Are very thin patients at a higher risk of complications when submitted to percutaneous nephrolithotomy?

ABSTRACT Purpose: To assess the impact of thinness on the outcome of the percutaneous nephrolithotomy (PCNL). Materials and Methods: A matched case-control study was performed using a prospectively collected database of all patients who underwent PCNL between June 2011 and October 2021. The patients were stratified into two groups according to their phenotypic characteristics, arbitrarily defined according to their body mass index (BMI): <20 kg/m2 (Group 1, very thin patients, G<20) and ≥25 kg/m2 (Group 2, non-thin patients, G≥25). Patients were randomly matched based on Guy's Stone Score (GSS) according to case complexity at a ratio of 1:3. Results: A total of 204 patients were enrolled in this study: 51 patients (G<20) and 153 controls (G≥25). Complications occurred in 15.2% of the patients, with 5.4% of these complications classified as major complications (Clavien grade ≥ 3). According to complications there were no significant differences between the groups. The overall complication rates were 17.6% in the G<20 and 14.4% in the G≥25 (p = 0.653). The major complication rates were 3.9% in the G<20 and 5.8% in the G≥25 (p=0.429). No differences in transfusion or urinary fistula rates were found. Conclusions: In this study, very thin patients were not at a higher risk of complications when submitted to PCNL than in those with a BMI of ≥25 kg/m2. Apparently, this technique can be used in these patients, just as it is used in any other type of patient, independently of their BMI.

Occurrence of ectoparasitic flies (Diptera: Streblidae)of bats (Chiroptera: Mammalia) in a semideciduousforest remnant in Northern Paraná, Brazil / Ocorrência de moscas ectoparasitas (Diptera: Streblidae) de morcegos (Chiroptera: Mammalia) em um remanescentede floresta semidecídua no Norte do Paraná, Brasil

This study constitutes the first record of parasitism and associations between bat flies ectoparasite of the Streblidae family and bats (Chiroptera: Phyllostomidae) in the São Francisco Forest State Park (SFFSP). The bats were captured using mist nets set up at various points along the park's visitor trail. Following collection, the bats were inspected for ectoparasites, which when found were collected with metal tweezers and stored in vials with 70% alcohol to be identified later. The captured bats were subjected to morphometrics so that the information obtained could help identify which bat species was the host of the ectoparasite collected and then they were released. A total of 36 dipterans from the Streblidae family belonging to six species from four genera: Aspidoptera falcata Wenzel, 1976; Aspidoptera phyllostomatis (Perty, 1833); Megistopoda aranea (Coquillett, 1899); Megistopoda proxima (Séguy, 1926); Paratrichobius longicrus (Miranda Ribeiro, 1907) and Trichobius joblingiWenzel, 1966, infesting phyllostomids of four species: Artibeus lituratus (Olfers, 1818); Artibeus planirostris (Spix, 1823); Carollia perspicillata (Linneaus, 1758) and Sturnira lilium (E. Geoffroy, 1810). The most abundant species were Trichobius joblingi (38.89%) and Aspidoptera phyllostomatis(27.78%).

Este estudo constitui o primeiro registro de parasitismo e associações entre moscas ectoparasitas de morcegos da família Streblidae e morcegos (Chiroptera: Phyllostomidae) no Parque Estadual Floresta São Francisco (PEFSF). Os morcegos foram capturados usando redes de neblina instaladas em vários pontos ao longo da trilha de visitantes do parque. Após a coleta, os morcegos foram inspecionados em busca de ectoparasitas, que, quando encontrados, eram coletados com pinças metálicas e armazenados em frascos com álcool 70% para serem identificados posteriormente. Os morcegos capturados foram submetidos à morfometria para que as informações obtidas pudessem ajudar a identificar qual espécie de morcego era a hospedeira do ectoparasita coletado e, em seguida, foram liberados. Um total de 36 dípteros de Streblidae foram coletados, pertencentes a seis espécies de quatro gêneros: Aspidoptera falcata Wenzel, 1976; Aspidoptera phyllostomatis (Perty, 1833); Megistopoda aranea (Coquillett, 1899); Megistopoda proxima (Séguy, 1926); Paratrichobius longicrus (Miranda Ribeiro, 1907) e Trichobius joblingi Wenzel, 1966, infestando filostomídeos de quatro espécies: Artibeus lituratus(Olfers, 1818); Artibeus planirostris (Spix, 1823); Carollia perspicillata (Linneaus, 1758) e Sturnira lilium (E. Geoffroy, 1810). As espécies mais abundantes foram Trichobius joblingi (38,89%) e Aspidoptera phyllostomatis (27,78%).

Predictive value of PAR and PNI for the acute complicated course of pediatric acute hematogenous osteomyelitis

Abstract Objective Platelet to albumin ratio (PAR) and prognostic nutritional index (PNI) are potential indicators for evaluating nutritional and inflammatory status. This study aimed to examine the relationship between PAR and PNI and the acute complicated course of acute hematogenous osteomyelitis (AHO). Methods AHO patients were divided into the simple course group and the acute complicated course group. The patient's gender, age, site of infection, body temperature, laboratory results, and pathogen culture results were collected and compared. Multivariate logistic regression analysis was used to determine the independent risk factors of the acute complicated course group. The receiver operating characteristic curve was applied to determine the optimal cut-off value. Results In total, 101 AHO patients with a median age of 7.58 years were included. There were 63 cases (62.4 %) in the simple course group and 38 cases (37.6 %) in the complicated course group. Binary logistic regression analysis revealed that PAR and PNI were independent risk factors for predicting the acute complicated course of AHO (p = 0.004 and p < 0.001, respectively). Receiver operating characteristic curve analysis demonstrated that the combination of PAR and PNI had an area under the curve of 0.777 (95 % CI: 0.680-0.873, p < 0.001) with a cut-off value of 0.51. Conclusions The incidence of acute complicated courses was significantly higher in patients with high PAR and low PNI. A combined factor greater than 0.51, derived from PAR and PNI measurements within 24 h of admission, may be useful for predicting AHO patients who are likely to develop severe disease.

