Self-reported body silhouettes: a diagnostic instrument for anthropometric parameters.

OBJECTIVE: Routine body size measurement of anthropometric values requires professionals, standardized techniques, and calibrated tools. Therefore, there is a need for easier screening tools such as the self-reported body silhouette (Self-bosi). The aim of this study was to analyze the performance of Self-bosi as a proxy of anthropometric values. STUDY DESIGN: Prospective analytic study of the Health Workers Cohort Study. METHODS: Adult participants of the Health Workers Cohort Study were included. Then, through the calculation sensitivity and specificity of Self-bosi to detect abnormal waist circumference (WC) (≥90 cm for male and ≥80 cm for female participants), elevated body fat percentage (BF%) (≥25% for male and ≥35% for female participants), as well as overweight and obesity (≥25 kg/m2) and obesity (≥30 kg/m2). RESULTS: A total of 2471 male and 5940 female participants were analyzed. Overall, Self-bosi discriminate high WC values (area under the curve [AUC]; male participants: 0.80, female participants: 0.82); increased BF% (AUC: male participants: 0.78, female participants: 0.83); overweight and obesity (AUC: male participants: 0.81, female participants: 0.86); and obesity (AUC: male participants: 0.83, female participants: 0.89). CONCLUSION: Self-bosi is an accurate method to assess increased WC, BF%, obesity, and overweight-obesity in Mexican adults. Given its simplicity and low-cost of the self-reported body silhouette, it might be considered a useful anthropometric screening instrument in large scale epidemiological research.

Comparison of International Reference Values for Bone Speed of Sound in Pediatric Populations: Meta-analysis.

The aim of this study was to compare international reference values (RV) for tibial and radial speed of sound (SoS) assessed by quantitative ultrasound (QUS) in pediatric populations. These values were compared by age and country of origin in a systematic review with meta-analysis from studies published on QUS (Sunlight Omnisense). A search was carried out in electronic databases. Nine studies with 6963 patients were included in the meta-analysis. For the newborn populations, 3 studies (from Italy, Portugal, and Israel) were used. These studies included subjects with 27-42 wk gestational age. The mean difference (Portugal-Israel) was found to be 23.62 m/s [95% confidence interval [CI] 6.29, 40.95]. Additionally, no difference was found between Italy-Portugal (p = 0.69), or Italy-Israel (p = 0.28). In pediatric populations, we compared 8 studies from Canada, Mexico, Israel, Greece, Portugal, and Turkey. No significant differences found for SoS RV between Israel-Turkey, Israel-Greece, or Israel-Canada (p > 0.05). Significant differences were found in Mexico-Israel -105.29 m/s (95% CI -140.05, -70.54) (p < 0.001); Mexico-Portugal -115.14 m/s (95% CI -164.86, -65.42) (p < 0.001); Mexico-Greece: -239.14 m/s (95% CI -267.67, -210.62) (p < 0.001); Mexico-Turkey: -115.14 m/s (95% CI -164.86, -65.42) (p < 0.001); Mexico-Canada: -113.51 m/s (95% CI -140.25, -86.77) (p < 0.001).This study demonstrates that there are differences in SoS-RV obtained by tibial and radial QUS in pediatric populations between Mexico and other countries (Israel, Portugal, Greece, Turkey, and Canada).

Adherence to prophylaxis and quality of life in children and adolescents with severe haemophilia A.

Treatment adherence in adolescents with chronic diseases is around 50%, and failure is more common in preventive therapy. In haemophilia, contradictory results are reported by the published studies. The objective of this study was to evaluate adherence with factor VIII (FVIII) prophylaxis in Spanish patients with severe haemophilia A between age 6 and 20 years. Data were collected retrosp-ectively in the previous 2 years. The primary endpoint was the absolute adherence index (AAI), and the endpoints were related to clinical status, age, prophylaxis regimen, responsibility for factor administration and quality of life (QoL), assessed by the Haemo-QoL questionnaires. A total of 78 patients from 14 Spanish hospitals were recruited. Adherence ranged between -64.4 and 66.7 (mean -3.08). No differences were observed between children and adolescents (7.11 vs. 6.39; P = 0.809). A statistically significant association (P < 0.010) between infra adherent group and target joint was found, as was a statistically significant difference (P < 0.010) between the number of bleeding episodes experienced by the adherent group (mean 1.4) and by infra adherents (mean 4.5). There was no significant difference between AAI and prophylactic regimen (6.35 vs. 6.96, P = 0.848), neither between AAI and the person responsible for factor administration (5.57 vs. 8.79, P = 0.326). The Haemo-QoL scores (8-12 years) were related to adherence level (P < 0.05). Adherence was approximately ideal and patients perceived a high QoL. Because of the repercussions for compliance, it is essential to work during puberty on emotional and self-acceptance aspects of the disease, as well as coping, and the patient's family, school and health team relationships.

Pharmacokinetics and safety of plasma-derived factor XIII concentrate (human) in patients with congenital factor XIII deficiency.

