Characterization of Brazilian Cordyceps fumosorosea isolates: Conidial production, tolerance to ultraviolet-B radiation, and elevated temperature.

Cordyceps fumosorosea is an entomopathogenic fungus with a global distribution and is used for the biological control of agricultural pests. High conidial productivity and tolerance to abiotic stresses such as elevated temperature and ultraviolet radiation (UV-B) are desired characteristics in candidate isolates for commercial products. Our goal in this study was to characterize promising isolates of C. fumosorosea from five Brazilian biomes regarding conidial production, tolerance to UV-B, and elevated temperature (45°). Seventy-two isolates out of 172 were chosen visually, based on growth and sporulation in culture medium, and grown on parboiled rice. Next, fourteen isolates were selected, based on productivity on rice and origin of isolation, for production in polypropylene bags and submitted to UV-B for 2, 4, 6, and 8 h or to 45 °C for 30, 60, and 90 min. High variations in conidial production were observed among isolates, and a positive correlation was observed between UV-B and heat tolerance. The isolates ESALQ4556 and ESALQ4778 showed the highest yields of conidial production in polypropylene bags (3.51 × 109 conidia/g dry rice), while ESALQ1296, an isolate recovered from insects, was the most tolerant to UV-B and 45 °C. Exposure to radiation for more than 4 h and placed directly at 45 °C for more than 30 min significantly reduced conidial germination for all C. fumosorosea isolates. These results contribute to a better understanding of the tolerance to abiotic factors of Brazilian isolates of C. fumosorosea.

45,X/46,XY Mosaicism with Male Phenotype: Case Report.

Mixed gonadal dysgenesis is the most common chromosomal abnormality with ambiguous genitalia, defined as a 45,X/46,XY mosaicism. It can present with a normal male phenotype, ambiguous genitalia, or features of Turner syndrome. A 14-year-old patient was referred to the genetics clinic due to hypospadia, cryptorchidism, and aortic coarctation. During the physical examination, short stature, webbed neck, and Blashko lines on his back were noted. He had a previous karyotype reported as normal. However, due to an inadequate evolution and a low resolution on the previous test, a higher resolution karyotype was performed, identifying a mosaicism 45,X/46,XY. A multidisciplinary board examined the case, and follow-up with tumor markers was carried out to evaluate the presence of gonadoblastoma, one of the main complications in these patients. Treatment should be transdisciplinary and focused on the particular characteristics of each case. Other treatment alternatives include corrective surgery and hormonal therapy.

Transcriptional profiles along cell programming into corneal epithelial differentiation.

Using the rabbit corneal epithelial cell line RCE1(5T5) as a model, we analyzed three differentiation stages, distinguished on basis to the growth state of cultured cells and after studying the expression of transcription factors such as Oct4, Pax6 and ΔNp63α, selected differentiation markers, and signaling or epigenetic markers such as Notch receptors and Prdm3. Namely, proliferative non-differentiated cells, committed cells, and cells that constitute a stratified epithelium with a limbal epithelial-like structure. RNAseq based transcriptome analysis showed that 4891 genes were differentially expressed among these stages displaying distinctive gene signatures: proliferative cells had 1278 genes as gene signature, and seem to be early epithelial progenitors with an Oct4+, KLF4+, Myc+, ΔNp63α+, ABCG2+, Vimentin+, Zeb1+, VANGL1+, Krt3-, Krt12- phenotype. Committed cells had a gene signature with 417 genes and displayed markers indicative of the beginning of corneal differentiation, and genes characteristic of proliferative cells; we found the possible participation of Six3 and Six4 transcription factors along this stage. The third stage matches with a stratified corneal epithelium (gene signature comprising 979 genes) and is typified by an increase in the expression of WNT10A and NOTCH 2 and 3 signaling and Cux1 transcription factor, besides Pax6, KLF4 or Sox9. The differentiated cells express about 50% of the genes that belong to the Epidermal Differentiation Complex (EDC). Analysis of the differences between corneal epithelium and epidermis could be crucial to understand the regulatory mechanisms that lead to the expression of the differentiated phenotype.

BRCA mutations: is everything said?

BACKGROUND: Mutations in the BRCA1 and BRCA2 genes constitute a risk factor for breast cancer development. BRCA mutation research has been an active field since the discovery of the genes, and new mutations in both genes are constantly described and classified according to several systems. AIM: We intend to provide an overview of the current state of BRCA1 and BRCA2 mutation description and classification. We wanted to know whether there was a trend towards a more frequently described mutation type and what the proportion of pathogenic mutations was. RESULTS: We found that, although new mutations are described each year as reflected in current database records, very few of them are reported in papers. Classification systems are highly heterogeneous and a consensus among them is still under development. Regarding their function, a large number of mutations are yet to be analyzed, a very complex task, due to the great number of possible variations and their diverse effect in the BRCA gene functions. After individual analysis, many variants of unknown significance turn out to be pathogenic, and many can disrupt interactions with other proteins involved in mechanisms such as DNA damage repair pathways. Recent data suggest that looking for mutation patterns or combinations would shed a wider light on BRCA-derived cancer susceptibility in the upcoming years.

