Masked priming under the Bayesian microscope: Exploring the integration of local elements into global shape through Bayesian model comparison.

To investigate whether local elements are grouped into global shapes in the absence of awareness, we introduced two different masked priming designs (e.g., the classic dissociation paradigm and a trial-wise probe and prime discrimination task) and collected both objective (i.e., performance based) and subjective (using the perceptual awareness scale [PAS]) awareness measures. Prime visibility was manipulated using three different prime-mask stimulus onset asynchronies (SOAs) and an unmasked condition. Our results showed that assessing prime visibility trial-wise heavily interfered with masked priming preventing any prime facilitation effect. The implementation of Bayesian regression models, which predict priming effects for participants whose awareness levels are at chance level, provided strong evidence in favor of the hypothesis that local elements group into global shape in the absence of awareness for SOAs longer than 50 ms, suggesting that prime-mask SOA is a crucial factor in the processing of the global shape without awareness.

Does perceptual grouping improve visuospatial working memory? Optimized processing or encoding bias.

Visual working memory has been defined as a system of limited capacity that enables the maintenance and manipulation of visual information. However, some perceptual features like Gestalt grouping could improve visual working memory effectiveness. In two different experiments, we aimed to explore how the presence of elements grouped by color similarity affects the change detection performance of both, grouped and non-grouped items. We combined a change detection task with a retrocue paradigm in which a six item array had to be remembered. An always valid, variable-delay retrocue appeared in some trials during the retention interval, either after 100 ms (iconic-trace period) or 1400 ms (working memory period), signaling the location of the probe. The results indicated that similarity grouping biased the information entered into the visual working memory, improving change detection accuracy only for previously grouped probes, but hindering change detection for non-grouped probes in certain conditions (Exp. 1). However, this bottom-up automatic encoding bias was overridden when participants were explicitly instructed to ignore grouped items as they were irrelevant for the task (Exp. 2).

Cervical spine radiographs in patients with vertigo and dizziness.

OBJECTIVE: The purpose of this study is to investigate the role of cervical radiography in the study of patients with vertigo and dizziness. PATIENTS: This is a retrospective single-institution case series study of 493 patients suffering from vertigo and dizziness who were referred (from January 2011 to December 2012) to the hospital to study those symptoms. METHODS: We studied cervical radiographies, CT and MRI of the cervical spine made in the sample and the radiological findings. We analyzed demographic characteristics, presence of psychiatric pathology and emergency assistance due to vertigo in patients who have undergone cervical study. RESULTS: A total of 57% of patients had cervical radiography made; this was more frequent in women, Spanish people, with psychiatric pathology and who have gone to the emergency department for vertigo (p < 0.05). Degenerative changes were found in 74.1% of the patients with radiography made, more frequently at an older age, osteophytes in 49.5% and abnormal cervical lordosis in 37.1%. CONCLUSIONS: There are sociodemographic factors that influence in the request for cervical radiographs in patients with vertigo and dizziness. Given the suspicion of cervical vertigo, we do not consider that the findings in the radiographs help in the diagnosis. In our opinion, an excessive use of cervical radiography is made in patients with vertigo and dizziness.

Interaction dynamics between grouping principles in touch: phenomenological and psychophysical evidence.

In two experiments, we investigated the interactions between the grouping principles of spatial proximity and texture similarity in touch. For that purpose, we adapted to touch two paradigms widely employed in vision. In Experiment 1, we used an experimental phenomenological task consisting of rating the strength of grouping in both acting alone and conjoined cooperative and competitive conditions. In Experiment 2, participants performed a psychophysical task in which an objective (in)correct response was defined by selectively attending to one grouping cue in different blocks of trials. The results showed that spatial proximity dominated over texture similarity when the two principles were conjoined in competition. In addition, the present results are compatible with an additive model of grouping effects as indicated by the greater grouping effect in the cooperative condition and the smaller grouping effect in the competitive condition relative to a.0cting alone grouping principles. The similarities and differences between vision and touch are discussed.

