[Dislocation due to injury with trajectory in the scaphoid-trapezoid-trapezoid periscaphoid-perisemilunar bones. Case report and literature review]. / Luxación por lesión con trayecto en los huesos escafoide-trapecio-trapezoidea periescafo-perisemilunar. Reporte de caso y revisión de la literatura.

INTRODUCTION: dislocations of carpal bones without associated fractures are considered a rare injury, the most common mechanism of injury being axial loading with wrist in extension plus ulnar deviation. The literature reports a wide variety of complex carpal injuries, even so, it is possible to identify previously undescribed injuries. OBJECTIVE: to present an atypical case of a patient with an injury to the midcarpal stabilizing mechanism and the stabilizing mechanism of the proximal row of the wrist following trauma to the hand that required carpectomy as definitive surgical treatment. PRESENTATION OF CASE: a 48 year old male patient is presented who is admitted to our hospital unit after presenting injury to the left hand after being run over by a motor vehicle, with axial load mechanism, presenting deformity in the left thoracic extremity, fracture of the proximal metaphysis of the second phalanx of the third finger as well as dislocation of the proximal interphalangeal joint, with traumatic amputation of the second phalanx of the fourth finger plus extensor injury in zone V of the fifth finger with loss of skin coverage of the fourth and fifth finger, attending our hospital unit 24 hours after the injury. CONCLUSIONS: carpal bone dislocations are an orthopedic emergency, with 20% going unnoticed in trauma centers. Early closed reduction is the initial treatment to avoid severe complications, however, surgical treatment is the gold standard for fixation. Carpectomy is considered a mostly adequate sequelae management treatment, however it is well accepted for complex injuries to the wrist stabilization mechanisms, as it can be performed in a short surgical time and early rehabilitation can be initiated and functional ranges of motion can be achieved with low sequelae.

INTRODUCCIÓN: las luxaciones de los huesos del carpo sin presentar fracturas asociadas se considera una lesión infrecuente; el mecanismo de lesión más común es la carga axial con muñeca en extensión más desviación cubital. La literatura reporta una gran variedad de lesiones complejas del carpo; aun así, es posible identificar lesiones no descritas previamente. OBJETIVO: presentar caso atípico de paciente con lesión a nivel del mecanismo estabilizador medio-carpiana y estabilizador de la fila proximal de la muñeca posterior a traumatismo en mano que requirió carpectomía como tratamiento quirúrgico definitivo. PRESENTACIÓN DEL CASO: paciente masculino de 48 años de edad, quien ingresa a nuestra unidad hospitalaria tras sufrir lesión en mano izquierda posterior a ser arrollado por vehículo automotor, con mecanismo de carga axial, presentando en extremidad torácica izquierda deformidad hacia volar, fractura de metáfisis proximal de segunda falange del tercer dedo así como luxación de articulación interfalángica proximal, con amputación traumática de segunda falange del cuarto dedo más lesión extensora en zona V del quinto dedo con pérdida de cobertura cutánea del cuarto y quinto dedos. Acude a nuestra unidad hospitalaria 24 horas después de la lesión. CONCLUSIONES: las luxaciones en huesos del carpo es una urgencia ortopédica, pasando desapercibidas en 20% en centros de traumatología. La reducción cerrada temprana es el tratamiento inicial para evitar complicaciones severas; sin embargo, el tratamiento quirúrgico es el estándar de oro para la fijación de las mismas. La carpectomía se considera un tratamiento mayoritariamente para el manejo adecuado de secuelas; sin embargo, es bien aceptado para las lesiones complejas que se presentan en los mecanismos estabilizadores de la muñeca, dado a que se puede realizar en un tiempo quirúrgico y se puede iniciar una rehabilitación temprana, con lo que se pueden alcanzar rangos de movimientos funcionales y con bajo grado de secuelas.

Lessons Learned for Emergency Feeding During Modifications to 11 School Feeding Programs in Latin America and the Caribbean During the COVID-19 Pandemic.

BACKGROUND: School feeding programs (SFPs) can play a crucial role in the emergency food and nutrition response, but there is a dearth of information on how SFPs operate during emergencies. DESIGN AND METHODS: A rapid comparative assessment of 11 SFPs throughout Latin America and the Caribbean during the COVID-19 pandemic. Data from (1) systematic document search and (2) surveys with key informants (n = 23) about barriers/facilitators to modifications were systematically analyzed using a multiple case study approach. RESULTS: During the pandemic, all SFPs continued (although continuation plans varied from a few days in Chile to > 1 month in Puerto Rico) via food kits, food vouchers, and/or grab n' go meals. The SFP implementation was highly dependent on the programs' autonomy and financial support, which impacted their logistics to acquire and distribute foods during the pandemic. The types of foods offered in some SFPs suggest that established nutritional guidelines were not always followed. Key informants expressed concerns about the deterioration of the nutritional quality of foods offered during the pandemic and lack of community engagement that impeded distribution to the neediest. CONCLUSIONS: Results underscore the urgency for clear implementation guidance on how to modify SFP during emergencies. Public health implications include (1) allocation of autonomous resources to an intersectoral working group to safeguard nutritional benefits during emergencies, (2) strengthening efforts of SFP community engagement before and during emergencies, and (3) establishing guidelines of the types of foods that can be distributed to meet the nutritional needs of beneficiaries during emergencies.

