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This study assessed the microbiological quality and safety of mozzarella during various production stages in northern Tocantins, Brazil, by identifying critical biological points in the industrial environment within a tropical climatic region. Batches of mozzarella were evaluated, from raw milk to primary packaging, with a shelf life of 120 d at 4°C. Indicator microorganisms were quantified, and through microbiological and biomolecular approaches, Salmonella spp. and Listeria monocytogenes were identified. In addition, the toxigenic potential of coagulase-positive staphylococci (CPS) was characterized. Results indicated that the raw milk used for mozzarella production had low microbiological quality; pasteurization of raw milk effectively eliminated all identified pathogens and reduced microbiological counts (p > 0.05). An increase in bacterial counts (>2 log colony-forming unit [CFU]/g) and recontamination with Salmonella spp. and CPS, which potentially produce staphylococcal enterotoxin B, were observed during milk coagulation and curd draining. Stretching of the fermented curd reduced the enterobacteria, total coliforms, and Escherichia coli median values by 2.56, 2.64, and 2.3 log CFU/mL, respectively. Similarly, brining the pieces by immersion reduced the quantity of enterobacteria and total coliforms by 2.3 and 1.6 log CFU/mL, respectively. Of interest, in the freshly finished product, Salmonella spp. was present but L. monocytogenes was absent; however, after the shelf-life period, L. monocytogenes was present but Salmonella spp. was absent. Considering the environmental conditions that can promote the multiplication and preservation of pathogens and spoilage of dairy products in tropical climates, it is necessary to review operational hygiene procedures, particularly in milk coagulation vats and fermentation tables. This will ensure the production of high-quality mozzarella cheese with a reduced consumption risk.

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BACKGROUND: Our aim was to assess the effect of high-intensity interval training (HIIT) on metabolic parameters and body composition in women with polycystic ovary syndrome (PCOS). METHODS AND ANALYSIS: A systematic review and meta-analysis of randomized controlled trials was conducted using Embase, MEDLINE (via Ovid), PubMed, Sport Discus, Scopus, Web of Science, Cochrane Library and Google Scholar (advanced feature) up to September 2020. Two authors independently screened citations and determined the risk of bias and quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were conducted using random effects model. RESULTS: Seven trials (n = 423) were included in the systematic review. The studies included HIIT interventions vs. moderate exercise or control groups. Most studies were small (average 32, range 24-110 participants) and of relatively short duration (10-16 weeks). The training intensity was performed between 90% and 95% of the maximum heart rate, three times a week, for at least 10 weeks. Insulin resistance, measured using homeostatic model assessment for insulin resistance (HOMA-IR), and body mass index (BMI) showed a significant decrease (MD -0.57; 95% CI, -0.98 to -0.16, p = 0.01), (MD -1.90, 95% CI -3.37, -0.42, p = 0.01) with moderate and high certainty of evidence, respectively. CONCLUSION: Results support that HIIT alone is effective for reducing HOMA-IR and BMI in women with PCOS. However, evidence is limited to discern the effect of HIIT on other outcomes. Future studies with a longer duration (> 16 weeks), larger sample sizes and other outcomes are needed.

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O estudo da dor e suas particularidades é de grande importância para o tratamento de diversas patologias e para a melhora na qualidade de vida dos pacientes. A maioria das disfunções orgânicas tem a dor como um ponto importante da sua manifestação. Dessa maneira, é justificável a elaboração de conteúdo para auxiliar os profissionais da saúde no entendimento e tratamento das principais causas de dores agudas e crônicas. Este livro foi elaborado com o objetivo de servir como um guia prático para o manejo da dor por profissionais e acadêmicos de Medicina. Engloba temas como conceitos e aspectos biopsicossociais da dor, além de questões mais complexas como a fisiologia da dor e o tratamento medicamentoso com o arsenal terapêutico existente. Finalmente, também trata dos diversos tipos de dor mais prevalentes e o conhecimento básico que envolve seu manejo.

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Objetivo. Describir la dinámica del desarrollo en los primeros años en niños que viven bajo condiciones socioeconómicas desfavorables. Población y métodos. En 5401 niños menores de 6 años de zonas con alta proporción de población con necesidades básicas insatisfechas de Florencio Varela y de la Cuenca Matanza-Riachuelo (Matanza, Villa 21-24, Wilde, Villa Inflamable y Acuba), se estimó, por regresión logística, la edad mediana de cumplimiento de 13 pautas de desarrollo psicomotor y se graficaron, en el eje de las "y", las diferencias entre esas edades y las de la referencia nacional, y, en el eje de las "x", la edad mediana según la referencia nacional. Resultados. Se observaron tres fases: una primera entre 0 y 270 días con desarrollo normal, en que la edad mediana de cumplimiento fue similar a la de la referencia nacional; una segunda de retraso progresivo del desarrollo; y una tercera de recuperación a partir de los 1260 días. Las pendientes de las splines lineales ajustadas fueron 0,06 (no significativo), -0,26 (p < 0,0001) y 0,26 (p < 0,01) para las fases 1, 2 y 3, respectivamente. Las tres pendientes fueron estadísticamente diferentes entre sí. La fase de desarrollo normal (fase 1) se atribuyó al efecto protector de la madre y el medio familiar; la fase 2 de retraso progresivo, a la influencia desfavorable del ambiente, y la fase 3 de recuperación parcial, a la concurrencia a guardería. Estos hallazgos permiten intervenciones eficaces en cada fase. Conclusión. Se identificaron tres períodos con diferente tempo de desarrollo.

