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The aim of this study was to evaluate the impact of non-surgical periodontal treatment (NS-PT) on periodontal parameters and inflammatory biomarkers in the concentration and level of calprotectin (CLP) in women with periodontitis and rheumatoid arthritis (RA). In this quasi-experimental study, we evaluated 30 women (mean age: 52.0 ± 5.8 years) with periodontitis and RA who had been diagnosed and treated for RA for more than 3 years and whose activity markers remained at similar values without significant reduction over three consecutive months. Patients underwent NS-PT, which included plaque control, scaling, and root planing. Serum and saliva samples, periodontal indices, RA activity markers, Disease Activity Score-28 (DAS28), the erythrocyte sedimentation rate (ESR), and the C-reactive protein (CRP) and CLP contents were measured at the beginning of the study and 6 and 12 weeks after NS-PT. Parametric and nonparametric tests were used in the analysis. The mean age was 52.0 ± 5.8 years. Compared to the baseline results, all periodontal indices were significantly reduced 6 and 12 weeks after NS-PT (p < 0.001). DAS28 was also significantly reduced after 12 weeks (p < 0.0001). Similarly, the serum CLP concentration decreased 6 and 12 weeks after NS-PT (p < 0.0001). Of the patients, 100% presented lower levels of CRP and ESR (p < 0.0001). Overall, NS-PT reduced inflammation and disease activity, highlighting the importance of oral health in the control and treatment of systemic diseases such as RA and confirming that NS-PT effectively reduces periodontitis activity and plays a key role in modulating RA activity. Therefore, NS-PT should be considered as an adjunct treatment for RA.

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Resumen El presente estudio valoró la influencia de una unidad híbrida sobre la motivación, la satisfacción de las NPB, la intención de ser físicamente activo y la satisfacción hacia la clase de EF. El género fue considerado como variable de interés. Se hibridaron los modelos Educación Deportiva (MED) y Teaching Games for Understanding (TGfU) en una unidad de minibalonmano para cuatro grupos de Educación Secundaria, de entre 13 y 15 años (n=70). En otras tres clases (grupo control, n=67) se planteó un enfoque tradicional. Se planteó un análisis inferencial MANOVA inter e intragrupo, pre y post test. El grupo experimental mostró mejoras significativas para casi todas las variables. Las diferencias de género previas se minimizaron o eliminaron en todas las variables. Ambos géneros parecen tener valores similares de motivación más autodeterminada, mejorando su satisfacción hacia las clases de EF y la intención de ser físicamente activos, favoreciendo un entorno más equitativo.

Resumo O presente estudo valorizou a influência em uma unidade híbrida sobre a motivação, satisfação das NPB, intenção de ser fisicamente ativo e a satisfação em relação à aula de EF. Considerou-se o gênero como variável de interesse. Recorrendo à hibridação dos modelos Educação Desportiva (MED) e Teaching Games for Understanding (TGfU) em uma unidade de mini-handebol dirigida a quatro turmas do Ensino Fundamental, entre 13 e 15 anos (n=70). Noutras três aulas (grupo de controlo, n=67) propôs uma abordagem tradicional. Propôs uma análise dedutiva MANOVA inter e intragrupal pré e pós-teste. A turma experimental melhorou significativamente em quase todas as variáveis. As diferenças de gênero prévias minimizaram ou foram eliminadas no que respeita a todas as variáveis. Além disso, os meninos e as meninas parecem ter valores semelhantes de motivação mais autodeterminada, melhorando a satisfação em relação à classe de educação física e a intenção de ser fisicamente ativo.

Abstract The present study analyzed the influence of a hybrid unit on Motivation, BPN satisfaction, Intention to be Physically Active and Satisfaction in PE class. Gender was considered as a variable of interest. Sport Education Model (SE) and Teaching Games for Understanding (TGfU) were hybridized in a mini handball unit for four secondary education groups, aged between 13 and 15 years (n=70). In other three classes (n=67) a traditional approach was proposed, working as a control group. Pre and post test MANOVA inferential analysis was conducted between and within groups. Experimental group showed significative results in almost all variables. Preliminary gender differences were removed or minimized for all variables. The hybridization of pedagogical models could support a more inclusive, equitable environment. Both genders showed similar values of self-determined motivation and improved both their satisfaction in PE classes and their intention to be physically active.

