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Fusarium oxysporum has been described as a pathogen causing onychomycosis, its incidence has been increasing in immunocompetent and disseminated infection can occur in immunosuppressed individuals. We describe the first case of congenital onychomycosis in a child caused by Fusarium oxysporum. The infection being acquired in utero was proven by molecular methods with the identification of the fungus both in the nail and placenta, most probably as an ascending contamination/infection in a HIV-positive, immunosuppressed mother.

The cloning, expression and characterization of three cellulosomal pectinolytic enzymes viz., two variants of PL1 (PL1A and PL1B) and PL9 from Clostridium thermocellum was carried out. The comparison of the primary sequences of PL1A, PL1B and PL9 revealed that these proteins displayed considerable sequence similarities with family 1 and 9 polysaccharide lyases, respectively. PL1A, PL1B and PL9 are the putative catalytic domains of protein sequence ABN54148.1 and ABN53381.1 respectively. These two protein sequences also contain putative carbohydrate binding module (CBM) and type-I dockerin. The associated putative CBM of PL1A showed strong homology with family 6 CBMs while those of PL1B and PL9 showed homology with family 35 CBMs. Recombinant derivatives of these three enzymes showed molecular masses of approximately 34 kDa, 40 kDa and 32 kDa for PL1A, PL1B and PL9, respectively. PL1A, PL1B and PL9 displayed high activity toward polygalacturonic acid and pectin (up to 55% methyl-esterified) from citrus fruits. However, PL1B showed relatively higher activity towards 55% and 85% methyl-esterified pectin (citrus). PL1A and PL9 showed higher activity on rhamnogalacturonan than PL1B. Both PL1A and PL9 displayed maximum activity at pH 8.5 with optimum temperature of 50°C and 60°C respectively. PL1B achieved highest activity at pH 9.8, under an optimum temperature of 50°C. PL1A, PL1B and PL9 all produced two or more unsaturated galacturonates from pectic substrates as displayed by TLC analysis confirming that they are endo-pectate lyase belonging to family 1 and 9, respectively. This report reveals that pectinolytic activity displayed by Clostridium thermocellum cellulosome is coordinated by a sub-set of at least three multi-modular enzymes.

The Hutchinson-Gilford syndrome or progeria is a rare autosomal dominant syndrome characterized by premature aging and involvement of internal systems, such as the circulatory and locomotor. The diagnosis is essentially clinical and the manifestations become more evident from the first year of life. Long term outcome data from Progeria Research Foundation clinical trials have demonstrated an increase in survival in recent years. Even though new trials are ongoing, the recognition of this syndrome is essential to prevent cardiovascular and cerebrovascular complications. A patient, initially asymptomatic, who developed characteristic signs of the syndrome at the age of 6 months is reported. She was referred for evaluation only when she was two years and eleven months old. The diagnosis of Hutchinson-Gilford syndrome was suspected owing to clinical characteristics. The diagnosis was confirmed by genetic testing. A mutation c.1824C> T in exon 11 of the LMNA gene was detected. She was registered in the Progeria Research Foundation and was invited to participate in the weighing and supplementation program. She was included in the lonafarnib protocol study. This medication is a farnesyl transferase inhibitor that prevents the production of progerina and slows cardiovascular and neurological complications of the syndrome. This case highlights the importance of diagnosing progeria patients because they may be referred to the Progeria Research Foundation, which offers genetic screening and inclusion in clinical and therapeutic follow-up protocols without any costs. Progeria trials and research may also contribute to new drug developments related to prevention of aging and atherosclerosis in the near future.

