A Surgical Complexity Factor for Clefts of Primary and Secondary Palates.

The surgical treatment of patients with cleft lip and palate depends on the characteristics of the affected anatomical structures (palate, lip and nose). The objective of this work was to develop a quantified classification for these clefts, to represent their surgical complexity. This work was developed with the team of surgeons of the SUMA Cleft Leadership Center (CLC) Smile Train Mexico. The method of Multiple-Criteria Decision Analysis was applied using the Analytic Hierarchy Approach. A surgical complexity factor associated with each cleft was defined and it was validated in a sample of fifty patients treated at the SUMA-CLC.Clinical Relevance- A quantitative classification that represents the surgical complexity of clefts provides an objective unified criteria for planning the surgical treatment of patients, as well as having standardized procedures for the surgical treatment of patients.

[Tumors that cause bone metastases]. / Tumores que producen metástasis óseas.

INTRODUCTION: A metastasis is the tumor cell capacity to migrate from the primary tumor and implant itself in tissues of an organ at a distance by hematogenous, lymphatic or contiguity. The main causes of bone metastases are: breast, prostate and lung cancer. It usually occurs in patients over 50 years of age. There is a predilection for metastasizing to the axial skeleton. OBJECTIVE: To determine the frequency of tumors that produce bone metastases in our institution. MATERIAL AND METHODS: Observational, cross-sectional, descriptive study, for retrospective analysis of the cases of patients diagnosed with bone metastases. RESULTS: 193 cases; 121 women and 72 men with an age range of 42 to 84 years. Cancers associated with bone metastases were breast, lung, prostate, cervical and renal cancers; to a lesser extent other such as colon, thyroid, liver and skin. The most affected bones were axial skeleton: lumbar and dorsal spine, and in appendicular skeleton the femur in the diaphysiary region and in the humerus the proximal third. At present it has not been possible to improve the effectiveness of timely detection strategies, so bone pain should begin with a protocol of tumor suspicion. CONCLUSIONS: More than 80% of the patients came for fracture. All patients had a history of pain greater than 12 months with no prior study protocol.

INTRODUCCIÓN: Una metástasis es la capacidad celular tumoral para migrar del tumor primario e implantarse en tejidos de un órgano a distancia por vía hematógena, linfática o contigüidad. Las principales causas de metástasis óseas son: cáncer de mama, próstata y pulmón. Habitualmente se da en pacientes mayores de 50 años. Existe predilección por metastatizar al esqueleto axial. OBJETIVO: Determinar la frecuencia de los tumores que producen metástasis óseas en nuestra institución. MATERIAL Y MÉTODOS: Estudio observacional, transversal, descriptivo, para análisis retrospectivo de los casos con diagnóstico de metástasis ósea. RESULTADOS: Ciento noventa y tres casos; 121 mujeres y 72 hombres con rango de edad de 42 a 84 años. Los cánceres asociados a metástasis ósea fueron cáncer de mama, pulmón, próstata, cervicouterino y renal; en menor proporción otros como colon, tiroides, hígado y piel. Los huesos más afectados fueron esqueleto axial: columna lumbar y dorsal; en esqueleto apendicular el fémur en la región diafisaria y en el húmero el tercio proximal. En la actualidad, no se ha logrado mejorar la efectividad de estrategias de detección oportuna, por lo que los cuadros de dolor óseo deben iniciar con un protocolo de sospecha tumoral. CONCLUSIONES: Más de 80% de los pacientes acudieron por fractura. Todos tenían historial de dolor mayor a 12 meses sin protocolo de estudio previo.

