Protective effects of Yerba mate (IIex paraguariensis) on prostate cancer development.

OBJECTIVES: Prostate cancer (PCa) is the most common adenocarcinoma in men >50 y of age. It has a long latency period, which provides time for preventive strategies like incorporating healthy eating habits. Yerba mate (YM) intake has been associated with numerous health benefits. Since YM is one of the most popular infusions in Argentina, the of this study was to examine the influence of YM on PCa development. METHODS: We carried out an in vivo model of PCa through subcutaneous inoculation of transgenic adenocarcinoma of the mouse prostate-C1 cells in C57BL/6 mice. Subsequently, the animals were divided into two groups: mate (25 mg/mL of YM in drinking water, n = 15), and control (only drinking water, n = 15). We also developed an in vitro model to study the direct effects of YM on three human PCa cell lines: lymph node carcinoma of the prostate (LNCaP), PC-3, and DU-145. RESULTS: Our in vivo model showed that YM intake slightly reduced body weight, increased the latency of tumor appearance (P <0.01), and diminished the tumor volume (P <0.05) compared with the control group. In agreement, the expression of proliferating cell nuclear antigen, and nuclear estrogen receptor α were lower in the tumors of the mate animals (P <0.05). In vitro, YM decreased the viability, proliferation, and adhesion of the three tumor cell lines (P < 0.001) and retarded the migration of LNCaP (P <0.05) and DU-145 (P <0.005), without modifying the migration of PC-3 cells. CONCLUSIONS: YM showed anticancer effects in vitro and in vivo and were more effective on the androgen-sensitive cell line (LNCaP).

NADES blend for bioactive coating design as a sustainable strategy for postharvest control.

Bioactive functional coatings constitute a trendy topic due to they reduce postharvest fruit losses worldwide. Also, they could be carriers of biocompounds providing health benefits to the consumer. In this work, an innovative natural bioactive coating based on Natural Deep Eutectic Solvents (NADES) and Larrea divaricata extract was optimized by mixture-mixture design for the management of postharvest diseases caused by Monilinia fructicola. A NADES composed of lactic acid-glucose-water (LGH) for phenolic extraction from L. divaricata was optimized by a Simplex Lattice design and response surface methodology (RSM).Then, a d-optimal mixture-mixture design was carried out in order to optimize the bioactive coating composition, being the optimal proportion of 0.7 L. divaricata-LGH extract and 0.3 NADES plasticizer (composed by glycerol, citric acid and water). The optimal biocoating achieved an in vitro antimicrobial activity of 72 % against M. fructicola. Interestingly, NADES plasticizer improves the biocoating functionality, creating a smooth and uniform surface.

Evaluación de la genotoxicidad de extractos acuosos de hojas de Moringa oleifera Lam. (Moringaceae) utilizando el test de Allium cepa / Evaluation of the genotoxicity of aqueous extracts of Moringa oleifera Lam. (Moringaceae) leaves using the Allium cepa test

Actualmente el uso corriente de plantas medicinales para el tratamiento de las diferentes afecciones se ha incrementado y en la mayoría de los casos se comercializan sin previos estudios de toxicidad. M. oleifera es un árbol distribuido en zonas tropicales y subtropicales, muy utilizado en la medicina tradicional para tratar múltiples afecciones. En el marco del Proyecto de Investigación incentivado 16Q626 "Evaluación de la Genotoxicidad de Extractivos de Especies Medicinales de uso corriente para las afecciones más frecuentes en la Ciudad de Posadas Provincia de Misiones Argentina", en esta instancia se propuso analizar la genotoxicidad de extractos acuosos de M. oleifera por medio del test de Allium cepa. El experimento consistió en dos etapas, donde además de determinar la concentración que detiene el crecimiento de las raíces un 50% en comparación con los controles y las anomalías macroscópicas, se buscaron los biomarcadores predeterminados de genotoxicidad (cromosomas rezagados, c-mitosis, anafase puente, etc) a concentraciones iguales o superiores a la concentración 50. Las concentraciones más elevadas probadas mostraron mayor inhibición de la mitosis con respecto a los controles, pero no se encontraron efectos genotóxicos, aunque las concentraciones utilizadas en el experimento, no son usuales de M. oleífera en la medicina tradicional.

