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Background: There is little study of lifetime trauma exposure among individuals engaged in medication treatment for opioid use disorder (MOUD). A multisite study provided the opportunity to examine the prevalence of lifetime trauma and differences by gender, PTSD status, and chronic pain., Methods: A cross-sectional study examined baseline data from participants (N = 303) enrolled in a randomized controlled trial of a mind-body intervention as an adjunct to MOUD. All participants were stabilized on MOUD. Measures included the Trauma Life Events Questionnaire (TLEQ), the Brief Pain Inventory (BPI), and the Posttraumatic Stress Disorder Checklist (PCL-5). Analyses involved descriptive statistics, independent sample t-tests, and linear and logistic regression., Results: Participants were self-identified as women (n = 157), men (n = 144), and non-binary (n = 2). Fifty-seven percent (n = 172) self-reported chronic pain, and 41% (n = 124) scored above the screening cut-off for PTSD. Women reported significantly more intimate partner violence (85%) vs 73%) and adult sexual assault (57% vs 13%), while men reported more physical assault (81% vs 61%) and witnessing trauma (66% vs 48%). Men and women experienced substantial childhood physical abuse, witnessed intimate partner violence as children, and reported an equivalent exposure to accidents as adults. The number of traumatic events predicted PTSD symptom severity and PTSD diagnostic status. Participants with chronic pain, compared to those without chronic pain, had significantly more traumatic events in childhood (85% vs 75%)., Conclusion: The study found a high prevalence of lifetime trauma among people in MOUD. Results highlight the need for comprehensive assessment and mental health services to address trauma among those in MOUD treatment., Trial Registration: NCT04082637., (© 2024. The Author(s).)

The study of Adverse Childhood Experiences (ACEs) has consistently demonstrated a strong relationship with poor behavioral health outcomes. Further research is needed to understand if a specific ACE, or subcategorizations of ACEs, matter more for behavioral health outcomes. A study of the association between ACEs and problem gambling involving a racially mixed sample (13,217 participants) in New Mexico is presented to illustrate how certain ACEs may have a larger impact on behavioral health outcomes. The researchers examined: 1.) the impact that each individual ACE have on participant's reported problem gambling; 2) which group (abuse or household challenges) had a greater odds ratio and marginal impact on participant's self-reported gambling; and 3) which BRFSS subcategories (emotional abuse, physical abuse, sexual abuse, IPV, substance abuse, mental illness, parental separation or divorce, and incarcerated household member) had a greater odds ratio and marginal impact on participant's self-reported gambling. The results of this study indicate ACEs had a significant influence on problem gambling, and data suggests that when BRFSS data is examined in groups or subcategories there is a difference in the influence that ACEs have on problem gambling. In particular, we found that odds ratio to be significant when participants reported mental health problems in the home (OR = 1.34, 95% CI [1.02, 1.76], p < 0.04), living with incarcerated household members (OR = 1.75, 95% CI [1.28, 2.41], p < 0.001), how often adults hit each other (OR = 1.29, 95% CI [1.10, 1.52], p < 0.001), and how often anyone at least 5 years older than them forced them to have sex (OR = 1.42, 95% CI [1.10, 1.82], p < 0.01) In relation to types of abuse, There was a significant difference in self-reported problem gambling for individuals who reported sexual abuse (OR = 1.64, 95% CI [1.10, 2.46], p < 0.016), as well as participants reporting living with an incarcerated household member (OR = 2.08, 95% CI [1.34, 3.22], p < 0.001); approaching significant results also included individuals who witnessed their parents act violent towards one another (OR = 1.52, 95% CI [.99, 2.33], p < 0.055), and having parents who were separated or divorced (OR = 0.68, 95% CI [0.46, 1.00], p < 0.053). Finally, there was a significant difference in self-reported problem gambling for individuals who reported abuse (OR = 1.36, 95% CI [1.11, 1.66], p < 0.003), while participants reporting household challenges did not quite reach statistical significance (OR = 1.49, 95% CI [0.99, 1.33], p < 0.062. These findings show us that the way we ask questions about the precedence and outcomes of risky behavior matter and warrant further attention., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Breast milk is a complex and dynamic biological fluid and considered an essential source of nutrition in early life. In its composition, the proteins have a relevant biological activity and are related to the multiple benefits demonstrated when compared with artificial milks derived from cow's milk. Understanding human milk composition provides an important tool for health care providers toward the management of infant feeding and the establishment of breastfeeding. In this work, a new technique was developed to increase the knowledge of human milk, because many of the components remain unknown. To isolate minor proteins present in breast milk by using WGA lectin, breast milk was centrifuged to remove cells and separate the fat phase from the serum phase. The serum obtained was separated into two groups: control ( n = 3; whole serum sample from mature milk) and WGA lectin ( n = 3; sample processed with WGA lectin to isolate glycosylated proteins). The samples were analyzed by high-performance liquid chromatography coupled to mass spectrometry (HPLC/MS). A total of 84 different proteins were identified from all of the samples. In the WGA lectin group, 55 different proteins were isolated, 77% of which had biological functions related to the immune response. Of these proteins, there were eight WGA lectin group exclusives, and two had not previously been described in breast milk (polyubiquitin-B and POTE ankyrin domain family member F). Isolation by WGA lectin is a useful technique to detect minor proteins in breast milk and to identify proteins that could not be observed in whole serum.

