Experiencias Adversas en la Infancia: Revisión de su impacto en niños de 0 a 5 años / Adverse Experiences during Childhood: A revision over their impact on children 0-5 years old / Experiências Adversas na Infância: Revisão do seu impacto em crianças de 0 a 5 anos

Se realiza una revisión narrativa acerca del impacto del parámetro Experiencias Adversas en la Infancia (EAI) de 0 a 5 años. Para esto, se enuncian las principales EAI que afectan en este rango de edad, para luego sintetizar la evidencia de las secuelas inmediatas que 3 o más EAI pueden provocar en el desarrollo general, cognitivo y socioemocional, así como en la salud general infantil y la trayectoria escolar. Posteriormente, se comenta la importancia de seleccionar estas experiencias, intervenir sobre las barreras de acceso a la salud que enfrentan los niños y niñas afectados por EAI y sus cuidadores, y promover relaciones estables, seguras y nutritivas como una estrategia para moderar la transmisión de los patrones de maltrato infantil. Se concluye que la exposición a EAI es un importante factor de riesgo para el desarrollo de niños y niñas, por lo que debe ser considerado como un eje relevante en el ámbito de la salud, especialmente durante los primeros 5 años de vida, cuando es posible impedir el ingreso a la cadena de riesgos asociados.

This is narrative review over the impact of Adverse Childhood Experiences (ACEs) on children in the range of 0-5 years old. The main related ACE in this range of age are stated and the evidence on the sequelae which 3 or more ACEs can provoke on the children's general, cognitive, social and emotional developments, as well as on their general health and school trajectory, are all discussed. Then, the importance of filtering these experiences, and overcoming the health barriers faced by these children, while promoting stable, secure, and nurturing relationships, as a strategy to challenge the transmission of violence patterns, are all discussed as well. A conclusion is that ACE are a serious risk to the development of children, and therefore, the issue should be timely addressed, particularly within the first 5 years of age when the negative impacts are greatest.

Realiza-se uma revisão narrativa acerca do impacto do parâmetro Experiências Adversas na Infância (EAI) de 0 a 5 anos. Para isto, enunciam-se as principais EAI que afeitam nesta faixa de idade, para logo sintetizar a evidencia das sequelas imediatas que 3 ou mais EAI podem provocar no desenvolvimento geral, cognitivo e socioemocional, assim como, na saúde geral infantil e a trajetória escolar. Posteriormente, comenta-se a importância de peneirar estas experiências, intervir sobre as barreiras de acesso à saúde que enfrentam meninos e meninas afeitados pelo EAI e os seus cuidadores, e promover relacionamentos estáveis, seguros e nutritivos como uma estratégia para moderar a transmissão dos padrões de maltrato infantil. Conclui-se que a exposição às EAI é um importante fator de risco para o desenvolvimento de meninos e meninas, pelo que deve ser considerado como eixo relevante no âmbito da saúde, especialmente durante os primeiros 5 anos de vida, quando é possível pedir o ingresso à cadeia de riscos associados.

Influence of gender on carcass yield of twin lambs Blackbelly x Pelibuey at 56 days of age / Influência do gênero no rendimento de carcaça em cordeiros gêmeos Blackbelly x Pelibuey aos 56 días de idade

The aim of this study was to determine the influence of gender on pre-weaning growth, yield and weight of primal cuts of the carcass of Blackbelly x Pelibuey lambs. 16 twin lambs were used. The lamb gender was the fixed factor. The variables evaluated were: body weight at birth and at weaning, average daily weight gain, weight and yield of carcass and primal cuts: neck, arm, thorax, abdomen and leg. Gender did not affect (P>0.05) body weight at birth. However, the pre-weaning average daily weight gain and body weight at weaning were affected (P<0.05) by the gender. Hot carcass yield and weight and primal cuts were not affected (P>0.05) by the gender of the lamb. Nevertheless, the area of the Longissimus dorsi muscle and cavity fat were different between males and females (P<0.05) 11.5±0.73cm2 and 198±0.05 g vs 9.3±0.73cm2 and 282±0.05g, respectively. In conclusion, in twin lambs Blackbelly x Pelibuey males had greater average daily weight gain and body weight at weaning than females. Carcass yield and weight and primal cuts were not affected by the gender of the lamb. However, males had greater area of the L. dorsi muscle than females and these in turn had a greater amount of cavity fat than males.(AU)

