RESUMEN
Parabens (PBs) are widely used in the cosmetic, pharmaceutical, and food industries as preservatives of products. Because of its great use, humans and other organisms are highly exposed daily. However, little is known about the effect of PBs on male infertility. Therefore, the aim of the present study was to evaluate the effect of methylparaben (MePB) and propylparaben (PrPB), alone or in combination, on the physiological characteristics of pig in vitro exposed sperm to different concentrations (0, 200, 500, and 700 µM) for viability, motility, and acrosome integrity evaluation and (0, 200, 500, 700, 1000, and 2000 µM) for DNA fragmentation index evaluation, after 4 h of exposure. The results showed that sperm viability decreased after exposure to MePB from the concentration of 500 µM. In the PrPB and mixture groups, viability decreased at all concentrations except for the control. The decrease in viability of sperm exposed to PrPB was greater than that of the mixture and MePB groups. Sperm motility decreased in all the experimental groups exposed to PBs, at all concentrations, except for the control group. Acrosome integrity was not decreased in the MePB group; however, in the PrPB group, it decreased at a concentration of 200 µM and in the mixture at 500 µM. All groups exhibited DNA damage at different concentrations, except for the control group. Additionally, the effect of PBs on sperm quality was concentration-dependent. The results demonstrated that MePB and PrPB alone or in combination can have adverse effects on sperm quality parameters. MePB had lower toxicity than did both PrPB and the mixture. The mixture did not have an additive effect on any of the parameters evaluated. This could partially explain the link between PB exposure and infertility.
Asunto(s)
Supervivencia Celular , Parabenos , Motilidad Espermática , Espermatozoides , Parabenos/toxicidad , Animales , Masculino , Espermatozoides/efectos de los fármacos , Motilidad Espermática/efectos de los fármacos , Porcinos , Supervivencia Celular/efectos de los fármacos , Conservadores Farmacéuticos/toxicidad , Fragmentación del ADN/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Acrosoma/efectos de los fármacosRESUMEN
The thymus is the anatomical site where T cells undergo a complex process of differentiation, proliferation, selection, and elimination of autorreactive cells which involves molecular signals in different intrathymic environment. However, the immunological functions of the thymus can be compromised upon exposure to different infections, affecting thymocyte populations. In this work, we investigated the impact of malaria parasites on the thymus by using C57BL/6 mice infected with Plasmodium berghei ANKA and Plasmodium yoelii 17XL; these lethal infection models represent the most severe complications, cerebral malaria, and anemia respectively. Data showed a reduction in the thymic weight and cellularity involving different T cell maturation stages, mainly CD4-CD8- and CD4+CD8+ thymocytes, as well as an increased presence of apoptotic cells, leading to significant thymic cortex reduction. Thymus atrophy showed no association with elevated serum cytokines levels, although increased glucocorticoid levels did. The severity of thymic damage in both models reached the same extend although it occurs at different stages of infection, showing that thymic atrophy does not depend on parasitemia level but on the specific host-parasite interaction.
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Malaria , Plasmodium yoelii , Animales , Ratones , Plasmodium berghei , Ratones Endogámicos C57BL , Atrofia , ParasitemiaRESUMEN
The implications of closing educational establishments during the COVID-19 pandemic and the dis cussion about the opening of them, invite and require us to consider, from different positions and responsibilities, the changes that we must make as a society at the educational level. In this article, a group of health professionals collects information and reflects on the repercussions of returning or not to school activities, in terms of physical and emotional health and academic education. Based on what is known to be protective factors and possible threats to return, it is possible to conclude that each local reality must make its own informed decision, with the participation of all its members, seeking the common good, which favors students, protects teachers, and privileges the role of the educational system in socio-emotional learning. School is a space for containing the emotions and adaptation needs that students and their families have experienced in these uncertain times. We all have a level of responsibility in building a new civilization around these issues that link education, physical and mental health, social collaboration, and individual responsibility. Differences in people's living conditions and unequal opportunities have become more visible than before (others are still hidden) and create an opportunity for changes that we must face together.