Comparison of clinical and electromyographic rest vertical dimensions in dolichofacial and brachyfacial young adults: A cross-sectional study.

STATEMENT OF PROBLEM: Therapeutic procedures that increase occlusal vertical dimension (OVD) may have different responses in patients with different craniofacial vertical patterns. The effect on these patients of increasing their OVD is not well understood. PURPOSE: The purpose of this clinical study was to compare measurements of vertical jaw separation (VJS) in patients with brachyfacial and dolichofacial craniofacial patterns in 2 vertical dimensions: the clinical rest/postural vertical dimension (CR/PVD) and electromyographic rest vertical dimension (EMGRVD). MATERIAL AND METHODS: Sixty healthy dental students were selected at random after a lateral skull radiograph was made. The Ricketts (VERT index) analysis was used to determine 30 brachyfacial (G1) and 30 dolichofacial (G2) types. The VJS was measured for G1 and G2 types in the 2 rest vertical dimensions specified. CR/PVD was recorded using 2 methods: swallowing (CR/PVD-P1) and the phonetic breathing method (CR/PVD-P2). The Shapiro-Wilk test was used for data distribution, and the Mann-Whitney U test was used to accept or reject the null hypothesis (α=.05). RESULTS: Mean VJS in CR/PVD-P1 was 1.92 ±1.14 mm for the brachyfacial and 1.36 ±0.58 mm for the dolichofacial facial group (P=.05). The mean VJS in CR/PVD-P2 was 1.89 ±1.17 mm for the brachyfacial and 1.31 ±0.58 mm for the dolichofacial group (P=.03). The mean VJS in EMGRVD was 8.23 ±2.21 mm for the brachyfacial and 16.55 ±4.29 mm the dolichofacial group (P<.001). CONCLUSIONS: CR/PVD measurements in dolichofacial individuals were lower than those in brachyfacial individuals. EMGRVD measurements were higher in dolichofacial individuals than those in brachyfacial individuals. Biomechanical, physiological, and behavioral reasons might explain such diversity.

[Potential distribution and geographic characteristics of wild populations of Vanilla planifolia (Orchidaceae) Oaxaca, Mexico]. / Distribución potencial y características geográficas de poblaciones silvestres de Vanilla planifolia (Orchidaceae) en Oaxaca, México.

Wild specimens of Vanilla planifolia represent a vital part of this resource primary gene pool, and some plants have only been reported in Oaxaca, Mexico. For this reason, we studied its geographical distribution within the state, to locate and describe the ecological characteristics of the areas where they have been found, in order to identify potential areas of establishment. The method comprised four stages: 1) the creation of a database with herbarium records, 2) the construction of the potential distribution based on historical herbarium records for the species, using the model of maximum entropy (MaxEnt) and 22 bioclimatic variables as predictors; 3) an in situ systematic search of individuals, based on herbarium records and areas of potential distribution in 24 municipalities, to determine the habitat current situation and distribution; 4) the description of the environmental factors of potential ecological niches generated by MaxEnt. A review of herbarium collections revealed a total of 18 records of V. planifolia between 1939 and 1998. The systematic search located 28 plants distributed in 12 sites in 95 364 Km(2). The most important variables that determined the model of vanilla potential distribution were: precipitation in the rainy season (61.9 %), soil moisture regime (23.4 %) and precipitation during the four months of highest rainfall (8.1 %). The species potential habitat was found to be distributed in four zones: wet tropics of the Gulf of Mexico, humid temperate, humid tropical, and humid temperate in the Pacific. Precipitation oscillated within the annual ranges of 2 500 to 4 000 mm, with summer rains, and winter precipitation as 5 to 10 % of the total. The moisture regime and predominating climate were udic type I (330 to 365 days of moisture) and hot humid (Am/A(C) m). The plants were located at altitudes of 200 to 1 190 masl, on rough hillsides that generally make up the foothills of mountain systems, with altitudes of 1 300 to 2 500 masl. In natural conditions, distribution of the species is not limited to high evergreen forests, since it was also found in mountain mesophyll and tropical evergreen forests. The location of new specimens of V. planifolia in its wild condition reduces the potential distribution area by 66 %. This area is fragmented into three geographically separated areas. Habitat reduction was due to the increased number of located plants that define the environmental conditions into a more accurate level. Conservation actions can thus be designed and implemented, focusing on more specific areas within the state of Oaxaca, Mexico.

Morphological effects of mesenchymal stem cells and pulsed ultrasound on condylar growth in rats: a pilot study.