Objective. To describe the dynamics of development along the early years of life among children living under unfavorable socioeconomic conditions. Population and Methods. In 5401 children younger than 6 years old living in Florencio Varela and in the Matanza-Riachuelo River Basin (Matanza, Villa 21-24, Wilde, Villa Inflamable and Acuba), areas with a high proportion of families with unmet basic needs, a logistic regression analysis was used to estimate the median age at attainment of 13 psychomotor developmental milestones; differences between these ages and median age at attainment of milestones as per the national reference were plotted on the y-axis, while the median age as per the national reference was plotted on the x-axis. Results. Three stages were observed: the first one between 0 and 270 days with normal development, in which the median age at attainment was similar to that of the national reference; a second one of progressive development delay; and a third one of recovery at 1260 days. Adjusted linear spline slopes were 0.06 (not significant), -0.26 (p < 0.0001) and 0.26 (p < 0.01) for stages 1, 2 and 3, respectively. The three slopes were statistically different from each other. The stage of normal development (stage 1) was attributed to the protective effect of the mother and the family environment; stage 2 of progressive delay, to the unfavorable impact of the environment, and stage 3 of partial recovery was attributed to attending a daycare center. These findings allow the implementation of effective interventions at each stage. Conclusion. Three periods with different developmental tempos were identified.

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Objetivo. Obtener el índice de desarrollo psicomotor (IDP) de cada provincia argentina. Población y Métodos. En una muestra nacional probabilística y estratificada de 13 323 niños y niñas menores de seis años seleccionada para la encuesta Nacional de Nutrición y Salud (ENNyS 2004) se calculó el IDP por provincia en base al cumplimiento de diez pautas de desarrollo. Se estimó la mediana de la edad de cumplimiento (edad mediana) de cada pauta ajustando una regresión logística. El IDP fue calculado como 100* (1 + b), siendo b el coeficiente de regresión de y= a + b x, donde y es: la edad mediana para la Referencia Nacional (x) menos la edad mediana de una pauta. El valor teórico esperable del IDP es 100. Resultados. Los valores obtenidos del IDP por provincia se encuentran en el rango de 72.1 a 106.4. En la mayoría de las provincias los coeficientes de regresión fueron negativos, indicando un aumento progresivo del retraso en la edad de cumplimiento de pautas con la edad de los niños. El coeficiente de correlación entre el IDP por provincia y la mortalidad infantil en 2005 fue extremadamente alto: -0.85, lo que sugiere que ambos indicadores comparten similares determinantes bio- sociales. El signo es negativo porque cuanto mayor es la mortalidad, menor es el IDP. Conclusión. El país dispone ahora de un indicador positivo de salud: el Índice de Desarrollo Psicomotor, simple de recoger, confiable y de bajo costo para ser incorporado a las estadísticas nacionales de salud.

Objective. To obtain a psychomotor development index (PDI) for each Argentine province. Population and methods. Using a national, probabilistic, and stratified sample of 13 323 male and female children younger than 6 years selected for the National Survey on Nutrition and Health (Encuesta Nacional de Nutrición y Salud, ENNyS 2004), we estimated the PDI per province based on compliance with 10 developmental milestones. The median age at attainment (median age) of each milestone was estimated adjusting a logistic regression. The PDI was estimated as 100* (1 + b), where "b" is the regression coefficient of y= a + b x, where "y" is the median age as per the national reference (x) minus the median age at attainment of a milestone. The theoretical value expected for the PDI was 100. Results. The PDI per province ranged between 72.1 and 106.4. Most provinces showed a negative regression coefficient, which indicated a progressive increase of the delay in the age at attainment of milestones. The correlation coefficient between the PDI per province and infant mortality in 2005was extremely high: -0.85, suggesting that both indicators share similar biological and social determinants. The PDI was negative because the higher the mortality, the lower the PDI. Conclusion. We have now a positive health indicator available in Argentina: the psychomotor development index, which is a low-cost, easy to collect, and reliable tool that may be used in national health statistics.

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OBJECTIVE: To describe the dynamics of development along the early years of life among children living under unfavorable socioeconomic conditions. POPULATION AND METHODS: In 5401 children younger than 6 years old living in Florencio Varela and in the Matanza-Riachuelo River Basin (Matanza, Villa 21-24, Wilde, Villa Inflamable and Acuba), areas with a high proportion of families with unmet basic needs, a logistic regression analysis was used to estimate the median age at attainment of 13 psychomotor developmental milestones; differences between these ages and median age at attainment of milestones as per the national reference were plotted on the y-axis, while the median age as per the national reference was plotted on the x-axis. RESULTS: Three stages were observed: the first one between 0 and 270 days with normal development, in which the median age at attainment was similar to that of the national reference; a second one of progressive development delay; and a third one of recovery at 1260 days. Adjusted linear spline slopes were 0.06 (not significant), -0.26 (p < 0.0001) and 0.26 (p < 0.01) for stages 1, 2 and 3, respectively. The three slopes were statistically different from each other. The stage of normal development (stage 1) was attributed to the protective effect of the mother and the family environment; stage 2 of progressive delay, to the unfavorable impact of the environment, and stage 3 of partial recovery was attributed to attending a daycare center. These findings allow the implementation of effective interventions at each stage. CONCLUSION: Three periods with different developmental tempos were identified.

