Real-World Evidence of Ribociclib Plus Aromatase Inhibitors as First-Line Treatment in Advanced Breast Cancer: The BrasiLEEira Study.

PURPOSE: Cyclin inhibitors plus endocrine therapy represent the reference standard for hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) locally advanced or metastatic breast cancer (ABC). Efficacy results on hard end points such as overall survival come from well-designed randomized clinical trials (RCTs). However, a limitation of RCTs is the low external results validity, and their extrapolation to a broader population may not be appropriate. Real-world studies can overcome these limitations, also increasing the reliability of RCTs. MATERIALS AND METHODS: The BrasiLEEira was an observational, longitudinal, retrospective, multicenter study to evaluate the effectiveness and safety of ribociclib plus nonsteroidal aromatase inhibitors in Brazilian women age 18 years or older with HR+/HER2- ABC. The study was approved by the institutional review boards of all 11 hospitals. Data were collected anonymously from medical records using an electronic case report form designed by an independent academic research organization, which conducted the study considering all recommendations of international guidelines. The primary end point was 1-year progression-free survival (PFS) rate. Secondary end points included mortality, dose reduction, and safety. RESULTS: The mean age of 76 patients was 57 years, and 28.9% were Black/Brown. The most prevalent comorbidity was arterial hypertension (34.7%). About 26.0% had endocrine-resistant disease, and 54.1% had more than three metastatic sites. The PFS rate was 77.6%. Three patients died (3.9%). Dose reductions occurred in 37.7% of patients. The most common adverse event was neutropenia (68.4%). CONCLUSION: The high-quality evidence from the BrasiLEEira study corroborates the RCTs' findings, expanding its validity to a broader spectrum and underrepresented population who may benefit from ribociclib treatment.

Advantages of Intraoperative Neuromonitoring Over Direct Visualization of the Recurrent Laryngeal Nerve During Thyroidectomy.

BACKGROUND: The well-recognized risk of injury to the recurrent laryngeal nerve (RLN) during thyroidectomy has instigated various preventive measures. One such measure involves directly visualizing the RLN, but this is not always feasible in practice. A more recent approach involves using intraoperative neuromonitoring to identify and preserve the RLN. This study aims to evaluate the effectiveness of intraoperative neuromonitoring compared to single visualization of the RLN in averting nerve injury. METHODS: We conducted a retrospective, observational, and descriptive study on a cohort of 218 patients. A Chi-square test was employed to determine the influence of intraoperative neuromonitoring on the incidence of nerve injury, with P < 0.05 considered statistically significant. We used Jamovi software version 2.3.18 to analyze the data. RESULTS: Of the 218 patients, intraoperative neuromonitoring was used in 150 (68.8%) cases; none of which resulted in nerve injury. Conversely, 68 (31.2%) patients underwent surgery without the use of neuromonitoring, with two (2.9%) patients in this group experiencing nerve injury (p=0.037). In comparison, the risk of nerve injury was 0% in the group monitored intraoperatively and 2.94% in the group that did not undergo intraoperatively neuromonitoring. Further, the relative risk of complications was 0.66% in patients operated with neuromonitoring, while it was 5.88% in the group operated without neuromonitoring, thus demonstrating a clinically significant protective against vasculonervous complications. CONCLUSION: The results advocate for the use of intraoperative neuromonitoring, whenever available, as it is a safe method for significantly decreasing the incidence of RLN injury during thyroidectomy compared with only visualization.

Anal Canal Duplication in a 25-Year-Old Female Patient.

Anal canal duplication (ACD) is a congenital malformation that typically presents and is diagnosed early in life. It can be associated with other syndromes or congenital malformations. ACD is one of the rarest duplications of the gastrointestinal tract, with no more than 90 to 100 cases reported in the literature. It can be confused with more frequent pathologies such as perianal fistula, especially when it occurs in adulthood. We present the case of a 25-year-old female patient who presents with a second orifice above the native anal orifice. An arthroscopic examination was performed, an incidental diagnosis of ACD was made, and a complete excision of the duplicated anal canal was performed. The aim of the study is to expand the information on this rare pathology in order to take it into account as a differential diagnosis in patients with abscesses, recurrent fistulous tracts, or any other anorectal pathology.