Objectives: This study aims to evaluate the characteristics and treatment response of patients with pityriasis lichenoides seen in the last 43 years in a pediatric dermatology service. Methods: This was a retrospective, analytical, longitudinal study of patients under 15 years of age. The medical records were reviewed and data were presented as frequencies, means and variances. Student's t-test, Mann-Whitney test, Fisher's exact test, Pearson/Yates chi-square test and multivariate logistic regression model were used, with p < 0.05 considered. Results: 41 patients were included, 32 (78.0%) with pityriasis lichenoides chronica (PLC), five (12.2%) with pityriasis lichenoides et varioliformis acuta (PLEVA) and four (9.8%) with clinical PLC without biopsy. The age range of school children and adolescents was 19 (46.3%) and 13 (31.7%) respectively and 27 (65.8%) were male. Two peaks of the highest frequency were observed between 2004 and 2006 (10 patients - 24.4%) and another between 2019 and 2021 (6 patients - 14.7%). There was remission in 71.9% (n = 23), with 56.6% (n = 17) of those who used antibiotic therapy and 80% (n = 4) of those who had phototherapy. The chance of remission was 13 times greater in patients with disease onset after 5 years of age. Conclusions: The clinical form most commonly found was PLC mainly in school children and adolescents. The frequency peaks coincided with infectious outbreaks. The remission rate was satisfactory with antibiotic therapy, but higher with phototherapy. Remission was greater in patients with disease onset after 5 years of age.

Purpose: This study aims to examine the partial and sequential mediating effects of work engagement (WE) and organizational citizenship behavior (OCB) on the relationship between human resources management practices (HRMP) and innovative work behavior (IWB) to find an integrative relationship mechanism. Design/methodology/approach: This study used a cross-sectional data collection technique to obtain a usable sample of 324 employees in Indonesia who work in the banking sector. The least squares structural equation modeling was applied to the data analysis in this study. Findings: The study's findings suggest that HRMP does not directly influence IWB. However, WE and OCB mediate partially or sequentially in the relationship between HRMP and IWB. These mediating mechanisms shed light on the psychological processes of employees, emphasizing the significance of innovative behavior in the workplace. Research limitations/implications: This research implies the importance of paying attention to the role of WE and OCB in designing and implementing HRMP to increase IWB. These results also highlight the importance of a holistic approach to creating meaning in the workplace that can encourage innovative behavior. Originality/value: This research offers a deeper understanding of the complex relationships between HRMP, WE, OCB, and IWB. These findings explore possible mediating mechanisms previously discovered in the literature and offer new insights for future research in this area.

Objective: Perfume (Parfum) or fragrance is a natural or synthetic cosmetic ingredient added to emit a pleasant aroma or to improve the odor of a cosmetic formula. It is a mixture of substances, not revealed by the manufacturer, which may contain ingredients with allergenic potential, endocrine disruptors, and other possible harmful effects on human health. This study aims to analyze children's cosmetics labels to assess the presence of Perfume. Methods: The researchers randomly visited points of sale in Curitiba, the capital of a southern Brazilian state; in order to catalog the largest possible number of children's cosmetics items. Results: 398 children's cosmetics were analyzed and found Parfum on 295 (74.1 %) of the labels, including 90.4 and 79,1 % of the shampoos and wet wipes, respectively. Conclusion: Exposure of children's skin to fragrances can lead to local side effects such as allergies, but also to systemic effects, and the lack of knowledge of the general population and health professionals about its possible deleterious effects emphasizes the importance of changes in the regulation of cosmetics aiming to reduce the use of this ingredient.

Background: Although Ewing sarcoma is one of the most common malignant bone tumours, its occurrence in the scapula is extremely rare. Case report: The authors present a case of a 23-yearold male with an Ewing sarcoma in the right scapula, managed through a limb-sparing procedure involving total scapulectomy (Malawer type III) and humeral head suspension to the clavicle. Two years post-surgery, the patient developed a clavicle stress fracture, an uncommon complication. Surgical repair with anatomic clavicle plating, and a pectoralis major pedicled flap for soft tissue coverage were performed. Discussion: Despite the occurrence of a rare complication, functional assessment and overall percepted impact on the patient were consistent with outcomes and scores reported in literature. Conclusion: This case reflects the authors experience with a challenging case, which ultimately resulted in an improved quality of life for the patient, enabling him to be well adapated in daily activities.

