Expanding the phenotypic spectrum of CLCN2-related leucoencephalopathy and ataxia.

Mutations in CLCN2 are a rare cause of autosomal recessive leucoencephalopathy with ataxia and specific imaging abnormalities. Very few cases have been reported to date. Here, we describe the clinical and imaging phenotype of 12 additional CLCN2 patients and expand the known phenotypic spectrum of this disorder. Informed consent was obtained for all patients. Patients underwent either whole-exome sequencing or focused/panel-based sequencing to identify variants. Twelve patients with biallelic CLCN2 variants are described. This includes three novel likely pathogenic missense variants. All patients demonstrated typical MRI changes, including hyperintensity on T2-weighted images in the posterior limbs of the internal capsules, midbrain cerebral peduncles, middle cerebellar peduncles and cerebral white matter. Clinical features included a variable combination of ataxia, headache, spasticity, seizures and other symptoms with a broad range of age of onset. This report is now the largest case series of patients with CLCN2-related leucoencephalopathy and reinforces the finding that, although the imaging appearance is uniform, the phenotypic expression of this disorder is highly heterogeneous. Our findings expand the phenotypic spectrum of CLCN2-related leucoencephalopathy by adding prominent seizures, severe spastic paraplegia and developmental delay.

Assessment of the Current State of Sports Coverage Participation, Training, and Confidence Ratings among Physical Medicine and Rehabilitation Residents and Residency Programs.

ABSTRACT: A significant proportion of physical medicine and rehabilitation residents are pursuing sports medicine-related fellowships and are recommended to participate in sports coverage during residency training. The purpose of this article is to assess the current state of sports coverage participation, training, and confidence ratings among physical medicine and rehabilitation residents and residency programs. Physical medicine and rehabilitation residents from Accreditation Council for Graduate Medical Education-accredited programs were invited to participate in a nationwide cross-sectional survey. A total of 90 resident responses from 43 programs were included. Residents from 91% of represented programs indicated that sports coverage opportunities were available. At least one resident from 63% of represented programs and 50% of responding residents reported sports coverage training during residency. Sports coverage confidence ratings were higher in 91% of topics among residents who received training. The results of this study indicate that sports coverage opportunities are common among physical medicine and rehabilitation residencies, and while sports coverage training is variable, a positive correlation with confidence ratings was identified.

Monitoring of antibody levels in healthcare workers after inactivated coronavirus disease 19 vaccination

SUMMARY OBJECTIVE: Because of the coronavirus disease 19 pandemic, studies on vaccination are being conducted in our country as well as across the world. In this study, the antibody levels in healthcare workers vaccinated with two doses of inactivated vaccine and the factors affecting these levels were investigated. METHODS: Randomly selected volunteers from healthcare workers, who had been vaccinated with two doses of inactivated vaccine in January to February 2021, were included in the study. Blood samples were drawn twice, 1 month and 6 months after the second dose vaccine (CoronaVac:Sinovac Life Science Co, Ltd, Beijing, China). The antibody levels were determined by the chemiluminescence microparticle immunoassay method using kits for quantitative detection of immunoglobulin class G antibodies to severe acute respiratory syndrome coronavirus 2. RESULTS: The mean antibody levels of 129 volunteers were 1232.5 (min: 103 to max: 7151) AU/mL in the first month and 403.5 (min: 23 to max: 4963) AU/mL in the sixth month. According to the survey results, 91 (71%) volunteers had not been diagnosed with coronavirus disease 19 before vaccination. The antibody levels 1 month and 6 months after the second dose of vaccination were significantly higher in those who had been diagnosed with coronavirus disease 19 before vaccination than in those who had not. It was found that age, gender, fast food, or healthy nutrition had no effect on antibody levels. CONCLUSION: Vaccines are very important both to protect against coronavirus disease 19 and to experience only a mild form of the disease. Immunoglobulin class G levels formed after vaccination may be affected by many factors and may decrease over time.