Association of Variants of the NFE2L2 Gene with Metabolic and Kidney Function Parameters in Patients with Diabetes and/or Hypertension.

Background: Type 2 diabetes mellitus (T2DM) and high blood pressure (HBP) are the main risk factors for chronic kidney disease (CKD). Relationships between variants within the NFE2L2 gene and the presence of environmental risk factors for CKD, such as HBP and hyperglycemia have been suggested; however, their interactions remains unclear. Aim: To analyze the association of NFE2L2 variants with metabolic and kidney parameters. Materials and Methods: Six-hundred and fifty-one patients grouped according to the diagnosis of T2DM (n =166), T2DM+HBP (n =348) and HBP (n =137) were included. Metabolic characteristics were evaluated to identify risk factors and presence of CKD. Genotyping was performed by polymerase chain reaction (PCR) using two pairs primers for rs35652124 and rs6721961 and by real-time PCR for rs2364723. Logistic regression analyses, adjusted for confounding factors and correction for multiple tests were performed. Results: Significant associations between decreased risk for presenting with CKD and the rs35652124 (A allele) and the rs2364723 (G allele) variants were detected. Other variables consistently associated with these alleles were HBP, BMI, waist circumference, uric acid and triglycerides. Haplotypes AAC and GCG (loci order: rs35652124-rs6721961-rs2364723) showed similar trends. After adjustment for age and sex and correction for multiple tests, only rs35652124 (Odds Ratio [OR] = 0.5; Confidence Interval at 95% (CI95%), 0.3-0.9; p = 0.04) and rs2364723 (OR = 0.3; CI95%, 0.1-0.8; p = 0.009) variants remained associated with deceased risk for CKD in T2DM patients. Conclusion: This study showed for the first time that NFE2L2 variants are associated with decreased risk for CKD in the presence of environmental/metabolic risk factors related to kidney damage, including HBP, hyperuricemia and albuminuria in Mexican patients with diabetes.

Performance evaluation of ceramic pot filters combined with adsorption processes for the removal of heavy metals and phenolic compounds.

It has been demonstrated that the ceramic pot filters (CPFs) with impregnated colloidal silver are efficient for the removal of turbidity and pathogens for household water treatment. This investigation evaluated the efficiency of two filter models for the removal of chemical contaminants (Hg, Pb, As and phenolic compounds) during 175 days. The first model is a traditional CPF impregnated with colloidal silver and the second consists of the ceramic silver-impregnated pot plus a post-filtration column with granular activated carbon and zeolite (CPF + GAC-Z). The results of the CPF showed average efficiencies of 91.5% (Hg), 92% (Pb), 50.2% (As) and 78.7% (phenols). The CPF + GAC-Z showed similar efficiencies for the removal of heavy metals (92.5% Hg, 98.1% Pb and 52.3% As) and a considerably higher efficiency for the removal of phenols (96.4%). The As concentration of the filtered water in both systems was higher than the regulatory limit. The ceramic pot was responsible for the highest removal of chemical compounds. It can be concluded that the traditional CPF is a viable option for water supply treatment at the household level for the removal of chemical contaminants. The efficiency of this filter can be improved with the post-filtration column mainly for the removal of organic constituents.

Effect of biosolids on the nitrogen and phosphorus contents of soil used for sugarcane cultivation.

The application of biosolids improves soil nutrient availability and crop productivity; however, their application needs to be carefully evaluated so as to avoid the risk of contamination. In this study, a 12-month field experiment using a randomized block design with factorial arrangement was conducted to evaluate the effects of biosolids on the nitrogen and phosphorus contents of a sugarcane-cultivated inceptisol. Three types of dewatered biosolids were used: anaerobically digested (B), anaerobically digested and thermally dried (BST), and anaerobically digested and lime-stabilized (BA) biosolids. The results showed that biosolid use increases soil nitrogen content by up to 37% of the total Kjeldahl nitrogen, 42% of NO3 -, 13% of NO2 -, and 32% of NH4 +. Biosolid treatments exceeded the phosphorus requirement for sugarcane cultivation by up to 277% for B, 170% for BST, and 368% for BA. The application of biosolids sufficient to meet crop nitrogen requirements significantly increased soil phosphorus content, suggesting an overdose and low crop response to the available phosphorus. The application of biosolids yielded results similar to those of mineral fertilizers, suggesting their potential use in agriculture.

