Dehydrated citrus pulp in rabbit feeding.

The objective of this study was to evaluate the effect of dehydrated orange by-product on the productive parameters, carcass yield, and meat quality of rabbits in the fattening stage. Four diets with increasing levels of orange by-products (0%, 10%, 20%, and 30%) were evaluated, each with six replicates of two 32-day-old crossbred rabbits that were randomly allocated. The experimental period was from 32 to 70 days of age of the rabbits. A higher weight gain (p < 0.05) was achieved for observed with 20% substitution, along with a better feed conversion, without any effects on carcass yield and meat quality parameters. The treatment with 30% citrus pulp showed no differences (p > 0.05) in the parameters evaluated. Based on our results, dehydrated orange by-product can replace up to 30% of the commercial feed concentrate without affecting performance, yield, and carcass quality in rabbits feeding since 32 to 72 days of age.

The effect of flavoured and non-flavoured tobacco on subjective experience, topography and toxicant exposure among waterpipe smokers.

INTRODUCTION: Flavoured waterpipe (WP) tobacco is a major factor in the resurgence of WP smoking and a main attractant of WP use among youth. Yet, evidence of the effects of limiting flavour on WP smoker's experiences and exposures is limited. This study examined the impact of flavour manipulation on WP smokers' toxicant exposure and smoking experiences. METHOD: A total of 144 WP smokers attended two, 45 min ad libitum smoking sessions (flavoured vs non-flavoured tobacco) in a crossover design study. Participants completed a battery of questions assessing subjective smoking experiences. Exhaled carbon monoxide (eCO) and plasma nicotine concentrations were measured before and after the smoking sessions. Puff topography was recorded throughout the smoking sessions. RESULTS: Compared with the non-flavoured WP tobacco, participants reported enhanced subjective smoking measures of satisfaction and enjoyment following smoking flavoured WP tobacco (ps <0.05). Although participants spent a longer time smoking flavoured tobacco, they took on average larger puffs while smoking the non-flavoured tobacco (ps <0.05). Greater levels of eCO were recorded following the non-flavoured tobacco session (p<0.05) compared with flavoured tobacco. No significant differences were observed in plasma nicotine concentrations between the two tobacco conditions. WP harm perception was higher among participants after smoking non-flavoured WP tobacco compared with their preferred flavour (p<0.05). CONCLUSION: Smoking the flavoured tobacco product was associated with enhanced subjective experiences compared with the non-flavoured, suggesting a potential role for flavour regulation in reducing WP use. Mixed results were observed for toxicants exposure in relation to smoking flavoured compared with non-flavoured products suggesting the need for a more comprehensive assessment of the effects of other tobacco constituents and additives on toxicant exposure in WP smokers.

Cochleopalpebral reflex: sensitivity and specificity in the auditory screening of newborns discharged from the neonatal intensive care unit.

BACKGROUND: The sensitivity and specificity of the clinical audiological evaluation in newborns are debatable compared to neurophysiological methods of a hearing evaluation. This study aimed to determine the sensitivity and specificity of the cochleopalpebral reflex as a clinical test for hearing screening in newborns. METHODS: A case-control study was designed. Newborns discharged from a neonatal intensive care unit (NICU) were included. Brainstem evoked auditory potentials were recorded. A wooden rattle was used to explore the cochleopalpebral reflex. The sensitivity and specificity of the cochleopalpebral reflex were calculated. Continuous data were analyzed with Student's t-test, with statistically significant p-values < 0.05. RESULTS: We selected 450 newborns who were divided into two groups: group A, with bilateral sensory neural hearing loss (n = 150), and group B, with normal hearing (n = 300). Group A showed a significantly lower gestation age at birth (p = 0.005) compared to group B (32.5 ± 2.6 vs. 34.4 ± 3.5 weeks). In group A, the cochleopalpebral reflex's sensitivity was 80% using the wooden rattle. In group B, the specificity was 98%. CONCLUSIONS: The NICU discharged newborns' clinical hearing evaluation is not enough to exclude hearing loss. Although it may be the only diagnostic tool for hearing loss in some settings, its limitations should be considered.

Prevalence and factors associated with food insecurity in Latin America and the Caribbean during the first wave of the COVID-19 pandemic.