Currently the current use of medicinal plants for the treatment of different conditions has increased and in most cases they are commercialized without previous toxicity studies. M. oleifera is a tree distributed in tropical and subtropical zones, widely used in traditional medicine to treat multiple conditions. Within the framework of the Research Project incentivized 16Q626 "Evaluación de la Genotoxicidad de Extractivos de Especies Medicinales de uso corriente para las afecciones más frecuentes en la Ciudad de Posadas Provincia de Misiones Argentina", in this instance it was proposed to analyze the genotoxicity of aqueous extracts of M. oleifera by means of the Allium cepa test. The experiment consisted of two stages, where in addition to determining the concentration that stops the growth of the roots by 50% in comparison with the controls and the macroscopic anomalies, the predetermined biomarkers of genotoxicity (lagged chromosomes, c-mitoses, anaphase bridge, etc.) at concentrations equal to or greater than the concentration 50. The highest concentrations tested showed greater inhibition of mitosis with respect to the controls, but no genotoxic effects were found, although the doses used in the experiment are not usual doses of M. oleifera in traditional medicine .

NADES-mediated folk plant extracts as novel antifungal agents against Candida albicans.

Candida albicans is an opportunistic pathogenic yeast commonly found in mouth, gastrointestinal tract and vagina. Under certain conditions, it causes skin, mucosal and systemic infections. With growing concern over the emergence of resistant strains to conventional antifungals, the development of novel antifungal agents for the management of this pathogen is an urgent need. In the present work, novel bioextracts from folk medicinal plants were directly used as active ingredient in a topical formulation for dermal candidiasis. With the aim to replace hazardous traditional reagents, a natural solvent composed by lactic acid: glucose: water (LGH) was used as vehicle for bioactive compound extraction. Furthermore, phenolic and alkaloid composition were determined by HPLC and their individual antifungal effect was evaluated. LGH extracts of Larrea spices demonstrate a significant antimicrobial activity against C. albicans being higher than their individual bioactive constituents. Notably, the mixture of Larrea cuneifolia and L divaricata extracts in topical formulations reveal a synergistic antifungal effect highlighting their potential for candidiasis treatment.

Natural deep eutectic solvents-mediated extractions: The way forward for sustainable analytical developments.

The concept of sustainable development has impacted in analytical chemistry changing the way of thinking processes and methods. It is important for analytical chemists to consider how sample preparation can integrate the basic concepts of Green Chemistry. In this sense, the replacement of traditional organic solvents is of utmost importance. Natural Deep Eutectic Solvents (NADES) have come to light as a green alternative. In the last few years, a growing number of contributions have applied these natural solvents proving their efficiency in terms of extraction ability, analyte stabilization capacity and detection compatibility. However, the arising question that has to be answered is: the use of NADES is enough to green an extraction process? This review presents an overview of knowledge regarding sustainability of NADES-based extraction procedures, focused on reported literature within the timeframe spanning from 2011 up to date. The contributions were analyzed from a green perspective in terms of energy, time, sample and solvent consumption. Moreover, we include a critical analysis to clarify whether the use of NADES as extraction media is enough for greening an analytical methodology; strategies to make them even greener are also presented. Finally, recent trends and future perspectives on how NADES-based extraction approaches in combination with computational methodologies can contribute are discussed.

Pressure ulcers' incidence, preventive measures, and risk factors in neonatal intensive care and intermediate care units.