OBJETIVO: Describir la dinámica del desarrollo en los primeros años en niños que viven bajo condiciones socioeconómicas desfavorables. POBLACIÓN Y MÉTODOS: En 5401 niños menores de 6 años de zonas con alta proporción de población con necesidades básicas insatisfechas de Florencio Varela y de la Cuenca Matanza-Riachuelo (Matanza, Villa 21-24, Wilde, Villa Inflamable y Acuba), se estimó, por regresión logística, la edad mediana de cumplimiento de 13 pautas de desarrollo psicomotor y se graficaron, en el eje de las "y", las diferencias entre esas edades y las de la referencia nacional, y, en el eje de las "x", la edad mediana según la referencia nacional. RESULTADOS: Se observaron tres fases: una primera entre 0 y 270 días con desarrollo normal, en que la edad mediana de cumplimiento fue similar a la de la referencia nacional; una segunda de retraso progresivo del desarrollo; y una tercera de recuperación a partir de los 1260 días. Las pendientes de las splines lineales ajustadas fueron 0,06 (no significativo), -0,26 (p < 0,0001) y 0,26 (p < 0,01) para las fases 1, 2 y 3, respectivamente. Las tres pendientes fueron estadísticamente diferentes entre sí. La fase de desarrollo normal (fase 1) se atribuyó al efecto protector de la madre y el medio familiar; la fase 2 de retraso progresivo, a la influencia desfavorable del ambiente, y la fase 3 de recuperación parcial, a la concurrencia a guardería. Estos hallazgos permiten intervenciones eficaces en cada fase. CONCLUSIÓN: Se identificaron tres períodos con diferente tempo de desarrollo.

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OBJECTIVE: To obtain a psychomotor development index (PDI) for each Argentine province. POPULATION AND METHODS: Using a national, probabilistic, and stratified sample of 13 323 male and female children younger than 6 years selected for the National Survey on Nutrition and Health (Encuesta Nacional de Nutrición y Salud, ENNyS 2004), we estimated the PDI per province based on compliance with 10 developmental milestones. The median age at attainment (median age) of each milestone was estimated adjusting a logistic regression. The PDI was estimated as 100* (1 + b), where "b" is the regression coefficient of y= a + b x, where "y" is the median age as per the national reference (x) minus the median age at attainment of a milestone. The theoretical value expected for the PDI was 100. RESULTS: The PDI per province ranged between 72.1 and 106.4. Most provinces showed a negative regression coefficient, which indicated a progressive increase of the delay in the age at attainment of milestones. The correlation coefficient between the PDI per province and infant mortality in 2005was extremely high: -0.85, suggesting that both indicators share similar biological and social determinants. The PDI was negative because the higher the mortality, the lower the PDI. CONCLUSION: We have now a positive health indicator available in Argentina: the psychomotor development index, which is a low-cost, easy to collect, and reliable tool that may be used in national health statistics.

OBJETIVO: Obtener el índice de desarrollo psicomotor (IDP) de cada provincia argentina. POBLACIÓN Y MÉTODOS: En una muestra nacional probabilística y estratificada de 13 323 niños y niñas menores de seis años seleccionada para la encuesta Nacional de Nutrición y Salud (ENNyS 2004) se calculó el IDP por provincia en base al cumplimiento de diez pautas de desarrollo. Se estimó la mediana de la edad de cumplimiento (edad mediana) de cada pauta ajustando una regresión logística. El IDP fue calculado como 100* (1 + b), siendo b el coeficiente de regresión de y= a + b x, donde y es: la edad mediana para la Referencia Nacional (x) menos la edad mediana de una pauta. El valor teórico esperable del IDP es 100. RESULTADOS: Los valores obtenidos del IDP por provincia se encuentran en el rango de 72.1 a 106.4. En la mayoría de las provincias los coeficientes de regresión fueron negativos, indicando un aumento progresivo del retraso en la edad de cumplimiento de pautas con la edad de los niños. El coeficiente de correlación entre el IDP por provincia y la mortalidad infantil en 2005 fue extremadamente alto: -0.85, lo que sugiere que ambos indicadores comparten similares determinantes bio- sociales. El signo es negativo porque cuanto mayor es la mortalidad, menor es el IDP. CONCLUSIÓN: El país dispone ahora de un indicador positivo de salud: el Índice de Desarrollo Psicomotor, simple de recoger, confiable y de bajo costo para ser incorporado a las estadísticas nacionales de salud.

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Long-term effects of COD/N ratios on the nitrogen removal performance and bacterial community of an anammox reactor were evaluated by adding a synthetic medium (with glucose) and real anaerobic effluent to a SBR. At a COD/N ratio of 2.8 (COD, 390mg·L(-1)) ammonium removal efficiency was 66%, while nitrite removal remained high (99%). However, at a COD/N ratio of 5.0 (COD, 300mg·L(-1)), ammonium and nitrite removal efficiencies were high (84% and 99%, respectively). High COD, nitrite, and ammonium removal efficiencies (80%, 90% and 95%, respectively) were obtained on adding anaerobically pre-treated municipal wastewater (with nitrite) to the reactor. DGGE revealed that the addition of anaerobic effluent changed the bacterial community structure and selected for DNA sequences related to Brocadia sinica and Chloroflexi. Adding glucose and anaerobic effluent increased denitrifiers concentration threefold. Thus, the possibility of using the anammox process to remove nitrogen from anaerobically pre-treated municipal wastewater was demonstrated.