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Cities have high demand and limited availability of water and energy, so it is necessary to have adequate technologies to make efficient use of these resources and to be able to generate them. This research focuses on developing and executing a methodology for an urban living lab vocation identification for a new water and energy self-sufficient university building. The methods employed were constructing a technological roadmap to identify global trends and select the technologies and practices to be implemented in the building. Among the chosen technologies were those for capturing and using rain and residual water, the generation of solar energy, and water and energy generation and consumption monitoring. This building works as a living laboratory since the operation and monitoring generate knowledge and innovation through students and research groups that develop projects. The insights gained from this study may help other efforts to avoid pitfalls and better design smart living labs and off-grid buildings.

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BACKGROUND: Global Asthma Network (GAN) was established in 2012 as a development to the International Study of Asthma and Allergies in Childhood to improve asthma care globally. OBJECTIVE: To survey asthma, allergic rhinitis and atopic dermatitis in primary and secondary school children and to investigate and evaluate its prevalence, severity, management and risk factors in Mexico. METHODS: GAN Phase I is a cross-sectional, multicentre survey carried out in 15 centres corresponding to 14 Mexican cities throughout 2016-2019 using the validated Spanish language version of the GAN Phase I questionnaires. The questionnaires were completed by parents of 6-7-year-old primary school pupils (school children) and by 13-14-year-old adolescents. RESULTS: A total of 35 780 school children and 41 399 adolescents participated. Wheezing ever prevalence was 26.2% (95% CI 25.8% to 26.7%) in school children and 23.9% (95% CI 23.4% to 24.3%) in adolescents. The corresponding frequencies for current wheeze were 10.2% (95% CI 9.9% to 10.5%) and 11.6% (95% CI 11.2% to 11.9%). In school children, the risk factors for current wheeze were rhinitis (OR 4.484; 95% CI 3.915% to 5.134%) and rash symptoms (OR 1.735; 95% CI 1.461% to 2.059%). For adolescents, rhinitis symptoms (OR 3.492; 95% CI 3.188% to 3.825%) and allergic rhinitis diagnosis (OR 2.144; 95% CI 1.787% to 2.572%) were the most significant. For both groups, there was a negative relation with centres' sea level altitude higher than 1500 m above mean sea level (p<0.005). CONCLUSIONS: The most important risk factors for asthma symptoms in both age groups were the presence of rhinitis and rash symptoms or diagnosis. On the other hand, sea level altitude higher than 1500 metres was a protective factor.

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BACKGROUND: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. METHODS: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, Supplementary data) concluded the following. RESULTS: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50-200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. CONCLUSIONS: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed.

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El objetivo del presente estudio fue analizar el efecto de un programa de enseñanza comprensiva, basado en el cuestionamiento, sobre la toma de decisiones en las habilidades del pase y del lanzamiento, en una unidad didáctica de baloncesto en Educación Primaria. Participaron 37 alumnos de 6º de Primaria con edades comprendidas entre los 11 y 12 años. La variable independiente fue el programa de intervención, basado en el modelo Teaching Games for Understanding (TGfU). La variable de toma de decisiones fue evaluada a través de la observación sistemática. Los resultados obtenidos mostraron que, tras la intervención, los alumnos que recibieron el cuestionamiento durante el desarrollo de las actividades formativas mejoraron su toma de decisiones en comparación con los alumnos que no lo recibieron. Estos resultados manifiestan la necesidad de incluir este modelo pedagógico en las programaciones docentes en los niveles superiores de la etapa de Primaria

O principal objetivo do estudo foi analisar o efeito de um programa de ensino centrado na compreensão, baseado no questionamento, na tomada de decisões nas ações de passe e do lançamento, numa unidade didática de basquetebol no ensino fundamental. Participaram 37 alunos com idades compreendidas entre 11 e 12 anos. A variável independente foi o programa de intervenção baseado no modelo Teaching Games for Understanding (TGfU). A variável dependente de tomada de decisão foi avaliada através da observação sistemática. Os resultados mostraram que, após a intervenção, os alunos que receberam o questionamento durante o desenvolvimento das atividades de treino melhoraram sua tomada de decisão em relação aos alunos que não o receberam. Esses resultados mostram a necessidade de incluir esse modelo pedagógico nos programas de ensino nos níveis superiores do ensino fundamental

