Características epidemiológicas del síndrome de Guillain-Barré en población chilena: estudio hospitalario en un período de 7 años / Clinical features of Guillain-Barré syndrome in 41 patients admitted to a public hospital

Background: Guillain-Barré syndrome (GBS) is the commonest cause of acute flaccid paralysis worldwide, with an incidence of 0.6-4 per 100.000 inhabitants per year. It affects all age groups and carries an incapacity burden of up to 20%. Aim: To describe the features of GBS in adult Chilean patients admitted to a tertiary care hospital. Material and Methods: Review of medical records of 41 patients aged 17 to 81 years (30 males) admitted to a public hospital with the diagnosis of GBS between 2003 and 2009. According to clinical and electrophysiological criteria, the patients were classified into different varieties of GBS. Results: The incidence of GBS was higher in males (2.7:1) and the demyelinated GBS variety was found in 66% of cases. According to the Hughes’ disability score, patients treated with plasmapheresis, showed non-statistically significant better outcomes than those treated with intravenous immunoglobulin. Conclusions: In this group of patients the demyelinated variety of GBS was more common than the axonal type. Although not statistically significant, the better response to plasmapheresis is encouraging and should prompt a controlled study.

Colonização bacteriana nas primeiras 24 horas das queimaduras / Bacterial colonization in burns patients before 24 hours

Introdução: Segundo a Sociedade Brasileira de Queimaduras, no Brasil acontecem 1 milhão de casos de queimaduras a cada ano. As queimaduras estão entre as principais causas externas de morte registradas no país. Sua alta taxa de mortalidade deve-se, principalmente, à infecção da ferida por micro-organismos, podendo evoluir para septicemia. Diante destas estatísticas, torna-se necessário um monitoramento contínuo da microbiota da escara do queimado. Os micro-organismos podem ser originários de locais diversos, como do próprio acidente ou até mesmo da pele íntegra ao redor das lesões. A ferida da queimadura a princípio é estéril, se não foram colocados materiais contaminados sobre a área queimada ou se o paciente não tiver caído sobre superfícies sujas. Este período, considerado estéril, varia de 24 a 72 horas. Por meio da análise microbiológica realizada com a técnica swab, o Staphylococcus aureus é o germe mais frequentemente encontrado nas lesões por queimadura, seguido da Pseudomonas aeruginosa e Escherichia coli. Objetivo: Analisar qualitativamente a microbiota colonizadora das lesões provocadas por queimaduras, nas primeiras 24 horas do ocorrido, em 25 pacientes atendidos no Centro de Tratamento de Queimados (CTQ) do Conjunto Hospitalar de Sorocaba. Métodos: Foi aplicado o Termo de Consentimento Livre e Esclarecido e um questionário aos pacientes e, posteriormente, foram estudadas as amostras da margem e da área central da ferida pela técnica de coleta com uso de swab estéril. Resultados: Das 50 amostras analisadas no laboratório de microbiologia, 15 (60%) pacientes possuíam positividade para colonização de micro-organismos tanto na região central quanto na margem destas. Nas amostras obtidas da região central da lesão, pudemos encontrar seis colonizadas pelo micro-organismo Staphylococcus sp e oito por Staphylococcus aureus...

