Utilidad del CANs SCORE para valoración clínica del estado nutricional del recién nacido de término / Utility of the CANs SCORE for clinical assessment of the nutritional the new born status of

Se conoce que la Desnutrición Fetal predispone a una mayor morbimortalidad perinatal, secundaria a sufrimiento fetal, aspiración de meconio, asfixia, hipoglucemia neonatal y síndrome de hiperviscosidad. También se asocia, a medio-largo plazo, a un mayor riesgo en comparación con la población general de presentar trastornos neurológicos o mentales (trastornos cognitivos y del aprendizaje), complicaciones endocrinológicas, metabólicas y cardiovasculares, por lo que sería conveniente identificar a estos recién nacidos precozmente, para promover una vigilancia e intervención adecuadas. Objetivo: demostrar la utilidad de la Evaluación Clínica Neonatal utilizando el CANs SCORE (Evaluación Clínica del Estado Nutricional), desarrollado y publicado por Mettcoff en 1994. Métodos: se realizó un estudio piloto transversal de marzo a junio de 2018, en el Hospital "Cochabamba", de nivel II, seleccionando 50 recién nacidos a término que presentasen signos clínicos para desnutrición según la escala de Mettcoff. Se realizaron mediciones antropométricas completas y exámenes de parámetros de laboratorio relacionados. Se utilizaron comparaciones de medias y correlaciones con valores del score-Z calculado mediante la herramienta Intergrowth- 21st, para evaluar los datos. Resultados: se encontraron diferencias estadísticamente significativas entre los parámetros antropométricos básicos evaluados como peso, talla, perímetro cefálico. Además, la evaluación mediante la escala de Mettcoff permitió la detección de DESNUTRICIÓN FETAL en recién nacidos que de otra manera se clasificarían como de peso adecuado para la Edad Gestacional (AEG). En el laboratorio los hallazgos fueron: disminución o aumento de las concentraciones de algunos de los parámetros bioquímicos evaluados; los más llamativos fueron la disminución de los niveles de albúmina sérica; también disminución de las concentraciones de calcio en más del 90% de la población estudiada y una elevación sistemática de los valores de creatinina en la mayoría, 80% de los casos. Conclusiones: el puntaje CANs es una herramienta clínica útil, sencilla y de fácil aplicación que permite identificar con mayor precisión el grado de desnutrición en recién nacidos y podría validarse estadísticamente en series más amplias y estudios sistemáticos.

It is known that Fetal Malnutrition predisposes to greater perinatal morbidity and mortality, secondary to fetal distress, meconium aspiration, asphyxia, neonatal hypoglycemia and hyperviscosity syndrome. It is also associated, in the medium-long term, with a higher risk compared to the general population of presenting neurological or mental disorders (cognitive and learning disorders), endocrinological, metabolic and cardiovascular complications, so it would be convenient to identify these newborns with DF early in life to promote appropriate surveillance and intervention. Objective:to demonstrate the usefulness of the Neonatal Clinical Assessment using the CANs SCORE (Clinical Assessment of Nutritional Status), developed and published by Mettcoff in 1994. Methods: a transversal pilot study was carried out from March to June 2018, in the second level Hospital "Cochabamba" , selecting 50 term neonates who had a positive score for malnutrition according to the Mettcoff scale. Complete anthropometric measurements and examinations of related laboratory parameters were performed. Comparisons of means and correlations were used to evaluate the data with Z-score values calculated using the Intergrowth -21st toolª. Results: statistically significant differences were found between the basic anthropometric parameters as weight, height, head circumference evaluated. Furthermore, the evaluation using the Mettcoff scale allowed the detection of FETAL MALNUTRITION in newborns who are otherwise classified as having adequate weight for Gestational Age (AEG). In the laboratory, the main findings were: decreased or increased concentrations of some of the biochemical parameters evaluated: the most striking findings being decreased serum albumin levels; also decreased calcium concentrations in 100% of the studied population and a systematic elevation of creatinine values in most of 90% of cases. Conclusions: the CANs score is a useful, simple and easy-to-apply clinical tool that allows the degree of malnutrition in Newborns to be identified with greater precision and it could be statistically validated in larger series and systematic studies.