OBJECTIVE: We assessed the prevalence of food insecurity (FI) and its associated factors in Latin American and the Caribbean (LAC) early during the COVID-19 pandemic. METHODS: We performed secondary data analysis of a survey conducted by Facebook and the University of Maryland. We included adults surveyed from April to May 2020. FI was measured by concerns about having enough to eat during the following week. Sociodemographic, mental health, and COVID-19-related variables were collected. We performed generalized Poisson regressions models considering the complex sampling design. We estimated crude and adjusted prevalence ratios with their 95% confidence intervals. RESULTS: We included 1,324,272 adults; 50.5% were female, 42.9% were under 35 years old, 78.9% lived in a city, and 18.6% had COVID-19 symptoms. The prevalence of food insecurity in LAC was 75.7% (n = 1,016,841), with Venezuela, Nicaragua, and Haiti with 90.8%, 86.7%, and 85.5%, respectively, showing the highest prevalence. Gender, area of residence, presence of COVID-19 symptoms, and fear of getting seriously ill or that a family member gets seriously ill from COVID-19 were associated with a higher prevalence of food insecurity. In contrast, increasing age was associated with a lower prevalence. CONCLUSION: The prevalence of food insecurity during the first stage of the COVID-19 pandemic in LAC was high and was associated with sociodemographic and COVID-19-related variables.

Results of the Universal Neonatal Hearing Screening in a Tertiary Care Hospital in Mexico city.

INTRODUCTION: Universal Neonatal Hearing Screening (UNHS) includes as its main objective, that all Newborns (NB) receive an audiological evaluation during their first month of life. OBJECTIVE: To determine the prevalence of hearing loss in a population of healthy NB in a tertiary care hospital in Mexico City. MATERIAL AND METHODS: A prospective cross-sectional study was designed. The period was from October 1, 2011 to May 15, 2019. UNHS was performed with a flowchart in three phases using Transient Evoked Otoacoustic Emissions and Brainstem auditory evoked potentials. Data were analyzed using descriptive statistics. RESULTS: 14,000 NB were evaluated, 28,000 ears. Gender was distributed in n = 7038 (50.3%) males and n = 6962 (49.7%) females. The mean age at the time of the first UNHS study was 48.3 ± 22.2 days. Hearing loss was confirmed in n = 31 (0.22%) NB, in 20 (64%) of the cases with hearing loss there were no documented audiological risk factors. CONCLUSIONS: The prevalence of hearing loss was 2.2 per 1000 NB in a tertiary care hospital in Mexico City. Diagnosis and early habilitation of hearing loss in NB constitute quality indicators in health care and guarantee the best prognosis for NB with hearing loss.

Nevus azul celular parotídeo, una tumoración inusual / Parotid cellular blue nevi, an unusual mass

Introducción: el nevus azul celular es una tumoración melanocítica dérmica benigna. En ocasiones, puede ser falsamente diagnosticada como lesiones malignas, entre ellas, el melanoma. Caso clínico: se trata de una mujer de 37 años que presentó una masa parotídea izquierda de cuatro meses de evolución correspondiente con un nevus azul celular. Discusión: la región de la cabeza y cuello es la tercera en frecuencia, tras la sacrococcígea y las extremidades. Ante una tumoración melanocítica, es importante la confirmación diagnóstica, debido a las similitudes, tanto clínicas como anatomopatológicas, del nevus azul celular con el melanoma maligno. Conclusiones: es muy importante el diagnóstico diferencial correcto, para lo cual es de ayuda el uso de las tinciones inmunohistoquímicas. El tratamiento de esta tumoración es la exéresis quirúrgica con márgenes, esto presenta un comportamiento benigno y baja tasa de recidiva.

Introduction: Cellular blue nevi is a benign dermal melanocytic tumor. Occasionally, it can be falsely diagnosed as malignant lesions, including melanoma. Clinical case: This is a 37-year-old woman who presented with a left parotid mass of four months of evolution, corresponding with a cellular blue nevi. Discussion: The region of the head and neck is the third in frequency, after the sacrococcygeal and the extremities. During the study of a melanocytic tumor, diagnostic confirmation with a biopsy is important, due to the similarities, both clinical and pathological, of cellular blue nevi with malignant melanoma. Conclusions: the correct differential diagnosis is very important, for which immunohistochemical study is helpful. The treatment of this tumor is the surgical excision with margins, presenting benign behaviour and low recurrence rate.