Introduction: Infantile hemangioma (IH) is a benign tumor of the vascular endothelium, characterized by early appearance, rapid growth, and slow involution. It is the most common tumor in the pediatric age group, and several risk factors are associated with its development. Case Report: Monozygotic twins, female, 29 weeks premature and with low birth weight, presenting reddish spots that after 15 days evolved into erythematous tumors, with a diagnosis of IH. Conclusion: This case report exemplifies simultaneously the main risk factors associated with the evelopment of IH. Recognition of these factors by pediatricians is crucial for early diagnosis, appropriate follow-up, and management.

Objectives: Determine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. Method: a cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital – including those admitted to the Neonatal Intensive Care Unit – were evaluated. Results: 61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67+1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. Conclusion: Dermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.

INTRODUCTION: The use of statins in hemodialysis patients is a topic of ongoing research and debate. Patients with chronic kidney disease on hemodialysis constitute a large proportion of patients treated in the vascular surgery field. Clinical data of the protective statin effect on this group is scarce and conflicting results exist regarding cardiovascular, cerebrovascular and limb outcomes. METHODS: We performed a thorough electronic search of the literature using PubMed and Embase databases to understand the relationship between statin effect and cardiovascular, limb outcomes and cerebrovascular outcomes. A narrative review was constructed, based on the obtained literature. RESULTS: Although the use of statins in hemodialysis patients may provide cardiovascular benefits, the optimal dosage and safety profile of these medications in this population remain uncertain. A carefully evaluation of the risks and benefits of statins should be made based on each patient's specific requirements and circumstances. CONCLUSION: The role of statins for patients with peripheral arterial disease who are on hemodialysis remains unclear. Further analyses should focus on this subgroup of dialysis patients, who are becoming more prevalent on the vascular surgery departments, allowing for an optimized treatment with better patient outcomes.

INTRODUCTION: The descending thoracic aorta (DTA) has been used as inflow mostly as a secondary option for revascularization after either graft failure/infection or other intra-abdominal pathologies contraindicating a standard abdominal aortic approach. The objective of this review is to summarize current evidence on the use of this inflow site for revascularization procedures. METHODS: A comprehensive electronic literature search was performed, using PubMed and Embase databases. All literature published in English in the last 30 years was considered. The main goal was to assess the feasibility and practicality of implementing this approach in cases of severe and complex aortoiliac lesions. RESULTS: Our review comprised 11 articles. DTA has been used predominately as a secondary option. The 30-day mortality rate was 4% (9/222). Secondary graft patency at 5-years was generally high across all studies. The use of DTA as inflow has been shown to be a safe and effective option for aorto-iliac reconstruction. CONCLUSION: DTA can be used safely as an inflow for lower-limb revascularization and it remains an important tool in the vascular surgeon's armamentarium.

OBJECTIVE: To assess the knowledge and the perceptions of acne among adolescents. METHODS: Cross-sectional study, carried out from May 2018 to May 2019. Data were collected through a questi-onnaire administered to students aged 13 to 20 years enrolled in two schools, with 793 participants (462 from a public school and 331 from a private school). Data were evaluated by Pearsons chi-square test, Yates test and Students t tests. RESULTS: The mean age was 15.02±1.25 years in the private school, and 16.21±1.45 years (p=0.07) in the public school. In the private school, 75.8% of adolescents had acne, against 79.6% from the public (p=0.08). In the private school, 54.7% consulted a doctor due to acne, against 45.8% in the public school (p

Ilio-iliac arteriovenous fistula occurs in 1% of all common iliac artery aneurysms, a rare complication of this identity. A variety of symptoms appear depending on the size and location of the fistula, making the correct diagnosis quite difficult, only 37–52% of the cases are diagnosed before surgery. We report a case of an abdominal infrarenal aneurysm and right common iliac aneurysm, with fistula into the left common iliac vein, presenting with acute nocturnal paroxysmal dyspnea and left leg edema, inducing to the incorrect diagnosis of venous thromboembolism.

