Socioeconomic inequalities in low birth weight risk before and during the COVID-19 pandemic in Argentina: A cross-sectional study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic may have exacerbated existing socioeconomic inequalities in health. In Argentina, public hospitals serve the poorest uninsured segment of the population, while private hospitals serve patients with health insurance. This study aimed to assess whether socioeconomic inequalities in low birth weight (LBW) risk changed during the first wave of the COVID-19 pandemic. METHODS: This multicenter cross-sectional study included 15929 infants. A difference-in-difference (DID) analysis of socioeconomic inequalities between public and private hospitals in LBW risk in a pandemic cohort (March 20 to July 19, 2020) was compared with a prepandemic cohort (March 20 to July 19, 2019) by using medical records obtained from ten hospitals. Infants were categorized by weight as LBW < 2500 g, very low birth weight (VLBW) < 1500 g and extremely low birth weight (ELBW) < 1000 g. Log binomial regression was performed to estimate risk differences with an interaction term representing the DID estimator. Covariate-adjusted models included potential perinatal confounders. FINDINGS: Of the 8437 infants in the prepandemic cohort, 4887 (57•9%) were born in public hospitals. The pandemic cohort comprised 7492 infants, 4402 (58•7%) of whom were born in public hospitals. The DID estimators indicated no differences between public versus private hospitals for LBW risk (-1•8% [95% CI -3•6, 0•0]) and for ELBW risk (-0•1% [95% CI -0•6, 0•3]). Significant differences were found between public versus private hospitals in the DID estimators (-1•2% [95% CI, -2•1, -0•3]) for VLBW risk. The results were comparable in covariate-adjusted models. INTERPRETATION: In this study, we found evidence of decreased disparities between public and private hospitals in VLBW risk. Our findings suggest that measures that prioritize social spending to protect the most vulnerable pregnant women during the pandemic contributed to better birth outcomes. FUNDING: No funding was secured for this study.

Utilización de kiwicha precocida ( Amaranthus caudatus ) para el desarrollo de barras funcionales

RESUMEN En el presente trabajo se utilizaron granos de kiwicha (Amaranthus caudatus) popeado y laminado como ingrediente funcional para elaborar una barrita destinadas a la población infantil/embarazo/lactancia y población en general. Por ello, el objetivo de este trabajo fue evaluar su aporte nutricional, calidad microbiológica y textura de los granos precocidos y de las barras formuladas. Se elaboraron dos productos precocidos de kiwicha: popeado y laminado. Las determinaciones fueron: Cuantificación de amilosa/amilopectina, almidón resistente (AR), fitoesteroles, lisina disponible, calidad proteica y caracterización microbiológica. A partir de estos productos obtenidos se formularon barras funcionales de kiwicha (con granos popeado y laminado) y se determinó: composición proximal y porcentaje del Valor Diario (% VD), % de Ingesta Dietética de Referencia (% IDR) y se realizó la prueba de Análisis de Perfil de Textura. Las barras funcionales de kiwicha presentaron un alto aporte calórico, proteico (9,83-9.85 g/100g), de buena calidad proteica (cómputo químico >100) y alto aporte de fibra. La porción cubre el 11% de IDR de proteínas para niños. Los granos de kiwicha precocidos tuvieron: bajo contenido de amilosa y AR, alto contenido de fitoesteroles. La textura de las barras fue diferente según el método de pre-cocción utilizado en el grano de kiwicha. La incorporación de granos de kiwicha precocidos permitió obtener un producto alimenticio funcional de alto valor nutricional por su aporte proteico, fibra y fitoesteroles, destinado a diferentes momentos biológicos.

ABSTRACT In the present work, popped and laminated kiwicha (Amaranthus caudatus) grains were used as a functional ingredient to elaborate a bar intended for the child / pregnant / lactating, and general population. Therefore, the aim of this work was to evaluate its nutritional contribution, microbiological quality and texture of precooked grains and formulated bars. Two precooked kiwicha products were made: popped and laminated. The determinations were: quantification of amylose / amylopectin, resistant starch (RS), phytosterols, available lysine, protein quality and microbiological characterization. From these obtained products, kiwicha functional bars (with popped and laminated grains) were formulated and the following were determined: proximal composition and percentage of Daily Value (% DV), % of Reference Dietary Intake (% RDI) and the Texture Profile Analysis test was performed. The functional kiwicha bars presented a high caloric and protein intake (9.83-9.85 g/100 g), good protein quality (chemical count>100) and high fiber intake. The serving covers 11% of the protein RDI for children. Precooked kiwicha grains had: low amylose and RS content and high phytosterols content. The texture of the bars was different according to the pre-cooking method used in the kiwicha grain. The incorporation of precooked kiwicha grains allowed for the obtainment of a functional food product of high nutritional value due to its protein and phytosterols contribution, destined for different biological moments.