Exposure to Stress and Separation-induced BDNF impairments in adolescents.

BACKGROUND: Although the deleterious effects of separation during early childhood have been extensively studied, little is known regarding other stress-sensitive periods in development, such as adolescence. Also unknown are the biological mechanisms explaining its deleterious effects. This study was carried out to determine how different types of separation can impact neurotrophic factors during adolescence. METHODS: A community sample of 450 Hispanic adolescents was queried in 3 separate visits about regarding four indicators of stress exposure: migration, low closeness to parents, divorce, and growing up with individuals other than their biological parents. Chronological age at the time of exposure to the stressor were documented. BDNF and Pro-BDNF levels were obtained at three time points during the length of the study. RESULTS: The expression of pro-BDNF and m-BDNF was altered by separation, both divorce and death. Of concern, near half of the sample reported their parents to be divorce as a result the majority had mothers that work full time. Exposure to recent life events such as a parent divorce resulted in a time-point dependent, differential down-regulation of m-BDNF levels. Parent-child conflict positively related to BDNF. Specifically, BDNF was affected only in those the father/male adolescent relationship. CONCLUSION: Our data confirmed that separation triggers alterations in BDNF, even after the growth spurt of the brain during early childhood. The important implication of this study is the persistent abnormal levels of BDNF. The prolonged alteration is of concern when considering that BDNF plays a critical role in the pruning process occurring during adolescence. Additional studies are needed to assess whether these alterations can lead to neuropsychological disruptions.

Cochleopalpebral reflex: sensitivity and specificity in the auditory screening of newborns discharged from the neonatal intensive care unit / Reflejo cocleopalpebral: sensibilidad y especificidad en el tamiz auditivo de recién nacidos egresados de una unidad de cuidados intensivos neonatales

Abstract Background: The sensitivity and specificity of the clinical audiological evaluation in newborns are debatable compared to neurophysiological methods of a hearing evaluation. This study aimed to determine the sensitivity and specificity of the cochleopalpebral reflex as a clinical test for hearing screening in newborns. Methods: A case-control study was designed. Newborns discharged from a neonatal intensive care unit (NICU) were included. Brainstem evoked auditory potentials were recorded. A wooden rattle was used to explore the cochleopalpebral reflex. The sensitivity and specificity of the cochleopalpebral reflex were calculated. Continuous data were analyzed with Student's t-test, with statistically significant p-values < 0.05. Results: We selected 450 newborns who were divided into two groups: group A, with bilateral sensory neural hearing loss (n = 150), and group B, with normal hearing (n = 300). Group A showed a significantly lower gestation age at birth (p = 0.005) compared to group B (32.5 ± 2.6 vs. 34.4 ± 3.5 weeks). In group A, the cochleopalpebral reflex's sensitivity was 80% using the wooden rattle. In group B, the specificity was 98%. Conclusions: The NICU discharged newborns' clinical hearing evaluation is not enough to exclude hearing loss. Although it may be the only diagnostic tool for hearing loss in some settings, its limitations should be considered.

Resumen Introducción: La sensibilidad y la especificidad de la evaluación audiológica clínica en recién nacidos son cuestionables en comparación con los métodos neurofisiológicos de evaluación auditiva. El objetivo de este estudio fue determinar la sensibilidad y la especificidad del reflejo cocleopalpebral como prueba clínica de tamizaje auditivo en recién nacidos. Métodos: Se diseñó un estudio de casos y controles en el que se incluyeron recién nacidos egresados de una unidad de cuidados intensivos neonatales (UCIN). Se les efectuaron potenciales auditivos evocados de tallo cerebral. Para la exploración del reflejo cocleopalpebral se utilizó una matraca de madera. Se calcularon la sensibilidad y la especificidad del reflejo cocleopalpebral. Los datos continuos se analizaron con la prueba t de Student y se consideraron estadísticamente significativos los valores de p < 0.05. Resultados: Se seleccionaron 450 recién nacidos y se dividieron en dos grupos: el grupo A (n = 150) con hipoacusia sensorineural y el grupo B (n = 300) con audición normal. El grupo A mostró una diferencia significativa (p = 0.005) en cuanto a la edad de gestación al nacer en comparación con el grupo B (32.5 ± 2.6 vs. 34.4 ± 3.5 semanas). En el grupo A, la sensibilidad del reflejo cocleopalpebral fue del 80% utilizando la matraca de madera. En el grupo B se encontró una especificidad del 98%. Conclusiones: La evaluación del reflejo cocleopalpebral como prueba clínica de tamizaje auditivo en una población de recién nacidos egresados de una UCIN no es suficiente para descartar la pérdida de la audición. Aunque puede ser la única herramienta de diagnóstico para evaluar la pérdida de la audición en algunos casos, es importante considerar sus limitaciones.

