Utilidad clínica del equivalente de hemoglobina reticulocitaria en niños en hemodiálisis / Clinical usefulness of the reticulocyte hemoglobin equivalent in children on hemodialysis

Introducción. La anemia por deficiencia de hierro en hemodiálisis es frecuente. Para su detección se utiliza la ferritina sérica y la saturación de transferrina (ST). El equivalente de hemoglobina reticulocitaria (RET-He) es un análisis que no se modifica en estados inflamatorios y refleja directamente el hierro disponible en médula ósea.Objetivo. Explorar la capacidad diagnóstica de deficiencia absoluta de hierro del RET-He y evaluar su correlación con marcadores tradicionales de ferropenia.Población y métodos. Estudio retrospectivo que comparó RET-He con ferritina y ST en niños en hemodiálisis atendidos en el Hospital Garrahan entre julio de 2016 y julio de 2019. Resultados. En 164 observaciones realizadas en 40 niños, se encontró correlación positiva débil entre hemoglobina y RET-He (r 0,35, p < 0,001), positiva significativa entre ST y RET-He (r 0,52, p < 0,001), negativa baja entre hemoglobina y ferritina (r -0,19, p 0,02) y ausencia de correlación entre hemoglobina y ST (r 0,05, p 0,5). El 50 % presentaba anemia; la ferropénica fue por marcadores tradicionales en el 13 % y por RET-He en el 44 %. El RET-He mostró sensibilidad del 90,9 % (IC 95: 57,1-99,5 %), especificidad del 74,5 % (IC 95: 66,7-81 %), valor predictivo negativo del 99,1 % (IC 95: 94,5-99,9 %) y positivo del 20,4 % (IC 95: 10,7-34,7 %) para detectar anemia ferropénica con valor de corte de 29 picogramos.Conclusiones. Pese a su capacidad limitada, el RET-He como biomarcador de deficiencia de hierro aumenta la detección de anemia ferropénica en niños en hemodiálisis

Introduction. Iron-deficiency anemia is common in hemodialysis patients. Serum ferritin and transferrin saturation (TS) are used for its detection. The reticulocyte hemoglobin equivalent (RET-He) is a marker that is not altered by inflammatory conditions and directly reflects iron availability in the bone marrow.Objective. To explore the diagnostic capability of RET-He to detect absolute iron deficiency and assess its correlation with traditional markers of iron deficiency.Population and methods. Retrospective study comparing RET-He with ferritin and TS in children on hemodialysis seen at Hospital Garrahan between July 2016 and July 2019.Results. In 164 observations carried out in 40 children, a weak positive correlation was found between hemoglobin and RET-He (r = 0.35, p < 0.001), a significant positive correlation between TS and RET-He (r = 0.52, p < 0.001), a low negative correlation between hemoglobin and ferritin (r = -0.19, p = 0.02), and a lack of correlation between hemoglobin and TS (r = 0.05, p = 0.5). Anemia was observed in 50 %; iron-deficiency anemia was detected by traditional markers in 13 % and by RET-He in 44 %. RET-He showed a sensitivity of 90.9 % (95 % CI: 57.1-99.5 %), a specificity of 74.5 % (95 % CI: 66.7-81 %), a negative predictive value of 99.1 % (95 % CI: 94.5-99.9 %), and a positive predictive value of 20.4 % (95 % CI: 10.7-34.7 %) to detect iron-deficiency anemia with a cut-off value of 29 pg.Conclusions. Despite its limited capability, the use of RET-He as a biomarker of iron deficiency increases the detection of iron-deficiency anemia in children on hemodialysis.

Clinical usefulness of the reticulocyte hemoglobin equivalent in children on hemodialysis. / Utilidad clínica del equivalente de hemoglobina reticulocitaria en niños en hemodiálisis.

