Resumen: Las infecciones respiratorias agudas bajas (IRAB) son la principal causa de hospitalización durante la estación invernal. El catéter nasal de alto flujo (CNAF) se ha establecido como parte del tratamiento de estas. Objetivo: Caracterizar la población de niños con insuficiencia respiratoria aguda hipoxémica tratados con CNAF y determinar los predictores de fracaso de esta terapia. Pacientes y Método: Estudio prospectivo en menores de 2 años ingresados por IRAB tratados con CNAF en el Centro Hospitalario Pereira Rossel! (CHPR), desde 20/5 al 20/09 de 2019. Se recolectaron datos a partir de historias clínicas y analizados con el software SPSS 21.0. Se analizaron variables cuantitativas: edad gestacional, peso al nacer, edad y peso actual, frecuencia respiratoria, pH, pCO2, HCO3-, BE y recuento de glóbulos blancos previos a la conexión. Las variables cualitativas evaluadas fueron: sexo, comorbilidades, alteraciones radiológicas, antígenos virales y antecedentes de episodios similares Se definieron dos grupos según el éxito o fracaso del tratamiento con CNAF, en los cuales se evaluaron diferentes variables: sexo, peso, edad, alteraciones gasométricas, recuento de glóbulos blancos. Resultados: Se incluyeron 449 pacientes, 274 (61%) tuvieron éxito. Aquellos que fracasaron tuvieron menor edad gestacional (p = 0,003), peso al nacer (p = 0,046) y mayor frecuencia respiratoria (FR) pre-conexión (p = 0,031). En el modelo de regresión logística múltiple se encontró que la FR pre-conexión fue predictora de fallo para el tratamiento con CNAF (OR: 1,035 IC 95%: (1,01-1,07)). El área bajo la curva (en el análisis con curvas ROC) para la frecuencia respiratoria fue de 0,558 (IC 0,503-0,613). La frecuencia respiratoria con mayor sensibilidad (53%) y especificidad (55%) es de 59 respiraciones por minutos. Conclusión: La FR pre-conexión al CNAF fue el principal predictor de fracaso de la técnica. Es necesario profundizar en otras características para encontrar predictores confiables de fracaso.

Abstract: Acute lower respiratory infections (ALRI) are the main cause of hospitalization during the winter season. High-flow nasal catheter (HFNC) has been established as part of the treatment of these infections. Objective: To characterize the population of children with acute hypoxemic respiratory failure treated with HFNC and to determine the predictors of failure of this therapy. Patients and Method: Prospective study in children under 2 years of age admitted due to ALRI treated with HFNC at the Pereira Rossell Hospital Center (CHPR), from 20/5 to 20/09 2019. Data were collected from medical records and analyzed with SPSS 21.0 software. The following quantitative variables were analyzed: gestational age, birth weight, current age and weight, respiratory rate, pH, pCO2, HCO3-, BE, and pre-connection white blood cell count. The qualitative variables evaluated were: sex, comorbidities, radiological alterations, viral antigens, and history of similar episodes. Two groups were defined according to the success or failure of treatment with HFNC, where the following variables were evaluated: sex, weight, age, gasometric alterations, and white blood cell count. Results: 449 patients were included, of which 274 (61%) were successful with the treatment. Those who failed had lower gestational age (p = 0.003), birth weight (p = 0.046), and pre-connection higher respiratory frequency (RF) (p = 0.031). In the multiple logistic regression model, pre-connection RF predicted failure for HFNC treatment (OR: 1.035 IC 95%: (1.01-1.07)). In the analysis with ROC curves, the area under the curve for RF was 0.558 (CI 0.503-0.613). The RF with the highest sensitivity (53%) and specificity (55%) was 59 breaths per minute. Conclusion: Pre-connection RF to HFNC was the main predictor of technique failure. It is necessary to deepen other characteristics to find reliable predictors of failure.