We designed and validated a test system that simulates a growth environment for  Zea mays L. maize seedlings under conditions of low moisture gradient in darkness. This system allowed us to simultaneously measure mesocotyl elongation and the primary root hydrotropic response in seedlings before the emergence phase in a collection of maize hybrids. We found great variation in these two traits with statistically significant reduction of their elongations under the low moisture gradient condition that indicate the richness of maize genetic diversity. Hence, the objective of designing a new test system that evaluates the association between these underground traits with the potential use to measure other traits in maize seedlings related to early vigor was achieved.

Objective: The aim of this study was to evaluate periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults., Methods: A total of 1159 adults aged 65 to 80 years and diagnosed with periodontal disease and CKD (stages 1, 2, and 3) were randomly selected for a cross-sectional study. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) and CKD was staged using the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines., Results: In patients with stage 1 CKD, the odds ratios (ORs) (95% confidence intervals [CIs]) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.13 (0.83-1.55), 1.47 (1.13-1.81), 1, and 1, respectively. In patients with stage 2 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.49 (1.14-1.93), 1.37 (1.02-1.78), 3.07 (2.81-3.25), and 3.65 (3.49-3.71), respectively. In patients with stage 3 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1, 1, 4.61 (4.47-5.21), and 5.23 (5.14-5.47), respectively., Conclusion: The highest CPITN values (CPITN-3 and CPITN-4) were associated with CKD stages 2 and 3. Thus, periodontal disease may be associated with progression of CKD.

Maize illustrates one of the most complex cases of embryogenesis in higher plants that results in the development of early embryo with distinctive organs such as the mesocotyl, seminal and primary roots, coleoptile, and plumule. After seed germination, the elongation of root and mesocotyl follows opposite directions in response to specific tropisms (positive and negative gravitropism and hydrotropism). Tropisms represent the differential growth of an organ directed toward several stimuli. Although the life cycle of roots and mesocotyl takes place in darkness, their growth and functions are controlled by different mechanisms. Roots ramify through the soil following the direction of the gravity vector, spreading their tips into new territories looking for water; when water availability is low, the root hydrotropic response is triggered toward the zone with higher moisture. Nonetheless, there is a high range of hydrotropic curvatures (angles) in maize. The processes that control root hydrotropism and mesocotyl elongation remain unclear; however, they are influenced by genetic and environmental cues to guide their growth for optimizing early seedling vigor. Roots and mesocotyls are crucial for the establishment, growth, and development of the plant since both help to forage water in the soil. Mesocotyl elongation is associated with an ancient agriculture practice known as deep planting. This tradition takes advantage of residual soil humidity and continues to be used in semiarid regions of Mexico and USA. Due to the genetic diversity of maize, some lines have developed long mesocotyls capable of deep planting while others are unable to do it. Hence, the genetic and phenetic interaction of maize lines with a robust hydrotropic response and higher mesocotyl elongation in response to water scarcity in time of global heating might be used for developing more resilient maize plants.

