Comparison of Outcomes and Survival of Two Cohorts of Patients with Simultaneous Pancreas-Kidney Transplantation: A Retrospective Cohort Study in a Latin American Hospital.

Background: Simultaneous pancreas-kidney transplantation (SPKT) is a complex and demanding procedure with a considerable risk of morbidity and mortality. Advances in surgical techniques and organ preservation have introduced changes in care protocols. Two cohorts of patients receiving SPKT with two different protocols were compared to determine overall survival and pancreatic and renal graft failure-free survival. Methods: This retrospective observational study was conducted in two cohorts of SPKT recipient patients that underwent surgery between 2001 and 2021. Outcomes were compared in transplant patients between 2001 and 2011 (cohort 1; initial protocol) and 2012-2021 (cohort 2; improved protocol). In addition to the temporality, the cohorts were defined by a protocolization of technical aspects and medical management in cohort 2 (improved protocol), compared to a wide variability in the procedures carried out in cohort 1 (initial protocol). Overall survival and pancreatic and renal graft failure-free survival were the primary outcomes. These outcomes were determined using Kaplan-Meier survival analysis and the log-rank test. Results: Fifty-five SPKT were performed during the study period: 32 in cohort 1 and 23 in cohort 2. In the survival analysis, an average of 2546 days (95% CI: 1902-3190) was found in cohort 1, while in cohort 2, it was 2540 days (95% CI: 2100-3204) (p > 0.05). Pancreatic graft failure-free survival had an average of 1705 days (95% CI: 1037-2373) in cohort 1, lower than the average in cohort 2 (2337 days; 95% CI: 1887-2788) (p = 0.016). Similarly, renal graft failure-free survival had an average of 2167 days (95% CI: 1485-2849) in cohort 1, lower than the average in cohort 2 (2583 days; 95% CI: 2159-3006) (p = 0.017). Conclusions: This analysis indicates that pancreatic and renal graft failure-free survival associated with SPKT decreased significantly in cohort 2, with results related to improvements in the treatment protocol implemented in that cohort.

Delayed care in carotid-cavernous fistula due to the Covid-19 pandemic / Atraso no atendimento de casos de fístula carótido-cavernosa devido à pandemia de Covid-19

ABSTRACT Direct carotid-cavernous fistula is a high-flow communication between the internal carotid artery and the cavernous sinus that requires early transarterial embolization for its resolution. We report a case of a patient with a direct carotid-cavernous fistula who subsequently developed a central retinal vein thrombosis due to a delay in treatment related to the health collapse experienced in the first months of the Covid-19 pandemic in Spain.

RESUMO A fístula carótido-cavernosa direta é uma comunicação de alto fluxo entre a artéria carótida interna e o seio cavernoso que requer embolização trans-arterial precoce para sua resolução. É relatado aqui o caso de um paciente com fístula carótido-cavernosa direta que posteriormente desenvolveu uma trombose da veia central da retina devido a um atraso no tratamento relacionado ao colapso de saúde experimentado nos primeiros meses da pandemia de Covid-19 na Espanha.

Effective residual convolutional neural network for Chagas disease parasite segmentation.

Considered a neglected tropical pathology, Chagas disease is responsible for thousands of deaths per year and it is caused by the parasite Trypanosoma cruzi. Since many infected people can remain asymptomatic, a fast diagnosis is necessary for proper intervention. Parasite microscopic observation in blood samples is the gold standard method to diagnose Chagas disease in its initial phase; however, this is a time-consuming procedure, requires expert intervention, and there is currently no efficient method to automatically perform this task. Therefore, we propose an efficient residual convolutional neural network, named Res2Unet, to perform a semantic segmentation of Trypanosoma cruzi parasites, with an active contour loss and improved residual connections, whose design is based on Heun's method for solving ordinary differential equations. The model was trained on a dataset of 626 blood sample images and tested on a dataset of 207 images. Validation experiments report that our model achieved a Dice coefficient score of 0.84, a precision value of 0.85, and a recall value of 0.82, outperforming current state-of-the-art methods. Since Chagas disease is a severe and silent illness, our computational model may benefit health care providers to give a prompt diagnose for this worldwide affection.

