Gene expression and characterization of clonally derived murine embryonic brown and brite adipocytes.

White adipocytes store energy, while brown and brite adipocytes release heat via nonshivering thermogenesis. In this study, we characterized two murine embryonic clonal preadipocyte lines, EB5 and EB7, each displaying unique gene marker expression profiles. EB5 cells differentiate into brown adipocytes, whereas EB7 cells into brite (also known as beige) adipocytes. To draw a comprehensive comparison, we contrasted the gene expression patterns, adipogenic capacity, as well as carbohydrate and lipid metabolism of these cells to that of F442A, a well-known white preadipocyte and adipocyte model. We found that commitment to differentiation in both EB5 and EB7 cells can be induced by 3-Isobutyl-1-methylxanthine/dexamethasone (Mix/Dex) and staurosporine/dexamethasone (St/Dex) treatments. Additionally, the administration of rosiglitazone significantly enhances the brown and brite adipocyte phenotypes. Our data also reveal the involvement of a series of genes in the transcriptional cascade guiding adipogenesis, pinpointing GSK3ß as a critical regulator for both EB5 and EB7 adipogenesis. In a developmental context, we observe that, akin to brown fat progenitors, brite fat progenitors make their appearance in murine development by 11-12 days of gestation or potentially earlier. This result contributes to our understanding of adipocyte lineage specification during embryonic development. In conclusion, EB5 and EB7 cell lines are valuable for research into adipocyte biology, providing insights into the differentiation and development of brown and beige adipocytes. Furthermore, they could be useful for the characterization of drugs targeting energy balance for the treatment of obesity and metabolic diseases.

A Genetic Lab-on-Phone Test for Point-of-Care Diagnostic of Lactose Intolerance near Patient and in less than 90 Minutes.

BACKGROUND: The -13910 C/T single nucleotide polymorphism located within the MCM6 gene, an enhancer region located upstream of the lactase-phlorizin hydrolase gene, is associated with lactase persistence/non-persistence traits among the Caucasian population. The performance of a new point-of-care CE-IVD (In Vitro Diagnostic) marked isothermal lab-on-phone lactose intolerance assay, using crude samples, was assessed in comparison with Sanger sequencing using purified DNA, as reference method. METHODS: The study was conducted following a non-probability sampling using direct buccal swab (n = 63) and capillary blood (n = 43) clinical samples from a total of 63 volunteers. A 3 × 3 confusion matrix/contingency table was used to evaluate the performance of the isothermal lab-on-phone lactose intolerance assay. RESULTS: The isothermal lab-on-phone lactose intolerance assay successfully detected the -13910 C/T variant with a limit of detection of 5 cells/assay and demonstrated an overall accuracy of 98.41% (95% CI, 91.47%-99.96%) for buccal swab samples and 100% (95% CI, 91.19%-100%) for capillary blood, taking just 90 min from sample to result, with only 2 min hands-on. CONCLUSIONS: The lab-on-phone pocket-sized assay displayed good performance when using direct buccal swab and capillary blood samples, enabling a low-cost, real-time, and accurate genotyping of the -13910 C/T region for the rapid diagnosis of primary lactose intolerance at point-of-care, which enables a prompt implementation of appropriate diet habits and/or intolerance therapies. To our knowledge, this is the first point-of-care genetic test for lactose intolerance to be made available on the market.

AELI® KINETEST, complemento para el diagnóstico clínico / AELI® KINETEST: A Complement for Clinical Diagnosis

Introducción: Con la meta permanente de mejorar la relación médico-paciente y favorecer que este último asuma una posición proactiva en la búsqueda de su salud, se implementa la metodología AELI® KINETEST, aceptada desde 2017 por la Oficina Cubana de la Propiedad Industrial, órgano estatal subordinado al Ministerio de Ciencia, Tecnología y Medio Ambiente. Esta emplea una forma diferente de realizar diagnóstico y tratamiento, con una marcada intención de lograr visión integral del paciente, que abarca contexto personal, familiar, laboral, y complementa así el método clínico. Objetivo: Describir los resultados de la atención a pacientes con AELI®KINETEST. Métodos: Estudio retrospectivo, descriptivo y de corte transversal. La población estuvo conformada por 582 pacientes del Hospital Universitario Clínico Quirúrgico Dr. Miguel Enríquez, entre marzo de 2016 y marzo de 2019. Se confeccionó una ficha personal que incluía los resultados de la aplicación del protocolo del test muscular de los miembros superiores para identificar las disarmonías energéticas. Resultados: Se halló una evolución positiva, predominante a partir de la segunda consulta, en la que se encontraba asintomático el 84,4 por ciento y en la tercera, el 91 por ciento. Conclusiones: AELI® KINETEST resulta una metodología que promueve salud desde una visión integral del ser humano; y permite crecimiento personal, control de los síntomas a corto plazo y rápida reincorporación laboral y familiar. Los resultados muestran la aceptación social y apuntan a una inmediata inclusión en el aprendizaje de las ciencias de la salud(AU)

