Escorpionismo en pediatría: estudio descriptivo, transversal y retrospectivo de factores predictores de gravedad / Pediatric scorpionism: a descriptive, cross-sectional, and retrospective study of predictors of severity

Introducción. El emponzoñamiento por Tityus carrilloi n. sp. representa una amenaza para la vida. Según las manifestaciones clínicas, se clasifica en leve, moderado y grave. Objetivo. Comparar las características epidemiológicas y bioquímicas en niños con escorpionismo leve, moderado y grave. Población y métodos. Estudio descriptivo, transversal y retrospectivo. Se analizaron las consultas de menores de 15 años picados por Tityus carrilloi n. sp. entre enero de 2017 y diciembre de 2018 en un hospital pediátrico de tercer nivel en Santa Fe (Argentina). Resultados. Se incluyeron 524 niños, el 81 % (421) con dolor local y el 19 % (103) con manifestaciones sistémicas. Los niños con síntomas sistémicos de escorpionismo fueron más pequeños en edad que los que presentaron manifestaciones locales (p <0,001). En el invierno los niños desarrollaron 8 veces más manifestaciones sistémicas de escorpionismo y durante la primavera, 2,4 veces más que durante el verano. De los 103 niños internados, 80 fueron casos moderados y 23, graves. No hubo diferencias entre grupos en edad (p = 0,29) ni en la demora en recibir suero antiescorpiónico (p = 0,81). El tiempo de internación fue mayor en los graves (p <0,001). Los valores de glóbulos blancos o glucemia mayores a 30 000 cel/ml y 300 mg/dl respectivamente estuvieron presentes casi exclusivamente en escorpionismos graves. Conclusión. En niños picados por el escorpión Tityus carrilloi n. sp., el riesgo de desarrollar manifestaciones sistémicas fue mayor cuanto menor fue la edad y durante el invierno y la primavera. Los valores de glóbulos blancos y de glucemia fueron mayores en niños con escorpionismo grave.

Introduction. Scorpion envenomation by Tityus carrilloi n. sp. represents a threat to life. Depending on its clinical manifestations, it is classified as mild, moderate or severe. Objective. To compare the epidemiological and biochemical characteristics among children with mild, moderate, and severe scorpionism. Population and methods. Descriptive, crosssectional, and retrospective study. The consultations at a tertiary care children's hospital in Santa Fe (Argentina) of children under 15 years of age stung by Tityus carrilloi n. sp. between January 2017 and December 2018 were analyzed. Results. In total, 524 children were included, 81% (421) with local pain and 19% (103) with systemic manifestations. Children with systemic symptoms of scorpionism were younger in age than those with local manifestations (p < 0.001). In the winter, children developed 8 times more systemic manifestations of scorpionism; during the spring, 2.4 times more than during the summer. Out of the 103 hospitalized children, 80 were moderate cases and 23 severe cases. There were no differences between age groups (p = 0.29) or in the delay in receiving the anti-scorpion serum (p = 0.81). The length of hospital stay was longer among severe cases (p < 0.001). WBC and blood glucose levels higher than 30 000 cell/mL and 300 mg/dL, respectively, were present almost exclusively in severe scorpionism cases. Conclusion. In children stung by the scorpion Tityus carrilloi n. sp., the younger the age and during winter and spring, the higher the risk for systemic manifestations. WBC and blood glucose levels were higher in children with severe scorpionism.

Microbiological and clinical effects of probiotics and antibiotics on nonsurgical treatment of chronic periodontitis: a randomized placebo- controlled trial with 9-month follow-up

