Questionnaire of core beliefs related to drug use and craving for assessment of relapse risk. / Cuestionario de creencias nucleares relacionadas con el consumo de drogas y el craving, para la valoración del riesgo de recaída.

This study was aimed at designing a questionnaire for the assessment of addiction-related core beliefs and craving. The sample comprised 215 patients (85.8% males and 14.2% females) in treatment for dependence to alcohol (40%), cocaine (36.3%) and cannabis (23.7%). Descriptive statistics were used to characterize the sample. Variance, regression and factorial analyses were conducted to study the questionnaire structure and its relation with variables such as abstinence and craving. Items about drug-related beliefs yielded a four-factor structure: what patient think that they could not do without drug use, lack of withdrawal, conditions required to use drugs again, and use of drugs as the only way to feel good. Items related to craving yielded three factors: negative emotions as precipitants of drug use, positive emotions, and difficulties attributed to coping with craving. Furthermore, beliefs were more important to predict craving than abstinence time. The present questionnaire allows to assess a set of significant factors to design prevention relapse programs.

El objetivo de la investigación fue diseñar un cuestionario para la evaluación de creencias nucleares en torno al consumo de drogas y el craving. La muestra estuvo compuesta por 215 pacientes, de los que el 85.8% eran hombres y el 14.2% mujeres en tratamiento por su adicción al alcohol (40%), cocaína (36.3%) y cánnabis (23.7%). Se realizó un análisis descriptivo de la muestra, análisis de varianza, de regresión y análisis factorial con la finalidad de indagar en la estructura del cuestionario y su relación con variables como la abstinencia o deseo de consumo. El apartado de creencias relacionadas con las drogas mostró una estructura de cuatro factores: lo que la persona cree que no podrá realizar en ausencia del consumo de drogas, la falta de renuncia al consumo, las condiciones que deben darse para volver a consumir y el consumo como única vía para sentirse bien. El apartado relacionado con el craving mostró tres factores: las emociones negativas como precipitantes del consumo, las emociones positivas y las dificultades atribuidas al afrontamiento del deseo. A su vez, se constata que las creencias tienen más peso en la predicción del deseo en comparación al tiempo de abstinencia. El cuestionario permite evaluar un conjunto de creencias que muestras factores significativos para el diseño de programas de prevención de recaídas.

[Differential aspects of treatment dropout risk in cocaine dependent patients with and without personality disorders]. / Aspectos diferenciales del riesgo de abandono al inicio del tratamiento de la adicción a la cocaína en pacientes con trastornos de la personalidad.

The aim of this study was to examine the link between psychosocial adjustment, impulsivity and comorbid Axis II psychopathology, and the risk of treatment dropout in cocaine dependent patients. The sample consisted of 95 cocaine dependent participants, 53.7% of whom had been diagnosed with Axis II personality disorders. We utilised a descriptive methodology, which allowed us to examine correlations between the different variables, group differences in these variables, and their ability to predict different dimensions associated with the risk of dropout. Results show that the risk of dropout during the first two months of treatment is not associated with the existence of comorbid personality disorders. With regard to the cognitive profiles of personality disorders, we show that the antisocial profile is associated with higher risk of dropout. The profile of patients at higher risk of treatment dropout is characterised by lower levels of perceived quality of life and elevated levels of impulsivity, especially the experience of strong impulses under positive affect. Therefore, the presence of psychological dimensions tightly associated with emotions, affects and subjective feelings are the more relevant to estimate the risk of treatment dropout in cocaine dependent patients. This study stresses the variables that need to be specifically addressed during early phases of cocaine addiction treatment, since they are associated with higher risk of treatment dropout.

A six degrees of freedom femtosecond laser system for fabrication of small-scale mechanical property specimens.

We present the details of a novel ultra-short pulsed laser machining workstation that has been employed for high-throughput laser machining of small-scale mechanical property specimens. This system employs a six degrees of freedom hexapod positioning stage capable of macroscopic movements at high positional accuracy. We developed a methodology that uses quantitative image analysis to measure key parameters required to minimize the hexapod positioning and rotational error. Application of this system to laser machining of small-scale 316L stainless steel tensile specimens and ultra-high molecular weight polyethylene compressive specimens using eucentric tilt and rotation about the specimen axis will be shown, where serial laser milling at a specimen tilt angle of 10° was used to effectively eliminate any taper in the sample cross section that is typically found in laser machining.