INTRODUCTION: Iron-deficiency anemia is common in hemodialysis patients. Serum ferritin and transferrin saturation (TS) are used for its detection. The reticulocyte hemoglobin equivalent (RET-He) is a marker that is not altered by inflammatory conditions and directly reflects iron availability in the bone marrow. OBJECTIVE: To explore the diagnostic capability of RET-He to detect absolute iron deficiency and assess its correlation with traditional markers of iron deficiency. POPULATION AND METHODS: Retrospective study comparing RET-He with ferritin and TS in children on hemodialysis seen at Hospital Garrahan between July 2016 and July 2019. RESULTS: In 164 observations carried out in 40 children, a weak positive correlation was found between hemoglobin and RETHe (r = 0.35, p < 0.001), a significant positive correlation between TS and RET-He (r = 0.52, p < 0.001), a low negative correlation between hemoglobin and ferritin (r = -0.19, p = 0.02), and a lack of correlation between hemoglobin and TS (r = 0.05, p = 0.5). Anemia was observed in 50 %; iron-deficiency anemia was detected by traditional markers in 13 % and by RET-He in 44 %. RET-He showed a sensitivity of 90.9 % (95 % CI: 57.1-99.5 %), a specificity of 74.5 % (95 % CI: 66.7-81 %), a negative predictive value of 99.1 % (95 % CI: 94.5-99.9 %), and a positive predictive value of 20.4 % (95 % CI: 10.7-34.7 %) to detect iron-deficiency anemia with a cut-off value of 29 pg. CONCLUSIONS: Despite its limited capability, the use of RET-He as a biomarker of iron deficiency increases the detection of iron-deficiency anemia in children on hemodialysis.

Introducción. La anemia por deficiencia de hierro en hemodiálisis es frecuente. Para su detección se utiliza la ferritina sérica y la saturación de transferrina (ST). El equivalente de hemoglobina reticulocitaria (RET-He) es un análisis que no se modifica en estados inflamatorios y refleja directamente el hierro disponible en médula ósea. Objetivo. Explorar la capacidad diagnóstica de deficiencia absoluta de hierro del RETHe y evaluar su correlación con marcadores tradicionales de ferropenia. Población y métodos. Estudio retrospectivo que comparó RET-He con ferritina y ST en niños en hemodiálisis atendidos en el Hospital Garrahan entre julio de 2016 y julio de 2019. Resultados. En 164 observaciones realizadas en 40 niños, se encontró correlación positiva débil entre hemoglobina y RET-He (r 0,35, p < 0,001), positiva significativa entre ST y RET-He (r 0,52, p < 0,001), negativa baja entre hemoglobina y ferritina (r -0,19, p 0,02) y ausencia de correlación entre hemoglobina y ST (r 0,05, p 0,5). El 50 % presentaba anemia; la ferropénica fue por marcadores tradicionales en el 13 % y por RETHe en el 44 %. El RET-He mostró sensibilidad del 90,9 % (IC 95: 57,1-99,5 %), especificidad del 74,5 % (IC 95: 66,7-81 %), valor predictivo negativo del 99,1 % (IC 95: 94,5-99,9 %) y positivo del 20,4 % (IC 95: 10,7-34,7 %) para detectar anemia ferropénica con valor de corte de 29 picogramos. Conclusiones. Pese a su capacidad limitada, el RET-He como biomarcador de deficiencia de hierro aumenta la detección de anemia ferropénica en niños en hemodiálisis.

Kidney transplantation in children with CAKUT and non-CAKUT causes of chronic kidney disease: Do they have the same outcomes?

