Título del artículo:

A new multiplex PCR for species-specific diagnosis of human candidiasis

Introduction: Candidiases is a group of opportunistic infections caused by yeasts belonging to the genus Candida. Candida albicans is the most prevalent species in both superficial and deep infections, however, the clinical importance of non-albicans Candida has increased during the last decade, driving an urgent need for diagnostic tests that allow for species-level resolution and selection of the optimum therapeutic approach. Objective: To design and to optimize a new multiplex PCR assay for the simultaneous identification of the five most relevant species of Candida involved in human candidiasis etiology. Materials and methods: For primers design, the physical and thermodynamic restrictions that affect multiplex PCR performance were analyzed using Gene Runner and Mult-PSOS. As templates, the internal transcribed region 2 (ITR2) was selected for C. albicans (AJ249486.1), and topoisomerase II (TOPII) for C. parasilopsis (AB049144.1), C. krusei (AB049139.1), C. tropicalis (AB049141.1), and C. guillermondii (AB049145.1). We used ATCC strains of all these five species and clinical isolates as templates. Results: We designed ten oligonucleotides for the simultaneous amplification of the Candida species. The electrophoresis band profile was: C. albicans (206 bp), C. guillermondii (244 bp), C. tropicalis (474 bp), C. parasilopsis (558 bp), and C. krusei (419 bp). Conclusion: The new multiplex PCR assay designed in this study allowed a simultaneous and efficient amplification of the amplicons corresponding to the five species of Candida under study, with an adequate resolution in standard agarose gel.

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Biomedica

Título del artículo:

Virtual Health Library in Nursing for Colombia: A new scientific communication portal

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Investigacion y Educacion en Enfermeria

Título del artículo:

Valledupar Mayors Office current electronic government inspired principles

The research describes the inspiring principles of electronic government in the Mayor\'s Office of Valledupar, Cesar. It is supported theoretically by the authors Rivera (2006), the Ibero-American Charter (2007) and Criado and others (2002). It is contextualized in the quantitative-positivist epistemological tendency, of descriptive type, under a field design, not experimental. Among the conclusions are that the principles that inspire e-government: equality, legality, conservation, transparency, technological adequacy; Must be evident in the egovernment policy to ensure its effectiveness.

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Espacios

Título del artículo:

Search and recompilation of information sources: Contributions for the development of states-of-the-art

This article shows the first part of a study aimed at strengthening of the formation for the entrepreneurship (FFE) in higher education. To do that, the aim of the study was the construction of a searching proposal and compilation of information sources in order to make a state of the art about the FFE. Methodologically, the proposal was made in three moments: consultation of guides, design and implementation. The results are: i) guidelines for the development of the heuristic phase of the state of art and ii) the construction of instruments for the searching stages and specialized information compilation about FFE in university contexts.

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Espacios

Título del artículo:

Rural microeconomic development from the transformation of taruya (eichornia cressipis) into peasant communities

An alternative microeconomic model from the design and development of rural production units in three associations of fishermen swampy Zapatosa complex, from the use of Taruya (Eichornia cressipis) to diversify productive activities of these communities was implemented. Within a population of 47 associations of peasant stock declared in the region of influence of the swamp complex The Zapatosa 4 chose a craft, two of fishermen and the elderly; of these was selected the most organized and formalized for who could act as an anchor association or leader. One of the strategies developed was to present the project to the European Aid/128929/M/ACT//CO in Colombia led by the Ministry of Industry, Trade and Tourism, once approved and availability of resources, a second strategy was used inclusive development model project where they were able to strengthen three production units from innovative processes based Taruya, thus improving the income of its members. A third strategy was achieving different co-funding sources IDECESAR, ADEL Zapatosa (Agency for Local Economic Development), SENA, governor of Cesar, in this regard technical training was obtained in the different alternatives to transform Taruya SENA and ADEL Zapatosa and resources for adaptation of installations of the UPR by the governor of Cesar whose contributions were important for the improvement of the processes of transformation of Taruya. Strategies for identifying markets and industry studies were also used, they could acquire innovative equipment and machinery as well as other goods and services, high quality according to the needs reflected to achieve standardize and make inroads with the regional market competitive products.