Abstract Malaria is the most important parasitic disease worldwide. In 2019, more than 679,441 cases of malaria were reported in the American region. During this study, Argentina was in malaria pre-elimination autochthonous transmission phase with the aim of being declared as malaria-free country. The aim of this work was to assess the influence of remote sensing spectral indices (NDVI, NDWI) and climatic variables (temperature, relative humidity and precipitation) on the distribution and abundance of Anopheles mosquitoes, in four localities with different degrees of anthropogenic disturbance and with previous malaria cases records located , in a historical malarious area in northeastern of Argentina. Between June 2012 and July 2014, mosquitoes were collected. We collected 535 Anopheles adult mosquitoes. Anopheles strodei s.l. was the most abundant species. The greatest richness, diversity and abundance of species were registered in wild and semi-urban environments. The abundance of Anopheles presented a negative association with relative humidity and mean temperature, but positive with mean maximum temperature. The most important variables determining Anopheles total abundance and distribution were NDWI Index and distance to vegetation. The abundance of An. strodei s.l., was positive associated with water areas whereas the NDVI Index was negatively associated.

ABSTRACT Knowing the amount of water used during the growing of garlic (Allium sativum) is essential to optimize the efficiency of its use and to promote sustainable production, especially in drylands, where water resources are scarce. Therefore, the purpose of this study is to determine the water footprint (WF total ) in the cultivation of white,purple and red cultivars, in different areas of the province of Mendoza, Argentina. To account for the total water footprint (WF total ) and each of its components (WF blue , WF greenan and WF gray ), the methodology proposed by the Water Footprint Network was followed according to the Water Footprint Assessment Manual. The results show that the highest WF total in Mendoza corresponds to red garlic (973 m 3 t - ) followed by white garlic (794 m 3 t - ) and purple garlic (550 m 3 t - ). Regarding the cultivation areas, it is observed that the highest values of WFtotal are found in the South region, followed by the North, Center and Valle de Uco regions respectively. On the other hand, the weighted WF value at the provincial level for the 3 varieties of garlic is 652 m 3 t - , where 20% corresponds to WF green , 58% to WF blue and finally 22% to WF gray . The variation of the WF results of each type of garlic and zones analyzed is associated mainly with climatic aspects and economics which determine the response to water consumption, productivity and yield.

RESUMEN Conocer la cantidad de agua utilizada por el cultivo de ajo (Allium sativum) es primordial para optimizar la eficiencia en su uso y promover una producción sostenible, especialmente en tierras áridas, donde el recurso hídrico es escaso. Por ello, el propósito de este estudio es determinar la huella hídrica (HH) en la fase agrícola del ajo blanco, morado y colorado, en las diferentes zonas de cultivo en la provincia de Mendoza, Argentina. Para la determinación de la huella hídrica total y cada uno de sus componentes (HH azul, HH verde y HH gris) se siguió la metodología propuesta por la Water Footprint Network según el Manual de Evaluación de Huella Hídrica. Los resultados muestran que la mayor HH total promedio en Mendoza corresponde al ajo colorado (973 m3 t-1), seguido por el ajo blanco (794 m3 t-1) y el ajo morado (550 m3 t-1). En cuanto a las zonas de cultivo, se observa que los mayores valores de HH total se presentan en el sur, seguido por el norte, centro y Valle de Uco . Por otra parte, el valor de HH ponderada a nivel provincial para los 3 tipos de ajos es de 652 m3 t-1, donde el 20% corresponde a HH verde, 58% a HH azul y el 22% a la HH gris. La variación de los resultados obtenidos en cada tipo de ajo y zona considerada responde principalmente a aspectos climáticos y económicos que determinan la respuesta al consumo de agua, el rendimiento y la productividad.

ABSTRACT Crohn’s disease (CD) is a relapse-remitting inflammatory bowel disease that can affect any part of the digestive system. This heterogeneous disease has multiple factors that contribute to an abnormal immune response to intestinal microorganisms. Treatment is based on the use of anti-inflammatories, corticosteroids, immunosuppressants and biologic biologic agents either alone or in combination. Surgical treatment is usual and, ten years after diagnosis, more than 80% of patients report having undergone surgical procedures related to the disease. Unfortunately, none of the treatments described offer a cure, and many cases become refractory or without therapeutic options. In this scenario, hematopoietic stem cell transplantation has been suggested because clinical remission was obtained in patients who had CD associated with malignant hematological diseases and an alternative since the first reports in 2010. In this report, the Transplantation Committee of the Brazilian Group for the Study of Inflammatory Bowel Diseases reviews the history and results of the procedure in patients with CD, detailing and discussing the various relevant points that permeate hematopoietic stem cell transplantation and cell therapy in this disease.

