Complicaciones pospancreatoduodenectomía de tumores periampulares en una unidad de cirugía hepatopancreatobiliar / Post pancreaticoduodenectomy complications of periampullary tumors in a hepatopancreatobiliary surgery unit

Resumen Introducción: Los tumores periampulares se definen como lesiones ubicadas en un radio de 2 cm alrededor de la ampolla de Vater, constituidos por 4 tipos de neoplasias con una alta tasa de malignidad que pueden originarse en páncreas, ampolla, vía biliar distal o duodeno. El manejo quirúrgico a través de la pancreatoduodenectomía sigue siendo la mejor elección en términos de resección curativa. Objetivo: Caracterizar los tumores peri-ampulares tratados en nuestra institución y que fueron llevados a pancreatoduodenectomía, asociando la relación entre tipo de tumor y complicaciones posoperatorias. Material y Método: Estudio transversal, retrospectivo y observacional con seguimiento a 45 pacientes sometidos a pancreatoduodenectomía en el Hospital Internacional de Colombia - Fundación Cardiovascular entre enero de 2011 y marzo de 2020 con diagnostico histopatológico de tumor peri-ampular. Resultados: Se realizaron 75 pancreatoduodenectomía de las cuales 45 pacientes presentaron tumor peri-ampular, siendo de origen pancreático en un 44%, seguido de ampolla 40%, vía biliar distal 8,8% y duodenal 6,6%. Las complicaciones posoperatorias más frecuentes fueron fístula pancreática y vaciamiento gástrico retardado. Falleció 1 paciente. Conclusión: La pancreatoduodenectomía es un procedimiento con alta morbilidad. Gracias al avance tecnológico, el diagnóstico de patología peri ampular es cada vez más exacto. El tipo de tumor peri-ampular puede influir no solo en su pronóstico, sino también en su morbilidad posquirúrgica.

Introduction: Periampullary tumors are defined as lesions that are located in a radius of 2 centimeters around the ampulla of Vater, constituted by 4 types of neoplasms with a high rate of malignancy originated in the pancreas, ampulla, distal bile duct or duodenum. Surgical management through the pancreatoduodenectomy remains the best choice in terms of curative resection. Objetive: To characterize periampullary tumors treated in our institution with pancreatoduodenectomy, associating the relationship between tumor type and postoperative complications. Material and Method: Cross-sectional, retrospective, observational study with a follow-up of 45 patients underwent pancreatoduodenectomy in the Hospital Internacional de Colombia - Fundación Cardiovascular between January 2011 and March 2020 with histopathological diagnosis of periampullary tumor. Results: Were performed 75 pancreatoduodenectomies, 45 patients presented with Periampullary tumor, 44% being of pancreatic origin, followed by ampulla 40%, distal bile duct 8.8% and duodenal 6.6%. Most frequent postoperative complications were pancreatic fistula and delayed gastric emptying. Mortality was of 1 patient. Conclusión: Pancreatoduodenectomy is a procedure with a high morbidity rate. Thanks to technological advances, the diagnosis of periampullary pathology is increasingly accurate. The type of periampullary tumor may influence not only in its prognosis, but also in its post-surgical morbidity.

Embarazo y nuevo coronavirus: experiencia global reportada / Pregnancy and novel coronavirus: worldwide reported experience

INTRODUCCIÓN: La Organización Mundial de La Salud ha reportado recientemente que el nuevo foco de la pandemia global de la enfermedad Covid-19 es el continente americano. OBJETIVO: Realizar una revisión de la literatura sobre la experiencia internacional de la pandemia Covid 19 y embarazo. MÉTODO: Se realiza una búsqueda de la base de datos PubMed para las palabras clave Pregnancy / Pregnant / Novel Coronavirus / SARS-CoV-2 / Covid-19, desde el 1 de noviembre 2019 hasta el 21 de mayo 2020. RESULTADOS: Un total de 365 artículos fueron inicialmente seleccionados de acuerdo con la estrategia de búsqueda diseñada. El total de artículos revisados de acuerdo con los criterios fueron 42. Las series clínicas seleccionadas acumularon un total de 1098 embarazadas y enfermedad de Covid-19. Las co-morbilidades mas frecuentes fueron hipertensión arterial, diabetes mellitus, obesidad y asma. La mortalidad en relación con el total de pacientes fue de un 1,2 % y la transmisión al recién nacido de 1,7% (15 de 875). CONCLUSIÓN: La información obtenida permite inferir que la presentación clínica de la enfermedad es a lo menos equivalente a la de mujeres de la misma edad no embarazadas. Dada la severidad de la enfermedad por SARS-CoV-2 reportada, las lecciones aprendidas deben ser rápidamente asimiladas y utilizadas en el contexto de la situación nacional epidémica.

