Valores referenciales de posturografía basada en Nintendo Wii en población chilena

Resumen Introducción: La posturografía es un método de exploración complementario para valorar el grado de desplazamiento del centro de gravedad (COP); no debe usarse de forma aislada al evaluar equilibrio, pero se acepta para seguimiento de la respuesta a tratamiento. Es de baja disponibilidad, por su alto costo comercial. Como alternativa se documenta la plataforma Wii Balance Board (WBB) de Nintendo para registro posturográfico. Objetivo: Describir valores de normalidad en parámetros posturográficos en población chilena sin patología vestibular, usando un registro simple y accesible. Material y Método: Estudio transversal de valores referenciales en herramienta para evaluación del equilibrio. Se registraron valores posturográficos con versión adaptada del Sensory Organization Test (SOT) a adultos sanos. Mediciones con software WBB Sway Program mediante WBB. Se midieron índices somatosensorial, visual y vestibular, y patrones de control postural en ejes anteroposterior y mediolateral durante SOT-adaptado. Resultados: Se obtuvieron valores de velocidad de desplazamiento del COP, área del COP y desviaciones estándar correspondientes para 4 situaciones del SOT-adaptado de 35 sujetos entre 18-65 años, 21 mujeres, 14 hombres. Discusión: WBB permitió evaluar estos parámetros en población sana, como aproximación a determinar rangos de referencia. Esta herramienta de uso rápido y accesible constituye una alternativa útil para determinar patrones de control postural en sujetos sanos. Presentamos valores a utilizar como rango referencial en nuestra población; se sugiere utilizar estos valores como objetivo terapéutico en rehabilitación vestibular en pacientes evaluados en conjunto con otros parámetros clínico-sintomáticos.

Abstract Introduction: Posturography is a complementary method for evaluating the center of pressure (COP) displacement; it should not be used in isolation when assessing balance, but it is accepted for follow-up of the treatment response. Due to its high commercial cost and low availability, we documented the Nintendo Wii Balance Board (WBB) as an alternative for posturography. Aim: To describe the normal range of posturography parameters in the Chilean population without vestibular pathology, using a simple and accessible registry method. Material and Method: Cross-sectional study of referential values in a balance assessment tool. Posturography values were registered using an adapted version of the Sensory Organization Test (SOT) on healthy adults. Measurements with WBB Sway Program software through WBB. With adapted-SOT, somatosensory, visual and vestibular indices, as well as anterior/posterior and mediolateral axes postural control patterns, were measured. Results: Values of displacement velocity of the COP, COP area and corresponding standard deviations were obtained for 4 SOT-adapted situations from 35 subjects between 18-65 years, 21 women, 14 men. Discussion: As an approach to determine referential range values, WBB allowed to evaluate these parameters in healthy population. To determine healthy subjects postural control patterns this quick and accessible tool is a useful alternative. We present referential range values to use in our population; it is suggested to use these values as therapeutic objectives in vestibular rehabilitation in patients evaluated along with other clinical-symptomatic parameters.

Priapismo: abordaje clínico y manejo de urgencia / Priapism: clinical approach and emergency management

Priapism is a persistent erection, often painful, lasting more than 4 hours and unrelated to sexual stimulation. Based on clinical and pathophysiological features, priapism can be classified as ischemic, nonischemic and stuttering. Ischemic priapism is the most frequent form and represents a urological emergency. Although it is described as a low frequency entity, its timely diagnosis and immediate intervention are essential in the reestablishment of cavernous blood flow and in the prevention of necrosis and permanent erectile dysfunction. Intracavernous blood aspiration and injection of a-adrenergic agents correspond to the first-line options for the management of cases of ischemic priapism. Surgical shunts continue to be the most widely used surgical option for the management of prolonged ischemic priapism refractory to non-invasive management, with emerging evidence supporting the early implantation of a penile prosthesis. The objective of this review article is to describe the keys to the clinical approach and acute management of priapism in the emergency department. (AU)

Influencia del exceso de peso en el éxito de la adenoamigdalectomía en pacientes con hiperplasia adenoamigdalina sintomática / The influence of overweight in the success of adenotonsillectomy in patients with adenotonsillar symptomatic hyperplasia