The main purpose of this study was to analyze the effect of a comprehensive questioning-based teaching program about decision-making on passing and throwing abilities in a Primary Education teaching unit focused on basketball. Thirty-seven students aged 11-12 participated in the study. The independent variable was the intervention program based on the Teaching Games for Understanding (TGfU). The decision-making variable was assessed by systematic observation. The results obtained showed that, after the intervention, the students who received the questioning when developing training activities improved their decision-making compared to those who did not. These results show the need to include this pedagogical model in teaching programs at the higher levels of Primary Education

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BACKGROUND: In Mexico, allergen immunotherapy (AIT) and immunotherapy with hymenoptera venom (VIT) is traditionally practiced combining aspects of the European and American school. In addition, both types of extracts (European and American) are commercially available in Mexico. Moreover, for an adequate AIT/VIT a timely diagnosis is crucial. Therefore, there is a need for a widely accepted, up-to-date national immunotherapy guideline that covers diagnostic issues, indications, dosage, mechanisms, adverse effects and future expectations of AIT (GUIMIT 2019). METHOD: With nationwide groups of allergists participating, including delegates from postgraduate training-programs in Allergy/Immunology-forming, the guideline document was developed according to the ADAPTE methodology: the immunotherapy guidelines from European Academy of Allergy and Clinical Immunology, German Society for Allergology and Clinical Immunology, The American Academy of Allergy, Asthma and Immunology and American College of Allergy, Asthma, and Immunology were selected as mother guidelines, as they received the highest AGREE-II score among international guidelines available; their evidence conforms the scientific basis for this document. RESULTS: GUIMIT emanates strong or weak (suggestions) recommendations about practical issues directly related to in vivo or in vitro diagnosis of IgE mediated allergic diseases and the preparation and application of AIT/VIT and its adverse effects. GUIMIT finishes with a perspective on AIT modalities for the future. All the statements were discussed and voted on until > 80 % consensus was reached. CONCLUSIONS: A wide and diverse group of AIT/VIT experts issued transculturized, evidence-based recommendations and reached consensus that might improve and standardize AIT practice in Mexico.

Antecedentes: En México, la inmunoterapia con alérgenos (ITA) y con veneno de himenópteros (VIT) se practica tradicionalmente combinando criterios de las escuelas europea y estadounidense; los dos tipos de extractos están comercialmente disponibles en México. Para una ITA adecuada es crucial un diagnóstico oportuno. Objetivo: Presentar GUIMIT 2019, Guía Mexicana de Inmunoterapia 2019, de base amplia, actualizada, que abarca temas de diagnóstico, indicaciones, dosificación, mecanismos, efectos adversos de la ITA y expectativas con esta modalidad de tratamiento. Método: Con la participación de múltiples grupos mexicanos de alergólogos, que incluían los centros formadores universitarios en alergia e inmunología, se desarrolló el documento de la guía según la metodología ADAPTE. Las guías de inmunoterapia de la European Academy of Allergy and Clinical Immunology, The American Academy of Allergy, Asthma and Immunology, German Society for Allergology and Clinical Immunology y del American College of Allergy, Asthma, and Immunology se seleccionaron como guías fuente, ya que recibieron la puntuación AGREE-II más alta entre las guías internacionales disponibles; su evidencia conforma la base científica de GUIMIT 2019. Resultados: En GUIMIT 2019 se emiten recomendaciones fuertes o débiles (sugerencias) acerca de temas directamente relacionados con el diagnóstico in vivo o in vitro de las enfermedades alérgicas mediadas por IgE, la preparación y aplicación de ITA o VIT y sus efectos adversos; se incluye la revisión de las modalidades de ITA para el futuro. Todos los argumentos que se exponen fueron discutidos y votados con > 80 % de aprobación. Conclusión: Un grupo amplio y diverso de expertos en ITA y VIT emitió recomendaciones transculturizadas basadas en evidencia, que alcanzaron consenso; con ellas se pretende mejorar y homologar la práctica de la inmunoterapia en México.

