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Introduction: Assessing Health-Related Quality of Life (HRQOL), in addition to evaluating functional status in stroke patients could complement clinician practice. Objective: To assess HRQOL, applying EuroQol-5-dimensions (EQ-5D) in Colombian patients with stroke and correlating its results with the modified Rankin Scale (mRS). Methods: Analytical cross-sectional study in a cohort of ischemic stroke patients in Colombia at three months as a median follow-up (Q1: 1- Q3:3) after their event. We correlated EQ-5D domains, EQ-5D index, mRS with EQ-5D VAS score. We generated a simple linear regression robust model to evaluate the variability between using r2. Results: A total of 91 patients completed the EQ-5D questionnaire, with a mean age of 71.2 years; 59.3% were male. We identified an inverse correlation between EQ-5D VAS and EQ-5D domains with the highest for mobility (rs = -0.69) and the lowest for pain/discomfort (rs -0.52, p<0.001). The r2 ranged from 0.25 (pain/discomfort) to 0.47 (EQ-5D index). Patients with mRS ≥ 3 significantly reduced their EQ-5D VAS score by 25.64 points (95% CI -33.04, -18.24). Variability in EQ-5D VAS scores occurred by EQ-5D index (47%) and by mRS (34%). Conclusions: The correlation between EQ-5D and mRS was favorable. Although EQ-5D and mRS evaluated different spheres on stroke patients, applying the EQ-5D instrument in real-world clinical settings might contribute multidimensional information on how life is affected after a stroke. This kind of information serves to orientate rehabilitation strategies on specific domains such as depression, self-care, anxiety, and pain. This is especially relevant for patients with disabilities (mRS ≥ 3).

Introducción: La evaluación de la Calidad de Vida Relacionada con la Salud (CVRS) y el estado funcional de pacientes con Ataque Cerebrovascular (ACV), podría complementar la práctica clínica. Objetivo: Evaluar la CVRS, aplicando EuroQol-5-dimensiones (EQ-5D) en pacientes colombianos con ACV y correlacionar sus resultados con la escala de Rankin Modificada (mRS). Métodos: Estudio de corte transversal analítico anidado a una cohorte de pacientes con ACV isquémico en Colombia con mediana de 3 meses de seguimiento (Q1: 1- Q3:3) post-ictus. Correlacionamos los dominios del EQ-5D, índice EQ-5D y mRS con la puntuación de EQ-5D VAS. Generamos un modelo de regresión lineal simple para evaluar la variabilidad usando r2. Resultados: Un total de 91 pacientes con una edad media 71,2 años; 59,3 % hombres. Se encontró correlación inversa entre los dominios EQ-5D, mayor para movilidad (rs = -0,69) y menor para dolor/malestar (rs -0,52, p < 0,001). El r2 osciló entre 0,25 (dolor/malestar) y 0,47 (índice EQ-5D). Los pacientes con mRS ≥ 3 redujeron significativamente su puntuación EQ-5D VAS en 25,64 puntos (IC 95%: -33,04; -18,24). La variabilidad en las puntuaciones EQ-5D VAS se produjo por el índice EQ-5D (47 %) y por mRS (34 %). Conclusiones: La correlación entre EQ-5D y mRS fue favorable. Aunque EQ-5D y mRS evalúan diferentes esferas en los pacientes con ACV, la aplicación del EQ-5D en podría aportar información multidimensional sobre cómo se afecta la vida después de un ictus, así como orientar estrategias de rehabilitación en esferas como depresión, autocuidado, ansiedad y dolor; especialmente relevante para pacientes con discapacidades (mRS ≥ 3).

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Introducción: El ataque cerebrovascular isquémico en el adulto joven se define como aquel que ocurre en la población entre los 18 y los 55 años, y representa el 15-18 % de todos los ACV isquémicos. Los factores de riesgo en jóvenes son comunes a los encontrados en adultos mayores. El objetivo de este trabajo es describir las características clínicas y los factores de riesgo de una población menor de 55 años con ACV isquémico atendida en un centro de referencia hospitalario en Colombia. Materiales y métodos: Estudio descriptivo, retrospectivo de corte transversal en pacientes entre los 18 y los 55 años; se incluyeron 100 pacientes sobrevivientes a un primer ACV isquémico agudo confirmado por neuroimagen, atendidos entre enero de del 2019 y noviembre del 2021. Resultados: De 1023 pacientes con diagnóstico de ACV isquémico agudo, el 9,8 % fueron adultos jóvenes. La media de edad fue de 45 ± 8,7 años, y el 59 % de estos pacientes fueron hombres. Discusión: Los factores de riesgo "tradicionales" se presentan en la mayoría de los jóvenes con ACV isquémico. La hipertensión arterial se mantiene como el antecedente más frecuente. Las mujeres presentan eventos de mayor severidad y peor desenlace funcional. Conclusión: Los pacientes mayores de 45 años tienen un perfil de factores de riesgo similar a lo observado en adultos mayores con ACV, mientras que en los menores de 45 años se encuentra un perfil de factores de riesgo diferente que plantea un diagnóstico etiológico particular de esta población.

