TwinsMX: Exploring the Genetic and Environmental Influences on Health Traits in the Mexican Population.

TwinsMX registry is a national research initiative in Mexico that aims to understand the complex interplay between genetics and environment in shaping physical and mental health traits among the country's population. With a multidisciplinary approach, TwinsMX aims to advance our knowledge of the genetic and environmental mechanisms underlying ethnic variations in complex traits and diseases, including behavioral, psychometric, anthropometric, metabolic, cardiovascular and mental disorders. With information gathered from over 2800 twins, this article updates the prevalence of several complex traits; and describes the advances and novel ideas we have implemented such as magnetic resonance imaging. The future expansion of the TwinsMX registry will enhance our comprehension of the intricate interplay between genetics and environment in shaping health and disease in the Mexican population. Overall, this report describes the progress in the building of a solid database that will allow the study of complex traits in the Mexican population, valuable not only for our consortium, but also for the worldwide scientific community, by providing new insights of understudied genetically admixed populations.

Estimating the Genetic Contribution to Astigmatism and Myopia in the Mexican Population.

Astigmatism and myopia are two common ocular refractive errors that can impact daily life, including learning and productivity. Current knowledge suggests that the etiology of these conditions is the result of a complex interplay between genetic and environmental factors. Studies in populations of European ancestry have demonstrated a higher concordance of refractive errors in monozygotic (MZ) twins compared to dizygotic (DZ) twins. However, there is a lack of studies on genetically informative samples of multi-ethnic ancestry. This study aimed to estimate the genetic contribution to astigmatism and myopia in the Mexican population. A sample of 1399 families, including 243 twin pairs and 1156 single twins, completed a medical questionnaire about their own and their co-twin's diagnosis of astigmatism and myopia. Concordance rates for astigmatism and myopia were estimated, and heritability and genetic correlations were determined using a bivariate ACE Cholesky decomposition method, decomposed into A (additive genetic), C (shared environmental) and E (unique environmental) components. The results showed a higher concordance rate for astigmatism and myopia for MZ twins (.74 and .74, respectively) than for DZ twins (.50 and .55). The AE model, instead of the ACE model, best fitted the data. Based on this, heritability estimates were .81 for astigmatism and .81 for myopia, with a cross-trait genetic correlation of rA = .80, nonshared environmental correlation rE = .89, and a phenotypic correlation of rP = .80. These results are consistent with previous findings in other populations, providing evidence for a similar genetic architecture of these conditions in the multi-ethnic Mexican population.

CO2 emissions and global value chains indicators:new evidence for 1995-2018.

Globalization and the configuration of production processes around Global Value Chains (GVCs) have become key factors for explaining the recent evolution of environmental and economic indicators. Indeed, previous research found evidence on the significant impact of GVCs indicators (participation and position) on CO2 emissions. Additionally, results obtained in previous literature vary depending on the time period and geographical areas considered. In this context, the main aims of this paper are to analyze the role the GVCs in explaining the evolution of CO2 emissions, and to identify possible structural breaks. This study uses the Multiregional Input-Output framework to calculate a position indicator and two different measures of participation in GVCs (interpreted either as trade openness or international competitiveness). The analysis useS Inter-Country Input-Output tables (ICIO) as main database, which includes 66 countries and 45 industries and covers the period 1995-2018. It is first concluded that upstream positions in GVCs are associated to lower global emissions. Additionally, the effect of participation depends on the measure used: trade openness is linked to lower emissions, while a higher competitiveness in international trade leads to higher emissions. Finally, two structural breaks are identified in 2002 and 2008, revealing that position is significant in the two first subperiods, while participation becomes significant from 2002 onwards. Thus, policies to mitigate CO2 emissions might to be different before and after 2008: currently, reductions in emissions can be achieved by increasing value-added embodied in trade while decreasing the volume of transactions.

Do agri-food market incentives improve food security and nutrition indicators? a microsimulation evaluation for Kenya.

