Performance in the Six-Minute Walking Test Does Not Discriminate Excessive Erythrocytosis Patients in a Severe Hypoxic Environment.

BACKGROUND: Chronic exposure to severe hypoxia causes an increase in hematocrit (Hct) and hemoglobin concentration ([Hb]), which can lead to excessive erythrocytosis (EE) and impact physical performance. This work aims to determine the differences in the six-minute walking test (6MWT) between EE and healthy subjects residing at more than 5000 m. METHODS: A prospective, cross-sectional study was performed on 71 men (36 healthy and 25 suffering from EE) living in La Rinconada, Peru (5100 m). Basal levels of [Hb] and Hct were obtained. All the subjects performed the 6MWT, and distance reached, vital signs, dyspnea, and fatigue (Borg scale) at the end of the test were recorded. RESULTS: The average [Hb] and Hct levels in the control group were 18.7 ± 1.2 g/dL and 60.4 ± 7.1%, respectively, contrasting with EE subjects, who showed 23.4 ± 1.6 g/dL and 73.6 ± 5.9% (p < 0.001). However, no statistically significant differences were observed in BMI or other anthropometric parameters. At the end of the 6MWT, the distance traveled and vital constants were similar between both groups, except for arterial oxygen saturation, which was consistently lower in subjects with EE throughout the test. CONCLUSION: EE does not significantly affect 6MWT performance at high altitudes, nor the hemodynamic control during moderate aerobic exercise of subjects who live permanently in a severely hypoxic environment.

What treatment outcomes matter in adolescent depression? A Q-study of priority profiles among mental health practitioners in the UK and Chile.

Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural "super profiles". We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed.

Examining Psychotherapeutic Processes with Depressed Adolescents: A Comparative Study of Two Psychodynamic Therapies.

To understand processes associated with better or poorer psychotherapy outcomes is vital. This study examined and contrasted interaction patterns between one therapist and two depressed 17-year-old girls, Johanna (good outcome) and Sonja (poor outcome), in short-term psychoanalytic therapies selected from an RCT. Outcome data were collected regarding level of inter- and intra-personal functioning and symptoms of depression. Process data were obtained using the Adolescent Psychotherapy Q-Set on all available sessions. Analyses yielded five relational patterns or "interaction structures" in the two therapy processes; Three explained most of the variance in sessions with Johanna (i.e., 'positive working alliance', 'therapist's active use of psychodynamic techniques', and 'a receptive patient') and two explained more of the variance in sessions with Sonja (i.e., 'therapist using a more problem-solving and symptom-oriented approach' and 'patient displaying limited capacity for mentalization'). The processes in the two cases presented differences related to mentalization, psychological mindedness, and attachment style of the patients. The therapist used different therapeutic approaches, favouring more psychodynamic interventions in the good outcome case and a more problem-solving and symptom-oriented approach with the poor outcome case. In the latter case, the relationship seemed to be more of a struggle.

Tracking Psychodynamic Foci: Trajectories Through the Therapeutic Process.

Brief psychodynamic psychotherapy has gained importance in current clinical practice. To achieve brevity, a focus must be established and worked through. Different conceptualizations have emphasized the relational patterns and/or conflict foci as central but adopting a mono-schematic approach. However, patients come to treatment with more than one issue that must be addressed. Thus, another focus must be included because of its relevance, i.e., personality functioning. The aims of this study were to identify the presence and depth level of three foci (relational pattern, conflict, and personality functioning) in episodes of change throughout the process, and to evaluate the relationship of each focus with the complexity of patients' change. Initial OPD foci and the presence and depth of each were evaluated in 13 successful brief psychodynamic therapies. Change episodes of those therapies were analyzed as well. Results showed differences between foci in the initial phase with a higher presence of conflict focus. Throughout the process, only the presence and level of personality functioning improved. Also, complexity of patients' change was related to conflict focus, specifically on the emergence of competence feelings. The results provide evidence and enrich process research of brief psychodynamic therapies.

Effect of the Addition of Different Vegetal Mixtures on the Nutritional, Functional, and Sensorial Properties of Snacks Based on Pseudocereals.

