Boletín COE Salud / Health COE Bulletin

El cuarto ejemplar del boletín digital "COE Salud", plataforma de la Dirección General de Gestión del Riesgo de Desastres y Defensa Nacional en Salud (DIGERD), con información destacada de las actividades realizadas por esta dirección del Ministerio de Salud. En esta oportunidad, encontraremos información sobre cómo el Ministerio de Salud mitigó los riesgos en salud, durante el período 2021 hasta Junio 2022. Además, la respuesta en emergencias como: los deslizamientos de tierra en Abancay, el incendio forestal en Amazonas, el conflicto social en Arequipa. Por otro lado, conoceremos la asistencia técnica que se realizó a los nosocomio que tuvieron dificultades en la gestión de su programa presupuestal 2022.

Carboxyhemoglobinemia as a laboratory finding in an outpatient

Resumen El monóxido de carbono (CO) es un gas producido principalmente por combustión incompleta de hidrocarburos. La intoxicación por exposición ambiental puede presentarse con síntomas inespecíficos y constituye la causa más importante de aumento de carboxihemoglobina (COHb). Su nivel en sangre depende de la duración de la exposición, la ventilación minuto y las concentraciones de CO y oxígeno en el ambiente. La elevada toxicidad radica en la hipoxia tisular que se genera. Se presenta el caso de un paciente masculino, 73 años, en seguimiento en el hospital por neumonía intersticial no específica como patología de base. En un control de laboratorio se encontró 11,9% de COHb, sin exposición a tabaco. No utilizaba calefacción a gas sino un panel cerámico eléctrico, recientemente pintado con esmalte sintético. La suspensión del uso del panel normalizó la COHb. El CO, producto de descomposición térmica del esmalte sintético, explica la causa de la intoxicación.

Abstract Carbon monoxide (CO) is a gas produced mainly by incomplete combustion of hydrocarbons. Poisoning from environmental exposure can present with nonspecific symptoms and is the most important cause of increased carboxyhemoglobin (COHb). Its blood level depends on the duration of exposure, minute ventilation, and the concentrations of CO and oxygen in the environment. The high toxicity lies in the tissue hypoxia that is generated. The case of a male patient, 73 years old, under follow-up in the hospital for non-specific interstitial pneumonia as the underlying pathology was presented. In a laboratory control, COHb 11,9% was found. There was no exposure to tobacco and there was no use of gas heating but of an electric ceramic panel, recently painted with synthetic enamel type paint. The suspension of the use of the panel normalised the COHb. The CO product of thermal decomposition of synthetic enamel explains the cause of poisoning.

Resumo O monóxido de carbono (CO) é um gás produzido principalmente pela combustão incompleta de hidrocarbonetos. A intoxicação por exposição ambiental pode se apresentar com sintomas inespecíficos e é a causa mais importante de aumento da carboxihemoglobina (COHb). Seu nível em sangue depende do tempo de exposição, da ventilação minuto e das concentrações de CO e oxigênio no ambiente. A alta toxicidade está na hipóxia tecidual gerada. Apresentamos o caso de um paciente do sexo masculino, 73 anos, em acompanhamento hospitalar por pneumonia intersticial inespecífica como patologia de bas. Em um controle laboratorial, achou-se 11,9% de COHb, sem exposição ao tabaco. Não utilizava aquecimento a gás e sim um painel elétrico cerâmico, recentemente pintado com esmalte sintético. A suspensão do uso do painel normalizou o COHb. O CO produto da decomposição térmica do esmalte sintético explica a causa da intoxicação.

