Standardised results of the Montreal Cognitive Assessment (MoCA) for neurocognitive screening in a Chilean population.

INTRODUCTION: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. METHOD: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. RESULTS: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1%-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. DISCUSSION: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.

A mild case of hemolytic disease of the fetus and newborn due to anti-Sc2.

We report the case of a newborn girl with jaundice due to increased indirect bilirubin with a positive direct antiglobulin test (DAT) and compensated hemolysis. The result of the newborn's DAT was discrepant with the negative result of the mother's indirect antiglobulin test. The multiparous mother had a previous history of fetal hydrops miscarriage, with no known cause, and no record of the cause was found at the hospital where she was treated. After referring samples from the mother and newborn to a reference laboratory, the rare alloanti-Sc2 was identified in the mother's plasma and in the newborn's eluate. HEA BeadChip genotyping of the newborn's DNA sample predicted the SC:1,2 phenotype.We report the case of a newborn girl with jaundice due to increased indirect bilirubin with a positive direct antiglobulin test (DAT) and compensated hemolysis. The result of the newborn's DAT was discrepant with the negative result of the mother's indirect antiglobulin test. The multiparous mother had a previous history of fetal hydrops miscarriage, with no known cause, and no record of the cause was found at the hospital where she was treated. After referring samples from the mother and newborn to a reference laboratory, the rare alloanti-Sc2 was identified in the mother's plasma and in the newborn's eluate. HEA BeadChip genotyping of the newborn's DNA sample predicted the SC:1,2 phenotype.

Standardized results of the Montreal Cognitive Assessment (MoCA) for neurocognitive screening in a Chilean population. / Resultados estandarizados del Montreal Cognitive Assessment (MoCA) para cribado neurocognitivo en población chilena.

INTRODUCTION: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. METHOD: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. RESULTS: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. DISCUSSION: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.

Sangrado intraoperatorio de amigdalectomía en población pediátrica. Influencia de factores quirúrgicos y anestésicos / Intraoperative bleeding of tonsillectomy in pediatric patients. Effects of surgical and anesthesia technique

INTRODUCTION: Tonsillectomy with or without adenoidectomy is one of the most frequent surgeries in the pediatric population. It has become predomi- nantly an outpatient procedure. Therefore, it is of utmost importance identi- fying the factors that influence the intraoperative bleeding to prevent posto- perative complications and rehospitalization. MATERIAL AND METHODS: An observational cross-sectional study was carried out. Patients between 1 and 14 years old that underwent to tonsillectomy with or without adenoidectomy since November 2015 to May 2017 were included. 709 cases were evaluated. Intraoperative bleeding was assessed by the volumetric method. A multivariate analysis was performed using a generalized linear regression model. RESULTS: The average intraoperative bleeding was estimated in 1.9 ml/kg (95% CI: 1.7 -2.05). The use of propofol (30% increase in bleeding) and surgical time (2% increase for every minute) were risk factors. The use of electrocautery was as- sociated with a 50% decrease in bleeding in comparison with conventional dis- section (p = 0.001). CONCLUSION: The use of propofol and a prolonged surgical time were risk factors for intraoperative bleeding. The use of electrosurgery was a protective factor.

INTRODUCCIÓN: La amigdalectomía con o sin adenoidectomía, es una de las cirugías más frecuente en población pediátrica. Desde hace varios años se ha vuelto una intervención predominantemente ambulatoria, por lo que lograr identificar los factores que influyen en el sangrado intraoperatorio es de suma importancia para prevenir complicaciones postoperatorias y reshospitalización. MATERIAL Y MÉTODO: Se realizó un estudio observacional de corte-transversal. Se incluyó a pacientes entre 1 y 14 años sometidos a amigdalectomía con o sin adenoidectomía entre noviembre de 2015 y mayo de 2017, obteniendo un total de 709 casos evaluados. Se determinó el sangrado intraoperatorio de forma volumétrica. Posteriormente, se realizó un análisis multivariado con un modelo de regresión lineal generalizado. RESULTADOS: Se cuantificó el sangrado intraoperatorio promedio en 1,9 ml/kg (IC 95%; 1,7-2,05). El uso de propofol (aumento del 30% del sangrado) y tiempo quirúrgico (2% por cada incremento de un minuto) fueron factores de riesgo. Mientras que el uso de electro bisturí se asoció con una disminución del 50% en relación al no uso (p = 0,001). CONCLUSIONES: Fueron factores de riesgo para sangrado intraoperatorio el uso de propofol y un tiempo quirúrgico prolongado. El uso de electrobisturí constituyó un factor protector.

Violencia escolar y su relación con síntomas ansiosos / Bullying and its association with anxiety symptoms

INTRODUCCIÓN: Violencia escolar es la persecución física o psicológica de un alumno o alumna contra otro, convirtiéndolo en víctima de repetidos ataques. Es un importante marcador de riesgo de conductas antisociales futuras, y se relaciona con mayor prevalencia de síntomas ansiosos. OBJETIVO: Establecer si existe asociación entre la presencia de ansiedad patológica y la práctica de violencia escolar. MATERIAL Y MÉTODOS: Estudio descriptivo observacional y transversal. Se estudió a 166 alumnos de cuarto a octavo básico, de un colegio particular subvencionado de la comuna de Lo Barnechea, en Santiago de Chile. De ellos, 77 fueron hombres y 89 mujeres, entre 9 y 16 años. Se aplicó la escala de Autoreporte de Ansiedad para Niños y Adolescentes (AANA) y el cuestionario de Maltrato entre Iguales por Abuso de Poder (MIAP). Además, se recopilaron datos tales como sexo, edad, número de personas que viven en el hogar y si vive o no con sus padres. RESULTADOS: De los estudiantes evaluados, el 46,99 por ciento clasificó como testigo de violencia escolar, 19,28 por ciento víctima, 10,84 por ciento agresor, 10,84 por ciento víctima-agresor, y un 12,05 por ciento no clasificó en ninguna categoría. Se obtuvo un 36,1 por ciento de prevalencia de ansiedad patológica en el total de individuos; un 41,67 por ciento en agresores y 30,61 por ciento en no agresores, con chi-cuadrado P > 0,05.DISCUSIÓN: La prevalencia de ansiedad patológica en agresores de violencia escolar es mayor que en quienes no la practican; sin embargo, esta asociación no llega a valores estadísticamente significativos.

INTRODUCTION: Bullying is the physical or psychological persecution of one student against another, making him a victim of recurrent attacks. It is one of the most important risk markers for future antisocial behavior, which has also been associated with higher prevalence of anxiety symptoms. OBJECTIVE: Establish if there is an association between pathological anxiety and bullying. METHODS: This is a descriptive, observational and transversal study. 166 students from fourth to eight grades were studied from a semi private school from Lo Barnechea, Santiago, Chile. From this population, 77 were male and89 female, between 9 and 16 years old. The Anxiety Scale for Children and Adolescents (AAA) and the Survey of High School Bullying Abuse of Power questionnaires were applied. Also, data such as sex, age, number of people who are living in their homes and whether they live with their parents or not was collected. RESULTS: From the students evaluated, 46.99 percent classified as bullying witnesses, 19.28 percent as victims, 10.84 percent as aggressors, 10.84 percent aggressor-victim and 12.05 percent didn't classify in any category. A 36.1 percent prevalence of pathologic anxiety was obtained from the totality of individuals. In the aggressor category 41.67 percent had pathological anxiety and 30.61 percent in non-aggressors, with a chi-square P > 0.05. DISCUSSION: Prevalence of pathological anxiety is higher in the aggressor than in the non-aggressor group, however this association is statistically non-significant