Descending thoracic aorta (DTA) inflow has been utilized as a secondary choice for restoring blood flow in cases of aortoiliac occlusive disease. This option is considered when graft failure, infection, or other intra-abdominal conditions contraindicates the use of the standard abdominal aortic approach. Additionally, when the abdominal aorta develops extensive and complicated circumferential calcified lesions, making it unsafe to clamp this segment, a DTA bypass can serve as a secure and effective alternative. It remains an important tool in the arsenal of vascular surgeons. The presence of coral reef aorta, a rare condition characterized by outwardly projecting calcified plaques on the juxtarenal and visceral aorta, poses a challenge in determining the best treatment approach, as it has yet to be defined.

A study is conducted to show that a family 35 carbohydrate binding module (CBM) member (CBM35), designated CtCBM35-Gal, binds to [alpha]-d-galactose (Gal) and, within the context of the plant cell wall, targets the [alpha]-1,6-Gal residues of galactomannan but not the [beta]-d-Gal residues in xyloglucan. The results from the site-directed mutagenesis revealed that although there is conservation of several functional residues within the binding sites of endo- and exo-CBM35s, the endo-CBM does not utilize Asn113 in mannan binding, despite the importance of the equivalent residue in ligand recognition across the CBM35 and CBM6 landscape.

Objective: Evaluate the effectiveness of a children's soap with physiological pH in maintaining cutaneous pH and moisture of the newborn (NB)’s skin after the first bath. Methods: Randomized, controlled and double-blind clinical trial in a rooming-in of a tertiary maternity hospital in southern Brazil with 204 newborns > 34 gestational weeks. Gestational and obstetric history was evaluated, and newborns were randomized into two groups according to the product applied in the bath: the control group (CG), which used common liquid soap with pH 7.0 and experimental group (EG), which used children's liquid soap with pH 5.8. Evaluation was made immediately before and after bath with skin pH measurement, corneometry and clinical parameters (erythema, scaling and moisture), on the forehead, abdomen and thigh. Results: There was no difference between groups regarding gestational, obstetric and family history (p > 0.05). In CG, skin pH increased in the abdomen and thigh (p

OBJECTIVE: To determine the frequency of dermatological diagnoses in preterm newborns and the associated perinatal factors. METHODS: This is a cross-sectional analytical study with a convenience sample and prospective data collection, carried out between November 2017 and May 2018. Were examined 151 premature and late preterm neonates admitted to the neonatal intensive care unit in a hospital of tertiary care level. The studied population was evaluated to evidence, describe and photograph the dermatological diagnoses present up to 28 days of life. RESULTS: The frequency of dermatological diagnoses was 99.3%, being the most observed: lanugo in 128 newborns (84.7%), salmon spot in 115 (76.1%), sebaceous hyperplasia in 89 (58. 9%), physiological flaking in 74 (49%), mongolian stain in 54 (35.7%), Epsteins pearl in 43 (28.4%), traumatic skin lesions in 42 (27.8%), milia cyst in 40 (26.4%), jaundice in 36 (23.8%) and toxic erythema in 20 (13.2%). Participants with a higher gestational age had a higher frequency of salmon spot, toxic erythema, mongolian spot, sebaceous hyperplasia, milia cyst and Epsteins pearl. CONCLUSION: Dermatological diagnoses were frequent and those of older gestational age had a higher frequency of physiological changes and birthmarks. Traumatic skin lesions were among the 10 most frequently observed, reinforcing the need to implement protocols for neonatal skin care, with emphasis on premature infants.