Introduction and Objectives: Mental disorders are very prevalent in the general population. Despite this, it is estimated that only about a third of the people affected is able to recognise problems on their own and to access health services. The aim was to determine the factors associated with the lack of self-recognition of mental problems and disorders in the Colombian population., Methods: The National Mental Health Survey (ENSM-2015) conducted in Colombia identified adults over 18 years that answered "yes' to the question 'Have you had a mental problem or disorder?', had a positive score in mental disorders measured by the Composite International Diagnostic Interview (CIDI) 3.0, or in mental problems detected by the SRQ-20. A bivariate analysis, as well as a logistic regression, were performed with possible related variables., Results: A sample of 10, 870 adults was obtained, of whom 12.25% (1,332) had mental disorders and 30.2% (3282) had mental problems. Of those individuals with disorders and problems, 7.9% recognised themselves as affected. The variables associated with self-recognition of disorders or problems were, among others: being female (OR=1.8; 95%CI, 1.4-2.3), family dysfunction (OR=1.5; 95%CI, 1.2-2.0), to have experienced a traumatic event (OR=1.8; 95%CI, 1.4-2.2), illegal substance consumption (OR=0.5; 95%CI, 0.4-0.7), not being poor (OR=1.9; 95%CI, 1.2-3.0), and having chronic illnesses (OR=1.6; 95%CI, 1.3-2.1)., Conclusions: Self-recognition is of great relevance to improve access to care by adults. The results provide associated variables that allow planning interventions that can promote the recognition of mental problems or disorders in this population., (Copyright © 2020. Publicado por Elsevier España, S.L.U.)

Introduction: The study of mental disorders in people with chronic conditions recognises the importance of actively seeking and treating both, since chronic conditions have a higher prevalence than mental disorders and their comorbidity generates greater burden than if each one was considered separately., Objectives: To measure the prevalence of mood disorders and anxiety in a Colombian population of 12 years and older and with and without different chronic conditions., Methods: The information is taken from the National Mental Health Survey 2015 in Colombia, which was an observational cross-sectional study with national representativeness for the age groups measured 12-17, 18-44, and 45 and older. Disorders measured where mood disorders and anxiety social phobia, generalised anxiety disorder, and panic disorder in the past 12 months, and several chronic conditions. Univariate and bivariate analyses were performed for these conditions., Results: The highest prevalence of mood and anxiety disorders were found in people with gastrointestinal diseases, followed by those with chronic pain, heart, and lung diseases, which corresponded to 27.1%, 13.3%, 12.2%, and 11.5%, respectively, in those between 18 and 44 years old, and 15.9%, 12.2%, 8.0%, and 7.4% of those 45 and older, respectively. This was greater than the prevalence of these mental disorders in people with no chronic condition, where the prevalence is 3.5% in the younger, and 1.1% in the older group. However, the risk of these mental disorders is higher in older people. Thus, in those with gastrointestinal diseases when compared to people of the same age without any chronic condition the prevalence is 14.9 times higher, but for the same disease in the younger group it is 7.8., Conclusions: These findings link chronic conditions with a higher prevalence of mental disorders, which in the present study also highlights the greater comorbidity of mood and anxiety disorders in the elderly., (Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

