Trastornos del desarrollo en niños y adolescentes de la región de Los Ríos, Valdivia, Chile, 2006-2008

ResumenObjetivoEstudiar los posibles hallazgos de factores asociados antenatales, perinatales o posnatales, tanto de la madre como del niño, que tengan relevancia significativa en la aparición de trastornos del desarrollo.Pacientes y métodoSe creó una base de datos de todas las fichas clínicas de los pacientes con patología del desarrollo F80 a F90 CIE10 ingresados a la Unidad de Psiquiatría Infantil del Hospital Regional de Valdivia entre agosto de 2006 y diciembre de 2008. Total: 493 pacientes (48,7% del total de consultantes); grupo control de 32 niños sanos de consultorios de la ciudad. Se aplicó método estadístico odds ratio (95% confianza) para el análisis de algunas variables.ResultadosDestacan como factores de riesgo para desarrollar patología del desarrollo (p<0,005, 25% de frecuencia en población consultante): la prematurez, ser de sexo masculino, tener una madre con baja escolaridad, hospitalizaciones tempranas y enfermedades médicas antes de los 3 años (todos con odds ratio significativa). Además tener una madre psiquiátrica aumenta el doble el riesgo de desarrollar trastorno del desarrollo.ConclusiónSe requiere un trabajo colaborativo interdisciplinario entre neonatólogos, obstetras, psiquiatras infantiles y la atención primaria para detectar precozmente niños en riesgo.AbstractObjectivesTo study possible findings of factors in the antenatal, perinatal or postnatal period, in the mother or the child that may have an influence on the appearance of a developmental disorder.Patients and methodA Data Base of Clinical Histories from every patient with a developmental disorder (F80-F90 ICD10) was created. The patients attended the Child Psychiatric Unit at Hospital Regional of Valdivia, Chile, from August 2006 to December 2008. Total: 493 patientes (48.7% of the total of patients consulting); Control group: 32 healthy patients. Statistical method: odds ratio (95% confidence).ResultsThe main risk factors for developing a developmental disorder (P<.005, 25% frequency in the consulting population) are: prematurity, male sex, mother with low education, early hospitalizations, and medical illnesses (all with a significant odds ratio). Also, having a mother with psychiatric illness doubles the risk of having a developmental disorder.ConclusionIt requires an interdisciplinary collaborative work between neonatologists, obstetricians, child psychiatrists and the primary care to detect early children at risk

Assessing population-sampling strategies for reducing the COVID-19 incidence

As long as critical levels of vaccination have not been reached to ensure heard immunity, and new SARS-CoV-2 strains are developing, the only realistic way to reduce the infection speed in a population is to track the infected individuals before they pass on the virus. Testing the population via sampling has shown good results in slowing the epidemic spread. Sampling can be implemented at different times during the epidemic and may be done either per individual or for combined groups of people at a time. The work we present here makes two main contributions. We first extend and refine our scalable agent-based COVID-19 simulator to incorporate an improved socio-demographic model which considers professions, as well as a more realistic population mixing model based on contact matrices per country. These extensions are necessary to develop and test various sampling strategies in a scenario including the 62 largest cities in Spain; this is our second contribution. As part of the evaluation, we also analyze the impact of different parameters, such as testing frequency, quarantine time, percentage of quarantine breakers, or group testing, on sampling efficacy. Our results show that the most effective strategies are pooling, rapid antigen test campaigns, and requiring negative testing for access to public areas. The effectiveness of all these strategies can be greatly increased by reducing the number of contacts for infected individual.This work has been supported by the Carlos III Institute of Health under the project grant 2020/00183/001, the project grant BCV-2021-1-0011, of the Spanish Supercomputing Network (RES) and the European Union's Horizon 2020 JTI-EuroHPC research and innovation program under grant agreement No 956748. The role of all study sponsors was limited to financial support and did not imply participation of any kind in the study and collection, analysis, and interpretation of data, nor in the writing of the manuscript.S

Efeito da dietílnitrosamína, associada ou não a fenobarbital e diazepam, sobre fígado de gerbil (Meriones unguiculatus)

Foram estudadas as alterações hepáticas induzidas quimicamente em gerbil, através de tratamento crônico com dietilnitrosamina subcutânea, associada ou não a fenobarbital oral e diazepam intraperitoneal. As observações foram realizadas a partir da 25ª semana, quando o tratamento foi suspenso, até a 50ª semana. A dietilnitrosamina exerceu efeito hematotóxico acentuado, evidenciado por citomegalia, necrose multifocal, proliferação ductular e fibrose. Este diminuiu intensamente com a administração simultânea de fenobarbital, mas o mesmo não aconteceu com a administração concomitante de diazepam. O tratamento concomitante de fenobarbital não anulou a ação carcinogênica da dietilnitrosamina, e a partir da 36ª semana ocorreram hepatocarcinomas, predominando o padrão trabecular; Já o diazepam parece ter diminuído o efeito hepatocarcinógeno e na 50ª semana registraram-se apenas lesões pré-neoplásicas

Spatiotemporal trends of cutaneous leishmaniasis in Costa Rica.