INTRODUCTION: The World Health Organization has recently reported that the new focus of the global pandemic of Covid-19 disease is the American continent. OBJECTIVE: To conduct a literature review on the international experience of the Covid 19 pandemic and pregnancy. METHOD: A PubMed database search is performed for the keywords Pregnancy / Pregnant / Novel Coronavirus / SARS-CoV-2 / Covid-19, from November 1, 2019 to May 21, 2020. RESULTS: A total of 365 articles were initially selected according to the designed search strategy. The total of articles reviewed according to the criteria was 42. The selected clinical series accumulated a total of 1098 pregnant women and Covid-19 disease. The most frequent comorbidities were hypertension, diabetes mellitus, obesity, and asthma. Mortality in relation to the total number of patients was 1.2% and transmission to the newborn was 1.7% (15 of 875). CONCLUSION: The information obtained allows us to infer that the clinical presentation of the disease is at least equivalent to that of non-pregnant women of the same age. Given the severity of the reported SARS-CoV-2 disease, the lessons learned must be quickly assimilated and used in the context of the national epidemic situation.

Una presentación no tan atípica: autismo en mujeres / Not an Atypical Presentation: Autism in Women

A pesar del conocimiento que tenemos en la actualidad de la amplia variedad de sintomatología y fenotipos de pacientes que engloban los Trastornos del Espectro Autista, algunos de estos fenotipos siguen sin estar claramente descritos en las clasificaciones psicopatológicas. Se propone un caso clínico de una paciente adolescente que consulta por sintomatología depresiva, descubriéndose tras la evaluación y durante la evolución un Trastorno del Espectro Autista subyacente que había pasado desapercibido

Despite current knowledge about the wide variety of symptoms and phenotypes of patients that meet criteria for Autism Spectrum Disorder, some of these phenotypes are still not clearly described in psychopathological classifications. A clinical case of a teenage patient who consults for depressive symptoms is proposed. After the evaluation, an underlying Autism Spectrum Disorder that had gone unnoticed was discovered

La paradoja de la inmigración: las madres haitianas y latinoamericanas en Chile / The Immigration Paradox: Haitian and Latin American Mothers in Chile

Introducción: Existe información internacional sobre las diferencias en parto prematuro y peso al nacer para madres migrantes de diferentes etnias originarias. El objetivo de este trabajo es evaluar parto prematuro y peso al nacer de madres de nacionalidad diferente, cuyos partos ocurrieron en Chile. Materiales y métodos Se utilizó la base de datos nacional del Departamento de Informática del Ministerio de Salud de Chile. Se incluyeron los recién nacidos del período Septiembre 2012 a Diciembre 2016. Se evaluaron los datos perinatales básicos, parto prematuro, bajo peso al nacer y su relación con la edad gestacional de nacidos de madres chilenas y de otras nacionalidades. Resultados En el periodo estudiado hubo 1.048490 nacimientos, de los cuales 50995 son de madres extranjeras. El porcentaje de nacidos antes de 37 semanas en madres de Bolivia, Colombia, Ecuador, Perú y Venezuela es entre un 4.8 y 7.3 %, versus 8% en madres chilenas. Los percentiles 10 para el peso al nacer entre 30 y 40 semanas para madres chilenas y Haitianas (en paréntesis) expresados en gramos: 1045 (1102), 1195 (1160), 1360 (1370), 1550 (1503), 1750 (1508), 2000 (1669), 2235 (1982), 2500 (2237), 2810 (2607), 2970 (2710), 3080 (2858). Los z-score de madres Haitianas fueron significativamente menores después de las 35 semanas. Conclusiones La paradoja de la inmigración se verifica en la experiencia nacional, con tasas de natalidad prematuras y bajo peso al nacer más favorables para las madres extranjeras en comparación con las mujeres chilenas y con sus países de origen. Las madres afro-caribeñas tuvieron nacimientos con peso menor, en edades gestacionales donde se toman decisiones frecuentes, con diferencias de hasta un 20 % entre las 35- 37 semanas.

