Factores precondicionantes de secuelas en niños menores de 5 años de edad con tortícolis muscular congénita / Precondicionant factors of sequela in children under 5 years with congenital muscular wryneck

Introducción: El espectro de secuelas de la tortícolis muscular congénita es amplio. Algunos niños con dichas secuelas requieren de costosas y complejas operaciones. Objetivo: Determinar los factores precondicionantes asociados a secuelas orgánicas de la tortícolis muscular congénita en pacientes desde un mes hasta 5 años de edad. Métodos: Se realizó un estudio retrospectivo, analítico, no experimental de casos y controles que incluyó a niños con diagnóstico de tortícolis muscular congénita, atendidos en la consulta de Neurodesarrollo del Hospital Infantil Antonio María Beguez César de Santiago de Cuba, desde enero del 2017 hasta diciembre del 2020. El grupo de casos quedó conformado por todos los pacientes con complicaciones orgánicas de la tortícolis muscular congénita (24 niños) y el de control, por quienes no presentaron dichas complicaciones (72), seleccionados mediante un muestreo aleatorio simple. Resultados: El sexo masculino predominó en los pacientes con complicaciones (62,5 %). La plagiocefalia y la asimetría facial fueron las secuelas más frecuentes. La edad menor de 6 meses en el momento del diagnóstico de la entidad constituyó un factor protector (OR = 0,12; IC 95 %: 0,04-0,33; p=0,000); hubo asociación de las complicaciones con el parto distócico (OR = 0,36; IC 95 %: 0,13-1,01; p=0,049) y con la macrosomía fetal (OR = 5,7; IC 95 %: 1,44-22,2; p=0,014). También existió asociación altamente significativa de las complicaciones con la asimetría de ambos músculos esternocleidomastoideos (OR = 11,4; IC 95 %: 3,7-34,9; p=0,000) y con el inicio tardío del tratamiento (OR = 8,5; IC 95 %: 3,0-24,1; p=0,000). Conclusiones: El parto distócico, la macrosomía fetal, la asimetría entre ambos músculos esternocleidomastoideos y el inicio tardío del tratamiento rehabilitador incrementaron el riesgo de complicaciones en los integrantes de la casuística.

Introduction: The spectrum of sequela of the congenital muscular wryneck is wide. Some children with these sequela require expensive and complex operations. Objective: To determine the precondicionant factors associated with organic sequela of the congenital muscular wryneck in patients since one month to 5 years. Methods: A retrospective, analytic, non experimental of cases and controls study was carried out that included children with diagnosis of congenital muscular wryneck, assisted in the Neurodevelopment Service of Antonio María Beguez Cesar Children Hospital in Santiago de Cuba, from January, 2017 to December, 2020. The group of cases was conformed by all the patients with organic complications of the congenital muscular wryneck (24 children) and the control group, for those who didn't present these complications (72), selected by means of a simple random sampling. Results: The male sex prevailed in the patients with complications (62.5 %). The plagiocephaly and the facial asymmetry were the most frequent sequela. The age under 6 months in the moment of the diagnosis of the entity constituted a protective factor (OR = 0.12; IC 95 %: 0.04-0.33; p=0.000); there was association of the complications with the dystocic childbirth (OR = 0.36; IC 95 %: 0.13-1.01; p=0.049) and with the fetal macrosomia (OR = 5.7; IC 95 %: 1.44-22,2; p=0.014). There was also highly significant association of the complications with the asymmetry of both sternocleidomastoid muscles (OR = 11.4; IC 95 %: 3.7-34.9; p=0-000) and with the late beginning of the treatment (OR = 8.5; IC 95 %: 3.0-24.1; p=0.000). Conclusions: The dystocic childbirth, fetal macrosomia, asymmetry between both sternocleidomastoid muscles and the late beginning of the rehabilitative treatment increased the risk of complications in the members of the case material.