Correlación y concordancia entre índice de masa corporal y perímetro abdominal para la detección de sobrepeso u obesidad en la población peruana, 2022 / Correlation and agreement between body mass index and abdominal perimeter for the detection of overweight or obesity in the Peruvian population, 2022

RESUMEN Introducción: el índice de masa corporal y el perímetro abdominal son medidas antropométricas que podrían ser concordantes en la población peruana para el cribado de sobrepeso u obesidad. Objetivo: analizar la correlación y concordancia entre las pruebas de índice de masa corporal y perímetro abdominal para la detección de sobrepeso u obesidad en adultos peruanos. Metodología: estudio observacional, analítico y transversal basado en datos de la encuesta nacional demográfica de salud familiar. La población fue de 28960 adultos. Las variables fueron: índice de masa corporal y perímetro abdominal. Se utilizó la prueba V de Cramer, t de student, correlación de Spearman y kappa de Cohen. Resultados: hubo una asociación fuerte entre índice de masa corporal y perímetro abdominal en mujeres (V=0,701), moderada en hombres (V=0,632). En la prueba kappa de Cohen, ambas variables concordaron sustancialmente en mujeres (kappa=0,677) y moderadamente en hombres (kappa=0,580). Mediante el Odds Ratio, las mujeres con índice de masa corporal elevado tuvieron una probabilidad 97,22 veces mayor de perímetro abdominal elevado, mientras que en hombres con índice de masa corporal elevado fue 110,76 veces mayor. La correlación de Spearman fue muy alta y positiva en ambos sexos Conclusiones: el perímetro abdominal y el índice de masa corporal están asociados y correlacionados significativamente en adultos peruanos, presentaron una concordancia sustancial en mujeres y moderada en hombres. Se sugiere priorizar el uso del perímetro abdominal, debido a que distingue sobrepeso u obesidad según sexo, optimizándolo mediante la determinación de un punto de corte ajustado a la población peruana.

ABSTRACT Introduction: body mass index and abdominal perimeter are anthropometric measurements that could be concordant in the Peruvian population for screening for overweight or obesity. Objective: to analyze the correlation and agreement between body mass index and abdominal circumference tests for the detection of overweight or obesity in Peruvian adults. Methodology: observational, analytical and cross-sectional study based on data from the national demographic family health survey. The population was 28,960 adults. The variables were: body mass index and abdominal perimeter. Cramer's V test, student's t, Spearman's correlation and Cohen's kappa were used. Results: there was a strong association between body mass index and abdominal perimeter in women (V=0.701), moderate in men (V=0.632). In Cohen's kappa test, both variables agreed substantially in women (kappa=0.677) and moderately in men (kappa=0.580). Using the Odds Ratio, women with a high body mass index had a 97.22 times greater probability of having a high abdominal circumference, while in men with a high body mass index it was 110.76 times greater. The Spearman correlation was very high and positive in both sexes. Conclusions: abdominal circumference and body mass index are significantly associated and correlated in Peruvian adults; they presented substantial agreement in women and moderate agreement in men. It is suggested to prioritize the use of the abdominal perimeter, because it distinguishes overweight or obesity according to sex, optimizing it by determining a cut-off point adjusted to the Peruvian population.

Correlación del índice de masa corporal y grosor de tejido adiposo en glúteos / Correlation of body mass index and adipose tissue thickness in glutes

Introducción: Con el aumento de la prevalencia de obesidad, se esperaría un mayor espesor glúteo, lo que sería un factor importante en futuras intervenciones en región glútea con fines de optimizar mejores resultados estéticos. Objetivo: Correlacionar el índice de masa corporal y el grosor de tejido adiposo en glúteos en voluntarias que acudieron al Servicio de Cirugía Plástica y Reconstructiva del Hospital Dr. Miguel Pérez Carreño entre enero a marzo, 2023. Métodos: El estudio fue prospectivo, descriptivo y de corte transversal. Se utilizó un sonógrafo Sono Eye 1 para realizar las medidas del glúteo. Mediante una báscula, se midió peso y talla, para posteriormente calcular el IMC, fueron 29 voluntarias de sexo femenino entre 18 a 60 años, sin antecedentes quirúrgicos estéticos previos. Las correlaciones fueron evaluadas con el coeficiente de correlación de Pearson. Se consideró un valor significativo si p < 0,05. Los datos fueron tabulados con STATA 17. Resultados: La edad promedio fue 39 ± 12 años. La mayoría con preobesidad (55,2 %). No hubo diferencias estadísticas en grosor de tejido adiposo, de musculo y espesor de glúteo de acuerdo a la lateralidad; de acuerdo al coeficiente de correlación de Pearson, el IMC no hubo asociación con las medidas combinadas del glúteo izquierdo y derecho del grosor de tejido graso (r = 0,137), grosor muscular (r = 0,115) y espesor glúteo (r = 0,193). Conclusión: Los cambios de las medidas antropométricas de acuerdo al índice de masa corporal, no presentaron correlación estadística con el espesor glúteo. (AU)

Introduction: With the increasing prevalence of obesity, a greater gluteal thickness would be expected, which would be an important factor in future interventions in the gluteal region aimed at optimizing better aesthetic outcomes. Objective: To correlate the body mass index (BMI) and the thickness of adipose tissue in the buttocks of volunteers who attended the Plastic and Reconstructive Surgery Service at Dr. Miguel Pérez Carreño Hospital from January to March, 2023. Methods: The study was prospective, descriptive, and cross-sectional. A Sono Eye 1 sonograph was used to measure the gluteal thickness. Using a scale, weight and height were measured to subsequently calculate the BMI; there were 29 female volunteers aged between 18 and 60 years, without previous aesthetic surgical history. Correlations were assessed using Pearson's correlation coefficient. A significant value was considered if p < 0.05. Data were tabulated using STATA 17. Results: The average age was 39 ± 12 years. The majority had pre-obesity (55,2%). There were no statistical differences in adipose tissue thickness, muscle thickness, and gluteal thickness according to laterality; according to Pearson's correlation coefficient, BMI was not associated with combined measurements of left and right buttock adipose tissue thickness (r = 0,137), muscle thickness (r = 0,115), and gluteal thickness (r = 0,193). Conclusion: Changes in anthropometric measurements according to body mass index did not show a statistical correlation with gluteal thickness. (AU)

