Epidemiología y factores predisponentes de los hallazgos dermatológicos en neonatos de Uruguay / Neonatal Dermatologic Findings in Uruguay: Epidemiology and Predisposing Factors

Introducción: La piel es fundamental en la transición de la vida intrauterina a la extrauterina. El recién nacido presenta cambios fisiológicos, siendo frecuente observar hallazgos cutáneos benignos y transitorios que varían según las características maternas, neonatales y de la gestación. Objetivos: Estimar la frecuencia de distintos hallazgos dermatológicos en neonatos en las primeras 72h de vida e identificar la existencia de diferencias de proporciones estadísticamente significativas con factores neonatales, maternos y de la gestación. Métodos Se realizó un estudio descriptivo, observacional de corte transversal entre abril-julio 2015 y julio-noviembre de 2017 en la maternidad del Centro Hospitalario Pereira Rossell. Se incluyeron neonatos de hasta 72h de vida, a los que se les practicó un examen dermatológico completo. Se presenta la proporción de cada uno de los hallazgos con el intervalo de confianza (IC) correspondiente. Se analiza la relación entre los hallazgos y determinados factores asociados. Resultado Se incluyeron 2811 neonatos. El 100% presentó al menos un hallazgo a nivel de la piel. La mediana fue de 8 lesiones por paciente (rango intercuartílico: 6-9/mínimo-máximo: 1-16). De los 46 hallazgos explorados clínicamente se encontraron 42. Las lesiones benignas y transitorias correspondieron al 99,9%. Entre ellas se observó: lanugo 98% (IC: 97,7-98,7), descamación fisiológica 79,7% (IC: 78,2-81,1) e hiperplasia sebácea 73,3% (IC: 71,6-74,9). El lanugo (p=0,001), la descamación fisiológica (p<0,001) y el eritema tóxico neonatal (p=0,001) se observaron con más frecuencia en los neonatos de término y postérmino. La hiperplasia sebácea (p=0,001) y la hiperpigmentación transitoria neonatal (p<0,001) se encontraron con mayor frecuencia en varones (AU)

Background: The skin is a fundamental organ in the transition from intrauterine to extrauterine life. The newborn infant experiences physiological changes and often presents benign, transient skin characteristics that vary according to maternal, gestational, and neonatal factors. Objectives: To estimate the frequency of various dermatologic findings during the first 72hours of life and to identify their association with maternal, gestational, or neonatal factors. Methods Descriptive, observational, cross-sectional study from April to July 2015 and July to November 2017 in the maternity ward of Centro Hospitalario Pereira Rossell. We examined the skin of neonates within 72hours of birth. Proportions and 95% CI were calculated for all findings. Associations between findings and factors were analyzed. Results A total of 2811 neonates were included. We observed at least one neonatal skin finding in all of the neonates and found a median (interquartile range) of 8 (6-9) findings (minimum–maximum, 1-16). We observed 42 of the 46 possible characteristics we looked for; 99.9% of the findings were benign and transient. Among the findings were lanugo (98%; 95% CI, 97.7%-98.7%), physiological scaling (79.7%; 95% CI: 78.2%-81.1%), and sebaceous hyperplasia (73.3%; 95% CI: 71.6%-74.9%). Lanugo (P=.001), physiological scaling (P<.001), and erythema toxicum (P=.001) were observed significantly more often in full- and late-term neonates. Sebaceous hyperplasia (P=.001) and transient hyperpigmentation (P<.001) were found more often in newborn males. Erythema toxicum was more common after vaginal births (P=.008). Transient hyperpigmentation (P<.001) and dermal melanocytosis (P<.001) were seen more often in neonates of African descent (AU)

Neonatal Dermatologic Findings in Uruguay: Epidemiology and Predisposing Factors. / Epidemiología y factores predisponentes de los hallazgos dermatológicos en neonatos de Uruguay.

