Causes of Microcephaly in the Zika Era in Argentina: A Retrospective Study.

There are gaps in understanding the causes and consequences of microcephaly. This paper describes the epidemiological characteristics, clinical presentations, and etiologies of children presenting microcephaly during the Zika outbreak in Argentina. This observational retrospective study conducted in the pediatric hospital of Juan P. Garrahan reviewed the medical records of 40 children presenting microcephaly between March 2017 and November 2019. The majority (60%) were males and born full-term. At first evaluation, microcephaly was defined as congenital (31/40, 77%) and associated with other features (68%) such as seizures, developmental delay, non-progressive chronic encephalopathy, and West Syndrome. It was found manifestations restricted to central nervous system (55%), ocular (8/40, 20%), and acoustic (9/40, 23%) defects, and abnormal neuroimaging findings (31/39, 79%). Non-infectious diseases were the primary cause of isolated microcephaly (21/37, 57%), largely related to genetic diseases (13/21, 62%). Only 3 were children were diagnosed with Congenital Zika infection (3/16, 7.5%).

Abordaje de paciente con enfermedad pulmonar obstructiva crónica en farmacia comunitaria rural / Approach to a patient with chronic obstructive pulmonary disease (COPD) at a rural community pharmacy

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Borrelia burgdorferi as a risk factor for Alzheimer's dementia and mild cognitive impairment.

OBJECTIVE: To determine the association of Borrelia burgdorferi infection with Alzheimer's disease or mild cognitive impairment (MCI) in older adults. METHODS: Case-control study. Patients older than 60 years, both sexes, were included. Three groups were created: with probable Alzheimer's disease cases with NINCDS-ADRDA criteria, MCI cases in those not meeting NINCDS-ADRDA criteria for dementia, but who had an abnormal cognitive evaluation and independence in instrumental activities of daily living (IADL), cognitively healthy controls were diagnosed with normal cognitive evaluation and independence in IADL were identified in the community. Western blot IgG against B. burgdorferi in serum was done in all the participants. Non-conditional logistic regression was applied to estimate the association of Alzheimer's disease or MCI and seropositive to B. burgdorferi. RESULTS: Thirty-eight patients with Alzheimer's disease, mean age of 75.6 ± 3.4 years, 69% were females, education 8.3 ± 4.8 years. 39 patients with MCI, mean age of 72.2 ± 6.8 years, 85% were females, education 11.2 ± 4.2 years. A total of 11/38 (29%) were positive to B. burgdorferi with Alzheimer's disease, 9/39 (23%) with MCI, and 11/108 (10%) of controls. In patients with Alzheimer's disease, an adjusted odds ratio (aOR) = 3.65 (95% CI 1.2-11.1) adjusted for education and a history of cerebrovascular disease (CVD) was estimated, and in patients with MCI an aOR = 3.2 (95% CI 1.1-9.1) for a history of diabetes mellitus and CVD was estimated. CONCLUSIONS: In our study, there was an increased risk of Alzheimer's disease and MCI in seropositive IgG patients to B. burgdorferi.

Series de Pediatría Garrahan. El niño y las infecciones / Garrahan Pediatrics Series. The child and the infections

Las consultas pediátricas por temas infectológicos son frecuentes y relevantes durante toda la infancia, desde la etapa neonatal hasta la adolescencia. En este nuevo volumen de las Series Garrahan: El ñino y las infecciones, se han seleccionado temas específicos, sobre la base de la actualización del conocimiento, los cambios epidemiológicos y de las conductas clínicas ocurridos en los últimos años y la necesidad del manejo adecuado de estas afecciones, ya sea ambulatorio o durante la internación. Entre sus aspectos sobresalientes se incluyen: El estudio de temas destacados como el abordaje del niño febril; las infecciones de piel y partes blandas, incluidas las asociadas con mordeduras; las infecciones en el recién nacido; las infecciones respiratorias bajas, incluida la tuberculosis; y las infecciones osteoarticulares, del sistema nervioso central e intraabdominales. La inclusión de un capítulo especial sobre la prevención de infecciones para ayudar a reducir su incidencia. El enfoque práctico, con discusión de casos clínicos y definición de conductas, y ubicando al pediatra en un papel central como coordinador de la atención interdisciplinaria. Aspectos clave y lecturas recomendadas en el cierre de cada capítulo. Una obra actualizada que aporta información científica y la experiencia de los profesionales del Hospital Garrahan, dedicada a todos los miembros del equipo de salud que atienden y cuidan niños dondequiera que trabajen al servicio de la salud infantil

Frequency and Clinical Epidemiology of Canine Monocytic Ehrlichiosis in Dogs Infested with Ticks from Sinaloa, Mexico.