A randomized clinical trial for the timing of tracheotomy in critically ill patients: factors precluding inclusion in a single center study.

INTRODUCTION: We investigated the potential benefits of early tracheotomy performed before day eight of mechanical ventilation (MV) compared with late tracheotomy (from day 14 if it still indicated) in reducing mortality, days of MV, days of sedation and ICU length of stay (LOS). METHODS: Randomized controlled trial (RCT) including all-consecutive ICU admitted patients requiring seven or more days of MV. Between days five to seven of MV, before randomization, the attending physician (AP) was consulted about the expected duration of MV and acceptance of tracheotomy according to randomization. Only accepted patients received tracheotomy as result of randomization. An intention to treat analysis was performed including patients accepted for the AP and those rejected without exclusion criteria. RESULTS: A total of 489 patients were included in the RCT. Of 245 patients randomized to the early group, the procedure was performed for 167 patients (68.2%) whereas in the 244 patients randomized to the late group was performed for 135 patients (55.3%) (P <0.004). Mortality at day 90 was similar in both groups (25.7% versus 29.9%), but duration of sedation was shorter in the early tracheotomy group median 11 days (range 2 to 92) days compared to 14 days (range 0 to 79) in the late group (P <0.02). The AP accepted the protocol of randomization in 205 cases (42%), 101 were included in early group and 104 in the late group. In these subgroup of patients (per-protocol analysis) no differences existed in mortality at day 90 between the two groups, but the early group had more ventilator-free days, less duration of sedation and less LOS, than the late group. CONCLUSIONS: This study shows that early tracheotomy reduces the days of sedation in patients undergoing MV, but was underpowered to prove any other benefit. In those patients selected by their attending physicians as potential candidates for a tracheotomy, an early procedure can lessen the days of MV, the days of sedation and LOS. However, the imprecision of physicians to select patients who will require prolonged MV challenges the potential benefits of early tracheotomy. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN22208087 . Registered 27 March 2014.

Evaluation of the PaO2/FiO2 ratio after cardiac surgery as a predictor of outcome during hospital stay.

BACKGROUND: The arterial partial pressure of O2 and the fraction of inspired oxygen (PaO2/FiO2) ratio is widely used in ICUs as an indicator of oxygenation status. Although cardiac surgery and ICU scores can predict mortality, during the first hours after cardiac surgery few instruments are available to assess outcome. The aim of this study was to evaluate the usefulness of PaO2/FIO2 ratio to predict mortality in patients immediately after cardiac surgery. METHODS: We prospectively studied 2725 consecutive cardiac surgery patients between 2004 and 2009. PaO2/FiO2 ratio was measured on admission and at 3 h, 6 h, 12 h and 24 h after ICU admission, together with clinical data and outcomes. RESULTS: All PaO2/FIO2 ratio measurements differed between survivors and non-survivors (p < 0.001). The PaO2/FIO2 at 3 h after ICU admission was the best predictor of mortality based on area under the curve (p < 0.001) and the optimum threshold estimation gave an optimal cut-off of 222 (95% Confidence interval (CI): 202-242), yielding three groups of patients: Group 1, with PaO2/FIO2 > 242; Group 2, with PaO2/FIO2 from 202 to 242; and Group 3, with PaO2/FIO2 < 202. Group 3 showed higher in-ICU mortality and ICU length of stay and Groups 2 and 3 also showed higher respiratory complication rates. The presence of a PaO2/FIO2 ratio < 202 at 3 h after admission was shown to be a predictor of in-ICU mortality (OR:1.364; 95% CI:1.212-1.625, p < 0.001) and of worse long-term survival (88.8% vs. 95.8%; Log rank p = 0.002. Adjusted Hazard ratio: 1.48; 95% CI:1.293-1.786; p = 0.004). CONCLUSIONS: A simple determination of PaO2/FIO2 at 3 h after ICU admission may be useful to identify patients at risk immediately after cardiac surgery.