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El desarrollo del presente trabajo se fundamenta en la importancia de apoyar los tratamientos de Rehabilitación Motriz por medio de Tecnología Informática para beneficio de los pacientes y especialistas del área. De acuerdo a un análisis realizado de las tecnologías existentes para la Rehabilitación Motriz, se ha identificado una serie de inconvenientes que limitan su uso en algunos tratamientos y por consecuencia los pacientes no continúan o no finalizan sus terapias, en este trabajo se propone emplear una herramienta de bajo costo (sensor Microsoft Kinect) que apoye en la captura de movimientos de los puntos clave de las extremidades superiores (manos, codos y hombros) usando pendientes lineales. Así mismo, se han realizado una serie de pruebas a 21 usuarios, en donde se evaluaron sus movimientos mediante umbrales que determinaron si un ejercicio fue realizado correctamente(AU)

The development of this researckneh is based on supporting Motor Rehabilitation treatments using Information Technology for the benefit of patients and specialists in the area. According to an analysis of current technologies for Motor Rehabilitation, we have identified some disadvantages that limit their use in the treatment and therefore patients do not continue or complete their therapies, this study intends to use a tool low cost (Microsoft Kinect sensor) to support the motion capture of the key points of the upper extremities (hands, elbows and shoulders) using a slopes. Also, the tests were conducted with 21 users, the algorithm evaluated some movements, the thresholds used determined the correct exercises(AU)

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UNLABELLED: Few studies have been made regarding carbonyl concentrations in Monterrey, México. The Monterrey Metropolitan Area (MMA) has the third largest population in the country and has increasing pollution issues. The concentrations of 10 aldehydes and two ketones were measured in the MMA, in the spring and fall of 2011 and 2012. Formaldehyde (16-42 ppbv) was the most abundant carbonyl, followed by acetaldehyde (5-15 ppbv) and acetone (7-15 ppbv). The concentrations showed marked diurnal trends with maximum values between 10:00 a.m. and 2:00 p.m., when photochemical activity is intense. Thus, secondary production of carbonyls is statistically significant in the city. Biogenic production of several carbonyls, such as 2-butanone, was supported by their mid correlation with solar radiation and low correlation with propionaldehyde, which is mainly emitted by anthropogenic sources. The seasonal variability of the concentrations was observed in the first three samplings, with the highest levels reached in the fall. The rainy conditions during the fourth sampling did not allow comparison. Carbonyl-NOx-O3 analysis was made. Results indicated a carbonyl-sensitive atmosphere, especially during the midday samplings of 10:00 a. m. to 2:00 p.m. and 2:00 p.m. and 6:00 p.m. because of the intense solar radiation during these periods. IMPLICATIONS: Monitoring of carbonyls in Monterrey, Mexico, was performed to quantify the pollutant concentration in the city's atmosphere. Although primary emission is significantly important, the secondary production of the pollutants, along with ozone production being carbonyl sensitive, indicates that air pollution controls must address the direct sources and the precursors of the pollutants to achieve air quality.

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BACKGROUND: The association between obesity and bronchial hyperreactivity (BHR) in children has not been fully demonstrated in cross-sectional or longitudinal studies, and no study has specifically addressed Latino children. METHODS: A cross-sectional study of 450 children (10-18 years) from public schools was conducted in Mexico city. Among this group, 260 met the study criteria (no chronic respiratory illnesses, including asthma and rhinitis; no acute respiratory infections; and no tobacco-exposure or endocrine or body dysmorphic disorders), and 229 performed reproducible pulmonary function and methacholine challenge tests and were fully analyzed. RESULTS: According to BMI percentiles, 40 were normal weight, 116 were obese, and 73 morbidly obese. Children in the morbidly obese group had significantly higher % FVC than those in the normal-weight group, and obese children had higher % PEF those in the morbidly obese and normal-weight groups. In the BHR methacholine challenge test, baseline FEV1 values among obese children were significantly lower than in the morbidly obese group. Using adjusted percentages for FEV1 , values were significantly lower among obese compared to morbidly obese children at metacholine concentrations of 0.25, 1, and 4 mg/ml. The proportion of positive BHR (PC20 ≤ 16 mg/ml) was higher in these two groups compared to normal-weight children (28.4%, 17.8%, and 12.5%, respectively), although differences were not significant. CONCLUSION: Our findings show that obesity by itself is not a sufficient condition to alter airway responsiveness to methacholine in a group of adolescents.