AIM: The aim of this study was to assess and describe the morphological effects of an intra-articular iniection of Mesenchymal Stem Cells (MSCs) and/or Low Intensity Pulsed Ultrasound (LIPUS) stimulation on the mandibular condyles of growing rats, using cone beam computed tomography (CBCT) and histology. METHODS: Twenty-six young (23-day-old) rats were divided into 5 groups identified as LIPUS-stimulated (20 minutes daily using 50 mW/cm2, 1MHz, 0.2 millisecond pulses), MSCs injected (1 x 10(5) cells/kg), LIPUS + MSCs, medium inlected, and untreated controls. All treatments were performed in the left temporomandibular joint of each rat (TMJs). At day 21, CBCTs were obtained for cephalometric analysis and 3D reconstructions. After animal sacrifice, left and right TMJ sections were histologically prepared and examined. The Wilcoxon sign rank test and the Kruskal-Wallis 2 test were applied for statistical comparison. RESULTS: Imaging results showed that left condyles were wider in all LIPUS-treated groups (p < 0.05), while the LIPUS-only group had a greater left sagittal condylar length. LIPUS-treated groups displayed a lower midline shift to the right (p < 0.02). No significant differences were observed in the MSC group. Bone marrow morphology and vascularity differed between the groups as LIPUS-treated groups exhibited increased vascularity in the erosive cartilage zone. CONCLUSION: It was established that LIPUS and MSC application to the TMJ region of growing rats favoured transverse condylar growth, while LIPUS application alone may enhance sagittal condylar development.The MSC injection model had little effect on sagittal condylar growth.

Comparison of the shear bond strength of new and recycled metallic brackets using different adhesive materials : an in vitro study.

Purpose: To evaluate and compare shear bond strength (SBS) of new and recycled metallic brackets bonded to conditioned and reconditioned enamel, using two different adhesive materials. Materials and methods: 72 extracted sound human premolars were randomly divided into 6 groups. Transbond XT light cured composite (LCC) and Fuji Ortho LC resin-modified glass ionomer (RMGI), were used as adhesive materials. In groups 1 and 2 (control), new brackets were bonded to sound premolars using either LCC or RMGI, respectively. In Groups 3 and 4, new brackets were bonded to reconditioned enamel; and in groups 5 and 6, sandblasted recycled brackets were rebonded to reconditioned enamel. After 5.000 thermal cycles between 5ºC and 55ºC, SBS was evaluated and adhesive remnant on the enamel assessed using the ARI index. Statistical analyses included Shapiro-Wilk, ANOVA, Fligner-Killeen ANOVA and Tukey tests. Results: The statistical analysis showed no significant difference in SBS comparing control and experimental groups for either new or recycled brackets (p = 0.848). The SBS was significantly higher in brackets bonded with LCC (15.7 MPa) than RMGI (11.6 MPa) (p = 0.006). Adhesive failure was the most frequent, with the adhesive remnant covering more than 50% of the bracket base. Conclusion: No significant differences were observed in SBS using either new or recycled brackets, regardless of the dental surface treatment (conditioned or reconditioned). Significantly higher SBS values were obtained with LCC adhesive. Adhesive failure prevails in all groups.

Comparison of shear bond strength of metal orthodontic brackets bonded to a CAD/CAM prosthetic provisional material after the use of a self-adhesive resin cement versus a light adhesive paste and different surface conditioning protocols: An in vitro study.

BACKGROUND: Adult orthodontic treatment has been increasingly popular, and brackets may need to be bonded to provisional crowns, including CAD/CAM crowns. The use of self-adhesive resin cement or light adhesive paste have been suggested with different surface conditioning protocols to improve the adhesion to CAD/CAM PMMA provisional crowns. Objective To determine and compare the in vitro shear bond strength (SBS) of metal brackets bonded to a provisional prosthetic CAD/CAM material after the use of different adhesive cements and surface conditioning protocols. MATERIALS AND METHODS: One hundred twenty Telio® CAD specimens were manufactured in 12 groups (n=10). Each specimen was bonded to a metal bracket and divided according to adhesive technique (3M™Transbond™ XT Light Cure Paste or 3M™RelyX™ U200) surface treatment (macroretentions) and the use of silane. Half of the specimens were thermocycled (5000 cycles, 5°C/55°C water baths). The SBS test was carried out using a shear bond strength tester, and the type of adhesive failure was determined by means of the adhesive remnant index. The data were analysed with the Mann-Whitney test (α=0.05). RESULTS: Statistically significant differences (P<0.001) in SBS were found among the groups. The group with macroretentions, silane, and not thermocycled was the one that obtained the highest average value (17.31±4.89MPa). The lowest average value was the group without macroretentions, without silane, and thermocycled (3.4±3.37MPa). CONCLUSION: The shear bond strength of brackets to provisional prosthetic CAD/CAM materials depended on the type of adhesive, surface treatment, and aging by thermocycling.

Comparative study of molar and incisor bite forces regarding deciduous, mixed, and definitive dentition.

