Exacerbación del síndrome de túnel del carpo secundario a síndrome doloroso regional complejo

Introducción: El síndrome doloroso regional complejo se caracteriza por hiperalgesia, dolor espontáneo o inducido, y alteraciones sensoriales, tróficas y motoras. Genera una limitación funcional severa y, en ocasiones, se asocia al inicio o la exacerbación del síndrome de túnel del carpo. Objetivo: Caracterizar la relación entre el síndrome de túnel del carpo y el síndrome doloroso regional complejo. Presentación de caso: Se describe el caso de una paciente del sexo femenino, con 54 años y antecedente de Síndrome de túnel del carpo en miembro superior derecho. Este se exacerbó por la aparición de un síndrome doloroso regional complejo secundario a celulitis. Conclusiones: La aparición y la exacerbación aguda del Síndrome de túnel del carpo se deben considerar complicaciones del síndrome doloroso regional complejo para manejar y reducir las secuelas funcionales.

Introduction: Complex regional pain syndrome is characterized by hyperalgesia, spontaneous or induced pain, and sensory, trophic, and motor alterations. It generates severe functional limitation and it is sometimes associated with the onset or exacerbation of carpal tunnel syndrome. Objective: To characterize the relationship between carpal tunnel syndrome and complex regional pain syndrome. Case report: We report the case of a 54-year-old female patient with a history of carpal tunnel syndrome in the right upper limb. This was exacerbated by the appearance of a complex regional pain syndrome secondary to cellulitis. Conclusions: The onset and acute exacerbation of carpal tunnel syndrome should be considered complications of complex regional pain syndrome to manage and reduce functional sequelae.

Optic nerve abnormalities in female-restricted Wieacker-Wolff syndrome by a novel variant in the ZC4H2 gene.

BACKGROUND: Wieacker-Wolff syndrome is an ultra-rare disease with X-linked inheritance characterized by arthrogryposis, intellectual disability, microcephaly, and distal limb muscle atrophy. Ophthalmic abnormalities such as ptosis, strabismus, and oculomotor apraxia have been reported in half of the patients. Wieacker-Wolff syndrome female-restricted (WRWFFR) is an even rarer disease recently used for females with a more severe phenotype. MATERIALS AND METHODS: Clinical geneticist and ophthalmic examination, neuroimaging, and exome sequencing. RESULTS: A 4 years-old girl with developmental and language delay, microcephaly, camptodactyly, digital pads, and arthrogryposis was identified by the clinical geneticist. Ophthalmic examination revealed deep-set eyes, high hyperopic astigmatism in both eyes, and reduced retinal nerve fiber layer thickness measured by optical coherence tomography. Exome sequencing identified a novel, probably pathogenic variant in the ZC4H2 gene NM_018684.3:c.145A>T p. (Lys49*) in heterozygosis. DISCUSSION: WRWFFR is an ultra-rare disease with X-linked inheritance by variants in the ZC4H2 gene. This case reports a girl with a novel nonsense variant in the ZC4H2 gene and a severe phenotype; previous reports have identified WRWFFR in females with large deletions and nonsense mutations which could explain the manifestations in the current case report. A complete ophthalmic examination should be considered in patients with WRWFFR to detect the possibly associated optic nerve involvement and other previously described manifestations such as ptosis and strabismus.

Case Report: Cerebral Phaeohyphomycosis Due to Chaetomium strumarium in a Child with Visceral Heterotaxy Syndrome.

Chaetomium sp. is a mold, member of the phylum Ascomycota. Clinical disease in humans is rare, particularly in children, for which only five cases have been reported. We report a 7-months-old female patient with a diagnosis of visceral heterotaxy syndrome who was admitted to a private center in Mexico. After two episodes of focal myoclonic seizure, a brain magnetic resonance imaging (MRI) revealed a right porencephalic cyst and a right frontal abscess with ventriculitis. Seventy-two hours after temporal abscesses drainage procedure, the culture showed a rapidly growing pale white fungal colony. Sequencing of internal transcribed spacer (ITS) and D1/D2 led to the identification of Chaetomium strumarium. Although Chaetomium sp. is a rare fungal infection in humans, clinicians should consider it as a plausible etiologic agent that can form brain abscess.