Effect of the aniline fragment in Pt(II) and Pt(IV) complexes as anti-proliferative agents. Standard reduction potential as a more reliable parameter for Pt(IV) compounds than peak reduction potential.

The problems of resistance and side effects associated with cisplatin and other chemotherapeutic drugs have boosted research aimed at finding new compounds with improved properties. The use of platinum(IV) prodrugs is one alternative, although there is some controversy regarding the predictive ability of the peak reduction potentials. In the work described here a series of fourteen chloride Pt(II) and Pt(IV) compounds was synthesised and fully characterised. The compounds contain different bidentate arylazole heterocyclic ligands. Their cytotoxic properties against human lung carcinoma (A549), human breast carcinoma (MCF7) and human colon carcinoma (HCT116 and HT29) cell lines were studied. A clear relationship between the type of ligand and the anti-proliferative properties was found, with the best results obtained for the Pt(II) compound that contains an aniline fragment, (13), thus evidencing a positive effect of the NH2 group. Stability and aquation studies in DMSO, DMF and DMSO/water mixtures were carried out on the active complexes and an in-depth analysis of the two aquation processes, including DFT analysis, of 13 was undertaken. It was verified that DNA was the target and that cell death occurred by apoptosis in the case of 13. Furthermore, the cytotoxic derivatives did not exhibit haemolytic activity. The reduction of the Pt(IV) compounds whose Pt(II) congeners were active was studied by several techniques. It was concluded that the peak reduction potential was not useful to predict the ability for reduction. However, a correlation between the cytotoxic activity and the standard reduction potential was found.

Ozonoterapia como adyuvante en el tratamiento periodontal no quirúrgico y quirúrgico / Ozonoterapia as adjuvant in the non-surgical and surgical periodontal treatment

Introducción: El ozono (O3) presenta múltiples acciones biológicas, entre ellas su efecto antimicrobiano, lo que ha sido beneficioso en odontología, siendo la presentación acuosa la más utilizada (20 µg/ mL), la cual presenta efectos similares a la clorhexidina. Reporte de caso: Paciente masculino de 76 años de edad, diagnosticado con periodontitis crónica moderada localizada, el cual fue tratado mediante ozonoterapia acuosa durante la fase inicial periodontal y la fase quirúrgica en colgajo por debridación. 12 semanas posteriores al acto quirúrgico se obtuvo la eliminación de las bolsas periodontales, encontrándose un surco de 3 y 2 mm y un buen control de placa dentobacteriana. Conclusión: No existen reportes acerca del uso de ozonoterapia acuosa durante un colgajo por debridación. El éxito del tratamiento periodontal consiste en la eliminación del factor causal así como en establecer y mantener un control de placa dentobacteriana adecuado (AU)

Introduction: Ozone (O3) has multiple biological actions, including its antimicrobial effect, which has been beneficial in dentistry, the aqueous presentation being the most used (20 µg/mL), which has similar effects to chlorhexidine. Case report: Male patient of 76 years of age, diagnosed with localized moderate chronic periodontitis, which was treated by aqueous ozone therapy during the initial periodontal phase and surgical phase in debridement flap. Twelve weeks after surgery, the periodontal pockets were eliminated, finding a 3 and 2 mm groove and good control of dentobacterial plaque. Conclusion: There are no reports about the use of aqueous ozone therapy during a debridement flap. The success of the periodontal treatment consists in the elimination of the causal factor, as well as establishing and maintaining an adequate control of plaque (AU)

A novel filtration system based on ceramic silver-impregnated pot filter combined with adsorption processes to remove waterborne bacteria.