Tumores que producen metástasis óseas / Tumors that cause bone metastases

Resumen: Introducción: Una metástasis es la capacidad celular tumoral para migrar del tumor primario e implantarse en tejidos de un órgano a distancia por vía hematógena, linfática o contigüidad. Las principales causas de metástasis óseas son: cáncer de mama, próstata y pulmón. Habitualmente se da en pacientes mayores de 50 años. Existe predilección por metastatizar al esqueleto axial. Objetivo: Determinar la frecuencia de los tumores que producen metástasis óseas en nuestra institución. Material y métodos: Estudio observacional, transversal, descriptivo, para análisis retrospectivo de los casos con diagnóstico de metástasis ósea. Resultados: Ciento noventa y tres casos; 121 mujeres y 72 hombres con rango de edad de 42 a 84 años. Los cánceres asociados a metástasis ósea fueron cáncer de mama, pulmón, próstata, cervicouterino y renal; en menor proporción otros como colon, tiroides, hígado y piel. Los huesos más afectados fueron esqueleto axial: columna lumbar y dorsal; en esqueleto apendicular el fémur en la región diafisaria y en el húmero el tercio proximal. En la actualidad, no se ha logrado mejorar la efectividad de estrategias de detección oportuna, por lo que los cuadros de dolor óseo deben iniciar con un protocolo de sospecha tumoral. Conclusiones: Más de 80% de los pacientes acudieron por fractura. Todos tenían historial de dolor mayor a 12 meses sin protocolo de estudio previo.

Abstract: Introduction: A metastasis is the tumor cell capacity to migrate from the primary tumor and implant itself in tissues of an organ at a distance by hematogenous, lymphatic or contiguity. The main causes of bone metastases are: breast, prostate and lung cancer. It usually occurs in patients over 50 years of age. There is a predilection for metastasizing to the axial skeleton. Objective: To determine the frequency of tumors that produce bone metastases in our institution. Material and methods: Observational, cross-sectional, descriptive study, for retrospective analysis of the cases of patients diagnosed with bone metastases. Results: 193 cases; 121 women and 72 men with an age range of 42 to 84 years. Cancers associated with bone metastases were breast, lung, prostate, cervical and renal cancers; to a lesser extent other such as colon, thyroid, liver and skin. The most affected bones were axial skeleton: lumbar and dorsal spine, and in appendicular skeleton the femur in the diaphysiary region and in the humerus the proximal third. At present it has not been possible to improve the effectiveness of timely detection strategies, so bone pain should begin with a protocol of tumor suspicion. Conclusions: More than 80% of the patients came for fracture. All patients had a history of pain greater than 12 months with no prior study protocol.

Rheological effects of high substitution levels of fats by inulin in whole cassava dough: chemical and physical characterization of produced biscuits.

Inulin has been used as a fat substitute in baked goods due to its gelling properties and functionality. However, it usually has been done in low substitution levels. The aim of this study was to evaluate the effect in rheological parameters in cassava dough caused by high substitution levels of fats by inulin. Physical and chemical characterization of biscuits were done for evaluation of dough's potential usage in bakery products. Substitution of mozzarella cheese by inulin showed that up to 12.5 g inulin per 100 g cassava flour led to a lower storage modulus, suggesting bakery potential for bread like products. Higher substitutions (25 g, 37.5 g, and 50 g per 100 g cassava flour) led to a higher storage modulus and suggest a potential for cookies and similar products. Hardness results obtained support rheological ones, suggesting higher substitution levels are suitable for cookies and similar products. This is inferred by observing an increase in hardness ranging from 5.80 N up to 17.47 N. Cassava dough with fat substituted by inulin in high levels, has potential in the development of different baked goods.

Tumores benignos que producen fracturas en niños / Benign tumors that cause fractures in children

Resumen: Introducción: Se define fractura patológica a la que se produce a través de un hueso anormal. Cada año se diagnostican aproximadamente 20,000 neoplasias benignas del sistema musculoesquelético. A menudo, el dolor de la fractura es el primer síntoma de un proceso patológico en el hueso. El sitio, la edad y la apariencia radiográfica crean un diagnóstico diferencial para las fracturas patológicas que sigue siendo amplio. El examen clínico evalúa la condición de la piel, palpar cualquier masa de tejido y determinar si hay signos inflamatorios locales como eritema, calor o edema. La toma de biopsia es muy recomendable para confirmar el diagnóstico de una fractura patológica. Objetivo: Determinar qué tumores óseos benignos y qué lesiones seudotumorales producen fracturas en huesos de niños con mayor frecuencia en nuestro hospital. Material y métodos: Estudio retrospectivo transversal, se revisaron expedientes de pacientes con diagnóstico de fractura en terreno patológico, atendidos en el período de Marzo de 2013 a Marzo de 2017. Resultados: Los tumores benignos que ocasionaron fracturas en terreno previamente dañado fueron: quiste óseo aneurismático 13, encondroma cinco, osteoma osteoide tres, tumor de células gigantes dos. Conclusión: En nuestra institución, los quistes óseos aneurismáticos fueron los tumores benignos que con mayor frecuencia producen fracturas patológicas en niños, con predominio en el sexo masculino.

