Maximum serum K+ concentration within 1 hour with enteral replacement in severe hypokalemia / Concentración sérica máxima de K+ en 1 hora por vía enteral en hipopotasemia severa

Introduction: we report two cases with severe hypokalemia. Patients and methods: a 68-year-old woman was admitted with lower limb swelling and urinary symptoms; on the fourth day serum K+ concentration (s[K+]) was 2.3 mmol/L. A 64-year-old woman was admitted with pain in the lumbosacral spine, she was diagnosed with multiple myeloma. After receiving specific therapy she showed s[K+] at 2.4 mmol/L. A KCl solution containing 26.8 mEq of K+ was administered enterally, which increased s[K+] by 0.7 mmol/L within 1 h. Results and conclusion: these cases reveal that peak s[K+] may be achieved within 1 hour after KCl intake in severe hypokalemia, which is probably faster than IV administration.(AU)

Introducción: se presentan dos casos clínicos con hipopotasemia severa. Pacientes y métodos: mujer de 68 años que ingresó por edema en miembros inferiores y síntomas urinarios; al cuarto día, el nivel sérico de K+ ([K+]s) era de 2,3 mmol/L. Una mujer de 64 años ingresó por dolor en la columna lumbosacra y fue diagnosticada de mieloma múltiple; luego de recibir terapia específi ca, presentó una [K +]s de 2.4 mmol/L. Se administró por vía enteral una solución de KCl que contenía 26,8 mEq de K +, aumentando la [K +]s en 0,7 mmol/L en 1 h. Resultados y conclusión: estos casos revelan que la [K + ]s máxima se alcanzaría 1 hora después de la ingestión de KCl en la hipopotasemia grave, probablemente en menos tiempo que por vía intravenosa.(AU)

JUN mRNA translation regulation is mediated by multiple 5' UTR and start codon features.

Regulation of mRNA translation by eukaryotic initiation factors (eIFs) is crucial for cell survival. In humans, eIF3 stimulates translation of the JUN mRNA which encodes the transcription factor JUN, an oncogenic transcription factor involved in cell cycle progression, apoptosis, and cell proliferation. Previous studies revealed that eIF3 activates translation of the JUN mRNA by interacting with a stem loop in the 5' untranslated region (5' UTR) and with the 5' -7-methylguanosine cap structure. In addition to its interaction site with eIF3, the JUN 5' UTR is nearly one kilobase in length, and has a high degree of secondary structure, high GC content, and an upstream start codon (uAUG). This motivated us to explore the complexity of JUN mRNA translation regulation in human cells. Here we find that JUN translation is regulated in a sequence and structure-dependent manner in regions adjacent to the eIF3-interacting site in the JUN 5' UTR. Furthermore, we identify contributions of an additional initiation factor, eIF4A, in JUN regulation. We show that enhancing the interaction of eIF4A with JUN by using the compound Rocaglamide A (RocA) represses JUN translation. We also find that both the upstream AUG (uAUG) and the main AUG (mAUG) contribute to JUN translation and that they are conserved throughout vertebrates. Our results reveal additional layers of regulation for JUN translation and show the potential of JUN as a model transcript for understanding multiple interacting modes of translation regulation.

Maximum serum K+ concentration within 1 hour with enteral replacement in severe hypokalemia.

Introduction: Introduction: we report two cases with severe hypokalemia. Patients and methods: a 68-year-old woman was admitted with lower limb swelling and urinary symptoms; on the fourth day serum K+ concentration (s[K+]) was 2.3 mmol/L. A 64-year-old woman was admitted with pain in the lumbosacral spine, she was diagnosed with multiple myeloma. After receiving specific therapy she showed s[K+] at 2.4 mmol/L. A KCl solution containing 26.8 mEq of K+ was administered enterally, which increased s[K+] by 0.7 mmol/L within 1 h. Results and conclusion: these cases reveal that peak s[K+] may be achieved within 1 hour after KCl intake in severe hypokalemia, which is probably faster than IV administration.

Introducción: Introducción: se presentan dos casos clínicos con hipopotasemia severa. Pacientes y métodos: mujer de 68 años que ingresó por edema en miembros inferiores y síntomas urinarios; al cuarto día, el nivel sérico de K+ ([K+]s) era de 2,3 mmol/L. Una mujer de 64 años ingresó por dolor en la columna lumbosacra y fue diagnosticada de mieloma múltiple; luego de recibir terapia específica, presentó una [K+]s de 2.4 mmol/L. Se administró por vía enteral una solución de KCl que contenía 26,8 mEq de K+, aumentando la [K+]s en 0,7 mmol/L en 1 h. Resultados y conclusión: estos casos revelan que la [K+]s máxima se alcanzaría 1 hora después de la ingestión de KCl en la hipopotasemia grave, probablemente en menos tiempo que por vía intravenosa.