Diagnóstico, manejo y tratamiento actual del mielomeningocele fetal / Current diagnosis, management and treatment of fetal myelomeningocele

Introducción: El mielomeningocele fetal, es la extrusión de la médula espinal que ocurre por un cierre incompleto del neuróporo caudal, lo cual expone la placa neural al trauma mecáni-co y químico de la pared uterina y líquido amniótico respectivamente, con graves secuelas. La detección prenatal innovó el diagnóstico y con ello la reparación intra útero ha mejora-do estrategias del tratamiento, generando opciones de atención en aquellas pacientes que cumplen con los criterios de selección para cirugía prenatal. Objetivo: Presentar una revisión bibliográfica sobre diagnóstico, manejo y tratamiento del mielomeningocele fetal y ofrecer a la comunidad científica una herramienta de consulta para mejorar los conocimientos del tema y alternativas de tratamiento oportuno para los fetos con esta malformación.Material y Métodos: Se trata de un estudio de revisión sistemática sin metaanálisis, realiza-do en base a las recomendaciones PRISMA. La búsqueda de información se estructuró bajo el sistema PICO. Las búsquedas se realizaron en Pubmed, Tripdatabase y Pubmed Central; seleccionando artículos publicados durante los últimos diez años en inglés o español, sobre diagnóstico, manejo y tratamiento del mielomeningocele fetal. Resultados: 120 artículos cumplieron con criterios de búsqueda, de los cuáles fueron ele-gibles 42, con información relevante para determinar el diagnóstico, manejo y tratamiento actual del mielomeningocele fetal a través de procedimientos innovadores.Discusión: Los defectos del tubo neural aparecen como consecuencia de una alteración del proceso de neurulación entre el día 21-28 después de la concepción. El mielomeningocele fetal es considerado el defecto congénito no letal más común del SNC. Se caracteriza por la protrusión de las meninges y la médula espinal con daño neurológico permanente. Por ello el diagnóstico y manejo oportuno de esta patología, han permitido que la cirugía fetal intra útero se considere el método óptimo, mejorando la hernia del rombencéfalo, reduciendo la necesidad de una derivación ventricular y manteniendo la motricidad inferior, así como la función neuronal, vesical y gastrointestinal, mejorando la calidad de vida del paciente afecto por esta patología

Introduction: Fetal myelomeningocele is spinal cord extrusion that occurs due to the caudal neuropore incomplete closure, which exposes the neural plate to mechanical and chemical trauma to the uterus wall and amniotic fluid respectively, with serious sequelae. Prenatal detection innovated the diagnosis and with this intra-uterine repair has improved treatment strategies, generating care options in those patients who comply the selection criteria for prenatal surgery.Objective: Submit a bibliographic review on the diagnosis, management and treatment of fetal myelomeningocele and to offer the scientific community a consultation tool to improve knowledge of the subject and timely treatment alternatives for fetuses with this malformation.Materials and Methods: This is a systematic review study without meta-analysis, based on the PRISMA recommendations. The information search was structured under the PICO sys-tem. The searches were carried out in Pubmed, Tripdatabase and Pubmed Central; selecting articles published during the last ten years in English or Spanish, on diagnosis, management and treatment of fetal myelomeningocele.Results: 120 articles met the search criteria, of which 42 were eligible, with relevant informa-tion for determining the current diagnosis, management and treatment of fetal myelomenin-gocele through innovative procedures.Discussion: Neural tube defects appear as a consequence of an alteration of the neurula-tion process between days 21-28 after conception. MMCf is considered the most common non-fatal congenital defect of the CNS. It is characterized by protrusion of the meninges and spinal cord with permanent neurological damage. For this reason, the diagnosis and timely management of this pathology have allowed intra utero fetal surgery to be considered the optimal method, improving rhombencephalon hernia, reducing the need for a ventricular shunt and maintaining the lower motor skills, as well as neuronal, bladder and gastrointestinal function, improving the quality of life of the patient affected by this pathology.

Hipercortisolismo severo e hipocalemia recurrente / Severe hypercortisolism and recurring hypocalemia

RESUMEN El síndrome de Cushing endógeno deriva de un aumento crónico, inapropiado y sostenido de glucocorticoides principalmente como respuesta al exceso en las concentraciones séricas elevadas de la hormona adrenocorticotropa (ACTH) desde un tumor adenohipofisiario, enfermedad de Cushing; o producida de forma ectópica por tumores neuroendocrinos. El Cushing suprarrenal se origina por tumores de la corteza adrenal que producen de forma autónoma cortisol y es independiente de ACTH. El curso clínico, tratamiento, pronóstico y posibles complicaciones dependen de identificar de forma correcta la lesión desencadenante; situación que en múltiples ocasiones resulta en una experiencia retadora para los clínicos. Se presenta el caso de una mujer de 62 años, ingresada por síntomas constitucionales con hipocaliemia severa de difícil corrección e hipercortisolismo severo.