Halving the proportion of the people without sustainable access to safe drinking water and basic sanitation is among the Sustainable Development Goals (SDG). Lack of access to safe drinking water has been associated with the prevalence of waterborne diseases. Due to this reported association, the development of household water treatment devices has been an alternative to improve the quality supply of domestic water. In this study, we aimed to evaluate the performance of a ceramic silver-impregnated pot filter (CSF) system coupled with an adsorption process, composed of silver-impregnated granular activated carbon and zeolite (CSF + GAC-Z), to remove waterborne bacteria Escherichia coli and Salmonella spp. from spiked water. The performance of this system was compared with the conventional CSF system. In this respect, we evaluated six CSF and six CSF + GAC-Z using spiked water with 103 and 102 CFU/mL of E. coli and Salmonella spp. The mean percentage of removals ranged between 98% and 99.98%. The highest bacterial removal efficiency was recorded by the CSF + GAC-Z (99%) and CSF (99.98%) for E. coli and Salmonella spp., respectively, but no significant statistical differences were found between filtration systems. Our findings suggest that the CSF + GAC-Z system was effective in the removal of waterborne bacteria from spiked water.

Removal of E. coli and Salmonella in pot ceramic filters operating at different filtration rates.

The use of pot ceramic filters PCF to improve the domestic water quality supply has been recognized as an alternative in regions where there is unsecure water treatment or contamination of the treated water during transport and storage and an absence of safe drinking water. The aim of this study was to evaluate a model of PCF impregnated with colloidal silver under three filtration rates (1.0, 2.0 and 3.0 L/h) and three E. coli and Salmonella spp concentrations (104, 103 and 102 CFU/mL). The evaluation was made using spiked water having a turbidity of 29.9 ±â€¯4.4 NTU and conductivity of 176 ±â€¯31.7 µS/cm. The results showed a turbidity removal efficiency of 97% and average effluent of 0.9 NTU. The microbiological efficiency removal was of 2 Log Reduction Value (LRV) for E. coli and 1 LRV for Salmonella spp. There were not found significant statistical differences between the filtration rates and the removal efficiencies for turbidity E. coli and Salmonella spp. It was observed that the microbiological removal efficiency was affected by biofilm formation a phenomenon that was attributed to the presence of Salmonella spp. The combination of chemical and mechanical cleaning methods contributed to the elimination of the biofilm.

Taste disorders following cancer treatment: report of a case series.

PURPOSE: To present the findings of combined oral assessment and gustometry testing of a series of head and neck and hematologic malignancies in patients with self-reported taste change after cytotoxic therapies. METHODS: Patients with acute myeloid leukemia (AML), multiple myeloma (MM), and head and neck cancer (HNC) were evaluated for taste function. Chemical gustometry was conducted assessing chemosensory qualities that included sweet, sour, salty, bitter, umami, and spicy. NCI Common Terminology Criteria for Adverse Events (CTCAE) 4.0 and the Scale of Subjective Total Taste Acuity (STTA) were used to describe taste symptoms. Saliva flow rates were measured to determine the presence of hyposalivation. Patients were provided treatment trials for taste dysfunction, including zinc supplements, or medications that included clonazepam, megestrol acetate, and the cannabinoid dronabinol. RESULTS: According to STTA, hematology cases reported the incidence of grades 2 and 3 taste disturbances as 60% and 40%, respectively. For HNC patients, the incidence of grades 2 and 3 was 44% each. Gustometry tests confirmed dysgeusia in all patients evaluated. In the hematology group, 80% of patients exhibited a decrease in sweet taste perception, and no patients correctly identified umami taste. In the HNC group, most patients could not identify salt taste, 66% of patients reported "no sensation" with spicy taste, bitter taste was reduced in some, and increased or altered in others, while only one patient could identify umami taste. In the hematologic and HNC patient groups, 80% and 66% reported grade 2 dry mouth, respectively, according to CTCAE 4.0. After treatment for taste dysfunction, 71% of all patients in the present study reported improvements in taste function. CONCLUSIONS: Persisting dysgeusia in cancer survivors may be assessed by patient report and taste testing. The taste most affected in our patients was umami. Treatment trials with current interventions for dysgeusia appeared effective and should be considered in cancer survivors. Understanding taste and flavor function during and following cancer treatment is important in developing rational prospective preventive and interventional strategies.

Checkpoint Blockade Strategies in the Treatment of Breast Cancer: Where We Are and Where We Are Heading.