[Vitamin D nutrition in Chilean pre-school children living in extreme latitudes]. / Estado nutricional de vitamina D en pre escolares chilenos de zonas australes.

BACKGROUND: Sunlight exposure is the main factor for adequate vitamin D (VitD) nutrition; in extreme latitudes there is an increased risk for its deficiency. AIM: To study VitD nutritional status in pre-school children living in austral latitudes of Chile. SUBJECTS AND METHODS: A blood sample was obtained from 60 pre-school healthy children (aged 2 to 5 years, 24 males), attending to public day-care centers in Coyhaique (45° 35' S), during March (time 1) and September (time 2). 250 HD, parathyroid hormone (PTH), calcium, phosphate and alkaline phosphatases (PA) were measured. Information about weather conditions during three months prior to the sample withdrawal was gathered. RESULTS: Forty nine percent of children had a normal weight and 11% were overweight. Vive children with unreliable 250 HD levels were excluded from analysis. At time 1, 250 HD levels were 21.6 ± 14.5 ngl mh (7.9-71.1). Sixty four percent of children had valúes < 20 ng/mL (deficiency). At time 2, the figures were 21.5 ± 13.2 ng/mL (9.4-68.5) and 67.3% of children were deficient. PTH, serum calcium, phosphate and PA were normal. Prior to time 1, the UVradiation Índex (UVI) was high to extreme (91.3%), with 3.3 and 73% of sunny and cloudy days, respectively. Mean minimal and maximal temperatures were 7 and 17.3°C respectively. Prior to time 2 the IUVwas low in 100%) of days; with 15.2 and 60.9 of sunny and cloudy days, respectively. Mean minimal and maximal temperatures were 0.3 and 6.7°C respectively. No association of 250 HD with the other metabolicparameters was found. CONCLUSIONS: Chilean pre-school children living in austral latitudes have a high rate of vitamin D deficiency, throughout the year, with no association with PTH, calcium, phosphate or PA. Further research is required to study vitamin D deficiency in other latitudes and magnitude of sunlight exposure.

[Changes in core beliefs associated with addiction among substance-dependent patients with vs. without comorbid personality disorders]. / Evolución de las creencias nucleares relacionadas con la adicción en drogodependientes con y sin trastornos de personalidad.

The aims of this study were: 1) To evaluate the predictive ability of cognitive beliefs about craving and alcohol use during treatment; and 2) To examine the course of cognitive beliefs, over a nine-month follow-up, as a function of comorbidity with personality disorders (PDs). Participants in the study were sixty-five alcohol-dependent patients initiating treatment at the Provincial Drug-Dependence Centre in Granada (Spain), 56.4% of whom had comorbid personality disorder. We administered the "Questionnaire on beliefs related to addiction and craving", taking number of alcohol-use episodes during treatment and degree of psychological adjustment as outcome variables. We used linear regression models to analyze the relation between questionnaire items and outcome variables, and related-samples t-tests to examine the course of beliefs throughout the follow-up. Results indicate that it is feasible to reliably measure a range of dysfunctional beliefs associated with addiction, that the degree of identification with these beliefs significantly predicts craving and alcohol use during treatment, and that the course of identification with these beliefs is considerably more irregular in alcohol-dependent individuals with comorbid PDs.

Brain networks alterations in cocaine use and gambling disorders during emotion regulation.

Background: Cocaine use disorder (CUD) and gambling disorder (GD) share clinical features and neural alterations, including emotion regulation deficits and dysfunctional activation in related networks. However, they also exhibit differential aspects, such as the neuroadaptive effects of long-term drug consumption in CUD as compared to GD. Neuroimaging research aimed at disentangling their shared and specific alterations can contribute to improve understanding of both disorders. Methods: We compared CUD (N = 15), GD (N = 16) and healthy comparison (HC; N = 17) groups using a network-based approach for studying temporally coherent functional networks during functional magnetic resonance imaging (fMRI) of an emotion regulation task. We focused our analysis in limbic, ventral frontostriatal, dorsal attentional (DAN) and executive networks (FPN), given their involvement in emotion regulation and their alteration in CUD and GD. Correlations with measures of emotional experience and impulsivity (UPPS-P) were also performed. Results: The limbic network was significantly decreased during emotional processing both for CUD and GD individuals compared to the HC group. Furthermore, GD participants compared to HC showed an increased activation in the ventral frontostriatal network during emotion regulation. Finally, networks' activation patterns were modulated by impulsivity traits. Conclusions: Functional network analyses revealed both overlapping and unique effects of stimulant and gambling addictions on neural networks underpinning emotion regulation.

