Falla en la extubación en el paciente con trauma raquimedular: parálisis diafragmática. Una entidad por considerar

La parálisis diafragmática es una entidad con epidemiologia no constatada, sin embargo, debe considerarse en el paciente con antecedente de trauma raquimedular asociado que presente signos tempranos de dificultad respiratoria, para de esta forma investigar y ofrecer manejos oportunos en esta condición clínica. Se presenta caso de varón de 65 años con debilidad diafragmática crónica por antecedente de herida por arma de fuego a nivel de la columna cervical.

Diaphragmatic paralysis is an entity with an unproven epidemiology. However, it should be considered in patients with a history of associated spinal cord trauma who present early signs of respiratory difficulty, to investigate and offer timely management to this clinical condition. We present the case of a 65-year-old man with chronic diaphragmatic weakness due to a history of gunshot wounds at the level of the cervical spine.

Effects of different plyometric training frequencies on physical performance in youth male volleyball players: a randomized trial.

This study aimed to analyze the effect of plyometric training (PT) at different frequencies on jump performance, running sprint speed, and service speed in youth male volleyball players. The participants were randomly assigned to one PT session per week (Experimental Group 1, EG1, n = 15), two PT sessions per week (Experimental Group 2, EG2, n = 14), and a control group (CG, n = 13). The total weekly jumping ranged between 98 and 196 jumps (equalized between, EG1 and, EG2). The assessments performed were squat jump (SJ), countermovement jump (CMJ), CMJ-arms, drop jump (DJ), 5-m sprint, 10-m sprint, and service speed. The intragroup comparisons showed that, EG1 significantly (p < 0.001) improved SJ (Δ = 12.74%; d = 1.30), CMJ (Δ = 11.94%; d = 1.71), CMJ-arms (Δ = 12.02%; d = 1.47), DJ (Δ = 10.93%; d = 1.30), 5-m sprint (Δ = -4.61%; d = 0.29), 10-m sprint (Δ = -3.95%; d = 0.40) and service speed (Δ = 8.17%; d = 1.53). Similarly, EG2 significantly (p˂ 0.001) improved SJ (Δ = 11.52%; d = 1.25), CMJ (Δ = 11.29%; d = 1.38), CMJ-arms (Δ = 11.42%; d = 1.26), DJ (Δ = 13.90%; d = 2.17), 5-m sprint (Δ = -3.85%; d = 0.25), 10-m sprint (Δ = -2.73%; d = 0.25) and service speed (Δ = 6.77%; d = 1.44). The CG significantly (p < 0.05) improved SJ (Δ = 2.68; d = 0.28), CMJ-arms (Δ = 2.30; d = 0.35), 5-m sprint (Δ = -1.27; d = 0.10) and service speed (Δ = 1.42; d = 0.30). Intergroup comparisons revealed significantly greater improvements in all variables (p < 0.001) in, EG1 and, EG2 concerning to CG. However, no significant differences were found between, EG1 and, EG2. A moderate weekly PT volume, distributed in one or two sessions per week, seems equally effective.

Long Term Veno-Pulmonary Arterial Extracorporeal Membrane Oxygenation as Bridge To Lung Transplantation And Its Challenges: A Case Report.

We present a case of a patient with acute respiratory distress syndrome due to severe acute respiratory syndrome coronavirus 2 infection who underwent an extracorporeal membrane oxygenation (ECMO) run of 8 months with various configuration changes, including off-label use of cannulas. The patient eventually underwent successful double lung transplantation after a follow-up of 17 months, demonstrating the successful application of a hybrid approach and careful monitoring in the face of supply shortages during the pandemic. This case highlights the challenges faced by ECMO and transplantation centers during the pandemic and the importance of careful communication and planning to optimize patient outcomes.

High seropositivity against NDO-LID in a group of household contacts of leprosy patients. Are we close to leprosy elimination in Colombia?

