Hábitos y trastornos de sueño en población pediátrica: un problema de salud pública / Sleep habits and disorders in a pediatric population: a public health problem

INTRODUCCIÓN: El buen dormir está ligado a un normal neurodesarrollo, el deterioro de esta función vital disminuye la calidad de vida de quien la padece y su familia, además conlleva consecuencias neurocognitivas negativas en la consolidación de la memoria y capacidad de atención durante la vigilia. MÉTODO: Se realiza un estudio transversal y descriptivo, con el fin de caracterizar los hábitos y trastornos de sueño en un grupo de preescolares y adolescentes chilenos. Se entrega el cuestionario de sueño pediátrico Chervin modificado a padres y/o apoderados de alumnos de 3 colegios de Santiago (establecimientos de tipo privado, subvencionado y municipal) de forma aleatoria en los diferentes niveles. RESULTADOS: Muestra total 308 estudiantes, 159 hombres y 149 mujeres. Rango etario de 3 a 18 años. Se obtuvieron los siguientes resultados: El promedio de horas de sueño de 9 horas en preescolares y escolares y 7,5 horas en adolescentes. 19% presenta dificultad para conciliar el sueño y 85% de estos tiene latencia mayor a 30 minutos. 6% despierta más de dos veces en la noche teniendo problemas para volver a dormir. 34% consume bebidas estimulantes y 13% duerme siesta. En relación a trastornos del sueño se encontró ronquido 30%, 2% tiene sospecha de apnea/hipopnea obstructiva del sueño. 32% síntomas de piernas inquietas, 25% bruxismo, 6% enuresis, 12% sonambulismo, 10% pesadillas, 44% somniloquia, 26% síntomas de insomnio, 18% somnolencia diurna y 2% sospecha de narcolepsia. Antecedente familiar de trastornos del sueño 5%. 12% de los niños tiene obesidad, 7% trastorno por déficit atencional (4% recibe psicoestimulantes). Además 5% declara trastornos emocionales asociados al mal dormir. DISCUSIÓN: Los hábitos y trastornos de sueño han sido poco estudiados en nuestro medio. Este trabajo evidencia la alta prevalencia de los mismos, constituyendo un problema de salud pública que no ha sido abordado. Es perentorio educar sobre higiene del sueño y buscar activamente alteraciones del sueño en los controles médicos habituales para así evitar los nocivos efectos que el mal dormir genera en los niños y adolescentes. Palabras claves: hábitos de sueño, trastornos de sueño, sueño pediátrico, higiene de sueño, encuesta de sueño.

INTRODUCTION: Good sleep is bound to normal neurodevelopment. The deterioration of this vital function decreases the quality of life of the one who suffers it and his family. It also brings negative neurocognitive consequences in the consolidation of memory and attention span during wakefulness. METHOD: A cross-sectional and descriptive study was carried out in order to characterize sleep habits and disorders in a group of Chilean preschoolers, schoolchildren and adolescents. The modified Chervin pediatric sleep questionnaire was given to parents and/or guardians of students from three schools in Santiago (private, subsidized and municipal establishments) randomly and at different levels. RESULTS: The total sample included the reception and analysis of 308 surveys (159 men, 149 women), between 3 to 18 years old. The following results were obtained: Average sleep time was 9 hours in preschool and schoolchildren and it was 7.5 hours in adolescents. 19% of all children have difficulty falling asleep, and in 85% of these, sleep latency is greater than 30 minutes. Bedtime: 9:00 pm for preschool and schoolchildren, 11:00 pm for adolescents, while of the total sample 6% wake up more than 2 times each night, 34% consume stimulant drinks, and 13% take a nap. Sleep disorders: 30% snoring, 2% suspect SAHOS, 32% restless legs, 25% bruxism, 6% bedwetting, 12% sleepwalking, 10% nightmares, 44% sleepiness, 26% insomnia, 18% daytime sleepiness and 2% suspected narcolepsy and 9% family sleep disorders. In addition, 12% have obesity, 7% attention deficit disorder (4% use psychostimulant medications). Finally, 5% declare emotional disorders associated with bad sleep. CONCLUSION: Sleep habits and disorders have been scarcely studied. This work shows their high prevalence, constituting a public health problem that has not been addressed. It is imperative to educate about sleep hygiene and actively seek sleep alterations in regular pediatric check-ups in order to avoid the harmful effects that bad sleep generates in children and adolescents.Keywords: Sleep habits, sleep disorders, schoolchildren sleep, sleep hygiene, sleep questionnaire.

