RESUMEN
OBJECTIVES: Colombia is considered one of the most violent countries in the world even though homicide mortality has decreased since 2002. Mexico's homicide rate has tripled since 2008, after a period of decreasing mortality; this fact has been compared with Colombia in the 1990s and defined as a 'Colombianization' of violence in Mexico. We analyzed and compared the trend and impact of homicide mortality in Colombia and Mexico between 1998 and 2015. STUDY DESIGN: Cross-sectional descriptive study. METHODS: We calculated the standardized mortality rates and the years of life lost using data from the National Institute of Statistics and Geography in Mexico and the National Management Department of Statistics in Colombia. We used the joinpoint regression analysis to identify significant changes in the mortality trend. RESULTS: During the 1990s, Colombia reached the highest homicide mortality rates in the world, but these rates have since decreased significantly. In Mexico, homicide mortality had a decreasing trend from 1998 to 2007; however, since 2008, the rate grew significantly, and although mortality tended to decrease after reaching its peak in 2011, a slight upturn was observed in 2015. CONCLUSIONS: We found that the trend in mortality in both countries has had certain similarities, such as the increase in mortality after the implementation of antidrug policies and the subsequent decrease; however, the political processes, the level of mortality reached, its impact on life expectancy, and its distribution by gender are dissimilar. We consider speaking of a 'Colombianization' of violence in Mexico to be inaccurate.
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Homicidio/estadística & datos numéricos , Homicidio/tendencias , Esperanza de Vida/tendencias , Mortalidad/tendencias , Violencia/estadística & datos numéricos , Adolescente , Adulto , Colombia/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Adulto JovenRESUMEN
In this work, the removal of the Cephalexin by Chlorella sp., nonliving modified by extraction of lipids was evaluated. First, the microalga was grown to completing 20â¯days and later, the biomass of crop was centrifuged and the extraction of lipids was performed. Two adsorption experiments were performed: (1) with nonliving Chlorella sp. (control), and (2) the obtained biomass after lipid extraction. The high antibiotic removal, 71.19% and 82.77% (control), were obtained at the lowest initial concentration. The contact time between the biosorbent and the antibiotic was 2â¯h. The adsorption isotherm follows the Freundlich model and the obtained maximum absorption capacity was 63.29â¯mg of antibiotic/g of biosorbent for lipid-extracted biomass, while the control follows best to the Langmuir model with 129.87â¯mg/g in maximum absorption capacity. In summary, this biosorbent provides a potential alternative in the removal of Cephalexin.
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Biodegradación Ambiental , Biomasa , Cefalexina , Adsorción , Chlorella , Concentración de Iones de Hidrógeno , Lípidos , MicroalgasRESUMEN
Phosphatase activity of Leishmania spp. has been shown to deregulate the signalling pathways of the host cell. We here show that Leishmania mexicana promastigotes and amastigotes secrete proteins with phosphatase activity to the culture medium, which was higher in the Promastigote Secretion Medium (PSM) as compared with the Amastigote Secretion Medium (ASM) and was not due to cell lysis, since parasite viability was not affected by the secretion process. The biochemical characterization showed that the phosphatase activity present in PSM was higher in dephosphorylating the peptide END (pY) INASL as compared with the peptide RRA (pT)VA. In contrast, the phosphatase activity in ASM showed little dephosphorylating capacity for both peptides. Inhibition assays demonstrated that the phosphatase activity of both PSM and ASM was sensible only to protein tyrosine phosphatases inhibitors. An antibody against a protein phosphatase 2C (PP2C) of Leishmania major cross-reacted with a 44·9 kDa molecule in different cellular fractions of L. mexicana promastigotes and amastigotes, however, in PSM and ASM, the antibody recognized a protein about 70 kDa. By electron microscopy, the PP2C was localized in the flagellar pocket of amastigotes. PSM and ASM induced the production of tumor necrosis factor alpha, IL-1ß, IL-12p70 and IL-10 in human macrophages.