INTRODUCTION: Leprosy is a chronic infectious disease caused by two mycobacteria (Mycobacterium leprae and Mycobacterium lepromatosis). The household contacts (HHC) of leprosy index cases are at higher risk of being infected with these mycobacteria. Therefore, serological testing in HHC would be an effective strategy to eliminate leprosy in Colombia. OBJECTIVE: To determine the seroprevalence and factors associated with the infection by M. leprae in HHC. METHODS: An observational study was conducted in 428 HHC located in the Colombian Caribbean, Andean, Pacific, and Amazonian regions. We evaluated the seropositivity and titrations of IgM, IgG, and protein A against NDO-LID. RESULTS: The evaluated HHC showed high seropositivity, precisely 36.9% anti-NDO-LID IgM, 28.3% anti-NDO-LID IgG, and 47.7% protein A. Furthermore, Protein A showed a greater capacity to detect infected individuals than other anti-NDO-LID conjugates (p < 0.0001). This study did not show differences in the seropositivity according to sex or age of the HHC (p > 0.05). Higher seropositivity for IgM was evidenced mainly in HHC located in the Colombian Pacific region (p 0.001). This research did not show differences in the seropositivity for these serological tests between HHC of PB or MB leprosy patients (p > 0.05). CONCLUSION: Leprosy transmission is still active between Colombian HHC. Consequently, controlling leprosy transmission in this population is fundamental to eradicating this disease.

After-school sports programmes and social inclusion processes in culturally diverse contexts: Results of an international multicase study.

This research aimed to understand the role of after-school sports programs in social inclusion processes in culturally diverse contexts through a multicase study within two locations. The first location was in Spain where immigrant and Spanish students were enrolled, and the other was in Chile with Mapuche-Huilliche students, immigrant and Chilean students. The implemented programs at both sites were similar in their educational focus on socio-educational values, and teaching models (hybridization of teaching games for understanding and cooperative learning) that enhance social inclusion. Using individual and group interviews with teachers, sports coordinators, parents, and students, a qualitative approach was used to identify the factors that facilitate or hinder the social inclusion processes. In addition, the researchers used qualitative observations of the programs over six months using "notes logbook" to record their impressions during the observation process. Results indicated that the implemented sports programs successfully facilitated social inclusion processes, enabling the development of interpersonal skills and relationships between students from different cultural backgrounds. The previous training and experiences of teachers in culturally diverse contexts, and incorporation of traditional sporting games from all cultures, seems to be an important facilitator factor for the inclusion potential of the implemented programs.

Tratamiento agudo de la migraña durante el embarazo / Acute treatment of migraine during pregnancy

RESUMEN INTRODUCCIÓN La migraña es una condición médica prevalente y altamente discapacitante. Por lo general, durante el embarazo hay una reducción de los síntomas migrañosos, sin embargo, en ocasiones la sintomatología puede no mostrar mejoría, y en algunos casos empeorar. Por tanto, es necesario que el médico del servicio de urgencias realice un correcto diagnóstico de esta enfermedad, que descarte otros tipos de cefaleas y brinde el mejor y el más seguro tratamiento analgésico de acuerdo con la edad gestacional y perfil clínico de cada paciente. En esta revisión se abordará la relación entre la migraña y el embarazo, el papel de los estrógenos en la génesis de la migraña, así como también los datos más actuales en cuanto al tratamiento del manejo agudo de esta patología durante la gestación. MATERIALES Y METODOS: Se realizó una revisión sistemática de la literatura mundial sobre la relación entre la migraña y el embarazo y el manejo agudo en esta población, obteniéndose un total de 83 referencia bibliográficas. RESULTADOS: Como manejo inicial, se recomienda el uso de Acetaminofén más metoclopramida en cualquier etapa de la gestación. El uso de AINE debe evitarse a partir de la semana 20 de gestación. El Sumatriptán puede ser utilizado como segunda línea en cualquier trimestre. A todas las pacientes se les debe brindar manejo no farmacológico. CONCLUSIONES: Actualmente se cuenta con varios medicamentos y procedimientos seguros para el manejo agudo de la migraña en gestantes, sin embargo, debe tenerse en cuenta la edad gestacional ante su administración.

