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Abstract Background: Ankyloglossia is a condition present in some newborns and can be associated with breastfeeding difficulties, leading to symptoms in the child and the mother. This study aimed to analyze the characteristics of newborns with tongue-tie and the symptoms reported by their mothers, and the short and long-term outcomes of frenotomy. Methods: We conducted a prospective and observational 7-month study in a Baby-Friendly Hospital (BFH). We included all the breastfed newborns without comorbidities that underwent a frenotomy. Results: A total of 33 frenotomies were performed. The most common findings before the procedure were maternal breastfeeding pain (29/33), ineffective latch (18/33), and maternal nipple lesions (18/33). We observed that newborns surgically intervened later showed a high incidence of jaundice (p = 0.03), weight loss greater than 10% at hospital discharge (p = 0.004), and their mothers experienced pain more often (p = 0.004). At one month of age, there was an improvement in breastfeeding-related pain (p = 0.012) and its intensity (p = 0.016), the presence of maternal cracked nipples (p < 0.01), and latching on (p < 0.01). Conclusions: Ankyloglossia can prevent the correct establishment of breastfeeding. Frenotomy is associated with few complications, and when appropriately indicated, may have a positive impact on breastfeeding, reducing maternal pain, the presence of nipple lesions, and latching problems.

Resumen Introducción: La anquiloglosia está presente en algunos recién nacidos y puede interferir en el amamantamiento, produciendo sintomatología en el niño y en la madre. El objetivo de este estudio fue analizar las características de los recién nacidos con anquiloglosia, así como la sintomatología referida por sus madres, y la evolución tras la frenotomía. Métodos: Estudio observacional analítico prospectivo de las frenotomías realizadas en la planta de maternidad de un hospital IHAN (Iniciativa para la Humanización de la Asistencia al Nacimiento y la Lactancia) durante 7 meses. Se incluyeron todos los recién nacidos alimentados inicialmente con lactancia materna a quienes se realizó una frenotomía. Resultados: Se realizaron 33 frenotomías. Los hallazgos más frecuentes previos a la frenotomía fueron dolor con las tomas (29/33), dificultad en el agarre (18/33) y presencia de grietas (18/33). Asimismo, se vio que los pacientes intervenidos más tarde presentaban con mayor frecuencia ictericia (p = 0.03) y pérdida de peso superior al 10% previa al alta (p = 0.004), y sus madres presentaron dolor con mayor frecuencia (p = 0.004). Al mes de vida se observó la mejoría del dolor con las tomas (p = 0.012) y su intensidad (p = 0.016), la presencia de grietas (p < 0.01) y el agarre al pecho (p < 0.01). Conclusiones: La anquiloglosia puede impedir el correcto establecimiento de la lactancia materna. La frenotomía presenta escasas complicaciones y, cuando está bien indicada, puede mejorar el amamantamiento, reduciendo el dolor, la presencia de grietas y las dificultades en el agarre.

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The aim of this work was to assess the effectiveness of dipping chicken breast in lactic, malic and fumaric acid 3% solutions for 15 s on Salmonella counts, as well as on chicken meat quality and sensory characteristics. All three treatments effectively reduced Salmonella counts. The values of Salmonella log reduction were 2.22, 1.55 and 1.30 log CFU/g for fumaric, malic and lactic treatments, respectively. Although fumaric acid was the most effective for reducing Salmonella counts, chicken meat quality and sensory characteristics were significantly affected, even in cooked samples. Conversely, malic and lactic acids treatments caused minimal changes in chicken meat quality and sensory characteristics compared to control samples. This study shows effective alternatives to reduce Salmonella contamination on chicken breast fillets, although further studies should be considered to improve the effects on quality and sensory attributes.