Low molecular weight heparin is useful in adult COVID-19 inpatients. Experience during the first Spanish wave: observational study

ABSTRACT BACKGROUND: The intensity of the thromboprophylaxis needed as a potential factor for preventing inpatient mortality due to coronavirus disease-19 (COVID-19) remains unclear. OBJECTIVE: To explore the association between anticoagulation intensity and COVID-19 survival. DESIGN AND SETTING: Retrospective observational study in a tertiary-level hospital in Spain. METHODS: Low-molecular-weight heparin (LMWH) status was ascertained based on prescription at admission. To control for immortal time bias, anticoagulant use was analyzed as a time-dependent variable. RESULTS: 690 patients were included (median age, 72 years). LMWH was administered to 615 patients, starting from hospital admission (89.1%). 410 (66.7%) received prophylactic-dose LMWH; 120 (19.5%), therapeutic-dose LMWH; and another 85 (13.8%) who presented respiratory failure, high D-dimer levels (> 3 mg/l) and non-worsening of inflammation markers received prophylaxis of intermediate-dose LMWH. The overall inpatient-mortality rate was 38.5%. The anticoagulant nonuser group presented higher mortality risk than each of the following groups: any LMWH users (HR 2.1; 95% CI: 1.40-3.15); the prophylactic-dose heparin group (HR 2.39; 95% CI, 1.57-3.64); and the users of heparin dose according to biomarkers (HR 6.52; 95% CI, 2.95-14.41). 3.4% of the patients experienced major hemorrhage. 2.8% of the patients developed an episode of thromboembolism. CONCLUSIONS: This observational study showed that LMWH administered at the time of admission was associated with lower mortality among unselected adult COVID-19 inpatients. The magnitude of the benefit may have been greatest for the intermediate-dose subgroup. Randomized controlled trials to assess the benefit of heparin within different therapeutic regimes for COVID-19 patients are required.

Adaptation of the Cuban version of the Coronavirus Anxiety Scale.

This study explores the psychometric properties of the Cuban version of Coronavirus Anxiety Scale (CAS). The sample comprised 376 Cuban participants. Concurrent validity and reliability were examined. A confirmatory factor analysis was performed. The CAS showed excellent psychometric characteristics. The internal consistency was very good (α = 0.88). There was a positive correlation between the CAS and the FCV-19S and an inverse association between anxiety and self-perceived quality of health. The results confirmed the presence of a single factor. The CAS is a valid and reliable instrument to explore the experience of anxiety in the Cuban population.

Low molecular weight heparin is useful in adult COVID-19 inpatients. Experience during the first Spanish wave: observational study.

BACKGROUND: The intensity of the thromboprophylaxis needed as a potential factor for preventing inpatient mortality due to coronavirus disease-19 (COVID-19) remains unclear. OBJECTIVE: To explore the association between anticoagulation intensity and COVID-19 survival. DESIGN AND SETTING: Retrospective observational study in a tertiary-level hospital in Spain. METHODS: Low-molecular-weight heparin (LMWH) status was ascertained based on prescription at admission. To control for immortal time bias, anticoagulant use was analyzed as a time-dependent variable. RESULTS: 690 patients were included (median age, 72 years). LMWH was administered to 615 patients, starting from hospital admission (89.1%). 410 (66.7%) received prophylactic-dose LMWH; 120 (19.5%), therapeutic-dose LMWH; and another 85 (13.8%) who presented respiratory failure, high D-dimer levels (> 3 mg/l) and non-worsening of inflammation markers received prophylaxis of intermediate-dose LMWH. The overall inpatient-mortality rate was 38.5%. The anticoagulant nonuser group presented higher mortality risk than each of the following groups: any LMWH users (HR 2.1; 95% CI: 1.40-3.15); the prophylactic-dose heparin group (HR 2.39; 95% CI, 1.57-3.64); and the users of heparin dose according to biomarkers (HR 6.52; 95% CI, 2.95-14.41). 3.4% of the patients experienced major hemorrhage. 2.8% of the patients developed an episode of thromboembolism. CONCLUSIONS: This observational study showed that LMWH administered at the time of admission was associated with lower mortality among unselected adult COVID-19 inpatients. The magnitude of the benefit may have been greatest for the intermediate-dose subgroup. Randomized controlled trials to assess the benefit of heparin within different therapeutic regimes for COVID-19 patients are required.