Multicentric glioblastoma multiforme. Report of 3 cases, clinical and pathological study and literature review.

Multicentric gliomas are uncommon lesions of the central nervous system. Their management remains controversial, but histopathologic diagnosis after complete or partial resection must be performed to differentiate these tumors from other multiple cerebral lesions. Three cases of multicentric glioma are presented, one of which had supra- and infratentorial lesions. Histological specimens were obtained from removal of at least one of the lesions. Neuropathological examinations confirmed the diagnosis of grade IV malignant glioma (glioblastoma). All 3 patients died soon after symptom onset. However, one patient, with metachronous glioblastomas, had a comparatively long survival. We discuss the pathogenetic hypotheses and the diagnostic problems, especially the differential diagnosis from other multifocal diseases of the central nervous system.

The HEV Ventilator: at the interface between particle physics and biomedical engineering.

A high-quality, low-cost ventilator, dubbed HEV, has been developed by the particle physics community working together with biomedical engineers and physicians around the world. The HEV design is suitable for use both in and out of hospital intensive care units, provides a variety of modes and is capable of supporting spontaneous breathing and supplying oxygen-enriched air. An external air supply can be combined with the unit for use in situations where compressed air is not readily available. HEV supports remote training and post market surveillance via a Web interface and data logging to complement standard touch screen operation, making it suitable for a wide range of geographical deployment. The HEV design places emphasis on the ventilation performance, especially the quality and accuracy of the pressure curves, reactivity of the trigger, measurement of delivered volume and control of oxygen mixing, delivering a global performance which will be applicable to ventilator needs beyond the COVID-19 pandemic. This article describes the conceptual design and presents the prototype units together with a performance evaluation.

[Attention-deficit/hyperactivity disorder and substance abuse. Scientific evidence]. / Trastorno por déficit de atención/hiperactividad y uso de sustancias. Evidencias científicas.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental alteration of biological basis that started in childhood may persist during adolescence-youth and, despite what was believed until not many years ago, also in adulthood up to 50-60% of those affected, producing a significant clinical and psychosocial deterioration. In spite of being a syndrome easily identifiable by the triad: inattention, hyperactivity and impulsivity that characterizes it, in clinical practice there are different circumstances that hinder and complicate its diagnosis and treatment. One of the most significant is the presence, both in childhood and adulthood, of other comorbid mental disorders. It is from adolescence-youth when together with ADHD we can detect the presence of personality, mood and anxiety disorders and especially the use of several substances. The evidences existing until now show how the comorbidity of ADHD and substance use disorder influence the evolutionary course of both, complicating the approach, the treatment and, therefore, aggravating the final prognosis. The difficulties in their approach and the scarcity of treatment options make us underline the importance of preventive treatment in the infantile stage, starting from psychoeducation programs focused on the vulnerability of these patients to substances and the consequences associated with consumption.

El trastorno por déficit de atención con hiperactividad (TDAH) es una alteración del neurodesarrollo de base biológica que iniciado en la infancia puede persistir durante la adolescencia-juventud y, a pesar de lo que se pensaba hasta hace no muchos años, también en la edad adulta hasta en un 50-60% de los afectados, produciendo un notable deterioro clínico y psicosocial. A pesar de tratarse de un síndrome fácilmente identificable por la triada: desatención, hiperactividad e impulsividad que le caracteriza, en la práctica clínica existen diferentes circunstancias que dificultan y complican su diagnóstico y tratamiento. Una de las más significativas es la presencia, tanto en la infancia como en la edad adulta, de otros trastornos mentales comórbidos. Es a partir de la adolescencia-juventud cuando junto al TDAH podemos detectar la presencia de trastornos de la personalidad, trastornos del estado de ánimo, trastornos de ansiedad y muy especialmente trastornos por uso de sustancias. Las evidencias existentes hasta el presente muestran como la comorbilidad del TDAH y el trastorno por uso de sustancias influyen en el curso evolutivo de ambos, complicando el abordaje, el tratamiento y consecuentemente agravando el pronóstico final. Las dificultades en su abordaje y la escasez de opciones de tratamiento nos hacen subrayar la importancia del tratamiento preventivo en la etapa infantil a partir de programas de psicoeducación centrados en la vulnerabilidad de estos pacientes a las sustancias y las consecuencias asociadas al consumo.