Avaliação da contaminação das superfícies de embalagens de alumínio de bebidas carbonatadas / Evaluation of the contamination of the aluminum packaging surfaces of carbonated beverages

O acondicionamento de bebidas carbonatadas em embalagens de alumínio e o aumento do consumo, intensifica a preocupação com relação à contaminação da superfície a ter contato com a boca e à necessidade da higienização das embalagens. O objetivo deste trabalho foi avaliar a contaminação microbiológica, por meio da pesquisa de coliformes totais, coliformes termotolerante, Escherichia coli, contagem total de bactérias aeróbias mesófilas e contagem total de bolores e leveduras, na superfície superior externa de latas de cervejas e de refrigerantes, refrigerados comercializadas em bares, restaurantes, ambulantes e quiosques; bem como avaliar a influência do selo de alumínio na proteção contra a contaminação em latas de cerveja. Foram avaliadas 90 latas de alumínio, sendo 30 seladas e 30 não seladas contendo cerveja e 30 latas não seladas contendo refrigerante. Os resultados mostraram que 34% das amostras estavam contaminadas por coliformes totais, sendo observado valor igual ou superior a 2400 NMP/cm² em uma amostra de cerveja selada e cerveja não selada, adquiridas de ambulante, e uma amostra não selada adquirida de bar. Quanto a coliformes termotolerante 2,2% das embalagens estavam contaminadas, sendo este detectado em duas amostras de cerveja não selada (4 e 7 NMP/cm²) proveniente de bar. Não foi detectada Escherichia coli nas amostras analisadas. Bactérias aeróbias mesófilas foram detectadas em 84 (93,3%) amostras, sendo a maior contagem observada em uma amostra de refrigerante adquirida de quiosque, com o valor de 2,8x10³ UFC/cm². A contaminação por bolores e leveduras foi observada em 59 (65,5%) amostras, sendo a maior contagem com o valor de 2,7x10³ UFC/cm², observada em uma embalagem de cerveja não selada. Concluiu-se que latas seladas ou sem selo apresentaram níveis de contaminação semelhante, indicando que o selo não promove proteção contra contaminação e as amostras que apresentaram maior contaminação foram aquelas refrigeradas em caixas de isopor com água e gelo.

The packaging of carbonated beverages in aluminum packaging and the increase in consumption increases the concern with regard to contamination of the surface to have contact with the mouth and the need for hygiene of the packages. The objective of this study was to evaluate the microbiological contamination of the external surface of beers and refrigerated cans, commercialized in bars, restaurants, street vendors and kiosks; as well as to evaluate the influence of the aluminum seal in the protection against contamination in beer cans. the following analyzes were performed: total coliforms, thermotolerant coliforms, Escherichia coli, count of mesophilic aerobic bacteria and counts of molds and yeasts. Ninety aluminum cans were evaluated, of which 30 were sealed and 30 unsealed containing beer and 30 unsealed cans containing refrigerant. The results showed that 34% of samples were contaminated by total coliforms, with a value of 2400 NMP / cm² being observed in a sample of sealed beer and unsealed beer, purchased on the street, and an unsealed sample purchased from the bar. Regarding thermotolerant coliforms, 2.2% of the packages were contaminated, being detected in two samples of unsealed beer (4 and 7 NMP / cm²) from the bar. No Escherichia coli was detected in the analyzed samples. Mesophilic aerobic bacteria were detected in 84 (93.3%) samples, the highest observed in a sample of kiosk purchased refrigerant, with a value of 2.8x10³ CFU / cm². Contamination by molds and yeasts was observed in 59 (65.5%) samples, the highest count being 2.7x10³ CFU / cm², observed in an unsealed beer package. It was concluded that sealed or unsealed cans had levels of similar contamination, indicating that the seal does not promote protection against contamination and the samples that presented the highest contamination were those refrigerated in styrofoam boxes with water and ice.