Introduction: Ischemic stroke in young adults is defined as occurring in individuals between the ages of 18 and 55, representing 15-18 % of all ischemic strokes. Risk factors in young adults are similar to those found in older adults. The objective of this study is to describe the clinical characteristics and risk factors of a population under 55 years of age with ischemic stroke treated at a hospital reference center in Colombia. Materials and methods: Descriptive, retrospective cross-sectional study in patients between 18 and 55 years old. A total of 100 patients between 18 and 55 years old who survived a first confirmed acute ischemic stroke, as confirmed by neuroimaging, were included. The study period was from January 2019 to November 2021. Results: Out of 1023 patients diagnosed with acute ischemic stroke, 9.8 % occurred in young adults. The mean age was 45 ± 8.7 years, of which 59 % were male. Discussion: "Traditional" risk factors are present in the majority of young adults with ischemic stroke. Hypertension remains the most common antecedent. Women experience more severe events and worse functional outcomes. Conclusion: Patients over 45 years old have a risk factor profile similar to what is observed in older adults with stroke, while in those under 45, a different risk factor profile is found, which poses a particular etio-logical diagnosis for this population.

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Polycyclic aromatic hydrocarbons (PAHs) were assessed in sediments (n = 7) collected from the mouth of the Balsas River, Pacific Coast, Mexico. The total PAH levels ranged between 142.1 and 3944.07 µg kg-1 in the summer and 137.65-3967.38 µg kg-1 in the winter, probably reflecting the anthropogenic activities of the region. Calculation of the four analytical ratios of [Anthracene/(Anthracene + Phenanthrene)]: [Fluoranthene/(Fluoranthene + Pyrene)], [Fluoranthene/Pyrene: Fluoranthene/(Fluoranthene + Pyrene)], [Indeno [123-cd]Pyrene/(Indeno [123-cd]Pyrene + Benzo [ghi]Perylene)]: [Benzo [a]anthracene/(Benzo [a]Anthracene + Chrysene)], and [Anthracene/Phenanthrene]: [Fluoranthene/(Fluoranthene + Pyrene)] revealed a mixed PAH source, from petroleum and biomass combustion. Significant statistical correlations (r2 = 0.90) between the 4 and 5 ringed PAHs denote that adsorption is the principal mechanism for accumulation in sedimentary archives. Ecotoxicological indices (Mean Effect Range Medium Quotient and Mean Probable Effect Level Quotient) indicated moderate pollution with adverse biological impacts on ambient benthonic organisms. The calculations of Toxicity Equivalent Quotient and Mutagen Equivalent Quotient values proposed that the region is highly polluted by mutagenic and carcinogenic PAH compounds. The genotoxic evaluation of Lutjanus guttatus (Spotted rose snapper) presented significant DNA damage and discrepancies in Ethoxyresorufin-O-Deethylase activity. Based on the toxicological and genotoxicological evaluation of PAHs in sediments, the region was observed to be largely impacted from biological damage.

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Introduction: we present a series of patients with neurological problems and SARS-CoV-2 infection, and review the respective evidence. Patients and methods: a retrospective descriptive study of consecutive RT-PCR SARS-CoV-2-positive patients in a neurology department from August 1 to December 31, 2020. Results: we recorded 30 patients: 16 men (53%), with a mean age of 65±17.3. In 53%, the neu rological problem preceded the respiratory symptoms and SARS-CoV-2 infection diagnosis. At the syndromic level, the following were found: CVAs 43% (13), seizures 10% (3), posterior reversible encephalopathy 10% (3), encephalopathy 7% (2), brief psychotic disorder 7% (2), myelopathy 3% (1), Guillain-Barré syndrome 3% (1), headache 3% (1), vasculitis 3% (1), intracerebral hemorrhage 3% (1), myasthenic crisis 3% (1) and recurrent optic neuritis 3% (1). Conclusions: SARS-CoV-2 induced neurological problems produce a wide variety of symptoms and may be the first manifestation, even without the development of respiratory symptoms from this infection. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2233).

