Usefulness of Ultrasonography and Radiography in the Evaluation of Distal Forearm Fractures in Children: A Narrative Review / Utilidad de la ecografía y la radiografía en la evaluación de las fracturas distales del antebrazo en niños: una revisión narrativa

Pediatric fractures, especially distal forearm fractures, represent a significant global medical concern, affecting up to 50% of pediatric fracture cases. This narrative review aims to compare diagnostic modalities to determine which offers higher accuracy, minimizes radiation exposure, and is adaptable to diverse clinical settings. In the choice between ultrasound and X-ray for diagnosing distal forearm fractures in children, each modality has its merits. X-ray provides accuracy and value in wellequipped facilities, while ultrasound, being radiation-free, is effective in resourcelimited areas and is essential for pediatric patients to avoid radiation exposure. Professional training and continual updates are crucial. Moreover, it underscores that alongside diagnostic imaging, comprehensive clinical assessment remains pivotal for making informed medical decisions. The choice of method should consider individual case factors and prioritize patient safety. (AU)

Las fracturas pediátricas, especialmente las fracturas distales del antebrazo, representan una importante preocupación médica mundial y afectan hasta el 50% de los casos de fracturas pediátricas. Esta revisión narrativa tiene como objetivo comparar modalidades de diagnóstico para determinar cuál ofrece mayor precisión, minimiza la exposición a la radiación y es adaptable a diversos entornos clínicos. A la hora de elegir entre ecografía y rayos X para diagnosticar fracturas distales del antebrazo en niños, cada modalidad tiene sus ventajas. Los rayos X proporcionan precisión y valor en instalaciones bien equipadas, mientras que el ultrasonido, al no tener radiación, es eficaz en áreas con recursos limitados y es esencial para que los pacientes pediátricos eviten la exposición a la radiación. La formación profesional y la actualización continua son cruciales. Además, subraya que, junto con el diagnóstico por imágenes, la evaluación clínica integral sigue siendo fundamental para tomar decisiones médicas informadas. La elección del método debe considerar factores de cada caso individual y priorizar la seguridad del paciente. (AU)

Encuesta sobre usos y prácticas de Doppler transcraneal en pacientes neurocríticos en unidades de cuidados intensivos pediátricos de Argentina / Survey on the use and practice of transcranial Doppler ultrasound in neurocritical patients in pediatric intensive care Units in Argentina

Introducción. El uso del Doppler transcraneal (DTC) en pacientes neurocríticos se reporta cada vez más en las terapias intensivas pediátricas. El objetivo de esta encuesta es conocer los usos y prácticas del DTC en la atención neurocrítica y el proceso de formación del personal que realiza el estudio. Materiales y métodos. Encuesta a profesionales de 23 unidades de terapia intensiva pediátrica de Argentina. Resultados. Porcentaje de respuesta del 86 %. Se utilizó en sospecha de muerte encefálica (n = 20), trauma de cráneo (n = 16) y accidente cerebrovascular (n = 16). El intensivista pediátrico es quien realiza los estudios (n = 13/20). Los encuestados utilizan el Doppler para decidir conductas y tratamientos, comenzar el proceso de evaluación de muerte encefálica, solicitar tomografía de cerebro y manejar la presión de perfusión cerebral con vasopresores. Conclusión. Todos los encuestados utilizan los hallazgos del DTC para guiar tratamientos o conductas. La mitad de los encuestados está poco conforme con la capacitación recibida.

Introduction. The use of transcranial Doppler (TCD) ultrasoundin neurocritical patients is reported to be increasingly common in pediatric intensive care units. The objective of this survey was to know about the use and practice of TCD ultrasound in neurocritical care and the training process of staff members performing it. Materials and methods. Survey administered to providers from 23 pediatric intensive care units of Argentina. Results. The percentage of response was 86%. TCD ultrasound was used for suspected brain death (n = 20), head injury (n = 16), and stroke (n = 16). Pediatric intensivists perform the test (n = 13/20). Surveyed participants use TCD ultrasound to decide on treatment and management, start brain death assessment, request brain computed tomography, and manage cerebral perfusion pressure with vasopressors. Conclusion. All surveyed participants use TCD ultrasound findings to guide management or treatments. Half of surveyed participants are little satisfied with their training.