Introduction: According to Brazilian Burns Society, about a million new cases of burn injuries occur in Brazil each year. Burn injuries are one of the main causes of external death in the country. Its high mortality rate is mainly because of the local infection of the wounds by microorganisms, with the capability to evolve to sepsis. So, its mandatory a continuous follow-up of the most common germs on the burn wounds. The microorganisms can be originally from several places, as the patient itself or even the healthy skin between the wounds.The burns wound initially is sterile, if no contaminated materials are put on the burn area or if the patient have not fell on dirty surfaces. This time gap, from 24 to 72 hours, is considered clean or sterile. Trough microbiological analysis with a swab technic, Staphylococcus aureus is the most frequently found germ on burn wounds, followed by Pseudomonas aeruginosa and Escherichia coli. Objective: quantitative analysis of the microbiota of the burn wounds, in the initial 24 hours of the injurie, in 25 patients from the Burns Unit of “Conjunto Hospitalar de Sorocaba” in Sorocaba-São Paulo. Methods: It was applied an authorization term to the study and a questionary was answered. Samples taken with swab technic from the center and periphery of the wounds were analysed. Results: In anammount of 50, 15 samples (60%) of the patients were tagged positive with peripheric and central colonization of microorganisms. In the sample’s central portion, 6 were colonized by Staphylococcus sp and 8 by Staphylococcus aureus. Conclusion: Burn wounds in the initial 24 hours are colonized with microorganisms. The main microbiota is similar to the previously consulted literature. With this conclusion, the early microbiological analysis seems pertinent to the confirmation of wound colonization and the following care to prevent its infection, contributing ndirectly to the decrease of morbidityand mortality related to burning.

Evaluación de instituciones de cuidados prolongados para ancianos en el Distrito Federal. Una visión crítica / Evaluation of long-term care institutions for the elderly in Mexico City. A critical viewpoint

Analizar la infraestructura, el personal y la organización aistencial de las institutciones de cuidados prolongados para ancianos en el Distrito Federal y describir el estado funcional y los requerimientos asistenciales de sus beneficiarios. Material y métodos. Se censaron las instituciones ubicadas en el área metropolitana de la Ciudad de México (115), y se clasificaron en tres categorías: instituciones privadas con fines lucrativos, instituciones de la Junta de Asistencia Privada (JAP) y las gubernamentales. A partir de esta clasificación, se seleccionaron aleatoriamente 33 instituciones que fueron evaluadas mediante la encuesta de firevicius. Asimismo, se aplicó la escala de Kuntzman para evaluar a 617 residentes (31.5 por ciento del total). Resultados. El promedio de calificación se ubicó por debajo de 50 por ciento respecto a una puntaje total máximo de 280. Las instituciones privadas con fines lucrativos y un subgrupo de instituciones oficiales obtuvieron los más bajos puntajes; los más elevados fueron para las institutiones de la JAP y del Sistema Nacional para el Desarrollo Integral de la Familia. En general, las carencias más signficativas se ubicaron en infraestructura, calidad de personal y formación profesional. La edad promedio de los residentes es de 76 años; al contrastrar el estado funcional promedio de los ancianos con las características de la institución, encontramos una absoluta falta de correlación entre los recursos asistenciales disponibles y los requerimientos de la población. Conslusiones. La calidad de la atención que se brinda en instituciones de cuidados prolongados es con frecuencia deplorable, en particular dentro de las privadas. La ausencia de una normatividad y supervisión adecuadas ha permitido la proliferación de instituciones no calificadas para brindar sus servicios. Ante la disordancia entre los recursos disponibles y los requerimientos asistenciales, es necesario revisar las políticas de selección para el acceso de los ancianos a las instituciones, así como crear modalidades de capacitación en el trabajo

To critically analyze the level and quality of infrastructure, human resources and organization of long term care institutions for the elderly in Mexico City and to describe the functional status and care requirements of their residents. Material and methods. A census was made of the institutions located in the metropolitan area of Mexico City which totalled 115. These were classified according to their belonging to the public or private sector (for profit and non-profit). In each category we made a random selection of 33 institutions which were all assessed according to the methodology described by Firevicius and applied by paho in several countries in Latin- America. This questionnaire was applied by a single interviewer. Within the selected institutions, 30% of the residents, who were also randomly selected, were assessed by means of the Kuntzman's care requirements scale. Out of a total population of 1955, 617 (34%) residents were assessed. Results. The mean score obtained by the institutions was under 50% of the maximum possible score with a great deal of dispersion of the results. The lowest scores were identified in the private for profit sector and in a subgroup of public institutions. The highest scores were found among private non-profit institutions and a sector of the public institutions. The most important shortcomings identified were related to infrastructure and quality of human resources. The mean age of the institutionalized elderly is 76; 48.1% are functionally independent, 21.3% partially dependent and 30.6% totally dependent. When trying to correlate the mean functional status of the population of a given institution with its resources for care-giving we usually found no correlation. It is commonplace to find highly dependent populations living in poorly staffed or inadequately equipped institutions and vice versa. Conclusions. Quality of care in long term care institutions in Mexico City is often poor and this is particularly true for private for profit institutions. Lack of norms and supervision pertaining to the functioning of such institutions contributes greatly to this reality.