El compostaje, una alternativa para el aprovechamiento de residuos orgánicos en las centrales de abastecimiento / Composting, an alternative for the use of organic residues In the supply centers / Compostagem, uma alternativa para o uso de resíduos orgânicos no suprimento central

Resumen La pérdida de alimentos a lo largo de la cadena de suministro se ha convertido en un tema de gran interés en el mundo, debido a que afecta la seguridad alimentaria de la sociedad. Uno de estos eslabones de la cadena de distribución de alimentos son las centrales de abasto local, donde diariamente se pierden importantes cantidades de alimentos especialmente por carencia de protocolos de poscosecha. El objetivo del presente estudio consistió en analizar la pérdida de alimentos en la central de abastos del municipio de Acacias, Colombia y evaluar el sistema de compostaje como alternativa de gestión ambiental. Se realizó mediante el método de cuarteo la estimación de la cantidad y tipo de residuos desperdiciados, que posteriormente se sometieron al proceso de compostaje donde se evaluó la calidad del producto. En conclusión, los residuos orgánicos son un problema ambiental que requiere de alternativas como el compostaje, que permite reducir la cantidad y aprovechar el contenido nutricional de la fracción orgánica, generando subproductos con alto valor agregado.

Abstract The loss of food along the supply chain has become a topic of great interest in the world, because this affect to the food security of society. One of these stages in the food distribution chain are the local supply centers, where important quantities of food are often lost, especially due to the lack of post-harvest protocols. The objective of this study was to analyze the loss of food in the supply center of the municipalities of Acacias, Colombia and evaluate the composting system as an alternative for environmental management. It was carried out by means of the quartering method the estimation of the quantity and type of residues lost, and subsequently, the composting process, where the quality of the product is evaluated. In conclusion, organic residues is an environmental problem that requires alternatives such as composting, which allows to reduce the amount and take advantage of the nutritional content of organic matter, generating by-products with high added value.

Resumo A perdida de alimentos ao longo da cadeia de fornecimento converteu-se em um tema de grande interesse no mundo, como isto afeta a segurança alimentar da sociedade. Um destes elos da cadeia de distribuição de alimentos são as centrais de abastecimento locais, onde diariamente se perdem importantes quantidades de alimentos especialmente por carência de protocolos de pós-colheita. O objetivo do presente estudo consistiu em analisar a perdida de alimentos na central de abastecimento do município de Acacias, Colômbia e avaliar o sistema de compostagem como alternativa de gerenciamento ambiental. Realizou-se mediante o método de cuarteo a estimativa da quantidade e tipo de resíduos perdidos, que posteriormente se submeteram ao processo de compostagem onde se avaliou a qualidade do produto. Em conclusão, os resíduos orgânicos são um problema ambiental que requer de alternativas como o compostagem, que permite reduzir a quantidade e aproveitar o conteúdo nutricional da fração orgânica, gerando subprodutos com alto valor agregado.

Remote sensing assessment of oil spills near a damaged platform in the Gulf of Mexico.

An oil platform in the Mississippi Canyon 20 (MC-20) site was damaged by Hurricane Ivan in September 2004. In this study, we use medium- to high-resolution (10-30 m) optical remote sensing imagery to systematically assess oil spills near this site for the period between 2004 and 2016. Image analysis detects no surface oil in 2004, but ~40% of the cloud-free images in 2005 show oil slicks, and this number increases to ~70% in 2006-2011, and >80% since 2012. For all cloud-free images from 2005 through 2016 (including those without oil slicks), delineated oil slicks show an average oil coverage of 14.9 km2/image, with an estimated oil discharge rate of 48 to ~1700 barrels/day, and a cumulative oil-contaminated area of 1900 km2 around the MC-20 site. Additional analysis suggests that the detected oil slick distribution can be largely explained by surface currents, winds, and density fronts.

PPIENSENLo: A Novel Mnemonics in Spanish for Alarm Criteria in Secondary Headaches in Children.

We present the first mnemonic in Spanish, "PPIENSENLo," for alarm criteria in secondary headaches in children in order to facilitate their identification, diagnosis, and treatment. A search was performed across different electronic databases for a mnemonics that applied to clinical alarm criteria in secondary headaches in children. None were found in English or Spanish. This tool is perhaps useful both for clinical and teaching purposes.

Schwann Cell Precursor Transplant in a Rat Spinal Cord Injury Model.

