Percepción de los médicos residentes de Pediatría sobre el impacto de la pandemia por COVID-19 en su proceso formativo / Pediatric residents' perceptions about the impact of the COVID-19 pandemic on their training

Introducción. Las residencias médicas experimentaron modificaciones que pudieron afectar la formación académica durante la pandemia por COVID-19. Objetivos. Describir la percepción de residentes de Pediatría en relación con el impacto de la pandemia en su formación. Efectuar la adaptación transcultural y validación al idioma español del instrumento "COVID-19 Resident Education and Experience Survey". Materiales y métodos. Estudio observacional, transversal. Participaron residentes de Pediatría de distintos hospitales del país. Se utilizó la encuesta de Ostapenko y col. modificada. Se realizó el análisis descriptivo utilizando SPSS vs. 21. El proyecto fue aprobado por el Comité de Ética institucional. Resultados. Completaron la encuesta 127 residentes. La mayoría dedicaba más de 50 horas a actividades asistenciales antes y durante la pandemia. El 43,3 % (IC95% 35-52) dedicaba hasta 1 hora diaria al estudio individual previo a la pandemia, y un 63 % (IC95% 54,3-70,9) dedicaba ese tiempo durante la pandemia. El 75,6 % (IC95% 67,4-82,2) reportó que el tiempo previo dedicado a actividades académicas era al menos de 4 horas semanales, descendiendo al 41,7 % (IC95% 33,5-50,4) en la pandemia. Más del 60 % (IC95% 54,3-70,1) percibió que la pandemia perjudicó su formación para convertirse en especialista y el 93,7 % (IC95% 88,1-96,8), que su nivel de estrés se incrementó. Conclusiones. La cantidad de horas destinadas a actividades académicas fue percibida como menor durante la pandemia. La mayoría de los encuestados refirió que su nivel de estrés aumentó y que la pandemia perjudicó su formación para convertirse en especialista.

Introduction. Medical residency programs suffered changes that may have affected academic training during the COVID-19 pandemic. Objectives. To describe the perceptions of pediatric residents about the pandemic's impact on their education. To transculturally adapt and validate the COVID-19 Resident Education and Experience Survey into Spanish. Materials and methods. Observational, cross-sectional study. Participants were pediatric residents from hospitals across the country. The survey by Ostapenko et al. was used. A descriptive analysis was done using the SPSS software, version 21. The project was approved by the Institutional Ethics Committee. Results. The survey was completed by 127 residents. Most did more than 50 hours of health care activities before and during the pandemic. Also, 43.3% (95% CI: 35­52) spent at least 1 hour a day studying individually before the pandemic, while 63% (95% CI: 54.3­70.9) did so during the pandemic. In relation to the time spent doing academic work, 75.6% (95% CI: 67.4­82.2) reported that, before the pandemic, they spent at least 4 hours a week doing academic activities, dropping to 41.7% (95% CI: 33.5­50.4) during the pandemic. More than 60% (95% CI: 54.3­70.1) perceived that the pandemic impaired their training to become a specialist and 93.7% (95% CI: 88.1­96.8), that their stress levels increased. Conclusions. The perception was that participants spent less hours doing academic activities during the pandemic. Most surveyed participants mentioned that their stress levels increased and that the pandemic impaired their training to become a specialist.

Pediatric residents' perceptions about the impact of the COVID-19 pandemic on their training. / Percepción de los médicos residentes de Pediatría sobre el impacto de la pandemia por COVID-19 en su proceso formativo.

Introduction. Medical residency programs suffered changes that may have affected academic training during the COVID-19 pandemic. Objectives. To describe the perceptions of pediatric residents about the pandemic's impact on their education. To transculturally adapt and validate the COVID-19 Resident Education and Experience Survey into Spanish. Materials and methods. Observational, cross-sectional study. Participants were pediatric residents from hospitals across the country. The survey by Ostapenko et al. was used. A descriptive analysis was done using the SPSS software, version 21. The project was approved by the Institutional Ethics Committee. Results. The survey was completed by 127 residents. Most did more than 50 hours of health care activities before and during the pandemic. Also, 43.3% (95% CI: 35-52) spent at least 1 hour a day studying individually before the pandemic, while 63% (95% CI: 54.3-70.9) did so during the pandemic. In relation to the time spent doing academic work, 75.6% (95% CI: 67.4-82.2) reported that, before the pandemic, they spent at least 4 hours a week doing academic activities, dropping to 41.7% (95% CI: 33.5-50.4) during the pandemic. More than 60% (95% CI: 54.3-70.1) perceived that the pandemic impaired their training to become a specialist and 93.7% (95% CI: 88.1-96.8), that their stress levels increased. Conclusions. The perception was that participants spent less hours doing academic activities during the pandemic. Most surveyed participants mentioned that their stress levels increased and that the pandemic impaired their training to become a specialist.

