Effect of 1,25(OH)2-vitamin D on bone mass in children with acute lymphoblastic leukemia.

BACKGROUND: Calcitriol deficit has been described in patients with acute lymphoblast leukemia (ALL). The aim of this randomized case-control trial is to investigate the effectiveness of calcitriol administration during the first year of treatment to protect bone mass. Sixteen children recently diagnosed with ALL, aged 1.7 to 11.5 years, average 5.5, completed the study. Anthropometrical measurements, food intake record, physical activity, and bone pain were registered. Dual energy x-ray absorptiometry was performed at the completion of remission induction chemotherapy (after 1 mo) to measure bone mineral density (BMD) at hip, lumbar spine and whole body, and total bone mineral content and 1 year after. Half of them were randomly assigned to receive calcitriol during 1 year. STATISTICAL: Kruskal-Wallis, Wilcoxon, Mann-Whitney, and Spearman. RESULTS: Both groups had similar anthropometric measurements and bone densitometric variables increments. Spine BMD significantly increased in calcitriol supplemented children with lower baseline BMD (r=-0.78 and P<0.05). CONCLUSIONS: One-year calcitriol administered to recently diagnosed ALL children did not show impact on bone mass. Greater increment in lumbar spine bone mass was observed in patients who received calcitriol and had lower baseline BMD.

Normalización de la densidad mineral ósea en niños nacidos prematuros en Viña del Mar, Chile / Normalization of bone mineral density in premature-born children from Viña del Mar, Chile

Background: In a previous study we reported that healthy children born at 34 or fewer gestational weeks, with adequate weight for gestational age, had not completed their bone catch-up at mean age of 6.3 years. Aim: This is a follow up report, performed on the same population one year later to determine at which age premature - born children achieve their bone mineral density (BMD) catch-up, compared to term-born controls. Material and methods: Fifteen children mean age 7years 3 months, born at 25 to 34 weeks of gestation, with a birth weight of 740 to 2.200 g were studied Radius, lumbar spine and femoral neck bone mineral density, whole body bone mineral content and body composition were assessed by DEXA. Results: Height, body mass index, peripheral BMD, axial BMD, fat and lean body mass in these children were not different from term born controls. Conclusions: Premature born children with adequate weight for gestational age, achieved peripheral and axial bone mineral density catch-up at the age of 7 to 8 years.

[Normalization of bone mineral density in premature-born children from Viña del Mar, Chile]. / Normalización de la densidad mineral ósea en niños nacidos prematuros en Viña del Mar, Chile.

BACKGROUND: In a previous study we reported that healthy children born at 34 or fewer gestational weeks, with adequate weight for gestational age, had not completed their bone catch-up at mean age of 6.3 years. AIM: This is a follow up report, performed on the same population one year later to determine at which age premature - born children achieve their bone mineral density (BMD) catch-up, compared to term-born controls. MATERIAL AND METHODS: Fifteen children mean age 7 years 3 months, born at 25 to 34 weeks of gestation, with a birth weight of 740 to 2.200 g were studied Radius, lumbar spine and femoral neck bone mineral density, whole body bone mineral content and body composition were assessed by DEXA. RESULTS: Height, body mass index, peripheral BMD, axial BMD, fat and lean body mass in these children were not different from term born controls. CONCLUSIONS: Premature born children with adequate weight for gestational age, achieved peripheral and axial bone mineral density catch-up at the age of 7 to 8 years.

Análisis fenotípico del complex Trichophyton rubrum en los medios de Sabouraud, Lactrimel y la técnica de Fischer & Kane: una experiencia regional / Phenotipic analysis of the Trichophyton rubrum complex in Sabouraud’ s dextrose agar, Lactrimel agar and the Fischer & Kane technique: A regional experience