BACKGROUND: Differentiation of mesenchymal stem cells into Schwann cell precursors could reverse established lesions and sequelae of medullary transection. OBJECTIVE: The objective of this study was to study the clinical response of mesenchymal stem cell transplantation with Schwann precursor cell transplantation in a rat spinal cord injury model, using motor function and histopathologic studies. MATERIALS AND METHODS: A total of 28 Sprague-Dawley rats were randomly divided among four groups (n = 7 in each): sham group, control group, mesenchymal stem cell transplant group, and Schwann cell precursor transplant group. The surgical procedure was a laminectomy with transection of the spinal cord at the T11 level in the transplant groups and the injury control group. After 1 week, the transplant groups received stem cells directly in the injury site. Hind limb motor function was assessed using the locomotive scale of Basso, Beattie, and Bresnahan. 1 month after transplantation, all specimens were sacrificed to make a histopathologic description of sections taken from the site of injury and where stem cells were transplanted. Mean scores of mobility were compared using analysis of variance (ANOVA) of one factor with 95% reliability between groups and ANOVA of repetitive measures to evaluate evolution in the same group. RESULTS: We observed that the control group had statistically greater mobility than the other groups (p < 0.0001) and that the group with spinal injury without treatment had the lowest mean mobility. The mobility score values from the Schwann cell precursor group were statistically higher than the group treated with mesenchymal stem cells (p < 0.0001). CONCLUSION: Schwann precursor cells had a greater effect on locomotive function than mesenchymal stem cells.

ANÁLISIS DE UN SISTEMA DE COSECHA DE AGUA LLUVIA A PEQUEÑA ESCALA CON FINALIDAD PECUARIA / ANALYSIS OF A SMALL-SCALE WATER HARVEST SYSTEM FOR LIVESTOCK PURPOSES

La demanda global de agua se ha incrementado durante los últimos años debido al crecimiento de la población y a la necesidad de producir mayor cantidad de bienes y servicios. Sumado a esto, el cambio climático ha modificado los patrones del clima de algunas regiones alterando los periodos de sequía y lluvia. Por tal motivo, se proponen sistemas de cosecha y almacenamiento de agua que permitan almacenar los excesos de agua para su posterior uso en los periodos secos, sin que se interrumpa la producción de alimentos. En la altillanura colombiana se evidencian estos efectos del cambio climático, generando pérdidas a los productores de ganado principalmente debido a la escasez hídrica en la época seca. Basados en lo anterior, el presente estudio tiene como objetivos; 1) caracterizar la dinámica de la precipitación del área de estudio con énfasis en la frecuencia e intensidad, 2) determinar el potencial de cosecha de agua del sistema a pequeña escala. Inicialmente se recopiló información en el periodo 2009­2014, de una estación pluviométrica propia de la granja. Asimismo, se calcularon las dimensiones de la infraestructura del sistema de cosecha para determinar su potencial. Los resultados ponen de manifiesto que en la zona se presenta una distribución de lluvias monomodal, donde el periodo de lluvias comprende los meses de abril a octubre y el periodo seco de noviembre a marzo. Por otro lado, el potencial de cosecha de agua de acuerdo a las condiciones del sistema fue de 820 m3/año y el consumo de los vacunos fue de 540 m3/año. En conclusión, el sistema de cosecha es una estrategia de adaptación al cambio climático ya que mitiga sus efectos negativos; además garantiza que los productores a pequeña escala y de regiones con temporalidad climática marcada tengan producción durante todo el año.

The global water demand has increased during the last years due to the growth of the population and the need to produce more goods and services. Added to this, climate change has varied weather patterns in some regions altering periods of drought and rain. For this reason, water harvesting and storage systems that allow storing excess water for later use in dry periods without interrupting food production are proposed. The effects of climate change are evident in the Colombian eastern highlands (the Altillanura), generating losses to livestock producers mainly because of water shortage in the dry season. Based on the above, this study aims 1) to characterize the dynamics of rainfall in the area of study with emphasis on frequency and intensity; 2) to determine the potential of a small-scale water harvesting system. Initially, information was compiled in the period 2009 - 2014 from a rainfall station typical of the farm. Likewise, the dimensions of the harvesting system infrastructure were calculated to determine their potential. The results show that a monomodal distribution of rainfall is present in the area, where the rainy season covers the months from April to October, and the dry season from November to March. On the other hand, the potential water harvesting, according to the system conditions, was 820 m3 / year, and the consumption of cattle was 540 m3 / year. In conclusion, the harvesting system is an adaptation strategy to climate change since it mitigates its potential damage and guarantees that small-scale producers and regions with marked climate temporality continue to produce all year.