ABSTRACT INTRODUCTION: Migraine is a prevalent and highly disabling condition. Usually during pregnancy there is relief of symptoms, however, sometimes headache cannot improve, and some cases may get worse. Therefore, it is necessary for physicians who work at the emergency department perform a correct diagnosis of this pathology, rule-out other types of headaches and give the best and safest treatment according to gestational age and clinical profile of each patient. This review will address the relationship between migraine and pregnancy, the role of estrogens in the genesis of migraine. Updated information with respect to acute treatment of migraine during this period will be discussed. METHODS: A systematic review of the world literature on the relationship between migraine and pregnancy and acute management in this population was carried out, obtaining a total of 83 bibliographic references. RESULTS: As an initial management, the use of acetaminophen plus metoclopramide is recommended at any stage of pregnancy. The use of NSAIDs should be avoided from week 20 of gestation. Sumatriptan can be used as a second line in any trimester. Non-pharmacological management should be provided to all patients. CONCLUSIONS: There are currently safe drugs and procedures for the acute management of migraine in pregnant women, however, gestational age should be taken into account before administering them.

Trends in the Use of Sedative-Hypnotics, Opioids, and Neuromuscular Blockers in Hospitalized Patients During the COVID-19 Pandemic: Observational Retrospective Study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has increased the use of drugs administered for mechanical ventilation, leading to shortages in some countries. OBJECTIVE: The aim was to identify trends in the consumption of sedatives, hypnotics, neuromuscular blockers, and opioids used for anesthetic induction and deep sedation in hospitals in Colombia. METHOD: This was a descriptive, longitudinal, and retrospective study with monthly follow-up of sedative, hypnotic, opioid, and neuromuscular blocker dispensing in 20 clinics and hospitals from January to November 2020. The frequencies of use of each drug and variations in the institutions and intensive care units (ICUs) were identified. RESULTS: A total of 1,252,576 units of the analyzed drugs were delivered to 79,094 treated patients, 55.0% of whom were women (n = 43,521). The drugs with the greatest increase in consumption were rocuronium (1058% variation in March-November) and propofol (511%). The consumption of midazolam and vecuronium initially increased, but by the end of the study period, it decreased. Among drugs dispensed only in ICUs, 920,170 units were delivered (73.5% of the drugs dispensed during the study), and the most often dispensed drugs were fentanyl (n = 251,519; 27.3% of the drugs used in the ICU) and midazolam (5 mg/5 mL) solution (n = 188,568; 20.5%). Specifically in the ICU, the drugs with the greatest increase in use were rocuronium (19,709%), propofol (2622%), and ketamine (2591%). CONCLUSION: Rapid changes in the use of drugs were evident, which demonstrates the need for closer cooperation among treating physicians, service providers, pharmaceutical managers, and state institutions to maintain a sufficient and timely supply of critical drugs in this type of contingency.

Social and environmental conditions related to Mycobacterium leprae infection in children and adolescents from three leprosy endemic regions of Colombia.

BACKGROUND: Leprosy is is still considered a public health issue and in Colombia 7-10% of new cases are found in children, indicating both active transmission and social inequality. We hypothesized that circulating antibodies against Natural Octyl Disaccharide-Leprosy IDRI Diagnostic (NDO-LID) (a combination of Mycobacterium leprae antigens) could reveal the social and environmental aspects associated with higher frequencies of M. leprae infection among children and adolescents in Colombia. METHODS: An observational cross-sectional study was conducted involving sampling from 82 children and adolescents (younger than 18 years of age) who had household contact with index leprosy patients diagnosed in the last 5 years. Data were analyzed through bivariate analysis made by applying a Pearson x2 test for qualitative variables, while quantitative variables, depending on their distribution, were analyzed using either a Student's t-test or Mann-Whitney U test. Multivariate analysis was performed using a multiple regression and binomial logistic approach. RESULTS: A bivariate analysis demonstrated that antibody titers against NDO-LID were significantly greater in children and adolescents with a low socioeconomic status that had: lived in vulnerable areas of the UAChR shared region; eaten armadillo meat; exposure of over 10 years to an index case and; not received BCG immunization. Moreover, a multivariate analysis showed that residing in the UAChR region has a strong association with a greater possibility of M. leprae infection. CONCLUSIONS: M. leprae transmission persists among young Colombians, and this is associated with social and environmental conditions. An intensification of efforts to identify new leprosy cases in vulnerable and forgotten populations where M. leprae transmission continues therefore appears necessary.