Introducción. Las residencias médicas experimentaron modificaciones que pudieron afectar la formación académica durante la pandemia por COVID-19. Objetivos. Describir la percepción de residentes de Pediatría en relación con el impacto de la pandemia en su formación. Efectuar la adaptación transcultural y validación al idioma español del instrumento "COVID-19 Resident Education and Experience Survey". Materiales y métodos. Estudio observacional, transversal. Participaron residentes de Pediatría de distintos hospitales del país. Se utilizó la encuesta de Ostapenko y col. modificada. Se realizó el análisis descriptivo utilizando SPSS vs. 21. El proyecto fue aprobado por el Comité de Ética institucional. Resultados. Completaron la encuesta 127 residentes. La mayoría dedicaba más de 50 horas a actividades asistenciales antes y durante la pandemia. El 43,3 % (IC95% 35-52) dedicaba hasta 1 hora diaria al estudio individual previo a la pandemia, y un 63 % (IC95% 54,3-70,9) dedicaba ese tiempo durante la pandemia. El 75,6 % (IC95% 67,4-82,2) reportó que el tiempo previo dedicado a actividades académicas era al menos de 4 horas semanales, descendiendo al 41,7 % (IC95% 33,5-50,4) en la pandemia. Más del 60 % (IC95% 54,3-70,1) percibió que la pandemia perjudicó su formación para convertirse en especialista y el 93,7 % (IC95% 88,1-96,8), que su nivel de estrés se incrementó. Conclusiones. La cantidad de horas destinadas a actividades académicas fue percibida como menor durante la pandemia. La mayoría de los encuestados refirió que su nivel de estrés aumentó y que la pandemia perjudicó su formación para convertirse en especialista.

[Circulation dynamics of respiratory syncytial virus and its relationship with ambient temperature. 25-year series in Buenos Aires] / Dinámica de circulación de virus sincicial respiratorio y su relación con la temperatura ambiental. Serie de 25 años en Buenos Aires.

Objective: To evaluate changes in RSV seasonality in the last 25 years and their correlation with the mean annual temperature. Methods: Cross-sectional study, based on RSV and temperature data from the City of Buenos Aires (1995-2019). For each year, we describe the beginning, end, and duration of the RSV season and the correlation with the mean annual temperature. Results: We identified 10,183 RSV infections. The duration of the RSV season decreased significantly (1995: 29 weeks vs. 2019: 18 weeks; R: 0.6 (p< 0.001)), due to an earlier ending (1995: week 45 vs. 2019: week 34; 0.6 (p<0.001)). No correlation was observed between mean annual temperature and the duration, start, or end of the RSV season. Conclusion: In the last 25 years, the duration of the RSV season has been significantly shortened due to an earlier ending, without correlation with temperature.

Introducción: El cambio climático global podría alterar la circulación del virus sincicial respiratorio (VSR). Objetivo: Evaluar modificaciones en la circulación de VSR en los últimos 25 años y su correlación con la temperatura ambiente. Métodos: Estudio transversal, utilizando registros de VSR y temperatura de la Ciudad de Buenos Aires (1995-2019). Para cada año, describimos inicio, fin y duración de la temporada de VSR y evaluamos su correlación con la temperatura media anual. Resultados: Se identificaron 10183 infecciones por VSR. La duración de la temporada disminuyó significativamente (1995: 29 semanas vs. 2019: 18 semanas; R: 0.6 (p< 0,001)), debido a una finalización más precoz (1995: semana 45 vs. 2019: semana 34; 0,6 (p<0,001)). No se observó correlación entre temperatura media anual y duración, comienzo ni finalización de la temporada de VSR. Conclusión: En los últimos 25 años, la duración de la temporada de VSR se acortó significativamente, sin correlación con la temperatura.

Evaluación de residentes de pediatría con una modalidad virtual durante la pandemia COVID 19: presentación de una experiencia / Using a virtual mode for the pediatric residents evaluation during the COVID 19 pandemic: report of an experience

El examen clínico objetivo estructurado (ECOE) es una herramienta válida para medir competencias clínicas. En el contexto de la pandemia por COVID-19 se debieron adaptar las evaluaciones, habitualmente presenciales, a un formato virtual. El objetivo de este artículo es comunicar la experiencia de utilizar una modalidad virtual del ECOE para residentes de primer año de pediatría durante la pandemia por COVID-19. El ECOE comprendió 12 estaciones utilizando casos simulados en línea y consultas virtuales a distancia. Participaron del ECOE 115 residentes, aprobaron 110 (95,7%) y solo 17 participantes aprobaron el 100% de las estaciones. Las estaciones con mejor rendimiento fueron las referidas a alimentación complementaria, abordaje del traumatismo encéfalo craneano, interpretación de resultados de laboratorio y de imágenes radiológicas. El menor rendimiento se observó en uso de equipo de protección personal y vacunas. La encuesta de satisfacción fue respondida por 80/115 participantes (69,5%). El 91% de los participantes encontró fácil de utilizar la plataforma virtual. La mayoría (73/80) consideró que los temas fueron acordes al nivel de formación. La estación de pautas madurativas fue identificada como la más difícil. El 57% refirió que el ECOE les resultó útil para identificar puntos débiles en su formación. La implementación de una modalidad virtual del ECOE fue posible y presentó buena aceptación de los participantes.