Ansiedad, depresión y calidad del sueño en estudiantes de Odontología / Anxiety, depression and sleep quality in dental students / Ansiedade, depressão e qualidade do sono em estudantes de Odontologia

La calidad del sueño en los estudiantes es un factor esencial que influye en el correcto desarrollo de los procesos cognitivos del aprendizaje, así como en la calidad de vida y la salud mental y física de los futuros profesionales. Objetivo: evaluar la relación entre la ansiedad, la depresión y la calidad del sueño en estudiantes de la carrera de Odontología de la Universidad Nacional del Altiplano de Puno. Materiales y métodos: estudio de tipo observacional de cohorte transversal con la participación de 78 estudiantes, con edad promedio de 22.63±2.87 años, con una distribución de género de 32 varones (41,0 %) y 46 mujeres (59,0 %). Se utilizó la escala de valoración de Hamilton para la evaluación de la ansiedad y la depresión, con una consistencia interna de α = 0,88 y 0,86, respectivamente y el cuestionario de Pittsburgh para medir el índice de calidad del sueño (α = 0,87). Resultados: en el modelo predictivo los coeficientes estandarizados ß señalan que la ansiedad psíquica (ß = -,870; p<0,001), la depresión (ß = ,119; p<0,05) y el desarrollo de prácticas clínicas (ß = -0,019; p<0,05) fueron los factores que más contribuyeron significativamente al índice de calidad del sueño de los estudiantes. Conclusión: estos hallazgos subrayan la importancia de abordar los problemas del sueño como parte integral del tratamiento de la ansiedad y la depresión, además de resaltar la necesidad de tener en cuenta la salud mental en la evaluación y el manejo de los trastornos del sueño

The quality of sleep-in students is an essential factor that influences the correct development of cognitive learning processes, as well as the quality of life and the mental and physical health of future professionals. Objective: to evaluate the relationship between anxiety, depression and sleep quality in students of the Dentistry program at the National University of the Altiplano of Puno. Materials and methods: observational cross-sectional cohort study with the participation of 78 students, with an average age of 22.63±2.87 years, with a gender distribution of 32 men (41.0%) and 46 women (59.0%). The Hamilton rating scale was used to evaluate anxiety and depression, with an internal consistency of α = 0.88 and 0.86, respectively, and the Pittsburgh questionnaire was used to measure the sleep quality index (α = 0.87). Results: in the predictive model, the standardized ß coefficients indicate that psychological anxiety (ß = -.870; p<0.001), depression (ß = .119; p<0.05) and the development of clinical practices (ß = -0.019; p<0.05) were the factors that contributed most significantly to the students' sleep quality index. Conclusion: these findings underscore the importance of addressing sleep problems as an integral part of the treatment of anxiety and depression, as well as highlighting the need to consider mental health in the assessment and management of sleep disorders

A qualidade do sono dos estudantes é um fator essencial que influencia o correto desenvolvimento dos processos de aprendizagem cognitiva, bem como a qualidade de vida e a saúde mental e física dos futuros profissionais. Objetivo: avaliar a relação entre ansiedade, depressão e qualidade do sono em estudantes do curso de Odontologia da Universidade Nacional do Altiplano de Puno. Materiais e métodos: estudo de coorte transversal observacional com a participação de 78 estudantes, com idade média de 22,63±2,87 anos, com distribuição por género de 32 homens (41,0%) e 46 mulheres (59,0%). A escala de avaliação de Hamilton foi utilizada para avaliar ansiedade e depressão, com consistência interna de α = 0,88 e 0,86, respectivamente, e o questionário de Pittsburgh foi utilizado para mensurar o índice de qualidade do sono (α = 0,87). Resultados: no modelo preditivo, os coeficientes ß padronizados indicam que a ansiedade psicológica (ß = -0,870; p<0,001), a depressão (ß = 0,119; p<0,05) e o desenvolvimento de práticas clínicas (ß = -0,019; p<0,05) foram os fatores que mais contribuíram significativamente para o índice de qualidade do sono dos estudantes. Conclusão: estas descobertas sublinham a importância de abordar os problemas do sono como parte integrante do tratamento da ansiedade e da depressão, bem como realçam a necessidade de considerar a saúde mental na avaliação e gestão dos distúrbios do sono

Evolución de los parámetros hematológicos y óbito en internados con COVID-19 en un hospital de Paraguay, 2021

Introducción: Los parámetros hematológicos proporcionan al equipo médico marcadores pronósticos útiles en la evolución clínica de la enfermedad de COVID-19. El objetivo fue analizar la relación entre la evolución desfavorable de los valores hematológicos y el óbito de los pacientes internados con COVID-19. Metodologia: El estudio es observacional, correlacional y longitudinal. Se realizó la revisión de fichas clínicas de los pacientes mayores a 18 años internados entre enero y marzo del 2021. Se registró en una planilla Excel el resultado de los parámetros hematológicos al ingreso, a las 48 horas, a los 8 días y al egreso. Los datos fueron analizados con Epi Info 7.1 (CDC, Atlanta) según estadística descriptiva. Resultados: De 144 pacientes, se observaron 68 (47,2%) muertes, con predominio del sexo masculino (63,2%) y, mayores a 60 años (47,1%). Los factores asociados a mortalidad fueron la hipertensión (52,9% vs 31,6%; p=0,009), la diabetes (50% vs 26,3%; p=0,003) y, la obesidad (41,2% vs 25%; p=0,039). Los parámetros hematológicos desfavorables asociados a la mortalidad se presentaron a partir de los 8 días de internación con leucocitosis (64,1% vs 33,3%; p=0,003), linfopenia (96,8% vs 79%; p=0,008), neutrofilia (98,5% vs 87,7%; p=0,029) y, un elevado índice neutrófilo/linfocito (INL) (96,9% vs 75,4%; p=0,001). Discusión: Los parámetros hematológicos que se asociaron con la mortalidad fueron leucocitosis con neutrofilia, linfopenia e INL elevado. Estos parámetros podrían tener valor pronóstico en el seguimiento para contribuir en el manejo de estos pacientes.