As two lineages diverge from one another, mitochondrial DNA should evolve fixed differences more rapidly than nuclear DNA due to its smaller effective population size and faster mutation rate. As a consequence, molecular systematists have focused on the criteria of reciprocal monophyly in mitochondrial DNA for delimiting species boundaries. However, mitochondrial gene trees do not necessarily reflect the evolutionary history of the taxa in question, and even mitochondrial loci are not expected to be reciprocally monophyletic when the speciation event happened very recently. The goal of this study was to examine mitochondrial paraphyly within the Orchard Oriole complex, which is composed of Icterus spurius (Orchard Oriole) and Icterus fuertesi (Fuertes' Oriole). We increased the geographic sampling, added four nuclear loci, and used a range of population genetic and coalescent methods to examine the divergence between the taxa. With increased taxon sampling, we found evidence of clear structure between the taxa for mitochondrial DNA. However, nuclear loci showed little evidence of population structure, indicating a very recent divergence between I. spurius and I. fuertesi. Another goal was to examine the genetic variation within each taxon to look for evidence of a past founder event within the I. fuertesi lineage. Based on the high amounts of genetic variation for all nuclear loci, we found no evidence of such an event - thus, we found no support for the possible founding of I. fuertesi through a change in migratory behavior, followed by peripheral isolates speciation. Our results demonstrate that these two taxa are in the earliest stages of speciation, at a point when they have fixed differences in plumage color that are not reflected in monophyly of the mitochondrial or nuclear DNA markers in this study. This very recent divergence makes them ideal for continued studies of species boundaries and the earliest stages of speciation.

Background: There are multiple factors associated with suicide in elderly people and include, among others, depression, loss of independence, medical comorbidities, not being satisfied with life, or loss of hope., Objective: To describe the prevalence of depression in a representative sample of the population over 60 years old and its associated factors., Methods: A cross-sectional study (Survey of Health, Wellbeing and Aging) was conducted in 2012. A structured questionnaire and the Yesavage depression scale were used in order to complete a descriptive analysis, as well as a chi-squared test of independence., Results: The prevalence of depression was 26.3%. The associated factors are being female, low education, not receiving a pension, hypertension, a diagnosed mental illness, having had hunger in the first 15 years of life, and in the last week, no leisure activities, and worse self-perception of health. People, who are not satisfied with their lives, who do not feel that it is wonderful to live, and those who feel hopeless, are at increased risk of depression., Conclusions: There is a high prevalence of depression, and various factors associated with it, as previously reported in the literature. Poor life satisfaction was shown to be a factor related to depression., (Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)

Objective: To identify the age, sex, mobility, education, work activity, working hours, street dwelling, and social security coverage in a group of children working in the streets in capital cities in Latin America., Material and Methods: Cross sectional study. A questionnaire was applied to 972 children working in the streets of Bogotá, Guatemala City, Mexico City, Quito and San Salvador., Results: A total of 63.3% subjects were boys; 39% were children from displaced families; 18% lived in the streets; 62% worked more than 40 hours per week; 19% were covered by the social security system, and 32% were street vendors. The behavior of variables differed significantly by city., Conclusion: Child labor in the streets is a dangerous activity characterized by long working hours and exposure to risk factors. Child work has different characteristics in each of the cities studied, which suggests that the solution to the problem must be designed on a case by case basis.

Introduction: Certain compounds belonging to the family of the 2-aryl oxazolines have been reported to act on the central nervous system with a number of different effects and applications, which make them useful as depressants, anaesthetics, anticonvulsants, and so on., Aims: Our aim was to study the possible effect of 4,4-bis(hydroxymethyl)-2-phenyl-2-oxazoline (OX), obtained by chemical synthesis using microwaves, in two experimental models of epilepsy., Materials and Methods: Two models were used: one involving (repeated stimulation) electroconvulsive shock in mice and the other consisted in inducing audiogenic seizures in Mongolian gerbils. Recordings were performed of the potentials in the dentate gyrus (DG) generated in response to electrical stimulation of the entorhinal cortex in anaesthetised gerbils, using the stereotactic technique., Results: A 150 mg/kg dose of OX lowered the number of electrical pulses required to induce the tonic seizures triggered by the electroshock, as well as their duration. This same dose blocked the seizures induced by audiogenic stimuli in the gerbils and significantly reduced their severity (degrees of seizures) and occurrence. OX diminished, in a dose-dependent manner, the amplitude of the excitatory post-synaptic potential and that of the population spike, triggered by stimulating the entorhinal cortex in the DG., Conclusions: OX acts as an antiepileptic agent and its mechanism of action could be related to the inhibiting effect it exerts on the entorhinal cortex-DG synapses in the hippocampus.