RESUMO A doença de Crohn (DC) é uma doença inflamatória intestinal (DII) recidivante recorrente que pode afetar qualquer parte do sistema digestivo. É doença heterogênea e possui múltiplos fatores que contribuem para uma resposta imune anormal aos microrganismos intestinais. O tratamento baseia-se no uso de anti-inflamatórios, corticosteroides e imunossupressores e imunobiológicos que são utilizados isoladamente ou em combinação. O tratamento cirúrgico é frequente e 10 anos após o diagnóstico, mais de 50% dos pacientes relatam terem sido submetidos a procedimentos cirúrgicos relacionados à doença. Infelizmente, nenhum dos tratamentos descritos oferece cura, e inúmeros casos tornam-se refratários ou sem opções terapêuticas. Nesse cenário, o transplante de células-tronco hematopoéticas (TCTH) em decorrência da remissão clínica de pacientes que apresentavam DC associada a doenças hematológicas malignas, passou a ser alternativa desde os primeiros resultados em 2010. Neste relato, a Comissão de Transplantes do Grupo Brasileiro de Estudo das Doenças Inflamatórias Intestinais revisa a história e os resultados do procedimento em pacientes com DC, detalhando e discutindo os diversos pontos relevantes que permeiam o TCTH e a terapia celular no tratamento da moléstia.

RESUMO: O estudo quantificou os parâmetros cinéticos de captação de K nas gramíneas Paspalum notatum, Paspalum urvillei e Axonopus affinis associados com o crescimento. Dez mililitros (10 ml) de solução nutritiva foram coletados em vasos de dois litros - com cinco repetições em 24 horas - para determinação das concentrações de K nas amostras. A matéria seca da parte aérea e raízes; comprimento, volume, diâmetro e área superficial radicular, bem como parâmetros cinéticos associados à absorção de nutrientes (Vmax, Km, Cmin e I) foram avaliados. A espécie P. notatum apresentou a maior produção de raiz, parte aérea e MS total, bem como o maior volume de raiz. P. urvillei apresentou o maior teor de K, que pode ser associado a raízes mais finas e resultando em maior área superficial. A. affinis registrou o maior valor de Vmax, o que levou a uma maior eficiência de absorção de K.

ABSTRACT: This study quantified K uptake kinetic parameters in grass species Paspalum notatum, Paspalum urvillei and Axonopus affinis to associate them with growth. Ten milliliters (10 ml) of nutrient solution were collected in two-liter pots - with five repetitions in 24 hours - in order to determine K concentrations in the samples. Shoot and root dry matter, root length, volume, diameter and surface area, as well as kinetic parameters associated with nutrient uptake (Vmax, Km, Cmin and I) were determined. Species P. notatum was the one presenting the highest root, shoot and total dry matter production, as well as the highest root volume. P. urvillei recorded the highest K content, which may be associated with thinner roots and greater root surface area. A. affinis recorded the highest Vmax value, which led to greater K uptake efficiency.

Abstract Zoonotic spillover is a phenomenon characterized by the transfer of pathogens between different animal species. Most human emerging infectious diseases originate from non-human animals, and human-related environmental disturbances are the driving forces of the emergence of new human pathogens. Synthesizing the sequence of basic events involved in the emergence of new human pathogens is important for guiding the understanding, identification, and description of key aspects of human activities that can be changed to prevent new outbreaks, epidemics, and pandemics. This review synthesizes the connections between environmental disturbances and increased risk of spillover events based on the One Health perspective. Anthropogenic disturbances in the environment (e.g., deforestation, habitat fragmentation, biodiversity loss, wildlife exploitation) lead to changes in ecological niches, reduction of the dilution effect, increased contact between humans and other animals, changes in the incidence and load of pathogens in animal populations, and alterations in the abiotic factors of landscapes. These phenomena can increase the risk of spillover events and, potentially, facilitate new infectious disease outbreaks. Using Brazil as a study model, this review brings a discussion concerning anthropogenic activities in the Amazon region and their potential impacts on spillover risk and spread of emerging diseases in this region.