Quick meals available in markets are popular among consumers. Generally, these products are not recognized as functional foods owing to nutrient-poor composition. In this study, energy snack bars were developed with different formulations, using puffed quinoa, amaranth, cacao liquor, and coconut oil, and the effects of the addition of commercial vegetal mixtures (VM) on nutritional and functional properties were assessed. VM addition showed significant effects on the protein, lipid, and fiber contents, phenolic compounds (PHC) content, and antioxidant activity of the snacks. The control snack showed higher levels of free and bound PHC. The oxygen radical absorbance capacity (ORAC) analyses recorded highest values of free PHC (9392.7 µmol TE/100 g dry weight) in PC65 (concentrate based on a combination of vegetal proteins), whereas the highest bound PHC levels of 47,087 and 46,531 µmol TE/100 g dry weight were observed in PC65 and the control snacks, respectively. Sensorial attributes assessment provided a high score on the hedonic scale, wherein panelists detected no differences among the samples. Altogether, the selection of non-conventional ingredients with high antioxidant activities emerged as a successful strategy to produce sensory acceptable meals.

Clinical and sociodemographic findings in a cohort of 4632 pediatric patients with language, speech and learning disorders.

OBJETIVO: Describir y analizar aspectos clínicos y sociodemográficos de una cohorte de pacientes con trastornos del lenguaje, del habla y del aprendizaje. MÉTODO: Estudio retrospectivo descriptivo. Se seleccionaron expedientes de 4632 pacientes (años 2011 a 2015). Se calcularon medias, desviaciones estándar, porcentajes y frecuencias, Con la finalidad de evaluar si existía diferencia significativa entre variables se utilizó la prueba de ji al cuadrado y se realizó un análisis de probabilidad condicional entre las variables para obtener la probabilidad a priori y a posteriori. RESULTADOS: Los trastornos del lenguaje, del habla y del aprendizaje se presentaron con mayor frecuencia en el sexo masculino, con 3358 pacientes (72.5%). El diagnóstico más frecuente fue el trastorno del lenguaje, diagnosticado en 2924 pacientes (63.1%). Se encontraron mayores incidencia y prevalencia de retraso del lenguaje en el sexo masculino (p < 0.05). CONCLUSIONES: De todas las variables estudiadas, solo la incidencia de retraso en el desarrollo del lenguaje con respecto al sexo masculino fue significativa; de cada cuatro pacientes, tres eran de sexo masculino y uno de sexo femenino. OBJECTIVE: To describe and analyze clinical and sociodemographic aspects of a cohort of patients with language, speech and learning disorder. METHOD: Descriptive retrospective study. Patient records (2011 to 2015) were selected, making up a total of 4632. Averages, standard deviations, percentages and frequencies were calculated; in order to assess whether there was a significant difference between variables, chi squared test and a conditional probability analysis was performed between the variables to obtain a priori and a posteriori probability. RESULTS: Disorders of language, speech and learning occurred more frequently in males, 3358 patients (72.5%). The most frequent diagnosis was language development disorder, diagnosed in 2924 patients (63.1%). A higher incidence and prevalence of language delay were found for the male sex (p < 0.05). CONCLUSIONS: Of all the variables studied, only the incidence of delay in language development with respect to the male sex was significant; three out of four patients were male and 1 female.

Estrategias de la Organización Mundial de la Salud en Medicina Tradicional y Reconocimiento de Sistemas de Medicina Tradicional / Strategies of the World Health Organization in Traditional Medicine and Recognition of Traditional Medicine Systems

La Constitución de la Organización Mundial de la Salud (OMS) entró en vigor el 7 de abril de 1948, fecha que conmemoramos cada año mediante el Día Mundial de la Salud , teniendo como definición de la salud a "un estado de completo bienestar físico, mental y social

Post-Streptococcal Uveitis: Case Report.

Background: Post-streptococcal uveitis is a rare ocular disease which is part of other auto-immune conditions associated with post-streptococcal syndrome. It was first mentioned in medical literature in 1991, with only a few cases published at that time. We are presenting the case of a patient with bilateral panuveitis subsequent to bacterial pharyngotonsillitis, with studies which had come back negative for other uveitis etiologies and which had responded very well to established treatment. Clinical Case: A case of post-streptococcal uveitis is presented with a review of current concepts of this rare eye disease.