UNLABELLED: Congenital factor XIII (FXIII) deficiency is a rare condition with substantial risk for life-threatening bleeding. Replacement of deficient FXIII with plasma-derived FXIII concentrate is a treatment option. The current 12-week study evaluated the steady-state pharmacokinetic (PK) and safety profile of prophylactic infusions of FXIII concentrate (human) in patients with congenital FXIII deficiency. Patients received FXIII concentrate (human) 40 IU kg(-1) on Days 0, 28, and 56. FXIII levels were assessed before and after each infusion; steady-state PK parameters were assessed up to 28 days after the infusion on Day 56. Treatment effectiveness in maintaining trough FXIII activity levels ≥ 5% over 28 days and safety parameters were also assessed. Fourteen patients received FXIII concentrate (human) and 13 completed the study. Post-infusion, FXIII activity levels increased to within the range found in patients without congenital FXIII deficiency without reaching supra-therapeutic levels. Non-baseline-adjusted trough FXIII activity levels were maintained at or above 10% at all post-baseline visits in all patients. Steady-state PK parameters were baseline-adjusted; maximum FXIII activity was 87.7% at 1.72 h post-infusion, subsequently declining to a minimum of 5.0%. The half-life was 6.6 days. FXIII concentrate (human) was generally well tolerated. Two patients had possibly treatment-related adverse events. There were no reports of thromboembolism, viral transmission, bleeding events or treatment-related hypersensitivity. These findings support use of FXIII concentrate (human) 40 IU kg(-1) every 28 days as an appropriate regimen for routine, long-term prophylaxis in children and adults with congenital FXIII deficiency. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov/ct2/show/NCT00883090.

A novel, fully automated, observer-independent program for semiquantifying striatal ¹²³I-FP-CIT uptake.

OBJECTIVE: To describe and validate a novel, fully automated program specifically designed for the semiquantification of striatal (123)I-FP-CIT uptake using volumes of interest (VOI) analysis. MATERIAL AND METHODS: The proposed algorithm is based on a template that mimics the striatal (123)I-FP-CIT uptake in a healthy subjects, derived from defined anatomical VOIs available from WFU PickAtlas. Four SPECT studies of the anthropomorphic Alderson phantom filled with variable radioactive concentrations were acquired for the experimental validation. Experimental SPECT images were spatially normalized with respect to the previously created template. The binary VOIs corresponding to left caudate and putamen and right caudate and putamen, which were used to construct the template, were projected onto the experimental images to obtain the counts for these regions. To minimize the partial volume effect, a percentage of the voxels in these regions (threshold), rather than all of them, was used. A binary occipital VOI was used to quantify the non-specific uptake. Experimental binding potentials (BPs) were calculated from the counts in these regions. True BPs were calculated from aliquots taken from the solutions used to fill the phantom. RESULTS: There were statistically significant differences in the experimental BP values (p<0.002) according to the percentage of voxels used. A highly significant correlation was achieved between true and experimental BP values, regardless of the percentage of voxels included for quantification. CONCLUSIONS: Our novel, observer-independent program automatically performs the semiquantification of striatal (123)I-FP-CIT uptake in experimental studies.

[Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer. Its relation with molecular subtypes]. / La biopsia del ganglio centinela después de quimioterapia neoadyuvante en el cáncer de mama. Relación con los subtipos moleculares.

OBJECTIVE: To evaluate the influence of the molecular subtype (MS) in the Sentinel Node Biopsy (SNB) technique after neoadjuvant chemotherapy (NAC) in women with locally advanced breast cancer (BC) and a complete axillary response (CR). MATERIAL AND METHODS: A prospective study involving 70 patients with BC treated with NAC was carried out. An axillary lymph node dissection was performed in the first 48 patients (validation group: VG), and in case of micro- or macrometastases in the therapeutic application phase (therapy group:TG). Classified according to MS: 14 luminal A; 16 luminal B HER2-, 13 luminal B HER2+, 10HER2+ non-luminal, 17 triple-negative. RESULTS: SNB was carried out in 98.6% of the cases, with only one false negative result in the VG (FN=2%). Molecular subtype did not affect SN detection. Despite the existence of axillary CR, statistically significant differences were found in the proportion of macrometastasis (16.7% vs. 35.7%, p=0.043) on comparing the pre-NAC cN0 and cN+. Breast tumor response to NAC varied among the different MS, this being lowest in luminal A (21.5%) and highest in non-luminal HER2+ group (80%). HER2+ and triple-negative were the groups with the best axillary histological response both when there was prior clinical involvement and when there was not. CONCLUSIONS: Molecular subtype is a predictive factor of the degree of tumor response to NAC in breast cancer. However, it does not affect SNB detection and efficiency. SNB can also be used safely in women with prior node involvement as long as a complete clinical and radiological assessment is made of the node response to NAC.

Pegylated interferons Lambda-1a and alfa-2a display different gene induction and cytokine and chemokine release profiles in whole blood, human hepatocytes and peripheral blood mononuclear cells.