Tamaulipan thornscrub after fire: an analysis of the composition of species / Espinho de Tamaulipan após incêndio: uma análise da composição das espécies

Abstract Forest fires are a natural element in many terrestrial ecosystems, in Mexico one of the main causes of loss of vegetation coverage is related to them. Nevertheless, no research has been carried out in the Tamaulipan thornscrub communities regarding post-fire regenerative strategies of plant species, therefore, is important to generate knowledge about the ecological role of fire in them. The aim of this study is to characterize the arboreal and shrub vegetation of a Tamaulipan thornscrub community in the Northeast of Mexico after a fire. To determine the composition, diversity and structure of the floral community consisting of trees and shrubs, 6 square-shaped sampling sites of 1,600 m2 were established 3 years after the fire. Margalef (DMg), Shannon-Weiner (H') and Pretzsch (A) indices were calculated to determine the richness, diversity and vertical stratification of species, respectively.23 species, 21 genera and 14 families of vascular plants were registered. The most species were Fabaceae (6) and Rhamnaceae (3) and Cordia boissieri was the specie with greater ecological weight (IVI = 20.3%). The indexes of richness and true diversity (DMg = 3.16; D = 16.44) showed high values, which suggests that the post-fire area has a good regeneration and a high species diversity. With these results we can conclude that the fire is an important agent of change in successional stages of Tamaulipan thornscrub with high values of regeneration after a surface fire.

Resumo Os incêndios florestais são um elemento natural em muitos ecossistemas terrestres, no México uma das principais causas de perda de cobertura vegetal está relacionada a eles, no entanto, nenhuma pesquisa foi realizada nas comunidades de espinheiros de Tamaulipan sobre as estratégias regenerativas pós-fogo de espécies de plantas, portanto, é importante gerar conhecimento sobre o papel ecológico do fogo neles. O objetivo deste estudo é caracterizar a vegetação arbórea e arbustiva de uma comunidade de plantas espinhosas no Tamaulipas, nordeste do México após um incêndio. Para determinar a composição, diversidade e estrutura da comunidade vegetal constituída por árvores e arbustos, seis locais de amostragem em forma de quadrado de 1.600 m2 cada um, foram estabelecidos três anos após o incêndio. Índices de Margalef (DMg), Shannon-Weiner (H') e Pretzsch (A) foram calculados para determinar a riqueza, diversidade e estratificação vertical das espécies, respectivamente. Foram registradas 23 espécies, 21 gêneros e 14 famílias de plantas vasculares. As mais ricas foram Fabaceae (6) e Rhamnaceae (3), Cordia boissieri foi a espécie com maior peso ecológico (IVI = 20,3%). Os índices de riqueza e diversidade verdadeira (DMg = 3,16; D = 16,44) apresentaram valores elevados, o que sugere que a área pós-fogo apresenta boa regeneração e alta diversidade Vegetal. Com estes resultados podemos concluir que o fogo é um importante agente de mudança nos estágios sucessionais do espinho de Tamaulipan com altos valores de regeneração após um incêndio na superfície.

Plan de evacuación en quirófano / Evacuation plan in the operating room

Todo quirófano debe adecuar el plan de evacuación según sus riesgos más probables y sus posibilidades operativas en forma realista y creativa. En el presente se tomó el incendio como el factor con mayor posibilidad que pueda producir una situación de desastre y/o emergencia. Objetivo: Diseñar, disponer e implementar un Plan de Evacuación que permita hacer frente a una situación peligrosa (un incendio, una inundación, un derrumbe del edificio, etc.) y ayude a que las personas y los bienes sufran el menor daño posible, en el servicio de quirófano del Sanatorio Allende sede Nueva Córdoba, en diciembre del año 2019. Es un proyecto de intervención, que se comenzó en mayo del mismo año y fue planificado para que se ejecute en el año 2020. El plan debe ser responsabilidad de todo el equipo quirúrgico. Conclusión: Contar con un plan de evacuación implica tener un equipo interdisciplinario capacitado permanentemente en condiciones de dar respuestas a amenaza de orden natural o generada por el hombre. Para ello es necesario la formación de brigadas en donde quedarán explícitos los roles y las acciones que cumple cada integrante ante un evento adverso. La seguridad no se improvisa, todos son responsables[AU]