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Background: Ankyloglossia is a condition present in some newborns and can be associated with breastfeeding difficulties, leading to symptoms in the child and the mother. This study aimed to analyze the characteristics of newborns with tongue-tie and the symptoms reported by their mothers, and the short and long-term outcomes of frenotomy. Methods: We conducted a prospective and observational 7-month study in a Baby-Friendly Hospital (BFH). We included all the breastfed newborns without comorbidities that underwent a frenotomy. Results: A total of 33 frenotomies were performed. The most common findings before the procedure were maternal breastfeeding pain (29/33), ineffective latch (18/33), and maternal nipple lesions (18/33). We observed that newborns surgically intervened later showed a high incidence of jaundice (p = 0.03), weight loss greater than 10% at hospital discharge (p = 0.004), and their mothers experienced pain more often (p = 0.004). At one month of age, there was an improvement in breastfeeding-related pain (p = 0.012) and its intensity (p = 0.016), the presence of maternal cracked nipples (p < 0.01), and latching on (p < 0.01). Conclusions: Ankyloglossia can prevent the correct establishment of breastfeeding. Frenotomy is associated with few complications, and when appropriately indicated, may have a positive impact on breastfeeding, reducing maternal pain, the presence of nipple lesions, and latching problems.

Introducción: La anquiloglosia está presente en algunos recién nacidos y puede interferir en el amamantamiento, produciendo sintomatología en el niño y en la madre. El objetivo de este estudio fue analizar las características de los recién nacidos con anquiloglosia, así como la sintomatología referida por sus madres, y la evolución tras la frenotomía. Métodos: Estudio observacional analítico prospectivo de las frenotomías realizadas en la planta de maternidad de un hospital IHAN (Iniciativa para la Humanización de la Asistencia al Nacimiento y la Lactancia) durante 7 meses. Se incluyeron todos los recién nacidos alimentados inicialmente con lactancia materna a quienes se realizó una frenotomía. Resultados: Se realizaron 33 frenotomías. Los hallazgos más frecuentes previos a la frenotomía fueron dolor con las tomas (29/33), dificultad en el agarre (18/33) y presencia de grietas (18/33). Asimismo, se vio que los pacientes intervenidos más tarde presentaban con mayor frecuencia ictericia (p = 0.03) y pérdida de peso superior al 10% previa al alta (p = 0.004), y sus madres presentaron dolor con mayor frecuencia (p = 0.004). Al mes de vida se observó la mejoría del dolor con las tomas (p = 0.012) y su intensidad (p = 0.016), la presencia de grietas (p < 0.01) y el agarre al pecho (p < 0.01). Conclusiones: La anquiloglosia puede impedir el correcto establecimiento de la lactancia materna. La frenotomía presenta escasas complicaciones y, cuando está bien indicada, puede mejorar el amamantamiento, reduciendo el dolor, la presencia de grietas y las dificultades en el agarre.

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In this work, we describe the photoisomerization of facial rhenium(i) tricarbonyl complexes bearing P,N-bidentate pyridyl/phosphine ligands with different chelating rings and anions: RePNBr, RePNTfO, and RePNNBr, which are triggered under irradiation at 365 nm in solutions. The apparent photodegradation rate constants (k app) depend on the coordinating ability of the solvent, being lowest in acetonitrile. The k app value increases as the temperature rises, suggesting a reactive IL excited state thermally populated from the MLCT excited state involved. Using the Eyring equation, positive activation enthalpies (ΔH ≠) accompanied by high negative values for the activation entropy (ΔS ≠) were obtained. These results suggest whatever the P,N-ligand or anion, the reaction proceeds through a strongly solvated or a compact transition state, which is compatible with an associative mechanism for the photoisomerization. A 100-fold decrease in the log10 CFU value is observed for E. coli and S. aureus in irradiated solutions of the compounds, which follows the same tendency as their singlet oxygen generation quantum yield: RePNBr > RePNTfO > RePNNBr, while no antibacterial activity is observed in the darkness. This result indicates that the generation of singlet oxygen plays a key role in the antibacterial capacity of these complexes.

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First references of the endangered autochthonous Majorcan Ca Mè dog date from the 13th century and enhance its skills and adaptability to the orography. Genealogical historical records were traced back to founders. Founder number in the reference population (397), maximum generations traced, and average number of complete generations were 32, 5, and 2.75, respectively. Structure assessment revealed the existence of subpopulations regarding criteria such as owners (402), breeders (55), coat colours (liver, lemon, black and orange) and spotting patterns (piebald, roan, solid colour, tie or star presence). Average inbreeding (F) within colour groups ranged from 6.3-10.4%, for orange and black populations, respectively. F ranged from 9.43-12.22% for roan patterns and star presence, respectively. Tan point markings showed an F coefficient of 5.85%. The study of genetic diversity revealed a slightly different genetic background between subpopulations. Average coancestry between and within coat colours suggested orange and roan traits could be ascribed to the original nuclei, without omitting the high relationships among other subpopulations. Breeding strategy should select breeding pairs holding a relatedness coefficient below 15%. Hence, coat patterns in dog breeds can help preserving the genetic diversity in endangered dogs, even when these are geographically isolated.

