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INTRODUCTION: Since their French naturalization in 1969, Amerindians of French Guiana have been facing a full and fast reorganization of their way of life. Teenagers, at the forefront of this cultural transition, are challenging French school institutions, as well as cultural society and care system organizations in Amazonian French remote villages. Rates of autolytic behaviors such as toxic substance abuse or suicide attempts, but mostly completed suicides, are alarming among this adolescent population. To improve care delivery to those teenagers, a mobile child psychiatric team was implemented in 2013. METHODS: We describe this device, its activities and the problematics encountered. RESULTS: This team's purpose is to lead a psychiatric evaluation of teenagers in order to determine a possible psychiatric diagnosis and elaborate a care plan. Although the results are mostly encouraging, this device seems to show some limitations: lack of time dedicated to these interventions, lack of psychiatric care available for follow-up in these villages, tremendous numbers of social distress situations implicated in psychological issues. Moreover, it appears that cultural aspects must be considered in the analysis of the Amerindian adolescent population's issues and the determination of providing care. CONCLUSION: Implementation of actions based on more educational and social levels might be a solution.

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BACKGROUND: Laparoscopic liver resections (LLR) have been increasingly performed in recent years. Most of the available evidence, however, comes from specialized centers in Asia, Europe and USA. Data from South America are limited and based on single-center experiences. To date, no multicenter studies evaluated the results of LLR in South America. The aim of this study was to evaluate the experience and results with LLR in South American centers. METHODS: From February to November 2019, a survey about LLR was conducted in 61 hepatobiliary centers in South America, composed by 20 questions concerning demographic characteristics, surgical data, and perioperative results. RESULTS: Fifty-one (83.6%) centers from seven different countries answered the survey. A total of 2887 LLR were performed, as follows: Argentina (928), Brazil (1326), Chile (322), Colombia (210), Paraguay (9), Peru (75), and Uruguay (8). The first program began in 1997; however, the majority (60.7%) started after 2010. The percentage of LLR over open resections was 28.4% (4.4-84%). Of the total, 76.5% were minor hepatectomies and 23.5% major, including 266 right hepatectomies and 343 left hepatectomies. The conversion rate was 9.7%, overall morbidity 13%, and mortality 0.7%. CONCLUSIONS: This is the largest study assessing the dissemination and results of LLR in South America. It showed an increasing number of centers performing LLR with the promising perioperative results, aligned with other worldwide excellence centers.

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Herbal drugs are commonly used in the treatment of several diseases, including periodontitis. So far, no systematic review had evaluated the evidence regarding the efficacy of these agents in the treatment of periodontal disease. Therefore, the purpose of this review was to evaluate the effect of local application of phytotherapic agents as adjuncts to scaling and root planing (SRP), compared to SRP alone, on clinical parameters of chronic periodontal patients. Only randomized controlled trials of at least 3 months follow-up, of SRP alone in association with local phytotherapic agents were included. MEDLINE (PubMed), Google Scholar and LILACS databases were searched for articles published up to October 2016. Random-effects meta-analyses were conducted for clinical attachment level and probing pocket depth (PPD) change after treatment. Of 1861 papers potentially relevant, 7 were included. All studies showed that periodontal treatment in association with local phytotherapic delivery promotes a significant PPD reduction and the majority of them showed clinical attachment level gain. The local use of phytotherapy as an adjunct to SRP may promote additional benefits in PPD reduction and clinical attachment level gain. However, these results must be interpreted with caution due to the small sample size, high risk of bias and heterogeneity of the studies.