Introduction: Hematological parameters provide the medical team with useful prognostic markers in the clinical evolution of COVID-19 disease. The objective was to analyze the relationship between the unfavorable evolution of hematological values and the death of patients hospitalized with COVID-19. Methodology: The study is observational, correlational, and longitudinal. A review of the clinical records of patients over 18 years of age hospitalized between January and March 2021 was carried out. The results of the hematological parameters at admission, at 48 hours, at 8 days and at discharge were recorded in an Excel spreadsheet. The data were analyzed with Epi Info 7.1 (CDC, Atlanta) according to descriptive statistics. Results: Of 144 patients, 68 (47.2%) deaths were observed, with a predominance of males (63.2%) and those over 60 years of age (47.1%). The factors associated with mortality were hypertension (52.9% vs 31.6%; p=0.009), diabetes (50% vs 26.3%; p=0.003) and obesity (41.2% vs 25 %; p=0.039). The unfavorable hematological parameters associated with mortality occurred after 8 days of hospitalization with leukocytosis (64.1% vs 33.3%; p=0.003), lymphopenia (96.8% vs 79%; p=0.008), neutrophilia (98.5% vs 87.7%; p=0.029) and a high neutrophil/lymphocyte ratio (NLR) (96.9% vs 75.4%; p=0.001). Discussion: The hematological parameters that were associated with mortality were leukocytosis with neutrophilia, lymphopenia, and elevated NLR. These parameters could have prognostic value in follow-up to contribute to the management of these patients.

¿Tienen los pacientes con tromboembolismo pulmonar agudo y un puntaje PESI (Índice de Severidad del Embolismo Pulmonar) intermedio o alto, asociado a cáncer activo, un mayor riesgo de presentar una evolución desfavorable respecto de aquellos sin cáncer? / Do Patients with Acute Pulmonary Embolism and an Intermediate or High PESI (Pulmonary Embolism Severity Index) Score Associated with Active Cancer Have Higher Risk of an Unfavorable Progression Versus Those Without Cancer?

RESUMEN Introducción: El Índice de Severidad del Embolismo Pulmonar (PESI) se utiliza para categorizar el riesgo de mortalidad en el tromboembolismo pulmonar agudo (TEP). Por definición, los pacientes con cáncer siempre presentarán un puntaje PESI simplificado alto y serán considerados de mayor riesgo. Existe información limitada respecto de si los pacientes con PESI intermedio o alto (≥86 puntos) y cáncer activo, tienen mayor riesgo de presentar una evolución desfavorable respecto de aquellos sin cáncer. Objetivos: Determinar si, en pacientes con TEP y un puntaje PESI ≥86 puntos, la presencia de cáncer activo se asocia a una evolución desfavorable respecto de aquellos sin cáncer. Material y métodos: Análisis retrospectivo en pacientes con TEP y un puntaje PESI ≥86, entre los años 2008 y 2022. Se evaluó la ocurrencia de muerte intrahospitalaria (MIH), uso de drogas vasopresoras (DV) y necesidad de asistencia respiratoria mecánica (ARM) en los pacientes con vs. sin cáncer. Resultados: Se analizaron 209 pacientes. La población con cáncer, respecto de aquella sin cáncer, resultó ser más joven (65 vs. 70 años; p=0,006), presentó valores de PESI simplificado altos con mayor frecuencia (100 % vs. 84 %; p<0,001), tuvo menor requerimiento de ARM (9 % vs. 34 %; p=0,005) y menor uso de DV (11 % vs. 23 %; p=0,019), aunque no se observaron dife rencias en las tasas de MIH (12,7 % vs. 8 %; p=NS). Conclusiones: Los pacientes con TEP y un puntaje PESI ≥86 con cáncer no presentaron mayor MIH e incluso tuvieron menor requerimiento de ARM y DV. En la población estudiada, los pacientes con TEP y cáncer no tuvieron mayor riesgo de presentar una evolución desfavorable.

ABSTRACT Background: The Pulmonary Embolism Severity Index (PESI) is used to categorize the risk of death in acute pulmonary em bolism (PE). By definition, cancer patients will always have a high simplified PESI score and will be considered at high risk. There is limited information regarding whether patients with an intermediate or high PESI score (≥86 points) and cancer are at greater risk of an unfavorable progression versus those without cancer. Objectives: To determine whether the presence of active cancer in patients with a PESI score ≥86 points is associated with an unfavorable progression versus those without cancer. Methods: A retrospective analysis in patients with PE and a PESI score ≥86, between 2008 and 2022. The occurrence of in-hospital mortality (IHM) the use of vasopressor drugs (VDs), and the need for mechanical ventilatory support (MVS) were evaluated in patients with vs. without cancer. Results: 209 patients were analyzed. The population with cancer was younger than patients without cancer (65 vs 70 years; p=0.006), showed high simplified PESI values more frequently (100% vs 84%; p<0.001), had lower MVS requirement (9% vs 34%; p=0.005), and used fewer VDs (11% vs 23%; p=0.019). However, no difference was observed in IHM rates (12.7% vs 8%; p=NS). Conclusions: Patients with PE and a PESI score ≥86 who have cancer did not show higher IHM and also had lower MVS and VDs requirement. Therefore, in the studied population, patients with PE and cancer had no greater risk of having an unfavorable progression.