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El agua de uso y consumo humano debe reunir ciertas características de potabilidad para evitar que causen enfermedades, los gobiernos de los países son responsables de la calidad del agua, la purificación se realiza por varios procesos que aseguran que esté libre de patógenos, de sustancias químicas, físicas y radiológicas, siguiendo pautas de la Organización Mundial de la Salud (OMS). Las diarreas infecciosas son causadas por diferentes patógenos y muy frecuentemente asociadas al consumo de agua no potable. Desde hace varios años, en Venezuela, se presentan fallas en el suministro regular de agua potable intra-domiciliario, por fallas en la cadena de distribución y almacenamiento, además son frecuentes problemas deficitarios del suministro de energía eléctrica. Más reciente, en marzo de 2019, se presentó a escala nacional un colapso total del suministro de energía eléctrica que duró de 3 a 7 días, lo cual dejó a los ciudadanos sin el suministro de agua en sus hogares, además de fallas del transporte, colapso hospitalario, colocando en riesgo socio-sanitario a millones de personas. El objeto del documento es servir de guía e informar a la comunidad sobre las enfermedades más frecuentes asociadas al consumo de agua no potable; aconsejar sobre los cuidados especiales en los niños y, brindar medidas preventivas prácticas recomendadas para la purificación del agua de uso y consumo humano.

Water use and human consumption must meet certain characteristics of drinking to avoid causing diseases, the Governments of the countries are responsible for the quality of the water, purification is performed by several processes which ensure that it is free of pathogenic substances chemical, physical and radiological, following guidelines of the World Health Organization (WHO). Infectious diarrhea are caused by different pathogens and often associated with the consumption of non-potable water. For several years, in Venezuela, failures occur at regular drinking water supply intra-household, for failures in the chain of distribution and storage, they are also frequent electricity supply deficit. Most recently, in March 2019, arose nationwide a total collapse of the supply of electrical energy that lasted from 3 to 7 days, which left the people without water in their homes, in addition to transport, hospital collapse in putting at risk health to millions of people. The object of the document is to guide and inform the community about the most frequent illnesses associated with the consumption of non-potable water; advise on special child care and, provide preventive measures recommended for purification practices water use and human consumption.

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Objective: To assess the impact of the empathy of physicians, perceived by patients with chronic pain, regarding pain relief and health-related quality of life (HR-QoL). Methods: A prospective noninterventional study was conducted in 2,898 patients with moderate to severe chronic pain who were referred to pain clinics. The same physician visited each patient at baseline and after one and three months. Study questionnaires included the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), the Life Orientation Test-Revised (LOT-R), the Pain Coping Questionnaire (CAD-R), the Brief Pain Inventory Short Form (BPI-SF), and the EuroQol-5D (EQ-5D). Regression analyses were used to evaluate the independent contribution of the changes in perceived empathy over pain intensity and improvement of HR-QoL. Results: BPI-SF scores for pain intensity, rated as worst, least, average, and current pain, decreased significantly (P < 0.001) from baseline to month 3, with reductions of 33.7%, 42.5%, 40.0%, and 46.9%, respectively. Pain intensity decreased from 6.3 ± 1.5 at baseline to 4.7 ± 1.8 at one month and 3.8 ± 1.9 at three months (P < 0.050). Significant (P < 0.001) improvements in the EQ-5D tariff (+37.1%) and EQ-5D VAS (+26.7%) were also recorded. In the linear regression analysis, JSPPPE and LOT-R, but not CAD-R, were significantly associated with pain relief and HR-QoL. Conclusions: Physicians' empathy and patients' dispositional optimism have a role in determining positive outcomes in patients with chronic pain. Physicians' empathy may therefore be a suitable, yet relatively unexplored, target for intervention.

