Temporal trends and predictors of gestational exposure to organophosphate ester flame retardants and plasticizers.

BACKGROUND: Organophosphate esters (OPEs), used as flame retardants and plasticizers, are chemicals of concern for maternal and infant health. Prior studies examining temporal trends and predictors of OPE exposure are primarily limited by small sample sizes. OBJECTIVES: Characterize temporal trends and predictors of OPE exposure biomarkers. METHODS: We determined urinary concentrations of eight biomarkers of OPE exposure at three timepoints during pregnancy for participants in the LIFECODES Fetal Growth Study (n = 900), a nested case-cohort recruited between 2007 and 2018. We examined biomarker concentrations, their variability during pregnancy, and temporal trends over the study period. In addition, we identified sociodemographic and pregnancy characteristics associated with biomarker concentrations. Analyses were conducted using both the within-subject pregnancy geometric means and biomarker concentrations measured at individual study visits. RESULTS: Five OPE biomarkers were detected in at least 60% of the study participants. Biomarkers were not strongly correlated with one another and intraclass correlation coefficients, measuring within-subject variability during pregnancy, ranged from 0.27 to 0.51. Biomarkers exhibited varying temporal trends across study years. For example, bis(1-chloro-2-propyl) phosphate (BCIPP) increased monotonically, whereas bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) and diphenyl phosphate (DPHP), displayed non-monotonic trends with concentrations that peaked between 2011 and 2014. We observed associations between sociodemographic characteristics and OPE biomarkers. In general, concentrations of most OPE biomarkers were higher among participants from racial and ethnic minority populations, participants who were younger, had higher pre-pregnancy body mass index (BMI), and less than a college degree. We observed consistent results using either averaged or visit-specific biomarker concentrations. SIGNIFICANCE: We observed widespread exposure to several OPEs and OPE biomarkers displayed varying temporal trends in pregnant people from 2007 to 2018. Concentrations of most OPE biomarkers varied according to sociodemographic factors, suggesting higher burdens of exposure among participants with higher pre-pregnancy BMI, those belonging to racial and ethnic minority populations, and lower educational attainment.

Social Determinants of Health and Adverse Outcomes in Adolescent Pregnancies.

The association between adolescent childbearing and adverse maternal and birth outcomes has been well documented. Adverse adolescent pregnancy outcomes are associated with substantial risk of long-term morbidities for the young mother and their newborns. Multiple levels of social disadvantage have been related to adverse pregnancy outcomes among adolescent mothers. Patterns of cumulative social adversity define the most marginalized group of adolescents at the highest risk of experiencing adverse maternal and birth outcomes. Using a social determinants of health (SDOH) framework, we present an overview of the current scientific evidence on the influence of these conditions on adolescent pregnancy outcomes. Multiple SDOH such as residence in remote areas, low educational attainment, low socioeconomic status, and lack of family and community support have been linked with increased risk of adverse pregnancy outcomes among adolescents. Based on the PROGRESS-Plus equity framework, this review highlights some SDOH aspects that perinatal health researchers, clinicians, and policy makers should consider in the context of adolescent pregnancies. There is a need to acknowledge the intersectional nature of multiple SDOH when formulating clinical and societal interventions to address the needs of the most marginalized adolescent in this critical period of life.

La vena femoral como vía de acceso alternativa para la estimulación cardiaca definitiva: experiencia de un centro / The femoral vein alternate path as for cardiac pacing final: Experience center

No disponible

Observatorio Nacional de Cáncer Colombia / The Colombian National Cancer Observatory / Observatório Nacional de Câncer Colômbia

En Colombia el cáncer es un problema de salud pública en aumento, que representa grandes repercusiones psicoafectivas, sociales y económicas imponiendo un reto para el sistema de salud. Según las estadísticas del Globocan, para Colombia en el año 2012, aproximadamente 104 personas fallecieron cada día por esta enfermedad y 196 personas enfermaron de cáncer. Esto exige generar intervenciones oportunas, eficaces y articuladas para promover los factores protectores, aumentar la detección temprana, reducir la discapacidad y mortalidad evitables, mejorar la calidad de vida de los pacientes afectados, así como asegurar un desempeño costo-efectivo del sistema sanitario. Aunque se presentan unas cifras breves para revisar el panorama del cáncer en el país, no es el propósito de este artículo proporcionar información estadística que ya se encuentra disponible en el Ministerio de Salud y Protección Social, el Instituto Nacional de Cancerología (inc), el Instituto Nacional de Salud (ins) y los registros poblacionales de cáncer en el país. En su lugar, este artículo describe de forma general los avances y desarrollos del Observatorio Nacional de Cáncer (ONC) Colombia en el marco del Sistema de Información Nacional en Cáncer SINCan, puntualizando las fuentes de información en cáncer disponibles en sispro, el set de indicadores para monitorear el panorama en el país, los planes de análisis y las salidas de información (canales de acceso y divulgación de la evidencia y publicaciones relevantes) como herramientas necesarias para gestionar adecuadamente el conocimiento sobre mortalidad, morbilidad, acceso a servicios y acciones para reducir las desigualdades en cáncer en Colombia.