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Espacios

Título del artículo:

An analisys of science, technology and innovation from the activity of the inside Colombia and Venezuela

This paper aims the dynamics of science, technology and innovation (CTeI) inside Colombia and Venezuela from the CTeI observatories\' role. We made a bibliographical review of the different justifications that define the CTeI of some countries (USA, Brasil) and documents review of observatories. The results show differences in the legal nature, in the strategic and operational conception of these observatories. In Colombia, the observatory is supported on a research group, while in Venezuela, it is a public administration entity.

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Espacios

Título del artículo:

Clinical practice guideline. Integral Care Guidelines for the prevention, early detection and treatment of pregnancy, childbirth and puerperium complications: Section on toxoplasmosis in pregnancy

Toxoplasma infection, an aspect included in the Integral Care Guidelines for prevention, early detection and treatment of complications during pregnancy developed and sponsored by the Department of Science, Technology and Innovation, Colciencias and the Ministry of Health and Social Protection; was selected to develop recommendations that may contribute to its prevention diagnostic and treatment. Guidelines were developed through systematic review of literature, two panels of evaluation, gradation of evidence: SIGN (Scottish Intercollegiate Guidelines Network), discussion panel with users and patients, external evaluation and socioeconomical evaluation of the impact of recommendations. The Toxoplasma gondii infection that occurs during pregnancy may cause serious complications for the fetus and important sequelae for the newborn. A clinical guideline based on the best available scientific evidence, with emphasis on Colombian references, was performed. Experts in parasitology, neonatology and infectious diseases (adult and pediatric) developed the recommendations. It is suggested that the recommendations included in this guideline be followed by healthcare professionals in pregnancy care programs nationwide, with the purpose of lowering the morbidity and mortality related to this disease. Specific recommendations for diagnosis during the first trimester of the pregnancy, recommendations for prevention in noninfected women, identification of fetal or newborn infection and recommendations for treatment in those given cases are included.

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Infectio

Título del artículo:

Generation of knowledge in security and health at work in Valledupar, Colombia

This paper analyzes the knowledge\'s generation in companies providing occupational safety and health in Valledupar, Colombia. It is supported by the theories of Davenport & Prusak (2001); and, Molina & Marsal (2001). This research is descriptive, non experimental, transversal and with field design. We applied the research to the all 17 companies. We interview the managers through a questionnaire of 25 items, validated by five experts, and 0.89 Cronbach\'s a reliability. We found the most common way of generating knowledge is informal networks. We discover there are deficiencies in the acquisition, merge, and adaptation of knowledge.

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Espacios

Título del artículo:

Perception of safety conditions for chronically ill patients in the hospital environment in colombia

Objectives: Describe, compare and associate the perception of safety conditions for chronically ill patients in the hospital environment in Colombia and in its five geographic macro-regions (Amazon, Andean, Caribbean, Orinoquía and Pacifico). Method: This is a descriptive, comparative and relationship-based study. The sample was comprised of 484 persons who have a chronic illness. The instruments used were the Characterization Survey for Care of the Person with Chronic Disease and the patient version of the Survey of the Perception of Safety Conditions in the Hospital. Results: Compared to the risk perception categories, only half are aware of the risks to which they are exposed and how to prevent them, and only half reported knowing their rights and obligations during hospitalization. Falls and phlebitis are the risks that are more likely to materialize. Conclusion: There is little appropriation of risk prevention and care. Consequently, there is a high degree of vulnerability to the conditions of the hospital environment in Colombia’s five geographic macro-regions.

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Aquichan

Título del artículo:

Sociodemographic factors related to handgrip strength in children and adolescents in a middle income country: The SALUS study

