miRNAs and NFKB1 and TRAF6 target genes: The initial functional study in CD14+ monocytes in rheumatoid arthritis patients.

We predicted miRNAs with regulatory impact on NFKB1 and TRAF6 gene expression and selected the miR-194-5p, miR-124-3p, miR-9-5p, and miR-340-5p and their target genes for expression analyses on CD14+ monocytes from rheumatoid arthritis (RA) patients and healthy controls. Additionally, we evaluated the influence of genes and miRNA expression on RA patients' cytokine levels. No difference was observed in genes or miRNAs expression when compared to healthy controls and RA patients or clinical parameters. However, we found a significant difference between miR-194-5p and miR-9-5p levels (FC=-2.31; p=0.031; FC=-3.05;p=0.031, respectively) and non-prednisone users as compared to prednisone using patients. We conducted correlation analyses to identify the strength of the relationship between expression data and cytokine plasma levels. We observed a moderate positive correlation between miR-124-3p expression and IL-6 plasma levels (r=0.46; p=0.033). In addition, overexpression of miRNAs was concomitant to TRAF6 and NFKB1 genes as indicated by correlation analyses: TRAF6 and miR-194-5p (r=0.60;p<0.001) and miR-9-5p (r=0.63;p<0.001) and NFKB1 and miR-194-5p (r=0.72;p<0.001), miR-9-5p (r=0.72;p<0.001) and miR-340-5p (r=0.61;p<0.001). NFKB1 and TRAF6 genes and miRNAs monocyte expression do not appear to be related to RA but showed a significant difference in different groups of RA therapy. In addition, increased levels of miRNAs can be linked to concomitant overexpression of TRAF6 and NFKB1 in monocytes and act as its regulators.

Combining red photobiomodulation therapy with polydioxanone threads for wrinkle reduction in the glabella region: A randomized, controlled, double-blind clinical trial.

The combination of polydioxanone (PDO) threads with other technologies has garnered significant interest for rejuvenation purposes. Photobiomodulation (PBM) has the potential to improve patient comfort and recovery after minimally invasive rejuvenation protocols and also contribute to the overall efficacy of these procedures, fostering an integrative approach to cutaneous rejuvenation. The objective os this work was to investigate concurrent application of PDO threads and red LED PBM on glabellar static wrinkles, in a parallel randomized sham-controlled trial. Forty individuals with Glogau aging classification levels 3 and 4, static glabellar wrinkles, and no significant comorbidities received PDO threads applied along glabellar line. Effective PBM group received 1.35 J and 630 nm red LED light punctually along threads, twice weekly for nine sessions over 30 days. The outcome measures were swelling assessment, dermal thickness and PDO thread degradation via linear ultrasound. No swelling was detected 24 h post-PDO thread application, hindering PBM effect assessment. PDO threads induced dermal thickening; no added effect with PBM. No significant difference in thread hydrolysis between groups, though some ultrasound records inconclusive on thread presence. The absence of swelling may stem from various factors, including the timing of post-procedure swelling assessment, operator proficiency in thread application, and procedural characteristics. No evidence supports the notion that PBM augments dermal thickening, however other light parameters should be studied. Insufficient data to demonstrate PBM's effectiveness in controlling post-procedure swelling. Combination of PBM with PDO thread application doesn't enhance dermal thickening, nor accelerate thread degradation at the parameters used here.

Fish Bones as Calcium Source: Bioavailability of Micro and Nano Particles.

The amount of by-products/waste in the fish industry is roughly 50%. Fish bones could be used to produce nanoparticles, which may have potential use in the food industry as a novel calcium source and at the same time, contribute to reduce waste production. The objective of this study was to evaluate the bioavailability of nano-size salmon fish bone particles compared to micro-size salmon fish bone particles, and calcium carbonate. The study was carried out in 21-28-day-old C57BL/6 male mice fed for 21 days with the experimental diets. The groups were as follows: CaCO3 0.5% Ca (CN 0.5); CaCO3 1.0% Ca (CN 1.0); salmon fish bone (SFB) microparticles 0.5% Ca (MP 0.5); SFB microparticles 1.0% Ca (MP 1.0); SFB nanoparticles 0.5% Ca (NP 0.5); and SFB nanoparticles 1.0% Ca (NP 1.0). Calcium bioavailability, defined as the percent calcium in femur showed an increasing trend from CN 0.5 to NP 1.0 group. According to ANCOVA, the greatest Ca content was observed in the NP 1.0 group compared with all groups but NP 0.5. In conclusion, in a murine model, salmon fish bone nanoparticles present higher calcium bioavailability than salmon fish bone microparticles, and both, in turn, have better bioavailability than calcium carbonate.