In Colombia, cancer is a public health problem on the rise that has major psycho-affective, social and economic repercussions. This poses a challenge for the health system. According to the statistics presented by Globocan, in 2012 approximately 104 people died each day in Colombia from this disease, and 196 developed it. This requires generating timely, effective and articulated interventions to promote protective factors, increase early detection, reduce avoidable disability and mortality, improve the quality of life of affected patients and ensure cost-effective health system performance. Although brief figures are presented to review the status of cancer in the country, this paper's authors do not intend to provide statistical data that has already been made available by the Ministry of Health and Social Protection, the National Cancer Institute, the National Institute of Health and the Cancer Population Records of Colombia. Instead, this article aims to broadly describe the progress and developments of the National Cancer Observatory (NCO) of Colombia within the National Information System on Cancer (SINCan). It also describes the cancer information sources available in SISPRO, the set of indicators to monitor the status of this disease in the Country, the analysis plans and the information output mechanisms (channels of access and dissemination of evidence and relevant publications) as the necessary tools to properly manage the knowledge on mortality, morbidity, health service access and actions to reduce cancer inequalities in Colombia.

Na Colômbia o câncer é um problema de saúde pública em aumento, que representa grandes repercussões psicoafetivas, sociais e econômicas impondo um desafio para o sistema de saúde. Segundo as estatísticas do Globocan, para a Colômbia no ano 2012, ao redor de 104 pessoas morreram cada dia e 196 pessoas adoeceram de câncer.Isto exige gerar intervenções oportunas, eficazes e articuladas para alavancar os fatores protetores, aumentar a detecção precoce, reduzir a deficiência e mortalidade evitáveis, melhorar a qualidade de vida dos pacientes afetados, bem como garantir um desempenho custo-efetivo do sistema sanitário. Embora sejam apresentadas umas curtas cifras para analisar o panorama do câncer no país, não é a intenção deste artigo fornecer informação estatística já disponível no Ministério da Saúde e Assistência Social, no Instituto Nacional de Cancerologia INC, no Instituto Nacional de Saúde INS e nos Registros Populacionais de Câncer no país. Em vez disso, este artigo descreve, grosso modo, os avanços e progressos do Observatório Nacional de Câncer (ONC) Colômbia no quadro do Sistema de Informação Nacional em Câncer SINCan, salientando as fontes de informação em câncer disponíveis em SISPRO, o conjunto de indicadores para monitorar o panorama no país, os planos de análise e as saídas de informação (canais de acesso e divulgação da evidência e publicações relevantes) como ferramentas necessárias para gerenciar adequadamente o conhecimento sobre mortalidade, morbilidade, acesso a serviços e ações para reduzir as desigualdades em câncer na Colômbia.

Progreso en el logro de los Objetivos de Desarrollo del Milenio: la mortalidad por cáncer de cérvix desciende en Colombia / Progress in the Achievement of the Millennium Development goals: the rate of mortality by cervical cancer decreases in Colombia / Progresso na consecução dos Objetivos de Desenvolvimento do Milênio: a mortalidade por câncer de cérvix diminui na Colômbia