Threatened amphibians sheltered under the big cat's umbrella: conservation of jaguars Panthera onca (Carnivora: Felidae) and endemic herpetofauna in Central America / Anfibios amenazados se refugiaron bajo la sombrilla del gato grande: evaluación de la conservación del jaguar Panthera onca (Carnivora: Felidae) y la herpetofauna endémica en Centro América

Abstract The umbrella species concept posits that protection of a single, wide-ranging species may confer protection to a large number of sympatric species. Due to their large home ranges, widespread distribution in the Mesoamerican Biodiversity Hotspot (MBH), and status as the focal species of numerous conservation initiatives, the jaguar Panthera onca is an ideal species to evaluate the umbrella strategy. After ground-truthing jaguar corridors from 2009-2016, we tested the umbrella value of jaguars for endemic herpetofauna (Amphibia, Reptilia) in Nuclear Central America (NCA), a ~ 370 000 km² sub-region of the MBH. NCA contains the greatest density of threatened reptiles in the Western Hemisphere and harbors extraordinary high diversity of amphibians, the most threatened class of vertebrate worldwide. Of the 304 regional endemics in NCA, the distributions of 187 (61.5 %) species of amphibians and reptiles overlapped ground-truthed jaguar range. The distributions of 14 reptiles, including a critically endangered Bothriechis spp. and two endangered Norops spp., occur exclusively within jaguar distribution. Similarly, the distributions of 19 amphibians, including four critically endangered Craugastor spp. and two critically endangered Plectrohyla spp. occur entirely within jaguar distribution. Our results indicate greater effectiveness of ground-truthed jaguar distribution than modeled and randomly selected networks in overlapping the distributions of endemic herpetofauna, especially threatened amphibians, in NCA. Substantiation of multi-taxa dependence on habitat in jaguar distribution would strengthen justification for wider application of the umbrella strategy beyond NCA and aid conservation planning in the MBH.

Resumen Las especies sombrilla son aquellas cuya conservación confiere protección a un gran número de especies simpátricas. Debido a sus ámbitos hogareños extensos, a una distribución generalizada en el Hotspot de Biodiversidad de Mesoaméricana (MBH), y su estatus como especie focal de numerosas iniciativas de conservación, el jaguar Panthera onca es una especie ideal para evaluar la estrategia sombrilla. Evaluamos el valor de los jaguares como estrategia sombrilla para la herpetofauna endémica en Centro América Nuclear (NCA), una subregión de ~ 370 000 km² que se encuentra dentro del MBH. La NCA contiene la mayor densidad de reptiles amenazados en el hemisferio occidental y alberga una diversidad extraordinaria de anfibios, que es la clase de vertebrados más amenazada del mundo. De las 304 especies endémicas regionales presentes en el NCA, las distribuciones de 187 (61.5 %) se sobrepusieron al área de distribución del jaguar verificada. Las distribuciones de 14 reptiles, incluyendo una Bothriechis spp. (en Peligro Crítico) y dos Norops spp. (en Peligro de Extinción), se dan exclusivamente dentro del rango del jaguar. Similarmente, 19 especies de anfibios, incluidas cuatro Craugastor spp. (en Peligro Crítico) y dos Plectrohyla spp. (en Peligro Crítico) están presentes exclusivamente dentro del área de distribución del jaguar. Nuestros resultados indican que los corredores verificados para el jaguar coinciden mejor con las distribuciones de la herpetofauna endémica dentro del NCA, especialmente anfibios, en comparación con los corredores modelados y seleccionados al azar. La confirmación del traslape de la distribución del hábitat del jaguar con la de múltiples taxones fortalece la justificación de una aplicación más amplia de la estrategia sombrilla, aún más allá del NCA, contribuyendo también en la selección de áreas de conservación previamente subestimadas dentro del MBH.

Estrés oxidativo, función pulmonar y exposición a contaminantes atmosféricos en escolares mexicanos con y sin asma / Oxidative stress, lung function and exposure to air pollutants in Mexican schoolchildren with and without asthma

Resumen: Objetivo: Evaluar la asociación entre la exposición a contaminantes atmosféricos y marcadores de estrés oxidativo, por un lado, y la función pulmonar, por el otro, en escolares, con y sin asma, de las ciudades de Salamanca y León, en Guanajuato, México. Material y métodos: Se realizaron determinaciones de marcadores de estrés oxidativo y pruebas de función pulmonar en 314 escolares, y se obtuvo información sobre contaminantes atmosféricos (ozono, dióxido de azufre, monóxido de carbono y partículas menores de 2.5 µm y menores de 10 µm) de las estaciones de monitoreo correspondientes. Para evaluar la asociación se corrieron modelos de regresión lineal múltiple. Resultados: Con un día de retraso a la exposición a partículas menores de 10 µm (PM10), se observó un incremento de 0.09 pmol en los dienos conjugados entre niños asmáticos de Salamanca (p<0.05). La exposición a ozono durante el mismo día incrementó la concentración de lipo-hidroperóxidos en 4.38 nmol entre asmáticos de Salamanca, así como en 2.31 nmol por la exposición a PM10 para dos días de retraso (p<0.05). La capacidad vital forzada disminuyó 138 y 203 ml en niños sin asma, respectivamente, por la exposición a monóxido de carbono (p<0.05). Conclusiones: La exposición a contaminantes atmosféricos incrementa el estrés oxidativo y disminuye la función pulmonar en escolares con y sin asma.