Farnesyl Diphosphate Synthase Gene Associated with Loss of Bone Mass Density and Alendronate Treatment Failure in Patients with Primary Osteoporosis.

Aminobisphosphonates (NBPs) are the first-choice medication for osteoporosis (OP); NBP treatment aims at increasing bone mineral density (BMD) by inhibiting the activity of farnesyl diphosphate synthase (FDPS) enzyme in osteoclasts. Despite its efficacy, inadequate response to the drug and side effects have been reported. The A allele of the rs2297480 (A > C) SNP, found in the regulatory region of the FDPS gene, is associated with reduced gene transcription. This study evaluates the FDPS variant rs2297480 (A > C) association with OP patients' response to alendronate sodium treatment. A total of 304 OP patients and 112 controls were enrolled; patients treated with alendronate sodium for two years were classified, according to BMD variations at specific regions (lumbar spine (L1-L4), femoral neck (FN) and total hip (TH), as responders (OP-R) (n = 20) and non-responders (OP-NR) (n = 40). We observed an association of CC genotype with treatment failure (p = 0.045), followed by a BMD decrease in the regions L1-L4 (CC = -2.21% ± 2.56; p = 0.026) and TH (CC = -2.06% ± 1.84; p = 0.015) after two years of alendronate sodium treatment. Relative expression of the FDPS gene was also evaluated in OP-R and OP-NR patients. Higher expression of the FDPS gene was also observed in OP-NR group (FC = 1.84 ± 0.77; p = 0.006) when compared to OP-R. In conclusion, the influence observed of FDPS expression and the rs2897480 variant on alendronate treatment highlights the importance of a genetic approach to improve the efficacy of treatment for primary osteoporosis.

A multi-country survey on the availability of intraoperative use of echocardiography for noncardiac surgery

BACKGROUND: This survey aimed to explore the availability and accessibility of echocardiography during noncardiac surgery worldwide. METHODS: An internet-based 45-item survey was sent, followed by reminders from August 30, 2021, to August 20, 2022. RESULTS: 1189 responses were received from 62 countries. Nearly seventy-one percent of respondents had intraoperatively used transesophageal or transthoracic echocardiography (TEE and TTE, respectively) for monitoring or examination. The unavailability of echocardiography machines (30.3%), lack of trained personnel (30.2%), and absence of clinical indications (22.6%) were the top 3 reasons for not using intraoperative echocardiography in noncardiac surgery. About 61.5% of participants had access to at least one echocardiography machine. About 41% had access to at least 1 TEE probe, and 62.2% had access to at least 1 TTE probe. Seventy-four percent of centers had a procedure to request intraoperative echocardiography if needed for noncardiac cases. Intraoperative echocardiography service was immediately available in 58% of centers. CONCLUSIONS: Echocardiography machines and skilled echocardiographers are still unavailable at many centers worldwide. National societies should aim to train a critical mass of certified TEE/TTE anesthesiologists and provide all anesthesiologists access to perioperative TEE/TTE machines in anesthesiology departments, considering the increasing number of older and sicker surgical patients scheduled for noncardiac surgery.

Valorization of the Salmon Frame as a High-Calcium Ingredient in the Formulation of Nuggets: Evaluation of the Nutritional and Sensory Properties.

In the Chilean population, calcium consumption is deficient. Therefore, several strategies have been implemented to increase calcium intake, such as consuming dairy products and supplements. In this study, an ingredient composed of bone flour (BF) and protein hydrolysate (PH) obtained from salmon frame was used as an innovative source of calcium. The objective was to evaluate the effect of the incorporation of BF and PH in a 1:1 ratio (providing two calcium concentrations to the nuggets, 75 and 125 mg/100 g) on calcium content and sensory attributes of salmon nuggets submitted to baking or shallow frying. Proximal chemical analyses, fatty acid composition, calcium content, and sensory evaluation (acceptability and check-all-that-apply test) were tested in the nuggets. The incorporation of BF/PH (1:1) in both concentrations increased the calcium content of salmon nuggets being higher for the 125 mg/100 g. On the other hand, no negative effects were observed on sensory properties where all samples showed good overall acceptability for baked and fried nuggets. Therefore, the incorporation of BF/PH (1:1) into salmon nuggets enhances the nutritional quality of these products by providing a higher calcium content without significantly affecting their sensory properties.