Exhausted grape marc and organic residues composting with polyethylene cover: Process and quality evaluation as plant substrate.

In Argentina, wine production is one of the most important economic activities, producing a large quantities of organic wastes. Composting is a viable alternative to treat these residues, with the possibility to obtain high-quality products. The objective of the present study was to evaluate the effect of the addition of goat manure, leaves from garden raking and alfalfa to exhausted grape marc and the influence of plastic cover on the composting process and the quality of the finished product. Composting was carried out in turned piles in a total randomized design. Temperature, moisture, pH, electrical conductivity, micro and macro elements, biological parameters, stability and structure were determined with the goal to assess product quality. Mixture compost presented higher macro and micro elements content (especially P, Mn and Zn) than grape marc compost. Plastic cover showed no significant effect on physico-chemical parameters, while microorganisms were affected, with higher cellulolytic and nitrifying content in uncovered piles. In all composts, parameters indicated stability and no pathogens (Salmonella sp.) were detected. Pot assay with Lactuca sativa suggested that all compost revealed adequate substrate quality, with higher plant biomass values than commercial substrate and sand (Control), even with fertilization. Mixture compost showed significantly higher biomass and nutrient absorption values relative to the remaining evaluated substrates, suggesting that the use of goat manure and leaves added to exhausted grape marc, as raw material resulted in higher compost quality. All together indicated that the use of polyethylene cover negatively affect microorganisms content and a higher diversity of organic residues composted would result in higher microbiological activity and nutritional grade product.

[Validation of the Montreal Cognitive Assessment (MoCA) as a screening tool for mild cognitive impairment in the population of Buenos Aires, Argentina]. / Validez de la prueba de Evaluación Cognitiva de Montreal (MoCA) como una herramienta de screening para detectar Deterioro Cognitivo Leve en población de Buenos Aires, Argentina.

INTRODUCTION: The Montreal Cognitive Assessment (MoCA) test is a brief tool for neuropsychological assessment. OBJECTIVE: to validate the MoCAin the population of Buenos Aires, Argentina, to allow for the use of the test for the detection of Mild Cognitive Impairment (MCI). METHODS: The sample consisted of 269 adults over 60 years old and of schooling of more than 6 years (healthy adults n = 115 and MCIn = 154). Receiver operating characteristic (ROC) analysis was used to establish the relationship between the diagnoses of the patients and the scores obtained at MoCA. The optimal cut-off points were selected, and the positive and negative predictive value were calculated for them. RESULTS: The area under the curve (AUC) was 0,741 (p <0001, 95% CI:.682 -.800) for the MMSE and 0.810 (p <0001, 95% CI:.759 -. 861) for the MoCA test. The cut point suggested using the MoCA test is 26 points, which throws .727 of sensitivity and a specificity of. 748. CONCLUSION: The MoCA test is a useful test for clinical consultation. Its brevity and simplicity place it as an interesting instrument for neuropsychological screening in the Argentinian population.

Neurología en el primer nivel de atención de salud de la provincia de Río Negro / Neurology at primary health care level in the province of Río Negro

Los equipos de salud de atención primaria se enfrentan a una tarea compleja: realizar el abordajede pacientes que viven en zonas rurales, acceder a los exámenes complementarios, hipotetizar undiagnóstico, emprender un tratamiento de acuerdo con los recursos disponibles y sostenerlo enel tiempo. Este artículo presenta una experiencia sobre la atención programada neurológica enpueblos rurales de la provincia de Río Negro.

Prevalencia de infecciones por Chlamydia trachomatis y Neisseria gonorrhoeae en adolescentes de colegios de la provincia de Sabana Centro, Cundinamarca, Colombia / Prevalence of infections by Chlamydia trachomatis and Neisseria gonorrhoeae among high school students in the Sabana Central area of Cundinamarca, Colombia