Survey on the use and practice of transcranial Doppler ultrasound in neurocritical patients in pediatric intensive care Units in Argentina. / Encuesta sobre usos y prácticas de Doppler transcraneal en pacientes neurocríticos en unidades de cuidados intensivos pediátricos de Argentina.

INTRODUCTION: The use of transcranial Doppler (TCD) ultrasound in neurocritical patients is reported to be increasingly common in pediatric intensive care units. The objective of this survey was to know about the use and practice of TCD ultrasound in neurocritical care and the training process of staff members performing it. MATERIAL AND METHODS: Survey administered to providers from 23 pediatric intensive care units of Argentina. RESULTS: The percentage of response was 86%. TCD ultrasound was used for suspected brain death (n = 20), head injury (n = 16), and stroke (n = 16). Pediatric intensivists perform the test (n = 13/20). Surveyed participants use TCD ultrasound to decide on treatment and management, start brain death assessment, request brain computed tomography, and manage cerebral perfusion pressure with vasopressors. CONCLUSIONS: All surveyed participants use TCD ultrasound findings to guide management or treatments. Half of surveyed participants are little satisfied with their training.

Introducción. El uso del Doppler transcraneal (DTC) en pacientes neurocríticos se reporta cada vez más en las terapias intensivas pediátricas. El objetivo de esta encuesta es conocer los usos y prácticas del DTC en la atención neurocrítica y el proceso de formación del personal que realiza el estudio. Materiales y métodos. Encuesta a profesionales de 23 unidades de terapia intensiva pediátrica de Argentina. Resultados. Porcentaje de respuesta del 86 %. Se utilizó en sospecha de muerte encefálica (n = 20), trauma de cráneo (n = 16) y accidente cerebrovascular (n = 16). El intensivista pediátrico es quien realiza los estudios (n = 13/20). Los encuestados utilizan el Doppler para decidir conductas y tratamientos, comenzar el proceso de evaluación de muerte encefálica, solicitar tomografía de cerebro y manejar la presión de perfusión cerebral con vasopresores. Conclusión. Todos los encuestados utilizan los hallazgos del DTC para guiar tratamientos o conductas. La mitad de los encuestados está poco conforme con la capacitación recibida.

MDA-LDL vaccination induces athero-protective germinal-center-derived antibody responses.

Atherosclerosis is a chronic inflammatory disease of the arteries that can lead to thrombosis, infarction, and stroke and is the leading cause of mortality worldwide. Immunization of pro-atherogenic mice with malondialdehyde-modified low-density lipoprotein (MDA-LDL) neo-antigen is athero-protective. However, the immune response to MDA-LDL and the mechanisms responsible for this athero-protection are not completely understood. Here, we find that immunization of mice with MDA-LDL elicits memory B cells, plasma cells, and switched anti-MDA-LDL antibodies as well as clonal expansion and affinity maturation, indicating that MDA-LDL triggers a bona fide germinal center antibody response. Further, Prdm1fl/flAicda-Cre+/kiLdlr-/- pro-atherogenic chimeras, which lack germinal center-derived plasma cells, show accelerated atherosclerosis. Finally, we show that MDA-LDL immunization is not athero-protective in mice lacking germinal-center-derived plasma cells. Our findings give further support to the development of MDA-LDL-based vaccines for the prevention or treatment of atherosclerosis.

Autoimmune manifestations in pediatric patients with human type I T - cell lymphotropic virus (HTLV-1) infection / Manifestaciones autoinmunes en pacientes pediátricos con infección por virus linfotrópico humano de células T tipo I (HTLV-1)

ABSTRACT HTLV-1 is a retrovirus that has an impact on human health due to its T-lymphocyte tropism. It occurs worldwide, but is more prevalent in tropical regions. Although most infected individuals will remain asymptomatic, the infection may manifest with complications such as uveitis, myelopathy, and leukemia, among others. The diagnosis is a chieved by the detection of anti-HTLV antibodies and a confirmatory test (Western Blot or proviral load). Although there is no specific treatment, medical treatments are aimed towards the management of secondary diseases. Three cases are described of pediatric patients diagnosed with HTLV-1 infection and associated autoimmune manifestations.