Con el propósito de comparar el rendimiento y la eficiencia de los medios utilizados de rutina en el laboratorio de Micología para la identificación de las especies que integran el complex T. rubrum presentes en la V Región, Chile, seleccionamos: Agar glucosa Sabouraud (SDA), Agar Lactrimel (AL) y el medio sólido leche, glucosa, adicionado con el indicador de púrpura de bromocresol (Fischer & Kane, 1971) (BCP-MS-G). Estos fueron probados en 304 cepas consideradas como T. rubrum en el medio SDA, provenientes de pacientes dermatológicos. Los parámetros que se consideraron fueron rango de crecimiento, pigmentación al reverso de las colonias y presencia de fructificaciones. Las variedades del complex identificadas fueron T. rubrum var. algodonosa (72,4 por ciento) y T. rubrum var. granular (14,5 por ciento) además de integrantes del complex T. mentagrophytes (13,2 por ciento) que no se consideraron en el estudio. La zona anatómica más afectada fueron las uñas de los pies (80,7 por ciento). La fructificación en los 3 medios fue considerada como el gold standard y en base a este criterio se estableció su sensibilidad y especificidad, obteniéndose para la var. granular una especificidad de un 100, 98,6 y 83,9 por ciento en BCP-MS-G, AL y SDA, respectivamente. Para la var. algodonosa, la mayor sensibilidad se obtuvo en BCP-MS-G (71,9 por ciento), pero con una nula especificidad, por lo que se sugiere considerar el rango de crecimiento limitado a los 7 días y la pigmentación al reverso de la colonia en este medio. La identificación fue complementada con la prueba de la ureasa, que fue 100 por ciento negativa para todo el complex T. rubrum. Se sugiere el uso del medio de Fischer & Kane en conjunto con AL y SDA para diferenciar las variedades de este complex.

The following media Sabouraud·s dextrose agar (SDA), Lactrimel Agar and BCP-Milk solids glucose agar(Fischer & Kane, 1971) (BCP-MS-G) were selected to evaluate the performance and the efficiency of the routine media used in mycological laboratory with the purpose of identifying the species that conformed T. rubrum complex in the V Region of Chile. These were tested in 304 strains considered as T. rubrum in the SDA media, obtained from dermatological patients. The following parameters were used: the radial growth of the colonies,the pigmentation at the back of the plates and the presence of fructification. T. rubrum variety downy (72,4 percent and T. rubrum variety granular (14,5 percent) were the only variants identified and T. mentagrophytes (Robin) Blanchard (13,2 percent), that were not consider in this study. The mosts affected anatomic zones were the toe nails (68,9 percent). In the three media used, we considered the presence of fructifications as the gold standard and based on this criteria we evaluated the sensibility and specificity of them.For the variant granular we obtained a specificity of 100, 98,6 y 83,9 percent en BCP-MS-G, AL y SDA, respectively. For the variant downy, the greatest specificity was obtained in BCP-MS-G 71,9 percent,but with a null specificity, a cause of this situation we propose to considerer the restricted radial growth of colonies on the seventh day and the red pigmentation at the back of the plates in this media. The identification of the complex was complemented by theurea test, that was negative for the whole complex. The use of Fischer and Kane media in combination with AL and SDA is suggested for the differentiation of the varieties of this complex.

Comunidad estacional de microhongos en la litera de coníferas del N.E. Argentino: énfasis en taxa de potencial interes médico / Seasonal microfungal community of coniferous litter of Argentine N. E.: emphasis on potential medical interest taxa

Se analizó la colonización in vitro de microhongos filamentosos de rápido crecimiento en la litera de coníferas (Pinus elliottii) en el N.E argentino, mediante muestras estacionales de acículas senescentes de 4 localidades con semejanzas climáticas, edáficas y vegetacionales. Veinte muestras (5 de cada lugar) se sembraron en agar papa dextrosa y agar agua (ambos adicionados con dichlorán) durante 21 días a t° ambiente, para enumerar la presencia relativa de su micota. Se contabilizó un total de 63 géneros fúngicos y 117 especies, representadas mayoritariamente por anamorfos de Ascomycota (85 por ciento). Ascomycita (9,9 por ciento) y Zygomycota (4,1 por ciento). Los hongos dematiáceos fueron dominantes (81,9 por ciento) y los 5 géneros más frecuentes y constantes en las 4 estaciones y localidades, presentaron un variado comportamiento estacional, tales como: Cladosporium (31,8 por ciento), Alternaria (13,5 por ciento), Epicoccum (8,8 por ciento), Trichoderma (5,7 por ciento) y Fusarium (4,9por ciento), con el 65 por ciento de la presencia total. Los géneros con mayor variedad de especies fueron: Curvularia (7), Fusarium (6), Phoma (6), Trichoderma (5) y Cladosporium (4). Las especies de interés médico fueron 52, con una presencia del 73,3 por ciento de la micota total. Las frecuencias más altas fueron: A.alternata, A.tenuisssima, Bipolaris cynodontis, C.cladosporiodes, C.oxysporum, Curvularia lunata, E. nigrum, F. semitectum, Nigrospora sphaerica, T. harzianum y T.viride.