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Se realizó un estudio observacional, descriptivo y transversal de 550 pacientes en estado crítico, ingresados en la Unidad de Cuidados Intensivos del Hospital General Docente "Orlando Pantoja Tamayo" de Contramaestre en la provincia de Santiago de Cuba, durante el bienio 2010-2011, con vistas a determinar la morbilidad y mortalidad en ellos mediante algunas variables clinicoepidemiológicas de interés: edad, sexo, estado al egreso, aplicación de ventilación mecánica, estadía, diagnósticos principales, entre otras. En la casuística se obtuvo predominio de los hombres, la ancianidad y el infarto agudo del miocardio. En general, la mortalidad no fue elevada, excepto en los afectados por enfermedades cerebrovasculares, con estadía prolongada, y en los que recibieron ventilación mecánica invasiva, aunque el índice de ventilación fue relativamente bajo.

An observational, descriptive and cross-sectional study was carried out in 550 patients in critical condition, admitted to the Intensive Care Unit of "Orlando Pantoja Tamayo" General Teaching Hospital of Contramaestre in Santiago de Cuba province during 2010-2011, in order to determine the morbidity and mortality in them by means of some clinical and epidemiological variates of interest: age, sex, status at discharge, mechanical ventilation, hospital stay, main diagnoses, among others. There were prevalence of males, old age and acute myocardial infarction in the case material. Overall, the mortality was not high, except for those affected by cerebrovascular diseases with long stay, and for those receiving invasive mechanical ventilation, although the ventilation rate was relatively low.

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The epidemiology of allergic diseases has not been studied extensively in Mexico. The present study, based on the International Study of Asthma and Allergies in Childhood Phase IIIB survey, reports the prevalence of allergic rhinitis and the associated risk factors in the pediatric population in four cities in northern Mexico. Children (6-7 years old) and adolescents (13-14 years old) in public elementary and secondary schools were surveyed in 2002 and 2003. The subjects were chosen randomly from Ciudad Victoria, Mexicali, Monterrey, and Tijuana. The following categories were analyzed: occurrence of rhinitis symptoms (currently or in the last 12 months), rhinoconjunctivitis symptoms, a previous diagnosis of allergic rhinitis, and relevant environmental factors. Factors associated with rhinitis that were identified previously with the chi-squared test were analyzed using logistic regression. The number of valid questionnaires was 10,892 for schoolchildren and 12,299 for adolescents. In 6- to 7-year-old children, the following frequencies were determined: rhinitis (ever), 27.9%; current rhinitis, 24.2%; rhinoconjunctivitis, 9.2%; and diagnosis of allergic rhinitis, 5.5%. The corresponding frequencies in 13- to 14-year-old children were 33.3, 34.1, 18.4, and 3.8%. In both 6- to 7-year-old and 13- to 14-year-old children, all rhinitis items were associated with asthma symptoms, dermatitis symptoms, paracetamol consumption, and maternal smoking (odds ratio, >1; p < 0.05). The main risk factors associated with allergic rhinitis symptoms in children and adolescents from cities in northern Mexico were other allergic conditions, paracetamol consumption, and passive smoking.

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Asthma is a chronic inflammatory syndrome of airways, in which different cells and their mediators play a role originating damage clinically expressed by recurrent respiratory symptoms. Current therapy of asthma is focused to reduce airway inflammation, diminishing long-term bronchial hyperactivity and rescue treatment (when required). Unfortunately, the failure of current therapies of asthma has increased the number of patients searching for approximations in complementary and alternative medicine. Scientific evidence is still scarce for establishing that alternative medicine is more effective than placebo in asthma. However, this does not mean that it is ineffective, maybe more multicentric clinical assays are needed, with methodological rigor, to establish final conclusions of efficacy and safety of complementary medicine. Thus, until such results are available, it is better to be skeptical and not to recommend acupuncture for asthma treatment.