Clinical Dosage Regimens of Voriconazole Evaluated by Monte Carlo Simulation / 中国药房

OBJECTIVE:To provide reference for clinical individual medication of voriconatole. METHODS:The distribution of MIC of voriconazole to Aspergillus fumigatus and Candida albicans were summarized as well as the pharmacokinetic parameters of voriconazole in different populations. Using probability of target attainment(PTA)and cumulative fraction of response(CFR)as indexes,crystal ball software 11.1.2.4 was used for Monte Carlo simulation of different dosage regimens of same population and same dosage regimen of different populations. RESULTS:For children with impaired immunity,when the drug doses of were 4,6 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%;when the drug doses was increased to 8 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%. For different populations receiving same dosage regimens(4 mg/kg),MIC of teenagers with impaired immunity was lower than 0.25 mg/L and those of healthy adults,patients underwent hematopoietic stem cell transplantation and adults with impaired immunity were all lower than 0.5 mg/L,PTA was higher than 90%. CFR to A. fumigatus were 42.53%,58.41%,77.74%,70.16%,89.40%,93.72%,95.42% and CFR to C. albicans were 96.68%,97.13%,97.94%, 97.54%,98.07%,98.28%,98.35%among children with impaired immunity receiving different drug doses(4,6,8 mg/kg)and dif-ferent populations receiving drug dose of 4 mg/kg(teenagers with impaired immunity,healthy adults,patients underwent hemato-poietic stem cell transplantation,adults with impaired immunity). CONCLUSIONS:Various dosage regimens of different popula-tions included in this study could effectively control C. albicans infection. It is necessary to increase the drug dose of children and teenagers with impaired immunity in order to meet the needs of A. fumigatus infection treatment.

A Study Of Work Related Complaints Of Arm, Neck And Shoulder (Cans) Among Office Workers In Selangor And Kuala Lumpur

The computer is well known as one of the important tools in the office that gives a lot of benefits but silently leads to musculoskeletal pain. There are many different kinds of musculoskeletal complaints pain but the most common seen among computer users in developed countries is the complaint of arm, neck and shoulder (CANS). Despite this, definite factors that can be associated with the prevalence of CANS have not been established. This study was conducted to identify the prevalence and factors associated with work-related complaints of arm, neck and shoulder (CANS) among office workers in Selangor and Kuala Lumpur. A survey study design was conducted where 110 (n=110) office workers were recruited from around the Selangor and Kuala Lumpur area for 5 months periods. Participants were required to answer the Maastricht Upper Extremity Questionnaire (MUEQ) and the Level of Ergonomic Knowledge Questionnaire. The study showed the highest percentage of CANS reported was at neck region (53.6% of participants), followed by shoulders with 53.0%. The majority of participants have low level of computer ergonomic awareness where only 19.09% (n=21) from government sector and 10% (n=11) office workers from private sector reported knowledge of ergonomics. Majority of the participants did not have the know-how in implementing correct computer ergonomics. However there was a weak association (r=<0.5) between CANS with work-related risk factors (work station, body posture, break time and social support), duration of hours using a computer and levels of ergonomic knowledge.

Rapid Determination of Bisphenol Diglycidyl Ethers and Its Migration Regulations in Interior Coating of Food Cans / 分析化学

A rapid and simple ultra performance liquid chromatographic method for determination the specific migration of bisphenol A diglycidyl ether ( BADGE ) , bisphenol F diglycidyl ether ( BFDGE ) and their derivatives in food simulants was developed. Water, 3% acetic acid, 10% ethanol and sunflower oil were used as food simulants to simulate the specific migration of bisphenol diglycidyl ethers from interior coating of food cans after 10 days storage at 60℃. After the migration period, the aqueous food simulants were directly measured without any further purification, while the sunflower oil simulant was extracted by acetonitrile followed by cleaning up using solid phase extraction. Among the migration process, BADGE and bisphenol A (3-chloro-2-hydroxypropyl)glycidyl ether (BADGE·HCl) migrated into aqueous simulants were hydrolysed into bisphenol A bis ( 2, 3-dihydroxypropyl ) ether ( BADGE · 2H2 O ) and bisphenol A ( 3-chloro-2-hydroxypropyl) (2,3-dihydroxypropyl) ether (BADGE·H2O·HCl), respectively. However, BADGE and BADGE·HCl migrated into sunflower oil were not hydrolysed. The calibrating curves showed a good linearity from 0. 05 to 10 mg/L for all the 9 target compounds. The detection limits of the method for aqueous food simulants and sunflower oil stimulant were 5μg/L and 20μg/kg, respectively. The method was applied to the determination of bisphenol diglycidyl ethers migrated from 10 kinds of food cans which were intended to contact with food. The results indicate that BADGE and its derivatives were detected at 5 of the cans, and the specific migration of BADGE(or BADGE·2H2O)and BADGE·HCl(or BADGE·H2O·HCl)in 1 cans even exceed the responding limitation regulated in EC/1895/2005 .