Every operating room must adapt their evacuation plan according to its most probable risks and its operational possibilities in a realistic and creative way. In the following, the fire was taken as the most likely factor that could produce a disaster and/ or emergency situation. Objective: Design, arrange and implement an Evacuation Plan that allows to deal with a dangerous situation (a fire, a flood, a collapsing building, etc.) and help people and property suffer the least possible damage, in the operating room service of the Sanatorio Allende, Nueva Córdoba headquarters, in December of 2019. It is an intervention project, which began in May of the same year and was planned to be executed in 2020. The plan must be the responsibility of the entire surgical team. Conclusion: Having an evacuation plan implies having an interdisciplinary team permanently trained in a position to respond to natural or man-made threats. This requires the formation of brigades where roles and actions that each member must fulfill in case of an adverse event, will be explicit. Security is not improvised, everyone is responsible[AU]

Toda sala de operações deve adaptar seu plano de evacuação de acordo com suas riscos mais prováveis e suas possibilidades operacionais de maneira realista e criativa. A seguir, o incêndio foi considerado o fator mais provável que poderia causar um desastre e / ou situação de emergência. Objetivo: projetar, organizar e implementar um plano de evacuação que permita lidar com uma situação perigosa (incêndio, inundação, prédio em colapso etc.) e ajude pessoas e propriedades a sofrerem o menor dano possível no serviço da sala de operações do hospital. Sanatório Allende, sede de Nueva Córdoba, em dezembro de 2019. Trata-se de um projeto de intervenção, iniciado em maio do mesmo ano e previsto para ser executado em 2020. O plano deve ser de responsabilidade de toda a equipe cirúrgica. Conclusão: Ter um plano de evacuação implica uma equipe interdisciplinar permanentemente treinada em uma posição para responder a ameaças naturais ou provocadas pelo homem. Isso requer a formação de brigadas onde serão explicitados os papéis e ações que cada membro deve cumprir em caso de evento adverso. A segurança não é improvisada, todos são responsáveis[AU]

Firearm-Related Fractures: Epidemiology and Infection Rate / Fraturas causadas por armas de fogo: Epidemiologia e taxa de infecção

Abstract Objective To investigate the incidence of infection in patients with gunshot-related fractures, and to correlate this finding with the occurrence of surgical debridement in the emergency room. Methods A retrospective, observational, descriptive study that included all cases of fractures caused by firearms between January 2010 and December 2014; 245 fractures in 223 patients were included. Results There was surgical-site infection in 8.5% of the fractures, and the mean number of debridements required to control the infectious process was of 1.273 ± 0.608. A correlation was identified between the surgical treatment chosen and the affected body segment (p< 0.001). The surgical treatment in the emergency room had a correlation with the occurrence of infection (p< 0.001; Chi-squared test). Conclusion Patients with gunshot injuries treated non-operatively presented less severe and stable lesions; thus, the incidence of complications in this group was found to be lower. On the other hand, those patients with complex lesions underwent debridement and external fixation. Therefore, a greater number of infectious complications in patients submitted to external fixation was found, as expected.

Resumo Objetivo Investigar a incidência de infecção em pacientes com fraturas por arma de fogo, e correlacionar esse achado com a ocorrência de desbridamento cirúrgico na sala de emergência. Métodos Estudo retrospectivo, observacional e descritivo, que incluiu todos os casos de fraturas causadas por armas de fogo entre janeiro de 2010 e dezembro de 2014; foram incluídas 245 fraturas em 223 pacientes. Resultados Houve infecção do local cirúrgico em 8,5% das fraturas, e a média de desbridamentos necessários para controlar o processo infeccioso foi de 1,273 ± 0,608. Foi identificada correlação entre o tratamento cirúrgico escolhido e o segmento corporal afetado (p< 0,001). O tratamento cirúrgico na sala de emergência teve correlação com a ocorrência de infecção (p< 0,001; teste do qui-quadrado). Conclusão Pacientes com ferimentos à bala tratados de forma não operatória apresentaram lesões menos graves e estáveis; portanto, a incidência de complicações nesse grupo foi menor. Por outro lado, os pacientes com lesões complexas foram aqueles submetidos a desbridamento e fixação externa. Portanto, como esperado, foi encontrado um maior número de complicações infecciosas em pacientes submetidos à fixação externa.

