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Electropolishing is a common treatment in the industry; however, how it behaves in the mouth and what benefits it can bring over metal dental attachments have not yet been established. Thus, the aim of this study was to determine the levels of corrosion, the released metal ions, and the changes in structural composition in metallic orthodontic appliances following electropolishing treatment. This study included 56 orthodontic brackets and 28 archwires. The samples were subjected to a pH cycle to simulate an oral environment. Using UV-Vis spectrophotometry, the release of metallic particles was evaluated, and using scanning electron microscopy, the structural and composition changes were evaluated. Groups were compared using Student's t-tests with a value of p ≤ 0.05. The cyclical pH solutions showed variations between groups and days (1, 3, 5, 7 and 15), reaching the highest acidification in the self-ligating brackets; the absorbance between solutions did not differ significantly. As seen from the SEM results, the experimental group showed minor irregularities compared with the control groups. The experimental brackets decreased in iron and increased in chromium after electropolishing, while for the NiTi archwires, they decreased in nickel. Therefore, electropolishing treatments in metallic orthodontic attachments improve their surface structure and corrosion resistance could reduce the risk of metal hypersensitivity, mainly from nickel.
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The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.
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Cárie Dentária , Doenças Periodontais , Humanos , Cárie Dentária/epidemiologia , Cárie Dentária/complicações , Extração Dentária , Estudos Transversais , Doenças Periodontais/epidemiologia , Doenças Periodontais/complicações , DemografiaRESUMO
Soon after the declaration of the COVID-19 pandemic, the Institute for Health Sciences Research (IICS) of the National University of Asunción, Paraguay became a testing laboratory (COVID-Lab) for SARS-CoV-2. The COVID-Lab testing performance was assessed from 1 April 2020 to 12 May 2021. The effect of the pandemic on the IICS and how the COVID-Lab contributed to the academic and research activities of the institute were also assessed. IICS researchers and staff adjusted their work schedules to support the COVID-Lab. Of the 13,082 nasopharyngeal/oropharyngeal swabs processed, 2704 (20.7%) tested positive for SARS-CoV-2 by RT-PCR. Of the individuals testing positive, 55.4% were female and 48.3% were aged 21-40 years. Challenges faced by the COVID-Lab were unstable reagent access and insufficient staff; shifting obligations regarding research, academic instruction, and grantsmanship; and the continuous demands from the public for information on COVID-19. The IICS provided essential testing and reported on the progress of the pandemic. IICS researchers gained better laboratory equipment and expertise in molecular SARS-CoV-2 testing but struggled to manage their conflicting educational and additional research obligations during the pandemic, which affected their productivity. Therefore, policies protecting the time and resources of the faculty and staff engaged in pandemic-related work or research are necessary components of healthcare emergency preparedness.
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COVID-19 , Humanos , Feminino , Masculino , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2/genética , Teste para COVID-19 , Pandemias , Paraguai/epidemiologia , VacinaçãoRESUMO
Abstract The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.
Resumo O objetivo do presente estudo foi identificar os motivos das extrações dentárias em pacientes que procuram atendimento odontológico em uma clínica odontológica universitária no México. Este é um estudo transversal que avaliou 284 pacientes consecutivos na Faculdade de Odontologia da Universidad Autónoma del Estado de México entre agosto de 2017 e novembro de 2018. No total, foram realizadas 505 extrações. A variável dependente foi o motivo da extração: 0) cárie dentária e sequelas subsequentes (categoria de referência); 1) doença periodontal e sequelas subsequentes; e 2) outros motivos. Variáveis sociodemográficas, socioeconômicas e clínicas foram incluídas como variáveis independentes. A análise foi feita com regressão logística multinomial (Stata 14.0). De todas as extrações, 63,6% (n=321) foram devidas a cárie dentária e sequelas subsequentes; 22,0% (n=111) foram devidas a doença periodontal e sequelas subsequentes; 5,3% (n=27) a insucesso endodôntico; 5,1% (n=26) a indicações protéticas; 1,6% (n=8) a indicações ortodônticas; e o restante (2,4%) foi devido a outros motivos. No modelo multivariado, as extrações por doença periodontal vs. cárie dentária foram associadas ao tabagismo ocasional (Odds Ratio, OR=3,90) ou ao uso diário de tabaco (OR=3,19); ao fato de o dente a ser extraído ter sido restaurado anteriormente (OR=2,35); à extração de dentes anteriores em vez de posteriores (OR=2,63); e a pacientes com extrações múltiplas (OR=2,68). No caso de extrações devido a "outros motivos", nenhuma variável foi significativa. A cárie dentária e a doença periodontal foram os principais motivos de extração dentária nessa amostra. Diversas variáveis, principalmente clínicas, foram associadas às extrações por motivos periodontais.