OPINION STATEMENT: Immunotherapy has become one of the greatest advances in medical oncology over the last century; however, the optimal application for the treatment of breast cancer remains an active area of investigation. Modern immunotherapy strategies augment the immune system and ideally, permit durable tumor-specific immune memory. In fact, several monoclonal antibodies that mediate the immune checkpoint receptors have provided the most clinically meaningful improvement for breast cancer patients to date, particularly for the triple negative subtype. Checkpoint blockade as monotherapy has demonstrated some encouraging results, although some combination strategies appear to augment those responses and may be particularly effective when administered earlier in the course of disease. For example, the combination of atezolizumab and nab-paclitaxel as first-line therapy for metastatic triple negative breast cancer demonstrated significant improvements in progression-free survival when compared with chemotherapy alone. Herein, we review the data for immune therapy in breast cancer and highlight promising future directions.

Influence of scope definition in recycling rate calculation for European e-waste extended producer responsibility.

Efficiency indicators have been frequently used to assess end-of-life chain performance, mostly. In terms of the percentage of mass sent to re-use, recycling, and/or energy recovery facilities. While legislation gives a standard definition for recycling and recovery rates, stakeholders sometimes redefine them to better fit their own scopes and objectives. Therefore, to accurately interpret the results of an efficiency indicator, during a decision-making process, it's necessary to fully understand the scope definition used to calculate it. This work discusses the influence of scope definition when establishing performance rates. It does this by introducing further alternative scope definitions and comparing them to those defined by legislation and stakeholders. As a case study, the proposed complementary scopes are applied to the recycling chain of flat panel displays in France.

Prevalence of Pica in Patients on Dialysis and its Association With Nutritional Status.

OBJECTIVE: Pica could be strongly implicated in nutritional status of patients on dialysis; however, very scarce data are currently available. The objective of this study was to evaluate the prevalence of pica and its association with nutritional status in dialysis patients. DESIGN AND METHODS: This is a cross-sectional study in a tertiary care teaching hospital. Four-hundred patients on dialysis, without previous pica diagnosis or transplant, pregnancy, mental illness, or infection, were included in the study. Pica, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, was classified as no pica, ice pica, or hard pica. Dialysis Malnutrition Score, 24-hour dietary recall, and biochemical measurements were obtained from patients. As part of statistical analysis, point prevalence and 95% confidence interval of pica were calculated. Comparisons between groups were performed by means of analysis of variance, Kruskal-Wallis test, χ2, or Fisher exact tests, as appropriate. A multivariate analysis was performed by multinomial logistic regression. RESULTS: Prevalence of pica was 42% (ice pica, 46%; soil, 29%; two substances, 14%; red brick, 5%; paper, 3%; soap, 2%; and cattle pasture, 1%). Comparing patients with pica (hard pica and ice pica) versus no pica, subjects with pica were of younger age (25 ± 7, 27 ± 9, 30 ± 11 years, respectively), were more frequently educated <9 years (57%, 46%, 30%, respectively), and had longer dialysis duration (36 ± 19, 32 ± 18, 27 ± 16 months, respectively). Patients with pica achieved the recommended calorie and macronutrients intake target less frequently than those without pica (40-64% vs. 66-77%, P <.05). Malnutrition was present in 74% of the whole sample: (1) 67% in no pica group, (2) 80% in ice pica group, and (3) 89% in hard pica group (P = .001). In the multivariate analysis (R2, 0.27; P < .0001), malnutrition, C-reactive protein, and lower educational level significantly predicted both ice and hard pica. CONCLUSIONS: A worse nutritional status was observed in patients with pica, who additionally were younger, had lower educational level, longer dialysis duration, and worse macronutrient intake routine than patients without pica. Malnutrition, C-reactive protein, and lower educational level significantly predicted both ice and hard pica.