The utility of Amies charcoal bacteriology swabs for storage of canine urine prior to culture.

OBJECTIVE: To determine the usefulness of bacteriology swabs as a storage method of canine urine samples and the effect on quantitative bacterial culture. MATERIALS AND METHODS: Two hundred fourteen canine urine samples were collected by cystocentesis. The reference aliquot was placed in a sterile tube and processed for quantitative bacterial culture within 6 hours. A bacteriology swab was then immersed in the urine for 5 seconds and returned to the charcoal Amies media container. The urine samples in the sterile tube and bacteriology swab were stored at room temperature for 48 hours and processed for quantitative bacterial culture. RESULTS: Thirty-seven of the samples were positive on reference culture with a total of 42 bacterial isolates. Samples stored in sterile tube and bacteriology swab had identical sensitivity and specificity for detection of bacteriuria (94.7% and 100%, respectively) with very good agreement (κ = 0.92; 95% CI 0.81 to 1.00). Agreement between the bacterial species of the reference sample and the bacteriology swab was higher (κ = 0.85; 95% CI 0.71 to 0.99) than compared to the sterile tube (κ = 0.78; 95% CI 0.62 to 0.94), but the overlapping confidence intervals mean improved agreement cannot be inferred. CLINICAL SIGNIFICANCE: Bacteriology swabs stored in Amies charcoal transport media should be considered an alternative method to preserve canine urine sample when immediate processing for quantitative bacterial culture is not possible. The sensitivity of culturing plain urine, stored for 48 hours in a sterile tube, for detection of bacteriuria, was higher than previously reported.

Utilidad diagnóstica de la audiometría de alta frecuencia en sujetos expuestos a ruido recreacional / Diagnostic utility of high frequency audiometry in subjects exposed to recreational noise

INTRODUCCIÓN: Recientes investigaciones mencionan que, debido a los altos niveles de ruidos, el 75% de los habitantes en las ciudades industrializadas padecen algún tipo de deficiencia auditiva. La audiometría de alta frecuencia es un examen complementario importante para detectar tempranamente la pérdida de audición. OBJETIVO: Determinar la utilidad diagnóstica de la audiometría de alta frecuencia en la detección temprana de la hipoacusia en sujetos expuestos a ruido recreacional. MATERIAL Y MÉTODO: Estudio analítico de corte transversal. Se evaluaron 87 estudiantes de fonoaudiología. Se aplicó una audiometría convencional y de alta frecuencia mediante audiómetro clínico. RESULTADOS: La audiometría de alta frecuencia presenta una sensibilidad del 100%, especificidad del 64,60%. El valor predictivo (+) es de 14,70%, mientras que el valor predictivo (-) es del 100%. La razón de verosimilitud (+) es de 2,28, y para la razón de verosimilitud (-) es de 0,0. CONCLUSIÓN: La audiometría de alta frecuencia puede ser utilizada para monitorizar la audición de los sujetos, comprobando que efectivamente los umbrales auditivos de alta frecuencia se encuentren dentro de rangos normales. Lo anterior, dado por sus valores de sensibilidad, valor predictivo negativo, razón de verosimilitud negativa y por el aumento entre la probabilidad preprueba y posprueba.

INTRODUCTION: Recent research mentions that, due to the high noise levels, 75% of the habitants in industrialized cities suffer from some type of hearing impairment. High frequency audiometry is an important complementary test to detect early hearing loss. AIM: To determine the diagnostic utility of high frequency audiometry in the early detection of hearing loss in subjects exposed to recreational noise. MATERIAL AND METHODS: Study analytical type and cross section. 87 speech therapy students were evaluated. A conventional and high frequency audiometry was applied, using a clinical audiometer. RESULTS: High frequency audiometry has a sensitivity of 100%, specificity of 64,60%. The predictive value (+) is 14,70%, while the predictive value (-) is 100%. The likelihood ratio (+) is 2,28, and for the likelihood ratio (-) it is 0,0. CONCLUSION: High frequency audiometry can be used to monitor the hearing of the subjects, checking that effectively the high frequency hearing thresholds are within normal ranges. The above, given by their values of sensitivity, negative predictive value, negative likelihood ratio and the increase between the pre-test probability and the posttest probability.

Association between ultrasonographic appearance of urine and urinalysis in dogs and cats.

