Determination of Whole Blood Loss From Minimally Invasive Myomectomy Using a Standardized Formula: A Pilot Study.

STUDY OBJECTIVE: To determine the median perioperative blood loss (PBL) during minimally invasive surgical (MIS) myomectomy. DESIGN: Prospective pilot study. SETTING: Large academic teaching hospital. PATIENTS: Thirty-one patients underwent laparoscopic or robotic myomectomy and completed a postoperative complete blood count (CBC) from November 2020 to August 2022. Patients had to have at least one fibroid greater than or equal to 3 cm on preoperative imaging. INTERVENTIONS: A CBC was collected preoperatively within 7 days of surgery. Estimated blood loss (EBL) was determined by the surgeon intraoperatively. A repeat CBC was drawn between postoperative days 2 through 4. PBL was calculated using the equation PBL = (patient weight in kg × 65 cc/kg) × (preoperative hematocrit - postoperative hematocrit)/preoperative hematocrit. MEASUREMENTS AND MAIN RESULTS: Median PBL (536.3 cc [270.0, 909.3]) was greater than median EBL (200.0 cc [75.0, 500.0]). PBL ranged from a net gain of 191.5 cc to net loss of 2362.5 cc. Median size of the largest fibroid on preoperative imaging was 8.8 cm (6.6, 11.5), and median weight of fibroids removed was 321 g (115, 519). About half of patients (51.6%) had one fibroid removed, and 48.4% had 2 or more fibroids removed. Five patients were converted to laparotomy, 4 from robotic approaches. Two patients required a blood transfusion. CONCLUSION: Calculated PBL was greater than intraoperative EBL. This suggests there is continued blood loss post myometrial bed closure. Blood loss should be evaluated both during and after myomectomy, as intraoperative EBL underestimates total PBL.

A comparative analysis of histologic types of thyroid cancer between career firefighters and other occupational groups in Florida.

BACKGROUND: Florida Firefighters experience a higher risk of thyroid cancer than non-firefighters. This study examines whether the histologic types and tumor stage of thyroid cancer is different among firefighters compared to other occupational groups. METHODS: Eligible cases were firefighters (n = 120) identified in a linkage of Florida Cancer Data System (FCDS) registry records (1981-2014) and Florida State Fire Marshal's Office employment and certification records, and non-firefighters classified into: blue-collar (n = 655), service (n = 834), white-collar (n = 4,893), and other (n = 1,789). Differences in thyroid histologic type (papillary, follicular, and rare/other less common forms of thyroid cancer), tumor stage, and age at diagnosis were evaluated using multinomial logistic regression models comparing blue-collar, service, white-collar, and other occupational groups with firefighters. Univariate odds ratios as well as odds ratios adjusted for age, gender, race, tumor stage, and year of diagnosis (aOR) and 95% confidence intervals (95%CI) were reported. RESULTS: Service (aOR = 4.12; 95%CI: 1.25-13.65), white-collar (aOR = 3.51; 95%CI: 1.08-11.36), and blue-collar (aOR = 4.59; 95%CI: 1.40-15.07) workers had significantly higher odds of being diagnosed with rare histologic types of thyroid cancer vs papillary type compared to firefighters. Service (aOR = 0.42; 95%CI: 0.27-0.66), white-collar (aOR = 0.39; 95%CI: 0.26-0.59), blue-collar (aOR = 0.36; 95%CI: 0.23-0.56), and other (aOR = 0.34; 95%CI: 0.22-0.53) occupational groups have a significantly lower odds of being diagnosed with rare vs papillary type at a younger age (30-49 years) vs 50-69 years compared to firefighters. However, stage at diagnosis was not significantly different among occupational groups. CONCLUSION: Firefighters diagnosed with thyroid cancer experience a higher odds of papillary compared to rare histologic types of thyroid cancer relative to other workers; there is no evidence of an increased odds of late-stage diagnosis in firefighters relative to other worker groups. Firefighters may benefit from routine screening and active surveillance of suspected thyroid tumors especially given the excellent treatment outcomes available for those diagnosed with early-stage papillary thyroid tumors.

Towards more specific treatment for diabetic dyslipidemia.

PURPOSE OF REVIEW: Treatment of diabetic dyslipidemia is necessary because of its impact on cardiovascular disease, which is the leading cause of death in patients with diabetes. In the past, standard treatment of diabetic dyslipidemia focused only on correcting lipids. Although this remains the mainstay of treatment, because new antihyperglycemic treatments reduce cardiovascular events with minimal effect on dyslipidemia, a new approach is both timely and relevant. RECENT FINDINGS: LDL-lowering remains the focus of treatment for diabetic dyslipidemia, especially in patients with both diabetes and cardiovascular disease (CVD). Higher intensity statin therapy or lower LDL cholesterol goals are recommended in these patients. Combination therapy, especially with ezetimibe, fibrates, bile acid sequestrants, PCSK9 inhibitors and omega 3 fatty acids should be considered along with selected new agents to reduce glycemia. SUMMARY: As diabetic dyslipidemia plays a key role in CVD, aggressive treatment is indicated. New research targets include apo-CIII and lipoprotein(a) [Lp(a)]. In addition, new antihyperglycemic therapy is changing diabetes care and altering treatment guidelines. The most recent American Diabetes Association Standards of Care has expanded its recommendations for people with CVD and diabetes, suggesting that medications validated to improve cardiac health should be strongly considered.