Expression of hemolytic and proteolytic activities throughout the growth cycle was investigated with two enterotoxic aeromonad strains assigned to the species Aeromonas hydrophila and Aeromonas veronii biovar sobria. Although growth kinetic data were dependent on strain, temperature, and substrate, maximum populations attained were higher than 9 log CFU/ml in aerated tryptone soya broth plus yeast extract (TSBYE) and salmon extract within the range 4 to 28 degrees C. For both strains in TSBYE, variable amounts of hemolytic activity were first detected at any temperature when aeromonad counts were over 9 log CFU/ml. Afterwards, this activity increased up to similar levels (109 to 112 hemolytic units per ml) without a significant increase in populations. Salmon extract supported hemolysin synthesis at 28 but not 4 degrees C. Proteolytic activity of the A. hydrophila strain was only expressed in salmon extract at 28 degrees C, whereas A. veronii biovar sobria did at 28 degrees C in both substrates and at 10 degrees C in TSBYE.

Fifty-four packages (each one belonging to a different lot) of vacuum-packed cold-smoked salmon (30) and trout (24) produced by six Spanish smokehouses were obtained at retail level after 3 weeks storage at 2+/-1 degrees C. Sensorial, chemical, physicochemical and microbiological characteristics were examined. Overall, pH, a(w), salt content in water phase, aerobic plate counts at 30 and 25 degrees C. levels of Enterobacteriaceae, lactic acid bacteria (LAB), fungi and presumptive aeromonads and staphylococci are in agreement with available data on lightly preserved fish products. Psychrotrophic clostridia ranged between 1.71 and 2.21 log CFU/g. Levels of ethanol were highly variable and not significantly related (p > 0.05) to sensory scores or to microbial numbers. Salmonella, Escherichia coli and Listeria monocytogenes were not detected in any sample. Listeriae other than L. monocytogenes were isolated from three packages. Levels of Staphylococcus aureus lower than 4 log CFU/g were also found in three packages. Among 377 bacteria randomly isolated from aerobic 25 degrees C plate counts, LAB predominated, with Carnobacterium (C. piscicola) and Lactobacillus (eight species) being the genera most frequently found. The second and third major groups were Enterobacteriaceae and Micrococcaceae, respectively. Proteus vulgaris, P. mirabilis and Serratia liquefaciens were dominant among Enterobacteriaceae and coagulase-negative staphylococci among Micrococcaceae. Minor microbial groups such as aerobic gram-negative bacilli (Acinetobacter; Moraxella and Pseudomonas), Brochothrix, Aeromonas, Bacillus and Vibrio constituted less than 17% of the total flora.

Twelve lots of fresh unskinned fillets of rainbow trout (Oncorhynchus mykiss) and 10 lots of fresh sliced salmon (Salmo salar) prepacked in trays wrapped with an oxygen-permeable film were obtained immediately after packing from two supermarkets having in-plant facilities for packaging wet fish. During storage at 3 degrees C, Listeria innocua was detected in eight lots of trout fillets after 4 days storage. L. monocytogenes was recovered from a single lot also contaminated with L. innocua. Initial numbers of aeromonads were significantly (p < 0.05) lower in trout fillets (3.35 +/- 0.62 log cfu g(-1)) than in salmon slices (4.20 +/- 0.89 log cfu g(-1)). In both fish products, these bacteria significantly (p < 0.05) increased up until spoilage. Most Aeromonas spp. isolates from trout fillets were assigned to A. veronii biovar sobria HG8 (hybridisation group 8), A. caviae HG4, A. eucrenophila HG6, A. hydrophila HG1 and A. veronii biovar veronii HG10. Strains of HG12 (A. schubertii), HG4 and HG8 formed the majority of aeromonads recovered from salmon slices.