Cost-Effectiveness of the Prenatal Detection of Congenital Heart Diseases: A Systematic Literature Review.

Background: Congenital heart disease is the most common congenital condition worldwide, with a prevalence of 80 cases per 10 000 live births. In addition to perinatal morbidity and mortality, it entails long-term consequences such as multiple surgeries, prolonged hospitalizations, lifelong cardiac follow-up, reduced quality of life, risk of heart failure, and premature mortality in adulthood. This significant health and economic burden on healthcare systems and families highlights the relevance of evaluating the cost-effectiveness of methods for early detection of this condition. Objective: To conduct a systematic literature review (SLR) to identify and analyze existing economic evaluations on prenatal detection of congenital heart diseases through ultrasound, focusing on the reported cost-effectiveness results and the methodological quality of the evaluated studies according to established criteria. Methods: An SLR of economic evaluations was conducted following PRISMA guidelines. A quantitative synthesis of key methodological components of each economic evaluation was performed. The incremental medical costs, effectiveness measures, and cost-effectiveness ratios reported in each study were compiled and compared. The methodological quality was assessed according to compliance with the 24 CHEERS criteria. Results: We found 785 articles, of which only 7 met all inclusion criteria. Most were cost-effectiveness analyses, with the most common outcome being number of cases detected. Screening with only 4-chamber views interpreted by general practitioners or cardiologists were dominant strategies compared with screening with 4-chamber plus outflow views interpreted by a general practitioner. Fetal echocardiography was most effective but most expensive. Screening with 4-chamber and outflow view, followed by referral to a specialist, were recommended as the least expensive strategy per defect detected. On average, articles met 17 of the 24 CHEERS criteria. Discussion: While recent cost-effectiveness analyses demonstrated improved methodological quality, there was a lack of homogeneity due to differences in comparators and population subgroups analyzed. Despite this heterogeneity, fetal ultrasonography screening was consistently identified as a cost-effective strategy, with its cost-effectiveness heavily influenced by the expertise of the interpreting physician. Conclusion: Most studies recommend implementing obstetric ultrasonography screening, without routine fetal echocardiography, for detecting congenital heart diseases.

A Systematic Review on Assessing Assessments: Unveiling Psychometric Properties of Instruments for Reactive Attachment Disorder and Disinhibited Social Engagement Disorder in Minors under Protective Measures.

BACKGROUND: Reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) manifest in individuals facing attachment system challenges, particularly observed in minors under protective measures. The lack of standardized tools for assessing these difficulties and uncertainty about the most effective instruments from a psychometric perspective prompted this study. AIM: Using the COSMIN checklist, we systematically reviewed instruments assessing RAD, adhering to PRISMA. METHODOLOGY: Examined tools included the Disturbance Attachment Interview, Preschool Age Psychiatric Assessment, Relationship Patterns Questionnaire, Assessment of RAD and DSED, Development and Well-Being Assessment, and Reactive Attachment Disorder Questionnaire. RESULTS: Of the 10 articles analyzed, the results highlight a research emphasis on internal consistency and structural and construct validity, sidelining other properties. CONCLUSION: Most articles review structural validity and internal consistency. These measures are satisfactory but insufficiently evaluated. It is necessary to evaluate these tools using other indicators such as cross-cultural validity, measurement error, or responsiveness in adolescents under protective measures.