Abstract: Introduction: A pathological fracture is defined as that which occurs through an abnormal bone. Approximately 20,000 benign neoplasms of the musculoskeletal system are diagnosed each year. Often the pain of the fracture is the first symptom of a pathological process in the bone. The site, age and radiographic appearance create a differential diagnosis for pathological fractures that remains broad. The clinical examination evaluates the condition of the skin, palpating any tissue mass and determining if there are local inflammatory signs such as erythema, heat or edema. The biopsy is highly recommended to confirm the diagnosis of a pathological fracture. Objective: To determine which benign bone tumors and pseudotumoral lesions produce fractures in children's bones more frequently in our institution. Material and methods: Cross-sectional retrospective study, review of records of patients with diagnosis of pathological fracture, attended in the period from March 2013 to March 2017, were reviewed. Results: The benign tumors that caused fractures in previously damaged areas were: aneurysmal bone cyst 13, enchondroma 5, osteoid osteoma 3, giant cell tumor 2. Conclusion: At our institution, aneurysmal bone cysts were the benign tumors that most frequently produce pathological fractures in children, with predominance in males.

Potential functional bakery products as delivery systems for prebiotics and probiotics health enhancers.

Several health benefits have been associated to probiotics and prebiotics, most of these are involved in the regulation of the host's gut microbiome. Their incorporation to diverse food products has been done to develop potential functional foods. In the case of bakery products, their incorporation has been seen to improve several technological parameters such as volume, specific volume, texture along with sensorial parameters such as flavor and aroma. Scientific literature in this topic has been divided in three main research branches: nutrition, physical quality and sensory analyzes, however, studies rarely cover all of them. Due to the harsh thermal stress during baking, sourdough technology along with microencapsulation of probiotics, has been studied as an alternative to enhance its nutritional values and increase cell viability, though in few occasions. The potential functional baked goods have maintained acceptable physical characteristics and sensorial acceptability, while in some cases an improvement is seen due to the effect of probiotics and prebiotics. The results obtained from several studies done, have shown the viability of developing functional bakery products by applying prebiotics or probiotics. This could be used as an encouragement for more research to be done in this topic.

Comparison of Single, Averaged, and Pooled Urine Protein:Creatinine Ratios in Proteinuric Dogs Undergoing Medical Treatment.

BACKGROUND: Monitoring urine protein:creatinine ratios (UPC) in dogs with protein-losing nephropathy (PLN) is challenging because of day-to-day variation in UPC results. HYPOTHESIS/OBJECTIVES: Determine whether single, averaged, or pooled samples from PLN dogs receiving medical treatment yield comparable UPCs, regardless of degree of proteinuria. ANIMALS: Twenty-five client-owned PLN dogs receiving medical treatment. METHODS: UPC ratios were prospectively measured in each dog utilizing 3 methods: single in-hospital sample (day 3), average sample (days 1-3), and pooled sample (equal pooling of urine from days 1-3). Bland-Altman analysis was performed to evaluate agreement between methods for all dogs, as well as in subgroups of dogs (UPC ≤4 or UPC >4). RESULTS: For all dogs, Bland-Altman log-transformed 95% limits of agreement were -0.07-0.18 (single versus pooled UPC), -0.06-0.16 (single versus average UPC), and -0.06-0.04 (pooled versus average UPC). For dogs with UPC ≤4, Bland-Altman 95% limits of agreement were -0.42-0.82 (single versus pooled UPC), -0.38-0.76 (single versus average UPC), and -0.27-0.25 (pooled versus average UPC). For dogs with UPC >4, Bland-Altman 95% limits of agreement were -0.17-2.4 (single versus pooled UPC), -0.40-2.2 (single versus average UPC), and -0.85-0.43 (pooled versus average UPC). CONCLUSIONS AND CLINICAL IMPORTANCE: UPC ratios from all methods were comparable in PLN dogs receiving medical treatment. In PLN dogs with UPC >4, more variability between methods exists likely because of higher in-hospital results, but whether this finding is clinically relevant is unknown.

[Benign tumors that cause fractures in children]. / Tumores benignos que producen fracturas en niños.