Epidemiological studies on pressure ulcers (PUs) in hospitalised infants are scarce. Spain lacks comprehensive research studies providing data on the prevalence or incidence in this population. This work was developed to determine the incidence of PUs in hospitalised infants admitted to intensive and intermediate care units, along with relevant risk factors and preventive measures. A prospective study appraising the incidence of PUs in infants was performed. The risk factors and preventive measures were evaluated using a multivariate logistic regression model. A sample of 268 infants was included. The cumulative incidence of PUs was 12.70% (95% confidence interval, CI95% = [8.95%-17.28%]). The cumulative incidence in the intermediate care units was 1.90% (CI95% = [0.39%-5.45%]), while it was 28.18% (CI95% = [20.02%-37.56%]) in the intensive care units. The PUs were categorised as stage I, 57.10%; stage II, 31.70%; and stage III, 11.10%. The multivariate analysis found the following to be risk factors: low scores in the Spanish version of the Neonatal Skin Risk Assessment Scale (e-NSRAS) (Relative Risk (RR) 0.80; CI95% = [0.66-0.97]), the use of non-invasive mechanical ventilation (RR 12.24; CI95% = [4.02-37.32]), and the length of stay (RR 1.08; CI95% = [1.02-1.15]), suggesting a direct impact of these factors on PU development in infants. Kangaroo care influenced the prevention of PUs (RR 0.26; CI95% = [0.09-0.71]). The infants admitted in intermediate care units suffered PUs. In the case of intensive care units, the incidence is even higher. The risk increases with the length of stay, while the presence of medical devices, particularly non-invasive mechanical ventilation, is the main causal relationship. Kangaroo care has been shown to be an important preventive measure.

Novel approaches mediated by tailor-made green solvents for the extraction of phenolic compounds from agro-food industrial by-products.

An environmentally friendly method for the phenolic compound extraction from agro-food industrial by-products was developed in order to contribute with their sustainable valorization. A Natural Deep Eutectic Solvent was chemometrically-designed for the first time and compared with traditional solvents in terms of analyte stabilization. The combination of lactic acid, glucose and 15% water (LGH-15) was selected as optimal. A high-efficiency ultrasound-assisted extraction mediated by LGH-15 prior to HPLC-DAD allows the determination of 14 phenols in onion, olive, tomato and pear industrial by-products. NADES synthesis as well as the extraction procedures were optimized by Response Surface Methodology. Thus, phenolic determination in these complex samples was achieved by a simple, non-expensive, eco-friendly and robust system. The application to different matrices demonstrated the versatility of the proposed method. NADES opens interesting perspectives for their potential use as vehicles of bioactive compounds as food additives or pharmaceuticals.

Complicaciones infecciosas severas del territorio maxilofacial: presentación de casos clínicos / Severe infectious complications of the maxillofacial territory: clinical cases presentation

RESUMEN: Las infecciones en el territorio maxilofacial, son cuadros frecuentes, de origen polimicrobiano, con manifestaciones clínicas muy variables y que están asociadas a múltiples vías de ingreso de los microorganismos al territorio. Un gran porcentaje de estas infecciones se origina en la cavidad oral, principalmente en lesiones bacterianas que sufren los dientes. La compleja anatomía de la cabeza y el cuello, permiten que muchas de estas infecciones se diseminen por espacios profundos, llegando a comprometer órganos o regiones anatómicas adyacentes, que pueden llevar a cuadros clínicos de alto riesgo vital. Los casos clínicos presentados en este artículo corresponden a pacientes tratados en el hospital San Juan de Dios a causa de procesos infecciosos del territorio maxilofacial, por equipos multidisciplinarios.

ABSTRACT: Infections in the maxillofacial territory are frequent cases of polymicrobial origin, with very variable clinical manifestations and are associated with multiple entering pathways of microorganisms in the territory. A large percentage of these infections originate in the oral cavity, mainly in bacterial lesions that undergo experienced by the teeth. The complex anatomy of the head and neck allows many of these infections to spread through deep spaces, leading to compromising adjacent organs or anatomical regions, which can lead to high-risk clinical conditions. The clinical cases presented in this article correspond to patients treated at the San Juan de Dios hospital because of infectious processes of the maxillofacial territory, by multidisciplinary teams.

Necrosis mamaria completa por acenocumarol / Complete mammary necrosis due to acenocoumarol

No disponible

Olive oil by capillary electrophoresis: characterization and genuineness.