ABSTRACT Objective: The aim of this double-blind, placebo-controlled and parallel- arm randomized clinical trial was to evaluate the effects of Lactobacillus rhamnosus SP1-containing probiotic sachet and azithromycin tablets as an adjunct to nonsurgical therapy in clinical parameters and in presence and levels of Tannerella forsythia, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Material and Methods: Forty-seven systemically healthy volunteers with chronic periodontitis were recruited and monitored clinically and microbiologically at baseline for 3, 6 and 9 months after therapy. Subgingival plaque samples were collected from four periodontal sites with clinical attachment level ≥1 mm, probing pocket depth ≥4 mm and bleeding on probing, one site in each quadrant. Samples were cultivated and processed using the PCR technique. Patients received nonsurgical therapy including scaling and root planing (SRP) and were randomly assigned to a probiotic (n=16), antibiotic (n = 16) or placebo (n = 15) group. L. rhamnosus SP1 was taken once a day for 3 months. Azithromycin 500mg was taken once a day for 5 days. Results: All groups showed improvements in clinical and microbiological parameters at all time points evaluated. Probiotic and antibiotic groups showed greater reductions in cultivable microbiota compared with baseline. The placebo group showed greater reduction in number of subjects with P. gingivalis compared with baseline. However, there were no significant differences between groups. Conclusions: The adjunctive use of L. rhamnosus SP1 sachets and azithromycin during initial therapy resulted in similar clinical and microbiological improvements compared with the placebo group.

Hiperinsulinismo congénito del recién nacido: A propósito de un caso clínico / Congenital hyperinsulinism of the newborn: a case report

El hiperinsulinismo congénito (HC) es la causa más frecuente de hipoglicemia persistente del recién nacido (RN), y se caracteriza por secreción no regulada de insulina frente a hipoglicemia. El manejo inicial es médico, pero en caso de fracaso, la pancreatectomía parcial es el tratamiento quirúrgico de elección. Objetivo: Comunicar el caso de un RN con HC con énfasis en el estudio genético, de imágenes y manejo quirúrgico, incluyendo la cirugía laparoscópica. Caso clínico: RN de término, con hipoglicemia prolongada por HC que no respondió al tratamiento médico. La ultrasonografía y resonancia nuclear magnética abdominal fueron normales. PET/CT Galio 68 evidenció aumento de metabolismo glucídico focalizado en el cuerpo pancreático. Se realizó pancreatectomía córporo-caudal laparoscópica sin incidentes, con mejoría de la hipoglicemia. El estudio genético fue compatible con HC focal, confirmado luego por biopsia. Conclusión: Se expone acerca de las características clínicas y diagnóstico del HC, en particular el rol de la cirugía y ventajas del abordaje laparoscópico.

Congenital hyperinsulinism (CH) is the most frequent cause of persistent hypoglycemia in the newborn and it is characterized by an inappropriately elevated insulin level in presence of hypoglycemia. Initial management is medical treatment, but if it fails, partial pancreatectomy is the surgical procedure of choice. Objective: To report a case of a newborn with CH to aware on this condition and update its multidisciplinary management. Case report: The case of a full term newborn with severe symptomatic hypoglycemia unresponsive to medical treatment is reported . Ultrasonography and abdominal MRI were normal, Gallium 68 PET/CT showed uptake in the body of the pancreas. Laparoscopic corporocaudal pancreatectomy was performed. The patient resolved hypoglycemia and was discharged without incidents. Genetic study was consistent with focal CH, confirmed later by biopsy. Discussion: This case report exposes the clinical presentation of CH and its diagnosis. It emphasizes on the surgical treatment and the advantages of minimally invasive technique.

Efecto clínico del uso de probiótico en el tratamiento de la periodontitis crónica: ensayo clínico / Clinical effect of probiotic in treatment of chronic periodontitis: clinical trial

Objetivo El objetivo de este ensayo clínico aleatorizado, doble ciego, de brazos paralelos y controlado por placebo fue evaluar el efecto clínico del consumo de Lactobacillus rhamnosus SP1 en un polvo de disolución oral, adicional a la terapia periodontal no quirúrgica. Material y método Cuarenta y nueve sujetos fueron examinados para participar en este estudio. Veintiocho participantes sistémicamente sanos, con diagnóstico de periodontitis crónica, fueron reclutados y monitorizados clínicamente en el tiempo basal, 3 y 6 meses después de la terapia periodontal. Los parámetros clínicos registrados fueron presencia de placa, sangrado al sondaje, profundidad al sondaje y pérdida de inserción clínica. Todos recibieron terapia periodontal no quirúrgica, incluyendo pulido y alisado radicular (PAR), y fueron asignados aleatoriamente al grupo experimental (PAR + probiótico, n = 14) o control (PAR + placebo, n = 14). Luego de la última sesión de PAR debieron ingerir un sobre con polvo de disolución oral de Lactobacillus rhamnosus SP1 o placebo, una vez al día durante 3 meses. Resultados Ambos grupos mejoraron sus parámetros clínicos en todos los tiempos evaluados. Además, el grupo experimental redujo significativamente el porcentaje de sitios, dientes y número de participantes con profundidad al sondaje ≥ 5 mm entre el tiempo basal y los 6 meses postratamiento. Conclusiones La administración oral de L. rhamnosus SP1 asociado a la terapia periodontal genera similares mejorías en los parámetros clínicos comparado con solo usar terapia periodontal en el tratamiento de la periodontitis crónica en adultos.