Resumo Significativamente menos mulheres do que homens escolhem estudar programas relacionados com ciência, tecnologia, engenharia ou matemática (STEM). No Chile, em 2020, 53,9% das matrículas em instituições de ensino superior são do sexo feminino. No entanto, apenas 20,3% estão inscritos em programas STEM. A lacuna deve-se a factores que afetam negativamente as mulheres antes de entrarem e durante os seus estudos. Por conseguinte, são necessárias políticas públicas para ajudar a encorajar mais mulheres a estudar programas relacionados com a STEM, juntamente com a melhoria da sua taxa de retenção. A investigação tem como objetivo propor soluções que contribuam para a abordagem da equidade de gênero. A proposta considera uma metodologia quantitativa, explicativa e não-experimental. Através de uma entrevista a 3500 cidadãos, foram identificadas as principais condições e desafios enfrentados pelas mulheres nos programas STEM. Posteriormente, foi realizada uma análise quantitativa dos resultados obtidos, e as principais causas das condições podem ser agrupadas em cinco áreas de ação. Finalmente, a Hack4women desenvolve-se como um espaço de colaboração e co-criação, onde se destaca a participação do Estado, empresas, cidadãos, academia e estudantes. Assim, é gerado um conjunto de 18 propostas cujo objetivo é mitigar ou fornecer soluções para as áreas de ação detectadas que provocam a desmotivação das mulheres para estudar carreiras STEM.

Abstract Women who decide to study programs related to science, technology, engineering or mathematics (STEM), are significantly less than men. In the Chile of 2020, 53.9% of enrollments in higher education institutions correspond to women. However, only 20.3% are enrolled in STEM programs. The gap is due to factors that negatively impact women before entering and during their studies. Therefore, public policies are needed to help encourage more women to study STEM-related programs, along with improving their retention rate. The objective of the research is to propose solutions that contribute to gender equity. The proposal considers a quantitative, explanatory and non-experimental methodology. Through a survey of 3500 citizens, the main conditions and challenges faced by women in STEM programs were identified. Subsequently, a quantitative analysis of the results obtained was carried out, and the main causes of the conditions can be grouped into five areas of action. Finally, Hack4women is developed as a collaborative and co-creation space, where the participation of the State, companies, citizens, academia and students is highlighted. Thus, a set of 18 proposals are generated with the objective of mitigating or providing solutions to the detected areas of action that cause the demotivation of women to study STEM careers.

Resumen Las mujeres que deciden estudiar programas relacionados con la ciencia, tecnología, ingeniería o matemáticas (STEM) son significativamente menores a los hombres. En el Chile del 2020, el 53,9 % de las matrículas a instituciones de educación superior corresponde a mujeres. Sin embargo, solo el 20,3 % se matrícula en programas STEM. La brecha se debe a factores que impactan negativamente a las mujeres antes de ingresar y durante sus estudios. Por ello, se requiere de políticas públicas que contribuyan a incentivar a más mujeres estudiar los programas afines a STEM, junto con mejorar su tasa de retención. La investigación tiene por objetivo proponer soluciones que contribuyan al lineamiento hacia la equidad de género. La propuesta considera una metodología de trabajo de tipo cuantitativo, explicativo y no experimental. Mediante una encuesta realizada a 3500 ciudadanos, se identificó las principales afecciones y desafíos que presentan las mujeres, adscritas a programas STEM. Posteriormente, se realizó un análisis cuantitativo de los resultados obtenidos, se puede agrupar las principales causas de las afecciones en cinco ámbitos de acción. Finalmente, se desarrolla Hack4women, espacio colaborativo y de co-creación, donde se destaca la participación de Estado, empresa, ciudadania, academia y alumnado. Así, se generan un conjunto de 18 propuestas cuyo objetivo es mitigar o dar solución a los ámbitos de acción detectados que ocasionan la desmotivación de las mujeres a estudiar carreras STEM.

