Caracterización de una población pediátrica seguida en una clínica de anticoagulación / Description of a pediatric population followed at an anticoagulation clinic

Resumen Introducción: En la población pediátrica, el 95% de las tromboembolias venosas son secundarias a un factor de riesgo; la presencia de catéter venoso central es el factor de riesgo más importante para el desarrollo de trombosis venosa profunda en esta población. Los estudios en población adulta sobre el uso de anticoagulantes se han extrapolado a la población pediátrica, y por ello es importante tener en cuenta las características diferenciales entre ambas poblaciones. Método: Se realizó un estudio descriptivo en el que se revisaron 2300 registros clínicos de pacientes seguidos por la Clínica de Anticoagulación institucional desde 2011 hasta 2019, buscando identificar pacientes menores de 18 años que hubieran recibido manejo anticoagulante ambulatorio. Resultados: Se encontraron 43 pacientes menores de 18 años, el 60% de sexo femenino, con una edad promedio de 9.8 ± 5.2 años. El antecedente patológico más prevalente fueron las valvulopatías (28%). Las principales indicaciones para recibir manejo anticoagulante incluyeron cardiopatías congénitas (21%), prótesis valvular cardíaca mecánica (21%, 5 aórticas y 4 mitrales) y trombosis venosa profunda (14%). La warfarina se utilizó en el 72% de los pacientes. El 81% de los pacientes recibieron tratamiento anticoagulante extendido. Las principales complicaciones durante el tratamiento anticoagulante fueron sangrado ginecológico y cutáneo, así como trombocitopenia. Conclusiones: Las cardiopatías congénitas y las valvulopatías cardíacas son las principales indicaciones para considerar el manejo anticoagulante en la población pediátrica. La warfarina es el medicamento más utilizado en forma ambulatoria en esta población. La adherencia adecuada y el seguimiento ambulatorio en esta población requieren herramientas adicionales para lograr un excelente tratamiento anticoagulante.

Abstract Introduction: In pediatric patients, 95% of venous thromboembolisms are secondary to a risk factor; the presence of central venous catheter is the most important risk factor for the development of deep vein thrombosis in this population. Studies about anticoagulation treatment in adult patients have been extrapolated to the pediatric population, it is important to consider the differential characteristics between these two populations. Method: A descriptive study was conducted; there were reviewed 2300 clinical records of patients followed by the institutional anticoagulation clinic from 2011 to 2019, looking for underage patients who have received ambulatory anticoagulation treatment management. Results: 43 patients under the age of 18 years old were found. 60% were female and the average age was 9.8 ± 5.2 years. The most prevalent pathological antecedent was valve disease (28%). The main indications for anticoagulant treatment included congenital heart disease (21%), mechanical heart valves (21%, 5 aortic and 4 mitral) and deep vein thrombosis (14%). Warfarin was found in 72% of patients. 81% of patients received extended anticoagulation therapy. The main complications during anticoagulant treatment included gynecological and cutaneous bleeding, as well as thrombocytopenia. Conclusions: Congenital heart disease and heart valve disease are the main indications for considering anticoagulation treatment in the pediatric population. Warfarin is the most formulated anticoagulant in this outpatient population. Adequate adherence and outpatient follow-up in requires additional tools to achieve excellent anticoagulant treatment.

Elaboración de harinas procesadas de semilla de gandul / Preparation of flour processed with pigeon pea seed

Pigeon pea is a legume grain of good production capacity and of a relatively high nutritive value, which has not been used in Latin America on the basis of the potential it offers. In this study experiments were conducted to learn about the possibility of processing pigeon pea to yield an intermediate flour with good functional characteristics for food product development. The intermediate pigeon pea flour was produced through a selection of a process to efficiently dehull the grain followed by a thermic process to improve its functional properties and nutritive value. The best dehulling process was subjecting the grain to a vapor treatment for five minutes, followed by a 2-hour dehydration of surface moisture with air at 60 degrees and dehulling with an 8-disc dehuller for 10 minutes. Yield was 84 per cent with 70.7 per cent dehulling efficiency. Pigeon pea flours were prepared by three thermic processes: pressure cooking at 15 lb (121 degrees C) for 5 and 10 minutes as a reference product; cooking and drying with a drum dryer at 120 degrees C and 4 rpm and by extrusion-cooking with the material with 18 and 21 per cent moisture at 270 and 300 degrees F, respectively. Process selection was based on the functional properties such as water absorption index, water solubility index, soluble nitrogen and viscosity, through chemical analysis of protein, available lysine and methionine and residual trypsin inhibitors, and through a biological evaluation of protein digestibility and quality. Both pressure cooking products had similar functional and chemical characteristics, however, the 5-minute cooked product has higher protein quality than the 10-minute product.(ABSTRACT TRUNCATED AT 250 WORDS)

Estudios sobre la posibilidad de aplicación de la harina de gandul en productos elaborados a base de arroz o harina de trigo / Possibility of using flour of pigeon pea in products prepared with rice or wheat flour

The present study reports on the development of foods containing processed pigeon pea (Cajanus cajan) flour. The pigeon pea flours described in a previous publication were prepared from dehulled pigeon peas by cooking in autoclave, by extrusion-cooking and by cooking/dehydration by drum-drying. Mixtures of cooked pigeon peas and rice were first evaluated biological through a protein complementation design using NPR. The results of this study showed that the two products had high protein quality and were similar when mixed in ratios of 80:20 to 40:60. For the evaluation of the processed pigeon pea flour, mixtures with rice (80:20) were used. All pigeon pea flours gave similar protein quality values. On the basis of these results three products were developed and tested. One was a gruel ( atole ), a second a fruit-flavored thick drink with and without 15 per cent milk. Cookies were also prepared with a series of blends of pigeon pea flour (extrusion-cooked) and wheat. The gruel and the fruit flavored products had high acceptability based on a sensory evaluation test. Cookies with 100 per cent pigeon pea flour were unacceptable, however, mixtures of 75 per cent wheat flour and 25 per cent pigeon pea flour gave cookies of attractive appearance and good taste. The study showed the possibility of preparing and utilizing tropical grain legume flours for food products of relatively high acceptability and nutritive value