RESUMEN El virus linfotrópico humano de células T tipo I (HTLV-1) es un retrovirus que causa impacto en la salud del ser humano debido al tropismo para infectar a linfocitos T. Está distribuido mundialmente, pero es más prevalente en regiones tropicales. La mayoría de las personas afectadas permanecen asintomáticas, sin embargo, al manifestarse puede causar complicaciones como uveítis, mielopatía y leucemia, entre otras. Su diagnóstico se hace mediante la determinación de anticuerpos anti-HTLV y prueba confirmatoria (Western Blot o carga proviral). No tiene tratamiento específico, las medidas están dirigidas a la prevención y el manejo de las afecciones secundarias. Se describen tres pacientes en edad pediátrica con diagnóstico de infección por HTLV-1 y manifestaciones autoinmunes.

Early Genomic, Epidemiological, and Clinical Description of the SARS-CoV-2 Omicron Variant in Mexico City.

Omicron is the most mutated SARS-CoV-2 variant-a factor that can affect transmissibility, disease severity, and immune evasiveness. Its genomic surveillance is important in cities with millions of inhabitants and an economic center, such as Mexico City. Results. From 16 November to 31 December 2021, we observed an increase of 88% in Omicron prevalence in Mexico City. We explored the R346K substitution, prevalent in 42% of Omicron variants, known to be associated with immune escape by monoclonal antibodies. In a phylogenetic analysis, we found several independent exchanges between Mexico and the world, and there was an event followed by local transmission that gave rise to most of the Omicron diversity in Mexico City. A haplotype analysis revealed that there was no association between haplotype and vaccination status. Among the 66% of patients who have been vaccinated, no reported comorbidities were associated with Omicron; the presence of odynophagia and the absence of dysgeusia were significant predictor symptoms for Omicron, and the RT-qPCR Ct values were lower for Omicron. Conclusions. Genomic surveillance is key to detecting the emergence and spread of SARS-CoV-2 variants in a timely manner, even weeks before the onset of an infection wave, and can inform public health decisions and detect the spread of any mutation that may affect therapeutic efficacy.

Understanding effects of floral products on bee parasites: Mechanisms, synergism, and ecological complexity.

Floral nectar and pollen commonly contain diverse secondary metabolites. While these compounds are classically thought to play a role in plant defense, recent research indicates that they may also reduce disease in pollinators. Given that parasites have been implicated in ongoing bee declines, this discovery has spurred interest in the potential for 'medicinal' floral products to aid in pollinator conservation efforts. We review the evidence for antiparasitic effects of floral products on bee diseases, emphasizing the importance of investigating the mechanism underlying antiparasitic effects, including direct or host-mediated effects. We discuss the high specificity of antiparasitic effects of even very similar compounds, and highlight the need to consider how nonadditive effects of multiple compounds, and the post-ingestion transformation of metabolites, mediate the disease-reducing capacity of floral products. While the bulk of research on antiparasitic effects of floral products on bee parasites has been conducted in the lab, we review evidence for the impact of such effects in the field, and highlight areas for future research at the floral product-bee disease interface. Such research has great potential both to enhance our understanding of the role of parasites in shaping plant-bee interactions, and the role of plants in determining bee-parasite dynamics. This understanding may in turn reveal new avenues for pollinator conservation.

Why Did the Bee Eat the Chicken? Symbiont Gain, Loss, and Retention in the Vulture Bee Microbiome.