Objetivou-se determinar a influência do gênero no crescimento pré-desmame, no rendimento e no peso dos cortes primários de carcaça de cordeiros Blackbelly x Pelibuey. Utilizaram-se 16 cordeiros gêmeos. Os dados foram analisados em um desenho completamente ao acaso, em que o gênero dos corderos foi o fator fixo. As variáveis avaliadas foram: peso vivo ao nascimento e ao desmame, ganho diário de peso, peso e rendimento de carcaças e dos cortes primários: pescoço, braço, tórax, abdômen e perna. O gênero não afetou (P>0,05) o peso vivo ao nascimento. No entanto, o ganho diário de peso e o peso vivo ao desmame foram afetados, sendo esses valores superiores nos machos (P<0,05). O peso e o rendimento das carcaças quentes e dos cortes primários não foram afetados (P>0,05) pelo gênero do cordeiro. Entretanto, a área do músculo Longissimus dorsi e a gordura cavitária foram diferentes entre machos e fêmeas (P<0,05): 11.5±0.73cm2 e 198±0.05g vs. 9.3±0.73cm2 e 282±0.05g, respectivamente. Em conclusão, nos cordeiros gêmeos Blackbelly x Pelibuey, os machos tiveram maior ganho diário de peso e maior peso vivo ao desmame do que as fêmeas. O peso e o rendimento da carcaça bem como os cortes primários não foram afetados pelo gênero do cordeiro. Todavia, os machos tiveram maior área do músculo L. dorsi que as fêmeas e estas tiveram maior quantidade de gordura cavitária que os machos.(AU)

Eficacia de cápsulas radiales en la promoción de alimentación saludable / Efficacy of radio capsules in promoting healthy eating

The high prevalence of obesity in children supports the need to implement preventive actions such as the development of programs to promote healthy food intake. Objective: To evaluate the effectiveness of radio capsules in developing a positive attitude towards healthy eating in children. Method: Under an experimental design with control group, were assessed using a scale attitudinal differences bifactorial pre and post intervention in two groups. The average age of each group was 10 years. In the experimental group 28 children participated in the pre-intervention assessment and 22 in the post intervention; in the control group 36 students participated in the pre-intervention assessment and 32 in post evaluation. Results: The factor attitude toward healthy eating, and healthy behaviors decreased in the control group, while in the experimental group there was a slight increase in the average factor both in attitude and behavior factor. The only statistically significant differences between the averages of the measurements before and after the intervention in the control group, were in both attitude factor (t (66) = -3.108, p = .003) compared to the behavior factor (t (65) = -3.350, P = .001). Conclusions: Students exposed to radio capsules had increased awareness of healthy eating, while the control group decreased significantly positive attitude towards healthy eating in both factors studied.

La alta prevalencia de obesidad en escolares de 10 años en promedio de edad, fundamenta la necesidad de implementar acciones preventivas como el desarrollo de programas de promoción de ingesta de alimentos saludables. Objetivo: Evaluar la eficacia de las cápsulas radiales en el desarrollo de una actitud favorable hacia la alimentación saludable en menores escolarizados, mensajes transmitidos en la radio del establecimiento educacional. Método: Bajo un diseño experimental con grupo control, se evaluaron mediante una escala actitudinal bi factorial las diferencias pre y post intervención en dos grupos similares, uno de ellos sometidos a cápsulas radiales. El promedio de edad de cada grupo fue de 10 años. En el grupo experimental, participaron en la evaluación pre intervención 28 menores y en la evaluación pos intervención 22; en tanto en el grupo control participaron en la evaluación pre intervención 36 estudiantes, y en la evaluación post 32. Resultados: tanto el factor actitud frente a la alimentación sana, como conductas saludables, disminuyeron en el grupo control, en tanto en el grupo experimental se observó un leve aumento en la media tanto en el factor actitud y en el factor conducta; sólo son estadísticamente significativas las diferencias entre las medias de las mediciones pre y post intervención en el grupo control, tanto para el factor actitud (t(66)=-3,108; p=.003) como para el factor conducta (t(65)=-3,350; p=.001). Conclusiones: Los estudiantes expuestos a las cápsulas radiales tuvieron mayor conciencia acerca de la alimentación saludable, en tanto los del grupo control disminuyeron significativamente la actitud positiva frente a la alimentación sana en ambos factores estudiados.