Genetic variants, structural, and functional changes of Myelin Protein Zero and Mannose-Binding Lectin 2 protein involved in immune response and its allelic transmission in families of patients with leprosy in Colombia.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Genetic factors associated with immune response contribute to infection development and disease. M. leprae has the capacity to invade Schwann cells in the peripheral nervous system and cause neuropathy. However, while the responsible molecular mechanisms remain to be fully unveiled, they have begun being elucidated. We studied genetic variants Myelin Protein Zero (MPZ), a major structural component of the myelin sheath, and Mannose Binding Lectin 2 (MBL2), a protein involved in immune response, in 112 family groups of 114 leprosy patients using PCR-RFLP, aiming to calculate the association and allelic transmission of variants associated in first, second and third-degree relatives. Polymorphisms found in MPZ and MBL2 showed association with leprosy. Different probabilities for allelic transmission were found for first and second-degree relatives, a fact that is important to take into account when evaluating risk in contacts of leprosy patients. Structural analysis allows the study of putative amino acids and their possible effect on protein structure and function, as well as on the assembly of a protein homotetramer. Our results suggest that the identified MPZ and MBL2 gene mutations are associated with leprosy in a Colombian population, which correlates with MPZ and MBL2 protein function, and increase the risk of M. leprae infection in leprosy-patients' family members. Additionally, structural analyses were carried out specifically for MPZ protein using information available in databases, and analyzing the substitutions in wildtype and mutant protein. The results show significant structural changes, which may be associated to infection and pathogenicity.

Anti-natural octyl disaccharide-leprosy IDRI diagnostic (NDO-LID) antibodies as indicators of leprosy reactions and neuritis.

Background: Leprosy is a complex infectious and neurological disease caused by Mycobacterium leprae. Nerve damage is related to immunological hypersensitivity responses known as leprosy reactions (LRs). Diagnostic tools to predict LRs are not available. We hypothesized that natural octyl disaccharide-leprosy IDRI diagnostic (NDO-LID) would be helpful as an indicator of LRs and neuritis. Methods: To assess the utility of NDO-LID in indicating reactions, ELISA were used to detect specific antibodies in serum samples from 80 Colombian leprosy patients (40 with and 40 without history of LRs). Responses were detected using a range of detection reagents detecting IgG, IgM or both isotypes. Results: Patients with a history of LRs had an increased seropositivity rate for anti-NDO-LID antibodies compared to patients without (anti-NDO-LID protein A [p=0.02], IgG anti-NDO-LID [p=0.01] and IgM anti-NDO-LID [p=0.01]). Further analyses of patients with a history of LRs indicated that both seropositivity rate and magnitude of responses were elevated among patients with neuritis versus those without neuritis (anti-NDO-LID protein A [p=0.03], IgG anti-NDO-LID [p=0.001] and IgM anti-NDO-LID [p=0.06]). Conclusions: Our data indicate that testing for serum anti-NDO-LID antibodies can be a useful screen to identify patients at risk of developing LRs and neuritis.

Influence of concentration on the radiolytic decomposition of thiamine, riboflavin, and pyridoxine in aqueous solution / Influencia de la concentración en la descomposición radiolítica de tiamina, riboflavina y piridoxina en solución acuosa / Influência da concentração na decomposição radiolítica de tiamina, riboflavina e piridoxina em solução aquosa

Vitamin loss during irradiation has been claimed as a critical area in food irradiation technology, especially that of thiamine (B1), which has been considered as the most sensitive to radiation. Although it has been suggested that no vitamin deficiency could result from consuming irradiated food, a long debate on the loss of vitamins and other nutrients during food irradiation has been maintained by the lack of experimental studies monitoring decomposition rates at different concentrations and doses. Since thiamine, riboflavin, and pyridoxine are labile vitamins, this study has focused on their radiolytic decomposition in dilute aqueous solutions in the presence of air. The decomposition process was followed by HPLC and UV-spectroscopy. The results obtained in aqueous solutions showed a dependence of the decomposition as a nonlinear function of the dose. Of these three compounds, the decomposition was higher for thiamine than for riboflavin and even less in pyridoxine.