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Rendimiento Académico , Salud del Adolescente , COVID-19/prevención & control , Salud Infantil , Educación a Distancia , Salud Mental , Pandemias/prevención & control , Rendimiento Académico/psicología , Adolescente , COVID-19/epidemiología , COVID-19/psicología , Niño , Desarrollo Infantil , Protección a la Infancia , Chile/epidemiología , Toma de Decisiones , Política de Salud , Disparidades en el Estado de Salud , Humanos , Distanciamiento Físico , Factores Protectores , Factores de Riesgo , Instituciones Académicas , Condiciones Sociales , Medio Social , Responsabilidad SocialRESUMEN
Cerebral malaria (CM) is a neurological complication derived from the Plasmodium falciparum infection in humans. The mechanisms involved in the disease progression are still not fully understood, but both the sequestration of infected red blood cells (iRBC) and leukocytes and an exacerbated host inflammatory immune response are significant factors. In this study, we investigated the effect of Monocyte Locomotion Inhibitory Factor (MLIF), an anti-inflammatory peptide, in a well-characterized murine model of CM. Our data showed that the administration of MLIF increased the survival and avoided the neurological signs of CM in Plasmodium berghei ANKA (PbA) infected C57BL/6 mice. MLIF administration down-regulated systemic inflammatory mediators such as IFN-γ, TNF-α, IL-6, CXCL2, and CCL2, as well as the in situ expression of TNF-α in the brain. In the same way, MLIF reduced the expression of CD31, CD36, CD54, and CD106 in the cerebral endothelium of infected animals and prevented the sequestration of iRBC and leucocytes in the brain microvasculature. Furthermore, MLIF inhibited the activation of astrocytes and microglia and preserved the integrity of the blood-brain barrier (BBB). In conclusion, our results demonstrated that the administration of MLIF increased survival and conferred neuroprotection by decreasing neuroinflammation in murine CM.
Asunto(s)
Antiinflamatorios/administración & dosificación , Malaria Cerebral/prevención & control , Fármacos Neuroprotectores/administración & dosificación , Oligopéptidos/administración & dosificación , Animales , Astrocitos/efectos de los fármacos , Astrocitos/inmunología , Encéfalo/efectos de los fármacos , Encéfalo/inmunología , Encéfalo/patología , Modelos Animales de Enfermedad , Regulación hacia Abajo/efectos de los fármacos , Regulación hacia Abajo/inmunología , Femenino , Humanos , Mediadores de Inflamación/antagonistas & inhibidores , Mediadores de Inflamación/metabolismo , Malaria Cerebral/inmunología , Malaria Cerebral/parasitología , Malaria Cerebral/patología , Ratones , Microglía/efectos de los fármacos , Microglía/inmunología , Plasmodium berghei/inmunologíaRESUMEN
More Smiles for Chile (MSCH) is a national program that helps women to access comprehensive dental care. OBJECTIVE: To assess the changes in oral health related quality of life (OHRQoL) of women attending the MSCH program. METHODS: Uncontrolled cohort study including all women registered in the National Health Fund (FONASA), who were at least 20 years old and received dental treatment in the MSCH program during 2016 or 2017 and completed OHIP-7 pre and post treatment. The median was used to describe central tendency and interquartile range to evaluate dispersion. RESULTS: The study included 11782 women in 2016 and 16533 in 2017. The median OHIP-7 scores pre and post treatment were 8 and 6 respectively. Reductions were significant (p⟨0.001) for the total score and OHIP-7 dimensions, especially physical pain, physiological discomfort and psychological disability. CONCLUSION: The OHRQoL of women improved after treatment in the Chilean MSCH program.