[Basic addictive beliefs and craving]. / Creencias básicas adictivas y craving.

AIM: To investigate the predictive ability of "core addiction-related beliefs" and "craving-related beliefs" on the desire to take drugs based on the cognitive model of addiction. In addition, we analyzed more in depth the influence of duration of abstinence on the degree of identification of participants with these beliefs and the intensity of craving. METHODS: We used three different questionnaires in order to measure: the intensity of the craving experienced by participants, and the degree to which they identify with "core addiction-related beliefs" and "craving-related beliefs". The sample was made up of 130 drug abusers with different main drugs of choice, course of addiction, duration of abstinence and gender. RESULTS: The "core addiction-related beliefs", together with clinical variables such as the main drug of choice and the duration of abstinence, significantly predicted the intensity of craving experienced by participants. The intensity of craving and the degree to which participants identify with "core addiction-related beliefs" and "craving-related beliefs" differed significantly as a function of duration of abstinence; this effect was due to the fact that patients with shorter abstinence periods were more likely to endorse these beliefs. "Core addiction-related beliefs" can significantly predict not only intensity of craving but also the degree to which participants identify with "craving-related beliefs". CONCLUSIONS: "Core addiction-related beliefs" constitute the best predictor of intensity of craving across treatment, and may therefore be highly relevant for difficulties in controlling craving, as proposed by the Beck cognitive model of addiction. This association may help to explain why some patients have a persistent desire to take drugs even after protracted abstinence, when a lack of desire for drugs would be expected.

[Longitudinal study on quality of life, craving and psychological adjustment in alcohol-dependent patients: variations depending on the personality disorders]. / Estudio longitudinal sobre calidad de vida, craving y ajuste psicológico en pacientes dependientes del alcohol: variaciones en función de los trastornos de la personalidad.

The goal of this study was to determine the evolution of variables such as quality of life, craving, or psychological adjustment during treatment in a sample of 65 patients with alcohol-dependence disorder, 56.3% of whom also presented a personality disorder (PD). Five measurements were taken over the course of the treatment, at 3-month intervals. The analysis of tendencies of the variables craving, quality of life, and psychological adjustment assessed at the five assessment points revealed that the cognitive-behavioral treatment influences each one of these variables differently: a quadratic and cubic relation was identified for craving, whereas for quality of life there were linear, quadratic and cubic relationships in its diverse scales depending on the time point in question, and for psychological adjustment there were linear and quadratic relationships. At the end of treatment, the patients assessed presented significantly higher levels of quality of life than at the beginning, but the results showed that, although the patients with PD had better perceived quality of life at three months, it was lower over the entire course of the treatment compared to patients without PD. It was also found that quality of life and craving at the start of the treatment predicted alcohol use during the first three months. The implications of these results are discussed with a view to psychological intervention with alcohol-dependent patients.

Ocular thelaziosis: A case report of an emerging zoonosis.

PURPOSE: To describe an unusual case of ocular thelaziosis due to Thelazia callipaeda, an underdiagnosed and emerging zoonosis. OBSERVATIONS: We report an 81-year-old woman presented to our emergency department with a week long history of bilateral redness and tearing that had not improved despite antibiotics and corticosteroid topical treatment. Slit-lamp biomicroscopy showed signs of bilateral conjunctivitis and mucopurulent discharge in fornices. Under the upper tarsal conjunctiva of the left eye, two filiform worms were identified, which were removed and sent on wet mount slides for microscopic examination and genetic identification. The rest of the ophthalmoscopic examination was rigorously normal. Polymerase chain reaction (PCR) assay turned positive for Thelazia callipaeda. During further questioning, the patient reported that she had been on summer vacation in contact with dogs which were infected with eye worms. CONCLUSIONS AND IMPORTANCE: Ocular thelaziosis is an emerging zoonosis in Spain, but also in the rest of the world. Ophthalmologists should include ocular thelaziosis in humans as a possible cause of conjunctivitis, tearing, and corneal ulcer, thus avoiding underdiagnosis and inappropriate treatments. The epidemiology of the disease makes anamnesis essential. A confocal biomicroscopy is a useful device for identifying this eyeworm but the definitive diagnosis will be made taking into account the morphological identification under microscope, together with the molecular identification by PCR techniques.