SUMMARY The immigration paradox: Haitian and Latin American mothers in Chile Introduction There is international information on the differences in preterm birth and birth weight for migrant mothers of different ethnicities. The objective is to evaluate prematurity and birth weight of mothers of different national origin, whose deliveries occurred in Chile. Materials and methods The national database of the Department of Informatics of the Ministry of Health of Chile was used. Newborns from the period of September 2012 to December 2016 were included. Basic perinatal data, preterm birth, low birth weight and their relationship with the gestational age of babies born to mothers of local origin and other nationalities were evaluated. Results 1,048,490 births, 50,995 foreign mothers were studied. The percentage of those born before 37 weeks of mothers from Bolivia, Colombia, Ecuador, Peru, and Venezuela is between 4.8 and 7.3%, compared to nationals with 8%. The 10th percentiles for birth weight from 30 to 40 weeks for Chilean and Haitian mothers (in parentheses) were (g): 1045 (1102), 1195 (1160), 1360 (1370), 1550 (1503), 1750(1508 ), 2000 (1669), 2235 (1982), 2500 (2237), 2810 (2607), 2970 (2710), 3080 (2858). The z-scores of Haitian mothers were significantly lower. Conclusions The immigration paradox is verified in the national experience, with preterm birth rates and low birth weight more favorable to foreign mothers compared to chileans Afro-Caribbean mothers had births with a lower weight, at gestational ages where relevant decisions are made, with differences of up to a 20% between 35-37 weeks.

Confiabilidad interevaluador de la prueba video head impulse test en estudiantes de primer año de la generación 2016 de la Escuela de Fonoaudiología de la Universidad de Valparaíso Casa Central / Inter-rater reliability of the video head impulse test in students from the School of Speech and Language therapist of the University of Valparaiso main campus class 2016

RESUMEN Introducción: El video head impulse test es un método rápido, no invasivo y cómodo para evaluar el reflejo vestíbulo ocular, el cual está siendo utilizado con mayor frecuencia en la evaluación de pacientes con alteraciones del equilibrio. Sin embargo, en Chile se evidencia una falta de estudios relacionados a la confiabilidad interevaluador de dicha prueba. Objetivo: Determinar el nivel de concordancia de los resultados de la eficiencia del reflejo vestíbulo ocular de los canales semicirculares horizontales, obtenidos mediante la aplicación de la prueba video head impulse test, por parte de 3 evaluadores. Material y método: Estudio cuantitativo, correlacional, no experimental transversal descriptivo, con muestreo no probabilístico, de participación voluntaria. La prueba video head impulse test fue aplicada por 3 examinadores a 30 estudiantes que cumplieron con los criterios de inclusión. Resultados: El método de Bland y Altman mostró gran concordancia en las mediciones realizadas entre los 3 examinadores. La correlación intraclase para la ganancia del canal semicircular horizontal derecho e izquierdo fue de 0,85 y 0,91 respectivamente y de 0,75 para el valor de asimetría. Conclusión: El estudio mostró una confiabilidad interevaluador adecuada de la prueba video head impulse test para la evaluación de los canales semicirculares horizontales.

ABSTRACT Introduction: The video head impulse test is a rapid, non-invasive and comfortable method for the evaluation of the vestibulo-ocular reflex that is being used more often in the evaluation of patients with balance disorders. In Chile there is a lack of studies related to the inter-rater reliability for this test. Aim: To determine the level of agreement on the results for the vestibulo-ocular reflex of the horizontal semicircular canals obtained by the execution of the video head impulse test by 3 raters. Material and method: Quantitative, correlational, non-experimental, cross-sectional descriptive study with a type of non-probability sampling with voluntary participation. The video head impulse test was applied by 3 raters to 30 students who fulfilled the inclusion criteria. Results: The Bland-Altman method demonstrated good agreement in the measurements made between the 3 raters. The inter-rater reliability for the gain of the left and right horizontal semicircular canals was 0.85 and 0.91 respectively and 0.75 for the asymmetry value. Conclusion: The study showed an adequate inter-rater reliability for the video head impulse test in the evaluation of the horizontal semicircular canals.

Artritis séptica tras ligamentoplastia artroscópica de la rodilla: análisis retrospectivo de casos / Septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee: retrospective case review