Objective: To compare maximum incisor (MBFinc) and molar (MBFmol) bite forces regarding the type of dentition and sex and to establish a relationship between them.Methods: One hundred-five individuals were divided into 3 groups: G1 - 22 females/13 males (4-5 years); G2 - 15 females/20 males (11-12 years); and G3 - 16 females/19 males (17- 18 years). The maximum bite force was recorded with an extraoral measuring device. Three measurements were recorded: right and left molar level (MBFmol) and incisor level (MBFinc). The ratio %MBFinc/MBFmol was determined.Results: MBFmol and MBFinc values increased with age (p < 0.05). MBFmol showed statistically higher values than MBFinc (p < 0.05), when compared within the same group.Conclusion: MBFinc and MBFmol increased with age. For all groups, MBFmol showed higher values than MBFinc, and %MBFinc/MBFmol ratio was 1:2. No differences were found in maximum bite force between sexes.

Comparison of the primary stability of orthodontic miniscrews after repeated insertion cycles.

OBJECTIVES: To compare the primary stability of miniscrews after repeated cycles of insertion through insertion torque (IT) measurements and resonance frequency analysis (RFA). MATERIALS AND METHODS: Sixty titanium miniscrews were divided into two groups according to the insertion protocol: one with predrilled sites and the other self-drilled into porcine iliac crest bone specimens. Each group had three cycles of reinsertion. After each insertion, the IT and RFA were measured. The IT was measured by using a torque meter, and the RFA was measured using the Osstell ISQ device. A total of five miniscrews of each group were selected for sequential assessment of the morphology of their tip and threads using scanning electron microscopy after each insertion cycle. RESULTS: No statistically significant differences were found in the IT values of miniscrews reinserted up to three times in the group with predrilled surgical sites. The IT value increased significantly with the number of reinsertions in the self-drilled group. The RFA value decreased as the number of insertions increased in both groups. CONCLUSIONS: Under the conditions of this in vitro study, reinserting miniscrews deteriorates the integrity of their tip and thread. Reinsertion should be discouraged particularly when insertion sites are not predrilled.

Shear bond strength evaluation of metallic brackets bonded to a CAD/CAM PMMA material compared to traditional prosthetic temporary materials: an in vitro study.

INTRODUCTION: Orthodontic treatment for adults is currently increasing, and therefore the need to bond brackets to restorations and temporary crowns. The use of CAD/CAM PMMA provisional restorations for orthodontic purposes have not yet been described, and there is currently insufficient information regarding the strength of bracket adhesion. OBJECTIVE: This study aimed at evaluating the effects of thermocycling (TC) and surface treatment on shear bond strength (SBS) of brackets to different provisional materials. METHODS: Forty specimens were made from each material [PMMA (Telio Lab), bis-acryl (Telio CS C&B), and PMMA CAD/CAM (Telio CAD)], sandpapered, and divided according to surface treatment (pumiced or sandblasted) and TC (half of the samples = 1,000 cycles, 5°C/55°C water baths) (n = 10/group). Stainless-steel brackets were bonded to the specimens (using Transbond XT), and SBS testing was performed. Data were analyzed by three-way ANOVA and LSD post-hoc tests (α = 0.05). Failure types were classified with adhesive remnant index (ARI) scores. RESULTS: SBS values ranged from 1.5 to 14.9 MPa. Sandblasted bis-acryl and sandblasted auto-curing PMMA groups presented similar values (p> 0.05), higher than the CAD/CAM material (p< 0.05), with or without TC. When thermocycled, pumiced bis-acryl showed higher SBS than pumiced acrylic (p= 0.005) and CAD/CAM materials (p= 0.000), with statistical difference (p= 0.009). TC showed negative effect (p< 0.05) for sandblasted bis-acryl and pumiced acrylic groups. ARI predominant score was mostly zero (0) for CAD/CAM, 1 and 2 for bis-acryl, and 1 for acrylic groups. CONCLUSION: In general, bis-acryl material showed the highest SBS values, followed by acrylic and CAD/CAM materials, which showed SBS values lower than an optimum strength for bonding brackets.

Association between antenatal steroids for lung maturation and hypoglycaemia in the first 48 hours in premature infants between 26 and 34 weeks of gestational age.

