Abstract The treatment of ocular tuberculosis (TB) remains controversial worldwide. The development of guidelines for ocular TB can facilitate the approach and management of these patients. These guidelines should be developed regionally, considering the local TB epidemiology. The objectives of this consensus are: to initiate an interdisciplinary discussion about the epidemiology, pathophysiology, clinical presentation, diagnosis, workup and treatment of patients with ocular TB, to establish a treatment algorithm and define which patients should be treated in Chile and how and, to analyze and discuss the published data regarding chemoprophylaxis for patients with latent TB who need to start immunosuppressive treatment due to inflammatory ocular conditions.

Resumen Introducción: El tratamiento de la tuberculosis (TB) ocular es un tema que genera controversia en el mundo. Para el correcto manejo de estos pacientes, es necesario el desarrollo de guías que consideren la epidemiología de la TB ocular en cada nación. El objetivo de este consenso fue discutir de forma interdisciplinaria la epidemiología, fisiopatología, clínica, diagnóstico, estudio y tratamiento de los pacientes con TB ocular, para establecer un algoritmo de tratamiento y proponer qué pacientes deben ser tratados en Chile y con qué tratamiento. Además, se establecieron acuerdos para efectuar quimioprofilaxis de los pacientes con TB latente que tienen indicación de tratamiento inmunosupresor por enfermedades inflamatorias oculares.

Background: Suicidal behavior is a public health problem, and adolescents are one of the main risk groups. Aim: To analyze the association among suicidal behavior, consumption of psychoactive substances, and Health Related Quality of Life (HRQoL) in adolescents attending schools in Valparaiso, Chile. Material and Methods: Five hundred-fifty adolescents enrolled in a public school participated in the study. HRQoL was evaluated through KIDSCREEN-27, while suicidal behavior and the consumption of psychoactive substances were measured with the Global School-based Student Health Survey (GSHS). Results: The prevalence of suicidal behavior was higher in women and in those who used tobacco or marijuana in the last month. Respondents with a bad perception of physical well-being reported a higher frequency of suicidal ideation than those with a good perception (Odds ratio (OR): 2.24; 95% confidence: 1.49-3.36). Likewise the frequency of suicidal ideation was higher in those with a bad perception of psychological well-being (OR: 3.87; 95%CI: 2.09-7.71), and a bad perception of autonomy and relation with parents (OR:2.46; 95%CI: 1.34-4.54). Suicide planning was also associated with dimensions of autonomy and relation with parents (OR: 2.32; 95% CI: 1.23-4.38) and dimensions of friends and social support (OR: 1.86; 95%CI:1.05-3.28). Suicide attempt was associated with the dimensions of friendship and social support (OR: 1.83; 95%CI: 1.02-3.28) and school environment (OR: 1,92; 95%CI: 1,23-3,01). Conclusions: Suicide ideation is associated with worse physical and psychological well-being. Suicide planning and suicide attempt is associated with a worse perception about the relation with parents or friends, social support, and school environment.

Background: Adolescents are more prone to develop health risk behaviors. Among these, early consumption of psychoactive drugs is relevant. Aim: To assess the association between early consumption of illicit drugs, tobacco and alcohol, suicide behaviors, risky sexual behaviors, eating habits and physical activity in school age adolescents from Valparaiso, Chile. Material and Methods: The online world survey of scholar health to identify the health risk behaviors was answered by 550 adolescents aged 15 to 18 years, from a public educational institution at Valparaiso, Chile. Results: Early consumption of alcohol, smoking and illicit drug use was reported by 59, 57 and 44% of respondents, respectively. The frequency of psychoactive drug consumption during the last month, risky sexual behaviors and missing breakfast was higher among those with an early onset of alcohol and illicit drug consumption and smoking. The frequency of suicidal risk behaviors and low consumption of fruits and vegetables was higher among those with an early onset of illicit drug use and smoking. A low physical activity level was associated with early smoking onset. Health risk behaviors were associated with early onset of alcohol and illicit drug consumption and smoking. Conclusions: Early onset of alcohol and illicit drug consumption and smoking is associated with health risk behaviors in Chilean adolescents.