ABSTRACT Endogenous Cushing syndrome derives from a chronic, inappropriate, and sustained increase in glucocorticoids, mainly in response to remarkably high serum concentrations of adrenocorticotropic hormone (ACTH) secreted from an adenohypophyseal tumor, Cushing's disease, or due to ectopic production by neuroendocrine tumors. Adrenal Cushing's disease is caused by tumors of the adrenal cortex that autonomously produce cortisol and this is independent from ACTH action. Clinical course, treatment, prognosis, and possible complications depend on correctly identifying the triggering lesion; this situation frequently becomes a challenging experience for clinicians. We present the case of a 62-year-old woman, admitted for constitutional symptoms with severe hypokalemia that was difficult to correct and severe hypercortisolism.

Evaluation and follow-up of antibody formation after CoronaVac vaccine

SUMMARY OBJECTIVE: The aim of this study was to monitor the time-dependent change by evaluating the antibody levels at the 4th, 7th, 10th, 13th, and 16th weeks after the second dose of the CoronaVac vaccine. METHODS: The study group (n=65) were between 21 and 60 years old and received two doses of the CoronaVac vaccine. Blood samples were collected after 4th, 7th, 10th, 13th, and 16th weeks of the second dose of the vaccine administration. There was a coronavirus disease 2019 recovered group (n=29) who were SARS-CoV-2 real-time PCR test result positive before the vaccination period, and no coronavirus disease 2019 history group (n=36). Age, BMI, gender, smoking, comorbidity, coronavirus disease 2019 contact history, and working in the coronavirus disease 2019 service history of the individuals were recorded. RESULTS: No statistically significant difference was found in the descriptive findings of the individuals according to coronavirus disease 2019 recovered group and no coronavirus disease 2019 history group. It was observed that antibody levels in the coronavirus disease 2019 recovered group were found to be higher for each period of serum collection compared to the no coronavirus disease 2019 history group, which were statistically significant. The distribution curves of the antibody levels according to the timing of blood collection in coronavirus disease 2019 recovered group, no coronavirus disease 2019 history group, and total subjects were extrapolated, and it was observed that the estimated time for the antibodies to reach the threshold value of the test was 214, 145, and 166 days after vaccination. CONCLUSION: It is important to make booster doses, as the CoronaVac vaccine will lose its effect after the fifth month due to the decrease in Ab levels. In addition, since the antibody levels decrease later in those who have a history of coronavirus disease 2019 infection and are vaccinated, individuals who have no previous history of coronavirus disease 2019 should be given priority for vaccination.

Estudio Descriptivo: Frecuencia y factores de riesgo de la enfermedad arterial periférica en pacientes con Diabetes Mellitus II del Hospital José Carrasco Arteaga, Cuenca / Descriptive Study: Frequency and risk factors of peripheral arterial disease in patients with type II Diabetes Mellitus of Hospital José Carrasco Arteaga, Cuenca

INTRODUCCIÓN: La enfermedad arterial periférica (EAP) es más frecuente en pacientes conDiabetes Mellitus tipo 2 (DM2) que en la población general, convirtiéndolos en un grupo de alto riesgo de morbimortalidad. El objetivo del presente estudio fue determinar la frecuencia de EAP, mediante la medición del ITB y la frecuencia de sus factores de riesgo en los pacientes con Diabetes Mellitus tipo 2 del Hospital José Carrasco Arteaga. MATERIALES Y MÉTODOS: Estudio descriptivo, de corte transversal, con una muestra aleatoria simple de pacientes con diagnóstico de DM2 que acudieron a consulta externa del Hospital José Carrasco Arteaga, Cuenca-Ecuador, en el año 2017 (315 pacientes).Se aplicó una entrevista a los pacientes con datos sobre las características sociodemográficas y ciertos antecedentes médicos de importancia para el estudio; se determinó el ITB; se valoraron los exámenes complementarios de laboratorio realizados en los seis meses previos al estudio. Finalmente, se describieron frecuencias y porcentajes de cada una de las variables, se utilizó el programa IBM SPSS versión 22. RESULTADOS: Del total de pacientes se observó un promedio de edad de 62.9 años, con predominio del sexo femenino. Se determinó que la frecuencia de EAP en los pacientes con DM2 fue del 35.30%. LA EAP fue más frecuente en: el grupo de edad mayor a 50 años (38.8%), el sexo masculino (43.9%), en el grupo de pacientes con tiempo de evolución de la DM2 ≥ a 5 años (35.5%), en los pacientes con tabaquismo (38.4%), en los pacientes con niveles elevados de hemoglobina glicosilada (HbA1c ≥7%) (40.6%), los pacientes con hipertrigliceridemia, en los pacientes con LDL elevado y en hombres con HDL por debajo de valores normales. CONCLUSIÓN: Podemos concluir que la frecuencia de enfermedad arterial periférica en los pacientes con Diabetes Mellitus tipo 2, en el Hospital José Carrasco Arteaga, utilizando el índice tobillo brazo como método diagnóstico fue del 35.30%.(au)