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INTRODUCTION: It is necessary to use health indicators describing the conditions of all individuals in a population, not just of those who have a disease or die. OBJECTIVES: To introduce a method to collect population indicators of psychomotor development in children younger than 6 years old and show its results. POPULATION AND METHODS: Data were obtained from a cross-sectional assessment regarding compliance with 13 developmental milestones (selected from the national reference) conducted in 5465 children using five surveys administered by the Matanza-Riachuelo River Basin Authority in areas of this basin where a high proportion of families with unmet basic needs live. For each survey, a logistic regression analysis was used to estimate the median age at attainment of the 13 developmental milestones. A linear regression model between the estimated age at attainment of the 13 milestones was adjusted for each survey based on the corresponding age at attainment of the national reference. Based on this model, three indicators were defined: overall developmental quotient, developmental quotient at 4 years old, and developmental trend. RESULTS: Results from the five surveys ranged between 0.74 and 0.85, 0.88 and 0.81, and -0.15 and -0.26 for the overall developmental quotient, developmental quotient at 4 years old, and developmental trend, respectively. A distinct developmental delay and an increasing trend in delay with age were observed. CONCLUSIONS: Indicators are easily interpreted and related to social indicators (unmet basic needs, etc.). Collecting the information necessary to make estimations takes little time and can be applied to population groups, but not on an individual level.

INTRODUCCIÓN: Resulta necesario utilizar indicadores de salud que expresen las condiciones de todos los individuos de una población y no solo de aquellos enfermos o que mueren. OBJETIVOS: Presentar un método para obtener indicadores poblacionales de desarrollo psicomotor en niños menores de seis años y mostrar sus resultados. POBLACIÓN Y MÉTODOS: Los datos provienen de la evaluación transversal del cumplimiento de 13 ítems de desarrollo (seleccionados de la referencia nacional) de 5465 niños en cinco encuestas realizadas por la Autoridad de Cuenca Matanza Riachuelo en dicha cuenca en áreas con alta proporción de familias con necesidades básicas insatisfechas. Para cada encuesta, se estimó, por regresión logística, la edad mediana de cumplimiento de los 13 ítems de desarrollo. Se ajustó un modelo de regresión lineal entre la edad de cumplimiento estimada de los 13 ítems de cada encuesta en función de las correspondientes edades de la referencia nacional. A partir de este modelo, se definieron tres indicadores: el cociente global de desarrollo, el cociente a los 4 años y la tendencia del desarrollo. RESULTADOS: Los resultados para las cinco encuestas variaron entre 0,74 y 0,85; 0,88 y 0,81 y -0,15 y -0,26 para el cociente global de desarrollo, cociente global a los 4 años y la tendencia del desarrollo, respectivamente. Se expresó un marcado retraso en el desarrollo y una tendencia progresiva del retraso con la edad. CONCLUSIONES: Los indicadores sondeinterpretación sencilla y se relacionan con indicadores sociales (necesidades básicas insatisfechas, etc.). La obtención de la informaciónnecesaria para realizar los cálculos toma poco tiempo y es aplicable a grupos de población, pero no a individuos.

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Introducción. Resulta necesario utilizar indicadores de salud que expresen las condiciones de todos los individuos de una población y no solo de aquellos enfermos o que mueren. Objetivos. Presentar un método para obtener indicadores poblacionales de desarrollo psicomotor en niños menores de seis años y mostrar sus resultados. Población y métodos. Los datos provienen de la evaluación transversal del cumplimiento de 13 ítems de desarrollo (seleccionados de la referencia nacional) de 5465 niños en cinco encuestas realizadas por la Autoridad de Cuenca Matanza Riachuelo en dicha cuenca en áreas con alta proporción de familias con necesidades básicas insatisfechas. Para cada encuesta, se estimó, por regresión logística, la edad mediana de cumplimiento de los 13 ítems de desarrollo. Se ajustó un modelo de regresión lineal entre la edad de cumplimiento estimada de los 13 ítems de cada encuesta en función de las correspondientes edades de la referencia nacional. A partir de este modelo, se definieron tres indicadores: el cociente global de desarrollo, el cociente a los 4 años y la tendencia del desarrollo. Resultados. Los resultados para las cinco encuestas variaron entre 0,74 y 0,85; 0,88 y 0,81 y -0,15 y -0,26 para el cociente global de desarrollo, cociente global a los 4 años y la tendencia del desarrollo, respectivamente. Se expresó un marcado retraso en el desarrollo y una tendencia progresiva del retraso con la edad. Conclusiones. Los indicadores sondeinterpretación sencilla y se relacionan con indicadores sociales (necesidades básicas insatisfechas, etc.). La obtención de la informaciónnecesaria para realizar los cálculos toma poco tiempo y es aplicable a grupos de población, pero no a individuos.