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OBJECTIVE: This multicentre cross-sectional study aims to estimate the prevalence of five neglected tropical diseases (Chagas disease, filariasis, schistosomiasis, strongyloidiasis and toxocariasis) among immigrants accessing health care facilities in five Italian cities (Bologna, Brescia, Florence, Rome, Verona). METHODS: Individuals underwent a different set of serological tests, according to country of origin and presence of eosinophilia. Seropositive patients were treated and further followed up. RESULTS: A total of 930 adult immigrants were enrolled: 477 men (51.3%), 445 women (47.9%), eight transgender (0.8%); median age was 37.81 years (range 18-80 years). Most of them had come from the African continent (405/930, 43.5%), the rest from East Europe, South America and Asia, and 9.6% (89/930) were diagnosed with at least one of the infections under study. Seroprevalence of each specific infection varied from 3.9% (7/180) for Chagas disease to 9.7% (11/113) for toxocariasis. Seropositive people were more likely to be 35-40 years old and male, and to come from South East Asia, sub-Saharan Africa or South America. CONCLUSIONS: The results of our study confirm that neglected tropical diseases represent a substantial health problem among immigrants and highlight the need to address this emerging public health issue.

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The paper describes an action research for indicative assessment of psychological problems of young children following the 2010 earthquake in Haiti, and the interest of using the Creole version of the questionnaire PSYCa 3-6. The survey took place in Port-au-Prince, and the evaluators were trained to a proper standardized administration of the questionnaire. BACKGROUND: The mental health needs of young children in natural disaster contexts often remain unaddressed. The lack of a rapid and simple tool for screening combined with few mental health professionals available to accurately diagnose and provide appropriate care mean that young children remain without care. Here, we present the results of psychological screening of young children aged 3 to 6 using the questionnaire PSYCa 3-6. METHODS: This study was conducted in Port-au-Prince, Haiti. The scale was translated into Haitian Creole using corroboration of independent translations and submitted twice to the parents at home, at the end of 2011 and again at the beginning of 2013. At the first stage 166 children 3 to 6 years old were included 49 of whom were included at the second stage. The results and diagnostic properties were assessed comparing the PSYCa 3-6 to the Clinical Global Impression Severity Scale as the gold standard. RESULTS: Boys were more prone to psychological disturbances than girls. The size and position among the siblings increased the score of psychological disturbance. The neighborhood and the perception of environmental violence had a significant impact on the score of psychological disturbance. The significant improvement in scores between the two examinations showed moderate resiliency whose main factors seemed to be the social support received by the family, the rapid return to school, faith and religious practice.

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The objective of this study was to investigate the influence of two cleaning and disinfection programs on broiler performance and on the microbiological status of the facilities. This trial was an observational study of comparative character. Two experiments were conducted, with 960 birds each. Both experiments were carried out in a positive-pressure broiler house. Broilers were distributed in pens equipped with a bell drinker and a tube feeder each. In the first experiment, new wood shavings were used as litter material, and in the second, reused wood shavings were used. Two treatments with16 replicates of 30 birds each were evaluated. The regular treatment consisted of dry and wet organic matter removal, followed by washing. The European treatment consisted of dry organic matter removal, humidification, washing with water under high pressure, detergent application, rinsing, and application of two combined disinfectants: glutaraldehyde 250g/L + formaldehyde 185g/L; p-chlor-m-cresol 210 g/L. Biosecurity measures were adopted during daily management tasks to prevent cross contamination between treatments. The effectiveness of the treatments was evaluated by microbiological analysis performed before and after treatment applications, as well as by broiler performance results. Live performance results were similar between both treatments when broilers were reared on new litter. When reused word-shavings were used as litter material, the European treatment promoted better broiler performance. The European treatment was more effective than the regular treatment in reducing total microbial counts in the facilities when reused wood shavings were used as litter material, and positively influenced broiler performance.

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The objective of this study was to investigate the influence of two cleaning and disinfection programs on broiler performance and on the microbiological status of the facilities. This trial was an observational study of comparative character. Two experiments were conducted, with 960 birds each. Both experiments were carried out in a positive-pressure broiler house. Broilers were distributed in pens equipped with a bell drinker and a tube feeder each. In the first experiment, new wood shavings were used as litter material, and in the second, reused wood shavings were used. Two treatments with16 replicates of 30 birds each were evaluated. The regular treatment consisted of dry and wet organic matter removal, followed by washing. The European treatment consisted of dry organic matter removal, humidification, washing with water under high pressure, detergent application, rinsing, and application of two combined disinfectants: glutaraldehyde 250g/L + formaldehyde 185g/L; p-chlor-m-cresol 210 g/L. Biosecurity measures were adopted during daily management tasks to prevent cross contamination between treatments. The effectiveness of the treatments was evaluated by microbiological analysis performed before and after treatment applications, as well as by broiler performance results. Live performance results were similar between both treatments when broilers were reared on new litter. When reused word-shavings were used as litter material, the European treatment promoted better broiler performance. The European treatment was more effective than the regular treatment in reducing total microbial counts in the facilities when reused wood shavings were used as litter material, and positively influenced broiler performance.(AU)