Resumen Introducción: En población pediátrica con malnutrición por exceso, existe controversia respecto al rol de la hiperplasia adenoamigdalina en la etiología de los trastornos del sueño y de la efectividad de la adenoamigdalectomía sobre dicha sintomatología. Objetivo: Comparar la efectividad de la adenoamigdalectomía entre pacientes pediátricos eutróficos y con malnutrición por exceso sometidos a adenoamigdalectomía por hiperplasia adenoamigdalina, en relación a la disminución de la sintomatología. Materiales y método: Estudio retrospectivo mediante revisión de fichas clínicas entre junio de 2016 y enero de 2017 de pacientes operados de adenoamigdalectomía por hiperplasia adenoamigdalina sintomática. Se clasificaron los pacientes de acuerdo a edad y estado nutricional en 4 grupos y se evaluó la resolución de la sintomatologia mediante interrogación a padres/tutores. Resultados: Se incluyeron 98 pacientes, con una edad media de 6,3 años. 44,9% de los pacientes fueron eutróficos y 55,1% con malnutrición por exceso. El análisis estadístico entre pacientes eutróficos y aquellos con malnutrición no demostró diferencias significativas en relación a la resolución de la sintomatología. Conclusión: La adenoamigdalectomía por hiperplasia adenoamigdalina sintomática se asocia a una reducción de la frecuencia de roncopatía con pausas en pacientes pediátricos, independientemente del estado nutricional.

Abstract Introduction: In pediatric population with malnutrition by excess, the role of the adenotonsillar hyperplasia in the etiology of breathing-related sleep disorders, and the effectivity of the adenotonsillectomy for reducing symptoms remains controversial. Aim: To compare and evaluate the effectiveness of the adenotonsillectomy between eutrophic and malnutrition by excess pediatric patients submitted to adenotonsillectomy by adenotonsillar hyperplasia, regarding to symptoms resolution. Material and method: A retrospective study was performed collecting data from clinical records between June 2016 and January 2017 of patients submitted to adenotonsillectomy by symptomatic adenotonsillar hyperplasia. Patients were assigned to 4 groups according to age and nutrional status and the rate of symptoms resolution was evaluated through interrogation to parents/guardians. Results: We included 98 patients, with an average age of 6.3 years. A 44.9% of patients were eutrophic and 55.1% had malnutrition by excess. Comparing eutrophic and malnutrition by excess patients, no significant differences were observed regarding to symptoms resolution. Conclusion: The adenotonsillectomy by symptomatic adenotonsillar hyperplasia was associated to an amelioration of the rate of snoring and respiratory pauses during sleeping in pediatric patients, independently of the nutritional status.

Dietary management and supplementation with branched-chain amino acids in cirrhosis of the liver. / Manejo dietético y suplementación con aminoácidos de cadena ramificada en cirrosis hepática.

One of the most important characteristics of malnutrition is the loss of muscle mass and the severe depletion of the protein reserve, secondarily affecting energy metabolism. That impacts nutritional status and the progression of disease-related complications. Nutritional treatment is one of the main factors in the comprehensive management of those patients. Achieving adequate energy intake that provides the macronutrients and micronutrients necessary to prevent or correct malnutrition is attempted through dietary measures. ESPEN, the European Society for Clinical Nutrition and Metabolism, recommends a caloric intake of 30-40kcal/kg/day, in which carbohydrates provide 45-60% of the daily energy intake and proteins supply 1.0-1.5g/kg/day. The remaining portion of the total energy expenditure should be covered by lipids. The administration of branched-chain amino acids has been shown to be beneficial not only in counteracting malnutrition, but also as a coadjuvant treatment in specific complications, thus playing a favorable role in outcome and quality of life. Therefore, branched-chain amino acids should be considered part of nutritional treatment in patients with advanced stages of cirrhosis of the liver, particularly in the presence of complications.

Effect of a high-protein, high-fiber diet plus supplementation with branched-chain amino acids on the nutritional status of patients with cirrhosis. / Efecto de una dieta rica en proteínas y alta en fibra más la suplementación con aminoácidos de cadena ramificada sobre el estado nutricional de pacientes con cirrosis.

