Cafeina vs aminofilina para la apnea del prematuro: estudio randomizado

La apnea del prematuro es una patología frecuente que se presenta en el 85% de los recién nacidos menores de 34 semanas de edad gestacional y en el 95-100% de los menores de 28 semanas. Con respecto al peso al nacer, se manifiesta en el 92% de los de peso menor a 1250 gramos y en el 50% de los de peso menor a 1500 gramos. Desde 2003, se aprobó en Colombia el uso de citrato de cafeína para la prevención y el tratamiento de la apnea del prematuro, basados en la evidencia. Metodología: Se realizó un estudio de interención simple comparando el citrato de cafeína con la aminofilina para la prevención y manejo de la apnea en pretérminos menores de 35 semanas de edad. Resultados: Se incluyeron 118 recién nacidos pretérminos de los cuales 18,6% fueron menores de 28 semanas, 79,7% de 34 semanas y dos 1,7% mayores o iguales a 34,1 semanas. 56 neonatos recibieron citrato de cafeína. De éstos, 33,9% de forma profiláctica y 66,1%, terapéutica; 28 (23,7%) recibieron aminofilina y 34 (28,8%) no recibieron ninguno de los dos medicamentos. El citrato de cafeína mostró menos efectos secundarios comparado con aminofilina (p <0,01). Discusión: El citrato de cafeína, administrado en forma profiláctica o terapéutica, mostró resultados superiores, estadísticamente significativos, en comparación con aminofilina y con los controles sin tratamiento, para la prevención y el tratamiento de la apnea del prematuro, presentando, además, menores efectos secundarios.

Factores de riesgo asociados al diagnostico de asfixia perinatal en el Hospital Universitario Mayor Méderi, Bogota, 2010-2011.

Objetivo: Determinar los factores de riesgo de anteparto, intraparto y fetales asociados a asfixia perinatal en los recién nacidos del servicio de neonatología del Hospital Universitario Mayor Méderi de Bogotá, 2010-2011. Materiales y métodos: Estudio de casos y controles pareado por fecha de nacimiento, con una relación 1:5(51:306). Las asociaciones se evaluaron con la prueba de ji-cuadrado de Mantel y Haenszel o Test de Fisher para datos pareados, con OR e intervalo de confianza del 95%, el análisis multivariado con un modelo de regresión logística condicional. Resultados: Los factores de riesgo con asociación significativa fueron: - Ante parto: Antecedentes patológicos maternos (OR=6.00,IC95%:1.55-23.19,p=0.013), primigestación (OR=1.91,IC95%:1.02-3.56,p=0,090), -Intraparto: Abruptio de placenta (OR=25,00,IC95%:2.92-213.99,p=0.001), hemorragia del tercer trimestre (OR=12.50,IC95%:2.43-64.43,p=0.001), Oligohidramnios(OR=6.25,IC95%:1.68-23.28,p=0.001), taquicardia fetal (OR=7.66,IC95%:1.67-35.04,p=0.011), monitoreo fetal intraparto anormal (OR=10.33,IC95%:4.38-24.34,p=0.001), expulsivo prolongado(OR=13.00,IC95%:4.63-36.46,p=0.001), fiebre materna(p<0.001), corioamnionitis(p<0.001), convulsiones maternas(p<0.001), bradicardia fetal (p=<0.001), -Fetales: Género masculino(OR=1.87,IC95%:1.02-3.44,p=0.026), edad gestacional por BALLARD igual ó <36semanas(OR=4.78(IC95%:2.21-10.35,p=0.001), vía del nacimiento instrumentado(OR=18,80,IC95%:3.69-39.55,p=0.001), líquido amniótico hemorrágico o teñido de meconio(OR= 9.00,IC95%:3.01-26.85,p=0.001), circular de cordón(OR=9.00,IC95%:3.59-22.52,p=0.001), peso al nacer igual ó <2500 gramos (OR=8.88,IC95%:3.73-21.15,p=0.001). Los subrayados y el síndrome hipertensivo asociado al embarazo se encontraron significativos en análisis multivariado. Conclusiones: Los factores de riesgo para asfixia perinatal fueron: antecedentes patológicos maternos, primigestación, abruptio de placenta, hemorragia del tercer trimestre, oligohidramnios, monitoreo fetal intraparto anormal, taquicardia y bradicardia fetal, expulsivo prolongado, corioamnionitis, fiebre materna, convulsiones maternas, género masculino, edad gestacional por BALLARD igual ó <36 semanas, vía del nacimiento instrumentado, líquido amniótico hemorrágico o teñido de meconio, circular de cordón, peso al nacer igual ó <2500 gramos.