Abstract: Objective. To assess the association between the air pollutants exposure on markers of oxidative stress and lung function in schoolchildren with and without asthma from Salamanca and Leon Guanajuato, Mexico. Materials and methods: We realized determinations of oxidative stress biomarkers and lung function tests in 314 schoolchildren. Information of air pollutants (O3, SO2, CO, PM2.5 and PM10) were obtained from monitoring stations and multiple linear regression models were run to assess the association. Results: An increase of 0.09 pmol in conjugated dienes was observed by exposure to PM10 lag 1 in asthmatics from Salamanca (p<0.05). The exposure to O3 during the same day increased the concentration of Lipohydroperoxides in 4.38 nmol in asthmatics of Salamanca, as well as in 2.31 nmol by exposure to PM10 lag 2 (p<0.05). The forced vital capacity decreased by 138 and 203 ml in children without asthma, respectively, due to exposure to carbon monoxide (p<0.05). Conclusions: Exposure to air pollutants increase oxidative stress and decreased lung function in schoolchildren, with and without asthma.

[Oxidative stress, lung function and exposure to air pollutants in Mexican schoolchildren with and without asthma]. / Estrés oxidativo, función pulmonar y exposición a contaminantes atmosféricos en escolares mexicanos con y sin asma.

OBJECTIVE.: To assess the association between the air pollutants exposure on markers of oxidative stress and lung function in schoolchildren with and without asthma from Salamanca and Leon Guanajuato, Mexico. MATERIALS AND METHODS: We realized determinations of oxidative stress biomarkers and lung function tests in 314 schoolchildren. Information of air pollutants (O3, SO2, CO, PM2.5 and PM10) were obtained from monitoring stations and multiple linear regression models were run to assess the association. RESULTS: An increase of 0.09 pmol in conjugated dienes was observed by exposure to PM10 lag 1 in asthmatics from Salamanca (p<0.05). The exposure to O3 during the same day increased the concentration of Lipohydroperoxides in 4.38 nmol in asthmatics of Salamanca, as well as in 2.31 nmol by exposure to PM10 lag 2 (p<0.05). The forced vital capacity decreased by 138 and 203 ml in children without asthma, respectively, due to exposure to carbon monoxide (p<0.05). CONCLUSIONS: Exposure to air pollutants increase oxidative stress and decreased lung function in schoolchildren, with and without asthma.

OBJETIVO: Evaluar la asociación entre la exposición a contaminantes atmosféricos y marcadores de estrés oxidativo, por un lado, y la función pulmonar, por el otro, en escolares, con y sin asma, de las ciudades de Salamanca y León, en Guanajuato, México. MATERIAL Y MÉTODOS: Se realizaron determinaciones de marcadores de estrés oxidativo y pruebas de función pulmonar en 314 escolares, y se obtuvo información sobre contaminantes atmosféricos (ozono, dióxido de azufre, monóxido de carbono y partículas menores de 2.5 µm y menores de 10 µm) de las estaciones de monitoreo correspondientes. Para evaluar la asociación se corrieron modelos de regresión lineal múltiple. RESULTADOS: Con un día de retraso a la exposición a partículas menores de 10 µm (PM10), se observó un incremento de 0.09 pmol en los dienos conjugados entre niños asmáticos de Salamanca (p<0.05). La exposición a ozono durante el mismo día incrementó la concentración de lipo-hidroperóxidos en 4.38 nmol entre asmáticos de Salamanca, así como en 2.31 nmol por la exposición a PM10 para dos días de retraso (p<0.05). La capacidad vital forzada disminuyó 138 y 203 ml en niños sin asma, respectivamente, por la exposición a monóxido de carbono (p<0.05). CONCLUSIONES: La exposición a contaminantes atmosféricos incrementa el estrés oxidativo y disminuye la función pulmonar en escolares con y sin asma.