Influencia familiar en el desarrollo de habilidades para el procesamiento numérico en niños preescolares / Family influence on the development of number processing skills in preschool children / Influência da família no desenvolvimento de habilidades de processamento numérico em crianças pré-escolares

RESUMEN Introducción: La competencia en matemáticas se encuentra relacionada con el desarrollo de habilidades básicas para el procesamiento numérico (simbólico y no simbólico) desde etapas tempranas del desarrollo y antes de la escolarización formal. Existe evidencia a favor de que el ambiente del hogar proporciona experiencias que facilitan la adquisición de habilidades específicas relacionadas con las matemáticas. Objetivo: Identificar actividades y estilos de relación presentes en el marco familiar que son buenos predictores del procesamiento numérico y el rendimiento aritmético de niños preescolares cubanos. Método: Entre septiembre y noviembre de 2019 se evaluaron 82 preescolares cubanos y sus padres a través de un estudio no experimental de tipo transeccional, con un carácter descriptivo-correlacional. Los instrumentos utilizados fueron el Numeracy Screener y Cuestionario para Padres, ambos adaptados al contexto cubano en el Centro de Neurociencias de Cuba. Resultados: El desarrollo de habilidades específicas para el procesamiento numérico básico, en formato simbólico y no simbólico, predijo de forma significativa el rendimiento matemático en la muestra estudiada. Se confirmó que la presencia en el marco familiar de estilos de relación y actividades que incluyen contenido numérico y cuantitativo, favorece el desarrollo de habilidades para el procesamiento numérico en los niños preescolares. Conclusiones: Entre los factores más significativos se encontraron: escolaridad de los padres, sus experiencias y actitudes hacia las matemáticas y la frecuencia con que comparten prácticas formales numéricas con sus hijos en el hogar.

ABSTRACT Introduction: Competence in mathematics is related to the development of basic skills for number processing (symbolic and non-symbolic) from early stages of development and before formal schooling. There is evidence that the home environment provides experiences that facilitate the acquisition of specific math-related skills. Objective: To identify activities and relationship styles present in the family setting that are good predictors of numerical processing and arithmetic performance in Cuban preschool children. Method: Between September and November 2019, 82 Cuban preschoolers and their parents were evaluated through a non-experimental transactional study, with a descriptive-correlational nature. The instruments used were the Numeracy Screener and Parent Questionnaire, both adapted to the Cuban context at the Centro de Neurociencias de Cuba. Results: The development of specific skills for basic numerical processing, in symbolic and non-symbolic format, significantly predicted mathematical performance in the sample studied. It was confirmed that the presence in the family of relationship styles and activities that include numerical and quantitative content favors the development of numerical processing skills in preschool children. Conclusions: Among the most significant factors found were: parental education, their experiences and attitudes towards mathematics and the frequency with which they share formal numerical practices with their children at home.

RESUMO Introdução: A competência em matemática está relacionada ao desenvolvimento de habilidades básicas para processamento de números (simbólicos e não simbólicos) desde as fases iniciais do desenvolvimento e antes da escolarização formal. Há evidências de que o ambiente domiciliar proporciona experiências que facilitam a aquisição de habilidades específicas relacionadas à matemática. Objetivo: Identificar atividades e estilos de relacionamento presentes no ambiente familiar que sejam bons preditores de processamento numérico e desempenho aritmético em crianças pré-escolares cubanas. Método: Entre setembro e novembro de 2019, 82 pré-escolares cubanos e seus pais foram avaliados por meio de um estudo transacional não experimental, de natureza descritivo-correlacional. Os instrumentos utilizados foram o Numeracy Screener e o Parent Questionnaire, ambos adaptados ao contexto cubano no Centro de Neurociencias de Cuba. Resultados: O desenvolvimento de habilidades específicas para processamento numérico básico, em formato simbólico e não simbólico, predisse significativamente o desempenho matemático na amostra estudada. Confirmou-se que a presença na família de estilos de relacionamento e atividades que incluem conteúdos numéricos e quantitativos favorece o desenvolvimento de habilidades de processamento numérico em crianças pré-escolares. Conclusiones: Entre os fatores mais significativos foram encontrados: a educação dos pais, suas experiências e atitudes em relação à matemática e a frequência com que compartilham práticas numéricas formais com seus filhos em casa.