INTRODUCTION AND OBJECTIVES: The potential benefits of branched-chain amino acids (BCAAs) in cirrhosis extend beyond just the improvement of nutritional status. Their effects include improvement of glucose tolerance, oxidative stress, and inflammatory markers, as has been shown in several studies. A dual nutritional approach of a high-protein, high-fiber diet plus BCAAs in cirrhosis could have additional benefits, compared with BCAAs alone. Such an approach has not been explored and therefore the aim of the present study was to evaluate the effect of a combination of a high-protein, high-fiber diet plus BCAA supplementation over a 6-month period of time on the nutritional status of patients with cirrhosis, as well as its safety and tolerability for those same patients. METHODS: An open, randomized clinical trial was conducted. Patients were randomized to one of two groups: the BCAAs+HPHF diet intervention group: a high-protein, high-fiber diet with 1.2g/kg protein and 30g of fiber plus supplementation with oral branched-chain amino acids 110g daily and the HPHF diet control group: a high-protein, high-fiber diet with 1.2g/kg protein and 30g of fiber. The differences between the treatment groups were compared using the unpaired T test and the differences at the end of treatment were compared using the paired T test. RESULTS: A total of 72 patients were included, 37 in the intervention group and 35 in the control group. At the end of the study period, ammonia and glucose levels showed no significant increase in either group, reflecting the safety of the BCAA supplement. Furthermore, muscle and fat mass were evaluated through triceps skinfold thickness and mid-arm muscle circumference measurements. There was an increase in muscle mass and a decrease in fat mass in the BCAA group, but not in the control group. After the intervention, there were no significant changes in the Psychometric Hepatic Encephalopathy Score or the Critical Flicker Frequency score results in either group, and no episodes of hepatic encephalopathy were observed during the treatment period. CONCLUSION: Supplementation with branched-chain amino acids plus a high-fiber, high-protein diet is a safe intervention in patients with cirrhosis. It helps increase muscle mass and does not raise the levels of ammonia or glucose, nor is it associated with the development of hepatic encephalopathy.

Effect of once-daily generic ciclesonide on exhaled nitric oxide in atopic children with persistent asthma

BACKGROUND: Ciclesonide (CIC) is an effective inhaled corticosteroid for treating asthmatic children. However, its effect on airway inflammation assessed by the fraction of exhaled nitric oxide (FENO) in children with persistent asthma is virtually unknown. We aimed to assess the effect of once-daily generic CIC, 80 or 160 μg, on FENO, lung function, asthma control and bronchial hyperresponsiveness, in atopic children with persistent asthma. METHODS: This was a 12-week, randomised, double-blind, parallel-group study. Sixty children with mild-to-moderate persistent asthma were recruited. Changes in FENO, asthma control score, lung function (FEV1) and bronchial hyperresponsiveness to methacholine (BHR) were used to assess the effects of both CIC doses. Non-normally distributed variables were log-transformed to approximate normality, and parametric tests were used for comparisons within and between groups at baseline and after 12 weeks of treatment. RESULTS: In the CIC 80 μg group, FENO decreased from 45.0 ppb (95% CI 37.8-53.7) to 32.7 ppb (95% CI 21.0-47.3) at the end of study (P = 0.021), whereas in the CIC 160 μg group, FENO decreased from 47.3 ppb (95% CI 40.4-55.3) to 30.5 ppb (95% CI 24.1-38.7) (P < 0.001). The difference between groups in FENO at the end of study was not significant (P = 0.693). There was a significant improvement of asthma control with both CIC doses but there was no significant change in BHR or FEV1 in either group. CONCLUSION: Once-daily generic ciclesonide (80 μg or 160 μg), for 12 weeks, is effective to improve airway inflammation and asthma control in atopic children with persistent asthma

No disponible

Effect of once-daily generic ciclesonide on exhaled nitric oxide in atopic children with persistent asthma.

