Percepción de riesgo a zoonosis y enfermedades transmitidas por alimentos en Tierra del Fuego / Perception of risk to zoonoses and foodborne diseases in Tierra del Fuego

INTRODUCCIÓN La valoración subjetiva que cada individuo le aporta a la presencia de factores de riesgo ambientales y de patologías como las zoonosis y enfermedades transmitidas por alimentos (ETA) se ve influenciada por cuestiones sociales y educativas, que determinan un comportamiento protector o no. OBJETIVOS Valorar la percepción de riesgo a enfermedades zoonóticas y de transmisión alimentaria, en relación con el ambiente y la tenencia de animales en la población de Tierra del Fuego, su vínculo con posibles variables socio-demográficas y educativas. MÉTODOS Se trató de un estudio de tipo descriptivo transversal, dirigido a personas de Tierra del Fuego. El tamaño muestral se basó en datos del Censo Nacional 2010. El muestreo fue probabilístico, por conglomerados bietápicos. La recolección de datos fue a través de encuestas por entrevista personal. RESULTADOS Se realizaron y analizaron 456 encuestas. La edad promedio fue de 39,4 años. En cuanto a la escolaridad, en su gran mayoría poseían secundario incompleto o más. Sólo la variable demográfica escolaridad se asoció a la percepción de riesgo de consumir agua no potable (OR=0,18; IC95% 0,06-0,52; X2=12,35; p 0,0039), observar presencia de basurales (OR=0,08; IC95% 0,02-0,29; X2=22,92; p 0,00032) y la ausencia de tratamiento de excretas (OR=0,17; IC95% 0,05-0,55; X2=10,93; p 0,0009). El conocimiento sobre el significado de "zoonosis" fue inferior al conocimiento sobre la existencia de enfermedades que se transmiten de los animales al hombre. En cuanto a las ETA, las respuestas y asociaciones tuvieron un comportamiento medianamente similar respecto a las enfermedades zoonóticas. Discusión Este estudio demostró que hay heterogeneidad en las asociaciones entre las distintas variables en la población fueguina. Existieron algunas actuaciones para prevenir los riesgos que, se suponía, serían más frecuentes. Es necesario utilizar todas las herramientas de la promoción de la salud para abordar las falencias halladas.

Nutrient and herbivore alterations cause uncoupled changes in producer diversity, biomass and ecosystem function, but not in overall multifunctionality.

Altered nutrient cycles and consumer populations are among the top anthropogenic influences on ecosystems. However, studies on the simultaneous impacts of human-driven environmental alterations on ecosystem functions, and the overall change in system multifunctionality are scarce. We used estuarine tidal flats to study the effects of changes in herbivore density and nutrient availability on benthic microalgae (diversity, abundance and biomass) and ecosystem functions (N2-fixation, denitrification, extracellular polymeric substances -EPS- as a proxy for sediment cohesiveness, sediment water content as a proxy of water retention capacity and sediment organic matter). We found consistent strong impacts of modified herbivory and weak effects of increased nutrient availability on the abundance, biomass and diversity of benthic microalgae. However, the effects on specific ecosystem functions were disparate. Some functions were independently affected by nutrient addition (N2-fixation), modified herbivory (sediment organic matter and water content), or their interaction (denitrification), while others were not affected (EPS). Overall system multifunction remained invariant despite changes in specific functions. This study reveals that anthropogenic pressures can induce decoupled effects between community structure and specific ecosystem functions. Our results highlight the need to address several ecosystem functions simultaneously for better ecosystem characterization and management.

Iodine stability in salt double-fortified with iron and iodine.

Deficiencies in small quantities of micronutrients, especially iodine and iron, severely affect more than a third of the world's population, resulting in serious public health consequences, especially for women and young children. Salt is an ideal carrier of micronutrients. The double fortification of salt with both iodine and iron is an attractive approach to the reduction of both anemia and iodine-deficiency disorders. Because iodine is unstable under the storage conditions found during the manufacturing, distribution, and sale of salt in most developing countries, the effects of packaging materials and environmental conditions on the stability of salt double-fortified with iron and iodine were investigated. Salt was double-fortified with potassium iodide or potassium iodate and with ferrous sulfate or ferrous fumarate. The effects of stabilizers on the stability of iodine and iron were followed by storing the salt under three conditions that represent the extremes of normal distribution and sale for salt in developing countries: room temperature (25 degrees C) with 50%-70% relative humidity, 40 degrees C with 60% relative humidity, and 40 degrees C with 100% relative humidity. The effects of stabilizers, such as sodium hexametaphosphate (SHMP), calcium carbonate, calcium silicate, and dextrose were investigated. None of the combinations of iron and iodine compounds was stable at elevated temperatures. Essentially all of the iodine was lost over a period of six months. SHMP effectively slowed down the iodine loss, whereas magnesium chloride, a typical hygroscopic impurity, greatly accelerated this process. Calcium carbonate did not have a sparing effect on iodine, despite contrary indications in the literature. Ferrous sulfate-fortified salts generally turned yellow and developed an unpleasant rusty flavor. Salt fortified with ferrous fumarate and potassium, iodide was reasonably stable and maintained its organoleptic properties, making it more likely to be acceptable to consumers. We confirmed that application of the iodine compounds as solutions resulted in a more even distribution of the iodine throughout the sample. The effect of the packaging materials was overshadowed by the other variables. None of the packaging materials was clearly better than any other. This may have been due to the fact that the polymer bags were not heat sealed, and thus some moisture penetration was possible. The results indicate that with careful control of processing, packaging, and storage conditions, a double-fortified salt could be stabilized for the six-month period required for distribution and consumption. Unfortunately, the processing and storage required are difficult to attain under typical conditions in developing countries.