Olive oil, obtained from Olea europaea L. (Oleaceae) fruits, is an important ingredient in the Mediterranean diet. The purpose of this paper is to review and evaluate olive oil analysis using capillary electrophoresis (CE). This review covers a selection of the literature published on this topic over the past decade. The current state of the art of the topic is evaluated, with special emphasis on separation conditions, analysis purpose, and analytes investigated. CE has been used to characterize or to carry out authenticity studies. Particular attention has been focused on the botanical origin because high-quality monovarietal olive oils have been recently introduced on the markets and their quality control requires the development of new and powerful analytical tools as well as new regulations to avoid fraud. CE represents a good compromise between sample throughput, sample volume, satisfactory characterization, and sustainability for the analysis of target compounds present in olive oils.

Conocimientos, percepciones y prácticas en relación con giardiasis / Knowledge, perceptions and practices related to giardiasis

OBJETIVO: determinar los conocimientos, percepciones y prácticas de los clínicos de los municipios Playa, Lisa y Marianao en relación con la infección por Giardia lamblia. MÉTODOS: previo consentimiento informado de los clínicos que prestaban servicios en la red de policlínicos y hospitales de los municipios antes mencionados en el período que se realizó la investigación (89 de 103), se les aplicó una encuesta sobre conocimientos, percepciones y prácticas en relación con esta parasitosis. La preparación de la encuesta pasó por 4 fases: 1) entrevistas a médicos relacionados con el diagnóstico, tratamiento y control de la giardiasis; 2) preparación de un cuestionario preliminar sobre la base de los resultados de esas entrevistas; 3) sometimiento del instrumento a criterio de expertos y 4) validación de este mediante su aplicación a un pequeño grupo de galenos. RESULTADOS: se evidenció que en relación con la giardiasis y, de manera particular, con las manifestaciones cutáneas asociadas a esta, los clínicos de los citados municipios mostraban conocimientos insuficientes (de 19 interrogantes que evaluaban aspectos cognoscitivos, la media de respuestas correctas entre todos los participantes fue de 7,46), percepciones inadecuadas y prácticas incorrectas. CONCLUSIONES: se hace necesario una intervención de tipo académica, que haga énfasis en los aspectos formativos relacionados con las enfermedades parasitarias, en general y la giardiasis, en particular.

OBJECTIVE: to determine the knowledges, perceptions and practices of clinicians from Playa, Lisa and Marianao municipalities related to Giardia lamblia infection. METHODS: subject to informed consent from clinicians provided services in polyclinic and hospital network of above mentioned municipalities during the research period (89 of 103), we applied a survey on knowledges, perceptions and practices related to this parasitosis. Survey preparation had 4 phases: Interviews to diagnosis-related physicians, giardiasis treatment and control; Preparation of preliminary questionnaire based on results from those interviews; Instrument submission to expert criteria and its validation according to its application to a small group of physicians. RESULTS: we evidenced that in relation with giardiasis and particularly, with skin manifestations associated with it, clinicians of mentioned municipalities had insufficient knowledges (from 19 question marks assessing cognitive features, mean of correct answers among the participants was of 7.46), inappropriate perceptions and wrong practices. CONCLUSIONS: it is necessary an academic intervention emphasizing in formative features related to parasitic diseases in general and the giardiasis in particular.

Conocimientos, percepciones y prácticas en relación con giardiasis / Knowledge, perceptions and practices related to giardiasis

OBJETIVO: determinar los conocimientos, percepciones y prácticas de los clínicos de los municipios Playa, Lisa y Marianao en relación con la infección por Giardia lamblia. MÉTODOS: previo consentimiento informado de los clínicos que prestaban servicios en la red de policlínicos y hospitales de los municipios antes mencionados en el período que se realizó la investigación (89 de 103), se les aplicó una encuesta sobre conocimientos, percepciones y prácticas en relación con esta parasitosis. La preparación de la encuesta pasó por 4 fases: 1) entrevistas a médicos relacionados con el diagnóstico, tratamiento y control de la giardiasis; 2) preparación de un cuestionario preliminar sobre la base de los resultados de esas entrevistas; 3) sometimiento del instrumento a criterio de expertos y 4) validación de este mediante su aplicación a un pequeño grupo de galenos. RESULTADOS: se evidenció que en relación con la giardiasis y, de manera particular, con las manifestaciones cutáneas asociadas a esta, los clínicos de los citados municipios mostraban conocimientos insuficientes (de 19 interrogantes que evaluaban aspectos cognoscitivos, la media de respuestas correctas entre todos los participantes fue de 7,46), percepciones inadecuadas y prácticas incorrectas. CONCLUSIONES: se hace necesario una intervención de tipo académica, que haga énfasis en los aspectos formativos relacionados con las enfermedades parasitarias, en general y la giardiasis, en particular(AU)