JUN mRNA Translation Regulation is Mediated by Multiple 5' UTR and Start Codon Features.

Regulation of mRNA translation by eukaryotic initiation factors (eIFs) is crucial for cell survival. In humans, eIF3 stimulates translation of the JUN mRNA which encodes the transcription factor JUN, an oncogenic transcription factor involved in cell cycle progression, apoptosis, and cell proliferation. Previous studies revealed that eIF3 activates translation of the JUN mRNA by interacting with a stem loop in the 5' untranslated region (5' UTR) and with the 5'-7-methylguanosine cap structure. In addition to its interaction site with eIF3, the JUN 5' UTR is nearly one kilobase in length, and has a high degree of secondary structure, high GC content, and an upstream start codon (uAUG). This motivated us to explore the complexity of JUN mRNA translation regulation in human cells. Here we find that JUN translation is regulated in a sequence and structure-dependent manner in regions adjacent to the eIF3-interacting site in the JUN 5' UTR. Furthermore, we identify contributions of an additional initiation factor, eIF4A, in JUN regulation. We show that enhancing the interaction of eIF4A with JUN by using the compound Rocaglamide A (RocA) represses JUN translation. We also find that both the upstream AUG (uAUG) and the main AUG (mAUG) contribute to JUN translation and that they are conserved throughout vertebrates. Our results reveal additional layers of regulation for JUN translation and show the potential of JUN as a model transcript for understanding multiple interacting modes of translation regulation.

Validación del instrumento: conocimientos, creencias y aceptación de la vacuna del virus del papiloma humano / Validation of the instrument: knowledge, beliefs and acceptance of the human papillomavirus vaccine

Introducción: El virus del papiloma humano es la primera causa de cáncer cervicouterino, contar con un instrumento que mida la aceptación de la vacuna del VPH, así como los factores que intervienen, es una necesidad para la prevención del VPH. El objetivo fue realizar la validación del instrumento conocimientos, creencias y aceptación de la vacuna del virus del papiloma humano.Materiales y Métodos: El proceso de validación se realizó a traves de un estudio descriptivo, transversal y de proceso de dos fases. La población fue de 393 madres de niñas de 9 a 11 años, pertenecientes al Estado de Puebla, con un muestreo no probabilístico por conveniencia, la muestra se consideró por razón de 10:1.Resultados: Se obtuvo un instrumento válido y confiable con un coeficiente de Alfa de Cronbach de .70, un valor de p<.000 para la prueba de esfericidad de Bartlett y la prueba de Kaiser-Meyer Olkin obtuvo un resultado de .82, en este sentido el análisis factorial dio como resultado un total de 40 ítems divididos en seis dimensiones.Discusión:El proceso metodológico permitió contar con un indicador empírico adaptado y valido al contexto mexicano, debido a que es el único dentro del contexto que mide los factores relacionados con la aceptación de la vacuna del virus del papiloma humano.Conclusión: Se concluye que tener un indicador empírico adaptado al idioma español, que mida la aceptación y los factores relacionados, es un aporte de gran importancia para la sociedad y un avance para la ciencia en enfermería (AU)

Introduction: The human papilloma virus (HPV) is the leading cause of cervical cancer. Having aninstrument that measures the acceptance of the HPV vaccine, as well as the factors involved in theacceptance process, is an urgent need for HPV prevention. The objective was to validate theknowledge, beliefs, and acceptance of the human papillomavirus vaccine instrument.Materials and Methods: The validation process was carried out through a descriptive, cross-sectional study and a two-phaseprocess. The population consisted of 393 mothers of girls between the ages of 9 and 11 years,belonging to the State of Puebla, with a non-probabilistic sampling for convenience; the sample wasconsidered at a ratio of 10: 1.Results: A valid and reliable instrument was obtained with a Cronbach's Alpha of .70, a value of p<.000 for Bartlett’s sphericity test, and .82 for the KMO test. In this sense, the factor analysis resulted ina total of 40 items divided into six dimensions.Discussion: The methodological process allowed to have an empirical indicator adapted and validatedfor the Mexican context, since it is the only one within the context that measures the factors related tothe acceptance of the HPV vaccine.Conclusion: We conclude that having an empirical indicator adapted to the Spanish language, whichmeasures acceptance and related factors, is a contribution of great importance to society and anadvance in nursing science (AU)

Subacute Combined Degeneration of the Cervical Spine Secondary to Inhaled Nitrous-Oxide-Induced Cobalamin Deficiency.