BACKGROUND: Ciclesonide (CIC) is an effective inhaled corticosteroid for treating asthmatic children. However, its effect on airway inflammation assessed by the fraction of exhaled nitric oxide (FENO) in children with persistent asthma is virtually unknown. We aimed to assess the effect of once-daily generic CIC, 80 or 160 µg, on FENO, lung function, asthma control and bronchial hyperresponsiveness, in atopic children with persistent asthma. METHODS: This was a 12-week, randomised, double-blind, parallel-group study. Sixty children with mild-to-moderate persistent asthma were recruited. Changes in FENO, asthma control score, lung function (FEV1) and bronchial hyperresponsiveness to methacholine (BHR) were used to assess the effects of both CIC doses. Non-normally distributed variables were log-transformed to approximate normality, and parametric tests were used for comparisons within and between groups at baseline and after 12 weeks of treatment. RESULTS: In the CIC 80 µg group, FENO decreased from 45.0 ppb (95% CI 37.8-53.7) to 32.7 ppb (95% CI 21.0-47.3) at the end of study (P=0.021), whereas in the CIC 160 µg group, FENO decreased from 47.3 ppb (95% CI 40.4-55.3) to 30.5 ppb (95% CI 24.1-38.7) (P<0.001). The difference between groups in FENO at the end of study was not significant (P=0.693). There was a significant improvement of asthma control with both CIC doses but there was no significant change in BHR or FEV1 in either group. CONCLUSION: Once-daily generic ciclesonide (80 µg or 160 µg), for 12 weeks, is effective to improve airway inflammation and asthma control in atopic children with persistent asthma.

Fraction of exhaled nitric oxide in healthy Chilean schoolchildren aged 8-15 years

BACKGROUND: The fraction of exhaled nitric oxide (FENO) measured using portable devices is increasingly used in the clinical setting to assess asthmatic children. However, there is little and variable information on the reference values obtained using these devices in healthy children from different populations. METHODS: 190 healthy non-smoker children (8-15 years old) were randomly selected from public schools participating in this study. The objective was to determine FENO reference values for healthy Chilean schoolchildren. Healthy individuals were identified by medical interview and parent questionnaire on the use of asthma medications, and current and past symptoms of asthma, rhinoconjunctivitis and eczema. FENO was measured at schools using a portable device with electrochemical sensor (NIO MINOX). Reference values of FENO were expressed as geometric mean and upper limit of the 95% reference interval (right-sided). The relationship of FENO with gender, age, height, body mass, and other factors was assessed by multiple regression, and the difference between groups was contrasted by ANOVA. RESULTS: The FENO geometric mean was 15.4 ppb with a 95% reference interval upper limit (right-sided), of 27.4 ppb (90%CI 25.6-29.2). The 5th and 95th percentiles were 9.0 ppb and 28.0 ppb, respectively. Height was the only factor significantly associated to FENO (p = 0.022). There was no significant difference in mean FENO regarding age, gender, weight, parent reported rhinoconjunctivitis and eczema. CONCLUSION: This study suggests that FENO values higher than 27 ppb are likely to be abnormal and would reflect airway inflammation in children as those in the present study

No disponible

Fraction of exhaled nitric oxide in healthy Chilean schoolchildren aged 8-15 years.

BACKGROUND: The fraction of exhaled nitric oxide (FENO) measured using portable devices is increasingly used in the clinical setting to assess asthmatic children. However, there is little and variable information on the reference values obtained using these devices in healthy children from different populations. METHODS: 190 healthy non-smoker children (8-15 years old) were randomly selected from public schools participating in this study. The objective was to determine FENO reference values for healthy Chilean schoolchildren. Healthy individuals were identified by medical interview and parent questionnaire on the use of asthma medications, and current and past symptoms of asthma, rhinoconjunctivitis and eczema. FENO was measured at schools using a portable device with electrochemical sensor (NIO MINOX). Reference values of FENO were expressed as geometric mean and upper limit of the 95% reference interval (right-sided). The relationship of FENO with gender, age, height, body mass, and other factors was assessed by multiple regression, and the difference between groups was contrasted by ANOVA. RESULTS: The FENO geometric mean was 15.4ppb with a 95% reference interval upper limit (right-sided), of 27.4ppb (90%CI 25.6-29.2). The 5th and 95th percentiles were 9.0ppb and 28.0ppb, respectively. Height was the only factor significantly associated to FENO (p=0.022). There was no significant difference in mean FENO regarding age, gender, weight, parent reported rhinoconjunctivitis and eczema. CONCLUSION: This study suggests that FENO values higher than 27ppb are likely to be abnormal and would reflect airway inflammation in children as those in the present study.