Ansiedad, depresión y calidad del sueño en estudiantes de Odontología

La calidad del sueño en los estudiantes es un factor esencial que influye en el correcto desarrollo de los procesos cognitivos del aprendizaje, así como en la calidad de vida y la salud mental y física de los futuros profesionales. Objetivo: Evaluar la relación entre la ansiedad, la depresión y la calidad del sueño en estudiantes de la carrera de Odontología de la Universidad Nacional del Altiplano de Puno. Materiales y métodos: Estudio de tipo observacional de cohorte transversal con la participación de 78 estudiantes, con edad promedio de 22.63±2.87 años, con una distribución de género de 32 varones (41,0 %) y 46 mujeres (59,0 %). Se utilizó la escala de valoración de Hamilton para la evaluación de la ansiedad y la depresión, con una consistencia interna de α = 0,88 y 0,86, respectivamente y el cuestionario de Pittsburgh para medir el índice de calidad del sueño (α = 0,87). Resultados: En el modelo predictivo los coeficientes estandarizados ß señalan que la ansiedad psíquica (ß = -,870; p<0,001), la depresión (ß = ,119; p<0,05) y el desarrollo de prácticas clínicas (ß = -0,019; p<0,05) fueron los factores que más contribuyeron significativamente al índice de calidad del sueño de los estudiantes. Conclusión: Estos hallazgos subrayan la importancia de abordar los problemas del sueño como parte integral del tratamiento de la ansiedad y la depresión, además de resaltar la necesidad de tener en cuenta la salud mental en la evaluación y el manejo de los trastornos del sueño.

The quality of sleep-in students is an essential factor that influences the correct development of cognitive learning processes, as well as the quality of life and the mental and physical health of future professionals. Objective: To evaluate the relationship between anxiety, depression and sleep quality in students of the Dentistry program at the National University of the Altiplano of Puno. Materials and methods: Observational cross-sectional cohort study with the participation of 78 students, with an average age of 22.63±2.87 years, with a gender distribution of 32 men (41.0%) and 46 women (59.0%). The Hamilton rating scale was used to evaluate anxiety and depression, with an internal consistency of α = 0.88 and 0.86, respectively, and the Pittsburgh questionnaire was used to measure the sleep quality index (α = 0.87). Results: In the predictive model, the standardized ß coefficients indicate that psychological anxiety (ß = -.870; p<0.001), depression (ß = .119; p<0.05) and the development of clinical practices (ß = -0.019; p<0.05) were the factors that contributed most significantly to the students' sleep quality index. Conclusion: These findings underscore the importance of addressing sleep problems as an integral part of the treatment of anxiety and depression, as well as highlighting the need to consider mental health in the assessment and management of sleep disorders.

A qualidade do sono dos estudantes é um fator essencial que influencia o correto desenvolvimento dos processos de aprendizagem cognitiva, bem como a qualidade de vida e a saúde mental e física dos futuros profissionais. Objetivo: Avaliar a relação entre ansiedade, depressão e qualidade do sono em estudantes do curso de Odontologia da Universidade Nacional do Altiplano de Puno. Materiais e métodos: Estudo de coorte transversal observacional com a participação de 78 estudantes, com idade média de 22,63±2,87 anos, com distribuição por género de 32 homens (41,0%) e 46 mulheres (59,0%). A escala de avaliação de Hamilton foi utilizada para avaliar ansiedade e depressão, com consistência interna de α = 0,88 e 0,86, respectivamente, e o questionário de Pittsburgh foi utilizado para mensurar o índice de qualidade do sono (α = 0,87). Resultados: No modelo preditivo, os coeficientes ß padronizados indicam que a ansiedade psicológica (ß = -0,870; p<0,001), a depressão (ß = 0,119; p<0,05) e o desenvolvimento de práticas clínicas (ß = -0,019; p<0,05) foram os fatores que mais contribuíram significativamente para o índice de qualidade do sono dos estudantes. Conclusão: Estas descobertas sublinham a importância de abordar os problemas do sono como parte integrante do tratamento da ansiedade e da depressão, bem como realçam a necessidade de considerar a saúde mental na avaliação e gestão dos distúrbios do sono.

Impact of intrinsic foot muscle training on foot posture and foot functional activity among female kathak dancers with flat feet

Background: Kathak being one of the very complex Indian classical dance forms, has a greater emphasis on foot work thus putting substantial amount of stress over foot which leads to weakness of intrinsic foot muscles, flat foot and functional impairments. Hence current study aimed to study the impact of intrinsic foot muscle strengthening on foot posture and functional activity among female kathak dancers with flat feet. Methods: In this Quasi-Experimental Study, 30 females kathak dancers with flat feet between the age group of 18-40 were selected according the inclusion and exclusion criteria from different Kathak dance academies in Pimpri and Pune. All participants were given intrinsic foot muscle strengthening (5 exercises) for 2 times a week for 4 weeks which were progressed after 2 weeks. Pre and post treatment assessments were done for foot deviations and foot functional activity by Foot posture index and foot function index respectively. Results: Paired T test for pre and post treatment analysis was done with statistical. significant at P<0.05 and 95% confidence interval. FFI score was reduced post treatment with mean difference of 1.26 which was statistically insignificant (p>0.05) but clinically significant. There was no statistically as well as clinically significant difference between the pre and post treatment FPI scores of both right and left leg (p>0.05). Conclusions: Intrinsic foot muscle training showed clinically significant improvement in foot function index but did not show any improvement in foot posture.