Pedicle Screw Placement under the Guidance of Computer-Assisted Navigation System / 中国微创外科杂志

Objective To investigate the clinical value of computer-assisted navigation system (CANS) in pedicle screw placement. Methods From August 2002 to June 2006, we carried out 66 cases of pedicle screw placement under the guidance of CANS; 66 cases of traditional pedicle screw placement were set as a control. Results The mean operation time of CANS group was significantly shorter [(142.3?5.3) min vs (173.4?7.1) min; t=-28.301, P=0.000] and the blood loss was significantly fewer [(798.3?10.9)ml vs (912.2?14.3) ml; t=-51.463, P=0.000] than those in the control. X-ray and CT scan respectively showed that the placement of pedicle screw in CANS group was significantly more accurate than that in the control. (?2=29.424, P=0.000; ?2=36.829, P=0.000). Conclusion Pedicle screw placement under the guidance of CANS is more accurate, safe, and micro-invasive than traditional operation.

Diagnosis and treatment of baseball elbow / 中华骨科杂志

Objective To evaluate the methods of early diagnosis and the surgical outcomes of se vere baseball elbow.Methods Six surgically treated cases of base ball elbow were included in this stud y.Two patients were treated with arthrosc opy to remove free loose bodies in elb ow joints and synovectomy.Another t wo patients had the big free loose bodie s removed with both arthroscopy and s urgical interventions through small incisions.The remaining 2underwen t d?bridement,cartilage repair and subchondral bone graft.Careful physical examinations as well as X -r ay,CT,3D -CT and MR were performed an d compared before and after operations.Results All the patients suffered from elbow pain and limitations of elbow extension.Limitations of elbow flexion and forearm supination could be seen in some severe cases.MRI was helpful for detecting early lesions.Compared with plain radiograph,it was more sensitive to conduct tomography or roentgenography at 45degrees flexion of elbow.3D -CT coul d illustrate the conditions of cartilage and free loose bodies vividly.T he patients were followed up with an average range of 8.2months postoperatively.The results were evaluated in 4aspects,which included elbow pain,range of motion,joint snap and image features.Three patients had ex-cellent results,two had good and one fair.Five patients got an average in crease of elbow extension for 10degrees.Two of them were competent f or their original job after operatio ns.One patient had gone back to the baseball fields after one-year rehabilitation.Conclusion Careful physical examination and im aging evalu-ations as MRI,tomography or roentge nography at 45degrees flexion of elb ow were essential for early diagnosis.For the patients suffering from base ball elbow,the best results could be obtained with early diagnosis and proper treatments.The surgical out comes tend to be better in the younger patients with the shorter duration o f the disease and less invasive treatm ents.[

Experience with an Image-Guided Surgery Device-CANS Navigator-

The authors describe their experience with the CANS navigator, which has been in use since January 1997. The device uses magnetic field modulation technology for intraoperative localization: using a built-in scanner, a preoperative image with fiducial markers is input to a computer, and intraoperative localization uses a suctiontube integrated probe. During the previous ten months, we have used the device to perform surgery in 60 cases of brain lesion, mostly tumors. In five early cases, precise intraoperative localization was not successful, probably due to error in image input or registration, but after 2 months, there were only two failures, and for surgery, the device was very helpful: it was useful in the dessign of scalp incisionand bone flap, and for assessing the extent of resection in tumors, especially in cases in which surrounding brain tissue was poorly demarcated. It was also helpful in skull base surgery, in which precise localization of the work area is critical. The CANS navigator uses a magnetic field for localization, but except for the skull clamp, there was no problem in using metallic surgical instruments: there was no interference with laser, CUSA, or monitoring devices, and no complication attributable to its use. We suggest that for neurosurgery, the CANS navigator is a useful device: it is helpful for performing minimally invasive surgery.