OBJECTIVE: To evaluate association between ultrasonographic urine echogenicity and sediment examination in dogs and cats. MATERIALS AND METHODS: Dogs and cats undergoing ultrasound-guided cystocentesis at a multidisciplinary referral hospital. Ultrasonographic images were stored and reviewed by a single, blinded, board-certified radiologist. Urine appearance was described as "echoic" or "anechoic". Urine sediment was examined for bacteriuria, pyuria, haematuria, crystalluria and urine-specific gravity and then classified as "active" or "inactive." RESULTS: Of the 194 cases included in this study, urine was echoic in 52 and anechoic in 142. Sediment was active in 52 and inactive in 142 samples. Sensitivity and specificity of echoic urine for active sediment were 40% (95% CI: 27 to 55%) and 78% (95% CI: 70 to 85%), respectively. Positive predictive value and negative predictive value of echoic urine for active sediment were 40% (CI 30 to 52%) and 78% (CI 74 to 82%), respectively. If urine-specific gravity was <1.015 urine was always described ultrasonographically as anechoic. CLINICAL SIGNIFICANCE: Association between sediment analysis and ultrasonographic appearance of urine is poor. Echoic urine had low positive predictive value for active sediment in this study, suggesting that echoic urine alone should not prompt urinary investigations in the absence of other clinical suspicion. Despite a negative predictive value of 78%, urinalysis is still indicated for anechoic urine, especially if urine specific gravity is low.

Using frequency analysis to improve the precision of human body posture algorithms based on Kalman filters.

With the advent of miniaturized inertial sensors many systems have been developed within the last decade to study and analyze human motion and posture, specially in the medical field. Data measured by the sensors are usually processed by algorithms based on Kalman Filters in order to estimate the orientation of the body parts under study. These filters traditionally include fixed parameters, such as the process and observation noise variances, whose value has large influence in the overall performance. It has been demonstrated that the optimal value of these parameters differs considerably for different motion intensities. Therefore, in this work, we show that, by applying frequency analysis to determine motion intensity, and varying the formerly fixed parameters accordingly, the overall precision of orientation estimation algorithms can be improved, therefore providing physicians with reliable objective data they can use in their daily practice.

Prevalencia de anemia y estado nutricional de escolares del área periurbana de Sucre, Bolivia / Anemia prevalence and nutritional status in children of a suburban area of Sucre, Bolivia

Background: There is limited data on the nutritional status and the prevalence of anemia among school children of Bolivia. This study aimed to determine the prevalence of anemia, iron deficiency and nutritional status by anthropometry in children of a suburban area in the Municipality of Sucre, Bolivia. Subjects and methods: A cross-sectional observational study was conducted involving all school children aged 6 to 10years (n=195) of a suburban school of Sucre-Bolivia (2750 m over sea level). We measured weight and height and calculated Z score for weight/age, height/age, and BMI/age indices using WHO standards. Blood samples were drawn to determine hemoglobin (Hb) and mean corpuscular volume (MCV). Anemia was defined using cut-offs points adjusted for age and corrected for altitude (Hb < 13.4 d/dl). Results: The prevalence of malnutrition observed by Z scores of height/age and weight/age were 20% and 8, 7%, respectively, and mean BMIz score was -0,07. Of these children, 17.9% showed anemia (17.4% iron deficiency anemia), 22.6% iron deficiency without anemia and 19.5% depleted iron stores. Conclusions: The school age children from the suburban area of Sucre-Bolivia presented a mild prevalence of anemia and medium prevalence of stunting.

Introducción: Existen escasos datos sobre el estado nutricional y la prevalencia de la anemia entre los escolares de Bolivia. Este estudio tuvo como objetivo determinar la prevalencia de anemia, deficiencia de hierro y el estado nutricional por antropometría en niños de una zona suburbana de la Municipalidad de Sucre, Bolivia. Sujetos y métodos: Se realizó un estudio observacional transversal en que participaron todos los escolares de 6 a 10 años (n=195) de una escuela suburbana de Sucre-Bolivia (2750 msnm). Se midió el peso y la talla y se calculó puntaje Z peso/edad, talla/edad, e IMC utilizando tablas de la OMS. Se extrajo una muestra de sangre para determinar hemoglobina, volumen corpuscular medio y ferritina sérica. La anemia se definió utilizando un punto de corte por edad y corregidos por la altitud (Hb <13.4 d/dl). Resultados: La prevalencia de malnutrición observado por las puntuaciones Z de talla/edad y peso/edad fueron de 20% y 9%, respectivamente, y la media del z de IMC fue -0,07. De estos niños, 17, 9% presentó anemia (17,4 anemia por deficiencia de hierro), 22,6% deficiencia de hierro sin anemia y 19,5% depósitos de hierro depletados. Conclusiones: Los niños en edad escolar de la zona suburbana de Sucre-Bolivia presentaron una prevalencia leve de anemia, y una moderada prevalencia de retraso del crecimiento.

Calcium as a nutrient involved in the synthesis and localization of proteins that facilitate iron uptake and efflux in enterocytes / El calcio como nutriente implicado en la síntesis y localización de proteínas que participan en la captación y eflujo del hierro en los enterocitos

Iron deficiency is the most common type of nutritional deficiency in the world, and calcium intake is low in many populations. Developing a supplement that contains both micronutrients would be an excellent method to prevent iron deficiency and increase calcium intake. Human and cellular studies have shown that calcium inhibits iron absorption. Currently, the mechanisms underlying this inhibitory effect have not been elucidated. Because calcium is involved in cell signaling pathways, it may affect the regulation of the expression or localization of proteins involved in iron uptake and efflux in enterocytes. The aim of this review was to describe the processes involved in the absorption of dietary iron and the regulation of the expression and activity of proteins involved in this absorption. Additionally, the potential mechanisms by which calcium affects the expression and localization of these proteins are also discussed.