ABSTRACT: In this work I address three works of robotic art developed by Latin American artists: ENT-e (2012) by Gabriela Munguía, TZ'IJK (2013/4) by Paula Gaetano-Adi and Gustavo Cremblin, and Cartografías Invisibles (2018) by Ana Laura Cantera and Demian Ferrari. I assay a de-colonial perspective, aimed at understanding the autonomy of their material, aesthetic and conceptual programs. I analyse the strategies by which these productions modulate alternative body imaginaries to those of the anthropomorphic, machinic and hyper intelligent model of modern humanism. I conclude that these robotic creatures not only challenge the mind-body opposition widespread to the one of software-hardware, but also, by means of materiality introductions such as mud, vegetables or fungi, as well as the raising of behaviors based on what is sensitive and somatic, they explore a natural-artificial continuum in which affective exchanges and collaborative relations with the environment are suggested. They, thus, set us closer to "this side" regarding sensitive western modernity orders.

RESUMEN: En este trabajo abordo tres obras de arte robótico desarrolladas por artistas latinoamericanas: ENT-e (2012) de Gabriela Munguía, TZ’IJK (2013/4) de Paula Gaetano-Adi y Gustavo Cremblin, y Cartografías invisibles (2018) de Ana Laura Cantera y Demian Ferrari. Ensayo una perspectiva decolonial, dirigida a comprender la autonomía de sus programas materiales, estéticos y conceptuales. El objetivo es analizar las estrategias con las que estas producciones modulan imaginarios del cuerpo alternativos al modelo antropomórfico, maquínico e hiperinteligente del humanismo moderno. Concluyo que estas criaturas robóticas no sólo desafían la oposición mente-cuerpo extendida a la de software-hardware, sino que, mediante la introducción de materialidades como barro, vegetales u hongos y la generación de comportamientos fundamentados en lo sensible y lo somático, exploran un continuum natural-artificial en el que se sugieren intercambios afectivos y vinculaciones colaborativas con el entorno. Nos sitúan, así, en un “más acá” de los órdenes sensibles de la modernidad occidental.

Abstract Cardiovascular mortality (CVM) has become the major contributor to overall Fabry disease (FD) mortality in the enzyme replacement therapy (ERT) era. Our objectives were to describe causes and potential predictors of mortality in FD adult patients in Argentina, and to assess risk of major adverse cardio vascular events (MACE) in the ERT era. We retrospectively studied 93 consecutive patients treated with alpha-galactosidase A (median follow up: 9.5 years from start of ERT). Mean age at ERT starting was 35±16.3 years. Prevalence of cardiomyopathy and renal disease reached 47% and 41%, respectively. Eleven subjects (11.8%, 95%CI: 5-18%) died during follow up (1.24/100 patient-years). Mean overall survival was 71 years (95%CI: 66-75 years). Seven cases were considered as CVM; main causes were sudden death and stroke. Risk of MACE was 14% (95%CI: 6.9-21.1%; 1.47 events/100 patient-years from start of ERT). All but 2 subjects had at least one comorbid cardiovascular risk factor; however, 86% of patients remained free of MACE during follow-up. CVM remained low and our study was underpowered for detection of predictors of mortality, but it is worth noting that age at diagnosis and ERT starting, left ventricular mass index and renal disease trended to correlate with CVM. Prevalence of hypertension, diabetes and dyslipidemia were lower in FD patients when compared to population level data. As in the Argentinean general population, CVM was the leading cause of mortality among this cohort of consecutive FD patients treated with agalsidase alfa.