[Effect of an intervention based on virtual reality on motor development and postural control in children with Down Syndrome]. / Efecto de una intervención basada en realidad virtual sobre las habi lidades motrices básicas y control postural de niños con Síndrome de Down.

There are few studies on the effect of a virtual reality-based intervention on motor development and postural control in children with Down Syndrome (DS). OBJECTIVE: To determine the effect of a virtual reality-based intervention on motor development and postural control in children with DS. PATIENTS AND METHOD: Study with a quantitative approach, with a quasi-experimental design, which included 16 children with DS randomly assigned to an experimental group (GWBB, n = 9) and con trol group (GC, n = 7). Postural control was evaluated by the center of pressure displacement and motor development with TGMD-2. The intervention program was carried out for five weeks, two times per week. The data were subjected to statistical analysis, the Shapiro Wilk test for the sample distribution, and the Student's T-test for the comparison of group means. RESULTS: Significant chan ges were observed in the TGMD-2 Test and its manipulation subtest (p <0.01) respectively. In the rest of the tests, there was an improvement, but no significant differences were observed. CONCLUSION: A virtual reality-based intervention was effective in GWBB, providing low-impact exercises to improve postural control and thus leading to improved motor skills in children with DS.

Sex differences in the reduction of arsenic methylation capacity as a function of urinary total and inorganic arsenic in Mexican children.

Chronic arsenic (As) exposure decreases adult and children's ability to methylate inorganic As (iAs); however, few studies have examined children's sex differences. We measured urinary concentrations of iAs, monomethylarsonic (MMA), and dimethylarsinic (DMA) acids, and calculated the primary (PMI: MMA/iAs) and secondary (SMI: DMA/MMA) methylation capacity indexes in 591 children 6-8 years in Torreón, Mexico. We determined iAs, MMA, and DMA by hydride generation cryotrapping AAS. Lineal regression models estimated associations between methylation capacity and total As (TAs) or iAs. Interactions with sex were tested at p<0.10. Boys had significantly higher TAs levels, (58.4µg/L) than girls (46.2µg/L). We observed negative associations between TAs and PMI (ß=-0.039; p<0.18) and SMI (ß=-0.08; p=0.002) with significant sex differences; PMI reduction was significant in boys (ß=-0.09; p=0.02) but not in girls (ß=0.021; p=0.63), p for interaction=0.06. In contrast, SMI reduction was significantly more pronounced in girls. Furthermore, negative associations PMI (ß=-0.19; p<0.001) and SMI (ß=-0.35; p<0.001) were a function of urinary iAs levels, independently of TAs; however, the reduction in PMI was more pronounced in boys (ß=-0.24; p<0.001; girls ß=-0.15; p<0.001), p for interaction=0.04. A significant negative association was observed between SMI and iAs levels without significant sex differences. TAs and iAs associations with metabolite percentages were in good agreement with those observed with methylation indexes. Our results suggest that iAs plays an important role in reducing As methylation ability and that significant sex differences are present in As metabolism. These differences merit further investigation to confirm our findings and their potential implications for arsenic toxicity in children.

Letter Spacing Does not Affect Memory and Metamemory.

Some perceptual manipulations, such as font size or bolding, can affect the estimations of future memorability (i.e., judgments of learning or JOLs). In two experiments, we studied the effect on JOLs of another perceptual manipulation: the interletter spacing. Spacing may decrease JOLs via beliefs on the effect of spacing on memory, or it may increase JOLs via feelings of processing fluency. In Experiment 1, we found that people do not hold any particular belief on the effect of spacing on memory for a list of words. In Experiment 2, we found that letter spacing did not affect JOLs. We also replicated the results that participants believe that words in large font size will be better remembered and that they rate words in large font size with higher JOLs. In sum, this research showed that not all the perceptual characteristics are used as cues to metamemory.

Correlates of Positive Thyroid Peroxidase Antibodies Among Firefighters: A Cross-Sectional-Study.

Context: Exposure to endocrine disrupting chemicals (EDCs) are associated with underactive thyroid glands, and possibly autoimmunity. Firefighters are exposed to EDCs from flame retardants; however, the prevalence and risk factor associations of thyroid antibodies among firefighters are unknown. Context: We aimed to determine the prevalence of thyroid peroxidase antibodies (TPOAb) and associated sociodemographic and occupational risk factors among firefighters. Methods: Firefighters attending professional health and safety conferences between November 2018 and January 2020, and with no prior diagnosis of thyroid disease were invited (n = 278) to submit a health survey, blood samples, and complete a thyroid ultrasound. The survey assessed for sociodemographic and occupational characteristics, including a history of familial thyroid disease, smoking, firefighter tenure, and job rank, radiation exposure, and mitigation practices of occupational exposures. Serum thyroid peroxidase antibody (TPOAb) was also assessed. Results: Approximately 39.9% of firefighters evaluated had a positive TPOAb test. The mean age for those TPOAb positive was lower than those who tested negative (41.4 ±â€…7.9 vs 43.1 ±â€…7.9 years, P = 0.07) but this difference was not significant. Firefighters with a family history of thyroid disease had a statistically significant higher prevalence of TPOAb compared with those without a family history (60.0% vs 37.5%, P = 0.02); this association remained significant after adjusting for sociodemographic and occupational factors (odds ratio 2.99; CI, 1.31-6.85). Conclusion: The prevalence of TPOAb is high among firefighters in our study, and family history is a significant determinant of testing positive for TPOAb. Firefighters may benefit from TPOAb and thyroid stimulating hormone tests, and screening for family history of thyroid disease at baseline employee medical check-ups. This finding suggests the need for further studies.