Hernia inguinal inusual en paciente de edad media: cuando el ovario y la trompa atraviesan el canal inguinal: a propósito de un caso / Unusual inguinal hernia in a middle-aged patient: when the ovary and fallopian tubepass through the inguinal canal: acase report / Hérnia inguinal incomum em paciente de meia-idade: quando o ovário e a trompauterina passam pelo canal inguinal: um relato de caso

La hernia inguinal supone la patología de pared abdominal más frecuente hoy en día. En el saco herniario podemos encontrar diferentes estructuras, como grasa preperitoneal, intestino delgado, colon o incluso la vejiga, resultando inusual la presencia de la trompa de Falopio y el ovario. El contenido tubo-ovárico supone un hallazgo frecuente en población pediátrica, mientras que resulta un hecho extremadamente raro en mujeres en edad reproductiva o menopáusica, siendo imprescindible su tratamiento con el fin de evitar complicaciones relacionadas con la fertilidad y la viabilidad de los anejos. Con el objetivo de revisar la bibliografía descrita al respecto dado la infrecuencia que supone este hallazgo en mujeres adultas, se presenta el siguiente caso clínico de forma resumida, con la consiguiente revisión de la literatura disponible. Se trata de una paciente mujer de 50 años, con antecedentes de mioma uterino, intervenida de forma programada de hernioplastia inguinal derecha, observando contenido tubo-ovárico en el saco herniario, en la cual se realiza hernioplastia inguinal según la técnica de Lichtenstein con preservación de anejos sin complicaciones postoperatorias. Como conclusiones finales, consideramos que los hallazgos intraoperatorios de contenido tubo-ovárico en la cirugía de hernia inguinal en mujeres adultas supone un hecho infrecuente, cuyo conocimiento y manejo resulta necesario para el cirujano general, precisando de un índice de alta sospecha con el fin de evitar complicaciones y otorgar el tratamiento quirúrgico más óptimo para el bienestar de los pacientes.

Inguinal hernia represents the most common pathology of the abdominal wall currently. In the hernia sac, various structures can be found, such as preperitonealphat, smallbowel, colon, oreventhe bladder, but the presence of the fall opiantube and ovaryisun common. Tubo-ovarian content is a frequent finding in pediatric population, while infection is extremely rare in women of reproductive or menopausal age, requiring essential treatment to prevent complications related to fertility and adnexal viability. In order to review the literature described in this regard, given the infrequency of this finding in adult women, we present the following clinical case, along with a review of the available literature. The patient is a 50-year-old woman with a history of uterine fibroids, who underwent surgery of a right inguinal hernioplasty, revealing tube-ovarian content in the hernia sac. Inguinal hernioplasty was performed using the Lichtenstein technique with preservation of adnexa, and there were no postoperative complications. In final conclusions, we consider that intraoperative finding of tube-ovarian content in inguinal hernia surgery in adult women are uncommon, and knowledge and management of this condition are necessary for the general surgeon. A high index of suspicion is required to avoid complications and provide the most optimal surgical treatment for the well-being of patients.

A hérnia inguinal representa uma patologia comum da parede abdominal nos dias seguintes. No saco herniário, podem ser encontradas diferentes estruturas, como gordura pré-peritoneal, intestino delgado, cólon propriamente dito com a bexiga, sendoincomum com presença da trompa de Falópio e do ovário. O conteúdo trompa-ovariano é muito comum em populações pediátricas, mas é extremamente raro em mulheres em saúde reprodutiva ou na menopausa, sendo essencial ou seutratamento para evitar complicações relacionadas à fertilidade e à viabilidade dos dois anexos. Com o objetivo de revisar a bibliografia descrita a esse respeito, dado pouco discutido em mulheres adultas, o seguinte caso clínico é apresentado de forma resumida, juntamente com uma revisão da literatura disponível. Trata-se de paciente do sexo feminino, 50 anos, com história de mioma uterino, submetida a hernioplastia inguinal direta programada, observando-se conteúdo da tuba ovariana e saco herniário. A hernioplastia inguinal foi realizada segundo a técnica de Lichtenstein, comprimindo dois anexos e sem complicações operatórias. Como conclusões finais, consideramos que a redução intraoperatória do conteúdo tubo-ovariano na cirurgia de hérnia inguinal em mulheres adultas é incomum, e o conhecimento e o manejo dos procedimentos necessários à cirurgia geral requerem um alto índice de suspeita para evitar complicações e proporcionar tratamento cirúrgico . maisadequado para ou bem-est dois pacientes.