Dengue y leptospirosis compartiendo el mismo nicho ecológico en la localidad ribereña de Carmen del Paraná (Itapúa) / Dengue and leptospirosis share the same ecological niche in Carmen del Paraná (Itapua), a riverside locality

Para conocer la prevalencia de dengue y leptospirosis en pobladores de Carmen del Paraná (Itapúa) realizamos un estudio transversal descriptivo. Aplicamos un cuestionario y toma de muestras sanguíneas, mediante un muestreo por hogares. Los jefes de familia fueron informados sobre la metodología, beneficios, posibles riesgos a fin de decidir su participación o de sus familiares en el estudio. Por el método de ELISA determinamos la presencia de anticuerpos IgG anti-leptospira en 211 mujeres y 107 varones, contra el virus del dengue en 255 mujeres y 142 varones. Hallamos una seroprevalencia de dengue de 25% (IC 95%:20,7-29,4), no habiendo diferencia entre varones y mujeres. La prevalencia de leptospirosis fue de 24,1% (IC95%:19,6-29,2), siendo mayor en mujeres que en varones (28,4% vs 15,9%; p <0,05). La seroprevalencia de dengue fue más alta en los mayores de 35 años (36% vs 17%, p<0,001), mientras que la leptospirosis lo fue en menores de 15 años (48% vs 21,6%, p<0,001). El 8% de los individuos tenía serología positiva tanto para leptospira como para dengue. En esta comunidad, un importante número de individuos tiene riesgo de desarrollar dengue hemorrágico. La coexistencia de dengue y leptospirosis en el mismo nicho ecológico es importante porqueal presentar características clínicas semejantes, implican un problema para el médico al momento de establecer el diagnóstico oportuno y el tratamiento apropiado, entonces sería importante el desarrollo de estrategias integrales de vigilancia epidemiológica, prevención y control de estas enfermedades que se basen en la participación conjunta del personal de salud, autoridades y comunidad.

This cross-sectional descriptive study was carried out to know the prevalence of dengue and leptospirosis in the inhabitants of Carmen del Paraná (Itapúa). Through a house hold sampling, we applied a questionnaire and collected blood samples. The heads of the families were informed about the methodology, benefits and possible risks so that they could decide about the participation of their families in the study. The presence of anti-leptospira IgG antibodies was determined by ELISA method in 320 individuals (211women and 107 men) and anti-dengue virus antibodies in 399 individuals (255 women and 142 men). We found a dengue virus seroprevalence 25% (IC 95 %:20.7-29.4) without any differences between men and women. The prevalence of leptospirosis was24.1% (IC95 %:19.6-29.2), higher in women than in men (28.4 % vs. 15.9 %; p value <0.05). Dengue seroprevalence was higher in the age group older than 35 years old(36% vs. 17%, value of p <0.001), where as leptospirosis was more prevalent in those younger than 15 years old (48% vs 21.6%, p value <0.001). Eight percent of the individuals who were leptospira positive were also dengue positive. In this community, there is an important number of individuals who has a risk of developing hemorrhagicdengue. The coexistence of dengue and leptospirosis in the same ecological niche is important because both diseases presented similar clinical characteristics, implying a problem for the physician at the time of determining the appropriate diagnosis andtreatment. Therefore, it would be important to develop integral strategies of epidemiological surveillance, prevention and control of these diseases, based on the jointparticipation of healthcare personnel, authorities and community.

Pruebas complementarias a la problemática del diagnóstico de la infección por los virus B y C en donantes de sangre / Complementary tests for the problem of B and C virus infection diagnosis in blood donors

El objetivo de este trabajo es determinar si las transaminasas hepáticas tienen valor como pruebas complementarias que orienten el diagnóstico de hepatitis B y C, en donantes de sangre con anticuerpos positivos por el método ELISA a estas infecciones virales; teniendo en cuenta que las pruebas confirmatorias como el inmunoensayo recombinante (RIBA) o la prueba de ácidos nucleicos por técnicas moleculares como PCR (RNA HCV) para hepatitis C y DNA viral (PCR) para hepatitis B no se realizan aún en nuestro país debido a sus elevados costos. Se busca sumar esfuerzos en salud pública desde los bancos de sangre debido a la trascendencia de llegar a un diagnóstico en los donantes seropositivos, que hayan sido captados en el tamizaje, para prevenir la propagación de estas hepatitis. Se realizaron pruebas serológicas para hepatitis C, anticuerpos frente al antígeno del core de la hepatitis B y determinaciones de los niveles de GPT o ALT (Transaminasa Glutámica Pirúvica o Alanina Amino Transferasa), GOT o AST (Transaminasa Glutámico Oxalacética o Aspartato Amino Transferasa) en 236 donantes de sangre seropositivos para hepatitis B y C del Banco de Sangre del Hospital de Clínicas de la Universidad Nacional de Asunción-Paraguay. Las transaminasas elevadas fueron clasificadas de acuerdo a los marcadores serológicos positivos para hepatitis B y C, encontrándose niveles elevados en un 13.9% de individuos con anti-HBc, 40% en individuos con anti HCV y 2 de 7 casos en individuos con serología positiva para ambos marcadores serológicos. Casi la mitad de los donantes con marcador serológico positivo para anti HCV presentan elevación de las transaminasas.

