Sulfohemoglobinemia secundaria a zopiclona. Casos clínicos / Sulfhemoglobinemia secondary to the use of zopiclone. Report of two cases

Sulfhemoglobin (SulfHb) is formed by hemoglobin (Hb) oxidation by sulfur compounds. Sulfhemoglobinemia is mainly associated with drugs or intestinal bacterial overgrowth. Patients present with central cyanosis, an abnormal pulse oximetry and normal arterial oxygen partial pressure. These features are shared with methemoglobinemia (MetHb) whose diagnosis requires an arterial co-oximetry. Depending on the device used, SulfHb may produce interference with this technique. We report two females aged 31 and 43 years, consulting at the emergency room with cyanosis. Both had a history of acute and chronic, high dose zopiclone ingestion. Pulse oximetry showed desaturation but with normal arterial oxygen partial pressure. Cardiac and pulmonary diseases were ruled out. Co-oximetry in two different analyzers showed interference or normal MetHb percentages. No other complications ensued, and cyanosis decreased over days. Since MetHb was discarded among other causes of cyanosis in a compatible clinical context, the diagnosis of sulfhemoglobinemia was made. The confirmatory method is not available in Chile. The presence of SulfHb is difficult to diagnose, confirmatory tests are not readily available, and it frequently interferes with arterial co-oximetry. This is attributed to a similar absorbance peak of both pigments in arterial blood. Venous co-oximetry can be useful in this context. SulfHb is a self-limited condition in most cases, however it must be differentiated from methemoglobinemia to avoid inappropriate treatments like methylene blue.

Investigaciones en salud mental infanto-juvenil en Chile durante la pandemia de COVID-19: una revisión de alcance / d and youth mental health research in Chile during the COVID-19 pandemic: a scoping review

En todo el mundo se han descrito efectos negativos de la pandemia de COVID-19 en la salud mental, especialmente en la población infanto-juvenil. Sin embargo, en Chile, la investigación disponible aún no se ha sistematizado. El objetivo de este estudio fue revisar sistemáticamente las publicaciones científicas sobre salud mental infanto-juvenil en Chile durante la pandemia de COVID-19. Se buscaron reportes de investigación en las bases de datos WoS, Scopus, SciELO y LILACS. Se incluyeron 13 estudios que cumplieron los criterios de inclusión. Los estudios son heterogéneos en cuanto a sus objetivos e instrumentos utilizados. Varios estudios coinciden en que hay un aumento de los síntomas internalizantes, externalizantes y somáticos en la población infanto-juvenil desde la pandemia. Es necesario promover investigaciones colaborativas y longitudinales e investigaciones que evalúen la eficacia de intervenciones preventivas y terapéuticas. Estos resultados pueden ser útiles para clínicos, académicos y tomadores de decisión en políticas públicas para que puedan adoptar medidas para mejorar la salud mental de esta población. Palabras Clave: Salud mental, niños, adolescentes, jóvenes, COVID-19.

Abstract. Negative effects of the COVID-19 pandemic on mental health have been described worldwide, especially in the child and youth population. However, in Chile, the available research has not yet been systematized. This study aimed to systematically review scientific publications on child and youth mental health in Chile during the COVID-19 pandemic. The WoS, Scopus, SciELO, and LILACS databases were searched for research reports. Thirteen studies that met the inclusion criteria were included. The studies are heterogeneous in terms of their objectives and instruments used. Several studies agree that there is an increase in internalizing, externalizing, and somatic symptoms in the child and youth population since the pandemic. There is a need to promote collaborative and longitudinal research, and research that evaluates the efficacy of preventive and therapeutic interventions. These results may be useful to clinicians, academics, and public policymakers so that they can take steps to improve the mental health of this population. Keywords: Mental health, children, adolescents, youth, COVID-19.

Jejunal hemorrhage syndrome in a Zebu cow in Brazil / Síndrome de jejuno hemorrágico em gado Zebu no Brasil

Clostridium perfringens type A has been incriminated as the etiologic agent in jejunal hemorrhage syndrome (JHS), which is a disease that affects dairy cattle. Although this microorganism is considered an important enteropathogen the pathogenesis of JHS is still not clear, and there have been no reports of its occurrence in Brazil so far. The aim of this study was to describe the occurrence of JHS by infection with a C. perfringens type A strain carrying the beta-2 toxin gene in a zebu cow in Brazil, for the first time.

Clostridium perfringens tipo A tem sido considerado agente etiológico da síndrome do jejuno hemorrágico (SJH), que é uma doença que afeta comumente os rebanhos de gado. Embora este microrganismo seja considerado um importante enteropatógeno, a patogênese da SJH ainda não foi elucidada, e não havia sido reportada no Brasil até então. O alvo deste estudo foi descrever pela primeira vez a ocorrência da SJH causada por C. perfringens tipo A, carreador do gene da toxina beta-2, em um zebuíno no Brasil.

Entre tomas, sobijos y consultorios: prácticas en la atención del embarazo-parto en el municipio del Charco, Costa Pacífica Colombiana / Between shots, shelters and clinics: practices in pregnancy-childbirth care in the municipality of Charco, Colombian Pacific Coast

Las alteraciones en la salud constituyen uno de los hechos más frecuentes que afectan la vida cotidiana de los conjuntos sociales, de esta manera, los individuos se encuentran permanentemente enfrentados a la necesidad de elaborar prácticas para la recuperación de la salud, bajo un contexto histórico, geográfico, cultural y socioeconómico determinado. A partir de esta investigación se realiza un acercamiento a las prácticas, los usos y respuestas cotidianas construidas frente al proceso salud-enfermedad-atención, enfocándose particularmente en el proceso de atención del embarazo-parto en el municipio de el Charco-Nariño, Costa Pacífica colombiana. El propósito fue describir y analizar las prácticas a las que recurre un grupo de mujeres afrocolombianas para el cuidado y la atención de su proceso de gestación, bajo las condiciones particulares de los diferentes escenarios de atención presentes en el municipio. Para lograr este objetivo se asume el embarazo-parto como un hecho social, enfocando la mirada en los diferentes escenarios de atención, los diversos agentes y las relaciones sociales que se articulan durante el dicho proceso.

Aspectos radiográficos de periostite ossificante em metatarso de vaca Holandesa / Radiografic aspects of ossifying periostitis in metatarsus of Holstein cow

Periostite ossificante é uma neoformação óssea inflamatória extensa, frequentemente oriunda de infecção de tecidos moles adjacentes ao osso afetado, sendo mais proeminente nos bovinos, especialmente em animais jovens. Neste trabalho, é descrito um caso de periostite ossificante no osso metatársico III direito de uma vaca Holandesa após trauma. O diagnóstico foi realizado com base nos achados clínicos e radiográficos e confirmado cirurgicamente.

Ossifying periostitis is an extensive inflamatory new bone formation frequently extensive from soft tissue infection next to these bones. It is more observed in young bovines. A case of pos traumatic ossifying periostitis in the right metatarsus of a Holstein cow is described. The diagnosis was made based on clinical and radiographic findings and confirmed cirurgically.