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Abstract Cystic fibrosis (CF) is an autosomal recessive disorder and is caused by variants in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene. We aimed to study the frequency of the F508del variant, the most common variant worldwide, in patients with CF from Paraguay. The frequency of the F508del variant in Paraguayan patients with a clinical diagnosis of CF was assessed using a polymerase chain reaction followed by the sequencing of the PCR products. 43 of the 86 patients (50%) were homozygous for the F508del variant, 28 were heterozygous (32.56%), and the remaining 15 (17.44%) were non-carriers. In terms of alleles, there were 114 mutated (114/172 or 66.28%) and 58 did not correspond to this variant (58/172 or 33.72%). This is the first study of the frequency of the F508del variant in patients with CF in Paraguay. This information is of utmost relevance when planning and offering treatments from health services.
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Recently, several studies have introduced nanotechnology into the area of dental materials with the aim of improving their properties. The objective of this study is to determine the antibacterial and mechanical properties of type I glass ionomers reinforced with halloysite nanotubes modified with 2% chlorhexidine at concentrations of 5% and 10% relative to the total weight of the powder used to construct each sample. Regarding antibacterial effect, 200 samples were established and distributed into four experimental groups and six control groups (4 +ve and 2 -ve), with 20 samples each. The mechanical properties were evaluated in 270 samples, assessing microhardness (30 samples), compressive strength (120 samples), and setting time (120 samples). The groups were characterized by scanning electron microscopy and Fourier transform infrared spectroscopy, and the antibacterial activity of the ionomers was evaluated on Streptococcus mutans for 24 h. The control and positive control groups showed no antibacterial effect, while the experimental group with 5% concentration showed a zone of growth inhibition between 11.35 mm and 11.45 mm, and the group with 10% concentration showed a zone of growth inhibition between 12.50 mm and 13.20 mm. Statistical differences were observed between the experimental groups with 5% and 10% nanotubes. Regarding the mechanical properties, microhardness, and setting time, no statistical difference was found when compared with control groups, while compressive strength showed higher significant values, with ionomers modified with 10% concentration of nanotubes resulting in better compressive strength values. The incorporation of nanotubes at concentrations of 5% and 10% effectively inhibited the presence of S. mutans, particularly when the dose-response relationship was taken into account, with the advantage of maintaining and improving their mechanical properties.
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SARS-CoV-2 variant detection relies on resource-intensive whole-genome sequencing methods. We sought to develop a scalable protocol for variant detection and surveillance in Paraguay, pairing rRT-PCR for spike mutations with Nanopore sequencing. A total of 201 acute-phase nasopharyngeal samples were included. Samples were positive for the SARS-CoV-2 N2 target and tested with the Spike SNP assay to detect mutations associated with the following variants: alpha (501Y), beta/gamma (417variant/484K/501Y), delta (452R/478K), and lambda (452Q/490S). Spike SNP calls were confirmed using amplicon (Sanger) sequencing and whole-genome (Nanopore) sequencing on a subset of samples with confirmed variant lineages. Samples had a mean N2 Ct of 20.8 (SD 5.6); 198/201 samples (98.5%) tested positive in the Spike SNP assay. The most common genotype was 417variant/484K/501Y, detected in 102/198 samples (51.5%), which was consistent with the P.1 lineage (gamma variant) in Paraguay. No mutations (K417 only) were found in 64/198 (32.3%), and K417/484K was identified in 22/198 (11.1%), consistent with P.2 (zeta). Seven samples (3.5%) tested positive for 452R without 478K, and one sample with genotype K417/501Y was confirmed as B.1.1.7 (alpha). The results were confirmed using Sanger sequencing in 181/181 samples, and variant calls were consistent with Nanopore sequencing in 29/29 samples. The Spike SNP assay could improve population-level surveillance for mutations associated with SARS-CoV-2 variants and inform the judicious use of sequencing resources.