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This study aimed to evaluate diets supplemented with prebiotic, probiotic and symbiotic as an alternative to antibiotics on the performance and immune response against the virus of Newcastle disease in broiler chickens. 1,400 one-day old male Cobb 500 chicks were raised until 42 days old in a completely randomized design with 2x2+1 factorial scheme with seven replications. The treatments were: diet without supplementation (base diet - BD), BD + prebiotic, BD + probiotic, BD + symbiotic (prebiotic + probiotic), and BD + antibiotic. The parameters evaluated were performance and antibody serum titers against Newcastle disease. No antibiotic effect was observed on performance. The symbiotic provided better results for weight gain and feed:gain ratio until 21 days old than isolated additives. At 28 days old, the broilers fed diets with prebiotic presented better feed: gain ratio. In the same period (28 d-old), there was an antibody production increase against the Newcastle disease virus in the group supplemented with prebiotic. It can be concluded that the utilization of symbiotic in broiler chickens' diets can substitute performance enhancing antibiotics. The inclusion of prebiotic in the diet improves feed: gain ratio at 1-28 days old. The chickens' immune response increases at 28 days against the Newcastle disease virus in the group supplemented with prebiotic.(AU)

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El adenocarcinoma gástrico, representa entre 90% y 95% de todas las neoplasias malignas gástricas, siendo de los más comunes del mundo y más frecuente en Japón, en nuestro país el cáncer gástrico es la primera causa de mortalidad por tumores malignos de las vías digestivas con 37%, seguido de los tumores hepatobiliares y colon. Su incidencia ha aumentado en pacientes menores de 40 años, la mayoría de nuestros pacientes se diagnostican en estadios avanzados. Presentamos el caso de un paciente masculino de 42 años quien ingresó con un cuadro de hemorragia digestiva superior y en shock hipovolémico, que luego de su estabilización y posterior estudio se diagnosticó un adenocarcinoma moderadamente diferenciado precoz, quien recibió el tratamiento oncológico adecuado

The gastric carcinoma represent the 90% to 95% of all malignant gastric neoplasia, is one of the most common in the world and most frequent in Japan, in our country the gastric cancer is the first cause of mortality for malignant tumors of the digestive system with a 37% of incidence follow for hepatobillary and colon cancer. His incidence is increased in patients less than 40 years old, the majority of them were diagnostic in advance disease. We presents the case of male patient of 42 years with a digestive superior hemorrhagic episode and hipovolemic shock, after his stabilization and posterior study received a diagnostic of early adenocarcinoma moderately differentiated , and him received the adequate oncology treatment

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Prefacio, los directores. Prólogo a la primera edición (1930), Teófilo Hernando. Farmacología básica. Sistema nervioso periférico. Sistema nervioso central. Aparato cardiovascular. Autacoides, inflamación y respuesta inmunológica. Aparato digestivo. Sistema nervioso endocrino. Aparato respiratorio. Sangre. Quimioterapia antiinfecciosa y antitumoral. Miscelánea. Farmacología clínica. Variabilidad de la repsuesta farmacológica. Efectos no deseados de los medicamentos. Evaluación de los efectos de los medicamentos. Evaluación y mejora del uso de medicamentos. Nuevas perspectivas

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Prefacio, los directores. Prólogo a la primera edición (1930), Teófilo Hernando. Farmacología básica. Sistema nervioso periférico. Sistema nervioso central. Aparato cardiovascular. Autacoides, inflamación y respuesta inmunológica. Aparato digestivo. Sistema nervioso endocrino. Aparato respiratorio. Sangre. Quimioterapia antiinfecciosa y antitumoral. Miscelánea. Farmacología clínica. Variabilidad de la repsuesta farmacológica. Efectos no deseados de los medicamentos. Evaluación de los efectos de los medicamentos. Evaluación y mejora del uso de medicamentos. Nuevas perspectivas