Delayed care in carotid-cavernous fistula due to the Covid-19 pandemic.

Direct carotid-cavernous fistula is a high-flow communication between the internal carotid artery and the cavernous sinus that requires early transarterial embolization for its resolution. We report a case of a patient with a direct carotid-cavernous fistula who subsequently developed a central retinal vein thrombosis due to a delay in treatment related to the health collapse experienced in the first months of the Covid-19 pandemic in Spain.

Blunt abdominal trauma managed with mesenteric embolization: case report.

Blunt abdominal trauma occurs in 20% of polytraumatized patients, of which approximately 5% may have mesenteric lesions. We present a case of a woman suffering from a blunt abdominal trauma, who underwent computed tomography with evidence of hematoma on the right flank, which was controlled by angioembolization of the superior mesenteric artery. Treatment of mesenteric lesions will be determined according to the hemodynamic status of the patient, since in view of stability, a choice can be made between open surgery and embolization, but in case of instability, laparotomy is recommended.

El trauma abdominal cerrado se presenta en el 20% de los pacientes politraumatizados, de los cuales aproximadamente el 5% pueden llegar a tener lesiones mesentéricas. Presentamos el caso de una mujer que sufre un traumatismo abdominal cerrado a la cual se le realizó tomografía computarizada con evidencia de un hematoma en el flanco derecho, que se logra controlar por angioembolización de la arteria mesentérica superior. El tratamiento de las lesiones mesentéricas se determinará según el estado hemodinámico del paciente, pues ante la estabilidad se puede escoger entre cirugía abierta y embolización, pero en caso de inestabilidad se recomienda la laparotomía.

The Risk Perception COVID-19 Scale (RP-COVID19-S): Initial Validation and Its Relationship with Gender and Age in a Cuban Population Sample.

BACKGROUND: Risk perception about COVID-19 constitutes an important variable contributing to promotion of personal protection practices. The aims of this study were to exploring the factorial structure of the risk perception COVID-19 scale (RP-COVID19-S) in a sample of Cuban adults and to identify its relationship with variables such as gender and age. METHODS: A cross-sectional web-based survey design was conducted. The sample comprised 394 Cuban participants. Categorical Principal Component Analysis (CATPCA) was used to explore internal factorial structure of the scale. Logistic regression was modeling to identify variables independently associated with RP about COVID-19. RESULTS: CATPCA allowed identifying a three-dimensional factorial structure into the scale: knowledge and beliefs, emotional reactions and behavioral dissonance, and motivations for change. The odds of a woman with middle RP compared to low RP was 2.17 times more than for a man. Also, the odds of a woman with high knowledge and beliefs compared to low knowledge and beliefs were 1.96 times more than for a man. The odds of a person in older group, with middle risk perception compared with low level, was 5.0 (global risk perception), 3.33 (knowledge and beliefs), and 3.13 (emotional reactions and behavioral dissonance) times more than for a person in younger group, respectively. CONCLUSION: The Risk Perception to COVD-19 Scale (RP-COVID-19-S) showed satisfactory psychometric properties to evaluated risk perception related to COVID-19 in Cuban population sample. Middle level of global risk perception was found in the sample. High level of risk perception about COVID-19 was found on participants older than 42 years old and in woman.