Low HIV/AIDS Knowledge among Hispanic Adolescents.

INTRODUCTION: Hispanic adolescents domiciling in Florida rank second in the U.S. with respect to HIV/AIDS incidence and prevalence. Extending studies showing that risky sexual behavior is associated with limited access to information, this project surveyed knowledge about HIV etiology, prevention and treatment. METHODS: The sample consisted of 400 Hispanic youth between 11-18 years of age living in Miami, Florida. The sample is enrolled in an ongoing project Role of Brain Derived Neurotrophic Factor in Decision Making (ROBIM). The HIV Knowledge Questionnaire (HIV-KQ-18), an 18 item self-administered questionnaire was used to measure HIV knowledge, particularly transmission and prevention. RESULTS: Less than 10% of the sample had comprehensive knowledge about HIV/AIDS. Approximately 25% incorrectly answered all of the questions. Questions pertaining to transmission were incorrectly answered by more than half of the sample. The most frequent topics reflecting absence of knowledge are related to high-risk sexual behaviors (sex during the menses) and infection prevention methods (e.g. condoms). A majority of youth believed incorrectly that HIV could be cured (61%), an effective vaccine is available (61%), and antibiotics protect against HIV infection (76%). School (28%) and parents (26%) were the most frequent sources of knowledge about HIV/AIDS. However, youth receiving information from parents had significantly higher knowledge scores than peers receiving education in school (7.4 ± 4.15 vs. 6.1 ± 4.5 scores, p = 0.037). Yet, 68% of the sample had never discussed condom use with their parents. CONCLUSIONS: These findings indicate Hispanic youths, although at very high risk, are poorly informed about prevention of HIV/AIDS. Moreover, the most frequent source of information, namely schools, inculcates less knowledge than parents. Lastly, youths who discuss sex with parents do not typically dialog about condoms, the most readily available protection from HIV/AIDS. These findings identify gaps that need to be addressed for lowering the high rate of HIV infection in Hispanic youths.

Mood Disorders and BDNF Relationship with Alcohol Drinking Trajectories among PLWH Receiving Care.

BACKGROUND: Despite the excessive rates of Hazardous Alcohol Use (HAU) among people living with HIV (PLWH), although largely speculated, psychological and physiological components associated with HAU, has not been actively measured. Therefore, the present study was geared toward determining: 1) the rates of mood disorders and its relationship with HAU, and 2) to assess the impact of Brain Derived Neurotrophic Factor (BDNF), a well-known regulator of alcohol and mood disorders. METHODS: For this study, participants of the longitudinal PADS Study n=400, were followed over time. Alcohol use (Alcohol Use Disorders Identification Test -AUDIT- and the Alcohol Dependence Scale -ADS) and moods (depression, anxiety, and stress) were assessed repeatedly. RESULTS: A cluster analyses shows three distinctive trajectories. The first one, revealed a group with increased drinking (Cluster 1: n=140), constant alcohol intake (Cluster 2: n = 60), and one with decreased consumption (Cluster 3: n =120). Analyses discovered higher AUDIT scores across the clusters with Cluster 1 being followed by Clusters 2 and 3 (1: 14.5 ± 8 vs. 2=8.7 ± 7.5 vs. 3= 6.6 ± 4.2, p = 0.001). Women in Clusters 1 and 2 had higher levels of stress (1:21 ± 7.5; 2:19.3 ± 7) and lower BDNF levels (7904 ± 1248 pg/ml and 10405 ± 909 pg/mL) than their counterparts in Cluster 3 (PSS: 3: 16.6 ±5, p = 0.02 BDNF: 10828 ± 1127 pg/mL, p = 0.08). Men in Cluster 1 differed in terms of stress (19.8 ± 7 vs. 21 ± 7.5 score) and BDNF levels (Cluster 1: 5204 ± 818 vs. Cluster 2: 7656 ± 843 pg/ml, p = 0.002) but not in the number of years living with HIV. The proportion of subjects with multiple mood comorbidities was disturbingly higher (26%), and all were members of Cluster 1. Multiple logistic regression analyses indicated that participants reporting high relative to low levels of perceived stress, dual mood comorbidity, altered BDNF levels and low income increased the likelihood of being a member of Cluster 1. CONCLUSION: This study found that stress and overlaying psychiatric comorbidities are linked with persistent alcohol use. Findings suggest that BDNF and social support seems to be a logical target as it seems to be the bridge linking mood disorders and alcohol consumption.