BACKGROUND: Peripheral arterial disease (PAD) is more common in patients with type 2 Diabetes Mellitus (DM2) than in the general population, making them a high-risk group for morbidity and mortality. The aim of this study was to determine the frequency of peripheral arterial disease, by measuring ankle-brachial index, and the frequency of its risks factors in patients with type 2 Diabetes Mellitus at Hospital José Carrasco Arteaga. METHODOS: descriptive, cross-sectional study, with a simply randomized sample of patients diagnosed with Type 2 Diabetes Mellitus, who attended the outpatient clinic of Hospital José Carrasco Arteaga, Cuenca - Ecuador, in 2017 ( 315 patients). An interview was applied to the patients, to collect data on sociodemographic characteristics and certain important medical history; ankle-brachial index was determined; complementary laboratory tests made six months prior to the study were evaluated. Finally, frequencies and percentages of each variable were described; we used IMB SPSS version 22 software. RESULTS: Of the total number of patients, the average age was 62.9 years, with a predominance of the female sex. The frequency of PAD in patients with DM2 was 35.30%. PAD was more frequent in: age group over 50 years (38.8%), male sex (43.9%), disease evolution time ≥ 5 years (35.5%), in smoking patients(38.4%), in patients with elevated glycosylated hemoglobin levels (HbA1c ≥7%)(40.6%),in patients with hypertriglyceridemia, in patients with elevated LDL and in men with low HDL values. CONCLUSION: we can conclude that the peripheral arterial disease frequency in patients with type 2 Diabetes Mellitus, at Hospital José Carrasco Arteaga, using the ankle-brachial index as a diagnostic method was 35.50%.(au)

Luminescent imaging of insulin amyloid aggregation using a sensitive ruthenium-based probe in the red region.

A sensitive and selective strategy to identify insulin fibrils remains a challenge for researchers in amyloid protein research. Thus, it is critical to detect, in vitro, the species generated during amyloid aggregation, particularly the fibrillar species. Here we demonstrate that the luminescent complex cis-[Ru(phen)2(3,4Apy)2]2+ (RuApy; phen = 1,10-phenanthroline; 3,4Apy = 3,4-diaminopyridine) is a rapid, low-cost alternative to in vitro detection of fibrillar insulin, using conventional optical techniques. The RuApy complex displays emission intensity enhancement at 655 nm when associated with insulin, which enables imaging of the conformational changes of the protein's self-aggregation. The complex shows high sensitivity to fibrillar insulin with a limit of detection of 0.85 µM and binding affinity of 12.40 ± 1.84 µM which is comparable to those of Thioflavin T and Congo red, with the advantage of minimizing background fluorescence, absorption of light by biomolecules, and light scattering from physiologic salts in the medium.

Intervenções não farmacológicas no controle da dor em recém-nascidos pré-termo: conhecimento da equipe de enfermagem / Non-pharmacological interventions in the control of pain in newborns pre-term: knowledge of nursing staff

Objetivo: Investigar o conhecimento da equipe de enfermagem sobre o manejo não farmacológico da dor e descrever os principais métodos não farmacológicos para o manejo da dor em recém-nascidos pré-termo sob cuidados intensivos. Método: Estudo exploratório-descritivo, com abordagem qualitativa, realizado em Unidade de Terapia Intensiva, de Fortaleza-CE, Brasil, cuja coleta de dados foi realizada de julho a agosto de 2018, por meio de entrevista e observação dos cuidados de enfermagem aos neonatos. Participaram duas enfermeiras e seis técnicas de enfermagem e observaram-se quatro recém-nascidos quanto às respostas fisiológicas e comportamentais aos procedimentos invasivos durante o tratamento intensivo. Resultados: Os métodos mais utilizados pela equipe de enfermagem na Unidade pesquisada foram: soro glicosado a 25%, sucção não nutritiva, contenção facilitada, leite materno e Método Canguru. Conclusão: Algumas participantes demonstraram não conhecer os métodos para manejo não farmacológico da dor em recém-nascidos pré-termo, constatando-se necessidade de mais pesquisas relacionadas à temática investigada.(AU)