Anxiety, Health Self-Perception, and Worry About the Resurgence of COVID-19 Predict Fear Reactions Among Genders in the Cuban Population.

The resurgence of COVID-19 could deepen the psychological impacts of the pandemic which poses new challenges for mental health professionals. Among the actions that should be prioritized is the monitoring of the groups that have shown greater psychological vulnerability during the first stage of the pandemic. The first aim of our study is to explore the fear reactions to COVID-19 between genders during the second wave of the outbreak in Cuba. Second, establish possible predictors of fear of COVID-19 in relation to gender. Specifically, we will evaluate how anxiety related to COVID-19, health self-perception, and worry about the resurgence of COVID-19 predict fear reactions among women and men in the Cuban population. A cross-sectional online study was designed. The research was conducted between August 16 and October 18, 2020. A total of 373 people completed the online survey. A socio-demographic questionnaire, the Fear of COVID-19 Scale and the Coronavirus Anxiety Scale were used. An independent-samples t-test was conducted to compare the fear, worry, anxiety and self-perceived health scores, between genders. The relationship between those variables and fear of COVID-19, was investigated using Pearson correlation coefficient. Finally, multiple linear regression was used to evaluate the possible associations (predictors) related to fear of COVID-19. In our study, women, compared to men, presented greater fear reactions, greater concern about resurgence of COVID-19 and poorer self-perceived health. Anxiety reactions in our sample showed no differences between genders. In women, anxiety of COVID-19, worry about resurgence of COVID-19, and self-perceived health are associated with fear reactions to COVID-19. In the case of men, the self-perceived health showed no associations with fear reactions. Our results confirm the results of several related investigations during the first wave of the pandemic where women have shown greater psychological vulnerability compared to men. However, we cannot rule out that the real impact of the pandemic on mental health in men is much greater than that described by the studies conducted to date. Additional studies are needed on the psychological impact of COVID-19 on men.

Estimación del consumo de alimentos en menores de dos años de la provincia Las Tunas / Estimate of food consumption in children under two years old in Las Tunas province

Introducción: La introducción de la alimentación complementaria es un importante momento en el crecimiento de un niño. Las guías alimentarias constituyen la traducción de los objetivos nutricionales en consejos prácticos y cobran un valor fundamental en las primeras etapas de la vida. Objetivos: Estimar el consumo de alimentos en menores de dos años de edad de la provincia Las Tunas. Métodos: Se realizó un estudio transversal, con muestreo aleatorio bietápico, en niños con edades entre 6 y 23 meses. El tamaño muestral fue de 495 niños. Se aplicó una encuesta de consumo de alimentos por recordatorio de 24 horas y se estimó la adecuación de las porciones de alimentos ingeridas según las recomendaciones de las guías alimentarias del menor de 2 años. Se calculó el índice de diversidad alimentaria. Resultados: La lactancia materna continuada al año de edad fue de un 34,5 por ciento en el grupo menor de un año y de un 10,6 por ciento en el grupo de 1 a 2 años. Se observó un bajo cumplimiento de consumo de las porciones de vegetales, frutas, grasas y huevo recomendadas en las guías alimentarias. El 84,5 por ciento de los menores de un año y el 42,1 por ciento de los de 1 a 2 años excedían el consumo diario recomendado de energía. Conclusiones: No se cumplen las porciones de alimentos recomendadas en las guías alimentarias para el logro de una alimentación saludable en menores de dos años. El alto porcentaje de niños con ingestas excesivas de energía constituye un factor predisponente a la obesidad desde las etapas tempranas de la vida(AU)