Resumen La mortalidad cardiovascular (MCV) se ha convertido en el principal contribuyente a la mortalidad general por enfermedad de Fabry (EF) en la era de la terapia de reemplazo enzimático (TRE). Nuestros objetivos fueron describir las causas y posibles predictores de mortalidad en pacientes adultos con EF en la Argentina, y evaluar el riesgo de eventos cardiovasculares mayores (MACE) en la actual era de TRE. Se estudiaron 93 pacientes consecutivos tratados con agalsidasa-alfa por una mediana de 9.5 años tras iniciar TRE. La edad al inicio de TRE fue 35 ± 16.3 años. La prevalencia de cardiomiopatía y enfermedad renal alcanzó 47% y 41%, respectivamente. Once sujetos (11.8%; IC95%: 5-18%) murieron durante el seguimiento (1.24/100 pacientes/año). La supervivencia global fue 71 años (IC95%: 66-75 años). Siete casos fueron considerados como MCV; las principales causas fueron muerte súbita e ictus. El riesgo de MACE fue 14% (IC95%: 6.9-21.1%; 1.47 eventos/100 pacientes/año desde la ERT). Todos menos 2 sujetos tenían al menos un factor de riesgo cardiovascular, pero el 86% permaneció libre de MACE. Los eventos de MCV fueron escasos. El estudio tuvo reducido poder estadístico para detectar predictores de mortalidad, pero la edad al diagnóstico y al iniciar la TRE, índice de masa ventricular izquierda y enfermedad renal tendieron a correlacionarse con MCV. La prevalencia de hipertensión, diabetes y dislipidemia fue menor en comparación con la población general. Como ocurre con la población general en Argentina, los eventos cardiovasculares fueron la principal causa de muerte en esta cohorte de pacientes consecutivos con EF tratados con agalsidasa-alfa.

RESUMO. No contexto da atual pandemia de covid-19, maior morbidade e mortalidade têm sido relatadas em idosos. Sabe-se que essa faixa etária apresenta alterações fisiológicas e condições clínicas próprias, como fragilidade, demência, entre outras. Objetivo: Descrever as características de pacientes com covid-19, maiores e menores de 80 anos, por meio de uma revisão sistemática da literatura que descreve relatos de casos, e resumir e avaliar criticamente essas características. Método: Revisão sistemática. O estudo foi registrado no Registro de Projetos de Pesquisa em Saúde (PRISA) do Instituto Nacional de Saúde do Peru (código EI00000631). Local: cinco bases de dados eletrônicas (Scopus, PubMed, PubMed Central, LILACS e SCIELO) foram sistematicamente pesquisadas entre 31 de dezembro de 2019 e 16 de abril de 2020. A busca se concentrou em relatos de caso, estudos de caso e séries de casos mais antigos pessoas com infecção por SARS-CoV-2 com mais e menos de 80 anos. Na seleção dos casos, a prioridade foi dada ao perfil clínico e epidemiológico, padrões laboratoriais e de imagem, e avaliação geriátrica abrangente. Resultados: Foram identificados 1.149 artigos. Após a aplicação dos filtros, obteve-se um total de 15 publicações de relatos de caso e registros completos de 27 idosos. A faixa etária mais frequente foi de 60 a 69 anos. Há pouca literatura sobre relatos de casos de adultos com mais de 80 anos. Os parâmetros mais frequentes foram hipertensão, febre, tosse, dificuldade respiratória, vidro fosco na radiografia e tomografia de tórax. Também foram observados diminuição da PaO2 / FiO2 e linfócitos, e aumento da proteína C reativa e Interleucina 6. Conclusões: Esta revisão sistemática encontrou poucas informações disponíveis sobre pacientes com menos de 80 anos, em quantidade ainda menor para aqueles com mais de 80 anos, além de uma ausência de avaliação geriátrica abrangente.

ABSTRACT. In the context of the current COVID-19 pandemic, higher morbidity and mortality have been reported in older adults. This age group presents physiological changes and its own clinical conditions such as frailty, dementia, among others. Objective: To describe the characteristics of COVID-19 patients, both over and under 80 years old, by conducting a systematic review of the literature describing case reports, and to summarize and critically assess these characteristics. Methods: Systematic review. The study was registered on the Registry of Health Research Projects (PRISA) of the Peruvian National Institute of Health (code EI00000631). Five electronic databases (Scopus, PubMed, PubMed Central, LILACS, and SCIELO) were systematically searched during the period between December 31, 2019 and April 16, 2020. The search focused on case reports, case studies, and case series of older people with COVID-19 infection aged over or under 80 years. When selecting the cases, priority was given to clinical and epidemiological profile, laboratory and imaging patterns, and comprehensive geriatric evaluation. Results: 1,149 articles were identified; after applying the filters, a total of 15 publications of case reports and complete records of 27 older adults were obtained. The most frequent age group was between 60 to 69 years old. There is little literature regarding case reports of older adults aged over 80 years. The most frequent parameters were hypertension, fever, cough, respiratory distress, ground-glass opacification in chest radiography and tomography. Furthermore, decrease in PaO2/FiO2 ratio and lymphocytes, and increase in C-reactive protein and Interleukin 6 were observed. Conclusions: This systematic review found little available information of patients under 80 years old, and far less for those over 80 years old, and an absence of comprehensive geriatric assessment.