La deficiencia de hierro es la deficiencia nutricional más común en el mundo y la ingesta de calcio es baja en la mayoría de poblaciones. El desarrollo de un suplemento que contenga ambos micronutrientes sería una excelente estrategia para prevenir la deficiencia de hierro y aumentar la ingesta de calcio. Estudios en humanos y en células han demostrado que el calcio inhibe la absorción del hierro. Actualmente los mecanismos que explican este efecto inhibitorio no están claramente dilucidados. Dado que el calcio está implicado en la señalización celular, podría afectar la regulación de la expresión y localización de proteínas implicadas en la captación y eflujo de hierro en los enterocitos. El objetivo de esta revisión es describir los procesos implicados en la absorción del hierro dietario y la regulación de la expresión y actividad de las proteínas implicadas en esta absorción. Además, se discutirán los posibles mecanismos por los cuales el calcio afecta la expresión y localización de esas proteínas.

Estado nutricional de hierro, cobre y zinc en relación con el uso de método anticonceptivo hormonal / Iron, copper and zinc status in relation with the hormonal contraceptive method

Childbearing age women are part of a vulnerable group to present micronutrient deficiencies. It has been associated the contraceptive method (CM) with iron (Fe) status, and the hormonal CM (HCM) with the alteration of copper (Cu) and zinc (Zn) biomarkers. The aim of this study was to assess the effect of CM over the biomarkers of Fe, Cu and Zn status, and the prevalence of micronutrient deficiency on 81 Chilean childbearing age women. We evaluated mean corpuscular volume (MCV), hemoglobin (Hb), zinc protoporphyrin (Zpp), serum Fe (FeS) , transferrin saturation (TS), total Fe binding capacity (TIBC), transferrin receptor (Tfr), serum ferritin (SF), serum copper (CuS), ceruloplasmin (Cp) mass, activity and specific activity and serum zinc (ZnS). From the total women, 40% used HCM and 49% did not use HCM. Women using HCM showed higher values of FeS, ST, CuS, Cp mass and activity (p<0.05) and lower Zpp (p<0.05) compared with those that did not use HCM. Not statistical differences were found on MCV, Hb, TIBC, Tfr, SF, ZnS and Cp specific activity values between groups. HCM utilization did not affect Fe, Cu and Zn status in the studied population.

Las mujeres en edad reproductiva conforman un grupo vulnerable de presentar deficiencia de micronutrientes. Se ha relacionado el método anticonceptivo (MA) con el estatus de hierro (Fe), y al MA hormonal (MAH) con la alteración de bio-marcadores de cobre (Cu) y zinc (Zn). El objetivo del presente estudio fue evaluar el efecto del MA sobre los biomarcadores del estatus de Fe, Cu y Zn y la prevalencia de deficiencia de éstos, en 81 mujeres chilenas en edad reproductiva. Se evaluó el volumen corpuscular medio (VCM), hemoglobina (Hb), Zinc protoporfirina (Zpp), Fe sérico (FeS), saturación de tranferrina (ST), capacidad total de unión de Fe (TIBC), receptor de transferrina (rTf), ferritina sérica (FS), cobre sérico (CuS), ceruloplasmina (Cp) masa, actividad y actividad específica y zinc sérico (ZnS). El 40% utilizó MAH y 49% no utilizaba MAH. Las mujeres que utilizaban MAH presentaron valores más altos de FeS, ST, CuS, Cp masa y actividad (p<0,05) y menor Zpp (p<0,05) que aquellas que no utilizaban MAH. No se encontraron diferencias en el VCM, Hb, TIBC, rTf, FS, ZnS, y Cp actividad específica entre ambos grupos. Se concluye que el uso de MAH no afectó el estatus de Fe, Cu y Zn en la población estudiada.

Consejería nutricional incrementa el consumo de alimentos ricos en calcio, pero la ingesta se mantiene por debajo del requierimiento diario / Nutritional counseling increases consumption of calcium-rich foods, but mean intake remains below the daily requirement

Calcium (Ca) plays a crucial role in the regulation of metabolic processes, especially neuromuscular function and bone health. In Chile, calcium intake in women of childbearing age does not meet the dietary requirement. Objective: To determine whether standard and virtual nutritional counseling increases the dietary calcium intake in Chilean women of childbearing age. Subjects and Methods: Dietary calcium intake in 20 women (mean age 39 ± 5 years) before and after a nutritional education intervention was compared. Nutritional counseling was provided to promote daily consumption of calcium-rich foods. Subsequently, a virtual space was provided to enhance standard counseling. On days 1, 30 and 62 a semi-quantitative food frequency questionnaire was completed by the women. Calcium intake significantly increased post intervention (ANOVA F = 4.43, P= 0.02). Dietary calcium intake was 308 ± 116mg/d at baseline, 354 ± 138mg/d at 30 days, and 412 ± 188mg/d after 62 days. Post intervention, 95% of the participants did not meet the daily intake requirement for calcium; the average percent of adequate intake of calcium was 68 ± 19%. Conclusion: Nutritional counseling increased dietary calcium intake in women of reproductive age, but the increase was not enough to meet the daily calcium requirements.