Introduction: The introduction of complementary feeding is an important moment in a child's growth. Food guides are the translation of nutritional goals into practical advice and take on fundamental value in the early stages of life. Objectives: Estimate food consumption in children under two years old in Las Tunas province. Methods: A cross-sectional study, with two-stage random sampling, was conducted in children aged from 6 to 23 months. The sample size was of 495 children. A food consumption by 24-hours reminder´s survey was applied and the adequacy of food portions ingested was estimated according to the recommendations of the children under 2 years´ food guides. The food diversity index was calculated. Results: Continued breastfeeding at 1 year of age was 34.5 percent in the group under one year and 10.6 percent in the 1 to 2 years group. Low consumption compliance with the portions of vegetables, fruits, fats and eggs recommended in food guides was observed. 84.5 percent of children under one-year-old and 42.1 percent of those in 1 to 2 years old exceeded the recommended daily energy consumption. Conclusions: The food portions recommended in the food guides for healthy eating in children under two years old are not met. The high percentage of children with excessive energy intakes is a factor that predispose to obesity in early stages of life(AU)

Saliva sample for the massive screening of SARS-CoV-2 infection: a systematic review.

OBJECTIVE: This systematic review aims to describe the value of saliva as a noninvasive sample for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in comparison with the current method for sample collection, the nasopharyngeal swab. STUDY DESIGN: We conducted a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. We searched in 5 databases (PubMed, Cochrane, EBSCO, Elsevier, and MEDLINE) and included articles published between December 2019 and July 2020. RESULTS: This review included 22 publications that met inclusion criteria, 17 of which were case series, 2 of which were case reports, and 3 of which were massive screenings. All articles compared saliva with nasopharyngeal swabs. The detection rate of SARS-CoV-2 in saliva was similar to that for nasopharyngeal swabs. The sensitivity ranged between 20% and 97%, and specificity ranged between 66% and 100%. CONCLUSIONS: This systematic review found that saliva might be an appropriate, fast, painless, simple, and noninvasive sample for SARS-CoV-2 detection, making it ideal for massive screening of SARS-CoV-2 infection.

Subjective Well-being during the Pandemic: A Pilot Study in the Cuban Population.

Background: The study of aspects related to positive mental health and well-being in the general population with a gender approach is a necessity in the current context imposed by COVID-19. Objective: To explore gender as a predictor of subjective well-being during COVID-19 in a sample of the Cuban population. Design: A cross-sectional web-based survey design was adopted. The sample consisted of 129 Cuban participants. The Subjective Well-being-Reduced Scale (SW-RS) was used to explore subjective well-being in the sample. Descriptive statistics were used to explore the participants' characteristics. A multinomial logistic regression analysis was conducted to identify variables independently associated with the participants' subjective well-being. Results: The gender of participants significantly predicted subjective well-being levels. The probability of males having middle or high levels of subjective well-being, rather than low levels, was 4.16 times greater than in females. The probability of males having a high self-image instead of a low one was 4.35 times greater than in females. According to the self-satisfaction dimension, the odds of males having high rather than low self-satisfaction were five times more than in females. In this sample, gender did not predict whether participants had middle or high levels of the hedonic dimension. Conclusion: Our results corroborated international studies that have indicated the coincidence of lower well-being and greater psychosocial risk in women during the COVID-19 pandemic. The results also indicated the need to dig deeper into the experiences of subjective well-being from a gender perspective, and to strengthen the sufficiency and effectiveness of the actions and guidance that are offered to the population from psychological care services, the media, and public policies.

Revisión sistemática sobre conducta suicida en niños menores de 12 años en Cuba / Systematic Review about Suicidal Behavior in Children under 12 Years of Age in Cuba