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Citocinas/inmunología , Interacciones Huésped-Parásitos , Leishmania mexicana/enzimología , Macrófagos/inmunología , Proteína Fosfatasa 2C/metabolismo , Proteínas Protozoarias/metabolismo , Animales , Transporte Biológico , Medios de Cultivo/química , Citocinas/biosíntesis , Humanos , Interleucina-10/biosíntesis , Interleucina-10/inmunología , Leishmania mexicana/genética , Leishmania mexicana/inmunología , Leishmania mexicana/ultraestructura , Ratones , Microscopía Electrónica , Proteína Fosfatasa 2C/inmunología , Proteínas Tirosina Fosfatasas/antagonistas & inhibidores , Proteínas Protozoarias/inmunología , Transducción de SeñalRESUMEN
Leishmania mexicana is the causal agent of cutaneous leishmaniasis in Mexico. Dendritic cells (DC) are one of the host cells of Leishmania parasites. Intracellular microorganisms inhibit host cell apoptosis as a strategy to ensure their survival in infected cells. We have previously shown that Leishmania mexicana promastigotes and amastigotes inhibit camptothecin-induced apoptosis of monocyte-derived dendritic cells (moDC), but the mechanisms underlying the inhibition of apoptosis of DC by Leishmania have not been established. MAP kinases and PI3K participate in the process of apoptosis and are modulated by different species of Leishmania. As shown in this study, the infection of moDC with L. mexicana amastigotes diminished significantly the phosphorylation of the MAP kinases p38 and JNK. The inhibition of both kinases diminished significantly DNA fragmentation in moDC stimulated with camptothecin. On the other hand, L. mexicana amastigotes were able to activate the anti-apoptotic pathways PI3K and AKT. Our results indicate that L. mexicana amastigotes have the capacity to diminish MAP kinases activation and activate PI3K and AKT, which is probably one of the strategies employed by L. mexicana amastigotes to inhibit apoptosis in the infected moDC.
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Apoptosis/efectos de los fármacos , Leishmania mexicana/inmunología , Leishmaniasis/inmunología , Leishmaniasis/parasitología , Proteína Quinasa 8 Activada por Mitógenos/metabolismo , Proteínas Quinasas p38 Activadas por Mitógenos/metabolismo , Adulto , Camptotecina/farmacología , Células Dendríticas/inmunología , Células Dendríticas/metabolismo , Células Dendríticas/parasitología , Células Dendríticas/patología , Humanos , Leishmania mexicana/crecimiento & desarrollo , Masculino , Fosfatidilinositol 3-Quinasas/metabolismo , Fosforilación/efectos de los fármacos , Adulto JovenRESUMEN
Se presenta el caso de un paciente de 16 años de edad, con el diagnostico de mucopolisacaridosis (MPS) tipo IV-A, con una breve revisión teórica del curso y progresión crónica de esta enfermedad multi-sistémica, que se manifiesta con amplia signo sintomatología, hallazgos de laboratorio y anomalías radiológicas. El objetivo es documentar el caso y difundir a la comunidad médica boliviana, la importancia de los errores innatos del metabolismo, consideradas enfermedades "raras", que a criterio nuestro, sufren un sub-diagnóstico debido a las pocas publicaciones científicas sobre el tema en el medio.
We report the case of a patient 16 years old with a diagnosis of mucopolysaccharidosis (MPS) type IV- A, with a brief theoretical review of chronic course and progression of this multisystem disease, which manifests with extensive signs symptoms, findings are presented, with laboratory and radiological reported abnormalities. The aim is to document the event and communicated to Bolivian medical community, the importance of inborn errors of metabolism, considered "rare" diseases, which in our opinion; suffer a sub- diagnosis because of the few Bolivian scientific publications on the topic.
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Mucopolisacaridosis IV/diagnóstico , Mucopolisacaridosis IV/patologíaRESUMEN
Exámenes serológicos, por Hemaglutinación indirecta (HAI) y Elisa para anticuerpos anti Toxoplasma gondii se practicaron a niños y adolescentes, distribuidos en 4 grupos: 0 < 5 .años, 5 < 10, 10 < 15 y de 15 < 20, para obtener los datos de prevalencia e incidencia quinquenal, así como, por entrevista para identificar factores de riesgo; los datos se analizaron estadísticamente, como variables independientes y correlaciones bivariadas. Se examinaron 578: 285 varones y 292 mujeres, (1 no consignado), promedio de edad 9,7 años. La prevalencia encontrada es 60,2 con descenso de 18 porciento respecto a 1989. Se discuten hipótesis para explicar esta disminución. La incidencia aumenta rápido hasta los 10 años. No se estableció ninguna correlación con los factores de riesgo incluidos, excepto en el contacto con gatos menores de 6 meses (gatitos). El riesgo de transmisión congénita se estima en 18 por diez mil; en consecuencia se esperarían 106 casos anuales, con 69 asintomáticos (65 porciento), y 37 (35 porciento) con síntomas: 17 con daños leves, 11 con graves y 9 mortinatos. Los 28 niños con lesiones manifiestas, más un número no determinado con lesiones tardías de los 69 asintomáticos incorporan una población que causa un impacto económico y social aún no establecido...
