Respiratory viruses detected in Mexican children younger than 5 years old with community-acquired pneumonia: a national multicenter study

Background: Acute respiratory infections are the leading cause of mortality in children worldwide, especially in developing countries. Pneumonia accounts for 16% of all deaths of children under 5 years of age and was the cause of death of 935 000 children in 2015. Despite its frequency and severity, information regarding its etiology is limited. The aim of this study was to identify respiratory viruses associated with community-acquired pneumonia (CAP) in children younger than 5 years old. Methods: One thousand four hundred and four children younger than 5 years of age with a clinical and/or radiological diagnosis of CAP in 11 hospitals in Mexico were included. Nasal washes were collected, placed in viral medium, and frozen at �70 C until processing. The first 832 samples were processed using the multiplex Bio-Plex/Luminex system and the remaining 572 samples using the Anyplex multiplex RT-PCR. Clinical data regarding diagnosis, clinical signs and symptoms, radiographic pattern, and risk factors were obtained and recorded. Results: Of the samples tested, 81.6% were positive for viruses. Respiratory syncytial virus (types A and B) was found in 23.7%, human enterovirus/rhinovirus in 16.6%, metapneumovirus in 5.7%, parainfluenza virus (types 1–4) in 5.5%, influenza virus (types A and B) in 3.6%, adenovirus in 2.2%, coronavirus (NL63, OC43, 229E, and HKU1) in 2.2%, and bocavirus in 0.4%. Co-infection with two or more viruses was present in 22.1%; 18.4% of the samples were negative. Using biomass for cooking, daycare attendance, absence of breastfeeding, and co-infections were found to be statistically significant risk factors for the presence of severe pneumonia. Conclusions: Respiratory syncytial virus (types A and B), human enterovirus/rhinovirus, and metapneumovirus were the respiratory viruses identified most frequently in children younger than 5 years old with CAP. Co-infection was present in an important proportion of the children

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Resurgimiento de enfermedad hemorrágica del recién nacido: Implicaciones para su prevención

Objetivo. Describir la experiencia con enfermedad hemorrágica del recién nacido en un hospital pediátrico del tercer nivel de atención. Material y métodos. Estudio retrospectivo efectuado en el Hospital del Niño Morelense de la ciudad de Cuernavaca, estado de Morelos, México, durante el periodo 1997-2000, con una muestra de 46 neonatos, afectados de enfermedad hemorrágica del recién nacido (EHRN), referidos de poblaciones de la periferia del estado. Resultados. De los pacientes, 91% presentó la forma tardía grave de EHRN. El 52% de los partos fueron atendidos por médico y 48% por parteras. Se desconoce aplicación de vitamina K en 61%, en 35% no fue aplicada y en 4% sí se aplicó. La mayoría presentó sintomatología severa secundaria a hemorragia intracraneana. Hubo defunción en 11% y secuelas severas en 41%. Conclusiones. La EHRN es un problema frecuente en el estado de Morelos y, por ello, se requiere analizar los programas de salud reproductiva e intensificar la capacitación de médicos y enfermeras sobre la prevención de ésta mediante el uso de vitamina K

Resurgimiento de enfermedad hemorrágica del recién nacido: Implicaciones para su prevención Is the hemorrhagic disease of the newborn re-emerging?: Issues related to its prevention

Objetivo. Describir la experiencia con enfermedad hemorrágica del recién nacido en un hospital pediátrico del tercer nivel de atención. Material y métodos. Estudio retrospectivo efectuado en el Hospital del Niño Morelense de la ciudad de Cuernavaca, estado de Morelos, México, durante el periodo 1997-2000, con una muestra de 46 neonatos, afectados de enfermedad hemorrágica del recién nacido (EHRN), referidos de poblaciones de la periferia del estado. Resultados. De los pacientes, 91% presentó la forma tardía grave de EHRN. El 52% de los partos fueron atendidos por médico y 48% por parteras. Se desconoce aplicación de vitamina K en 61%, en 35% no fue aplicada y en 4% sí se aplicó. La mayoría presentó sintomatología severa secundaria a hemorragia intracraneana. Hubo defunción en 11% y secuelas severas en 41%. Conclusiones. La EHRN es un problema frecuente en el estado de Morelos y, por ello, se requiere analizar los programas de salud reproductiva e intensificar la capacitación de médicos y enfermeras sobre la prevención de ésta mediante el uso de vitamina K.Objective. To describe the occurrence of hemorrhagic disease of the newborn (HDN) at a tertiary care pediatric hospital of Morelos state. Material and Methods. A retrospective case series study was conducted between 1997-2000 at Hospital del Niño Morelense (Morelos State Children's Hospital), in 46 newborns aged under 12 weeks. Study subjects were referred from peripheral units with a diagnosis of HDN. Results. The severe late-onset form of HDN was present in 91% of the cases. Fifty-two percent of childbirths were assisted by a physician and 48% by an empiric midwife. Application of vitamin K was unknown in 61% of cases, in 39% it was not applied and in 4% it was applied. The majority of infants presented severe symptoms due to intra-cranial bleeding, 11% died, and 41% had severe disease sequelae. Conclusions. Given the high prevalence of HDN in the State of Morelos, reproductive health programs should be reviewed and training programs intensified to promote the utilization of vitamin K by physicians and nurses for preventing this disease

Violencia doméstica y riesgo de conducta suicida en universitarios adolescentes Domestic violence and risk of suicidal behavior among university students

OBJETIVO: Estimar el grado de asociación entre violencia doméstica física, verbal y sexual con la conducta suicida en adolescentes universitarios. MATERIAL Y MÉTODOS: Estudio de casos y controles pareado en estudiantes universitarios de Colima. Los casos fueron 235 adolescentes que presentaron tanto ideación suicida como intento suicida; los controles fueron 470 individuos de la misma edad y sexo. RESULTADOS: El abuso sexual mostró el mayor grado de asociación con conducta suicida (RM= 27.4), seguido de violencia verbal (RM= 9.28), uso de drogas (RM= 8.6), violencia física (RM= 5.5) y tabaquismo (RM= 3.6). La regresión logística multivariada mostró que la violencia verbal se asoció con conducta suicida en forma independiente, mientras que violencia física, abuso sexual, tabaquismo y uso de drogas parecen depender de aquella. CONCLUSIONES: La violencia intrafamiliar, particularmente la verbal, está fuertemente asociada con la conducta suicida en adolescentes y debe ser considerada dentro de programas preventivos contra suicidio.<br>OBJECTIVE: To estimate the degree of association between domestic violence -physical, verbal or sexual- with suicidal behavior among university students. MATERIAL AND METHODS: A matched case-control study was done with students attending the University of Colima, Mexico. The cases were 235 teenagers who presented both suicidal ideation and suicide attempt; the controls were 470 individuals of the same age and sex. RESULTS: Sexual abuse showed the highest degree of association with suicidal behavior (OR= 27.4), followed by verbal violence (OR= 9.28), drug use (OR= 8.6), physical violence (OR= 5.5) and smoking (OR= 3.6). Multivariate logistic regression showed that verbal violence was associated with suicidal behavior independently of the other variables, while physical violence, sexual abuse, smoking and drug use seem to depend on verbal violence. CONCLUSIONS: Domestic violence, particularly verbal or sexual, is strongly associated with suicidal behavior in adolescents and should be considered in suicide prevention programs