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BACKGROUND AND AIM: Resection of colorectal liver metastases has become a standard of care, although the value of this procedure in non-colorectal non-neuroendocrine (NCRNNE) metastases remains controversial and is still a matter of debate. The aim of the study was to determine the utility of liver resection in the long-term outcome of patients with NCRNNE metastases. MATERIAL AND METHODS: The records of 106 patients who underwent liver resection for NCRNNE metastases in the period 1989 to 2006 at 5 HPB Centers in Argentina were analyzed. Patient demographics, tumor characteristics, type of resection, long-term outcome and prognostic factors were analyzed. Depending on primary tumor sites, a comparative analysis of survival was performed. RESULTS: Mean age was 54 (17-76). Hepatic metastases were solitary in 62.3% and unilateral in 85.6%. Primary tumor sites: Urogenital (37.7%), sarcomas (21.7%), breast (17.9%), gastrointestinal (6.6%), melanoma (5.7%), and others (10.4%). Fifty-one major hepatectomies and 55 minor resections were performed. Twenty patients underwent synchronous resections. An R0 resection could be achieved in 89.6%. Perioperative mortality was 1.8%. Overall, 1-year, 3-year, and 5-year survival rates were 67%, 34%, and 19%, respectively. Survival was significantly longer for metastases of urogenital (p=0.0001) and breast (p=0.003) origin. Curative resections (p=0.04) and metachronous disease (p=0.0001) were predictors of better survival. CONCLUSIONS: Liver resection is an effective treatment for NCRNNE liver metastases; it gives satisfactory long-term survival especially in metachronous disease, in patients with metastases from urogenital and breast tumors and when R0 procedures can be performed.

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Antecedentes: El trasplante hepático es el tratamiento de elección para pacientes con enfermedad hepática terminal. La disponibilidad de órganos es el factor limitante para su empleo. El empleo de injertos provenientes de donantes vivos desde hace años se aplica a la población pediátrica y en los últimos años se ha generalizado su uso en receptores adultos. Objetivo: Analizar la experiencia con el empleo de esta técnica en nuestro programa de trasplante. Lugar de aplicación: Hospital Privado de la comunidad. Diseño: Estudio retrospectivo y descriptivo. Población: 458 pacientes a los que se le realizaron 492 trasplantes hepáticos ortotópicos (TOH). 79 (TOH) con donante vivo (50 niños y 29 adultos). Método: Se realizó la evaluación de los donantes con exámenes de laboratorio. Ecodoppler y tac abdominal, posteriormente arteriografía y biopsia hepática en caso de sospechar hepatopatía. Los niños fueron trasplantados con segmentos II y III (n = 45) o con monosegmento (n = 5). 28 adultos recibieron hígado derecho (LD) y uno hígado izquierdo (LI). Resultados: De 120 potenciales donantes pediátricos 60 fueron rechazados (50 por ciento). Presentaron complicaciones 6 de los 50 (12 por ciento). Se evaluaron 71 potenciales donantes para adultos, fueron rechazados 25 (35,2 por ciento). Cinco de los 29 (17,2 por ciento) donantes presentaron complicaciones. La indicación más frecuente fue la atresia de vías biliares en la población pediátrica (65,9 por ciento) y cirrosis por Virus C en los adultos (44 por ciento). Las complicaciones vasculares en la población pediátrica ocurrieron en 8 pacientes (16 por ciento) y las biliares en 14 (28 por ciento). La supervivencia actuarial de pacientes e injertos a 10 años fue de 94 por ciento y 90 por ciento respectivamente. Los adultos presentaron complicaciones vasculares en el 6,89 por ciento y biliares en el 37 por ciento. La supervivencia actuarial de pacientes e injertos fue de 89,8 por ciento y 89,3 por ciento al año y de 83,7 por...