Reconstruction of the lower lip after broad oncologic resection by Colmenero flap: a reliable option.

OBJECTIVE: Reconstruction of the lower lip is complex. The Colmenero flap is an effective albeit rarely described method for the repair of medium- to large-sized defects of the lower lip. METHODS: A retrospective review was carried out using data gathered from patients who had undergone Colmenero flap reconstruction of the lower lip at our centre between 2015 and 2020. We analysed demographic, histologic and anatomic variables as well as surgical results. This review assessed flap functionality based on proper mouth closure, absence of microstomia and oral competence. RESULTS: Thirteen Colmenero flaps were performed in 9 patients, with the flap being used bilaterally in four cases. All patients had squamous cell carcinoma of the lower lip. The mean length of the reconstructed defect was 4.1 cm (ranging between 3-7.5 cm). None of the flaps exhibited signs of necrosis. Five patients required minor surgical touch up during the second procedure: two for dehiscence, two for oral leakage and one for esthetic improvement. All patients had excellent functional and aesthetic final outcomes. CONCLUSIONS: The Colmenero flap is a good resource for medium- and large-sized lower lip reconstructions due to its reliability, limited complications, and good aesthetic and functional results.

[Quality of life in patients with alcohol dependence disorder with personality disorders: relation to psychological adjustment and craving]. / La calidad de vida en pacientes con trastorno por dependencia al alcohol con trastornos de la personalidad: relación con el ajuste psicológico y craving.

The purpose of this study is to determine the self-perceived quality of life of abstinent patients with alcohol dependence disorder during the first month of treatment, and how the presence of personality disorders, psychological adjustment, and the level of craving affect this perception. For this purpose, a sample was used comprising 65 participants with mean age of 43.26 years, of whom 70.8% were male and 29.2% female, with a mean duration of addiction to alcohol consumption of 11.83 years. The results show that quality of life is not related to the duration of abstinence or the course of the addiction. Moreover, the patients who present a personality disorder perceive poorer quality of life in areas such as health status, mood, and social relations. Self-perception of quality of life is affected by psychological adjustment and beliefs about craving. These data should be taken into account when considering quality of life as a measurement of the effectiveness of a treatment for drug addicts with personality disorders.

Unpacking common and distinct neuroanatomical alterations in cocaine dependent versus pathological gambling.

Pathological gambling and cocaine dependence are highly pervasive disorders. Functional neuroimaging evidence implicates aberrant activity of prefrontal striatal pathways in both disorders. It is unclear if the neuroanatomy of these areas is also affected. Participants with pathological gambling (n = 18), cocaine dependence (n = 19) and controls (n = 21) underwent high-resolution structural MRI scan and cognitive assessments. In line with emerging functional neuroimaging findings, we hypothesised (i) lower volumes of corticostriatal areas ascribed to decision-making/inhibitory control, craving and reward processing (i.e., orbitofrontal cortex, inferior frontal gyrus, amygdala, striatum, insula) in both pathological gamblers and cocaine dependent participants versus controls; (ii) selected dopaminergic/glutamatergic pathways directly taxed by cocaine (i.e., superior, dorsolateral and anterior cingulate cortices) would be altered in cocaine dependent versus control participants only. Analyses were conducted with a bonferroni correction. Our results showed that both pathological gambling and cocaine dependent participants, compared to controls, had larger volumes of the right inferior frontal gyrus (ps <.01, ds = 0.66 and 0.62). Cocaine dependent participants had lower nucleus accumbens and medial orbitofrontal cortex volumes than pathological gamblers (ps <.05, ds = 0.51 and 0.72), with the latter being predicted by higher negative urgency scores. Inferior frontal gyrus volume may reflect common alterations of cocaine and gambling addictions, whereas cocaine dependence may be uniquely associated with reduced volume in dorsolateral and middle frontal regions. Cocaine's supra-physiological effects on mesolimbic neurons may explain reduced accumbens-orbitofrontal structure compared to gambling.

The neural interface between negative emotion regulation and motivation for change in cocaine dependent individuals under treatment.