Diet and gut microbiomes are intricately linked on both short and long timescales. Changes in diet can alter the microbiome, while microbes in turn allow hosts to access novel diets. Bees are wasps that switched to a vegetarian lifestyle, and the vast majority of bees feed on pollen and nectar. Some stingless bee species, however, also collect carrion, and a few have fully reverted to a necrophagous lifestyle, relying on carrion for protein and forgoing flower visitation altogether. These "vulture" bees belong to the corbiculate apid clade, which is known for its ancient association with a small group of core microbiome phylotypes. Here, we investigate the vulture bee microbiome, along with closely related facultatively necrophagous and obligately pollinivorous species, to understand how these diets interact with microbiome structure. Via deep sequencing of the 16S rRNA gene and subsequent community analyses, we find that vulture bees have lost some core microbes, retained others, and entered into novel associations with acidophilic microbes found in the environment and on carrion. The abundance of acidophilic bacteria suggests that an acidic gut is important for vulture bee nutrition and health, as has been found in other carrion-feeding animals. Facultatively necrophagous bees have more variable microbiomes than strictly pollinivorous bees, suggesting that bee diet may interact with microbiomes on both short and long timescales. Further study of vulture bees promises to provide rich insights into the role of the microbiome in extreme diet switches. IMPORTANCE When asked where to find bees, people often picture fields of wildflowers. While true for almost all species, there is a group of specialized bees, also known as the vulture bees, that instead can be found slicing chunks of meat from carcasses in tropical rainforests. In this study, researchers compared the microbiomes of closely related bees that live in the same region but vary in their dietary lifestyles: some exclusively consume pollen and nectar, others exclusively depend on carrion for their protein, and some consume all of the above. Researchers found that vulture bees lost some ancestral "core" microbes, retained others, and entered into novel associations with acidophilic microbes, which have similarly been found in other carrion-feeding animals such as vultures, these bees' namesake. This research expands our understanding of how diet interacts with microbiomes on both short and long timescales in one of the world's biodiversity hot spots.

Increasing temperatures reduce invertebrate abundance and slow decomposition.

Decomposition is an essential ecosystem service driven by interacting biotic and abiotic factors. Increasing temperatures due to climate change can affect soil moisture, soil fauna, and subsequently, decomposition. Understanding how projected climate change scenarios will affect decomposition is of vital importance for predicting nutrient cycling and ecosystem health. In this study, we experimentally addressed the question of how the early stages of decomposition would vary along a gradient of projected climate change scenarios. Given the importance of biodiversity for ecosystem service provisioning, we measured the effect of invertebrate exclusion on red maple (Acer rubrum) leaf litter breakdown along a temperature gradient using litterbags in warming chambers over a period of five weeks. Leaf litter decomposed more slowly in the warmer chambers and in the litterbag treatment that minimized invertebrate access. Moreover, increasing air temperature reduced invertebrate abundance and richness, and altered the community composition, independent of exclusion treatment. Using structural equation models, we were able to disentangle the effects of average air temperature on leaf litter loss, finding a direct negative effect of warming on the early stages of decomposition, independent of invertebrate abundance. This result indicates that not only can climate change affect the invertebrate community, but may also directly influence how the remaining organisms interact with their environment and their effectiveness at provisioning ecosystem services. Overall, our study highlights the role of biodiversity in maintaining ecosystem services and contributes to our understanding of how climate change could disrupt nutrient cycling.

Draft Genome Sequences of 10 Bacteria from the Marine Pseudoalteromonas Group.

Here, we report the draft genome sequences of 10 marine Pseudoalteromonas bacteria that were isolated, assembled, and annotated by undergraduate students participating in a marine microbial genomics course. Genomic comparisons suggest that 7 of the 10 strains are novel isolates, providing a resource for future marine microbiology investigations.

Comprehensive omic characterization of breast cancer in Mexican-Hispanic women.

Breast cancer is a heterogeneous pathology, but the genomic basis of its variability remains poorly understood in populations other than Caucasians. Here, through DNA and RNA portraits we explored the molecular features of breast cancers in a set of Hispanic-Mexican (HM) women and compared them to public multi-ancestry datasets. HM patients present an earlier onset of the disease, particularly in aggressive clinical subtypes, compared to non-Hispanic women. The age-related COSMIC signature 1 was more frequent in HM women than in those from other ancestries. We found the AKT1E17K hotspot mutation in 8% of the HM women and identify the AKT1/PIK3CA axis as a potentially druggable target. Also, HM luminal breast tumors present an enhanced immunogenic phenotype compared to Asiatic and Caucasian tumors. This study is an initial effort to include patients from Hispanic populations in the research of breast cancer etiology and biology to further understand breast cancer disparities.