Introduction. It is necessary to use health indicators describing the conditions of all individuals in a population, not just of those who have a disease or die. Objectives. To introduce a method to collect population indicators of psychomotor development in children younger than 6 years old and show its results. Population and methods. Data were obtained from a cross-sectional assessment regarding compliance with 13 developmental milestones (selected from the national reference) conducted in5465 children using five surveys administered by the Matanza-Riachuelo River Basin Authority in areas of this basin where a high proportion of families with unmet basic needs live. For each survey, a logistic regression analysis was used to estimate the median age at attainment of the 13 developmental milestones. A linear regression model between the estimated age at attainment of the 13 milestones was adjusted for each survey based on the corresponding age at attainment of the national reference. Based on this model, three indicators were defined: overall developmental quotient, developmental quotient at 4 years old, and developmental trend. Results. Results from the five surveys ranged between 0.74 and 0.85, 0.88 and 0.81, and -0.15 and -0.26 for the overall developmental quotient, developmental quotient at 4 years old, and developmental trend, respectively. A distinct developmental delay and an increasing trend in delay with age were observed. Conclusions. Indicators are easily interpreted and related to social indicators (unmet basic needs, etc.). Collecting the information necessary to make estimations takes little time and can be applied to population groups, but not on an individual level.

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Endodontics is a special branch of dentistry constantly guided by imaging examinations. From a forensic scope, endodontics plays a valuable role providing solid antemortem (AM) radiographic evidence for comparison with postmortem findings in human identifications. This study illustrates the interface between endodontics and forensic odontology describing three cases of human identification based on radiographic endodontic records. From 2009 to 2012, three unknown male victims of murder were examined in a local Brazilian medico-legal institute to retrieve identity and potential cause of death. Specifically, when asked for AM data, a relative of the three victims provided periapical radiographs of endodontic treatments. Based on that, forensic dentists reproduced the same imaging acquisition techniques obtaining similar periapical radiographs, enabling a comparative dental identification. All the victims were positively identified based on patterns of dental morphology and treatment intervention. This study draws the attention of general and forensic dentists highlight the importance of properly recording dental treatments and searching for evidence in AM endodontic data, respectively.

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The comparison between antemortem and portmortem data comprehends the basis of the dental identification process. High-tech devices allow for optimal manipulation of postmortem data. However, in especial situations, the victims do not have records of dental treatments, making necessary the search for antemortem data from personal belongings. Smile photographs are one of the most common sources of dental information detected from personal belongings. In this context, the present study reports a forensic case in which a charred body was positively identified through the application of 3 techniques for the analysis of smile photographs.

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INTRODUCCION: El desarrollo psicomotor del niño tiene que ver con la expresión de sus potencialidades, su integración social y su desempeño en la vida. La oportuna detección de problemas mediante tamizaje permite realizar intervenciones eficaces y costo-efectivas. La Dirección General de SaludAmbiental (DGSA) de la Autoridad Cuenca Matanza-Riachuelo (ACUMAR) realiza encuestas en población vulnerable. OBJETIVO: Detectar problemas de nutrición y desarrollo psicomotor en niños menores de seis años, realizar un análisis toxicológico yuna investigación cualitativa sobre crianza y percepción de problemasambientales, y efectuar una georreferenciación. METODOS:Se recurrió a la Prueba Nacional de Pesquisa (PRUNAPE) y al Cuestionario PRUNAPE Pre-Pesquisa (CPPP) a cargo de la DGSA. Se realizaron nueve encuestas en las jurisdicciones dela Cuenca û14 municipios del conurbano y parte de la Ciudad Autónoma de Buenos Aires (aproximadamente 5 millones de habitantes)û en más de 7.000 niños. RESULTADOS: El estudioreveló: alta proporción de riesgo de problemas de desarrollo, mayor prevalencia en varones, aumento desde el nacimiento hasta los cuatro años y disminución a los cinco. Los principalesdeterminantes fueron: nivel de pobreza/indigencia, nivel educativoparental y bajo peso al nacer. CONCLUSIONES: La instalaciónde esta problemática en la agenda de la DGSA implica un progreso en el enfoque de la salud pública y permite actuarsobre los determinantes para promover el desarrollo infantil.

INTRODUCTION: Childpsychomotor development is related to the expression of potentialities, to social integration andto performance in life. Early detection of problems with screening techniques ensures appropriate and cost-effective interventions. The General Direction of Environmental Health (DGSA) fromMatanza-Riachuelo Basin Authority (ACUMAR) performs surveys on vulnerable population in that highly polluted area. OBJECTIVE: To detect problems of nutrition and psychomotor development in children under six years of age, to perform a toxicological analysis and a qualitative research on rearing practices and environmentalrisk perception, and to make a georeferenced image. METHODS:The DGSA used the National Screening Test (PRUNAPE) and the PRUNAPE Pre-Screening Questionnaire (CPPP). Nine surveys were carried out in more than 7000 children living in the jurisdictionsof the Basin: 14 municipalities of the Buenos Aires metropolitan area and part of the Autonomous City of Buenos Aires (with over 5 million inhabitants). RESULTS: The study showed a high rateof risk of developmental problems, a higher prevalence in boys than in girls, a growing prevalence from birth up to four years and a decrease at five. The main determinants were poverty and indigence levels, parental educational level and low birth weight. CONCLUSIONS: The inclusion of this issue in the DGSA agenda means a significant progress in the public health approach and allows the tackling of major determinants to improve thedevelopment of children.