INTRODUCTION: Hypoglycaemia is frequent in premature infants and can generate neurological alterations. There is controversy concerning exposure to antenatal corticosteroids for pulmonary maturation and hypoglycaemia. AIM OF THE STUDY: To evaluate whether there is a relationship between neonatal hypoglycaemia and the use of antenatal corticosteroids for lung maturation in preterm infants between 26 and 34 weeks of gestational age, and to correlate this with other variables. MATERIAL AND METHODS: A prospective closed cohort study in preterm infants between 26 and 34 weeks of gestation, who were born in the University Hospital of Santander (HUS) between 2017 and 2018, divided into two cohorts: exposed and not exposed to antenatal corticosteroids for lung maturation. The data was analysed using Stata 12.0 Software. RESULTS: Of 173 preterm infants, 152 (87.9%) received lung maturation. There were no significant differences between the maternal characteris-tics of both cohorts. In the neonatal group, sex, gestational age, birth weight, Apgar score, and glucose infusion rate were evaluated without significant differences. The cumulative incidence of hypoglycaemia in the first 48 hours was 28.6% in those not exposed to antenatal corticosteroids and 25.4% among the exposed ones (RR 0.875, IC95% 0.421-1.815), while the incidence density of hypogly-caemia was 8.80 and 6.36 events/1000 person-hours, respectively (HR 0.743 IC95% 0.314-1.759). CONCLUSIONS: There was no significant difference in the incidence of hypoglycaemia among those exposed and those not exposed to antenatal steroids for lung maturation in this study.

Impacto psicológico y estrategias innovadoras incluyentes de la gestión por procesos de habilidades para aprender a cuidar la salud mental

Fundamento: Las estrategias innovadoras incluyen a la gestión por procesos para evitar que trabajadores resulten propensos a tener dificultades en su desempeño a causa del impacto psicológico. Resulta necesario que la administración adopte procesos de aprendizaje para el desarrollo de habilidades sociales que permitan el cuidado de la salud mental de los trabajadores y contrarrestar el efecto negativo del impacto psicológico. Objetivo: Determinar la influencia en el impacto psicológico de las estrategias innovadoras con habilidades sociales para cuidar la salud mental desarrolladas mediante el aprendizaje por indagación en la gestión por procesos. Métodos: Se realizó un estudio transversal, no experimental, con alcance descriptivo y correlacional y un enfoque cuantitativo. La muestra fue de 64 trabajadores de la subgerencia de educación, salud y deportes de una municipalidad. Para la recopilación de la información de las variables definidas se utilizaron cuestionarios empleados en investigaciones efectuadas en Perú. La hipótesis nula fue: no influye en el impacto psicológico las estrategias innovadoras que incluyen la gestión por procesos de habilidades sociales adquiridas mediante aprendizaje por indagación para cuidar la salud mental de los trabajadores de una municipalidad del Perú. Resultados: Existió una relación entre el impacto psicológico y las estrategias innovadoras que incluyen la gestión por procesos, determinada por las habilidades sociales adquiridas mediante el aprendizaje por indagación para cuidar la salud mental; con una relación de 0,86 y un nivel de significación de 0,000. Conclusiones: Existe alta influencia en el impacto psicológico de las estrategias innovadoras que incluyen a la gestión por procesos de las habilidades sociales desarrolladas mediante el aprendizaje por indagación para cuidar la salud mental de los trabajadores.

Foundation: Innovative strategies include process management to prevent workers from being prone to difficulties in their performance due to the psychological impact. It is necessary for the administration to adopt learning processes for the development of social skills that allow the care of the mental health of workers and counteract the negative effect of the psychological impact. Objective: To determine the influence on the psychological impact of innovative strategies with social skills to care for mental health developed through inquiry learning in process management. Methods: The research had a cross-sectional, non-experimental design, with a descriptive and correlational scope and a quantitative approach. The sample was 64 workers from the deputy management of education, health and sports of a municipality. To collect information on the defined variables, questionnaires used in research carried out in Peru were used. The null hypothesis was: in the psychological impact does not influence the innovative strategies on process management of social skills acquired through inquiry learning to care for the mental health of workers in a municipality in Peru. Results: There was a relationship between the psychological impact and the innovative strategies on process management determined by the social skills acquired through inquiry learning to care for mental health; with a ratio of 0.86 and a significance level of 0.000. Conclusions: There is a high influence on the psychological impact of innovative strategies that include process management of social skills developed through inquiry learning to care for the mental health of workers.

Level of tumor-infiltrating lymphocytes and density of infiltrating immune cells in different malignancies.

Aim: To correlate levels of tumor-infiltrating lymphocytes (TIL) evaluated using the International Immuno-Oncology Biomarker Working Group methodology, and both density of tumor-infiltrating immune cell and clinicopathological features in different malignancies. Methods: 209 pathological samples from gastric cancer, cervical cancer (CC), non-small-lung cancer, cutaneous melanoma (CM) and glioblastoma were tested for TIL in hematoxylin eosin, and density of CD3+, CD4+, CD8+, CD20+, CD68+ and CD163+ cells by digital analysis. Results: TIL levels were higher in invasive margin compartments (IMC). TIL in IMC, intratumoral and stromal compartments predicted survival. CC and gastric cancer had higher TIL in intratumoral; CC and CM had higher TIL in stromal compartment and IMC. CM had the highest density of lymphocyte and macrophage populations. CD20 density was associated with survival in the whole series. Conclusion: Standardized evaluation of TIL levels may provide valuable prognostic information in a spectrum of different malignancies.