Do Room Acoustics Affect the Amplitude of Sound-Field Auditory Steady-State Responses?

The sound-field auditory steady-state response (ASSR) is a promising measure for the objective validation of hearing-aid fitting in patients who are unable to respond to behavioral testing reliably. To record the sound-field ASSR, the stimulus is reproduced through a loudspeaker placed in front of the patient. However, the reverberation and background noise of the measurement room could reduce the stimulus modulation used for eliciting the ASSR. As the ASSR level is heavily dependent on the stimulus modulation, any reduction due to room acoustics could affect the clinical viability of sound-field ASSR testing. This study investigated the effect of room acoustics on the level and detection rate of sound-field ASSR. The study also analyzed whether early decay time and an auditory-inspired relative modulation power model could be used to predict the changes in the recorded ASSR in rooms. A monaural auralization approach was used to measure sound-field ASSR via insert earphones. ASSR was measured for 15 normal-hearing adult subjects using narrow-band CE-Chirps® centered at the octave bands of 500, 1000, 2000, and 4000 Hz. These stimuli were convolved with simulated impulse responses of three rooms inspired by audiological testing rooms. The results showed a significant reduction of the ASSR level for the room conditions compared with the reference anechoic condition. Despite this reduction, the detection rates for the first harmonics of the ASSR were unaffected when sufficiently long recordings (up to 6 min) were made. Furthermore, the early decay time and relative modulation power appear to be useful predictors of the ASSR level in the measurement rooms.

Mitochondrial bioenergetics, glial reactivity, and pain-related behavior can be restored by dichloroacetate treatment in rodent pain models.

Glial reactivity in the dorsal horn of the spinal cord is a hallmark in most chronic pain conditions. Neuroinflammation-associated reactive glia, in particular astrocytes, have been shown to exhibit reduced mitochondrial respiratory function. Here, we studied the mitochondrial function at the lumbar spinal cord tissue from complete Freund's adjuvant-induced inflammatory pain rat and chronic constriction injury mouse models by high-resolution respirometry. A significant decrease in mitochondrial bioenergetic parameters at the injury-related spinal cord level coincided with highest astrocytosis. Oral administration of dichloroacetate (DCA) significantly increased mitochondrial respiratory function by inhibiting pyruvate dehydrogenase kinase and decreased glial fibrillary acidic protein and Iba-1 immunoreactivity in spinal cord. Importantly, DCA treatment significantly reduced the ipsilateral pain-related behavior without affecting contralateral sensitivity in both pain models. Our results indicate that mitochondrial metabolic modulation with DCA may offer an alternative therapeutic strategy to alleviate chronic and persistent inflammatory pain.

Lower Arch Dimensions in Children with Anterior Open Bite and Normal Vertical Overbite: A Cross-sectional Study.

AIM: Dental arch is a dynamic structure and its size depends on genetic and environmental factors. The aim of this study was to determine lower arch dimensions in children between 8 and 16 years with anterior open bite (AOB) and normal vertical overbite (NVO). MATERIALS AND METHODS: A cross-sectional study was performed in 132 individuals with AOB and 132 with NVO between 8 and 16 years selected from public schools. Intercanine width, arch length, intermolar and interpremolar distances, and arch perimeter of the lower arch were measured in previously digitalized models using the GOM inspection program and an optical three-dimensional scanner. RESULTS: Individuals with NVO presented smaller lower arch size with statistical differences in intercanine (P = 0.024, 95% confidence interval [CI]: 0.01, 0.02) and intermolar (P = 0.000, 95% CI: -1.76, -0.53) width and nonsignificant differences in the arch perimeter (P = 0.239, 95% CI: -1.57, 0.39) according to Mann-Whitney U-test. CONCLUSION: Individuals between 8 and 16 years of age with NVO showed smaller lower dental arch than individuals with AOB in most dimensions.

Mitochondrial Modulation by Dichloroacetate Reduces Toxicity of Aberrant Glial Cells and Gliosis in the SOD1G93A Rat Model of Amyotrophic Lateral Sclerosis.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by motor neuron (MN) degeneration and gliosis. Neonatal astrocytes obtained from the SOD1G93A rat model of ALS exhibit mitochondrial dysfunction and neurotoxicity that can be reduced by dichloroacetate (DCA), a metabolic modulator that has been used in humans, and shows beneficial effects on disease outcome in SOD1G93A mice. Aberrant glial cells (AbGC) isolated from the spinal cords of adult paralytic SOD1G93A rats exhibit highly proliferative and neurotoxic properties and may contribute to disease progression. Here we analyze the mitochondrial activity of AbGC and whether metabolic modulation would modify their phenotypic profile. Our studies revealed fragmented mitochondria and lower respiratory control ratio in AbGC compared to neonatal SOD1G93A and nontransgenic rat astrocytes. DCA (5 mM) exposure improved AbGC mitochondrial function, reduced their proliferative rate, and importantly, decreased their toxicity to MNs. Furthermore, oral DCA administration (100 mg/kg, 10 days) to symptomatic SOD1G93A rats reduced MN degeneration, gliosis, and the number of GFAP/S100ß double-labeled hypertrophic glial cells in the spinal cord. DCA treatment of AbGC reduced extracellular lactate levels indicating that the main recognized DCA action, targeting the pyruvate dehydrogenase kinase/pyruvate dehydrogenase complex, may underlie our findings. Our results show that AbGC metabolic phenotype is related to their toxicity to MNs and indicate that its modulation can reduce glial mediated pathology in the spinal cord. Together with previous findings, these results further support glial metabolic modulation as a valid therapeutic strategy in ALS.