Serological testing, by indirect haemagglutination and ELISA was performed in 4 age groups: 0 to <5, 5 to <10, 10 to <15 and 15 to <20 years old, to find prevalence and quinquennial incidence. An interview to assess risk factors was performed. The statistical analysis was performed for independent variables and bivariate correlations to calculate the odds ratio. The total number of observations was 578: 285 male and 292 female (1 not determined) and median age was 9.7. An increase in the prevalence was related to age, reaching 60.2 percent in the group between 15 and 20 years old, when compared to the same age group in 1989 (78.3 percent) showing an 18 percent decrease. Several hypotheses to explain this decrease were proposed. There is a steep increase at the age of 10. The statistical analysis does not demonstrate a direct correlation with any of the risk factors consigned in the interview, with the exception of exposure to young felines (kittens). The risk for acquiring congenital toxoplasmosis was estimated as 1.8 per thousand (18 per ten thousand), hence 106 cases are expected per year, with 69 (65 percent) of them being asymptomatic, and 37 with different degrees of severity: 17 with mild, 11 severe and 9 with death at birth. Each year there would be 28 newborns with evident lesions and additionally an undetermined number of cases with late onset lesions within the initially asymptomatic group (65 percent), with unknown socioeconomic impact...
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Niño , Adolescente , Toxoplasma , Toxoplasmosis/diagnóstico , Toxoplasmosis/epidemiología , Toxoplasmosis/transmisiónRESUMEN
INTRODUCTION: Basal cell carcinoma accounts for 75% of all nonmelanoma skin cancer. Although various treatment modalities are available, the most frequently used option is surgical excision. Here, we evaluate the efficacy of Mohs micrographic surgery for the treatment of basal cell carcinoma. MATERIAL AND METHODS: A retrospective review of cases of basal cell carcinoma treated with Mohs micrographic surgery between October 2003 and June 2009 was performed using patient records from Hospital Italiano in Buenos Aires, Argentina. RESULTS: A total of 2412 basal cell carcinomas treated with Mohs micrographic surgery were identified; 50.5% were in women and 49.5% in men. The mean age of the patients was 70.7 years (range, 8-100 years). The histologic type of the tumor was solid in 65.3% of cases and in 89% of cases the tumor was located on the head or neck. Ten percent of the tumors were recurrent following previous treatment. A mean of 1.74 Mohs stages were used, with a mean of 3.81 sections. The mean size of the initial defect was 0.86 cm² and the mean final defect was 1.88 cm². The ratio of initial tumor size to final defect was estimated at 1.02. Over a mean follow-up of 32 months, there were 9 cases of tumor recurrence (0.37%). CONCLUSIONS: In our experience, Mohs micrographic surgery is effective for the treatment of high-risk basal cell carcinoma.
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Carcinoma Basocelular/cirugía , Cirugía de Mohs , Neoplasias Cutáneas/cirugía , Anciano , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
The title 2:1 complex of 3-nitrophenol (MNP) and 4,4'-bipyridyl N,N'-dioxide (DPNO), 2C(6)H(5)NO(3) x C(10)H(8)N(2)O(2) or 2MNP.DPNO, crystallizes as a centrosymmetric three-component adduct with a dihedral angle of 59.40 (8) degrees between the planes of the benzene rings of MNP and DPNO (the DPNO moiety lies across a crystallographic inversion centre located at the mid-point of the C-C bond linking its aromatic rings). The complex owes its formation to O-H...O hydrogen bonds [O...O = 2.605 (3) A]. Molecules are linked by intermolecular C-H...O and C-H...N interactions forming R(2)(1)(6) and R(2)(2)(10) rings, and R(6)(6)(34) and R(4)(4)(26) macro-rings, all of which are aligned along the [1 01] direction, and R(2)(2)(10) and R(2)(1)(7) rings aligned along the [010] direction. The combination of chains of rings along the [1 01] and [010] directions generates the three-dimensional structure. A total of 27 systems containing the DNPO molecule and forming molecular complexes of an organic nature were analysed and compared with the structural characteristics of the dioxide reported here. The N-O distance [1.325 (2) A] depends not only on the interactions involving the O atom at the N-O group, but also on the structural ordering and additional three-dimensional interactions in the crystal structure. A density functional theory (DFT) optimized structure at the B3LYP/6-311G(d,p) level is compared with the molecular structure in the solid state.