Introducción: La complejidad del comportamiento suicida en niños menores de 12 años, así como las dificultades en el reporte y descripción epidemiológica de este problema de salud en Cuba, complejizan su estratificación sociodemográfica y, por tanto, el conocimiento de los profesionales que lo atienden. Objetivo: Caracterizar el comportamiento suicida en población menor de 12 años en Cuba. Métodos: Con un enfoque de investigación mixto, se desarrolló una revisión sistemática. Los artículos se extrajeron de las bases de datos: Web of Science, SCOPUS y SciELO; mediante una estrategia de búsqueda definida. Los documentos recuperados se procesaron utilizando el gestor bibliográfico Endnote X7. Primeramente se eliminaron duplicados, y posteriormente se realizó un análisis de contenido de los títulos y resúmenes a partir de los siguientes criterios: 1) artículos académicos sobre conducta suicida en niños menores de 12 años, 2) todos los estudios realizados en Cuba desde 1973 hasta el 2018. Los resultados se procesaron mediante un análisis cuantitativo para describir características bibliométricas de los artículos, seguido de un procesamiento cualitativo del contenido de los mismos. Conclusiones: Se han publicado 16 artículos, la mayoría con enfoque epidemiológico sobre los factores de riesgo de los intentos suicidas. Según contenido, las causas se relacionaron con antecedentes de conducta suicida personal y familiar, así como vivencias de violencia intrafamiliar. El estado de la producción científica demuestra la necesidad de investigaciones que profundicen desde perspectivas más psicológicas sobre este comportamiento en menores de 12 años(AU)

Introduction: The complexity of suicidal behavior in children under 12 years of age, as well as the difficulties in epidemiological description and report of this health concern in Cuba, complicates its sociodemographic stratification and, therefore, the knowledge of the professionals who attend it. Objective: To characterize suicidal behavior in a population under 12 years of age in Cuba. Methods: With a mixed research approach, a systematic review was developed. The articles were extracted from the databases Web of Science, SCOPUS, and SciELO, using a defined search strategy. The recovered documents were processed using the reference manager Endnote X7. Firstly, duplicates were eliminated, and later a content analysis of the titles and abstracts was carried out based on the following criteria: 1) academic articles on suicidal behavior in children under 12 years of age, 2) all studies carried out in Cuba from 1973 to 2018. The results were processed using quantitative analysis to describe the bibliometric characteristics of the articles, followed by a qualitative processing of the content of the articles. Conclusions: 16 articles have been published, most of which present an epidemiological approach about the risk factors of suicide attempts. Regarding content, the causes were related to a history of personal and family suicidal behavior, as well as experiences of intra-family violence. The state of scientific production shows the need for research that elaborates, from more psychological perspectives, on this behavior in children under 12 years of age(AU)

Meta-networks for the study of biogeographical traits in ecological networks: the Mexican hummingbird-plant assemblage.

Recent studies on ecological networks have quantified the contribution of ecological, historical, and evolutionary factors on the structure of local communities of interacting species. However, the influence of species' biogeographical traits, such as migratory habits or phylogeographical history, on ecological networks is poorly understood. Meta-networks, i.e., networks that cover large spatial extensions and include species not co-occurring locally, enable us to investigate mechanisms that operate at larger spatial scales such as migratory patterns or phylogeographical distributions, as well as indirect relationships among species through shared partners. Using a meta-network of hummingbird-plant interaction across Mexico, we illustrate the usefulness of this approach by investigating (1) how biogeographical and morphological factors associate with observed interactions and (2) how species-specific biogeographical characteristics associate with species' network roles. Our results show that all studied hummingbird and plant species in the meta-network were interrelated, either directly or through shared partners. The meta-network was structured into modules, resulting from hummingbirds and plants interacting preferentially with subsets of species, which differed in biogeographical, and, to a lesser extent, morphological traits. Furthermore, migrants and hummingbirds from Nearctic, Transition, and widespread regions had a higher topological importance in the meta-network. Our study illustrates how meta-networks may contribute to our current knowledge on species' biogeographical traits and biotic interactions, providing a perspective complementary to local-scale networks.

Trait evolution, resource specialization and vulnerability to plant extinctions among Antillean hummingbirds.