Introducción: se presenta una serie de pacientes con compromiso neurológico e infección por SARS-CoV-2 y se revisa la evidencia al respecto. Pacientes y métodos: estudio descriptivo, retrospectivo de pacientes consecutivos RT-PCR positivos para SARS-CoV-2 del servicio de neurología desde el 1° de agosto hasta 31 de diciembre de 2020. Resultados: registramos 30 pacientes, 16 hombres (53%), edad media: 65±17.3. En el 53% el compromiso neurológico antecedió los síntomas respiratorios y el diagnóstico de infección por SARS-CoV-2. A nivel sindromático se observó: ACV 43% (13), crisis convulsivas 10% (3), encefalopatía posterior reversible 10% (3), encefalopatía 7% (2), trastorno psicótico breve 7% (2), mielopatía 3% (1), síndrome de Guillain-Barré 3% (1), cefalea 3% (1), vasculitis 3% (1), hemorragia intracerebral 3% (1), crisis miasténica 3% (1) y neuritis óptica recurrente 3% (1). Conclusiones: el compromiso neurológico por el SARS-CoV-2 produce una gran variedad de síntomas y puede ser la primera manifestación incluso sin el desarrollo de síntomas respiratorios por esta infección. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2233).

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RESUMEN Objetivo Describir los CD y GB en pacientes con ACV isquémico en Colombia. Materiales y Métodos Se recolectó información de 67 pacientes con diagnóstico de ACV isquémico agudo que ingresaron por el servicio de urgencias o fueron remitidos a dos instituciones de tercer nivel de complejidad durante el año 2017. Se realizaron entrevistas donde se evaluaron CD y GB durante la hospitalización y un año posterior. Resultados 74 % realizaron algún gasto durante la hospitalización, con un costo promedio de 1 619 USD en los pacientes con Rankin-m de 2 o menos. Por otra parte, 56,7% efectuó un gasto posterior al alta, con un costo entre 444 y 5 909 USD por paciente. Conclusión El ACV es una enfermedad de gran impacto tanto en los pacientes, debido a la discapacidad residual, como en las familias, por su alto costo. Los CD y GB en ACV son elevados, lo que podría significar un gasto catastrófico, potencialmente empobrecedor, y representan una barrera para acceder a los servicios. Es importante investigar el gasto catastrófico en pacientes con ACV y abrir el debate sobre financiación de servicios no incluidos en el PBS en poblaciones de escasos recursos.

ABSTRACT Objectives To describe the direct cost and out-of-pocket expenses that stroke survivors face in Colombia. Materials and Methods We collected data from 67 stroke patients, who came to the emergency department or were referred to two institutions during 2017. We applied a questionnaire on which we asked about direct cost and out-of-pocket expenses at the moment of hospitalization and one year after the stroke. Results 74% of patients made payments during hospitalization, the average cost for Ran-kin score 0 to 2 or less was $1,619. On the other hand, 56,7% of patients made payments after hospital discharge, the average cost for patients was between $444 and $5,909. Conclusion Stroke is a disease with a great impact on patients because of their disability and families because of its high cost. Direct cost and out-of-pocket expenses in stroke are high which can mean a catastrophic expenditure even leading to an impoverishing expenditure and a barrier to patients and families. We consider necessary to investigate the catastrophic costs in this population and open up the debate to finance goods excluded from health insurance plans in low-income families.

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The coronavirus disease 2019 (COVID-19) represents a health problem with multidimensional impacts and heterogeneous respiratory involvement in children, probably due to the interaction between different and complex mechanisms that could explain its variable degrees of severity. Although the majority of reports reveal that children develop less severe cases, the number of patients is increasing with more morbidity. Most serious respiratory manifestations are acute respiratory distress syndrome (ARDS) and pneumonia. By understanding the key aspects that can be used to differentiate between pediatric and adult respiratory compromise by COVID-19, we can improve our knowledge, and thus decrease the negative impact of the disease in the pediatric population. In this mini review, we summarize some of the mechanisms and findings that distinguish between adult and pediatric COVID-19 and respiratory involvement, taking into account some issues related to the physiopathology, diagnosis, clinical and paraclinical presentation, severity, treatment, and control of the disease.

