Consultas tardías en los servicios de emergencias pediátricas durante la pandemia por COVID-19 en Uruguay, entre el 13 de marzo y el 29 de julio de 2020

En diciembre de 2019, en Wuhan, China, se detectaron los primeros casos de SARS-CoV-2. En Uruguay, desde el 16 de marzo de 2020 se suspendieron las actividades de enseñanza, deportivas y espectáculos públicos. Varios países reportaron una marcada disminución de las visitas a urgencias. Algunos niños presentaron enfermedades ocasionales o descompensaciones de enfermedades crónicas, consultando en forma tardía con el riesgo que ello implica. El objetivo de este trabajo es realizar una descripción de las consultas tardías durante la pandemia. Se realizó un estudio multicéntrico y descriptivo entre el 13 de marzo y el 29 de julio de 2020. Se definió consulta tardía como los ingresos por injurias agudas con más de 6 horas de evolución, fiebre mayor a 72 horas de evolución, dificultad respiratoria con más de 12 horas de evolución, síntomas agudos, como dolor abdominal, de más de 24 horas de evolución, síntomas de más de 12 horas de evolución en niños con enfermedades crónicas que determinaron descompensación e ingreso. Se incluyeron 27 centros. Se registraron un total de 34.260 consultas en urgencia, se incluyeron 189 niños para el estudio. El promedio de edad fue de 6 años; 17 pacientes requirieron ingreso a unidad de cuidados intensivos (UCI). Predominó la apendicitis entre los diagnósticos al alta. Esta investigación puso en evidencia la existencia de consultas tardías en nuestro país. Esto contribuye a ponderar el impacto negativo de la pandemia en la población pediátrica.

Summary: In December 2019, the first cases of SARS-CoV-2 were detected in Wuhan. In Uruguay, since March 16, teaching, sports and public entertainment activities were suspended. Several countries reported a marked decrease in emergency room visits. Some children presented occasional illnesses or decompensations from chronic illnesses, consulting late with the risk that this implies. The objective of the work is to make a description of late consultations during the pandemic. A multicenter and descriptive study was carried out between March 13 and July 29, 2020. "Late consultation" was defined as admissions for: Acute injuries with more than 6 hours of evolution, fever greater than 72 hours of evolution, difficulty respiratory disease with more than 12 hours of evolution, acute symptoms such as abdominal pain of more than 24 hours of evolution, symptoms of more than 12 hours of evolution in children with chronic diseases that determined decompensation and admission. 27 centers were included. A total of 34260 emergency consultations were registered, 189 children were included for the study. The average age was 6 years. 17 patients required admission to the ICU. Appendicitis predominated among the diagnoses at discharge. This research revealed the existence of late consultations in our country. This helps to weigh the negative impact of the pandemic on the pediatric population.

Em dezembro de 2019, em Wuhan, foram detectados os primeiros casos de SARS-CoV-2. No Uruguai, desde 16 de março, as atividades de ensino, esporte e entretenimento público foram suspensas. Vários países relataram uma diminuição acentuada nas visitas ao pronto-socorro. Algumas crianças apresentavam doenças ocasionais ou descompensações de doenças crônicas, consultando tardiamente os riscos que isso implica. O objetivo do trabalho é fazer uma descrição das consultas tardias durante a pandemia. Um estudo multicêntrico e descritivo foi realizado entre 13 de março e 29 de julho de 2020. Consulta tardia foi definida como internações por: Lesões agudas com mais de 6 horas de evolução, febre maior que 72 horas de evolução, dificuldade respiratória com mais de 12 horas de evolução, sintomas agudos como dor abdominal com mais de 24 horas de evolução, sintomas com mais de 12 horas de evolução em crianças com doenças crônicas que determinaram descompensação e internação. 26 centros foram incluídos. Um total de 34.260 consultas de emergência foram registradas, 189 crianças foram incluídas no estudo. A idade média era de 6 anos. 17 pacientes necessitaram de internação na UTI. Apendicite predominou entre os diagnósticos na alta. Esta pesquisa revelou a existência de consultas tardias em nosso país. Isso ajuda a pesar o impacto negativo da pandemia na população pediátrica.

Genomic diversity in Fructobacillus spp. isolated from fructose-rich niches.

The Fructobacillus genus is a group of obligately fructophilic lactic acid bacteria (FLAB) that requires the use of fructose or another electron acceptor for their growth. In this work, we performed a comparative genomic analysis within the genus Fructobacillus by using 24 available genomes to evaluate genomic and metabolic differences among these organisms. In the genome of these strains, which varies between 1.15- and 1.75-Mbp, nineteen intact prophage regions, and seven complete CRISPR-Cas type II systems were found. Phylogenetic analyses located the studied genomes in two different clades. A pangenome analysis and a functional classification of their genes revealed that genomes of the first clade presented fewer genes involved in the synthesis of amino acids and other nitrogen compounds. Moreover, the presence of genes strictly related to the use of fructose and electron acceptors was variable within the genus, although these variations were not always related to the phylogeny.