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Salud Bucal , Calidad de Vida , Adulto , Chile , Estudios de Cohortes , Femenino , Humanos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Land clearing for agricultural use is a primary driver of biodiversity loss and fragmentation of natural ecosystems. Restoring natural habitat connectivity by retaining quality habitats and increasing on-farm tree cover contributes to species' mobility and persistence in agricultural landscapes. Nonetheless, remarkably few studies have quantified the impacts of on-farm practices for species' mobility measured as functional connectivity within the context of farm and broader spatial levels of landscape organization. We tested how adding and removing trees in different configurations on a farm comprised of coffee plantations and cattle pastures can help evaluate species' mobility at the farmscape level (an area comprising the farm plus a 1.5â¯km buffer area). We coupled bird capture data and scenario modeling to assess species mobility of five neotropical bird species with distinct life history characteristics representing a gradient of forest dependency. We used seven years of mist-netting data to estimate species habitat affinity and to predict species mobility using the Circuitscape model across a 4371â¯ha farmscape in Costa Rica. Circuitscape allowed us to estimate changes in movement probability and relative changes in resistance to movement that species experience during dispersal (measured as resistance distance and passage area through which species can move) under four farmscape management scenarios. The four land-use scenarios included: (a) the 2011 farmscape land-use composition and configuration, b) converting all existing live fences to post-and-wire fence lines in the farm c) converting simplified coffee agroforests to multistrata coffee agroforests in the farm, and d) placing multistrata live fences around the perimeter of every parcel and roads on the farm. Model results suggest that existing multistrata live fences maintain the sporadic movement of all five species irrespective of forest dependence. Likewise, adding multistrata live fences around individual fields presents a more efficient strategy for increasing species mobility than multistrata coffee agroforestry systems in the assessed farmscape, by doubling the passage areas available to all species, although it created labyrinths with "dead-ends" for two species. While retaining large habitat patches remains important for conservation, managing on-farm connectivity complements these efforts by increasing movement probability and reducing dispersal resistance for forest-dependent bird species.
Asunto(s)
Aves , Ecosistema , Animales , Biodiversidad , Bovinos , Conservación de los Recursos Naturales , Costa Rica , BosquesRESUMEN
Neglected tropical diseases (NTDs) share certain traits: they are parasitic infections, prevailing in tropical environments and affecting marginalized sectors of the population. Six NTDs - ascariasis, cysticercosis, echinococcosis, hookworm infection, onchocerciasis and trichuriasis - all of them endemic in Latin America and the Caribbean (LAC), are analysed in this work. This review aims to discuss key information on the function of excretory/secretory (E/S) proteins from these parasites in their infectivity, pathogeny and diagnosis. The modulation of the host immune system to favour the permanence and survival of the parasite is also discussed. An updated knowledge on the function of E/S molecules in endemic parasitoses in LAC may lead to new approaches for the clinical management and diagnosis of these diseases. In turn, this could allow us to optimize their treatment and make it more affordable - a relevant goal given the economic constraints that the region is facing.
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Enfermedades Endémicas , Proteínas del Helminto/fisiología , Helmintiasis/epidemiología , Sistema Inmunológico/parasitología , Enfermedades Desatendidas/parasitología , Animales , Región del Caribe/epidemiología , Manejo de la Enfermedad , Helmintiasis/inmunología , Helmintiasis/parasitología , Interacciones Huésped-Parásitos , Humanos , América Latina/epidemiología , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/inmunología , Medicina TropicalRESUMEN
The Ages and Stages questionnaires (ASQ) has been recently validated in our country for developmental screening. The objective of this study is evaluate the validity of ASQ to predict low cognitive performance in the early years of schooling. PATIENTS AND METHOD: Diagnostic test studies conducted on a sample of children of medium-high socioeconomic level were evaluated using ASQ at least once at 8, 18 and/or 30 months old, and later, between 6 and 9 years old, reevaluated using the Wechsler Intelligence Scale for Children-third edition (WISC-III). Each ASQ evaluation was recorded independently. WISC-III was standardized, considering underperformance when the total score were under -1 standard deviation. RESULTS: 123 children, corresponding to 174 ASQ assessments (42 of them were 8 months old, 55 were 18 months and 77 were 30 months of age) were included. An area under the ROC curve of 80.7% was obtained, showing higher values at 8 months (98.0%) compared to 18 and 30 months old (78.1 and 79.3%, respectively). Considering different ASQ scoring criteria, a low sensitivity (27.8 to 50.0%), but a high specificity (78.8 to 96.2%) were obtained; the positive predictive value ranged between 21 and 46%, while the negative value was 92.0-93.2%. Conclusion ASQ has low sensitivity but excellent specificity to predict a low cognitive performance during the first years of schooling, being a good alternative to monitor psychomotor development in children who attend the private sector healthcare in our country.