Pegylated interferon-lambda-1a (Lambda), a type III interferon (IFN) in clinical development for the treatment of chronic HCV infection, has shown comparable efficacy and an improved safety profile to a regimen based on pegylated IFN alfa-2a (alfa). To establish a mechanistic context for this improved profile, we investigated the ex vivo effects of Lambda and alfa on cytokine and chemokine release, and on expression of IFN-stimulated genes (ISGs) in primary human hepatocytes and peripheral blood mononuclear cells (PBMCs) from healthy subjects. Our findings were further compared with changes observed in blood analysed from HCV-infected patients treated with Lambda or alfa in clinical studies. mRNA transcript and protein expression of the IFN-λ-limiting receptor subunit was lower compared with IFN-α receptor subunits in all cell types. Upon stimulation, alfa and Lambda induced ISG expression in hepatocytes and PBMCs, although in PBMCs Lambda-induced ISG expression was modest. Furthermore, alfa and Lambda induced release of cytokines and chemokines from hepatocytes and PBMCs, although differences in their kinetics of induction were observed. In HCV-infected patients, alfa treatment induced ISG expression in whole blood after single and repeat dosing. Lambda treatment induced modest ISG expression after single dosing and showed no induction after repeat dosing. Alfa and Lambda treatment increased IP-10, iTAC, IL-6, MCP-1 and MIP-1ß levels in serum, with alfa inducing higher levels of all mediators compared with Lambda. Overall, ex vivo and in vivo induction profiles reported in this analysis strongly correlate with clinical observations of fewer related adverse events for Lambda vs those typically associated with alfa.

Evaluation of the effects of a therapeutic renal diet to control proteinuria in proteinuric non-azotemic dogs treated with benazepril.

BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) are currently used to control proteinuria in dogs with chronic kidney disease. Renal diets (RDs) have beneficial effects in the management of azotemic dogs, but its role in proteinuric non-azotemic (PNAz) dogs has been poorly documented. HYPOTHESIS: Administration of a RD to PNAz dogs treated with benazepril (Be) improves proteinuria control compared with the administration of a maintenance diet (MD). ANIMALS: Twenty-two PNAz (urine protein/creatinine ratio [UPC] >1) dogs. METHODS: Randomized open label clinical trial design. Dogs were assigned to group-MD (5.5 g protein/100 kcal ME)/Be or to group-RD (3.7 g protein/100 kcal ME)/Be group during 60 days. Dogs with serum albumin (Alb) <2 g/dL received aspirin (1 mg/kg/12 hours). A physical examination, systolic blood pressure (SBP) measurement, complete blood count (CBC), biochemistry panel, urinalysis, and UPC were performed at day 0 (D0) and day 60 (D60). RESULTS: At D0, there were no significant differences between groups in the evaluated variables. During the study, logUPC (geometric mean (95% CI) and SBP (mean±SD mmHg) significantly decreased (paired t-test, P = 0.001) in Group-RD (logUPC(D0) = 3.16[1.9-5.25]; UPC(D60) = 1.20 [0.59-2.45]; SBP(D0) = 160 ± 17.2; SBP(D60) = 151 ± 15.8), but not in Group-MD (UPC(D0) = 3.63[2.69-4.9]; UPC(D60) = 2.14 [0.76-6.17]; SBP(D0) = 158 ± 14.7; SBP(D60) = 153 ± 11.5). However, RM-ANOVA test did not confirm that changes were consequence of dietary modification. Weight and Alb concentration did not change significantly in any group. CONCLUSION AND CLINICAL RELEVANCE: The administration of a RD to PNAz dogs treated with Be might help to control proteinuria and SBP compared with the administration of a MD, without inducing clinically detectable malnutrition, but more studies are warranted.

Acute venous thrombosis as complication and clue to diagnose a SAPHO syndrome case. A case report.

This report concerns a male adult admitted for sternal and left arm pain, who was diagnosed and treated for acute deep venous thrombosis in the left subclavian and axillary veins. X-ray and a hybrid single photon emission tomography and computed tomography (SPECT-CT) scintigraphy scan revealed high intensity uptake in both sternoclavicular joints, which corresponded to hyperostosis, thereby suggesting a SAPHO syndrome. Upon reviewing the patient's medical history, we found dermatological pustulosis disease and an intermittent sternal chest pain untreated since 10 years ago. In the biochemical study we found erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) elevation, hyperglobulinemia, and mild anaemia. Initial treatment included nonsteroidal anti-inflammatory drugs (NSAIDs) with low response, which then changed to methotrexate, sulfasalazine, and prednisone. The patient's pain was controlled almost completely in 10 months. A control bone scan revealed a marked decrease in intensity of bone deposits according to clinical response. To our knowledge, there are only a few cases of SAPHO and thrombosis and none are followed up with a bone SPECT-CT scan.

Aspectos clínico-epidemiológicos sobre pediculosis capitis en arenales, Estado Falcón, Venezuela / Clinical and epidemiological aspects on pediculosis capitis in, Falcon State, Venezuela