RESUMEN Las benzodiazepinas y los “fármacos Z” (BZD-Z) se prescriben en exceso en muchos países. Este estudio evaluó su consumo en una organización de la seguridad social (obra social) de Argentina de alcance nacional. A partir de un diseño observacional descriptivo se analizó la dispensa ambulatoria de BZD-Z, entre abril 2020 y marzo 2021, a mayores de 18 años; desagregada por sexo, edad, principio activo y vida media. Se encontró una prevalencia anual de uso del 11,6% entre los 431.445 afiliados adultos, con valores más elevados en las mujeres y mayores de 60 años. El consumo global de BZD-Z fue de 77,6 dosis diarias definidas (DDD) cada 1.000 afiliados-día. El usuario promedio recibió 5,1 dispensas anuales y el equivalente a 1,4 DDD por cada día del año. Las BZD-Z más usadas fueron las de vida media larga. El consumo de BZD-Z resultó elevado y más prolongado que lo recomendado. Es necesario mejorar la calidad en el consumo y reducir el impacto negativo del uso inapropiado de estos fármacos entre los individuos tratados.

ABSTRACT: Benzodiazepines and “Z-drugs” (BZD/Z) are overprescribed in many countries. This study evaluates their consumption in a social security sector health insurance provider with national coverage in Argentina. With a descriptive and observational approach, outpatient dispensations of BZD/Zs were analyzed for people over 18 years old from April 2020 to March 2021, disaggregated by sex, age, active ingredient, and half-life. An annual prevalence of use of 11.6% was found among the 431,445 adult affiliates, with higher rates in women and in those over age 60. Overall consumption of BZD/Zs was 77.6 defined daily doses (DDD) per 1000 enrollee-days. The average user received 5.1 annual dispensations and the equivalent of 1.4 DDD for each day of the year. BZD/Zs with long half-life were the most used. We found high levels of BZD/Z consumption and for longer periods than recommended. It is necessary to improve the quality of consumption and reduce the negative impact of inappropriate use of these drugs among treated individuals.

ABSTRACT: Benzodiazepines and “Z-drugs” (BZD/Z) are overprescribed in many countries. This study evaluates their consumption in a social security sector health insurance provider with national coverage in Argentina. With a descriptive and observational approach, outpatient dispensations of BZD/Zs were analyzed for people over 18 years old from April 2020 to March 2021, disaggregated by sex, age, active ingredient, and half-life. An annual prevalence of use of 11.6% was found among the 431,445 adult affiliates, with higher rates in women and in those over age 60. Overall consumption of BZD/Zs was 77.6 defined daily doses (DDD) per 1000 enrollee-days. The average user received 5.1 annual dispensations and the equivalent of 1.4 DDD for each day of the year. BZD/Zs with long half-life were the most used. We found high levels of BZD/Z consumption and for longer periods than recommended. It is necessary to improve the quality of consumption and reduce the negative impact of inappropriate use of these drugs among treated individuals.