Evaluación longitudinal del diagnóstico funcional del neurodesarrollo según el método de Munich en niños pretérmino / Longitudinal evaluation of functional neurodevelopmental diagnosis according to the Munich Method in preterm infants

RESUMEN Objetivos La adquisición natural de habilidades motoras en la infancia, puede afectarse por una edad gestacional menor que 40 semanas. La detección temprana favorece el manejo oportuno y la prevención de secuelas, por esto, es necesario contar con una herramienta confiable para la evaluación del desarrollo motor en los niños prematuros. Una herramienta útil para evaluar el neurodesarrollo es el diagnóstico funcional según el método de Munich, el cual evalúa la ontogenia durante el primer año de vida en los niños. El objetivo de este estudio fue analizar la correlación entre la valoración del desarrollo según el método de Munich y la evaluación clínica con el fin de validar la utilidad de este método en pacientes prematuros. Métodos Estudio descriptivo y retrospectivo en el cual se evaluaron las historias clínicas de 165 niños con edad corregida entre 0 y 12 meses de edad y antecedentes de edad gestacional menor que 40 semanas. A todos los niños se les aplicó el método durante la consulta de seguimiento realizada en el Instituto Materno Infantil de Bogotá entre 2008 y 2011. Resultados Se evidenció una alta correlación entre la edad corregida y la edad motora obtenida a partir del diagnóstico funcional del desarrollo según el método de Munich. Conclusiones La alta correlación entre cada hito evaluado y la edad corregida de los prematuros demuestra que el método de Múnich, además de ser una prueba corta y de fácil aplicación, es útil para la evaluación del desarrollo motor en niños prematuros.(AU)

ABSTRACT Objective The natural acquisition of motor skills during childhood can be affected by a gestational age of less than 40 weeks. Early detection favors timely management and prevention of sequelae, therefore, having a reliable tool for evaluating motor development in preterm children is necessary. A useful tool for this purpose is the Munich functional developmental diagnosis, which evaluates development ontogeny during the first year of life in children. This paper aims at analyzing the correlation between the Munich functional developmental diagnosis and the clinical assessment to determine the usefulness of such method in preterm patients. Methods Descriptive and retrospective study, in which the clinical records of 165 children with corrected age between 0 and 12 months of age and a history of gestational age of less than 40 weeks were evaluated. The method was used with all the children during a follow-up visit at Instituto Materno Infantil in Bogotá, between 2008 and 2011. Results A high correlation between corrected age and motor age obtained was found according to the Munich functional developmental diagnosis method. Conclusions The high correlation between each milestone evaluated and the corrected age of preterm infants makes the Munich method useful for the evaluation of motor development since this is a short test, easy to apply.(AU)

[Longitudinal evaluation of functional neurodevelopmental diagnosis according to the Munich Method in preterm infants]. / Evaluación longitudinal del diagnóstico funcional del neurodesarrollo según el método de Munich en niños pretérmino.

OBJECTIVE: The natural acquisition of motor skills during childhood can be affected by a gestational age of less than 40 weeks. Early detection favors timely management and prevention of sequelae, therefore, having a reliable tool for evaluating motor development in preterm children is necessary. A useful tool for this purpose is the Munich functional developmental diagnosis, which evaluates development ontogeny during the first year of life in children. This paper aims at analyzing the correlation between the Munich functional developmental diagnosis and the clinical assessment to determine the usefulness of such method in preterm patients. METHODS: Descriptive and retrospective study, in which the clinical records of 165 children with corrected age between 0 and 12 months of age and a history of gestational age of less than 40 weeks were evaluated. The method was used with all the children during a follow-up visit at Instituto Materno Infantil in Bogotá, between 2008 and 2011. RESULTS: A high correlation between corrected age and motor age obtained was found according to the Munich functional developmental diagnosis method. CONCLUSIONS: The high correlation between each milestone evaluated and the corrected age of preterm infants makes the Munich method useful for the evaluation of motor development since this is a short test, easy to apply.