Crisis adrenal neonatal secundaria a hipoplasia hipofisaria / Neonatal Adrenal Crisis Secondary to Pituitary Hypoplasia

Introducción: La insuficiencia adrenal hipotálamo hipofisaria usualmente se manifiesta secundaria a tumores y, cuando resulta congénita se asocia, con frecuencia, con otras deficiencias hormonales. La crisis adrenal suele presentarse en su debut y puede resultar potencialmente mortal. Objetivo: Examinar el caso de una paciente con insuficiencia adrenal central que debutó con una crisis adrenal congénita. Presentación del caso: Recién nacida a término, padres no consanguíneos, hospitalizada a los 9 días de vida por clínica de una semana con múltiples episodios eméticos y apnea. Ingresó con deshidratación severa, hipotensa y estuporosa. Además, se encontró acidosis metabólica severa, hipoglucemia persistente, hiponatremia e insuficiencia prerrenal. Ante la no mejoría de su estado hemodinámico, a pesar del uso de cristaloides y vasopresores, finalmente mejoró con la administración de dosis altas de hidrocortisona. El diagnóstico de deficiencia de cortisol de origen central se realizó con un test dinámico de insulina y la resonancia magnética nuclear hipofisaria. Conclusiones: La crisis adrenal se debe tener presente como diagnóstico diferencial en episodios agudos con inestabilidad hemodinámica persistente e hipoglucemia de difícil manejo. Adicionalmente, hay que considerar que existen otras causas menos comunes de insuficiencia adrenal en neonatos como la hipoplasia hipofisaria(AU)

Introduction: Hypothalamic-pituitary adrenal insufficiency usually manifests secondary to tumors and, when congenital, is often associated with other hormonal deficiencies. Adrenal crisis usually occurs at its onset and can be life threatening. Objective: To review the case of a patient with central adrenal insufficiency who had an onset with a congenital adrenal crisis. Case presentation: Term newborn, non-consanguineous parents, hospitalized at 9 days of life for a week-long clinical presentation with multiple emetic episodes and apnea. She was admitted with severe dehydration, hypotensive and stuporous. In addition, severe metabolic acidosis, persistent hypoglycemia, hyponatremia and prerenal failure were found. Given the lack of improvement of her hemodynamic status, despite the use of crystalloids and vasopressors, she finally improved with the administration of high doses of hydrocortisone. The diagnosis of cortisol deficiency of central origin was made with a dynamic insulin test and pituitary nuclear magnetic resonance imaging. Conclusions: Adrenal crisis should be kept in mind as a differential diagnosis in acute episodes with persistent hemodynamic instability and difficult-to-manage hypoglycemia. Additionally, other less common causes of adrenal insufficiency in neonates, such as pituitary hypoplasia, should be considered(AU)

Revisión documental sobre el software GeoGebra aplicado a la Cultura Física y el deporte

El software GeoGebra es muy útil en las simulaciones de movimientos físicos porque con la ayuda de este el profesional del deporte es capaz de interpretar con valores matemáticos y geométricos la realización de un lanzamiento, una acción que a simple vista es muy difícil descifrar. Sin embargo, a pesar de ser este recurso una vía recurrente para contribuir al desarrollo de la cultura física y el deporte, no ha sido muy generalizado su uso en esta área del conocimiento. Es por ello que los autores de esta investigación se proponen como objetivo: realizar una sistematización documental sobre el software Geogebra enfocado en la cultura Física para que se convierta en un referente a tener en cuenta para futuras innovaciones e investigaciones referente al tema. Con vistas a lograr esta meta consultaron un grupo de artículos en bases de datos de Scopus y Google Académico y publicados en los últimos cinco años referente al uso del Software GeoGebra y se visualizaron las características de este medio y los diversos beneficios que ha ofrecido a través del tiempo. Los artículos hallados se sistematizaron considerando la matriz de análisis, conteniendo aspectos preponderantes en cantidad de publicaciones durante el año 2021 con 12 publicaciones y menor cantidad de publicaciones durante el 2022. Se estudió un prototipo de 29 artículos, en los últimos cinco años referente al uso del Softwares educativos que implican al GeoGebra.

O software GeoGebra é muito útil na simulação de movimentos físicos porque com a ajuda dele o profissional do esporte consegue interpretar com valores matemáticos e geométricos a execução de um arremesso, ação muito difícil de decifrar a olho nu. Contudo, apesar deste recurso ser uma forma recorrente de contribuir para o desenvolvimento da cultura física e do desporto, a sua utilização nesta área do conhecimento não tem sido muito difundida. É por isso que os autores desta pesquisa propõem como objetivo: realizar uma sistematização documental sobre o software Geogebra voltado para a Cultura Física para que ele se torne uma referência a ser levada em conta para futuras inovações e pesquisas sobre o tema. do tempo. Os artigos encontrados foram sistematizados considerando a matriz de análise, contendo aspectos predominantes no número de publicações durante o ano de 2021 com 12 publicações e um menor número de publicações durante 2022. Foi estudado um protótipo de 29 artigos, nos últimos cinco anos quanto ao uso de software educacional que envolve o GeoGebra.