Functional traits linked to pathogen prevalence in wild bee communities.

Reports of pollinator declines have prompted efforts to understand contributing factors and protect vulnerable species. While pathogens can be widespread in bee communities, less is known about factors shaping pathogen prevalence among species. Functional traits are often used to predict susceptibility to stressors, including pathogens, in other species-rich communities. Here, we evaluated the relationship between bee functional traits (body size, phenology, nesting location, sociality, and foraging choice) and prevalence of trypanosomes, neogregarines, and the microsporidian Nosema ceranae in wild bee communities. For the most abundant bee species in our system, Bombus impatiens, we also evaluated the relationship between intra-specific size variation and pathogen prevalence. A trait-based model fit the neogregarine prevalence data better than a taxa-based model, while the taxonomic model provided a better model fit for N. ceranae prevalence, and there was no marked difference between the models for trypanosome prevalence. We found that Augochlorella aurata was more likely to harbor trypanosomes than many other bee taxa. Similarly, we found that bigger bees and those with peak activity later in the season were less likely to harbor trypanosomes, though the effect of size was largely driven by A. aurata. We found no clear intra-specific size patterns for pathogen prevalence in B. impatiens. These results indicate that functional traits are not always better than taxonomic affinity in predicting pathogen prevalence, but can help to explain prevalence depending on the pathogen in species-rich bee communities.

Crithidia bombi can infect two solitary bee species while host survivorship depends on diet.

Pathogens and lack of floral resources interactively impair global pollinator health. However, epidemiological and nutritional studies aimed at understanding bee declines have historically focused on social species, with limited evaluations of solitary bees. Here, we asked whether Crithidia bombi, a trypanosomatid gut pathogen known to infect bumble bees, could infect the solitary bees Osmia lignaria (females) and Megachile rotundata (males), and whether nutritional stress influenced infection patterns and bee survival. We found that C. bombi was able to infect both solitary bee species, with 59% of O. lignaria and 29% of M. rotundata bees experiencing pathogen replication 5­11 days following inoculation. Moreover, access to pollen resulted in O. lignaria living longer, although it did not influence M. rotundata survival. Access to pollen did not affect infection probability or resulting pathogen load in either species. Similarly, inoculating with the pathogen did not drive survival patterns in either species during the 5­11-day laboratory assays. Our results demonstrate that solitary bees can be hosts of a known bumble bee pathogen, and that access to pollen is an important contributing factor for bee survival, thus expanding our understanding of factors contributing to solitary bee health.

Astrocyte modulation of extinction impairments in ethanol-dependent female mice.

Rates of alcohol use disorders are increasing in women, and there is growing evidence that both the cognitive and biological consequences of alcohol dependence are distinct in women as compared to men. Despite this, the neurobehavioral outcomes of chronic alcohol exposure are poorly characterized in women and female animals. In this study, we find that ethanol dependence impaired extinction of reward seeking in a food conditioned place preference task in female mice. At the same time point, ethanol-dependent females exhibited astrocytic dysregulation as indicated by a brain region-specific reduction in glial fibrillary acidic protein (GFAP) expression. Using a chemogenetic strategy, we demonstrate that modulating astrocyte function via chemogenetic activation of Gq-signaling in nucleus accumbens astrocytes transiently rescued extinction in ethanol-dependent females without impacting basal reward seeking. These findings identify astrocyte function as a potential target for the restoration of behavioral flexibility following chronic alcohol exposure in females.

Landscape simplification shapes pathogen prevalence in plant-pollinator networks.