RESUMEN
The El Niño event of 1997/1998 provided an opportunity to carry out a field experiment in which the relationship of sea surface temperature and the association of Vibrio cholerae with marine plankton could be assessed in Mexican coastal and estuarine areas. Plankton samples were collected from May 1997 through June 1999. Sites included the Mexican ports of Veracruz, Coatzacoalcos and Frontera in the Gulf of Mexico and Ensenada, Guaymas, Mazatlán, Manzanillo, Acapulco and Oaxaca in the Pacific Ocean. Sampling was also accomplished during two oceanographic cruises in the Yucatan channel of the Caribbean Sea. Bacteriological analyses for V. cholerae serogroups O1 and O139 were carried out. Also, the taxonomic structure of the plankton populations was determined. Vibrio cholerae O1 was detected only in Veracruz samples collected during April, May and June 1999, when La Niña climatic conditions prevailed. It is concluded that V. cholerae O1 in Mexico derives from its marine and estuarine origin and not from sewage contamination. The significant number of Acartia tonsa copepodites and V. cholerae copepodite-positive samples suggests a significant role of this copepod in the occurrence and distribution of V. cholerae in coastal areas of Mexico.
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Plancton/microbiología , Agua de Mar/microbiología , Vibrio cholerae O139/aislamiento & purificación , Vibrio cholerae O1/aislamiento & purificación , Animales , Copépodos/microbiología , MéxicoRESUMEN
Las grasas y los aceites procesados, oxidados y calentados pueden tener propiedades nutricionales diferentes de la materia prima de donde provienen; existen cambios fisico-químicos inducidos o provocados en las diferentes etapas a las que se someten durante la obtención comercial, lo que trae como consecuencia una modificación desde el punto de vista de la nutrición. Estos cambios van desde la modificación isométrica de los dobles enlaces naturales de las grasas poli insaturadas que se someten a procesos de hidrogenación, con la consiguiente formación de isómeros trans, con los efectos biológicos que éstos ocasionan al organismo humano. Por otra parte, los fenómenos de auto oxidación de las grasas produciéndose no sólo radicales libres de oxígeno...
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Ácidos Grasos , Metabolismo , Valor NutritivoRESUMEN
We studied microorganisms associated with infant diarrhea in a group of 256 children admitted to a public pediatric hospital in Montevideo, Uruguay. Diagnostic procedures were updated to optimize detection of potential pathogens, which were found in 63.8% of cases, and to be able to define their characteristics down to molecular or antigenic type. Coinfection with two or more agents was detected in more than one-third of positive studies. Escherichia coli enteric virotypes, especially enteropathogenic E. coli (EPEC), were shown to be prevalent. Rotavirus, Cryptosporidium, Campylobacter (mainly Campylobacter jejuni), and Shigella flexneri were also often identified. Enterotoxigenic E. coli, Salmonella, and Giardia lamblia were sporadically recognized. Unusual findings included two enteroinvasive E. coli strains, one Shigella dysenteriae 2 isolate, and a non-O:1 Vibrio cholerae culture. EPEC bacteria and S. flexneri (but not Salmonella) showed unusually frequent antimicrobial resistance, especially towards beta-lactam antibiotics, which is the subject of ongoing work.