La pérdida de vitaminas durante procesos de irradiación ha sido considerada como un área crítica en la tecnología de irradiación de alimentos, especialmente la tiamina (B1), que ha sido considerada como la más sensible a la radiación ionizante. La deficiencia de vitaminas en humanos no es producida por el consumo de alimentos irradiados, sin embargo, existen debates sobre la pérdida de vitaminas y otros nutrientes provocada por la irradiación de alimentos, esta discusión sigue latente debido a que hay pocos estudios experimentales de la descomposición de vitaminas a diferentes dosis y concentraciones. Esta investigación se centró en el estudio de la descomposición radiolítica de tiamina, riboflavina y piridoxina en soluciones acuosas y en presencia de aire. El proceso de descomposición fue seguido por cromatografía líquida con detección UV. Los resultados obtenidos en soluciones acuosas mostraron una dependencia no lineal entre la descomposición en función de la dosis. De estos tres compuestos, la descomposición fue mayor en tiamina que en riboflavina y menor en la piridoxina.

A perda de vitaminas durante processos de irradiação tem sido considerada uma área crítica na tecnologia de irradiação de alimentos, especialmente no caso da tiamina (B1), que tem sido considerada como a mais sensível à radiação ionizante. Embora a deficiência de vitaminas em seres humanos não seja produzida pelo consumo de alimentos irradiados, longos debates sobre as perdas de vitaminas e outros nutrientes causadas pela irradiação de alimentos tem sido mantidos devido aos estudos experimentais limitados monitorando a proporção da decomposição em diferentes concentrações de vitaminas e doses de radiação aplicadas. Considerando que a tiamina, riboflavina e piridoxina são vitaminas instáveis, o presente estudo focalizou a decomposição radiolítica dessas vitaminas em soluções aquosas diluídas e na presença de ar. O processo de decomposição foi analizado por cromatografia líquida com detecção UV. Os resultados obtidos em soluções aquosas mostraram uma dependência da decomposição como função não linear da dose. Destes três compostos, a descomposição foi mais alta para tiamina que na riboflavina e menor para piridoxina.

Analysis of good production practices in pig farms on the departamento del Tolima and risk factors associated with presence of Salmonella spp / Análisis de las buenas prácticas de producción en granjas porcícolas del departamento del Tolima y factores de riesgo asociados a la presencia de Salmonella spp / Analise das boas práticas de produção em granjas suínas do departamento de Tolima e fatores de risco associados à presença de Salmonella spp

The porcine production in Colombia has experienced an important growth and has improved significantly its productivity during the past 15 years. However, an increase in national and international demand for harmless pig-based products for human consumption has been currently evidenced, with actions they promote food innocuity and they guarantee its hygienic quality for consumer benefit, in addition to workers security, animal welfare and environmental sustainability. The purpose of this work was to formulate an analysis and review of good production practices in farms destined to pig production in the Department of Tolima, taking into account the requirements established by national entities, specially, the basic guidelines of the Asociación Nacional de Porcicultores (ACP), in order to determine and quantify the risk factors associated to the presence of porcine Salmonella.

En Colombia, el sector porcícola ha experimentado un importante crecimiento y ha mejorado significativamente su productividad durante los últimos 15 años. Sin embargo, es evidente el incremento en la demanda nacional e internacional de productos de origen porcino que no causen daño a la salud humana, haciéndose imprescindible el establecimiento de acciones que promuevan la inocuidad de los alimentos y que garanticen su calidad higiénica para beneficio de consumidores, además de la seguridad de los trabajadores, el bienestar animal y la sustentabilidad medio ambiental. El propósito de este trabajo es el análisis de la aplicación de las Buenas Prácticas de Producción (BPPs), en granjas destinadas a la producción porcina del Departamento del Tolima, tomando en consideración los requerimientos establecidos por los organismos nacionales, en especial, los lineamientos básicos establecidos por la Asociación Nacional de Porcicultores (ACP), con el fin de determinar y cuantificar factores de riesgo asociados a la presentación de salmonelosis porcina.