Introduction: With the permanent goal of improving the doctor-patient relationship and encouraging the latter to assume a proactive position in the pursuit of her or his health, the AELI®KINETEST methodology is implemented. It has been accepted since 2017 by the Cuban Office of Industrial Property, a state body subordinated to the Ministry of Science, Technology and the Environment. This methodology uses a different way of making a diagnosis and carrying out treatment, with a marked intention to achieve an comprehensive vision of the patient, covering the individual, family, work, and other contexts. Objective: To describe the results of patient care with AELI®KINETEST. Methods: A retrospective, descriptive and cross-sectional study was conducted. The population consisted of 582 patients from Hospital Universitario Clínico Quirúrgico Dr. Miguel Enríquez, during March 2016 and March 2019. An individual file was prepared, including the results of the application of the upper limb muscle test protocol for identifying energetic disharmonies. Results: A positive evolution was observed, predominantly from the second consultation, at which moment 84.4 percent were asymptomatic; while at the moment of the third consultation, 91 percent were asymptomatic. Conclusions: AELI® KINETEST is a methodology that promotes health with an approach towards a comprehensive vision of the human being, as well as it allows individual growth, short-term symptom control and a rapid reincorporation to work and family. The results show social acceptance and point to an immediate inclusion in the learning of health sciences(AU)

Herramienta de Detección de Maltrato Infantil para la Clínica Odontológica

RESUMEN: El maltrato infantil es una grave vulneración a los derechos humanos de los niños, que afecta su salud física, mental y emocional, y que puede provocar además graves consecuencias en su vida adulta. El odontólogo tiene la responsabilidad de detectar los posibles casos de maltrato infantil y tomar acciones para detenerlo en una etapa temprana. Sin embargo, muchas veces la decisión de intervenir y/o denunciar un caso se hace difícil, pues no se posee las herramientas para objetivar la sospecha. Aplicando el método Delphi, con el apoyo de destacados expertos nacionales, se desarrolló un breve formulario de auto-aplicación para el odontólogo, en el que se definieron siete puntos clave que se deben examinar al enfrentarse a un niño lesionado que llega a la clínica odontológica. Este formulario guía al cirujano dentista en el reconocimiento de las señales y signos clínicos de abuso, y le permite determinar cuándo un caso presenta suficientes elementos que apuntan a posible maltrato infantil y se hace recomendable su denuncia, tal como indica la ley. La aplicación del formulario mejorará la pesquisa de los casos, que es el primer paso para asegurar el bienestar de las niñas y los niños maltratados.

ABSTRACT: Child abuse is a serious violation of children's human rights, that affects their physical, mental and emotional health, and can, furthermore, have serious consequences in their adult life. Dentists have the responsibility to detect possible cases of child abuse and take actions to put a stop to it at an early stage. However, often the decision to report a case is made difficult due to a lack of tools to express an objective suspicion. Applying the Delphi method with the support of prominent national experts, a short self-application questionnaire was developed to be applied by odontologists in the dental clinic, defining seven key points that should be examined when handling the case of an injured child. The questionnaire guides dentists in recognizing the signs of abuse and deciding when a case has enough elements suggesting possible child abuse that it is advisable to report it, as required by law. Applying this questionnaire will improve the detections of cases, which is the first step to ensure the wellbeing of abused children.

Multimedia como herramienta educativa e instructiva para mejorar la calidad de vida del adulto medio / Multimedia as an educational and instructive tool to improve the quality of life in middle-aged adults

RESUMEN Introducción: Villa Clara es la provincia más envejecida del país, pues el adulto medio ocupa un alto porciento dentro de su población. Durante esta etapa de la vida, si bien algunos cambios fisiológicos se deben a factores genéticos y biológicos personales, también es importante considerar la influencia del modo de vida, experimentado en la actual calidad de vida del adulto medio, que puede ser mejorada con la actividad física. Objetivos: Diseñar una multimedia como herramienta educativa e instructiva para mejorar la calidad de vida del adulto medio, en la Facultad de Tecnología de la Salud-Enfermería, de la Universidad de Ciencias Médicas de Villa Clara. Métodos: Se realizó un estudio de tipo innovación tecnológica en el período de septiembre de 2018 a septiembre de 2019. El universo de estudio estuvo constituido por 397 profesores, que constituyen el total de docentes a tiempo completo; la muestra fue de 40 profesores. Como criterio de exclusión se consideró a los que no estaban ubicados en el rango de edad correspondiente con el adulto medio. Las variables fueron: edad, peso, talla, sexo, ejercicios físicos, enfermedades crónicas no transmisibles y tipo de alimentación. Se utilizaron métodos teóricos, empíricos y de nivel matemático-estadístico. Resultados: El producto final proporcionó beneficios, pues con él se motivó al adulto medio hacia el desarrollo de habilidades y capacidades que le permitan tomar decisiones correctas para elevar la calidad de vida. Conclusiones: La multimedia educativa constituye una vía novedosa y motivadora para influir en la calidad de vida del adulto medio.