El calcio juega un rol crucial en la regulación de procesos metabólicos, especialmente en la función neuromuscular y en la salud ósea. Sin embargo, la ingesta dietaria de calcio en mujeres en edad fértil de Chile no cubre los requerimientos. Objetivo: determinar sí la consejería nutricional presencial y virtual incrementa la ingesta dietaria de calcio en mujeres chilenas de edad fértil. Sujetos y métodos: la ingesta dietaria de calcio en 20 mujeres (edad media de 39 ± 5 años) antes y después de una intervención de educación alimentaria y nutricional fue comparada. La consejería nutricional fue impartida para promover el consumo diario de alimentos ricos en calcio. Además, se habilitó un espacio virtual para reforzar la consejería nutricional. En el día 1, 30 y 62 se aplicaron cuestionarios de frecuencia de consumo semi-cuantitativos. La ingesta dietaria de calcio incrementó significativamente (ANOVA F = 4.43, P= 0.02) después de la intervención. La ingesta dietaria de calcio fue 308 ± 116mg/d al día 1, 354 ± 138mg/d al día 30, e incrementó a 412 ± 188mg/d después de 62 días. Al final de la intervención, el 95% de las participantes no cubrieron sus requerimientos diarios de calcio; la media del porcentaje de adecuación para la ingesta de calcio fue 68 ± 19%. La consejería nutricional podría incrementar la ingesta dietaria de calcio en mujeres de edad media en Chile. Sin embargo, el aumento no es suficiente para cubrir los requerimientos de calcio.

[Hepcidin as a central mediator of anemia of chronic diseases associated with obesity]. / Anemia de las enfermedades crónicas asociada a obesidad: papel de la hepcidina como mediador central.

Recent evidence suggests that obesity-related inflammation may play a central role in hepcidin regulation. Hepcidin is a key regulator ofiron homeostasis and has now been suggested as a central mediator ofiron metabolism disorders involved in the pathogenesis of anemia of chronic disease. In this review, we focus on subclinical inflammation in obesity and its effect on hepcidin levels, as the most plausible explanation for the relationship between anemia of chronic disease and obesity.

Efectividad de un cereal de maíz precocido fortificado con gluconato ferroso estabilizado con glicina o bisglicinato ferroso sobre el estatus de hierro de niños de 24 a 59 meses / Effectiveness of a precooked maize-based cereal fortified with ferrous gluconate stabilized with glycine or ferrous bisglycinate on iron status of children 24-59 months of age

Food fortification is the most effective and sustainable strategy to combat iron deficiency anemia (IDA). The objective of this was to evaluate the effectiveness of a precooked corn-based cereal (Nutricrema®) fortified with ferrous gluconate stabilized with glycine or ferrous bisglycinate chelate on iron status in of preschool children. A prospective, double-blind, cluster-randomized trial was conducted in a rural and indigenous area of Panama. During a six month period, 36 rural community soup-kitchens were divided into two groups randomly assigned to receive either: Group-A: 90 g of cereal with 10 mg of iron as ferrous gluconate stabilized with glycine; or Group-B (n=129): 90 g of cereal with 10 mg of iron as ferrous bisglycinate chelate. A total of 393 children aged 24 to 59 months of both sexes were recruited. Before and after the fortification trial iron status was evaluated. Two hundred and fifty-four children ended the follow-up (125 and 129 in groups A and B, respectively). Prevalence of IDA in group A was 29.6% and 26.4% (NS) before and after the trial, respectively; the corresponding figure for group B was 32.6% and 10.9% (p <0.05), respectively. In conclusion, the precooked corn-based cereal fortified with ferrous bisglycinate is effective in reducing the prevalence of IDA, while the cereal fortified with ferrous gluconate stabilized with glycine did not have a significant effect on the prevalence of IDA.

La fortificación de los alimentos es la estrategia más efectiva y sustentable para combatir la anemia por deficiencia de hierro (ADH). El objetivo de este estudio fue evaluar la efectividad de un alimento basado en maíz precocido (Nutricrema®) fortificado con gluconato ferroso estabilizado con glicina o bisglicinato ferroso sobre la nutrición de hierro de preescolares. Se realizó un estudio prospectivo aleatorizado por grupos, doble ciego, en un área rural indígena de Panamá. Treinta y seis comedores infantiles se asignaron aleatoriamente en dos grupos para que los niños recibieran, durante 6meses, 90 g de cereal fortificado con 10 mg de hierro como gluconato ferroso estabilizado con glicina (grupo comedores A) o con 10 mg como bisglicinato ferroso (grupo comedores B). Se reclutaron 393 niños de 24 a 59 meses de ambos sexos. Se evaluó la nutrición de hierro antes y después de la intervención. Doscientos cincuenta y cuatro niños finalizaron el estudio (125 y129 en los grupos A y B). La prevalencia de ADH en el grupo A fue 29,6% y 26,4% (NS) antes y después de la intervención; las prevalencias correspondientes en el grupo B fueron 32,6% y 10,9% (p <0,05). En conclusión, el cereal precocido basado en maíz fortificado con bisglicinato ferroso es efectivo en reducir la prevalencia de ADH, mientras el fortificado con gluconato ferroso estabilizado con glicina no tuvo un impacto significativo sobre la prevalencia de ADH.