Conflict-induced poverty: Evidence from Colombia

En Colombia, la pobreza y el conflicto están estrechamente relacionados. Este estudio usa medidas de disuasión del gobierno como instrumentos de varias variables específicas de conflicto para estimar el impacto del conflicto sobre la pobreza en Colombia. Usando datos del censo a nivel municipal para el año 2005, evalúo el efecto sobre la incidencia urbana y rural del recientemente-desarrollado Índice de Pobreza Multidimensional. Los resultados sugieren que el conflicto aumenta significativamente la pobreza rural. Esto es consistente con el hecho que la mayor parte del conflicto en Colombia ocurre en las áreas rurales. También evalúo el efecto rezagado del conflicto en la pobreza para concluir que éste dura por al menos tres años pero que decae en el tiempo. Finalmente, pruebo que mis resultados son robustos a una batería de especificaciones adicionales, incluyendo una versión modificada de mi variable dependiente y el uso de una base alternativa de conflicto.

Presión arterial en preescolares de la localidad de Usaquén en Bogotá

Introducción: La hipertensión arterial es un problema de salud pública tanto en países industrializados como en vía de desarrollo. Su prevalencia en la infancia viene en aumento por lo que es relevante determinarla en niños preescolares a nivel local. Objetivo: Determinar la prevalencia de hipertensión arterial en niños de tres a cinco años de una cohorte de 14 hogares infantiles del ICBF de la localidad de Usaquén en Bogotá. Materiales y métodos: Se realizó un estudio de corte transversal analítico, utilizando la base de datos de un ensayo aleatorizado y controlado del año 200913, y se evaluaron las cifras de tensión arterial de acuerdo a sexo, edad, talla y su correlación con el IMC con un nivel de confianza del 95% y precisión del 1%. Se calcularon las medias, desviaciones estándar, percentiles y prevalencia. Resultados: Se obtuvo una muestra de 1035 casos, encontrándose una prevalencia de 4,5% de HTA sistólica, 10,4% de diastólica, ambas en estadio I; teniendo en cuenta tanto sistólica como diastólica, fue de 11,6% en estadio I. Se determinaron los valores de presión arterial sistólica y diastólica en cuartiles de acuerdo a edad, sexo y talla. El coeficiente de correlación entre el IMC y los niveles de presión arterial sistólica y diastólica fueron de 0.0992 y 0.0362 respectivamente. Conclusión: La prevalencia de HTA general fue de 11,6%, predominando la diastólica en estadio I en niños preescolares. No se encontró correlación entre el IMC y las cifras de tensión arterial sistólica y diastólica.

Violence and growth in colombia : a review of the quantitative literature

This is a critical review of the empirical literature on the relationship between violence and economic growth in Colombia: an interesting case study for social scientists studying violence, conflict, crime and development. We argue that, despite the rapid development of this literature and the increasing use of new techniques, there is still much room for research. After assessing the contribution of the most influential papers on the subject, we suggest directions for future research.