Exposure to wood smoke pollution during pre-gestational period of rat has effects on placenta volume and fetus size / La exposición a la contaminación por humo de leña durante el período pregestacional de la rata tiene efectos sobre el volumen de la placenta y el tamaño del feto

SUMMARY: Studies in humans showed that prenatal exposure to urban air pollution (AP) influences fetal development, and increases the incidence of adverse pregnancy outcomes and some diseases in postnatal life. However, most of these were performed in environments where the main source of environmental particulate matters (PM) emission is diesel combustion by motor vehicles and industries, thereby ignoring the effects produced by wood smoke pollution. We hypothesized that morphological changes in the placenta could contribute to the reduction in fetal size associated with different periods of exposure to AP produced by wood smoke pollution prior to and during pregnancy. The objective of the study was to investigate the quantitative effects of long-term exposure to environmental levels of wood smoke pollution on the macroscopic and microscopic morphology of the placenta in rats. To test this, pregnant rats were exposed during pregestational and gestational periods to wood smoke pollution in indoor and outdoor environments. At 19 days of gestation, the placentas were obtained by caesarean and were prepared for histological, planimetric and stereological analysis. The volume and proportions of the placental compartments were estimated. In addition, stereological estimators in fetal capillaries were calculated in the labyrinth region. Crown rump length, fetus weight and litter weight were influenced by pregestational and gestational exposure periods. Exposure to wood smoke pollution during pregestational period has significant effect on the volume of the placenta, and consequently on fetal height. In conclusion, this study demonstrated that long-term outdoor exposure to wood smoke pollution from residential heating affects fetal health, decreasing the absolute volume of the entire placenta and the placental interface between the mother and fetus, decreasing the total volume of blood vessels present in the labyrinth region ofthe placenta and affecting the size of the fetus.

RESUMEN: Estudios en humanos demostraron que la exposición prenatal a la polución del aire urbano influye en el desarrollo fetal y aumenta la incidencia de resultados adversos de la gestación y algunas enfermedades postnatales. Sin embargo, la mayoría de ellos fueron realizados en entornos donde la principal fuente de emisión de material particulado, fue la combustión de petróleo por vehículos a motor e industrias, ignorando los efectos producidos por el humo de leña producido por la calefacción intradomiciliaria. Hipotetizamos respecto a que los cambios de la placenta contribuirían a la disminución del tamaño fetal relacionado a los períodos de exposición al humo de leña durante los periodos pregestacional y gestacional. El objetivo del estudio fue investigar los efectos cuantitativos de la exposición al humo de leña sobre la morfología macroscópica y microscópica en placenta de ratas. Para probar esto, ratas preñadas fueron expuestas durante los períodos pregestacional y gestacional a la contaminación por humo de leña en ambientes interiores y exteriores. A los 19 días de gestación, las placentas fueron obtenidas por cesárea y fueron preparadas para un análisis histológico, planimétrico y estereológico. Fue estimado el volumen absoluto y las proporciones de los compartimentos placentarios. Además, fueron calculados estimadores estereológicos en capilares fetales del laberinto y trofoblasto. La longitud, el peso del feto y el peso de la camada fueron influenciados por los períodos de exposición pregestacional y gestacional. La exposición a la contaminación por humo de leñá durante el período pregestacional tuvo un efecto significativo en el volumen de la placenta y, en consecuencia, en la altura del feto. En conclusión, este estudio demostró que la exposición a largo plazo al humo de leña afecta la salud del feto, disminuyendo el volumen absoluto de la placenta, además, afecta la interfaz placentaria entre la madre y feto, disminuyendo el volumen total de vasos sanguíneos presentes en la región del laberinto placentario y por consecuente afectando el tamaño del feto.