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Dengue is a mosquito-borne viral disease that has evolved from a sporadic infection to a major public health problem in the Americas, Southeast Asia and the western Pacific, and Africa. Its incidence has increased 30-fold over the past 50 years, and although the true disease burden is not well known, the annual incidence in some areas of the Americas may reach 5%-10% of all children when underreporting is considered. We recently analyzed the disease burden of dengue in Venezuela, and we found an overall decline in case numbers and mortality over the period of 1950-2011. However, there were increases in case number and mortality during epidemic years, especially among children. In this report, we focus on the most recent period of data, from 2000 to 2011, comparing pediatric and adult case numbers and mortality.

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Several technical developments have led to a comeback of the continuous scintillators in positron emission tomography (PET). Important differences exist between the resurgent continuous scintillators and the prevailing pixelated devices, which can translate into certain advantages of the former over the latter. However, if the peculiarities of the continuous scintillators are not considered in the iterative reconstruction in which the measured data is converted to images, these advantages will not be fully exploited. In this paper, we review which those peculiarities are and how they have been considered in the literature of PET reconstruction. In light of this review, we propose a new method to compute one of the key elements of the iterative schemes, the system matrix. Specifically, we substitute the traditional Gaussian approach to the so-called uncertainty term by a more general Monte Carlo estimation, and account for the effect of the optical photons, which cannot be neglected in continuous-scintillators devices. Finally, we gather in a single scheme all the elements of the iterative reconstruction that have been individually reformulated, in this or previous works, for continuous scintillators, providing the first reconstruction framework fully adapted to this type of detectors. The preliminary images obtained for a commercially available PET scanner show the benefits of adjusting the reconstruction to the nature of the scintillators.

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En la actualidad, la actividad física es un tema de uso común y de práctica no tan reciente. Sin embargo, para que ella produzca los efectos deseados en el ser humano, debe ir acompañada de una dieta adecuada y balanceada que proporcione los nutrientes necesarios que nos protejan contra las enfermedades y permitan tener estilos de vida saludables. Estudios recientes demuestran que la actividad física disminuye la incidencia de enfermedades crónicas, mejora la resistencia cardiorrespiratoria y muscular. Al mismo tiempo que se generan investigaciones acerca de la actividad física, también se hacen consideraciones sobre los efectos de la inactividad, el sedentarismo, la alimentación inadecuada, eventos a los cuales se le suman la disminución de instalaciones recreativas, el urbanismo, la delincuencia y la inseguridad, hechos que no han contribuido a la construcción colectiva de hábitos de promoción de la salud dentro del abordaje de los diferentes modelos de salud, enfermedad y sus determinantes.

Today, physical activity is common subject and not a recent practice. But for her to produced the desired effects in humans has to be accompanied by an correct and balanced diet that will provides the necessary nutrients to protect us against diseases and allow us to have healthy lifestyles. Recent studies show that physical activity reduces the incidence of chronic diseases, improving muscular and cardiorespiratory resistence. At the same time general research on physical activity are made, observations on the effects of inactivity, sedentary lifestyle, poor diet are made; situacions in which can also add the reduction of recreational facilities, town planning, crime and insecurity, events that have not contributed to the collective habits of health promotion inside of the different approach models of health, disease and its determinants.

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OBJECTIVES: Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare disease characterized by the formation of a fibrocollagenous membrane that wraps around the loops of the small bowel, producing obstruction. We present the results of the surgical treatment of this disease in three patients with chronic renal failure who developed SEP during the course of peritoneal dialysis (PD) and provide a literature review on the subject aimed at the general surgeon. PATIENTS AND METHOD: In our area, the PD program treated 150 patients in 14 years, with seven cases of suspected SEP. In three patients, exploratory laparotomy was required. Clinical data, diagnostic imaging tests, type of surgery, immediate postoperative course, and status of the patient during subsequent follow-up are described. RESULTS: In one of the three patients, bowel obstruction led to perforation requiring resection with anastomosis; the postoperative course was complicated and the patient died. In the remaining two patients, elective surgery was performed with the aim of removing the capsule enclosing the intestinal loops. In both patients the immediate postoperative course was favorable, although recurrence of intestinal encapsulation occurred in one patient. CONCLUSIONS: The success of surgery in this disease is determined by the technique used. The correct technique consists of freeing the adhesions and extirpating of the capsule as far as possible. Perforation, as well as resection and intestinal anastomosis, significantly increase mortality.