The aim of this study was to determine if liver transaminases had value as complementary tests to orientate the diagnosis of hepatitis B and C in blood donors with positive antibody to these viral infections by the EIA method, considering that confirmatory tests such as the recombinant immunoassay (RIBA) or nucleic acid test by molecular techniques such as PCR (HCV RNA) for hepatitis C and viral DNA (PCR) for hepatitis B are not performed in our country due to their high costs. We are looking for joining efforts in public health from the blood banks due to the importance of reaching a diagnosis of seropositive donors who have been detected in the screening to prevent the spread of hepatitises. Serologic tests for hepatitis C, antibodies against the core antigen of hepatitis B and determinations of the levels of ALT or GPT (Alanine aminotransferase or Glutamic pyruvic transaminase), AST or GOT (Aspartate aminotransferase or Glutamic oxalacetic transaminase) were carried out in 236 blood donors seropositive for hepatitis B and C of the Blood Bank of the Hospital de Clinicas, National University of Asuncion, Paraguay. Elevated transaminases were classified according to the positive serological markers for hepatitis B and C finding high levels in 13.9% in donors with anti-HBc, 40% in donors with anti HCV and two of seven cases in donors with positive serology for both serological markers. Almost half of the donors with positive serologic marker for anti HCV had elevated transaminases.

Riesgo de adquirir ITS/SIDA en niños de barrios marginales de Asunción, Paraguay / Risk of acquiring STD/AIDS in children of slums of Asunción, Paraguay

La diseminación de las infecciones de transmisión sexual/síndrome de inmunodeficiencia adquirida(ITS/SIDA) se presenta principalmente en jóvenes, con una tendencia creciente a la asociación conpobreza y falta de acceso a educación y salud pública. El objetivo del estudio fue explorar lasituación de riesgo y el conocimiento sobre el VIH/SIDA en niños de 9-15 años que asistían a loscolegios del Barrio Santa Ana y Ricardo Brugada. El consentimiento para el estudio fue solicitado alas autoridades del colegio y a los padres. Se les aplicó un cuestionario administrado por unaencuestadora, que incluía el nivel de conocimientos sobre los factores de riesgo, sobre las formasde prevención para la infección por VIH. Un total de 297 niños participaron en el estudio, 173(58%) de sexo femenino, la mayoría (86%) vivían en condiciones de hacinamiento. Del 28 % quetrabajaban, 66% de los varones eran vendedores ambulantes y el 49 % de las niñas eranempleadas domésticas. El 80 % no conocía las formas de transmisión del ITS/SIDA, ni que elpreservativo puede prevenir la transmisión. El 9% (11/24) de los varones y el 2% (3/173) de lasniñas tuvieron relaciones sexuales. El 10% refieren abusos sexuales. El 25% ingieren bebidasalcohólicas, el 2% consume drogas inhalantes. En conclusión, este estudio muestra un importantedesconocimiento sobre las ITS/SIDA, formas de prevenirlas, la falta de percepción de riesgo concondiciones ambientales y socioeconómicas que la favorecen. Estos resultados plantean la urgentenecesidad de iniciar campañas de prevención en este grupo

Angiotensin II type 1 receptor A1166C gene polymorphism and essential hypertension in San Luis

Essential hypertension is considered a multifactorial trait resulting from a combination of environmental and genetic factors. The angiotensin II type 1 receptor mediates the vasoconstrictor and growth-promoting effects of Ang II. The A1166C polymorphism of the AT1 receptor gene may be associated with cardiovascular phenotypes, such as high arterial blood pressure, aortic stiffness, and increased cardiovascular risk. We investigated the association between this A1166C polymorphism and hypertension in hypertense and normotense subjects from San Luis (Argentina) by mismatch PCR-RFLP analysis. Hypertense patients exhibited significant increases in lipid related values and body mass index. The frequency of occurrence of the C1166 allele was higher among patients with hypertension (0.19) than in the control group (0.06). No significant association was found between this polymorphism and essential hypertension in the study population, although the AC genotype prevalence was higher in patients with hypertension and positive family history of hypertension (32%) than in control subjects (12%). Patients with the A1166C polymorphism exhibited higher levels of serum total cholesterol, LDL-cholesterol and BMI than in control subjects. Taken together the genotype and biochemical parameters and considering the restrictive selection criteria used, the present results suggest a correlation between AT1 A1166C gene polymorphism and risk of cardiovascular disease.