Síndrome de Sjögren juvenil con acidosis tubular renal distal de debut / Juvenile Sjögren's syndrome with a presentation of renal distal tubular acidosis

RESUMEN Introducción: el Síndrome de Sjögren es una exocrinopatía autoinmune caracterizada por un infiltrado inflamatorio, con predominio de linfocitos en glándulas exocrinas y tejidos extraglandulares. La lesión glandular se caracteriza por la hiposecreción en mucosa oral y ocular. Caso Clínico: paciente femenina de 13 años de edad, procedente del municipio de Consolación del Sur, en la provincia de Pinar del Río, con Síndrome de Sjögren, cuya manifestación clínica inicial fue extraglandular, con el riñón como principal órgano afectado bajo la forma de acidosis tubular renal distal tipo I. Conclusiones: se demuestra que la realización de una minuciosa anamnesis, exploración clínica y la utilización de distintas herramientas diagnósticas, hacen posible un diagnóstico precoz de la enfermedad y de sus manifestaciones extraglandulares.

ABSTRACT Introduction: the Syndrome of Sjögren is an exocrinopatía autoinmune characterized by an infiltrated inflammatory, with linfocitos prevalence in glands exocrinas and knitted extraglandulares. The glandular lesion is characterized by the hiposecreción in mucous oral and ocular. Clinical case: a 13-year-old female adolescent with Sjögren's Syndrome is presented, whose initial clinical manifestation was extra-glandular, with the kidney as the main affected organ in type-I distal renal tubular acidosis. Conclusions: it is demonstrated that the realization of a meticulous anamnesis, clinical exploration and the use of different diagnostic tools, they make possible a precocious diagnosis of the illness and of their manifestations extraglandulares.

Validación y aplicación de un ELISA para la cuantificación de anticuerpos IgG contra polisacárido capsular Vi de Salmonella Typhi / Validation and application of an ELISA for the quantification of IgG antibodies against Salmonella Typhi Vi capsular polysaccharide

Como parte de las etapas de investigación y desarrollo de un candidato vacunal conjugado contra Salmonella Typhi, se desarrolló un ELISA indirecto para la cuantificación de anticuerpos IgG contra el polisacárido Vi de esta bacteria. En este trabajo se presentan los resultados del proceso de validación, en el que se determinaron el intervalo y linealidad de la curva, la precisión intra e interensayo, la exactitud, la especificidad, el límite de detección y la robustez. La curva de calibración, generada con un suero estándar interno, presentó un buen ajuste a una función polinómica y un intervalo entre las diluciones 1/100 y 1/3200. Los coeficientes de variación en los ensayos de precisión y robustez y los porcentajes de recobrado estuvieron en los intervalos establecidos para cada uno (≤10 por ciento, ≤20 por ciento y 90-110 por ciento respectivamente). El ensayo presentó una especificidad óptima, obteniéndose señales de DO superiores a 1,3 para sueros positivos contra Vi y bajas para sueros contra antígenos no relacionados. Los resultados avalan el empleo de este ELISA cuantitativo en ensayos de inmunogenicidad para la liberación de lotes de conjugados de Vi. Igualmente, sustentan su uso para la evaluación de la inmunogenicidad de formulaciones de polisacárido Vi y conjugados de polisacárido Vi a proteínas en fases de investigación y desarrollo(AU)