The sustainable development goal #2 aims at ending hunger and malnutrition by 2030. Given the numbers of food insecure and malnourished people on the rise, the heterogeneity of nutritional statuses and needs, and the even worse context of COVID-19 pandemic, this has become an urgent challenge for food-related policies. This paper provides a comprehensive microsimulation approach to evaluate economic policies on food access, sufficiency (energy) and adequacy (protein, fat, carbohydrate) at household level. The improvement in market access conditions in Kenya is simulated as an application case of this method, using original insights from households' surveys and biochemical and nutritional information by food item. Simulation's results suggest that improving market access increases food purchasing power overall the country, with a pro-poor impact in rural areas. The daily energy consumption per capita and macronutrients intakes per capita increase at the national level, being the households with at least one stunted child under 5 years old, and poor households living areas outside Mombasa and Nairobi, those which benefit the most. The developed method and its Kenya's application contribute to the discussion on how to evaluate nutrition-sensitive policies, and how to cover most households suffering food insecurity and nutrition deficiencies in any given country. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-021-01215-2.

Raw versus cooked food matching: Nutrient intake using the 2015/16 Kenya Integrated Household Budget Survey.

In many countries, statistics from household consumption and expenditure surveys are increasingly being used to inform policies and programs. In household surveys, foods are typically reported as they are acquired (the majority are raw). However, the micronutrient content of some foods diminishes during processing and cooking. Using food consumption data from the 2015/16 Kenya Integrated Household Budget Survey, this study analyzes whether mean consumption estimates of dietary energy, macronutrients, and eight micronutrients are equivalent (applying a two-side paired equivalence test) when matching foods: (1) considering the nutrient content in raw foods (as reported in the survey), and (2) considering the nutrient content in foods as typically consumed, thus applying yield and retention factors as needed. Both food matching approaches rendered statistically equivalent mean consumption estimates, at national and county levels, for dietary energy, protein, fats, available carbohydrates, total fiber, calcium and zinc. Non-equivalent means were found for iron, vitamins A, B1, B2, B12, and C. The higher differences between the means were, in percentage change, for vitamin C (47 %), B1 (34 %) and B12 (26 %).

Sulfur Deprivation Modulates Salicylic Acid Responses via Nonexpressor of Pathogenesis-Related Gene 1 in Arabidopsis thaliana.

Mineral nutrients are essential for plant growth and reproduction, yet only a few studies connect the nutritional status to plant innate immunity. The backbone of plant defense response is mainly controlled by two major hormones: salicylic acid (SA) and jasmonic acid (JA). This study investigated changes in the macronutrient concentration (deficiency/excess of nitrogen, phosphorus, potassium, magnesium, and sulfur) on the expression of PR1, a well-characterized marker in the SA-pathway, and PDF1.2 and LOX2 for the JA-pathway, analyzing plants carrying the promoter of each gene fused to GUS as a reporter. After histochemical GUS assays, we determined that PR1 gene was strongly activated in response to sulfur (S) deficiency. Using RT-PCR, we observed that the induction of PR1 depended on the function of Non-expressor of Pathogenesis-Related gene 1 (NPR1) and SA accumulation, as PR1 was not expressed in npr1-1 mutant and NahG plants under S-deprived conditions. Plants treated with different S-concentrations showed that total S-deprivation was required to induce SA-mediated defense responses. Additionally, bioassays revealed that S-deprived plants, induced resistance to the hemibiotrophic pathogen Pseudomonas syringae pv. DC3000 and increase susceptibility to the necrotrophic Botrytis cinerea. In conclusion, we observed a relationship between S and SA/JA-dependent defense mechanisms in Arabidopsis.

Developmental differences in preschoolers' definition assessment and production.

Children are able to assess the quality of information presented to them, most notably in the domains of causal explanations and arguments. However, children are also presented with another form of verbal information-definitions. Very little empirical work has investigated how children assess and produce definitions. Two experiments explored preschoolers' comprehension and production of definitions. In Experiment 1, a selective trust paradigm was used to assess 3-year-olds' (n = 28) and 5-year-olds' (n = 28) endorsements of informative and uninformative definitions. Participants were provided with two informants: one who always provided a circular definition (e.g., "Silly means when you are silly") and one who always provided a noncircular definition (e.g., "Silly means when you are goofy"). The 5-year-olds endorsed noncircular definitions over circular definitions for both frequent and infrequent words, but they chose to learn only from informants who provided information about infrequent words. The 3-year-olds, on the other hand, did not systematically endorse either definition type. In Experiment 2, new groups of 3-year-olds (n = 25) and 5-year-olds (n = 24) were asked to provide definitions, and their responses were coded for correctness and circularity. Results demonstrated that 5-year-olds provided more definitions than 3-year-olds. In addition, 5-year-olds provided more noncircular definitions than 3-year-olds for infrequent words but not for frequent words. Together, the results from Experiments 1 and 2 suggest that children's understanding of definitions emerges during the preschool period. This work presents an important first step in addressing an understudied facet of lexical development.

