Related factors to human toxocariasis in a rural community of Argentina

The objective of this study was to evaluate the relationship between toxocariasis frequency and demographic, environmental, sanitary variables, eosinophylia, and other intestinal parasites in a rural population of Argentina. Serological examination of 100 individuals was carried out by using ELISA technique for the detection of antitoxocara antibodies. Eosinophiles in peripheral blood, presence of intestinal parasites, and demographic, environmental, and socio-cultural data were evaluated. Eighty-one feces samples of dogs belonging to the studied people were analyzed to detect eggs of Toxocara canis. Thirty of them were from 30 dogs and 51 were pools from dog feces. Samples of dirt from around the homes (n: 47) and from public park (n: 4) were taken. To determine the associations, the X2 and Fisher tests were used. The seroprevalence was 23%. Eosinophilia in peripheral blood was detected in 86.95% seropositive individuals and in 37.66% seronegative individuals (p < 0.001, OR = 11.03). Of the 23 people with positive serology, 69.56% had at least one intestinal parasite. All individuals with positive serology had dogs in their homes. Among the dog owners there was a significant association between the presence of anti-toxocara antibodies and home flooding. Eggs of T. canis were detected in the feces of 5/81 dogs and three of these dogs belonged to individuals with positive serology. Eggs of Toxocara spp. were found in 41.17% of the dirt samples, eight of which came from the area surrounding the homes of individuals with positive serology (p = 0.032; OR = 4.36). Taking into account all the variables influencing the frequency of toxocariasis in this population, the implementation of Public Health programs specifically focused on anti-parasitic treatment of dogs is recommended

Estudio cuali-cuantitativo del estado nutricional y la alimentación en niños de 1 a 3 años de familias de bajos recursos en dos grupos poblacionales con diferentes actividades productivas (Buenos Aires, Argentina), 2007-2008

The aim of this article is to describe the nutritional status and eating patterns of children aged 1-3 years from low-income families who reside in areas with different productive activities: primary production and production of goods and services. A descriptive cross-sectional study was performed with a qualitative and quantitative methodology, evaluating anthropometric and biochemical nutritional status, food intake, economic and demographic characteristics, dietary practices and representations. The results show that children from areas of primary production had a lower prevalence of anemia and iron deficiency. They also had a higher consumption of energy, calcium, zinc, vitamin A and protein and a greater diversity and quality in food consumption. We can conclude that the geographical context of families closer to sources of primary production favors interaction with individuals outside of the family, expanding both the informal social network and access to better quality nutritional food.El objetivo de este artículo es describir el estado nutricional y los patrones de alimentación de niños de 1 a 3 años de familias de bajos recursos, que residen en dos áreas con diferentes actividades productivas: producción primaria y de bienes y servicios. Se realizó un estudio descriptivo de corte transversal, con metodología cuali-cuantitativa; se evaluó el estado nutricional antropométrico y bioquímico, ingesta alimentaria, características económicas y sociodemográficas, prácticas alimentarias y representaciones. Los resultados muestran que los niños del área de producción primaria presentaron menor prevalencia de anemia y deficiencia de hierro. Asimismo tuvieron un consumo superior de energía, calcio, zinc, vitamina A y proteínas y una mayor diversidad y calidad en el consumo de alimentos. Podemos concluir que el contexto geográfico de las familias que residen cerca de fuentes de producción primaria favorecería la interacción con individuos ajenos a la familia, ampliando la red social informal y el acceso a alimentos de mejor calidad nutricional

Use of sedatives and neuromuscular blockers in a cohort of patients receiving mechanical ventilation.