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La pandemia de enfermedad por el virus SARS-CoV-2 (COVID-19) ha representado que alrededor del mundo millones de personas se encuentren en estado de aislamiento social o en cuarentena preventiva. Son mas de 33.7 millones de casos confirmados y aproximadamente 1 010 381 casos fatales, según los recientes datos de la Universidad Johns Hopkins. En Colombia se han reportado a la fecha (septiembre 30) 829 679 casos (con un pico importante de 5637 casos nuevos en el ultimo día) y 25 998 defunciones (1). En Italia de acuerdo con los estudios publicados, se estimó que alrededor del 20% de los pacientes con COVID-19 tenían cáncer (2). Estados Unidos, un estudio de cohortes retrospectivo con la muestra mas grande de 928 pacientes adultos hasta el momento con cáncer activo o previo y con síndrome respiratorio agudo grave por COVID-19, captados de EE. UU., Canadá y España [Cancer Consortium (CCC19)], entre el 17 de marzo y el 16 de abril de 2020 se evidencia que, la mediana de edad fue de 66 años, un 30% mayo-res de 75 años y de los cuales 50% eran hombres. Los cánceres más prevalentes fueron cáncer de mama (191 [21%]) y cáncer de próstata (152 [16%]). En tratamiento activo se encontraban 366 (39%) pacientes de los cuales sólo 121 (13%) pacientes habían muerto. En el análisis de regresión logística, los factores independientes asociados con el aumento de la mortalidad a los 30 días, fueron: edad avanzada (por 10 años; odds ratio parcial-mente ajustado 1.84, IC 95% 1.53­2.21), sexo masculino (1.63, 1.07­2.48), tabaquismo (ex fumador versus nunca había fumado: 1.60, 1.03­2.47), número de comorbilidades (dos versus ninguno: 4.50, 1.33­15.28), estado de desempeño del Eastern Cooperative Oncology Group con un puntaje de 2 o más (estado de 2 vs 0 o 1:3. 89, 2.11­7.18), un cáncer activo (progresivo vs remisión: 5.20, 2.77-9.77), y tratamiento con azitromicina más hidroxicloroquina (versus tratamiento con ninguno: 2.93, 1.79­ 4.79). La raza y el origen étnico, el estado de obesidad, el tipo de cáncer y de tratamiento oncológico, y la cirugía reciente no se asociaron con una mayor tasa de mortalidad (3).

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Microalgae, including cyanobacteria, represent a valuable source of natural compounds that have remarkable bioactive properties. Each microalga species produces a mixture of antioxidants with different amounts of each compound. Three aspects are important in the production of bioactive compounds: the microalga species, the medium composition including light supplied and the photobioreactor design, and operation characteristics. In this study, the antioxidant content and productivity performance of four microalgae were assessed in batch and continuous cultures. Biomass productivity by the four microalgae was substantially enhanced under continuous cultivation by 5.9 to 6.3 times in comparison with batch cultures. The energetic yield, under the experimental conditions studied, ranged from 0.03 to 0.041 g biomass kJ-1. Phenols, terpenoids, and alkaloids were produced by Spirulinaplatensis, Isochrysisgalbana, and Tetraselmissuecica, whereas tocopherols and carotenoids were produced by the four microalgae, except for phycocyanin and allophycocyanin, which were only produced by S. platensis and Porphyridiumcruentum. The findings demonstrate that the continuous cultivation of microalgae in photobioreactors is a convenient method of efficiently producing antioxidants.

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Introduction: Type II diabetes mellitus (DMII) is one of the main causes of morbidity and mortality both worldwide and in Colombia. It mainly affects men and women over 45 years of age. Inadequate control of this disease can generate greater health complications making it one of the most costly diseases in the country. Treatment includes activities other than glycemic control and requires constant monitoring by medical personnel and educational processes directed at the patient and his or her family. Objective: To characterize the feeding of patients with DMII in three public hospitals of Cundinamarca. Materials and methods: We conducted a cross-sectional descriptive study of 212 patients that analyzed sociodemographic characteristics, frequency of consumption and feeding practices. Results: Most of the population was over 45 years old and had a low educational level. In total, 52% had a dietary plan, but only 8.9% received nutritional guidance from a nutritionist. The consumption of carbohydrates predominated, with low consumption of proteins, vitamins, minerals, and fiber. The consumption of sugars was lower in patients with a dietary plan (p <0.05). Conclusions: Most of the patients did not have an adequate nutrition; moreover, there was low adherence to dietary treatment, weakness in nutritional counseling and barriers to food access. These results can contribute to improving policies for the prevention and control of DMII and strategies based on the sociocultural context of the patients.