Are Serotonin Alterations the Link between Thrombocytopenia and Poor Immune Status among HIV Infected Individuals?

OBJECTIVE: Thrombocytopenia (TCP<150 × 103 cells/mm3) has emerged as a relevant factor in the clinical course of HIV. However, the mechanisms mediating such observations have not been well characterized, limiting the possibility of creating targeted interventions. Notably, platelets are the storage and transporter system for serotonin and Brain derived neurotrophic factor (BDNF), which recent laboratory studies associated with viral replication and lymphocyte survival. Thus, we posit that (1) TCP will be associated with reduced levels of BDNF and serotonin (2) That these alterations will lead to poor viro-immune responses to antiretroviral therapy. METHODS: To achieve this goal, a total of 400 people living with HIV were consecutively enrolled to characterize the frequency of thrombocytopenia in hazardous and non-hazardous alcohol user populations in the HAART era. Then, participants underwent immune and laboratory assessments, to determine if TCP was associated with alterations in serotonin (5-HT) and brain derived neurotrophic factor (BDNF). RESULTS: The prevalence of thrombocytopenia in this antiretroviral treated cohort was 14%. Rates were significantly higher in the heavy alcohol users, HAU versus the non HAU group (Heavy: 25% versus HAU: 15% versusnon-HAU: 10%). Multivariate model analyses indicated that having TCP, low BDNF levels (<5000 pg/ml), and number of drinks per day were predictors of serotonin levels. PLWH with TCP had about 2-fold lower PPP-BDNFlevels (5037.4 ± 381 vs. 9137.5 ± 7062 pg/ml p=0.0001). Other significant predictors of BDNF levels at the last visit included receiving selective serotonin reuptake inhibitors and PPP serotonin levels. Multivariate analyses also confirmed that altered serotonin levels were associated withhigh viral loadsboth low CD4 cell counts. CONCLUSIONS: Thrombocytopenia is a relatively frequent complication of HIV, andis particularly prevalent among hazardous alcohol users (HAU). These findings suggest that TCP is associated with altered levels of BDNF and serotonin, suggesting that they may be the bridge linking TCP and poor viro-immune responses observed in this group. These results could have important clinical and therapeutic implications.

Menthol cigarettes and the cardiovascular risks of people living with HIV.

The possibility that menthol cigarettes add to the deleterious cardiovascular effects of smoking has been barely discussed. Although cardiovascular diseases (CVD) are at the forefront of medical concerns of people living with HIV (PLWH), an important, yet unknown, issue for clinicians and public health authorities is whether use of menthol-flavored cigarettes heightens CVD risk factors. Our study aims to assess traditional (10-year risk using the Framingham Risk Model) and nontraditional CVD risk factors and to contrast the effects of menthol-flavored versus non-menthol-flavored cigarettes on these risk factors. Compared to controls, menthol smokers were twice as likely to have hypertension. Users of menthol-flavored cigarettes had higher body mass index values, and increased risk of abdominal obesity. Multivariate analyses indicated that menthol smokers doubled the odds of having moderate to high CVD risk. This finding is highly significant given the widespread use of menthol-flavored cigarettes, particularly among women, minorities, and PLWH.

Beyond the Brain: The Role of Brain-Derived Neurotrophic Factor in Viroimmune Responses to Antiretroviral Therapy among People Living with HIV with and without Alcohol Use.