Ehrlichia canis is a rickettsial intracellular obligate bacterial pathogen and agent of canine monocytic ehrlichiosis. The prevalence of this disease in veterinary medicine can vary depending on the diagnostic method used and the geographic location. One hundred and fifty-two canine blood samples from six veterinary clinics and two shelters from Sinaloa State (Mexico) were analyzed in this study. All animals were suspected of having Canine Monocytic Ehrlichiosis (CME). The diagnostic methods used were the ELISA (Snap4Dx, IDEXX) together with blood smear and platelet count. From all dogs blood samples analyzed, 74.3% were positive to E. canis by ELISA and 40.1% were positive by blood smear. The sensitivity and specificity observed in the ELISA test were 78.8% and 86.7%. In addition, thrombocytopenia was presented in 87.6% of positive dogs. The predominant clinical manifestations observed were fever, anorexia, depression, lethargy, and petechiae. Consequently, this is the first report in which the morulae were visualized in the blood samples, and E. canis-specific antibodies were detected in dogs from Sinaloa, Northwest of Mexico.

[Outpatient medical attention demand due to diabetes mellitus in the health primary care]. / Demanda de atención médica por diabetes mellitus en el primer nivel de atención.

Outpatient visits for medical attention because of Diabetes mellitus in the Instituto Mexicano del Seguro Social became very important for the magnitude that it represents. There is a clear increasing tendency for the coming years. The available data indicates a higher frequency and increased demand of women. Higher number of patients is observed between 40 and 59 years old. However, earlier age groups present considerable amount of cases. Having the number of patients allows knowing the average of consultations per patient, this parameter allows having an estimate of the follow up by the physician and it must be part of the evaluation of the medical attention programs. Diabetes mellitus is strongly associated with obesity, this condition affects a high percentage of diabetic patients in the Institution and weight loss must be encouraged.

[Mortality from the HIV/AIDS in the Instituto Mexicano del Seguro Social]. / Mortalidad por VIH/SIDA en el Instituto Mexicano del Seguro Social.

Mortality is an indicator that allow us to evaluate HIV infection control programs. From the middle of the last decade, mortality presents a tendency to decrease in the population covered by the Instituto Mexicano del Seguro Social). In relation to gender and age group the most affected are men between 25 to 44 years of age with mortality rates ranging from 30 to 12 by 100,000 men (1995 to 2009 respectively). In 2009, at least half of the Delegaciones (administrative units by State) present larger mortality rates than the institutional average, particularly Campeche with 14.9 by 100,000 men. It is clear that introduction of control measures against the disease from infected people represents a modification in the course of the illness in the population covered by IMSS.

[Smoking habits in beneficiaries of the social security]. / Consumo de tabaco en derechohabientes del IMSS.

OBJECTIVE: To determine the prevalence of tobacco consumption (TC) and frequency according to demographics and health aspects. METHODS: A cross-sectional study from the Mexican Family Life Survey Project was conducted. The past and present TC according to sociodemo-graphic variables and the presence of chronic diseases (CD) were achieved. RESULTS: The prevalence of TC in the past was 21.4 % with a male/female ratio of 2.5. Nowadays TC was 15.2 % and the ratio between male/female was 2.6 (23.0: 8.9); exposure levels by age decreased at present. Out of the total smokers in the past 71 % continue with the habit, 75 % began TC before the age of 20. In the 15 to 19 years group, 50 % of them started before the age of 14. The highest cigarette pack consumption mean was 2.5 per week and for the present smokers was 1.8; the prevalence for CD in the smoking population was above 20 %; present smoking diminished in those with a history of CD, especially cancer and heart disease. CONCLUSIONS: The prevalence of past and present TC is lower than that reported in other studies in the Mexican population, because of how the exposure to TC was measure.

Estudio de casos y controles en un brote de S. marcescens en una unidad neonatal de cuidados intensivos / A case control study of an outbreak of S. Marcescens in a neonatal intensive care unit

Objetivo. Analizar un brote epidémico de Serratia marcescens en una unidad de cuidados intensivos neonatales (UCIN) e identificar los factores de riesgo asociados al brote. Material y métodos. Estudio de 24 casos y 39 controles durante un brote de marzo a julio de 1995. Se registró: edad, sexo, dispositivos intravasculares, nebulizadores, asistencia a la ventilación, uso de nutrición perenteral total (NPT), enfermedades subyacentes, intervenciones quirúrgicas, sondas, tratamiento antimicrobiano previo y días de exposición. Se calculó razón de momios e intervalo de confianza del 95 por ciento (RM, IC 95 por ciento) y se efectuó análisis multivariado. Resultados. Los factores de riesgo en el análisis univariado (RM, IC 95 por ciento) fueron uso de catéter venoso central (4.57, 1.01-23.5), días de uso de NPT (4.38, 1.03-16.5), días de tratamiento antimicrobiano previo (4.87, 1.60-22.4) y días de exposición (2.7, 2-65-27.6). En el análisis multivariado los factores fueron: tratamiento antimicrobiano previo (3.98, 2.36-18.2), días de tratamiento antimicrobiano (6.76, 3.02-24.6) y días de uso de NPT (4.87, 1.67-15.6). Conclusiones. Los factores de riesgo en nuestro estudio fueron el tratamiento previo con antimicrobianos y su duración, así como los días de uso de NPT