INTRODUCTION: A pathological fracture is defined as that which occurs through an abnormal bone. Approximately 20,000 benign neoplasms of the musculoskeletal system are diagnosed each year. Often the pain of the fracture is the first symptom of a pathological process in the bone. The site, age and radiographic appearance create a differential diagnosis for pathological fractures that remains broad. The clinical examination evaluates the condition of the skin, palpating any tissue mass and determining if there are local inflammatory signs such as erythema, heat or edema. The biopsy is highly recommended to confirm the diagnosis of a pathological fracture. OBJECTIVE: To determine which benign bone tumors and pseudotumoral lesions produce fractures in childrens bones more frequently in our institution. MATERIAL AND METHODS: Cross-sectional retrospective study, review of records of patients with diagnosis of pathological fracture, attended in the period from March 2013 to March 2017, were reviewed. Results: The benign tumors that caused fractures in previously damaged areas were: aneurysmal bone cyst 13, enchondroma 5, osteoid osteoma 3, giant cell tumor 2. CONCLUSION: At our institution, aneurysmal bone cysts were the benign tumors that most frequently produce pathological fractures in children, with predominance in males.

INTRODUCCIÓN: Se define fractura patológica a la que se produce a través de un hueso anormal. Cada año se diagnostican aproximadamente 20,000 neoplasias benignas del sistema musculoesquelético. A menudo, el dolor de la fractura es el primer síntoma de un proceso patológico en el hueso. El sitio, la edad y la apariencia radiográfica crean un diagnóstico diferencial para las fracturas patológicas que sigue siendo amplio. El examen clínico evalúa la condición de la piel, palpar cualquier masa de tejido y determinar si hay signos inflamatorios locales como eritema, calor o edema. La toma de biopsia es muy recomendable para confirmar el diagnóstico de una fractura patológica. OBJETIVO: Determinar qué tumores óseos benignos y qué lesiones seudotumorales producen fracturas en huesos de niños con mayor frecuencia en nuestro hospital. MATERIAL Y MÉTODOS: Estudio retrospectivo transversal, se revisaron expedientes de pacientes con diagnóstico de fractura en terreno patológico, atendidos en el período de Marzo de 2013 a Marzo de 2017. RESULTADOS: Los tumores benignos que ocasionaron fracturas en terreno previamente dañado fueron: quiste óseo aneurismático 13, encondroma cinco, osteoma osteoide tres, tumor de células gigantes dos. CONCLUSIÓN: En nuestra institución, los quistes óseos aneurismáticos fueron los tumores benignos que con mayor frecuencia producen fracturas patológicas en niños, con predominio en el sexo masculino.

Estudio antropométrico en una población infantil con síndrome de Down / Anthropometric survey on children with Down syndrome

Objetivo. Estudio de los valores antropométricos registrados en las historias clínicas de un grupo representativo de pacientes en edad pediátrica en la Unidad de Síndrome de Down del Servicio de Pediatría del Hospital Clínico Universitario de Valencia, entre los años 2000 y 2014, inclusive. Pacientes y métodos. Estudio observacional descriptivo en una muestra de 140 pacientes de entre 1 y 13 años. La muestra se configuró a partir de los criterios de inclusión y de exclusión. Se extrajeron del informe de la primera visita, los datos relevantes referentes al nacimiento y, de las visitas sucesivas (643 mediciones), el estado del paciente en dicho momento. Resultados. Se estudiaron 103 pacientes con síndrome de Down portadores de trisomía regular, que superaron los criterios de inclusión y exclusión, cuya distribución por sexos corresponde a 59 (57%) niños y 44 (43%) niñas. Posteriormente, se analizaron, obteniendo percentiles. Discusión. Se comparó la mediana con aquella de los percentiles propuestos por la Fundación Catalana Síndrome de Down. Conclusiones. Presentamos un estudio observacional con las mediciones antropométricas de una muestra de pacientes menores con síndrome de Down de la población valenciana. Las medidas han sido inferiores a las de la población general, pero similares a las de los pacientes del estudio de la Fundación Catalana Síndrome de Down. Se reafirma la necesidad de continuar empleando unas tablas percentiladas propias para la población con síndrome de Down, siendo necesaria una revisión periódica de dichas tablas (AU)