Objective The aim of this double- blind, placebo- controlled parallel- arm, randomised clinical trial was to evaluate the clinical effects of a sachet of Lactobacillus rhamnosus SP1-containing probiotic as an adjunct to non-surgical therapy. Material and method Fourty- nine subjects were screened for their elegibility to participate in this study. Twenty-eight systemically healthy volunteers with chronic periodontitis were enrolled and monitored clinically at baseline, and at 3 and 6 months after therapy. Clinical parameters measured included plaque index, bleeding on probing, pocket probing depths (PPD), and clinical attachment loss. Patients received non-surgical therapy including scaling and root planing (SRP), and were randomly assigned to a test (SRP + probiotic, n = 14) or control (SRP + placebo, n = 14) group. The administration of a sachet of Lactobacillus rhamnosus SP1 probiotic once a day for 3 months commenced after the last session of SRP. Results Both test and control groups showed improvements in clinical parameters at all time points evaluated. Furthermore, at initial visits and after 6 months follow-up, the test group showed a statistically significant reduction in percentage of sites, teeth, and number of participants with PPD ≥ 5 mm. Conclusions The results of this trial indicate that oral administration of L. rhamnosus SP1 sachets during initial therapy resulted in similar clinical improvements compared to SRP alone.

Relações de causa e efeito entre condições ambientais, urediniósporos e severidade de ferrugem-asiática da soja / Relations of cause and effect among environmental conditions, airborne urediniospores and asian soybean rust severity

O objetivo deste trabalho foi estabelecer relações entre condições ambientais, o número de urediniósporos de Phakopsora pachyrhizi e a severidade da ferrugem-asiática-da-soja. Para quantificar urediniósporos de P. pachyrhizi, coletores foram instalados em campos de soja, em Itambé e Mandaguari, PR. Avaliações de severidade foram realizadas e dados climáticos foram coletados nos dois locais. As variáveis elaboradas foram: número de dias com umidade favorável (>60%), número de dias com temperatura favorável (18 a 32º C), preciptação acumulada e urediniósporos coletados. Uma variável baseada no controle químico também foi elaborada. Correlações entre as variáveis foram estimadas. A análise de trilha foi empregada para desdobrar as correlações. Cerca de 76% da variação das relações de causa e efeito entre as variáveis foi explicada pela análise de trilha. O número de dias para efetuar o controle químico teve efeito direto sob a severidade. O número de dias com temperatura favorável e as precipitações tiveram efeito indireto na severidade, atuando via manutenção de condições favoráveis de umidade.

The objective of this work was to study the relationships among environmental conditions, airborne urediniospores of P. pachyrhizi and the Asian soybean rust (ASR) severity. To quantify airbone urediniospores, collectors were installed in soybean fields in Itambé and Mandaguari, PR. Severity assessments were conducted and climatic data were collected in the two locations. The variables elaborated were: number of days with favorable humidity (<60%), number of days with favorable temperature (18-32ºC), rainfall accumulated and urediniospores collected. A variable based on the chemical control was also created. Correlations between variables were estimated. Path analysis was performed for correlations. Path analysis explained about 76% of the relations of cause and effect among the variables. Number of days to the chemical control had direct effect on severity. Number of days with favorable temperature and rainfall had indirect effect on severity. This two variables provided favorable humidity conditions for ASR development.