The GeoGebra software is very useful in simulating physical movements because with the help of it the sports professional is able to interpret with mathematical and geometric values the execution of a throw, an action that is very difficult to decipher with the naked eye. However, although this resource is a recurring way to contribute to the development of physical culture and sports, its use in this area of knowledge has not been very widespread. That is why the authors of this research propose as an objective: to carry out a documentary systematization on the Geogebra software focused on Physical culture so that it becomes a reference to be taken into account for future innovations and research on the topic. With a view to achieving this goal, they consulted a group of articles in Scopus and Google Scholar databases and published in the last five years regarding the use of GeoGebra Software and the characteristics of this medium, as well as the various benefits it has offered to users through time were visualized. The articles found were systematized considering the analysis matrix, containing predominant aspects in the number of publications during the year 2021 with 12 publications and a smaller number of publications during 2022. A prototype of 29 articles was studied, in the last five years regarding the use of Educational software that involves GeoGebra.

Tratamiento de Superficie utilizados en Microtornillos de Ortodoncia y su Efecto en la Estabilidad Primaria y Secundaria: Revisión Bibliográfica

Resumen: Los microtornillos de ortodoncia corresponden a dispositivos de anclaje temporal que sirven como coadyuvantes en el tratamiento ortodóncico y cuyo uso se ha ido incrementando en el último tiempo. Las fallas de los microtornillos tienden a ocurrir durante la primera semana de inserción por lo que mejorar la estabilidad es un paso importante para mejorar la confiabilidad del tratamiento. Una posible solución a esto es modificar la superficie del microtornillo. Objetivo: Identificar en la literatura actual los tratamientos de superficie más utilizados que favorezcan la estabilidad primaria y secundaria en el éxito de los microtornillos en ortodoncia. Material y método: Se realizó una búsqueda en Pubmed y EBSCO con los términos en idioma inglés "miniscrew"/"mini implant" AND "surface", "treatment" and "stability". Se incluyeron los estudios realizados in vivo con el objetivo de comparar y/o evaluar el efecto de los tratamientos realizados en la superficie del microtornillo en el éxito o estabilidad de éste, artículos disponibles en inglés y español. Se excluyeron estudios realizados en implantes dentales y/o médicos, in vitro, estudios clínicos sin grupo control. Resultados: 25 publicaciones fueron utilizadas en la revisión, habiendo 11 tipos de tratamiento de superficie estudiados. La generación de ma trices de nanotubos de óxido de titanio, fotofuncionalización mediada por rayos ultravioleta y anodizado de superficie evidenciaron aumento de la estabilidad de los microtornillos. El uso de técnicas convencionales: grabado ácido, arenado-grabado ácido, no es concluyente en cuanto a su efecto en la estabilidad. Conclusión: Hay escasa evidencia sobre los tratamientos de superficie realizados en microtornillos de ortodoncia para la mejora de su estabilidad. Técnicas pioneras como la generación de matrices de nanotubos de óxido de titanio, fotofuncionalización mediada por rayos ultravioleta y anodizado de superficie evidenciaron aumento de la estabilidad de los microtornillos, siendo necesaria la replicación de los estudios en humanos. La utilización de técnicas convencionales tales como grabado ácido y arenado-grabado ácido, no es concluyente en cuanto a su efecto en la estabilidad de los microtornillos.

Abstract: Orthodontic miniscrews are temporary anchoring devices that help as adjuvants in orthodontic treatment and whose use has increased in recent times. Miniscrew failures can happen during the first week of insertion, so improving stability is an important step to enhance treatment reliability. A possible solution to this issue is to modify the miniscrew surface. Objective: To identify in the current literature the most widely used surface treatments that favor the primary and secondary stability and success of orthodontic miniscrews. Material and method: A search was made in Pubmed and EBSCO with the English terms "miniscrew"/"mini implant" AND "surface", "treatment" and "stability". In vivo studies were included with the aim of comparing and/or evaluating the effect of the treatments performed on the miniscrew's surface and their success or stability, articles available in English and Spanish. Studies performed in dental and/or medical implants, in vitro, clinical studies without control group were excluded. Results: 25 publications were used in the review, with 11 types of surface treatment studied. The generation of titanium oxide nanotube matrices, ultraviolet-mediated photofunctionalization and surface anodizing showed an increase in the stability of the miniscrews. The use of conventional techniques: acid etching, sandblasting-acid etching, is inconclusive as to its effect on stability. Conclusion: There is little evidence of surface treatments performed on orthodontic miniscrews to improve their stability. Pioneering techniques such as the generation of titanium oxide nanotube matrices, ultraviolet-mediated photofunctionalization and surface anodizing showed increased stability of the miniscrews, and require their replication on human studies. The use of conventional techniques such as acid etching and acid sandblasting-etching is inconclusive as to its effect on the stability of the miniscrews.