RESUMEN Las benzodiazepinas y los “fármacos Z” (BZD-Z) se prescriben en exceso en muchos países. Este estudio evaluó su consumo en una organización de la seguridad social (obra social) de Argentina de alcance nacional. A partir de un diseño observacional descriptivo se analizó la dispensa ambulatoria de BZD-Z, entre abril 2020 y marzo 2021, a mayores de 18 años; desagregada por sexo, edad, principio activo y vida media. Se encontró una prevalencia anual de uso del 11,6% entre los 431.445 afiliados adultos, con valores más elevados en las mujeres y mayores de 60 años. El consumo global de BZD-Z fue de 77,6 dosis diarias definidas (DDD) cada 1.000 afiliados-día. El usuario promedio recibió 5,1 dispensas anuales y el equivalente a 1,4 DDD por cada día del año. Las BZD-Z más usadas fueron las de vida media larga. El consumo de BZD-Z resultó elevado y más prolongado que lo recomendado. Es necesario mejorar la calidad en el consumo y reducir el impacto negativo del uso inapropiado de estos fármacos entre los individuos tratados.

ABSTRACT The actions of social, cultural, economic, political and technological development influence the production, access, availability, income, market, quality and supply of food aimed at the vulnera ble population. It is a challenge to present concrete actions to promote efficient processes that guarantee food security in Latin America. In this work, some aspects in the form of mutual su pport that propose the development of a society in order to achieve a dignified life are actively, dynamically and jointly integrated. Markets and family farming, accompanied by the application of agroecology, decent employment, environmental culture, obtaining safe and nutritious pro ducts, as well as cultural availability, refer efforts to endorse health and education within the framework of sustainability; all this with the support of specific collaboration programs, which are complements of national and international commitments, necessary to satisfy the demand of a growing society and to subtract the effects of food globalization in our región.

RESUMEN Las acciones de desarrollo social, cultural, económico, político y tecnológico, influyen en la pro ducción, acceso, disponibilidad, ingreso, mercado, calidad y abastecimiento de alimentos dirigi dos la a la población vulnerable. Es un reto presentar acciones concretas para promover proce sos eficientes que garanticen la seguridad alimentaria en América Latina. En el presente trabajo, se integran de forma activa, dinámica y conjunta, algunos aspectos en forma de apoyo mutuo que proponen el desarrollo de una sociedad con el fin de lograr una vida digna. Los mercados y la agricultura familiar, acompañados de la aplicación de la agroecología, empleo decente, cultura ambiental, obtención de productos inocuos y nutritivos, además de una disponibilidad cultural, refieren esfuerzos para refrendar la salud y educación en el marco de la sostenibilidad; todo esto con el respaldo de programas específicos de colaboración, que son complementos de com promisos nacionales e internacionales, necesarios para satisfacer la demanda de una sociedad creciente y para restar los efectos de la globalización alimentaria en nuestra región.

RESUMO INTRODUÇÃO: A gastroenterostomia ecoguiada é um novo procedimento para paliação da obstrução maligna gastroduodenal. Nosso objetivo foi avaliar os resultados dessa técnica em nossa experiência inicial. MÉTODOS: Foram incluídos pacientes com obstrução maligna gastroduodenal de nossa instituição. O sucesso técnico foi definido como a realização adequada de uma gastroenterostomia. O sucesso clínico foi definido como boa aceitação de dieta pastosa durante a internação. Os eventos adversos e a aceitação alimentar foram avaliados um mês após o procedimento. RESULTADOS: Três pacientes foram incluídos. Os sucessos técnico e clínico foram alcançados em todos os casos. Não houve eventos adversos e a aceitação alimentar permaneceu adequada um mês após o procedimento nos pacientes incluídos. CONCLUSÃO: O EUS-GE é um tratamento promissor para pacientes com obstrução maligna gastroduodenal.

SUMMARY INTRODUCTION: EUS-guided gastroenterostomy (EUS-GE) is a novel procedure for palliation of malignant gastric outlet obstruction (GOO). Our aim was to evaluate the outcomes of this technique in our initial experience. METHODS: Patients with GOO from our institute were included. Technical success was defined as the successful creation of a gastroenterostomy. Clinical success was defined as the ability to tolerate a soft diet after the procedure. We assessed adverse events and diet tolerance 1 month after the procedure. RESULTS: Three patients were included. Technical and clinical success was achieved in all cases. There were no adverse events and good diet tolerance was observed 1 month after the procedure in the included patients. CONCLUSION: EUS-GE is a promising treatment for patients with GOO.