INTRODUCCIÓN: La rotura de los ligamentos cruzados de la rodilla es frecuente y se repara mediante ligamentoplastia artroscópica. Entre sus complicaciones está la artritis séptica. El objetivo de este trabajo es describir las características clínicas y microbiológicas de esta entidad. MÉTODOS: Revisión retrospectiva de casos de artritis séptica tras ligamentoplastia de rodilla ocurridos en una institución durante los años 2000-2015. Según los días transcurridos desde la ligamentoplastia, la infección se consideró aguda (< 14 días), subaguda (> 14 días y < 30 días) o tardía (> 30 días). Se realizó un análisis descriptivo y comparativo, estratificado según el tipo de infección y microorganismo causante. RESULTADOS: Se intervinieron 3.219 pacientes; 30 (0,9%) desarrollaron artritis séptica. Diecisiete (57%) infecciones fueron agudas, 12 (40%) subagudas y una tardía. Los microorganismos causantes fueron Staphylococcus coagulasa-negativos (n = 13; 43%), Staphylococcus aureus (n = 12; 40%), otros cocos grampositivos (n = 3; 10%) y bacilos gramnegativos (n = 2; 7%). Se realizó desbridamiento artroscópico en todos los casos; en ninguno fue necesario retirar la plastia. Los pacientes recibieron tratamiento antibiótico durante una mediana de 23,5 días (rango, 14 - 78 días); todas las infecciones se curaron. No se evidenciaron diferencias significativas en ninguna de las variables analizadas entre el tipo de infección o el microorganismo responsable. CONCLUSIONES: La artritis séptica es una complicación poco frecuente de la ligamentoplastia de rodilla. Se manifiesta generalmente dentro de las 4 semanas después de la cirugía y está causada por Staphylococcus. El tratamiento consiste en desbridamiento artroscópico precoz (pudiendo no ser necesario retirar la plastia) y antibioterapia

INTRODUCTION: Rupture of cruciate ligaments of the knee is a common injury that is repaired by arthroscopic reconstruction, which can give rise to septic arthritis. The objective of this article is to describe the clinical and microbiological aspects of this entity. METHODS: Retrospective review of cases of septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee that occurred at a single institution from 2000-2015. According to time elapsed from surgery, infections were classified as acute (< 14 days), subacute (> 14 days and < 30 days), and late (> 30 days). A descriptive and comparative analysis stratified by type of infection and causative microorganism was performed. RESULTS: 3,219 patients underwent arthroscopic reconstruction of cruciate ligaments of the knee and 30 (0.9%) developed septic arthritis. Seventeen (57%) were acute infections and 12 (40%) subacute; there was one late infection. The causative microorganisms were coagulase-negative Staphylococci (n = 13; 43%), Staphylococcus aureus (n = 12; 40%), other grampositive cocci (n = 3; 10%), and gramnegative bacilli (n = 2; 7%). All patients underwent arthroscopic debridement; no grafts were removed. All patients received antibiotic therapy for a median of 23.5 days (range: 14 - 78 days); all infections were cured. No significant differences were found in any of the variables analysed among the infection type or the causative microorganism. CONCLUSIONS: Septic arthritis after arthroscopic reconstruction of cruciate ligaments of the knee is uncommon. It generally presents within 4 weeks of surgery and is caused by Staphylococci. Its treatment consists of arthroscopic debridement (without necessarily removing the graft) and antibiotic therapy

Septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee: retrospective case review. / Artritis séptica tras ligamentoplastia artroscópica de la rodilla: análisis retrospectivo de casos.

INTRODUCTION: Rupture of cruciate ligaments of the knee is a common injury that is repaired by arthroscopic reconstruction, which can give rise to septic arthritis. The objective of this article is to describe the clinical and microbiological aspects of this entity. METHODS: Retrospective review of cases of septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee that occurred at a single institution from 2000-2015. According to time elapsed from surgery, infections were classified as acute (< 14 days), subacute (> 14 days and<30 days), and late (> 30 days). A descriptive and comparative analysis stratified by type of infection and causative microorganism was performed. RESULTS: 3,219 patients underwent arthroscopic reconstruction of cruciate ligaments of the knee and 30 (0.9%) developed septic arthritis. Seventeen (57%) were acute infections and 12 (40%) subacute; there was one late infection. The causative microorganisms were coagulase-negative Staphylococci (n=13; 43%), Staphylococcus aureus (n=12; 40%), other grampositive cocci (n=3; 10%), and gramnegative bacilli (n=2; 7%). All patients underwent arthroscopic debridement; no grafts were removed. All patients received antibiotic therapy for a median of 23.5 days (range: 14 - 78 days); all infections were cured. No significant differences were found in any of the variables analysed among the infection type or the causative microorganism. CONCLUSIONS: Septic arthritis after arthroscopic reconstruction of cruciate ligaments of the knee is uncommon. It generally presents within 4 weeks of surgery and is caused by Staphylococci. Its treatment consists of arthroscopic debridement (without necessarily removing the graft) and antibiotic therapy.