OBJECTIVE: To describe the use of sedatives and neuromuscular blocking agents (NMBs) and their impact in outcome in an international cohort of patients receiving mechanical ventilation. METHODS: We analyzed the database of a prospective, multicenter cohort of 5,183 adult patients who received mechanical ventilation for > 12 h. We considered that a patient received a given agent when it was administered for at least 3 h in a 24-h period. RESULTS: A total of 3,540 patients (68%; 95% confidence interval [CI], 67 to 69%) received a sedative at any time while receiving mechanical ventilation. The median number of days of use was 3 (interquartile range [IQR], 2 to 6 days). The persistent use of sedative was associated with more days of mechanical ventilation (median, 4 days [IQR, 2 to 8 days], vs 3 days [IQR, 2 to 4 days] in patients who did not receive sedatives [p < 0.001]); more weaning days (median, 2 days [IQR, 1 to 3 days], vs 2 days [IQR, 1 to 5 days] in patients who did not receive sedatives [p < 0.001]); and longer length of stay in the ICU (median, 8 days [IQR, 5 to 15 days], vs 5 days [IQR, 3 to 9 days] in patients who did not receive sedatives [p < 0.001]). Six hundred eighty-six patients (13%; 95% CI, 12 to 14%) received an NMB for at least 1 day. The median number of days of use was 2 (IQR, 1 to 4 days). The administration of an NMB was independently related with age, a normal previous functional status, main reason of mechanical ventilation (patients with ARDS received more NMBs), and with patient management (patients requiring permissive hypercapnia, prone position, high level of positive end-expiratory pressure, and high airways pressure). CONCLUSIONS: The use of sedatives is very common, and their use is associated with a longer duration of mechanical ventilation, weaning time, and stay in the ICU. NMBs are used in 13% of the patients and are associated with longer duration of mechanical ventilation, weaning time, stay in the ICU, and higher mortality

Weight and height centiles of Argentinian children and adolescents: A comparison with WHO and national growth references

Background: Studies in several countries comparing the performance of WHO references and their own national growth standards reported differences that could affect screening and growth monitoring.Aim: To estimate weight and height centiles on a sample of Argentinian children and adolescents and compare selected centiles with WHO and national growth references.Subjects and methods: A cross-sectional school survey was conducted on 6239 boys and girls aged 5-18. Data were collected between 2005-2009 in Santa Rosa, Argentina. Smoothed weight and height centiles were estimated by the LMS method and compared with WHO 2007 and Argentinian (ARG) growth references.Results: Weight centiles were higher than those of WHO and ARG. Height centiles were above the ARG and below the WHO ones. The greatest differences with ARG were seen before puberty and then declined up to age 18. In contrast, differences with WHO increased from puberty onwards.Conclusion: Compared with the ARG reference, linear growth of these schoolchildren shows a secular acceleration without substantial improvements in the adult height. In relation to WHO, the results suggest that around the adolescent growth spurt differences in linear growth between populations became larger, limiting the clinical usefulness of international growth references in adolescents.Fil: Orden, Alicia Bibiana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños ; ArgentinaFil: Apezteguía, María C.. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños ; Argentin

Towards a non-invasive method of appraisal of the regular suction in 0 to 5-months-old lactating infants

Objetivos: Encontrar una técnica alternativa a la de la videodeglución, que permita identificar el comportamiento de succión-deglución normal o compensado, sin necesidad de llegar a la instancia radiológica. Material y métodos: Como instancia preliminar, una vez diseñado y desarrollado el equipo electromédico necesario, se realizaron estudios a fin de investigar si los diagramas manométricos obtenidos presentan alguna correlación con las conclusiones de los estudios videofluoroscópicos, e identificar las posibles variables a tener en cuenta para encontrar dicha correlación. Resultados: Se identificaron las curvas de succión productiva en 139 casos de lactantes de entre 0 y 6 meses de edad, y de allí se determinaron los valores promedio de amplitud en [mmHg] y frecuencia [Succ/seg] para cada caso. Se calcularon las regiones de normalidad para las categorías elegidas por peso y edad respectivamente. Conclusiones: Los resultados permiten predecir que esta podría validarse como una técnica alternativa y complementaria de diagnóstico que pueda indicarse previamente a solicitar el estudio radiológico correspondiente, y que sería conveniente automatizar el cálculo de los parámetros de interés, para facilitar la transferencia del método al sector hospitalario.Objectives To find an alternative technique to videofluoroscopic swallow study, which would allow for the distinction of the regular or facilitated suction-deglutition behavior, with no need for reaching the radiological instance. Material and methods As a preliminary instance, once the electromedical equipment had been designed and developed, studies were carried out in order to investigate if the obtained manometrical diagrams show any correlation with the conclusions derived from the videofluoroscopic studies, and to identify the possible variants to be taken into account so as to achieve such correlation. Results The curves of productive suction have been found in all the 139 cases of lactating infants between 0 and 6 months old, from which the average values of breadth in [mmHg] and frequency [Suct/sec] were determined for each case. The areas of normality for the categories determined in terms of weight and age has been respectively calculated. Conclusions The results allow for the prediction that the technique could be validated as an alternative and complementary one for diagnosis that can be asked for before requesting the corresponding radiologic study, and that it would be convenient automating the calculations of the parameter of interest to enhance the appliance of such method to the hospital sector.Fil: Jury, Silvia. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor Maria Ludovica" de la Plata. Instituto de Desarrollo e Investigaciones Pediatricas; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; ArgentinaFil: Zerbino, Lia Maria. Universidad Nacional de la Plata. Facultad de Ingeniería. Departamento de Ciencias Básicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico la Plata. Centro de Investigaciones Opticas (i); Argentina. Universidad Tecnologica Nacional. Facultad Regional La Plata; ArgentinaFil: Laquidara, Anibal Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico la Plata. Centro de Investigaciones Opticas (i); Argentina. Universidad Nacional de la Plata. Facultad de Ingenieria. Departamento de Electrotecnia; ArgentinaFil: Apezteguía, M. C.. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; Argentin