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: An Initial Cluster Randomized Wait-List-Controlled Trial.

Anxiety and depression are common debilitating conditions that show high comorbidity rates in adolescence. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A; Ehrenreich-May et al., 2018) is one of the few existing resources aimed at applying transdiagnostic treatment principles across the core dysfunctions implicated in the development of both anxiety and depression using a single protocol. This is the first known controlled study to examine the efficacy of the UP-A adapted as a nine-session universal preventive intervention program delivered in a school setting. A total of 151 students (mean age: 15.05) participated in this randomized wait-list-controlled trial conducted in Madrid, Spain. An unexpected decline in anxiety and depression levels from pre- to posttreatment and follow-up was found in both groups (p = .009, d = -0.22), and overall differences between conditions did not reach significance. Exploratory analyses of baseline emotional symptom severity as a potential predictor trended toward a significantly greater decrease in symptoms of depression for those with greater baseline emotional symptoms in the UP-A group compared to the wait-list-control group. Future trials with larger samples are justified to estimate the effect of the UP-A adapted as a selective prevention program for anxiety and depression.

Effects of multidomain versus single-domain training on executive control and memory in older adults: study protocol for a randomized controlled trial.

BACKGROUND: Previous research suggests that both cognitive training and physical exercise help to maintain brain health and cognitive functions that decline with age. Some studies indicate that combined interventions may produce larger effects than each intervention alone. The aim of this study is to investigate the effects of combined cognitive and physical training compared to cognitive training and physical training alone on executive control and memory functions in healthy older adults. OBJECTIVES: The main objectives of this four-arm randomized controlled trial (RCT) are: to investigate the synergetic effects of a simultaneous, group-based multidomain training program that combines cognitive video-game training with physical exercise, in comparison to those produced by cognitive training combined with physical control activity, physical training combined with cognitive control activity, or a combination of both control activities; to investigate whether event-related potential latencies of the P2 component are shorter and N2 and P3b components assessed in a memory-based task switching task are enhanced after training; and to find out whether possible enhancements persist after a 3-month period without training. METHODS: In this randomized, single-blind, controlled trial, 144 participants will be randomly assigned to one of the four combinations of cognitive training and physical exercise. The cognitive component will be either video-game training (cognitive intervention, CI) or video games not specifically designed to train cognition (cognitive control, CC). The physical exercise component will either emphasize endurance, strength, and music-movement coordination (exercise intervention, EI) or stretching, toning, and relaxation (exercise control, EC). DISCUSSION: This RCT will investigate the short and long-term effects of multidomain training, compared to cognitive training and physical training alone, on executive control and memory functions in healthy older adults, in comparison with the performance of an active control group. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03823183. Registered on 21 January 2019.

Behavioral and electrophysiological correlates of interactions between grouping principles in touch: Evidence from psychophysical indirect tasks.

In two experiments we investigated the behavioral and brain correlates of the interactions between spatial-proximity and texture-similarity grouping principles in touch. We designed two adaptations of the repetition discrimination task (RDT) previously used in vision. This task provides an indirect measure of grouping that does not require explicit attention to the grouping process. In Experiment 1, participants were presented with a row of elements alternating in texture except for one pair in which the same texture was repeated. The participants had to decide whether the repeated texture stimuli (similarity grouping) were smooth or rough, while the spatial proximity between targets and distractors was varied either to facilitate or hinder the response. In Experiment 2, participants indicated which cohort (proximity grouping) contained more elements, while texture-similarity within and between cohorts was modified. The results indicated additive effects of grouping cues in which proximity dominated the perceptual grouping process when the two principles acted together. In addition, the independent component analysis (ICA) performed on electrophysiological data revealed the implication of a widespread network of sensorimotor, prefrontal, parietal and occipital brain areas in both experiments.