Species traits are thought to predict feeding specialization and the vulnerability of a species to extinctions of interaction partners, but the context in which a species evolved and currently inhabits may also matter. Notably, the predictive power of traits may require that traits evolved to fit interaction partners. Furthermore, local abiotic and biotic conditions may be important. On islands, for instance, specialized and vulnerable species are predicted to be found mainly in mountains, whereas species in lowlands should be generalized and less vulnerable. We evaluated these predictions for hummingbirds and their nectar-food plants on Antillean islands. Our results suggest that the rates of hummingbird trait divergence were higher among ancestral mainland forms before the colonization of the Antilles. In correspondence with the limited trait evolution that occurred within the Antilles, local abiotic and biotic conditions-not species traits-correlate with hummingbird resource specialization and the vulnerability of hummingbirds to extinctions of their floral resources. Specifically, hummingbirds were more specialized and vulnerable in conditions with high topographical complexity, high rainfall, low temperatures and high floral resource richness, which characterize the Antillean Mountains. These findings show that resource specialization and species vulnerability to extinctions of interaction partners are highly context-dependent.

Prácticas de alimentación en niños de 6 a 23 meses de edad / Feeding practices in children aged 6-23 months

Introducción: las prácticas óptimas de alimentación del lactante y el niño pequeño se sitúan entre las intervenciones con mayor efectividad para mejorar la salud de la niñez. Las encuestas de consumo de alimentos revisten gran importancia en la detección precoz de un consumo inadecuado de alimentos y sus repercusiones sobre la salud. Objetivos: identificar las prácticas reales de alimentación complementaria, y determinar la adecuación de la ingesta de energía y nutrientes. Métodos: se realizó un estudio transversal en niños con edades entre 6 y 23 meses. Comprendió un muestreo aleatorio bietápico. Se calculó la muestra en 560 niños. Se obtuvo información sociodemográfica del niño y su medio familiar. Se aplicó una encuesta de consumo de alimentos por recordatorio de 24 horas. Resultados: se encuestaron 543 madres de niños entre 6 y 23 meses de edad. El 42,4 por ciento de los menores de un año son amamantados con una disminución hasta el 20,9 por ciento durante el segundo año de vida, existe bajo consumo de frutas y vegetales, los menores de 1 año de edad consumieron como promedio 914 kcal, el 45,3 por ciento sobrepasa las recomendaciones de energía para esas edades y presenta un consumo excesivo, mientras los de 1 a 2 años consumen 1 052 kcal. Respecto a los minerales, se destaca el bajo consumo de hierro, con 51,1 por ciento de niños con un consumo deficitario de este mineral. Conclusiones: el elevado porcentaje de niños con ingestas excesivas de energía constituye un factor predisponente a la obesidad desde las etapas tempranas de la vida(AU)

Introduction: optimal infant and young child feeding practices are among the most effective interventions to improve child health. Food consumption surveys are extremely important for early detection of inadequate food intake and its impact on health. Objectives: identify actual complementary feeding practices and determine the adequacy of energy and nutrient intake. Methods: a cross-sectional study was conducted with children aged 6-23 months. The study included two-staged random sampling. The sample was composed of 560 children. Sociodemographic information was obtained about the children and their family environment. A food intake survey was applied based on 24-hour recall. Results: the survey was applied to 543 mothers of children aged 6-23 months. It was found that 42.4 percent of the children under one year of age are breastfed, a percentage that falls to 20.9 percent during the second year of life. Fruit and vegetable intake is low. Children under one year of age consumed 914 kcal on average, and 45.3 percent exceed the energy intake recommendations for that age, which constituted excessive consumption. Children aged 1-2 years consume 1 052 kcal. As to minerals, low iron intake stands out, with 51.1 percent of the children consuming less than required. Conclusions: the high percentage of children with an excessive energy intake is a risk factor for obesity since early life stages(AU)

Prácticas de alimentación en niños de 6 a 23 meses de edad / Feeding practices in children aged 6-23 months