Cardiovascular disease leads to a new algorithm for diabetes treatment.

Patients with diabetes mellitus have increased rates of atherosclerotic cardiovascular disease (CVD) and heart failure (HF). This increase occurs despite optimal lipid-lowering therapies. We reviewed clinical trials of diabetes treatments and their effects on circulating plasma lipoproteins and CVD. Several earlier studies failed to demonstrate clear CVD benefit from diabetes therapies. In addition, triglyceride-reducing agents did not reduce overall CVD in large clinical trials although these trials were not conducted in cohorts selected as hypertriglyceridemic. Specific classes such as the thiazolidinediones increased HF. After Food and Drug Administration mandates for more rigorous safety data, recent studies have not only demonstrated CVD safety for many diabetes mellitus agents, but have also shown that certain newer medications such as empagliflozin, canagliflozin, liraglutide, and semaglutide reduce CVD. Moreover, pioglitazone use in insulin-resistant patients has resulted in decreased cerebrovascular and cardiovascular events, suggesting a protective vascular effect of this agent. Benefits from these newer classes of medications are unlikely to be because of improved lipoprotein profiles. These disparities in diabetes medication effects on CVD are likely attributable to each drug or drug class' cardiometabolic effects. Selecting medications based solely on their potential to lower hemoglobin A1C is an outdated therapeutic approach. We propose a new algorithm for treatment of patients with type II diabetes such that medication selection is based on the presence or risk of coronary artery disease and/or HF.

Características actuales de la población pediátrica asistida en un centro de salud del primer nivel de atención en 2020-2021: Montevideo, Uruguay / Characteristics of the pediatric population assisted at primary care level in Montevideo, Uruguay / Características da população pediátrica assistida no nível de atenção primária em Montevidéu, Uruguai

Introducción: alrededor del 30% de las enfermedades infantiles responden a factores sociofamiliares y ambientales, asociados a condiciones de vida, dinámica familiar y exposición a sustancias tóxicas. Conocer las características de la población pediátrica que asiste este centro de salud nos ayudará a identificar factores que pueden estar influyendo en su salud. Objetivos: Describir las características clínico-epidemiológicas de la población menor de 15 años que recibió asistencia en el Centro de Salud Badano Repetto en el período 2020-2021. Conocer diferentes variables que pueden influir en la salud de esta población Identificar asociación de variables familiares y socioculturales con el desarrollo en las diferentes edades. Metodología: estudio descriptivo, retrospectivo, corte transversal. Se incluyó una muestra por conveniencia del 15% del total de los niños y adolescentes menores de 15 años asistidos en el centro de salud desde 1/10/2020 hasta 31/3/2021. Variables estudiadas: del niño: sexo, edad, antecedentes perinatales, crecimiento y desarrollo, controles en salud, inmunizaciones, escolarización, actividades extracurriculares. De los padres: edad, nivel educativo, consumo de sustancias psicoactivas, antecedentes patológicos, empleo, privación de libertad. Familia y vivienda: estado civil de los padres, antecedentes de violencia doméstica, convivientes, características de la vivienda, servicios básicos, transferencias directas de ayuda, intervención de equipos de territorio. Fuente de datos: historias clínicas y vía telefónica. Registro en planilla prediseñada. Los resultados se expresan en frecuencias absolutas, relativas y medidas de tendencia central con su rango. Se utilizó test de Chi cuadrado o exacto de Fisher. Nivel de significación: 0,05. Programa Epi Info™ versión 7.2. Consentimiento informado telefónico a padres y asentimiento a adolescentes. Aprobado por el Comité de Ética del CHPR. Resultados: consultaron 2.826 menores de 15 años, se incluyeron 426 (15%), pero solo 263 (62%) fueron analizados, dado que 163 (38%) no pudieron ser contactados telefónicamente. El 52% eran de sexo femenino. Media de edad: 4 años (5 días-14 años), 69% ≤5 años. 83% de los pacientes tenían adecuados controles de salud y 91% estaban al día con sus inmunizaciones. 12% tenían sobrepeso/obesidad. El desarrollo neurológico fue adecuado en 93% en los menores de 5 años y en 56% de los mayores de 5 años de edad. En el caso de aquellos con trastornos del neurodesarrollo mayores de 5 años, 46% tenían trastornos del aprendizaje, 39% trastorno de conducta, 32% trastornos del lenguaje, 10% déficit intelectual. 56% estaba escolarizado, todos en escuelas públicas. En el caso de aquellos que no asistían a la escuela, 4 estaban en edad de asistencia obligatoria (6, 7, 9 y 10 años de edad). 20% de los niños/adolescentes había repetido por lo menos un año en escuela o liceo. Datos perinatales: 14% de las madres consumieron drogas; las más frecuentes fueron tabaco y pasta base de cocaína (PBC). 85% fueron recién nacidos de término, 10% presentaron depresión neonatal. 15% de niños/ adolescentes estuvo expuesto a violencia doméstica y 32% de ellos (12/38) tenía por lo menos un padre con uso de drogas psicoactivas en el domicilio. 21% de los niños/adolescentes expuestos a violencia doméstica tenía una dificultad de aprendizaje. 8% de estos pacientes tenía por lo menos un padre que no había terminado educación primaria y 28% que no había terminado ciclo básico. Se encontró una relación significativa entre uso de drogas psicoactivas, declarada por uno o ambos padres, y violencia doméstica. No se encontró una relación significativa entre alteración del neurodesarrollo y violencia doméstica. Conclusiones: estos hallazgos muestran una población social y económicamente vulnerable, padres con baja escolaridad, uso de pasta base de cocaína durante el embarazo en un porcentaje mayor al reportado nacionalmente, y 15% de niños/adolescentes expuestos a violencia doméstica, pero con un buen número de controles de salud. La mayor fortaleza encontrada por este estudio es la importancia de mantener una buena conexión con estas familias, que mostraron un alto nivel de compromiso con el centro de salud. Esto nos desafía a priorizar la prevención y promoción en salud como herramientas valiosas para adquirir salud de calidad para estos niños/adolescentes. Nuevos estudios, con otras metodologías, serán necesarios para analizar estas variables encontradas.