Anemia de las enfermedades crónicas asociada a obesidad: papel de la hepcidina como mediador central / Hepcidin as a central mediator of anemia of chronic diseases associated with obesity

Recent evidence suggests that obesity-related inflammation may play a central role in hepcidin regulation. Hepcidin is a key regulator ofiron homeostasis and has now been suggested as a central mediator ofiron metabolism disorders involved in the pathogenesis of anemia of chronic disease. In this review, we focus on subclinical inflammation in obesity and its effect on hepcidin levels, as the most plausible explanation for the relationship between anemia of chronic disease and obesity.

Efecto de la estacionalidad sobre el estado nutricional de Hierro, Zinc y Cobre / Effect of seasonality on nutritional status of Iron, Zinc and Copper

Food consumption and therefore the nutritional status of micro-nutrients are influenced by various factors such as seasonality. This study aimed to determine the effect of seasonality on the nutritional status of Fe, Zn and Cu in adult subjects. A longitudinal study was conducted during the months of September 2005 and August 2006. Fifty subjects of both sexes belonging to the urban area of the city of Santiago de Chile were evaluated. Blood samples were drawn during the first week of each month; serum iron, copper and zinc, hemoglobin, mean cell volume, serum ferritin, zinc-protophorphyrin and ceruloplasmin were determined. Serum copper and zinc levels showed significant seasonal variations but not serum iron. Mean cell volume, hemoglobin and ceruloplasmins were significantly lower during spring and summer while serum ferritin and zinc-protophorphyrin showed lower concentrations during autumn and winter. We conclude that during the spring and summer levels of serum iron, copper and zinc could be diminished by reduced food intake.

El consumo de alimentos y por lo tanto el estado de nutrición de los micronutrientes está condicionado por diferentes factores como la estacionalidad. El presente estudio tuvo como objetivo determinar el efecto de la estacionalidad sobre el estado nutricional de hierro, zinc y cobre de sujetos adultos habitantes de la ciudad de Santiago de Chile. Un estudio longitudinal en 50 sujetos de ambos sexos se realizó entre los meses de septiembre del 2005 y agosto del 2006. Durante la primera semana de cada mes se extrajo muestras de sangre para la determinación de hierro, zinc y cobre sérico, hemoglobina, volumen corpuscular medio, ferritina sérica zinc-protoporfirina y ceruloplasmina. Los niveles de cobre, zinc, hemoglobina, volumen corpuscular medio, y ceruloplasmina fueron significativamente menores durante primavera y verano mientras ferritina sérica y zinc-protoporfirina presentaron niveles más bajas durante otoño e invierno. Concluimos que la estacionalidad es un factor a considerar cuando se realicen mediciones de estado de nutrición de los microminerales hierro, zinc y cobre.

Consumo y valoración social de la leche purita fortificada y cereal del Programa Nacional de Alimentación Complementaria (PNAC) en Chile / Consumption and social assessment of fortified milk delivered by the National Complementary Feeding Program in Chile

Introducción: El Programa Nacional de Alimentación Complementaria (PNAC), es considerado la mayor intervención nutricional en Chile. Objetivo: Evaluar el consumo y valoración social de "Leche-Purita-Fortificada®" (LPF) y "Leche-Purita-Cereal®" (LPC) en beneficiarios del PNAC. Sujetos y métodos: Estudio transversal. Se aplicó una encuesta de consumo a 544 ninos entre 11 y 72 meses de muestra representativa de las Regiones Metropolitana y Quinta de Chile. La valoración social fue evaluada en 11 grupos focales. Resultados: El 73% y 69% de las madres declaró alimentar a su hijo con LPF y LPC, respectivamente. Las madres declararon entregar una mediana de 60 (45-75)g de LPF y 50 (40-75)g de LPC; diluidas al 10 (8-10)% y 10 (10-10)%, respectivamente. Existe una buena valoración social de los alimentos. Discusión: Los alimentos LPF y LPC son ampliamente consumidos y bien valorados por la población beneficiaria. Sin embargo, el consumo y uso de estos productos puede ser mejorado.