The in vitro colonization of fast growthfilamentous microfungi in the coniferous litter (Pinus elliottii) in northern-eastern Argentina was analysed by using seasonal samples of senescent acicules from four localities showing similar climatic, edaphic and vegetational characteristics. Twenty samples (five from each site) were cultured in dextrose potato agar and water agar (both dichloran added) for 21 days at room temperature in order to assess the relative presence of their mycota. A total sixty three fungal genera and 117strains were detected , most of them being anamorphs of Ascomycota (85 percent), Ascomycota (9.9 percent) and Zygomycota (4.1 percent). Dematiaceous fungi were dominant (81.9 percent) whereas the five genera most frequent and constant inthe four stations and localities showed a varied seasonal behaviour such as:Cladosporium (31.8), Alternaria(13.5 percent), Epicoccum (8.8 percent), Trichoderma (5.7 percent) and Fusarium (4.9 percent) with 65 percent of the entire presence. Genera bearing a higher variety of species were: Curvularia(7),Fusarium (6), Phoma (6), Trichoderma (5) and Cladosporium (4). Species showing medical interest were 52, with a 73.3 percent presence of the total mycota. The highest frequencies were:A:alternata A.tenuisssima, Bipolaris cynodontis, C. cladosporiodes, C.oxysporum, Curvularia lunata, E. nigrum, F.semitecnum, Nigrospora sphaerica, T.harzianum and T.viride.

[Eating and affective disorders: a comparative study]. / Trastornos de la conducta alimentaria y trastornos afectivos: un estudio comparativo.

BACKGROUND: The relationship between eating disorders and affective disorders still remains unclear. Eating disordered patients may have affective disorders and vice versa, depressed and maniac patients may experience eating problems. AIM: To compare eating symptoms, attitudes and behaviors in patients with affective disorders and normal subjects. SUBJECTS AND METHODS: A structured clinical interview, the Eating Attitudes Test (EAT-40) and the Eating Disorder Inventory (EDI) were administered to 194 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders, to 45 patients with affective disorders and to 82 normal female students. RESULTS: Patients with eating disorders ranked significantly higher on the EAT-40 and on the EDI and its factors (p <0.001). Patients with affective disorders ranked between eating disordered patients and the students (p <0.001). Compulsive-purgative type of anorectics and purgative type of bulimics showed the highest scores on these measures (p <0.001). Restrictive type of anorectics scored significantly highest on EDI maturity fears item (p <0.001). Not significant difference was observed on the EDI ineffectiveness item, between purgative bulimics and depressive patients and between the latter and compulsive-purgative anorexics, on the EDI interpersonal distrust item. CONCLUSIONS: Compulsive-purgative type of anorectics and purgative type of bulimics showed the more severe psychological and behavioral disturbances. Restrictive types of anorectics were the most immature. Both purgative bulimics and depressive patients showed feelings of general inadequacy, and both compulsive-purgative anorexics and depressive patients displayed an interpersonal distrust. As a whole, patients with affective disorders did not show the core eating disordered behaviors and attitudes as seen in patients suffering from eating problems.

[Impact of regulatory measures in the trends of community consumption of antibiotics in Chile]. / Impacto de medidas regulatorias en la tendencia de consumo comunitario de antibióticos en Chile.