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OBJECTIVE OF WORK: The present study aims to report a case of successful human identification based on the comparison of ante-mortem and post-mortem records of endodontic treatment. Based on these, the legal value of storing and updating clinical records is highlighted throughout the text. CASE REPORT: An unknown body was recovered from a traffic accident site. Forensic examination was conducted in order to establish the identity of the victim. Based on the absence of ante-mortem fingerprint registration in the national database, the search for AM data was performed using periapical radiographic records from private dental clinics. A positive dental identification was achieved analyzing evidence of endodontic treatment. CONCLUSION: Dental radiographs play a valuable role as legal tools supporting the criminal demands on the daily forensic practice. Specifically in endodontics, periapical radiographs are essential for a proper treatment. In forensics, these radiographs represent a solid source of ante-mortem data for human identifications.

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Population aging has taken place intensively worldwide, even in developing countries. These countries have population groups with low resources and basic unmet needs that are frequently omitted from epidemiological studies. OBJECTIVE: The purpose of this study was to determine the prevalence of cognitive impairment (CI) and dementia in an economic and socially vulnerable population from Argentina. METHODS: A door-to-door observational population-based survey among adults over 60 years of cognitive impairment and dementia in the social vulnerable area of the Matanza Riachuelo Basin, in the suburban area of Buenos Aires, Argentina was conducted. Trained psychologists interviewed subjects and a proxy informant. A standardized protocol including a socio-demographic questionnaire, the Mini-Mental State Examination, the Geriatric Depression Scale and a functional inventory for IADL and ADL was administered. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment-no dementia (CIND) and dementia. RESULTS AND CONCLUSIONS: A total of 2437 elderly persons were assessed, of which 73.6% fulfilled inclusion criteria. The prevalence of CI among those over 60 was 26.4% (18.1% CIND and 8.3% dementia) with higher prevalence of dementia in younger individuals than rates reported in developed counties, probably due to low control of vascular risk factors. This information can help inform health public decisions in the generation of programs and plans for the prevention, diagnosis and treatment of cognitive impairment in this type of socially vulnerable population.

O envelhecimento da população idosa tem aumentado mundialmente, mesmo em países em desenvolvimento. Estes países têm grupos populacionais de poucos recursos, com necessidades básicas não satisfatórias, frequentemente omitidas nos estudos epidemiológicos. OBJETIVO: O propósito deste estudo foi determinar a prevalência de comprometimento cognitivo (CC) e demência em uma população socioeconomicamente vulnerável na Argentina. MÉTODOS: Foi realizada pesquisa observacional de base populacional porta-a-porta entre adultos acima de 60 anos numa área de vulnerabilidade social em Matanza Riachuelo, no subúrbio de Buenos Aires, Argentina. Psicólogos treinados entrevistaram o sujeito e um acompanhante. Um protocolo estandardizado que incluiu um questionário sociodemográfico, o MEEM, a escala de depressão geriátrica e um inventário funcional para ABVD e AIVD foram administrados. Os diagnósticos foram divididos em três categorias: função cognitiva normal, comprometimento cognitivo sem demência (CCSD) e demência. RESULTADOS: Foram avaliados um total de 2437 de idosos, dos quais 73,6% preencheram os critérios de inclusão. A prevalência de CC entre aqueles acima de 60 anos foi de 26,4% (18,1% CCSD e 8,3% de demência) com maiores prevalência de demência em indivíduos mais jovens do que os reportados em países desenvolvidos, provavelmente devido a controle inadequado dos fatores de risco vasculares. CONCLUSÃO: Esta informação pode contribuir para tomada de decisões em saúde pública para geração de programas e planos que apontem para a prevenção, diagnóstico e tratamento de CC neste tipo de população em vulnerabilidade social.

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Introducción. La administración de la Prueba Nacional de Pesquisa (PRUNAPE), herramienta efcaz para la detección de trastornos inaparentes del desarrollo en menores de 6 años, requiere capacitación, tiempo, espacio y mobiliario adecuados. Para facilitar esta pesquisa en grandes grupos de población, podría ser útil un cuestionario sencillo a fn de identifcar a los niños en riesgo. Objetivo. Evaluar la validez del cuestionario PRUNAPE pre-pesquisa (CPPP) para identifcar a los niños en riesgo de no pasar la prueba. Métodos. Se transformaron en preguntas 57 pautas PRUNAPE, organizadas en cinco formularios (uno para cada grupo etario entre 6 y 71 meses) con dibujos ilustrativos. El trabajo se realizó en Florencio Varela y en Promoción de la Salud del Hospital de Niños Ricardo Gutiérrez de la Ciudad Autónoma de Buenos Aires. En una muestra de 533 niños sanos con sus madres, de bajo nivel socioeconómico, el CPPP fue sucesivamente: a) autoadministrado por cada madre (CPPP-A), b) por personal de salud (CPPP-PS), y fnalmente, c) se administró la PRUNAPE a cada niño por profesionales capacitados. Cada paso fue realizado por un profesional diferente en forma de triple ciego. En la elección del punto de corte se priorizó el valor predictivo positivo (VPP) para lograr el menor número posible de falsos positivos. Resultados. Para el CPPP-A y el CPPP-PS, los resultados globales fueron respectivamente: coeficiente kappa de Cohen: 0,23 y 0,28; sensibilidad: 0,41 y 0,42; especifcidad: 0,81 y 0,85; valor predictivo negativo 0,57 y 0,59, y VPP 0,71 y 0,76. Conclusiones. El CPPP resulta una herramienta válida para identifcar a los niños que más necesitan que se les administre la PRUNAPE.(AU)