Genitourinary syndrome of menopause exploring the history, updates and treatment

The biological factors and physiological functions fundamental to the female anatomy delineate the complexity of reproductive phenomenon in this population. When women experience menopausal transition, genital, sexual, and urinary signs and symptoms materialize often. These longstanding signs and symptoms, presently referred to as the genitourinary syndrome (GUS) of menopause, a relatively new term, impact their quality of life and sexual health with the emergence of vulvovaginal and urogenital atrophy, typical of irritation, soreness, dryness, dyspareunia, and itching. Despite its prevalence, GUS of menopause often goes unreported due to embarrassment, leading to underdiagnoses, diminished intervention, and under-treatment. Moreover, the rising life expectancy is also emerging as a contributing factor to the increasing prevalence of GUS of menopause, directly affecting women's health. While there are notable awareness, education, and healthcare frameworks in place aimed at addressing the unique needs of menopausal women, there is a need to explore further GUS� prevalence, pathophysiology, risk factors, clinical features, diagnosis, and treatment to understand, diagnose, and effectively manage this condition.

Relevance of copper/zinc ratio and its association with redox status in chronic obstructive pulmonary disease

Background: Chronic obstructive pulmonary disease is a progressive and persistent inflammatory condition associated with significant morbidity and mortality. Increased oxidative stress amongst others, plays an important role in the pathogenesis of this disease. The objective of the present study was to conduct a preliminary yet comprehensive examination of metal exposure specifically copper and zinc levels and their association with overall oxidative stress in COPD. Methods: A cross sectional study was carried out in a tertiary care hospital in South India. Two groups were included in the study. One group with 20 COPD patients and the other group of 20 healthy controls. Plasma samples were obtained from both the groups and serum levels of copper and zinc were studied by atomic absorption spectrometry. Cu/Zn ratio obtained from the results was further correlated with oxidative stress index calculated from total oxidant status and total antioxidant status in COPD with respect to controls. Results: The copper levels were significantly higher and the zinc levels lower in the COPD group as compared to the control group. The copper/zinc ratio was higher in COPD as compared to control population. The correlation between Cu/Zn ratio and oxidative stress index showed a positive correlation with a regression coefficient of 0.7. Conclusions: The study throws light on the trace element imbalance in COPD and how these could induce oxidative stress, contributing to persistent inflammation in COPD. In the clinical perspective, monitoring Cu/Zn ratio in COPD patients may lead to better risk mitigation and thereby better therapeutic management of the disease.

Fetomaternal outcome in abnormal liquor volume pregnancies

Background: Variation in the amniotic fluid reflects fetal compromise, and congenital anomalies and also may predict perinatal morbidity and mortality.Methods: Singleton pregnancy subjects with well-established dates at ?28 weeks of gestational age were taken into study. These subjects were ultrasonographically diagnosed to have abnormal liquor volumes. This study was a hospital-based single-center prospective observational study conducted in Midnapore medical college and hospital, west Bengal. The chi-square test was applied for statistical significance and a p<0.05 was considered to be significant.Results: In all subjects of abnormal liquor volume, the incidence of oligohydramnios and polyhydramnios are in the proportion of 3:1 in our study. Postdated pregnancy (28.4%), hypertensive disease (16.8%), intrauterine growth restriction (IUGR) (12.6%), and anemia (2.2%) were associated with oligohydramnios. Congenital anomalies (23.3%), GDM (16.6%), and Rh-incompatibility (3.3%) were associated with polyhydramnios. The incidence of caesarean section, meconium-stained liquor and 5-minute APGAR score <7 and NICU admission was higher in the oligohydramnios group as compared to polyhydramnios. In abnormal liquor volume, the statistical association was significant with onset of labour (p=0.00), mode of delivery (p=0.00), the colour of liquor(p-0.00), and fetal outcome (p=0.00).Conclusions: Postdated pregnancy, IUGR, and hypertensive disorders were associated with oligohydramnios and congenital anomalies, and GDM and Rh-isoimmunization were associated with polyhydramnios. In abnormal liquor volume onset of labour, mode of delivery, the colour of the liquor, and fetal outcome were significant.

Evaluation of Antiulcer Potential of Bougainvillea spectabilis Extracts on Cysteamine Hydrochloride-Induced Duodenal Ulceration in Rats

Bougainvillea spectabilis has long been utilized for its diverse range of medicinal characteristics, including antibacterial, antiviral, hepato-protective, anti-inflammatory, antifungal, anti-diabetic, antioxidant, antifertility, antiulcer, anticancer and antiviral effects. The objective of this research was to find out how B. spectabilis (both ethanolic and aqueous extract) affected the development of duodenal ulcers. The investigation was conducted on a model of duodenal ulceration utilizing the chemical cysteamine hydrochloride, which has the potential to induce ulcers in conjunction with ranitidine, a conventional medicine. Then, a treatment group consisting of the plant’s ethanolic and aqueous extract was compared to the chemical that causes duodenal ulcers. The ethanolic extract derived from the B. spectabilis plant demonstrated a strong ability to treat duodenal ulcers produced by the chemical cysteamine hydrochloride. The ethanolic extract effectively protected the duodenum and stomach regions from chemical-induced damage, as demonstrated by its superior performance compared to the conventional treatment. Both stomach as well as duodenal ulcer healing and protection against experimentally induced duodenal ulcers in rats were improved by the plant B. spectabilis.

Development and Characterization of Ultrasound-assisted PLGA Nanobubbles for the Triggered Delivery of Pemigatinib by Design of Experiments

This study used a central composite design (CCD) to evaluate how the independent attributes—sonication distance (X1), amplitude (X2), time (X3), & power (X4)—impacted two outcomes—droplet-size (Y1) & polydispersity index (PDI) (Y2). With the time-consuming & inefficient "changing one factor at a time" approach would have been an option for this multifactor optimization, but we opted against it since we wanted to be sure we had the best possible values. Here, a mathematical model of the combined influence of the processing elements led to the selection of a CCD, which is known to be significantly more dependable. Using a double emulsion technique, we created and fine-tuned a drug delivery system consisting of nanobubbles loaded with pemigatinib. Pemigatinib nanobubbles were studied for their shape, surface charge, and particle size to determine their physicochemical characteristics and found that they were spherical with the Zeta potential (ZP) and particle size of -25.3±2.98 & 38.53±2.14 respectively. Pemigatinib-loaded nanobubbles were also tested for their release behaviors and drug encapsulation effectiveness. Finally, we tried to study the anti-tumor activity and cellular absorption of poly (lactic-co-glycolic acid) nanobubbles-Pemigatinib in vitro.