la pediculosis capitis humana es una infestación del cuero cabelludo y del pelo, ocasionada por el Pediculus humanus capitis, la que puede producir infecciones bacterianas secundarias en el sitio del rascado, anemia y estrés social y psicológico con alteración en la calidad de vida y consternación. Entre Marzo y Julio de 2011, se realizó un trabajo para estudiar aspectos epidemiológicos y clínicos de la pediculosis capitis en 199 personas (79 varones y 120 mujeres), habitantes de diferentes grupos etéreos (0-75 años; ? ± D.S= 21,28 ± 17) de la población rural Arenales, zona semiárida del estado Falcón, región nor-occidental de Venezuela. El diagnóstico ectoparasitológico se realizó por observación directa con peine "ad hoc" de huevos (liendres), estados imaginales y/o pre-imaginales sobre el cuero cabelludo. Los insectos se clarificaron y montaron en medio de Hoyer para observación microscópica. Los resultados revelaron una prevalencia global de pediculosis capitis del 10,10% (20/199), con porcentajes de infestación significativamente mayores en las niñas (90 vs 10%) [Odds Ratio (OR) = 3,04; p = 0,01] en edad escolar (OR= 1,02; p =0,015;) con longitudes de cabello mayores de 3 cm (OR = 2,44; p = 0,004) y de tipo lisotrico (OR = 2,25; p = 0,015), sin embargo, no fueron diferentes entre grupos étnicos y color de pelo (P > 0,05). Se detectó un predominio de liendres (65%) desde 1 hasta 64/individuos, ubicadas entre 0,1 y 9 cm del cuero cabelludo en todas las regiones de la cabeza, teniendo los individuos de menor edad las mayores cargas ectoparasitarias. Los síntomas significativamente asociados a pediculosis fueron el prurito (6,53% en individuos infestados y 12,06% en los no infestados; OR =11,99; p = 0,000) y las excoriaciones (1,51% en niños infestados y 3,52% en los no infestados; OR =4,34; p = 0,03). Otros posibles factores de riesgo significativamente involucrados en la dinámica de transmisión y mantenimiento de la infestación fueron: jugar en piso de tierra (OR = 2,20; p = 0,012) y lavarse el cabello ≥2 /semana (OR = 1,01; p = 0,002). A la luz de los resultados obtenidos, es recomendable mejorar las condiciones socio-sanitarias del sector y mantener campañas de promoción y educación para la salud.

The human pediculosis capitis is a scalp and hair infestation caused by head lice Pediculus humanus capitis, which may result in bacterial secondary infections by intense scratching as well as anemia, anxiety and embarassment which are increased by children' exclusion from school under "no-nit" policy. From March to July 2011, a cross-sectional study was designed to determine the prevalence and clinical and epidemiological profiles of head lice infestation among 199 (79 males and 120 females) inhabitants of all age groups (0-75 years; ? ± D.S= 21.28 ± 17) of a rural and small town Arenales, from the semiarid region of Falcon state, north-western Venezuela.The diagnosis of head lice infestation was made by clinical naked eye inspection of scalp and hair for the presence of adult lice, nymphal stage, or eggs (nit) by line-toothed head lice comb. Lice was cleared and mounted in Hoyer’s medium for microscopic observation. All individuals were evaluated by physical examinationand a detailed, structured questionnaire. The overall prevalence of head lice infestation was 10.10% (20/199). The prevalence of infestation was significantly higher in girls (90%) than in boys (10%) [Odds Ratio (OR) = 3.04; p = 0.01] and school-aged children (OR= 1.02;p=0,015;) with hair length >3cm (OR = 2,44; p = 0.004) and lissotrichic type (OR = 2.25; p = 0.02), (OR= 2.25; 0.98 - 5.18), however, these were not significantly different among races or hair colours (P > 0.05). 65% of the individuals had only nits with 1 up to 64 per individuals, found between 0.1 and 9 cm from scalp on all anatomical regions of the head, and having school-aged children the higher ectoparasitic loads. Among clinical signs and symptoms, head pruritus (6.53 vs. 12.06%; OR =11.99; p =0.000) and excoriations (1.51% vs. 3.52%; OR =4.34; p = 0.03) showed significantly higher percentages in infested children than in uninfested ones. Other independent risk factors by logistic regression analysis signficantly associated with pediculosis captitis were playing on dust floor (OR = 2.20; p = 0.012), and frequency of hair washing ≥2 /week (OR = 1.01; p = 0.002). These results suggest that pediculosis capitis remains as a common and endemic public health problem in Venezuelan northwestern semiarid region. Thus, education campaigns by health care officials, physicians and teachers, as well as improving standards of living and personal hygiene might significantly reduce pediculosis capitis in those human populations endemically exponed.

Aspectos clínico-epidemiológicos sobre pediculosis capitis en arenales, Estado Falcón, Venezuela / Clinical and epidemiological aspects on pediculosis capitis in, Falcon State, Venezuela

la pediculosis capitis humana es una infestación del cuero cabelludo y del pelo, ocasionada por el Pediculus humanus capitis, la que puede producir infecciones bacterianas secundarias en el sitio del rascado, anemia y estrés social y psicológico con alteración en la calidad de vida y consternación. Entre Marzo y Julio de 2011, se realizó un trabajo para estudiar aspectos epidemiológicos y clínicos de la pediculosis capitis en 199 personas (79 varones y 120 mujeres), habitantes de diferentes grupos etéreos (0-75 años; ñ D.S= 21,28 ñ 17) de la población rural Arenales, zona semiárida del estado Falcón, región nor-occidental de Venezuela. El diagnóstico ectoparasitológico se realizó por observación directa con peine "ad hoc" de huevos (liendres), estados imaginales y/o pre-imaginales sobre el cuero cabelludo. Los insectos se clarificaron y montaron en medio de Hoyer para observación microscópica. Los resultados revelaron una prevalencia global de pediculosis capitis del 10,10% (20/199), con porcentajes de infestación significativamente mayores en las niñas (90 vs 10%) [Odds Ratio (OR) = 3,04; p = 0,01] en edad escolar (OR= 1,02; p =0,015;) con longitudes de cabello mayores de 3 cm (OR = 2,44; p = 0,004) y de tipo lisotrico (OR = 2,25; p = 0,015), sin embargo, no fueron diferentes entre grupos étnicos y color de pelo (P > 0,05). Se detectó un predominio de liendres (65%) desde 1 hasta 64/individuos, ubicadas entre 0,1 y 9 cm del cuero cabelludo en todas las regiones de la cabeza, teniendo los individuos de menor edad las mayores cargas ectoparasitarias. Los síntomas significativamente asociados a pediculosis fueron el prurito (6,53% en individuos infestados y 12,06% en los no infestados; OR =11,99; p = 0,000) y las excoriaciones (1,51% en niños infestados y 3,52% en los no infestados; OR =4,34; p = 0,03). Otros posibles factores de riesgo significativamente involucrados en la dinámica de transmisión y mantenimiento de la infestación fueron: jugar en piso de tierra (OR = 2,20; p = 0,012) y lavarse el cabello ≥2 /semana (OR = 1,01; p = 0,002). A la luz de los resultados obtenidos, es recomendable mejorar las condiciones socio-sanitarias del sector y mantener campañas de promoción y educación para la salud.(AU)