Objective: To determine sociodemographic factors associated with handgrip (HG) strength in a representative sample of children and adolescents from a middle income country. Methods: We evaluated youth between the ages of 8 and 17 from a representative sample of individuals from the Department of Santander, Colombia. Anthropometric measures, HG strength, and self-reported physical activity were assessed, and parents/guardians completed sociodemographic questionnairres. Multinomial logistic regression models were used to estimate the association between sociodemographic and anthropometric characteristics and tertiles of relative HG strength. We also produced centile data for raw HG strength using quantile regression. Results: 1,691 young people were evaluated. HG strength increased with age, and was higher in males than females in all age groups. Lower HG strength was associated with indicators of higher socioeconomic status, such as living in an urban area, residence in higher social strata neighborhoods, parent/guardian with secondary education or higher, higher household income, and membership in health insurance schemes. In addition, low HG strength was associated with lower physical activity levels and higher waist-to-hip ratio. In a fully adjusted regression model, all factors remained significant except for health insurance, household income, and physical activity level. Conclusions: While age and gender specific HG strength values were substantially lower than contemporary data from high income countries, we found that within this middle income population indicators of higher socioeconomic status were associated with lower HG strength. This analysis also suggests that in countries undergoing rapid nutrition transition, improvements in socioeconomic conditions may be accompanied by reduction in muscle strength.

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American Journal of Human Biology

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Effect of Lippia alba and Cymbopogon citratus essential oils on biofilms of Streptococcus mutans and cytotoxicity in CHO cells

Background Caries is a public health problem, given that it prevails in 60 to 90% of the school-age global population. Multiple factors interact in its etiology, among them dental plaque is necessary to have lactic acid producing microorganisms like Streptococcus from he Mutans group. Existing prevention and treatment measures are not totally effective and generate adverse effects, which is why it is necessary to search for complementary strategies for their management. Aim The study sought to evaluate the eradication capacity of Streptococcus mutans biofilms and the toxicity on eukaryotic cells of Lippia alba and Cymbopogon citratus essential oils. Methodology Essential oils were extracted from plant material through steam distillation and then its chemical composition was determined. The MBEC-high-throughput (MBEC-HTP) (Innovotech, Edmonton, Alberta, Canada) assay used to determine the eradication concentration of S. mutans ATCC 35668 strain biofilms. Cytotoxicity was evaluated on CHO cells through the MTT cell proliferation assay. Results The major components in both oils were Geraniol and Citral; in L. alba 18.9% and 15.9%, respectively, and in C. citratus 31.3% and 26.7%. The L. alba essential oils presented eradication activity against S. mutans biofilms of 95.8% in 0.01 mg/dL concentration and C. citratus essential oils showed said eradication activity of 95.4% at 0.1, 0.01 mg/dL concentrations and of 93.1% in the 0.001 mg/dL concentration; none of the concentrations of both essential oils showed toxicity on CHO cells during 24 h. Conclusion The L. alba and C. citratus essential oils showed eradication activity against S. mutans biofilms and null cytotoxicity, evidencing the need to conduct further studies that can identify their active components and in order to guide a safe use in treating and preventing dental caries.

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Journal of Ethnopharmacology

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Nonintrusive power estimation of residential appliances under voltage variation

Nonintrusive Load Monitoring (NILM) systems aim to estimate the individual appliance operation and consumption in a household from measurements at a single point, in order to motivate energy conservation behaviors. Power estimation based on appliance rated powers is not always accurate because of the voltage supply variations, thus misleading load disaggregation algorithms. In this paper we propose models of power as a function of voltage for correcting the power estimation. Measurements in the laboratory of residential loads are performed under multiple voltage levels. These data are processed to find regression models. Moreover, some analytic expressions to calculate the powers are proposed. Proposed models result more accurate than the rated powers and other models in the scientific literature.

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Proceedings of International Conference on Harmonics and Quality of Power, ICHQP

Título del artículo:

Wealth and cardiovascular health: A cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Background: Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household\'s ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study. Methods: A cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples. Results: Overall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden). Conclusion: Inequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level.

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International Journal for Equity in Health

Título del artículo:

Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study

Background: The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions. Methods: HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged 35-70 years from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study. Results: HGS values differed among individuals from different geographic regions. HGS values were highest among those from Europe/North America, lowest among those from South Asia, South East Asia and Africa, and intermediate among those from China, South America, and the Middle East. Reference ranges stratified by geographic region, age, and sex are presented. These ranges varied from a median (25th–75th percentile) 50 kg (43–56 kg) in men <40 years from Europe/North America to 18 kg (14–20 kg) in women >60 years from South East Asia. Reference ranges by ethnicity and body-mass index are also reported. Conclusions: Individual HGS measurements should be interpreted using region/ethnic-specific reference ranges.