Protein recovery from brewery solid wastes.

Brewing produces significant amounts of solid waste during the process: spent cereals (BSG), hops and spent yeast (BSY). These residues are sustainable sources of valuable nutrients and functional compounds like proteins, polyphenols, and polysaccharides. This review describes the three solid wastes and the different extraction techniques for protein recovery. The protein obtained can be used as a new source of non-animal protein or as a functional and bioactive ingredient. Particular attention was given to methods using conventional technologies (alkaline and ethanolic extraction) and more innovative approaches (enzymes, microwaves, ultrasound, pressurized liquids and sub-critical water extraction). Although the BSG is used in some industrial applications, studies in operating conditions, cost, energy efficiency, and product performance are still required to consolidate these solid wastes as a source of non-animal protein. The application of proteins is also an important question when choosing the extraction method.

Repercusión de la pandemia por SARS-COV-2 sobre las consultas en los Servicios de Emergencia Pediátrica en Uruguay / Consequences of the SARS-COV-2 pandemic on Pediatric Emergency Services in Uruguay / Repercussão da pandemia de SARS-COV-2 nas consultas nos Serviços de Emergência Pediátrica do Uruguai

En marzo de 2020 se confirma el primer caso de enfermedad por coronavirus en Uruguay, recomendándose un confinamiento social. La atención sanitaria se redujo a servicios de urgencia y emergencia (SE). Objetivo: analizar las características de las consultas pediátricas en los SE del subsector público y privado en Uruguay, durante los primeros 4 meses de la pandemia por SARS-CoV-2. Metodología: estudio descriptivo, retrospectivo, multicéntrico. Resultados: participaron 23 SE de todas las regiones del país. Período 1 prepandemia: 14/03/19-29.07.19, período 2: 14/03/20-29/07/20 Consultas: período 1 n=121.116, período 2 n=33.099 (desciende 73%). Hospitalizaciones desde el SE: período 1 n= .6649 (tasa 5,5%). Período 2: n=2.948 (tasa 9,5%). Diagnósticos período 1: infección respiratoria aguda (IRA) alta 39.892 (33%), IRA baja 86.56 (7%), trauma menor 8.651 (7%), gastroenteritis 8.044 (6,6%), crisis asmática/CBO 7.974 (6,5%), lesiones 4.389 (3,6%), dolor abdominal 3.528 (3%), problemas de salud mental 859 (0,7%), convulsiones 758 (0,7%), patología social 678 (0,5%). Diagnósticos 2020: IRA alta 5.168 (16%), trauma menor 2.759 (8%), lesiones 2.652 (8%), dolor abdominal 1.494 (4,5%), gastroenteritis 1.296 (4%), asma/CBO 1.095 (3,3%), IRA baja 700 (2,1%), patología social 522 (1,6%), problemas de salud mental 471 (1,4%), convulsiones 408 (1,2%). Conclusiones: en los primeros meses de la pandemia hubo una reducción sostenida y significativo de consultas pediátricas en los SE. No hubo aumento en frecuencia absoluta de ninguno de los diagnósticos. Se registró un descenso histórico de las IRA bajas y las hospitalizaciones por esta causa en todo el país. Mantener una vigilancia de las consultas en los SE permitiría identificar e intervenir oportunamente si se produjeran cambios o situaciones de riesgo hasta el momento no detectadas.

In March 2020 the first case of coronavirus disease was confirmed in Uruguay, and lockdown was recommended. Health care services were reduced to Urgency and Emergency Services (ES). Objectives: to analyze the epidemiological characteristics of pediatric visits to the ES of the public and private subsector in Uruguay, during the first 4 months of the SARS-CoV-2 pandemic. Methods: descriptive, retrospective. Results: 23 institutions participated. 2 periods were considered: 1) pre-pandemic, 03/14/19 to 07/29/19, 2) 03/14/20 to 07/29/20. Visits: period 1: n=121,116 (< 15 years), period 2: n=33.099 (73% decrease). Hospital admissions: period 1: n=6,649 (rate 5.5). Period 2: n=2.948 (rate 9,5). Diagnoses period 1: High acute respiratory infection 39,892 (33%), low acute respiratory infection 8,656 (7%), minor trauma 8,651 (7%), gastroenteritis 8,044 (6,6%), asthmatic crisis/CBO 7.974 (6,5%), injuries 4,389 (3,6%), abdominal pain (3,528) 3%, mental health problems 859 (0.7%), seizures 758 (0.7%), social pathology 678 (0.5% ). 2020 diagnoses: high acute respiratory infection 5.168 (16%), minor trauma 2,759 (8%), injuries 2,652 (8%), abdominal pain 1,494 (4.5%), gastroenteritis 1,296 (4%), asthma/CBO 1,095 (3,3%), low acute respiratory infection 700 (2,1%), social pathology 522 (1,6%), mental health problems 471 (1,4%), seizures 408 (1,2%). Conclusions: in the first months of the pandemic there was a sustained and significant reduction in pediatric consultations in ES. There was no increase in absolute frequency of any of the diagnoses. There was a historical decrease in low respiratory infections and hospitalizations due to this cause in the whole country. Maintaining a surveillance of the visits in the ES would enable practitioners to identify and take action in case of changes or previously undetected risk situations.