The human pediculosis capitis is a scalp and hair infestation caused by head lice Pediculus humanus capitis, which may result in bacterial secondary infections by intense scratching as well as anemia, anxiety and embarassment which are increased by children exclusion from school under "no-nit" policy. From March to July 2011, a cross-sectional study was designed to determine the prevalence and clinical and epidemiological profiles of head lice infestation among 199 (79 males and 120 females) inhabitants of all age groups (0-75 years; ñ D.S= 21.28 ñ 17) of a rural and small town Arenales, from the semiarid region of Falcon state, north-western Venezuela.The diagnosis of head lice infestation was made by clinical naked eye inspection of scalp and hair for the presence of adult lice, nymphal stage, or eggs (nit) by line-toothed head lice comb. Lice was cleared and mounted in Hoyer’s medium for microscopic observation. All individuals were evaluated by physical examinationand a detailed, structured questionnaire. The overall prevalence of head lice infestation was 10.10% (20/199). The prevalence of infestation was significantly higher in girls (90%) than in boys (10%) [Odds Ratio (OR) = 3.04; p = 0.01] and school-aged children (OR= 1.02;p=0,015;) with hair length >3cm (OR = 2,44; p = 0.004) and lissotrichic type (OR = 2.25; p = 0.02), (OR= 2.25; 0.98 - 5.18), however, these were not significantly different among races or hair colours (P > 0.05). 65% of the individuals had only nits with 1 up to 64 per individuals, found between 0.1 and 9 cm from scalp on all anatomical regions of the head, and having school-aged children the higher ectoparasitic loads. Among clinical signs and symptoms, head pruritus (6.53 vs. 12.06%; OR =11.99; p =0.000) and excoriations (1.51% vs. 3.52%; OR =4.34; p = 0.03) showed significantly higher percentages in infested children than in uninfested ones. Other independent risk factors by logistic regression analysis signficantly associated with pediculosis captitis were playing on dust floor (OR = 2.20; p = 0.012), and frequency of hair washing ≥2 /week (OR = 1.01; p = 0.002). These results suggest that pediculosis capitis remains as a common and endemic public health problem in Venezuelan northwestern semiarid region. Thus, education campaigns by health care officials, physicians and teachers, as well as improving standards of living and personal hygiene might significantly reduce pediculosis capitis in those human populations endemically exponed.(AU)

Aspectos clínico-epidemiológicos sobre pediculosis capitis en arenales, Estado Falcón, Venezuela / Clinical and epidemiological aspects on pediculosis capitis in, Falcon State, Venezuela

la pediculosis capitis humana es una infestación del cuero cabelludo y del pelo, ocasionada por el Pediculus humanus capitis, la que puede producir infecciones bacterianas secundarias en el sitio del rascado, anemia y estrés social y psicológico con alteración en la calidad de vida y consternación. Entre Marzo y Julio de 2011, se realizó un trabajo para estudiar aspectos epidemiológicos y clínicos de la pediculosis capitis en 199 personas (79 varones y 120 mujeres), habitantes de diferentes grupos etéreos (0-75 años; ± D.S= 21,28 ± 17) de la población rural Arenales, zona semiárida del estado Falcón, región nor-occidental de Venezuela. El diagnóstico ectoparasitológico se realizó por observación directa con peine "ad hoc" de huevos (liendres), estados imaginales y/o pre-imaginales sobre el cuero cabelludo. Los insectos se clarificaron y montaron en medio de Hoyer para observación microscópica. Los resultados revelaron una prevalencia global de pediculosis capitis del 10,10% (20/199), con porcentajes de infestación significativamente mayores en las niñas (90 vs 10%) [Odds Ratio (OR) = 3,04; p = 0,01] en edad escolar (OR= 1,02; p =0,015;) con longitudes de cabello mayores de 3 cm (OR = 2,44; p = 0,004) y de tipo lisotrico (OR = 2,25; p = 0,015), sin embargo, no fueron diferentes entre grupos étnicos y color de pelo (P > 0,05). Se detectó un predominio de liendres (65%) desde 1 hasta 64/individuos, ubicadas entre 0,1 y 9 cm del cuero cabelludo en todas las regiones de la cabeza, teniendo los individuos de menor edad las mayores cargas ectoparasitarias. Los síntomas significativamente asociados a pediculosis fueron el prurito (6,53% en individuos infestados y 12,06% en los no infestados; OR =11,99; p = 0,000) y las excoriaciones (1,51% en niños infestados y 3,52% en los no infestados; OR =4,34; p = 0,03). Otros posibles factores de riesgo significativamente involucrados en la dinámica de transmisión y mantenimiento de la infestación fueron: jugar en piso de tierra (OR = 2,20; p = 0,012) y lavarse el cabello ≥2 /semana (OR = 1,01; p = 0,002). A la luz de los resultados obtenidos, es recomendable mejorar las condiciones socio-sanitarias del sector y mantener campañas de promoción y educación para la salud.(AU)