ABSTRACT Introduction: Villa Clara is the oldest province in the country, since middle-aged adults occupy a high percentage of its population. During this stage of life, although some physiological changes are due to individuals' genetic and biological factors, it is also important to consider the influence of lifestyle, experienced in the current quality of life in middle-aged adults, which can be improved with physical activity. Objective: to design a multimedia, at the Faculty of Health Technology and Nursing in the University of Medical Sciences of Villa Clara, as an educational and instructive tool to improve the quality of life in middle-aged adults. Methods: a technological innovation study was carried out from September 2018 to September 2019. The universe of study consisted of 397 teachers, who constituted the total number of full-time teachers; the sample was 40 teachers. Those who were not in the age range corresponding to middle-aged adults were considered as an exclusion criterion. Age, weight, height, gender, physical exercises, non-communicable chronic diseases and type of diet were among the variables studied. Theoretical, empirical and mathematical-statistical methods were used. Results: the final product provided benefits, since middle-aged adults were motivated towards the development of skills and abilities, allowing them to make correct decisions in order to improve their quality of life. Conclusions: educational multimedia is a novel and motivating way to influence the quality of life in middle-aged adults.

Determinants of the risk of intraoperative complications in phacoemulsification among patients with pseudoexfoliation.

PURPOSE: The purpose of the study was to study the relationship between pseudoexfoliation (PES) and other predictors in the development of complications in cataract surgery by phacoemulsification in patients with PES. METHODS: A retrospective cohort study of patients undergoing cataract surgery by phacoemulsification in the health area of Cee in northwestern Spain during the 2-year period from 2009 to 2010. Capsule rupture, choroidal hemorrhage, and vitreous loss were included as complications and intraoperative nucleus or lens dislocation as the independent variable. PES, age, hardness, type of cataract, myopia, preoperative visual acuity, antiplatelet use, anticoagulant uses, alpha agonist use, mydriasis prior to surgery, anterior chamber depth, and axial length were included as predictor variables. All predictive hierarchical models were tested using as a selection criterion the one minimizing the Akaike index. RESULTS: A total of 551 patients were initially identified from hospital register, of which 48 were excluded due to the presence of an exclusion factor. After the initial selection, the final sample was 681 eyes of 503 patients. Of the 8192 possible models, a model with the following seven variables was selected: PES, steroid use, alpha agonist use, nuclear hardness, mydriasis, anterior chamber depth, and axial length. The selected model had an Akaike index of 435.4 and an area under the curve of 0.7895 corresponding to a sensitivity of 6.2% and a specificity of 98.5%. CONCLUSION: PES, nuclear hardness, and alpha agonist use are risk factors strongly predictive of complications.

Portafolio de evaluación: una experiencia novedosa en la asignatura Introducción a la Medicina General Integral / Assessment portfolio: a novel experience in the Introduction to Comprehensive General Medicine course

RESUMEN Se hace referencia a la novedosa aplicación del portafolio en la asignatura Introducción a la Medicina General Integral en primer año de la carrera de Medicina para la evaluación de las actividades de educación en el trabajo. El portafolio representa un nuevo escenario para la evaluación, es una técnica que informa sobre las competencias que el estudiante puede demostrar, así como la naturaleza y el aprovechamiento del proceso de aprendizaje, permite acumular evidencias e incluye la evaluación de los aspectos educativos en vínculo indisoluble a lo instructivo. Por su pertinencia y novedad, los autores consideran oportuno compartir sus experiencias sobre esta modalidad de evaluación a través de la presente comunicación.

ABSTRACT Reference is made to the novel application of the portfolio in the Introduction to Comprehensive General Medicine subject in the first year of the Medicine degree for the evaluation of the in-service training activities. The portfolio represents a new scenario for evaluation, it is a technique that informs about the competences that the student can demonstrate, as well as the nature and use of the learning process, allows the accumulation of evidence and includes the evaluation of educational aspects in an indissoluble link to the instructive. Due to its relevance and novelty, the authors consider it appropriate to share their experiences on this type of evaluation through this research paper.