Escalas para predicción de resultados tras traumatismo grave / Scales for predicting outcome after severe trauma

En este artículo se ha hecho una revisión sobre el desarrollo de las escalas más utilizadas en los pacientes con traumatismo grave desde hace 40 años. Es sabido que, las escalas anatómicas son eficaces, tanto para medir la severidad de las lesiones, como para predecir resultados. Las escalas fisiológicas miden el componente dinámico tras el trauma, con gran influencia en el pronóstico de los traumatizados. Los índices metabólicos, tanto lactato como el déficit de base, son reflejo de un estado de hipoperfusión tisular, y por tanto de shock. Las escalas combinadas sirven para la predicción y comparación evaluativa de los resultados. La incorporación de factores que influyen en el pronóstico de los traumatizados ha conllevado al desarrollo de nuevas escalas. Sin embargo, carecen de estudios de validación externa para su uso generalizado. Hasta que estos estudios se lleven a cabo, estas escalas deben usarse con precaución (AU)

In this article we review the development of the most-used scales for severe trauma patients over the past 40 years. It is well known that anatomical scales are effective for measuring the severity of injuries and for predicting results. Physiological scales measure the dynamic component after trauma, with a great influence on the prognosis of injured patients. Metabolic scales, both lactate and base deficit, are reflections of tissue hypoperfusion states and therefore shock. The combined scales are used for prediction and comparative assessment of results. The inclusion of factors that influence the prognosis of trauma patients has led to the development of new scales. However, they lack external validation studies for their widespread use. Until these validation studies are conducted caution should be taken with the use of existing scales (AU)

[Scales for predicting outcome after severe trauma]. / Escalas para predicción de resultados tras traumatismo grave.

In this article we review the development of the most-used scales for severe trauma patients over the past 40 years. It is well known that anatomical scales are effective for measuring the severity of injuries and for predicting results. Physiological scales measure the dynamic component after trauma, with a great influence on the prognosis of injured patients. Metabolic scales, both lactate and base deficit, are reflections of tissue hypoperfusion states and therefore shock. The combined scales are used for prediction and comparative assessment of results. The inclusion of factors that influence the prognosis of trauma patients has led to the development of new scales. However, they lack external validation studies for their widespread use. Until these validation studies are conducted caution should be taken with the use of existing scales.

Diseases due to unhealthy environments: an updated estimate of the global burden of disease attributable to environmental determinants of health.

Background: The update of the global burden of disease attributable to the environment is presented. The study focuses on modifiable risks to show the potential health impact from environmental interventions. Methods: Systematic literature reviews on 133 diseases and injuries were performed. Comparative risk assessments were complemented by more limited epidemiological estimates, expert opinion and information on disease transmission pathways. Population attributable fractions were used to calculate global deaths and global disease burden from environmental risks. Results: Twenty-three percent (95% CI: 13-34%) of global deaths and 22% (95% CI: 13-32%) of global disability adjusted life years (DALYs) were attributable to environmental risks in 2012. Sixty-eight percent of deaths and 56% of DALYs could be estimated with comparative risk assessment methods. The global disease burden attributable to the environment is now dominated by noncommunicable diseases. Susceptible ages are children under five and adults between 50 and 75 years. Country level data are presented. Conclusions: Nearly a quarter of global disease burden could be prevented by reducing environmental risks. This analysis confirms that eliminating hazards and reducing environmental risks will greatly benefit our health, will contribute to attaining the recently agreed Sustainable Development Goals and will systematically require intersectoral collaboration to be successful.

Salivary Urease and ADS Enzymatic Activity as Endogenous Protection against Dental Caries in Children.

UNLABELLED: The aim of this cross sectional study was to evaluate the ureolytic and arginolytic activities of saliva in children and associate them with their caries status. STUDY DESIGN: 65, 8 year old children, were randomly selected. The ureolytic and arginolytic activity of non stimulated saliva was studied and associated with DMFT and dmft index. Saliva of children were sampled under fasting conditions; Children refrained from any oral hygiene procedures during the 12 hours that preceded the sample collection. Caries activity was scored and divided in 3 groups: Group A: Index zero: without lesions; Group B: Moderate Index: 1 to 3 enamel caries lesions; and Group C: High Index: more than 4 dentin caries lesions. RESULTS: DMFT scores were moderate: 0.4(±0.79) and dmft: 2.78(±2.45). Results expressed in µmol/min/mg/protein, for urease activity were statistically significant (p=0.048): Group A= 0.69 (±0.7); Group B= 0.45 (±0.43); and Group C= 0.39 (±0.55). The arginine deiminase activity was not statistically significant (p=0.16): Group A= 2.53 (±1.42), Group B= 2.31 (±1.57) and Group C= 1.97 (±2.0). CONCLUSION: Higher levels of ureolytic (statistically significant) and arginolytic activity (trend) in saliva were associated with lower DMFT/dmft scores in 8 year old children. There was a higher production of ammonia from the arginine deiminase system than the urease enzyme in saliva (p>0.05).