Objective: To investigate the knowledge of the nursing staff on non-pharmacological pain management and describe the main non-pharmacological methods for pain management in preterm newborns under intensive care. Method: Exploratory-descriptive study, with a qualitative approach, carried out in an Intensive Care Unit, in Fortaleza-CE, Brazil, whose data collection was carried out from July to August 2018, through interviews and observation of nursing care to neonates. Two nurses and six nursing technicians participated and four newborns were observed for physiological and behavioral responses to invasive procedures during intensive care. Results: The methods most used by the nursing team in the researched unit were: 25% glucose serum, non-nutritive suction, facilitated containment, breast milk and Kangaroo Method. Conclusion: Some participants demonstrated that they do not know the methods for non-pharmacological management of pain in preterm newborns, confirming the need for more research related to the theme investigated. (AU)

Objetivo: Investigar los conocimientos del equipo de enfermería sobre manejo no farmacológico del dolor y describir los principales métodos no farmacológicos para manejo del dolor en recién nacidos prematuros en cuidados intensivos. Método: Estudio exploratorio descriptivo, cualitativo, realizado en Unidad de Cuidados Intensivos, en Fortaleza-CE, Brasil, cuya recolección de datos se realizó de julio a agosto de 2018, a través de entrevistas y observación de cuidados de enfermería a neonatos. Participaron dos enfermeras y seis técnicos de enfermería y se observaron a cuatro recién nacidos para determinar las respuestas fisiológicas y conductuales a los procedimientos invasivos durante los cuidados intensivos. Resultados: Los métodos más utilizados por el equipo de enfermería en la unidad investigada fueron: suero de glucosa al 25%, succión no nutritiva, contención facilitada, leche materna y método canguro. Conclusión: Algunos participantes señalaron no conocen los métodos para manejo no farmacológico del dolor en recién nacidos prematuros, por lo que se necesitan más investigaciones relacionadas al tema investigado.(AU)

Comparison of Aß (1-40, 1-28, 11-22, and 29-40) aggregation processes and inhibition of toxic species generated in early stages of aggregation by a water-soluble ruthenium complex.

Neurotoxicity of amyloid beta (Aß) species generated in early stages of aggregation has been associated with development of Alzheimer's disease (AD). Consequently, the field of action of compounds that can identify and inhibit the formation of these species has enlarged considerably. This study investigates the effect and influence of the luminescent, water soluble metal complex cis-[Ru(phen)2(3,4Apy)2]2+ (RuApy, 3,4Apy = 3,4-diaminopyridine, phen = 1,10-phenanthroline) on the aggregation process and toxicity of Aß1-40 and its Aß1-28, Aß11-22 and Aß29-40 fragments since their early stages. The absence of correlation between the conformations generated by Aß fragments and the full length 1-40 peptide during aggregation and the absence of toxicity of Aß fragments to PC12 cells in all stages of aggregation indicated that the aggregation pathway and toxicity found to the full-length Aß1-40 depends on specific interactions between the three fragments. The toxicity of Aß1-40 was dependent on the aggregation step investigated: species generated at the beginning (15 min) of aggregation were toxic, whereas mature (120 min) fibrils were not. The RuApy complex is not toxic to PC12 cells up to 60 µM, and does not interfere with the aggregation pathway of the Aß fragments, but interferes with the aggregation of Aß1-40 and protects the PC12 cells, maintaining 100% of cell viability against the toxicity of Aß1-40 species generated in early stages of aggregation.

Influência da manta geotêxtil e altura da camada de lodo no desaguamento de lodo anaeróbio em leito de drenagem / Influence of the geotextile blanket and sludge height in anaerobic sludge dewatering using drainage bed

RESUMO As estações de tratamento de esgoto (ETEs) geram resíduos, com destaque para o lodo de esgoto, que tem aproximadamente 95% de água e se classifica como resíduo sólido, necessitando de disposição final ambientalmente adequada. Assim, o desaguamento é fundamental no gerenciamento do lodo, já que promove redução de volume. O leito de drenagem (LD) é um sistema natural, sem uso de energia elétrica e produtos químicos, com resultados promissores para o desaguamento de lodo de estações de tratamento de água (ETAs). Nesse sentido, esta pesquisa visou a avaliar o desaguamento de lodo gerado em ETE, proveniente de reator Upflow Anaerobic Sludge Blanket (UASB). A análise foi realizada por meio de nove ensaios usando LD em escala de bancada com área de fundo de 31 × 31 cm. Os ensaios foram realizados com 3 diferentes geotêxteis: HaTe 55/55, 80/80 e 105/105 DW; e 3 alturas de lodo bruto: 10, 15 e 20 cm. Nos ensaios, mediu-se o teor de sólidos inicial do lodo bruto e em intervalos de tempo predeterminados: vazão de drenagem, volume drenado, cor aparente, turbidez, pH e condutividade do líquido drenado. Os ensaios com a manta 55/55 obtiveram melhor desempenho, com redução final do volume de lodo superior a 65%, independentemente da altura da camada de lodo. Os resultados de cor e turbidez do líquido drenado para a manta HaTe 55/55 demonstraram tendência de melhoria de qualidade com o aumento da altura da camada de lodo, fato não observado para as outras mantas. Obteve-se melhoria da qualidade do líquido drenado, principalmente após 15 minutos, quando o percentual drenado atingiu 35%.