Factores de riesgo que influyen en la enfermedad renal crónica en San Juan y Martínez / Risk factors influencing in chronic kidney disease in San Juan y Martinez municipality

RESUMEN Introducción: en la actualidad existe en el mundo una verdadera epidemia de las llamadas "enfermedades crónicas no comunicables": diabetes mellitus, hipertensión arterial, enfermedad cardiovascular y enfermedad renal crónica. Objetivo: caracterizar los factores de riesgo que influyen en la enfermedad renal crónica en el municipio San Juan y Martínez en el 2017. Métodos: se realizó un estudio observacional, descriptiva y transversal. El universo estuvo constituido por 51 pacientes que fueron diagnosticados con esta enfermedad en el período estudiado; el universo coincide con la muestra de estudio. Resultados: predominó el sexo masculino con edades entre 50 y 59 años, los hábitos tóxicos que favorecieron la progresión de la enfermedad renal crónica a su estadio terminal fueron el alcohol y el tabaco, entre las enfermedades asociadas estuvo la hipertensión arterial, la diabetes mellitus y las dislipidemias, la mayoría de los pacientes padecen esta enfermedad desde hace más de cinco años y reciben tratamiento farmacológico. Conclusiones: la prevención primaria está orientada en un principio a evitar la aparición de enfermedades renales, por lo que debe promoverse y divulgarse en la población la necesidad de cambios de estilos de vida saludables.

ABSTRACT Introduction: in current times there is a true epidemic of the known "chronic non-communicable diseases" worldwide: diabetes mellitus, high blood pressure, cardiovascular diseases and chronic kidney disease. Objective: to characterize the risk factors influencing in chronic kidney disease in San Juan y Martinez municipality during 2017. Methods: an observational, descriptive and cross-sectional study was conducted; the target group comprised 51 patients diagnosed with this disease in the period studied, coinciding this with the sample of study, patients meeting the inclusion criteria established for this research were included. Results: male gender predominated with ages between 50-59 years old, the toxic habits favoring the progression of chronic kidney disease up to its end-stages were alcohol addiction and smoking; high blood pressure, diabetes mellitus and dyslipidemias were among the associated diseases; the majority of the patients suffer from this disease for more than five years and undergoing pharmacological treatment. Conclusions: primary prevention is basically oriented to avoid the onset of kidney diseases therefore the need for practicing healthy lifestyles should be promoted and spread.

Genetic diversity of HLA system in three populations from Guanajuato, Mexico: Guanajuato City, León and rural Guanajuato.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 262 Mexicans from the state of Guanajuato living in the cities of Guanajuato (N = 78), León (N = 22) and rural communities (N = 162), to obtain information regarding allelic and haplotypic frequencies. We find that the most frequent haplotypes found in the state of Guanajuato include 12 Native American and three European haplotypes. Admixture estimates revealed that the main genetic components in the state of Guanajuato are Native American (50.64 ±â€¯2.11% by ML, 43.35% of Native American haplotypes) and European (44.14 ±â€¯1.14% by ML; 39.35% of European haplotypes), while African genetic component is less apparent (5.22 ±â€¯2.08% by ML; 8.36% of African haplotypes).

Importancia de la enfermera escolar según la percepción de funcionarios de colegios básicos de una provincia de chile / Importance of the school nurse according to the perception of officials of basic schools of a province of chile / Importância da enfermagem escolar de acordo com a percepção de funcionários de escolas básicas de uma província do chile

RESUMEN Objetivo: Describir la importancia de la enfermera escolar según la percepción de los funcionarios de colegios básicos de una provincia al sur de Chile. Material y Método: Estudio cuantitativo, descriptivo, transversal que, a partir de un universo de 169 funcionarios de 5 colegios públicos y privados, obtuvo una muestra de 126 (75%) personas quienes, posterior a dar su consentimiento informado, respondieron el instrumento "Percepción de la importancia de la enfermera escolar", desde la perspectiva de sus funciones asistenciales, educativas, investigativas, administrativas y de gestión. La investigación fue aprobada por el Comité de ética de la Universidad Adventista de Chile. Resultados: El 94% de los funcionarios refieren que es importante la enfermera escolar para actuar en emergencias ocurridas durante el horario escolar; un 93,5% percibe que la enfermera es indispensable para atender en primeros auxilios; un 92,25% cree que los padres estarán tranquilos al saber que hay un profesional de salud en la escuela y un 91,75% dice que el profesional de enfermería puede educar al alumnado sobre infecciones de transmisión sexual. Conclusión: Según los funcionarios de los colegios, la presencia de una enfermera escolar es importante y debiera estar presente para mantener la salud de los estudiantes.