Em março de 2020, foi confirmado o primeiro caso de doença por coronavírus no Uruguai, recomendando o confinamento. A assistência à saúde foi reduzida a serviços de urgência e emergência (SE). Objetivo: analisar as características das consultas pediátricas no SE do subsetor público e privado no Uruguai, durante os primeiros 4 meses da pandemia de SARS-CoV-2. Metodologia: estudo descritivo, retrospectivo, multicêntrico. Resultados: participaram 23 SEs de todas as regiões do país. Período pré-pandemia 1: 14/03/19-29/07/19, período 2: 14/03/20-29/07/20 Consultas: período 1 n=121.116, período 2 n=33.099 (redução de 73%) . Internações da SE: período 1 n= 0,6649 (taxa 5,5%). Período 2: n=2.948 (taxa de 9,5%). Diagnósticos do período 1: infecção respiratória aguda alta (IRA) 39.892 (33%), LRA baixa 86,56 (7%), trauma menor 8.651 (7%), gastroenterite 8.044 (6,6%), crise asmática/CBO 7.974 (6, 5% ), lesões 4.389 (3,6%), dor abdominal 3.528 (3%), problemas de saúde mental 859 (0,7%), convulsões 758 (0,7%), patologia social 678 (0,5%). Diagnósticos 2020: IRA alta 5.168 (16%), trauma leve 2.759 (8%), lesões 2.652 (8%), dor abdominal 1.494 (4,5%), gastroenterite 1.296 (4%), asma/CBO 1.095 (3, 3%), IRA baixa 700 (2,1%), patologia social 522 (1,6%), problemas de saúde mental 471 (1,4%), convulsões 408 (1,2%). Conclusões: nos primeiros meses da pandemia houve uma redução sustentada e significativa das consultas pediátricas no SE. Não houve aumento na frequência absoluta de nenhum dos diagnósticos. Foi registrado um decréscimo histórico de IRAs baixas e internações por essa causa em todo o país. A manutenção de uma vigilância das consultas no SE permitiria identificar e intervir atempadamente nos casos de alterações ou situações de risco que até agora não tinham sido detectadas.

Spatial Control of Microbial Pesticide Degradation in Soil: A Model-Based Scenario Analysis.

Microbial pesticide degraders are heterogeneously distributed in soil. Their spatial aggregation at the millimeter scale reduces the frequency of degrader-pesticide encounter and can introduce transport limitations to pesticide degradation. We simulated reactive pesticide transport in soil to investigate the fate of the widely used herbicide 4-chloro-2-methylphenoxyacetic acid (MCPA) in response to differently aggregated distributions of degrading microbes. Four scenarios were defined covering millimeter scale heterogeneity from homogeneous (pseudo-1D) to extremely heterogeneous degrader distributions and two precipitation scenarios with either continuous light rain or heavy rain events. Leaching from subsoils did not occur in any scenario. Within the topsoil, increasing spatial heterogeneity of microbial degraders reduced macroscopic degradation rates, increased MCPA leaching, and prolonged the persistence of residual MCPA. In heterogeneous scenarios, pesticide degradation was limited by the spatial separation of degrader and pesticide, which was quantified by the spatial covariance between MCPA and degraders. Heavy rain events temporarily lifted these transport constraints in heterogeneous scenarios and increased degradation rates. Our results indicate that the mild millimeter scale spatial heterogeneity of degraders typical for arable topsoil will have negligible consequences for the fate of MCPA, but strong clustering of degraders can delay pesticide degradation.

Fruits and fruit by-products as sources of bioactive compounds. Benefits and trends of lactic acid fermentation in the development of novel fruit-based functional beverages.