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Antecedentes: El trasplante hepático es el tratamiento de elección para pacientes con enfermedad hepática terminal. La disponibilidad de órganos es el factor limitante para su empleo. El empleo de injertos provenientes de donantes vivos desde hace años se aplica a la población pediátrica y en los últimos años se ha generalizado su uso en receptores adultos. Objetivo: Analizar la experiencia con el empleo de esta técnica en nuestro programa de trasplante. Lugar de aplicación: Hospital Privado de la comunidad. Diseño: Estudio retrospectivo y descriptivo. Población: 458 pacientes a los que se le realizaron 492 trasplantes hepáticos ortotópicos (TOH). 79 (TOH) con donante vivo (50 niños y 29 adultos). Método: Se realizó la evaluación de los donantes con exámenes de laboratorio. Ecodoppler y tac abdominal, posteriormente arteriografía y biopsia hepática en caso de sospechar hepatopatía. Los niños fueron trasplantados con segmentos II y III (n = 45) o con monosegmento (n = 5). 28 adultos recibieron hígado derecho (LD) y uno hígado izquierdo (LI). Resultados: De 120 potenciales donantes pediátricos 60 fueron rechazados (50 por ciento). Presentaron complicaciones 6 de los 50 (12 por ciento). Se evaluaron 71 potenciales donantes para adultos, fueron rechazados 25 (35,2 por ciento). Cinco de los 29 (17,2 por ciento) donantes presentaron complicaciones. La indicación más frecuente fue la atresia de vías biliares en la población pediátrica (65,9 por ciento) y cirrosis por Virus C en los adultos (44 por ciento). Las complicaciones vasculares en la población pediátrica ocurrieron en 8 pacientes (16 por ciento) y las biliares en 14 (28 por ciento). La supervivencia actuarial de pacientes e injertos a 10 años fue de 94 por ciento y 90 por ciento respectivamente. Los adultos presentaron complicaciones vasculares en el 6,89 por ciento y biliares en el 37 por ciento. La supervivencia actuarial de pacientes e injertos fue de 89,8 por ciento y 89,3 por ciento al año y de 83,7 por...(AU)

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Antecedentes: El trasplante hepático es el tratamiento de elección para pacientes con enfermedad hepática terminal. La disponibilidad de órganos es el factor limitante para su empleo. El empleo de injertos provenientes de donantes vivos desde hace años se aplica a la población pediátrica y en los últimos años se ha generalizado su uso en receptores adultos. Objetivo: Analizar la experiencia con el empleo de esta técnica en nuestro programa de trasplante. Lugar de aplicación: Hospital Privado de la comunidad. Diseño: Estudio retrospectivo y descriptivo. Población: 458 pacientes a los que se le realizaron 492 trasplantes hepáticos ortotópicos (TOH). 79 (TOH) con donante vivo (50 niños y 29 adultos). Método: Se realizó la evaluación de los donantes con exámenes de laboratorio. Ecodoppler y tac abdominal, posteriormente arteriografía y biopsia hepática en caso de sospechar hepatopatía. Los niños fueron trasplantados con segmentos II y III (n = 45) o con monosegmento (n = 5). 28 adultos recibieron hígado derecho (LD) y uno hígado izquierdo (LI). Resultados: De 120 potenciales donantes pediátricos 60 fueron rechazados (50 por ciento). Presentaron complicaciones 6 de los 50 (12 por ciento). Se evaluaron 71 potenciales donantes para adultos, fueron rechazados 25 (35,2 por ciento). Cinco de los 29 (17,2 por ciento) donantes presentaron complicaciones. La indicación más frecuente fue la atresia de vías biliares en la población pediátrica (65,9 por ciento) y cirrosis por Virus C en los adultos (44 por ciento). Las complicaciones vasculares en la población pediátrica ocurrieron en 8 pacientes (16 por ciento) y las biliares en 14 (28 por ciento). La supervivencia actuarial de pacientes e injertos a 10 años fue de 94 por ciento y 90 por ciento respectivamente. Los adultos presentaron complicaciones vasculares en el 6,89 por ciento y biliares en el 37 por ciento. La supervivencia actuarial de pacientes e injertos fue de 89,8 por ciento y 89,3 por ciento al año y de 83,7 por...(AU)