Nota informativa nº 03 /2020-GST/DVAST/SVS/SES: nota informativa- recomendações para trabalhos em postos de revenda de combustível-prevenção ao Covid-19 / Informative note nº 03/2020-GST / DVAST / SVS / SES: informative note- recommendations for work in fuel-prevention stations at Covid-19

Recomenda os procedimentos necessários para garantir a segurança de forma que não haja contaminação de trabalhadores e clientes dos postos de revenda de combustíveis no Estado do Tocantins. Ações de enfrentamento ao Corvid-19.

Recommends the necessary procedures to ensure safety so that there is no contamination of workers and customers at fuel resale stations in the State of Tocantins. Actions to confront Corvid-19.

Recomienda los procedimientos necesarios para garantizar la seguridad para que no haya contaminación de trabajadores y clientes en las estaciones de reventa de combustible en el estado de Tocantins. Acciones para enfrentar a Corvid-19.

Fogo em campo cirúrgico - Medidas preventivas para cirurgia palpebral segura / Operating room fire prevention - preventive measures for safe eyelid surgery

Resumo Fogo em campo cirúrgico durante cirurgia palpebral é uma complicação intra-operatória que é dramática tanto para o paciente quanto para a equipe médica. Relatamos um caso de acidente cirúrgico durante cirurgia palpebral onde o paciente sofreu queimadura de supercílio. Houve interação entre o oxigênio usado para sedação (máscara aberta) e uma fonte de ignição representada pelo cautério monopolar. Embora o paciente tenha apresentado boa evolução clínica com recuperação total da lesão cutânea, este caso é um alerta para se evitar tais tipo de ocorrência. Ressaltamos neste trabalho quais as condições implicadas e o modo de prevenção.

Abstract Fire in the surgical field during eyelid surgery is an intra-operative complication that is dramatic for both the patient and the medical staff. It's being reported a case of surgical accident during eyelid surgery where the patient suffered a brow burn. There was interaction between the oxygen used for sedation (open mask) and a source of ignition represented by monopolar cautery. Although the patient presented good clinical evolution with complete recovery of the cutaneous lesion, this case is an alert to avoid such type of occurrence. This work highlights the conditions involved and the way of prevention.

Letter to the Editor: An Indian Perspective on Universal Open Access Publishing: Think of the Fire before Venturing Out of the Frying Pan!

No abstract available.

Validity assessment of self-reported smoking status in firefighters using the urine cotinine test

Contra-Lateral Unintended Upper Arm Movement during Unimanual Tasks in Children with Cerebral Palsy

PURPOSE: To characterize associated reactions (ARs) in the contralateral arm across multiple muscles during unimanual tasks and to identify factors related to ARs in children with cerebral palsy (CP).MATERIALS AND METHODS: This was a prospective, cross-sectional study of 35 children with CP. The extent of ARs of the contra-lateral, non-task hand was assessed while performing three unimanual tasks (opening and clenching the fist, a finger opposition task, and tapping fingers). The occurrence of ARs in each trial was evaluated separately for each task using a four-point scale (total scores ranged from 0 to 12). Surface electromyography (SEMG) was used to measure the firing activity of the muscles of the opposite arm during the task. The Manual Ability Classification System and Melbourne Assessment 2 (MA-2) were used to evaluate upper limb function.RESULTS: AR scores were higher in the more-affected limb than in the less-affected limb. SEMG data on the non-task hand showed motor overflow up to the elbow muscles in the more-affected limb. Root mean square ratios of EMG signals were significantly higher in children with ARs than in children without ARs. Multiple regression analysis showed both age and MA-2 to be significant factors related to ARs in the more-affected limb.CONCLUSION: Children with visible ARs showed motor overflow in the non-task limb during unimanual hand tasks. Age and upper limb function were significantly related to the extent of ARs in the more-affected limb of children with CP.