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Journal of Cachexia, Sarcopenia and Muscle

Título del artículo:

A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension

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The Lancet

Título del artículo:

A prospective cohort study to assess seroprevalence, incidence, knowledge, attitudes and practices, willingness to pay for vaccine and related risk factors in dengue in a high incidence setting

Background: Dengue is one of the most important vector-borne diseases in the world, causing significant morbidity and economic impact. In Colombia, dengue is a major public health problem. Departments of La Guajira, Cesar and Magdalena are dengue endemic areas. The objective of this research is to determine the seroprevalence and the incidence of dengue virus infection in the participating municipalities from these Departments, and also establish the association between individual and housing factors and vector indices with seroprevalence and incidence. We will also assess knowledge, attitudes and practices, and willingness-to-pay for dengue vaccine. Methods: A cohort study will be assembled with a clustered multistage sampling in 11 endemic municipalities. Approximately 1000 homes will be visited to enroll people older than one year who living in these areas, who will be followed for 1 year. Dengue virus infections will be evaluated using IgG indirect ELISA and IgM and IgG capture ELISA. Additionally, vector indices will be measured, and adult mosquitoes will be captured with aspirators. Ovitraps will be used for continuous estimation of vector density. Discussion: This research will generate necessary knowledge to design and implement strategies with a multidimensional approach that reduce dengue morbidity and mortality in La Guajira and other departments from Colombian Caribbean.

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BMC Infectious Diseases

Título del artículo:

Comparative metagenomic analysis of PAH degradation in soil by a mixed microbial consortium

In this study, we used a taxonomic and functional metagenomic approach to analyze some of the effects (e.g. displacement, permanence, disappearance) produced between native microbiota and a previously constructed Polycyclic Aromatic Hydrocarbon (PAH)-degrading microbial consortium during the bioremediation process of a soil polluted with PAHs. Bioaugmentation with a fungal-bacterial consortium and biostimulation of native microbiota using corn stover as texturizer produced appreciable changes in the microbial diversity of polluted soils, shifting native microbial communities in favor of degrading specific populations. Functional metagenomics showed changes in gene abundance suggesting a bias towards aromatic hydrocarbon and intermediary degradation pathways, which greatly favored PAH mineralization. In contrast, pathways favoring the formation of toxic intermediates such as cytochrome P450-mediated reactions were found to be significantly reduced in bioaugmented soils. PAH biodegradation in soil using the microbial consortium was faster and reached higher degradation values (84% after 30 d) as a result of an increased co-metabolic degradation when compared with other mixed microbial consortia. The main differences between inoculated and non-inoculated soils were observed in aromatic ring-hydroxylating dioxygenases, laccase, protocatechuate, salicylate and benzoate-degrading enzyme genes. Based on our results, we propose that several concurrent metabolic pathways are taking place in soils during PAH degradation.

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Journal of Hazardous Materials

Título del artículo:

Results from Colombia\'s 2016 report card on physical activity for children and youth

Background: Physical activity (PA) is vital to the holistic development of young people. Regular participation in PA is associated with substantial benefits for health, cognitive function, and social inclusion. Recognizing the potential of PA in the context of the current peace process in Colombia, the purpose of this article is to present the methodology and results of Colombia\'s second Report Card on PA for children and youth. Methods: A group of experts on PA graded 14 PA indicators based on data from national surveys and policy documents. Results: National and departmental policy indicators received a grade of B, while organized sport participation, overweight, obesity, community influence, and nongovernment initiatives indicators received a grade of C. Overall PA levels, active transportation, sedentary behaviors, and school influence received a grade of D. Active play, low physical fitness, and family influence received an Incomplete grade. Conclusion: PA levels are low and sedentary behaviors are high in Colombian children and youth, with notable geographic differences. A broad policy framework translated into specific actions could provide unique opportunities to bridge the gap between knowledge and practice, and contribute to social integration goals in a postconflict setting.

