Consultas de demanda espontánea sobre trastornos del desarrollo en el Hospital Garrahan / Spontaneous consultations for developmental disorders at Garrahan Hospital

Introducción: Los trastornos del desarrollo (TD) constituyen un motivo de consulta muy frecuente en la práctica pediátrica. El Hospital Garrahan recibe por demanda espontánea al servicio de Mediano Riesgo (MR) consultas de cuidadores con preocupaciones sobre el desarrollo de los niños, niñas y adolescentes (NNyA). Allí son valorados por pediatras clínicos, quienes realizan la interconsulta al servicio de Clínicas Interdisciplinarias del Neurodesarrollo (CIND) según necesidad (representan el 10% del total de consultas en MR). El objetivo del trabajo es comparar las características de los pacientes de MR que fueron consultados al área de Maduración de CIND durante el bimestre marzo/abril de 2016, 2021 y 2022. Materiales y métodos: estudio retrospectivo, observacional y comparativo. Se revisaron las historias clínicas analizando las siguientes variables: edad, procedencia, contar con pediatra de cabecera, cobertura de salud, motivo de consulta y sospecha diagnóstica. Resultados: La cantidad de consultas aumentó por encima del 20%, con un descenso en la mediana de edad de alrededor de un año. Aproximadamente el 70% de los pacientes procedían del conurbano en los tres períodos. Observamos un descenso respecto al número de NNyA con seguimiento pediátrico y cobertura social. El lenguaje y la conducta fueron los motivos más frecuentes de consulta y la mayor sospecha diagnóstica fue el Trastorno del Espectro Autista (TEA). Conclusiones: Los datos observados pueden relacionarse con el impacto de la pandemia así como también con las condiciones socio-económicas de los últimos cinco años, con un mayor conocimiento acerca del desarrollo y un probable aumento de la prevalencia de los TD (AU)

Introduction: Developmental disorders (DD) are a frequent reason for consultation in pediatric practice. The Garrahan Hospital receives spontaneous consultations at the department of Intermediate Risk (IR) from caregivers with concerns about the development of children and adolescents. At the IR department, children and adolescents are evaluated by clinical pediatricians, who consult with specialists at the Interdisciplinary Neurodevelopmental Clinic (INDC) as needed (accounting for 10% of the total number of consultations at the IR department). The aim of this study was to compare the characteristics of IR patients who were consulted at the INDC during the bimonthly period March/April 2016, 2021, and 2022. Materials and methods: a retrospective, observational, and comparative study was conducted. Medical records were reviewed analyzing the following variables: age, provenance, having a primary care pediatrician, healthcare insurance, reason for consultation, and diagnostic suspicion. Results: The number of consultations increased by over 20%, with a decrease in median age of around one year. Approximately 70% of the patients came from Greater Buenos Aires in the three periods. A decrease in the number of children and adolescents with pediatric follow-up and a social health insurance was observed. Language and behavior disorders were the most frequent reasons for consultation and autism spectrum disorder (ASD) was most often suspected. Conclusions: The observed data may be related to the impact of the pandemic as well as socio-economic conditions over the last five years, together with increased knowledge about development and a probable increase in the prevalence of ASD (AU)

Automated method for volatile fatty acids determination in anaerobic processes using in-syringe magnetic stirring assisted dispersive liquid-liquid microextraction and gas chromatography with flame ionization detector.

Volatile fatty acids (VFAs) are key parameters to monitor anaerobic digestion processes. Thus, a fast, simple and precise determination of these analytes is necessary for a timely characterization of the biological processes present in municipal solid waste and wastewater treatment plants. In this work, an automated method for the extraction and preconcentration of VFAs, based on dispersive liquid-liquid microextraction with magnetic stirring in syringe, and gas chromatography with flame ionization detector for the separation and detection, is described. The effect of parameters such as the type and volume of extraction solvent, pH, salting out effect and stirring time, was studied using a multivariate and univariate experimental design. Extraction and preconcentration were performed simultaneously using tert-butyl methyl ether (TBME) as the extraction solvent, after stirring 100 s at a constant rate. The detection limits were in the range of 0.1 - 1.3 mg L-1 and a good linearity was observed up to 1000 mg L-1 of the studied VFAs, with a range of R2 between 0.9997 and 0.9999. The intra and interday precision expressed as relative standard deviation (n= 5) varied between 0.7 and 2.4% and between 1.7 and 7.0%, respectively. Subsequently, the developed method was successfully applied to evaluate the presence of VFAs in wastewater samples from anaerobic treatments and an average relative recovery of 102% was obtained.