ABSTRACT Background: it is necessary to improve the subject "National Security and Primary Assistance" in the 1st year of the Nursing Bachelor's degree in which there have been affectations on the educational results of the students, with some frequency. Objective: to design methodological actions for the improvement of the subject "National Security and Primary Assistance", based on a diagnosis of the teaching process. Methods: a descriptive, cross-sectional study was carried out, with a mixed approach in the Bachelor of Nursing degree, with information from the 2015-2016 to 2018-2019 courses. Theoretical, empirical and statistical-mathematical methods were used. The professors who participated acted as experts to assess the proposal made. Results: insufficiencies were found in the teaching-learning process of the subject "National Security and Primary Care" in the 1st year of the Nursing Bachelor's degree, which motivated the design of general and particular methodological actions in different topics that contribute to the improvement of the course. Conclusions: the methodological actions proposed after the diagnosis of the teaching process of the subject "National Security and Primary Assistance", respect the amount of time devoted to the subject and according to the experts; they should have a foreseeable potential positive impact on 1st year students of the Bachelor's Degree in Nursing.

RESUMEN Fundamento: es necesario el perfeccionamiento de la asignatura “Seguridad Nacional y Asistencia Primaria” en 1er año de la carrera de Licenciatura en Enfermería en la que se han visto afectaciones en los resultados docentes de los alumnos, con cierta frecuencia. Objetivo: diseñar acciones metodológicas para el perfeccionamiento de la asignatura “Seguridad Nacional y Asistencia Primaria”, a partir de un diagnóstico de su proceso de enseñanza. Métodos: se realizó un estudio descriptivo, transversal, con un enfoque mixto en la carrera de Licenciatura en Enfermería, con información de los cursos 2015-2016 al 2018-2019. Se emplearon métodos teóricos, empíricos y estadístico-matemáticos. Los profesores que participaron actuaron como expertos para valorar la propuesta realizada. Resultados: se constataron insuficiencias en el proceso enseñanza aprendizaje de la asignatura “Seguridad Nacional y Asistencia Primaria” en 1er año de la carrera de Licenciatura en Enfermería, que motivaron al diseño de acciones metodológicas generales y particulares en diferentes temas que contribuyen al perfeccionamiento de la asignatura. Conclusiones: las acciones metodológicas propuestas tras el diagnóstico del proceso de enseñanza de la asignatura “Seguridad Nacional y Asistencia Primaria”, respetan el fondo de tiempo de la asignatura y deben tener, según los expertos, un impacto potencial previsible positivo en los estudiantes de 1er año de Licenciatura en Enfermería.

Abstract Avocado is the third most produced crop in the State of Mexico, with 11,296 ha, where the predominant variety is ‘Hass.’ Due to a lack of knowledge about its development in different environments, its agronomic management is highly heterogeneous, since it is based on experiences in other states. The objective of this study was to analyze, describe and quantify the phenological development of ‘Hass’ avocado in three environments in the State of Mexico. The vegetative, flowering, root and fruit development of ‘Hass’ avocado was recorded during the 2011-2012 cycle. Two periods were distinguished for vegetative growth (December-April and October-November), flowering (December-February and August-October), harvest (November-February and August-October) and root growth (April-July and October-December). The vegetative growth (0.40 and 0.06 cm increase in shoot length and diameter, respectively) and root growth (36 and 24 g fresh weight and dry matter, respectively) were lower than fruit growth (70.1 mm increase in diameter) in Coatepec Harinas (temperate with andosol soil and isotherms from 14-18 °C). In contrast, the same growth measurements were higher in the localities with cambisol-luvisol soil and isotherms from 16-20 °C: Ixtapan del Oro (temperate/semi-warm, with 0.69 and 0.12 cm in shoot, and 56 and 48.8 g in root) and Temascaltepec (semi-warm, with 0.78 and 0.23 cm in shoot, and 69.3 and 31.3 g in root), but lower increases in fruit (59.4 and 56.6 mm, respectively). The phenological differences observed among environments will be useful for the technical management of the crop.