Objectives: To evaluate the impact of invasive mechanical ventilation associated with two serum inflammatory cytokines and clinical indicators, on the second day of life, as predictors of bronchopulmonary dysplasia in very low birth weight preterm infants. It was hypothesized that the use of invasive mechanical ventilation in the first hours of life is associated with biomarkers that may predict the chances of preterm infants to develop bronchopulmonary dysplasia. Methods: Prospective cohort of 40 preterm infants with gestational age

Peripheral venous catheters (PVCs) are the most used vascular access devices in the world. However, failure rates remain considerably high, with complications such as PVC-related infections posing significant threats to patients’ well-being. In Portugal, studies evaluating the contamination of these vascular medical devices and characterizing the associated microorganisms are scarce and lack insight into potential virulence factors. To address this gap, we analyzed 110 PVC tips collected in a large tertiary hospital in Portugal. Experiments followed Maki et al.’s semi-quantitative method for microbiological diagnosis. Staphylococcus spp. were subsequently studied for the antimicrobial susceptibility profile by disc diffusion method and based on the cefoxitin phenotype, were further classified into strains resistant to methicillin. Screening for the mecA gene was also done by a polymerase chain reaction and minimum inhibitory concentration (MIC)-vancomycin as determined by E-test, proteolytic and hemolytic activity on skimmed milk 1% plate and blood agar, respectively. The biofilm formation was evaluated on microplate reading through iodonitrotetrazolium chloride 95% (INT). Overall, 30% of PVCs were contaminated, and the most prevalent genus was Staphylococcus spp., 48.8%. This genus presented resistance to penicillin (91%), erythromycin (82%), ciprofloxacin (64%), and cefoxitin (59%). Thus, 59% of strains were considered resistant to methicillin; however, we detected the mecA gene in 82% of the isolates tested. Regarding the virulence factors, 36.4% presented α-hemolysis and 22.7% β-hemolysis, 63.6% presented a positive result for the production of proteases, and 63.6% presented a biofilm formation capacity. Nearly 36.4% were simultaneously resistant to methicillin and showed expression of proteases and/or hemolysins, biofilm formation, and the MIC to vancomycin were greater than 2 µg/mL. Conclusion: PVCs were mainly contaminated with Staphylococcus spp., with high pathogenicity and resistance to antibiotics. The production of virulence factors strengthens the attachment and the permanence to the catheter’s lumen. Quality improvement initiatives are needed to mitigate such results and enhance the quality and safety of the care provided in this field.

Abstract Background The severity of nail disease, the presence of arthralgia and fatigue are predictors of development of psoriatic arthritis (PsA) in patients with psoriasis (Pso). In children, little is known about the musculoskeletal (MSK) impairment in patients with Pso and its effect on health-related quality of life (HRQoL). Objectives To determine the frequencies of pain and MSK inflammation (i.e., arthritis, enthesitis, and sacroiliitis) among children and adolescents with Pso and its relationship to HRQoL and fatigue. Methods Pediatric patients with Pso underwent a rheumatologic physical examination to evaluate synovitis, enthesalgia, sacroiliac joint (SIJ) pain and tender points of fibromyalgia. The core set of domains recommended by the GRAPPA - OMERACT to be measured in PsA studies was assessed. Ultrasound (US) was performed in clinical cases of enthesitis, and magnetic resonance imaging (MRI) was performed in cases of SIJ pain. Results Forty-three participants (10 ± 2.9 years old) were evaluated. Pain on palpation of the entheses was observed in 10 (23.2%) patients and pain on SIJ palpation was observed in 3 (7%). No patient presented with synovitis; one presented with enthesitis on US, but MRI did not confirm sacroiliitis in any case. Patients with MSK pain had greater skin disease severity (PASI 5.4 vs. 2, p

Merkel Cell Carcinoma is a rare type of aggressive and often fatal neuroendocrine tumor of the skin. We report a clinical case of a 56-year-old female with a Merkel cell carcinoma on the left hand, without distant metastasis, treated with surgical excision of the lesion and radiotherapy. Based on this clinical case a research and review of the literature on this rare neoplasia was carried out.

Cesar Barreto was the photographer hired by the City Hall of Rio to document the revitalization process of the port area for the 2016 Olympic Games. His photos were published in the institutional website ‘Cidade Olímpica’, which contained information about the works and projects in progress. This paper discusses the role of photographs produced by Barreto for the city's urban memory, as well as the main ideas behind the Porto Maravilha project in the context of the global cities. The urban reforms implemented in Rio were based on a neoliberal urban policy, valuing the city brand to make it competitive in the international market.