BACKGROUND: Emotion regulation is important for cocaine addiction treatment success, particularly during early abstinence. In addition, the neural underpinnings of emotion processing overlap with those of motivation and goal-directed behavior. We examined if the neural underpinnings of emotion maintenance and its regulation correlate with cocaine treatment motivation. METHODS: Forty-five cocaine dependent individuals (CDIs) starting outpatient treatment in a public specialized addiction treatment clinic in Granada (Spain) underwent fMRI scans while performing a Reappraisal task, and completed the University of Rhode Island Change Assessment Scale (URICA), to measure treatment motivation. We conducted correlation analyses to examine the association between emotion maintenance and regulation related brain activation and URICA's Readiness to Change scores. We also explored links between Emotional reports during the fMRI reappraisal task, duration of abstinence, and anxiety and depression symptoms. RESULTS: Readiness to Change scores were positively correlated with activations in the right dorsolateral prefrontal and right parietal cortices, the midbrain (p ≤ 0.001, cluster extents ≥109 voxels), and basolateral amygdala (PFWE-SVC<0.05), while negatively with emotion maintenance related activation in the same cortical areas and activations in the dorsomedial frontal cortex, the nucleus accumbens and the left fusiform gyrus. Emotional reactivity negatively correlated with right dorsolateral prefrontal cortex reappraisal related activation (r= -0.40, p = 0.007), and the Regulate score positively correlated with the left fusiform gyrus emotion maintenance related activation (r = 0.31, p = 0.04). CONCLUSIONS: Emotional related activation in frontoparietal, accumbens, fusiform, amygdala and midbrain regions engaged during emotion regulation and its maintenance correlate with early treatment motivation in CDIs.

[Influence of personality disorders and consumption patterns on the efficacy of a relapse-prevention program for the treatment of alcoholism]. / Influencia de los trastornos de la personalidad y patrones de consumo en la eficacia de un programa de prevención de recaídas para el tratamiento del alcoholismo.

The purpose of this study is to analyze to efficacy of a cognitive-behavioral treatment program, in individual and group format, for people with alcohol problems, and to determine the role of some personality variables in the process of therapeutic recovery. The sample was made up of 80 patients diagnosed as alcoholics, 83.8% of whom were men (n=67) and 16.3% were women (n=13). Mean age was 42.73 years, with a standard deviation of 9.63 years. Basically, we found a high incidence of obsessive-compulsive personality disorder and consumption patterns that change as a function of the presence or absence of personality disorders. We also observed that the results varied in relation to physiological variables and environmental situations associated with the presence of craving responses. Treatment of such patients with dual pathology demands greater effort from the therapist to promote treatment adherence, an aspect crucial to completion of treatment programs and to achieve therapeutic success. Cognitive-behavioral intervention for relapse prevention was observed to produce satisfactory results in patients with personality disorders. Neither consumption patterns nor personality disorders predict the type of treatment termination.

Acceso y adhesión a proceso de intervención psicosocial diferenciado para los servicios y sistemas de salud en varones gay adultos viviendo con el VIH, Paraguay, 2022 / Access and adherence to a differentiated psychosocial intervention process for health services and systems in adult gay men living with HIV, Paraguay, 2022

Introducción: el acceso a los servicios de salud en Paraguay, está determinado por varios tipos de barreras. Por ello, es preciso describir el impacto que tienen las políticas públicas y sus implicancias en la mitigación de las mismas. Objetivo: describir el acompañamiento diferenciado y su contribución al apoyo socio emocional, adhesión al tratamiento y acceso a servicios de salud en el área de atención a personas varones que viven con el VIH. Metodología: estudio de carácter cualitativo, descriptivo, con entrevistas semi estructuradas y muestra no probabilística, dirigida e intencional; Resultados: este estudio cualitativo exploró las experiencias de personas viviendo con VIH que recibieron acompañamiento psicosocial diferenciado en un servicio de atención integral. Los participantes destacaron la importancia del acompañamiento para afrontar la crisis posterior al diagnóstico. La orientación presencial, escucha empática y seguimiento facilitaron la vinculación y adherencia al servicio de salud y al tratamiento antirretroviral. El apoyo psicosocial fue clave para desmitificar ideas erróneas sobre el VIH/SIDA, empoderarse sobre su estado serológico y mejorar la calidad de vida. Se enfatizó el rol de los grupos de pares para brindar contención. Algunos participantes reportaron experiencias previas de revelación no consentida y vulneración de confidencialidad. El acompañamiento psicosocial diferenciado resultó fundamental para facilitar la inserción y permanencia de las personas con VIH en los servicios de atención integral (adhesión al tratamiento). Conclusiones: el acompañamiento psicosocial diferenciado resultó clave para facilitar la vinculación y adherencia en personas con VIH. La atención integral requiere identificar situaciones particulares, establecer relaciones de confianza y comunicación efectiva. El apoyo inicial es fundamental brindando contención ante el impacto emocional del diagnóstico. El seguimiento continuo es esencial dada la doble discriminación. La confidencialidad y capacidad de generar vínculos empáticos son elementos centrales. Los factores mencionados favorecen la adhesión al tratamiento. Los resultados sugieren que estas prácticas psicosociales pueden optimizar modelos de atención integral a personas con VIH.