[Spontaneous rupture of the papillary muscle with angiographically normal coronary vessels]. / Rotura espontánea de músculo papilar con coronarias angiográficamente normales.

Papillary muscle rupture is an unusual pathology, commonly being a mechanical complication of an acute myocardial infarction or a blunt chest trauma. In this case report we describe a patient with a spontaneous complete posteromedial papillary muscle rupture, secondary to an isolated papillary muscle infarction, in the absence of coronary artery disease, resulting in severe mitral regurgitation, cardiogenic shock and uneventful urgent mitral valve replacement. The clinical and histopathologic literature, and mechanisms to explain this kind of rupture, are reviewed.

Partial impairment of immune functions in peripheral blood leukocytes from aged men with Down's syndrome.

Down's syndrome (DS) has been considered a model of accelerated aging and of Alzheimer's disease. We investigated immunologic functions using peripheral blood leukocytes in order to correlate the production of cytokines and development of neuropathological changes of Alzheimer type in aged persons with DS. Cytokine production (IL-1beta, IL-2, IL-6, IL-8, and TNF-alpha), phytohemagglutinin (PHA)-stimulated proliferation of nonadherent monocytes, and superoxide anion production from polymorphonuclear leukocytes were measured. PHA-stimulated proliferation in aged individuals (>30 years old) with DS was significantly lower than that of age- and sex-matched controls (DS vs control, 55,707+/-5810 vs 88,310+/-6994 cpm, P < 0.001). PHA-stimulated IL-2 production was also significantly decreased in aged individuals with DS (DS vs control, 7.1+/-2.1 vs 10.7+/-1.3 ng/ml). Interestingly, the decrease of proliferation and IL-2 production in aged males with DS is significantly greater than in aged women with DS. PHA-stimulated proliferation and IL-2 production of nonadherent monocytes in females was not significantly reduced. IL-1beta production by LPS-activated adherent monocytes was significantly decreased in older adults with DS compared with non-DS controls. Other immune parameters measured in DS were not significantly different from that of age-matched controls. We conclude that there is partial impairment of T lymphocytes in aged persons with DS that is significantly greater in males than in females.

[A double fistulous communication between the aortic root and both left cardiac chambers. Its diagnosis by multiplanar transesophageal echocardiography]. / Doble trayecto fistuloso entre la raíz aórtica y ambas cavidades cardíacas izquierdas. Diagnóstico mediante ecocardiografía transesofágica multiplanar.

The case of a patient with mitral and aortic mechanical valve prostheses is presented who developed early postoperative infective endocarditis and, subsequently, a fistulous communication between the posterior aortic sinus and both the left atrium and the left ventricle. A diastolic murmur of apparent aortic prosthesis regurgitation was heard, although an abnormal aortic valve function could not be demonstrated in the transthoracic echocardiographic study. Instead, the presence of a systolic high velocity flow by continuous wave Doppler suggested prosthetic mitral leakage. The clinical presentation of progressive congestive heart failure and pulmonary hypertension by Doppler prompted a further study by means of transesophageal echocardiography with multiplanar probe showing the above mentioned double fistulous communication. The diagnosis was later confirmed by angiography and also at surgery.

Inorganic arsenic species in groundwater: a case study from Purbasthali (Burdwan), India.

A regional groundwater quality survey from 20 tube wells in the Purbasthali area of the Burdwan district of West Bengal province (India) identified arsenic pollution in this area. Arsenic was detected in 19 cases at a concentration level 0.5 to 135.9 micrograms/L. Speciation studies indicate that As(III) is present in only one sample and organo-arsenic compounds have not been detected. Iron, antimony and pH of such water samples were also studied to see if there is any correlation of the presence of arsenic and these parameters. A high concentration of iron (0.3 to 10.7 mg/L) has been detected. Antimony is present in all these water samples (0.03 to 0.9 microgram/L). The pH value of the groundwater in this area shows that it is more or less neutral.

Cardiovascular risk factor knowledge and belief in prevention among adults in Chicago.

