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Concern about atmospheric microplastic (MP) contamination has increased in recent years. This study assessed the abundance of airborne anthropogenic particles, including MPs, deposited in rainfall in Bahia Blanca, southwest Buenos Aires, Argentina. Rainwater samples were collected monthly from March to December 2021 using an active wet-only collector consisting of a glass funnel and a PVC pipe that is only open during rain events. Results obtained show that all rain samples contained anthropogenic debris. The term "anthropogenic debris" is used to refer to the total number of particles as not all the particles found could be determined as plastic. Among all the samples, an average deposition of 77 ± 29 items (anthropogenic debris) m-2d-1 was found. The highest deposition was observed in November (148 items m-2d-1) while the lowest was found in March (46 items m-2d-1). Anthropogenic debris ranged in size from 0.1 mm to 3.87 mm with the most abundant particles being smaller than 1 mm (77.8%). The dominant form of particles found were fibers (95%), followed by fragments (3.1%). Blue color predominated (37.2%) in the total number of samples, followed by light blue (23.3%) and black (21.7%). Further, small particles (<2 mm), apparently composed of mineral material and plastic fibers, were recognized. The chemical composition of suspected MPs was examined by Raman microscopy. The analysis of µ-Raman spectra confirmed the presence of polystyrene, polyethylene terephthalate, and polyethylene vinyl acetate fibers and provided evidence of fibers containing industrial additives such as indigo dye. This is the first assessment of MP pollution in rain in Argentina.

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A multi-year monitoring data set of potentially harmful elements (PHEs), which are present in the chemical composition of atmospheric settleable particulate matter (SPM) in the urban, industrial and port areas in Bahía Blanca, was studied in order to assess potential ecological risk. The selected PHEs were metal elements of local and regional environmental importance (Cd, Cr, Cu, Ni, Pb, and Zn). Seventeen sampling campaigns were carried out between April 2013 and September 2019. After the microwave-assisted acid digestion of samples, the total contents of the PHEs were determined by ICP-OES. The annual dry deposition rate, the indexes associated with the potential ecological risk (RI) and the degree of geo-accumulation (Igeo) of each PHE were calculated. The results indicated that: (a) there are 3 groups (I, II, III) of PHEs with differentiated concentration levels, ranked I (Pb > Zn > Cu) > II (Cr ≈ Ni) > III (Cd) (p < 0.01) in all the studied areas; (b) the median of the total deposition rate was 1 mg cm-2. month-1 with a significant relative contribution of Pb; (c) a considerable increase in geo-accumulation of Pb indicated that SPM was functioning as a sink for Pb, and also reflected a significant progressive increase in the potential ecological risk in all sites (p < 0.01); and (d) there were chemometrically identified potential sources of Pb, Cu and Zn emissions that would be associated mainly to the resuspension of dust from geogenic, industrial and urban origin, and to a lesser extent, to other gaseous emissions of the industrial sector. This work highlights three major aspects of environmental assessment: (a) the value of continuous monitoring as an important tool to detect long-term trends; (b) the importance of the role of dust fall as a useful environmental indicator of lead geo-accumulation; and (c) the great utility of geo-accumulation and potential ecological risk indices as rapid quantitative assessment tools of environmental pollution.

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The aims of this research were 1) to find out the possible microbiological contamination and residues of pesticides (chlorpyrifos and cypermethrin) in lettuce grown in Bahía Blanca's horticultural belt, and bacteriological quality of waters used for irrigation and post-harvest washing, 2) to investigate and compare the internalization capacity of a strain of Escherichia coli isolated from irrigation water with another hospital uropathogenic strain. Some strains of bacteria can internalize into the plant tissue. This capability presents food safety threats as they cannot be removed with standard sanitation practices. To determine bacteriological quality of lettuce, E. coli, Salmonella spp and E. coli O157: H7/NM (n = 10) were investigated. Bacteriological quality of water was determined by quantification of fecal coliforms/100 mL (n = 20). Pesticides were determined by using an improved and validated QuEChERS method combined with GC-MSD. Irrigation water in 19/20 samples did not present health risk. Bacteriological quality of lettuce met demands in 9/10 samples. Pesticides were detected in half of the samples, values exceeding the FAO recommendations. An effort is strongly recommended to implement both, best phytosanitary practices and monitoring programmes. Uropathogenic strain was able to internalize into plant tissue, while the nonpathogenic one was not.