Newborn cystic fibrosis screening in southeastern Mexico: Birth prevalence and novel CFTR gene variants.

OBJECTIVE: To use the results of the first five years of a cystic fibrosis newborn screening program to estimate the cystic fibrosis birth prevalence and spectrum of cystic fibrosis transmembrane conductance regulator ( CFTR) gene variants in Yucatan, Mexico. METHODS: Screening was performed from 2010 to 2015, using two-tier immunoreactive trypsinogen testing, followed by a sweat test. When sweat test values were >30 mmol/L, the CFTR gene was analyzed. RESULTS: Of 96,071 newborns screened, a second sample was requested in 119 cases. A sweat test was performed in 30 newborns, and 9 possible cases were detected (seven confirmed cystic fibrosis and two inconclusive). The most frequently detected CFTR pathogenic variant (5/14 cystic fibrosis alleles, 35.7%) was p.(Phe508del); novel p.(Ala559Pro) and p.(Thr1299Hisfs*29) pathogenic variants were found. CONCLUSIONS: Cystic fibrosis birth prevalence in southeastern Mexico is 1:13,724 newborns. Immunoreactive trypsinogen blood concentration is influenced by gestational age and by the time of sampling. The spectrum of CFTR gene variants in Yucatan is heterogeneous.

[Acute asthma prevalence in children and teenagers from Merida, Yucatan, Mexico]. / Prevalencia de asma aguda en niños y adolescentes de Mérida, Yucatán, México.

OBJECTIVE: To quantify the number of asthma attacks treated in the emergency room of a public hospital and to study seasonal fluctuations. MATERIAL AND METHODS: A retrospective survey was conducted in the pediatrician emergency room of General Hospital Agustin O'Horan in Merida, Yucatan, Mexico during one year (January 1 to December 31st, 2005). A total of 7,674 emergency room consultations were registered during a period of one year. All patients were younger than 14 years old. RESULTS: Among the conditions treated, acute asthma (10.3%) was the third most common diagnosis. There were 622 children with asthma, 376 boys (60%). Most of the asthma consultations (22.6%) involved children of 1 year old of age. The consultation for asthma attacks increased in December (18.4%), October (14.1%) and September (12.2%). A significative association was found between the monthly number of emergency room visits due to acute asthma and upper respiratory infections (r = 0.9059, p = < 0.001, I.C. 99%). CONCLUSION: The acute asthma is one of the most frequent emergency consult causes in children and there was a positive association between acute asthma and upper respiratory infections.

Insuficiencia renal secundaria a litiasis urinaria en niños / Renal failure related to urolithiasis in children

Introducción. Debido a que la litiasis urinaria (LU) es endémica en Yucatán, es deseable conocer la prevalencia, cuadro clínico y alteraciones metabólicas de la insuficiencia renal (IR) secundaria a LU en niños. Material y métodos. Se registraron en forma prospectiva, pacientes con edad menor o igual a 15 años y diagnóstico de IR, ingresados de marzo de 2001 a febrero de 2006. Se seleccionaron los casos asociados a LU. Se registró la edad, sexo, condiciones de ingreso, localización de los litos, tratamiento médico y quirúrgico, complicaciones y evolución; aquéllos en los que revirtió la IR se les efectuaron pruebas metabólicas, al recuperarse la función renal. Resultados. Se captaron 104 pacientes con IR, en 13 se observó la asociación de IR con LU (8 mujeres y 5 hombres). La edad osciló entre 8 meses y 12 años; 10 pacientes fueron menores a 3 años. El signo predominante (9/13) fue anuria. Todos tuvieron litos múltiples. Diez pacientes sufrían algún grado de desnutrición. Un caso tuvo hipouricemia e hipouricosuria, 1 con hiperuricosuria (HUU) e hipercalciuria, 8 con HUU, en 3 no se pudo determinar la causa metabólica de la LU. Dos casos requirieron diálisis; 2, instalación de sondas de nefrostomía. Todos requirieron litotomía. Diez evolucionaron en forma satisfactoria, 2 con IR crónica y 1 falleció por urosepsis a pocas horas de su ingreso a urgencias. Conclusiones. La LU puede causar IR en niños y eventualmente llevar a la muerte. La HUU es la alteración metabólica predominante.