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COVID-19 , SARS-CoV-2 , COVID-19/diagnóstico , COVID-19/epidemiologia , Humanos , Paraguai/epidemiologia , SARS-CoV-2/genéticaRESUMO
Abstract In Paraguay, neonatal screening for congenital hypothyroidism (CH) and phenylketonuria (PKU) started in October 1999, in 2005 cystic fibrosis (CF) was selectively incorporated. The National Program for Neonatal Screening has a centralized laboratory that encompasses 1.132 Sample Collecting Sites (SCS) distributed in the 18 Health Regions, with over 80% coverage of live births; the incidence of CH being 1:2.060, HPA/PKU 1:6.328 and CF 1:5.671 newborns. The newborn screening program headed by the Ministry of Public Health and Social Welfare in Paraguay has been consolidated itself as a public health program. This publication describes the historic 20-year process, the strategies and activities carried out as well as the results and achievements, among which it is important to point out the achievement of newborns screening laws that make mandatory to detect, diagnose and treat those affected, as well as the human resources committed to newborn screening.
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The goal of this study was to investigate the association of body composition components and to elucidate whether any of these components is a risk factor for Lumbar Disc Herniation (LDH). The group of study consisted of 90 adults involved in a physical activity program due to overweight and obesity. 19 adults with medical diagnostic through Magnetic Resonance Imaging with LDH. Body composition data was obtained with a bioelectrical impedance analyzer. Descriptive statistics and principal components analysis permitted to analyze the information's structure and to visualize information clusters. A logistic regression analysis allowed us to find the association between some of the variables of body composition with LDH. The Degree of Obesity, Body Mass Index, Visceral Fat Area and the Abdominal Circumference resulted associated (P values of 0.0388, 0.0171, 0.0055 and 0.0032, respectively). The application of Odd Ratio allowed us to declare the Visceral Fat Area and Abdominal Circumference as risk factors to develop Lumbar Disk Herniation. Our results provide a new record for future studies, and support for prescription of physical activity and changes in diet, to correct or prevent the development of LDH in the population of Baja California.
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Composição Corporal , Degeneração do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/fisiopatologia , Vértebras Lombares/fisiopatologia , Idoso , Índice de Massa Corporal , Dieta , Impedância Elétrica , Feminino , Humanos , Degeneração do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/complicações , Gordura Intra-Abdominal , Imageamento por Ressonância Magnética , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/complicações , Análise de Componente Principal , Fatores de RiscoRESUMO
Introducción: La fibrosis quística (FQ) es una patología autosómica recesiva, pasible de ser detectada en el periodo neonatal, causada por mutaciones en el gen regulador de conductancia transmembrana de FQ (CFTR, por sus siglas en inglés), la patología es multisistémica y el tratamiento precoz incide en la expectativa y calidad de vida de los afectados. Objetivo: Presentar las principales estrategias y los resultados logrados para la detección, diagnóstico y tratamiento de las personas con FQ, en el Programa Nacional de Detección Neonatal. Metodología: Se realizó una revisión del plan operativo anual, informes, publicaciones y documentos emitidos del 2004 al 2018. Resultado: En 15 años se ejecutaron 16 estrategias que permitieron la detección, el diagnóstico así como el tratamiento de individuos afectados por la FQ. Entre las que se destacan el desarrollo de un proyecto piloto para el tamizaje de la FQ en RN, mediante dosaje de la tripsina inmunoreactiva (TIR), entrega de una canasta básica de medicamentos, insumos y equipos para el tratamiento de los individuos con FQ detectados por el programa así como los diagnosticados con anterioridad, implementación del test del sudor, elaboración de una Guía Clínica multidisciplinaria, automatización del dosaje de la TIR, que permitió la universalización del screening, y por último la identificación de las mutaciones presentes en los individuos afectados. En el 2015 se logró llegar al 100 % de cobertura