Eventración subxifoidea incarcerada: una patología infrecuente y potencialmente mortal / Incarcerated subxiphoid eventration: a rare and potentially fatal pathology / Eventração subxifóide encarcerada: uma patologia rara e potencialmente fatal

Se trata de un paciente de sexo masculino de 89 años de edad, portador de prótesis mitral, intervenido hace 20 años, acude a urgencias por dolor abdominal y vómitos. Se realiza una tomografía computarizada (TC) toraco-abdominal que confirma la presencia de eventración subxifoidea con sufrimiento parietal, requiriendo resección intestinal y eventroplastia con malla intraperitoneal. La eventración subxifoidea constituye una patología infrecuente, que tiene lugar, de forma mayoritaria, en pacientes que han precisado intervenciones del área cardíaca, o hepatobiliopancreática. Su diagnóstico se basa en la clínica y examen físico. Esta patología supone un reto para el cirujano dada la complejidad quirúrgica de la región anatómica donde aparece, pues las estructuras condrocostales adyacentes dificultan la sutura y eventroplastia. En casi todas las series la reparación ha sido electiva, siendo la cirugía de urgencia por incarceración algo anecdótico. La técnica sugerida sería la eventroplastia preperitoneal con malla retroxifoidea irreabsorbible, sin embargo, ésta se encuentra condicionada a los hallazgos intraoperatorios, especialmente a la estrangulación.

Reactive Attachment Disorder and Its Relationship to Psychopathology: A Systematic Review.

This study aimed to determine, through a systematic review, the relationship between Reactive Attachment Disorder (RAD) and the presence of psychopathology in children and adolescents, and to determine the existence of differences in terms of internalising and externalising psychological problems between the RAD group and groups with other disorders or with typical development. Following the PRISMA methodology, a search was carried out in the Web of Science, PubMed and Scopus databases. The search yielded 770 results, of which only 25 met the inclusion criteria. The results indicate a relationship between the presence of RAD and/or disinhibited social engagement disorder (DSED), with the presence of internalising and externalising problems. These difficulties are more present in children with RAD compared to children without personal difficulties, or children with DSED, children with autism, children with intellectual disabilities or children with hyperactivity. It can be concluded that the presence of RAD has negative consequences on the mental health of children and adolescents, with these being greater in the inhibited group than in the disinhibited group, and with respect to children with autism or hyperactivity.

Eficiência clínica de fios de polidioxanona no tratamento da flacidez tissular abdominal pós-parto: relato de caso / Clinical efficiency of polydioxanone threads in the treatment of postpartum abdominal tissue flaccidity: case report

Este estudo relata um caso de flacidez abdominal após 3 gestações no qual foi utilizada a técnica de fios de polidioxanona (PDO) lisos e espiculados, técnica ainda não descrita na literatura paratratarestaqueixa.Apacientefoiacompanhadapor90dias,ehouvemelhoradaabertura da prega umbilical, do tônus da pele, de densidade dérmica e da flacidez tissular após 60 dias. Neste período, a paciente declarou estar totalmente satisfeita e foiestabelecidaaaltadotratamento.Comestepresenterelatodecasopodemosconcluirquea terapia combinada de fios de PDO parafusos e fios de PDO espiculados (Sculpt®) apresentam resultados muito expressivos em relação a qualidade da pele promovendo melhora visível na flacidez tissular

Thisstudyreportsacaseofabdominalflaccidityafterthreepregnancies,inwhichthetechnique ofsmoothandspiculatedpolydioxanonethreadswasused,atechniquenotyetdescribedinthe literature to treat this complaint. The patient was followed up for 90 days, but there was an improvement in the opening of the umbilical fold, skin tone, increase in dermal density and especially a reduction in tissue flaccidity in 60 days. During this period, the patient declared thatshewascompletelysatisfied,anddischargefromtreatmentwasestablished.Withthiscase report, we can conclude that the combined therapy of PDO threads screws and PDO threads spiculated (Sculpt®) presentvery expressive results about the quality of the skin, promoting a visible improvement in tissue flaccidity

Chemical Composition, Fatty Acid Profile, and Optimization of the Sacha Inchi (Plukenetia volubilis L.) Seed-Roasting Process Using Response Surface Methodology: Assessment of Oxidative Stability and Antioxidant Activity.