Objective. Study of anthropometric values in the medical records of a representative group of paediatric patients with Down Syndrome, from the Down Syndrome Unit of the Paediatric Department of Valencia's Hospital Clínico Universitario, from 2000 to 2014. Patients and methods. Descriptive observational study in a group of 140 patients between 1 and 13 years. The group was configured based on the inclusion and exclusion criteria. We extracted data about birth from their first visit, and subsequently patient data at the time of each visit (643 measurements). Results. 103 patients with regular trisomy of Down syndrome were recorded and studied. There were 59 (57%) boys and 44 (43%) girls. The records were then analysed and percentiles were calculated. Discussion. The median was compared to that of percentiles from the Catalan Down Syndrome Foundation. Conclusions. We present an observational study with anthropometric measurements of a group of Down syndrome children from Valencia. Measurements were lower than those of the WHO for the general population, but similar to those recorded by the Catalan Down Syndrome Foundation. The need to continue using customised Down Syndrome percentiles is reaffirmed, with periodic review of these tables (AU)

Health care utilization and costs of a support program for patients living with the human immunodeficiency virus and tuberculosis in Peru.

OBJECTIVE: To evaluate a support program for patients co-infected with the human immunodeficiency virus and tuberculosis in terms of its impact on clinical outcomes and resource utilization. METHODS: We compared co-infected patients receiving Community-Based Accompaniment with Supervised Antiretrovirals (CASA) with matched patients receiving standard of care (control group) in two health districts of Lima, Peru. We recorded clinical outcomes, costs of the intervention, and health care utilization by each patient during 24 months of follow-up. RESULTS: There were 33 patients in each group, representing 58.0 person-years (py) in the CASA group and 45.6 py in the control group. At 24 months of follow-up, the CASA group had a lower hazard of dying or defaulting from treatment (HR adj 0.34, 95%CI 0.12-0.98), experienced fewer hospital days (IRR adj 0.37, 95%CI 0.14-0.99) and had fewer out-patient visits (IRR adj 0.75, 95%CI 0.63-0.89). Assigning costs to significantly different measures of health care utilization using WHO-CHOICE (World Health Organization-Choosing interventions that are cost effective) data, CASA was associated with savings of US$551/py. Considering intervention costs of US$2097/py, the net costs of CASA were US$1546/py. CONCLUSIONS: Our intervention was associated with clinical improvements and reduced health care utilization, which significantly offset the cost of the intervention over 2 years of follow-up.

Efectividad de una intervención en educación alimentaria y actividad física para prevenir obesidad en escolares de la ciudad de Casablanca, Chile (2003-2004) / Effectiveness of a dietary and physical activity intervention to prevent obesity in school age children

Background: With the aim of contributing to he Healthy Goal 2010 of reducing significantly the prevalence of childhood obestiy we developed and implemented during 2003 and 2004, a school-based obesity prevention intervention which included nutrition education and the promotion of physical activity. Aim To report the results of the intervention. Material and methods: The sample included 1760 children (1st to 7th grade) from 3 elementary public schools in Casablanca (experimental group) and 671 from a similar school located in Quillota, a neighboring city (control). Primary outcomes were body mass index (BMI) Zscore, the mile and shuttle-run tests and obesity prevalence. We also compared changes in waist circumference and triceps skinfold between both groups. Effectiveness of the intervention was assessed by analyzing separately the group *age* time interaction for the first 3 outcomes (follow-up-baseline), using a mixed model of covariance and by comparing variations in obesity prevalence between both groups. Results: There was a significant decline in BMI Z scores in experimental schools for both genders, but greater in boys (p <0.001 versus p =0.0034 in girls), while in controls, BMI Z scores increased. Obesity prevalence declined significantly in experimental schools; from 17 to 12.3 percent and from 14.1 to 10.3 percent in boys and girls respectively, while in the control group, it remained unchanged. Also, triceps skinfold in girls from Casablanca increased significantly ¡ess than that of control girls. Conclusion: This intervention proved that it is possible to reduce significantly the prevalence of obesity in Chilean schoolchildren attending public elementary schools.

[Acral eruptive nevi after chemotherapy in children with acute lymphoblastic leukemia]. / Nevos acrales eruptivos tras quimioterapia en niños afectados de leucemia linfoblástica aguda.