Introducción. Las infecciones por Chlamydia trachomatis y Neisseria gonorrhoeae son las dos infecciones bacterianas de transmisión sexual más frecuentes en el mundo, principalmente en menores de 25 años, en cuya salud sexual, reproductiva y materno-infantil producen secuelas. Objetivo. Estimar la prevalencia de las infecciones por C. trachomatis y N. gonorrhoeae entre adolescentes en colegios de la provincia de Sabana Centro, Cundinamarca, Colombia. Materiales y métodos. Se hizo un estudio de corte transversal en adolescentes de 14 a 19 años matriculados en colegios ubicados en los 11 municipios de la zona de estudio. Después de obtener el consentimiento informado, los participantes llenaron una encuesta y recolectaron una muestra de orina para la detección de C. trachomatis y N. gonorrhoeae mediante la técnica de reacción en cadena de la polimerasa en tiempo real. Resultados. En una muestra de 972 adolescentes sexualmente activos, se encontró una prevalencia de infección por C. trachomatis del 2,24 % y, por N. gonorrhoeae , del 0,10 %. No se detectaron infecciones concomitantes. De las estudiantes positivas para C. trachomatis , el 21,4 % eran asintomáticas. Se encontró una relación significativa entre la infección por C. trachomatis y el sexo femenino, el consumo de alcohol u otras sustancias durante la última relación sexual, el tener una o varias parejas y la presencia de alguna infección de transmisión sexual. Conclusiones. La prevalencia de infecciones por C. trachomatis fue inferior a la reportada en grupos similares y se presentaron menos casos asintomáticos en comparación con la tendencia general. Se recomienda implementar en el país un sistema de vigilancia epidemiológica para estas dos infecciones de transmisión sexual mediante la tamización con técnicas moleculares no invasivas, para priorizar estrategias preventivas en las poblaciones de mayor riesgo.

Introduction: Infections by Chlamydia trachomatis and Neisseria gonorrhoeae are the two most common bacterial sexually transmitted infections in the world. These infections affect principally less than 25-year-old individuals with sexual, reproductive and maternal and child health consequences. Objective: This study sought to estimate the prevalence of C. trachomatis and N. gonorrhoeae among high school students in the 11 municipalities of the Sabana Central area of Cundinamarca, Colombia. Materials and methods: A cross-sectional study was conducted among 14 to 19-year old adolescents attending schools in the study area. After signing their consent, participants completed a questionnaire and provided a urine sample for the detection of C. trachomatis and N. gonorrhoeae by real-time polymerase chain reaction. Results: In the sample of 972 sexually active adolescents, the prevalence of C. trachomatis and N. gonorrhoeae was 2.24% and 0.10%, respectively. No co-infections were detected. Overall, 21.4% of women who tested positive for C. trachomatis were asymptomatic. Significant relationships were found between C. trachomatis infection and female gender, the consumption of alcohol or other substances during the previous sexual relationship, having one or more partners and the presence of sexually transmitted infections. Conclusions: The prevalence of C. trachomatis detected in this study was lower than the prevalence reported for similar groups; besides, contrary to the general trends, fewer asymptomatic cases were identified in this study. To prioritize preventive strategies in high-risk populations, an epidemiological surveillance system for C. trachomatis and N. gonorrhoeae should be implemented in Colombia, with screening performed using non-invasive molecular techniques.

Electronic Health Record System Contingency Plan Coordination: A Strategy for Continuity of Care Considering Users' Needs.

Electronic Health Record system downtimes may have a great impact on patient care continuity. This paper describes the analysis and actions taken to redesign the Contingency Plan Procedure for the Electronic Health Record System of Hospital Italiano de Buenos Aires. After conducting a thorough analysis of the data gathered at post-contingency meetings, weaknesses were identified in the procedure; thus, strategic actions were recommended to redesign the Contingency Plan to secure an effective communications channel, as well as a formal structure for functions that may support the decision-making process. The main actions were: 1) to incorporate the IT Contingencies Committee (Plan management); 2) to incorporate the Coordinator (general supervision of the procedure); and 3) to redefine the role of the Clinical Informatics Resident, who will be responsible for managing communication between the technical team and Electronic Health Record users. As users need the information for continuity of care, key users evaluated the impact of the new strategy with an adapted survey.

[Prevalence of infections by Chlamydia trachomatis and Neisseria gonorrhoeae among high school students in the Sabana Central area of Cundinamarca, Colombia]. / Prevalencia de infecciones por Chlamydia trachomatis y Neisseria gonorrhoeae en adolescentes de colegios de la provincia de Sabana Centro, Cundinamarca, Colombia.