Introduction. Because urolithiasis (UL) in an endemic disease in the Yucatan peninsula, we carried out a prospective to study over a 5 year period to determine the prevalence, clinical course and metabolic disturbances of renal failure (RF) secondary to UL in children admitted to our institution. Material and methods. Patients 15 years old and younger, diagnosed with RF, and hospitalized from March 2001 to February 2006, were prospectively examined. Cases associated to UL were selected. Age, sex, hospitalization conditions, litho locus, medical and surgical treatment, complications, and evolution, were registered. Metabolic tests were performed in those in whom RF reverted, posterior to the recovery of renal function. Results. One hundred four patients with RF were detected; 13 cases (8 females and 5 males) had RF and UL. Age was between 8 months and 12 years old and 10 patients were registered to be less than 3 years old. Anuria was the principal clinical data. Every case had multiple stones. Some undernourishment degree was diagnosed in 10 patients. Hypouricemia and hypouricosuria were present in one case whereas hyperuricosuria and hypercalciuria were present in another; hyperuricosuria was found in 8 cases and the metabolic cause for UL in 3 cases could not be identified. Dialysis was required in 2 cases and nephrostomy probes were used in 2 more cases. All cases needed lithotomy. A satisfactory evolution was achieved in 10 patients and chronic RF developed in 2; one patient died due to urosepsis after few hours of been hospitalized in the emergency room. Conclusions. RF in children can be caused by UL and in some cases irreversible damage and even death can occur. Hyperuricosuria was the predominant metabolic alteration.

Behavior and orofacial characteristics of children with attention-deficit hyperactivity disorder during a dental visit.

ADHD is a neuropsychological disorder, affecting attention, impulsiveness and activeness. The study included 36 children with ADHD, 47 without, and two silent observers. A dental form, SNAP-IV and ADHDT symptom checklists were used. Statistically significant differences were observed in hospitalization histories, oral habits, tongue characteristics, and facial biotype. Differences in orofacial characteristics and behavior between the groups were confirmed.

Longitud radiográfica estimada y localización electrónica apical en endodoncia. Comparación de técnicas. (Clínicas de la Facultad de Odontología de la Universidad de El Salvador) / Estimated radiographic length and apical electronic location in endodontics. Techniques comparison. (Clinics of the Faculty of Dentistry of the University of El Salvador)

El objetivo general por el que se lleva a cabo este estudio; donde específicamente se busca determinar la longitud de trabajo de treinta piezas dentales indicadas para extracción, de pacientes que asisten a las instalaciones de dicha institución; primero, utilizando una radiografía preoperatoria se determinó la longitud del diente midiendo con una regla milimetrada el órgano dental en dicha radiografía, para establecer una medida provisional; y segundo haciendo uso de un Localizador Electrónico Apical, el cual permite obtener la longitud de trabajo de manera electrónica. Posteriormente, se extrajeron estas piezas, en su mayoría por problemas periodontales, y razones ortodónticas; para poder así determinar la posición de la lima dentro del conducto radicular en ambas técnicas, realizando cortes por desgaste siguiendo el eje longitudinal del diente, y así establecer una comparación entre los datos obtenidos en ambas técnicas. Del total de piezas multiradiculares analizadas se obtuvo un 69.23% con medida longitudinal adecuada utilizando Localizador Electrónico Apical, y un 21.74% con Longitud Radiográfica Estimada. Además, en las piezas monoradiculares analizadas el 80% presentó medida de trabajo adecuada utilizando Localizador Electrónico Apical y un 28.57% con Longitud Radiográfica Estimada. Dichos resultados fueron analizados por medio de cuadros de frecuencias. En base a los resultados antes mencionados se concluye que al utilizar correctamente el Localizador Electrónico Apical se pueden obtener medidas más exactas en la toma de la conductometria para garantizar mejores resultados en los tratamientos de conductos radiculares.

The general objective for which this study is carried out; where it is specifically sought to determine the working length of thirty dental pieces indicated for extraction, of patients who attend the facilities of said institution; First, using a preoperative X-ray, the length of the tooth was determined by measuring the dental organ in said X-ray with a millimeter ruler, to establish a provisional measurement; and second by making use of an Apical Electronic Locator, which allows to obtain the working length electronically. Later, these pieces were extracted, mostly due to periodontal problems and orthodontic reasons; in order to thus determine the position of the file within the root canal in both techniques, making wear cuts following the longitudinal axis of the tooth, and thus establish a comparison between the data obtained in both techniques. Of the total multiradicular pieces analyzed, 69.23% were obtained with adequate longitudinal measurement using the Electronic Apical Locator, and 21.74% with Estimated Radiographic Length. In addition, in the single-rooted pieces analyzed, 80% presented adequate work measurement using the Electronic Apical Locator and 28.57% with Estimated Radiographic Length. Said results were analyzed by means of frequency tables. Based on the aforementioned results, it is concluded that by using the Electronic Apical Locator correctly, more exact measurements can be obtained in taking the conductometry to guarantee better results in root canal treatments.