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Introducción. En Colombia, la práctica de lactancia exclusiva y total es inadecuada y de corta duración, especialmente en mujeres adolescentes. Teniendo en cuenta que las adolescentes constituyen un grupo social con sus propios estilos de vida, es necesario conocer cuáles son los significados que construyen alrededor de la lactancia y cuáles son las características de su experiencia de lactar para identificar aspectos que limitan o facilitan esta práctica, generando conocimientos para mejorar las estrategias de promoción de la lactancia. Objetivo. Caracterizar la experiencia de lactancia materna en adolescentes en período de lactancia, e identificar aspectos positivos, limitaciones y necesidades sentidas desde su propia perspectiva. Materiales y métodos. Se trata de un estudio cualitativo con enfoque fenomenológico. Se hicieron 24 entrevistas y se conformaron tres grupos de mujeres adolescentes en diferentes períodos posparto. La información se recolectó en Bogotá con mujeres que participaban en un programa de la Secretaría Distrital de Integración Social. El proceso de sistematización se desarrolló paralelamente con el proceso de análisis. Este proceso comprendió las relaciones entre categorías y las redes que se forman entre ellas. Resultados. Las adolescentes no alimentan sus hijos con lactancia materna exclusivamente y refieren varias dificultades en el acto de lactar. La alimentación complementaria incluye alimentos no naturales. La maternidad y la lactancia no son acordes con la percepción de ser adolescente. Conclusiones. Las adolescentes reconocen los beneficios que ofrece la lactancia materna para sus hijos y para ellas; sin embargo, su experiencia de lactancia materna difiere de las recomendaciones para lograr una lactancia materna exclusiva y una alimentación complementaria saludable. Entre las causas identificadas, sobresale la ausencia de acompañamiento acertado y oportuno.

Introduction: In Colombia, breastfeeding is inadequate and -especially in teenage girls- short. Given that adolescents are a social group with their own lifestyles, we need to know what meanings they have regarding breastfeeding, and also what the characteristics of their breastfeeding experience are, in order to identify issues that limit or facilitate this practice, which will produce the knowledge to improve breastfeeding promotion strategies. Objective: To characterize the experience of breastfeeding in nursing adolescents and identify strengths, limitations and perceived needs from their own perspective. Materials and methods: This was a phenomenological qualitative study. We conducted 24 interviews and had three focal groups with female adolescents in different postpartum periods. Data collection was carried out in Bogotá, with women participating in a program of the Secretaría Distrital de Integración Social. The systematic process was developed in parallel with the analysis process. It involved the relationships between categories and the networks that form among them. Results: Teenagers do not breastfeed exclusively, identifying several difficulties in the act of breastfeeding. Complementary feeding includes unnatural foods. Maternity and breastfeeding are not consistent with the perception of being a teenager. Conclusions: Adolescents recognize the benefits of breastfeeding for their children and for them; however, their breastfeeding experience differs from the recommendations to achieve exclusive breastfeeding and a healthy complementary feeding. Among the identified causes, we highlight the lack of accurate backing and timely support.

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INTRODUCTION: In Colombia, breastfeeding is inadequate and -especially in teenage girls- short. Given that adolescents are a social group with their own lifestyles, we need to know what meanings they have regarding breastfeeding, and also what the characteristics of their breastfeeding experience are, in order to identify issues that limit or facilitate this practice, which will produce the knowledge to improve breastfeeding promotion strategies. OBJECTIVE: To characterize the experience of breastfeeding in nursing adolescents and identify strengths, limitations and perceived needs from their own perspective. MATERIALS AND METHODS: This was a phenomenological qualitative study. We conducted 24 interviews and had three focal groups with female adolescents in different postpartum periods. Data collection was carried out in Bogotá, with women participating in a program of the Secretaría Distrital de Integración Social. The systematic process was developed in parallel with the analysis process. It involved the relationships between categories and the networks that form among them. RESULTS: Teenagers do not breastfeed exclusively, identifying several difficulties in the act of breastfeeding. Complementary feeding includes unnatural foods. Maternity and breastfeeding are not consistent with the perception of being a teenager. CONCLUSIONS: Adolescents recognize the benefits of breastfeeding for their children and for them; however, their breastfeeding experience differs from the recommendations to achieve exclusive breastfeeding and a healthy complementary feeding. Among the identified causes, we highlight the lack of accurate backing and timely support.

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The members of the genus Aeromonas are currently considered important gastrointestinal pathogens in different geographical areas. From February 1985 to January 2005 several case-control studies were coordinated by the National Reference Laboratory for Diarrheal Diseases from the Pedro Kouri Institute. The study purpose was to analyze a possible pathogenic role for Aeromonas spp in Cuban children with acute diarrhea. In that period 2,322 children less than 5 years old with acute diarrhea were studied for diarhoeal pathogens and another group of 2,072 non hospitalized children without diarrhea during the similar time from the same geographical areas and matched by ages were recruited. In the group of children with diarrheas (cases), Aeromonas spp. was isolated in 166 (7.15%) and in the control group the microorganism was found in only 35 (1.76%). When Aeromonas isolation rates were compared between both groups, we found that probability to isolate this specie was significantly higher in cases than in controls (OR = 4.48, 95% IC: 3.05-6.60; P < 0.001). The Aeromonas species more frequently isolated were A. caviae, A. hydrophila, and A. veronii bv sobria. Other enteric pathogens detected in children with diarrhea were: Shigella spp in 418 (18%) (P < 0.0001), Salmonella spp in 53 (2.3%) (P < 0.01), and enteropathogenic E. coli in 58 (2.49%) (P < 0.05).

