Educative Intervention for parents or Tutors of asthmatic children

Foundation: in Cuba, bronchial asthma constitutes an important health problem with relevant incidence in children. Parent´s knowledge about its management results essential. Objective: to apply a program of educative intervention to increase the level of information of parents and children. Methods: intervention study developed from May 2016, in doctor´s office 8 Cumanayagua. All parents whose children had been diagnosed bronchial asthma in ages from 0 to 15 were included. A diagnosis was realized to identify the level of information about the management of bronchial asthma and on those bases four educative topics were prepared to be taught to parents. After the intervention it was it was checked the level of assimilation. The variables measured were age and sex of the children, knowledge of parents about symptom identification, management and measures for its prevention, precipitating factors. Results: the male sex predominated among children (72%) and ages from 5-9 (54,6%). Initial diagnosis showed that parents and tutors had a low level of information about bronchial asthma, 63, 5 % was evaluated poor or low. The biggest gaps were on the prodromal symptoms of asthma (63, 64 % low), figures that were reduced to 9% and 0% respectively after the intervention. Precipitating factors for crisis mostly identified were tobacco smoke, respiratory infections, climate changes and the least known emotional experiences. A high knowledge of preventive measures was elevated from 9.09% to 81,82 % after the intervention. Educative actions increased the percentage of those evaluated good in knowledge which went up to 81,82 %. Conclusion: not all parents of asthmatic children have adequate knowledge about the management of their children, which may be modified by applying strategies to educate them

PrimerCongreso Internacional de Enfermedades Crónico Degenerativas y de Rezago

Verificar como influyen los factores socioeconómicos culturales en el control metabólico del paciente con diabetes mellitus de manera parcial o determinante.La diabetes es una enfermedad crónica con un impacto importante en la vida del sujeto siendo la enfermedad que concentra mayor volumen de recursos económicos del sector salud

Changes in the requirement for early surgery in inflammatory bowel disease in the era of biological agents

This is the peer reviewed version of the following article: Changes in the requirement for early surgery in inflammatory bowel disease in the era of biological agents. Journal of Gastroenterology and Hepatology (2020): 29 April, which has been published in final form at https://doi.org/10.1111/jgh.15084. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsBiological therapies may be changing the natural history of inflammatory bowel diseases, reducing the need for surgical intervention. We aimed to assess whether the availability of anti‐TNF agents impacts the need for early surgery in Crohn's disease (CD) and ulcerative colitis (UC). Methods Retrospective, cohort study of patients diagnosed within a 6‐year period before and after the licensing of anti‐TNFs (1990‐1995 and 2007‐2012 for CD; 1995‐2000 and 2007‐2012 for UC) were identified in the ENEIDA Registry. Surgery‐free survival curves were compared between cohorts. Results A total of 7,370 CD patients (2,022 in Cohort 1 and 5,348 in Cohort 2) and 8,069 UC patients (2,938 in Cohort 1 and 5,131 in Cohort 2) were included. Immunosuppressants were used significantly earlier and more frequently in both CD and UC post‐biological cohorts. The cumulative probability of surgery was lower in CD following anti‐TNF approval (16% and 11%, 22% and 16%, and 29% and 19%, at 1, 3 and 5 years, respectively p<0.0001), though not in UC (3% and 2%, 4% and 4%, and 6% and 5% at 1, 3 and 5 years, respectively; p=0.2). Ileal involvement, older age at diagnosis and active smoking in CD, and extensive disease in UC, were independent risk factors for surgery, whereas high‐volume IBD centres (in both CD and UC) and immunosuppressant use (in CD) were protective factors. Conclusions Anti‐TNF availability was associated with a reduction in early surgery for CD (driven mainly by earlier and more widespread immunosuppressant use) but not in U

Multiplicación de Ipomoea batatas clon ‘INIVITB2-2005’ en Sistema de Inmersión Temporal

Use of temporary immersion system (TIS) have been not reported for in vitro culture of Ipomoea batatas . This technique would help to increase the number of plants needed for in vitro mass propagation of clone ‘INIVITB2-2005’ with great productive potential. The aim of this paper was to multiply this clone in TIS of 200 ml capacity. Influence of immersion time, frequency of immersion, volume of culture medium per explant and subculture time on growth and multiplication of in vitro plants in TIS was determined. Length of explants (cm) was measured. Number of internodes per explant and number of active leaves was quantified . Fresh mass (g) of in vitro plants and multiplication coefficient was also determined . The best results were achieved with an immersion frequency of 10 minutes every three hours, using 15 ml of culture medium per explant and subcultures every 30 days. A multiplication coefficient of 8.01was reached.Keywords: multiplication coefficient, immersion frequency, subculture timePara el cultivo in vitro de Ipomoea batatas no se tienen referencias del uso de los Sistemas de Inmersión Temporal (SIT), esto podrían contribuir a incrementar el número de plantas in vitro necesarias para la propagación masiva del clon ‘INIVITB2-2005’ con gran potencial productivo. El objetivo del trabajo fue multiplicar este clon en SIT de 200 ml de capacidad. Se determinó la influencia del tiempo de inmersión, la frecuencia de inmersión, el volumen de medio de cultivo por explante y el tiempo de subcultivo sobre el crecimiento y multiplicación de las plantas in vitro en los SIT. En cada experimento se midió la longitud del explante (cm) y se cuantificó el número de entrenudos por explante y el número de hojas activas. Además, se determinó la masa fresca (g) de las plantas in vitro y se calculó el coeficiente de multiplicación. Los mejores resultados se alcanzaron al utilizar un tiempo y una frecuencia de inmersión de 10 minutos cada tres horas, 15 ml de medio de cultivo por explante con subcultivos cada 30 días. Con ello se alcanzó un coeficiente de multiplicación de 8.01.Palabras clave: coeficiente de multiplicación, frecuencia de Inmersión, tiempo de subcultiv