BACKGROUND: The skin is a fundamental organ in the transition from intrauterine to extrauterine life. The newborn infant experiences physiological changes and often presents benign, transient skin characteristics that vary according to maternal, gestational, and neonatal factors. OBJECTIVES: To estimate the frequency of various dermatologic findings during the first 72hours of life and to identify their association with maternal, gestational, or neonatal factors. METHODS: Descriptive, observational, cross-sectional study from April to July 2015 and July to November 2017 in the maternity ward of Centro Hospitalario Pereira Rossell. We examined the skin of neonates within 72hours of birth. Proportions and 95% CI were calculated for all findings. Associations between findings and factors were analyzed. RESULTS: A total of 2811 neonates were included. We observed at least one neonatal skin finding in all of the neonates and found a median (interquartile range) of 8 (6-9) findings (minimum-maximum, 1-16). We observed 42 of the 46 possible characteristics we looked for; 99.9% of the findings were benign and transient. Among the findings were lanugo (98%; 95% CI, 97.7%-98.7%), physiological scaling (79.7%; 95% CI: 78.2%-81.1%), and sebaceous hyperplasia (73.3%; 95% CI: 71.6%-74.9%). Lanugo (P=.001), physiological scaling (P<.001), and erythema toxicum (P=.001) were observed significantly more often in full- and late-term neonates. Sebaceous hyperplasia (P=.001) and transient hyperpigmentation (P<.001) were found more often in newborn males. Erythema toxicum was more common after vaginal births (P=.008). Transient hyperpigmentation (P<.001) and dermal melanocytosis (P<.001) were seen more often in neonates of African descent. CONCLUSIONS: All neonates have skin characteristics that are part of their adaptation to extrauterine life. Most are benign and transient. Maternal age, type of delivery, and certain neonatal factors such as gestational age, birth weight, sex, and ethnicity are associated with specific findings.

[Beta-glucan content and hydration properties of filamentous fungi].

The aim of this work was to isolate and identify filamentous fungi from several sources to study the dietary fiber and beta-glucan content. The fungal hydration properties such as water absorption and water holding capacities were also evaluated. Total dietary fiber of isolates exhibited a noticeable variability from 16 to 53% and the highest values were obtained for the genera Paecilomyces and Penicillium, a fact consistent with a higher content of beta-glucans (24 and 17%, respectively), higher than previously reported for Basidiomycetes and yeast. We observed a large decrease (75%) in the water holding capacity when the mycelia were dried. Isolates of filamentous fungi with greater water holding capacity also exhibited greater absorption capacity. Paecilomyces variotii and Penicillium nalgiovense had the best hydration properties. Our results contribute to the search for new unconventional ingredients providing a high protein and beta-glucans content. The addition of these dried mycelia could change the hydration properties in the food system.

Toxigenic Alternaria species from Argentinean blueberries.

Blueberries are traditionally consumed in North America, some European countries and Japan. In Argentina, the blueberry crop is profitable because production starts in November, when the northern hemisphere lacks fresh fruit. Fungal contaminants can grow and produce mycotoxins in fresh fruit. The aims of this work were to identify the main genera of the mycobiota of blueberries grown in Argentina and to determine the toxicogenic potential, pathogenicity and host specificity of the species isolated. The genus Alternaria was the main component of the blueberry mycobiota (95%); minor proportions of Phoma spp. (4%) and Penicillium spp. (1%) were also isolated. According to their sporulation patterns, 127 Alternaria isolates belonged to the Alternaria tenuissima species-group, 5 to the Alternaria alternata species-group and 2 to the Alternaria arborescens species-group. The last mentioned species-group was not isolated at 5°C. Of the 134 isolates, 61% were toxicogenic in autoclaved rice; 97% of these produced alternariol (AOH) in a range from 0.14 to 119.18 mg/kg, 95% produced alternariol methylether (AME) in a range from 1.23 to 901.74 mg/kg and 65% produced tenuazonic acid (TA) in a range from 0.13 to 2778 mg/kg. Fifty two isolates co-produced the three mycotoxins. According to the size of the lesion that they caused on blueberries, the isolates were classified as slightly pathogenic, moderately pathogenic and very pathogenic. No significant differences in pathogenicity were found on different blueberry varieties. In this work, high incidence and toxicogenic potential of the Alternaria isolates from blueberries were demonstrated. Thus, more studies should be done to evaluate the health risk posed by the presence of the Alternaria toxins in blueberries and in the manufactured by-products.