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Antecedentes: La termoablación por radiofrecuencia ocupa un lugar importante actualmente en el tratamiento de los tumores malignos de hígado. Objetivo: Comunicar nuestra experiencia con el uso de la radiofrecuencia en el tratamiento de los tumores de hígado. Lugar de aplicación: Hospital privado de comunidad. Diseño: Serie de casos, retrospectivo. Material y método: 44 pacientes tratados con radiofrecuencia entre enero de 1999 y diciembre de 2002. Población: Fue dividida según el origen tumoral en: 1. primario, 2. metástasis colorrectal, 3. metástasis neuroendocrina y 4. metástasis no colorrectal no neuroendocrina. La radiofrecuencia fue utilizada: 1. como única modalidad, 2. asociada a cirugía y 3. combinada con otro procedimiento. Se evaluaron la vía de abordaje, la morbilidad, mortalidad, control local, recurrencia local y supervivencia. Resultados: Media de edad 64 años. Masculinos 65 por ciento. Origen del tumor: colorrectal 50 por ciento, hepatocarcinoma 32 por ciento y no colorrectal no neuroendocrino 18 por ciento. Vía de abordaje: Laparotómica 82 por ciento, percutánea 13,5 por ciento y laparoscópica en 4,5 por ciento. Estadía hospitalaria promedio: 4 días. Complicaciones: 8 pacientes (18 por ciento). No hubo mortalidad, ni necesidad de reoperación. Se observó una recidiva parietal luego del abordaje percutáneo. En 8 pacientes (18 por ciento) se indicó radiofrecuencia por segunda vez. Supervivencia actuarial global: 28 por ciento a los 4 años. Conclusiones: La radiofrecuencia es un procedimiento válido y seguro en pacientes seleccionados. Puede ser considerada un tratamiento alternativo en pacientes con imposibilidad o rechazo al tratamiento quirúrgico. En pacientes seleccionados la radiofrecuencia se puede indicar asociada a tratamiento quirúrgico resectivo

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Antecedentes: La termoablación por radiofrecuencia ocupa un lugar importante actualmente en el tratamiento de los tumores malignos de hígado. Objetivo: Comunicar nuestra experiencia con el uso de la radiofrecuencia en el tratamiento de los tumores de hígado. Lugar de aplicación: Hospital privado de comunidad. Diseño: Serie de casos, retrospectivo. Material y método: 44 pacientes tratados con radiofrecuencia entre enero de 1999 y diciembre de 2002. Población: Fue dividida según el origen tumoral en: 1. primario, 2. metástasis colorrectal, 3. metástasis neuroendocrina y 4. metástasis no colorrectal no neuroendocrina. La radiofrecuencia fue utilizada: 1. como única modalidad, 2. asociada a cirugía y 3. combinada con otro procedimiento. Se evaluaron la vía de abordaje, la morbilidad, mortalidad, control local, recurrencia local y supervivencia. Resultados: Media de edad 64 años. Masculinos 65 por ciento. Origen del tumor: colorrectal 50 por ciento, hepatocarcinoma 32 por ciento y no colorrectal no neuroendocrino 18 por ciento. Vía de abordaje: Laparotómica 82 por ciento, percutánea 13,5 por ciento y laparoscópica en 4,5 por ciento. Estadía hospitalaria promedio: 4 días. Complicaciones: 8 pacientes (18 por ciento). No hubo mortalidad, ni necesidad de reoperación. Se observó una recidiva parietal luego del abordaje percutáneo. En 8 pacientes (18 por ciento) se indicó radiofrecuencia por segunda vez. Supervivencia actuarial global: 28 por ciento a los 4 años. Conclusiones: La radiofrecuencia es un procedimiento válido y seguro en pacientes seleccionados. Puede ser considerada un tratamiento alternativo en pacientes con imposibilidad o rechazo al tratamiento quirúrgico. En pacientes seleccionados la radiofrecuencia se puede indicar asociada a tratamiento quirúrgico resectivo (AU)

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