Colombia a dos años de cumplirse la fecha establecida para el alcance de los Objetivos de Desarrollo del Milenio (ODM), ha logrado un descenso progresivo en las tasas de incidencia y mortalidad por cáncer de cuello uterino durante el decenio 2000 - 2010. En este período, la tasa de mortalidad descendió significativamente para las mujeres de todas las edades (11,4% en 1998 - 6,9 en 2011, meta a 2015: 6,8%) y aumentó la proporción de casos in situ detectados oportunamente (63,31% en 2012). Colombia asumió el cáncer como un problema de salud pública y logró posicionarlo en la agenda pública. De igual forma, el cambio en el conocimiento y el autocuidado de la población, dieron como resultado un aumento en el pronóstico de las pacientes. A pesar de estos avances, el país continúa concentrando esfuerzos en reducir tasas de incidencia y mortalidad, aumentar los niveles de tecnología y promover mayor desarrollo en las regiones, mejorar sustancialmente el derecho de las mujeres a ser protegidos contra esta enfermedad, a través de acceso sin barreras a los programas de tamización y tratamientos del cáncer de cuello uterino. Y finalmente, la inclusión más amplia de la vacuna contra el VPH con intervalo de cada 5 años, y que tiene un mayor potencial, especialmente entre las mujeres más jóvenes. La pregunta clave hoy en día es cómo acelerar ese ritmo de progreso en otros indicadores ODM para 2015, y ofrecer suficientes ejemplos de estrategias eficaces y adecuadas, y proporcionar experiencias en un contexto latinoamericano.

Two years before the deadline set for the achievement of the Millennium Development Goals (MDG), Colombia is experiencing a steady decline in the incidence and mortality rates of cervical cancer during the 2000-2010 decade. During this time, the mortality rate decreased significantly for women of all ages (11.4% in 1998 - 6.9 in 2011; goal for 2015: 6.8%) and the ratio of in-situ cases detected in time increased (63.31% in 2012). Colombia perceives cancer as a public health problem and managed to include it in the public agenda. Similarly, the changes in the population's knowledge and self-care practices resulted in increased prognosis among patients. In spite of these advances, the Country continues focusing its efforts on reducing incidence and mortality rates, increasing levels of technology, promoting further development in the regions and substantially improving woman's right to be protected against this disease via full access to screening programs and treatments for cervical cancer. Finally, the Country also focuses on wider inclusion of the HPV vaccine with an interval of 5 years, as it has more potential, especially for younger women. The main question today is how to accelerate this progress for other MDG indicators by 2015 and how to provide enough examples of effective and appropriate strategies along with evidence of experiences in a Latin American context.

Colômbia a dois anos de cumprir-se o prazo estabelecido para a consecução dos Objetivos de Desenvolvimento do Milênio (ODM), tem conseguido uma diminuição progressiva nas taxas de incidência e mortalidade por câncer de colo do útero durante o decênio 2000 - 2010. Neste período, a taxa de mortalidade diminuiu expressivamente para as mulheres de todas as idades (11,4% em 1998 - 6,9 em 2011, meta a 2015:) 6,8%) e aumentou a proporção de casos in situ detectados oportunamente (63,31% em 2012). A Colômbia assumiu o câncer como um problema de saúde pública e conseguiu posicioná-lo na agenda pública.Da mesma maneira, a mudança no conhecimento e autocuidado da população, tiveram como resultado um aumento no prognóstico das pacientes. A pesar destes avanços, o país continua reunindo esforços para reduzir as taxas de incidência e mortalidade, aumentar os níveis de tecnologia e promover maior desenvolvimento nas regiões, melhorar substancialmente o direito das mulheres a serem protegidas contra esta doença, através do acesso sem obstáculos aos programas de peneiração e tratamento do câncer de colo do útero.E finalmente, a inclusão mais ampla da vacina contra o HPV com intervalo de cada 5 anos, e que tem um maior potencial, especialmente entre as mulheres mais jovens. A pergunta chave na atualidade é como acelerar esse ritmo de progresso em outros indicadores ODM para 2015, e oferecer suficientes exemplos de estratégias eficazes e adequadas, e fornecer experiências em um contexto latino-americano.

Sistemas de efluxo multidrogas em Escherichia coli e uso de inibidores como possíveis adjuvantes na terapia da mastite bovina / Multidrug efflux systems in Escherichia coli and the use of inhibitors as possible adjuvant therapy in bovine mastitis