An indirect ELISA for the quantification of IgG antibodies against the Vi polysaccharide of this bacteria was developed as a part of the stages of Research and Development of a conjugate vaccinal candidate against Salmonella Typhi. The results of the validation process are presented in this paper, in which the interval and linearity of the curve, the intra- and inter-assay precision, accuracy, specificity, limit of detection and robustness were determined. The calibration curve generated with an internal standard serum provided a good fit to a polynomial function and an interval between 1/100 and 1/3200 dilutions. The coefficients of variation in the precision and robustness tests and the percentages of recovery were in intervals established for each one (≤10 percent, ≤20 percent and 90-110 percent, respectively). The assay presented an optimal specificity, obtaining OD signals above 1.3 for positive sera against Vi and low for sera against unrelated antigens. The results support the use of this quantitative ELISA in immunogenicity assays for batch release of Vi conjugates. Likewise, they support their use for the immunogenicity evaluation of Vi polysaccharide formulations and Vi polysaccharide conjugates to proteins in phases of research and development(AU)

Epidemiología del cáncer de pulmón en el Hospital provincial docente Dr Antonio Luaces Iraola de Ciego de Ávila / Lung cancer epidemiology in the provincial teching hospital “Dr. Antonio Luaces Iraola” from Ciego de Avila

El cáncer de pulmón resulta del crecimiento anormal de células en el tejido pulmonar. Constituye mundialmente una de las primeras causas de incidencia y mortalidad por enfermedades oncológicas. El objetivo de la investigación fue caracterizar el comportamiento epidemiológico del cáncer de pulmón en el hospital provincial docente Dr. Antonio Luaces Iraola de Ciego de Ávila entre enero de 2008 y diciembre de 2010. Se realizó un estudio observacional descriptivo. La muestra quedó constituido por 182 pacientes con diagnóstico cito- histológico. Luego de aplicar instrumentos científicos avalados se constató marcada prevalencia de la enfermedad entre fumadores con 80.7 por ciento del total con predominio entre los hombres. El 31.3 por ciento de pacientes tenían antecedentes de Enfermedad pulmonar obstructiva crónica. Al diagnóstico el 87.9 por ciento presentaban síntomas propios del tumor, seguido de la presencia de manifestaciones paraneoplásicas, encontradas en 48.3 por ciento de pacientes. Al 85.2 por ciento se les diagnosticó cáncer de pulmón de células no pequeñas, predominó el carcinoma epidermoide entre los hombres y el Adenocarcinoma entre las féminas. La mortalidad en sentido general fue alta con 48.3 por ciento de fallecidos antes del año y 83 por ciento antes del tercer año del diagnóstico, se evidenció escasa supervivencia a los 3 años, peor pronóstico para pacientes con cáncer de pulmón de células pequeñas (AU)

The lung cancer is from the abnormal growth of cells in the pulmonary tissue. It constitutes one of the first causes of incidence and mortality by oncologic diseases. The objective was to characterize the epidemiologist behavior of lung cancer at Dr. Antonio Luaces Iraola hospital from Ciego de Avila between January 2008 and December 2010. A descriptive observacional study was carried out. The sample was constituted by 182 patients with cytohistologic diagnosis. After applying guaranteed scientific instruments noticeable prevalence of the disease between smokers with 80,7 percent predominating between men. The 31,3 percent of patients had chronic obstructive pulmonary disease antecedents.the 87,9 percent presented own symptoms of the tumor, followed by paraneoplasic manifestations in 48.3 percent of patients. 85,2 percent of patients were diagnosed lung cancer of nonsmall cells, predominating the squamous cell carcinoma in men and the adenocarcinoma in women. Mortality in general was high with a 48,3 percent of deceaseds before the year and 83 percent before the third year of diagnosis, demonstrating little survival in 3 years, worse prognosis for patients with lung cancer of small cells (AU)

Clinical features and treatment outcomes of pediatric acute promyelocytic leukemia in a Mexican pediatric hospital.