de los RN atendidos en los servicios del Ministerio de Salud Pública y Bienestar Social. De enero del 2004 a diciembre del 2018, 179 individuos reciben su tratamiento en el programa, 144 de los cuales fueron detectados en el periodo neonatal. Conclusión:Las estrategias ejecutadas han tenido resultados muy auspiciosos que nos permitieron universalizar la detección neonatal y tratamiento, lo que conlleva a una mejor calidad y expectativa de vida de los individuos afectados por la FQ. En la actualidad solo faltaría implementar un Centro de Atención Multidisciplinario para las personas con Fibrosis Quística Palabras claves: Programa, Detección neonatal, Fibrosis Quística
Introduction:Cystic fibrosis (CF) is an autosomal recessive pathology, capable of being detected in the neonatal period, caused by mutations in the CF transmembrane conductance regulator gene (CFTR), the pathology is multisystemic and Early treatment affects the expectation and quality of life of those affected. Objective:Present the main strategies and the results achieved for the detection, diagnosis and treatment of people with CF, in the National Neonatal Screening Program. Methodology:A review of the annual operating plan, reports, publications and documents issued from 2004 to 2018 was made. Result:In 16 years, 16 strategies were implemented that allowed the detection, diagnosis and treatment of individuals affected by CF. Among those that stand out the development of a pilot project for the screening of CF in RN, by means of immunoreactive trypsin (TIR), delivery of a basic basket of medicines, supplies and equipment for the treatment of the individuals with CF detected by the program as well as those previously diagnosed, implementation of the sweat test, elaboration of a multidisciplinary Clinical Guide, automation of the TIR dose, which allowed the universalization of the screening, and finally the identification of the mutations present in the affected individuals . In 2015, it was possible to reach 100% coverage of the RNs assisted in the services of the Ministry of Public Health and Social Welfare. From January 2004 to December 2018, 179 individuals received their treatment in the program, 144 of which were detected in the neonatal period. Conclusion:The strategies implemented have had very auspicious results that allowed us to universalize neonatal detection and treatment, which leads to a better quality and life expectancy of the individuals affected by CF. At present, it would only be necessary to implement a Multidisciplinary Care Center for people with Cystic Fibrosis. Keywords: Program, Neonatal screening, Cystic fibrosis
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Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Planos e Programas de Saúde , Fibrose Cística , Doenças do Recém-Nascido , Paraguai/epidemiologia , Estratégias de Saúde Nacionais , Programas de RastreamentoRESUMO
Introducción: Fibrosis quística (FQ) patología genética, autosómica recesiva por mutaciones en el gen de la proteína reguladora de la conductancia transmembrana (CFTR cystic fibrosis transmembrane regulator). En una enfermedad multisistémica, afecta el aparato respiratorio, sistema digestivo, glándulas sudoríparas y conducto deferente. En Paraguay la detección, diagnóstico y tratamiento es obligatoria y gratuita para todo recién nacidos (RN). El tamizaje neonatal es realizado a través del dosaje de la tripsinainmuno reactiva (TIR) y la confirmación diagnóstica con el test del sudor. Objetivo: Reportar la incidencia de la FQ en la población de RN de Paraguay. Es un Materiales y Métodos: trabajo descriptivo, retrospectivo de corte trasversal, donde se analizaron los datos del Programa Nacional de Detección Neonatal (PNDN), de enero del 2015 a diciembre del 2017, para el análisis de la base de datos se utilizó una planilla Excel. Resultados: En el 2015 un 91% (79.093/87.181) de las muestras ingresadas al Programa reunieron los criterios (edad y calidad de la muestra) para el estudio de la TIR, arrojando una incidencia de 1 en 6.591 RN. Para el 2016, esto correspondió a un 97% (83.525/86.094) con una incidencia de 1 en 4.176 RN y por último en el 2017, se tuvo un 97% (87.075/90.037) con una incidencia de 1 en 5.112 RN. Conclusión: La incidencia de la FQ en la población de recién nacidos del Paraguay, en los tres años que abarca este estudio, no presentan entre sí diferencias significativas, tampoco con las reportadas para la población hispánica.