Current awareness about the benefits of a balanced diet supports ongoing trends in humans towards a healthier diet. This review provides an overview of fruits and fruit-by products as sources of bioactive compounds and their extraction techniques, and the use of lactic acid fermentation of fruit juices to increase their functionality. Fruit matrices emerge as a technological alternative to be fermented by autochthonous or allochthonous lactic acid bacteria (LAB such as Lactiplantibacillus plantarum, Lacticaseibacillus rhamnosus, and other Lactobacillus species), and also as probiotic vehicles. During fermentation, microbial enzymes act on several fruit phytochemicals producing new derived compounds with impact on the aroma and the functionality of the fermented drinks. Moreover, fermentation significantly reduces the sugar content improving their nutritional value and extending the shelf-life of fruit-based beverages. The generation of new probiotic beverages as alternatives to consumers with intolerance to lactose or with vegan or vegetarian diets is promising for the worldwide functional food market. An updated overview on the current knowledge of the use of fruit matrices to be fermented by LAB and the interaction between strains and the fruit phytochemical compounds to generate new functional foods as well as their future perspectives in association with the application of nanotechnology techniques are presented in this review.

Cambios en la ergonomía en tiempos de COVID-19 en estudiantes de una universidad Peruana / Changes in ergonomics in times of COVID-19 in students of a Peruvian university

La enfermedad por COVID-19 ha traído consigo cambios que forman parte de la nueva normalidad. Muchos de estos cambios podrían repercutir de mala manera en la población y traer enfermedades o riesgo de comorbilidades como diabetes, estrés, obesidad o problemas ergonómicos. El presente estudio tuvo como objetivo evaluar los factores asociados a la ergonomía en estudiantes universitarios durante el contexto de clases virtuales en Lima, Perú debido a la COVID-19. Se realizó una encuesta virtual mediante la plataforma de Google Forms, a 121 estudiantes del primer ciclo en una universidad limeña. La encuesta contenía preguntas sobre los cambios ergonómicos percibidos durante las clases virtuales debido a la COVID-19. Respecto al peso, 43.85 % presentó variación, mientras que el 44,6% reportó que no. Sobre las molestias corporales y visuales el 83.5 % presentaron dolores musculares, mientras que el 16.5 % no tenían estas molestias. Entre estos prevalecían el dolor de espalda, cuello, cintura, hombros y piernas. Por otro lado, el 78.5 % presentaban incomodidad visual, mientras que el otro 21.5 % no lo presentó. Entre las molestias visuales más frecuentes estaban ardor, picazón, sensación de ojo seco, cansancio de la vista y lagrimeo durante las clases. El dispositivo más usado por los estudiantes para las clases virtuales fue la laptop (81 %). Respecto a los ejercicios físicos, el 46,3 % sí lo realizaban terminada las clases, y los estiramientos un 62.8 %. Igualmente, se evaluó la ingesta de líquidos, frutas y comida chatarra. De los encuestados, un 52.9 % no varió su ingesta de líquidos, el 60.3 % no varió el de frutas, y el 48.8 % disminuyó la ingesta de comida chatarra. Los problemas ergonómicos que se evaluaron, podrían estar relacionados con los altos periodos de tiempo que los estudiantes se exponen al uso de los equipos electrónicos debido a las clases virtuales y también al no tener un lugar fijo de estudio, por lo que se debería realizar otras actividades adicionales como hacer ejercicio y/o estiramientos después de clase, además de ingerir más frutas, líquidos y mantener un estilo de vida saludable.

The increasing attention that is given to the protection of health professionals and patients has stimulated researchers and organizations to create alternatives to improve safety practices in health services, including in the Magnetic Resonance Imaging (MRI) environment. However, this theme still needs to be further explored in the MRI field. This paper aims to review the current literature, explore the approach to the MRI Safety Supervisor, to describe the role of the MRI Safety Supervisor and how it could serve as an agent to enhance the safety of health professionals and patients in the MRI environment. To achieve this, a narrative literature review was carried out in the electronic databases: ScienceDirect, PubMed, Scielo and Google Scholar, using as inclusion criteria, articles published in Portuguese and English between the years 2008 to 2019. The articles were filtered according to relevant aspects, such as authorship, title, year of publication, objectives, methodology and main results. Lastly, it considered aspects related to adverse events, international and national regulations on security and safety management in the MRI sector. Nevertheless, in the search for actions that effectively mitigate risks on this modality, it was observed that studies on the MRI Safety Supervisor are scarce, which reinforce the need for further studies on this matter.

Gene-Centric Model Approaches for Accurate Prediction of Pesticide Biodegradation in Soils.