INTRODUCTION: Acute promyelocytic leukemia (APL) is a distinct type of acute myeloid leukemia (AML) characterized by chromosomal translocations involving the retinoid acid receptor α (RARA) gene on chromosome 17. APL is a relatively rare blood disease that is highly curable with current treatment strategies; however, patient outcomes are heterogeneous in countries with limited resources. Promyelocytic leukemia accounts for 20-25% of all AML cases in Latin American countries. MATERIAL AND METHODS: We conducted a study from July 2007 to July 2012 and applied the IC-APL2006 protocol. This case study reports the results from eleven patients with AML M3 (five males and six females). In all cases, the diagnoses were made by aspirating bone marrow and evaluating the t(15:17) or t(11:17) transcript. In eight cases, the molecular biology-based diagnostics for the PLM-RARa transcript were positive, and they were negative in two cases. One patient was positive for the PLZF-RARa transcript. RESULTS: The mean WBC at the time of diagnosis was 10.1 x 10(9)/L, and the mean platelet count was 17.1 x 10(9)/L. The mean percentage of abnormal promyelocytes in the bone marrow aspirates was 68%. Of the eleven patients, four presented with disseminated intravascular coagulation. All of the patients began treatment with transretinoic acid (ATRA) (45 mg/m(2)/day), which led to 4 cases of ATRA syndrome. There were 2 relapses, and the patient died in one case. The remaining ten patients were alive after the median follow-up period of 33.6 months (range from 11 to 60 months). CONCLUSION: The authors report on a series of cases involving pediatric patients with AML M3 seen at a single institution; the patients were stratified and treated with a standard protocol to obtain satisfactory results. Although the number of patients is limited, the health outcomes are relevant. To our knowledge, this is the first series of pediatric APL patients in Mexico who were treated with the IC-APL2006 protocol.

Epitope mapping of anti-human transferrin monoclonal antibodies: potential uses for transferrin-transferrin receptor interaction studies.

Human transferrin (hTf) is an 80 kDa glycoprotein involved in iron transport from the absorption sites to the sites of storage and utilization. Additionally, transferrin also plays a relevant role as a bacteriostatic agent preventing uncontrolled bacterial growth in the host. In this work we describe a well-characterized Mabs panel in terms of precise epitope localization and estimate affinity for the two major hTf isoforms. We found at least four antigenic regions in the hTf molecule, narrowed down the interacting antigen residues within three of such regions, and located them on a molecular model of hTf. Two of the antigenic regions partially overlap with previously described transferrin-binding sites for both human receptor (antigenic region I: containing amino acid residues from Asp-69 to Asn-76 at the N-lobe) and bacterial receptors from two pathogenic species (antigenic region III: amino acid residues from Leu-665 to Ser-672 at the C-lobe). Hence, such monoclonal antibodies (Mabs) could be used as an additional tool for conformational studies and/or the characterization of the interaction between hTf and both types of receptor molecules.

Adesão ao tratamento dos pacientes hipertensos da unidade básica de saúde João Francisco dos Santos da comunidade São Joaquim no município Cardoso Coreira, RJ

A Hipertensão Arterial Sistêmica é um grave problema de saúde pública, sendo considerado um dos principais fatores de risco para as doenças cardiovasculares, responsável por altas taxas de mobilidade. O controle da HAS depende direitamente do grão de adesão dos pacientes ao esquema terapêutico indicado, aspecto fundamental para garantir o controle da doença e evitar complicações. Na UBS "João Francisco dos Santos" da comunidade São Joaquim no município Cardoso Moreira acharam se dificuldade no controle da maioria dos pacientes hipertensos associado à falta de adesão aos esquemas terapêutica impostos e a desconhecimento sobre a doença, pelo que realizara- se uma intervenção comunitária com o objetivo de aumentar grão de adesão ao tratamento e nível de conhecimento sobre a doença dos pacientes Hipertensos não controlados da unidade. Com a realização do projeto espera- se identificar o 100% dos pacientes hipertensos cadastrados na UBS com dificuldades no controle da doença por falta de adesão ao tratamento. Espera- se aumentar o grão de conhecimento deles sobre a HAS. Garantir maior apego ao tratamento, não farmacológico e farmacológico, assim como aumentar o comprometimento da equipe com o acompanhamento e controle dos pacientes, incidindo positivamente na historia natural da doença e diminuindo as complicações.