The objective structured clinical examination (OSCE) is a helpful tool for assessing clinical competencies. During the COVID-19 pandemic, assessments usually carried out in person had to be adapted to a virtual format. We aim to report our experience using a virtual OSCE administered to first-year pediatric residents during the COVID-19 pandemic. The OSCE included 12 stations, including online simulated cases and virtual remote consultations. In total 115 residents participated in the OSCE; 110 (95.7%) passed the test, but only 17 participants passed all stations. The stations with the highest performance were related to complementary feeding, management of traumatic head injury, interpretation of lab test results and imaging. The lowest performance was observed using personal protective equipment and checking vaccine schedules. The user satisfaction survey was completed by 80 out of 115 participants (69.5%); 91 % of the participants found the virtual platform easy to use. Most of the residents (73/80) considered the topics to be appropriate for their training level. The station related to child development guidelines was identified as the most challenging. 57% reported that the OSCE was helpful for identifying weaknesses in their training. Conclusion: the implementation of a virtual OSCE was feasible and it was well accepted by the participants.

Time Interval Between the End of Neoadjuvant Therapy and Elective Resection of Locally Advanced Rectal Cancer in the CRONOS Study.

Importance: The treatment for extraperitoneal locally advanced rectal cancer (LARC) is neoadjuvant therapy (NAT) followed by total mesorectal excision (TME). Robust evidence on the optimal time interval between NAT completion and surgery is lacking. Objective: To assess the association of time interval between NAT completion and TME with short- and long-term outcomes. It was hypothesized that longer intervals increase the pathologic complete response (pCR) rate without increasing perioperative morbidity. Design, Setting, and Participants: This cohort study included patients with LARC from 6 referral centers who completed NAT and underwent TME between January 2005 and December 2020. The cohort was divided into 3 groups depending on the time interval between NAT completion and surgery: short (≤8 weeks), intermediate (>8 and ≤12 weeks), and long (>12 weeks). The median follow-up duration was 33 months. Data analyses were conducted from May 1, 2021, to May 31, 2022. The inverse probability of treatment weighting method was used to homogenize the analysis groups. Exposure: Long-course chemoradiotherapy or short-course radiotherapy with delayed surgery. Main outcome and Measures: The primary outcome was pCR. Other histopathologic results, perioperative events, and survival outcomes constituted the secondary outcomes. Results: Among the 1506 patients, 908 were male (60.3%), and the median (IQR) age was 68.8 (59.4-76.5) years. The short-, intermediate-, and long-interval groups included 511 patients (33.9%), 797 patients (52.9%), and 198 patients (13.1%), respectively. The overall pCR was 17.2% (259 of 1506 patients; 95% CI, 15.4%-19.2%). When compared with the intermediate-interval group, no association was observed between time intervals and pCR in short-interval (odds ratio [OR], 0.74; 95% CI, 0.55-1.01) and long-interval (OR, 1.07; 95% CI, 0.73-1.61) groups. The long-interval group was significantly associated with lower risk of bad response (tumor regression grade [TRG] 2-3; OR, 0.47; 95% CI, 0.24-0.91), systemic recurrence (hazard ratio, 0.59; 95% CI, 0.36-0.96), higher conversion risk (OR, 3.14; 95% CI, 1.62-6.07), minor postoperative complications (OR, 1.43; 95% CI, 1.04-1.97), and incomplete mesorectum (OR, 1.89; 95% CI, 1.02-3.50) when compared with the intermediate-interval group. Conclusions and Relevance: Time intervals longer than 12 weeks were associated with improved TRG and systemic recurrence but may increase surgical complexity and minor morbidity.

Ética en investigación: desafíos durante la pandemia / Research ethics: challenges during the pandemic

Durante la pandemia de Covid-19 los hospitales pediatricos se vieron menos afectados, debido a la menor infección en niños, y sus recursos fueron reasignados en distintas tareas.. El Comité de Ética en Investigación del Hospital General de Niños Pedro de Elizalde presenta los distintos procedimientos implementados en esta emergencia, para sostener diferentes investigaciones, y que les permitió una rápida respuesta a esta situación.

Hemitiroidectomía vía abordaje axilo-mamario unilateral (UABA) con insuflación de gas vs. convencional abierta: estudio prospectivo comparativo / Unilateral axilo-breast approach (UABA) with gas insufflation versus open conventional hemithyroidectomy: A prospective comparative study

Antecedentes: El objetivo de este estudio fue comparar con el abordaje abierto convencional, los resultados quirúrgicos y estéticos de la tiroidectomía endoscópica por abordaje axilo-mamario unilateral (UABA) con insuflación de gas en pacientes con nódulo tiroideo unilateral. Métodos: Entre agosto de 2017 y agosto de 2020, se llevó a cabo un estudio prospectivo comparativo de cohortes en pacientes propuestos para hemitiroidectomía. Los pacientes se asignaron a un tipo de abordaje (abierto o endoscópico) de manera sucesiva. Los resultados quirúrgicos y la satisfacción estética al alta hospitalaria y durante el seguimiento a 12 meses fueron evaluados y comparados entre ambos grupos. Resultados: Un total de 200 pacientes fueron incluidos en el estudio: 100 se asignaron al abordaje abierto y 100 al endoscópico. Las características demográficas de los pacientes fueron similares entre ambos grupos. El tiempo operatorio total fue mayor en el abordaje endoscópico, debido al tiempo necesario para la disección subcutánea (el tiempo de hemitiroidectomía fue similar en ambos grupos). No hubo diferencia significativa en la frecuencia de complicaciones mayores. El tiempo de estancia hospitalaria fue mayor (por un día) en el grupo endoscópico. La satisfacción estética de los pacientes fue significativamente mayor en el grupo endoscópico que en el abierto (p<0,001), al alta hospitalaria y al seguimiento a 12 meses. Conclusión: El UABA con insuflación de gas para la hemitiroidectomía representa una opción terapéutica segura y eficaz para el tratamiento de patologías benignas tiroideas unilaterales. (AU)