Species interaction networks, which play an important role in determining pathogen transmission and spread in ecological communities, can shift in response to agricultural landscape simplification. However, we know surprisingly little about how landscape simplification-driven changes in network structure impact epidemiological patterns. Here, we combine mathematical modelling and data from eleven bipartite plant-pollinator networks observed along a landscape simplification gradient to elucidate how changes in network structure shape disease dynamics. Our empirical data show that landscape simplification reduces pathogen prevalence in bee communities via increased diet breadth of the dominant species. Furthermore, our empirical data and theoretical model indicate that increased connectance reduces the likelihood of a disease outbreak and decreases variance in prevalence among bee species in the community, resulting in a dilution effect. Because infectious diseases are implicated in pollinator declines worldwide, a better understanding of how land use change impacts species interactions is therefore critical for conserving pollinator health.

Bee pathogen transmission dynamics: deposition, persistence and acquisition on flowers.

Infectious diseases are a primary driver of bee decline worldwide, but limited understanding of how pathogens are transmitted hampers effective management. Flowers have been implicated as hubs of bee disease transmission, but we know little about how interspecific floral variation affects transmission dynamics. Using bumblebees ( Bombus impatiens), a trypanosomatid pathogen ( Crithidia bombi) and three plant species varying in floral morphology, we assessed how host infection and plant species affect pathogen deposition on flowers, and plant species and flower parts impact pathogen survival and acquisition at flowers. We found that host infection with Crithidia increased defaecation rates on flowers, and that bees deposited faeces onto bracts of Lobelia siphilitica and Lythrum salicaria more frequently than onto Monarda didyma bracts . Among flower parts, bracts were associated with the lowest pathogen survival but highest resulting infection intensity in bee hosts. Additionally, we found that Crithidia survival across flower parts was reduced with sun exposure. These results suggest that efficiency of pathogen transmission depends on where deposition occurs and the timing and place of acquisition, which varies among plant species and environmental conditions. This information could be used for development of wildflower mixes that maximize forage while minimizing disease spread.

[Spatio-temporal analysis of the biophysical and ecological conditions of Triatoma dimidiata (Hemiptera: Reduviidae: Triatominae) in the northeast region of Colombia].

INTRODUCTION: Due to the lack of information regarding biophysical and spatio-temporal conditions (hydrometheorologic and vegetal coverage density) in areas with Triatoma dimidiata in the Colombian departments of Santander and Boyacá, there is a need to elucidate the association patterns of these variables to determine the distribution and control of this species. OBJECTIVE: To make a spatio-temporal analysis of biophysical variables related to the distribution of T. dimidiate observed in the northeast region of Colombia. MATERIALS AND METHODS: We used the Intergovernmental Panel on Climate Change Special Report on Emissions Scenarios (IPCC SRES) data bases registering vector presence and hydrometheorologic data. We studied the variables of environmental temperature, relative humidity, rainfall and vegetal coverage density at regional and local levels, and we conducted spatial geostatistic, descriptive statistical and Fourier temporal series analyses. RESULTS: Temperatures two meters above the ground and on covered surface ranged from 14,5°C to 18,8°C in the areas with the higher density of T. dimidiata. The environmental temperature fluctuated between 30 and 32°C. Vegetal coverage density and rainfall showed patterns of annual and biannual peaks. Relative humidity values fluctuated from 66,8 to 85,1%. CONCLUSIONS: Surface temperature and soil coverage were the variables that better explained the life cycle of T. dimidiata in the area. High relative humidity promoted the seek of shelters and an increase of the geographic distribution in the annual and biannual peaks of regional rainfall. The ecologic and anthropic conditions suggest that T. dimidiata is a highly resilient species.

Análisis espacio-temporal de las condiciones biofísicas y ecológicasde Triatoma dimidiata (Hemiptera: Reduviidae: Triatominae)en la region nororiental de los Andes de Colombia / Spatio-temporal analysis of the biophysical and ecological conditions of Triatoma dimidiata(Hemiptera: Reduviidae: Triatominae) in the northeast region of Colombia