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The members of the genus Aeromonas are currently considered important gastrointestinal pathogens in different geographical areas. From February 1985 to January 2005 several case-control studies were coordinated by the National Reference Laboratory for Diarrheal Diseases from the Pedro Kouri Institute. The study purpose was to analyze a possible pathogenic role for Aeromonas spp in Cuban children with acute diarrhea. In that period 2,322 children less than 5 years old with acute diarrhea were studied for diarhoeal pathogens and another group of 2,072 non hospitalized children without diarrhea during the similar time from the same geographical areas and matched by ages were recruited. In the group of children with diarrheas (cases), Aeromonas spp. was isolated in 166 (7.15%) and in the control group the microorganism was found in only 35 (1.76%). When Aeromonas isolation rates were compared between both groups, we found that probability to isolate this specie was significantly higher in cases than in controls (OR = 4.48, 95% IC: 3.05-6.60; P < 0.001). The Aeromonas species more frequently isolated were A. caviae, A. hydrophila, and A. veronii bv sobria. Other enteric pathogens detected in children with diarrhea were: Shigella spp in 418 (18%) (P < 0.0001), Salmonella spp in 53 (2.3%) (P < 0.01), and enteropathogenic E. coli in 58 (2.49%) (P < 0.05).

Los miembros del género Aeromonas son considerados patógenos importantes del tracto gastrointestinal en diferentes áreas geográficas. De febrero de 1985 a enero de 2005 se realizaron estudios de casos y controles en el Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto Pedro Kourí con el objetivo de conocer el comportamiento de los microorganismos pertenecientes al género Aeromonas en niños con diarreas en Cuba. La muestra estuvo constituida por 2.322 niños bajo 5 años de edad, ingresados por enfermedad diarreica aguda y como grupo control se estudió un total de 2.072 niños con edades y áreas geográficas similares que acudieron a los hospitales correspondientes en ese mismo período de tiempo. En el grupo de niños que presentaron diarreas, Aeromonas spp fue aislada en 166 (7,15%), y en los controles fue encontrada en 35 (1,76%). Al comparar la positividad para Aeromonas entre ambos grupos, la probabilidad de diagnosticar este microorganismo fue 4,28 veces mayor en los casos que en los controles (OR = 4,28; IC al 95%: 2,96-6,20; P < 0,001). Las especies más frecuentemente aisladas fueron A. caviae, A. hydrophila, y A. veronii bv sobria. Otros enteropatógenos aislados en niños que presentaban diarrea fueron: Shigella spp. en 418 (18%) (P < 0,0001, Salmonella spp en 53 (2,3%) (P < 0,01),) y E. coli enteropatógena en 58 (2,49%) (P < 0,05).

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OBJETIVO: A fibrose cística (FC) é uma doença hereditária, multissistêmica e crônica, para a qual é importante uma abordagem multidisciplinar. O objetivo deste estudo foi mostrar a evolução de um grupo de pacientes com FC após a implantação desse tipo de atendimento. MÉTODOS: Foram analisados retrospectivamente 19 pacientes (idades entre 6 e 29 anos) em acompanhamento clínico no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, na cidade de Ribeirão Preto (SP). Os pacientes foram divididos em dois grupos: grupo 6-12 (6-12 anos) e grupo 13+ (> 12 anos). Dados referentes a índice de massa corporal (IMC), escore Z, escore de Shwachman (ES), número de exacerbações/ano, colonização crônica por Pseudomonas aeruginosa e medidas espirométricas (CVF, VEF1, VEF1 por cento e FEF25-75 por cento) foram obtidos. Os dados foram coletados em dois momentos (antes e após a implantação de atendimento multidisciplinar) e foram analisados com o teste dos postos sinalizados de Wilcoxon. RESULTADOS: A mediana de idade de início de sintomas foi de 10 meses. No grupo 6-12, houve somente um aumento significativo do IMC e da CVF. As outras medidas espirométricas aumentaram, mas não significativamente. No grupo 13+, não houve diferenças significativas entre os dois momentos, sendo que o ES apresentou uma diminuição com significância limítrofe. Houve diminuição não significativa das medidas espirométricas. Entretanto, o número de pacientes com volumes e fluxos alterados diminuiu nos dois grupos. CONCLUSÕES: Apesar do grupo pequeno, a manutenção dos parâmetros espirométricos pode significar estabilidade clínica e funcional. Os pacientes estudados mantiveram estabilidade clínica, funcional e nutricional durante o período, e a implantação de abordagem multidisciplinar pode ter contribuído nesse sentido.