Resumen El cultivo de aguacate en el Estado de México representa el tercer lugar de producción en México con 11,296 ha, en donde la variedad predominante es ‘Hass’. Por desconocimiento de su desarrollo, en los diferentes ambientes, su manejo agronómico resulta altamente heterogéneo, ya que se basa en experiencias de otros estados. El objetivo de este estudio fue analizar, describir y cuantificar el desarrollo fenológico de aguacate ‘Hass’ en tres ambientes del Estado de México. Se registró el desarrollo vegetativo, floración, raíz y fruto de aguacate ‘Hass’ durante el ciclo 2011-2012. Se distinguieron dos épocas de crecimiento vegetativo (diciembre-abril y octubre-noviembre), floración (diciembre-febrero y agosto-octubre), cosecha (noviembre-febrero y agosto-octubre) y crecimiento de raíz (abril-julio y octubre-diciembre). Los crecimientos vegetativo (0.40 y 0.06 cm de incremento en longitud y diámetro de brote, respectivamente) y de raíz (36 y 24 g de peso fresco y materia seca, respectivamente) fueron menores que el de fruto (70.1 mm de incremento en diámetro) en Coatepec Harinas (templada con suelo andosol e isotermas de 14-18 °C). En contraste, los mismos crecimientos fueron mayores en las localidades con suelo cambisol-luvisol e isotermas de 16 a 20 °C: Ixtapan del Oro (templada-semicálida, con 0.69 y 0.12 cm de brote, y 56 y 48.8 g en raíz) y Temascaltepec (semicálida, con 0.78 y 0.23 cm en brote, y 69.3 y 31.3 g en raíz), pero menores incrementos en fruto (59.4 y 56.6 mm, respectivamente). Las diferencias fenológicas observadas entre ambientes servirán para el manejo técnico del cultivo.

Background: Adolescence is considered a nutritionally vulnerable period of life, since their eating habits are influenced by factors that can promote the consumption of non-nutritious food. Aim: To analyze the relation between eating habits, obesity, and the perception of Health-Related Quality of Life in school-aged adolescents. Material and Methods: A cross-sectional study of 550 adolescents aged 16 ± 1 years (60% women) attending a public education institution in Valparaíso, Chile. The Global School-based Student Health Survey (GSHS) for eating habits and the KIDSCREEN-27 survey for health-related quality of life were self-administered online. The answers were anonymous. A logistic regression analysis was conducted to evaluate the relationship between the variables, which was adjusted for age and sex. Results: Ten percent of men and 6% of women were obese. Those with an inadequate consumption of fruits had a worst perception of their physical well-being, autonomy and relationship with their parents. Psychological well-being and school environment were perceived worst among those that did not consume breakfast. Obese respondents also reported a poorest physical health. Conclusions: Inadequate eating habits and obesity have a negative effect of health-related quality of life among adolescents.

ABSTRACT Ectodermic dysplasias are alterations of the ectoderm embryologic derivatives. This is a case of an adult female patient with hypoparathyroidism, drawing attention due to her phenotype; she was remitted by the consultation of Neurology to the Genetic one. She was diagnosed a hypohidrotic ectodermal dysplasia, of genetic origin with autosomal dominant inheritance, what is very rare for this entity. The case is presented with the aim of describing the clinical manifestation of this genetic alteration that never drew medical interest and nobody diagnosed or studied. It is associated to a pathologic condition like hypothyroidism and was not reported in medical literature before. The clinical evaluation of the patient allowed arriving to the diagnostic and explaining many problems that were unexplained, and also offering the adequate genetic advice to her and her relatives likewise at risk of suffering a similar genetic condition.

RESUMEN Las displasias ectodérmicas constituyen alteraciones de los derivados embriológicos del ectodermo. Paciente adulta, con hipoparatiroidismo, llamó la atención por su fenotipo y fue remitida de la consulta de Neurología a la consulta Genética. Se diagnosticó una displasia ectodérmica hipohidrótica, de origen genético con herencia autosómica dominante, poco común para esta entidad. Se presenta este caso con el objetivo de describir las manifestaciones clínicas de esta alteración genética, las cuales nunca fueron objeto de interés médico resultando inadvertidas para su estudio y diagnóstico. Esta alteración se asocia a una condición patológica como el hipoparatiroidismo, en la literatura revisada no se encontraron reportes de la misma. La evaluación clínica de la paciente permitió hacer el diagnóstico y explicar muchos de los problemas para los cuales no existían respuestas, así como ofrecer un asesoramiento genético adecuado para ella y para sus familiares con riesgo de padecer una condición genética similar.

