genotyping the positive samples. RESULTS: In the current study, the HuSaV prevalence was determined to be 3.7% (149/3974). A higher prevalence, 5.7% (118/2074), was observed in children under 2 years of age. During the surveillance period, 13 outbreaks were detected: 12 outbreaks in children under 3 years old and one outbreak in adults. Among the 149 HuSaV positive cases, 106 samples (71%) were successfully sequenced. The most prevalent genotype found was GI.1 (44.3%), followed by GI.2 (21.7%), GI.3 (3.8%), GI.6 (2.8%), GII.1 (5.7%), GII.2 (8.5%), GII.3 (2.8%), GII.4 (2.8%), GII.5 (5.7%) and GIV.1 (1.9%). Two GIV.1 strains characterized in this study are, to date, the only strains of this genotype reported in Brazil. CONCLUSIONS: The present study elucidated the circulation of HuSaV in Brazil and highlight that HuSaV has not assumed an epidemiological importance in the country after the introduction of the RVA vaccine.

Nutritional profile of cancer patients treated at an outpatient oncology center in the south region of Brazil

To evaluate the nutritional profile of cancer patients treated at an oncology center in South Brazil.This is a descriptive, exploratory and sectional study that was developed in a process that involved 100 patients aged between 18 and 75 years old, suffering from cancer.The anthropometric variables studied were weight, height, Body Mass Index (BMI), arm circumference (AC), arm muscle circumference (AMC),triceps skinfold (TSF) and corrected arm muscle area (cAMA). For subjective nutritional assessment, we used the Patient-Generated Subjective Global Assessment (PG-SGA). Nearly half of the patients evaluated had a critical need for nutritional intervention. There was a statistically significant association between cAMA and marital status, age and gender; between AC and age, gender and staging; between AMC and staging; between BMI and marital status and age; and between TSF and marital status. Patients diagnosed with IV stage had the lowest values for nutritional variables. There was no significant association between nutritional status of patients obtained by the PG-SGA instrument and sociodemographic characteristics. Malnutrition should be diagnosed as soon as possible,aiming at early intervention and improving survival and quality of life. Therefore, early nutritional assessment in cancer patients is required, combining subjective and objective methods.

Avaliação da Qualidade de Vida e Prevalência de Sintomas Depressivos em Pacientes Oncológicos Submetidos à Radioterapia / Assessment of Quality of Life and Prevalence of Depressive Symptoms in Oncologic Patients submitted to Radiotherapy / Evaluación de la Calidad de Vida y Prevalencia de Síntomas Depresivos en Radioterapia en Pacientes Oncológicos

Introdução: A qualidade de vida de pacientes oncológicos tem sido objeto de estudo em muitos trabalhos brasileiros. Contudo, apesar da alta prevalência de indivíduos submetidos à radioterapia, poucos estudos com ênfase nesse grupo de pacientes foram identificados. Objetivo: Avaliar a qualidade de vida e a prevalência de sintomas depressivos em pacientes com neoplasias malignas durante o tratamento radioterápico. Método: Estudo transversal quantitativo realizado com 153 pacientes oncológicos em vigência de tratamento radioterápico em um centro especializado em oncologia e radioterapia, localizado no Noroeste do Estado do Paraná. Os dados foram coletados entre março e setembro de 2018. O European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) e o Inventário de Depressão de Beck foram utilizados para avaliar a qualidade de vida e os sintomas depressivos, respectivamente. Resultados: Os domínios "qualidade de vida", "função cognitiva" e "função social" foram os que menos se mostraram prejudicados na amostra estudada, enquanto "insônia", "perda de apetite" e "dificuldades financeiras" destacaram-se entre os maiores preditores de baixa qualidade de vida. Ademais, contatou-se que 22% dos indivíduos avaliados apresentaram algum grau de transtorno de humor, sendo 11% diagnosticados com depressão. Conclusão: O declínio na qualidade de vida e a prevalência de sintomas depressivos em pacientes oncológicos, mesmo os em vigência de radioterapia, enaltecem a importância de intervenções precoces que visem a restabelecer a funcionalidade e o bem-estar.

