Showing papers by "National Autonomous University of Nicaragua published in 2004"

Central nervous system effects of acute organophosphate poisoning in a two-year follow-up

Abstract: Objectives Patients hospitalized for acute organophosphate poisoning in Leon, Nicaragua, were followed for effects on the central nervous system (CNS) over a 2-year period. Methods Immediate verbal memory (Rey verbal learning), visuomotor performance (digit symbol), and neuropsychiatric symptoms (Q-16) were assessed for 53 poisoned persons at the time of hospital discharge, 7 weeks postpoisoning, and 2 years postpoisoning, and, at the same time intervals, for 28 persons who had never been poisoned. The poisonings were classified as moderate occupational (31), severe occupational (15), and severe through the oral route (7), representing low, medium, and high exposure, respectively. Longitudinal confounder-adjusted between-category comparisons and longitudinal analyses of variance and covariance were used to assess the effects of the exposure. Results Immediate verbal learning showed deficits in the high-exposure group, in particular at the time of discharge, but the estimate of the difference when compared with the values of the unexposed was imprecise. Visuomotor performance showed a deficit at 7 weeks in the medium-exposure group, but it had improved after 2 years relative to that of the unexposed, for whom improvement had occurred at 7 weeks and persisted during the 2 years of follow-up, possibly a test-retest effect. Neuropsychiatric symptoms were in excess 2 years after the hospital discharge in the low- and medium-exposure groups and all the groups combined. All the results were imprecise for the small high-exposure group. Conclusions Visuomotor performance and possibly short-term verbal memory seem to be affected early after severe acute organophosphate poisoning and recover, either truly or by some compensatory mechanism. Neuropsychiatric symptoms seem to increase after a longer latency period.

Reliability of a visual scoring system with fluorescent tracers to assess dermal pesticide exposure.

Abstract: Background and objectives: We modified Fenske’s semi-quantitative ‘visual scoring system’ of fluorescent tracer deposited on the skin of pesticide applicators and evaluated its reproducibility in the Nicaraguan setting. Methods: The body surface of 33 farmers, divided into 31 segments, was videotaped in the field after spraying with a pesticide solution containing a fluorescent tracer. A portable UV lamp was used for illumination in a foldaway dark room. The videos of five farmers were randomly selected. The scoring was based on a matrix with extension of fluorescent patterns (scale 0–5) on the ordinate and intensity (scale 0–5) on the abscissa, with the product of these two ranks as the final score for each body segment (0–25). Five medical students rated and evaluated the quality of 155 video images having undergone 4 h of training. Cronbach alpha coefficients and two-way random effects intraclass correlation coefficients (ICC) with absolute agreement were computed to assess inter-rater reliability. Results: Consistency was high (Cronbach alpha = 0.96), but the scores differed substantially between raters. The overall ICC was satisfactory [0.75; 95% confidence interval (CI) = 0.62– 0.83], but it was lower for intensity (0.54; 95% CI = 0.40–0.66) and higher for extension (0.80; 95% CI = 0.71–0.86). ICCs were lowest for images with low scores and evaluated as low quality, and highest for images with high scores and high quality. Conclusions: Inter-rater reliability coefficients indicate repeatability of the scoring system. However, field conditions for recording fluorescence should be improved to achieve higher quality images, and training should emphasize a better mechanism for the reading of body areas with low contamination.

Pérdida dental y patrones de caries en preescolares de una comunidad suburbana de Campeche

Abstract: Objectives: The dental caries is an infectious, chronic, multifactorial and transmissible illness. It's very prevalent during infancy and the major cause of tooth loss among children. The objectives of this study were to determine prevalence of tooth loss and to identify patterns of caries in the dentition of preschool children of a suburban community of Campeche, Mexico. Methods: A cross-sectional study in 109 preschoolers 5-6 years old was carried-out. The criteria to diagnose dental caries were the index dmft (WHO) and "magnitude of lesion caries criteria". Dental loss is considered to be total absence of the tooth or grade 4 on the MLCC scale (a loss of more than ¾ parts of clinical crown). The attack patterns of caries registered were: 1) anterior pattern, 2) posterior pattern and 3) anterior-posterior subsequent pattern. All subjects were evaluated clinically by two examiners (kappa>0.85). Statistical analysis consisted of calculation of frequency measures, central tendency and dispersion, according to the variables measurement scale. Bivariant analysis was done using chi 2 test. Results: 2041 temporary teeth were examined. Thirteen (11.9%) of the 109 subjects had 34 (1.7%) teeth lost. The lost were principally of the lower second molars. Of the subjects with caries (n=82), 47.6% presented the anterior-posterior patterns, 46.3% showed posterior pattern and 6.1% exhibited anterior pattern. There was no significant difference between attack patterns and age and sex. Conclusions: The tooth loss in