We present our findings on cardiovascular risk factor knowledge and belief in prevention from a survey administered to adult family members of children participating in a Chicago school health education program. The major risk factor most frequently recognized and understood appeared to be hypertension. Cigarette smoking and cholesterol were least frequently recognized. Few respondents could identify all three of the major risk factors, high blood pressure, cigarette smoking, and cholesterol. Non-high-school graduates and the Hispanic subgroup demonstrated less knowledge and understanding. The results confirm the benefits of the extensive high blood pressure education programs of the past decade and support the need for similar interventions in nutrition and smoking prevention and cessation. Innovative approaches toward the less-educated and the Hispanic subgroups within the population also appear necessary to accelerate the encouraging decline in cardiovascular diseases seen over the past two decades.

[Carcinoid tumor of Vater's ampulla]. / Tumor carcinoide de la ampolla de Vater.

We present the case of a patient with a Vater's papilla carcinoid tumor treated with total duodenopancreatectomy followed by re-gastrectomy because of a second localization of the tumor in the gastrojejunal anastomoses. The patient remains asymptomatic after 3 years and 6 months survival. Digestive carcinoid tumors are described, analyzing their physiopathologic, clinical and prognostic aspects, having done a bibliographic revision of the item.

Tumor carcinoide de la ampolla de Vater. / [Carcinoid tumor of Vaters ampulla]

We present the case of a patient with a Vaters papilla carcinoid tumor treated with total duodenopancreatectomy followed by re-gastrectomy because of a second localization of the tumor in the gastrojejunal anastomoses. The patient remains asymptomatic after 3 years and 6 months survival. Digestive carcinoid tumors are described, analyzing their physiopathologic, clinical and prognostic aspects, having done a bibliographic revision of the item.

Ingredients in nutrition education: family involvement, reading and race.

The Chicago Heart Health Curriculum Program ( CHHCP ) is a comprehensive cardiovascular disease risk-reduction program specially designed for a multiracial population of sixth-grade students and their families. It was implemented in a large urban school system with Asian, black, Hispanic and white students. Pretest, posttest and follow-up data were collected. The purposes of this study were to compare the differential involvement of the four race/ethnic groups in the family intervention and to evaluate the program's immediate and long-term impact on students' nutrition knowledge, attitude and behaviors. Results indicated it was possible to conduct a family intervention with an educationally and racially diverse urban population. The patterns of family involvement and student outcomes varied for the different groups. Reading was significantly related to nutrition knowledge and attitude but not to behavior. Reinforcement appears to be necessary for students to maintain changes over time.

[Primary malignant melanoma of the esophagus associated with melanosis of the esophagus and stomach]. / Melanoma maligno primitivo del esófago asociado a melanosis del esófago y del estómago.

A case of malignant melanoma primary of the esophagus with association to melanosis of the esophagus and stomach is presented, with outlive of 18 months. Considerations about esophagic origin of the lesion are made, emphasizing that the existing melanosis, the junctional changes and the absence of another primary localization lets us certificate the presence primary esophagus melanoma. The therapeutic criteria used in this case has been described therein before guide lines.

Cirugia derivativa en el cancer de la cabeza del pancreas. / Derivative surgery in cancer of the pancreas head

Se considera a la colecistoyeyunostomia como la derivacion quirurgica paliativa de eleccion para la ictericia en el cancer de la cabeza del pancreas. La asociacion de una gastroenteroanastomosis simultanea permite prevenir una eventual obstruccion duodenal por invasion neoplasica, la cual se presenta frecuentemente en la evolucion natural de la enfermedad. La presencia de litiasis vesicular no contraindica formalmente el uso de la vesicula biliar para la derivacion biliodigestiva

Melanoma maligno primitivo del esofago asociado a melanosis del esofago y del estomago. / Primary malignant melanoma of the esophagus associated with melanosis of the esophagus and stomach

Se presenta un caso de melanoma maligno primario de esofago. Se hace mencion de la bibliografia mundial en cuanto a incidencia. Se realizan consideraciones diagnosticas y terapeuticas que se aplican al caso presentado

Melanoma maligno primitivo del esófago asociado a melanosis del esófago y del estómago. / [Primary malignant melanoma of the esophagus associated with melanosis of the esophagus and stomach]

A case of malignant melanoma primary of the esophagus with association to melanosis of the esophagus and stomach is presented, with outlive of 18 months. Considerations about esophagic origin of the lesion are made, emphasizing that the existing melanosis, the junctional changes and the absence of another primary localization lets us certificate the presence primary esophagus melanoma. The therapeutic criteria used in this case has been described therein before guide lines.

Cirugia derivativa en el cancer de la cabeza del pancreas. / Derivative surgery in cancer of the pancreas head

Se considera a la colecistoyeyunostomia como la derivacion quirurgica paliativa de eleccion para la ictericia en el cancer de la cabeza del pancreas. La asociacion de una gastroenteroanastomosis simultanea permite prevenir una eventual obstruccion duodenal por invasion neoplasica, la cual se presenta frecuentemente en la evolucion natural de la enfermedad. La presencia de litiasis vesicular no contraindica formalmente el uso de la vesicula biliar para la derivacion biliodigestiva