Introduction: The quality of life of cancer patients has been studied in many Brazilian papers. However, despite the high prevalence of individuals undergoing radiotherapy, few studies with emphasis in this group of patients have been identified. Objective: To evaluate the quality of life and the prevalence of depressive symptoms in patients with malignant neoplasms undergoing radiotherapy treatment. Method: Quantitative cross-sectional study with 153 cancer patients undergoing radiotherapy treatment at an oncology and radiotherapy specialized center, located in the northwest of Paraná state. Data were collected between March and September 2018. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Beck Inventory were used to assess quality of life and depressive symptoms, respectively. Results: The domains "quality of life", "cognitive function" and "social function" were the least affected in the studied sample, while "insomnia", "loss of appetite" and "financial difficulties" stood out among the higher predictors of poor quality of life. In addition, it was found that 22% of the individuals evaluated had some degree of mood disorder, 11% being diagnosed with depression. Conclusion: The decline in quality of life and the prevalence of depressive symptoms in cancer patients, even those undergoing radiotherapy, emphasize the importance of early interventions aimed at restoring functionality and well-being.

Introducción: La calidad de vida de los pacientes con cáncer se ha estudiado en muchos estudios brasileños. Sin embargo, a pesar de la alta prevalencia de individuos sometidos a radioterapia, se han identificado pocos estudios con énfasis en este grupo de pacientes. Objetivo: Evaluar la calidad de vida y la prevalencia de síntomas depresivos en pacientes con neoplasias malignas sometidas a radioterapia. Método: Estudio transversal cuantitativo realizado con 153 pacientes con cáncer sometidos a tratamiento de radioterapia en un centro especializado en oncología y radioterapia, ubicado en el Noroeste del Estado de Paraná. Los datos se recopilaron entre marzo y septiembre de 2018. El European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) y el Inventario Beck se utilizaron para evaluar la calidad de vida y los síntomas depresivos, respectivamente. Resultados: Los dominios "calidad de vida", "función cognitiva" y "función social" fueron los menos afectados en la muestra estudiada, mientras que el "insomnio", la "pérdida de apetito" y las "dificultades financieras" se destacaron entre los dominios. predictores más altos de mala calidad de vida. Además, se encontró que el 22% de los individuos evaluados tenían algún grado de trastorno del estado de ánimo, y el 11% fue diagnosticado con depresión. Conclusión: La disminución de la calidad de vida y la prevalencia de síntomas depresivos en pacientes con cáncer, incluso en aquellos que reciben radioterapia, enfatizan la importancia de las intervenciones tempranas destinadas a restaurar la funcionalidad y el bienestar.

Avaliação positiva da assistência às pessoas com Diabetes Mellitus na atenção básica / Positive evaluation of the assistance provided to people with Diabetes Mellitus in primary care

Objetivo: Verificar os fatores associados à avaliação positiva da assistência prestada às pessoas com diabetes tipo 2 na Atenção Primária. Método:Estudo descritivo transversal, no qual foram entrevistadas 408 pessoas com diabetes tipo 2, da zona urbana de um município da região Sul do Brasil, de 65 equipes da Estratégia Saúde da Família. Foi utilizado questionário contendo variáveis sociodemográficas, clínicas, comportamentais e indicadores da assistência e do acesso ao serviço de saúde na atenção básica; realizado o teste qui-quadrado de Pearson, regressão logística múltipla e cálculo do Odds Ratio para análise dos fatores relacionados à avaliação positiva da assistência. Resultados:A prevalência da avaliação positiva da assistência prestada foi de 81,9%. Os fatores que apresentaram associação significativa com a avaliação positiva foram: sexo masculino (OR=2,96), atividade física (OR=2,54), ser atendido no mesmo dia em que vai à Unidade Básica (OR=2,60), receber os antidiabéticos orais e/ou insulina (OR=0,12) e orientações sobre alimentação adequada (OR=2,72); e conseguir mostrar os resultados de exames com maior facilidade (OR=3,09). Conclusão:O diabetes tipo 2 pode ser um indicador da qualidade do serviço prestado pelas equipes da ESF e a satisfação dos usuários está relacionada ao serviço de qualidade, ao acolhimento às demandas e ao cuidado contínuo.