Vinte e sete isolados de Escherichia coli provenientes de leite de bovinos com mastite clínica foram submetidos a teste de sensibilidade aos principais antimicrobianos usados no tratamento desta doença. Avaliou-se também a efetividade in vitro de dois inibidores de sistemas de efluxo multidrogas, fenilalanina arginyl ß naftilamida (PAβN) e 1-(1-Naphthylmethyl)-piperazine (NMP), utilizando-se a concentração inibitória mínima (CIM) como referência. A CIM e o sistema de efluxo foram detectados com base nas curvas de crescimento, utilizando-se a densidade óptica (D.O550), em diferentes concentrações da droga e na presença e ausência dos inibidores. Apenas quatro isolados apresentaram resistência à ampicilina e ao sulfametoxazol∕trimetoprim, simultaneamente, enquanto todos os 27 foram sensíveis aos demais antimicrobianos. Observaram-se valores para ampicilina variando de 6µg/mL a 250µg/mL e para sulfametoxazol∕trimetoprim de 12µg/mL a 1500µg/mL. Houve redução das CIMs desses antimicrobianos em todos os isolados na presença dos inibidores, exceto para sulfametoxazol∕trimetoprim na presença de NMP. Conclui-se que esses isolados possuem um estreito perfil de resistência e que PAßN apresentou melhor efeito inibitório em relação à ampicilina e ao sulfametoxazol∕trimetoprim, apresentando-se como um candidato a adjuvante no tratamento da mastite...

Twenty-seven isolates of Escherichia coli from cattle with clinical mastitis were subjected to sensitivity tests regarding main antimicrobials used in the treatment of this disease. We also evaluated in vitro effectiveness of two inhibitors of multidrug efflux systems, fenilalanina arginyl ß naftilamida (PAβN) and 1-(1-Naphthylmethyl)-piperazine (NMP), using the minimum inhibitory concentration (MIC) as a reference. MIC and multidrug efflux systems were detected in the growth curves, using optical density (D.O550) at different drug concentrations and the presence and absence of inhibitors. Only four isolates of E. coli were resistant to ampicillin and trimethoprim/sulfamethoxazole, simultaneously. However, all isolates were sensitive to the other antimicrobials. Were observed values ranging from 6mg to 250mg ampicillin/mL, and 12mg to 1500mg/mL trimethoprim/sulfamethoxazole. There was a reduction of the MIC of antimicrobials for all isolates in the presence of inhibitors, except for trimethoprim/sulfamethoxazole in the presence of NMP. In conclusion, these isolates have a narrow resistance profile and PAßN showed better inhibitory effect against ampicillin and trimethoprim/sulfamethoxazole, and is a candidate for the adjuvant treatment of mastitis...

Espermicida y espermiostático: ¿hacen referencia a lo mismo? / Spermicide and spermiostatic: Is it the same?

Antecedentes: La literatura científica ha definido los espermicidas como agentes químicos que pueden inmovilizar y algunas veces matar los espermatozoides en la vagina, sin embargo estos términos se usan de forma arbitraria y no hay un consenso que defina si la palabra espermicida debe referirse exclusivamente a una sustancia que causa la muerte espermática o a sustancias que sólo causan la inmovilización espermática y no necesariamente la muerte. Objetivo: Especificar la definición más adecuada para las sustancias que ejercen un efecto sobre la movilidad o la viabilidad espermática. Método: Revisión de la literatura en distintas bases de datos utilizando los criterios de búsqueda "espermicida" y "espermiostático", con sus equivalentes en inglés. Se seleccionaron algunos reportes en inglés y en español de los últimos 31 años, se evaluó si hacen referencia a la inhibición de la movilidad o de la viabilidad de los espermatozoides. Resultado: Se encontró que algunos reportes refieren la muerte de los espermatozoides mientras que otros sólo a su inmovilización. Conclusión: Se propone que para lograr definir si algún compuesto, extracto o sustancia con efecto sobre los espermatozoides es un agente espermiostático o espermicida es necesario que se realicen evaluaciones tanto del efecto sobre la movilidad como de la viabilidad espermática...

Background: The literature has defined spermicides as chemical agents that immobilize and occasionally kill sperm cells in the vagina, however these terms are used arbitrarily and there is no consensus that defines whether the word spermicide must refer exclusively to a substance that kills sperm or substances that only cause sperm immobilization and not necessarily the cell death. Aim: To specify the most appropriate definition for substances those have an effect on sperm motility or viability. Method: We conducted a review of the literature in different databases using the search criteria "spermicide" and "espermiostátic". We selected some reports in English and Spanish for the last 31 years, and then we evaluated if they refer to the inhibition of the mobility or sperm viability. Results: We found that some reports relate the death of sperm cells while others only affect the sperm motility. Conclusion: We propose that in order to determine whether a compound or substance extract is a spermicidal or spermiostatic agent, is necessary to conduct tests of the effect on both motility and sperm viability...