Prácticas de lactancia y alimentación complementaria en menores de 6 meses en Argentina. Estimación a partir de una encuesta multipropósito / Práticas de lactância e alimentação complementarem crianças menores de 6 meses na Argentina.Estimativas de uma enquete multi-propósito / Breast feeding and complementary feeding practices in under 6-month-old children in Argentina. Estimations based on multipurpose survey

Se realizó un análisis de base de datos secundaria paraestimar indicadores de lactancia materna y alimentacióncomplementaria en menores de 6 meses en Argentina, a partirde la Encuesta Nacional de Salud Sexual y Reproductiva2013, la cual utilizó un muestreo polietápico abarcandotodas las regiones estadísticas del país. Se realizaron análisisdescriptivos y multivariados sobre 3.137 mujeres querespondieron el bloque de lactancia materna de la encuestaen relación al último hijo nacido vivo. Los resultados indicanque el 65,9% de los lactantes fue amamantado hasta los seismeses de vida o más; el 43% recibió fórmula para lactantesantes de los 6 meses, el 58,5% recibió agua antes de los 6meses, y el 33,5% recibió alimentos semisólidos antes de los 6meses. Se puede concluir que el hecho de identificar factoresasociados a determinadas prácticas de alimentación enlactantes puede orientar para la promoción de una lactanciamaterna adecuada.

Analysis of secondary database was performed to estimatebreastfeeding and complementary feeding indicators in under 6-month-old children in Argentina based on the National Survey on Sex andReproductive Health 2013 which used multistage sampling covering all the statisticalregions of the country. Descriptive and multivariate analyses were performed on 3137women who answered the breastfeeding module in the survey regarding the last child bornalive. Results show that 65.9% of the infants was breastfed until 6 month of life or older;43% received baby formula before 6 months, 58.5% was given water before 6 months,and 33.5% received semi-solid food before six months. We can conclude that identifyingfactors associated to certain eating practices in infants can orientate towards the promotionof adequate breastfeeding.

Mortalidad por trastornos mentales y por causas externas: análisis de una Década en Argentina / Mortality due to mental disorders and external causes: analysis of a decade in Argentina

Objetivo: analizar las tasas de mortalidad de Trastornos Mentales y del Comportamiento (TMyC) y de las Causas Externas (CE) en las Estadísticas Vitales de Argentina, periodo 2000-2009.Metodología: se utilizó las bases de datos de defunciones, Argentina, años 2000 a 2009, de la Dirección de Estadísticas e Información en Salud Ministerial. Se construyeron tasas generales y específicas. Las estimaciones poblacionales, se obtuvieron a partir del aplicativo AGEINT. Según la distribución de la variable, se utilizó análisis de la varianza o test no paramétricos. Resultados: se observa un comportamiento disímil de la tasa de mortalidad por TMyC según sexo, pero con un comportamiento similar por cada año. Los TMyC y las CE, comprometen a la población adulta del país, con tasas mayores en el grupo de varones.Conclusión: tener en cuenta el impacto de los TMyC y CE, permite diseñar políticas públicas en salud adecuadas a las realidades de cada contexto

Objective: To analyze mortality rates due to mental and behavioral disorders (MBD) and external causes (EC) using Vital Statistics of Argentina, 2000-2009.Methods: Mortality data 2000-2009 were obtained from the Bureau of Statistics and Information, Ministry of Health, Argentina. General and specific rates were set up. Population estimates were obtained from the AGEINT application. According to the distribution of the variable, analysis of variance or nonparametric tests were used.Results: Dissimilar MBD mortality rates according to sex were observed, but with a similar pattern each year. The MBD and EC affect the adult population of the country, with higher rates in the male group.Conclusion: Taking into account the impact of MBD and EC, allows the design of public policies suitable to the realities of each health context

Mortalidad por trastornos mentales y por causas externas: análisis de una Década en Argentina / Mortality due to mental disorders and external causes: analysis of a decade in Argentina

Objetivo: analizar las tasas de mortalidad de Trastornos Mentales y del Comportamiento (TMyC) y de las Causas Externas (CE) en las Estadísticas Vitales de Argentina, periodo 2000-2009.Metodología: se utilizó las bases de datos de defunciones, Argentina, años 2000 a 2009, de la Dirección de Estadísticas e Información en Salud Ministerial. Se construyeron tasas generales y específicas. Las estimaciones poblacionales, se obtuvieron a partir del aplicativo AGEINT. Según la distribución de la variable, se utilizó análisis de la varianza o test no paramétricos. Resultados: se observa un comportamiento disímil de la tasa de mortalidad por TMyC según sexo, pero con un comportamiento similar por cada año. Los TMyC y las CE, comprometen a la población adulta del país, con tasas mayores en el grupo de varones.Conclusión: tener en cuenta el impacto de los TMyC y CE, permite diseñar políticas públicas en salud adecuadas a las realidades de cada contexto(AU)