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OBJECTIVES: To gather basic information of the double-blinded, placebo controlled studies about the use of immunostimulant agents to prevent acute respiratory infections in children and to make a meta-analysis of each one of them after six months of treatment. MATERIAL AND METHODS: Articles related to immunostimulant agents were looked up in Medline and EMBASE, and the ones referring to controlled studies were selected. Average data and the dispersion of the number of acute respiratory infections were extracted and combined as average differences considering the random-effect model for each one of the immunostimulant agents. RESULTS: Only D53, LW50020, OM-85, pidotimod, and RU41740 had controlled studies. It was only possible to calculate the combined effects of D53, OM-85, pidotimod, and RU41740. The effects in the reduction of the number of acute respiratory infections were: global D53 -0.92 (-1.46, -0.39), average difference (confidence interval 95%) (p < 0.05); global OM-85 -1.20 (-1.70, -0.69) (p < 0.05), OM-85 in Mexico City -1.55 (-2.00, -1.10) (p < 0.05); global pidotimod -0.82 (-1.84, +0.21) (p > 0.05); global RU41740 -0.81 (-2.24, +0.62) (p > 0.05), RU41740 in Mexico City -1.20 (-4.33, +1.94) (p > 0.05). Effects in the reduction of acute respiratory infections as percentages were: global D53 31.86% (-34.32, -29.40) (p < 0.05); global OM-85 -39.28% (-52.58, -25.98) (p < 0.05), OM-85 in Mexico City -46.85% (-54.98, -38.72) (p < 0.05); global pidotimod -31.26% (-42.51, -20.01) (p < 0.05); global RU41740 -27.60 (-73.88, +18.69) (p > 0.05), RU41740 in Mexico City -27.89 (-104.11, +48.33) (p > 0.05). DISCUSSION: Only D53 and OM-85 proved to have significant effect in the prevention of acute respiratory infections in children. Only OM-85 showed significant efficacy in Mexico City. LW50020, pidotimod, and RU41740 have some evidence of their efficacy, contrary to other immunostimulant agents that do not have it.

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Se realizó un estudio en un grupo poblacional constituido por 481 personas aparentemente sanas, para determinar los valores de flujo expiratorio forzado en la población cubana; se aplicó una encuesta y se realizaron 3 mediciones del mismo a cada persona. Se compararon los resultados con los valores de flujo pico existente en las tablas inglesas, de forma general estas fueron inferiores. Se puso en evidencia la necesidad de una norma cubana de flujo pico. Después de un serio análisis estadístico se propuso una nueva norma. Se realizó el cálculo de error relativo según la norma inglesa y la norma cubana, para hombres y mujeres, el error de la norma inglesa fue de 1,12 superior al de la cubana para las mujeres y 1,25 superior en el caso de los hombres

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Se realizó un estudio prospectivo y longitudinal de la mortalidad por bronconeumonía en el Hospital Militar Provincial Clinicoquirúrgico "Manuel Fajardo Rivero" de Santa Clara, durante el período comprendido entre enero de 1997 y octubre de 1999. Fallecieron con bronconeumonía 342 pacientes. El 21,9 % adquirió la bronconeumonía en el hospital. Entre los principales factores de riesgo se encontraron el uso de catéter intravenoso, sonda nasogástrica, ventilación mecánica y enfermedades como la enfermedad pulmonar obstructiva crónica (EPOC), la insuficiencia cardíaca y bronconeumonía extrahospitalaria. Las enfermedades a las que se asoció la bronconeumonía fueron: la EPOC (13,5 %), accidentes vasculares encefálicos (13,2 %), diabetes mellitus (10,8 %), enfermedad diarreica aguda (10,5 %). El mayor porcentaje de fallecidos se ubicó en el grupo de edades de 81 a 90 años (28,6 %). La bronconeumonía extrahospitalaria constituyó la causa directa de la muerte en el 66,7 %, y en el 31,8 %, la causa intermedia. El nosocomio se consideró como el responsable de la causa directa de la muerte en el 72 %, mientras que en el 21,3 %, la causa intermedia. En ambos tipos de bronconeumonía es más frecuente que esta sea la causa directa que la intermedia, lo cual se presenta más marcado en las intrahospitalarias. La bronconeumonía fue causa directa o intermedia de la muerte en el 97,4 % de los 342 pacientes fallecidos por esta causa.