The human pediculosis capitis is a scalp and hair infestation caused by head lice Pediculus humanus capitis, which may result in bacterial secondary infections by intense scratching as well as anemia, anxiety and embarassment which are increased by children exclusion from school under "no-nit" policy. From March to July 2011, a cross-sectional study was designed to determine the prevalence and clinical and epidemiological profiles of head lice infestation among 199 (79 males and 120 females) inhabitants of all age groups (0-75 years; ± D.S= 21.28 ± 17) of a rural and small town Arenales, from the semiarid region of Falcon state, north-western Venezuela.The diagnosis of head lice infestation was made by clinical naked eye inspection of scalp and hair for the presence of adult lice, nymphal stage, or eggs (nit) by line-toothed head lice comb. Lice was cleared and mounted in Hoyer’s medium for microscopic observation. All individuals were evaluated by physical examinationand a detailed, structured questionnaire. The overall prevalence of head lice infestation was 10.10% (20/199). The prevalence of infestation was significantly higher in girls (90%) than in boys (10%) [Odds Ratio (OR) = 3.04; p = 0.01] and school-aged children (OR= 1.02;p=0,015;) with hair length >3cm (OR = 2,44; p = 0.004) and lissotrichic type (OR = 2.25; p = 0.02), (OR= 2.25; 0.98 - 5.18), however, these were not significantly different among races or hair colours (P > 0.05). 65% of the individuals had only nits with 1 up to 64 per individuals, found between 0.1 and 9 cm from scalp on all anatomical regions of the head, and having school-aged children the higher ectoparasitic loads. Among clinical signs and symptoms, head pruritus (6.53 vs. 12.06%; OR =11.99; p =0.000) and excoriations (1.51% vs. 3.52%; OR =4.34; p = 0.03) showed significantly higher percentages in infested children than in uninfested ones. Other independent risk factors by logistic regression analysis signficantly associated with pediculosis captitis were playing on dust floor (OR = 2.20; p = 0.012), and frequency of hair washing ≥2 /week (OR = 1.01; p = 0.002). These results suggest that pediculosis capitis remains as a common and endemic public health problem in Venezuelan northwestern semiarid region. Thus, education campaigns by health care officials, physicians and teachers, as well as improving standards of living and personal hygiene might significantly reduce pediculosis capitis in those human populations endemically exponed.(AU)

The prevalence of radiographic vertebral fractures in Mexican men.

SUMMARY: The prevalence of radiographically ascertained vertebral fractures in a random sample of 413 in Mexican men is 9.7% (95% CI 6.85-12.55). Increase of vertebral fracture rises with age from 2.0% in the youngest group (50-59 years) to 21.4% in the oldest group (80 years and over). INTRODUCTION: This is the first population-based study of vertebral fractures in Mexican men using a standardized methodology reported in other studies. METHODS: The presence of radiographic vertebral fractures increases with age. This same pattern was found in Mexican women with steady age increments, but the higher prevalence of fractures in women starts at age 70, whereas in men, the higher prevalence starts a decade later (80 years and over). RESULTS: The standardized prevalence per 1,000 men 50 years and over in the Mexican population for the year 2005 is 65.8 (95% CI 29.9-105.5), and it is 68.6 (95% CI 32.2-108.7) in the US population for the year 2000.

Calcium and phosphorus homeostasis in dogs with spontaneous chronic kidney disease at different stages of severity.

BACKGROUND: Studies in dogs with experimental chronic kidney disease (CKD) have demonstrated that abnormalities of calcium-phosphorus (Ca-P) homeostasis occur frequently and have a negative effect on kidney function and survival. However, the prevalence of these alterations in dogs with naturally occurring CKD at different stages of severity has not yet been investigated. HYPOTHESIS: Abnormalities of Ca-P metabolism occur early in the course of CKD with an increased prevalence in more severe stages. ANIMALS: Fifty-four dogs with CKD and 22 healthy dogs. METHODS: Blood and urine samples were obtained for a CBC, biochemistry, determination of parathyroid hormone (PTH), calcitriol, and ionized calcium concentrations and urinalysis. Based on urine protein/creatinine ratio and serum creatinine concentration, dogs were grouped according to the IRIS classification for CKD. RESULTS: Hyperparathyroidism (HPTH) (PTH > or = 48 pg/mL) was diagnosed in 41 (75.9%) dogs with CKD. Its prevalence increased from 36.4% (stage 1) to 100% (stage 4). Hyperphosphatemia (P > 5.5 mg/dL) was present in 37 (68.5%) dogs; increasing in prevalence from 18% (stage 1) to 100% (stage 4). Receiver-operating characteristic curve analysis showed that serum phosphorus concentration in the 4.5-5.5 mg/dL range correctly identified the presence of HPTH in most dogs. Calcitriol concentration progressively decreased in dogs with CKD and differences became statistically significant by stage 3. CONCLUSION AND CLINICAL RELEVANCE: HPTH and hyperphosphatemia occur frequently in dogs with naturally occurring CKD, even at early stages of CKD in some dogs. These findings highlight the importance of monitoring these parameters early in the course of CKD.