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Journal of Physical Activity and Health

Título del artículo:

Availability, affordability, and consumption of fruits and vegetables in 18 countries across income levels: findings from the Prospective Urban Rural Epidemiology (PURE) study

Background Several international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability and affordability. Methods We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data from participants in these communities; we also recorded the diversity and non-sale prices of fruits and vegetables from grocery stores and market places between Jan 1, 2009, and Dec 31, 2013. We determined the cost of fruits and vegetables relative to income per household member. Linear random effects models, adjusting for the clustering of households within communities, were used to assess mean fruit and vegetable intake by their relative cost. Findings Of 143 305 participants who reported plausible energy intake in the food frequency questionnaire, mean fruit and vegetable intake was 3·76 servings (95% CI 3·66–3·86) per day. Mean daily consumption was 2·14 servings (1·93–2·36) in low-income countries (LICs), 3·17 servings (2·99–3·35) in lower-middle-income countries (LMICs), 4·31 servings (4·09–4·53) in upper-middle-income countries (UMICs), and 5·42 servings (5·13–5·71) in high-income countries (HICs). In 130 402 participants who had household income data available, the cost of two servings of fruits and three servings of vegetables per day per individual accounted for 51·97% (95% CI 46·06–57·88) of household income in LICs, 18·10% (14·53–21·68) in LMICs, 15·87% (11·51–20·23) in UMICs, and 1·85% (−3·90 to 7·59) in HICs (ptrend=0·0001). In all regions, a higher percentage of income to meet the guidelines was required in rural areas than in urban areas (p<0·0001 for each pairwise comparison). Fruit and vegetable consumption among individuals decreased as the relative cost increased (ptrend=0·00040). Interpretation The consumption of fruit and vegetables is low worldwide, particularly in LICs, and this is associated with low affordability. Policies worldwide should enhance the availability and affordability of fruits and vegetables. Funding Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.

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The Lancet Global Health

Título del artículo:

Kodamaea ohmeri infection in a newborn with a mediastinal mass

Invasive fungal infections are a considerable cause of morbidity, mortality, increased hospital stay durations, and high health care costs, during neonatal period. In this period, the premature infants are the most affected. Candida species are the leading cause of invasive fungal infections. The majority of neonatal Candida infections are caused by C. Albicans, C. parapsilosis, C. glabrata and C. tropicalis, although other fungus species are being reported. One such emerging pathogen is K. ohmeri. This organism has been reported as a pathogen in the neonatal period, principally in premature infants. The risk factors associated with fungal infection are central line, immunosuppression, prolonged hospital stay, endotracheal intubation and exposure to antibiotics. We present a term baby with a mediastinal mass, who required several procedures, as pericardiocentesis, central catheters, mechanical ventilation, antibiotics. During his evolution, he presented infection by K. ohmeri. The baby was treated with amphotericin B, with satisfactory clinical course.

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Archivos Argentinos de Pediatria

Título del artículo:

Main drivers of human capital, learning and performance

The aim of this study was to show the relationships between the enablers for knowledge creation and human capital (HC); the effect of HC on feedback and feedforward; and the influence of these learning flows on organizational performance. To achieve this, we developed a novel theoretical model of relationships and tested this model empirically. We quantitatively test this model using data from firms in the Spanish biotechnology sector. Results show strong relationships between HC and enablers for knowledge creation (redundancy, trust, and autonomy); HC and learning flows (feedback and feedforward); and learning flows and organizational performance. The originality of this study lies in linking—theoretically, empirically, and through a novel model—independent theories of HC, learning, and knowledge creation.

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Journal of Technology Transfer

Título del artículo:

Sensory aspects in myasthenia gravis: A translational approach

Myasthenia gravis is a paradigmatic muscle disorder characterized by abnormal fatigue and muscle weakness that worsens with activities and improves with rest. Clinical and research studies done on nicotinic acetylcholine receptors have advanced our knowledge of the muscle involvement in myasthenia. Current views still state that sensory deficits are not “features of myasthenia gravis”. This article discusses the gap that exists on sensory neural transmission in myasthenia that has remained after > 300 years of research in this neurological disorder. We outline the neurobiological characteristics of sensory and motor synapses, reinterpret the nanocholinergic commonalities that exist in both sensory and motor pathways, discuss the clinical findings on altered sensory pathways in myasthenia, and propose a novel way to score anomalies resulting from multineuronal inability associated sensory troubles due to eugenic nanocholinergic instability and autoimmunity. This medicine-based evidence could serve as a template to further identify novel targets for studying new medications that may offer a better therapeutic benefit in both sensory and motor dysfunction for patients. Importantly, this review may help to re-orient current practices in myasthenia.