Introduction: Cystic fibrosis (CF), is an autosomal recessive genetic pathology that is caused by mutations in the transmembrane conductance regulatory protein (CFTR cystic fibrosis transmembrane regulator) gene. As a multisystem disease, it affects the respiratory system, digestive system, sweat glands and vas deferens. In Paraguay, detection, diagnosis and treatment is mandatory and free for all newborns (NB). Neonatal screening is performed by the immunoreactive trypsinogen assay (IRT) and diagnostic confirmation is performed by the sweat test. Objective: To report the incidence of CF in the NB population of Paraguay. Materials and Methods: This was a descriptive, retrospective, cross-sectional study, where data from the National Neonatal Screening Program (NNSP) were analyzed, from January 2015 to December 2017. To analyze the database, we used an Excel spreadsheet. Results: In 2015, 91% (79,093 / 87,181) of the samples sent to the Program met the criteria (age and sample quality) for the IRT study, with an incidence of 1 in 6,591 NB. In 2016, 97% (83,525 / 86,094) met criteria, with an incidence of 1 in 4,176 NB, while in 2017, 97% (87,075 / 90,037) met criteria, with an incidence of 1 in 5,112 NB. Conclusion: The incidence of CF in the newborn population of Paraguay, during the three years of this study, did not show significant differences between years, nor with those reported for the Hispanic population.
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Introducción: El cáncer de cuello uterino es un problema de salud pública en Paraguay. Objetivo: Determinar conocimientos, actitudes y prácticas sobre virus del papiloma humano (VPH) y cáncer de cuello uterino en mujeres de 12 Unidades de Salud Familiar (USF) de Bañado Sur-Asunción, periodo abril-octubre 2012. Metodología: Estudio descriptivo de corte transversal, utilizando cuestionario estructurado autoadministrado. Resultados: La edad promedio de las encuestadas fue 42 años, la mayoría en unión libre o casadas (70%); 65% tienen educación básica y media, 56% son amas de casa. El 83% tienen seguro médico; 78% escuchó hablar sobre cáncer de cuello uterino, 74% de éstas en los centros de salud. El 10% de las encuestadas conoce el VPH y lo relaciona con la enfermedad, 90 % escuchó hablar sobre la prueba de Papanicolaou, el 27 % de ellas sabe en qué consiste; 90% de las mujeres demostró actitud favorable y 56% prácticas favorables respecto a la prevención de la enfermedad. Conclusiones: El estudio permite conocer la percepción que tiene una población de mujeres de un barrio marginal de la capital del país, respecto al cáncer de cuello uterino y el principal factor de riesgo que lo produce, a fin de incrementar la prestación de servicios de prevención de este tipo de cáncer, además de propiciar el trabajo interinstitucional e intersectorial en la prevención y control de la enfermedad en el país.
Introduction: Cervix cancer is a public health problem in Paraguay. Objective: To determine knowledge, attitudes and practices on human papilloma virus (HPV) and uterine cervix cancer in women from 12 Family Health Units (FHU) of the Bañado Sur- Asunción, April-October 2,012 period. Methodology: Descriptive cross-sectional study that used self-administered structured questionnaires. Results: The mean age was 42 years, most of them cohabitated or were married (70%); 65% had elementary and secondary education and 56% was housewife; 83% had medical insurance and 78% heard about uterine cervix cancer, 74% of them in health posts. Only 10% knew HPV and related it to a disease, 90% heard about Papanicolaou test, but only 27% knew what is, 90% showed favorable attitude and 56% favorable practices in relation to the disease prevention. Conclusions: The study provided information on the perception that a population of women from a marginal zone of the capital have in relation to cervical cancer and its main risk factor. This will allow increasing the supply of prevention services for this type of cancer, along with promoting inter-institutional and inter-sectorial work on the prevention and control of this disease in the country.