Effects of Nonaction Videogames on Attention and Memory in Young Adults.

Objective: In this intervention study, we investigated the benefits of nonaction videogames on measures of selective attention and visuospatial working memory (WM) in young adults. Materials and Methods: Forty-eight young adults were randomly assigned to the experimental group or to the active control group. The experimental group played 10 nonaction adaptive videogames selected from Lumosity, whereas the active control group played two nonadaptive simulation-strategy games (SimCity and The Sims). Participants in both groups completed 15 training sessions of 30 minutes each. The training was conducted in small groups. All the participants were tested individually before and after training to assess possible transfer effects to selective attention, using a Cross-modal Oddball task, inhibition with the Stroop task, and visuospatial WM enhancements with the Corsi blocks task. Results: Participants improved videogame performance across the training sessions. The results of the transfer tasks show that the two groups benefited similarly from game training. They were less distracted and improved visuospatial WM. Conclusion: Overall, there was no significant interaction between group (group trained with adaptive nonaction videogames and the active control group that played simulation games) and session (pre- and post-assessment). As we did not have a passive nonintervention control group, we cannot conclude that adaptive nonaction videogames had a positive effect, because some external factors might account for the pre- and post-test improvements observed in both groups.

Cathelicidin Peptides Restrict Bacterial Growth via Membrane Perturbation and Induction of Reactive Oxygen Species.

All metazoans produce antimicrobial peptides (AMPs) that have both broad antimicrobial and immunomodulatory activity. Cathelicidins are AMPs that preferentially kill Gram-negative bacteria in vitro, purportedly by assembling into higher-order structures that perforate the membrane. We utilized high-resolution, single-cell fluorescence microscopy to examine their mechanism of action in real time. Engineered cathelicidins rapidly bound to Gram-negative and Gram-positive cells and penetrated the cytoplasmic membrane. Rapid failure of the peptidoglycan superstructure in regions of active turnover caused leakage of cytoplasmic contents and the formation of membrane-bound blebs. A mutation anticipated to destabilize interactions between cathelicidin subunits had no effect on bactericidal activity, suggesting that cathelicidins have activities beyond perforating the membrane. Nanomolar concentrations of cathelicidins, although not bactericidal, reduced the growth rate of Gram-negative and Gram-positive bacteria. The cells exhibited expression changes in multiple essential processes, including protein synthesis, peptidoglycan biosynthesis, respiration, and the detoxification of reactive oxygen species (ROS). Time-lapse imaging revealed that ROS accumulation preceded bleb formation, and treatments that reduced cellular ROS levels overcame these bactericidal effects. We propose that that the primary effect of cathelicidins is to induce the production of ROS that damage bacterial molecules, leading to slowed growth or cell death. Given their low circulating levels in vivo, AMPs may serve to slow bacterial population expansion so that cellular immunity systems can respond to and battle the infection.IMPORTANCE Antimicrobial peptides (AMPs) are an important part of the mammalian innate immune system in the battle against microbial infection. How AMPs function to control bacteria is not clear, as nearly all activity studies use nonphysiological levels of AMPs. We monitored peptide action in live bacterial cells over short time frames with single-cell resolution and found that the primary effect of cathelicidin peptides is to increase the production of oxidative molecules that cause cellular damage in Gram-positive and Gram-negative bacteria.

Alpha and beta band correlates of haptic perceptual grouping: Results from an orientation detection task.