Nitrous oxide is clinically used as an inhaled anesthetic in surgical and dental procedures. It is also used as an inhaled recreational drug and can be incredibly addictive. It tends to irreversibly oxidize cobalamin (Vitamin B12), rendering it inactive as a coenzyme in the production of methionine. Methionine is required in myelin sheath phospholipid production, and thus overuse of this anesthetic can affect myelin formation. Furthermore, other substrates that require this coenzyme (such as methylmalonate and propionate) accumulate and get incorporated in the myelin sheath, resulting in subacute combined degeneration of the spinal cord. We present a case of a young, avid hunter with a history of polysubstance use to include inhaled nitrous-oxide abuse, prior cocaine use, current marijuana use, and tobacco abuse, who presented with ascending paresthesias without appreciable motor dysfunction. Initial labs showed isolated macrocytosis without anemia in the setting of low vitamin B12 levels. Relevant studies showed elevated methylmalonic acid, normal anti-parietal cell, and anti-intrinsic factor antibodies. Heavy metals screens were negative for high levels of lead, iron, copper, or zinc. Cervical spine MRI demonstrated dorsal cord signal abnormalities without enhancement, in a pattern consistent with vitamin B12 deficiency. The patient was diagnosed with subacute combined degenerative disease secondary to depleted vitamin B12 as a result of recreational inhaled nitrous-oxide abuse. After cessation of nitrous oxide abuse, in addition to three months of B12 replacement, he reported complete resolution of symptoms.

Ruxolitinib as a treatment strategy for SARS-CoV-2 pneumonia: clinical experience in a real-world setting.

INTRODUCTION: Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19. METHODOLOGY: We analysed the data obtained by an observational cohort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician's criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured. RESULTS: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% received ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients. CONCLUSIONS: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality.

Severe Trichotillomania: An Unusual Trigger of Recurrent Diabetic Ketoacidosis.

Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes that is most often seen in patients with type 1 diabetes mellitus. Current DKA management focuses on rapid treatment to prevent acute complications, educational intervention, and early discharge. However, patients with mental health conditions face additional barriers to establishing control over their diabetes and may be hospitalized often for DKA recurrence. Understanding a patient's mental health and intervening where necessary may be a crucial step in the effective treatment of DKA. We present a case of recurrent DKA in a young male who suffered from severe trichotillomania. Trichotillomania is a mental health disorder in which an individual has the compulsion to pull on hair because it feels good. By doing so, the skin barrier is compromised. This can lead to disfiguring lesions that can be very distressing for the individual; however, they report an inability to control the compulsion to stop pulling their hair. In our case, the patient disrupted the skin barrier, leading to increased susceptibility for recurrent infection and DKA.

Espacios Amigos de la Lactancia Recomendaciones del Ministerio de Salud de la Nación para instituciones laborales / Breastfeeding Friendly Spaces Recommendations of the National Ministry of Health for labor institutions

Los principales objetivos de estas recomendaciones son orientar a las instituciones laborales para que puedan apoyar y acompañar adecuadamente a las personas que amamantan. Visibilizar y concientizar acerca de las dificultades que enfrentan las personas que desean conciliar la lactancia con otras actividades (como trabajar, estudiar, hacer trámites, etc.). Contribuir a la disminución de las barreras como así también a la implementación de estrategias para favorecer e amamantamiento.

Infected Mosquitoes Have Altered Behavior to Repellents: A Systematic Review and Meta-analysis.