Introduction: around 30% of childhood diseases are caused by social, environmental and family issues, as well as by life conditions, family dynamics and exposure to toxic substances. Understanding the characteristics of the pediatric population assisted at this Health Center, will help us identify health-threatening factors. Objectives: Describe the clinical and epidemiological characteristics of the population under 15 years of age assisted at Badano Repetto Health Center between 2020 and 2021. Understand the different variables that could influence this population´s health. Identify the link between family, social and cultural variables and neurological development at different ages. Methodology: descriptive, retrospective cross-sectional study. Convenience sampling of 15% of the total number of children and adolescents under 15 years of age, assisted at the Health Center from 10/01/2020 to 3/31/2021. Variables: children: sex, age, perinatal history, growth and neurological development, health checkups, vaccines, school attendance, extracurricular activities. Parents: age, education, psychoactive substance use, pathological background, job, prison. Family and household: parent`s marital status, domestic violence history, cohabitants, housing characteristics, basic household services, government aids, community interventions. Data source: medical records and telephone conversations. Data was recorded on template charts. We used results in absolute and relative frequencies, and their measures of central tendency measures and their range, Chi-square test or Fisher´s exact test. Significance level 0,05. Epi Info Program, version 7.2. Informed parent and adolescent consent. Approved by the CHPR Ethics Committee. Results: out of the 2826 patients under 15 years of age assisted at the clinic, we included 426 (15%), but only 263 (62%) were analyzed, since we were not able to reach 163 (38%) by phone. 52% were female. The average age was 4 years of age (5 days-14 years old). 69% of children were under 5 years old. 83% of patients had adequate number of checkups and 91% had an updated vaccination chart. 12% were overweight/obese. Neurodevelopment was adequate in 93% of those under 5 years of age, and 56% of those over 5 years of age. Regarding those with neurodevelopmental difficulties and over 5 years of age, 46% had learning disabilities, 39% had behavioral disorders, 32% language disorders, 10% intellectual deficit. 56% attended school, all of them public schools. For those who did not attend school, 4 of them were old enough to attend mandatory school (6, 7, 9 and 10 years of age). 20% of the children and adolescents had failed at least one year in school or high school. Perinatal findings: 14% of mothers had substance use during pregnancy, mainly tobacco and cocaine base paste. 85% of them had been born to term, 10% had neonatal depression 15% of children/adolescents had been exposed to domestic violence and 32% of them (12/38) had one parent with psychoactive drug use at home. 21% of children/adolescents exposed to domestic violence had a learning disability. 8% had at least one parent who did not finish primary school and 28% who did not finish middle school. Statistically, a significant link was found between psychoactive substance use, declared by one or both parents, and domestic violence. No statistically significant link was found between neurodevelopmental difficulties and domestic violence. Conclusions: these findings show a socially and economically vulnerable population, parents with little formal education, higher cocaine paste base use during pregnancy than the national statistics and 15% of children/adolescents exposed to domestic violence, even though they a high number of them had received their health checkups. The biggest strength shown by this study is the importance of maintaining a good bond with these families, who showed a high level of commitment with the health center. This leads us to prioritize health prevention and promotion as a valuable tool to achieve health quality standards for these children and adolescents. New studies, using other methodologies, will be necessary to analyze this data.