Adolescent psychotherapy process research: adaptation of the instrument APQ / Adolescent psychotherapy process research: adaptation of the instrument APQ / Investigación del proceso de psicoterapia en la adolescencia: adaptación del instrumento APQ

The aim of this paper is to present the Brazilian version of the instrument APQ (Adolescent Psychotherapy Q-Set), including its translation and initial adaptation, followed by the construction of psychotherapy prototypes for psychoanalytic and cognitivebehavioral approaches. A total of 10 psychoanalytic and 10 cognitive-behavioral therapists were asked to classify the APQ items in relation to relevance to their theoretical model. Data were analyzed with factor analysis. The extraction of two factors explained 48.07% of the total variance. The Cronbach's alpha for the psychoanalytic factor was 0.85 and for the cognitivebehavioral factor, 0.86. The former presented factor loadings ranging from .61 to .73, whilst the latter from .49 to .80. The prototypes were developed through linear regression calculations of each APQ item's contribution to each of the factors. It was observed that the two prototypes adequately discriminated psychoanalytic and cognitive behavioral approaches, indicating thatthe APQ is an appropriate tool for research in psychotherapy.AU)

O objetivo deste artigo é apresentar a versão brasileira do instrumento APQ (Adolescent Psychotherapy Q-Set), incluindo sua tradução e adaptação inicial, seguida da construção de protótipos de psicoterapia na adolescência de orientação psicanalítica e cognitivo-comportamental. Solicitou-se a dez psicoterapeutas psicanalíticos e dez cognitivo-comportamentais que classificassem os itens do APQ, considerando sua relevância ao seu modelo teórico. Os dados foram submetidos à análise fatorial. A extração de dois fatores explicou 48,07% da variância total. O alpha de Cronbach do fator psicanalítico foi 0,85 e do cognitivo--comportamental foi 0,86. O primeiro fator apresentou cargas fatoriais entre 0,61 a 0,73 e o segundo entre 0,49 a 0,80. Cálculos de regressão linear identificaram os escores da contribuição de cada item do APQ para cada fator, desenvolvendo-se assim os protótipos. Observou-se que as abordagens psicanalítica e cognitivo-comportamental foram discriminadas, indicando que o instrumento é apropriado para o desenvolvimento de pesquisas em psicoterapia.AU)

El objetivo de este artículo es presentar la versión brasileña del instrumento APQ (Adolescent Psychotherapy Q-Set), incluyendo su traducción y adaptación inicial, y la construcción de prototipos de psicoterapia en la adolescencia de orientación psicoanalítica y cognitivo-conductual. Se solicitó a diez psicoterapeutas psicoanalíticos y diez cognitivo-conductuales que clasificasen los ítems del APQ, teniendo en cuenta su relevancia para el modelo teórico. Los datos fueron sometidos a análisis factorial y la extracción de dos factores explicó 48,07% de la varianza total. El alfa de Cronbach del factor psicoanalítico fue 0,85, y del cognitivo-conductual 0,86. El primer factor presentó cargas factoriales entre 0,61 y 0,73 y el segundo entre 0,49 y 0,80. Cálculos de regresión lineal identificaron los resultados de contribución de cada ítem del APQ para cada factor, desarrollándose así los prototipos. Se observó que el enfoque psicoanalítico y cognitivo-conductual fueron discriminados, indicando que el instrumento es apropriado para el desarrollo de investigaciones en psicoterapia.(AU)

Metals in Bone Tissue of Antillean Manatees from the Gulf of Mexico and Chetumal Bay, Mexico.

Concentrations of seven metals (As, Cd, Cr, Cu, Pb, Ni, and Zn) were analyzed in 33 bone tissue samples of Antillean manatees (Trichechus manatus manatus) found dead in lagoons and rivers of Tabasco and Campeche in the Gulf of Mexico and Chetumal Bay in the Caribbean region. The concentrations of Cr, Cu, Pb, and Zn were significantly different between regions, with greater levels found in the Gulf of Mexico group than in the Mexican Caribbean group (p < 0.05). Pb concentrations differed significantly between adults and calves. No differences were observed between sexes. Metal concentrations detected in the manatee bones were higher than most of those reported for bones in other marine mammals around the world. Future studies are necessary to establish whether the metal concentrations represent a risk to the health of the species.

An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students.

