Hipoacusia neurosensorial en niños nacidos con muy bajo peso, atendidos en un hospital pediátrico de alta complejidad / Sensorineural hearing loss in children borned with very low weight, attended at a high complexity pediatric hospital / Perda auditiva em crianças nascidas con muito baixo peso, atendidas em um hospital pediátrico de alta complexidade

INTRODUCCIÓN: El peso al nacer menor a 1.500 gramos es considerado un factor de riesgo auditivo. Analizamos una muestra de 137 niños nacidos con muy bajo peso, atendidos en un hospital pediátrico de alta complejidad. OBJETIVOS: Determinar la frecuencia de hipoacusia neurosensorial; analizar las diferencias entre los subgrupos: screening auditivo neonatal y pacientes de consultorio externo; valorar si existen diferencias entre los subgrupos de peso menor a 1.000 gramos y mayor a 1.000 gramos; investigar el grado de hipoacusia y determinar si la misma es unilateral o bilateral; estimar el porcentaje de niños de screening auditivo que regresaron para seguimiento; describir los factores de riesgo auditivo que presenta la muestra.

INTRODUCTION: Birth weight less than 1,500 grams is considered an auditory risk factor. We analyzed a sample of 137 children born with very low weight and treated in a high complexity pediatric hospital. OBJECTIVE: Determine frequency of sensorineural hearing loss; to analyze differences between the subgroups: neonatal auditory screening and patients from the outpatient clinic; assess if there are differences between subgroups of less and than 1,000 grams; investigate the degree of hearing loss and determine whether it is unilateral or bilateral; estimate the percentage of hearing screening children who returned for follow-up; describe the auditory risk factors presented by the sample.

INTRODUÇÃO: O peso do bebe ao nascer menor do que 1500 gramas é considerado um fator de risco auditivo. Neste trabalho, foi analisada uma amostra de 137 crianças nascidas com muito baixo peso, atendidos em um hospital pediátrico de alta complexidade. Os objetivos do trabalho foram: determinar a frequência de perda auditiva neurossensorial; analisar diferenças entre os subgrupos: screening auditivo neonatal e pacientes de consultório externo; avaliar se existem diferenças entre os subgrupos de peso menor do que 1000 gramas; investigar o grau de perda auditiva e determinar se a mesma foi unilateral ou bilateral; estimar a percentagem de crianças de screening auditivo que regressaram para acompanhamento; descrever os fatores de risco auditivo que apresentou a amostra. MATERIAL E MÉTODO: Foram excluídos pacientes oncológicos, com traumatismo cranioencefálico, transplantados ou com cirurgias do ouvido prévias ao diagnóstico da perda auditiva.

Factors associated with a positive attitude towards receiving cancer information: a population-based study in Spain.

BACKGROUND: It is necessary to raise a positive attitude towards cancer information to improve disease prevention and control. OBJECTIVE: To identify social factors, health characteristics and cancer-related perceptions and knowledge associated with a positive attitude towards cancer information. DESIGN: We ran multivariate logistic regression models to analyse population-based data from OncoBarómetro-2010, a Spanish representative survey on perceptions and knowledge, related to cancer, conducted among 7938 people aged 18 years or more. MEASUREMENT: Attitudes towards cancer information. A positive attitude includes feeling motivated to keep informed, to have screening tests or to change lifestyle. A negative attitude includes feeling indifference, concern, frustration or fear. RESULTS: 38.3% of the studied population reported having received information related to cancer (within the last 6 months). Among those, 31.5% expressed a negative attitude towards cancer information. People more likely to have a positive attitude towards cancer information (reference category: negative attitude) were people aged 35-74 (ref: aged 18-34) (P < 0.001) and cancer survivors (ref: those who had not had cancer) (OR: 3.05; 95% CI: 1.73-5.38). The likelihood of a positive attitude increased with the level of education (P < 0.001). The variables negatively associated with a positive attitude towards cancer information were poor self-rated health status (ref: fair) (OR: 0.63; 95% CI: 0.42-0.95) and high self-perceived risk of developing cancer (ref: low) (OR: 0.75; 95% CI: 0.60-0.92). CONCLUSIONS: These findings have potential to inform programmes designed to promote cancer prevention behaviours. Policies should target population groups with low socio-economic groups, those with poor self-rated health and individuals with high self-perceived risk of cancer. Further, in order to increase knowledge of cancer symptoms, we need to focus on individuals with unhealthy lifestyles.