Trastorno bipolar desde la perspectiva de los familiares / Bipolar disorder viewed from the familiy caregiver´s perspective

Objectives: Comprehend the Bipolar syndrome from the perspective of the family caregivers and identify the strategies used to help the well being of the patient and the family. Methods and Materials: Thirteen caregivers of patients with bipolar disorder, with previous informed consent, were interviewed in depth. The analysis was based on a proven theory. In meetings with the participants, relevant issues of the analysis were discussed in order to produce the final report. Results: In view of the diagnosis, the family caregivers receive a double emotional impact: the first, a chronic disease, the second an unknown disease. In addition to the low coverage by the health system for bipolar patients and their families and the differences in therapeutic recommendations with cultural practices associated with amusement and gender relations. The more experienced caregivers have constructed strategies for taking care: attitude changes in the patients, alternative practices in health and changes in the physical and emotional environment of the family. There are few strategies for self care in the family caregivers, they often show post stress syndrome symptoms and postponement of their needs and projects. Conclusions: There is a need to implement opportune interventions with the family members that will permit: reduce the impact, the anguish and elaborate the mourning related to the diagnosis, familiarize with the etiology and treatment of the disease, collective education on the caring and self caring and promote a social support network and mental health education that will permit the patients and family to obtain the most benefit from the health system.

Objetivo: Comprender el Trastorno Bipolar desde la perspectiva de los cuidadores familiares e identificar estrategias de cuidado que ayuden al bienestar del paciente y su familia. Materiales y Métodos: 13 cuidadores familiares de pacientes con Trastorno Bipolar, previo consentimiento informado, fueron entrevistados en profundidad. El análisis se condujo según la teoría fundada. En reuniones con los participantes se discutieron aspectos relevantes de las entrevistas para redactar el informe final. Resultados: Frente al diagnóstico, los cuidadores familiares reciben un doble impacto emocional: el de una enfermedad crónica y el de una enfermedad desconocida. Se suma la baja cobertura del sistema de salud para los pacientes bipolares y sus familias y las dificultades que algunas recomendaciones terapéuticas se presentan para aquellos. Los cuidadores de mayor experiencia han construido estrategias de cuidado, tales como, cambios actitudinales hacia los pacientes, prácticas alternativas de salud y cambios en el entorno físico y emocional de la familia. Son escasas las estrategias de autocuidado en los cuidadores familiares, observándose en ellos síntomas propios de estrés postraumático y postergación de sus necesidades y proyectos. Conclusiones: Se sugiere la necesidad de implementar intervenciones oportunas con los familiares que les permitan reducir el impacto emocional, la angustia y elaborar la temática frente al diagnóstico; familiarizarse con la etiología y tratamiento de la enfermedad, lograr aprendizaje colectivo sobre el cuidado y autocuidado además de fomentar redes de apoyo social y educación en salud mental que les permita a los pacientes y familiares obtener mejores beneficios del sistema de salud.

Evaluación de txxtura a cinco cortes de carne d res conservados por esterilizaación en envase de hojalata / Assessng texturee to five beef meat cuts preserved by terilization inn tinplate packaging

Las variables que influyen en la calidad de los cortes de carne bovina para enlatar, definen la aceptación del consumidor por análisis de la textura usando método instrumental y sensorial. Se seleccionan, caracterizan y evalúan cinco cortes de carne de bovino, de uso frecuente por el consumidor, para someterlos a cocción, desmecharlos, enlatarlos, llevarlos a esterilización comercial a dos niveles de tratamiento térmico (F0= 8 y F0= 20), a 121°C, 20 libras de presión, y 5 repeticiones, para determinar cuál de los 5 cortes presenta mejor respuesta en textura, costos y rendimientos. Los cortes utilizados son: músculo romboides o huevo de solomo; cutáneo del tronco o sobrebarriga; supraespinoso o sabaleta; bíceps femoral o posta; dorsal ancho, o gran dorsal o espaldilla,. Los cortes son analizados por jueces entrenados y no entrenados, en el Laboratorio de Análisis Sensorial de Alimentos de la Universidad de Antioquia, La calidad textural es medida con texturómetro por fuerza de corte, a las muestras seleccionadas. Se valora además: el costo, el rendimiento del corte, la calidad microbiológica y prueba de esterilidad comercial de las latas incubadas a 37 y 55°C, para los valores F0, definidos. La correlación estadística entre el análisis sensorial e instrumental demuestra que el mejor corte para desmechar y esterilizar corresponde a la espaldilla gruesa con un tratamiento térmico de 16 minutos a 121°C y 20 libras de presión, con un menor costo, una mejor textura y un buen rendimiento.