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Cryptosporidium/aislamiento & purificación , Diarrea/etiología , Giardia lamblia/aislamiento & purificación , Bacterias Gramnegativas/aislamiento & purificación , Rotavirus/aislamiento & purificación , Animales , Antibacterianos/farmacología , Criptosporidiosis/parasitología , Cryptosporidium/clasificación , Giardia lamblia/clasificación , Giardiasis/parasitología , Bacterias Gramnegativas/clasificación , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Lactante , Pruebas de Sensibilidad Microbiana , Rotavirus/clasificación , Infecciones por Rotavirus/virología , UruguayRESUMEN
OBJECTIVE: To report the results of the use of antimicrobial guidelines for the management of children with community-acquired bacterial pneumonia. METHODS: Admittance and discharge criteria and algorithms for diagnosis and treatment were established. The decision to treat with antibiotics was based on radiologic findings in pneumonia with pulmonary consolidation and left to the attending physician's criteria in the remaining cases. The use of antibiotics was limited to penicillin and derivatives (ampicillin, amoxicillin) and macrolides. RESULTS: Of the 1163 children treated as bacterial pneumonia, hospitalized in public and private health facilities in Montevideo from September, 1997, through September, 1998, standard case management was applied in 1082 (93%). Age distribution was: <1 month, 1%; between 1 and 11 months, 29%; between 1 and 5 years, 50%; >5 years, 20%. Chest radiography showed evidence of pulmonary consolidation in 843 children (73%). Bacteria were detected in blood culture and/or pleural fluid of 57 children (5%). In 51 the identified microorganism was Streptococcus pneumoniae, susceptible to penicillin in 30, intermediate in 6 and resistant in 5 (maximum MIC, 4 microg/ml); in 10 cases etiologic diagnosis was made by antigen detection. Empyema was present in 62 children (5.3%); 38 (3.27%) required treatment in an intensive care unit; and 5 (0.4%) died. CONCLUSIONS: Compliance with standard case management was highly satisfactory. Outcome of children treated with penicillin and derivatives was good, including children with empyema and pneumatocele and two patients with penicillin-resistant S. pneumoniae. At the present time S. pneumoniae resistant to penicillin is not an important problem in children with pneumonia in Uruguay. Surveillance of identified microorganisms and their antimicrobial susceptibility must continue.
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Antibacterianos/uso terapéutico , Penicilinas/uso terapéutico , Neumonía Bacteriana/tratamiento farmacológico , Algoritmos , Niño , Preescolar , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Farmacorresistencia Microbiana , Empiema Pleural/complicaciones , Femenino , Adhesión a Directriz , Hospitalización , Humanos , Lactante , Recién Nacido , Macrólidos , Masculino , Pruebas de Sensibilidad Microbiana , Neumonía Bacteriana/complicaciones , Guías de Práctica Clínica como Asunto , Radiografía Torácica , Resultado del Tratamiento , UruguayRESUMEN
In the present work we study the association between chronic active gastritis (CAG), atypical regeneration and dysplasia and gastric Helicobacter pylori (HP) infection. We study two groups of endoscopic biopsies. Regenerative changes and dysplasia were evaluated according to Gandur-Maymneh et al. classification which was simplified in typical and atypical regeneration, and mild and severe dysplasia. The group I included 94 patients with CAG, 9 with chronic non active gastritis (CNAG) and 2 with normal gastric mucosa. CAG was graded according to activity in; severe 28 patients; moderate 54 patients and; mild 12 patients. HP association in these cases was 100%, 77% and 25%. In cases of CNAG HP was present in 22%, there were not HP in normal gastric mucosa. There were atypical regeneration in 25% of moderate CAG and in 42% of severe CAG. Mild dysplasia was present in 7.5 and 25% in cases of moderate and severe CAG. Two biopsies showed severe dysplasia. In addition, intestinal metaplasia was found in 15% of CAG, the metaplasia was present in 25% of cases with CAG and atypical regeneration; in 54% of cases with mild dysplasia and; in 100% on cases with severe dysplasia. The group II included 9 cases of gastric cancer of intestinal type, 7 cases of diffuse type, and 4 cases of mixed type. In all these cases there was viewed CAG associated to HP infection in non-neoplastic mucosa. In 75% of cases there were showed atypical regeneration and 60% presented some type of dysplasia. There was transition between atypical regeneration and dysplasia in 6 cases of intestinal gastric cancer and in 3 cases of mixed type. We found relationship between the intensity of CAG and HP colonization, and the association with atypical regeneration and dysplasia.