Objective:To verify the factors associated with the positive evaluation of the assistance provided to people with type 2 diabetes in Primary Health Care. Method:Descriptive cross-sectional study with interview of 408 people with type 2 diabetes from the urban area of a city in the southern region of Brazil covered by 65 Family Health Strategy teams. A questionnaire containing sociodemographic, clinical, behavioral variables and indicators of assistance and access to health services in primary care was used; the Pearson's chi-square test, multiple logistic regression and Odds Ratio were performed to analyze which factors were related to a positive evaluation of the care provided. Results:The prevalence of positive evaluation of the care provided was 81.9%. The factors that showed a significant association with a positive evaluation were: male gender (OR = 2.96), physical activity (OR = 2.54), receiving care on the same day the person goes to the Basic Unit (OR = 2.60), receiving oral antidiabetics and/or insulin (OR = 0.12), receiving guidance on proper nutrition (OR = 2.72), and being able to show test results more easily (OR = 3.09). Conclusion:Type 2 diabetes can be an indicator of the quality of service provided by FHS teams and user satisfaction is related to the quality of the service, embracement of demands, and continuous care.

Surveillance and molecular characterization of human adenovirus in patients with acute gastroenteritis in the era of rotavirus vaccine, Brazil, 2012-2017.

BACKGROUND: In Brazil, limited data are available regarding the incidence and molecular epidemiology of Human Adenovirus (HAdV) in diarrheic disease, especially in the post rotavirus (RVA) vaccine era. OBJECTIVE: The aims of the study were to investigate the frequency of HAdV infections in patients with gastroenteritis during a 6-year period (2012-2017); conduct molecular typing of positive strains, and obtain further information on the HAdV seasonality. STUDY DESIGN: A total of 3003 fecal samples negative for both, RVA and Norovirus, were selected and tested for HAdV by PCR. Positive HAdV samples were sequenced to obtain genotype identification. RESULTS: HAdV was detected in 3.9% (117/3003); 76 belong to species F (70 HAdV-F41; 6 HAdVF40), 31 to species C (15 HAdV-C1; 13 HAdV-C2; 3 HAdV-C5), 5 belong to species D (3 HAdVD56 and 2 untyped), 4 belong to species A (2 HAdV-A12; 2 HAdV-A31), and 1 belong to HAdVB3. Detection rate significantly varied according to the year, suggesting that HAdV infections show a tendency to occur in natural oscillatory fluctuation. No consistent seasonal pattern was identified. Children ≤5 years exhibited higher positivity rate, reinforcing that HAdV is an important pathogen in childhood diarrhea. Genetic analysis indicated that HAdV strains circulating in Brazil were closely related to worldwide strains, and there is no evidence for the introduction of a particular HAdV variant in the country. CONCLUSIONS: The present investigation does not suggest that HAdV has assumed an epidemiological importance in Brazil after the RVA vaccine introduction and contributed to the definition of the clinical and public health significance of HAdV infections.

Prevalencia de alteraciones periodontales y necesidad de tratamiento, asociada a factores sociodemográficos en población adulta atendida por dos unidades comunitarias de salud familiar en el año 2015 / Prevalence of periodontal alterations and need for treatment, associated with sociodemographic factors in the adult population attended by two community family health units in 2015

Establecer la prevalencia de las alteraciones periodontales y la necesidad de tratamiento asociada a factores sociodemográficos en población adulta de dos municipios de El Salvador. Metodología: Estudio observacional-descriptivo transversal, con asociación de variables, entre alteraciones periodontales (sangrado gingival, presencia o no de bolsas periodontales y cálculo dental) necesidad de tratamiento y factores sociodemográficos (edad, sexo, ocupación del tiempo productivo, área de residencia, nivel de escolaridad, conocimiento y práctica de higiene bucal). Durante 9 meses (junio 2015-febrero 2016), se aplicó el Índice Periodontal Comunitario en guía de observación y una cédula de entrevista a 540 usuarios de las Unidades Comunitarias de Salud Familiar de Mizata, Teotepeque y Oratorio de Concepción. Resultados: El 50.56% de la población presenta sondaje de 3.5 mm y cálculo supra y subgingival, cuya necesidad de tratamiento es educación y motivación más raspaje y profilaxis; seguido del 22.04 % con sondaje de 4 a 5 mm quienes necesitan además de la educación y motivación raspado, alisado radicular y profilaxis; el 2.2% fueron pacientes sanos. Los hombres padecen alteraciones periodontales de mayor gravedad 1.10 veces más que las mujeres. Las personas que mantienen un trabajo informal presentan 1.11 más veces mayor alteración periodontal. Los que cursaron entre educación media y superior tienen 3.23 veces menos riesgo de presentar alteraciones periodontales de mayor gravedad y la prevalencia de alteraciones periodontales está asociada a las prácticas en salud bucal (P valor= 0.000). Conclusión: La alteración periodontal prevalente se encuentra en los códigos 2 y 3 del CPITN, Existe asociación significativa entre los factores sociodemográficos (edad, sexo, ocupación del tiempo productivo, nivel de escolaridad, conocimiento y práctica de higiene bucal) con la gravedad de alteraciones periodontales.

