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OBJECTIVES: To assess the risk of dental anomaly presentation in permanent teeth in a group of Colombian children with nonsyndromic cleft lip and palate (NSCLP) and to determine the frequency of the anomalies according to the cleft type. METHODS: An analytical matched case-control study was conducted with 210 controls and 210 patients with NSCLP. The patients were classified into 3 groups: complete right unilateral cleft lip and palate (RCLP), complete left unilateral cleft lip and palate (LCLP), and complete bilateral cleft lip and palate (BCLP). Univariate and multivariate Poisson regression models were used to analyze paired samples (Bonferroni adjustment, P ≤ .002). RESULTS: A high risk of finding agenesis of the maxillary lateral incisors, supernumerary teeth, microdontia of the maxillary lateral incisors, and rotation of the maxillary central incisors adjacent to the cleft (P < .0001) was observed in the patients with NSCLP. One or more dental anomalies were found in 98% of patients with BCLP, in 96% of those with LCLP, and in 87% of those with RCLP. Most of the anomalies were located on the cleft area. The incidence relative risk (IRR) of anomalies was highest in patients with BCLP (IRR: 10.5; 95% confidence interval [CI]: 6.76-16.3), followed by in those with LCLP (IRR: 8.51; 95% CI: 5.64-12.8). CONCLUSIONS: Most dental anomalies were found in the cleft area; this was expected because the cleft area was the most affected in the patients included in this study.

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Stunting, defined as height-for-age Z score equal to or lower than -2, is associated with increased childhood mortality, cognitive impairment, and chronic diseases. The aim of the study was to investigate the relationship between linear growth, intestinal damage, and systemic inflammation in infants at risk of stunting. We followed up 78 infants aged 5-12 months living in rural areas of Peru for 6 months. Blood samples for biomarkers of intestinal damage (intestinal fatty-acid-binding protein [I-FABP] and zonulin) and systemic inflammation (interleukin-1ß, interleukin-6, tumor necrosis factor α [TNF-α], soluble CD14, and lipopolysaccharide-binding protein [LBP]) and fecal samples for microbiome analysis were collected at baseline and closure of the study. The children's growth and health status were monitored through biweekly home visits by trained staff. Twenty-one percent of the children became stunted: compared with non-stunted children, they had worse nutritional parameters and higher levels of serum I-FABP at baseline. The likelihood of becoming stunted was strongly associated with an increase in sCD14 over time; LBP and TNF-α showed a trend toward increase in stunted children but not in controls. The fecal microbiota composition of stunted children had an increased beta diversity compared with that of healthy controls throughout the study. The relative abundance of Ruminococcus 1 and 2, Clostridium sensu stricto, and Collinsella increased in children becoming stunted but not in controls, whereas Providencia abundance decreased. In conclusion, stunting in our population was preceded by an increase in markers of enterocyte turnover and differences in the fecal microbiota and was associated with increasing levels of systemic inflammation markers.

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Diarrheagenic Escherichia coli (DEC) are common pathogens of childhood gastrointestinal infections worldwide. To date, research tracking DEC has mainly been completed in urban areas. This study aims to determine the prevalence and pathotype distribution of DEC strains in children from rural Peruvian communities and to establish their association with malnutrition. In this prospective cohort, 93 children aged 6-13 months from rural communities of Urubamba (Andes) and Moyobamba (jungle) were followed for 6 months. Diarrheal and control stool samples were analyzed using multiplex real-time polymerase chain reaction to identify the presence of virulence genes of DEC strains. The overall isolation rate of DEC was 43.0% (352/820). Enteroaggregative E. coli (EAEC, 20.4%), enteropathogenic E. coli (EPEC, 14.2%), and diffusely aggregative E. coli (DAEC, 11.0%) were the most prevalent pathotypes. EAEC was more frequently found in Moyobamba samples (P < 0.01). EPEC was the only strain significantly more frequent in diarrheal than asymptomatic control samples (P < 0.01). DEC strains were more prevalent among younger children (aged 6-12 months, P < 0.05). A decline in height-for-age Z-score (HAZ) was observed in 75.7% of children overall. EAEC was more frequently isolated among children who had a greater HAZ decline (P < 0.05). In conclusion, DEC strains were frequently found in stool samples from children in rural communities of the highlands and jungle of Peru. In addition, children with a greater decline in their growth rate had higher EAEC isolation rates, highlighting the importance of this pathogen in child malnutrition.

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Introducción: El insomnio y la somnolencia presentan elevada prevalencia y causan graves problemas de salud física, mental y social; uno de los principales grupos de riesgo para estos trastornos son los estudiantes de medicina. Objetivo: Determinar la prevalencia de insomnio y somnolencia en estudiantes de una facultad de medicina de Medellín y su asociación con algunas condiciones socio demográficas y académicas. Materiales y métodos: Estudio de prevalencia en 230 estudiantes seleccionados aleatoriamente. Para la tamización de los dos trastornos del sueño se emplearon las escalas Epworth para somnolencia e insomnio. Los análisis se basaron en medidas de resumen, frecuencias, pruebas no paramétricas, prevalencias y razones de prevalencia. Resultados: La edad promedio fue 20 años, la media de créditos matriculados fue 20, el 70 % de la población estaban en el ciclo básico. Se halló prevalencia de tabaquismo del 10 % y consumo de alcohol en el 51 %. La prevalencia global de insomnio fue 93 %, siendo más frecuente en grado leve, éste presentó asociación estadísticamente significativa con la presencia de enfermedades de base y el sexo. La prevalencia de somnolencia fue 73,5 % siendo más común el grado moderado, ésta presentó asociación estadística con el ciclo de formación. Conclusión: La elevada prevalencia de los dos trastornos del sueño hallada en este grupo, pone de manifiesto la necesidad de implementar medidas de prevención primaria y secundaria, dado los impactos negativos que presentan para actividades cotidianas, el rendimiento académico y para la salud física y mental…

Objective: To determine the prevalence of insomnia and sleepiness in students froma medical school in Medellin and its association with sociodemographic and academic conditions. Insomnia and sleepiness have high prevalence and they cause serious problems of physical, mental and social health, one of the main groups at risk for these disorders are the medical students. Materials and Methods: Prevalence study in 230students randomly selected. For the screening of the disorders were used the scales of sleepiness and insomnia of Epworth. The analyzes were based on summary measures, frequency, nonparametric tests, prevalence and prevalence ratios. Results:The meanage was 20 years, the average of credits enrolled was 20, 70% of the population wasin the basic cycle. Smoking prevalence was 10% and consumption of alcohol of 51%The overall prevalence of insomnia was 93%, being more common in mild degree,it was presented statistically significant association with the presence of underlying diseases and sex. The prevalence of somnolence was 73.5% being more commonthe moderate grade, it was statistically associated with the training cycle. Conclusion: The high prevalence of both sleep disorders found in this group, highlights the need to implement actions of primary and secondary prevention, due to negatives impacts foreveryday activities, academic performance and physical andmental health.

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