Garantía de la calidad de los laboratorios de microbiología alimentaria

Señala criterios mínimos que debe tener en cuenta un laboratorio de microbiología y alimentos, para el desarrollo de su programa de control de calidad, para evaluar la confiabilidad de la información que proporciona. Presenta la organización del programa de control de calidad y de los diversos componentes: recursos materiales, físicos y humanos que influyen en la validez de la información producida. Incluye pautas para el diseño de laboratorios, organización del personal, mantenimiento preventivo de los equipos y normas de higiene y seguridad

Las comidas callejeras en la ciudad de la Paz / The street meat in the city of La Paz

Un analisis socioeconomico de las vendedoras de comidas callejeras, como tambien las del consumidor, hace un estudio microbiologico de todas las comidas que se venden en la calle dandose a conocer la composicion y valor nutritivo de dichas comidas

Grupos vulnerables en las economías en el desarrollo: el caso boliviano / Vulnerable groups in development economy the bolivian situation

El presente trabajo trata del Desarrollo y Pobreza en Bolivia, poniendo particular énfasis en los problemas relativos a la salud, nutrición y educación, siguiendo la guía establecida por UNICEF. Ese es el objeto del presente texto, en el que se intenta describir los principales rasgos de la sociedad boliviana asociados a su doble herencia cultural y algunos puntos en relación a la organización de su economía.

Health education and promotion and food safety

The thrust of interpersonal community health education is not only to develop new methods and technologies for transmitting health messages, but to more effectively utilize old media that already exist. Channels such as the family, informal clubs and gatherings in the community or the work place and trained community leaders are becoming more widely used. This públication is composed of seven Annexes. Annex I is entitled "Review of Social Science Research in Health Communications, Education and Community Participation - Analysis and Recommendations". Annexes II to VII provide some examples of what countries in Latin América and the Caribbean are doing in health education to promote safe and healthy handling of foods. It is important to note that educational materials have not taken into consideration the target audience in the design and testing processes to ensure that messages are clearly communicated, nor have the specific characteristics of the audience (education, culture, age, litercy and economic levels) been taken into consideration. Additionally, the materials included here reveal that existing community groups and structures are not utilized to the fullest extent possible, which would have helped to ensure community support and continuity for the behavior changes being sought

Importancia del recuento de eosinófilos en secreciones respiratorias de lactantes con síndrome bronquial obstructivo recurrente / Usefulness of the eosinophil recount in respiratory secretions in bronchial obstructive syndrome of infants

El aumento de eosinófilos en secreciones del tracto respiratorio se ha relacionado con formas clínicas más severas del síndrome bronquial obstructivo recurrente (SBOR). Hemos comparado 200 lactantes menores de dos años con esta enfermedad; 100 con eosinófilos nasales o bronquiales positivos en proporción igual o mayor a a 10%, y 100 con eosinófilos negativos. El grupo de niños con recuento de eosinófilos positivos tuvieron un promedio mayor de hospitalizaciones (p<0.02), mayor número de crisis bronquiales obstructivas (p<0.005) y mayor severidad de la enfermedad (p<0.003), en comparación con el grupo de lactantes con eosinófilos negativos. - Estos resultados sugieren que el recuento de eosinófilos igual o mayor a 10% en secreciones respiratorias es un examen útil para identificar a un grupo de lactantes con SBOR de evolución más severa, haciendo recomendable la implementación de planes especiales de atención, tratamiento y control de este grupo de alto riesgo