Introduction: access to healthcare services in Paraguay is influenced by various barriers. Thus, it is essential to describe the impact of public policies and their implications in mitigating these barriers. Objective: to describe the differentiated support and its contribution to socio-emotional support, therapeutic adherence, and access to healthcare services in the area of care for males living with HIV. Methodology: a qualitative, descriptive study with semi-structured interviews and a non-probabilistic, directed, and intentional sample. Results: this qualitative study explored the experiences of individuals living with HIV who received differentiated psychosocial support in an integrated care service. Participants emphasized the importance of support in coping with the post-diagnosis crisis. In-person guidance, empathetic listening, and follow-up facilitated engagement and adherence to healthcare services and antiretroviral treatment. Psychosocial support played a critical role in debunking misconceptions about HIV/AIDS, empowering individuals regarding their serostatus, and improving their quality of life. The role of peer groups in providing emotional support was emphasized. Some participants reported previous experiences of non-consensual disclosure and confidentiality breaches. Differentiated psychosocial support was essential in promoting the integration and retention of people with HIV in integrated care services (therapeutic adherence). Conclusions: differentiated psychosocial support was crucial in facilitating the engagement and adherence of individuals with HIV. Comprehensive care necessitates identifying specific situations, establishing trust-based relationships, and effective communication. Initial support is vital for providing emotional support in the face of the diagnostic impact. Ongoing follow-up is essential due to the dual discrimination faced. Confidentiality and the ability to build empathetic relationships are central elements. The aforementioned factors favor adherence to treatment. The results suggest that these psychosocial practices can enhance models of comprehensive care for people with HIV.

Electrochemical monitoring of ROS influence on seedlings and germination response to salinity stress of three species of the tribe Inuleae.

Solid-state electrochemical methods have been applied to the establishment of patterns of plant growth and response to saline stress using seedlings of Inula helenium L., Dittrichia viscosa (L.) Greuter (Inula viscosa (L.) Aiton), Limbarda crithmoides (L.) Dumort (Inula crithmoides L.). Upon in situ electrochemical generation of reactive oxygen species (ROS) the reactivity with such species was monitored using voltammetric signals associated to the oxidation of polyphenolic components of the plants. A simple kinetic model based on second-order reaction between ROS and polyphenolic components is applied to electrochemical data yielding apparent rate constants which can be correlated with the level of saline stress revealing significant differences between the tested species. These results were contrasted with the seed germination response to salt concentration in order to check potentiality of voltammetric techniques as analytical tools for evaluating salt stress tolerance in plants.

Transoral oropharyngeal resection classification: Proposal of the SCORL working group. / Clasificación de las resecciones transorales en la orofaringe: propuesta del grupo de trabajo de la Sociedad Catalana de Otorrinolaringología.

INTRODUCTION AND GOALS: There has been a very significant increase in the use of minimally invasive surgery has in the last decade. In order to provide a common language after transoral surgery of the oropharynx, a system for classifying resections has been created in this area, regardless of the instrumentation used. METHODS: From the Oncology Working Group of the Catalan Society of Otorhinolaryngology, a proposal for classification based on a topographical division of the different areas of the oropharynx is presented, as also based on the invasion of the related structures according to the anatomical routes of extension of these tumours. RESULTS: The classification starts using the letter D or I according to laterality either right (D) or left (I). The number of the resected area is then placed. This numbering defines the zones beginning at the cranial level where area I would be the soft palate, lateral area II in the tonsillar area, area III in the tongue base, area IV in the glossoepiglottic folds, epiglottis and pharyngoepiglottic folds, area V posterior oropharyngeal wall and VI the retromolar trigone. The suffix p is added if the resection deeply affects the submucosal plane of the compromised area. The different proposed areas would, in theory, have different functional implications. CONCLUSIONS: Proposal for a system of classification by area to definedifferent types of transoral surgery of the oropharynx, and enable as sharing of results and helps in teaching this type of technique.