Fauna parasitaria gastrointestinal en el pingüino Adelia (Pygoscelis adeliae) de zona antártica especialmente protegida (ZAEPN°150) / Gastrointestinal parasite fauna in Adelia penguin (Pygoscelis adeliae) in an antarctic territory protected zone

Usando diferentes técnicas parasicológicas, fueron analizadas 167 muestras de heces y 3 tractos digestivos completos obtenidos de pingüinos Adelia {Pygoscelis adeliae) de una zona Antartica protegida. Se reporta la presencia de: huevos y una estróbila de Tetrabothrius spp. (Cestoda: Pseudophyllida); una tenia con un rostellum inerme (Cestoda: Cyclophyllida) en estado inmaduro; ooquistes de Esporozoos y huevos de Nematodos sin identificación; una gran cantidad de Streptocara spp. (Nematoda: Acuariidae) en diferentes estados de evolución.

One hundred and sixty seven fecal samples and three complete digestive tracts obtained from these penguins were analyzed using different parasitological methodologies. The presence ofTetrabothrius spp. eggs (Cestoda: Pseudophyllida), and the observation of Sporozoa oocists and Nematoda eggs both of undetermined species in the fecal samples is reported. In the same way a large number of nematodes identified as Streptocara spp. (Nematoda: Acuariidae) in different evolutionary stages in stomach, and the recovery of a whole 81 cm. Tetrabothrius spp. specimen (without the scolex) and one inmature tapeworm (Cestoda: Cyclophyllida) with unarmed rostellum in guts of Adéliepenguins chiks found dead in a protected zone of the Antarctic territory is reported.

Genetic control of soybean (Glycine max) yield in the absence and presence of the Asian rust fungus (Phakopsora pachyrhizi)

Soybean is one of the most important crops in Brazil and continuously generates demands for production technologies, such as cultivars resistant to diseases. In recent years, the Asian rust fungus (Phakopsora pachyrhizi Syd. & P. Syd 1914) has caused severe yield losses and the development of resistant cultivars is the best means of control. Understanding the genetic control and estimating parameters associated with soybean (Glycine max) resistance to P. pachyrhizi will provide essential information for cultivar selection. We investigated quantitative genetic control of P. pachyrhizi and estimated parameters associated to soybean yield in the absence and presence of this phytopathogen. Six cultivars and their 15 diallel derived F2 and F3 generations were assessed in experiments carried out in the absence and presence of P. pachyrhizi. The results indicated that soybean yield in the presence and absence of P. pachyrhizi is controlled by polygenes expressing predominantly additive effects that can be selected to develop new cultivars resistant or tolerant to P. pachyrhizi. These cultivars may prove to be a useful and more durable alternative than cultivars carrying major resistance genes.

Relação entre medidas de refletância e área foliar sadia, severidade da ferrugem asiática e produtividade da cultura da soja / Relationships between measures of reflectance and health leaf area, soybean rust severity and soybean yield

O objetivo do trabalho foi verificar se as medidas de refletância detectavam variações na área foliar sadia a fim de serem utilizadas como parâmetros para estimar danos na produção decorrentes da ferrugem asiática, bem como determinar a influência da doença na eficiência fotossintética das plantas em condições de campo. O experimento foi conduzido na área experimental pertencente à Embrapa Soja, no município de Londrina, PR, utilizou-se a cultivar de soja BRS 154. O delineamento experimental utilizado foi de blocos ao acaso, com oito tratamentos (diferentes estádios de início da aplicação do fungicida) comquatro repetições O produto utilizado foi azoxistrobin + ciproconazole (60+24 g i.a./ha) + óleo mineral (0,5%). As leituras de refletância foram feitas em oito comprimentos de onda, de 460 a 810 nm, em intervalos de 50 nm. Calculou-se o Índice Vegetativo de Diferença Normalizada (NDVI), onde NDVI=(810- 660)/(810+660). A produção apresentou incremento linear (P<0,01) com a Duração da Área Foliar Sadia (HAD) (r2=37,7%), com a Absorção da Radiação Solar pela Área Foliar Sadia (HAA) (r2=21,6%), com aÁrea Abaixo da Curva de Progresso da Doença (AUDPC) (r2=25,4%) e com a Integral da Diferença Normalizada (AURNDVI) (r2=54,8%). Verificou-se diferença significativa (P<0,05) na Eficiência Fotossintética (RUE) entre a testemunha e o tratamento que recebeu três aplicações de fungicida (primeira em R4), sendo esse também o único tratamento que diferiu significativamente (P<0,05) da testemunha em produtividade. Apesar dos baixos valores para os coeficientes de determinação, a sensibilidade dasmedidas de NDVI e RUE apresentaram potencial para captar variações entre os tratamentos. Sugerem-se novos estudos para verificar e eliminar possíveis interferências decorrentes da calibração do radiômetro e dos demais parâmetros antes dessas medidas poderem ser utilizadas no processo de tomada de decisão para controle da ferrugem asiática.