OBJECTIVE: to determine the knowledges, perceptions and practices of clinicians from Playa, Lisa and Marianao municipalities related to Giardia lamblia infection. METHODS: subject to informed consent from clinicians provided services in polyclinic and hospital network of above mentioned municipalities during the research period (89 of 103), we applied a survey on knowledges, perceptions and practices related to this parasitosis. Survey preparation had 4 phases: Interviews to diagnosis-related physicians, giardiasis treatment and control; Preparation of preliminary questionnaire based on results from those interviews; Instrument submission to expert criteria and its validation according to its application to a small group of physicians. RESULTS: we evidenced that in relation with giardiasis and particularly, with skin manifestations associated with it, clinicians of mentioned municipalities had insufficient knowledges (from 19 question marks assessing cognitive features, mean of correct answers among the participants was of 7.46), inappropriate perceptions and wrong practices. CONCLUSIONS: it is necessary an academic intervention emphasizing in formative features related to parasitic diseases in general and the giardiasis in particular(AU)

Características psicopatológicas en un grupo de pacientes con cefalea / Psychopathologic characteristics in a groups of patients with headache

La cefalea es una de las causas más frecuentes de consulta en el adulto. El objetivo de este estudio es conocer las características de personalidad y el índice de depresión en un grupo de 100 pacientes adultos con cefalea primaria, de la consulta que se da en el Departamento de Tratamientos Especializados (Neurología) de la Habana. Se clasificaron los pacientes según el tipo de dolor referido en: cefalea tensional; migraña común; migraña clásica y cefalea histamínica: se aplicó a los 100 pacientes un cuestionario de preguntas diseñado para consultas de cefalea, el test de Eysenck para el estudio de personalidad, el test CRS mide depresión. Se realizaron análisis estadísticos de los resultados.La cefalea más frecuente fue la tensional (n=36) , seguida por la migraña común (n= 29), la migraña clásica (n=20), la cefalea tensional asociada a migraña común (n=13), con y con cefalea en racimos (n=2).Los pacientes en total referían más de 10.6 años de dolor con una desviación estándar de 10 añosCon personalidad inestable 68 casos. Con personalidad introvertida 64 y equilibrada 27. Con signos moderados y severos de depresión 49 pacientes. Según los resultados encontrados, más de la tercera parte de los pacientes estudiados tienen cefalea tensional seguida de la migraña común y de la clásica. Mientras que en más de la mitad del total de los pacientes con cefalea vistos predomina una personalidad inestable con signos de neurosis y depresión que obliga a un proceder psicoterapéutico correspondiente(AU)

Headache is one of the most frequent causes of medical consultation in adults. The objective of this study is to know the personality traits and the depression index in a group of 100 mature patients with primary migraine that go to a doctors office in the Department of Specialized Treatments (Neurology) of the Havana.The patients were classified according to the pain type referred: tensional headache; common migraine; classic migraine and clusters migraine.A questionnaire designed for migraine was applied to the 100 patients that came to see the physician; also the Eysenck test for personality type and the CRS test for depression were used. Statistical analyses were applied to the results of theses questionnaires. Tensional Migraine was the most frequent type of headache (n=36), followed by Common Migraine (n = 29) and Classic Migraine (n=20).The average time of suffering the disease was 10.6 years with a standard deviation between 10 years According to the psychological test we use, 68 cases present an unstable personality and 64 patients showed an introverted personality. Forty-nine patients showed moderate or severe signs of depression. According to the results, more than one third of the studied patients suffer from tensional headache followed in order of frequency by common and classic migraine. More than half of the studied patients showed an unstable personality with signs of neurosis and depression, a fact that forces to proceed with the corresponding psychotherapeutic assessment(AU)

Mild hyperhomocysteinemia and low folate concentrations as risk factors for cervical arterial dissection.