OBJECTIVE: Given the emerging data suggesting the key role of brain-derived neurotrophic factor (BDNF) in the immune system, we assessed longitudinally whether BDNF depletions induced by hazardous alcohol use (HAU) would impact a response to antiretroviral therapy (ART). METHODS: In a prospective single-site cohort, virological and immunological responses to ART in 200 hazardous and 200 nonhazardous users were obtained, along with plasma BDNF levels. RESULTS: Hazardous drinkers were more likely to have BDNF levels <4000 pg/mL (odds ratio [OR] = 1.6, P = .01). Participants with BDNF <4000 pg/mL were less likely to have CD4 counts of more than 500 cells/mm(3) (P = .02) and to achieve viral suppression over the follow-up period (OR = 1.5, P = .03). Multivariate analysis confirmed the significant role of HAU and low BDNF in predicting viroimmune responses. CONCLUSION: Hazardous alcohol use was associated with BDNF alterations, which in turn were linked to a limited response to ART in terms of viral suppression and CD4 count improvements.

Brain derived neurotrophic factor and cognitive status: the delicate balance among people living with HIV, with and without alcohol abuse.

INTRODUCTION: The advent of combination antiretroviral therapy(cART) has lead to a significant reduction in morbidity and mortality among people living with HIV(PLWH). However, HIV-associated neurocognitive disorders (HAND) still remain a significant problem. One possible mechanism for the persistence of these disorders is through the effect of HIV on brain-derived neurotrophic factor (BDNF). BDNF is influenced by various factors including hazardous alcohol use (HAU), which is prevalent among PLWH. This study attempts to elucidate the relationships between HAU, BDNF and HAND. METHODS: Cross-sectional analyses were conducted on a sample of 199 hazardous alcohol users and 198 non-HAU living with HIV. Members of each group were matched according to sociodemographic characteristics and CD4 count. Research procedures included validated questionnaires, neuropsychological assessments and a blood sample to obtain BDNF and immune measurements. RESULTS: Hazardous alcohol users showed either significantly lower or significantly higher BDNF levels compared to the Non-hazardous (OR=1,4; 95% CI: 1-2.1, p = 0.003). Therefore, for additional analyses, subjects were categorized based on BDNF values in: Group 1 < 4000, Group 2: 4001-7,999 (reference group), and Group 3 for those >8,000 pg/mL. Groups 1 and 3 performed significantly worse than those in Group 2 in the domains of processing speed, auditory-verbal and visuospatial learning and memory. Multivariate analyses confirmed that HAU and BDNF are significant contributors of HAND. CONCLUSION: Our findings offer novel insights into the relationships between BDNF, and alcohol use among PLWH. Our results also lend support to expanding clinical movement to use BDNF as an intervention target for PLWH, in those with evidence of deficiencies, and highlight the importance of including HAUat the inception of clinical trials.

Neurodesarrollo en infantes con antecedente de hipotiroidismo congénito / Neurodevelopment in infants with congenital hypothyroidism antecedents

Introducción: Los estudios de seguimiento de infantes con hipotiroidismo congénito con tratamiento temprano, muestran que no existen diferencias con respecto al coeficiente intelectual que se encuentra en la población general. Material y métodos: Estudio de cohorte retrospectivo. Veinticuatro hipotiroideos fueron detectados a través del Programa de Tamiz Neonatal y comparados con un grupo testigo. Los recién nacidos fueron valorados entre los seis meses y los siete años de edad mediante el índice de desarrollo (ID) de Bayley, el coeficiente intelectuales (Cl) de Terman Merril y la prueba Hiskey Nebraska para detectar infantes con hipoacusia. Resultados: Dieciocho infantes hipotiroideos mostraron Cl o ID normal o alto. Uno con ID de Bayley porabajo del promedio, dos con Cl por abajo del promedio y uno con hipoacusia y capacidad de aprendizaje baja. No se encontraron diferencias con respecto al grupo control. El uso de ototóxicos, prematurez e hiperbilirrubinemia, fueron las causas que explicaron los coeficientes bajos entre los hipotiroideos y el grupo control. Conclusiones: El Cl y el ID en el grupo de hipotiroidismo tratado tempranamente no difirió con los resultados del grupo testigo.

Introduction: Follow-up studies of hypothyroid infants who received early treatment evidence the presence of the same IQ vs. the general population. Material and methods: Retrospective cohort study. Twenty-four hypothyroid infants detected in neonatal screening were compared to a control group. The newborns were assessed from six months to seven years based on Bayley's infant development scales (ID), the Terman-Merril IQ (Cl) and the learning aptitude of the heard of hearing with the Hiskey-Nebraska test (CA). Results: Twenty hypothyroid infants showed a normal or high Cl or ID. One of the infants with a ID result below the mean, two with an Cl below the mean, one hearing impaired infant with low learning aptitude. No differences were found vs. the control group. The use of ototoxic medications, prematurity and hyperbilirubinemia explain the low coefficients between the hypothyroid individuals and the control. Conclusions: The Cl and the ID results in the hypothyroid group who received early treatment showed no difference vs. the control group.