Role of Seroalbumin in the Cytotoxicity of cis-Dichloro Pt(II) Complexes with (N

Given the potent anticancer properties of cis-diamminedichloroplatinum(II) and knowing its mode of action, we synthesized four new cis-[PtCl2(N^N)] organoplatinum complexes, two with N-substituted pbi ligands (pbiR = 1-R-2-(2-pyridyl)benzimidazole) (namely, 1 and 2) and two more with 4,4'-disubstituted bpy ligands (bpy = 2,2'-bipyridine) (namely, 3 and 4). We explored their cytotoxicity and ability to bind to deoxyguanosine monophosphate (dGMP), DNA, and albumin models. By 1H NMR and UV-vis spectroscopies, circular dichroism, agarose gel electrophoresis, differential scanning calorimetry measurements, and density functional theory calculations, we verified that only 3 can form aquacomplex species after dimethyl sulfoxide solvation; surprisingly, 1, 2, and 3 can bind covalently to DNA, whereas 4 can form a noncovalent complex. Interestingly, only complexes 1 and 4 exhibit good cytotoxicity against human ovarian carcinoma (HeLa) cell line, whereas 2 and 3 are inactive. Although lung carcinoma (A549) cells are more resistant to the four platinum complexes than HeLa cells, when the protein concentration in the extracellular media is lower, the cytotoxicity becomes substantially enhanced. By native electrophoresis of bovine seroalbumin (BSA) and inductively coupled plasma mass spectrometry uptake studies we bear out, on one hand, that 2 and 3 can interact strongly with BSA and its cellular uptake is negligible and, on the other hand, that 1 and 4 can interact with BSA only weakly, its cellular uptake being higher by several orders. These results point up the important role of the protein binding features on their biological activity and cellular uptake of cis-"PtCl2" derivatives. Our results are valuable in the future rational design of new platinum complexes with improved biological properties, as they expose the importance not only of their DNA binding abilities but also of additional factors such as protein binding.

Cationic Bis(cyclometalated) Ir(III) Complexes with Pyridine-Carbene Ligands. Photophysical Properties and Photocatalytic Hydrogen Production from Water.

Precursors of chelate pyridine-N-heterocyclic carbene (N^C:) ligands with methyl- or benzyl-substituted imidazolylidene fragments were synthesized. They were used to obtain 12 iridium bis-cyclometalated complexes of the type [Ir(C^N)2(N^C:)]+ (C^N = 2-(phenyl)pyridinato-C2,N, ppy, 2-(4,6-difluorophenyl)pyridinato-C2,N, dfppy). The ancillary N^C: ligands contain different structural modifications. The aim of the work was to analyze the effect that changes in the two types of ligands have on the photophysical and electrochemical properties and also on the behavior of these materials as photosensitizers. The X-ray crystal structures of five complexes were determined. The complexes emitted in the blue-green region. It was expected that the frontier orbitals and thus the photophysical and electrochemical properties would be controlled by the main C^N ligands, and it was demonstrated that the effect of the modifications in the N^C: ligand, especially the presence of a nitro group in the pyridine ring or the interruption of conjugation between the two rings, also affected these properties. The quenching with O2 and photostability studies were also performed. Density functional theory calculations were used to explain the behavior of some derivatives. The complexes and other previously reported compounds were employed as photosensitizers (PS) in preliminary studies on the production of H2 from water using [Co(bpy)3]Cl2 (bpy = 2,2'-bipyridine) as catalyst and triethanolamine (TEOA) as the sacrificial reductant. The absence of quenching of the PS with TEOA allowed us to propose an oxidative quenching mechanism.

Prevalence and risk factors of chronic kidney disease in the comprehensive care program DiabetIMSS / Prevalencia de enfermedad renal crónica y factores de riesgo en el programa de atención DiabetIMSS