Background: The objective of this study was to compare with the conventional open approach, the surgical and aesthetic results of endoscopic thyroidectomy via unilateral axillo-breast approach (UABA) with gas insufflation in patients with a unilateral thyroid nodule. Methods: Between August 2017 and August 2020, a prospective comparative cohort study was carried out in patients proposed for hemithyroidectomy. The patients were assigned to one type of approach (Open or Endoscopic) in a successive manner. Surgical results and aesthetic satisfaction at hospital discharge and during the 12-month follow-up were evaluated and compared between both groups. Results: A total of 200 patients were included in the study: 100 for the Open approach and 100 for the Endoscopic. The baseline patient characteristics were similar between both groups. Total operative time was longer in the Endoscopic approach, due to the time required for subcutaneous dissection (the hemithyroidectomy time was similar in both groups). There was no significant difference in the frequency of major complications. The length of hospital stay was longer (for 1 day) in the Endoscopic group. The aesthetic satisfaction of the patients was significantly higher in the Endoscopic than in the Open group (p<0.001), at hospital discharge and at 12-month follow-up. Conclusion: UABA with gas insufflation for hemithyroidectomy represents a safe and effective therapeutic option for the treatment of unilateral benign thyroid pathologies. (AU)

Unilateral axilo-breast approach (UABA) with gas insufflation versus open conventional hemithyroidectomy: A prospective comparative study.

BACKGROUND: The objective of this study was to compare with the conventional open approach, the surgical and aesthetic results of endoscopic thyroidectomy via unilateral axillo-breast approach (UABA) with gas insufflation in patients with a unilateral thyroid nodule. METHODS: Between August 2017 and August 2020, a prospective comparative cohort study was carried out in patients proposed for hemithyroidectomy. The patients were assigned to one type of approach (Open or Endoscopic) in a successive manner. Surgical results and aesthetic satisfaction at hospital discharge and during the 12-month follow-up were evaluated and compared between both groups. RESULTS: A total of 200 patients were included in the study: 100 for the Open approach and 100 for the Endoscopic. The baseline patient characteristics were similar between both groups. Total operative time was longer in the Endoscopic approach, due to the time required for subcutaneous dissection (the hemithyroidectomy time was similar in both groups). There was no significant difference in the frequency of major complications. The length of hospital stay was longer (for 1 day) in the Endoscopic group. The aesthetic satisfaction of the patients was significantly higher in the Endoscopic than in the Open group (p < 0.001), at hospital discharge and at 12-month follow-up. CONCLUSION: UABA with gas insufflation for hemithyroidectomy represents a safe and effective therapeutic option for the treatment of unilateral benign thyroid pathologies.

Women authorship in Latin American pediatric journals. A 35 years analysis / Participación de la mujer en revistas pediátricas latinoamericanas. Análisis de 35 años

Background: Women authorship in scientific publication is still limited, especially in hierarchical positions. Objective: To analyze the participation of women as authors in Latin American pediatric publications and its variation over 35 years. Methods: All articles from Archivos Argentinos de Pediatria, Jornal de Pediatria, and Revista Chilena de Pediatria from the analyzed years (1985, 1995, 2005, 2015, 2020) were identified, calculating the proportion of women as authors, and as first and last author. For each variable, changes in the studied period were evaluated  (X2 for trend). Results: We evaluated 1860 articles (6039 authors). After a significant increase during the analyzed period , in 2020, 59.1% of the co-authors, 59.7% of the first and 44.4% of the last authors were women. Conclusion: The proportion of women authors in Latin American pediatric journals has increased in 35 years, reaching 59.1%. However, their participation in prestigious areas is still limited.

Introducción: La participación de la mujer en publicación científica es limitada, especialmente en posiciones jerárquicas. Objetivo: Estimar la participación de la mujer en publicaciones pediátricas latinoamericanas y su variación en 35 años. Métodos: Se identificaron todos los artículos de Archivos Argentinos de Pediatría, Jornal de Pediatria y Revista Chilena de Pediatría de los años analizados (1985,1995, 2005, 2015, 2020), calculando la proporción de mujeres autoras, y como primer y último autor. Para cada variable, se evaluaron las modificaciones en el período estudiado (X2 para tendencia). Resultados: Evaluamos 1860 artículos (6039 autores). Luego de un incremento significativo en el período evaluado, en 2020, 59,1 % de los autores, 59,7 % de los primeros autores, y 44,4 % de los últimos eran mujeres. Conclusión: La proporción de mujeres autoras en revistas pediátricas latinoamericanas se incrementó en 35 años, alcanzando 59,1 %, pero su participación en lugares de prestigio es aún limitada.