BACKGROUND AND PURPOSE: Elevated homocysteine (Hcy) plasma levels are associated with an increased risk of spontaneous cervical artery dissection (sCAD). We examined the potential association between Hcy, folate, vitamin B(12) levels and 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphisms in patients with cerebral infarct caused by sCAD. PATIENTS AND METHODS: 39 patients who survived a cerebral infarct caused by sCAD [20 (51%) women; 24 (61.5%) vertebral and 15 (38.5%) internal carotid arteries], and 76 healthy control subjects were included. Hcy plasma levels (fasting and after methionine load), folate and vitamin B(12) levels were measured. We also performed polymorphisms of MTHFR. Hcy, vitamin B(12), folates and polymorphisms of MTHFR were assessed and any associations were analyzed using multivariate statistics. RESULTS: Mean plasma fasting Hcy level was 9.81 mumol/l for cases and 6.38 for controls (p = 0.001). The occurrence of sCAD was associated with elevated fasting Hcy levels (>95th percentile over the control group) with an adjusted odds ratio of 7.9 (95% CI 1.66-35). The association between low plasma folate values (<5th percentile) and the presence of CAD was 7.9 (95% CI 1.6-31) after adjusting for confounding variables. The distribution of the MTHFR genotype showed a higher TT mutant frequency among CAD patients (p = 0.034). CONCLUSIONS: High plasma concentrations of Hcy and low plasma levels of folate were associated with an increased risk of sCAD in the sample studied. We conclude that deficiencies in nutritional status may contribute to the relatively high incidence of CAD in Mexico.

Hyperhomocysteinemia, low folate and vitamin B12 concentrations, and methylene tetrahydrofolate reductase mutation in cerebral venous thrombosis.

BACKGROUND AND PURPOSE: Elevated plasma levels of homocysteine are associated with an increased risk of deep-vein thrombosis. Through a case-control study, we examined the potential association among homocysteine, folate and vitamin B12 levels, and the common C677-->T mutation in the methylene tetrahydrofolate reductase (MTHFR) gene in patients with cerebral venous thrombosis (CVT). METHODS: Forty-five patients with CVT and 90 control subjects were studied. Plasma levels of homocysteine (fasting and after methionine load), folate, and vitamin B12 were measured. Genotyping of the MTHFR gene was also performed. The estimated risk of CVT associated with hyperhomocysteinemia, low vitamin levels, and MTHFR mutation were expressed as odds ratio (OR) and its 95% CI (crude and after adjusting by other independent variables). RESULTS: The adjusted OR for CVT associated with high (>90th percentile) fasting levels of homocysteine was 4.6 (1.6 to 12.8). The association between low plasma folate values (<10th percentile) and presence of CVT was 3.5 (1.2 to 10.0) after adjustment for confounding factors. There was a higher frequency of MTHFR mutation in patients with CVT (22% versus 10%), but it was not statistically significant (P=0.098). Patients with MTHFR mutation and low folate levels presented the highest homocysteine levels. CONCLUSIONS: High plasma concentrations of homocysteine and low plasma folate levels were associated with an increased risk of CVT in this population in which low socioeconomic conditions and deficient nutritional status may contribute to its relatively high incidence.