Mercados laborales en entornos de conflictos armados: un análisis empírico para Colombia

Históricamente se ha reconocido que los conflictos internos afectan de manera directa variables a nivel individual como la salud de las personas, los niveles de escolaridad y el desplazamiento forzoso de los afectados. Sin embargo, solo hasta la última década las investigaciones académicas se han inclinado en documentar y cuantificar rigurosamente los efectos colaterales de la violencia sobre las condiciones de vida de los individuos. La presente investigación estudia cómo la exposición al conflicto en Colombia ha afectado las decisiones en términos de mercado laboral de las personas. La estrategia de identificación internaliza los reconocidos problemas de endogeneidad del conflicto con variables de actividad y desarrollo económico y presenta resultados robustos a fenómenos de migración interna y desplazamiento. En términos de participación laboral y desempleo, se encuentran efectos heterogéneos a nivel de género como respuestas a la violencia experimentada. En particular, la probabilidad de participación laboral de las mujeres se incremente como consecuencia de la exposición al conflicto, mientras que la de desempleo disminuye. Para los hombres, los resultados muestran una menor probabilidad de participación, efecto contrario al de las mujeres, y un efecto análogo en términos de desempleo. La investigación no encuentra efectos diferenciales en términos de informalidad laboral.

Bioinspired iron and manganese catalysts for the effective and selective oxidation of alkanes and alkenes

La gran eficiència, selectivitat i les condicions suaus exhibides per les reaccions que tenen lloc al centre actiu de les metal·looxigenases són la font d'inspiració per la present dissertació. Amb l'objectiu de dissenyar catalitzadors d'oxidació eficients hem fet ús de dues estratègies: la primera consisteix en el disseny de complexos amb baix pes molecular inspirats en aspectes estructurals de la primera esfera de coordinació del centre metàl·lic d'enzims de ferro i de manganès. Aquests complexos s'han estudiat com a catalitzadors en l'oxidació selectiva d'alcans i d'alquens fent servir oxidants "verds" com ara l'H2O2. La segona estratègia està basada en l'ús de la química supramolecular per tal de desenvolupar estructures moleculars auto-acoblades amb la forma i les propietats químiques desitjades. Concretament, la construcció de nanocontenidors amb un catalitzador d'oxidació incrustat a la seva estructura ens permetria dur a terme reaccions més selectives, tal com passa en les reaccions catalitzades per enzims.

Enhanced phytoextraction: In search of EDTA alternatives

Enhanced phytoextraction proposes the use of soil amendments to increase the heavy-metal content of above-ground harvestable plant tissues. This study compares the effect of synthetic aminopolycarboxylic acids [ethylenediamine tetraacetatic acid (EDTA), nitriloacetic acid (NTA), and diethylenetriamine pentaacetic acid (DTPA)] with a number of biodegradable, low-molecular weight, organic acids (citric acid, ascorbic acid, oxalic acid, salicylic acid, and NH4 acetate) as potential soil amendments for enhancing phytoextraction of heavy metals (Cu, Zn, Cd, Pb, and Ni) by Zea mays. The treatments in this study were applied at a dose of 2 mmol/kg(-1) 1 d before sowing. To compare possible effects between presow and postgermination treatments, a second smaller experiment was conducted in which EDTA, citric acid, and NH4 acetate were added 10 d after germination as opposed to 1 d before sowing. The soil used in this screening was a moderately contaminated topsoil derived from a dredged sediment disposal site. This site has been in an oxidized state for more than 8 years before being used in this research. The high carbonate, high organic matter, and high clay content characteristic to this type of sediment are thought to suppress heavy-metal phytoavailability. Both EDTA and DTPA resulted in increased levels of heavy metals in the above-ground biomass. However, the observed increases in uptake were not as large as reported in the literature. Neither the NTA nor organic acid treatments had any significant effect on uptake when applied prior to sowing. This was attributed to the rapid mineralization of these substances and the relatively low doses applied. The generally low extraction observed in this experiment restricts the use of phytoextraction as an effective remediation alternative under the current conditions, with regard to amendments used, applied dose (2 mmol/kg(-1) soil), application time (presow), plant species (Zea mays), and sediment (calcareous clayey soil) under study.