Mesoporous silica particles are phagocytosed by microglia and induce a mild inflammatory response in vitro.

Aim: Mesoporous silica particles (MSPs) are broadly used drug delivery carriers. In this study, the authors analyzed the responses to MSPs of astrocytes and microglia, the two main cellular players in neuroinflammation. Materials & methods: Primary murine cortical mixed glial cultures were treated with rhodamine B-labeled MSPs. Results: MSPs are avidly internalized by microglial cells and remain inside the cells for at least 14 days. Despite this, MSPs do not affect glial cell viability or morphology, basal metabolic activity or oxidative stress. MSPs also do not affect mRNA levels of key proinflammatory genes; however, in combination with lipopolysaccharide, they significantly increase extracellular IL-1ß levels. Conclusion: These results suggest that MSPs could be novel tools for specific drug delivery to microglial cells.

Mesoporous silica particles (MSPs) are broadly used drug delivery carriers. In this study, the authors analyzed the responses of two types of brain cells, astrocytes and microglia, to MSPs. Mouse astrocytes and microglia were kept alive in cultures and were treated with MSPs that were labeled with a red fluorescent agent to facilitate visualization under the microscope. MSPs are avidly internalized by microglial cells and remain inside the cells for at least 14 days. Despite this, MSPs do not affect glial cell viability or morphology, basal metabolic activity or oxidative stress. When given alone, MSPs do not affect mRNA levels of key proinflammatory genes. However, MSPs given in combination with lipopolysaccharide, a strong proinflammatory agent, significantly increase extracellular levels of IL-1ß, one of the proinflammatory mediators studied. These results suggest that MSPs could be novel tools for specific drug delivery to microglial cells.

Thyroidectomy via unilateral axillo-breast approach (UABA) with gas insufflation: prospective multicentre European study.

BACKGROUND: Extracervical approaches for thyroidectomy are seldom explored in the western population. The objective of this study was to evaluate the outcomes of hemithyroidectomy via endoscopic unilateral axillo-breast approach (UABA) with gas insufflation. METHOD: Consecutive patients undergoing UABA hemithyroidectomy for symptomatic benign or cytologically indeterminate nodules (Bethesda III lesions) of less than 5 cm from July 2015 to December 2020 at three European institutions were included. Patients were excluded if presenting with a BMI more than 25 kg/m2, had previous neck surgery and/or radiation, had bilateral thyroid lesions, retrosternal goitre, Hashimoto thyroiditis or Graves' disease. Follow-up was carried out at 2 weeks, 3 months and 1 year. Outcomes of interest were surgical (including operating time, mean duration of hospital stay and complications) and self-assessed cosmetic outcomes. RESULTS: Out of 984 patients treated with hemithyroidectomy during the study interval, 253 were selected, including 214 women and 39 men. Patients' mean age was of 46.6 years with a mean BMI of 22.57. Mean operating time was 72.9 minutes. A transient recurrent laryngeal nerve injury was reported in 3.6 per cent of the patients, but none was persistent. Transient pectoral/cervical hypoesthesia was noted in 24.1 per cent of patients, with no permanent hypoesthesia. Skin burns and subcutaneous hematoma developed in 2.4 per cent and 2 per cent of patients but resolved within the third month after surgery. There was no tracheal/oesophageal perforation, conversion to open surgery or reoperation. The final pathology revealed 241 benign nodules, nine underlying papillary thyroid carcinomas, and three cases of follicular carcinoma. Hospital discharge was achieved on the first in 68.8 per cent of the patients and on the second postoperative day in 31.2 per cent of the cases. All patients were satisfied with the cosmetic aspect. CONCLUSION: In selected patients, UABA with gas insufflation for hemithyroidectomy could be performed for the treatment of unilateral thyroid pathologies.

Quantitative exposure assessment and risk characterization for fipronil residues in laying hen eggs.

Poultry production is linked to veterinary drug use to treat diseases. Few ectoparasitic compounds are approved for poultry. Fipronil is a pesticide widely used in agriculture. It is also a drug authorized to control ectoparasites in small animals and, in some countries, in cattle. There has been evidence of fipronil extra-label use in laying hens, mainly to control the red mite Dermanyssus gallinae. Fipronil's popularity is due to its high toxicity to invertebrates. It could be metabolized to more toxic metabolites that potentially damage human health. In the present study, we carry out a quantitative exposure assessment and risk characterization for fipronil residues in laying hen eggs for local consumption in five cities of Buenos Aires province in Argentina, namely, Azul, Balcarce, Juarez, Chaves, and Tandil. Consumption surveys and egg sampling were conducted for three summer periods. Eggs were analyzed by UFLC-MS-MS. Fipronil prevalence, residue concentrations, residue stability to cooking methods, egg consumption, among the most important variables were modeled. The results indicated that 20.7% of samples contained fipronil residues. The highest residue was fipronil sulfone metabolite. Fipronil concentrations quantified ranged between 10 and 2510 ppb (median value = 150 ppb). When eggs were cooked, fipronil residues were stable. The exposure assessment and risk characterization revealed that the highest probability of consuming eggs with fipronil residues above the admissible limits was for young adults (20.8%), followed by babies (16.9%), young children (16.4%), children (13.4%), teenagers (10.3%), older adults (9.41%), and adults (8.65%). These results suggest an unacceptable risk associated with egg consumption with fipronil residues for all age groups. PRACTICAL APPLICATION: Fipronil is widely used as an extra-label way on laying hens since its use is prohibited in poultry production both in Argentina and in most countries. This molecule has been classified as Class II, a moderately hazardous pesticide because it could damage various human organs. Fipronil residues in eggs could be one of the exposure pathways for consumers. Monitoring residual levels and carrying out the health risk assessment in eggs are thus in an urge.