Resumen El síndrome de apnea-hipopnea obstructiva del sueño (SAHOS) influye en la calidad de vida de las personas que lo padecen de manera diferente. Es importante medir esta repercusión, de forma objetiva, al momento de hacer el diagnóstico y durante el tratamiento, porque puede mejorar la adherencia a este último. A partir de diferentes estudios, se han creado escalas de medición generales para las enfermedades y específicas para SAHOS, las cuales permiten evaluar diferentes dimensiones como los síntomas diurnos y nocturnos, la somnolencia diurna, las emociones y la repercusión de la enfermedad sobre las interacciones sociales de las personas y la percepción del paciente frente al tratamiento establecido.

Abstract Obstructive sleep apnea-hypopnea syndrome (OSAHS) has a direct influence on the quality of life of people who suffer from it. Objectively measuring this impact at diagnosis and during treatment is important to improve the subsequent adherence to treatment. Based on different studies, general and specific disease scales for OSAHS have been created, which allow to evaluate different dimensions such as daytime symptoms, nocturnal symptoms, daytime sleepiness, emotions, the repercussion of the disease on the social interactions of people, as well as the patient's perception of the treatment indicated.

Background The use of psychoactive substances among adolescents is a major social and public health concern. Aim To analyze association of substance abuse and multiple drug use with health-related quality of life (HRQOL) in adolescents attending a high school in Valparaiso, Chile. Material and Methods Analytical cross-sectional study conducted in a sample of adolescents attending high school. HRQOL was assessed using KIDSCREEN-52 questionnaire and substance use was measured using the Global school-based student health survey. Participants had to complete online, self-administered, anonymous questionnaires. Multiple logistic regression analyses were conducted to calculate Odd ratios. Results A total of 550 adolescents aged 16 ± 1 years old completed the questionnaires. Thirty nine percent consumed alcohol during the last month, 31% smoked, 33% used marijuana and 33% admitted the use of multiple drugs. High-risk alcohol consumption was associated with a lower perception of psychological well-being, self-perception and school environment. This last dimension was affected in those who admitted marijuana use during the last month. Multiple drug use (three substances) was associated with a lower perception of physical and psychological well-being, self-perception, relationship with parents, family life and school environment. Conclusions High-risk alcohol consumption and multiple drug use (three substances) have a negative impact on the HRQOL of school age adolescents.

Resumen El síndrome de piernas inquietas (SPI) es un trastorno sensitivo y motor en el que el paciente refiere un deseo incontenible de mover las extremidades, que puede estar acompañado por una sensación desagradable, mal definida, y hasta en el 50 % de los casos con dolor, difícil de ubicar en un punto específico, y que inicialmente se manifiesta en las piernas. Se presenta principalmente en las noches impidiendo el sueño y subsecuentemente afectando la calidad de vida del paciente. Clásicamente se divide en síndrome de piernas inquietas primario y secundario, por la presencia o no de enfermedades concomitantes relacionadas con el tratamiento y pronóstico del SPI. Esta enfermedad tiene una incidencia en la población general de 9 a 22 pacientes por cada 1.000 personas al año (equivalente a 1,7 % por año); con una prevalencia de 5-13 % de la población general. El diagnóstico del SPI se realiza mediante el uso de los criterios establecidos por el Grupo Internacional de Estudio de SPI, divididos en esenciales y de soporte. Su tratamiento tiene como piedra angular a los agonistas dopaminérgicos, y otros medicamentos como el gabapentin enacarbil que han ganado terreno en los últimos años. La importancia del conocimiento de la enfermedad radica en el impacto negativo que ejerce sobre la calidad de vida de los pacientes afectados en general, y el aumento de la mortalidad en los pacientes con comorbilidad de enfermedad renal terminal en particular. Su diagnóstico es clínico y debe buscarse como causa de insomnio.