Objective: To analyze mortality rates due to mental and behavioral disorders (MBD) and external causes (EC) using Vital Statistics of Argentina, 2000-2009.Methods: Mortality data 2000-2009 were obtained from the Bureau of Statistics and Information, Ministry of Health, Argentina. General and specific rates were set up. Population estimates were obtained from the AGEINT application. According to the distribution of the variable, analysis of variance or nonparametric tests were used.Results: Dissimilar MBD mortality rates according to sex were observed, but with a similar pattern each year. The MBD and EC affect the adult population of the country, with higher rates in the male group.Conclusion: Taking into account the impact of MBD and EC, allows the design of public policies suitable to the realities of each health context(AU)

Climate change and nutrition: creating a climate for nutrition security.

BACKGROUND: Climate change further exacerbates the enormous existing burden of undernutrition. It affects food and nutrition security and undermines current efforts to reduce hunger and promote nutrition. Undernutrition in turn undermines climate resilience and the coping strategies of vulnerable populations. OBJECTIVES: The objectives of this paper are to identify and undertake a cross-sectoral analysis of the impacts of climate change on nutrition security and the existing mechanisms, strategies, and policies to address them. METHODS: A cross-sectoral analysis of the impacts of climate change on nutrition security and the mechanisms and policies to address them was guided by an analytical framework focused on the three 'underlying causes' of undernutrition: 1) household food access, 2) maternal and child care and feeding practices, 3) environmental health and health access. The analytical framework includes the interactions of the three underlying causes of undernutrition with climate change,vulnerability, adaptation and mitigation. RESULTS: Within broad efforts on climate change mitigation and adaptation and climate-resilient development, a combination of nutrition-sensitive adaptation and mitigation measures, climate-resilient and nutrition-sensitive agricultural development, social protection, improved maternal and child care and health, nutrition-sensitive risk reduction and management, community development measures, nutrition-smart investments, increased policy coherence, and institutional and cross-sectoral collaboration are proposed as a means to address the impacts of climate change to food and nutrition security. This paper proposes policy directions to address nutrition in the climate change agenda and recommendations for consideration by the UN Framework Convention on Climate Change (UNFCCC). CONCLUSIONS: Nutrition and health stakeholders need to be engaged in key climate change adaptation and mitigation initiatives, including science-based assessment by the Intergovernmental Panel on Climate Change (IPCC), and policies and actions formulated by the UN Framework Convention on Climate Change (UNFCCC). Improved multi-sectoral coordination and political will is required to integrate nutrition-sensitive actions into climate-resilient sustainable development efforts in the UNFCCC work and in the post 2015 development agenda. Placing human rights at the center of strategies to mitigate and adapt to the impacts of climate change and international solidarity is essential to advance sustainable development and to create a climate for nutrition security.

Hospitalización por trastornos mentales y consumo de sustancias en adolescentes: 2005-2006 / Hospitalization due to mental disorders and substance consumption in argentine adolescents: 2005-2006

Objetivo: Determinar la prevalencia de trastornos mentalesy del comportamiento como causadehospitalización en lapoblación adolescente de 10 a 19 años en Argentina en elperíodo 2005 -2006.Metodología: estudio observacional, analítico ytransversal, se utilizaron las Bases de Datos delosInformesEstadísticos de Egresos Hospitalarios (IEH) de la DireccióndeEstadística e Información de Salud del Ministerio deSalud de la Nación, años 2005-2006. Los datos fueronanalizados según sexo, edad y causa de egreso hospitalario. Elprocesamiento estadístico de los datos consistió en test dechi–cuadrado, Mantel Haenzel o test de Fisher,p<0,05.Resultados: el 2% de los egresos hospitalarios fueron porTrastornos Mentales y del Comportamiento (TMyC).LosTMyC de mayor frecuencia para el grupo de 10-14 años fueron:trastornos neuróticos (29,89%), consumo de sustancias(23,49%) (p<0,001) y trastornos del comportamiento deinicio en la infancia (15,40%) y para el grupo de 15-19años fueron: consumo de sustancias (30,94%) (p<0,001),alcohol la más frecuente, trastornos neuróticos (21,04%) yesquizofrenia (17,34%) (p<0,001). La distribución por sexosy edad mostró al consumo de sustancias (p< 0,0001) comolapatología más frecuente en varones y trastornos neuróticos(p< 0,0001) en mujeres de ambos grupos de edad.