ABSTRACT Objective: To describe the importance of the school nurse as perceived by school staff members of elementary schools from a province south Chile. Materials and Methods: Quantitative, descriptive, cross-sectional study, using a sample of 126 (75%) participants from a population of 169 school staff members of 5 public and private schools. After giving informed consent, the participants answered the instrument "Perception of the importance of the school nurse", from the perspective of their caregiving, educational, research and management functions. The research was approved by the Ethics Committee of the Chilean Adventist University. Results: 94% of school staff members indicate that the school nurse is important when acting in emergencies during school hours; 93.5% consider that the school nurse is vital when it comes to providing first aid; 92.25% believe that parents feel reassured when there is a health professional in the school, and 91.75% say that nurses can educate students on sexually transmitted infections. Conclusion: According to school staff members, the presence of a school nurse is important and should be promoted for maintaining student's health.

RESUMO Objetivo: Descrever a importância da enfermeira escolar de acordo com a percepção dos funcionários da escola básica de uma província sul do Chile. Material e Método: Estudo quantitativo, descritivo, transversal que, de um universo de 169 funcionários de 5 escolas públicas e privadas, obteve uma amostra de 126 (75%) pessoas que, depois de dar o consentimento informado, responderam ao instrumento "Percepção da importância da enfermeira escolar", na perspectiva de suas funções assistenciais, educacionais, de pesquisa, administrativas e gerenciais. A pesquisa foi aprovada pelo Comité de Ética da Universidade Adventista do Chile. Resultados: 94% dos funcionários relata que a enfermeira escolar é importante para atuar em emergências durante o horário escolar; 93,5% percebe que a enfermeira é indispensável para o atendimento de primeiros socorros; 92,25% acredita que os pais ficam calmos sabendo que existe um profissional de saúde na escola e 91,75% diz que o profissional de enfermagem pode educar os alunos sobre infecções sexualmente transmissíveis. Conclusão: Segundo os funcionários da escola, a presença de uma enfermeira escolar é importante e deve estar presente para manter a saúde dos alunos.

Prevalence of cataract complications in patients with pseudoexfoliation syndrome in Northwestern Spain / A prevalência de complicações de catarata em pacientes com síndrome pseudoesfoliativa no noroeste da Espanha

ABSTRACT Purpose: To assess the relationship between pseudoexfoliation syndrome and incidence of complications and related clinical factors in patients undergoing cataract surgery. Methods: We conducted a retrospective cohort study of 503 of 551 patients who underwent phacoemulsification surgery over 2 years in a health care district in Northwest Spain. In total, 120 of 681 eyes undergoing the procedure had pseudoexfoliation syndrome. Data on the surgical procedure and associated complications were extracted from the medical record. Complications included any combination of posterior capsular rupture, vitreous loss, zonular dialysis, and nuclear or lens luxation. Results: We found a significant association between pseudoexfoliation syndrome and zonular dialysis (odds ratio [OR], 6.89; 95% CI, 2.27-20.93), intraoperative miosis (OR, 2.15; 95% CI, 1.10-4.22), and lens luxation >1.5 mm (OR, 9.49; 95% CI, 0.85-105.54). However, when adjusting for the overall risk of complications in pseudoexfoliation syndrome patients in consideration of myopia, use of anticoagulants or α-agonists, previous mydriasis, and anterior chamber length, the OR decreased to 1.02 (95% CI, 0.47-2.21) and was therefore not significant. Conclusion: Zonular dialysis and intraoperative miosis were intraoperative complications in cataract surgery patients with pseudoexfoliation syndrome when compared to controls.

RESUMO Objetivo: Avaliar a relação entre a síndrome de pseudoexfoliação e a prevalência de complicações e fatores clínicos relacionados em pacientes submetidos à cirurgia de catarata. Métodos: Foi realizado um estudo retrospectivo de coorte de 503 de 551 pacientes que se submeteram à cirurgia de facoemulsificação durante 2 anos em um distrito de saúde no noroeste da Espanha. No total, 120 dos 681 olhos submetidos ao procedimento apresentavam síndrome de pseudoexfoliação. Dados sobre o procedimento cirúrgico e complicações associadas foram obtidos dos prontuários médicos. As complicações incluíram qualquer combinação de ruptura da cápsula posterior, perda de humor vítreo, diálise zonular e luxação do núcleo ou do cristalino. Resultados: Encontramos uma associação significativa entre síndrome de pseudoexfoliação e diálise zonular (razão de probabilidade [RP]: 6,89; IC 95%, 2,27-20,93), a miose perioperatória (RP: 2,15; IC 95%, 1,10-4,22) e luxação do cristalino >1,5 mm (RP: 9,49; IC 95%, 0,85-105,54). Porém, ao ajustar para o risco global de complicações em pacientes com síndrome de pseudoexfolição em consideração à miopia, uso de anticoagulantes ou α-agonistas, midríase prévia e comprimento da câmara anterior, a RP diminuiu para 1,02 (IC 95%, 0,47-2,21) e não foi, portanto, significativo. Conclusão: A diálise zonular e a miose intraoperatória foram complicações intraoperatórias em pacientes submetidos à cirurgia de catarata com síndrome de pseudoexfoliação quando comparados aos controles.