ABSTRACT Objective: To assess the prevalence of hypothermia in the delivery room, at admission, and 2 to 3 hours after admission in the neonatal intensive care unit (NICU), factors associated and possible relationship with morbidity and mortality in preterm infants with very low birth weight (VLBW). Methods: Cross-sectional study with data collection based on a retrospective review of medical records and including infants born in 2016 and 2017, with birth weights

Introduction Time-critical neonatal trials in low-and-middle-income countries (LMICs) raise several ethical issues. Using a qualitative-dominant mixed-methods design, we explored informed consent process in Hypothermia for encephalopathy in low and middle-income countries (HELIX) trial conducted in India, Sri Lanka and Bangladesh.Methods Term infants with neonatal encephalopathy, aged less than 6 hours, were randomly allocated to cooling therapy or usual care, following informed parental consent. The consenting process was audio-video (A-V) recorded in all cases. We analysed A-V records of the consent process using a 5-point Likert scale on three parameters—empathy, information and autonomy. In addition, we used exploratory observation method to capture relevant aspects of consent process and discussions between parents and professionals. Finally, we conducted in-depth interviews with a subgroup of 20 parents and 15 healthcare professionals. A thematic analysis was performed on the observations of A-V records and on the interview transcripts.Results A total of 294 A-V records of the HELIX trial were analysed. Median (IQR) score for empathy, information and autonomy was 5 (0), 5 (1) and 5 (1), respectively. However, thematic analysis suggested that the consenting was a ceremonial process; and parental decision to participate was based on unreserved trust in the treating doctors, therapeutic misconception and access to an expensive treatment free of cost. Most parents did not understand the concept of a clinical trial nor the nature of the intervention. Professionals showed a strong bias towards cooling therapy and reported time constraints and explaining to multiple family members as key challenges.Conclusion Despite rigorous research governance and consent process, parental decisions were heavily influenced by situational incapacity and a trust in doctors to make the right decision on their behalf. Further research is required to identify culturally and context-appropriate strategies for informed trial participation.

Abstract Background Combination of current antidiabetic agents with natural antioxidants to manage diabetes mellitus and its complications has appeared as an emerging trend. Curcumin, a yellow pigment isolated from Curcuma longa rhizomes, has gained attention due to its beneficial effects in controlling the disturbances observed in diabetes mellitus. The purpose of this study was to investigate if yoghurt enriched with curcumin and metformin, individually or as mixtures, ameliorates physiometabolic parameters, glycoxidative stress biomarkers, and paraoxonase 1 (PON 1) activity in diabetic rats. Methods Streptozotocin-diabetic rats (6-week-old Wistar rats) were treated for 30 days with curcumin and metformin, isolated or as mixtures in yoghurt (10 rats/group). After treatments, the plasma levels of glucose, triacylglycerol, cholesterol, thiobarbituric acid reactive substances (TBARS, a biomarker of lipid oxidation), fluorescent advanced glycation end products (AGEs), and the activity of PON 1, an antioxidant enzyme were assessed. Data were analyzed using one-way analysis of variance (ANOVA) followed by Student–Newman–Keuls test. Results Treatment of diabetic rats with curcumin or metformin alone decreased the plasma levels of glucose, triacylglycerol, cholesterol, TBARS, and fluorescent AGEs, as well as increased the activity of PON 1. The combination of metformin with curcumin further decreased dyslipidemia and TBARS levels in diabetic rats, indicating synergy, and maintained the high levels of PON 1. Conclusion These findings indicated that curcumin combined with metformin may act synergistically on dyslipidemia and oxidative stress, as well as increased PON 1 levels. Therefore, it might be a promising strategy for combating diabetic complications, mainly the cardiovascular events.