Frecuencia de disfunción de oído medio en preescolares con historia de cuidados intensivos neonatales / Frequency of middle ear dysfunction in pre-school children with history of neonatal intensive care

Los recién nacidos egresados de las Unidades de Cuidados Intensivos Neonatales (UCIN) presentan con frecuencia disfunción de oído medio. Objetivo: Determinar la frecuencia de disfunción de oído medio en niños preescolares con antecedente de haber egresado de una UCIN y su posible asociación con algunas variables perinatales y ambientales. Material y métodos: Se seleccionaron a 90 niños preescolares con edad media de 4.6+- 0.8 años. Se les practicó timpanometría, reflejo estapedial ipsilateral y audiometría de tonos puros. Resultados: 42 niños presentaron oído medio normal bilateral (grupo A) y 48 disfunción de oído medio (grupo B). El promedio días de estancia en la UCIN fue de 12 +-9.1 días, 71 (0.79) niños fueron sometidos a ventilación mecánica. La morbilidad más frecuente en la (UCIN) fue la hiperbilirrrubinemia neonatal (n=61). El factor de riesgo ambiental para otitis media más frecuente fue acudir a estancia infantil (n=70), seguido de alimentación al seno materno menor a 3 meses (n=41). Los análisis de regresión logística bivariada por oído no mostraron significancia en ningún factor de riesgo para otitis media. Tres (0.03) niños resultaron con hipoacusia bilateral de tipo sensorio-neural. Conclusiones: La disfunción de oído medio documentada correspondió a un 44 por ciento de los oídos explorados. Los sujetos egresados de las UCIN constituyen una población de alto riesgo otológico y audiológico que amerita vigilancia médica durante su niñez.

Valoración del lenguaje en preescolares con pero al nacer menor de 1 500 g / Language evaluation in preschool children with antecedent of low birth weight

Introducción. Objetivo: documentar las habilidades lingüísticas de un grupo de preescolares con peso al nacer igual o menor de 1 500 g.Material y métodos. En forma longitudinal, con corte transversal y comparativo, se efectuó evaluación audiológica y lingüística a niños preescolares con peso al nacer igual o menor de 1 500 g, independientemente de su edad gestacional y morbilidad al nacer, con audición normal bilateral, pertenecientes a una clínica de seguimiento pediátrico del recién nacido de alto riesgo. Los cuales se compararon con niños de bajo riesgo. Para la valoración del lenguaje se utilizó la Batería de la Evaluación de la Lengua Española. Considerándose algunas variables biológicas y ambientales para el desarrollo del lenguaje.Resultados. Se evaluaron a 98 niños preescolares con edad media de 4.2 años, distribuidos en dos grupos: grupo A (n=49) formado por niños con peso al nacer igual o menor de 1 500 g, y grupo B (n=49) constituido por niños de bajo riesgo. La edad gestacional promedio al nacer del grupo A fue de 32.5 semanas por Capurro y peso de 1 220 g; 32 niños ameritaron cuidados intensivos neonatales y 22 ventilación mecánica. La morbilidad del grupo A durante el período neonatal la ocupó en primer término la septicemia neonatal (0.67) seguida de la hiperbilirrubinemia (0.55). Se encontró diferencia estadísticamente significativa entre los valores promedio de ambos grupos con P menor de 0.004 en la escala de articulación del lenguaje. Conclusiones. Los niños preescolares con peso al nacer igual o menor de 1 500 g presentan características lingüísticas de menor calidad en comparación con población de bajo riesgo. Lenguaje; valoración; recién nacido de bajo peso.