Introdução: cerca de 30% das doenças infantis são causadas por questões sociais, ambientais e familiares, bem como por condições de vida, dinâmica familiar e exposição a substâncias tóxicas. Compreender as características da população pediátrica atendida neste Centro de Saúde, nos ajudará a identificar fatores de risco à saúde. Objetivos: Descrever as características clínico-epidemiológicas da população menor de 15 anos de idade atendida no Centro de Saúde Badano Repetto no período 2020-2021. Compreender diferentes variáveis que podem influenciar a saúde dessa população. Identificar uma relação entre as variáveis familiares e socioculturais e o desenvolvimento em diferentes idades. Metodologia: estudo descritivo, retrospectivo, transversal. Foi incluída uma amostra por conveniência de 15% de todas as crianças e adolescentes menores de 15 anos atendidos no Centro de Saúde entre 01/10/2020 e 31/03/2021. Variáveis estudadas: da criança: sexo, idade, história perinatal, crescimento e desenvolvimento, controles de saúde, imunizações, escolaridade, atividades extracurriculares. Dos pais: idade, escolaridade, consumo de substâncias psicoativas, histórico médico, emprego, privação de liberdade. Família e habitação: estado civil dos pais, história de violência doméstica, coabitantes, características da moradia, serviços básicos, transferências de ajuda de custo, intervenção das equipes no território. Fonte de dados: prontuários e enquetes telefônicas. Cadastro em planilha padrão. Os resultados são expressos em frequências absolutas e relativas e medidas de tendência central com sua amplidão. Utilizou-se o teste do qui-quadrado ou exato de Fisher. Nível de significância 0,05. Programa Epi Info™ versão 7.2. Consentimento informado por telefone pais e consentimento dos adolescentes. Aprovado pelo Comitê de Ética do CHPR. Resultados: 2.826 crianças menores de 15 anos consultadas, 426 (15%) foram incluídas, mas 263 (62%) foram analisadas, pois 163 (38%) não puderam ser contatadas por telefone. 52% eram do sexo feminino. Idade média 4 anos (5 dias -14 anos), 69% ≤ 5 anos. 83% dos pacientes possuíam controles de saúde adequados e 91% estavam com suas imunizações em dia. 12% com sobrepeso/obesidade. O desenvolvimento neurológico foi adequado em 93% dos menores de 5 anos e em 56% dos maiores de 5 anos. No caso dos portadores de transtornos de neurodesenvolvimento com mais de 5 anos, 46% apresentavam transtorno de aprendizagem, 39% transtorno de conduta, 32% transtorno de linguagem, 10% déficit intelectual. 56% estavam na escola, todos em escolas públicas. No caso dos que não frequentaram a escola, 4 deles estavam em idade em idade escolar obrigatória (6, 7, 9 e 10 anos). 20% das crianças/adolescentes repetiram pelo menos um ano na escola ou no ensino médio. Dados perinatais: 14% das mães usavam drogas; pasta base de tabaco e maiormente pasta base de cocaína (PBC). 85% eram recém-nascidos a termo, 10% tinham depressão neonatal. 15% das crianças/adolescentes foram expostos à violência doméstica e 32% deles (12/38) tinham pelo menos um dos pais que usava drogas psicoativas em casa. 21% das crianças/adolescentes expostas à violência doméstica tinham dificuldade de aprendizagem. 8% desses pacientes possuíam pelo menos um dos pais com escola primária incompleta e 28% com ensino médio incompleto. Encontrou-se relação significativa entre o uso de drogas psicoativas, declarado por um ou ambos os pais, e a violência doméstica. Não foi encontrada relação significativa entre transtornos do neurodesenvolvimento e violência doméstica. Conclusões: esses achados mostram uma população social e economicamente vulnerável, pais com baixa escolaridade, uso de pasta base de cocaína durante a gravidez em porcentagem superior ao reportado a nível nacional, e 15% de crianças/adolescentes expostos à violência doméstica, mas com um alto número de controles de saúde. A maior fortaleza encontrada por este estudo é a importância de manter um bom vínculo com essas famílias, que demonstraram alto nível de comprometimento com o centro de saúde. Isso nos leva a priorizar a prevenção e promoção da saúde como ferramentas valiosas para a aquisição de saúde de qualidade para essas crianças/adolescentes. Novos estudos, com outras metodologias, serão necessários para poder analisar essas variáveis encontradas.

Dexmedetomidina intranasal en sedación para ginecoobstetricia / Intranasal dexmedetomidine in sedation for OB/GYN

Objetivos: evaluar el uso de la dexmedetomidina intranasal como coadyuvante para sedación en LUI y AMEU asociado al sistema de infusión controlado por objetivo. Métodos: ensayo clínico no controlado, prospectivo y simple ciego. Muestra de 48 pacientes que cumplen los criterios de inclusión. Grupo CD se administró Dexmedetomidina IN a dosis de 0,9 µg/kg y otro grupo de control. Para el análisis estadístico de variables continuas se usó media y DE; para variables ordinales se calculó frecuencia. Además de prueba T de Student y Chi χ2. Nivel de confianza de 95 % y margen de error 12%. Resultados: edad media de 32 ± 7 años; en el grupo CD la dosis de inducción y mantenimiento de remifentanil fue de 2 ± 0,7 ng/ml y en el grupo SD la dosis de inducción fue de 4,1 ± 0,7 ng/ml y de mantenimiento 3,9 ± 0,5 ng/ml; para el propofol la dosis de inducción y mantenimiento fue 3,7 ± 0,5 mcg/ml en el grupo SD mientras que, en el grupo CD la dosis de inducción y mantenimiento fue de 2,1 ± 0,5 mcg/ml. La frecuencia cardiaca de 64 - 62 y en el grupo SD fue de 70 - 67 latidos/min. La PAM asociado al dexme está por 73 mmHg y el grupo de SD es de 78 mmHg. No se verifico complicaciones por la administración de la Dexmedetomidina. Conclusiones: la dexmedetomidina IN permite disminuir la dosis de los fármacos, con estabilidad de los cambios hemodinámicos, la dosis utilizada no produce complicaciones.

