Derecho al consumo informado: el caso de las bebidas azucaradas en Colombia / Right to informed consumption: the case of sugar-sweetened beverages in Colombia

Introducción: se presenta un análisis sobre el derecho al consumo informado en el caso de las bebidas azucaradas, a través del recorrido administrativo y judicial en Colombia. Metodología: se hace desde una perspectiva jurídica, bioética y médica, señalando cómo la protección judicial de este derecho se da gracias al activísimo social y judicial que se enfrenta con el lobby de la industria, cuyos intereses también inciden, no en el ámbito del acceso a la justicia, pero si en el del diseño de políticas públicas en salud para reducir el consumo de bebidas azucaradas. Conclusiones: de la revisión de la literatura se encontró que ciertas enfermedades no transmisibles se asocian con el consumo de estos productos, por lo cual en diferentes regiones del mundo se han replanteado medidas para mitigar su impacto, mientras en Colombia el escenario desde las políticas públicas no ha sido favorable.

Introduction: an analysis of the right to informed sugar-sweetened beverages consumption is herein presented from the administrative and legal background in Colombia. Methodology: a study conducted from the legal, bioethical and medical perspective, pointing out how legal protection of this right is possible thanks to social and legal activism which faces industrial lobby whose interests do not influence the access to justice institutions but does influence the design of health public policy for reducing sugar-sweetened beverages intake. Conclusions: our review of the literature found that certain non-communicable diseases are associated with the intake of these products for which measures to mitigate their impact have been reconsidered in different regions of the world, while in Colombia the public policy scenario has been unfavorable.

Intra-hospital mortality among neonates transported by ambulance in Colombia.

BACKGROUND: The aims of this study were to identify the main variables associated with intra-hospital mortality among patients transferred to a specialized neonatal care center, and to evaluate agreement and accuracy of referring and admission diagnoses. METHODS: A 6 month observational study was conducted to obtain clinical variables for intra-hospital mortality among patients requiring interfacility transport. Association among variables was estimated using Poisson regression with robust variance. Agreement was evaluated between diagnosis before and after transfer using Cohen's kappa, sensitivity, specificity and Youden's I. RESULTS: The study included 191 neonates, 12.57% of whom died. Increased mortality was associated with the Transport Risk Index of Physiologic Stability (TRIPS). The associated variables were as follows: TRIPS (adjusted prevalence ratio [aPR], 1.05; 95% confidence interval [CI]: 1.02-1.08), weight 1500-2499 g (aPR, 0.08; 95%CI: 0.01-0.40), weight >2500 g (aPR, 0.56; 95%CI: 0.02-0.19), cardiopathy (aPR, 0.20 95%CI: 0.05-0.75), congenital defects (aPR, 4.59; 95%CI: 0.97-21.82) and renal failure (aPR, 3.69; 95%CI: 1.26-10.78). Diagnosis remained unchanged for 71.15% of the neonates. The greatest differences were hyaline membrane disease (49.4%) followed by transient tachypnea (59.9%). Youden's I for referral diagnosis was 0.22 for transient tachypnea, 0.66-0.69 for cardiopathy, esophageal atresia and pneumonia, 0.72-0.74 for hyaline membrane disease and pulmonary hypertension, and >0.90 for the remaining diagnoses. CONCLUSIONS: Weight <1500 g, renal failure, congenital defects (except congenital cardiopathies) and high TRIPS were associated with a higher risk of intra-hospital mortality. The findings suggest that improving transfer time and quality of care in ambulances would decrease mortality.

Alteraciones en el neurodesarrollo infantil del niño indígena Arhuaco / Neural development disorders in Arhuaco children

El objetivo principal de este estudio fue evaluar aspectos relacionados con el neurodesarrollo infantil de la población indígena arhuaca en el grupo de la primera infancia, basado en una valoración global y general de determinadas áreas o procesos de desarrollo, desde cuatro aspectos fundamentales: la motricidad gruesa, fina, audición y lenguaje, y personal social, a través de la escala abreviada del desarrollo de Nelson–Ortiz validada en el país. Se les aplicó a 55 niños menores de seis años que no tuvieran patologías crónicas o comorbilidades asociadas, en Nabusimake y Pueblo Bello, Sierra Nevada de Santa Marta, con el previo consentimiento de las autoridades locales indígenas y de sus padres, en el período abril de 2009...

The main aim of this study was to evaluate childhood neural development in the Arhuaco indigineous population in the preschool age group. The study was based on a global and overall assessment of specific neural development areas or processes, assessing four core aspects: gross motor skills, fine motor skills, audition and speech and personal and social skills, using a child development abbreviated scale designed by Nelson–Ortiz, validated in our country. The scale was applied to 55 children aged six years or less with no chronic diseases or comorbidities, in the towns of Nabusimake and Pueblo Bello, Sierra Nevada of Santa Marta...

A new DTPw-HBV/Hib vaccine is immunogenic and safe when administered according to the EPI (Expanded Programme for Immunization) schedule and following hepatitis B vaccination at birth.

New combination vaccines and reliable sources of vaccine components are essential to ensure the success of mass immunisation programmes in the 21st century. We evaluated a new combined diphtheria-tetanus-whole-cell-pertussis-hepatitis B vaccine, extemporaneously mixed with a Haemophilus influenzae type b conjugate vaccine (DTPw-HBV/Hib) containing 2.5 microg PRP in 913 Philippino infants, administered according to the EPI schedule at 6, 10 and 14 weeks of age after a birth dose of hepatitis B vaccine (HBV; trial DTPw-HBV/Hib-001). One month after the third dose of DTPw-HBV/Hib (N = 182), 99.4% and 94.2% of subjects had anti-PRP antibody levels > or =0.15 microg/mL and > or =1.0 microg/mL, respectively. In addition, 95.9%, 100.0% and 87.6% of subjects had seroprotective antibody concentrations against diphtheria, tetanus and hepatitis B, respectively. The seroprotection rate to hepatitis B increased significantly to 94.3% in subjects who received a dose of HBV at birth. The pertussis vaccine response rate was > or =95%. Seroprotection/vaccine response rates to all antigens after DTPw-HBV/Hib were at least as good as those observed after vaccination with GSK Biologicals' licensed Tritanrix HepB/Hiberix (containing 10 microg PRP) which was used as comparator. Although redness >20 mm in diameter and fever > or = 37.5 degrees C (axillary route) occurred more often after the new DTPw-HBV/Hib vaccine (p < 0.05), other Grade 3 adverse events occurred similarly between the groups. The new DTPw-HBV/Hib vaccine was as immunogenic and well tolerated as the licensed control vaccine when administered according to the immunologically challenging EPI schedule. A birth dose of HBV is important to maximize protection against hepatitis B in endemic regions where the EPI schedule is in place.