Introduction.The administration of the National Screening Test (PruebaNacional de Pesquisa, PRUNAPE), a tool which is effective to screen inapparent developmental disorders in children under 6 years old, requires adequate training, time, space and furniture. A simple questionnaire to help screen large population groups could be useful to identify children at risk. Objective.To evaluate the validity of the PRUNAPE pre-screening questionnaire (cuestionario PRUNAPE pre-pesquisa, CPPP) to identify children at risk of not passing the test. Methods.Fifty seven PRUNAPE milestones were transformed into questions; they were organized in fve questionnaires (one for each age group between 6 and 71 months old) with illustrative pictures. The study was performed in Florencio Varela and in the Health Promotion Unit of Hospital de Niños "Ricardo Gutiérrez" in the Autonomous City of Buenos Aires. In a sample of 533 healthy children and their mothers, of a low socio-economic level, the CPPP was consecutively: a) self-administered by each mother (CPPP-SA), b) by healthcare personnel (CPPP-HP), and fnally, c) the PRUNAPE test was administered to each child by qualifed professionals. Each step was performed by a different professional in a triple-blind fashion. When choosing the cutoff point, the positive predictive value (PPV) was prioritized to reach the least possible number of false positives. Results.For the CPPP-SA and the CPPP-HP, the overall results were, respectively: Cohens kappa coeffcient: 0.23 and 0.28; sensitivity: 0.41 and 0.42; specifcity: 0.81 and 0.85; negative predictive value 0.57 and 0.59; and PPV 0.71 and 0.76. Conclusions.The CPPP is a valid tool to identify children who most require the PRUNAPE to be administered.(AU)

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RESUMEN

Introducción. La administración de la Prueba Nacional de Pesquisa (PRUNAPE), herramienta efcaz para la detección de trastornos inaparentes del desarrollo en menores de 6 años, requiere capacitación, tiempo, espacio y mobiliario adecuados. Para facilitar esta pesquisa en grandes grupos de población, podría ser útil un cuestionario sencillo a fn de identifcar a los niños en riesgo. Objetivo. Evaluar la validez del cuestionario PRUNAPE pre-pesquisa (CPPP) para identifcar a los niños en riesgo de no pasar la prueba. Métodos. Se transformaron en preguntas 57 pautas PRUNAPE, organizadas en cinco formularios (uno para cada grupo etario entre 6 y 71 meses) con dibujos ilustrativos. El trabajo se realizó en Florencio Varela y en Promoción de la Salud del Hospital de Niños Ricardo Gutiérrez de la Ciudad Autónoma de Buenos Aires. En una muestra de 533 niños sanos con sus madres, de bajo nivel socioeconómico, el CPPP fue sucesivamente: a) autoadministrado por cada madre (CPPP-A), b) por personal de salud (CPPP-PS), y fnalmente, c) se administró la PRUNAPE a cada niño por profesionales capacitados. Cada paso fue realizado por un profesional diferente en forma de triple ciego. En la elección del punto de corte se priorizó el valor predictivo positivo (VPP) para lograr el menor número posible de falsos positivos. Resultados. Para el CPPP-A y el CPPP-PS, los resultados globales fueron respectivamente: coeficiente kappa de Cohen: 0,23 y 0,28; sensibilidad: 0,41 y 0,42; especifcidad: 0,81 y 0,85; valor predictivo negativo 0,57 y 0,59, y VPP 0,71 y 0,76. Conclusiones. El CPPP resulta una herramienta válida para identifcar a los niños que más necesitan que se les administre la PRUNAPE.

Introduction.The administration of the National Screening Test (PruebaNacional de Pesquisa, PRUNAPE), a tool which is effective to screen inapparent developmental disorders in children under 6 years old, requires adequate training, time, space and furniture. A simple questionnaire to help screen large population groups could be useful to identify children at risk. Objective.To evaluate the validity of the PRUNAPE pre-screening questionnaire (cuestionario PRUNAPE pre-pesquisa, CPPP) to identify children at risk of not passing the test. Methods.Fifty seven PRUNAPE milestones were transformed into questions; they were organized in fve questionnaires (one for each age group between 6 and 71 months old) with illustrative pictures. The study was performed in Florencio Varela and in the Health Promotion Unit of Hospital de Niños "Ricardo Gutiérrez" in the Autonomous City of Buenos Aires. In a sample of 533 healthy children and their mothers, of a low socio-economic level, the CPPP was consecutively: a) self-administered by each mother (CPPP-SA), b) by healthcare personnel (CPPP-HP), and fnally, c) the PRUNAPE test was administered to each child by qualifed professionals. Each step was performed by a different professional in a triple-blind fashion. When choosing the cutoff point, the positive predictive value (PPV) was prioritized to reach the least possible number of false positives. Results.For the CPPP-SA and the CPPP-HP, the overall results were, respectively: Cohen's kappa coeffcient: 0.23 and 0.28; sensitivity: 0.41 and 0.42; specifcity: 0.81 and 0.85; negative predictive value 0.57 and 0.59; and PPV 0.71 and 0.76. Conclusions.The CPPP is a valid tool to identify children who most require the PRUNAPE to be administered.