Hallazgos audiológicos en pacientes con hipoacusia súbita manejados con esteroides y extracto de ginkgo biloba / Audiologic findings in patients with sudden hearing loss treated with steroids and extract of ginkgo biloba

Propósito: Evaluar los resultados audiológicos en pacientes con hipoacusia súbita manejados con Ginkgo biliba y esteroides. Así mismo, evaluar el efecto de este tratamiento médico sobre el acúfeno que surge como secuela del padecimiento. Material y Métodos: Se realizó un estudio prospectivo, lineal y descriptivo, en el cual se revisó una muestra de 52 pacientes. Se administró tratamiento a base de esteroides y extracto de Ginkgo biloba. A todos los pacientes se les realizaron audiometrías seriadas cada 8 o 10 días hasta que se encontró estabilidad audiométrica. Resultados: En los umbrales de tonos puros, se observó mejoría de l a 30 dB HL en el 36.8 por ciento de los pacientes, de 31.60 dB HL en el 40.3 por ciento y de 61.90 dB HL en el 7.0 por ciento. La discriminación mejoró en el 61.66 por ciento. El acúfeno mostró mejoría importante en todos los casos. Conclusión: Aunque se ha reportado que en la hipoacusia súbita puede existir recuperación espontánea, la combinación de esteroides con extracto de Ginkgo biloba produjo recuperación en los umbrales de audiometría tonal y mejoría en la discriminación en la mayoría de los casos estudiados, incluso en pacientes que tenían de 1 a 2 meses de evolución y en los que no había existido mejoría espontánea. La recuperación no fue completa, pero si útil para obtener umbrales aceptables para la rehabilitación mediante una prótesis auditiva

Neurodesarrollo a los dos años de edad en recién nacidos con peso menor o igual a 1 000 g / Frequency and intensity sequel, at two years of age of surviving newborns weighting equal or minor of 1 000 g

Introducción. Los avances en el tratamiento perinatal y neonatal han incrementado dramáticamente la sobrevida en los recién nacidos con peso al nacer igual o menor de 1 000 g. A pesar de esto, existen fuertes controversias en cuanto a la existencia de modificaciones a favor o en contra de la frecuencia y el grado de secuelas neurológicas. El objetivo fue conocer las alteraciones del neurodesarrollo de un grupo de niños con peso al nacer igual o menor de 1 000 g que fueron evaluados a los 2 años de edad comparados con un grupo de niños con peso al nacer igual o mayor de 2 500 g. Material y métodos. Se efectuó evaluación neurológica de la Clínica Mayo, psicológica de Bayley, audiometría y lingüística. Resultados. Se evaluaron 198 niños, distribuidos en 2 grupos: el A (n=75) con peso al nacer igual o menor de 1 000 g y el B (n=123) con peso al nacer igual o mayor de 2 500 g. La valoración neurológica presentó un aumento de riesgo (Rm) para el grupo A de 2.44 (1.27-4.70), P=0.010. La evaluación psicológica de Bayley presentó mayor riesgo, 2.51 (1.10-5.70), P=0.041 y 3.82 (1.56-9.35), P=0.0045 para la escala mental y psicomotriz, respectivamente para el grupo A. La evaluación audiológica alterada fue de 3 por ciento y el lenguaje mostró incremento de riesgo de 2.25 (1.11-4.55), P=0.033 para el mismo grupo. La coordinación motora gruesa y fina mostró mayor número de alteraciones, Rm de 3.61 (1.19-10.92), P=0.033 y 3.31 (1.17-9.29), P=0.033 para el grupo A. Conclusiones. Los niños con peso al nacer igual o menor de 1 000 g presentan riesgo incrementado para alteraciones en las valoraciones neurológica, audiológica, del lenguaje, del desarrollo mental, psicomotriz y coordinación motora gruesa y fina.

Morbilidad y mortalidad del paciente geriátrico Hospitalizado: estudio de un semestre en el servicio de medicina interna / Morbidity and mortality of hospitalized geriatric patients: study of a 6-month period at the internal medicine service

Se estudiaron 496 pacientes geriátricos que ingresaron en dos salas del Servicio de Medicina y se determinaron las primeras causas de morbilidad y mortalidad, se establecieron asociaciones entre algunas variables, tales como: edad, sexo, raza, municipio de residencia, percápita familiar, ocupación. Se encontró asociación entre algunas de ellas, además, se determinó que la principal caus de morbilidad y mortalidad en mayores de 65 años lo constituyó la influenza y la neumonía, y las principales complicaciones registradas fueron flebitis, influenza, neumonía, enfermedades de la circulación pulmonar y otras enfermedades del corazón. Entre los fallecidos se encontró alta correlación clinicopatológica. Se obtuvieron resultados y se elaboraron conclusiones