The aim of this research was to verify if some measures of reflectance could detect variations in the healthy leaf area which could be used as parameter to estimate damages in the production due to soybean rust, and to determine the influence of the disease on photosinthetic efficiency of plants underfield conditions. The experiment was lead in the experimental area of Embrapa, in Londrina, PR. The experimental design was randomly blocks, with eight treatments (different fungicide application times) with four replications. The fungicide used was azoxistrobin + ciproconazole (60+24 g i.a./ha) + mineral oil (0.5%). The reflectance readings were made at eight wave lengths, between 460 and 810 nm, with intervals of 50 nm. It was estimated the Normalized Difference Vegetation Index (NDVI), where NDVI=(810-660)/ (810+660). The yield presented linear increments (P<0.01) with Healthy Leaf Area Duration (HAD)(r2=37.7%), with Healthy Area Absorption (HAA) (r2=21.6%), with Area Under Disease Progress Curve(AUDPC) (r2=25.4%) and with Integral of Normalized Difference (AURNDVI) (r2=54.8%). Significant difference in Photosynthetic Efficiency (RUE) (P<0.05) was observed between the control plot and the treatment with three fungicide applications (first at R4), which was the only treatment that differed significantly (P<0.05) in production from untreated control. The sensitivity of the measures NDVI andRUE presented a potential to detect variations among the treatments. However additional studies are still needed to verify and eliminate some possible interferences, such as the calibration of the radiometer and other parameters before it can be used for taking of decisions.

Estudio exploratorio descriptivo de la práctica profesional de los terapeutas ocupacionales en el sistema educativo regular que apoyan los procesos de integración educativa en las Regiones Quinta y Metropolitana durante el año 2005 / Descriptive exploatory study about occupational therapist professional practice in the regular education system that supports scholar integration processes in the fifth and Metropolitan Regions, Throughout 2005

Objetivos: Conocer características demográficas, de formación profesional, y características de la práctica profesional de Terapeutas Ocupacionales que apoyan los procesos de integración educativa al Sistema Educativo Regular, en las regiones Quinta y Metropolitana, durante el año 2005.Metodología: Estudio no experimental, transversal y descriptivo, muestra no probabilística, constituida por 41 Terapeutas Ocupacionales. Se construye el instrumento “Cuestionario para Terapeutas Ocupacionales en Educación Regular”, aplicado durante el 12 de diciembre de 2005 y 06 de enero de 2006. Análisis y tratamiento de datos según estadística descriptiva; muestra se subdivide en Terapeutas Ocupacionales que trabajan en Proyectos de Integración Escolar (PIE) y estrategias complementarias (SIN PIE).Resultados y conclusiones: Existen Terapeutas Ocupacionales apoyando procesos de integración educativa, con diferencias en la práctica profesional entre ambas estrategias. Se desempeñan en Quinta Región y Metropolitana, egresan de Universidad de Chile y Universidad de Playa Ancha de Ciencias de la Educación, se perfeccionan en distintas áreas, la mayoría no realiza publicaciones. Diferencias en condiciones laborales y población intervenida; similitudes en nivel educativo de los estudiantes que reciben el apoyo y marcos teóricos utilizados. Ambos grupos evalúan distintos ámbitos del desempeño ocupacional, preferentemente con instrumentos no estandarizados; incluyen actividades en el contexto de desempeño escolar físico y social, modalidad de trabajo individual y grupal, y otras funciones; trabajan mayormente en equipo multiprofesional. Terapeutas Ocupacionales de ambas estrategias apoyan integración y realizan acciones inclusivas.