Objective: To establish the prevalence of periodontal alterations and the need for treatment associated with sociodemographic factors in adult population in two municipalities of El Salvador. Methodology: A cross-sectional and observational-descriptive study, with association of variables, among periodontal changes (bleeding, presence or not of periodontal pockets and calculus) need for treatment and sociodemographic factors (age, sex, occupation of productive time, area of residence, education level, and knowledge and practice of oral hygiene). During 9 months (June 2015 - February 2016), the Community Periodontal Index was applied on a observation guide and interviews were conducted with 540 users of the Family Community Health Centers of Mizata, Teotepeque and Oratorio de Concepción. Results: 50.56% of the population had a 3.5 mm of periodontal probing, and a supra and subgingival calculus, whose need for treatment is education and motivation plus scaling and prophylaxis; followed by 22.04% with probing of 4 to 5 mm who need education and motivation, scaling, root planing and prophylaxis; 2.2% were healthy patients. Men suffer from periodontal alterations of greater severity 1.10 times more than women. The people who maintain an informal work present 1.11 more times greater periodontal alteration. Those who attended secondary and higher education are 3.23 times less likely to have periodontal alterations of greater severity and the prevalence of periodontal alterations is associated with oral health practices (P value = 0.000). Conclusion: The prevalence of periodontal alteration is found in codes 2 and 3 of the CPITN. There is a significant association between sociodemographic factors (age, sex, occupancy of productive time, educational level, and knowledge and practice of oral hygiene) with the severity of periodontal alterations.

Development of a tandem repeat-based multilocus typing system distinguishing Babesia bovis geographic isolates.

Mini- and microsatellite sequences have proven to be excellent tools for the differentiation of strains and populations in several protozoan parasites due to their high variability. In the present work we have searched the genome of the tick-transmitted bovine hemoprotozoon Babesia bovis for tandem repeats (TRs) that could be useful for a multilocus typing system. Hundred and nineteen sequences were shortlisted and tested in five common B. bovis reference isolates originating from distinct geographic locations of North and South America: Texas, USA (T2Bo), Mexico (RAD and Mo7), and Santa Fe and Salta, Argentina (R1A and S2P, respectively). Satellite sequences were PCR-amplified using specific primers, separated by polyacrylamide gel electrophoresis, visualized by silver staining and sized. Fourteen TR sequences could be reliably amplified in all isolates and displayed length polymorphism. All primers used were specific for B. bovis and did not amplify genomic DNA from the bovine host or from Babesia bigemina, the principal co-infecting bovine parasite in the Americas, allowing their future use in field surveys. The 14 satellite markers identified are distributed throughout the four chromosomes of B. bovis as follows: chromosome 1 (n=3), chromosome 2 (n=2), chromosome 3 (n=5), and chromosome 4 (n=4). Within the five B. bovis isolates we identified nine satellite marker loci with two alleles, three with three alleles, one with four and another with five alleles. In comparison to Theileria parva, a bovine hemoprotozoan that pertains to the same piroplasmida order and own a genome of similar size, the number of polymorphic TRs and the average number of alleles per TR locus seem to be significantly reduced in the B. bovis genome. Furthermore, the ratio of micro- to minisatellites in both B. bovis and T. parva is considerably lower than in other eukaryotes, as confirmed by bioinformatic analysis. The multilocus genotype of the five B. bovis isolates was assessed and the genetic distance between each other determined followed by cluster analysis based on neighbor joining. The resulting phenogram showed that B. bovis isolates segregated into three clusters according to their geographic origin. The presented marker system is suitable to explore various parameters of B. bovis populations such as genetic diversity, infection dynamics and their structure under different epidemiological situations, which are of crucial importance for improved control strategies.