The effects of repetitive firing processes on the optical, thermal, and phase formation changes of zirconia

PURPOSE: The aim of this study was to investigate the effect of different numbers of heat treatments applied to superstructure porcelain on optical, thermal, and phase formation properties of zirconia.MATERIALS AND METHODS: Forty zirconia specimens were prepared in the form of rectangular prism. Specimens were divided into four groups (n = 10) according to the number of firing at heating values of porcelain. Color differences and translucency parameter were measured, and X-ray diffraction (XRD) analysis and differential scanning calorimetry (DSC) were performed. Data were analyzed with analysis of variance (ANOVA).RESULTS: There were no statistically significant differences in ΔE, TP, L, a, and b value changes of the zirconia specimens as a result of repetitive firing processes (P>.05).CONCLUSION: Although additional firing processes up to 4 increase peak density in thermal analysis, additional firing processes up to 4 times can be applied safely as they do not result in a change in color and phase character of zircon frameworks.

Impacto da queima da cana-de-açúcar sobre internações hospitalares por doenças respiratórias / The impact of sugarcane burning on hospitalization due to respiratory diseases

Resumo O objetivo deste artigo é avaliar o impacto das emissões da queima da cana-de-açúcar sobre o número de internações hospitalares por doenças respiratórias em uma região canavieira. Registros de internações hospitalares por doenças respiratórias foram adquiridas a partir da base de dados referentes ao sistema de informações hospitalares do sistema único de saúde (SIH-SUS), no período de 28 de março de 2011 a 28 de dezembro de 2012. Níveis de MP10, NO2, O3, temperatura e umidade relativa foram registradas. Modelos de regressão logística foram construídos para analisar a associação entre o número total de internações, poluentes atmosféricos e variáveis meteorológicas. Foram registradas 1.179 internações, dentre elas a pneumonia mostrou aumento significativo no período de queima (p = 0,005). Neste mesmo período observou-se que o cluster MP10 e NO2 influenciou 67,9% (IC95%: 11,111-2,537), seguido do cluster MP10, NO2, O3 e temperatura que influenciou 91,1% (IC95%: 1,116; 3,271) no número total de internações. Durante o período de queima houve maior número de internações por doenças respiratórias, principalmente de pneumonia, quando foi observada a influência dos poluentes e temperatura no processo de adoecimento da população.

Abstract The scope of this article is to evaluate the impact of emissions from sugarcane burning on hospital admission numbers for respiratory diseases in a sugarcane region. Hospital admission records for respiratory diseases were acquired from the database of the Hospital Information System of the Unified Health System (SIH-SUS) in the period from March 28, 2011 to December 28, 2012. Levels of PM10, NO2, O3, Temperature and Relative Humidity were recorded. Logistic regression models were created to analyze the association between the total number of hospitalizations, atmospheric pollutants and meteorological variables. A total of 1,179 hospitalization admissions were recorded, with a significant increase in cases of pneumonia in the burning period (p = 0.005). Likewise, it was observed that the cluster of PM10 and NO2 was influenced 67.9% (95% CI: 11.111-2.537) followed by cluster PM10, NO2, O3 and Temperature that influenced 91.1% (95% CI: 1.116; 3.271) in the total number of hospitalization admissions. During the sugarcane burning period there were more hospitalization admissions due to respiratory tract diseases, mainly pneumonia, where the influence of air pollutants and temperature in the process of illness in the population was detected.

"Among dead and wounded": mapping, characterization and analysis of fires with victims in Recife's metropolitan zone / "Entre mortos e feridos": mapeamento, caracterização e análise dos incêndios com vítimas na região metropolitana do Recife / "Entre muertos y heridos": cartografía, caracterización y análisis de los incendios con víctimas en la zona metropolitana de Recife

This article presents the mapping and analysis of fires with dead and wounded people in the Metropolitan Region of Recife (MRR) served by the Firefighters Department from 2013 to 2016. There was an average rate of 1 death per million inhabitants, similar to countries such as Singapore and Vietnam. The weighted number of fires per wounded or dead person results in rates of 0.5 and 1.7 per 100 recorded fires, respectively. These numbers are concerning, especially when compared to rates from other regions in the world. The victims of fires in MRR were shown to generally not be a perceivable problem in terms of common sense, yet they are real and require accurate analysis and effective measures.