BACKGROUND: Cutaneous leishmaniasis (CL) remains an important neglected tropical disease in Costa Rica, which has one of the largest burdens of this disease in Latin America. METHODS: We identified district-level hotspots of CL from 2006 to 2017 and conducted temporal analysis to identify where hotspots were increasing across the country. RESULTS: Clear patterns of CL risk were detected, with persistent hotspots located in the Caribbean region, where risk was also found to be increasing over time in some areas. CONCLUSIONS: We identify spatiotemporal hotspots, which may be used in support of the leishmaniasis plan of action for the Americas

Dietary Fat Patterns and Outcomes in Acute Pancreatitis in Spain

Background/Objective: Evidence from basic and clinical studies suggests that unsaturated fatty acids (UFAs) might be relevant mediators of the development of complications in acute pancreatitis (AP). Objective: The aim of this study was to analyze outcomes in patients with AP from regions in Spain with different patterns of dietary fat intake. Materials and Methods: A retrospective analysis was performed with data from 1,655 patients with AP from a Spanish prospective cohort study and regional nutritional data from a Spanish cross-sectional study. Nutritional data considered in the study concern the total lipid consumption, detailing total saturated fatty acids, UFAs and monounsaturated fatty acids (MUFAs) consumption derived from regional data and not from the patient prospective cohort. Two multivariable analysis models were used: (1) a model with the Charlson comorbidity index, sex, alcoholic etiology, and recurrent AP; (2) a model that included these variables plus obesity. Results: In multivariable analysis, patients from regions with high UFA intake had a significantly increased frequency of local complications, persistent organ failure (POF), mortality, and moderate-to-severe disease in the model without obesity and a higher frequency of POF in the model with obesity. Patients from regions with high MUFA intake had significantly more local complications and moderate-to-severe disease; this significance remained for moderate-to-severe disease when obesity was added to the model. Conclusions: Differences in dietary fat patterns could be associated with different outcomes in AP, and dietary fat patterns may be a pre-morbid factor that determines the severity of AP. UFAs, and particulary MUFAs, may influence the pathogenesis of the severity of AP

Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients.

Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB

HCN emission from translucent gas and UV-illuminated cloud edges revealed by wide-field IRAM 30m maps of Orion B GMC: Revisiting its role as tracer of the dense gas reservoir for star formation

We present 5 deg^2 (~250 pc^2) HCN, HNC, HCO+, and CO J=1-0 maps of the Orion B GMC, complemented with existing wide-field [CI] 492 GHz maps, as well as new pointed observations of rotationally excited HCN, HNC, H13CN, and HN13C lines. We detect anomalous HCN J=1-0 hyperfine structure line emission almost everywhere in the cloud. About 70% of the total HCN J=1-0 luminosity arises from gas at A_V < 8 mag. The HCN/CO J=1-0 line intensity ratio shows a bimodal behavior with an inflection point at A_V < 3 mag typical of translucent gas and UV-illuminated cloud edges. We find that most of the HCN J=1-0 emission arises from extended gas with n(H2) < 10^4 cm^-3, even lower density gas if the ionization fraction is > 10^-5 and electron excitation dominates. This result explains the low-A_V branch of the HCN/CO J=1-0 intensity ratio distribution. Indeed, the highest HCN/CO ratios (~0.1) at A_V < 3 mag correspond to regions of high [CI] 492 GHz/CO J=1-0 intensity ratios (>1) characteristic of low-density PDRs. Enhanced FUV radiation favors the formation and excitation of HCN on large scales, not only in dense star-forming clumps. The low surface brightness HCN and HCO+ J=1-0 emission scale with I_FIR (a proxy of the stellar FUV radiation field) in a similar way. Together with CO J=1-0, these lines respond to increasing I_FIR up to G0~20. On the other hand, the bright HCN J=1-0 emission from dense gas in star-forming clumps weakly responds to I_FIR once the FUV radiation field becomes too intense (G0>1500). The different power law scalings (produced by different chemistries, densities, and line excitation regimes) in a single but spatially resolved GMC resemble the variety of Kennicutt-Schmidt law indexes found in galaxy averages. As a corollary for extragalactic studies, we conclude that high HCN/CO J=1-0 line intensity ratios do not always imply the presence of dense gas.Comment: accepted for publication in A&A. 24 pages, 18 figures, plus Appendix. Abridged Abstract. English language not edite