This study aimed to optimize the roasting conditions for sacha inchi (Plukenetia volubilis L.) seeds using the central composite design (CCD) of the response surface methodology (RSM). The antioxidant activity and oxidation indicators (peroxide and TBA values) were assessed, along with the impact of roasting on the fatty acid profile and chemical characterization of the seeds using gas chromatography. The results demonstrated that roasting partially increased the indicators of lipid oxidation in the oil extracted from roasted seeds, as well as the antioxidant activity of the seeds. The optimal roasting conditions were determined using CCD and RSM, resulting in an optimized temperature of 134.28 °C and 18.84 min. The fatty acid contents were not significantly affected by the roasting intensity, whereas a higher presence of amino acids was found in the seeds roasted at 140 °C for 15 min. In conclusion, it is suggested that the optimal roasting conditions for enhancing amino acid presence, improving antioxidant activity, and maintaining oxidative stability in sacha inchi seeds fall within the temperature range of 134-140 °C and a roasting duration of 15-20 min.

Preformulation and Long-Term Stability Studies of an Optimized Palatable Praziquantel Ethanol-Free Solution for Pediatric Delivery.

To date, the treatment for cysticercosis and neurocysticercosis consists of a single oral intake of praziquantel (5-10 mg/kg), which since it is only available as tablets, hinders its administration to pediatric patients. Praziquantel is a poorly water-soluble drug which represents a challenge for its formulation in solution, particularly for the pediatric population. Thus, this study aimed to develop a palatable solution for praziquantel using pharmaceutical-accepted co-solvent systems. A design of experiments approach was applied to identify the optimal conditions for achieving a suitable amount of praziquantel in solution using co-solvent mixtures. Thus, praziquantel solubility increased from 0.38 up to 43.50 mg/mL in the optimized system. A taste masking assay in healthy human volunteers confirmed a successful reduction of drug bitterness after the addition of selected flavors and a sweetener. Stability studies were also conducted at different temperatures (4, 25, and 40 °C) for 12 months Even though the presence of the three known impurities of praziquantel was observed, their amounts never exceeded the acceptance criteria of the USP. Thus, this novel approach should be considered a valuable alternative for further preclinical studies considering the high prevalence of this infection worldwide.

A Feasible Approach to Developing Fiber-Enriched Bread Using Pomegranate Peel Powder: Assessing Its Nutritional Composition and Glycemic Index.

The consumption of dietary fiber (DF) has been associated with a reduced incidence of non-communicable diseases. Despite various strategies implemented worldwide to increase DF intake, it remains low. Therefore, the development of new fiber-rich food products that are widely consumed could be a strategy to improve DF intake. In this study, an agro-industrial by-product, pomegranate peel powder (PPP), was used as an innovative source of DF and antioxidant. The objective was to develop a bread enriched with DF, antioxidants, and sensory characteristics by partially replacing wheat flour (WF) with PPP at levels of 0%, 2.5%, 5%, 7.5%, and 10%. Bread with 2.5% and 5% PPP was chosen for a clinical trial to evaluate glycemic response (GR) in healthy subjects and determine the bread's glycemic index (GI). As the percentage of PPP increased, both the DF and total polyphenol content increased significantly. The highest overall acceptability was achieved with bread containing up to 5% PPP. Consumption of bread with 2.5% and 5.0% PPP significantly reduced the GI compared to the control bread, while the decrease in GR was not significant. PPP could be a potential food and low-cost ingredient to improve the bread's nutritional quality through its contribution to DF and antioxidants.

Manifestaciones neuropsiquiátricas del lupus eritematoso sistémico: revisión bibliográfica / Neuropsychiatric manifestations of systemic lupus erythematosus: bibliographic review

Neuropsychiatric syndromes in systemic lupus erythematosus (SLE) are one of the many clinical manifestations in which this pathology presents. They have a wide range of prevalence, from 37- 95% due to factors like absence of standardized definitions and non-nespecific clinical manifestations. Physiopathology is mediated by autoimmune mechanisms commonly differentiated in ischemic and inflammatory; there is a clear relationship between the pathologic pathway and the neuropsychiatric manifestation. Moreover, the blood-brain barrier plays a key role, since an alteration of the permeability allows the pass of autoantibodies to the cerebrospinal fluid. There are 19 neuropsychiatric syndromes described which include both diffuse and focal manifestations. The diagnosis must be of exclusion in sights of the more prevalent, severe and potentially deadly etiologies of the neuropsychiatric manifestations, being indispensable to conduct a full study of the patient. The therapyfocuses on symptomatic treatment for each manifestation. Immunotherapy and antithrombotic treatments should be prescripted depending on the underlying pathophysiological mechanism; however, to uncover the predominant pathological route remains a challenge. Future studies should be focused in a better understanding of the physiopathological routes in order to develop standardized diagnosis criteria and optimize an early treatment. This would have a major impact in the life of patients suffering from neuropsychiatric manifestations of SLE, whose late diagnosis is linked with greater organic damage and a poorer quality of life.