Almost half the children who undergo kidney transplantation (KTx) have congenital abnormalities of the kidney and urinary tract (CAKUT). We compared patient, graft survival, and kidney function at last follow-up between CAKUT and non-CAKUT patients after KTx. We divided the analysis into two eras: 1988-2000 and 2001-2019. Of 923 patients, 52% had CAKUT and 48% non-CAKUT chronic kidney disease (CKD). Of the latter, 341 (77%) had glomerular disease, most frequently typical HUS (32%) and primary FSGS (27%); 102 had non-glomerular disease. CAKUT patients were more often boys, younger at KTx, transplanted more frequently preemptively, but with longer time on chronic dialysis. They had less delayed graft function (DGF) and better eGFR, but higher incidence of urinary tract infection (1 year post-KTx). In both eras, 1-, 5-, and 10-year patient survival was similar in the groups, but graft survival was better in CAKUT recipients vs those with primary glomerular and primary recurrent glomerular disease: Era 1, 92.3%, 80.7%, and 63.6% vs 86.9%, 70.6%, and 49.5% (P = .02), and 76.7%, 56.6%, and 34% (P = .0003); Era 2, 96.2%, 88%, and 73.5% vs 90.3%, 76.1%, and 61% (P = .0075) and 75.4%, 54%, and 25.2% (P < .0001), respectively. Main predictors of graft loss were DGF, late acute rejection (AR), and age at KTx in CAKUT group and disease relapse, DGF, early AR, and number of HLA mismatches in recipients with glomerular disease. Graft survival was better in CAKUT patients. DGF was the main predictor of graft loss in all groups. Disease recurrence and early AR predicted graft failure in patients with glomerular disease.

Description and phylogeny of a new species of Liolaemus (Iguania: Liolaemidae) endemic to the south of the Plurinational State of Bolivia.

The Liolaemus montanus group is a diverse group of lizards that ranges from central Peru to southwestern Mendoza, Argentina, including much of the Plurinational State of Bolivia ("Bolivia") and Chile. The species of this group mainly inhabit high elevation areas with cold temperatures. In the last years, several species of this group have been described, mostly in Argentina and Chile. In Bolivia, there are at least thirteen valid species belonging to the L. montanus group. In this study, we describe a new species of the L. montanus group with a marked endemism in the Cordillera de Sama of the Tarija Department, Bolivia, and a combination of unique character states that allows its formal description as a new species. The phylogenetic relationships based on analysis of 159 morphological characters suggest that it belongs to the L. montanus group, and that it is closest to Liolaemus pulcherrimus, which is found allopatrically in a small area of the Jujuy Province, Argentina. The multivariate analyses of 66 morphological characters support the phylogenetic relationships. Statistical analyses of inter-species comparisons of morphological characters are not considered the only methods due to the non-independence of some characters states among species; thus, a phylogenetic analysis is recommended. The detailed revision of specimens of the L. montanus group held in the collections of Bolivia is filling major geographic gaps and improving our understanding of the phylogenetic and biogeographic relationships of this widely distributed group of South American lizards.

Study of lipid reserves in Liolaemus koslowskyi (Squamata: Liolaemidae): reproductive and ecological implications.

In reptiles, many lipid reserve structures were recognized, and different patterns of storage and utilization of lipids have been identified. In this study, a population of Liolaemus koslowskyi was studied to analyze the diversity and functioning of the lipid reserve structures. The specific objectives were to identify the main lipid reserve structures, and to describe their seasonal patterns; to study sexual and seasonal variations of the reserve structures; and to analyze the relation between seasonal patterns of such reserves with the sexual cycle and other biological aspects. Individuals of both sexes collected at five different times of the year were analyzed. The abdominal fat bodies, livers, tails, fat deposits of the lateral folds of the neck, the fat bodies of the axillary region and gonads were weighted. The fat content of livers, tails and neck fat reserves were determined through the extraction in a Soxhlet device. The volume of the ovaries, oviductal oocytes and testicles, and the average surface and thickness of the epididymides were estimated. The abdominal fat bodies and the tail-extracted fats were the main lipid reserves. In general, females showed higher lipid contents, and significant seasonal variations in weight and lipid content in both sex were found, while seasonal variations in the liver fresh weight and liver fat content were found only in males. The axillar and neck fats deposits probably function as auxiliary reserves, and the caudal autotomy did not significantly affect tail fat content. The sexual cycles were synchronic in both sexes.