Pesticides are widely used in agriculture despite their negative impact on ecosystems and human health. Biogeochemical modeling facilitates the mechanistic understanding of microbial controls on pesticide turnover in soils. We propose to inform models of coupled microbial dynamics and pesticide turnover with measurements of the abundance and expression of functional genes. To assess the advantages of informing models with genetic data, we developed a novel "gene-centric" model and compared model variants of differing structural complexity against a standard biomass-based model. The models were calibrated and validated using data from two batch experiments in which the degradation of the pesticides dichlorophenoxyacetic acid (2,4-D) and 2-methyl-4-chlorophenoxyacetic acid (MCPA) were observed in soil. When calibrating against data on pesticide mineralization, the gene-centric and biomass-based models performed equally well. However, accounting for pesticide-triggered gene regulation allows improved performance in capturing microbial dynamics and in predicting pesticide mineralization. This novel modeling approach also reveals a hysteretic relationship between pesticide degradation rates and gene expression, implying that the biodegradation performance in soils cannot be directly assessed by measuring the expression of functional genes. Our gene-centric model provides an effective approach for exploiting molecular biology data to simulate pesticide degradation in soils.

Romances familiares e heranças psicossociais / Family romances and psychossocial heritage / Romances familiares y herencias psicossociales

Este artigo examina a influência da família e dos efeitos das heranças psicossociais na trajetória do sujeito. A psicossociologia ­ e suas interseções com a psicanálise e a sociologia ­ é discutida como referencial teórico-metodológico que possibilita explorar essa problemática. O estudo "Romance Familiar e a Trajetória Social", que se apoia no método de história de vida em grupo, fundamenta a discussão, que é seguida pela análise do relato de uma participante de um grupo intitulado "Mudanças de vida: entre perdas e vínculos", que nos fornece elementos para discutir a transmissão sociopsíquica entre gerações e seus traços nas produções subjetivas do indivíduo (AU).

This article examines the influence of the family and the effects of the psychosocial heritage in the trajectory of the subject. Psycosociology, and its intersections with psychoanalysis and sociology, is discussed as theoreticalmethodological referential that allows us to explore such issue. We will present the device "Family Romances and psychosocial heritage", that utilizes the history of life in groups. We will analyze as furthers as the report of a participant of a group entitled "Life changes: between losses and bonds", which allows us to analyze the socio-psychic transmission among generations and their traits in the subjective productions of the individual (AU).

Este artículo examina la influencia de la familia y los efectos de las herencias psicosociales en la trayectoria de un individuo. La psicosociología, y sus intersecciones con el psicoanálisis y la sociología, es discutida como un marco teórico-metodológico que permite explorar tal problema. Presentamos, entonces, un dispositivo grupal llamado "Romance familiar y trayectoria social" apoyado en el método de historia de vida. Seguimos con un análisis de un participante en un grupo titulado "Cambios en la vida: entre restricciones y vínculos", que nos proporcionan elementos para discutir la transmisión psicológica entre las generaciones y sus rasgos en las producciones subjetivas del individuo (AU).

Exploring the Genome of Fructobacillus tropaeoli CRL 2034, a Fig-Origin Strain that Produces High Levels of Mannitol from Fructose.

We report the draft genome sequence of Fructobacillus tropaeoli CRL 2034, a strain isolated from ripe fig in Tucumán province, Argentina. The interest in studying the genome of this fructophilic lactic acid bacterium strain was motivated by its ability to produce high levels of mannitol from fructose. This polyol has multiple industrial applications; however, it is mainly used as low calorie sugar in the food industry. The assembled genome of this strain consists of a 1.66-Mbp circular chromosome with 1465 coding sequences and a G+C content of 44.6%. The analysis of this genome supports the one step reaction of fructose reduction to mannitol by the mannitol 2-dehydrogenase enzyme, which together with a fructose permease, were identified as involved in mannitol synthesis. In addition, a phylogenetic analysis was performed including other Leuconostocaceae members to which the Fructobacillus genus belongs to; according to the 16S rRNA gene sequences, the strain CRL 2034 was located in the Fructobacillus clade. The present genome sequence could be useful to further elucidate regulatory processes of mannitol and other bioactive metabolites and to highlight the biotechnological potential of this fruit-origin Fructobacillus strain.

Experiencia en la utilización de cánula nasal de alto flujo en niños con infecciones respiratorias agudas hospitalizados en un sector de internación / Use of high flow nasal cannula in hospitalized children with acute respiratory infections / Uso de cânula nasal de alto fluxo em crianças hospitalizadas com infecções respiratórias agudas