Behavioral and neurophysiological findings in vision suggest that perceptual grouping is not a unitary process and that different grouping principles have different processing requirements and neural correlates. The present study aims to examine whether the same occurs in the haptic modality using two grouping principles widely studied in vision, spatial proximity and texture similarity. We analyzed behavioral responses (accuracy and response times) and conducted an independent component analysis of brain oscillations in alpha and beta bands for haptic stimuli grouped by spatial proximity and texture similarity, using a speeded orientation detection task performed on a novel haptic device (MonHap). Behavioral results showed faster response times for patterns grouped by spatial proximity relative to texture similarity. Independent component clustering analysis revealed the activation of a bilateral network of sensorimotor and parietal areas while performing the task. We conclude that, as occurs in visual perception, grouping the elements of the haptic scene by means of their spatial proximity is faster than forming the same objects by means of texture similarity. In addition, haptic grouping seems to involve the activation of a network of widely distributed bilateral sensorimotor and parietal areas as reflected by the consistent event-related desynchronization found in alpha and beta bands.

[Flexibility competencies: emotional organization management]. / Competencias para la flexibilidad: la gestión emocional de las organizaciones.

The aim of this article is to analyse the transferral of flexibility from contemporary organizations to workers. Through the approach of management by competencies, organizations try to develop in their workers behaviours that are related to efficient job performance. In order to appraise the importance of this approach, we used a critical-rational perspective to discuss the productivity demands that are characteristic of advanced industrial societies. The article shows how the link between workers' flexibility management and their emotional competencies affects their lives, which, like the organizations, should be versatile and adaptable to change.

Effects of Video Game Training on Measures of Selective Attention and Working Memory in Older Adults: Results from a Randomized Controlled Trial.

Video game training with older adults potentially enhances aspects of cognition that decline with aging and could therefore offer a promising training approach. Although, previous published studies suggest that training can produce transfer, many of them have certain shortcomings. This randomized controlled trial (RCT; Clinicaltrials.gov ID: NCT02796508) tried to overcome some of these limitations by incorporating an active control group and the assessment of motivation and expectations. Seventy-five older volunteers were randomly assigned to the experimental group trained for 16 sessions with non-action video games from Lumosity, a commercial platform (http://www.lumosity.com/) or to an active control group trained for the same number of sessions with simulation strategy games. The final sample included 55 older adults (30 in the experimental group and 25 in the active control group). Participants were tested individually before and after training to assess working memory (WM) and selective attention and also reported their perceived improvement, motivation and engagement. The results showed improved performance across the training sessions. The main results were: (1) the experimental group did not show greater improvements in measures of selective attention and working memory than the active control group (the opposite occurred in the oddball task); (2) a marginal training effect was observed for the N-back task, but not for the Stroop task while both groups improved in the Corsi Blocks task. Based on these results, one can conclude that training with non-action games provide modest benefits for untrained tasks. The effect is not specific for that kind of training as a similar effect was observed for strategy video games. Groups did not differ in motivation, engagement or expectations.

Effects of Video Game Training on Behavioral and Electrophysiological Measures of Attention and Memory: Protocol for a Randomized Controlled Trial.

BACKGROUND: Neuroplasticity-based approaches seem to offer promising ways of maintaining cognitive health in older adults and postponing the onset of cognitive decline symptoms. Although previous research suggests that training can produce transfer effects, this study was designed to overcome some limitations of previous studies by incorporating an active control group and the assessment of training expectations. OBJECTIVE: The main objectives of this study are (1) to evaluate the effects of a randomized computer-based intervention consisting of training older adults with nonaction video games on brain and cognitive functions that decline with age, including attention and spatial working memory, using behavioral measures and electrophysiological recordings (event-related potentials [ERPs]) just after training and after a 6-month no-contact period; (2) to explore whether motivation, engagement, or expectations might account for possible training-related improvements; and (3) to examine whether inflammatory mechanisms assessed with noninvasive measurement of C-reactive protein in saliva impair cognitive training-induced effects. A better understanding of these mechanisms could elucidate pathways that could be targeted in the future by either behavioral or neuropsychological interventions. METHODS: A single-blinded randomized controlled trial with an experimental group and an active control group, pretest, posttest, and 6-month follow-up repeated measures design is used in this study. A total of 75 cognitively healthy older adults were randomly distributed into experimental and active control groups. Participants in the experimental group received 16 1-hour training sessions with cognitive nonaction video games selected from Lumosity, a commercial brain training package. The active control group received the same number of training sessions with The Sims and SimCity, a simulation strategy game. RESULTS: We have recruited participants, have conducted the training protocol and pretest assessments, and are currently conducting posttest evaluations. The study will conclude in the first semester of 2017. Data analysis will take place during 2017. The primary outcome is transfer of benefit from training to attention and working memory functions and the neural mechanisms underlying possible cognitive improvements. CONCLUSIONS: We expect that mental stimulation with video games will improve attention and memory both at the behavioral level and in ERP components promoting brain and mental health and extending independence among elderly people by avoiding the negative personal and economic consequences of long-term care. TRIAL REGISTRATION: Clinicaltrials.gov NCT02796508; https://clinicaltrials.gov/ct2/show/NCT02796508 (archived by WebCite at http://www.webcitation.org/6nFeKeFNB).