Este artigo apresenta o mapeamento e a análise de incêndios com mortes e feridos na Região Metropolitana do Recife ­ RMR, atendidos pelo Corpo de Bombeiros, no período de 2013 a 2016. Verificou-se uma taxa média de 1 morte por milhão de habitantes, semelhante a países como Singapura e Vietnam. Quando se pondera a quantidade de incêndios para que haja um ferido ou morto, as taxas se apresentam respectivamente em 0,5 e 1,7 por 100 incêndios registrados ­ sendo estes números preocupantes, principalmente quando comparados com taxas de outras regiões no mundo. Conclui-se que as vítimas de incêndios na Região (RMR) são um problema silente ao senso comum, mas real e que exige análise acurada e providências efetivas.

Este artículo presenta la cartografía y análisis de incendios con muertes y heridos en la Zona Metropolitana de Recife (ZMR), atendidos por el Cuerpo de Bomberos, en el período de 2013 a 2016. Se ha verificado un promedio de 1 muerte por millón de habitantes, semejante a países como Singapur y Vietnam. Cuando se examina la cantidad de incendios para que haya un herido o muerto, los promedios se presentan respectivamente de 0,5 y 1,7 por 100 incendios registrados, lo cual es preocupante, principalmente en comparación con los promedios de otras regiones del mundo. Se concluye que las víctimas de incendios en la ZMR son un problema silencioso y real, lo que exige un análisis cuidadoso y diligencias efectivas.

A Computational Modeling Reveals That Strength of Inhibitory Input, E/I Balance, and Distance of Excitatory Input Modulate Thalamocortical Bursting Properties

The thalamus is a brain structure known to modulate sensory information before relaying to the cortex. The unique ability of a thalamocortical (TC) neuron to switch between the high frequency burst firing and single spike tonic firing has been implicated to have a key role in sensory modulation including pain. Of the two firing modes, burst firing, especially maintaining certain burst firing properties, was suggested to be critical in controlling nociceptive behaviors. Therefore, understanding the factors that influence burst firing properties would offer important insight into understanding sensory modulation. Using computational modeling, we investigated how the balance of excitatory and inhibitory inputs into a TC neuron influence TC bursting properties. We found that intensity of inhibitory inputs and the timing of excitatory input delivery control the dynamics of bursting properties. Then, to reflect a more realistic model, excitatory inputs delivered at different dendritic locations—proximal, intermediate, or distal—of a TC neuron were also investigated. Interestingly, excitatory input delivered into a distal dendrite, despite the furthest distance, had the strongest influence in shaping burst firing properties, suggesting that not all inputs equally contribute to modulating TC bursting properties. Overall, the results provide computational insights in understanding the detailed mechanism of the factors influencing temporal pattern of thalamic bursts.

Modulation of Dopaminergic Neuronal Excitability by Zinc through the Regulation of Calcium-related Channels

Depending on the intracellular buffering of calcium by chelation, zinc has the following two apparent effects on neuronal excitability: enhancement or reduction. Zinc increased tonic activity in the depolarized state when neurons were intracellularly dialyzed with EGTA but attenuated the neuronal activity when BAPTA was used as an intracellular calcium buffer. This suggests that neuronal excitability can be modulated by zinc, depending on the internal calcium buffering capacity. In this study, we elucidated the mechanisms of zinc-mediated alterations in neuronal excitability and determined the effect of calcium-related channels on zinc-mediated alterations in excitability. The zinc-induced augmentation of firing activity was mediated via the inhibition of small-conductance calcium-activated potassium (SK) channels with not only the contribution of voltage-gated L-type calcium channels (VGCCs) and ryanodine receptors (RyRs), but also through the activation of VGCCs via melastatin-like transient receptor potential channels. We suggest that zinc modulates the dopaminergic neuronal activity by regulating not only SK channels as calcium sensors, but also VGCCs or RyRs as calcium sources. Our results suggest that the cytosolic calcium-buffering capacity can tightly regulate zinc-induced neuronal firing patterns and that local calcium-signaling domains can determine the physiological and pathological state of synaptic activity in the dopaminergic system.