Water activity and temperature effects on mycotoxin production by Alternaria alternata on a synthetic tomato medium.

Alternaria spp. have been reported to be the most frequent fungal species invading tomatoes. Certain species, in particular the most common one, A. alternata, are capable of producing several mycotoxins in infected plants and in agricultural commodities. Alternariol (AOH), alternariol monomethyl ether (AME), and tenuazonic acid (TA) are some of the main Alternaria mycotoxins that can be found as contaminants of food. The objective of this study was to determine the effect of water activity (a(w), 0.904, 0.922, 0.954, and 0.982) and temperature (6, 15, 21 and 35 degrees C) on mycotoxin production on a synthetic tomato medium of a cocktail inoculum of five strains of A. alternata isolated from tomato fruits affected by Blackmould. The optimum AOH production occurred at 0.954 a(w) after 28days of incubation at 21 degrees C. A temperature of 21 degrees C was the most favourable for AOH synthesis at all a(w) levels. The maximum concentration of AME was determined at 0.954 a(w) and 35 degrees C. The optimum conditions for TA accumulation were 0.982 a(w) and 21 degrees C. At the 0.904 a(w) no growth or germination was registered at 6 degrees C and 15 degrees C over the whole incubation period. At 21 degrees C and 35 degrees C growth occurred slowly but none of the toxins were detected at this a(w) level. In general, high a(w) levels were favourable for mycotoxin production. None of the other toxins was detected at quantifiable levels at 6 degrees C after the whole incubation period. A storage temperature of 6 degrees C or below could be considered as safe for tomato fruits and high moisture tomato products (a(w)>0.95), in relation with Alternaria toxins. The results obtained here could be extrapolated to evaluate the risk of spoilage in tomato fruits and tomato products caused by this pathogen.

Effect of water activity and temperature on growth of Alternaria alternata on a synthetic tomato medium.

Alternaria alternata is a toxigenic fungus, predominantly responsible for Blackmould of ripe tomato fruits, a disease frequently causing substantial losses of tomatoes, especially those used for canning. The objective of this study was to determine the effect of water activity (a(w), 0.904, 0.922, 0.954, 0.982) and temperature (6, 15, 21 and 35 degrees C) on germination and radial growth rate on a synthetic tomato medium of a cocktail inoculum of five strains of A. alternata isolated from tomato fruits affected by Blackmould. The shortest germination time (1.5 days) was observed at 0.982 a(w), both at 21 degrees C and 35 degrees C. The germination time increased with a reduction on a(w). The fastest growth rate was registered at 0.982 a(w) and 21 degrees C (8.31 mm/day). Growth rates were higher when a(w) increased. No growth or germination was observed at the lowest a(w) level evaluated (0.904) after 100 days of incubation at 6 degrees C and 15 degrees C. A temperature of 6 degrees C caused a significant reduction in growth rates, even at the optimum a(w) level. The knowledge on the ecophysiology of the fungus in this substrate is necessary to elaborate future strategies to prevent its development and evaluate the consumer health risk.

Comparison of growth characteristics and roquefortin C production ofPenicillium roqueforti from blue-veined cheese.