ABSTRACT Sewage Treatment Plants generate sewage sludge, which has approximately 95% of water and requires a proper disposal. Thus, dewatering is fundamental in sludge's management since it promotes volume reduction of the residue. The drainage bed (DB) is a natural system, without the use of energy and chemicals, with prosperous results for the dewatering of sludge from Water Treatment Plants. In this sense, this research aimed to evaluate sewage sludge's dewatering from Upflow Anaerobic Sludge Blanket (UASB). The analysis was performed through nine tests in DB models from laboratory scale with a bottom area of 31 × 31 cm. The tests were performed with three different geotextiles blankets: HaTe 55/55; 80/80 and 105/105 DW and three heights of applied crude sludge: 10, 15 and 20 cm. In the tests, the crude sludge's initial solid content was measured. Then, at predetermined time intervals were measured: drainage flow, drained volume, apparent color, turbidity, pH and drained liquid's conductivity. The tests with the HaTe 55/55 geotextile blanket obtained the best performance, with final reduction of the sludge volume above 65%, independent of the height of the sludge applied. The color and turbidity results of the drained liquid for the HaTe 55/55 geotextile blanket showed a tendency to improve quality with the increase of the sludge height, a fact not observed for the other geotextiles blankets.

Riesgo de desnutrición en adultos mayores hospitalizados: estudio transversal en un hospital de Quito-Ecuador / Risk of undernutrition in geriatric inpatients: a cross- sectional study in a hospital from Quito-Ecuador

La valoración geriátrica integral debe incluir una adecuada evaluación nutricional al momento del ingreso hospitalario. Objetivo Determinar la prevalencia de un estado nutricional de riesgo, en pacientes adultos mayores hospitalizados. Diseño Transversal de prevalencia Lugar y sujetos Adultos mayores de 65 años, ingresados en el Hospital Quito N°1, durante el periodo julio - agosto 2018. Mediciones principales Datos demográfcos, antropométricos y riesgo nutricional determinado mediante el MNA. Resultados Se estudiaron 62 pacientes (66.1% hombres) con una edad media de 77.9 ± 8.2 años. Al ingreso solamente el 41.9% habían sido referidos para una valoración a cargo de nutricionista. El test MNA aplicado a la totalidad de pacientes mostró que el 79% (IC95%: 67.2% - 87.4%) de los adultos mayores estaban en riesgo de desnutrición, el 16.1% tenían desnutrición y apenas el 4.8% podían considerarse bien nutridos. Durante el tiempo de hospitalización, el 56.5% (IC95%= 44.1% - 68.1%) de los pacientes habían disminuido un promedio del 2.5% del peso respecto al registrado en el momento del ingreso. La pérdida de peso fue leve (38.7%), moderada (9.7%) y severa (8.1%), durante una estancia media de 6.4 ± 2.3 días. Conclusión Un elevado porcentaje de los adultos mayores hospitalizados presentan riesgo de desnutrición, pero pocos son referidos al nutricionista para su evaluación al momento del ingreso hospitalario. Es importante aplicar una herramienta de tamizaje nutricional para determinar el riesgo nutricional al ingreso y contribuir con una intervención nutricional adecuada en el adulto mayor hospitalizado

An integral geriatric assessment must include an adequate nutritional assessment at the time of hospital admission. Objective To determine the prevalence of a nutritional risk status in geriatric inpatients. Design Cross sectional study. Subjects and setting Adults over 65 years of age, admitted to the Hospital Quito No. 1, during the period July - August 2018. Main measurements Demographic and anthropometric data. Nutritional risk assessment with the mini nutritional assessment (MNA) test. Results We studied 62 patients (66.1% men) with an average age of 77.9 ± 8.2 years. At admission, only 41.9% had been referred for an assessment by a nutritionist. The MNA test applied to all patients showed that 79% (95%CI: 67.2% - 87.4%) were at risk of undernutrition, 16.1% had malnutrition and only 4.8% were with a good nutritional status. During the hospital lenght of stay, 56.5% (95%CI = 44.1% - 68.1%) of the patients showed an 2.5% decrease in their weight. The weight loss was mild (38.7%), moderate (9.7%) and severe (8.1%), in a lenght of stay of 6.4 ± 2.3 days. Conclusion A high percentage of geriatric inpatients are at risk of undernutrition, but few are referred to the nutritionist for evaluation at the time of hospital admission. It is important to apply a nutritional screening tool to determine the nutritional risk at admission and to contribute with an adequate nutritional intervention in the hospitalized older adult