INTRODUCTION: Infections by Chlamydia trachomatis and Neisseria gonorrhoeae are the two most common bacterial sexually transmitted infections in the world. These infections affect principally less than 25-year-old individuals with sexual, reproductive and maternal and child health consequences. OBJECTIVE: This study sought to estimate the prevalence of C. trachomatis and N. gonorrhoeae among high school students in the 11 municipalities of the Sabana Central area of Cundinamarca, Colombia. MATERIALS AND METHODS: A cross-sectional study was conducted among 14 to 19-year old adolescents attending schools in the study area. After signing their consent, participants completed a questionnaire and provided a urine sample for the detection of C. trachomatis and N. gonorrhoeae by real-time polymerase chain reaction. RESULTS: In the sample of 972 sexually active adolescents, the prevalence of C. trachomatis and N. gonorrhoeae was 2.24% and 0.10%, respectively. No co-infections were detected. Overall, 21.4% of women who tested positive for C. trachomatis were asymptomatic. Significant relationships were found between C. trachomatis infection and female gender, the consumption of alcohol or other substances during the previous sexual relationship, having one or more partners and the presence of sexually transmitted infections. CONCLUSIONS: The prevalence of C. trachomatis detected in this study was lower than the prevalence reported for similar groups; besides, contrary to the general trends, fewer asymptomatic cases were identified in this study. To prioritize preventive strategies in high-risk populations, an epidemiological surveillance system for C. trachomatis and N. gonorrhoeae should be implemented in Colombia, with screening performed using non-invasive molecular techniques.

Population data on 15 autosomal STRs in a sample from Colombia.

We present population genetic data of 15 STRs (CSF1PO, D3S1358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, D21S11, FGA, PENTA D, PENTA E, TH01, TPOX and VWA) obtained from a sample of 617 unrelated individuals from Colombia. Deviations from Hardy-Weinberg equilibrium were assessed and allele frequencies and parameters of forensic interest for each STR were calculated. The combined power of exclusion (PE) and the combined power of discrimination (PD) for the 15 tested STR loci were 0, 99999895 and more than 0, 9999999, respectively. The combined MP value was 1 in 1, 07888 x 10(-17). Population comparisons between our sample and neighbouring populations from Latin America were carried out. Significant differences in above six markers were observed between our sample and two populations from Rio de Janeiro.

Un esquema clasificatorio para las intervenciones en terapia interpersonal / A classificatory schema for psychotherapeutic interventions in interpersonal therapy

En el presente artículo exponemos la evolución de las tareas que, como miembros de EIPSI (Equipo de Investigación en Psicología Clínica), venimos desarrollando sobre la evaluación de las intervenciones clínicas de distintos marcos teóricos. En trabajos anteriores hemos descripto la estructura general para la clasificación de intervenciones en tratamientos psicoterapéuticos adherentes a los marcos teóricos psicoanalítico, por un lado, y cognitivo-conductual, por el otro (para mayor información ver: Roussos, Etchebarne y Waizmann, 2006; y Roussos, Waizmann y Etchebarne, 2003). En el presente artículo, presentamos su expansión hacia un nuevo marco teórico: el marco teórico de la Terapia Interpersonal (TIP). Por lo cual, se detalla y se discute la metodología empleada para integrar nuevos elementos específicos sobre un marco de evaluación ya organizado (obstáculos y formas de solucionarlo) y se presentan las tablas para la clasificación de intervenciones específicas interpersonales. Asimismo se presentan los resultados preliminares obtenidos mediante la aplicación de la presente metodología de evaluación de intervenciones en los tratamientos cognitivos y los tratamientos psicoanalíticos.

Determinación por medio de marcadores moleculares SSCP y RAPD de la diversidad genética en la especie Taenia solium en Colombia / Determination by SSPC and RAPD of genetic diversity in Taenia solium especies, main causative agent of teniosis and cysticercosis in Colombia

Utilizando las técnicas moleculares de SSCP y RAPD se pudo evidenciar rápida y claramente la variabilidad genética en Colombia de larvas del céstodo Taenia solium analizando fragmentos de genes de ADN mitocondrial y fragmentos aleatorios de ADN nuclear. El ADN estudiado se obtuvo de ocho aislados de cisticercos de cerdo provenientes de tres departamentos de Colombia: Antioquia, Nariño y Sucre. Los fragmentos obtenidos por PCR de los genes NADH deshidrogenasa 1 (ND1) y citocromo oxidasa c subunidad I (COI) al ser denaturados y analizados en geles no denaturantes de acrilamida, mostraron al menos tres patrones diferentes por cada gen analizado, verificando que estos genes conservados mitocondriales son polimórficos en T. solium colombiana. Por otra parte, los cebadores decaméricos de RAPD produjeron patrones polimórficos, corroboraron la diversidad genética entre los diferentes aislamientos analizados.