Background: The National Complementary Feeding Program (NCFP) is a universal nutritional intervention in Chile. Objective: To evaluate the consumption and social assessment ofiron fortified milk "Leche-Purita-Fortificada® (LPF)" and "Leche-Purita-Cereal® (LPC)" in NCFP's beneficiaries. Subjects and methods: Cross-sectional study. A feeding questionnaire was conducted in 544 children aged 11 to 72 months in a representative sample from the Metropolitan and fifth Chilean Regions. The social assessment was evaluated through 11 focus groups. Results: Seventy three % and 69% ofbeneficiaries consumed LPF and LPC, respectively. The mothers claimed to deliver a median of 60 (45-75) g of LPF and 50 g of LPC (40-75) g, with a dilution of 10 (8-10) %% and 10 (10-10) %%, respectively. The perceived social value of these foods was positive. Discussion: LPF and LPC were consumed for most beneficiaries and well appreciated by the target population. However, the consumption of these milks can be improved.

[Usefulness of IPC continuous monitoring in shunt dysfunction]. / Utilidad de la monitorizacion de la PIC en pacientes con sospecha de disfuncion valvular.

Shunt dysfunction is a common situation in neurosurgery. Often symptoms, physical examination and radiology are not enough to set a diagnosis. ICP continuous monitoring is a safe and reliable tool that provides valuable information about CSF dynamics in these patients. Not only quantitative analysis is needed but also a qualitative one that enables pathological waves identification, because high amplitude B waves are strongly related to shunt dysfunction. In this paper experience about ICP continuous monitoring in patients with shunt dysfunction suspect is presented. Quantitative and qualitative data analysis led to a correct diagnosis, improving all the patients treated according to this criterion. An intraparenchymatous Camino® sensor and neuroPICture software (developed by first author) for data collection and graphic representation were used. Complications related to monitoring were absent and graphics obtained useful for qualitative analysis.

Utilidad de la monitorizacion de la PIC en pacientes con sospecha de disfunción valvular / No disponible

La sospecha de disfunción valvular constituye una situación frecuente en neurocirugía. En numerosas ocasiones ni la clínica, ni la exploración, ni la radiología pueden confirmar o descartar el diagnóstico. La monitorización continua de la PIC es un método seguro y fiable que aporta valiosa información acerca de la situación de la dinámica del LCR en estos pacientes. El sistema de registro debe permitir no sólo el análisis cuantitativo de la PIC sino también morfológico deltrazado, para identificar ondas patológicas (como las B de alta amplitud) relacionadas con situaciones de disfunción valvular. En el presente trabajo se recogela experiencia de monitorización continua de la PIC en pacientes con sospecha de disfunción valvular sincriterios clínicos y radiológicos concluyentes, en los que el análisis morfológico del registro permitió un diagnósticofiable que se tradujo en la mejoría de todos los pacientes tratados conforme a este criterio. El método utilizado fue un sensor intraparenquimatoso Camino®con software de recogida y representación neuroPICture© (desarrollado por el primer autor). Las complicaciones relacionadas con la monitorización fueron nulas y el registro obtenido útil para las objetivos propuestos (AU)

Shunt dysfunction is a common situation in neurosurgery. Often symptoms, physical examination and radiology are not enough to set a diagnosis. ICP continuous monitoring is a safe and reliable tool that provides valuable information about CSF dynamics in these patients. Not only quantitative analysis is needed but also a qualitative one that enables pathological waves identification, because high amplitude B waves are strongly related to shunt dysfunction. In this paper experience about ICP continuous monitoring in patients with shunt dysfunction suspect is presented. Quantitative and qualitative data analysis led to a correctdiagnosis, improving all the patients treated according to this criterion. An intraparenchymatous Camino®sensor and neuroPICture software (developed by firstauthor) for data collection and graphic representation were used. Complications related to monitoring wereabsent and graphics obtained useful for qualitative analysis (AU)

Suplementación con cobre entre comidas no tiene efecto sobre la nutrición de hierro en hombres / Copper supplementation between meals has no effect on iron status of men

Iron deficiency is prevalent in most of the developing world where it coexists with other micronutrient deficiencies such as copper. Combined supplementation with iron and copper is one of the strategies that can be used to improve the iron and copper status of a population. However, there is concern about potential negative interactions between these two micronutrients due to a competitive binding to the divalent metal transporter 1 (DMTl), a proton-coupled transporter of a variety of divalent metals including copper. The aim of this study was to measure the effect of daily supplementation with 8 mg of copper, as copper sulfate during 6 months on the iron status. Sixty healthy male adults were randomized to receive a copper supplement or a placebo. Fasting blood samples were obtained before and after copper supplementation to evaluate the iron and copper nutritional status. Copper supplementation did not change significantly iron and copper status parameters. In conclusion, daily supplementation with 8 mg of copper during 6 months does not deteriorate iron nutrition in adult men.

La deficiencia de hierro coexiste con otras carencias, entre ellas de cobre. La suplementación combinada con estos nutrientes es una de las estrategias utilizadas en su prevención. Sin embargo, existe la posibilidad de interacciones negativas, ya que el DMT1, principal transportador de hierro no hem a nivel intestinal, también transporta cobre. El propósito del estudio fue medir el efecto de la suplementación con 8 mg diarios de cobre, como sulfato de cobre, durante 6 meses, sobre la nutrición de hierro. Sesenta hombres adultos, aparentemente sanos, fueron seleccionados al azar para recibir el suplemento de cobre o un placebo. Se tomaron muestras de sangre en ayunas antes y después de finalizada la suplementacion para evaluar la nutrición de hierro y de cobre. La suplementacion con cobre no determinó cambios significativos en los indicadores de nutrición de cobre y de hierro. En conclusión, la suplementacion con 8 mg diarios de Cu administrado entre comidas durante 6 meses no deterioró la nutrición de hierro en hombres adultos.