Participación comunitaria en el control de las parasitosis intestinales en una localidad rural de Argentina Community participation in the control of intestinal parasitoses at a rural site in Argentina

OBJETIVOS: Diseñar, implementar y evaluar un plan complejo de acciones dirigido a reducir las parasitosis en una localidad rural de la provincia de Buenos Aires, Argentina, con la participación de la comunidad. MÉTODOS: El trabajo se realizó en General Mansilla, provincia de Buenos Aires, Argentina, en tres etapas. 1) Se evaluó la situación epidemiológica inicial de las parasitosis intestinales en la comunidad mediante análisis coproparasitológico seriado y de escobillado anal en una muestra de 522 personas. 2) Se implementaron dos intervenciones: el tratamiento farmacológico de las personas parasitadas y la educación sanitaria de la población con la participación activa de divulgadores locales. 3) El tratamiento antiparasitario se evaluó mediante análisis coproparasitológico de seguimiento de todas las personas tratadas; la intervención educativa se evaluó mediante una encuesta y análisis coproparasitológico a personas que solo habían participado en el plan de educación sanitaria. RESULTADOS: La frecuencia de parasitosis intestinal fue de 58,2%; del total, 43,9% por protozoos y 35,2% por helmintos. Los patógenos más frecuentes fueron Enterobius vermicularis, Blastocystis hominis y Giardia lamblia. El tratamiento antiparasitario redujo la parasitosis intestinal a 15,1% (P < 0,001), más eficaz en helmintos que en protozoos. La parasitosis intestinal disminuyó después de la intervención educativa sanitaria, tanto en sentido general (de 58,2% a 47,9%; P = 0,019) como por helmintos (de 35,2% a 20,3%; P < 0,001) y se mejoraron significativamente los hábitos higiénicos. CONCLUSIONES: El tratamiento parasitológico y la intervención educacional mediante divulgadores locales permitieron reducir las parasitosis en la comunidad estudiada, especialmente las provocadas por helmintos. Se recomienda extender esta experiencia a otras comunidades rurales y ampliarla con intervenciones adicionales dirigidas a cortar otras vías de transmisión, como el agua y los alimentos.<br>OBJECTIVES: To design, implement, and evaluate a complex plan of actions aimed at reducing parasitoses in a rural town in the province of Buenos Aires, Argentina, with the involvement of the community. METHODS: The project took place in General Mansilla, Buenos Aires province, in three stages. First, the initial epidemiological situation of intestinal parasitoses in the community was assessed by analyzing for parasites a series of stool samples and anal swabs taken from a sample of 522 individuals. Second, interventions were implemented: the pharmacological treatment of the infected individuals, and health education for the public involving local promoters. Third, the pharmacological treatment was evaluated with followup stool testing for those treated; the health education effort was evaluated through a survey and stool testing for parasites of those who had participated solely in the education. RESULTS: The frequency of intestinal parasitoses was 58.2%; of the total, 43.9% were protozoa and 35.2%, helminths. The most common pathogens were Enterobius vermicularis, Blastocystis hominis, and Giardia lamblia. The deworming treatment reduced intestinal parasitoses to 15.1% (P < 0.001), and was more effective in helminths than in protozoa. Intestinal parasitoses declined following the health education intervention, in general (from 58.2% to 47.9%; P = 0.019), as well as for helminths (from 35.2% to 20.3%; P < 0.001), and hygiene habits improved significantly. CONCLUSIONS: Treatment of parasitosis and the educational intervention provided by local promoters made it possible to reduce parasitic diseases-particularly those caused by helminths-in the community under study. We recommend extending this experience to other rural communities and broadening the interventions to cutoff additional modes of transmission, such as water and food