Na Colômbia, o setor suíno tem experimentado um importante crescimento e tem melhorado significativamente sua produtividade durante os últimos 15 anos. Contudo, é evidente o incremento na demanda nacional e internacional de produtos de origem suína que não causem dano à saúde humana, fazendo necessário o estabelecimento de ações que promovam a inocuidade dos alimentos e que garantam sua qualidade higiênica para beneficio de consumidores, ademais da segurança dos trabalhadores, o bem-estar animal e a sustentabilidade ambiental. O propósito deste trabalho é a analise da aplicação das Boas Praticas de Produção (BPPs), em granjas destinadas à produção suína do Departamento de Tolima, tendo em consideração os requerimentos estabelecidos pelos organismos nacionais, em especial, os lineamentos básicos estabelecidos pela “Asociación Nacional de Porcicultores (ACP)” (Associação Nacional de Criadores de Suínos), com o fim de determinar e quantificar fatores de risco associados à apresentação de salmonelose suína.

Estudio sobre la brucelosis y la leptospirosis canina y humana en Bogotá, D. C.

Con el objeto de obtener información acerca de la leptospirosis y la brucelosis en caninos y humanos del Distrito Capital, se desarrolló un estudio epidemiológico transversal (cross sectional) aplicando un formato de encuesta estructurada. El estudio incluyó 625 predios, en los que se encuestaron y muestrearon serológicamente 1.307 personas y 795 caninos. Se generó con las muestras un banco de sueros. En dichos sueros se determinó la prevalencia serológica para B. canis y B. abortus en caninos y humanos (seroprevalencia combinada de 10,4% y 0,4%, respectivamente). Para determinar la seroprevalencia de la leptospirosis se utilizó una batería de antígenos compuesta por ocho serovares: Austro/is, Autumnalis, Bratislava, Canica/a, Copenhageni, Hardjoprajitno, lcterohaemorrhagiae y Pomona; la seroprevalencia combinada en caninos fue de 73 ,6%. La información serológica se relacionó estadísticamente con la obtenida mediante las encuestas para determinar posibles factores de riesgo; de esta manera se determinaron como posibles factores de riesgo para B. canis en caninos la cercanía a lotes baldíos y para humanos la presencia de terraza en el predio, mientras que para B. abortus no se obtuvieron asociaciones que permitieran determinar factores de riego. En lo relacionado con leptospirosis canina se determinaron asociaciones dependiendo del serovar. A partir de los hallazgos obtenidos se propone un modelo preliminar para la vigilancia epidemiológica de estas enfermedades, cuyo desarrollo e implementación dependerá de la Secretaría de Salud de Bogotá, Distrito Capital.

Estudios sobre la brucelosis y la leptospirosis canina y humana en Bogotá, D. C / Studies on brucellosis and leptospirosis, canine and human Bogota, D C

Con el objeto de obtener información acerca de la leptospirosis y la brucelosis en caninos y humanos del Distrito Capital, se desarrolló un estudio epidemiológico transversal (cross sectional) aplicando un formato de encuesta estructurada. El estudio incluyó 625 predios, en los que se encuestaron y muestrearon serológicamente 1.307 personas y 795 caninos. Se generó con las muestras un banco de sueros. En dichos sueros se determinó la prevalencia serológica para B. canis y B. abortus en caninos y humanos (seroprevalencia combinada de 10,4% y 0,4%, respectivamente). Para determinar la seroprevalencia de la leptospirosis se utilizó una batería de antígenos compuesta por ocho serovares: Australis, Autumnalis, Bratislava, Canicola, Copenhageni, Hardjoprajitno, Icterohaemorrhagiae y Pomona; la seroprevalencia combinada en caninos fue de 73,6%. La información serológica se relacionó estadísticamente con la obtenida mediante las encuestas para determinar posibles factores de riesgo; de esta manera se determinaron como posibles factores de riesgo para B. canis en caninos la cercanía a lotes baldíos y para humanos la presencia de terraza en el predio, mientras que para B. abortus no se obtuvieron asociaciones que permitieran determinar factores de riego. En lo relacionado con leptospirosis canina se determinaron asociaciones dependiendo del serovar. A partir de los hallazgos obtenidos se propone un modelo preliminar para la vigilancia epidemiológica de estas enfermedades, cuyo desarrollo e implementación dependerá de la Secretaría de Salud de Bogotá, Distrito Capital.