Eruptive melanocytic nevi have mainly been associated with blistering cutaneous diseases and with immunosuppression, particularly after renal allograft transplantation, hematological neoplasms, or HIV infection. Thus, immunosuppression has been suggested to increase the possibility of melanocyte proliferation. We report two cases of children with acute lymphoblastic leukemia who, after receiving chemotherapy, developed severe motor polyneuropathy, and sudden onset of multiple melanocytic nevi on the soles.

Nevos acrales eruptivos tras quimioterapia en niños afectados de leucemia linfoblástica aguda / Acral eruptive nevi after chemotherapy in children with acute lymphoblastic leukemia

La aparición repentina de múltiples nevos melanocíticos se ha relacionado fundamentalmente con enfermedades ampollosas cutáneas y con estados de inmunosupresión, especialmente tras trasplante renal alogénico, neoplasias hematológicas, o asociados a infección por el virus de la inmunodeficiencia humana. Por este motivo, se ha sugerido que la inmunosupresión favorecería la proliferación de los melanocitos. Describimos 2 casos de niños afectados por una leucemia linfoblástica aguda que, tras recibir quimioterapia, sufrieron una severa polineuropatía motora y la aparición súbita de múltiples nevos melanocíticos, fundamentalmente de localización plantar

Eruptive melanocytic nevi have mainly been associated with blistering cutaneous diseases and with immunosuppression, particularly after renal allograft transplantation, hematological neoplasms, or HIV infection. Thus, immunosuppression has been suggested to increase the possibility of melanocyte proliferation. We report two cases of children with acute lymphoblastic leukemia who, after receiving chemotherapy, developed severe motor polyneuropathy, and sudden onset of multiple melanocytic nevi on the soles

Estrategia de promoción de la salud en escolares de educación básica municipalizada de la comuna de Casablanca, Chile / School-based health promotion intervention for primary school children from Casablanca, Chile

Se diseñó, implementó durante tres años (de 2002 a 2004) y evaluó una intervención en alimentación/nutrición y actividad física en escolares de educación básica de Casablanca. El objetivo general fue determinar la evolución en la prevalencia de obesidad en los mismos niños durante los tres años del estudio. La muestra incluyó 1103 escolares que en el 2002 estaban entre 1º a 6º básico en las tres escuelas municipales de la ciudad y que contaban con mediciones durante el período completo. Los componentes más importantes de la intervención incluyeron la aplicación de programa educativo FAO/INTA, charlas a los padres, aumento de las clases de educación física y un programa motivacional de actividad física. Los resultados muestran que la prevalencia de obesidad fue muy alta al inicio y que disminuyó de 21,6 por ciento a 12,2 por ciento en hombres y de 19,4 por ciento a 8,7 por ciento en mujeres. Este mismo análisis según categoría de edad al inicio y sexo, mostró una disminución a un tercio de la prevalencia original en mujeres que tuvieron entre 8 y 10 años y hombres entre 10 y 12 años al comienzo del estudio. Esta intervención fue exitosa en reducir significativamente la obesidad en escolares.

We designed, implemented during three years (from 2002 to 2004) and evaluated a school-based food/nutrition and physical activity intervention for primary school children from Casablanca, Chile. The general objective was to determine the trend in obesity prevalence during the three years of study of children followed longitudinally. The sample included 1103 children that attended 1st to 6th grade in 2002 in the three existing public primary schools of the city. The most important components of the intervention included the application of a educational program for primary school children developed by FAO/INTA, educational sessions for parents, increase in the number of physical (PE) education classes and a motivational PE program. Results showed that the baseline obesity prevalence was very high and decreased from 21.6 percent to 12.2 percent in boys and from 19.4 percent to 8.7 percent in girls. This same analysis done by age category at baseline and sex, showed that the prevalence was one third of the initial one in girls aged 8 to 10 years and boys aged 10 to 12 years at baseline. This intervention proved to decrease significantly the obesity prevalence among school children.