Prevalence of cataract complications in patients with pseudoexfoliation syndrome in Northwestern Spain.

PURPOSE: To assess the relationship between pseudoexfoliation syndrome and incidence of complications and related clinical factors in patients undergoing cataract surgery. METHODS: We conducted a retrospective cohort study of 503 of 551 patients who underwent phacoemulsification surgery over 2 years in a health care district in Northwest Spain. In total, 120 of 681 eyes undergoing the procedure had pseudoexfoliation syndrome. Data on the surgical procedure and associated complications were extracted from the medical record. Complications included any combination of posterior capsular rupture, vitreous loss, zonular dialysis, and nuclear or lens luxation. RESULTS: We found a significant association between pseudoexfoliation syndrome and zonular dialysis (odds ratio [OR], 6.89; 95% CI, 2.27-20.93), intraoperative miosis (OR, 2.15; 95% CI, 1.10-4.22), and lens luxation >1.5 mm (OR, 9.49; 95% CI, 0.85-105.54). However, when adjusting for the overall risk of complications in pseudoexfoliation syndrome patients in consideration of myopia, use of anticoagulants or α-agonists, previous mydriasis, and anterior chamber length, the OR decreased to 1.02 (95% CI, 0.47-2.21) and was therefore not significant. CONCLUSION: Zonular dialysis and intraoperative miosis were intraoperative complications in cataract surgery patients with pseudoexfoliation syndrome when compared to controls.

Conservative Management of Scrotal Hematoma Secondary to Adrenal Hemorrhage in Newborns.

A 24-hour-old male presented with bruising and swelling of the right hemiscrotum and groin. Testicular torsion was ruled out in a Doppler sonography, signs of an evolving right adrenal hemorrhage was demonstrated in the abdominal ultrasound. The imaging follow-up proved the disappearance of both scrotal and adrenal hematomas. Including the adrenal hemorrhage of the newborn in the differential diagnosis of an acute scrotum can prevent unnecessary surgical explorations.

Lesiones orales en víctimas del síndrome de munchausen por poder / Oral lesions in victims of munchausen syndrome by proxy

Resumen La presente es una revisión bibliográfica de casos publicados de niños con manifestaciones orales de maltrato físico, específicamente del Síndrome de Munchausen por poder. Tiene como objetivo resumir y presentar las características de las lesiones de víctimas del Síndrome, utilizando las principales bases de datos de publicaciones científicas. Se encontraron 9 casos, en todos ellos la victimaria fue la madre. Las lesiones se localizaron en la mucosa orofaríngea, las encías, la lengua, el paladar y los labios; fueron causadas por sustancias tóxicas administradas por vía oral o por compresión manual de la boca. En dos casos la víctima falleció. Se registró la muerte previa de 6 hermanos de las víctimas. Finalmente, se propone un esquema de evaluación odontológica forense para establecer o descartar que las lesiones de la cavidad oral sean parte del Síndrome.

Abstract This is a literature review of published cases of children with oral manifestations of physical abuse, specifically of Munchausen Syndrome by proxy. It is intended to summarize and present the characteristics of injuries of victims of the Syndrome, using the main databases of scientific publications. 9 cases were found, all of them the perpetrator was the mother. The lesions were found in the oropharyngeal mucosa, gums, tongue, palate and lips; they were caused by toxic substances administered orally or by manual compression of the mouth. In two cases the victim died. The previous death of 6 brothers of the victims was recorded. Finally, a forensic dental evaluation scheme intends to establish or rule out that lesions of the oral cavity are part of the syndrome.

Solid-phase microextraction of heavy metals in natural water with a polypyrrole/carbon nanotube/1, 10-phenanthroline composite sorbent material.