Nuevo Liolaemus (Iguania: Liolaemidae) con novedoso carácter morfológico, de la frontera entre Argentina y Chile / New Liolaemus (Iguania: Liolaemidae) with a new morphological character from the border between Argentina and Chile

Liolaemus belongs to the Eulaemus subgenus, that is included in the Liolaemus montanus group or section, and is distributed in Argentina, Bolivia, Chile and Peru. The species members of this clade inhabit arid and high altitude environments, usually above 2 800m, and have a strong tendency to herbivory and a viviparous reproductive type. In a herpetological expedition to the Salta Province highlands, Argentina, in April 2012, we collected individuals of this new species for their description. The specimens were collected with loop, slaughtered by anesthesia and deposited in the herpetological collection of Fundación Miguel Lillo in Tucumán (FML). To characterize this new taxon, we analyzed 144 external morphological characters, referring primarily to lepidosis, color pattern, and body proportions, comparing with data from 66 constituent species of the L. montanus group (45 taxa from collection specimens and 21 from literature). Description of the colors in life was made in the field and based on photographs taken during the capture. The species described in this work inhabits a very narrow mountain range area in Salta Province (Argentina), and the Atacama Region (Chile), always above the 3 600m. This new taxon shows characteristics of lepidosis and color patterns clearly different from the other species members of the L. montanus group: the maximum snout-vent length is 72.9mm; shows 74-96 scales around midbody, 89-104 dorsal scales between the occiput and hind limbs, 92-109 ventrals, precloacal pores are evident in both, males and females, and supernumerary pores in males. Also, the presence of postcloacal pores stands out as unique among all Liolaemus. This is a new character, not only for the genus, but also to all Reptilia, becoming a morphological discovery of great importance, since in reptiles only precloacal and femoral pores are known. Based on our field observations, this new Liolaemus is related to rocky environments, which are used as refuge by this omnivorous species, and when handled, very aggressive males.

Liolaemus, es el segundo género más diverso dentro de Iguania, con más de 245 especies. Se describe una nueva especie de Liolaemus, perteneciente al subgénero Eulaemus, grupo o sección de Liolaemus montanus. Esta especie habita en un sector cordillerano muy restringido de la Provincia de Salta, Argentina, y en la provincia de Atacama, Chile; siempre por arriba de los 3 600msnm. Este nuevo taxón presenta características de lepidosis y patrón de coloración claramente diferente a los de las demás especies que integran el grupo de L. montanus, se destaca como carácter exclusivo entre todos los Liolaemus, la presencia de poros postcloacales. Este carácter es novedoso, no sólo en el género, sino también en todos los Reptilia, tornándose un descubrimiento morfológico de suma importancia, ya que sólo se conocen para algunos reptiles únicamente poros precloacales y femorales. Con base en las observaciones de campo realizadas, este nuevo Liolaemus es una lagartija relacionada a los ambientes rocosos, que utiliza para refugiarse, es una especie omnívora y los machos son muy agresivos al ser manipulados.

[New Liolaemus (Iguania: Liolaemidae) with a new morphological character from the border between Argentina and Chile]. / Nuevo Liolaemus (Iguania: Liolaemidae) con novedoso carácter morfológico, de la frontera entre Argentina y Chile.

Liolaemus belongs to the Eulaemus subgenus, that is included in the Liolaemus montanus group or section, and is distributed in Argentina, Bolivia, Chile and Peru. The species members of this clade inhabit arid and high altitude environments, usually above 2800 m, and have a strong tendency to herbivory and a viviparous reproductive type. In a herpetological expedition to the Salta Province highlands, Argentina, in April 2012, we collected individuals of this new species for their description. The specimens were collected with loop, slaughtered by anesthesia and deposited in the herpetological collection of Fundación Miguel Lillo in Tucuman (FML). To characterize this new taxon, we analyzed 144 external morphological characters, referring primarily to lepidosis, color pattern, and body proportions, comparing with data from 66 constituent species of the L. montanus group (45 taxa from collection specimens and 21 from literature). Description of the colors in life was made in the field and based on photographs taken during the capture. The species described in this work inhabits a very narrow mountain range area in Salta Province (Argentina), and the Atacama Region (Chile), always above the 3600 m. This new taxon shows characteristics of lepidosis and color patterns clearly different from the other species members of the L. montanus group: the maximum snout-vent length is 72.9 mm; shows 74-96 scales around midbody, 89-104 dorsal scales between the occiput and hind limbs, 92-109 ventrals, precloacal pores are evident in both, males and females, and supernumerary pores in males. Also, the presence of postcloacal pores stands out as unique among all Liolaemus. This is a new character, not only for the genus, but also to all Reptilia, becoming a morphological discovery of great importance, since in reptiles only precloacal and femoral pores are known. Based on our field observations, this new Liolaemus is related to rocky environments, which are used as refuge by this omnivorous species, and when handled, very aggressive males.