Usabilidad, confiabilidad y validez de un método para la evaluación de factores de riesgos en el manejo manual de cargas / Usability, reliability and validity of a method for the assessment of risk factors in the manual handling of loads

Esta investigación corresponde a la tercera etapa del proyecto “Manejo Manual de Cargas” de la Asociación Chilena de Seguridad y consiste en Evaluar la Usabilidad, la Confiabilidad y Validez de la metodología MAC, adaptada y propuesta por la ACHS en su guía evaluación de factores de riesgo en manipulación de cargas. El trabajo muestra las características del método MAC, Manual handling Assessment Charts – MAC (Health & Safety Laboratory - Health & Safety Executive. UK. 2003), la metodología usada en el estudio, y las principales conclusiones del mismo, entre las que destacan las ventajas del MAC como método de screening, además de ser concordante y de más fácil uso que los métodos con los que se lo comparó en el estudio.

This research corresponds to the third stage of the project “Manual Handling of Loads” of the Asociación Chilena de Seguridad and consists in evaluating the usability, Reliability and Validity of MAC methodology, adapted and proposed by the ACHS in its evaluation guide of risk factors in handling of loads. The study shows the characteristics of the MAC method, Manual handling Assessment Charts – MAC (Health & Safety Laboratory - Health & Safety Executive. UK. 2003), the methodology used in the study and the main conclusions of it, among which we may highlight the advantages of MAC as a screening method, in addition to being in agreement with and being easier to use than the methods with which it was compared in the study.

Evaluación del sistema de turnos de una empresa minera de la III Región – Chile / Evaluation of the shift system of a mining company in the IIIrd Region – Chile

En la industria minera nacional es posible encontrar turnos de trabajo con esquemas continuos de 8 ó 12 horas de trabajo diarias. Los sistemas más comunes son 4x4, 4x3, 5x2 u otros con 6 jornadas semanales. Los resultados de numerosas investigaciones han demostrado que el trabajo en turnos y nocturno puede comprometer la salud, bienestar y rendimiento laboral. Este trabajo se fundamenta en la permanente preocupación de ENAMI Paipote en mejorar las condiciones de trabajo de sus funcionarios. En esta investigación se aplicaron metodologías publicadas en la literatura científica (BESIAK, Standart Shiftwork Index y escala de hipersomnia Epworth). Se evaluó una muestra de 149 trabajadores, desarrollada durante el segundo semestre del año 2006. La evaluación de la arquitectura del sistema de turnos de ENAMI Paipote (6x1 6x3 6x2), permite concluir que no representa riesgo significativo en los ámbitos de la salud, bienestar, vida social, adaptación y rendimiento de los trabajadores. No existen alteraciones significativas en cuanto a la percepción de fatiga física en los trabajadores. Aunque la percepción de alteraciones sociales es superior a lo reportado en otras poblaciones de referencia, ninguno de los turnos exhibe una accidentabilidad significativamente mayor respecto de los otros.

In national mining industry it is possible to find shiftwork with continuous schemes of 8 to 12 hours a day. Most common systems are 4x4, 4x3, 5x2 or others with 6 work hours weekly. The results of numerous investigations have shown that shiftwork and night work,may compromise health, well being and work performance. This paper, is based on the permanent concern of ENAMI Paipote for improving work conditions of its employees. This research used methodologies published in scientific literature (BESIAK, Standard Shiftwork Index and Epworth Sleepiness Scale).A sample of 149 workers was evaluated during the second semester of 2006. The evaluation of the architecture of the shift system of ENAMI Paipote (6x1 6x3 6x2), allows to conclude that it does not represent a significant risk with regard to health, well being, social life, adaptation and performance of workers.There are no significant alterations regarding perception of physical fatigue in workers. However, the perception of social alterations is higher to that reported in other reference populations, none of the shifts shows an accidentability significantly higher than others.

Determinación de la resistencia a insecticidas en Aedes aegypti, Anopheles albimanus y Lutzomyiaperuensis procedentes del norte peruano / Determination of resistance to insecticides in Aedes aegypti, Anopheles albimanus y Lutzomyia peruensis in Northern Peru