Prevalence of Hamstring Tightness in Nursing Students Using 90-90 SLR Test: A Cross-Sectional Study

Background: Flexibility is a range of movement available at a joint. Tightness of muscle is caused by a decline in the ability of muscle to disfigure. Hamstring tightness can lead to low back pain, bad posture, imbalances of muscles and knee pain. According to previously performed studies, prolonged sitting can be a factor that leads to hamstring tightness; therefore, we selected nursing students as a participant in the study who have a daily sitting time of 6-8 hours. Hence objective of the study is to find out the prevalence of hamstring tightness among nursing students. Aim: The study’s aim was to find out if Nursing Students have hamstring tightness due to Prolonged Sitting using a 90-90 SLR test. Study design: Observational study. Methodology: In this cross-sectional study, 145 participants were included by verifying inclusion and exclusion criteria. Consent was taken before evaluation. Hamstring tightness was measured by a 90-90 SLR test. After that, height and weight were measured, and BMI was calculated. After evaluating all participants, prevalence was calculated. Then, it was compared with BMI. Result: 20.68 percent of participants had hamstring tightness. Conclusion: The result indicates that the prevalence of hamstring tightness is low in nursing students.

Prevalence of the Fabella and Determination of the Fabella Index / Prevalencia de la Fabela y Determinación del Índice Fabelar

SUMMARY: The fabella is a bony anatomical variable, which in humans is located posterior to the lateral condyle of the femur, in the tendinous portion of the lateral head of the gastrocnemius muscle. Its prevalence rate has been reported in different populations, ranging from 3% to 86%. This study aimed to create an index that classifies the fabella according to its dimensions, determine the prevalence of the fabella in the Colombian population, and identify possible differences according to the fabella index (FI), sex, age, laterality, and degree of fabellar degeneration. A retrospective study used 93 lateral knee radiographs belonging to Colombian individuals. A fabella index was established to classify fabellae into longifabellar, medifabellar, and equifabellar, and radiological classification was used to identify the degree of fabellar degeneration (DFD). The prevalence of fabella was 36.30 %, and this variant was associated with the individual's sex, with male subjects having 2.66 times the probability of presenting fabella. A higher prevalence of medifabellar fabellae (57.60 %) was observed, followed by longifabellar (24.20 %) and equifabellar (18.20 %). There was a positive and moderate correlation between the DFD and age. We consider that larger fabellae can cause entrapment of the common fibular nerve, compression of the popliteal artery, and tear of the medial meniscus, so the FI becomes relevant in clinical practice, providing information on the type of fabella and its associated pathological manifestations. This study introduces a novel fabella index and investigates the frequency of fabella in the Colombian population. The findings of this study will serve as a reference for future research and contribute to the field of knee orthopedics and surgery in this population.

La fabela es una variable anatómica ósea, que en humanos se localiza posterior al cóndilo lateral del fémur, en la porción tendinosa de la cabeza lateral del músculo gastrocnemio. Su tasa de prevalencia se ha reportado en diferentes poblaciones, cuyos valores oscilan entre 3 % y 86 %. El objetivo de este estudio fue crear un índice que clasifique la fabela según sus dimensiones, determinar la prevalencia de la fabela en población colombiana, así como identificar posibles diferencias en función del índice fabelar, sexo, edad, lateralidad y grado de degeneración de la fabela. Se desarrolló un estudio retrospectivo en el que se dio uso a 93 radiografías laterales de rodilla, pertenecientes a individuos colombianos. Se estableció un índice fabelar que clasificó las fabelas en longifabelares, medifabelares y equifabelares, además utilizamos la clasificación radiológica para identificar los grados de degeneración fabelar (GDF). La prevalencia de la fabela fue del 36,30 %, se encontró asociación de esta variante al sexo del individuo, siendo los hombres quienes tuvieron 2,66 veces más probabilidades de presentar la fabela. Se observó mayor prevalencia de fabelas tipo medifabelar 57,60 %, seguido de tipo longifabelar 24,20 % y equifabelar 18,20 %. Hubo correlación positiva y moderada entre la edad y el grado de degeneración fabelar. Consideramos que las fabelas con mayores dimensiones podrían causar atrapamiento del nervio fibular común, compresión de la arteria poplítea y desgarro del menisco medial, por lo que el índice fabelar adquiere relevancia en la práctica clínica, al dar información del tipo de fabela y sus manifestaciones patológicas asociadas. El presente estudió es el primero en proponer un índice fabelar y la frecuencia de la fabela en población colombiana, por lo que servirá de referencia para futuras investigaciones, además de brindar un aporte al área traumatológica y quirúrgica de la rodilla en esta población.