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Journal of the Neurological Sciences

Título del artículo:

Quantitative parameters of milky fatty globules by conventional microscopy: Potential treatment of bovine raw milk with UV rays at the point of primary production in the dairy chain of Cesar

The high bacterial/ml registration of raw milk, over 400 thousand in the Cesar forced to seek technological alternatives for reducing it at the origen. International institutes have made significant progress in conservation of maternal milk with UV rays without altering its nutritional properties. Additionally, the amount and diameters of MFG could be optically quantified in cow’s raw milk and breast milk by obtaining and digital image processing, finding an average of 5.1 microns in average size of milk fat globules. This is a first determinant to potentiate the use of ultraviolet rays on the site of origin of bovine milk to lower microbial load of pathogen.

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Revista Chilena de Nutricion

Título del artículo:

Respiratory muscle dysfunction in patients undergoing cardiovascular surgery

Motivation To assess the presence of alterations in respiratory muscle strength in patients with a programmed cardiovascular surgery, the impact of the surgery on respiratory muscle function and their relationship with ventilatory alterations during mediate postoperative period. Methods Prospective observational study. Respiratory function tests (spirometry) and respiratory muscle strength tests (inspiratory: maximum inspiratory pressure, and expiratory: maximum expiratory pressure) were conducted in two moments: immediate preoperative (2 ± 1 days before surgery) and mediate postoperative period (2 ± 1, before being discharged). Respiratory complications included prolonged mechanical ventilation, pulmonary thromboembolism, pneumothorax, hemothorax; pneumonia; pleural effusion; pulmonary edema and atelectases. Results 30 adult patients were assessed (n = 30) (ages 62 ± 12). Spirometry performance decreased by 54% in the preoperative period (35% obstructive alteration, 19% non-obstructive) and inspiratory and expiratory weakness was confirmed at 67 and 100% respectively. Respiratory complications were present in 93% (more frequently atelectasis and pleural effusion). Severe postoperative deterioration of maximum inspiratory pressure increased by 10-fold the risk of atelectasis (OR = 10, IC 95% 0.85-117.02; p = 0.067). Upon discharge, ejection fraction of the left ventricle was 29% lower, forced vital capacity –32%, maximum inspiratory pressure –32% and maximum expiratory pressure –32% with regards to baseline values. Conclusion Patients undergoing cardiovascular surgery suffer an unsuspected respiratory muscle dysfunction that worsens with surgery and hospitalisation, associated to a increase of the risk of respiratory complications.

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Revista Colombiana de Cardiologia

Título del artículo:

Association between gross motor function and nutritional status in children with cerebral palsy: a cross-sectional study from Colombia

Aim: To determine the association between gross motor function and nutritional status in children with cerebral palsy (CP) residing in an urban area in a developing country. Method: We conducted a cross-sectional study in 177 children (ages 2–12y, 59.3% male) with a diagnosis of CP who were attending rehabilitation centres in Bucaramanga, Colombia (2012–2013). A physiotherapist evaluated patients using the Gross Motor Function Classification System (GMFCS, levels I to V). Nutritional status was evaluated by nutritionists and classified according to the World Health Organization growth charts. We used linear and multinomial logistic regression methods to determine the associations. Results: There were 39.5%, 6.8%, 5.6%, 16.4%, and 31.6% patients classified in levels I to V respectively. The mean adjusted differences for weight-for-age, height-for-age, BMI-for-age, and height-for-weight z-scores were significantly larger for children classified in levels II to V compared with those in level I. The children classified in levels IV and V were more likely to have malnutrition (adjusted odds ratio [OR] 5.64; 95% confidence interval [CI] 2.27–14.0) and stunting (OR 8.42; 95% CI 2.90–24.4) than those classified in GMFCS levels I to III. Interpretation: Stunting and malnutrition are prevalent conditions among paediatric patients with CP, and both are directly associated with higher levels of gross motor dysfunction.

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Developmental Medicine and Child Neurology