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Objetivos. La peritonitis esclerosante encapsulante (PES) o cocoon abdominal es una rara enfermedad que se caracteriza por la formación de una membrana fibrocolagenosa que envuelve las asas de intestino delgado y llega a producir cuadros de obstrucción intestinal. En este artículo presentamos los resultados del tratamiento quirúrgico en 3 pacientes con insuficiencia renal crónica que desarrollaron una PES en el curso de la diálisis peritoneal (DP) y se realiza asimismo una revisión de la literatura para acercar esta entidad al cirujano general. Pacientes y método. En nuestra área, el programa de DP ha tratado a 150 pacientes en 14 años, y se ha encontrado 7 casos de sospecha de PES. En 3 pacientes fue preciso realizar una laparotomía exploradora. Se describen los datos clínicos, las pruebas diagnósticas de imagen, el tipo de cirugía, la evolución en el postoperatorio inmediato y la situación del paciente en revisiones posteriores. Resultados. En 1 de los 3 pacientes, una obstrucción intestinal culminó en una perforación que obligó a una resección con anastomosis; la evolución postoperatoria fue muy complicada y desembocó en muerte. En los otros 2 casos, la intervención se realizó de manera electiva con el objetivo de extirpar la cápsula que envolvía las asas intestinales; la evolución postoperatoria inmediata en ambos fue favorable, aunque en uno de ellos terminó por recidivar la encapsulación intestinal. Conclusiones. El éxito de la intervención quirúrgica en esta afección está determinado por la técnica utilizada y el momento de la cirugía. La técnica correcta consiste en la liberación de las adherencias y extirpación de la cápsula en la medida de lo posible. Una complicación del cuadro obstructivo o la realización de resección y anastomosis intestinal aumentan la mortalidad de manera significativa (AU)

Objectives. Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare disease characterized by the formation of a fibrocollagenous membrane that wraps around the loops of the small bowel, producing obstruction. We present the results of the surgical treatment of this disease in three patients with chronic renal failure who developed SEP during the course of peritoneal dialysis (PD) and provide a literature review on the subject aimed at the general surgeon. Patients and method. In our area, the PD program treated 150 patients in 14 years, with seven cases of suspected SEP. In three patients, exploratory laparotomy was required. Clinical data, diagnostic imaging tests, type of surgery, immediate postoperative course, and status of the patient during subsequent follow-up are described. Results. In one of the three patients, bowel obstruction led to perforation requiring resection with anastomosis; the postoperative course was complicated and the patient died. In the remaining two patients, elective surgery was performed with the aim of removing the capsule enclosing the intestinal loops. In both patients the immediate postoperative course was favorable, although recurrence of intestinal encapsulation occurred in one patient. Conclusions. The success of surgery in this disease is determined by the technique used. The correct technique consists of freeing the adhesions and extirpating of the capsule as far as possible. Perforation, as well as resection and intestinal anastomosis, significantly increase mortality (AU)

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Con la idea de ejercitar el plan de catástrofe interna del hospital, se simuló un incendio en el sector del depósito de farmacia, que presenta dificultad en el acceso, y almacena gran cantidad de combustibles sólidos y líquidos

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Con la idea de ejercitar el plan de catástrofe interna del hospital, se simuló un incendio en el sector del depósito de farmacia, que presenta dificultad en el acceso, y almacena gran cantidad de combustibles sólidos y líquidos(AU)

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Como primer paso al desarrollo de un curso de capacitación en lactancia materna dirigido a los estudiantes y profesionales del área de salud, se elaboraron dos prototipos de lecciones instruccionales utilizando las tecnologías de la información y la comunicación: un software educativo sobre la anatomía y fisiología de la mama, y una página web sobre las técnicas de extracción de leche materna. Ambos prototipos fueron evaluados mediante una prueba de validación por expertos y una prueba piloto, encontrándose ambos productos atractivos e interactivos y de alta calidad técnica y educativa. Se determinó que es recomendable una inducción en el uso de la tecnología a los usuarios para la adquisición de las habilidades necesarias para su manejo. Se recomienda su uso para capacitar a distancia,o como complemento de una actividad docente presencial

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