Prevalence of DFNB1 mutations in Argentinean children with non-syndromic deafness. Report of a novel mutation in GJB2.

OBJECTIVE: Mutations in DFNB1 locus, containing GJB2 (connexin 26) and GJB6 (connexin 30) genes, are the most common cause of autosomal recessive non-syndromic hearing loss. More than 100 mutations in GJB2 have been reported worldwide. Two deletions in GJB6, del(GJB6-D13S1830) and del(GJB6-D13S1854), have been found to be frequent in the Spanish population. The aim of this study was to determine the prevalence of GJB2 mutations and both GJB6 deletions in Argentinean children with non-syndromic deafness. METHODS: This study included 94 unrelated children with moderate to profound non-syndromic sensorineural hearing impairment. Molecular analysis was performed using a tiered approach. All DNA samples were screened for c.35delG mutation by PCR/RFLP. Samples from patients who were not homozygous for c.35delG were analysed for the presence of GJB6 deletions by PCR multiplex. The samples that remained unresolved after screening were further analysed by direct sequencing of GJB2 coding region. Finally, the splice site mutation IVS1+1G-->A was analysed by PCR/RFLP. RESULTS: Sequence variations in the GJB2 and GJB6 genes were found in 49 of the 94 unrelated patients. The most prevalent GJB2 mutation, c.35delG, was found in 40 of the 68 pathogenic alleles with the second most common allele being p.R143W (4/68). Fourteen sequence variations other than c.35delG were identified. Seven already described mutations were present in more than one allele; among them, IVS1+1G-->A, the rare splice site mutation flanking exon 1. In addition to known disease-related alterations, a novel GJB2 mutation, c.262G>C (p.A88P), was also identified. Six alleles were identified carrying GJB6 deletions; the most prevalent was del(GJB6-D13S1830). The frequency of the latter was found to be as high as that found in Spain from where Argentina has received one of its major immigration waves. CONCLUSIONS: The overall frequency of GJB2/GJB6 mutations in the present sample is in agreement with other Caucasian populations. As expected, c.35delG was the most prevalent mutation. The deletion del(GJB6-D13S1830) was the second most common mutation. These findings reinforce the importance of the study of GJB2/GJB6 genes in diagnosis to provide early treatment and genetic counselling.

Modelo para la identificación de competencias laborales y definición de criterios de desempeño en salud pública de los profesionales de enfermería y médicina en el departamento de Caldas, 2005-2006 / Model for the identification of work competences and definition of performance criteria in public health of the nursing and medicine professionals in the department of Caldas, 2005-2006 / Modelo para a identificacão de competências laborais e definicão de criterios de desempenho em saúde publica dos profissionais de enfermaria e medicina no estado decaldas, 2005-2006

La OPS en el año 2000 puso en evidencia el escaso desarrollo de los países de América Latina respecto a los recursos humanos en salud pública, resaltando la falta de: caracterización de la fuerza de trabajo, identificación de las competencias necesaria para el ejercicio de las funciones esenciales de salud pública y el mejoramiento de la calidad de la fuerza de trabajo. En respuesta a estos desafíos, y teniendo en cuenta dichas funciones, se realizó el presente estudio que define las competencias para los profesionales de enfermería y medicina. El resultado fue la construcción de un instrumento que permite la identificación de parámetros de autoevaluación, heteroevaluación e interevaluación como punto de referencia para la planeación de las intervenciones en salud pública. Para su validación fue aplicada a profesionales de enfermería y medicina a través de la técnica de informantes claves y posteriormente se realizaron las mediciones estadísticas de confiabilidad y validez. La formulación de competencias y conductas asociadas definidas en la presente investigación permiten: cualificar y evaluar el recurso humano que labora en el área de Salud Pública, generar en los miembros de las organizaciones de salud compromisos con el desempeño eficiente de sus funciones, mediante la utilización del modelo propuesto que contiene la información básica de éstas y proporciona información de soporte para la planeación e implementación de medidas de mejoramiento, modernización administrativas y el análisis de cargas de trabajo.