Introducción: las prácticas óptimas de alimentación del lactante y el niño pequeño se sitúan entre las intervenciones con mayor efectividad para mejorar la salud de la niñez. Las encuestas de consumo de alimentos revisten gran importancia en la detección precoz de un consumo inadecuado de alimentos y sus repercusiones sobre la salud. Objetivos: identificar las prácticas reales de alimentación complementaria, y determinar la adecuación de la ingesta de energía y nutrientes. Métodos: se realizó un estudio transversal en niños con edades entre 6 y 23 meses. Comprendió un muestreo aleatorio bietápico. Se calculó la muestra en 560 niños. Se obtuvo información sociodemográfica del niño y su medio familiar. Se aplicó una encuesta de consumo de alimentos por recordatorio de 24 horas. Resultados: se encuestaron 543 madres de niños entre 6 y 23 meses de edad. El 42,4 por ciento de los menores de un año son amamantados con una disminución hasta el 20,9 por ciento durante el segundo año de vida, existe bajo consumo de frutas y vegetales, los menores de 1 año de edad consumieron como promedio 914 kcal, el 45,3 por ciento sobrepasa las recomendaciones de energía para esas edades y presenta un consumo excesivo, mientras los de 1 a 2 años consumen 1 052 kcal. Respecto a los minerales, se destaca el bajo consumo de hierro, con 51,1 por ciento de niños con un consumo deficitario de este mineral. Conclusiones: el elevado porcentaje de niños con ingestas excesivas de energía constituye un factor predisponente a la obesidad desde las etapas tempranas de la vida(AU)

Introduction: optimal infant and young child feeding practices are among the most effective interventions to improve child health. Food consumption surveys are extremely important for early detection of inadequate food intake and its impact on health. Objectives: identify actual complementary feeding practices and determine the adequacy of energy and nutrient intake. Methods: a cross-sectional study was conducted with children aged 6-23 months. The study included two-staged random sampling. The sample was composed of 560 children. Sociodemographic information was obtained about the children and their family environment. A food intake survey was applied based on 24-hour recall. Results: the survey was applied to 543 mothers of children aged 6-23 months. It was found that 42.4 percent of the children under one year of age are breastfed, a percentage that falls to 20.9 percent during the second year of life. Fruit and vegetable intake is low. Children under one year of age consumed 914 kcal on average, and 45.3 percent exceed the energy intake recommendations for that age, which constituted excessive consumption. Children aged 1-2 years consume 1 052 kcal. As to minerals, low iron intake stands out, with 51.1 percent of the children consuming less than required. Conclusions: the high percentage of children with an excessive energy intake is a risk factor for obesity since early life stages(AU)

Worldwide pattern of antibiotic prescription in endodontic infections.

BACKGROUND: Odontogenic infections, and especially endodontic infections, are polymicrobial, involving a combination of Gram-positive and Gram-negative facultative anaerobes and strictly anaerobic bacteria. Therefore, antibiotics can be used as an adjunct to endodontic treatment. However, most chronic and even acute endodontic infections can be successfully managed by disinfection of the root-canal system, which eliminates the source of infection, followed by abscess drainage or tooth extraction, without the need for antibiotics. The literature provides evidence of inadequate prescribing practices by dentists. The aim of this concise review was to analyse the worldwide pattern of antibiotic prescription in endodontic infections. METHODS: Comprehensive searches were conducted in MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. The databases were searched up to 13 March 2016 for studies in which dentists used systemic antibiotics to treat endodontic lesions and which reported data on the type of antibiotic prescribed and on the diagnosis of the endodontic disease treated. RESULTS: The electronic and hand searches identified 69 titles, of which 25 were included in the final analysis. Amoxicillin was reported as the drug of choice for endodontic infections in most countries, and clindamycin and erythromycin were the choice for patients allergic to penicillin. Dentists worldwide prescribe antibiotics for non-indicated conditions, such as pulpitis. CONCLUSION: Antibiotics are overprescribed for the management of endodontic infections. It is necessary to improve antibiotic-prescribing habits in the treatment of endodontic infections, as well as to introduce educational initiatives to encourage the coherent and proper use of antibiotics in such conditions.