La profesión periodística en el Caribe Colombiano: Entre percepción y significados

El objetivo de esta investigación fue conocer cómo perciben su oficio los periodistas en las principales ciudades de la región Caribe colombiana; para alcanzarlo se utilizó un método de investigación mixto, aplicando una fase cualitativa y otra cuantitativa, que posteriormente fue interrelacionada mediante una triangulación de datos. Entre los hallazgos se logró establecer que para los periodistas de la región Caribe colombiana el ejercicio de su oficio brinda gran satisfacción profesional (entendida como el gusto que se experimenta al ejercer el periodismo) pero poca satisfacción laboral (que refiere a las condiciones de contratación y remuneración). Se encontró que existe la intención de los periodistas por cualificarse, sin embargo, el poco tiempo libre con el que cuentan y la baja remuneración salarial les dificulta este propósito. También se evidenciaron desencuentros en el interior de los medios entre los periodistas empíricos y los periodistas con una formación profesional: falta de pasión por el oficio y ausencia de métodos para la investigación periodística, son ejemplos de ello.

The objective of this research was to understand how journalists perceive their trade in major cities of the Colombian Caribbean region; to achieve a mixed research method was used, applying a qualitative and a quantitative phase, which was subsequently interconnected by a triangulation of data. Among the findings it was established that journalists in the Colombian Caribbean region exercising their profession gives great job satisfaction (defined as the pleasure experienced when practicing journalism) but little job satisfaction (which refers to conditions recruitment and remuneration). It was found that there is an intention of journalists qualify, however, with little free time they have low wages and remuneration, difficult for them to this end. Lack of passion for the job and lack of methods for investigative journalism, are examples of this: disagreements within the empirical media between journalists and journalists with professional training in the field wreaked.

Functional brain networks in treatment-resistant schizophrenia.

INTRODUCTION: Up to 20% of individuals with schizophrenia show minimal or no response to medication and are considered to have 'treatment-resistant' schizophrenia (TRS). Unlike early and established schizophrenia, few studies have investigated resting-state functional connectivity (rs-FC) in TRS. Here, we test for disruptions in FC and altered efficiency of functional brain networks in a well-characterized cohort of TRS patients. METHODS: Resting-state functional magnetic resonance imaging was used to investigate functional brain networks in 42 TRS participants prescribed clozapine (30 males, mean age=41.3(10)) and 42 healthy controls (24 males, mean age=38.4(10)). Graph analysis was used to characterize between-group differences in local and global efficiency of functional brain network organization as well as the strength of FC. RESULTS: Global brain FC was reduced in TRS patients (p=0.0001). Relative to controls, 3.4% of all functional connections showed reduced strength in TRS (p<0.001), predominantly involving fronto-temporal, fronto-occipital and temporo-occipital connections. Global efficiency was reduced in TRS (p=0.0015), whereas local efficiency was increased (p=0.0042). CONCLUSIONS: TRS is associated with widespread reductions in rs-FC and altered network topology. Increased local functional network efficiency coupled with decreased global efficiency suggests that hub-to-hub connections are preferentially affected in TRS. These findings further our understanding of the neurobiological impairments in TRS.

[Smoking-attributable mortality in Tucumán, Argentina 2001-2010]. / Mortalidad atribuible al tabaquismo en Tucumán, Argentina 2001-2010.

Smoking is the leading preventable cause of death in the world. In Argentina, in 2000, 16% of deaths were attributable to tobacco in over 35 years. In Tucuman it exis data on prevalence of, snuff consumption but not on mortality related to smoking. Our objective was to estimate the number of deaths attributable to tobacco smoking, the percentage attributable fraction, the rate of age-adjusted mortality and disability-adjusted life years. A cross-sectional descriptive study of mortality associated with smoking in adults over 35 years in Tucuman was conducted between 2001 and 2010; 19 causes provided by Centers for Disease Control and Prevention were grouped in cardiovascular diseases, malignancies and respiratory diseases. In the last decade, from a total of 77 220 deaths documented in Tucuman, 3131 [4.1% (CI 95%: 3.9-4.2)] were attributed to snuff, 77% in men with the highest attributable fraction percentage in the range of 35 to 64 years. Rate age-adjusted mortality ranged from 87.5 in 2001 to 52.1 in 2008. In the first half period cardiovascular diseases predominated, followed by malignancies. On average 3203 years of potential life lost were quantified; where cardiovascular diseases accounted for 55.3%. The percentage of deaths attributable to snuff in Tucuman was lower than that recorded for Argentina. Even though there is anti-tobacco legislation in Tucuman, it is necessary to strengthen it.