OBJETIVOS: La adquisición natural de habilidades motoras en la infancia, puede afectarse por una edad gestacional menor que 40 semanas. La detección temprana favorece el manejo oportuno y la prevención de secuelas, por esto, es necesario contar con una herramienta confiable para la evaluación del desarrollo motor en los niños prematuros. Una herramienta útil para evaluar el neurodesarrollo es el diagnóstico funcional según el método de Munich, el cual evalúa la ontogenia durante el primer año de vida en los niños. El objetivo de este estudio fue analizar la correlación entre la valoración del desarrollo según el método de Munich y la evaluación clínica con el fin de validar la utilidad de este método en pacientes prematuros. MÉTODOS: Estudio descriptivo y retrospectivo en el cual se evaluaron las historias clínicas de 165 niños con edad corregida entre 0 y 12 meses de edad y antecedentes de edad gestacional menor que 40 semanas. A todos los niños se les aplicó el método durante la consulta de seguimiento realizada en el Instituto Materno Infantil de Bogotá entre 2008 y 2011. RESULTADOS: Se evidenció una alta correlación entre la edad corregida y la edad motora obtenida a partir del diagnóstico funcional del desarrollo según el método de Munich. CONCLUSIONES: La alta correlación entre cada hito evaluado y la edad corregida de los prematuros demuestra que el método de Múnich, además de ser una prueba corta y de fácil aplicación, es útil para la evaluación del desarrollo motor en niños prematuros.

[Evaluating language acquisition using the Early Language Milestone (ELM) and Munich developmental scales]. / Evaluación del lenguaje mediante la escala de Early Language Milestone y el método de Múnich.

OBJECTIVE: Evaluating language development by comparing the Munich Development method to the Early Language Milestone scale for identifying both diagnostic tests' agreement and enriching neurodevelopmental consultation. METHODS: The clinical histories of a cohort of 129 children were evaluated, as prematurity is a risk factor for deviation in children's language development. The children had less than 40 weeks gestational age and 0 to 12 months corrected age. They were given both tests between 2008 and 2011. The results from both scales were compared regarding receptive and expressive language and visual response (Early Language Milestone scale) and evaluation of verbal response, vocal play, understanding and expression (Munich scale). Student's T-test was used for comparing means for paired samples. Results: A statistically significant correlation (p<0.05) was found between both tests and between them and corrected age. It was seen that the higher the corrected age, the greater correlation there was between tests. CONCLUSION: The Early Language Milestone and Munich Development scales, regarding their components dealing with language, both represent useful tools for following-up premature children's language development.

Mini-temporal and perilobular approach to facelift: mini-TAPA-facelift.

BACKGROUND: Many people today are looking to preserve their youthful appearance for as long as possible. Current techniques of facial rejuvenation consist of superficial muscular aponeurotic system and/or deep tissue manipulation to relocate the tissues to their former positions. Scars continue to be a limiting factor for many patients who are interested in a facial rejuvenation procedure that has minimal risk and a short recovery period and that truly complies with the term minimally invasive. METHODS: This surgical protocol included a complete medical history, analysis of the degree of aging, and development of a surgical plan. We obtained pre- and postoperative photographic controls for medium- and long-term follow-up and evaluation of results. RESULTS: We treated 67 patients with this minimally invasive technique. The follow-up period ranged from 6 months to 4 years. The results were satisfactory, showing a more harmonious facial appearance. CONCLUSIONS: The mini-temporal and perilobular approach to facelift (mini-TAPA-facelift) is a facial rejuvenation procedure with limited incisions, which allows us to reaffirm the soft tissues of the corners of the eyelids and upper cheek. It also restores the lower midface and the mandibular contour, thus eliminating undesirable jowls. The procedure clearly defines the face from the neck, providing a high level of satisfaction among patients.

Cell-assisted lipotransfer for the treatment of parry-romberg syndrome.

Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome.

Evaluación del lenguaje mediante la escala de Early Language Milestone y el método de M únich / Evaluating language acquisition using the Early Language Milestone (ELM) and Munich developmental scales

