Objective: To describe the effect of reoxygenation with 100% O₂ as compared to the effect of room air in newborn rat brains after asphyxia. Methods: Experimental asphyxia (carotid artery ligation followed by hypoxic exposure with 8% O₂ for 2 h) was performed on 7-day-old rats. After hypoxia-ischemia the rats were reoxygenated with either 100% O₂ (hyperoxia group) or 21% O₂ (room air group) for 24 h and then returned to the dam. The rats were killed 1 week after the experiment to study the cerebral cortex and hippocampus. Results: Rats reoxygenated with 100% O₂ post-asphyxia showed more frequency of cortical damage (10 of 24 rats) than those reoxy genated with room air (3 of 24 rats) (χ² test, p = 0.02). Conclusion: We consider that hyperoxia with 100% oxygen after hypoxia-ischemia can cause more damage in the cerebral cortex than room air in newborn rats.

The dimensions showing an increase in the dissatisfaction index were tangible aspects, hygiene and others for hospitalization and emergency services. On the other hand, the medical capabilities dimension for outpatient visits showed a decrease in the level of dissatisfaction over the evaluated period.

The double burden of malnutrition is the coexistence of two different conditions, mainly reflected as excess or deficit in weight. Anemia is a specific nutritional deficit not always included in the double burden assessment. We reviewed overweight and/or obesity (OW/OB) and anemia studies from Latin-American Children over the last ten years up to 2019. Two authors evaluated the MEDLINE, SCOPUS, and LILACS databases. A scale of ten questions was used to assess the risk of bias in prevalence studies. Fourteen studies were selected. The population studies' size ranged from 147 to 20,342 children with different socioeconomic backgrounds, such as urban, peri-urban and rural settings, socioeconomic status, schooling, population (ethnic minorities and indigenous), and environmental differences (sea level or high altitude). The prevalence of OW/OB ranged from 4.9% to 42%. The prevalence of anemia was from 3.4% to 67%. The double burden, including OW/OB and anemia, ranged from 0.7% to 67%. A higher prevalence of excess weight and anemia was found in rural and high altitude above sea level environments, extreme poverty, low education level, and indigenous communities. These heterogeneous data, before the 2020 (COVID-19 pandemic), reflect the vast inequities between countries and within each country. Food insecurity linked to poverty and the induced change in eating habits and lifestyles threaten optimal child nutrition in ongoing and future scenarios. The existence of OW/OB and anemia and their simultaneous coexistence in the community, home, and individual levels, indicates that interventions should be comprehensive to face the double burden of malnutrition.

Las reclamaciones de los usuarios externos en un centro pediátrico de referencia nacional en Lima, Perú reclamaciones, siendo los más frecuentes: trato inapropiado 32,1%, tiempo de espera prolongado 18,4%, información deficiente 14,5%, dificultad para el acceso en la atención 9,5%, extravío de documentación 7,8%, problemas de comunicación 7,5%, privilegios 5,9%, disconformidad con aspectos tangibles 4,2%. Las áreas que recibieron más reclamaciones fueron: consultorios externos 41,7% (tasa de 0,5 por mil pacientes), vigilancia 9,2%, Servicio Bajo Tarifario Diferenciado (privado) 9,2% y Caja 6,0%. El 60% de las reclamaciones fueron resueltas y, de estas, el 84,2% antes de los 28 días. En relación al personal de salud aludido en los reclamos estuvieron: médico (26,4%), técnica de enfermería (13,9%), personal administrativo (12,2%), vigilante (12,2%), personal de archivo (9,7%), enfermera (9,0%), cajero (5,9%), admisionista (2,1%). Conclusiones: Las características de las reclamaciones sugieren intervenciones correctivas y educativas más apropiadas para así minimizar los reclamos de los usuarios o disminuirlas. Es necesario evaluar periódicamente las reclamaciones para aumentar la satisfacción de los usuarios. Most frequent complaint reasons were: inappropriate attitude 32.1%, long waiting time 18.4%, deficient information 14.5%, deficient access to services 9.5%, loss of documentation (laboratory results or x-rays, formats, clinical records, among others) 7.8%, problems in communication 7.5%, privileged access to attention 5.9%, objective aspects (facilities, appearance, cleaning, equipment) 4.2%. The areas that received more complaints were: outpatient attention by physicians 41.7% (rate of 0.5 per thousand patients), security 9.2%, private hospital service 9.2%, and cashiers 6.0%. Sixty per cent of claims were solved, and of these 84.2% were solved before 4 weeks since the complaint. Occupational groups generating complaints were: physician (26,4%), nurse technician (13,9%), administrative personnel (12,2 %), security personnel (12,2%), archive personnel (9,7 %), nurse (9,0 %), cashier (5,9 %), admission (2,1%). Conclusions: Complaints' characteristics suggest the need to take appropriate corrective and educational measures, so as to avoid or decrease them. Routine periodic evaluation of complaints is necessary to increase user's satisfaction. Keywords: Complaints, quality of health care, user´s satisfaction, hospitals, specialized hospitals, child, Lima, Peru. An