Mortalidad atribuible al tabaquismo en Tucumán, Argentina 2001-2010 / Smoking-attributable mortality in Tucumán, Argentina 2001-2010

El tabaquismo es la principal causa evitable de muerte en el mundo. En la Argentina, en 2000, el 16% de las muertes fueron atribuibles al tabaco en mayores de 35 años. En Tucumán existen datos de prevalencia de consumo de tabaco pero no del efecto del tabaquismo sobre la mortalidad. El objetivo fue estimar el número de muertes atribuibles al tabaco, la fracción atribuible porcentual, la tasa de mortalidad ajustada por edad y los años de vida potencialmente perdidos. Se realizó un estudio descriptivo transversal de mortalidad asociada al tabaquismo en adultos mayores de 35 años en Tucumán, entre 2001 y 2010. Se seleccionaron 19 causas provistas por Centers for Disease Control and Prevention agrupadas en enfermedades cardiovasculares, neoplasias malignas y enfermedades respiratorias. En el último decenio se encontró que de 77 220 muertes en Tucumán, 3131 [4.1% (IC: 95%: 3.9-4.2)] fueron atribuibles al tabaco. El 77% fue en hombres, quienes también presentaron la mayor fracción atribuible porcentual en el rango de 35 a 64 años. La tasa de mortalidad ajustada por edad varió entre 87.5 en 2001 a 52.1 en 2008. En el primer quinquenio predominaron las enfermedades cardiovasculares, y en el segundo las neoplasias malignas. En promedio se cuantificaron 3203 años de vida potencialmente perdidos por año; de los cuales, las enfermedades cardiovasculares aportaron el 55.3%. El porcentaje de muertes atribuibles al tabaco en Tucumán resultó menor que el registrado para la Argentina. Si bien existe legislación anti tabáquica en Tucumán, resulta necesario fortificarla.

Smoking is the leading preventable cause of death in the world. In Argentina, in 2000, 16% of deaths were attributable to tobacco in over 35 years. In Tucuman it exis data on prevalence of, snuff consumption but not on mortality related to smoking. Our objective was to estimate the number of deaths attributable to tobacco smoking, the percentage attributable fraction, the rate of age-adjusted mortality and disability-adjusted life years. A cross-sectional descriptive study of mortality associated with smoking in adults over 35 years in Tucuman was conducted between 2001 and 2010; 19 causes provided by Centers for Disease Control and Prevention were grouped in cardiovascular diseases, malignancies and respiratory diseases. In the last decade, from a total of 77 220 deaths documented in Tucuman, 3131 [4.1% (CI 95%: 3.9-4.2)] were attributed to snuff, 77% in men with the highest attributable fraction percentage in the range of 35 to 64 years. Rate age-adjusted mortality ranged from 87.5 in 2001 to 52.1 in 2008. In the first half period cardiovascular diseases predominated, followed by malignancies. On average 3203 years of potential life lost were quantified; where cardiovascular diseases accounted for 55.3%. The percentage of deaths attributable to snuff in Tucuman was lower than that recorded for Argentina. Even though there is anti-tobacco legislation in Tucuman, it is necessary to strengthen it.

Luminescent Ru(II) Phenanthroline Complexes as a Probe for Real-Time Imaging of Aß Self-Aggregation and Therapeutic Applications in Alzheimer's Disease.

The complexes cis-[Ru(phen)2(Apy)2]2+, Apy = 4-aminopyridine and 3,4-aminopyridine, are stable in aqueous solution with strong visible absorption. They present emission in the visible region with long lifetime that accumulates in the cytoplasm of Neuro2A cell line without appreciable cytotoxicity. The complexes also serve as mixed-type reversible inhibitors of human AChE and BuChE with high active site contact. cis-[Ru(phen)2(3,4Apy)2]2+ competes efficiently with DMPO by the OH• radical. Luminescence using fluorescence lifetime imaging (FLIM) enables real-time imaging of the conformational changes of the self-aggregation of Aß with incubation of complexes (0-24 h) in phosphate buffer at micromolar concentrations. By this technique, we identified protofibrills in the self-assembly of Aß1-40 and globular structures in the short fragment Aß15-21 in aqueous solution.