Asunto(s)
Cognición/fisiología , Discapacidades del Desarrollo/diagnóstico , Encuestas y Cuestionarios/normas , Niño , Desarrollo Infantil/fisiología , Preescolar , Femenino , Humanos , Lactante , Masculino , Tamizaje Masivo/métodos , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
El Ages and Stages questionnaires (ASQ) fue validado en nuestro país para el tamizaje del desarrollo psicomotor. El objetivo es evaluar la validez del ASQ para predecir un menor rendimiento cognitivo en los primeros años de educación escolar. Pacientes y Método: Estudio de pruebas diagnósticas en una muestra de niños de nivel socioeconómico medio alto evaluados previamente con ASQ a los 8, 18 y/o 30 meses, y luego con la Escala de inteligencia para niños de Wechsler-tercera edición (WISC-III) entre los 6 y 9 años de edad. Cada evaluación con ASQ se contabilizó en forma independiente. La Escala de WISC-III fue estandarizada para la muestra, considerando rendimiento bajo cuando el puntaje total estaba bajo una desviación estándar de la media. Resultados: Se incluyeron 123 niños, correspondientes a 174 evaluaciones ASQ (42 de 8; 55 de 18; 77 de 30 meses de edad). El área bajo la curva ROC fue 80,7%, siendo superior a los 8 meses (98,0%) que a los 18 y 30 meses (78,1 y 79,3%, respectivamente). Considerando distintos criterios de corte con ASQ se obtuvo sensibilidad baja (27,8% a 50,0%), pero especificidad elevada (78,8% a 96,2%); el valor predictivo positivo varió entre 21,4% y 45,5%, mientras que el valor predictivo negativo fue 92,0-93,2%. Conclusión: El ASQ tiene baja sensibilidad pero excelente especificidad para predecir un menor rendimiento cognitivo durante los primeros años de educación escolar, siendo una buena alternativa para monitorizar el desarrollo psicomotor de niños que se atienden en el sector privado de salud de nuestro país.
The Ages and Stages questionnaires (ASQ) has been recently validated in our country for developmental screening. The objective of this study is evaluate the validity of ASQ to predict low cognitive performance in the early years of schooling. Patients and Method: Diagnostic test studies conducted on a sample of children of medium-high socioeconomic level were evaluated using ASQ at least once at 8, 18 and/or 30 months old, and later, between 6 and 9 years old, reevaluated using the Wechsler Intelligence Scale for Children-third edition (WISC-III). Each ASQ evaluation was recorded independently. WISC-III was standardized, considering underperformance when the total score were under -1 standard deviation. Results: 123 children, corresponding to 174 ASQ assessments (42 of them were 8 months old, 55 were 18 months and 77 were 30 months of age) were included. An area under the ROC curve of 80.7% was obtained, showing higher values at 8 months (98.0%) compared to 18 and 30 months old (78.1 and 79.3%, respectively). Considering different ASQ scoring criteria, a low sensitivity (27.8 to 50.0%), but a high specificity (78.8 to 96.2%) were obtained; the positive predictive value ranged between 21 and 46%, while the negative value was 92.0-93.2%. Conclusion ASQ has low sensitivity but excellent specificity to predict a low cognitive performance during the first years of schooling, being a good alternative to monitor psychomotor development in children who attend the private sector healthcare in our country.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Discapacidades del Desarrollo/diagnóstico , Encuestas y Cuestionarios/normas , Cognición/fisiología , Desarrollo Infantil/fisiología , Tamizaje Masivo/métodos , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