Resumen: Introducción: las infecciones respiratorias agudas bajas (IRAB) constituyen la principal causa de ingreso hospitalario en menores de 2 años. La utilización de cánula nasal de alto flujo (CNAF) es un instrumento terapéutico eficaz para evitar la ventilación invasiva, especialmente para los pacientes menores de 6 meses que constituyen el grupo de mayor riesgo. Objetivos: presentar la experiencia en la implementación de la terapia con CNAF en pacientes menores de 2 años con IRAB con insuficiencia respiratoria tratados en un sector de internación de infecciones respiratorias virales y analizar la población derivada a sectores de mayor complejidad. Pacientes y método: estudio observacional prospectivo en el que se incluyeron pacientes menores de 2 años con IRAB e insuficiencia respiratoria que recibieron tratamiento con CNAF, desde el 1° de junio al 31 de agosto del 2015 en un sector de internación del Hospital Pediátrico del Centro Hospitalario Pereira Rossell (HP/CHPR) de Montevideo, Uruguay. Resultados: se incluyeron 125 pacientes, 47 niñas y 78 varones, con una mediana de edad de 3 meses (16 días - 24 meses). En el 53% de ellos se identificó VRS. La duración de la terapia con CNAF tuvo una mediana de 69 horas (4 - 192 horas). La mediana del score de TAL modificado previo a su utilización fue de 7 (rango 5 - 9) y a las dos horas de 5 (rango 3 - 8). La terapia con CNAF se acompañó de una reducción significativa de la frecuencia cardíaca (FC). No se observaron efectos adversos ni complicaciones por la técnica. Requirieron ingreso a sectores de mayor complejidad (unidad de cuidados intensivos UCI o cuidados respiratorios especiales agudos CREA) el 38% (n=47), de los cuales el 36% (n=17) requirió asistencia ventilatoria mecánica invasiva (AVMI), el 25% (n=12) ventilación no invasiva (VNI) y el 38% (n=18) continuó recibiendo tratamiento con CNAF. Los menores de 3 meses requirieron derivación a sectores de mayor complejidad con más frecuencia (p=0,0036). Conclusiones: la utilización de CNAF pudo ser implementada sin complicaciones en una sala de internación pediátrica. El 62% de los pacientes no requirió otro tipo de apoyo respiratorio. Los menores de 3 meses requirieron traslado a cuidados críticos con mayor frecuencia.

Summary: Introduction: acute lower respiratory infections (LRTI) are the leading cause of hospitalization in children under 2 years of age. High-Flow Oxygen (HFO) is a highly effective method to prevent invasive ventilation, even for patients under 6 months of age, the highest-risk group. Objective: to present our experience and results for patients under 2 years of age with LRTI and moderate or severe respiratory distress treated with HFO and to analyze the subgroup of patients that needed to be transferred to other hospital units to continue their treatment. Patients and method: patients under 2 years of age with LRTI and respiratory failure who required HFO were included in a prospective observational study carried out between June 1 and August 31, 2015 at the Inpatient Area of the Pediatric Hospital, Centro Hospitalario Pereira Rossell (PH/CHPR), Montevideo, Uruguay. Results: 125 patients were included. 47 girls and 78 boys with a median age of 3 months (16 days-24 months). 53% of them were RSVs positive. The median connection time was 69 hours (Range 4 -192). The median for the modified TAL score was 7 (Range 5-9) and 5 (Range 3-8) before connection and 2 hours later respectively. HFO resulted into a significant reduction of heart rate. No adverse effects or complications were observed. 38% (n = 47) of patients were transferred to intensive care or special acute respiratory care but just a 36% (n = 17) of them needed mechanical ventilation and 25.5% (n = 12) needed non-invasive ventilation (NIV); the remaining 18 patients continued receiving HFO. Patients under 3 months of age needed to be transferred to ICU more often than older ones (p = 0.0036) Conclusions: the HFO technique could be implemented without complications in pediatric units. 62% of patients did not need additional respiratory support. Patients under 3 months of age needed to be transferred to Intensive Care more often than older patients.

Resumo: Introdução: as infecções respiratórias agudas inferiores (IRA) são a principal causa de hospitalização em crianças menores de 2 anos. O oxigênio de alto fluxo (OAF) é um método altamente eficaz para prevenir a ventilação invasiva, mesmo em pacientes com menos de 6 meses de idade, o grupo de maior risco. Objetivo: apresentar nossa experiência e resultados nos pacientes com menos de 2 anos de idade com IRA com dificuldade respiratória moderada ou grave tratados com OAF e analisar o subgrupo de pacientes que precisaram ser transferidos para outras áreas hospitalares para continuar o seu tratamento. Pacientes e método: pacientes com menos de 2 anos de idade com ITRI e insuficiência respiratória que necessitaram de OAF foram incluídos em um estudo observacional prospectivo realizado entre 1 de junho e 31 de agosto de 2015 na Área de Internação do Hospital Pediátrico, Centro Hospitalario Pereira Rossell (PH / CHPR), Montevidéu, Uruguai. Resultados: 125 pacientes foram incluídos. 47 meninas e 78 meninos com idade média de 3 meses (16 dias a 24 meses). 53% deles foram positivos para o VSR. O tempo médio de conexão foi de 69 horas (Faixa 4 -192). A mediana do escore TAL modificado foi de 7 (intervalo 5-9) e 5 (intervalo 3-8) antes da conexão e 2 horas depois, respectivamente. HFO resultou em uma redução significativa na frequência cardíaca. Não foram observados efeitos adversos ou complicações. 38% (n = 47) dos pacientes foram transferidos para tratamento intensivo ou respiratório agudo especial, mas apenas 36% (n = 17) deles necessitaram de ventilação mecânica e 25,5% (n = 12) necessitaram de ventilação não invasiva (VNI); os 18 pacientes restantes continuaram recebendo HFO. Pacientes com menos de 3 meses de idade precisaram ser transferidos para UTI mais frequentemente do que os outros (p = 0,0036) Conclusões: a técnica OAF poderia ser implementada sem complicações em unidades pediátricas. 62% dos pacientes não precisaram de suporte respiratório adicional. Pacientes com menos de 3 meses de idade precisaram ser transferidos para terapia intensiva com mais frequência do que pacientes mais velhos.