Estado nutricional y resistencia aeróbica en escolares de educación básica: línea base de un Proyecto de Promoción de la Salud / Nutritional status and aerobic capacity among children attending public elementary schools in Chile

Background: The Chilean Ministry of Health has developed a health promotion program called «Vida Chile¼, whose aim is to target risk factors for chronic diseases. To achieve this, school-based initiatives in nutrition and physical activity have been implemented. The evaluation of these initiatives includes a baseline assessment of these two variables. Aim: Baseline assessment of the nutritional status and aerobic capacity of elementary school children (1st to 8th grade). Material and methods: Children from seven public schools were studied. Weight, height, triceps skinfold thickness and waist circumference were measured. To test the aerobic capacity, the 20-m Shuttle Run Test (Navette) was utilized. Results: The assessment included 4,271 children, mean age was 10.2 years. The percentile of body mass index, as compared to the CDC 2000 Reference was 67.8±26.7 and 68±26.7 for boys and girls, respectively. The prevalence of obesity among children from 6 to 8 years, was 20.3 and 17.7% for boys and girls, respectively. Approximately 30% of males and 15% of females with normal weight had a good aerobic resistance, compared to 15 and 4% of their overweight counterparts. Aerobic capacity decreased with increasing age. Conclusions: There is a high prevalence of obesity and a deficient level of aerobic capacity among children attending public schools in Chile.

Deficiencia de IgA / IgA deficiency

El déficit selectivo de IgA es la forma más leve de inmunodeficiencia primaria. En la mayoría de estos niños, si no hay una enfermedad asociada, el pronóstico es excelente. Muchos de los deficientes, diagnosticados o no, continuarán su vida sin ningún tipo de problema. Sin embargo otros tienen abundantes problemas porque la deficiencia aislada de IgA puede asociarse con enfermedades como alergia, enfermedades con base autoinmune (enfermedad celíaca, hipotiroidismo, colagenosis, etc.). Por tanto, en la deficiencia de IgA que se asocia a otras enfermedades, el pronóstico lo marca la enfermedad a la que se asocia. Algunos niños con deficiencia selectiva de IgA presentan recuperaciones espontáneas. Estos niños son subsidiarios de seguimiento para la detección temprana de los trastornos y las complicaciones concomitantes (AU)

Paciente neutropénico / No disponible

No disponible

School-based obesity prevention in Chilean primary school children: methodology and evaluation of a controlled study.

OBJECTIVE: To assess the impact of a 6 months nutrition education and physical activity intervention on primary school children through changes in adiposity and physical fitness. DESIGN: Longitudinal school-based controlled evaluation study. SUBJECTS: Children from 1st to 8th grade, 2141 in intervention and 945 in control schools. INTERVENTION: Nutrition education for children and parents, 'healthier' kiosks, 90 min of additional physical activity (PA) weekly, behavioral PA program and active recess. MEASUREMENTS: Adiposity indices (BMI, BMI Z-score, triceps skinfold thickness (TSF), waist circumference and physical fitness (20 m shuttle run test and lower back flexibility). RESULTS: Positive effect on adiposity indices (except TSF) was observed in boys (P<0.001 for BMI Z), while both physical fitness parameters increased significantly in both boys (P<0.001 for each test) and girls (P<0.0001 for each test). A differential effect in BMI Z was observed according to baseline nutritional status. CONCLUSIONS: This intervention showed a robust effect on physical fitness in both genders and decreased adiposity only in boys.

[Arterial gas embolism progressing to a massive stroke]. / Embolismo gaseoso arterial con evolución a accidente cerebrovascular masivo.

INTRODUCTION: Arterial gas embolism (AGE) is a main iatrogenic complication resulting from the use of invasive procedures. It is difficult to diagnose if it is not clinically suspected. CASE REPORT: A 67-year-old male patient, with a history of interventions involving a mitral prosthesis and a double aortocoronary bypass, who visited Emergency room with symptoms of a high temperature and general malaise. He was canalised peripherally and the electrocardiogram (ECG) showed an auricular fibrillation that had already been detected. While under observation he suffered a loss of consciousness, generalised hypotonia, conjugated gaze deviation towards the right, lower left facial paralysis and left Babinski positive. A new ECG showed ST segment elevation in V2-V5. A cranial computerised tomography (CAT) scan with no contrast revealed a number of serpiginous images caused by the presence of air in vascular structures. A second cranial CAT scan showed the disappearance of the visible air and signs of ischemic stroke in the territory of the right middle and posterior cerebral arteries and the left middle cerebral artery. Clinical-radiological findings suggested an AGE in the brain with massive stroke and acute myocardial infarct with similar causation. CONCLUSIONS: It is not clear what caused the air embolism in this patient but it can most probably be explained by air accidentally entering a peripheral vein. Carrying out an early cranial CAT scan can provide us with a diagnosis and a later CAT scan can evaluate the consequences of the embolism.