The use of the apparent diffusion coefficient (ADC) in magnetic resonance imaging (MRI) has been shown to be useful in the task of differentiating primary brain tumors. Our objective is to evaluate its use to differentiate between medulloblastomas and ependymomas. We analyzed 37 cases: 21 medulloblastomas (average age 12 years) and 16 ependymomas (average age 5 years) of the posterior fossa treated at the Carlos Van Buren Hospital in Valparaíso between december 2005 and June 2015. There were 15 and 5 males in each group respectively. In addition to age and gender, ADC values of tumors (ADCt) and healthy tissue were collected. The ADCt values for medulloblastoma and ependymoma averaged 0.64 and 0.92 [x10-3 mm²/s] respectively (p< 0.001). The multivariate model included gender and ADCt, with a sensitivity of 0.95 and a specificity of 0.87 to predict medulloblastoma. We can conclude that ADC measurement helps differentiate tumors of different cellularity such as medulloblastoma and ependymoma.
El uso del coeficiente de difusión aparente (ADC) en resonancia magnética (RM) ha demostrado ser útil en la tarea de diferenciar tumores cerebrales primarios. Nuestro objetivo es evaluar su uso para diferenciar entre meduloblastomas y ependimomas. Se analizaron 37 casos: 21 meduloblastomas (edad promedio 12 años) y 16 ependimomas (edad promedio 5 años) de fosa posterior tratados en el hospital Carlos Van Buren de Valparaíso, entre diciembre de 2005 y junio de 2015. Hubo 15 y 5 hombres en cada grupo respectivamente. Además de edad y sexo se recolectaron valores ADC tumorales (ADCt) y de tejido sano. Los valores ADCt para meduloblastoma y ependimoma promediaron 0,64 y 0,92 [x 10-3 mm²/s] respectivamente (p<0,001). El modelo multivariado incluyó sexo y ADCt, con sensibilidad de 0,95 y especificidad 0,87 para predecir meduloblastoma. Podemos concluir que la medición de ADC ayuda a diferenciar tumores de distinta celularidad como el meduloblastoma y el ependimoma.
Asunto(s)
Humanos , Masculino , Preescolar , Niño , Adolescente , Adulto , Espectroscopía de Resonancia Magnética , Ependimoma , Meduloblastoma , Imagen por Resonancia Magnética , Ependimoma/diagnóstico por imagen , Meduloblastoma/diagnóstico , Meduloblastoma/diagnóstico por imagenRESUMEN
La comida chatarra se ha convertido en parte de los hábitos alimentarios de nuestra sociedad, siendo un factor determinante del sobrepeso y obesidad, entre otras enfermedades crónicas no transmisibles, que atentan contra la buena salud que deberían gozar los estudiantes para un óptimo rendimiento académico. Una investigación realizada en Chile a estudiantes mostró que el 58,6 % consume comida chatarra debido a una ingesta inadecuada del desayuno, la omisión de ciertos tiempos de comida; el consumo de alimentos de mala calidad preparados en cafeterías de la misma universidad o lugares aledaños a causa de la falta de tiempo por la distancia hasta sus hogares. La misma realidad se ha observado en nuestra ciudad, de ahí la importancia de realizar y obtener resultados con este estudio. OBJETIVO: Identificar factores y determinantes de consumo de comida chatarra en estudiantes de la Facultad de Medicina, Nutrición, Enfermería y Tecnología Médica de la Universidad Mayor de San Andrés - 2016. METODOLOGÍA: Descriptivo - transversal el análisis estadístico se utilizó SPSS Vr. 19 RESULTADOS: De 100 encuestados 69% son mujeres y 31% varones, el promedio de edad de la población estudiada fue de 22 años, 43% estudian medicina, 58% residentes en La Paz, 59% realiza actividad física, el 28% de las mujeres consume bocaditos, 38% sabe que la comida chatarra causa ECNT y su consumo en La Paz llega al 28% siendo el mayor, 36% consume al menos una vez/semana bebidas gaseosas y el 50,7% del sexo femenino reemplaza el almuerzo por comida chatarra frente al sexo masculino de 48,38%. El consumo de agua es bajo en mujeres, el 32% de 1 a 3 veces/día, el 48% reemplaza el almuerzo por comida chatarra y el 38% de medicina y 28% de nutrición tienen conocimiento de las ECNT que causan la comida chatarra.