Aims: Development of a PCR assay for detection of aeromonads carrying the hlyA and/or aerA genes in fish., Methods and Results: The protocol involves an overnight selective enrichment step in tryptic soy broth yeast extract containing 10 microg ml(-1) of ampicillin followed by extraction of DNA and PCR amplification of two haemolysin genes that contribute to the virulence of Aer. hydrophila. This procedure can detect initial populations of 1-10 cfu g(-1) within 24 h in artificially contaminated samples. In naturally contaminated fish, both genes were detected in 13 out of 14 fresh fish lots (aeromonads levels between < 1 and 5.42 log cfu g(-1)) and in 4 out of 16 lots of vacuum-packed cold-smoked fish (aeromonads levels between < 1 and 3.37 log cfu g(-1)). Before enrichment, dominant species were Aer. hydrophila HG1 (aerA+hlyA+), Aer. bestiarum HG2 (aerA+hlyA+) and Aer. caviae HG4 (aerA-hlyA-). After enrichment, Aer. hydrophila HG1 (aerA+hlyA+) was dominant., Conclusions: Fresh fish and even smoked fish carry hlyA+ and/or aerA+ aeromonads that can be detected by PCR within 24 h., Significance and Impact of the Study: The PCR assay described offers considerable potential as a rapid method with specificity, sensitivity and simplicity.

Fresh trout fillets and salmon slices packed in trays were obtained from two multinational chain supermarkets and evaluated for freshness and bacteriological quality immediately after packaging and during storage at 3 degrees C. Initial aerobic counts at 30 and 25 degrees C were significantly (P < 0.05) lower in trout fillets (5.27 +/- 0.57 and 4.87 +/- 0.80 log CFU/g, respectively) than in salmon slices, where levels in excess of 6 log CFU/g were found. In both products, initial Enterobacteriaceae counts were slightly higher than 3 log CFU/g and increased significantly during shelf life by approximately 3 log CFU/g. Most of the enterobacteria were identified as Citrobacter freundii, Hafnia alvei, and Enterobacter cloacae. On day 0, most probable number (MPN) counts of total and fecal coliforms were not significantly different, numbers of the latter group being approximately 4 MPN/g. Escherichia coli was only detected when fish was spoiled. Although initial presumptive Staphylococcus aureus counts were approximately 3 log CFU/g, only 4 of 84 selected colonies belonged to this species. Neither Salmonella nor antimicrobial residues were detected in any sample. Ethanol content in salmon slices did not significantly (P > 0.05) increase until they became inedible. Significant correlation (r = +0.72, P < 0.05) was observed between this chemical index and viable counts at 30 degrees C only when salmon slices were inedible. Trout fillets were acceptable for 7 days, and salmon slices showed signs of spoilage after 4 days. Although public health concerns associated with packed trout and salmon appear to be minimal, data on sensory quality, shelf life, and total viable and Enterobacteriaceae counts strongly suggest the need to improve the quality control systems used by European multinational retailers, especially for imported salmon.

Introduction and Objectives: Despite the magnitude of the Colombian health system reform, introduced in 1993, changes in specialized medical practice have not been evaluated. This paper is the follow-up of a similar study on the practice of neurology done by the authors before the reform., Material and Methods: Of the 62 members of the Colombian Association of Neurology living in Bogotá, 47 (76%) of them responded an anonymous survey inquiring on the characteristics of their medical practice and registering all the medical encounters during one week in October 1998., Results: Two thirds of the total working time is devoted by neurologists to clinical work. Half of the neurologists in the sample have invested in diagnostic equipment. There was no significant change in the total number of patients attended during the week, as compared with the 1993 study, and the diagnostic profile was similar. The proportion of private patients was significantly lower, while patients from prepaid medical schemes increased. Patients belonging to the Obligatory Health Plan, designed to cover lowest income population, and to prepaid medicine are not distributed homogeneously throughout all ages. The first year of life is particularly uncovered by the Obligatory Health Plan, while prepaid schemes do not address the problems of individuals age 60 or more., Conclusions: There has been a significant reduction in private practice compensated by an increase in prepaid medicine. There is no evidence of increased coverage for neurological disorders.