A simple and sensitive method for simultaneous microextraction and determination of heavy metals using a new direct immersion solid-phase microextraction (DI-SPME) sorbent material combined with inductively coupled plasma mass spectrometry (ICP-MS) was investigated. In this method, sorbent coating composites were prepared by simultaneous electropolymerization of pyrrole on pencil lead in the presence of carbon nanotubes (CNTs) and different metal chelating ligands. Among the coatings evaluated, a polypyrrole coating with entrapped CNTs and the chelator 1, 10 phenanthroline allowed the determination of silver, cadmium, cobalt, iron, nickel, lead, and zinc. Parameters influencing microextraction efficiency including pH, extraction time, and desorption time were optimized. The linear dynamic ranges were 1-1000 µg L-1 for Ag, 1-750 µg L-1 for Cd, Pb, and Zn, and 1-500 µg L-1 for Co, Fe, and Ni with limits of detection of 0.012-0.163 µg L-1 and limits of quantification of 0.039-0.542 µg L-1. The relative standard deviations (RSDs, n = 5) ranged from 1.85% to 5.01%. The effect of inorganic interferences on the determination of the heavy metals also was examined and finally, the method was successfully applied for the determination of heavy metals in real water samples.

Enfermedad de Castleman multicéntrica en una paciente postrasplantada de médula ósea / Multicentric Castleman's disease in a patient post-transplanted of bone marrow

Resumen La enfermedad de Castleman es un grupo heterogéneo de trastornos linfoproliferativos con dos formas de manifestación: variedad unicéntrica y multicéntrica. En términos histológicos se caracteriza por ganglios linfáticos con hiperplasia del centro germinal y aumento en la vascularidad. Se comunica el caso de una paciente de 70 años de edad con antecedente de trasplante autólogo de células troncales y progenitoras hematopoyéticas, que acudió a consulta por padecer astenia, pérdida de peso, dolor abdominal y disnea de evolución progresiva; a la que se le encontró un tumor retroperitoneal y derrame pleural derecho. Se plantea el abordaje del caso y se revisa la bibliografía, ya que se estima la incidencia en 21-25 casos por un millón de habitantes, sólo 14% de los casos reportados con manifestación retroperitoneal.

Abstract Castleman's disease is a heterogeneous group of lymphoproliferative disorders (LPD'S), which has two types of presentation, unicentric (UCD) and multicentric (MCD) variety. Histologically it is characterized by lymph nodes with hyperplasia of germinal centers and increased vascularity. This article reports the clinical case of a 70-year-old female with previous autologous haematopoietic stem cell transplant. She arrived with asthenia, weight loss, abdominal pain and progressive dyspnea. A retroperitoneal tumor and right pleural effusion were found. Clinical approach and bibliographic review are reported, the incidence estimation for this disorder is 21-25 cases per million population, and only 14% of reported cases had a retroperitoneal presentation.

Ultrasonography in Experimental Reproductive Investigations on Rats.

With the development of assisted reproductive technology and the ethical limitations of research on humans, rat animal models have been widely used in reproductive medicine. In the past, the study of reproductive system development in rodents has been based on one-time histological examination of excised tissues. Recently, with the development of high-resolution transabdominal ultrasound, high-quality sonography can now be performed to evaluate the reproductive organs of rats, allowing a new method for studying the reproductive system. Images were obtained using a high-resolution ultrasonographic system. Gynecological ultrasonography was performed on 28 eight-week-old non-pregnant rats and 5 pregnant Sprague-Dawley rats. We describe how to recognize organs of the reproductive system and associated structures in typical views during different phases of the estrus cycle. Color flow Doppler was used to measure uterine artery blood flow and evaluate uterine blood flow pattern changes during different stages of pregnancy. We have demonstrated that ultrasound exploration is a useful method for evaluating changes in internal reproductive organs. Its use raises the possibility of conducting additional experiments, including medical or surgical procedures, and provides the ability to monitor sonographic changes to internal organs without sacrificing animals.

Effectiveness of Intracameral Phenylephrine in Achieving Mydriasis and Reducing Complications During Phacoemulsification: A Systematic Review and Meta-Analysis.

PURPOSE: To compare the effectiveness of intracameral phenylephrine and topical mydriatics in achieving mydriasis and protecting against complications during phacoemulsification. METHODS: A systematic search of the literature comparing the mydriatic effect and surgical safety profile of intracameral phenylephrine and topical mydriatics in phacoemulsification was conducted in the Medline, Embase, Lilacs, Web of Science, Cochrane, ClinicalTrials.gov , and Teseo databases. The search targeted clinical trials, cohort studies, and case-control studies published between April 20, 2003 and August 14, 2016. Mydriatic effect was assessed by difference in means in pupil of all the patients in the studies [mean difference (MD)] and intraoperative complications were assessed by using inverse-variance weighted odds ratios (ORs), with adjustment for dose. A meta-regression analysis was also conducted, with adjustment for dose, use of epinephrine, tamsulosin use, and type of surgery and type of intraocular lens. RESULTS: We found 7 articles about mydriatic effect and another 7 about complications. Intracameral phenylephrine achieved a similar mydriatic effect to topical mydriatics, with a difference of less than 10% (MD -0.74 mm, 95% CI: -1.67 to 0.18, I2 = 95.8%, P < 0.0001). The pooled OR for complications was OR 0.50, 95% CI: 0.19-1.31, I2 = 0.0%, P = 0.670, and posterior capsular rupture was the most common complication in the different studies analyzed. CONCLUSION: Intracameral phenylephrine achieves a similar mydriatic effect to topical mydriatics (difference <15%) and is associated with a not-significant effect on reducing the odds of intraoperative complications.