In order to obtain information regarding Leptospirosis and Brucellosis present in dogs and humans in the Capital District, we developed a cross-sectional study, applying a structured survey format. The study included 625 households in which we took samples of blood serum from 1307 persons and 795 canines were taken. In these samples we determined the serological prevalence for B. canis and B. abortus in canines and humans (combined seroprevalence of 10.4% and 0.4% respectively). To determine the seroprevalence of Leptospirosis, a group of antigens consisting of eight serovars: Australis, Autumnalis, Bratislava, Canicola, Copenhageni, Hardjoprajitno, Icterohaemorrhagiae and Pomona was used. The combined seroprevalence in canines was 73.6%. This serological information was compared statistically with that obtained from other surveys to identify possible risk factors. In this way, the proximity of vacant lots was identified as a possible risk factor for B. canis in canines and for humans, the presence of open terraces in the house. As for B. abortus no associations were obtained which could be considered risk factors. With regards to canine Leptospirosis different associations were obtained, depending on the serovar. Based on the obtained results, a preliminary model is proposed for the surveillance of these diseases, and its development and implementation will depend on the Health Secretary of Bogotá DC.

Estado nutricional de niños y niñas indígenas de hasta seis años de edad en el resguardo Embera-Katío, Tierralta, Córdoba, Colombia / Nutritional status of indigenous children aged up to six years in the Embera-Katio Indian reserve in Tierralta, Cordoba, Colombia

Introducción. El conocimiento del estado nutricional de la población infantil es un valioso indicador del desarrollo de una población. Objetivo. Determinar la prevalencia de desnutrición en niños y niñas indígenas Embera-Katío de hasta seis años de edad e identificar algunos de sus factores condicionantes. Materiales y métodos. Se realizó un estudio transversal en el resguardo Embera-Katío, municipio de Tierralta, departamento de Córdoba, Colombia, en 272 niños de hasta seis años de edad a quienes se les midió el peso, la estatura y el perímetro cefálico. En 194 hogares se realizó una encuesta sobre aspectos alimentarios y de salud y a 172 niños y niñas se les practicó un examen de materia fecal. Resultados. La prevalencia de desnutrición crónica moderada y grave fue de 63,6 por ciento y de desnutrición aguda leve y moderada fue de 8,8 por ciento. La desnutrición crónica se asoció con el incremento de la edad (p < 0,005) y fue mayor en hombres que en mujeres (89,9 vs. 80,4 por ciento: p = 0,028). Se observó mayor prevalencia de desnutrición crónica en los niños con infección respiratoria aguda, con enfermedad diarreica aguda y en hogares con más de tres niños y niñas menores de cinco años. En 74 por ciento de los niños y niñas, el perímetro cefálico fue inferior al percentil 5. La alimentación de los niños y niñas después del destete fue básicamente arroz y maíz (92,8 por ciento) y plátano (80,9 por ciento). Sólo 28,9 por ciento consumió carne, 4,6 por ciento huevos y 4,1 por ciento leche. La prevalencia de parasitosis intestinal fue de 78,1por ciento. Conclusiones. La prevalencia de desnutrición crónica en los niños y niñas Embera-Katio fue elevada, lo cual es el reflejo de las condiciones adversas a las que están sometidos.

Introduction. Knowledge of the nutritional state of the children is an valuable indicator of the general state of development in an entire population. Objective. The prevalence of malnutrition was determined in Embera-Katio’s indigenous children, aged 0-6 years, and associated factors associated with malnutrition were identified. Materials and methods. A cross-sectional study was undertaken in the Resguardo Embera- Katío, in Tierralta in the Province of Cordoba, located in northern Colombia. The weight, height and cephalic perimeter was assessed for each of 272 children under six years of age. Nutritional paramterers were surveyed in194 homes; fecal samples of 172 children were examined for evidence of intestinal parasites. Results. Prevalence of moderate and severe chronic malnutrition was found in 63.6% of the children’s; 8.8% were categorized with slight and moderate acute malnutrition. Chronic malnutrition was associated with age increase (p=0.005) and was greater in males than in females (89.9% versus 80.4%; p=0.028). Chronic malnutrition was greater in children with acute respiratory infection, acute diarrheas, and in homes with three or more children below the age of five. In 74% of the children, the cephalic perimeter was below the fifth percentile. After weaning, the children were fed a basic diet of rice and corn (80.4%) and plantain (80.9%). Only 28.9% ate meat, 4.6% eggs, 4.1% milk and 1.5% fruits and vegetables. The prevalence of intestinal parasitism was 78.1%. Conclusions. The prevalence of chronic malnutrition in the Embera-Katio children was high, reflecting the adverse nutritional and economic conditions in which they live.