Serum phosphorus concentrations in dogs with leishmaniosis at different stages of chronic kidney disease.

Serum phosphorus concentrations were measured in 155 dogs with leishmaniosis at different stages of chronic kidney disease (CKD), and in 54 healthy dogs. CKD was classified into six stages, as follows: stage 0 (dogs with no evidence of CKD), serum creatinine (SCr) less than 125 micromol/l and urine protein:creatinine ratio (UPC) less than 0.2; stage 1A, SCr less than 125 micromol/l and UPC 0.2 to 0.5; stage 1B, SCr less than 125 micromol/l and UPC over 0.5; stage 2, SCr 125 micromol/l to 180 micromol/l; stage 3, SCr 181 micromol/l to 440 micromol/l; stage 4, SCr over 440 micromol/l. The dogs' serum phosphorus concentrations correlated significantly with the severity of CKD (P<0.001), and hyperphosphataemia (>1.8 mmol/l) affected 12 per cent, 11.8 per cent, 50 per cent, 76.9 per cent and 100 per cent of the dogs at stages 1A, 1B, 2, 3 and 4, respectively.

The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS).

UNLABELLED: In the first population-based study of vertebral fractures in Latin America, we found a 11.18 (95% CI 9.23-13.4) prevalence of radiographically ascertained vertebral fractures in a random sample of 1,922 women from cities within five different countries. These figures are similar to findings from studies in Beijing, China, some regions of Europe, and slightly lower than those found in the USA using the same standardized methodology. INTRODUCTION: We report the first study of radiographic vertebral fractures in Latin America. METHODS: An age-stratified random sample of 1,922 women aged 50 years and older from Argentina, Brazil, Colombia, Mexico, and Puerto Rico were included. In all cases a standardized questionnaire and lateral X-rays of the lumbar and thoracic spine were obtained after informed consent. RESULTS: A standardized prevalence of 11.18 (95% CI 9.23-13.4) was found. The prevalence was similar in all five countries, increasing from 6.9% (95% CI 4.6-9.1) in women aged 50-59 years to 27.8% (95% CI 23.1-32.4) in those 80 years and older (p for trend < 0.001). Among different risk factors, self-reported height loss OR = 1.63 (95% CI: 1.18-2.25), and previous history of fracture OR = 1.52 (95% CI: 1.14-2.03) were significantly (p < 0.003 and p < 0.04 respectably) associated with the presence of radiographic vertebral fractures in the multivariate analysis. In the bivariate analyses HRT was associated with a 35% lower risk OR = 0.65 (95% CI: 0.46-0.93) and physical activity with a 27% lower risk of having a vertebral fracture OR = 0.73 (95% CI: 0.55-0.98), but were not statistically significant in multivariate analyses CONCLUSION: We conclude that radiographically ascertained vertebral fractures are common in Latin America. Health authorities in the region should be aware and consider implementing measures to prevent vertebral fractures.

[Sentinel node biopsy in T2 breast cancers larger than 3 cm and clinically negative axilla compared with the T1-T2 <3 cm standard indication]. / La biopsia del ganglio centinela en cáncer de mama de más de 3 cm y axila clínicamente negativa frente a la indicación estándar T1-T2 < 3 cm.

OBJECTIVE: To present our experience in the application of sentinel node (SN) biopsy in patients with breast cancer T > 3 cm without clinical evidence of axillary metastasis. MATERIAL AND METHOD: Retrospective study of 393 cases in the period 2001--2006, divided into group (A) 47 patients with 3-5 cm T2N0 tumours and group (B) 346 patients T < 3 cm, N0. We employed the combined technique with 99mTc-colloidal rhenium sulphide and isosulfan blue dye. Preoperative lymphoscintigraphy was performed and the SN was located intraoperatively with a gamma ray detection probe and the blue dye. Axillary lymph node dissection was completed only when the SN was positive for metastasis in the histopathology analysis or not located. RESULTS: The SN detection rate for T2 > 3 cm was 94 % in the scintigraphy and 96 % with the probe, with no statistically significant differences between T < 3 cm (97 % and 98 %). In T2 > 3 cm, the final staging was 45 % pN0, 8 % pN1mi, 34 % pN1a, 11 % pN2a and 2 % pN3a. We found statistically significant differences (p < 0.05) when compared with palpable T < 3 cm and non-palpable cancer (62 % pN0 and 74 % pN0, respectively). In the follow-up of T2 > 3 cm (median 42.88 months) we did not find any axillary relapse which could be considered a false negative of the technique. CONCLUSION: The detection of sentinel lymph nodes is feasible and safe in tumours larger than 3cm with clinically negative axilla. Axillary lymph node dissection can be avoided in 45 % of these patients and therefore, we consider that they should be included as a general indication in breast cancer SN detection.