Índice de analgesia y nocicepción durante el mantenimiento anestésico en cirugía laparoscópica pediátrica / Analgesia and nociception index during anesthetic maintenance in pediatric laparoscopic surgery

Resumen: Introducción: Habitualmente el monitoreo analgésico está basado en parámetros hemodinámicos. Estas variables son insuficientes para garantizar una adecuada anestesia. La evaluación nociceptiva durante la cirugía es esencial para mejorar la recuperación postoperatoria. Objetivo: Describir el comportamiento del índice de analgesia y nocicepción (ANI) durante el mantenimiento anestésico en pacientes pediátricos sometidos a cirugía laparoscópica. Material y métodos: Serie de casos de pacientes pediátricos programados para cirugía laparoscópica con monitorización ANI. Se analizaron distintas variables en cinco momentos diferentes de la cirugía. Resultados: Se incluyeron 24 pacientes. Se observaron cambios significativos de ANI al inicio de la cirugía 58.5 ± 6.0, al neumoperitoneo 57.4 ± 6.4 y en la emersión 70.9 ± 6.3, mientras que la presión arterial media (PAM) incrementó en la emersión 74.2 ± 5.1 y la frecuencia cardíaca (FC) disminuyó al inicio de neumoperitoneo 96.3 ± 8.2 y al término de éste. La dosis de fentanilo presentó diferencias significativas al término de neumoperitoneo 0.003 ± 0.0007 y emersión 0.002 ± 0.0007. Conclusiones: No existe relación entre las variables hemodinámicas y el valor ANI, sugiriendo que dicho índice parece más sensible que la FC y la PAM para moderar la estimulación nociceptiva en pacientes pediátricos sometidos a cirugía laparoscópica.

Abstract: Introduction: Analgesic monitoring is usually based on hemodynamic parameters. These variables are insufficient to guarantee adequate anesthesia. Nociceptive assessment during surgery is essential to improve postoperative recovery. Objective: To describe the behavior of the analgesia and nociception index (ANI) during anesthetic maintenance in pediatric patients undergoing laparoscopic surgery. Material and methods: Case series of pediatric patients scheduled for laparoscopic surgery using an ANI monitor. Different variables were analyzed at 5 different moments of surgery. Results: 24 patients were included. Significant changes were observed in ANI at the beginning of surgery 58.5 ± 6.0, at the pneumoperitoneum 57.4 ± 6.4 and at emersion 70.9 ± 6.3, while the mean arterial pressure (MAP) increased at emersion 74.2 ± 5.1 and heart rate (HR) decreased at the beginning of the pneumoperitoneum 96.3 ± 8.2 and at its end. The fentanyl dose presented significant differences at the end of pneumoperitoneum 0.003 ± 0.0007 and emersion 0.002 ± 0.0007. Conclusions: There is no relationship between the hemodynamic variables and the ANI value, suggesting that this index seems more sensitive than HR and MAP to moderate nociceptive stimulation in pediatric patients undergoing laparoscopic surgery.

Utilidad del Surgical Pleth Index como factor predictor de dolor en el postoperatorio / Usefulness of the Surgical Pleth Index as a predictor of pain in the postoperative period

Resumen: Introducción: Aunque existen elementos para guiar la analgesia en el transoperatorio, no hay una herramienta estandarizada que además sea predictora de dolor en el postoperatorio. El Surgical Pleth Index (SPI) podría ser esa prueba diagnóstica. Objetivo: Establecer un valor de corte para SPI para predecir el dolor postoperatorio de moderado a intenso. Material y métodos: Fueron evaluados 60 pacientes, sometidos a cirugía programada con anestesia general balanceada. Las variables analizadas: frecuencia cardíaca, presión arterial media y entropía de estado (SE) se registraron cada dos minutos durante los últimos 10 minutos de la cirugía y al despertar. Durante la recuperación, se midió el dolor postoperatorio mediante la escala numérica análoga (ENA), cada tres minutos durante 15 minutos. Resultados: Se analizaron los datos obtenidos mediante una curva ROC que reveló un valor de corte óptimo intraoperatorio de 36 SPI discriminando entre pacientes sin dolor o dolor leve (ENA = 0-3) vs pacientes con dolor moderado a severo (ENA = 4-10) en el postoperatorio. Para este valor corte, tanto el valor predictivo negativo, como el valor predictivo positivo, fueron altos, (80 y 88.7%, respectivamente). Conclusiones: Un valor de SPI de 36 puede ser un predictor útil de dolor postoperatorio, con mayor efectividad que las variables hemodinámicas analizadas.

Abstract: Introduction: Although there are elements to guide intraoperative analgesia, there is no standardized tool that is also a predictor of postoperative pain. Surgical Pleth Index (SPI) could be that diagnostic test. Objective: To establish a cut-off value for SPI to predict moderate to severe postoperative pain. Material and methods: 60 patients who underwent elective surgery with balanced general anesthesia were evaluated. The analyzed variables: heart rate, mean arterial pressure and state entropy (SE) were recorded every 2 minutes during the last 10 minutes of surgery and upon awakening. During recovery, postoperative pain was measured using the numerical rating scale (NRS) every 3 minutes for 15 minutes. Results: The data obtained were analyzed using a ROC curve that revealed an optimal intraoperative cut-off value of 36 SPI, discriminating between patients without pain or mild pain (NRS = 0-3) vs patients with moderate to severe pain (NRS = 4-10) in the postoperative period. For this cut-off value, both the negative predictive value and the positive predictive value were high (80 and 88.7%, respectively). Conclusions: An SPI value of 36 can be a useful predictor of postoperative pain, with greater effectiveness than the hemodynamic variables analyzed.

Brazilian growth charts for Williams-Beuren Syndrome at ages 2 to 18 years

Abstract Objective: To develop growth charts for weight-for-age, height-for-age, and body mass index (BMI)-for-age for both genders aged 2 to 18 years for Brazilian patients with Williams-Beuren Syndrome (WBS). Methods: This is a multicenter, retrospective, and longitudinal study, data were collected from the medical records of boys and girls with a confirmed diagnosis of WBS in three large university centers in the state of Sao Paulo, Brazil. Growth charts stratified by gender and age in years were developed using LMSchartmaker Pro software. The LMS (Lambda Mu Sigma) method was used to model the charts. The quality of the settings was checked by worm plots. Results: The first Brazilian growth charts for weight-for-age, height-for-age, and BMI-for-age stratified by gender were constructed for WBS patients aged 2 to 18 years. Conclusion: The growth charts developed in this study can help to guide family members and to improve the health care offered by health professionals.