Intervención en el lenguaje con niños bilingües y sus familias: una revisión / Language intervention with bilingual children and their families: a review

La atención clínica y educativa que se ofrece a niños bilingües es actualmente un reto para los profesionales. Es necesario investigar sobre la conceptualización del bilingüismo, su naturaleza y su relación con los diferentes entornos de aprendizaje. El objetivo del presente trabajo es revisar la literatura científica con el fin de explorar el papel del entorno familiar y las competencias del fonoaudiólogo/logopeda para garantizar una intervención fonoaudiológica/logopédica funcional en población bilingüe. Para ello, se ha estudiado la información más representativa disponible sobre el enfoque naturalista de intervención en multilingüismo. Así, se pretende reflexionar sobre los modelos de intervención que mejor se adecúan a las necesidades específicas de los niños bilingües y el papel que puede adoptar la familia para contribuir al desarrollo comunicativo de los niños en contacto con varias lenguas.En primer lugar, se ofrece una aclaración terminológica, así como una visión del marco naturalista de intervención. A continuación, se presentan la metodología y los resultados de la revisión efectuada para niños bilingües con diversidad funcional y alteraciones del lenguaje oral. Se incluyen también recomendaciones en relación a las competencias del fonoaudiólogo que trabaje con población bilingüe. Finalmente, se concluye con una propuesta de futuras líneas de investigación aplicada en este campo considerando los modelos naturalistas centrados en la familia para proponer su adaptación a las intervenciones realizadas con niños bilingües

The clinical and educative response required for bilingual children continues to be a challenge for professionals. It is necessary to research the conceptualization of bilingualism, its nature, and its relationship with different learning environments. The purpose of this paper is to review the literature to explore the role of the family environment and the speech & language therapist's (SLT) competence in guaranteeing a functional language intervention in the bilingual population. To this end, the most significant information available about multilingualism and the naturalistic intervention approach has been reviewed. With this evidence, the best models of bilingual intervention are presented, as well as a reflection on how families can contribute to improve the language development of children speaking different languages.In the first section, a terminological clarification of bilingualism is given, alongside the naturalistic frame of intervention, followed by research developed with bilingual children with functional diversity and oral language disorders. In that sense, recommendations about competence of the Speech and Language Therapist working with bilingual special needs children are also included. Finally, this paper provides a suggestion of future applied research in this field on naturalistic family-centered approaches used in language intervention with bilingual children

Evaluation of gastric and bladder tonometry as indicators of tissue perfusion in induced hypotension in dogs.

OBJECTIVE: To evaluate the use of gastric (PgCO2 ) and bladder (PbCO2 ) tonometry for assessing tissue hypoperfusion in dogs during sevoflurane-induced hypotension, and to compare these measurements with delivery of oxygen, arterial oxygen content, and plasma lactate concentration. DESIGN: Prospective experimental trial. SETTING: University veterinary teaching hospital. ANIMALS: Fourteen adult Beagle dogs. INTERVENTIONS: Anesthetic induction was performed by mask with sevoflurane and oxygen. Heart rate, direct arterial pressures, respiratory rate, and end-tidal carbon dioxide were recorded; arterial blood samples were taken to measure blood gases, and venous samples were sampled to measure plasma lactate. A tonometric catheter was introduced into the stomach to measure PgCO2 . Samples of saline from the balloon of a Foley catheter placed in the bladder were collected every 10 minutes and used to measure PbCO2 by gas analysis. Tonometry measurements, plasma lactate, and oxygen delivery and consumption were compared at 3 time points: at baseline, during hypotension, and during treatment periods. A hypotensive period (mean arterial pressure (MAP) < 60 mm Hg) of 15 minutes was induced by an overdose of sevoflurane, whereas during the treatment period, a constant-rate infusion of dopamine (10 µg/kg/min) was administered intravenously for 40 minutes. MEASUREMENTS AND MAIN RESULTS: Values for PgCO2 and PbCO2 increased significantly during the hypotensive period, and correlations were found between these values and the delivery of oxygen. Gastric tonometry values had stronger correlations compared with bladder tonometry values. CONCLUSIONS: Gastric and bladder tonometry can be used to detect hypoperfusion. Further studies are warranted to determine the potential use of gastric and bladder tonometry in assessing dogs in clinical situations.