Junk food has become part of the eating habits of our society; being a determinant of overweight and obesity are chronic non communicable diseases. According to research students in Chile was observed that 56.8% consumes junk food due to inadequate intake of breakfast, the omission of certain meal times, the consumption of this type of food do in snacks at the university or in surrounding areas because of the lack of time for the trip they make to their homes. OBJECTIVE: To identify factors and determinants of consumption of junk food students of the Faculty of Medicine of the University of San Andres 2016. METHODOLOGY: A descriptive cross-sectional study was conducted using the survey to students of the Faculty of Medicine for the descriptive analysis of data SPSS 19 was used. RESULTS: Sample of 100 students 69% female and 31% are male, The mean age of the study population was 22 years, 43% from medicine, 58% live in the city of La Paz, the total 59% do physical activity, females have a frequency of 28% consumption of snacks, 38% know that junk food causes chronic disease, eating junk reaches 28% in La Paz being the highest, 36% consumes once / week fizzy drinks and 50.7% female replaced by junk food lunch male versus 48.38%. water consumption is low in women of 32% from 1 to 3 times / day, 48% replaces lunch for junk food and 38% medical and 28 % knowledge of nutrition have chronic disease causing junk food.
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Conducta Alimentaria , Alimentos/efectos adversosRESUMEN
Autosomal recessive interleukin-12 receptor ß1 (IL-12Rß1) deficiency has been described as the most common cause of Mendelian susceptibility to mycobacterial disease (MSMD), characterized by clinical disease due to weakly virulent mycobacteria such as Bacille Calmette-Guérin (BCG) vaccines and environmental mycobacteria (EM) in children who are normally resistant to most infectious agents. Here, we report the cases of five patients with mycobacterial infection, including one with systemic lupus erythematosus (SLE). Blood samples from patients and healthy controls were activated in vitro with BCG, BCG+IL-12, and BCG+IFN-γ. The results showed reduced or no production of IFN-γ after IL-12 stimulation in all samples. IL-12Rß1 expression on the cell surface was negligible or absent. Genetic analysis showed five novel mutations.
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Receptores de Interleucina-12/deficiencia , Receptores de Interleucina-12/genética , Adolescente , Secuencia de Bases , Niño , Preescolar , Análisis Mutacional de ADN , Resultado Fatal , Humanos , Lactante , Interleucina-12/sangre , Masculino , Datos de Secuencia Molecular , Linfocitos T/metabolismoAsunto(s)
Bancos de Leche Humana/organización & administración , Leche Humana , Lactancia Materna , Chile , Femenino , Hospitales , HumanosRESUMEN
INTRODUCTION: Tumors of the digestive system are considered to be a public health problem because of their elevated mortality rate. In Mexico, gastric cancer and colon cancer rank fourth and fifth, respectively, following tracheal, bronchial, and lung cancer, and there has been an increase in their frequency in the last few years. However, there are no specific studies that have evaluated their epidemiologic behavior in Veracruz. OBJECTIVE: To determine the frequency of digestive system cancer in five health institutions in the city of Veracruz and to describe its epidemiologic behavior over a five-year period. MATERIAL AND METHODS: Annual statistics from the following hospitals were reviewed: the Instituto Mexicano del Seguro Social, the Secretaría de Salud, the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Petróleos Mexicanos, and the Secretaría de la Defensa Nacional within the time frame of January 2005 to December 2009. Diagnoses based on histopathology were recorded, along with patient age and sex. RESULTS: A total of 1803 cases of digestive tract cancers were detected: 52% were men and 48% were women. A yearly increase in the number of cases was observed with colon cancer being in first place, followed by stomach cancer and rectal cancer. CONCLUSIONS: The increase in digestive system cancer cases over the last five years in Veracruz underlines the need to evaluate the implementation of screening programs for the at-risk population and to study the different etiologic factors involved in its manifestation.