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OBJETIVO: Este trabajo presenta el inicio de un proyecto de largo término que analiza la dinámica local de circulación de pacientes y colaboración profesional entre el conjunto de efectores localizados en los partidos de Florencio Varela, Berazategui, Alte. Brown y Quilmes, denominado la Red del Sudeste Bonaerense. Ésta articula efectores de primer, segundo y tercer nivel de atención (169 en total), asiste a 2 millones de personas anualmente en una de las áreas con mayor población del país y con altos niveles de necesidades básicas insatisfechas. METODOLOGÍA: La metodología se plantea desde los métodos mixtos que articulan técnicas cualitativas y cuantitativas para la recolección, procesamiento y análisis de la información de los efectores de la Red, a partir de: registros de pacientes pediátricos, datos epidemiológicos y trabajo de campo etnográfico. Complementariamente, se articulan tres líneas multi-disciplinarias: Análisis de sistemas y servicios de salud en red; Análisis espacial entre centros de salud; Análisis de redes sociales (identifica estructuras y dinámicas de flujo y colaboración). RESULTADOS: Los resultados sugieren: a) la estructura de derivaciones la HEC tiene una forma de "estrella", b) mayor cantidad de derivaciones desde los distritos de la Red del Sudeste que de otros efectores, c) Coeficiente de Jaccard es bajo, d) dificultades en el mecanismo de contra-referencia, e) la estructura de colaboración entre 25 especialidades es un modelo "centro/periferia", f) emergen subgrupos de acuerdo a las patologías derivadas. CONCLUSIÓN: Se concluye con una discusión sobre la importancia de la interacción estructural entre las especialidades para la atención compleja de patologías pediátricas. Finalmente, la centralidad del HEC en la dinámica de derivaciones pediátricas se corresponde con su condición de único efector de tercer nivel de la región, su robusta comunicación con los efectores en el territorio así como por su posicionamiento como referente nacional de derivación por patologías específicas.

OBJECTIVE: This paper presents the beginning of a long-term project that analyses local dynamics of patient transfers and professional collaboration among a formal assistance network of health providers called the "Southeastern Network" localized in four districts in the Metropolitan Area of Buenos Aires: F. Varela, Berazategui, Alte. Brown y Quilmes. This network connects primary, secondary and tertiary care levels (169 in total) and assists over 2 million people annually in the region, one of the most populated and deprived areas in Argentina. METHODS: Methodological strategies point toward a mixed methods approach, which articulates qualitative and quantitative methods for collecting, processing and analyzing the information from the network care providers: patients institutional registers, epidemiological data and ethnographic field work.Additionally, we follow three multi-disciplinary lines: health systems and services analysis, special analysis regarding care providers, Social Network Analysis (identifying structures and dynamics of patients flow and professional collaboration). RESULTS: Suggest: a) the structure of patients' referral is "star" model b) there are more referrals from the Network's districts than from other areas c) Jaccard Coefficient is low, d) there are some difficulties in counter-referral mechanisms e) professional collaboration structure among 25 medical specialties is a "center/periphery" model f) some subgroups emerge from assisting certain pathologies. CONCLUSIONS: We conclude with a discussion on the importance of structural interaction among medical specialties for complex pediatric care. Finally, the centrality of El Cruce Hospital within pediatric referrals in this area correspond to the fact that it is the only tertiary care provider, it maintains robust communications with other care providers and it is positioned as national reference for specific pathologies referral.

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INTRODUCCIÓN En el año 2012 como consecuencia de la necesidad asistencial de generar nuevas camas en terapia intensiva pediátrica se creó la Unidad de Cuidados Intensivos pediátricos II (UTIP II) que se dedicó principalmente a la asistencia de pacientes con necesidades especiales de atención médica, con una repercusión en el intercambio asistencial y sus consecuencias indirectas en la red pediátrica no estudiadas hasta la fecha. OBJETIVOS El objetivo de nuestro estudio es analizar las repercusiones en el intercambio asistencial con la red pediátrica en la unidad de terapia intermedia pediátrica (CIPED) como consecuencia de la creación de la UTIP II. METODOS Estudio observacional, retrospectivo realizado en la CIPED del HEC, desde enero de 2009 a diciembre de 2016. Se evaluaron el nᵒ/% de derivaciones aceptadas respecto a las solicitadas, origen de los pacientes (Red/Extrared/HEC), nᵒ de egresos, % de ocupación de camas, giro cama. RESULTADOS Se observa un aumento en los rechazos de solicitudes de ingreso a CIPED a partir de 2013(p de tendencia <0,000001); comparando el período 2009/2012 (pre UTIP 2) con el período 2013/2016 considerando el origen de los pacientes ingresados a CIPED, se observa un aumento en los ingresos directos desde el HEC y un descenso de los ingresos procedentes de los hospitales de la red (p <0,000001) y un porcentaje creciente de pacientes que egresan directamente desde UTIP. El porcentaje de ocupación de cama resulto alto en los tres sectores mientras que el giro cama es bajo, intermedio y alto en la UTIP2, UTIP y CIPED respectivamente. CONCLUSIONES los indicadores evaluados alertan acerca de una disminución en la respuesta a las necesidades asistenciales de la red pediátrica desde la CIPED del HEC y evidencian ineficiencias en el sistema que atentan contra la calidad asistencial y profundización de las relaciones en la red.