Abrupt Change in Electrophysiological Properties Begins From Postnatal Day 7 Before Hearing Onset in the Developing Mice Auditory Cortical Layer II/III Neurons

OBJECTIVES: In the developing auditory cortex, maturation of electrophysiological properties and cell types before and after hearing onset has been reported previously. However, the exact timing of firing pattern change has not been reported. In this study, firing pattern change was investigated from postnatal day 3 (P3) to P12 in auditory cortical layer II/III neurons to investigate whether firing pattern changes dramatically after a specific point during development. METHODS: ICR mice pups aged from P3 to P12 were sacrificed to obtain 300-mm-thick brain slices containing the primary auditory cortex. From cortical layer II/III neurons, the patterns of action potential firing generated by current injection were examined using whole cell current clamp technique and the characteristics of Na⁺ currents involved in action potential firing were investigated using whole cell voltage clamp technique. RESULTS: From P3 to P6, most cells did not show action potential firing (29 of 46 cells), and some cells responding to current injection showed a single action potential at the initial depolarizing current step (17 of 46 cells). This firing pattern changes from P7. From P7 to P9, cells begin to show regular spiking to current injection. The spiking frequency increased after P10. In studying Na⁺ current with whole cell voltage clamp, Na⁺ current densities increased gradually (32.0±2.0 pA/pF [P3–P6, n=7], 51.2±2.0 pA/pF [P7–P9, n=13], and 69.5±3.7 pA/pF [P10–P12, n=13]) in low external [Na⁺] condition. Na⁺ current recovery was accelerated and inactivation curves shifted to hyperpolarization with age. CONCLUSION: As regular spiking cells were observed from P7 but never from P3 to P6, P7 might be regarded as an important milestone in the development of auditory cortical layer II/III neurons. This change might mainly result from the increase in Na⁺ current density.

Analysis of risk factors affecting a suicidal attempter exposing suicidal intensions for the development of the active intervention strategy for suicide prevention

OBJECTIVE: This study examined the clinical characteristics of suicide attempters who exposed their suicidal intension to suggest an active intervention strategy for suicide prevention based on the regional emergency medical service system. METHODS: A prospective database of suicide attempters who visited the emergency department of Chungbuk National University Hospital between October 2013 and December 2017 was used. All of the adult patients who provided consent for the initial assessment for suicidal attempters were eligible, excluding cases with unknown exposure of suicidal intension. The primary and secondary endpoints were the risk factors affecting exposure to the suicidal intension and characteristics of the exposure group. The adjusted odds ratios (AORs) of exposure to suicidal attempts after adjusting for potential confounders was calculated. RESULTS: Of a total 1,035 suicidal attempters enrolled, 332 (32.1%) were included in the exposure group. The exposure group was more likely to have an educational level above high school and no religion, and have suicidal characteristics at night time (18:00–08:00), under the influence of alcohol, suicidal plan before 1 week, and suicidal method involving asphyxia (P<0.05). The exposure group was more likely to have no guardian (AORs, 1.46; 95% confidence interval [CI], 1.00–2.12), use methods involving asphyxia (AORs, 2.07; 95% CI, 1.46–2.91), and attempt suicide at night (18:00 to 08:00) (AORs, 1.38; 95% CI, 1.05–1.83) compared to the no exposure group. CONCLUSION: Models need to be established, where regional mental health welfare center, local government, fire headquarter, and tele-communication companies can participate in the implementation of an active intervention strategy.