Summary Restless leg syndrome (RLS) is a sensory motor disorder in which the patient referred an urge to move the limbs, which may be accompanied by an ill-defined sense, and up to 50% of cases with pain, difficult to locate, and initially manifests in the legs. It occurs mostly at night, disrupting sleep and subsequently affecting the quality of life of patients. It is classically divided into primary and secondary restless legs syndrome, based on the presence or absence of comorbidities related to the treatment and prognosis of RLS. This disease has an incidence in the general population of 9-22 patients per 1,000 people per year (equivalent to 1.7% per year); with a prevalence of 5-13% of the general population. The diagnosis of RLS is done by using the criteria established by the International RLS study group, divided into essential and supportive. The treatment's cornerstone are dopamine agonists, and other drugs, such as gabapentin enacarbil that have been used more recently. The importance of the disease lies in the negative impact it has on the quality of life of affected patients in general, and increased mortality in patients with end stage renal disease comorbidity in particular.

Las áreas naturales protegidas representan una de las estrategias para la mitigación del cambio climático. El objetivo de esta investigación consistió en estimar el contenido de carbono en biomasa forestal en suelos minerales y calcular las pérdidas de carbono por cambios de uso del suelo en el Parque Nacional Malinche (PNM). La superficie de bosque del PNM es de 17.496,34 ha y almacena 1.544.377,66 mg en bosque y 4.148.985,97 mg en suelos. Para estimar el contenido de biomasa forestal se aplicaron ecuaciones alométricas y se trabajó con la cartografía del Instituto Nacional de Estadística y Geografía (INEGI) en el análisis espacio-temporal de los cambios de uso de suelo. Para el carbono en suelos se aplicaron los valores del Panel Intergubernamental de Cambio Climático (IPCC).

The protected natural areas represent one of the strategies for the mitigation of climate change. The aim of this research consists of estimating the carbon content in forestry biomass found in mineral soils and calculating the carbon losses due to changes in soil use in the Park (PNM). The surface area of the Park (PNM) is 17.496,34 ha and houses 1.544,377,66 mg in Wood and 4.148,958,97 mg in soil. To estimate the content of forestry biomass allometric equations were applied and work was done with the cartography of the INEGI (National Institute of Statistics and Geography) in the spacetemporal analysis of the changes in soil use. For soil carbon the values of IPCC (Intergovernmental Panel of Climate Change) were applied.

As áreas naturais protegidas representam uma das estratégias para a mitigação da mudança climática. O objetivo desta pesquisa consistiu em estimar o conteúdo de carbono em biomassa florestal em solos minerais e calcular as perdas de carbono por mudanças de uso do solo no Parque Nacional Malinche (PNM). A superfície da floresta do PNM é de 17.496,34 ha e armazena 1.544.377,66 mg em floresta e 4.148.985,97 mg em solos. Para estimar o conteúdo de biomassa florestal, aplicaramse equações alométricas e trabalhou-se com a cartografia do Instituto Nacional de Estatística e Geografia (Inegi) na análise espaço-temporal das mudanças de uso do solo. Para o carbono em solos, aplicaram-se os valores do Painel Intergovernamental sobre Mudança do Clima (IPCC, por sua sigla em inglês).

La evaluación de la formación universitaria en la Enseñanza del Francés, realizada por los entes patronales, se ve reflejada en las condiciones del contrato laboral de los egresados de este campo del conocimiento. El resultado de dicha valoración orienta a los formadores dado el compromiso educativo de proveer a la sociedad profesionistas que respondan a sus necesidades emergentes. En este artículo se realizó una entrevista abierta a 19 empleadores de diferentes niveles educativos y modalidades de enseñanza del francés, en la ciudad de Puebla, México, durante el 2014, abordando su apreciación sobre la calidad de la formación de competencias: ocupacionales, humanas y de mercado. Los resultados convergen en algunos puntos: necesidad de elevación del nivel de certificación de lengua, especialización de FOS (negocios y turismo), orientación al público de educación básica y media superior, relaciones públicas y comunicación, y el manejo de marketing. La concientización de las necesidades explícitas señaladas por el sector patronal, permite vislumbrar los cambios que experimenta la demanda en este momento histórico en cuanto a la formación de formadores de francés lengua extranjera se refiere. El resultado de este trabajo puede ser útil a los formadores de profesores de lengua extranjera en general, en un macro-contexto que rebase los límites del contexto de estudio.