The properties of 21 isolates ofPenicillium roqueforti from just as many commercial blue-veined cheeses, purchased from the Argentinean market (domestic and imported products) were comparatively examined. Isolates were investigated for their ability to grow at different temperatures, pH values and concentration of NaCl, as well as for their proteolytic and lipolytic activities, respectively. The potential of these strains to produce roquefortin in vitro, and the actual levels of roquefortin in 10 of these cheeses were analysed by TLC. All strains showed similar growth properties in aspects of salt concentration and pH-value of the medium, and all grew well at 10 °C. Only four strains showed proteolytic activity on casein agar, while all strains were lipolytic on trybutirin agar. After incubation at 25 °C for 16 days, all strains produced roquefortin in Yeast Extract Sucrose (25.6-426.7 µg/g) and in reconstituted (10%) sterile skim milk (26.9-488 µg/g). Roquefortin at >0.1 µg/g was also found in 9 out of 10 analysed samples of blue-veined cheeses (8 from Argentine, 1 from Spain), with a maximum value 3.6 µg/g. During the ripening process of blueveined cheese, production of roquefortin seems to be unavoidable. Care should be taken to select strains with low toxin production characteristics, to minimize potential health risks. Roquefortin C production byP. roqueforti in vitro was not correlated with roquefortin C levels found in cheese.

Post-cardiotomy circulatory support with the Terumo Baby-Rx oxygenator in a newborn.

Some patients with severe post-cardiotomy ventricular dysfunction are unable to be separated from cardiopulmonary bypass (CPB). In this setting, extracorporeal circulatory support (ECS) should be instituted to obtain eventual myocardial recovery. We present a newborn in whom an ECS was established with the oxygenator used for the surgical correction.

Occurrence of alternariol, alternariol monomethyl ether and tenuazonic acid in Argentinean tomato puree.

The occurrence ofAlternaria mycotoxins was investigated in 80 samples of tomato puree processed and sold in Argentina. Alternariol (AOH), alternariol monomethyl ether (AME) and tenuazonic acid (TA) were searched for by liquid chromatography. Thirty-nine of the 80 samples showed mycotoxin contamination. TA was found in 23 samples (39-4021 µg/kg), AOH in 5 samples (187-8756 µg/kg), and AME in 21 samples (84-1734 µg/kg). Co-occurrence of two of these toxins was detected in 10 samples. This is the first report of natural occurrence of AOH, AME and TA in tomato products in Argentina.

Mycotoxin production byAlternaria strains isolated from tomatoes affected by Blackmold in Argentina.

A survey on 28 samples of Blackmold" affected tomatoes cultivated in Argentina was made.A. alternata was the most frequently occurring species.A. tenuissima, A. longipes yUdocladium spp. were also isolated. All theAlternaria strains (25) were able to produce mycotoxins, including Alternariol, Alternariol Monomethyl Ether and Tenuazonic Acid, on autoclaved rice (at 25°C and 8°C) and in fresh surface disinfected tomatoes at 25°C.

[The nutrition situation of the population in the former East Germany: results of household budget surveys in 1989]. / Die Ernährungssituation der Bevölkerung der ehemaligen DDR: Ergebnisse von Haushaltsbudgeterhebungen 1989.

The last representative nutritional surveys in households of the former GDR date back to 1989. Trends towards excessive energy intake have continued, resulting, above all, from high fat consumption. A considerable proportion of employed persons have their meals outside the home. The proportion of food used as animal feed was high in households of members of agricultural cooperatives.

[The informativeness of 2-month surveys of food consumption in private households]. / Zur Aussagefähigkeit zweimonatiger Lebensmittelerfassungen in Personenhaushalten.

All-year surveys of the food consumption in private households are very laborious. They may be simplified by shortening the period of time covered by the survey. 712 surveys taken in 1974 led to the conclusion that surveys covering only two months (April and August) permit to make statements the validity of which is but slightly inferior to that of an all-year survey. Of the 45 food groups considered, only 5 (potatoes, fresh vegetables, fresh fruit, tropical and subtropical fruit, and sugar) play an important role as to the selection of suitable months for such a survey.