In order to define consumer acceptance by texture analysis, the variables that affect quality of beef cuts for canning are analyzed by instrumental and sensory methods. Five beef cuts, commonly used by consumers, are selected, characterized and evaluated, so as to subject them to cooking, mincing and canning in tin containers, then, commercial sterilization in two levels of thermal treatment (F0=8 and F0=20), to 121°C; and 20 pounds of pressure, with 5 repetitions, is carried out. This procedure is aimed to determinate which of the five cuts offer a better response regarding to texture, costs and yield. The cuts used are: Muscle Romboides or "Huevo de Solomo', Cutaneous of Trunk or Sobrebarriga, Supraespinoso or Sabaleta, Biceps Femoral or Posta, Dorsal Broad or Great Dorsal, its commercial name is "Punta de Espaldilla'. All beef cuts are analyzed by expert and non-trained judges in the Sensorial Analysis of Food Laboratory at the University of Antioquia. A Texturometer is used to measure the applied force upon beef cuts. Additionally, costs, yield of cuts, microbiological quality and the test of commercial sterility are also evaluated in tins incubated at 37°C and 55 °C, for the defined F0 values. The statistical correlation among the Sensorial and Instrumental Analysis shows that the best cut for mincing and sterilizing corresponds to 'Espaldilla' following a thermal treatment of 16 minutes to 121°C, and 20 pounds of pressure, since it offers a lower cost and a better texture and yield.

Probiotics for the prevention of pediatric antibiotic-associated diarrhea.

BACKGROUND: Antibiotics alter the microbial balance within the gastrointestinal tract. Probiotics may prevent antibiotic-associated diarrhea (AAD) via restoration of the gut microflora. Antibiotics are prescribed frequently in children and AAD is common in this population. OBJECTIVES: To assess the efficacy and adverse effects of probiotics (any specified strain or dose) for the prevention of antibiotic-associated diarrhea in children. To assess adverse events associated with the use of probiotics when co-administered with antibiotics in children. SEARCH STRATEGY: MEDLINE, EMBASE, CENTRAL, CINAHL , AMED, and the Web of Science (inception to August 2006) were searched along with specialized registers including the Cochrane IBD/FBD Review Group, CISCOM, Chalmers PedCAM Research Register and trial registries from inception to 2005. Letters were sent to authors of included trials, nutra/pharmaceutical companies, and experts in the field requesting additional information on ongoing or unpublished trials. Conference proceedings, dissertation abstracts, and reference lists from included and relevant articles were hand searched. SELECTION CRITERIA: Randomized, parallel, controlled (placebo, active, or no treatment) trials comparing co-administered probiotics with antibiotics for the prevention of diarrhea secondary to antibiotic use in children (0 to 18 years). DATA COLLECTION AND ANALYSIS: Methodological quality assessment and data extraction were conducted independently by two authors (BCJ, AS). Dichotomous data (incidence of diarrhea, adverse events) were combined using pooled relative risks, and continuous data (mean duration of diarrhea, mean daily stool frequency) as weighted mean differences, along with their corresponding 95% confidence intervals. Adverse events were summarized using risk difference. For overall pooled results on the incidence of diarrhea, a priori sensitivity analyses included per protocol versus intention to treat, random versus fixed effects, and methodological quality criterion. Subgroup analysis were conducted on probiotic strain, dose, definition of antibiotic-associated diarrhea, and antibiotic agent. MAIN RESULTS: Ten studies met the inclusion criteria. Trials included treatment with either Lactobacilli spp., Bifidobacterium spp., Streptococcus spp., or Saccharomyces boulardii alone or in combination. Six studies used a single strain probiotic agent and four combined two probiotic strains. The per protocol analysis for 9/10 trials reporting on the incidence of diarrhea show statistically significant results favouring probiotics over active/non active controls (RR 0.49; 95% CI 0.32 to 0.74). However, intention to treat analysis showed non-significant results overall (RR 0.90; 95% CI 0.50 to 1.63). Five of ten trials monitored for adverse events (n = 647); none reported a serious adverse event. AUTHORS' CONCLUSIONS: Probiotics show promise for the prevention of pediatric AAD. While per protocol analysis yields treatment effect estimates that are both statistically and clinically significant, as does analysis of high quality studies, the estimate from the intention to treat analysis was not statistically significant. Future studies should involve probiotic strains and doses with the most promising evidence (e.g., Lactobacillus GG, Lactobacillus sporogenes, Saccharomyces boulardii at 5 to 40 billion colony forming units/day). Research done to date does not permit determination of the effect of age (e.g., infant versus older children) or antibiotic duration (e.g., 5 days versus 10 days). Future trials would benefit from a validated primary outcome measure for antibiotic-associated diarrhea that is sensitive to change and reflects what treatment effect clinicians, parents, and children consider important. The current data are promising, but it is premature to routinely recommend probiotics for the prevention of pediatric AAD.