Genetic and non-genetic effects on productive and reproductive traits of cows in dual-purpose herds in southeastern Mexico

Data on productive and reproductive performance of cows in dual-purpose herds were analyzed to determine the effect of some environmental and genetic factors on saleable milk yield (SMY), lactation length (LL), daily saleable milk per lactation (DMYL), calving interval (CI), and daily saleable milk per calving interval (MYCI) in dual-purpose herds in Yucatan, Mexico. Repeatabilities (re) for these traits were also estimated. Data were obtained from monthly visits to 162 herds from 1996 to 2000. The fixed factors studied were: region (central, eastern and southern), parity number (1 to 6), calving year (1996 to 2000) and calving season (dry, rainy and windy and rainy), genetic group (low- (< 0.50%), medium- (50%) and high- (> 50%) grade cows with European genes). About 2700 to 7700 cows were evaluated for each trait. All factors had significant effects (P < 0.05) on the traits except for region on CI and calving season on DMYL. The overall means for SMY, LL, DMYL, CI, and MYCI were: 1322.3 +/- 80.5 kg, 224.8 +/- 1.3 days, 5.8 +/- 0.1 kg, 555.1 +/- 16.5 days, and 3.0 +/- 0.1 kg, respectively. The re values for SMY, LL, DMYL, CI, and MYCI traits were: 0.19 +/- 0.03, 0.08 +/- 0.04, 0.16 +/- 0.04, 0.00 +/- 0.08, and 0.08 +/- 0.07, respectively. First parity cows had lower SMY, shorter LL, longer CI, and lower MYCI means than cows with more than one parity. Medium grade cows produced more SMY, DMYL and MYCI and had shorter CI than low- and high-grade cows. Therefore, under Yucatan conditions medium-grade cows should be exploited, and more attention should be given to first parity cows in order to improve the productivity in the herd. The relatively high re estimates for SMY and DMYL can be used to calculate most probable producing abilities, in order to identify which cows should be culled.

Diarrea asociada a Clostridium difficile: frecuencia de detección en un centro médico de Buenos Aires, Argentina / Clostridium difficile diarrhea: frequency of detection in a medical center in Buenos Aires, Argentina

Clostridium difficile has been recognized as the most important enteric pathogen of nosocomial antibiotic-associated diarrhea (CDAD) in adults from industrialized countries. The importance of C. difficile as a cause of diarrhea in ambulatory patients appears underestimated or under-recognized. Since the 1980's, outbreaks of CDAD have been increasingly reported, but there are few data available in Argentina. We developed a retrospective study to provide some information about CDAD in our country. From July 1998 to November 1999, a total of 245 fecal specimens from hospitalized and some ambulatory patients were tested in order to confirm the diagnosis of CDAD. C. difficile cytotoxin (toxin B) was identified by detecting its cytopathic effect on monolayers of McCoy culture cells. For culture and isolation of C. difficile, stool samples were prepared by ethanol shock prior to plating onto a selective medium which contained blood, cefoxitin and fructose. Of the 245 samples, 14 (5.8) were identified as positive by the cell cytotoxicity assay. Using the criteria of isolation of cytotoxigenic C. difficile positivity increased to 6.5 (16 samples). Thirteen of the positive results were from hospitalized patients (81.3) and 3 (18.7) from outpatients. The mean age of inpatients was 72.9 years (ranging from 47 to 88). All patients had received 2 or more antimicrobial agents (most of them beta-lactams) 2 months before the appearance of diarrhea. There was one patient who had received only chemotherapy. The prevalence of CDAD in this study was less than in others previously reported. This difference may be due to the fact that not all general practitioners include testing for C. difficile when the patient with diarrhea had previously received antibiotics. More educational programs should be directed to all physicians, concerning the role of C. difficile as an important enteric pathogen in patients who have undergone treatment with antimicrobial or chemotherapeutic agents.