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Carcinoma in Situ/patología , Mucosa Gástrica/patología , Gastritis/patología , Infecciones por Helicobacter/patología , Helicobacter pylori , Neoplasias Gástricas/patología , Adulto , Anciano , Atrofia , Biopsia , Carcinoma in Situ/microbiología , Enfermedad Crónica , Femenino , Mucosa Gástrica/microbiología , Gastritis/microbiología , Infecciones por Helicobacter/microbiología , Humanos , Masculino , Metaplasia , Persona de Mediana Edad , Regeneración , Neoplasias Gástricas/microbiologíaRESUMEN
A retrospective study was made on 9 cases with pains due to advanced head and neck cancer, attended to at the Pain Clinic of the National Institute of Oncology and Radiobiology between 1988 and 1991. An epidural catheter was implanted to these patients at the CNS level for the administration of a morphine solution. 7 patients (77.8%) showed total pain relief; and 2 cases showed easily-controlled slight pains. The most frequent complications were; fever (3 cases) and alterations of the level of consciousness (2 cases). No infections were reported. The importance of an adequate preparation of the patient and a strict follow up, where oncology nursing personnel play an important role, is pointed out.
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Analgesia Epidural/enfermería , Neoplasias de Cabeza y Cuello/fisiopatología , Dolor/tratamiento farmacológico , Investigación en Enfermería Clínica , Humanos , Morfina/uso terapéutico , Enfermería Oncológica , Dolor/etiología , Estudios RetrospectivosRESUMEN
The case of a 12-year-old boy with the diagnosis of intrahepatic biliary duct cystadenoma is presented. A critical review of the literature revealed less than 100 cases described at present. Differential diagnosis with other intrahepatic cystic lesions of varied etiology is discussed too.
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Adenoma de los Conductos Biliares/diagnóstico , Neoplasias de los Conductos Biliares/diagnóstico , Conductos Biliares Intrahepáticos , Cistoadenoma/diagnóstico , Adenoma de los Conductos Biliares/patología , Adenoma de los Conductos Biliares/cirugía , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/cirugía , Conductos Biliares Intrahepáticos/patología , Conductos Biliares Intrahepáticos/cirugía , Niño , Cistoadenoma/patología , Cistoadenoma/cirugía , Humanos , MasculinoRESUMEN
Acute respiratory tract infection (ARI) was investigated in children less than 5 years old in a longitudinal community-based study of 166 families living in a socioeconomically depressed area in Montevideo, Uruguay. Pediatricians made home visits every 10 days from May 1985 to December 1987, and symptoms and signs of ARI were recorded. The incidence of ARI was 5.8 episodes per child-year during the first 12 months of life and decreased with increasing age of the index children; the rate was highest in children 1-5 months old. Children observed from birth were ill during 21% of the visits. According to the definitions of the study, the incidence of lower respiratory tract infection was 11.6% higher than the incidence of upper respiratory tract infections. The rates of ARI were higher during the colder months. Most risk factors for ARI were only marginally statistically significant.
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Infecciones del Sistema Respiratorio/epidemiología , Enfermedad Aguda , Factores de Edad , Preescolar , Frío , Humanos , Incidencia , Lactante , Mortalidad Infantil , Recién Nacido , Estudios Longitudinales , Infecciones del Sistema Respiratorio/mortalidad , Factores de Riesgo , Estaciones del Año , Factores Socioeconómicos , Población Urbana , Uruguay/epidemiologíaRESUMEN
Fournier gangrene is a disease which primarily affects adults. This finding makes it rarely seen within the pediatric population. Therefore, we feel it convenient to inform of a case of Fournier gangrene which occurred in an eight day old neonate, successfully treated with surgical debridement, the administering of solutions and antibiotics. This is the youngest patient ever described in the medical literature. Neonate; Fournier; gangrene.
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Fascitis/patología , Escroto , Gangrena , Ingle , Humanos , Recién Nacido , MasculinoRESUMEN
In order to establish a guide for the diagnosis of acute appendicitis, we reviewed the charts of patients with appendectomy. In a 7-year period, 385 patients were studied. The age range was 3 to 15 years. In 53% there was an administration of medications prior to surgery. Perforated appendicitis was found in the majority (53%) of the cases. We could not find any association between age and perforation. Only localized, persistent abdominal pain, peritoneal irritation, anorexia, and vomiting were useful for differential diagnosis. In patients with acute appendicitis (p greater than 0.05), leukocytosis (greater than 10,000/mm3), neutrophilia (greater than 70%) and bands (greater than 3%) were observed in 80% of the cases. The frequency of complications was elevated (39.5%), and the mortality was five times higher than referred in other studies. We propose an algorithm for both opportune diagnosis and treatment of the disease.