Diversity and Functional Properties of Lactic Acid Bacteria Isolated From Wild Fruits and Flowers Present in Northern Argentina.

Lactic acid bacteria (LAB) are capable of converting carbohydrate substrates into organic acids (mainly lactic acid) and producing a wide range of metabolites. Due to their interesting beneficial properties, LAB are widely used as starter cultures, as probiotics, and as microbial cell factories. Exploring LAB present in unknown niches may lead to the isolation of unique species or strains with relevant technological properties. Autochthonous rather than allochthonous starter cultures are preferred in the current industry of fermented food products, due to better adaptation and performance of autochthonous strains to the matrix they originate from. In this work, the lactic microbiota of eight different wild tropical types of fruits and four types of flowers were studied. The ability of the isolated strains to produce metabolites of interest to the food industry was evaluated. The presence of 21 species belonging to the genera Enterococcus, Fructobacillus, Lactobacillus, Lactococcus, Leuconostoc, and Weissella was evidenced by using culture-dependent techniques. The isolated LAB corresponded to 95 genotypically differentiated strains by applying rep-PCR and sequencing of the 16S rRNA gene; subsequently, representative strains of the different isolated species were studied for technological properties, such as fast growth rate and acidifying capacity; pectinolytic and cinnamoyl esterase activities, and absence of biogenic amine biosynthesis. Additionally, the strains' capacity to produce ethyl esters as well as mannitol was evaluated. The isolated fruit- and flower-origin LAB displayed functional properties that validate their potential use in the manufacture of fermented fruit-based products setting the background for the design of novel functional foods.

Enhanced mannitol biosynthesis by the fruit origin strain Fructobacillus tropaeoli CRL 2034.

Mannitol is a natural low-calorie sugar alcohol produced by certain (micro)organisms applicable in foods for diabetics due to its zero glycemic index. In this work, we evaluated mannitol production and yield by the fruit origin strain Fructobacillus tropaeoli CRL 2034 using response surface methodology with central composite design (CCD) as optimization strategy. The effect of the total saccharide (glucose + fructose, 1:2) content (TSC) in the medium (75, 100, 150, 200, and 225 g/l) and stirring (S; 50, 100, 200, 300 and 350 rpm) on mannitol production and yield by this strain was evaluated by using a 22 full-factorial CCD with 4 axial points (α = 1.5) and four replications of the center point, leading to 12 random experimental runs. Fermentations were carried out at 30 °C and pH 5.0 for 24 h. Minitab-15 software was used for experimental design and data analyses. The multiple response prediction analysis established 165 g/l of TSC and 200 rpm of S as optimal culture conditions to reach 85.03 g/l [95% CI (78.68, 91.39)] of mannitol and a yield of 82.02% [95% CI (71.98, 92.06)]. Finally, a validation experiment was conducted at the predicted optimum levels. The results obtained were 81.91 g/l of mannitol with a yield of 77.47% in outstanding agreement with the expected values. The mannitol 2-dehydrogenase enzyme activity was determined with 4.6-4.9 U/mg as the highest value found. To conclude, F. tropaeoli CRL 2034 produced high amounts of high-quality mannitol from fructose, being an excellent candidate for this polyol production.