Cobertura de úlceras por presión trocantéricas con colgajo de tensor de fascia lata en V-Y / Treatment of trochanteric pressure sores with V-Y and tensor fasciae latae flaps

Background: Trochanter pressure sores can be treated with random, myocutaneous, fasciocutaneous or free flaps. Aim: To report the use of V-Y and tensor fasciae latae flaps for the treatment of trochanteric pressure sores. Material and Methods: Prospective study of 14 males and two females aged 24 to 64 years, with 17 sores. The surgical technique consisted in the design of a V shaped flap with irrigation in its superior base and lower vertex with one of its extremes in contact with the sore. A resection is made until a vital base is obtained, excising the prominent bone until a plane in which healthy tissue is seen. The flap is raised and rotated, covering the defect. A V-Y primary closure without tensión is performed, leaving drainages that are withdrawn ten days later. Results: The complications recorded were three serranas, which were treated using a closed system with external and internal negative pressure. Two wound dehiscence episodes and two hematomas required a surgical correction. Conclusions: This type of flap is other therapeutic alternative for pressure trochanteric sores.

Las úlceras por presión trocantéricas representan un problema importante a nivel extra e intrahospitalario. Existen múltiples opciones terapéuticas, ya sean colgajos random, musculocutáneos, fasciocutáneos o libres. El objetivo de este estudio es presentar la técnica quirúrgica del Colgajo en V-Y de Tensor de Fascia Lata. Técnica Quirúrgica: Se diseña un colgajo en V con irrigación por su base superior y vértice inferior, contactando uno de sus extremos con la úlcera. La forma del colgajo es de una V-Y. Se reseca esta hasta obtener un lecho vital, resecando además el hueso prominente hasta un plano en que se visualiza tejido sano. Se levanta y rota el colgajo, cubriendo el defecto. Finalmente, se realiza el cierre primario en VY sin tensión, con drenajes que se retiran a los 10 días. Tratamos 17 úlceras en 16 pacientes. Hubo 3 seromas, los que fueron resueltos con sistema de cierre con presión negativa externa e interna. Además hubo 2 casos de dehiscencia de sutura y 2 hematomas resueltos en quirófano. Este colgajo debe estar presente dentro de las posibilidades terapéuticas que se ofrezcan a pacientes con úlceras trocantéricas por decúbito.

Efecto de la inflamación subclínica sobre el estado nutricional de hierro, cobre y zinc en adultos / Effects of subclinic inflammation on iron, copper and zinc nutrition status in adults

Chile is undergoing an epidemiological transition, where micronutrient deficiencies coexist with chronic diseases. The aim of this study was to determine the effect of mild infections on the prevalence of iron, copper and zinc deficiencies in apparently healthy adults. A venous blood sample was obtained from 377 apparently healthy adults, 20-55 years of age, from the south area of Peñalolén (Santiago, Chile), to measure white blood cell count, MCV and hemoglobin, free erythrocyte protoporphyrin, serum ferritin, serum copper and zinc, transaminases, and C reactive protein concentrations. The prevalence of anemia was 3.9 percent in women and 0.6 percent in men. All cases of anemia were due to iron deficiency and 20 percent of women presented depleted iron stores. Furthermore, 8.6 percent of men and 5.9 percent of women had low serum copper levels and 25.1 percent of women and 24.7 percent of men had low serum zinc concentrations. The presence of a subclinical inflammation neither modified the prevalence of anemia or the status of iron, zinc and copper in this population.

Chile se encuentra en la etapa de transición epidemiológica, en la que coexisten las deficiencias de micronutrientes con las enfermedades crónicas no transmisibles. El objetivo de este estudio fue medir el efecto de infecciones leves sobre la prevalencia de la deficiencia de hierro, cobre y zinc en adultos. Participaron 377 adultos aparentemente sanos (20-55 años), provenientes del área sur de la comuna de Peñalolén de Santiago de Chile. Se midió hemoglobina, VCM, protoporfirina libre eritrocitaria, ferritina sérica, niveles séricos de cobre y zinc, transaminasas, recuento de leucocitos y proteína C reactiva. Como resultado se obtuvo que solo el 3.9 por ciento de las mujeres y el 0,6 por ciento de los hombres presentaron anemia, todos los casos por déficit de hierro y un 20 por ciento de las mujeres mostraron depleción de depósitos de este mineral. El 8,6 por ciento de los hombres y el 5.9 por ciento de las mujeres tuvieron bajos niveles de cobre y en ambos grupos se encontraron altos porcentajes de deficiencia de zinc (25.1 por ciento en mujeres y 24,7 por ciento en hombres). El estado de inflamación sub-clínica no alteró la prevalencia de anemia o el estado nutricional de hierro, cobre y zinc en esta población.