[Nutritional status of indigenous children aged up to six years in the Embera-Katio Indian reserve in Tierralta, Cordoba, Colombia]. / Estado nutricional de niños y niñas indígenas de hasta seis años de edad en el resguardo Embera-Katío, Tierralta, Córdoba, Colombia.

INTRODUCTION: Knowledge of the nutritional state of the children is an valuable indicator of the general state of development in an entire population. OBJECTIVE: The prevalence of malnutrition was determined in Embera-Katio's indigenous children, aged 0-6 years, and associated factors associated with malnutrition were identified. MATERIALS AND METHODS: A cross-sectional study was undertaken in the Resguardo Embera-Katío, in Tierralta in the Province of Cordoba, located in northern Colombia. The weight, height and cephalic perimeter was assessed for each of 272 children under six years of age. Nutritional paramterers were surveyed in 194 homes; fecal samples of 172 children were examined for evidence of intestinal parasites. RESULTS: Prevalence of moderate and severe chronic malnutrition was found in 63.6% of the children's; 8.8% were categorized with slight and moderate acute malnutrition. Chronic malnutrition was associated with age increase (p=0.005) and was greater in males than in females (89.9% versus 80.4%; p=0.028). Chronic malnutrition was greater in children with acute respiratory infection, acute diarrheas, and in homes with three or more children below the age of five. In 74% of the children, the cephalic perimeter was below the fifth percentile. After weaning, the children were fed a basic diet of rice and corn (80.4%) and plantain (80.9%). Only 28.9% ate meat, 4.6% eggs, 4.1% milk and 1.5% fruits and vegetables. The prevalence of intestinal parasitism was 78.1%. CONCLUSIONS: The prevalence of chronic malnutrition in the Embera-Katio children was high, reflecting the adverse nutritional and economic conditions in which they live.

Observación de los efectos del ejercicio dinámico continuo controlado en la variación de los niveles de química sanguínea, cuadro hematico, y tension arterial media, en pacientes con insuficiencia renal cronica sometidos a hemodialisis en la caja nacional de prevision de Santafé de Bogotá D.C., 1991-1992 / Analysis about the changes in the blood chemistry, blood pressure and hematologic values in patients with chronic renal failure

En el siguiente estudio se realizó un análisis del ejercicio dinámico contínuo controlado en la variación de los valores de química sanguínea, cuadro hemático y presión arterial en pacientes con insuficiencia renal crónica sometidos a hemodiálisis. En el estudio se trabajó con 8 pacientes de la Caja Nacional de Previsión, de Santafé de Bogotá D.C., durante 1991-1992 a quienes se les realizó una prueba de esfuerzo inicial para medir la capacidad de ejercicio tolerable por paciente. Esta prueba se realizó bajo supervisión médica contínua, se hizo un registro electrocardiográfico y control de la presión arterial antes, durante y después de la prueba de esfuerzo. Con los resultados de la prueba de esfuerzo se elaboró un protocolo único de ejercicios para todos los pacientes, teniendo como base que no sobrepasara los límites superiores de la carga máxima del paciente que toleró menos. Este protocolo era realizado por los pacientes antes de cada hemodiálisis. A los mismos se les tomaban exámenes paraclínicos mensualmente antes de la hemodiálisis, de los cuales se realizaron 3 cortes, tiempo considerado adecuado para observar cambios significativos. Para los análisis de los datos, se uso el Test no paramétrico de Friedman. Con los hallazgos concluímos que no se encontró una variación clínica y que estadísticamente no fué significativa excepto para la glicemia. El ejercicio no presentó efectos adversos en los pacientes, aunque el protocolo realizado era por debajo de la carga tolerada que podía soportar cada uno, lo ideal es la realización de un estudio en el cual se elabore un protocolo de ejercicios dado por las características individuales de cada paciente, basados en parámetros encontrados en la prueba de esfuerzo, para someter al paciente a una carga submáxima que pueda tolerar y que modifique su condición física