Olhares sobre o corpo na atualidade: tatuagem, visibilidade e experiência tátil / Miradas acerca del cuerpo en la actualidad: tatuaje, visibilidad y experiencia táctil / Current visions about the body: tattoo, visibility and tactile experience

Este artigo, com base na psicossociologia, problematiza processos de subjetivação sobre o corpo na atualidade, tomando o uso da tatuagem como analisador. O incremento das demandas para essa prática chama atenção, visto que a tatuagem remete à permanência e as subjetivações atuais prezam a efemeridade. A imagem e o tempo imediato são também valorizados, bem como a visibilidade. Estes colocam a tatuagem em sintonia com os movimentos de culto ao corpo, exacerbados atualmente. São movimentos distintos que apontam para divergências e convergências do mesmo fenômeno, e que tornam as problemáticas do corpo e tatuagens paradigmáticas na atualidade. De forma a encaminhar essas discussões, são utilizados trechos de entrevistas com adultos tatuados, realizadas durante o trabalho de campo em que se pôde notar a grande importância da visibilidade e experiência tátil no processo de escolha e feitura de tatuagens.(AU)

Este artículo, basado en la Psicosociología, analiza los procesos de subjetividad en el cuerpo hoy en día, teniendo el uso del tatuaje como un analizador. El aumento de la demanda de esta práctica llama la atención, ya que el tatuaje se refiere a la permanencia, cuando las subjetivaciones actuales aprecian el efémero. La imagen y el tiempo inmediato también se valoran, así como la visibilidad. El tatuaje está en sintonía con los movimientos de culto al cuerpo, exacerbados en la actualidad. Son movimientos distintos que revelan divergencias y convergencias de un mismo fenómeno, y que hacen las cuestiones del cuerpo y de los tatuajes paradigmáticos en la actualidad. Para avanzar este debate, nos utilizamos de entrevistas con adultos tatuados, hechas en trabajo de campo, donde se puede tener en cuenta la importancia de la visibilidad y la experiencia táctil en el proceso de selección y elaboración de los tatuajes.(AU)

This study is based on the Psychosociology and analyzes subjectivity's processes about the body in our days, taking the use of tattooing as a analyzer. The increased demands of this practice is interesting, because the tattoo refers to the permanence, and the current value today appreciate is the ephemerality. On the other hand, the image and the immediate time are also valued, as well as the visibility. In this way, the tattoo fits well with the movements of body's worship that is so exacerbated today. These are distinct movements that reveal divergences and convergences of the same phenomenon, and make the themes "body" and "tattoos" paradigmatic in our days. To conduct these discussions, some interviews with tattooed adults are used. They pointed the importance of visibility and tactile experience in the process of choosing and making the tattoo.(AU)

Olhares sobre o corpo na atualidade: tatuagem, visibilidade e experiência tátil / Miradas acerca del cuerpo en la actualidad: tatuaje, visibilidad y experiencia táctil / Current visions about the body: tattoo, visibility and tactile experience

Este artigo, com base na psicossociologia, problematiza processos de subjetivação sobre o corpo na atualidade, tomando o uso da tatuagem como analisador. O incremento das demandas para essa prática chama atenção, visto que a tatuagem remete à permanência e as subjetivações atuais prezam a efemeridade. A imagem e o tempo imediato são também valorizados, bem como a visibilidade. Estes colocam a tatuagem em sintonia com os movimentos de culto ao corpo, exacerbados atualmente. São movimentos distintos que apontam para divergências e convergências do mesmo fenômeno, e que tornam as problemáticas do corpo e tatuagens paradigmáticas na atualidade. De forma a encaminhar essas discussões, são utilizados trechos de entrevistas com adultos tatuados, realizadas durante o trabalho de campo em que se pôde notar a grande importância da visibilidade e experiência tátil no processo de escolha e feitura de tatuagens...

Este artículo, basado en la Psicosociología, analiza los procesos de subjetividad en el cuerpo hoy en día, teniendo el uso del tatuaje como un analizador. El aumento de la demanda de esta práctica llama la atención, ya que el tatuaje se refiere a la permanencia, cuando las subjetivaciones actuales aprecian el efémero. La imagen y el tiempo inmediato también se valoran, así como la visibilidad. El tatuaje está en sintonía con los movimientos de culto al cuerpo, exacerbados en la actualidad. Son movimientos distintos que revelan divergencias y convergencias de un mismo fenómeno, y que hacen las cuestiones del cuerpo y de los tatuajes paradigmáticos en la actualidad. Para avanzar este debate, nos utilizamos de entrevistas con adultos tatuados, hechas en trabajo de campo, donde se puede tener en cuenta la importancia de la visibilidad y la experiencia táctil en el proceso de selección y elaboración de los tatuajes...

This study is based on the Psychosociology and analyzes subjectivity's processes about the body in our days, taking the use of tattooing as a analyzer. The increased demands of this practice is interesting, because the tattoo refers to the permanence, and the current value today appreciate is the ephemerality. On the other hand, the image and the immediate time are also valued, as well as the visibility. In this way, the tattoo fits well with the movements of body's worship that is so exacerbated today. These are distinct movements that reveal divergences and convergences of the same phenomenon, and make the themes "body" and "tattoos" paradigmatic in our days. To conduct these discussions, some interviews with tattooed adults are used. They pointed the importance of visibility and tactile experience in the process of choosing and making the tattoo...