Vesicular systems for delivering conventional small organic molecules and larger macromolecules to and through human skin

The history of using vesicular systems for drug delivery to and through skin started nearly three decades ago with a study utilizing phospholipid liposomes to improve skin deposition and reduce systemic effects of triamcinolone acetonide. Subsequently, many researchers evaluated liposomes with respect to skin delivery, with the majority of them recording localized effects and relatively few studies showing transdermal delivery effects. Shortly after this, Transfersomes were developed with claims about their ability to deliver their payload into and through the skin with efficiencies similar to subcutaneous administration. Since these vesicles are ultradeformable, they were thought to penetrate intact skin deep enough to reach the systemic circulation. Their mechanisms of action remain controversial with diverse processes being reported. Parallel to this development, other classes of vesicles were produced with ethanol being included into the vesicles to provide flexibility (as in ethosomes) and vesicles were constructed from surfactants and cholesterol (as in niosomes). Thee ultradeformable vesicles showed variable efficiency in delivering low molecular weight and macromolecular drugs. This article will critically evaluate vesicular systems for dermal and transdermal delivery of drugs considering both their efficacy and potential mechanisms of action.

Selective and highly efficient dye scavenging by a pH-responsive molecular hydrogelator

A structurally simple low molecular weight hydrogelator derived from isophthalic acid forms robust pH-responsive hydrogels capable of highly efficient and selective dye adsorption.

Influence of porcine genotype on the abundance of thyroid hormones and leptin in sow milk and its impact on growth, metabolism and expression of key adipose tissue genes in offspring

Neonatal mortality is greater in commercial porcine genotypes, compared with the ancient Meishan breed that rapidly lay down adipose tissue; this may be related to hormones, such as triiodothyronine (T3) or leptin. Leptin is present in maternal milk; however, the extent to which this supply provides the neonate with leptin is unknown, but may play a role in growth and development. We investigated whether thyroid hormones and leptin concentrations in maternal milk differed between genotypes; and whether this influenced piglet concentrations or expression of genes involved in adipose tissue regulation. Eight Meishan and six commercial sows were entered into the study and milk samples from the day of parturition to day 4 postpartum was taken daily. The median birth weight piglet in each litter had a daily venous blood sample taken and was euthanised on day 4. Gene expressions of IGF-I, IGF-binding protein 3 (IGFBP-3), peroxisome proliferators activated receptor (PPAR) and glucocorticoid receptor (GR) were measured in adipose tissue using real-time PCR. T3 was increased in Meishan milk, but not in piglet plasma. Milk thyroxine was similar between breeds but commercial piglet levels were significantly higher. Leptin was higher in commercial sow milk throughout the study. Milk leptin was strongly correlated to plasma leptin during the first postnatal days and also to organ and body weight in Meishan piglets that also had significantly higher expression of GR, but not IGF-I, IGFBP-3 or PPAR. In conclusion, we have found a significant disparity in the provision of thyroid hormones in Meishan and commercial sow’s milk. These changes are not always translated to plasma concentrations of hormone in the piglet. Leptin appears to have a stronger role in growth and development in the Meishan genotype compared with commercial; along with the increased GR expression, this may also represent a potential mechanism behind the rapid accumulation of adipose tissue in Meishan piglets.

The survival, growth and carcase characteristics of crossbred beef cattle in Tanzania

Sires of seven Bos taurus beef breeds were mated with Bos indicus Boran cows at two sites, one near sea level and the other at about 1000 m altitude, and over three years. Purebred Boran calves provided controls for comparisons between sire breeds for growth to 4 years of age, mortality and carcase characteristics in a range environment where all the animals were kept under a similar management regime. Numerous sire breed x site, sire breed x year of birth and site x year of birth interactions were established. Mortality was high, but there was no significant sire breed effect, although purebred Borans had a higher survival than crossbred calves. There was no significant difference between genotypes in birth weight. Generally, Bos taurus cross steers achieved greater live weight gains and heavier carcase weights at 4 years of age than did purebred Borans. Limousin-cross steers had significantly (p<0.05) less fat in the tenth rib sample joint than any of the other genotypes. A productivity index that combined calf survival and carcase weight indicated that the Chianina crosses were more productive than any other genotype at either site. Purebred Borans were more productive than all the Bos taurus crossbreds with the exception of the Chianina crosses at site 1, but were only superior to the Limousin crosses at site 2, which was at the higher altitude. When lean meat yield was introduced into the productivity index, the Boran purebreds were the least productive at site 2.