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Humanos , Feminino , Paraguai , Neoplasias do Colo do Útero , Estágio Clínico , Conhecimento , Papillomaviridae , Atitude , Displasia do Colo do Útero , Colo do ÚteroRESUMO
El término de valores de referencia es un concepto ampliamente aceptado y aplicado internacionalmente y puede ser expresado como el establecimiento y uso de datos relevantes para lainterpretación de observaciones médicas. La hormona estimulante de la tiroides (TSH), juega un papel determinante en la detección temprana de una de las pocas causas prevenibles de retardo mental, el hipotiroidismo congénito. Los valores de referencia utilizados en el PPFQRM han sido establecidos según la recomendación del valor dado por la prueba comercialutilizada (<9 Normal, 9-18 borderline, >18μU/ml hipotiroidismo), en muestras de sangre en papel de filtro de reciénnacidos entre 2 a 6 días de vida.Se realizó un estudio observacional de corte transverso con 20.168 muestras de sangre seca de recién nacidos de 1 a 7 días de vida a término, para determinar el valor de referencia de la TSH de la población de RN en el Paraguay, utilizándose las medidas de tendencia central y de dispersión: media, mediana, percentiles y ladistribución de frecuencias a fin de caracterizar a la variable deinterés. El 22% de las muestras presentó valores de TSH entre0.01-1.0, 25% entre 1.1-2, 19% entre 2.1-3.0, 12% entre 3.1-4, 8% entre 4.1-5 y 14% mayor a 5 μU/ml. Se encontraron los siguientes valores de TSH; media: 2.74, mediana: 2.22, moda:0.01 y el desvió estándar: 2.14 μU/ml. Para el percentil 75: 3.26, el 95: 6.68 y el percentil 99: 9 μU/ml. En base a estasobservaciones se confirma como punto de corte un valor de TSH igual a 10 μU/ml.
The term reference values" is widely accepted and applied internationally and can be expressed as the establishment and use of data relevant to the interpretation of medical observations.Thyroid stimulating hormone (TSH) plays a role in early detection of one of the few preventable causes of mentalretardation, congenital hypothyroidism. The reference values used in the program for prevention of cystic fibrosis and mental retardation (PPFQRM) were those recommended by the commercial test used (<9 Normal, 9-18 borderline, >18 ìU/mL hypothyroidism) using filter paper with blood samples from newborns at 2-6 days of life. We performed a cross-sectional, observational study with 20,168 dried blood samples from fullterm newborns at 1-7 days of life to determine the reference value for TSH in the NB population of Paraguay using themeasures of central tendency and dispersion: mean, median, percentiles, and frequency distribution in order to describe the variable under study. A TSH of between 0.01--1.0 μU/ml wasfound in 22% of samples, 1.12 μU/ml in 25% of samples, from 2.1--3.0 μU/ml in 19%, between 3.14 μU/ml in 12%, from 4.15 μU/ml in 8%, and more than 5 μU/ml in 14%. TSH valuesfound were: mean: 2.74, median: 2.22, mode: 0.01, and standard deviation was 2.14 μU/ml. For the 75th percentile: 3.26 μU/ml; 95th: 6.68 μU/ml; and 99th: 9 μU/ml. Based on these observations a cutoff point for TSH was confirmed equivalent to 10 μU/ml.
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Humanos , Recém-Nascido , Hipotireoidismo Congênito , Receptores dos Hormônios Tireóideos , Valores de ReferênciaRESUMO
El Hipotiroidismo Congénito, una de las causas tratables más comunes de retardo mental, ocurre en aproximadamente uno en 3000 recién nacidos. Se investiga la incidencia del hipotiroidismo congénito en Paraguay,país considerado endémico para los Desordenes por Deficiencia de Yodo.
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Hipotireoidismo Congênito , HipotireoidismoRESUMO
One hundred eighty-four clinical isolates of Klebsiella pneumoniae were recovered from August 1996 to October 1997 at the Pediatric Hospital of the Instituto Mexicano del Seguro Social in Mexico City, Mexico. Most of the isolates were collected from the neonatal intensive care unit and infant wards, which are located on the same floor of the hospital. Isolates were genotypically compared by pulsed-field gel electrophoresis with XbaI restriction of chromosomal DNA. Of 184 clinical isolates, 91 belonged to cluster A and comprised three subtypes (A1, A2, and A3), while 93 isolates, comprising two minor clones, B (10 isolates) and C (7 isolates), and 76 unique patterns, were considered unrelated isolates (URI). Susceptibility patterns were indistinguishable in both groups. Fifty extended-spectrum beta-lactamase-producing isolates, including 34 from clone A and 16 from URI, were examined for further studies. Molecular and genetic analysis showed that 47 of 50 clinical isolates expressed the SHV-5 beta-lactamase. This enzyme, in combination with TEM-1, was encoded in a >or=170-kb conjugative plasmid. Results indicate that dissemination of this resistance was due to clonal and horizontal spread.