Aplicación del método canguro durante la vacunación en población pediátrica / Application of Kangaroo-Mother care method (development-focused care) during vaccination in pediatric population

Objetivo principal: Comparar el dolor de niños menores de 12 meses durante la vacunación inyectada, aplicada con técnica convencional (TCon) o técnica canguro (TC), y evaluar nivel de satisfacción de padres con estas técnicas. Metodología: Estudio transversal con 70 niños en consultas de enfermería pediátrica de Atención Primaria. Se evaluó dolor inmediato tras vacunación con escala LLANTO y nivel de satisfacción de padres con escala “semáforo”. Se analizaron datos con prueba t-Student, análisis de varianza, regresión lineal, prueba de Bonferroni y análisis multivariante. Resultados principales: La puntuación media de dolor de niños vacunados con TC (1,43 ± 0,6) fue menor respecto a los vacunados con TCon (3,94 ± 1,3 puntos), siendo la diferencia estadísticamente significativa (p<0,001). El nivel de satisfacción de padres fue mayor en los vacunados con TC (83,3 % VS 3,3 %). Conclusión principal: El grupo TC mostró menores puntuaciones de dolor y mayor nivel de satisfacción de los padres.(AU)

Objective: To compare pain showed in children under 12 months during vaccine injection, applied either with conventional technique (CT) or kangaroo-mother care method (KC), and to assess satisfaction level of parents with these techniques. Methods: Cross-sectional study with 70 children in pediatrics nursing consultations in Primary Healthcare. Immediate pain after vaccination was assessed with LLANTO scale and satisfaction level of parents was assessed with “signal” scale. Data were analyzed with Student-t test, analysis of variance, lineal regression, Bonferroni test and multivariate analysis. Results: The mean pain score of the children vaccinated with KC (1.43 ± 0.6) was lower than those vaccinated with the CT (3.94 ± 1.3 points), being statistically significant difference (p<0.001). The satisfaction level of parents was higher in children vaccinated with KC (83.3% VS 3.3%). Conclusions: The CT group showed lower pain scores and higher satisfaction level of parents.(AU)

Prognostic factors for cancer of the oral cavity.

OBJECTIVE: A survival analysis was conducted on 101 patients with oral cancer to determine the influence of certain clinical and pathological parameters on survival. METHODS: Kaplan-Meier analysis and Cox proportional hazard models were used to assess survival and estimate hazard ratios adjusted for potential confounders. RESULTS: Survival rates were influenced by tumor diameter (P = .030), clinical T (P = .028), clinical N (P = .019), clinical stage (P = .006), lymph node involvement (P = .003) and histologic malignancy grade (P = .0063). The multivariate analysis included only 1 variable, the lymph node involvement. For clinical stage, the mean histologic malignancy grade was 1.71, 2.27, 2.53, and 2.61, respectively, for stages I through IV (r(s) = 0.423, P < .001). CONCLUSION: This study proposes considering the tumor size as the most significant clinical variable for predicting the survival of oral cancer patients at the time of diagnosis and the degree of lymph node involvement after the treatment.