Objetivo: Determinar los niveles de resistencia a temephos y deltametrina en cinco poblaciones naturales de Aedesaegypti del norte de Perú (La Libertad y Piura), dos cepas de Anopheles albimanus (Sullana y Tambogrande) y unacepa de Lutzomyía spp (Santiago de Chuco, La Libertad). Materiales y métodos: Se realizaron bioensayos en larvasy adultos siguiendo la metodología de la Organización Mundial de la Salud. La visualización de bandas de B-esterasasse hizo por electroforesis en gel de poliacrilamida en larvas de cuarto estadio. Resultados: Las poblaciones de Ae.aegypti de Sullana y Tambogrande (Piura) presentaron factores de resistencia (FR) a temephos de 6,84 con un KDT50= 160,42 minutos y 70 de mortalidad a las 24 horas; en tanto en la población de Tambogrande se observó un FR de5,60, KDT50 = 107,20 y 80 de mortalidad, a diferencia de las cepas de La Esperanza, El Porvenir y Florencia de Mora(La Libertad) que fueron susceptibles. Se identificó resistencia en las poblaciones de Ae. aegypti y A. albimanus procedentesde Piura (Tambogrande y Sullana) para deltametrina, a diferencia de las poblaciones de Ae.aegypti y Lutzomyiaspp de La Libertad que fueron susceptibles. Se identificó la esterasa B2 con un Rf de 0,23 en la población de Ae. aegyptide Sullana. Conclusiones: Dada la susceptibilidad de la población de La Libertad al insecticida temephos, puede seguirsiendo usado en el control vectorial de Aedes aegypti; por lo contrario, dada la resistencia observada en poblaciones deAnopheles en Sullana y Tambogrande se debe evaluar el uso de la deltametrina en estas poblaciones. Finalmente, lapoblación de Lutzomyia spp. no presentó resistencia a deltametrina.

Objective: To determine resistance levels to temephos and deltamethrin in native populations of the following insects: Aedes aegypti (La Libertad and Piura), Anopheles albimanus strains (Sullana and Tambogrande), and Lutzomyia spp. (Santiago de Chuco) in Northern Peru. Materials and methods: Bioassays in larvae and adults were performed following the methodology designed by the World Health Organization. B-estearase band visualization in fourth-stage larvae was performed using electrophoresis in a polyacrylamide gel. Results: A. aegypti from Sullana had a 6,84 resistance factor (RF) to temephos, a KDT50 = 107,20 minutes and 70% mortality rate at 24 hours; while the Tambogrande mosquito population had a 5,50 RF, a KDT50 = 98,35, and 80% mortality rate at 24 hours. These results were different from what was found in La Esperanza, El Porvenir, and Tambo de Mora mosquito strains, which were reported as susceptible to temephos. Deltamethrin resistance was reported in A. aegypti and A. albimanus from Piura (Tambogrande and Sullana), differently from La Libertad A. aegypti and Lutzomyia mosquito populations, which were reported as susceptible. B2 estearase was identified with a 0,23 RF in A. aegypti from Sullana. Conclusions: Given that mosquitoes from La Libertad are susceptible to temephos, this agent may still be used for Aedes aegypti vector control; on the contrary, considering observed resistance in Anopheles populations in Sullana and Tambogrande, the use of deltamethrin must be assessed in these areas. Finally, Lutzomyia spp. populations did not show deltamethrin resistance.

Trabajo en turnos en el sector de la salud chileno: una comparación entre el sector público y privado / Shiftwork in chilean health sector: a comparison between public and private sectors

En el sector de la salud chileno, un esquema de turnos tradicional es el denominado “cuarto turno”. Si bien este sistema es preferido por una proporción significativa de enfermeras y técnicos paramédicos, habitualmente se presume que el sector público presentaría alteraciones significativamente superiores a las que presenta el personal que se desempeña en el sector privado. La necesidad de respaldo científico al respecto, motivó esta investigación. En esta investigación, se aplicaron metodologías publicadas en la literatura científica (BESIAK, Standart Shiftwork Index y escala de hipersomnia de Epworth). Se encuestó una muestra de 44 trabajadores pertenecientes a un hospital privado y 43 trabajadores de un hospital público, ambos localizados en Santiago de Chile. La evaluación de la arquitectura de este sistema de turnos permite concluir que no representa riesgo significativo para las personas en los ámbitos de la salud, bienestar, vida social, adaptación y rendimiento. No existen diferencias significativas en la percepción de fatiga física, alteraciones sociales y presencia de trastornos del sueño entre el personal del sector privado y público. Las principales debilidades del sistema de cuarto turno son su alta irregularidad. Sus principales fortalezas son el alto número de días libres por semana, moderado impacto sobre el ritmo sueño-vigilia y moderada desvinculación social y familiar.