Goals: To determjne demographic characteristics, professional training and professional practice characteristics of Occupational Therapists that support scholar integration processes to the Regular Education System in the Fifth and Metropolitan Regions, throughout 2005.Methodology: Non-experimental, cross sectional and descriptive study, non-probabilistic sample, composed by 41 Occupational Therapists. The “Questionaire for Occupational Therapists in Regular Education” was developed, which was applied during December 12, 2005, and January 6, 2006. Analysis and data processing were carried out according to descriptive statistics; sample is subdivided in Occupational Therapists who work in Scholar Integration Projects (SIP) and complementary strategies (without SIP).Results and conclusions: There are Occupational Therapists supporting educational integration processes, with differences in the professional practice between both strategies. They work in the Fifth and Metropolitan regions, graduated from Universidad de Chile and Universidad de Playa Ancha de Ciencias de la Educacion, they perform further training in different areas, most of them do not make publications. Differences in laboral condition and in the intervening population are present; similarities in the educational level of the students and in the theorical frameworks used. Both groups evaluate different field of the occupational performance, especially non-standardized instruments; they include activities in the physical and social context of scholar performance, individual and group work modality, and other functions; they work mainly in multiprofessional teams. Occupational Therapists of both strategies support the integration and make inclusive actions.

Influência da severidade de mancha angular na eficiência fotossintética da área foliar sadia de feijoeiro, sob condições de campo / Photosynthetic efficiency of healthy leaf area influenced by angular leaf spot severity in bean field

O objetivo do trabalho foi demonstrar, em parcelas experimentais sob condições de campo, a relação entre área foliar sadia, severidade de mancha angular e produção em feijoeiro indicando influência desta relação na eficiência fotossintética do tecido foliar remanescentes nas plantas. Area foliar e severidade de mancha angular (phaeoisariopsis griseola(Sacc.) Ferraris) de feijoeiro foram avaliadas semanalmente, iniciando-se aos 30 dias após a emergência (DAE). Obtiveram-se diferentes níveis de severidade variando-se a data de início de aplicação da mistura fungicida (fentin hydroxide 0,10 por cento + tebuconazole 0,04por cento). Variações na quantidade de área foliar foram obtidas em função da variação inerente entre plantas e das diferenças de condições físico-químicas encontradas no solo das parcelas. A relação entre duração de área foliar sadia (HAD) e a àrea sob a curva de progresso da doença (AUDPC) e a produção (gm-2) apresentou r2=74,8 por cento e entre absorção da área foliar sadia (HAA), AUDPC e a produção (gm-2) apresentou r2=74,7 por cento. Os resultados indicaram que houve redução na produção em parcelas com valores altos de AUDDPC, mesmo naquelas com mesmo nível de área foliar sadia (HAD), ou seja, a doença influenciou a eficiência fotossintética da área foliar sadia das plantas, além de impedir que a área doente necrosada produzisse.

Castigo y factores que influyen en su utilización / Punishment and factors that influence it use

El castigo se define como una pena impuesta por un acto determinado y puede manifestarse de 3 formas: física, psicológica y por supresión. A su incidencia se asocian innumerables factores de riesgo y puede traer graves consecuencias en el desarrollo del niño. El objetivo de esta investigación es conocer los factores asociados al uso del castigo por parte de las madres de niños de 1 y 2 años que se controlan en dos consultorios de Santiago (público y privado). Para ello se estudiaron a 50 madres de cada consultorio, a las cuales se les aplicó un instrumento diseñado por las autoras y validado por expertos. El análisis de los resultados permite concluir que, si bien sólo un 20 por ciento de las madres reconoce abiertamente la utilización del castillo, existe un alto porcentaje de utilización de castigo en madres que no lo reconocen. Las formas más utilizadas son "el reto" y "los gritos", principalmente frente a situaciones que involucran algun riesgo para el niño