Efecto del empleo de prescripciones informatizadas en la seguridad de pacientes pediátricos hospitalizados / Effect of electronic prescriptions on the safety of hospitalized pediatric patients

Introducción. Los errores en prescripción médica (EPM) son la causa más frecuente de errores prevenibles. El empleo de sistemas de prescripción informatizada (PI) contribuiría a disminuir el error y a mejorar la calidad de atención. Objetivos. Evaluar el efecto de la PI en la prevalencia de EPM y eventos adversos (EA) relacionados en pacientes pediátricos hospitalizados. Evaluar la adherencia, aceptabilidad y apropiabilidad de la herramienta por parte de los usuarios. Método. Diseño híbrido, descriptivo y cuasiexperimental tipo antes-después. Se incluyeron prescripciones médicas de pacientes hospitalizados, calculando la prevalencia de EPM y EA relacionados, en los períodos pre-y pos implementación de la PI en un hospital pediátrico (HP) y en uno general (HG) que se tomó como control. Se evaluó la adherencia mediante la proporción de las PI sobre las totales registradas en el período posimplementación. Se evaluó la aceptabilidad y apropiabilidad de la implementación por encuesta a los usuarios. Resultados. Al comparar la prevalencia de EPM pre- y posimplementación en el HP, se observó una disminución estadísticamente significativa en los dos hospitales: HP 29,1 versus 19,9 EPM/100 prescripciones (OR: 1,65; IC95 %: 1,34-2,02; p < 0,01). En el HG 24,9 versus 13,6 EPM/100 prescripciones (OR: 2,1; IC95 %: 1,5-2,8; p < 0,01). La tasa de adherencia global a la PI fue del 83 %. La implementación presentó aceptabilidad y apropiabilidad satisfactoria. Conclusión. La prevalencia de EPM se redujo un 30 % posimplementación. La adherencia global a la herramienta fue satisfactoria

Introduction. Prescription errors are the most common cause of preventable errors. Electronic prescription (EP) systems may help to reduce errors and improve the quality of care. Objectives. To assess the effect of EP on the prevalence of prescription errors and related adverse events (AE) among hospitalized pediatric patients. To assess EP adherence, acceptability, and suitability among users. Method. Hybrid, descriptive, and quasi-experimental, before-and-after design. Prescriptions made to hospitalized patients were included, estimating the prevalence of prescription errors and related AE in the pre- and post- EP implementation periods at a children's hospital (CH) and a general hospital (GH) used as control. Adherence was assessed based on the proportion of EP among all prescriptions registered in the post-implementation period. The acceptability and suitability of EP implementation was assessed via a user survey. Results. The prevalence of prescription errors pre- and post-EP implementation at the CH was compared and a statistically significant reduction was observed in both hospitals: CH: 29.1 versus 19.9 prescription errors/100 prescriptions (OR: 1.65; 95% CI: 1.34-2.02;p < 0.01). GH: 24.9 versus 13.6 prescription errors/100 prescriptions (OR: 2.1; 95% CI: 1.5-2.8; p < 0.01). The rate of overall adherence to EP was 83%. The implementation of EP was adequately acceptable and suitable. Conclusion. The prevalence of prescription errors reduced 30% after the implementation of EP. The overall adherence to EP was adequate.

Effect of electronic prescriptions on the safety of hospitalized pediatric patients. / Efecto del empleo de prescripciones informatizadas en la seguridad de pacientes pediátricos hospitalizados.

INTRODUCTION: Prescription errors are the most common cause of preventable errors. Electronic prescription (EP) systems may help to reduce errors and improve the quality of care. OBJECTIVES: To assess the effect of EP on the prevalence of prescription errors and related adverse events (AE) among hospitalized pediatric patients. To assess EP adherence, acceptability, and suitability among users. METHODS: Hybrid, descriptive, and quasi-experimental, before-and-after design. Prescriptions made to hospitalized patients were included, estimating the prevalence of prescription errors and related AE in the pre- and post- EP implementation periods at a children's hospital (CH) and a general hospital (GH) used as control. Adherence was assessed based on the proportion of EP among all prescriptions registered in the post-implementation period. The acceptability and suitability of EP implementation was assessed via a user survey. RESULTS: The prevalence of prescription errors pre- and post-EP implementation at the CH was compared and a statistically significant reduction was observed in both hospitals: CH: 29.1 versus 19.9 prescription errors/100 prescriptions (OR: 1.65; 95% CI: 1.34-2.02; p < 0.01). GH: 24.9 versus 13.6 prescription errors/100 prescriptions (OR: 2.1; 95% CI: 1.5-2.8; p < 0.01). The rate of overall adherence to EP was 83%. The implementation of EP was adequately acceptable and suitable. CONCLUSION: The prevalence of prescription errors reduced 30% after the implementation of EP. The overall adherence to EP was adequate.