In 2000, the OPS made evident the lack of growth of the Latin American countries, regarding human resources in public health. The organization stressed aspects such as the lack of characterization in the work force; the lack of identification of the competences needed for the execution of the essential functions in Public Health and in the improvement of the quality of the labor force. The following study was conducted as an answer to these challenges taking into consideration all the aspects stressed by the OPS, defining the competencies needed by professionals in nursing and medicine. By means of a structure questionnaire, parameters for auto-evaluation, hetero-evaluation and inter-evaluation were identified as points of reference to plan the interventions in Public Health. It was administered to professionals in nursing and medicine through the technique of key informants. Statistical measurements of validity and reliability were also carried out. The formulation of competences and behaviors associated, defined in the present study allows to qualify and evaluate the professionals who work in the field of Public Health, generating among the members of health organizations compromises regarding the efficiency of their functions through the use of the proposed model, which provides support information to plan and implement improvement and modernization measures in the administration, as well as the analysis of workloads.

A OPS no ano 2000 pôs em evidencia o escasso desenvolvimento dos países de America Latina respeito aos recursos humanos na saúde publica, ressaltando a falta de: caracterização da força de trabalho, identificação das competências necessárias para o exercício das funções essenciais de saúde publica e melhoramento da qualidade de força de trabalho; como resposta a estes desafios e tendo em conta estas funções, realizou se o presente estudo que define as competências para os profissionais de enfermaria e medicina. O resultado foi à construção de um instrumento que permita a identificação de parâmetros de auto-evacuação, hetero-evaluacão e inter-evaluacão como ponto de referência para planejar as intervenções em saúde publica. Para sua validação foi aplicada a profissionais de enfermaria e medicina a través da técnica de informantes claves e posteriormente realizaram se as medições estadísticas de confiabilidade e validade. A formulação de competências e condutas associadas definidas na presente investigação permite: qualificar e avaliar o recurso humano que trabalha na área de Saúde Publica, gerar nos membros das organizações de saúde compromissos com o desempenho eficiente de suas funções mediante a utilização do modelo proposto que contem a informação básica destas e proporciona informação de suporte para a planejar e implementar medidas de melhoramento, modernização administrativa e o analise de cargas de trabalho

Evaluación del compromiso vestibular en el traumatismo del hueso temporal en niños / Evaluation of vestibular compromise in temporal bone trauma in children

El objetivo del presente trabajo es evaluar a 63 niños con traumatismo del hueso temporal,con o sin fractura,ingresados al Servicio de Otorrinología del Hospital de Pediatría Garrahan,en el período comprendido entre Febrero de 1993 y Junio de 1998 e investigarel compromiso vestibular secundario.Se utilizó un diseño retrospectivo,descriptivo y observacional.La edad de la población estudiada fue de 4 a 14 años.Las evaluaciones fueron realizadas en forma inmediata a la consulta,a los 7 y a los 30 días.A todos los pacientes se le realizó Otomicroscopía,tomografía computada,evaluación audiológica y vestibular.Resultados:del total de la muestra(n=63)13 presentaron,11 de sexo masculino y 2 de sexo femenino.De los 13 paciente,solo 7 pudieron completar las evaluaciones dependiendo de la integridad de la menbrana timpánica para la evaluación de la Electronistagmografía.10 pacientes presentaron fractura de hueso temporal.ocho pacientes presentaron hipoacusia.todos los pacientes fueron evaluados con pruebas calóricas persentaron arreflexia vestibular.a los 30 días la totalidad de la muestra conservó la arreflexia vestibular realizando una compensación central(contralateral a la lesión)con ausencia de sintomatología vestibular