Modelo QSAR para la predicción de los tiempos de vida media de bifenilos policlorados en humanos / QSAR model for the prediction of the half life of polychlorinated biphenyls in humans

La velocidad con que los bifenilos policlorados (PCBs) son eliminados en humanos, representada por sus períodos de vida media (t1/2), es de gran relevancia ambiental. En este trabajo, a partir de datos reportados en la literatura, se elabora una base de datos de esta variable tóxico-cinética de PCBs en humanos. 14 estructuras de PCBs son optimizadas energéticamente, haciendo previamente un barrido del ángulo diedro entre sus anillos fenilícos , utilizando AM1 para encontrar la conformación más estable. Los PCBs mono-orto sustituidos presentan un ángulo diedro aproximado de 120° y los poli-orto sustituidos de 90°. A partir de las estructuras optimizadas se calculan diversos descriptores moleculares, empleando el método B3LYP/6-31G**. Los descriptores son asociados con los t1/2 mediante análisis de regresión lineal múltiple. Este análisis revela que el t1/2 de PCBs es función de la sumatoria de cargas de átomos de cloro (?QCl) y el valor total de cargas de carbonos en posición meta (?QC-meta). El coeficiente de regresión es de 0.84 y P<0.01 (rango 1.2-24 años). Un análisis discriminante permite corroborar las características moleculares que mejor describen el t1/2. La función de discriminación realizada para dos grupos, encuentra que el descriptor ?QC-meta es el más importante para clasificar a los PCBs de acuerdo con su t1/2. Teniendo en cuenta que el metabolismo de PCBs depende de la sustitución de los carbonos en posiciones meta-para, ya que este inicia con la formación de epoxi-PCB en estos átomos, el descriptor electrónico ?QC-meta puede explicar este ambiente químico local y la susceptibilidad metabólica del congénero por isoenzimas citocromo P450 (CYPs)

Inflamación de glándulas salivales, revisión bibliográfica / Salivary glands inflammation: a review of the literature

Las glándulas salivales son estructuras pares, simétricas y localizadas junto a la rama y el cuerpo de la mandíbula, involucran glándulas parótida (saliva serosa), submaxilar (predominantemente serosa) y sublingual (predominantemente mucosa). Además existen numerosas glándulas salivales menores en la superficie de la mucosa bucal, yugal, palatina y sublingual de la cavidad bucal (300-400 aproximadamente) que producen saliva mucosa. El objetivo de esta revisión bibliográfica es hacer una reseña sobre los diversos proceos infecciosos que afectan las glándulas salivales, los diferentes enfoques diagnósticos y pautas de tratamiento. Los trastornos infecciosos de las glándulas salivares entran en el área de responsabilidad de la odontología, todo facultativo debe estar familiarizado con estos tratornos, las técnicas de diagnóstico aplicables y estar en capacidad de referir aquellos casos que son competencia de los especialistas.

High-performance liquid chromatography method to analyze free and total urinary pyridinoline and deoxypyridinoline.

The pyridinium cross-links pyridinoline (PYD) and deoxypyridinoline (DPD) are established markers of bone resorption measured in blood and urine and are used to investigate bone metabolism and manage bone diseases. Unfortunately, the currently observed interlaboratory variability caused by inconsistent assay calibration limits the optimal use of these markers. A high-performance liquid chromatography (HPLC)-based assay was developed using synthetic PYD and DPD as calibrators to analyze free and total PYD and DPD in urine. The spectroscopic characteristics of the synthetic calibrators were identical to those of calibrators isolated from bone. The mean intraassay variabilities of the HPLC method were 4.1 and 3.8%, respectively, for total DPD and PYD and 9.8 and 9.5%, respectively, for free DPD and PYD. The mean interassay variabilities were 9.1 and 8.2% for total DPD and PYD and 8.6 and 7.0% for free DPD and PYD, respectively. The mean recoveries were 98.1% for total DPD, 100.8% for total PYD, 98.6% for free DPD, and 94.9% for free PYD. The method exhibits a good correlation with a commercial immunoassay and with other HPLC assays currently used in hospital laboratories.