Introducción. Los errores en prescripción médica (EPM) son la causa más frecuente de errores prevenibles. El empleo de sistemas de prescripción informatizada (PI) contribuiría a disminuir el error y a mejorar la calidad de atención. Objetivos. Evaluar el efecto de la PI en la prevalencia de EPM y eventos adversos (EA) relacionados en pacientes pediátricos hospitalizados. Evaluar la adherencia, aceptabilidad y apropiabilidad de la herramienta por parte de los usuarios. Método. Diseño híbrido, descriptivo y cuasiexperimental tipo antes-después. Se incluyeron prescripciones médicas de pacientes hospitalizados, calculando la prevalencia de EPM y EA relacionados, en los períodos pre-y posimplementación de la PI en un hospital pediátrico (HP) y en uno general (HG) que se tomó como control. Se evaluó la adherencia mediante la proporción de las PI sobre las totales registradas en el período posimplementación. Se evaluó la aceptabilidad y apropiabilidad de la implementación por encuesta a los usuarios. Resultados. Al comparar la prevalencia de EPM pre- y posimplementación en el HP, se observó una disminución estadísticamente significativa en los dos hospitales: HP 29,1 versus 19,9 EPM/100 prescripciones (OR: 1,65; IC95 %: 1,34-2,02; p < 0,01). En el HG 24,9 versus 13,6 EPM/100 prescripciones (OR: 2,1; IC95 %: 1,5-2,8; p < 0,01). La tasa de adherencia global a la PI fue del 83 %. La implementación presentó aceptabilidad y apropiabilidad satisfactoria. Conclusión. La prevalencia de EPM se redujo un 30 % posimplementación. La adherencia global a la herramienta fue satisfactoria.

Pharmacokinetics and milk excretion pattern of eprinomectin at different dose rates in dairy cattle.

This study aimed at determining the plasma disposition kinetics of eprinomectin (EPM) and EPM excretion pattern through milk after topical administration to dairy cattle at the recommended dose of 0.5 mg/kg and at 1 and 1.5 mg/kg. A high variability in the plasma concentration profiles was observed among animals, particularly in the Cmax values, with a coefficient of variation between 39 and 53%. The Cmax and AUC values were significantly affected by the dose administered at 1.5 mg/kg. However, such differences did not seem to follow a linear pattern among treatments. These parameters did not differ among dose rates after dose normalization; nevertheless, the simulation of a linear kinetic disposition showed a mean plasma AUC value of 254 ng.d/ml instead of the observed value of 165 ng.d/ml. EPM concentration profiles in milk were significantly lower than those measured in plasma. The Cmax and AUC milk-to-plasma ratios ranged from 0.14 to 0.26 and 0.16 to 0.21, respectively (p>0.05). The low milk-to-plasma ratio of EPM accounted for a low percentage of the fraction of the administered dose excreted through milk, being significantly higher at a dose rate of 0.5 mg/kg (0.07%) of EPM than at 1.5 mg/kg (0.04%) (p<0.05). The topical administration of EPM to lactating dairy cows at higher doses than that recommended for gastrointestinal nematodes showed a milk excretion pattern with a zero milk withdrawal period. In conclusion, the administration of topical EPM formulation at 1 or 1.5 mg/kg may be a valuable tool to be used in regional strategic deworming programs aimed to control ectoparasite infections in dairy production systems.

An algorithm for identifying visits due to pediatric lower acute respiratory infections in electronic clinical records. / [Algoritmo para identificación de consultas por infección respiratoria aguda baja en pediatría en registros clínicos electrónicos.]

Background: Due to ambiguities in terminology, acute lower respiratory infections (ALRI) in childhood are frequently not properly recorded, especially during outpatient visits. A tool that accurately identifies them, would assess the impact on respiratory health of massive harms, and design policies to prevent or mitigate their effects. We aimed to design an algorithm that allows identifying children with ALRI based on data from the electronic clinical record (ECR) of the Government of the City of Buenos Aires (GCBA). Methods: From the ECR-GCBA database, we randomly selected 1000 outpatient visits of patients aged under 2 years. Terms showing that the visit was due to LARI were searched using an algorithm based on hard rules. Another dataset including 800 visits was used to adjust the algorithm and, finally, its performance was tested in a third dataset of 800 queries corresponding to the entire year 2018. Results: In the validation set, our tool identified LARI with sensitivity 88.24%, specificity 97.5%, PPV 86.07% and NPV 97.93%. Conclusion: Our search algorithm allows us to identify with acceptable precision the outpatient visits related to LARI in children under 2 years of age from electronic clinical records.