Influencia de reguladores e inhibidores del crecimiento en la multiplicación de brotes axilares del cultivar híbrido ‘FHIA-21’ (AAAB) en Sistema de Inmersión Temporal

This work was carried out at the Plant Biotechnology Laboratory from the Instituto de Investigaciones en Viandas Tropicales (INIVIT) in order to determine the culture medium for the multiplication of hybrid ‘FHIA–21’ (AAAB) in Temporary Immersion Systems. Different combinations of growth regulators and growth inhibitors (6-BAP, IAA and PBZ) were studied. Results permitted to determinate the effect of 6-benzil-amino-purine (6-BAP), Indol Acetic Acid (AIA) and Paclobutrazol (PBZ) for multiplication of hybrid ‘FHIA–21’ (AAAB) in the Temporary Immersion System, which involved supplemented MS salts with 2.0 mg.l-1 6-BAP; 0.65 mg.l-1 IAA and 10.0 mg.l-1 ascorbic acid; as well as, 1.0 mg.l-1 paclobutrazol. A decrease of unnecessary growing of shoots and leaves from sprouts in the multiplication phase and a greater sprout number per inoculated explant without multibuds and hyperhydricity were achieved. The Temporary Immersion System allowed to increase the number of axillary sprouts by micropropagation of hybrid ´FHIA-21´ (AAAB) and a higher quality of in vitro plants.Key words: multiplication coefficient, micropropagation, paclobutrazolEl trabajo fue desarrollado en el Laboratorio de Biotecnología Vegetal del Instituto de Investigaciones en Viandas Tropicales (INIVIT) con el objetivo de determinar el medio de cultivo para la multiplicación en sistema de inmersión temporal (SIT) del cultivar híbrido ‘FHIA-21’ (AAAB). Se estudiaron diferentes combinaciones de reguladores y un inhibidor del crecimiento: 6-Bencilaminopurina (6-BAP), Ácido indolacético (AIA) y el Paclobutrazol (PBZ). Los resultados permitieron la multiplicación del cultivar híbrido ‘FHIA-21’ (AAAB) en el sistema de inmersión temporal con un medio de cultivo compuesto por las sales Murashige y Skoog (MS), 2.0 mg.l-1 de 6-BAP; 0.65 mg.l-1 de AIA; 10.0 mg.l-1 de ácido ascórbico y 1.0 mg.l-1 de paclobutrazol. Se logró disminuir el crecimiento innecesario de los brotes en la fase de multiplicación y se alcanzó un mayor número de brotes obtenidos por explantes inoculados sin la presencia de multiyemas ni síntomas de hiperhidricidad. Estos resultados utilizando el Sistema de Inmersión Temporal permitieron incrementar el número de brotes axilares del cultivar híbrido ‘FHIA-21’ (AAAB) así como la calidad de las plantas.Palabras clave: coeficiente de multiplicación, micropropagación, paclobutrazo

Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU

(1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-gamma-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18-20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50-0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66-0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20-22%] vs. 14% [95% CI 13-16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM

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

Multiplicación in vitro de ‘FHIA-25’ (Musa spp., AAB) en Sistemas de Inmersión Temporal

Necessity to produce high quality planting material has required searching new alternatives to increase the efficiency of in vitro propagation methods and their automation, as in Temporary Immersion Systems (TIS). This work was aimed to multiply the hybrid ‘FHIA-25’ (Musa spp. AAB) in TIS. The effect of different culture medium volumes per explant and densities of planting materials per culture flask at the same immersion frequency was determined. These two factors showed influence on the evaluated variables. A volume of 40 ml of culture medium per explant and densities of 80 explants per flask were selected to multiply this cultivar in TIS. These results permitted to increase in vitro production of high-quality plants for rooting stage.Key words: multiplication coefficient, culture flasks, liquid culture mediumLa necesidad de producir material vegetal de plantación de alta calidad, ha requerido de la búsqueda de alternativas que garanticen el incremento de la eficiencia en los métodos de propagación in vitro y su automatización, como el uso del Sistema de Inmersión Temporal (SIT). El presente trabajo fue desarrollado con el objetivo de multiplicar en SIT cultivar híbrido ‘FHIA-25’ (Musa spp., AAB). Se determinó el efecto de diferentes volúmenes de medio de cultivo por explante y densidades de material vegetal por frasco de cultivo a una misma frecuencia de inmersión. Se comprobó que estos dos factores tuvieron influencia sobre las variables evaluadas. Se seleccionaron 40 ml de volumen de medio de cultivo por explante y una densidad de 80 explantes/frasco para multiplicar este cultivar en SIT. Estos resultados permitieron incrementar la producción de plantas in vitro de mayor calidad para la fase de enraizamiento.Palabras clave: coeficiente de multiplicación, frasco de cultivo, medio de cultivo líquid