Resumen Introducción. Ante el desconocimiento del contexto espacio-temporal de las condiciones biofísicas (hidrometereológicas y de densidad de la cobertura vegetal) de las zonas con presencia deTriatoma dimidiata en Santander y Boyacá, es necesario dilucidar los patrones asociados con estas variables para determinar su distribución y control. Objetivo. Hacer el análisis espacio-temporal de las variables biofísicas relacionadas con la distribución de Triatoma dimidiata de los departamentos de Santander y Boyacá en la región nororiental de Colombia. Materiales y métodos. Se utilizaron las bases de datos de los registros de presencia de T. dimidiata y de factores hidrometereológicos del Special Report on Emissions Scenarios (SrES) del Intergovernmental Panel on Climate Change, IPCC. Se estudiaron las variables de temperatura, humedad relativa, pluviosidad y densidad de la cobertura vegetal a nivel regional y local, se hizo el análisis espacial y el geoestadfstico, asf como el análisis estadfstico descriptivo y temporal de las series de Fourier. Resultados. En las áreas con mayor presencia de T. dimidiata, las temperaturas a dos metros del suelo y en suelo cubierto oscilaron entre 14,5 y 18,8 °C, y la temperatura ambiente fue de 30 a 32 °C. La densidad de la cobertura vegetal y la pluviosidad en las áreas de mayor presencia de T. dimidiata exhibieron patrones de picos anuales y bienales. Los valores de la humedad relativa fluctuaron entre 66,8 y 85,1 %. Conclusiones. Las temperaturas a nivel de superficie y a dos metros del suelo fueron las variables determinantes de la distribución espacio-temporal de T. dimidiata. La elevada humedad relativa incentivó la búsqueda de refugios e incrementó la distribución geográfica en los picos anual y bienal de pluviosidad a nivel regional. Las condiciones ecológicas y antrópicas sugieren que T. dimidiata es una especie de gran resiliencia.

Abstract Introduction: Due to the lack of information regarding biophysical and spatio-temporal conditions (hydrometheorologic and vegetal coverage density) in areas with Triatoma dimidiata in the Colombian departments of Santander and Boyacá, there is a need to elucidate the association patterns of these variables to determine the distribution and control of this species. Objective: To make a spatio-temporal analysis of biophysical variables related to the distribution of T. dimidiate observed in the northeast region of Colombia. Materials and methods: We used the Intergovernmental Panel on Climate Change Special Report on Emissions Scenarios (IPCC SRES) data bases registering vector presence and hydrometheorologic data. We studied the variables of environmental temperature, relative humidity, rainfall and vegetal coverage density at regional and local levels, and we conducted spatial geostatistic, descriptive statistical and Fourier temporal series analyses. Results: Temperatures two meters above the ground and on covered surface ranged from 14,5°C to 18,8°C in the areas with the higher density of T. dimidiata. The environmental temperature fluctuated between 30 and 32°C. Vegetal coverage density and rainfall showed patterns of annual and biannual peaks. Relative humidity values fluctuated from 66,8 to 85,1%. Conclusions: Surface temperature and soil coverage were the variables that better explained the life cycle of T. dimidiata in the area. High relative humidity promoted the seek of shelters and an increase of the geographic distribution in the annual and biannual peaks of regional rainfall. The ecologic and anthropic conditions suggest that T. dimidiata is a highly resilient species.

Aplicación precoz de presión positiva continua en el tratamiento de la infección respiratoria aguda baja moderada-grave en pacientes menores de 2 años / Early use of continuous positive airway pressure in the treatment of moderate to severe acute lower respiratory tract infections among patients younger than 2 years old

Objetivo. Analizar las características de los pacientes menores de 2 años que padecieron una infección respiratoria aguda baja moderada-grave tratados precozmente con presión positiva continua en la vía aérea de burbuja y los factores asociados al éxito de la intervención. Método. Estudio retrospectivo y descriptivo. Niños menores de 2 años internados en Cuidados Intermedios Pediátricos del Hospital Provincial Neuquén entre junio de 2009 y diciembre de 2010. Se aplicó presión positiva continua en la vía aérea de burbuja y se midieron frecuencias cardíacas y respiratorias, puntaje de Tal, saturación y fracción inspirada de oxígeno a las 0, 2, 6, 24 y 48 h. Resultados. Se incluyeron 120 pacientes. La mediana de edad fue 3 meses. La intervención fue exitosa en el 72% de los casos. A las 2 h, un descenso del 15% de la frecuencia respiratoria y de 2 puntos en el puntaje de Tal fueron predictores del éxito, con un OR 6,41 (IC 95%: 2,68-15,36) y 9,07 (IC 95%: 3,72-22,19), respectivamente.Conclusiones. La disminución de la frecuencia respiratoria, de la frecuencia cardíaca y del puntaje de Tal a las 2 horas de inicio fueron predictores de éxito.