Objetivo: caracterizar el perfil epidemiológico del Síndrome Metabólico y sus factores de riesgo asociados en población general mayor ,18 años en la ciudad de Cochabamba, Bolivia, durante la gestión II-2016. Métodos: se realizó un estudio observacional, analítico de corte transversal, en población general de 18 o más años, con una muestra de n=186 sujetos ajustados por grupo etario y sexo en base a la pirámide poblacional de Cochabamba-Bolivia. Se aplicó la metodología STEPS (pasos) de la OPS/OMS para la recolección de la información centrada en datos sociodemográficos, hábitos de vida, evaluación física y laboratorial. Se calcularon proporciones e intervalos de confianza al 95% conforme lo establecido en el manual de implementación de la metodología STEP; y regresión logística multivariada para la obtención del OR ajustado para el nivel de riesgo asociados al Síndrome Metabólico. Resultados: la prevalencia global de Síndrome metabólico fue de 44,1%; la prevalencia de sus factores de riesgo asociados fue: STEP-1, Tabaquismo 11,29%; consumo actual de alcohol 63,44%; bajo consumo de frutas y vegetales 76,88%; sedentarismo o bajo nivel de actividad física 75,81%. STEP-2: sobrepeso 44,62%; obesidad 24,73%; obesidad abdominal 38,7% y presión arterial elevada en 35,14%. STEP3: Glicemia alterada en ayunas 36,02%; Insulina basal alterada 36,56%; colesterol total elevado 36,02%; Triglicéridos elevados 46,77% y HDL-colesterol reducido en el 66,67%. Los niveles de OR ajustado fueron >1 y estadísticamente significativas para las medidas físicas y laboratoriales. Conclusión: el síndrome metabólico en altamente prevalente en la población general de la ciudad de Cochabamba y se asocia a niveles elevados de IMC, presión arterial elevada y perfil laboratorial alterado.

Falls can be defined as unintentional displacements of the body to a level below the starting position due to the inability to be corrected in timely manner. Falls among the elderly are a major public health problem due to complications that can cause health problems and the high costs for health assistance both for the hospital as well as the family. Loss of autonomy, of independence, the presence of fractures, restricted activity and immobility may cause increased risk of institutionalization of the elderly. This outcome increases functional decline, may lead to psychological problems such as depression, fear of suffering new falls and the risk of death as well as social impairments related to the family. Many factors are responsible for the development of such events and it is necessary to know both intrinsic and extrinsic risk factors to plan and implement measures to prevent falls among the elderly. This paper aims to identify the risk factors associated with falls among the elderly. We used the literature review method and as research sources: journals, theses and scientific articles indexed in electronic databases. The most commonly found factors in the literature associated with falls among the elderly were: advanced age, sedentary lifestyle, a greater number of the use of continuous medications, the use of benzodiazepine, the presence of chronic diseases - including dementia -, impaired visual acuity, history of falls, self-perception of poor health, depression, obstacles in the household, presence of abnormal gait and balance. We conclude that knowledge of risk factors is important to guide the planning of preventive measures and public policies to avoid falls and their consequences, aiming the reduction of functional decline and improvement of the quality of life of the elderly population. [ABSTRACT FROM AUTHOR]

A diez años de la promulgación del Programa Desnutrición Cero, y más de un quinquenio de la implementación de las Unidades de Nutrición Integral (UNI), no se cuenta con información epidemiológica local acerca de su repercusión a nivel poblacional. Objetivo: analizar las desigualdades en las prevalencias de los factores de riesgo asociados a la desnutrición infantil en municipios con y sin UNI del departamento de Cochabamba. Métodos: se realizó un estudio ecológico de corte transversal con datos agregados por municipio, utilizando la información recabada por el estudio departamental sobre Factores de Riesgo Asociados a Malnutrición Infantil en Cochabamba (FRAMIC). Las unidades de análisis fueron los municipios con y sin UNI de Cochabamba. Se calcularon promedios de las prevalencias municipales por grupo de estudio, acompañadas de desviaciones estándar y prueba de T de student para las diferencias estadísticas. Resultados: la prevalencia de lactancia materna exclusiva fue más alta en los municipios con UNI (75%). El inicio adecuado de alimentación complementaria y la cobertura de entrega de Nutribebé fue mayor en los municipios con UNI (76% y 83%). No se encontraron diferencias estadísticamente significativas en el uso adecuado del Nutribebe y chispitas nutricionales entre municipios con y sin UNI. La reducción de la prevalencia de desnutrición crónica fue mayor en municipios con UNI. Conclusión: no existen diferencias estadísticamente significativas en las prevalencias de desnutrición infantil entre los municipios con y sin UNI, smostrando que la presencia de las UNI’s contribuyó a disminuir la brecha de desigualdad en la prevalencia de desnutrición crónica entre los grupos poblacionales estudiados.