The evaluation of university formation in the teaching of French, made by the employer entities is reflected in the conditions of the employment contract of the graduates of this field of knowledge. The result of this assessment, guides trainers given the commitment to provide educational professionals to society, to meet their emerging needs. In this article an unstructured interview with 19 employers from different educational levels and modalities of teaching French was performed in the city of Puebla, México, addressing their judgment as to the quality of the formation of skills: occupational, human and marketing. The results converge on some points: The need to raise the level of language, specialization of FOS (business and tourism), facing the public of basic and high school education, public relations, communication management and marketing. Explicit awareness of the needs identified by the employer sector offers a glimpse of the changes in demand in this historical moment in terms of the training of trainers of French language is refereed. The result of this work can be useful to foreign language teacher educators in general, on a macro - context that goes beyond the limits of the study context.

Este artículo, tomando como referencia básica los conceptos de Orientación al Mercado (OM) y Responsabilidad Social Corporativa (RSC) pretende i) identificar y analizar la importancia real de aquellos factores que determinan el mayor o menor nivel de preocupación por el cliente, y ii) establecer un nexo entre ambos conceptos (OM y RSC). Para alcanzar los objetivos propuestos la investigación está basada en un estudio de casos múltiple (multiple case-study) de empresas pertenecientes a sectores diversos. Los datos sugieren que la presión competitiva y las normas legales son los factores críticos de dicha preocupación, mientras que el patrón de responsabilidad social de la empresa es un elemento secundario. Por tanto, en determinadas situaciones el mercado puede actuar como mecanismo de ajuste soberano a largo plazo, mientras que en otras será necesario articular un conjunto de normas y leyes que regulen la actividad de las empresas y protejan al consumidor. Las implicaciones de estos resultados y las conclusiones del estudio se incluyen en la parte final del artículo.

Este artigo, tomando como referência básica os conceitos de Orientação ao Mercado (OM) e Responsabilidade Social Corporativa (RSC) pretende i) identificar e analisar a importância real daqueles fatores que determinam o maior ou menor nível de preocupação pelo cliente e ii) estabelecer um nexo entre ambos os conceitos (OM e RSC). Para alcançar os objetivos propostos a investigação está baseada em um estudo de casos múltiplos (multiple case-study) de empresas pertencentes a setores diversos. Os dados sugerem que a pressão competitiva e as normas legais são os fatores críticos de tal preocupação, enquanto que o padrão de responsabilidade social da empresa é um elemento secundário. Por conseguinte, em determinadas situações o mercado pode atuar como mecanismo de ajuste soberano a longo prazo, enquanto que em outras será necessário articular um conjunto de normas e leis que regulem a atividade das empresas e protejam ao consumidor. As implicações destes resultados e as conclusões do estudo estão incluídas na parte final do artigo.

This article, which uses the concepts of Market Orientation (MO) and Corporate Social Responsibility (CSR) as a basic reference, aims i) to identify and analyze the real importance of those factors that determine a greater or lesser degree of concern for the customer and ii) to establish a connection between both concepts (MO and CSR). To analyze the proposed objectives, the research is based on a multiple case-study of companies from diverse sectors. The data suggests that competitive pressure and legal rules and regulations are the critical factors of that concern, whereas the company's pattern of social responsibility is a secondary element. Therefore, in certain situations the market can act as a sovereign adjustment mechanism over the long term, whereas in others a set of laws and regulations must be created to protect consumers. The implications of these results and the conclusions of the study are included in the final part of the article.

Cet article prend pour référence de base les concepts d'Orientation du Marché (OM) et de Responsabilité Sociale Corporative (RSC) et a pour objectif i) l'identification et l'analyse de l'importance réelle des facteurs déterminant le niveau élevé ou moins élevé de préoccupation pour le client ii) l'établissement d'un lien entre les deux concepts (OM y RSC). Pour atteindre les objectifs proposés la recherche est fondée sur une étude de cas multiple (multiple case-study) d'entreprises appartenant à divers secteurs. Les données suggèrent que la pression compétitive et les normes légales sont les facteurs critiques de préoccupation, tandis que le modèle de responsabilité sociale de l'entreprise représente un élément secondaire. Par conséquent, dans certaines circonstances, le marché peut agir comme mécanisme d'ajustement principal à long terme, alors que, dans d'autres cas, il sera nécessaire d'articuler un ensemble de normes et de lois réglementant l'activité des entreprises et protégeant le consommateur. Les implications des résultats et les conclusions de l'étude sont comprises dans la partie finale de l'article.