BACKGROUND: The indiscriminate use of antibiotics increases the appearance of bacterial resistance and forces the use of more expensive alternatives. The Chilean Ministry of Health is regulating the consumption of antibiotics since September 1999. These regulatory measures restricted the sale of antibiotics only when these were prescribed by an MD or an DS. AIM: To study the impact of these regulatory measures on antibiotics sales in pharmacies. MATERIAL AND METHODS: A retrospective analysis of antibiotics sales in pharmacies from 1996 to 2000. The information was obtained from the International Marketing System (IMS Health), an auditing system of pharmacy sales. The consumption unit used was the Defined Daily Dose per 1000 inhabitants/day (DDD). RESULTS: There was an important reduction in DDD, after the introduction of regulatory measures, for amoxicillin, ampicillin, erythromycin, trimethoprim/sulpha, chroramphenicol, cloxacillin and phenoxymethylpenicillin. There was also a important fall in sales, expressed in dollars. CONCLUSIONS: The regulatory measures of the Ministry of Health, had an immediate and great impact on antibiotics sales in Chile.

Creencias populares sobre saneamiento básico, Viña del Mar, Chile / Popular beliefs about basic sanitation, Viña del Mar, Chile

Con objeto de identificar creencias relacionadas con el saneamiento básico y la transmisión de enfermedades infecciosas, en 1978 se realizó una encuesta a una población suburbana de Viña del Mar, Chile. Estas creencias se dedujeron de las razones expuestas por las amas de casa en relación con el manejo del agua, los desperdicios, los insectos y las ratas en el hogar. La encuesta mostró que un bajo porcentaje (37%) de las amas de casa manifestaban creencias correctas sobre saneamiento y transmisión, expresadas a través de las razones que justificaban su comportamiento relativo al tratamiento de agua y basuras y al control de insectos y ratas. En general, las nociones más correctas se refieren al tratamiento de agua y desperdicios; a veces, las entrevistadas no mostraban fundamentación lógica pero actuaban de manera adecuada. De las personas entrevistadas 6% daba más importancia a las actividades de saneamiento destinadas a proteger a los niños que aquellas dirigidas a los adultos, a quienes consideraban menos vulnerables. Alrededor de un 37% fundamentó comportamientos correctos en higiene por razones de aseo o limpieza sin relacionarlas específicamente con salud; el 20% por evitar molestias (no referentes a enfermedades) a los miembros del hogar y el 10% dio otras justificaciones aun menos relacionadas con salud o, simplemente, no fue capaz de justificar una conducta favorable. Las conductas negativas siempre se justificaron por creencias populares que no asociaban de manera lógica el saneamiento básico con la salud

Prevención de ceguera en población diabética semirrural / Blindness prevention of diabetic patients from a semirural area

En un estudio de tipo piloto se examinan en terreno 127 pacientes diabéticos de procedencia semirural agrupados en un Club de Diabéticos de un Hospital tipo B. Se detecta una prevalencia de retinopatía diabética de 39%. 20% de los pacientes examinados, 54% de los que presentaban retinopatía, tienen complicaciones que implican alto riesgo de ceguera, tales como maculopatía y retinopatía proliferante. Se evidencia consulta tardía en los casos de mayor gravedad. Se plantea la necesidad de implementar acciones de salud urgentes y concretas tendientes a prevenir la ceguera en la poblacion diabética

Complicaciones oculares en diabéticos: factores de riesgo / Ocular complications in diabetic patient: risk factors

En un estudio de corte transversal se examinan oftalmológicamente 101 pacientes diabéticos , clínicamente estudiados, cuantificando la prevalencia de las complicaciones oculares de la diabetes y la significancia de algunos factores de riesgo. La prevalencia de la retinopatía diabética alcanzó un 58% y su severidad se traduce en un 8% de retinopatía proliferante y un 52% de pacientes con lesiones isquémicas. Entre los factores de riesgo relacionados con la presencia de retinopatía alcanzan significancia estadística los siguientes: duración de la diabetes, tratamiento con insulina por fracaso de hipoglicemiantes orales, hipertensión arterial y polineuropatía