Asunto(s)
Neoplasias del Sistema Digestivo/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Salud Urbana , Adulto JovenRESUMEN
Objective: Describe the psychomotor development (PMD) in upper middle class children, utilizing Bayley's Scale of Intellectual Development (BSID), internationally standarized. Patients and Methods: A total of 119 children in groups of 8, 18 and 30 months were enrolled at the well-baby clinic in a Private Hospital in Santiago, Chile. BSID III was utilized in all cases. Children born preterm, or with neurological, genetic, or metabolic diseases were excluded. Results: BSID scores followed a normal distribution (100.3 +/- 10). Prevalence of déficit was found to be 30%) at 8 months, 7.7%> at 18 months, and 2.7%> at 30 months, without gender difference. Gross motor development and language predominated at 8 months. Ther threee subscales showed an upward trend, cognitive and motor scales most significantly. Gross motor scales, which had been deficient at 8 months became normal at 18 months. Conclusions: The high frequency of motor deficits found at 8 months of age was striking. While all scales improved, cognitive and motor scales were most significant. The effect of stimulation and upbringing patterns upon chil development is discussed, being important for future studies of causality.
Objetivo: Describir los puntajes de desarrollo psicomotor (DSM) en niños sanos de nivel socio económico medio alto mediante la Escala de Bayley de Desarrollo Infantil (BSID), estandarizada internacionalmente. Pacientes y Métodos: Estudio transversal descriptivo. Se enrolaron 119 niños 8, 18 y 30 meses, que acudieron a control sano en una Clínica privada de Santiago de Chile, para la aplicación de BSID III. Se excluyeron los nacidos de pre-término o con enfermedad neurológica, genética o metabólica conocida. Resultados: Los puntajes obtenidos en BSID siguieron una distribución normal (100,3 +/- 10). La prevalencia de déficit en el DSM fue 30% a los 8 meses, 7,7% a los 18 y 2,7% a los 30 meses, no hubo diferencia por sexo. A los 8 meses predominó el déficit motor grueso y posteriormente el lenguaje. Las tres subescalas mostraron una tendencia al alza, las áreas cognitiva y motriz siguieron una progresión significativa. La motricidad gruesa, que estaba en el rango inferior a los 8 meses, fue normal a los 18. Conclusiones: Destaca la alta frecuencia de déficit motor en la población evaluada, especialmente a la edad de 8 meses. Todas las subescalas mostraron una tendencia al alza, siendo ésta diferencia significativa en las áreas cognitiva y motora. Se discute el efecto de la estimulación y los patrones de crianza en el desempeño de los niños, siendo necesario planificar estudios prospectivos para conocer su relación de causalidad.