Here we conducted a systematic review and meta-analysis to reach a consensus on whether infected and uninfected mosquitoes respond differently to repellents. After screening 2,316 published studies, theses, and conference abstracts, we identified 18 studies that tested whether infection status modulated the effectiveness of repellents. Thirteen of these studies had outcomes available for meta-analysis, and overall, seven repellents were tested (typically DEET with 62% of outcomes), six mosquito species had repellence behaviors measured (typically Aedes aegypti (L.) (Diptera: Culicidae) mosquitoes with 71% of outcomes), and a broad diversity of infections were tested including Sindbis virus (Togaviridae: Alphavirus) (33% of outcomes), Dengue (Flaviviridae: Flavivirus) (31%), malaria (Plasmodium berghei Vincke & Lips (Haemospororida: Plasmodiidae) or P. falciparum Welch (Haemospororida: Plasmodiidae); 25%), Zika (Flaviviridae: Flavivirus) (7%), and microsporidia (4%). Pooling all outcomes with meta-analysis, we found that repellents were less effective against infected mosquitoes-marking an average 62% reduction in protective efficacy relative to uninfected mosquitoes (pooled odds ratio = 0.38, 95% confidence interval = 0.22-0.66; k = 96). Older infected mosquitoes were also more likely to show altered responses and loss of sensitivity to repellents, emphasizing the challenge of distinguishing between age or incubation period effects. Plasmodium- or Dengue-infected mosquitoes also did not show altered responses to repellents; however, Dengue-mosquito systems used inoculation practices that can introduce variability in repellency responses. Given our findings that repellents offer less protection against infected mosquitoes and that these vectors are the most dangerous in terms of disease transmission, then trials on repellent effectiveness should incorporate infected mosquitoes to improve predictability in blocking vector-human contact.

Manual para el manejo comunitario de la desnutrición aguda / Manual for community management of acute malnutrition

El Manual para el MCDA se enfoca especialmente en la identificación, el tratamiento y el manejo de la desnutrición aguda moderada y severa en niños y niñas de 6 a 59 meses de edad, en el marco de un abordaje comunitario e integrado al sistema de atención primaria de la salud. Para ello, brinda marcos conceptuales y teóricos sobre las causas y consecuencias de la DA, la fisiopatología y los fundamentos sobre los que se postula este abordaje. Aspectos prácticos en la implementación del MCDA y/o información más detallada, se desarrolla en los anexos. Como herramienta de apoyo para los equipos de salud, el Manual propone realizar un abordaje integral y continuo. Esto supone un tratamiento ambulatorio para la mayoría de los casos y uno hospitalario para los que presentan complicaciones, enmarcado en un sólido vinculo con la comunidad.

Alimentación complementaria para los niños y niñas menores de 2 años / Complementary feeding for children under 2 years of age

Las «Guías Alimentarias para la Población Infantil¼ (GAPI) fueron publicadas por última vez en el año 2010. Desde ese entonces, las modificaciones en el perfil epidemiológico-nutricional de la población, los cambios en los patrones de consumo de alimentos y las nuevas exigencias metodológicas para la elaboración de una guía de práctica clínica (GPC), hicieron necesaria su actualización, la cual se realizó siguiendo los lineamientos metodológicos del Programa Nacional de Garantía de Calidad de la Atención Médica. Las conclusiones alcanzadas se presentan en forma de recomendaciones referidas a aspectos de la alimentación diaria de los niños sanos menores de 2 años en cuya práctica el equipo elaborador, en su conjunto, identificó variabilidad. En cuanto al resto de las recomendaciones no abordadas en este documento, siguen vigentes de la versión anterior. Con esta Guía procuramos difundir ampliamente pautas para una alimentación saludable en este grupo de edad. Así, confiamos en contribuir a la reducción del riesgo, tanto de las patologías nutricionales por carencia (anemia ferropénica, desnutrición aguda y baja talla, entre otras), como de aquellas provocadas por el exceso (obesidad, enferme dades no transmisibles ­como diabetes tipo 2, enfermedades cardiovasculares, algunos tipos de cáncer y osteoporosis­), ya sea a corto plazo o bien en la vida futura de los niños, como adolescentes o adultos.

Origin and evolution of tomato production Lycopersicon esculentum in México / Origem e evolução da produção de tomate Lycopersicon esculentum no México

ABSTRACT: Lycopersicon esculentum known as tomato, although has an Andean origin is a contribution of Mexico to the world is, being the first agricultural product to be exported. This research aimed to review the literature in relation to the origin and evolution of the production of tomato in Mexico within the historical development of the country. In ancient times, the tomato was cultivated in milpas (open field) and chinampas (artificial islands for riparian agriculture) using sustainable methods. Spanish colonizers showed the tomato to the rest of the world and diversified its uses. In independent Mexico, haciendas and railroads integrated the different farming regions. Production decreased during the Mexican revolution, and with land reform, the milpa returned. During the Green Revolution (1970), Sinaloa stood out, with the separation of two systems, subsistence, and modern with technology programs. Biotechnological development (1990) emerged parallel to organic production. So actually with this system, we could return to more sustainable pre-Hispanic ecological principles with less environmental impact.