Objectives: to evaluate the use of intranasal dexmedetomidine as an adjunct for sedation in LUI and AMEU associated with the objective controlled infusion system. Methods: uncontrolled, prospective, single-blind clinical trial. Sample of 48 patients who meet the inclusion criteria. Group CD was administered Dexmedetomidine IN a dose of 0.9 µg / kg and another control group. For the statistical analysis of continuous variables, mean and SD were used; For ordinal variables, frequency was calculated. In addition to Student's T-test and Chi χ2. 95% confidence level and 12% margin of error. Results: age of 32 ± 7 years; in the CD group the induction and maintenance dose of remifentanil was 2 ± 0.7 ng / ml and in the SD group the induction dose was 4.1 ± 0.7 ng / ml and maintenance dose 3.9 ± 0.5 ng / ml; for propofol the induction and maintenance dose was 3.7 ± 0.5 mcg / ml in the SD group, while in the CD group the induction and maintenance dose was 2.1 ± 0.5 mcg / ml. The heart rate was 64-62 and in the SD group it was 70-67 beats / min. The MAP associated with dexme is 73 mmHg and the SD group is 78 mmHg. No complications were verified by the administration of Dexmedetomidine. Conclusions: dexmedetomidine IN allows to decrease the dose of drugs, with stability of hemodynamic changes, the dose used does not cause complications.

Diferencias en una tarea de teoría de la mente entre mujeres con y sin conducta delictiva / Differences in a theory of mind task between women with and without criminal behavior

Resumen El objetivo de este estudio fue establecer diferencias en las puntuaciones en una tarea de teoría de la mente (ToM) en mujeres con y sin antecedentes de conducta delictiva e indicar el nivel de predicción de la teoría de la mente sobre la conducta antisocial. El estudio resulta de una búsqueda sobre investigaciones en el tema que dan cuenta de la importancia de entender los factores asociados en la conducta antisocial, principalmente el de ToM. Por otro lado, no existe suficiente documentación sobre el funcionamiento de ToM, específicamente en mujeres. El estudio se realizó desde un enfoque empírico analítico, comparativo-predictivo. Muestra: participaron 68 mujeres, 34 con antecedentes penales y 34 sin antecedentes penales. Se aplicó una ficha de caracterización y el Test de las Miradas.: Se encontraron diferencias significativas en la tarea de ToM para los dos grupos (Con antecedentes X̄ = 22.97[SD= 4.75] vs. Sin antecedentes X̄ = 25.50[SD = 3.87]; U = 406,500; P = 0.03). La ToM predice la conducta delictiva (OR = 1,152; IC 95 % [1,017 a 1,306]; P = 0.02). De los hallazgos, se concluye la importancia de la teoría de la mente para la neurociencia cognitiva, dado su valor modulador y predictor de conductas de riesgo.

Abstract It is intended to establish to establish differences in scores on a theory of mind (ToM) task in women with and without a history of criminal behavior and to indicate the level of prediction of the theory of mind on antisocial behavior. The study is the result of a search on research in the field that shows the importance of understanding the factors associated with antisocial behavior, mainly the ToM. On the other hand, there is not enough documentation on the functioning of ToM, specifically in women. The study was conducted from an empirical analytical, comparative-predictive approach. Sample: 68 women participated, 34 with criminal records and 34 without. A characterization card and the Gaze Test were applied. Significant differences were found in the ToM task for the two groups (With criminal record X̄= 22.97 [SD= 4.75] vs Without criminal record X̄ = 25.50 [SD = 3.87]; U = 406,500; P = 0.03). The ToM predicts criminal behavior (OR = 1,152; 95% CI [1,017 to 1,306]; P = 0.02). From the findings, it is concluded the importance of the theory of mind for cognitive neuroscience, given its modulating and predicting value of risk behaviors.

Comparison of the intrinsic dynamics of aminoacyl-tRNA synthetases.

Aminoacyl-tRNA synthetases (AARSs) are an important family of enzymes that catalyze tRNA aminoacylation reaction (Ibba and Soll in Annu Rev Biochem 2000, 69:617-650) [1]. AARSs are grouped into two broad classes (class I and II) based on sequence/structural homology and mode of their interactions with the tRNA molecule (Ibba and Soll in Annu Rev Biochem 2000, 69:617-650) [1]. As protein dynamics play an important role in enzyme function, we explored the intrinsic dynamics of these enzymes using normal mode analysis and investigated if the two classes and six subclasses (Ia-c and IIa-c) of AARSs exhibit any distinct patterns of motion. The present study found that the intrinsic dynamics-based classification of these enzymes is similar to that obtained based on sequence/structural homology for most enzymes. However, the classification of seryl-tRNA synthetase was not straightforward; the internal mobility patterns of this enzyme are comparable to both IIa and IIb AARSs. This study revealed only a few general mobility patterns in these enzymes--(1) the insertion domain is generally engaged in anticorrelated motion with respect to the catalytic domain for both classes of AARSs and (2) anticodon binding domain dynamics are partly correlated and partly anticorrelated with respect to other domains for class I enzymes. In most of the class II AARSs, the anticodon binding domain is predominately engaged in anticorrelated motion with respect to the catalytic domain and correlated to the insertion domain. This study supports the notion that dynamic-based classification could be useful for functional classification of proteins.