OBJETIVO: Comparar a eficácia da fototerapia simples (1 painel) versus dupla (2 painéis) na redução da hiperbilirrubinemia não-hemolítica em recém-nascidos a termo. MÉTODOS: Os recém-nascidos a termo foram randomizados prospectivamente para receber fototerapia simples ou dupla. Os níveis de bilirrubina foram medidos no momento da internação e em intervalos de 12 horas, assim como em seguimento 48 horas após a alta. RESULTADOS: Trinta e sete pacientes receberam fototerapia simples, e 40, dupla. A redução média dos níveis de bilirrubina nas primeiras 24 horas de tratamento foi maior no grupo que recebeu fototerapia dupla (5,1±2,2 mg/dL versus 4,3±2,1 mg/dL), porém sem significância estatística (p = 0,18). As taxas de readmissão foram similares e nenhum dos grupos apresentou efeitos adversos. CONCLUSÃO: A fototerapia dupla não foi mais eficaz do que a fototerapia simples no tratamento da hiperbilirrubinemia não-hemolítica em recém-nascidos a termo. Entretanto, nossos resultados sugerem que a fototerapia dupla possa ser mais eficaz em recém-nascidos a termo com níveis de bilirrubina mais altos no momento da internação.

OBJECTIVES: To compare the effectiveness of single (1 panel) vs. double (2 panels) phototherapy in reducing nonhemolytic hyperbilirubinemia in term newborns. METHODS: Term newborns with hyperbilirubinemia were prospectively randomized to receive double or single phototherapy. Bilirubin levels were measured at admission and at 12-hour intervals, as well as at a follow-up 48 hours after discharge. RESULTS: Thirty-seven patients received single and 40 double phototherapy. The mean decrease in bilirubin level in the first 24 hours of treatment was greater in the double phototherapy group (5.1±2.2 mg/dL vs. 4.3±2.1 mg/dL), but without statistical significance (p = 0.18). Readmission rates were similar and no adverse effects were found in either group. CONCLUSIONS: Double-surface was not more effective than single-surface phototherapy in the treatment of nonhemolytic hyperbilirubinemia in term newborns. However, our results suggest that double phototherapy may be more effective in those term newborns with higher bilirubin levels at admission.

Dans la dernière décennie, une étude rétrospective descriptive de 79 patients suivis pour syndrome de Marfan au Département de génétique et à l’Hôpital pédiatrique universitaire " Eliseo Noel Camaño " de Matanzas, a été réalisée. Les troubles musculo-squelettiques les plus fréquemment rencontrés ont été : taille démesurément grande du segment inférieur, arachnodactylie et scoliose, associées à des découvertes radiologiques tels que l’amincissement du cortex des os longs, l’augmentation de l’indice métacarpien et la scoliose. On a rencontré un nombre élevé de patients, 41 au total (51,6%), associés à des activités de surcharge physique inadéquates pour leur maladie.

A retrospective descriptive study of 79 patients with the diagnosis of Marfan’s Syndrome that received attention at the physicians’ offices of the Provincial Department of Genetics and of “Eliseo Noel Camaaño” Provincial Teaching Hospital during the last 10 years was conducted. It was determined that the most frequently found musculoskeletal disorders were: tall stature with disproportion of the inferior segment, arachnodactyly and scoliosis associated with radiological findings, such as thinness of the cortical substance of the long bones, increase of the metacarpial index and scoliosis. It was observed that a high number of patients, 41 in all (51.6 %), were linked to physical overload activities that were not suitable for their disease.

Se realiza un estudio retrospectivo descriptivo de 79 pacientes estudiados con el diagnóstico de síndrome de Marfan en los últimos diez años, en las consultas del Departamento Provincial de Genética y del Hospital Pediátrico Docente "Eliseo Noel Caamaño", de Matanzas. Se determina que los trastornos musculoesqueléticos más frecuentemente hallados fueron: la talla alta con desproporción del segmento inferior, la aracnodactilia y la escoliosis, asociados a hallazgos radiológicos como el adelgazamiento de la cortical de los huesos largos, el aumento del índice metacarpiano y la escoliosis. Se encontró un elevado número de pacientes, 41 en total (51,6 %), vinculados a actividades de sobrecarga física inadecuadas para su enfermedad