RESUMO Lycopersicon esculentum conhecido como tomate, uma contribuição do México para o mundo a partir de sua domesticação, embora sua origem seja andina, é o primeiro produto de exportação agrícola. Esta pesquisa tem como objetivo realizar uma revisão da literatura em relação à origem e evolução da produção de tomate no México e, no desenvolvimento histórico do país. Nos tempos antigos, o tomate foi cultivado em milpas (campo aberto) e chinampas (ilhas artificiais para a agricultura ribeirinha), utilizando métodos sustentáveis. Colonizadores espanhóis introduziram o tomate no restante do mundo, diversificando seus usos. No México independente, fazendas e estradas de ferro integram as diferentes regiões agrícolas. A produção diminuiu durante a revolução mexicana, e com a reforma agrária ocorreu o retorno da milpa. Sinaloa destacou-se durante a Revolução Verde (1970), com a separação dos dois sistemas de subsistência e moderno e, com programas de tecnologia. O desenvolvimento biotecnológico (1990) surge em paralelo à produção biológica. Dada a complexidade do panorama dos alimentos, atualmente, com estes sistemas, podem-se retomar os princípios ecológicos pré-hispânicos mais sustentáveis, com menor impacto ambiental.

ß-Arrestin scaffolds and signaling elements essential for the obestatin/GPR39 system that determine the myogenic program in human myoblast cells.

Obestatin/GPR39 signaling stimulates skeletal muscle repair by inducing the expansion of satellite stem cells as well as myofiber hypertrophy. Here, we describe that the obestatin/GPR39 system acts as autocrine/paracrine factor on human myogenesis. Obestatin regulated multiple steps of myogenesis: myoblast proliferation, cell cycle exit, differentiation and recruitment to fuse and form multinucleated hypertrophic myotubes. Obestatin-induced mitogenic action was mediated by ERK1/2 and JunD activity, being orchestrated by a G-dependent mechanism. At a later stage of myogenesis, scaffolding proteins ß-arrestin 1 and 2 were essential for the activation of cell cycle exit and differentiation through the transactivation of the epidermal growth factor receptor (EGFR). Upon obestatin stimulus, ß-arrestins are recruited to the membrane, where they functionally interact with GPR39 leading to Src activation and signalplex formation to EGFR transactivation by matrix metalloproteinases. This signalplex regulated the mitotic arrest by p21 and p57 expression and the mid- to late stages of differentiation through JNK/c-Jun, CAMKII, Akt and p38 pathways. This finding not only provides the first functional activity for ß-arrestins in myogenesis but also identify potential targets for therapeutic approaches by triggering specific signaling arms of the GPR39 signaling involved in myogenesis.

A measure of regularity for polygonal mosaics in biological systems.

BACKGROUND: The quantification of the spatial order of biological patterns or mosaics provides useful information as many properties are determined by the spatial distribution of their constituent elements. These are usually characterised by methods based on nearest neighbours distances, by the number of sides of cells, or by angles defined by the adjacent cells. METHODS: A measure of regularity in polygonal mosaics of different kinds in biological systems is proposed. It is based on the condition of eutacticity, expressed in terms of eutactic stars, which is closely related to regularity of polytopes. Thus it constitutes a natural measure of regularity. The proposed measure is tested with numerical and real data. Numerically is tested with a hexagonal lattice that is distorted progressively and with a non-periodic regular tiling. With real data, the distribution of oak trees in forests from three locations in the State of Querétaro, Mexico, and the spiral pattern of florets in a flowering plant are characterised. RESULTS: The proposed measure performs well and as expected while tested with a numerical experiment, as well as when applied to a known non-periodic tiling of the plane. Concerning real data, the measure is sensitive to the degree of perturbation observed in the distribution of oak trees and detects high regularity in a phyllotactic pattern studied. CONCLUSIONS: The measure here proposed has a clear geometrical meaning, establishing what regularity means, and constitute an advantageous general purposes alternative to analyse spatial distributions, capable to indicate the degree of regularity of a mosaic or an array of points.

Treatment of a textile effluent from dyeing with cochineal extracts using Trametes versicolor fungus.