INTRODUCTION The Pediatric Intensive Care Unit II (PICU II) was created in 2012,as a result of the health care need to generate new beds in pediatric intensive care. It was devote d mainly to provide care to patients with special health care needs and had an impact on health care exchange and its indirect effects in the pediatric network, which have not been studied to date. Our study aims at examining the impact of creating the PICU II on the health care exchange with the pediatric network in the pediatric intermediate care unit (PIMCU). METHODS Retrospective observational study by the PIMCU of HEC from January 2009 to December 2016. Number/percentage of accepted referrals versus requested referrals, sources of patients' referrals(In-network/ Out-of-network/ HEC), number of discharges, % of bed occupancy and bed turnover rate were evaluated. RESULTS Increased denials in admission requests to the PIMCU are observed from 2013 (P for trend <0.000001). Comparing the 2009/2012 period (pre-PICU 2) with the 2013/2016 period and considering the sources of patients admitted to the PIMCU, increased direct admissions to PIMCU, decreased admissions of patients from in-network hospitals (p <0.000001) and an increased percentage of patients discharged directly from the PICU are observed. Bed occupancy percentage was high in the three sectors while the bed turnover was low, intermediate and high in PICU2, PICU and PIMCU, respectively. CONCLUSIONS Evaluated indicators warn about a diminished response by HEC's PIMCU to pediatric network's healthcare needs and evidence system inefficiencies that target healthcare quality and relationship deepening in the network.

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Measurement uncertainty is one of the most required parameters of analytical quality in environmental decision-making. Several approaches have been reported for estimating uncertainty in analytical measurements. The use of proficiency test (PT) is an alternative, not only for assessing the performance of individual analytical laboratories, but also for estimating the concordance of an analytical method and their measurement uncertainties. Here we develop a PT scheme for a limited number of analytical laboratories that took part in the analysis of total mercury in samples with complex matrix (chlor-alkali process wastewater effluent) in absence of references of the highest metrological hierarchy (e.g. primary method, primary CRM). Two in-house reference materials (IHRMs) were prepared at different levels of analyte concentration and the homogeneity required was verified for the intended use. A set of parametric and robust statistical tests were applied to evaluate the assigned values of each IHRM. Metrological compatibility assessment of PT results, evaluation of individual and global performance of the laboratories, and determination of uncertainty of the analytical measurements were evaluated in this restricted study scenario. Between-laboratory differences were found not significant (α=0.05). For both concentration levels we computed a relative standard uncertainty of 30% for the total Hg content.

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Forty-nine superficial sediment samples used in this study were collected from eight sites in the Bahia Blanca Estuary, located in the Buenos Aires Province southwest, Argentina, in a period between April 2005 and March 2009, to assess the concentration levels, spatial and seasonal distribution, and putative input sources of 18 selected organochlorine pesticides (OCs), following UNEP-IAEA procedures. Average concentration levels in sediments ranged between 3.54 and 63.79 ng g⁻¹, d.w. (mean = 15.99 ng g⁻¹, d.w.), for ∑OCs, and from nondetectable to 8.03 ng g⁻¹, d.w. (mean = 2.16 ng g⁻¹, d.w.), and from nondetectable to 3.20 ng g⁻¹ (mean = 0.97 ng g⁻¹, d.w.) for hexachlorocyclohexanes (HCHs) and dichlorodiphenyltrichloroethanes (DDTs), respectively. Principal component analysis allowed the classification of sampling sites according to the main OCs inputs over the estuary. In comparison to other worldwide locations and to the world coastal sediment concentrations range, sediment DDTs and HCHs levels were in the low range; on the opposite, ∑OCs average was in the medium range. OCs seasonal distribution was found to be highly correlated with the precipitations seasonality and sowing seasons in the adjacent agriculture fields. In addition, an ecotoxicological risk assessment pointed industrial and agriculture catchment zones with intermediate probability of adverse effects to biota, while the city sewage outfall was classified with none indication of an immediate threat. Data indicated that the estuary sediments were functioning as a sink for persistent OC pesticides (either in use or banned), however, it was found a declining trend on their environmental burden.

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El síndrome bronquial obstructivo es un motivo de consulta frecuente en la edad pediátrica. En este trabajo se presenta el caso de un paciente con antecedentes de internaciones recurrentes por infecciones respiratorias agudas bajas y trastorno de deglución con diagnóstico de hendidura laríngea. Se realiza una breve descripción de la hendidura laríngea, sus características clínicas, diagnóstico y tratamiento. Se enumeran los diagnósticos diferenciales de los niños con sibilancias atípicas, sus signos y síntomas y su evaluación inicial.

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