Efecto de una intervención basada en realidad virtual sobre las habi lidades motrices básicas y control postural de niños con Síndrome de Down / Effect of an intervention based on virtual reality on motor development and postural control in children with Down Syndrome

Resumen: Los estudios sobre intervenciones basadas en realidad virtual y su efecto en el desarrollo motor y control postural en niños con Síndrome de Down (SD) son escasos. Objetivo: Determinar el efec to de una intervención basada en realidad virtual, sobre el desarrollo motor y el control postural en niños con SD. Pacientes y Método: Estudio con un enfoque cuantitativo, con un diseño cuasi experimental, que incluyó a 16 niños con SD asignados aleatoriamente a un grupo experimental (GWBB, n = 9) y grupo control (GC, n = 7). Se evaluó control postural mediante el desplazamien to del centro de presión y desarrollo motor con TGMD-2. El programa de intervención se llevó a cabo durante 2 veces por semana por 5 semanas. Los datos fueron sometidos a análisis estadísti cos, el test de Shapiro Wilk para la distribución de la muestra, y T de Student para la comparación de medias de los grupos. Resultados: Se observaron cambios significativos en el Test TGMD-2 y en su subtest de manipulación (p < 0,01) respectivamente. En el resto de las pruebas hubo una mejora, pero no se observan diferencias significativas. Conclusión: Una intervención basada en realidad virtual fue efectiva solo en el GWBB, proporcionando ejercicios de bajo impacto para mejorar el control postural y provocando con ello una mejora de las habilidades motoras en niños con SD.

Abstract: There are few studies on the effect of a virtual reality-based intervention on motor development and postural control in children with Down Syndrome (DS). Objective: To determine the effect of a virtual reality-based intervention on motor development and postural control in children with DS. Patients and Method: Study with a quantitative approach, with a quasi-experimental design, which included 16 children with DS randomly assigned to an experimental group (GWBB, n = 9) and con trol group (GC, n = 7). Postural control was evaluated by the center of pressure displacement and motor development with TGMD-2. The intervention program was carried out for five weeks, two times per week. The data were subjected to statistical analysis, the Shapiro Wilk test for the sample distribution, and the Student's T-test for the comparison of group means. Results: Significant chan ges were observed in the TGMD-2 Test and its manipulation subtest (p <0.01) respectively. In the rest of the tests, there was an improvement, but no significant differences were observed. Conclusion: A virtual reality-based intervention was effective in GWBB, providing low-impact exercises to improve postural control and thus leading to improved motor skills in children with DS.

Relación entre control postural y desarrollo motor en niños con síndrome de down y con desarrollo típico de Chillán / Relationship between postural control and motor development in children with down syndrome and with typical development of Chillán

El objetivo de esta investigación es relacionar el desarrollo motor y control postural en niños con Síndrome de Down de la ciudad de Chillán. La investigación tiene un diseño no experimental, transeccional, correlacional. La muestra intencionada no probabilística está constituida por un total de 36 niños entre 6 y 12 años con Síndrome de Down (n=16) y con Desarrollo Típico (n=20). Se evalúo el desarrollo motor grueso por medio del Test of Gross Development (Ulrich, 2000), y control postural mediante una plataforma Wii Balance Board (Rey-Martinez & Perez-Fernandez, 2016) calculando el área de desplazamiento del centro de presiones en posición estática con ojos abiertos y cerrados. Los resultados muestran diferencias significativas entre ambos grupos tanto en desarrollo motor como control postural (p<0,05) siendo mejores en el grupo de desarrollo típico. No se encontró una co-rrelación entre control postural y desarrollo motor en el grupo de niños con Síndrome de Down. En conclusión, los niños con Síndrome de Down presentan un retraso en el control postural y desarrollo motor en comparación a los niños con desarrollo típico, sin embargo, es necesario realizar más inves-tigación para determinar la relación entre ambas variables.

The objective of this research is to relate motor development and postural control in children with Down syndrome in the city of Chillán. The research has a non-experimental, transactional, correlational design. The sample is non-probabilistic intentional and consists of a total of 36 children between 6 and 12 years old with Down Syndrome (n = 16) and with Typical Development (n = 20). The gross motor development was evaluated through the Test of Gross Development (Ulrich, 2000), and postu-ral control through a Wii Balance Board platform (Rey-Martinez & Perez-Fernandez, 2016) calcula-ting the displacement area of the center of pressures in position static with open and closed eyes. The results show significant differences between the two groups both in motor development and postural control (p <0.05), being better in the typical development group. Not found a correlation between pos-tural control and motor development in children with Down Syndrome group. In conclusion, children with Down syndrome show a delay in postural control and motor development compared to children with typical development, however, it's necessary to carry out further research to determine the rela-tionship between the two variables.