Recovering biomethane and nutrients from anaerobic digestion of water hyacinth (Eichhornia crassipes) and its co-digestion with fruit and vegetable waste.

The potential to recover bioenergy from anaerobic digestion of water hyacinth (WH) and from its co-digestion with fruit and vegetable waste (FVW) was investigated. Initially, biogas and methane production were studied using the biochemical methane potential (BMP) test at 2 g volatile solids (VS) L(-1) of substrate concentration, both in the digestion of WH alone and in its co-digestion with FVW (WH-FVW ratio of 70:30). Subsequently, the biogas production was optimized in terms of total solids (TS) concentration, testing 4 and 6% of TS. The BMP test showed a biogas yield of 0.114 m(3) biogas kg(-1) VSadded for WH alone. On the other hand, the biogas potential from the WH-FVW co-digestion was 0.141 m(3) biogas kg(-1) VSadded, showing an increase of 23% compared to that of WH alone. Maximum biogas production of 0.230 m(3) biogas kg(-1) VSadded was obtained at 4% of TS in the co-digestion of WH-FVW. Using semi-continuously stirred tank reactors, 1.3 m(3) biogas yield kg(-1) VSadded was produced using an organic loading rate of 2 kg VS m(-3) d(-1) and hydraulic retention time of 15 days. It was also found that a WH-FVW ratio of 80:20 improved the process in terms of pH stability. Additionally, it was found that nitrogen can be recovered in the liquid effluent with a potential for use as a liquid fertilizer.

Methane production and hydrolysis kinetics in the anaerobic degradation of wastewater screenings.

Anaerobic biodegradability and hydrolysis rates of wastewater screenings were determined using the biochemical methane potential test at 37 °C. The extent and rate of screenings conversion to methane of this complex and particulate substrate were investigated and since two stages of hydrolysis were identified, corresponding to the different types of materials in screenings, a linear and non-linear model was used. No accumulation of intermediary products was observed and so it was possible to use the methane production rate and a linear model to estimate the hydrolysis rate in the first phase of hydrolysis. The measured values of 0.061-0.127 d(-1) are in the range reported for other comparable organic wastes. It was also observed that the inoculum-to-substrate ratio has a large impact on methane production rate of screenings. The difference in biodegradation rates from the materials in screenings and the overall hydrolysis could be represented by the modified Gompertz non-linear model which was able to describe the methane production rate of screenings with a high confidence. Screenings were found to have 52% biodegradability on average and this shows the potential for volatile solids destruction. A two-stage process with an improved hydrolysis rate is proposed to ensure that the full potential of the material is exploited.

A cross-over randomised clinical trial of eccentric occlusion in complete dentures.

The objective of this study is to compare the effects of canine guidance (CG) and bilateral balanced occlusion (BBO) on denture satisfaction and kinesiographic parameters of complete denture wearers, by means of a cross-over trial. Fifty edentulous patients received new maxillary and mandibular complete dentures. After the intra-oral adjustments and adaptation period, 44 participants were enrolled in the trial and randomly received a sequence of occlusal schemes: BBO followed by CG, or CG followed by BBO. Outcomes were assessed after 30 days of each occlusal scheme. Participants answered a denture satisfaction questionnaire and a kinesiograph instrument recorded mandibular physiologic movements and pattern of maxillary denture movement during chewing. Wilcoxon test and paired sample t-test were used to compare satisfaction levels and kinesiographic data for each occlusal scheme, respectively (α=0.05). The results showed no differences between occlusal schemes on participant's satisfaction and in any of the kinesiographic parameters studied, except for the vertical intrusion of the maxillary complete denture during chewing, which was lower with CG. It can be concluded that the occlusal scheme did not influence on satisfaction and kinesiographic parameters evaluated, as long as volume and resilience of residual edentulous ridges of the participants were normal. Clinical Trial Registration Identifier: NC.T01420536.

A comprehensive analysis of preoperative patient education.

1. One of the most important responsibilities of a nurse is preoperative preparation of the patient for surgery. Preoperative teaching helps to relieve some of the emotional stress patients have when facing surgery. 2. By providing a structured preoperative teaching class, the nurse can inform, support, and collaborate with adult surgical patients about the planned care. The nurse can also involve patients as partners in making the best possible decisions about their care. 3. Patient evaluations about the preoperative education class revealed a high level of satisfaction. The classes were believed to be an important contribution to patient education.