Objective. To analyze the characteristics of patients younger than 2 years old who had a moderate to severe acute lower respiratory tract infection and were treated early with bubble continuous positive airway pressure, and factors associated with a successful intervention. Method. Retrospective and descriptive study. Children younger than 2 years old admitted to the Pediatric Intermediate Care Unit of Hospital Provincial Neuquen between June 2009 and December 2010. Bubble continuous positive airway pressure was used, and the following outcomes were measured: heart rate, respiratory rate, Tal's score, oxygen saturation, and fraction of inspired oxygen at 0, 2, 6, 24, and 48 h. Results. One hundred and twenty patients were included. Their median age was 3 months old. The intervention was successful in 72% of patients. At 2 h, a 15% reduction in respiratory rate, and a 2-point decrease in Tal's score were predictors of success, with an odds ratio of 6.41 (95% confidence interval: 2.68-15.36), and of 9.07 (95% confidence interval: 3.72-22.19), respectively. Conclusions. A reduction in respiratory rate, heart rate, and Tal's score at 2 hours of starting the intervention were predictors of success.

Early use of continuous positive airway pressure in the treatment of moderate to severe acute lower respiratory tract infections among patients younger than 2 years old. / Aplicación precoz de presión positiva continua en el tratamiento de la infección respiratoria aguda baja moderada-grave en pacientes menores de 2 años.

OBJETIVE: To analyze the characteristics of patients younger than 2 years old who had a moderate to severe acute lower respiratory tract infection and were treated early with bubble continuous positive airway pressure, and factors associated with a successful intervention. METHOD: Retrospective and descriptive study. Children younger than 2 years old admitted to the Pediatric Intermediate Care Unit of Hospital Provincial Neuquen between June 2009 and December 2010. Bubble continuous positive airway pressure was used, and the following outcomes were measured: heart rate, respiratory rate, Tal's score, oxygen saturation, and fraction of inspired oxygen at 0, 2, 6, 24, and 48 h. RESULTS: One hundred and twenty patients were included. Their median age was 3 months old. The intervention was successful in 72% of patients. At 2 h, a 15% reduction in respiratory rate, and a 2-point decrease in Tal's score were predictors of success, with an odds ratio of 6.41 (95% confidence interval: 2.68-15.36), and of 9.07 (95% confidence interval: 3.72-22.19), respectively. CONCLUSIONS: A reduction in respiratory rate, heart rate, and Tal's score at 2 hours of starting the intervention were predictors of success.

OBJETIVO: Analizar las características de los pacientes menores de 2 años que padecieron una infección respiratoria aguda baja moderada-grave tratados precozmente con presión positiva continua en la vía aérea de burbuja y los factores asociados al éxito de la intervención.Estudio retrospectivo y descriptivo. Niños menores de 2 años internados en Cuidados Intermedios Pediátricos del Hospital Provincial Neuquén entre junio de 2009 y diciembre de 2010. Se aplicó presión positiva continua en la vía aérea de burbuja y se midieron frecuencias cardíacas y respiratorias, puntaje de Tal, saturación y fracción inspirada de oxígeno a las 0, 2, 6, 24 y 48 h. RESULTADOS: Se incluyeron 120 pacientes. La mediana de edad fue 3 meses. La intervención fue exitosa en el 72% de los casos. A las 2 h, un descenso del 15% de la frecuencia respiratoria y de 2 puntos en el puntaje de Tal fueron predictores del éxito, con un OR 6,41 (IC 95%: 2,68-15,36) y 9,07 (IC 95%: 3,72-22,19), respectivamente. CONCLUSIONES: La disminución de la frecuencia respiratoria, de la frecuencia cardíaca y del puntaje de Tal a las 2 horas de inicio fueron predictores de éxito.