¿Qué saben de pubertad, relaciones de pareja y reproducción, un grupo de jóvenes chilenos con Síndrome de Down? / What do a Group of Young Chilean with Down Syndrome Know about Puberty, Relationshipsand Reproduction?

Introducción: vivir la sexualidad y afectividad de forma plena es fundamental en todo ser humano; sin embargo, las personas con síndrome de Down (SD) tienen escasas instancias de educación sexual y pocos espacios de socialización para experimentarla. Objetivos: describir el conocimiento que tienen jóvenes con SD sobre temáticas básicas de pubertad, relaciones de pareja y reproducción. Metodología: estudio cualitativo, descriptivo, exploratorio, en dos grupos focales de jóvenes con SD, entre 13 y 18 años, separados por género. La información fue grabada, transcrita y codificada según categorías emergentes. Resultados: sobre la palabra “sexualidad”, las mujeresdeclararon no haberla escuchado y los hombres hicieron referencia a “sexo”, “relaciones de pareja”, “amor” y “familia”. Para “cambios puberales”, ambos grupos señalaron los cambios más visibles, pero nada respecto a reproducción. Solo un participante entendía el concepto de “relación sexual”. Las mujeres consideraron el “inicio de la vida humana” como un evento de generación espontánea y los hombres plantearon una teoría fantasiosa. La familia fue la principal fuente de información. Discusión: los participantes mostraron un manejo deficiente e infantilizado de la información. Son urgentes la investigación y el desarrollo de programas de Educación Sexual y así dignificar la sexualidad y afectividad de personas con SD, desde un enfoque de derechos. (AU)

Introduction: living sexuality and affectivity fully is fundamental in every human being, however, people with Down syndrome (DS) have few instances of sex-ual education and few spaces for socialization to experience it. Objectives: describe the knowledge that young people with DS have on basic issues of puberty, relationships and reproduction. Methodology: qualitative, descriptive, exploratory study in two focus groups of young people with DS, between 13 and 18 years old, separated by gender. The information was recorded, coded according to categories. Results: regarding the word “sexuality”, the women declared that they had not heard it and the men referred to “sex”, “couple relationships”, “love” and “family”. For “pubertal changes”, both groups reported the most visible changes, but nothing regarding reproduction. Only one participant understood the concept of “sexual relationship”. Women considered the “beginning of human life” as a spontaneous generation event and the men came up with a fanciful theory. The family was the main source of information. Discussion: par-ticipants showed deficient and infantilized handling of information. Research and devel-opment of Sex Education programs are urgent to dignify the sexuality and affectivity of people with DS, from a rights’ perspective. (AU)

[Cornelia de Lange Syndrome and multiple hormonal deficiency, an unusual association. Clinical case]. / Síndrome de Cornelia de Lange y deficiencias hormonales pituitáricas múltiples, una asociación inusual. Caso clínico.

Cornelia de Lange syndrome is a genetic disease characterized by distinctive facial features, failure to thrive, microcephaly and several malformations associated. Its main endocrinological features are anomalies of the genitalia. We present a 13-year-old boy, who suffered from complicated aspiration pneumonia and showed Cornelia de Lange syndrome phenotype, with global developmental delay, suction-swallowing abnormalities, short stature and abnormal genitalia associated. His bone age was delayed, so he underwent full endocrinological panel. Central hypothyroidism, growth hormone deficiency and low luteinizing hormone-follicle-stimulating hormone levels were observed and multiple pituitary hormone deficiencies diagnosis was made. Basal cortisol, adrenocorticotropic hormone and prolactin levels were normal. He received thyroid hormonal substitution. Multiple pituitary hormone deficiencies are an unusual feature of De Lange syndrome. We suggest evaluating all different endocrine axes in these patients.

El síndrome de Cornelia de Lange es una enfermedad genética caracterizada por rasgos faciales distintivos, falla de medro, microcefalia y varias malformaciones asociadas. Sus principales alteraciones endocrinológicas son las anomalías genitales. Se presenta un adolescente de 13 años, tratado por neumonía aspirativa complicada y que presentaba el fenotipo del síndrome de Cornelia de Lange, que incluía retraso global del desarrollo, trastorno de succión-deglución, talla baja y alteración del desarrollo sexual. Su edad ósea era muy retrasada, por lo que se realizó un estudio endocrinológico completo. Se le diagnosticaron hipotiroidismo central, deficiencia de la hormona de crecimiento y deficiencia de hormona luteotrópica y folículoestimulante, compatibles con el diagnóstico de deficiencias hormonales pituitáricas múltiples. Tuvo cortisol basal, hormona adrenocorticotrópica y prolactina normales. Recibió suplencia hormonal tiroidea. Es inusual la asociación de este síndrome con deficiencias hormonales pituitáricas múltiples. Se sugiere la evaluación de los distintos ejes endócrinos en estos pacientes.