Bone turnover and density in obese premenopausal women during moderate weight loss and calcium supplementation.

Bone turnover is increased during weight loss in postmenopausal women and can be suppressed with calcium supplementation. In this study, we assessed the influence of energy restriction with and without calcium supplementation (1 g/day) in premenopausal women. Thirty-eight obese premenopausal women (body mass index [BMI] of 35.0 +/- 3.9 kg/m2) completed a 6-month study of either moderate weight loss or weight maintenance. During weight loss, women were randomly assigned to either a calcium supplementation (n = 14) or placebo group (n = 14) and lost 7.5 +/- 2.5% of their body weight. The control group of women (n = 10) maintained their body weight. Total body and lumbar bone mineral density (LBMD) and content were measured by dual-energy X-ray absorptiometry (DXA) at baseline and after weight loss. Throughout the study, blood and urine samples were collected to measure bone turnover markers and hormones. During moderate energy restriction, dietary calcium intake decreased (p < 0.05) and the bone resorption marker deoxypyridinoline (DPD) increased slightly (p < or = 0.05) without evidence of bone loss. Calcium supplementation during weight loss tended to increase lumbar BMD by 1.7% (p = 0.05) compared with the placebo or weight maintenance groups. In contrast to our previous findings in postmenopausal women, premenopausal obese women who consume a low calcium diet do not lose bone over a 6-month period, whether their weight is stable or decreasing moderately.

Oseointegración: una cascade de eventos / Osseointegration: a cascade of events

Por medio de esta revisión bibliográfica se pretende mostrar lo que existe en la actualidad sobre la biocompatibilidad, las características del titanio y su uso para implantes dentales y los eventos celulares y moleculares que se desencadenan con la colocación de un implante intraóseo en los maxilares. Se discute la terminología de: biotolerante, bioinerte, bioactivo, biointegración, bioaceptabilidad. Se establecen las características que hacen del titanio el material de eleción para su uso en los implantes dentales y los factores que permiten que se logre con ellos la oseointegración. En cuanto a los fenómenos celulares, se destaca el papel del osteoblasto como el blanco perfecto que permite desencadenar el proceso biológico que lleva a la oseointegración. A la vez se discute a nivel molecular todo el proceso de fenomenologías que ocurre desde el momento de la colocación del implante para permitir por parte del organismo una cicatrización normal alrededor de un cuerpo extraño. Esta información nos lleva a pensar que el entendimiento y manejo de todos estos eventos celulares y moleculares serían de gran utilidad para mejorar el éxito de los implantes dentales y extender su uso a sitios anatómicos que presentan dificultad a la terapéutica actual

Synthesis of Secondary Amines via N-(Benzoyloxy)amines and Organoboranes.

A variety of primary amines (R-NH(2)) were converted to their corresponding N-(benzoyloxy)amines (i.e., R-NHOCOPh) under biphasic conditions in excellent yields (63-90%). The intermediate N-(benzoyloxy)amines were converted to their N-ethylamine derivatives upon reaction with triethylborane in THF in good yield (54-89%). These experiments demonstrated the similar chemistry of N-chloro- and N-(benzoyloxy)amines with organoboranes.

Characterization of cassava common mosaic virus and a defective RNA species.

The genome of cassava common mosaic potexvirus (CsCMV) has been sequenced from cDNA clones and consists of 6376 nucleotides (nt). A 76 nt untranslated region (UTR) at the 5' terminus was followed by ORF1 which potentially encodes a protein of 1449 amino acids (aa). ORFs 2, 3, and 4 were predicted to encode proteins of 231, 112 and 97 aa, respectively. ORF5 potentially encodes a 229 aa protein of 25 kDa that is similar to the coat proteins of other potexviruses. The 3'-terminal UTR of 114 nt was followed by a poly(A) tail. The genomic organization of the CsCMV genome is similar to that of other potexviruses. A cDNA clone that was apparently obtained from a defective RNA species contained both the 5' and 3' UTRs and an ORF that potentially encodes the first 263 aa of ORF1 and the last 33 aa of the coat protein. Defective RNA species were found both in purified preparations of the virus and in total nucleic acid isolated from CsCMV-infected plants.