OBJECTIVE: Cystic fibrosis (CF) is a chronic multisystemic hereditary disease for which a multidisciplinary approach must be taken. The objective of this study was to show the evolution of a group of patients with CF after the implementation of multidisciplinary treatment. METHODS: A retrospective study involving 19 patients (6-29 years of age) under clinical follow-up treatment at the University of São Paulo at Ribeirão Preto School of Medicine Hospital das Clínicas, located in the city of Ribeirão Preto, Brazil. The patients were divided into two groups: 6-12 (6-12 years of age) and 13+ (> 12 years of age). We collected data regarding body mass index (BMI), Z score, Shwachman score (SS), number of exacerbations/year, chronic colonization by Pseudomonas aeruginosa, and spirometric measurements (FVC, FEV1, FEV1 percent, and FEF25-75 percent). Data were collected at two different time points (before and after the implementation of the multidisciplinary treatment) and were analyzed with the Wilcoxon signed rank test. RESULTS: The median age at the onset of symptoms was 10 months. In the 6-12 group, only BMI and FVC increased significantly. Although the other spirometric values increased, the differences were not significant. In the 13+ group, there were no significant differences between the two time points. There was a borderline significant decrease in SS and less than significant decreases in the spirometric measurements. However, the number of patients with alterations in volumes and flows decreased in both groups. CONCLUSIONS: Although our patient sample was small, the lack of changes in the spirometric parameters might reflect clinical and functional stability. In all of the patients evaluated, clinical, functional, and nutritional parameters remained stable throughout the study period. The implementation of a multidisciplinary approach might have contributed to this result.

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OBJECTIVE: Cystic fibrosis (CF) is a chronic multisystemic hereditary disease for which a multidisciplinary approach must be taken. The objective of this study was to show the evolution of a group of patients with CF after the implementation of multidisciplinary treatment. METHODS: A retrospective study involving 19 patients (6-29 years of age) under clinical follow-up treatment at the University of São Paulo at Ribeirão Preto School of Medicine Hospital das Clínicas, located in the city of Ribeirão Preto, Brazil. The patients were divided into two groups: 6-12 (6-12 years of age) and 13+ (> 12 years of age). We collected data regarding body mass index (BMI), Z score, Shwachman score (SS), number of exacerbations/year, chronic colonization by Pseudomonas aeruginosa, and spirometric measurements (FVC, FEV1, FEV1%, and FEF25-75%). Data were collected at two different time points (before and after the implementation of the multidisciplinary treatment) and were analyzed with the Wilcoxon signed rank test. RESULTS: The median age at the onset of symptoms was 10 months. In the 6-12 group, only BMI and FVC increased significantly. Although the other spirometric values increased, the differences were not significant. In the 13+ group, there were no significant differences between the two time points. There was a borderline significant decrease in SS and less than significant decreases in the spirometric measurements. However, the number of patients with alterations in volumes and flows decreased in both groups. CONCLUSIONS: Although our patient sample was small, the lack of changes in the spirometric parameters might reflect clinical and functional stability. In all of the patients evaluated, clinical, functional, and nutritional parameters remained stable throughout the study period. The implementation of a multidisciplinary approach might have contributed to this result.

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Objetivo: Avaliar o estado nutricional e a prevalência da carência de ferro em crianças frequentadoras de uma creche. Métodos: Estudo de corte transversal que avaliou 111 crianças de 11 a 88 meses de idade as quais frequentavam a creche "Sinharinha Neto", em Catanduva, SP. O estado nutricional foi determinado por antropometria em 94 por centos dos casos e dosagens sanguíneas foram realizadas em 90 por cento dos casos. Utilizou-se o escore Z do índice peso/estatura (P/E) para classificar o estado nutricional em desnutrição aguda (Z2) e o índice estatura/idade (E/I) para classificar o estado nutricional em desnutrição crônica. O diagnóstico de carência de ferro foi realizado pela dosagem de hemoglobina (<11g/dL em crianças<60 meses ou <12g/dL em crianças com mais de 60 meses) e ferro sérico (<50 u/dL) e ferritina (<10ng/mL). Resultados: Observou-se 3,9 por cento de desnutrição aguda, 1,9 por cento de desnutrição crônica e 6,7 por cento de obesidade. Das 100 crianças com avaliação hematimétrica, 34 por cento apresentaram valores de hemoglobina baixos. Os valores de ferro sérico estavam alterados em 23 por cento das crianças e os de ferritina em 14 por centos delas. Na avaliação global, 48 por cento apresentaram carência de ferro. A faixa etária mais acometida foi aquela com menos que 60 meses. Conclusões: A alta prevalência de carência de ferro de obesidade observada em crianças na creche "Sinharinha Neto" mostrou a necessidade de introduzir dietas balanceadas, com suplementação de ferro e incentivo aos desenvolvimento de hábitos alimentares saudáveis