Objective: To determine the prevalence of behavioral and mental disorders as the causeof hospitalization in adolescent population from age 10 to 19 in Argentina in the period2005-2006.Method: Observational, analytical and transversal study. The databases of StatisticalRecords of Hospital Discharge from the Department of Health Statistics and Information ofthe National Ministry of Health, years 2005-2006, were used. Data were analyzed accordingto sex, age and cause of hospital discharge. The statistical processing of data was done withthe chi-squared test, Mantel Haenzel or Fisher’s test,p<0.05.Results: 2% of hospital discharges were for Behavioral and Mental Disorders. The mostfrequent of these disorders for the age group 10-14 were: neurotic disorders (29.89%),substance consumption (23.49%) (p<0.001), and behavioral diseases starting in childhood(15.40%). For the age group 15-19 the most frequent were: substance consumption(30.94%) (p<0,001) -alcohol the most frequent-, neurotic disorders (21.04%) andschizophrenia (17.34%) (p<0.001). Distribution according to sex and age showed drugconsumption (p< 0.0001) as the most frequent pathology among boys and neuroticdisorders (p< 0.0001) among girls of both age groups.

Hospitalización por trastornos mentales y consumo de sustancias en adolescentes: 2005-2006 / Hospitalization due to mental disorders and substance consumption in argentine adolescents: 2005-2006

Objetivo: Determinar la prevalencia de trastornos mentalesy del comportamiento como causadehospitalización en lapoblación adolescente de 10 a 19 años en Argentina en elperíodo 2005 -2006.Metodología: estudio observacional, analítico ytransversal, se utilizaron las Bases de Datos delosInformesEstadísticos de Egresos Hospitalarios (IEH) de la DireccióndeEstadística e Información de Salud del Ministerio deSalud de la Nación, años 2005-2006. Los datos fueronanalizados según sexo, edad y causa de egreso hospitalario. Elprocesamiento estadístico de los datos consistió en test dechiûcuadrado, Mantel Haenzel o test de Fisher,p<0,05.Resultados: el 2% de los egresos hospitalarios fueron porTrastornos Mentales y del Comportamiento (TMyC).LosTMyC de mayor frecuencia para el grupo de 10-14 años fueron:trastornos neuróticos (29,89%), consumo de sustancias(23,49%) (p<0,001) y trastornos del comportamiento deinicio en la infancia (15,40%) y para el grupo de 15-19años fueron: consumo de sustancias (30,94%) (p<0,001),alcohol la más frecuente, trastornos neuróticos (21,04%) yesquizofrenia (17,34%) (p<0,001). La distribución por sexosy edad mostró al consumo de sustancias (p< 0,0001) comolapatología más frecuente en varones y trastornos neuróticos(p< 0,0001) en mujeres de ambos grupos de edad.(AU)

Objective: To determine the prevalence of behavioral and mental disorders as the causeof hospitalization in adolescent population from age 10 to 19 in Argentina in the period2005-2006.Method: Observational, analytical and transversal study. The databases of StatisticalRecords of Hospital Discharge from the Department of Health Statistics and Information ofthe National Ministry of Health, years 2005-2006, were used. Data were analyzed accordingto sex, age and cause of hospital discharge. The statistical processing of data was done withthe chi-squared test, Mantel Haenzel or FisherÆs test,p<0.05.Results: 2% of hospital discharges were for Behavioral and Mental Disorders. The mostfrequent of these disorders for the age group 10-14 were: neurotic disorders (29.89%),substance consumption (23.49%) (p<0.001), and behavioral diseases starting in childhood(15.40%). For the age group 15-19 the most frequent were: substance consumption(30.94%) (p<0,001) -alcohol the most frequent-, neurotic disorders (21.04%) andschizophrenia (17.34%) (p<0.001). Distribution according to sex and age showed drugconsumption (p< 0.0001) as the most frequent pathology among boys and neuroticdisorders (p< 0.0001) among girls of both age groups.(AU)

Lentiginosis unilateral parcial / Unilateral partial lentiginosis

La lentiginosis unilateral parcial (LUP) es un raro desorden pigmentario caracterizado por numerosos lentigos, dispuestos en grupo, que se presentan durante la infancia, asintomáticos, y comprometen de manera unilateral un segmento del cuerpo: cabeza, cuello, tronco, extremidades, etc. Pocas veces sobrepasan la línea media, permaneciendo estables en el tiempo. Presentamos cinco casos clínicos y una breve revisión del tema...

Partial Unilateral Lentiginosis (PUL) is a rare pigmentarydisorder characterized by numerous asymptomatic andstable lentigines confined to one side of the body.It begins in childhood, affecting different body segmentsincluding the head, neck, trunk and extremities.Lentigines rarely surpass the midline.We present five cases and briefly review the subject...