Weaning preterm infants: a randomised controlled trial

Objective: To assess the effect on growth and iron status in preterm infants of a specially devised weaning strategy compared with current best practices in infant feeding. The preterm weaning strategy recommended the early onset of weaning and the use of foods with a higher energy and protein content than standard milk formula, and foods that are rich sources of iron and zinc. Subjects and design: In a blinded, controlled study, 68 preterm infants (mean (SD) birth weight 1470 (430) g and mean (SD) gestational age 31.3 (2.9) weeks) were randomised to either the preterm weaning strategy group (n = 37) or a current best practice control group (n = 31), from hospital discharge until 1 year gestation corrected age (GCA). Main outcome measures: Weight, supine length, occipitofrontal head circumference, and intakes of energy, protein, and minerals were determined at 0, 6, and 12 months GCA. Levels of haemoglobin, serum iron, and serum ferritin were assayed at 0 and 6 months GCA. Results: Significant positive effects of treatment included: greater increase in standard deviation length scores and length growth velocity; increased intake of energy, protein, and carbohydrate at 6 months GCA and iron at 12 months GCA; increased haemoglobin and serum iron levels at 6 months GCA. Conclusions: The preterm weaning strategy significantly influenced dietary intakes with consequent beneficial effects on growth in length and iron status. This strategy should be adopted as the basis of feeding guidelines for preterm infants after hospital discharge. School of Applied Statistics Faculty of Life Sciences

A novel self-healing supramolecular polymer system

Utilising supramolecular pi-pi stacking interactions to drive miscibility in two-component polymer blends offers a novel approach to producing materials with unique properties. We report in this paper the preparation of a supramolecular polymer network that exploits this principle. A low molecular weight polydiimide which contains multiple pi-electron-poor receptor sites along its backbone forms homogeneous films with a siloxane polymer that features pi-electron-rich pyrenyl end-groups. Compatibility results from a complexation process that involves chain-folding of the polydiimide to create an optimum binding site for the pi-electron-rich chain ends of the polysiloxane. These complementary pi-electron-rich and -poor receptors exhibit rapid and reversible complexation behaviour in solution, and healable characteristics in the solid state in response to temperature. A mechanism is proposed for this thermoreversible healing behaviour that involves disruption of the intermolecular pi-pi stacking cross-links as the temperature of the supramolecular film is increased. The low T-g siloxane component can then flow and as the temperature of the blend is decreased, pi-pi stacking interactions drive formation of a new network and so lead to good damage-recovery characteristics of the two-component blend.

Catalytic oxidation of alcohols using molecular oxygen mediated by poly(ethylene glycol)-supported nitroxyl radicals

The selective catalytic oxidation of alcohols over a mixture of copper(l) chloride and a number of linear 'linker-less' or 'branched' poly(ethylene glycol)-supported nitroxyl radicals of the 2,2,6,6-tetramethyl-piperidine-1-oxyl (TEMPO) family as a catalyst system has been investigated in the presence of molecular oxygen in a batch reactor. It is found that the activity profile of the polymer-supported nitroxyl radicals is in good agreement with that of low-molecular weight nitroxyl catalysts, for example, allylic and benzylic alcohols are oxidised faster than aliphatic alcohols. The oxidations can be tuned to be highly selective such that aldehydes are the only oxidation products observed in the oxidation of primary alcohols and the oxidations of secondary alcohols yield the corresponding ketones. A strong structural effect of the polymeric nitroxyl species on catalytic activity that is dependent upon their spatial orientation of the nitroxyl radicals is particularly noted. The new soluble macromolecular catalysts can be recovered readily from the reaction mixture by solvent precipitation and filtration. In addition, the recycled catalysts demonstrate a similar selectivity with only a small decrease in activity compared to the fresh catalyst even after five repetitive cycles. (c) 2005 Elsevier B.V. All rights reserved.