Rotavirus: Enfermedad emergente de transmisión digestiva / Rotavirus: an emergent food borne disease

Las enfermedades diarreicas agudas (EDA), constituyen una de las principales causas de morbilidad y mortalidad infantil al nivel mundial. En los últimos años han sido descubiertos algunos virus asociados con la producción de manifestaciones diarreicas, y esto se corrobora con la presencia de partículas virales observadas al microscopio electrónico en heces fecales de pacientes con episodios de diarreas. Entre los agentes virales asociados con enfermedad diarreicas, son los rotavirus los de mayor importancia médica, por lo que la detección, la identificación, los estudios de inmunización, así como la obtención de una vacuna para la prevención de este agente infeccioso, resultan de gran valor epidemiológico, puesto que la gastroenteritis viral es causa de deshidratación en casi aproximadamente 500 000 niños anualmente, tanto en países desarrollados como en subdesarrollados, y resulta en costos médicos directos de $ 264 millones y $ 1 billón de costos totales para la sociedad.

Rotavirus: Enfermedad emergente de transmisión digestiva / Rotavirus: an emergent food borne disease

Las enfermedades diarreicas agudas (EDA), constituyen una de las principales causas de morbilidad y mortalidad infantil al nivel mundial. En los últimos años han sido descubiertos algunos virus asociados con la producción de manifestaciones diarreicas, y esto se corrobora con la presencia de partículas virales observadas al microscopio electrónico en heces fecales de pacientes con episodios de diarreas. Entre los agentes virales asociados con enfermedad diarreicas, son los rotavirus los de mayor importancia médica, por lo que la detección, la identificación, los estudios de inmunización, así como la obtención de una vacuna para la prevención de este agente infeccioso, resultan de gran valor epidemiológico, puesto que la gastroenteritis viral es causa de deshidratación en casi aproximadamente 500 000 niños anualmente, tanto en países desarrollados como en subdesarrollados, y resulta en costos médicos directos de $ 264 millones y $ 1 billón de costos totales para la sociedad(AU)

Atención de la diarrea con sangre / Care of Bloody diarrhea

La diarrea con sangre es uno de los problemas de salud que han emergido en la década de los 90, después de la consolidación de las sales de rehidratación oral en la prevención de la deshidratación por diarrea; como consecuencia disminuyeron las defunciones por ésta y aparecen como causas importantes de muerte la disentería bacilar y la diarrea persistente. Nuestro país no está éxento de los problemos que surgen en el mundo de hoy, pues en los últimos años se ha producido el mismo fenómeno y hemos visto que todavía el trato de la diarrea con sangre en la atención primaria de salud tiene dificultades, tanto en el diagnóstico como en el tratamiento. Debe realizarse un trabajo de prevención de la diarrea basada en el mejoramiento de la situación sanitaria a nivel local con la ayuda del médico de la familia. Es importante mejorar el diagnóstico de Shigellosis y Amebiasis basado en el cuadro clínico en el examen físico en menores de 15 años y adultos. En el tratamiento ambulatorio del paciente con diarreas es necesario mantener la alimentación y tener en cuenta que los antimicrobianos sólo tienen indicación en la diarrea por Cólera y Shigella. En estos momentos en nuestro país el tratamiento de elección de la Shigella es el ácido nalidíxico. Se insiste en no emplear medicamentos antidiarreicos, ni antimotílicos en las diarreas de los niños y adultos. Evitar el uso indiscriminado de metronidazol, pues puede llevar al paciente a una diarrea persistente (AU)

Mortalidad infantil y sus componentes en el municipio Cerro, 1980-1991 / Infant mortality and its factors in Cerro municipe, 1980-1991

Se realizó un estudio sobre la mortalidad infantil ocurrida en el municipio Cerro en el período 1980-1991. Los datos se obtuvieron a partrir de las tarjetas de registro de defunciones de la Dirección de Salud de Ciudad de La Habana por años, grupos de edades y causas. Los resultados obtenidos entre 1980 y 1991 se expresan por una reducción de la mortalidad infantil en el 69,0 por ciento, la cual se debió a reducciones importantes en la mortalidad neonatal precoz (menos de 7 días) y en la mortalidad posneonatal (28 días-11 meses), ya que la mortalidad neonatal tardía aumentó en el 54,5 por ciento. Las causas de muerte que mayor relación tuvieron en los menores de 1 año fueron los rubros lesiones al nacer (B45), anomalías congénitas (B42) e influencia y neumonía (B31 y B32). Se señalan los factores que han contribuido a lograr estos resultados (AU)