Introducción: Debido a ambigüedades en la nomenclatura, las infecciones respiratorias agudas bajas (IRAB) en la infancia frecuentemente no son debidamente registradas, especialmente durante las consultas ambulatorias. Contar con una herramienta que las identifique con precisión, permitirá evaluar el impacto en la salud respiratoria de noxas de alcance masivo y diseñar las políticas para prevenirlas o mitigar sus efectos. Nuestro objetivo fue construir un algoritmo que permita identificar niños con IRAB a partir de los datos de la historia clínica electrónica (HCE) del Gobierno de la Ciudad de Buenos Aires (GCBA). Métodos: Utilizando la HCE-GCBA, se seleccionaron aleatoriamente 1000 consultas ambulatorias de pacientes menores de 2 años. Se buscaron términos que hicieran referencia a que la consulta era motivada por IRAB, con los que se desarrolló un algoritmo basado en reglas duras. Se utilizó otro set de datos de 800 consultas para ajustar el algoritmo y, finalmente, se validó su desempeño en un tercer set de 800 consultas correspondientes a todo el año 2018. Resultados: En el set de validación, la herramienta desarrollada identificó IRAB con sensibilidad 88,24%, especificidad 97,5%, VPP 86,07% y VPN 97,93%. Conclusión: El algoritmo de búsqueda desarrollado permite identificar con aceptable precisión las consultas ambulatorias relacionadas con IRAB en niños menores de 2 años.

Children hospitalized for COVID-19 during the first winter of the pandemic in Buenos Aires, Argentina.

BACKGROUND: Although there are reports on COVID-19 in pediatrics, the characteristics of the population of each country, its health systems, and how the pandemic was addressed could give the disease distinctive features worldwide. We aimed to describe the characteristics of patients hospitalized for COVID-19 in a tertiary pediatric hospital in the City of Buenos Aires, Argentina. METHODS: We conducted a descriptive study, including all patients hospitalized for COVID-19 from 04/26/2020 to 10/31/2020 in a tertiary pediatric hospital. We described the demographic, clinical, and epidemiological characteristics of the patients. RESULTS: During the period studied, 578 patients were hospitalized with COVID-19. The median age was 4.2 years, and 83% reported close contact with a confirmed COVID-19 case. Regarding severity, 30.8% were asymptomatic, and 60.4% showed mild, 7.4% moderate, and 1.4% severe symptoms. Among symptomatic patients, fever was the most frequent symptom, followed by sore throat and cough. CONCLUSIONS: We reported 578 cases of children and adolescents hospitalized with COVID-19, of which the majority showed mild or asymptomatic disease.

Social Connectivity, Sentiment and Participation on Twitter during COVID-19.

In a transnational context defined by the irruption of COVID-19 and the social isolation it has generated around the world, social networking sites are essential channels for communicating and developing new forms of social coexistence based on connectivity and interaction. This study analyzes the feelings expressed on Twitter through the hashtags #YoMeQuedoEnCasa, #stayhome, #jeresteàlamaison, #restealamaison, #stoacasa, #restaacasa, #ficaemcasa, #euficoemcasa, #ichbleibezuHause and #Bleibzuhause, and the communicative and social processes articulated from network participation, during the lockdown in 2020. Through Gephi software, the aspects underlying the communicative interaction and the distribution of the network at a global level are studied, with the identification of leaderships, communities and connectivity nodes. As a result of this interaction, the emergence of social and organizational links derived from community participation and motivated by the common interest of preserving health and general wellbeing through collective action is detected. The study notes the presence of feelings of solidarity, a sense of community and social support among connected crowds who, despite being in geographically dispersed settings, share similar concerns about the virus effect.

Impacto de la pandemia por SARS-CoV-2 en la administración de vacunas del Calendario Nacional de Inmunizaciones en menores de 2 años / Impact of the SARS-CoV-2 pandemic on the administration of vaccines as per the national immunization schedule in children younger than 2 years

Introducción. El menor número de consultas a los centros de atención desde el comienzo de la pandemia por SARS-CoV-2podría afectar la vacunación obligatoria.Objetivo. Evaluar el impacto de la pandemia por SARS-CoV-2en la administración de vacunas pentavalente y triple viral a niños menores de 2 años en el vacunatorio de un hospital pediátrico de la Ciudad de Buenos Aires.Método. Estudio transversal, que utilizó registros informatizados del vacunatorio, de enero a mayo de 2019 y 2020.Resultados. Desde la segunda quincena de marzo de 2020, se observó un 64,2 % de disminución en la aplicación de vacunas. Al examinar la primera dosis de pentavalente y triple viral, la reducción fue del 74,9 % y del 55,1 %, respectivamente.Conclusión. A partir de la segunda quincena de marzo de 2020, se observó una disminución del 64,2 % en las vacunas aplicadas respecto del mismo período en el año anterio

Introduction. The reduction in the number of visits to health care centers since the onset of the SARS-CoV-2 pandemic may affect mandatory vaccination.Objective. To assess the impact of the SARS-CoV-2 pandemic on the administration of the pentavalent and the measles, mumps, and rubella (MMR) vaccines to children younger than 2 years at the vaccination center of a children's hospital in the Autonomous City of Buenos Aires.Method. Cross-sectional study using the vaccination center's digital records from January to May 2019 and 2020.Results. In the second fortnight of March 2020, vaccinations dropped by 64.2 %. When examining the first dose of the pentavalent and MMR vaccines, such reduction was 74.9 % and 55.1 %, respectively.Conclusion. As of the second fortnight of March 2020, vaccinations dropped by 64.2 % compared to the same period of the previous year.