INTRODUCTION: Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. METHODOLOGY: An educational strategy for high school students in Mexico (2011-2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test-Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. RESULTS: An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = - 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. CONCLUSIONS: The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.

Obesity and pregnancy: a transversal study from a low-risk maternity.

BACKGROUND: Obesity is a public health problem and is increasing in all populations, including pregnant women. It influences maternal and neonatal outcomes; however, data are scarce in developing countries. We aimed to compare perinatal results between obese and non-obese pregnant women in a low-risk maternity. METHODS: Transversal study of 1,779 40-week-pregnancies from 2005 to 2009 that completed a standard questionnaire with sociodemographic, obstetrical and neonatal variables and performed an ultrasound with amniotic fluid index (AFI) measurement and foetal vitality (FBP, non-stress test). They were analysed about their association with obesity on pregnancy. RESULTS: When compared with non-obese women, the group of obese patients had higher systolic (118.1 vs 109.2 mmHg; p < 0.01) and diastolic (76.6 vs 70.4 mmHg; p < 0.01) pressure levels, AFI (12.52 vs. 9.61 cm; p = 0.02), presence of meconium on labour (20.52 vs. 14.67%; p = 0.02), birthweight (3602 vs. 3437 g; p < 0.01) and caesarean section (39.74 vs. 29.98%, p < 0.01). CONCLUSIONS: Labour induction before 40 weeks in the antenatal period associated with foetal weight estimation should be considered as a recommendation for decreasing high percentages of caesarean delivery found in obese women.

Estado Nutricional en niños de 6 a 10 años de edad de la comunidad infantil "Sagrada Familia". Lima, Marzo 2011 / Nutritional status in children 6 to 10 year old child

OBJETIVO: Describir el estado nutricional de niños de 6 a 10 años, de la Comunidad de Niños ôSagrada Familiaõ de Lima-Perú, durante marzo 2011. MATERIAL Y MÉTODO: Estudio descriptivo, transversal y prospectivo. Se estudió a 126 niños y niñas entre 6 y 10 años. Se consideró como variables: peso, talla e IMC. Para los diagnósticos de malnutrición se utilizaron: índices de Peso/edad, Talla/edad e IMC/edad, según el criterio actual de la OMS. Se determinó el valor ôzõ mediante programa OMS-AnthroPlus v1.0.4. El análisis de datos se realizó con el programa SPSS v15.0. RESULTADOS: 73% hombres y 27% mujeres, la mayoría tenían 10 años (29,4%). La media de peso, talla e IMC fueron 25,23 kg; 122,14 cm y 16,82 kg/m2. En cuanto al diagnóstico nutricional; 5,6% de niños presentaron desnutrición global, 23,8% desnutrición crónica, 21,4% sobrepeso y 2,4% obesidad, los hombres presentaron mayor porcentaje de desnutrición global (7,7%), desnutrición crónica (27,5%) y sobrepeso (23,1%), en cambio las mujeres presentaron mayor porcentaje de obesidad (2,9%). 71,4% de niños con desnutrición global eran desnutridos crónicos, 22,2% con sobrepeso poseían desnutrición crónica y 100% de obesos tenían crecimiento normal. CONCLUSIONES: El diagnóstico de malnutrición con mayor prevalencia es la desnutrición crónica. Además, se encontró solo casos de desnutridos crónicos con sobrepeso. Por tanto, a pesar que la desnutrición crónica está disminuyendo, no evita que sea la de mayor prevalencia a nivel escolar.

OBJETIVE: To describe the nutritional status of children from 6 to 10 years of age in the ôSagrada Familiaõ child community in Lima, Perú, in March 2011. MATERIALS AND METHOD: Type of study is descriptive, transversal and prospective. We studied 126 children between 6 and 10 years of the ôSagrada Familiaõchild community. The variables considered were weight, height and BMI as well as the diagnosis of malnutrition rates using weight / age, height / age and BMI / age current WHO criteria. We determined the value ôzõ using WHO-AnthroPlus v1.0.4. Data analysis was performed using SPSS v15.0. RESULTS: 73% were male and 27% female, most were 10 years of age (29.4%). Mean weight, height and BMI were 25.23 kg, 122.14 cm and 16.82 kg/m2 respectively. As for the nutritional diagnosis, 5.6% of children had global malnutrition, 23.8% had chronic malnutrition, 21.4% were overweight and 2.4% obese, males had a higher percentage of global malnutrition (7.7%), chronic malnutrition (27.5%) and overweight (23.1%), whereas women had a higher percentage of obesity (2.9%). 71.4% of children with global malnutrition had chronic malnutrition, 22.2% who were overweight had chronic malnutrition, and 100 % of obese have normal growth. CONCLUSIONS: The diagnosis of malnutrition is most prevalent as chronic malnutrition. It was also found only cases of chronically undernourished with overweight. Therefore, although chronic malnutrition is declining, it doesn´t stop being the most prevalent at school level.