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INTRODUCTION: The administration of the National Screening Test (PruebaNacional de Pesquisa, PRUNAPE), a tool which is effective to screen inapparent developmental disorders in children under 6 years old, requires adequate training, time, space and furniture. A simple questionnaire to help screen large population groups could be useful to identify children at risk. OBJECTIVE: To evaluate the validity of the PRUNAPE pre-screening questionnaire (cuestionario PRUNAPE pre-pesquisa, CPPP) to identify children at risk of not passing the test. METHODS: Fifty seven PRUNAPE milestones were transformed into questions; they were organized in fve questionnaires (one for each age group between 6 and 71 months old) with illustrative pictures. The study was performed in Florencio Varela and in the Health Promotion Unit of Hospital de Niños "Ricardo Gutiérrez" in the Autonomous City of Buenos Aires. In a sample of 533 healthy children and their mothers, of a low socio-economic level, the CPPP was consecutively: a) self-administered by each mother (CPPP-SA), b) by healthcare personnel (CPPP-HP), and fnally, c) the PRUNAPE test was administered to each child by qualifed professionals. Each step was performed by a different professional in a triple-blind fashion. When choosing the cutoff point, the positive predictive value (PPV) was prioritized to reach the least possible number of false positives. RESULTS: For the CPPP-SA and the CPPP-HP, the overall results were, respectively: Cohen's kappa coeffcient: 0.23 and 0.28; sensitivity: 0.41 and 0.42; specifcity: 0.81 and 0.85; negative predictive value 0.57 and 0.59; and PPV 0.71 and 0.76. CONCLUSIONS: The CPPP is a valid tool to identify children who most require the PRUNAPE to be administered.

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The administration of the National Screening Test (Prueba Nacional de Pesquisa, PRUNAPE) at households with unmet basic needs (UBNs) can be associated with a high proportion of false positive results. In order to reduce such proportion, the adequacy of the household was assessed in a survey conducted in 2012 by the Environmental Health Division of ACUMAR in La Matanza and Florencio Varela districts, based on five factors: uneven floor, scarce space according to certain PRUNAPE guidelines, environmental noise, privacy, and lack of necessary furniture. If household conditions were inadequate, the PRUNAPE was administered in a trailer located nearby; if the child was "non collaborative" at home, the test was readministered in the trailer. Psychomotor development was evaluated in 2174 children younger than 6 years old. All surveyed households were adequate for the administration of the PRUNAPE. In households, 98 children (4.4%) were "non collaborative" with the PRUNAPE and were referred to the trailer; 58 (59%) of them attended the trailer and 28 (48%) passed the test. The PRUNAPE may be administered in the field, in households with unmet basic needs provided the described precautions are taken.

La administración de la Prueba Nacional de Pesquisa (PRUNAPE) en hogares con necesidades básicas insatisfechas (NBI) podría asociarse a una alta proporción de falsos positivos. Para reducir esta proporción, en una encuesta de 2012 de Salud Ambiental de ACUMAR en La Matanza y Florencio Varela, se evaluó la adecuación del domicilio a partir de cinco factores: piso irregular, espacio escaso para ciertas pautas PRUNAPE, ruidos molestos, falta de privacidad y ausencia de mobiliario necesario. Si el domicilio era inadecuado, se administraba la PRUNAPE en un tráiler; si el niño "no colaboraba" en el domicilio, se administraba la prueba en el tráiler por segunda vez. Se evaluó el desarrollo psicomotor en 2174 niños menores de 6 años. Todos los hogares encuestados fueron adecuados para administrar la PRUNAPE. En el domicilio, 98 niños (4,4%) "no colaboraron" con la PRUNAPE y se derivaron al tráiler; 58 (59%) concurrieron, de los cuales 28 (48%) pasaron la prueba. La PRUNAPE puede administrarse en terreno en hogares NBI tomando las precauciones descritas.

RESUMEN

INTRODUCTION: The administration of the National Screening Test (PruebaNacional de Pesquisa, PRUNAPE), a tool which is effective to screen inapparent developmental disorders in children under 6 years old, requires adequate training, time, space and furniture. A simple questionnaire to help screen large population groups could be useful to identify children at risk. OBJECTIVE: To evaluate the validity of the PRUNAPE pre-screening questionnaire (cuestionario PRUNAPE pre-pesquisa, CPPP) to identify children at risk of not passing the test. METHODS: Fifty seven PRUNAPE milestones were transformed into questions; they were organized in fve questionnaires (one for each age group between 6 and 71 months old) with illustrative pictures. The study was performed in Florencio Varela and in the Health Promotion Unit of Hospital de Niños "Ricardo Gutiérrez" in the Autonomous City of Buenos Aires. In a sample of 533 healthy children and their mothers, of a low socio-economic level, the CPPP was consecutively: a) self-administered by each mother (CPPP-SA), b) by healthcare personnel (CPPP-HP), and fnally, c) the PRUNAPE test was administered to each child by qualifed professionals. Each step was performed by a different professional in a triple-blind fashion. When choosing the cutoff point, the positive predictive value (PPV) was prioritized to reach the least possible number of false positives. RESULTS: For the CPPP-SA and the CPPP-HP, the overall results were, respectively: Cohens kappa coeffcient: 0.23 and 0.28; sensitivity: 0.41 and 0.42; specifcity: 0.81 and 0.85; negative predictive value 0.57 and 0.59; and PPV 0.71 and 0.76. CONCLUSIONS: The CPPP is a valid tool to identify children who most require the PRUNAPE to be administered.

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