Glomerular filtration rate in dogs with leishmaniasis and chronic kidney disease.

BACKGROUND: Glomerular filtration rate (GFR) measurement is an indicator of kidney function. However, its usefulness in dogs at early stages of spontaneous chronic kidney disease (CKD) of glomerular origin, where routine laboratory techniques are not sufficiently sensitive, remains unproved. HYPOTHESIS: That GFR is reduced in proteinuric nonazotemic or mildly azotemic dogs with CKD secondary to leishmaniasis. ANIMALS: Twenty-six dogs with CKD secondary to leishmaniasis and 10 healthy dogs (control group). METHODS: CBC, serum biochemistry, and urinalysis (microalbuminuria and urine protein/creatinine ratio [UPC]) were performed in all dogs. GFR was calculated by measuring exogenous creatinine clearance. Based on degree of proteinuria and serum creatinine concentration (SCr), dogs were classified as group A (control; n = 10): UPC < 0.2, SCr < 1.4 mg/dL; group B (n = 8): UPC, 0.2-0.5, SCr < 1.4 mg/dL; group C (n = 10): UPC > 0.5, SCr < 1.4 mg/dL; group D (n = 5): SCr, 1.4-2 mg/dL; group E (n = 3): SCr > 2 mg/dL. RESULTS: GFR (mL/kg/min) was 3.9 +/- 0.29, 4.4 +/- 0.74, 4.5 +/- 1.44, 2.8 +/- 0.97, and 1.5 +/- 0.43 for groups A, B, C, D, and E, respectively. Eleven dogs (1 from group B, 3 from group C, 4 from group D, and all 3 dogs from group E) had an abnormally low GFR. Four dogs from group B and 5 dogs from group C had a GFR above the upper reference range (>4.5 mL/min/kg). CONCLUSION AND CLINICAL RELEVANCE: Some proteinuric nonazotemic or mildly azotemic dogs with leishmaniasis have low GFR, but glomerular hyperfiltration occurs in other dogs.

Staging the axilla with selective sentinel node biopsy in patients with previous excision of non-palpable and palpable breast cancer.

PURPOSE: To present our experience in the therapeutic approach of the sentinel node biopsy (SNB) in patients with previous excision of the breast cancer, divided in non-palpable and palpable lesions, in comparison with time treatment and stagement of breast cancer. METHODS: In the period 2001-2006, 138 patients with prior diagnostic excisional biopsy (96 non-palpable and 42 palpable breast cancer) and 328 without previous surgery (32 non-palpable; 296 palpable cancer) were treated. The combined technique ((99m)Tc-colloidal rhenium and isosulfan blue dye) was the approach for sentinel lymph node (SLN) detection. Axillary lymph node dissection (ALND) was completed only when the SLN was positive for metastasis or not located. RESULTS: Detection rate, if there was prior surgery, was 95% for non-palpable and 98% for palpable cancer, and 99% for one-time treatment group. Metastasis rate in the SLN was 15% in non-palpable cancer (14/91), significantly smaller than in palpable breast cancer (39% if prior surgery and 37% in one-time surgery). According to tumoral size, ALND metastasis rate was similar for T1 and T2 tumors (43-44%). In the follow-up of the groups with prior diagnostic biopsy or surgery of the breast cancer we have not found any false negative in the axilla. CONCLUSION: The detection of the SLN is also feasible in patients with previous surgery of breast cancer. Because SLN metastasis rates are significantly smaller in non-palpable lesions, the effort in screening programs for early detection of breast cancer and also in improving histopathological confirmation of malignancy with ultrasound or stereotactic guided core biopsies must continue.

Hip axis length variation: its correlation with anthropometric measurements in women from three ethnic groups.

UNLABELLED: We compared hip axis length (HAL) in 157 non-Hispanic white women, 292 African-American women, and 210 Mexican-American women. After adjusting for maximal hip girth, there were no residual differences in HAL by ethnicity. Differences in hip fracture risk seen between these groups cannot be explained by ethnic differences in HAL. INTRODUCTION: Hip axis length (HAL) has been reported to be an independent predictor of hip fracture. Significant ethnic differences in HAL have been noted, but no direct comparison has been made between African-American, Mexican-American, and non-Hispanic white women using the same protocol. METHODS: We compared 157 non-Hispanic white women from the Rancho Bernardo Study, 292 women from the Health Assessment Study of African-American Women, and 210 women from the Skeletal Health of Mexican-American Women Project. A standardized questionnaire was used to obtain medical history; height, weight, waist girth, and hip girth were measured; and percentage body fat and HAL were obtained using dual energy X-ray absorptiometry. All HAL comparisons were adjusted for maximum hip girth to control for differences in size magnification by fan-beam absorptiometry. RESULTS: Though there were ethnic differences in the unadjusted HAL measurement, after adjusting for hip circumference, there were no residual differences in HAL with regard to ethnicity: 10.7 cm in Mexican-American women vs. 10.8 in non-Hispanic white women and African-American women (p = 0.61). CONCLUSIONS: There were no ethnic differences in HAL in women from the three ethnic groups. Differences in fracture risk among these groups cannot be explained by ethnic differences in HAL.