BACKGROUND: The aim of this paper is to determine prevalence and risk factors of chronic kidney disease (CKD) in the comprehensive care program DiabetIMSS. METHODS: Cross-sectional study in 488 patients with type 2 diabetes mellitus (DM2) included in the program DiabetIMSS. Sociodemographic, clinical, biochemical, and kidney function variables were collected. RESULTS: Prevalence of CKD was 32% [early nephropathy (EN) 19% and overt nephropathy (ON) 13%]. Patients with more severe nephropathy significantly (p < 0.05) had: older age [normal kidney function (NKF) 54±11, EN 54±10, ON 63±9, years)], cardiovascular disease (NKF 1%, EN 5%, ON 11%), hypertension (NKF 65%, EN 63%, ON 85%), longer duration of DM2 (NKF 5%, EN 5%, ON 9%,) and of hypertension (NKF 5%, EN 6%, ON 9%), glycemic lack of control (NKF 46%, EN 62%, ON 60%), hyperuricemia (NKF 7%, EN 13%, ON 23%), anemia (NKF 1%, EN 4%, ON 10%) and metabolic syndrome (NKF 79%, EN 82%, ON 93%). Uncontrolled hypertension and DM2, cardiovascular disease and hyperuricemia significantly predicted the presence of nephropathy CONCLUSIONS: A third of patients attending to DiabetIMSS had CKD and has not been previously diagnosed. Multiple risk factors are present in this high-risk population; their identification and control are extraordinarily important. Moreover, educative interventions for primary health-care professionals to improve health of this kind of patients are needed.

INTRODUCCIÓN: el objetivo de este trabajo es determinar la prevalencia de enfermedad renal crónica (ERC) e identificar factores de riesgo para nefropatía en el programa DiabetIMSS. MÉTODOS: estudio transversal analítico en 488 pacientes con diabetes mellitus tipo 2 (DM2) atendidos en el programa de atención integral DiabetIMSS. Se recolectaron variables sociodemográficas, clínicas, bioquímicas y de función renal. RESULTADOS: la prevalencia de ERC fue 32% [nefropatía temprana (NT) 19% y nefropatía establecida (NE) 13%]. A nefropatía más avanzada, los pacientes tenían significativamente (p < 0.05): mayor edad [función renal normal (FRN) 54 ± 11, NT 54 ± 10, NE 63 ± 9 años)], enfermedad cardiovascular (FRN 1%, NT 5%, NE 11%), hipertensión (FRN 65%, NT 63%, NE 85%), mayor evolución de DM2 (FRN 5%, NT 5%, NE 9%,) y de hipertensión (FRN 5%, NT 6%, NE 9%), descontrol glucémico (FRN 46%, NT 62%, NE 60%), hiperuricemia (FRN 7%, NT 13%, NE 23%), anemia (FRN 1%, NT 4%, NE 10%) y síndrome metabólico (FRN 79%, NT 82%, NE 93%). La hipertensión y DM2 descontroladas, la enfermedad cardiovascular y la hiperuricemia predijeron significativamente la presencia de nefropatía. CONCLUSIONES: un tercio de los pacientes atendidos en DiabetIMSS tenían ERC y no habían sido identificados. Múltiples factores de riesgo están presentes en esta población de alto riesgo; su identificación y control son de extraordinaria importancia. Son necesarias, además, intervenciones educativas para el personal del primer nivel de atención médica para mejorar la salud de este tipo de pacientes.

[Epidemiological characterization of hospitalizations due to mental and behavior disorder in children and adolescents in Córdoba, Argentina]. / Caracterización epidemiológica de las hospitalizaciones por trastornos mentales y del comportamiento en niños y adolescentes en Córdoba, Argentina.

UNLABELLED: Mental health needs of children and adolescents show epidemiological changes and sometimes require psychiatric hospitalization. OBJECTIVE: to perform an epidemiological characterization of children and adolescents hospitalized for mental disorders in Hospital de Niños of Córdoba. MATERIALS AND METHODS: observational retrospective study, based on clinical reports on 144 cases hospitalized during years 2009-2010. Data was processed using frequency analysis with a significance level of 0.05. RESULTS: 54.86% of cases corresponded to women and 45.14% to men. They were aged between 6 and 16 years, showing a higher media in women 12.87. Most frequent causes for hospitalization were: suicide attempt (25%), psychomotor agitation episodes (21.53%) and psychotic episodes (15.97%). Cases admitted for suicide attempt were not frequently treated. Most relevant psychopathological diagnoses were: behavior disorder of childhood in male, and personality disorders in women. Average stay was 21.9 days, cases that needed re-admission showed a longer time. CONCLUSIONS: most frequent causes for hospitalization were related to impulsivity-aggression symptoms showing different distributions according to gender. Pathologies must be recognized, diagnosed and treated more promptly.