There is a pediatric consensus that maternal milk is the best food for the new born, but when this is impossible, one turns to artificial nutrition. The main objective of infant formulae is to achieve a gastrointestinal tolerance that is similar to maternal milk. With this in mind, we carried out an observational, prospective, and multicentric study with the objective of evaluating the gastrointestinal tolerance of Similac, taking maternal milk and other formulae on the market as reference. The study included 2 pediatric visits, a diary in which the parents recorded the gastrointestinal parameters, and a final questionnaire to evaluate the degree of satisfaction. Information was obtained from 6,617 evaluable cases, 82.2% fed with Similac (S), 8.8% with maternal milk (MM) and 9% with other formulae (OF). The analysis of the data showed that the percentage of children with signs of gastrointestinal intolerance, was reduced to more than half when using S compared to OF (5.6% S, 5% LM, and 14.1% OF). The color and consistency of the feces was significantly associated with the formula group, and in both cases S showed a greater similarity to the pattern obtained with MM compared to the OF group. 18.6% of the children with OF presented hard feces, and this percentage was reduced to at least half with S (6.2%). The S group showed a greater percentage of lack of regurgitations and no aerophagia and the lowest percentage for three or more regurgitations and severe aerophagia. Those questioned considered that S was easier to reconstitute up, is liked better, and is better tolerated than the OF used. Similac achieved a greater similarity in gastrointestinal tolerance to that of maternal milk than other formulae did.

Background: The use of enemas during labor usually depends on the preference of the attending physician and available resources. However enemas cause discomfort in women and increase the costs of delivery., Objectives: The objective of this review was to assess the effects of enemas during the first stage of labor on infection rates in mothers and newborns, duration of labor, perineal wound dehiscence in the mother, perineal pain, faecal soiling and costs., Search Strategy: We searched the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effectiveness, Medline and reference lists of articles., Selection Criteria: Randomised trials in which an enema was administered during the first stage of labor and which included assessment of possible neonatal or puerperal morbidity or mortality., Data Collection and Analysis: Selected studies were assessed by three reviewers independently., Main Results: Two trials involving 665 women were included. These showed no clear difference in infection rates for puerperal mothers (odds ratio 0.61, 95% confidence interval 0.36 to 1.04) or newborn children., Reviewer's Conclusions: There is not enough evidence to evaluate the use of routine enemas during the first stage of labor.

The four primary objectives of this descriptive study were to: 1) design a quality-measurement instrument for institutional cancer registries (ICRs), 2) evaluate the existing ICRs in Colombia with the designed instrument, 3) categorize the different registries according to their quality and prioritize efforts that will efficiently promote better registries with the limited resources available, and 4) determine the institution with the greatest likelihood of successfully establishing Colombia's second population-based cancer registry. In 1990 the National Cancer Institute of Colombia developed 13 institution-based cancer registries in different Colombian cities in order to promote the collection of data from a large group of cancer diagnostic and treatment centers. During the first half of 1997, this evaluation reviewed 12 registries; one of the original 13 no longer existed. All of the Colombian institutions (hospitals) that maintain institution-based cancer registries were included in the study. At each institution, a brief survey was administered to the hospital director, the registry coordinator, and the registrar (data manager). Researchers investigated the institutions by looking at six domains that are in standard use internationally. Within each domain, questions were developed and selected through the Delphi method. Each domain and each question were assigned weights through a consensus process. In most cases, two interviewers went to each site to collect the information. The university hospitals in Cali, Pereira, and Medellín had substantially higher scores, reflecting a good level of performance. Four of the 12 institutions had almost no cancer registry work going on. Five of the 12 hospital directors considered that the information provided by the cancer registries influenced their administrative decisions. Three of the registries had patient survival data. Four of the institutions allocated specific resources to operate their cancer registries; in the other 8 hospitals there was no clear budget allocation. Seven of the hospital directors could not identify five or more objectives of a cancer registry. Data management was usually poor and resources insufficient at most of the institutions. In summary, the cancer registry system in Colombia varies greatly from institution to institution. A few of the hospitals do a good job while others have neglected the registries. The high, identical total scores for Pereira and Medellín suggest they would be good locations to establish new population-based cancer registries similar to the existing one in Cali. However, the overall characteristics in Pereira may provide a more appropriate environment for the second registry, with Medellín as an alternative.