Autocuidado y bienestar en residencias de psiquiatría: encuesta de opinión a los docentes / Well-Being and self-care activities in psychiatric residency training: A survey of perceptions to facultative and program directors

Introducción: los residentes de especialidad médica están expuestos a un alto nivel de burnout lo cual impacta negativamente en el profesionalismo. Esto ha promovido que los programas de residencias instalen curricularmente actividades de bienestar y autocuidado. Este estudio busca identificar la presencia de actividades de autocuidado/bienestar en residencias de psiquiatría de Chile y conocer la opinión docente respecto del tema. Materiales y métodos: se realizó un estudio descriptivo transversal invitando vía correo electrónico a 80 docentes de 3 departamentos de psiquiatría a contestar un cuestionario sobre el tema de bienestar/autocuidado de sus residentes en sus programas de formación. Se realizó un análisis cuantitativo de los datos. Resultados: un 69,4% de los encuestados señaló que su residencia no cuenta con contenidos curriculares formales o un programa de autocuidado/bienestar para sus residentes. Las actividades existentes para las residentes relacionadas al autocuidado/bienestar y mencionadas por los docentes son: supervisión, resolución de conflictos, habilidades de comunicación y apoyo o trabajo grupal guiado. Las principales barreras son la limitación de tiempo, la falta de conocimiento y el financiamiento. Discusión: el bienestar de los residentes ha ganado relevancia en los últimos años. El Consejo de Acreditación de Educación Médica para Graduados (ACGME) lo promueve activamente. En Chile, según los programas encuestados, hay poca presencia sistemática de actividades estandarizadas o programas dirigidos al autocuidado y bienestar de este grupo. Parece necesario incluir este aspecto considerando el impacto del burnout en el personal de salud especialmente en un contexto de pandemia o crisis sanitaria.

Introduction: medical speciality residents are exposed to high burnout, which harms professionalism. This mental health situation has led to creating programs promoting well-being and self-care, which have not been installed transversally in medical education. The present study seeks to identify self-care/well-being activities in psychiatry residences in Chile and the teaching interest in implementing them. Methods: 80 professors from 3 Departments of Psychiatry were invited via email to answer a questionnaire on aspects of well-being. A quantitative analysis was performed. Results: 69.4% of those surveyed said their residence does not have formal content or a self-care/well-being program for its residents. The self-care/well-being activities most included in the residents surveyed were su-pervision, conflict resolution and communication skills, and support or guided group work. The main barriers are limited time and lack of knowledge. Discussion: The well-being of residents has gained relevance in recent years, so much so that the Accreditation Council for Graduate Medical Education (ACGME) actively promotes it. In Chile, the situation seems to be different; there is a systematic lack of standardized activities aimed at self-care and the resident's well-being. Including mental health advocating programs is an essential challenge considering the context of pandemic and the relevance of preventing burnout in health personnel.

Systematic Observation of Emotional Regulation in the School Classroom: A Contribution to the Mental Health of New Generations.

Emotional regulation is a developmental milestone, as it promotes well-being throughout life. Children between 10 and 12 years old are expected to reach capacities that allow them to regulate themselves emotionally, the school context being a natural setting for this challenge. With the objective of analyzing the forms of expression and regulation of emotions that are observed in the school classroom, this research was conducted through a mixed methods study that systematically observed nine classes during five sessions each. The design was Nomothetic, Follow-up and Multidimensional; the observations were recorded on audio and in person and were later transformed into data by coding them according to an ad hoc designed instrument. The concordance of the records was evaluated, a sequential analysis of delays (GSEQ5) was performed to detect regularities and existing sequences, and a polar coordinate analysis (HOISAN) observed the relationships between the categories. Finally, the presence of multiple cases was detected. The results detail the ways in which different actors express emotions and interact, regulating the emotions of other people. The results are discussed based on the need to foster educational intentionality and allow students' emotional self-regulation.