Estudio de riesgos de cáncer en barrios de la ciudad de Bahía Blanca entre 1989 al 2002 / Cancer risk analysis in several neighborhoods in Bahía Blanca city in the period 1989-2002

El objetivo de esta investigación fue determinar si la incidencia de cáncer ocurrida en las áreas cercanas al Polo Petroquímico fue mayor a la observada en el resto de la ciudad de Bahía Blanca. En mayo de 2005, debido a temores expresados por los vecinos de dichas áreas, nuestro Registro de Tumores fue convocado para llevar a cabo un estudio que aportara información calificada respecto a esta posible situación. Se calcularon y compararon las Tasas de Incidencia (razón entre el número de casos nuevos de cáncer y la población total por 100.000) en los períodos 1989-1992; 1993-1997; 1998-2002, utilizando métodos de ajuste directo e indirecto. No se encontraron diferencias estadísticamente significativas en la ocurrencia de tumores entre los barrios presumiblemente afectados y el resto de la ciudad, cuando se utilizaron técnicas directas. Utilizando técnicas de comparación indirectas se observó que el cáncer de pulmón en varones fue significativamente mayor en Ingeniero White. Esta situación podría estar vinculada con un mayor consumo de tabaco.

The aim of this research work was to determine whether the incidence of cancer in the areas close to the Petrochemical Complex was higher compared with that observed in the rest of Bahía Blanca city. Therefore, due to the fears expressed by the residents of that area, in May 2005 the Tumor Record office was asked to carry out a study in order to supply qualified information on this possible situation. Incidence rates were calculated and compared (ratio between the number of new cancer cases and total population by 100,000) for the periods 1989-1992; 1993-1997; 1998-2002 using direct and indirect adjustment methods. No statistically significant differences were found in tumor occurrence in the allegedly affected neighborhoods and the rest of the city when direct techniques were used. When using indirect comparison techniques, it was observed that lung cancer was significantly higher in males living near the Petrochemical Complex (at Ingeniero White town) Such situation could be related to smoking habits in male population.

Proyecto municipio saludable y vejez: informe de evaluación / Project healthy municipio and old age: report evaluation

El objetivo de este estudio es de encontrar elementos estratégicos para el empoderamiento de los adultos mayores, sus familias y comunidades, en tornos saludables, a partir de la observación del proceso seguido en uno de los cuatro municipios seleccionados para implementar una experiencia piloto desarrollada por HelAge Internacional y el Centro de Orientación Sociolegal, con la participación de la municipalida.(au)

Uso de la comunicación en la movilización social y en la movilización comunitaria en salud / Use of communication in the social mobilization and in the community mobilization in health

De lo que se trata es de lograr,a traves de la movilización comunitaria y la promoción de la salud un incremento sostenido del control de la población sobre la salud y sobre los determinantes de la salud, ya sea a partir de un impulso generado en los servicios o de un esfuerzo asumido independientemente por la comunidad.

Las ONgs y las carpas lila / The ONGs and the tents lilac

Con juegos y música, las carpas lila están dando una lección práctica de salud y comunicación por entretenimiento; creando una lógica de promoción y orientación, difundiendo mensajes por medios interactivos, articulándose fácilmente con los procesos existentes y reanimándolos y profundizándolos, asumiendo compromisos y renovando sentimientos de solidaridad