ABSTRACT Objective: To evaluate the hygiene practices and frequency of use of personal hygiene products, cosmetics, and sunscreen among children and adolescents. Methods: Cross-sectional study with interviews about skincare conducted with caregivers through closed-ended questions. We included patients up to 14 years of age waiting for consultation in pediatric outpatient clinics of a tertiary hospital. We performed a descriptive statistical analysis and applied the Kruskal-Wallis test and Fisher’s exact test to compare the practices according to maternal schooling. Results: We conducted 276 interviews. The median age of the participants was age four, and 150 (54.3%) were males. A total of 143 (51.8%) participants bathed once a day and 128 (46.3%) bathed two or more times a day, lasting up to ten minutes in 132 (47.8%) cases. Adult soap was used by 103 (37.3%) children and bar soap by 220 (79.7%). Fifty-three (19.2%) participants used sunscreen daily. Perfume was used by 182 (65.9%) children, hair gel by 98 (35.5%), nail polish by 62 (22.4%), and some type of make-up by 71 (25.7%) - eyeshadow by 30 (10.8%), lipstick by 52 (18.8%), face powder and mascara by 13 (4.7%). Make-up use started at a median age of 4 years. Henna tattoo was done in eight children. Conclusions: The children studied used unsuitable products for their skin, such as those intended for adults, used sunscreen inadequately, and started wearing make-up early, evidencing the need for medical orientation.

Background: Although thalamic magnetic resonance (MR) spectroscopy (MRS) accurately predicts adverse outcomes after neonatal encephalopathy, its utility in infants without MR visible deep brain nuclei injury is not known. We examined thalamic MRS metabolite perturbations in encephalopathic infants with white matter (WM) injury with or without cortical injury and its associations with adverse outcomes. Methods: We performed a subgroup analysis of all infants recruited to the MARBLE study with isolated WM or mixed WM/cortical injury, but no visible injury to the basal ganglia/thalamus (BGT) or posterior limb of the internal capsule (PLIC). We used binary logistic regression to examine the association of MRS biomarkers with three outcomes (i) WM injury score (1 vs. 2/3); (ii) cortical injury scores (0/1 vs. 2/3); and (iii) adverse outcomes (defined as death, moderate/severe disability) at two years (yes/no). We also assessed the accuracy of MRS for predicting adverse outcome. Findings: Of the 107 infants included in the analysis, five had adverse outcome. Reduced thalamic N-acetylaspartate concentration [NAA] (odds ratio 0.4 (95% CI 0.18–0.93)) and elevated thalamic Lactate/NAA peak area ratio (odds ratio 3.37 (95% CI 1.45–7.82)) were significantly associated with higher WM injury scores, but not with cortical injury. Thalamic [NAA] (≤5.6 mmol/kg/wet weight) had the best accuracy for predicting adverse outcomes (sensitivity 1.00 (95% CI 0.16–1.00); specificity 0.95 (95% CI 0.84–0.99)). Interpretation: Thalamic NAA is reduced in encephalopathic infants without MR visible deep brain nuclei injury and may be a useful predictor of adverse outcomes. Funding: The National Institute for Health Research (NIHR). Keywords: Therapeutic hypothermia, Magnetic resonance spectroscopy, Magnetic resonance imaging, Biomarkers, Neonatal encephalopathy