Evaluación renal y multiorgánica en el paciente con encefalopatía hipóxico-isquémica / Renal and multiorgan evaluation in infants with post-asphyxial hypoxic-ischaemic encephalopathy

Resumen Introducción: La encefalopatía hipóxico-isquémica (EHI) moderada-grave secundaria a asfixia perinatal puede afectar a cualquier órgano, empeorando el pronóstico. Objetivo: Evaluar la afectación renal y multiorgánica de estos pacientes. Material y método: Se incluyó a recién nacidos > 35 semanas con EHI moderada-grave tratados con hipotermia activa entre 2010 y 2020. Se evaluó la creatinina en tres periodos: 48-72 horas de vida, entre el 3.o y 7.o día de vida y del 7.o al 28.o día de vida. Resultados: Se incluyeron 135 pacientes: 112 con EHI moderada y 23 con EHI grave. Al comparar ambos grupos, se obtuvieron diferencias significativas a las 48-72 horas y entre 3.o-7.o día de vida. No hubo diferencias al comparar el método de hipotermia. Los pacientes con EHI grave presentaron mayor afectación hemodinámica, respiratoria y hepática. Conclusiones: Neonatos con EHI grave presentan aumento de los niveles de creatinina sérica y mayor afectación multiorgánica respecto a aquellos con EHI moderada.

Abstract Background: Hypoxic-ischemic encephalopathy (HIE) secondary to perinatal asphyxia can affect any organ, worsening the prognosis. Objective: To describe renal and multiorgan involvement in moderate-severe HIE. Material and method: Newborns > 35 weeks diagnosed with moderate-severe HIE who required active hypothermia between 2010-2020 were included. To assess renal involvement, serum creatinine was measured in three different periods: at 48-72 hours, between the 3rd and the 7th day, and from the 7th to the 28th day. Results: A total of 135 patients were included, 112 (83%) with moderate and 23 (17%) with severe HIE. Significant differences were obtained when comparing median creatinine levels at 48-72 hours and between 3-7 days in both groups. There were no differences in creatinine according to the hypothermia method. Patients with severe HIE presented greater hemodynamic, respiratory, and hepatic involvement. Conclusions: Neonates with severe HIE present increased serum creatinine levels and greater multi-organ involvement than those with moderate HIE.

Vitamin D receptor gene polymorphisms influence on clinical profile and bone mineral density at different skeletal sites in postmenopausal osteoporotic women.

Bone remodeling is marked by bone synthesis and absorption balance, and any altered dynamic in this process leads to osteoporosis (OP). The interaction of hormonal, environmental and genetic factors regulate bone metabolism. Since vitamin D displays a classic role in bone metabolism regulation, acting through vitamin D receptor (VDR), the genetic variants within VDR were the first ones associated with bone density and remodelling. Therefore, we investigated whether three single nucleotide polymorphisms (SNPs) within VDR were associated with OP differential susceptibility and clinical profile from postmenopausal versus healthy women from Northeast Brazil. Genetic association study enrolling 146 postmenopausal osteoporotic women as the patient group and 95 healthy age-matched women as the control group. We assessed three SNPs within VDR (rs11168268, rs1540339 and rs3890733), considering the clinical profile of all patients. Our results showed an association of rs11168268 G/G genotype with higher bone mineral density (BMD) mean for the total hip (A/A = 0.828 ± 0.09; A/G = 0.081 ± 0.13; G/G = 0.876 ± 0.12, p = .039), and the rs3890733 T/T genotype was associated with increased OP risk in patients below 60 years old (odds ratio [OR] = 5.12, 95% confidence interval [CI ]= 1.13-23.27, p = .012). The rs1540339 T/T genotype was associated with protection for individuals with low melanin deposition when compared to the high melanin deposition group (OR = 0.24, 95%CI = 0.06-0.94, p = .029). Additionally, 61% of patients presented deficient vitamin D serum levels. The SNP rs11168268 G/G was associated with a significantly increased mean total hip BMD in patients OP, highlighting this SNP and its relationship with BMD.