Trametes versicolor (Tv) fungus can degrade synthetic dyes that contain azo groups, anthraquinone, triphenylmethane polymers, and heterocyclic groups. However, no references have been found related to the degradation of natural dyes, such as the carminic acid that is contained in the cochineal extract. Experiments to determine the decolorization of the effluent used in the cotton dyeing process with cochineal extract by means of Tv fungus were done. Treatments to determine decolorization in the presence or absence of Kirk's medium, glucose, and fungus, with an addition of 50% (v v-1) of nonsterilized effluent were performed. Physicochemical characterization was performed at the start and end of the treatment. Degradation kinetics were determined. A direct relationship was found between the dry weight of fungi, pH, and the decolorization system, with higher decolorization at lower pH levels (pH ~4.3). High decolorization (81% ± 0.09; 88% ± 0.17; and 99% ± 0.04) for three of the eight treatments (Kirk's medium without glucose, Kirk's medium with glucose, and without medium with glucose, respectively) was found. Toxicity tests determined an increase in the initial effluent toxicity (7.33 TU) compared with the final treatment (47.73 TU) in a period of 11 days. For this system, a degradation sequence of the carminic acid structure present in the effluent by the Tv fungus is suggested, in which it is seen that metabolites still containing aromatic structures are generated.

Suplementación de hierro en lactantes mapuches de la Provincia de Cautin, Chile / Iron supplementation in Chilean Mapuche infants

Con el propósito de profundizar la caracterización del metabolismo del hierro, en lactantes mapuches, se realizó un estudio de suplementación con Sulfato Ferroso (Fer-In-Sol) de 1.8 ml diarios durante 90 días, a 76 lactantes mapuches de 12 meses de edad, de ambos sexos, rurales, de la Provincia de Cautín. se evaluó la nutrición de hierro antes y después de la suplementación, mediante: Hemoglobina, Hematocrito, Saturación de Transferrina (Fe/IBC) y Ferritina Sérica. Para confirmar la ingesta del suplemento, se tomó en el domicilio de los lactantes, muestras de deposiciones para medir el hierro excretado. Para estudiar el aporte de hierro dietario, se aplicó la Encuesta Recordatorio 24 hrs (ER) y análisis Químico Proximal (AQP), en muestras de comidas obtenidas en los hogares de los lactantes. La prevalencia de anemia a los meses, antes de iniciar la suplementación fue de 28.3 por ciento, la que desapareció complementamente como producto de la intervención. El 65.3 por ciento de los lactantes, aumentaron su Hemoglobina en 1 g o más, lo que índica que eran anémicos al iniciar la suplementación. Es decir, mediante esta prueba terapéutica se pesquizó un 31 por ciento más de lactantes anémicos, lo que indica mayor sensibilidad de este método. La alta prevalencia de anemia se debe fundamentalmente, a la baja ingesta de hierro dietético, que según la ER alcanza un promedio de 2.8 ñ 1.2 mg de Fe/día, versus 4.8 ñ 4.0 mg de Fe/día, según AQP. La diferencia entre ambos aportes demostró que hay un proceso de contaminación ambiental de los alimentos, por el uso de utensilios de hierro y el gran contacto con la tierra. Este hecho también se pudo comprobar por la alta excreción de Fe a través de las deposiciones (140 mg de Fe/100 g deposiciones), cifra considerablemente más alta, que las reportadas en lactantes urbanos (30 mg de Fe/100 g deposiciones). Este método para medir la excreción de Fe del suplemento, no discrimina entre la excreción de la ingesta y la contaminación ambiental, que es extremadamente alta. Sin embargo, en el grupo suplementado, la excreción fue considerablemente más alta que en el grupo control, lo que estaría comprobado la ingesta de Fe. Para prevenir el desarrollo de anemia por carencia de hierro, en los lactantes, se hace imprescindible, dar un alimento fortificado con hierro, a partir de los 6 meses de vida como complemento de la leche materna

Niveles de estradiol plasmático y duración de la amenorrea de lactancia / Plasmatic estradiol levels and length of lactational amenorrhea

En Temuco, Chile, se estudiaron 114 mujeres en lactancia exclusiva de acuerdo a la duración con la amenorrea de lactancia y su relación con los niveles de estradiol plásmático al tercer mes postparto. Sesenta y seis madres (58 por ciento ) recuperaron la menstruación antes del sexto mes postparto. La duración de la amenorrea de lactancia fue de 100,7+ - 5,28 y 277,9 + - 10,5 días para aquellas con menstruación y amenorrea respectivamente. Los niveles de estradiol fueron 99 pmol/l mayores en las mujeres con corta duración de amenorrea de lactancia (p=0,0001). Este estudio confirma la corta duración de amenorrea de lactancia descrita en población chilena. La diferencia en los niveles de estradiol puede ser un indicador de la recuperación precoz de la fertilidad postparto