A prospective and longitudinal study of the mortality from bronchopneumonia registered at "Manuel Fajardo Rivero" Clinical and Surgical Provincial Military Hospital of Santa Clara from January, 1997, to October, 1999, was conducted. 342 patients died of bronchopneumonia. 21.9 % caught bronchopneumonia at the hospital. The use of intravenous catheter, nasogastric tube, mechanical ventilation and diseases such as chronic obstructive pulmonary disease (COPD), heart failure and extrahospital bronchopneumonia were among the main risk factors. Bronchopeumonia was associated with COPD (13.5 %), cerebrovascular accidents (13.2 %), diabetes mellitus (10.8 %) and acute diarrheal disease (10.5 %). The highest percentage of deaths occurred in the age group 81-90 (28.6 %). Extrahospital bronchopneumonia was the direct cause of death in 66.7 % , whereas in 31.8 %, it was the intermediate cause. The hospital was considered as the responsible for the direct cause of death in 72 % and as the intermediate cause in 21.3 %. In both types of bronchopneumonia it is more frequent the direct cause than the intermediate, which is more significant in intrahospital bronchopneumonias. Bronchopneumonia was the direct or intermediate cause of death in 97.4 % of the 342 deaths from this cause.

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Se estudiaron en forma prospectiva 42 pacientes, en quienes se evaluó la utilidad de la prueba de esfuerzo en la programación de los marcapasos bicamerales en relación al funcionamiento con frecuencia superior, relación entre la frecuencia de bloqueo del marcapasos y el límite superior de frecuencia previamente establecida. Fueron excluidos pacientes sin prueba de esfuerzo después de la implantación del marcapasos. Durante la prueba de esfuerzo 7 (17 por ciento) pacientes presentaron conducción AV 1:1 (grupo I); 16 (38 por ciento) bloqueo AV de segundo grado con periodicidad de Wenckebach (grupo II); 14 (33 por ciento) bloqueo AV de segundo grado 2:1 (grupo III); y 5 (12 por ciento) inhibición del marcapasos por aparición de ritmo propio (grupo IV). La frecuencia de bloqueo del marcapasos en grupo I y II fue mayor al límite superior de frecuencia, 156.85 ñ 22.16 vs 141.43 ñ 20.82 y 135.25 ñ 11.54 vs 121.25 ñ 5.9, respectivamente. En el grupo III y IV fue inferior, 120.36 ñ 15.31 vs 138.57 ñ 13.29 y 121.0 ñ 7.38 vs 142.0 ñ 14.39. El análisis comparativo de la frecuencia de bloqueo del marcapasos con respecto al límite superior de frecuencia mostró diferencias estadísticamente significativas (p< 0.05) entre el grupo I y II, y entre el grupo I y III. La aparición de bloqueo AV de segundo grado 2:1 no es fisiológica, debido a una caída brusca del gasto cardiaco. Esta situación se puede predecir y corregir mediante la programación no invasiva, con el uso de telemetría de parámetros como el retraso AV, el límite superior de frecuencia y el periodo refractario atrial post-ventricular, para obtener un adecuado funcionamiento con frecuencia superior del marcapasos, basado en los resultados obtenidos durante una prueba de esfuerzo

Assuntos

RESUMO

La dermatitis atópica afecta del 10 al 15 por ciento de la población general; aproximadamente el 80 por ciento de los casos se manifiestan antes del año de edad y el 95 por ciento a los 5 años. La IgE así como los linfocitos T tienen un papel importante en el procesamiento de antígenos relacionados con la fisiopatología de esta enfermedad. Las manifestaciones clínicas dependen de la edad de presentación y del estadio de las lesiones. El manejo es en forma integral, principalmente evitando los factores precipitantes y manteniendo una piel lubricada

Assuntos

RESUMO

Los casos de anafilaxia potencialmente mortal causada por alimentos son raros; sin embargo, se identificaron tres casos pediátricos en el servicio de alergia del Hospital Infantil de México Federico Gómez y se logró detectar los alimentos implicados y se capacitó a los familiares para identificar las manifestaciones clínicas de anafilaxia, así como su tratamiento, basado en la administración oportuna de adrenalina. Además, se realizó una revisión amplia de la literatura respecto a estas afecciones y se encontró semejanza con nuestra comunicación

Assuntos