Niveles de empatía en médicos residentes: un estudio del Hospital de Clínicas de la Universidad Nacional de Asunción / Empathy levels in resident physicians: a study of the Hospital de Clinicas of the National University of Asunción

Introducción: En general se presenta una disminución de la empatía durante la formación médica, que genera médicos con baja empatía. Es por ello que la empatía debe ser estudiada desde el pregrado y, sobre todo, en aquellos profesionales de la salud que pasan varias horas realizando actividades asistenciales como lo son los médicos residentes. Metodología: Este fue un estudio observacional, analítico de prevalencia, con muestreo no probabilístico de casos consecutivos. Se incluyeron médicos residentes de Medicina Interna, Medicina Familiar, Clínica Quirúrgica, Psiquiatría y Pediatría. El tamaño de muestra quedó establecido en 98 participantes. Para medir la empatía se utilizó el Índice de Reactividad Interpersonal. Resultados: Los resultados informaron que el 55% eran mujeres y el 33,7% de Medicina Interna. Las medias en las subescalas, toma de perspectiva, fantasía, preocupación empática y distrés fueron: 33,33; 2,84; 3,71 y 2,57; respectivamente. Se observaron diferencias significativas en los puntajes de empatía observados entre médicos distintas especialidades. Conclusión: Esto podría reflejar la noción de que diferentes individuos con diferentes grados de habilidades interpersonales, reflejados en sus puntajes de empatía, se sienten atraídos por diferentes especialidades médicas. Palabras clave: empatía; cuerpo médico de hospitales; psicometría.

Introduction: In general, there is a decrease in empathy during medical training, which generates doctors with low empathy. That is why empathy must be studied from the undergraduate school and, above all, in those health professionals who spend several hours doing medical activities such as resident physicians. Methodology: This was an observational, analytical of prevalence study, with non-probabilistic sampling of consecutive cases. Resident physicians of Internal Medicine, Family Medicine, Surgical Clinic, Psychiatry and Pediatrics were included. The sample size was established in 98 participants. To measure empathy, the Interpersonal Reactivity Index was used. Results: The results reported that 55% were women and 33.7% of Internal Medicine. The averages in the subscales, perspective taking, fantasy, empathic concern and distress were: 33.33; 2.84; 3.71 and 2.57; respectively. Significant differences were observed in the empathy scores observed among different medical specialties. Conclusion: This could reflect the notion that different individuals with different degrees of interpersonal skills, reflected in their empathy scores, are attracted to different medical specialties. Keywords: Empathy; Medical Staff, Hospital; Psychometrics.

Male vulnerability explains the occurrence of sexual cannibalism in a moderately sexually dimorphic wolf spider.

Sexual cannibalism is a widespread phenomenon among a few animal taxa. Its occurrence is interpreted as female and/or male optimal reproductive decisions or as a non-adaptive side effect of selection for efficiently foraging females. In spite of the amount of research addressed at understanding its evolutionary origins, we lack accurate information about the proximate causes of sexual cannibalism. In a moderately sexually dimorphic wolf spider (Hogna radiata, Araneae, Lycosidae) we assessed the factors mediating the occurrence of sexual cannibalism and its fitness benefits to females. Sexual cannibalism was a rather common outcome of laboratory mating interactions, occurring in more than a quarter percent of courtship interactions involving virgin females. Sexual cannibalism mostly followed mating. Occurrence of sexual cannibalism depended on male vulnerability to female attacks: relatively smaller males were at higher risk of being attacked and older males were less likely to avoid female attacks. Sexual cannibalism had direct and positive effects on female fitness, as sexually cannibalistic females exhibited increased fecundity irrespective of their size, condition and foraging rate. Male consumption was almost complete and represented a relevant food intake to females. We interpret sexual cannibalism as a strategic foraging decision for H. radiata females that adjust their aggressive behaviour towards males so as to limit its potential costs.