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Antigen profiles were described for Giardia duodenalis cysts and trophozoites that are recognized by IgG and its anti-G. dudodenalis subclasses (IgG1, IgG2, IgG3, IgG4). Antigens were identified by Western blot from G. duodenalis cyst and trophozoite isolates. Cysts and trophozoites were each subjected to protein separation by SDS-PAGE. The proteins were then transferred to nitrocellulose membranes by electroimmunoblot, and their antigenicity was determined by exposing them to sera from patients with confirmed diagnosis of G. duodenalis infection. The antigen-antibody reaction was revealed by specific alkaline phosphatase antibody conjugates against IgG, IgG2, IgG3, IgG4: bands were visualized by addition of the substrate 5-bromo-4-chloro-3-indolyl-phosphate and the stain nitro blue tetrazolium. The bands were read and analyzed by linear regression using Quantity One software. Thirty two antigens were simultaneously recognized by total IgG anti-G. duodenalis in the cyst and trophozoite stages. The antigens varied in molecular weight from 22 to 185 kDa. Nineteen antigens were identified by both IgG, and IgG3 anti-G duodenalis, with molecular weights ranging from 42 to 180 kDa. IgG2 and IgG4 did not identify any antigen in either stage. The antigens of molecular weights 27, 30, 31, 33, 45, 49, 57, 78, 89 and 170 kDa are shared with G. duodenalis isolates from other geographical regions of Colombia. The recognition of cyst and trophozoite antigens of Colombian G. duodenalis isolates by IgG, IgG1 and IgG3 anti-G. duodenalis suggested that they are involved in the induction of the host immune response.

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Se conocen investigaciones realizadas sobre la respuesta inmune humoral en giardiosis. Sin embargo, estudios sobre perfiles de antígenos de quistes y de trofozoítos de Giardia duodenalis reconocidos por IgG y subclases (IgG1, IgG2, IgG3, IgG4) anti-G. duodenalis no se han realizado en la misma magnitud. Con el fin de determinar los antígenos de los aislamientos colombianos de G. duodenalis reconocidos por IgG y sus subclases anti-G. duodenalis, se utilizó la metodología de Western blot. Quistes y trofozoítos del parásito, independientemente, se sometieron a separación de proteínas mediante SDS-PAGE. Las proteínas separadas fueron transferidas a membrana de nitrocelulosa mediante inmunoelectrotransferencia y su antigenicidad determinada confrontando éstas con IgG y sus subclases anti-G. Duodenalis presentes en el suero de pacientes con giardiosis comprobada parasitológicamente. La unión antígeno-anticuerpo se detectó con conjugados anti-inmunoglobulina específicos unidos a fosfatasa alcalina, la cual permitió evidenciar los polipéptidos antigénicos cuando se adicionó el sustrato 5-bromo-4-cloro-3-indolil-fosfato/azul de nitrotetrazolio. Se leyeron y analizaron las bandas mediante análisis de regresión lineal, utilizando el programa Quantity One(c). Se reconocieron 32 antígenos, simultáneamente en quistes y trofozoítos de aislamientos colombianos del parásito por IgG total anti-G. duodenalis, que oscilaron entre 22-185 kDa y 19 en un rango de 42 a 180 kDa, reconocidos tanto por IgG1 como por IgG3 anti-G. duodenalis. Las IgG2 e IgG4 anti-parásito no reconocieron antígenos en ninguno de los dos estadios. Los antígenos de 27, 30, 31, 33, 45, 49, 57, 78, 89 y 170 kDa son compartidos con aislamientos de G. duodenalis circulantes en otras regiones geográficas. El reconocimiento de antígenos de quistes y trofozoítos de los aislamientos colombianos de G. duodenalis por IgG, IgG1 e IgG3 anti-G. duodenalis de pacientes infectados sugiere que los antígenos del par sito originan respuesta inmune humoral en el hospedero.

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