Evaluación del mobiliario utilizado por párvulos JUNJI basada en un estudio de antropometría. Comparación con la normativa de mobiliario institucional / Evaluation of the furniture used by JUNJI toddlers based on an anthropometric study. Comparison with the norm for institutional furniture

El mobiliario escolar inadecuado es considerado como la razón de problemas posturales severos durante la edad adulta. Objetivo: evaluar las alturas de mesas y sillas utilizadas por los párvulos de la Junta Nacional de Jardínes Infantiles (JUNJI). Se midió una muestra de 42 niñas y 40 niños entre 1 y 5 años de edad, de un universo de 1.613 que asistían a 8 jardínes infantiles de la comuna de La Pintana. Los resultados permiten concluir que las alturas del asiento y mesa utilizadas en el Nivel Sala Cuna no se ajustan a las características antropométricas de estos párvulos. La altura de la mesa actualmente utilizada en los niveles Medio y Transición, tampoco son adecuados y la altura del asiento correspondiente, permite acomodar sólo al 29 por ciento de estos párvulos. Para acomodar a los párvulos de los niveles considerados (Sala Cuna, Medio y Transición) se requieren 3 tamaños de mobiliario; actualmente se utilizan 2. Los resultados de este estudio evidencian la necesidad de desarrollar un estudio de mayor envergadura, utilizando una muestra representativa de los párvulos a nivel nacional. En un proyecto como éste, es recomendable la formación de una equipo interdisciplinario.

[Cuban epidemic neuropathy: the risk factors in the population]. / Neuropatía epidémica cubana: algunos factores de riesgo en la población.

A cross-sectional study was conducted in 1995 in a representative sample of the Cuban population aged 15 years or over with the objective of describing prevalence and characteristics of smoking, alcohol consumption, and physical inactivity in the urban population which could have been affected by epidemic neuropathy from 1991-1993. The sampling was stratified at provincial and municipal levels and then by cluster samplings. 93% of the sample was surveyed (14 300 people). 30% of the population aged 17 years and over smoked; the highest proportion of smokers was located in 40-49 years age group; men smoked more than woman regardless of age. The prevalence of alcohol consumption was 45.2% in which Eastern provinces exceeded the domestic average with males predominating. The prevalence of physical inactivity at national level was 33%, 25.7% for males and 39.8% for females. 47.3% of males and 25.4% of females classified as physically active because of their useful extra activity. It was considered that irregular relationships between these 3 risk factors and the incidence of epidemic neuropathy at the ecological level make it think that, although they have a real influence on the determinants of the disease, other factors may also better account for the occurrence of these cases.

Mortality among homeless shelter residents in New York City.

OBJECTIVES: This study examined the rates and predictors of mortality among sheltered homeless men and women in New York City. METHODS: Identifying data on a representative sample of shelter residents surveyed in 1987 were matched against national mortality records for 1987 through 1994. Standardized mortality ratios were computed to compare death rates among homeless people with those of the general US and New York City populations. Logistic regression analysis was used to examine predictors of mortality within the homeless sample. RESULTS: Age-adjusted death rates of homeless men and women were 4 times those of the general US population and 2 to 3 times those of the general population of New York City. Among homeless men, prior use of injectable drugs, incarceration, and chronic homelessness increased the likelihood of death. CONCLUSIONS: For homeless shelter users, chronic homelessness itself compounds the high risk of death associated with disease/disability and intravenous drug use. Interventions must address not only the health conditions of the homeless but also the societal conditions that perpetuate homelessness.

A typology based on measures of substance abuse and mental disorder.

The data of this study were derived from comprehensive interviews of 311 women and 949 men residing in the New York City public shelters for homeless adults during the summer of 1987. Interviews, guided by a 57 page interview protocol, were conducted by thoroughly trained interviewers who had worked in agencies and service systems focused on mental disorders, child abuse, substance abuse and problems of homeless people. Included in the content of the interview were seven dichotomous measures of substance use, substance abuse and mental disorder. A typology of ten groups comprised of individuals with similar profiles on the seven measures served as the independent variable. Three pairs of dependent variables were suicide attempts and current thoughts of suicide, a need for medical services reported by shelter residents and by their interviewers, and disclosure of a drug problem and a need for help in treating it. Consistently meaningful associations between group memberships and the 3 pairs of dependent variables, and 16 measures of health status in previous work, were interpreted as evidence for predictive validity of the typology.