Changes in fetal and maternal Doppler parameters observed during acute severe hypertension treatment with hydralazine or labetalol: a randomized controlled trial.

We evaluated 16 pregnant women with gestational age between 20 and 32 weeks in acute severe hypertension which were randomly allocated to receive either hydralazine or labetalol. Blood pressure and Doppler ultrasound parameters from maternal uterine and fetal middle cerebral and umbilical arteries were assessed during acute severe hypertension and after treatment. A significant reduction in systolic and diastolic blood pressure was observed in both groups. A significant change in Doppler parameters was observed only in pregnant women who received hydralazine: an increase in uterine arteries resistance index. We concluded that both drugs were highly effective in reducing blood pressure in these women. Despite the observed increase in resistance index of uterine arteries associated with hydralazine, the use of hydralazine and labetalol were not related to any significant changes in fetal Doppler, which is reassuring about the safety of these drugs when treating acute severe hypertension in pregnancy.

Ultrasonography in pregnant women with antiphospholipid syndrome using salicylic acid and heparin.

PURPOSE: The objective of the present study was to evaluate fetal biometry, Doppler values, and perinatal outcomes in pregnant women with antiphospholipid syndrome treated with acetylsalicylic acid and heparin. STUDY DESIGN: Twenty-five pregnant women with antiphospholipid syndrome using 100 mg/day acetylsalicylic acid and 5,000 IU heparin every 12 h were evaluated in this prospective observational study. Ultrasonography was performed between 24 and 38 weeks of gestational age to assess estimated fetal weight, placental thickness, amniotic fluid index, fetal biophysical profile and Doppler evaluation of maternal uterine arteries, and fetal middle cerebral and umbilical arteries. Data regarding Apgar score, gender, delivery mode, and birth weight and length were recorded after birth. RESULTS: The observed values for ultrasonographic assessment and perinatal outcomes were not very different from the expected values for normal pregnancies. The birth weight was 2863.3 ± 737.7 g (mean ± SD) and length was 46.8 ± 4.2 cm. Only one newborn (4%) had the 1-min Apgar score <7 and all had the 5-min Apgar score >7. CONCLUSION: Gestational and perinatal evaluation of pregnant women with antiphospholipid syndrome using both acetylsalicylic acid and heparin was reassuring.

Caracterización de pacientes adultos con anemia hemolítica autoinmune atendidos en el Instituto de Hematología e Inmunología / Characterization of adult patients presenting with autoimmune hemolytic anemia seen in Hematology and Immunology Institute

Las anemias hemolíticas autoinmunes (AHAI) se caracterizan por la destrucción, mediada por autoanticuerpos, de los eritrocitos del paciente. Los autoanticuerpos causantes del proceso hemolítico se clasifican en calientes y fríos en dependencia de la temperatura óptima de su reacción in vitro. Esta enfermedad se asocia frecuentemente con otras enfermedades autoinmunes, con las hemopatías malignas y con el tratamiento con determinados fármacos. En el Instituto de Hematología e Inmunología se atienden actualmente en consulta externa 35 pacientes adultos con AHAI, con un rango de edad entre 18 y 60 años, 65,7 por ciento del sexo femenino y 94 por ciento de la raza blanca. Treinta y tres de los casos (94,2 por ciento) presentan AHAI por anticuerpos calientes y 2 (5,7 por ciento) un síndrome de aglutininas frías. La prueba de antiglobulina directa (PAD) en el momento del diagnóstico fue positiva en 32 pacientes (91,43 por ciento) y mostró los patrones: IgG+C3d (62,50 por ciento), IgG (18,75 por ciento), C3d (16,62 por ciento) e IgA (3,12 por ciento). En 3 pacientes (8,57 por ciento) la PAD fue negativa. De acuerdo con la etiología, 30 son idiopáticas y 5 secundarias a otras enfermedades. El 68, 5 por ciento de los pacientes respondió satisfactoriamente al tratamiento con esteroides y los restantes requirieron tratamiento con otros inmunosupresores (azatioprina, ciclofosfamida) o esplenectomía. Actualmente, 17 se mantienen sin tratamiento(AU)