Objetivo Evaluar el desarrollo del lenguaje mediante la comparacion de dos pruebas: el método del desarrollo de MUNICH y la escala de evaluación del lenguaje EARLY LANGUAGE MILESTONE, con el proposito de identificar la correspondencia de los dos test diagnosticos y enriquecer la consulta de neurodesarrollo. Método Teniendo en cuenta que La prematurez es un factor de riesgo para presentar desviaciones del desarrollo del lenguaje en el niño; se evaluaron las historias clínicas de una cohorte de 129 niños, con edad gestacional menor de 40 semanas y edad corregida de 0 a 12 meses, a quienes se les había aplicado los dos test, entre los años 2008 y 2011, se compararon los resultados de las dos escalas en lo que tiene que ves al lenguaje comprensivo, lenguaje expresivo y respuesta visual, de EARLY LANGUAJE MILESTONE, como la evaluacion de respuesta verbal, juego vocal, conprensión y expresión de la escala de MUNICH. Se realizo una comparación de medias mediante la prueba de T de Student para muestras paredas. Resultados Se encontró una correlación estadísticamente significativa (p<0,05) entre los dos test y entre estos con la edad corregida. Se evidenció que a mayor edad corregida existe mayor correlación entre las pruebas. Conclusión La escala de Early Language Milestone y el método diagnóstico funcional del desarrollo según M únich, en sus tópicos de lenguaje, son herramientas útiles para el seguimiento del desarrollo del lenguaje en los niños con antecedente de prematurez.

Objective Evaluating language development by comparing the Munich Development method to the Early Language Milestone scale for identifying both diagnostic tests' agreement and enriching neurodevelopmental consultation. Methods The clinical histories of a cohort of 129 children were evaluated, as prematurity is a risk factor for deviation in children's language development. The children had less than 40 weeks gestational age and 0 to 12 months corrected age. They were given both tests between 2008 and 2011. The results from both scales were compared regarding receptive and expressive language and visual response (Early Language Milestone scale) and evaluation of verbal response, vocal play, understanding and expression (Munich scale). Student's T-test was used for comparing means for paired samples. Results A statistically significant correlation (p<0.05) was found between both tests and between them and corrected age. It was seen that the higher the corrected age, the greater correlation there was between tests. Conclusion The Early Language Milestone and Munich Development scales, regarding their components dealing with language, both represent useful tools for following-up premature children's language development.

Modification of the technique for subclavian-vein catheterization.

INTRODUCTION: In invasive monitoring, subclavian-vein puncture is a routine procedure indicated for central vein cathe-terization. It is indicated in patients according to hospital stay, including the administration of drugs and the treatment of chronic and cardiac disease. The techniques described to date include infraclavicular percutaneous puncture; others place catheters using angiographic methods, and the use of magnetic resonance imaging and ultrasound has also been reported. Studies have been done in cadavers to get a better understanding of the procedure since the relationship between vascular elements and surrounding tissues are obtained. The usual technique is with the patient in Trendelenburg position, with the arm in adduction, the placement of an interscapular roll, and the head turned away from the puncture site. OBJECTIVE: The aim of this study was to demonstrate less frequent technical failures and complications using a modification of the usual technique. We propose catheterization of the right subclavian vein with the patient in decubitus, without an interescapular roll, with the arm in abduction and using the distal third of the clavicle and the suprasternal notch as anatomical references. RESULTS: Two technical puncture failures and three complications occurred in a total of 42 patients with a statistically significant difference (p = 0.0410) in frequency (11.9%) from that reported with the traditional technique (21.8%). CONCLUSIONS: Greater efficacy with the technique modified by the authors was confirmed. Anatomical cadaver dissections showed a greater space between the right subclavian vein and the clavicle.

Efetividade do ferro bis-glicina quelato em achocolatado no controle da deficiência de ferro em pré-escolares / Effectiveness of iron bis-glycine chelate in chocolate drink in the control of iron deficiency in preschool children

A população pediátrica, mesmo a considerada saudável, recebe uma quantidade inadequada de ferro, o que a coloca em situação de risco de desenvolvimento de deficiência quando surgirem condições de maior demanda metabólica, como a aceleração de crescimento. Dentre as estratégias para o controle desse desvio nutricional, a fortificação de alimentos com ferro é a que mais se destaca pela sua efetividade e pelos aspectos positivos da relação custo-benefício. O objetivo desse trabalho foi avaliar o efeito de uma bebida achocolatada fortificada com ferro aminoácido quelato, na dosagem proposta pela legislação brasileira, para considerá-la fonte de ferro (1,5mgFe/200mL). Participaram do estudo 157 crianças entre 3 e 6 anos e, após 3 meses de intervenção, os resultados foram positivos, com um aumento significativo dos níveis de hemoglobina, ferritina e eritrócitos (p<0,001). O achocolatado pode ser um excelente veículo para a fortificação, desde que, para tanto, seja utilizado um composto estável de ferro, cuja configuração molecular o proteja dos principais fatores inibidores de sua absorção