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Humanos , Lactante , Preescolar , Desarrollo Infantil/fisiología , Desempeño Psicomotor/fisiología , Pruebas Neuropsicológicas , Clase Social , Cribado de Líquidos , Análisis de Varianza , Estudios Transversales , Cognición/fisiología , Discapacidades del Desarrollo/diagnóstico , Discapacidades del Desarrollo/fisiopatología , LenguajeRESUMEN
Introduction: Psychomotor Development (PMD) is an essential component of health care. Several authors have attempted to facilitate this evaluation through quick and inexpensive tools that do not prolong the time of consult. The "Ages and Stages Questionnaire" (ASQ) is a well-known and validated parent-directed survey. Objective: To evaluate the psychometric validity of ASQ, through comparison with Bayley's Scale of Infant Development (BSID), a universally accepted tool which measures similar parameters, and is administered by an expert. Patients and Methods: Children seen at an upper-middle class Private Clinic in Santiago, Chile were admitted to this study, with the exception of pre-term newborns, or children with known neurological, genetic or metabolic disease. Groups were formed at 8, 18 and 30 months of age. A sample of nearly 40 children per age Group was formed. After parents responded to the ASQ, an expert, blind to the results of the ASQ, evaluated each patient within two weeks. Results: Total number of children enrolled was 119. PMD deficit was scored in 19.3 percent of children according to ASQ, 14.3 percent according to BSID (not significant). While the results obtained with both tests were found to be correlated (r = 0.52), scores obtained through BSID were lower among children with deficit, compared to those rated through ASQ (p < 0.001). The sensitivity of ASQ was 58.8 percent and the specificity was 87.2 percent. Conclusions: Both tests are correlated. ASQ was found to be highly specific, suggesting its use as a screening tool in outpatient clinics, at least in a similar a population. These results should be reevaluated after national validation, to determine cutting points and test potency in all populations.
Introducción: La evaluación del desarrollo psicomotor (DSM) es un componente esencial en la supervisión de salud. Distintos investigadores han buscado formas de facilitar esta evaluación en forma rápida y económica, sin prolongar el tiempo destinado a la consulta pediátrica. El Ages and Stages Questionnaires (ASQ) es un cuestionario de auto-reporte de los padres, validado ampliamente para este fin. Objetivo: Evaluar las propiedades psicométricas del ASQ. Para eso se compara con la Escala de Bayley III de Desarrollo Infantil (BSID), el cual es universalmente aceptado, mide parámetros similares, y es administrado por un experto. Pacientes y Métodos: Estudio transversal analítico. En forma secuencial se enrolaron niños de 8, 18 y 30 meses, de nivel socio económico medio alto, que acudieron a control sano en una Clínica privada de Santiago de Chile. Se excluyeron los nacidos de pretérmino o con enfermedad neurológica, genética o metabólica conocida. Se obtuvo una muestra cercana a 40 niños por grupo etáreo. Tras responder el ASQ, los niños fueron evaluados con la BSID III, por un experto, ciego a los resultados ASQ. La latencia entre ambas evaluaciones no superó las dos semanas. Resultados: Participaron 119 niños. La frecuencia global de déficit de DSM fue de 19,3 por ciento de acuerdo al ASQ y 14,3 por ciento según el BSID (no significativo). El rendimiento promedio del BSID fue inferior en el grupo de niños con déficit según el ASQ comparado con el grupo con ASQ normal (p < 0,001). Se demostró correlación entre ambos test (r 0,52). La sensibilidad del ASQ fue 58,8 por ciento y la especificidad fue 87,2 por ciento. Conclusiones: Se demostró una adecuada correlación entre el ASQ y el BSID. El ASQ resultó altamente específico, por lo que odría ser usado como método de screening del DSM en la consulta pediátrica. Estos resultados deberían ser reevaluados luego de completar la validación nacional, para establecer los puntos de corte y real potencia del teste.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Desarrollo Infantil , Encuestas y Cuestionarios , Tamizaje Masivo/métodos , Atención Ambulatoria , Chile , Estudios Transversales , Discapacidades del Desarrollo/prevención & control , Valor Predictivo de las Pruebas , Psicometría , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Factores SocioeconómicosRESUMEN
Acalculous cholecystitis has been associated with several infectious agents, but its relation with Plasmodium falciparum infection has not been clearly defined. This is the first case of acalculous cholecystitis produced by Plasmodium falciparum infection that is directly documented and should be included among the differential diagnoses of acalculous cholecystitis.