The autoimmune hemolytic anemias (AIHA) are characterized by the destruction of auto-antibodies-mediated patient's erythrocytes. The autoantibodies causing the hemolytic process are classified in hot and cold depending of the optimal temperature of its in vitro reaction. This disease is frequently associated with other autoimmune diseases, with malignant blood diseases, and with the treatment using specific drugs. At the present times, in the external consultation of the Hematology and Immunology Institute are seen 35 adult patients presenting with AIHA, with an age rank between 18 and 60 years, the 65,7 percent is female sex and the 94 percent of white race. Thirty three of the cases (94,2 percent) has AIHA by hot antibodies and 2 (5,7 percent) with a cold agglutinins syndrome. The direct antiglobulin test (DAT) at diagnosis was positive in 32 patients (91,43 percent) and showed the following patterns: IgG+C3d (62,50 percent), IgG (18,75 percent), C3d (16,62 percent) and IgA (3,12 percent). In three patients (8.75 percent) the DAT was negative. According to etiology, 30 are idiopathic and 5 secondary to other diseases. The 68,5 percent of patients respond adequately to treatment with steroids and remainder, required treatment with other immunosuppressive agents (azathioprine, cyclophosphamide) or splenectomy. At present time, 17 have not treatment(AU)

Caracterización de pacientes adultos con anemia hemolítica autoinmune atendidos en el Instituto de Hematología e Inmunología / Characterization of adult patients presenting with autoimmune hemolytic anemia seen in Hematology and Immunology Institute

Las anemias hemolíticas autoinmunes (AHAI) se caracterizan por la destrucción, mediada por autoanticuerpos, de los eritrocitos del paciente. Los autoanticuerpos causantes del proceso hemolítico se clasifican en calientes y fríos en dependencia de la temperatura óptima de su reacción in vitro. Esta enfermedad se asocia frecuentemente con otras enfermedades autoinmunes, con las hemopatías malignas y con el tratamiento con determinados fármacos. En el Instituto de Hematología e Inmunología se atienden actualmente en consulta externa 35 pacientes adultos con AHAI, con un rango de edad entre 18 y 60 años, 65,7 % del sexo femenino y 94 % de la raza blanca. Treinta y tres de los casos (94,2 %) presentan AHAI por anticuerpos calientes y 2 (5,7 %) un síndrome de aglutininas frías. La prueba de antiglobulina directa (PAD) en el momento del diagnóstico fue positiva en 32 pacientes (91,43 %) y mostró los patrones: IgG+C3d (62,50 %), IgG (18,75 %), C3d (16,62 %) e IgA (3,12 %). En 3 pacientes (8,57 %) la PAD fue negativa. De acuerdo con la etiología, 30 son idiopáticas y 5 secundarias a otras enfermedades. El 68, 5 % de los pacientes respondió satisfactoriamente al tratamiento con esteroides y los restantes requirieron tratamiento con otros inmunosupresores (azatioprina, ciclofosfamida) o esplenectomía. Actualmente, 17 se mantienen sin tratamiento.

The autoimmune hemolytic anemias (AIHA) are characterized by the destruction of auto-antibodies-mediated patient's erythrocytes. The autoantibodies causing the hemolytic process are classified in hot and cold depending of the optimal temperature of its in vitro reaction. This disease is frequently associated with other autoimmune diseases, with malignant blood diseases, and with the treatment using specific drugs. At the present times, in the external consultation of the Hematology and Immunology Institute are seen 35 adult patients presenting with AIHA, with an age rank between 18 and 60 years, the 65,7% is female sex and the 94% of white race. Thirty three of the cases (94,2%) has AIHA by hot antibodies and 2 (5,7%) with a cold agglutinins syndrome. The direct antiglobulin test (DAT) at diagnosis was positive in 32 patients (91,43%) and showed the following patterns: IgG+C3d (62,50%), IgG (18,75%), C3d (16,62%) and IgA (3,12%). In three patients (8.75%) the DAT was negative. According to etiology, 30 are idiopathic and 5 secondary to other diseases. The 68,5% of patients respond adequately to treatment with steroids and remainder, required treatment with other immunosuppressive agents (azathioprine, cyclophosphamide) or splenectomy. At present time, 17 have not treatment.