Superposición de desórdenes gastrointestinales funcionales en escolares y adolescentes latinoamericanos / Overlapping of functional gastrointestinal disorders in latinamerican schoolchildren and adolescents

Resumen: Introducción: Hay pocos estudios sobre Desórdenes Gastrointestinales Funcionales superpuestos (DGFs-s). Objetivo: Describir la prevalencia y posibles factores de riesgo en niños Latinoamericanos (Latam) para presentar DGFs-s. Pacientes y Método: Estudio de prevalencia en niños escolares La tam entre 8-18 años. Se incluyeron variables sociodemográficas; se utilizaron los Criterios de Roma III en español, y se consideró DGFs-s cuando se presentaron 2, 3 o 4 y más DGFs en un mismo niño. El análisis estadístico incluyó t de student, chi cuadrado, prueba exacta de Fisher, análisis uni y multivariados y cálculo de los ORs e IC95%, siendo considerada una p < 0,05 significativa. Resul tados: Fueron analizados 6193 niños Latam (11,8 ± 2,2 años; 62,2% entre 8-12 años; 50,4% niñas; 68,0% colegio público), con diagnóstico de algún DGFs del 23,4%. Hubo superposición de DGFs en un mismo niño, en 8,4% (5,5% con 2 DGFs; 2,1% con 3 DGFs y 0,9% con 4 o más DGFs), siendo las principales superposiciones el Síndrome de intestino irritable (SII) + Dolor abdominal funcio nal (DAF) (2,6%) y el SII + DAF + Estreñimiento funcional (1,1%). Hubo predomino del género femenino. Conclusión: Hay una baja prevalencia de DGFs-s en escolares y adolescentes Latam, con predominio en el sexo femenino y de presentación muy variable.

Abstract: Introduction: There are few studies on overlapping Functional Gastrointestinal Disorders (FGIDs). Objective: To describe the prevalence and possible risk factors in Latin American children (Latam) to present overlapping FGIDs. Patients and Method: Prevalence study in Latam schoolchildren bet ween 8-18 years of age. Sociodemographic variables were included; the Rome III Criteria in Spanish were used, and overlapping FGIDs were considered when two, three or four and more FGIDs were presented in the same child. The statistical analysis included Student's T-test, chi-square test, Fisher's exact test, univariate and multivariate analysis, and calculation of ORs and 95% CI, being considered a significant p < 0.05. Results: 6,193 Latam children were analyzed (11.8 ± 2.2 years, 62.2% between 8-12 years of age, 50.4% girls, 68.0% public school), and 23.4% with a diagnosis of some kind of FGIDs. There was overlap of FGIDs in the same child, in 8.4% (5.5% with 2 FGIDs, 2.1% with 3 FGIDs and 0.9% with 4 or more FGIDs), the main overlaps were irritable bowel syndrome (IBS) + functional abdominal pain (FAP) (2.6%), and IBS + FAP + functional constipation (1.1%). There was predominance of the female gender. Conclusion: There is a low prevalence of overlapping FGIDs in Latam schoolchildren and adolescents, with a predominance in females and of very variable pre sentation.

[Irritable bowel syndrome subtypes and characteristics in children from Panama, Ecuador,El Salvador, Nicaragua and Mexico]. / Caracterización y subtipos del síndrome de intestino irritable en niños de Panamá, Ecuador, El Salvador, Nicaragua y México.

INTRODUCTION: Few pediatric studies classify the irritable bowel syndrome (IBS) subtypes. OBJECTIVE: To describe the characteristics and subtypes of IBS in children from Panama, Ecuador, El Salvador, Nicaragua and Mexico. MATERIAL AND METHODS: Prevalence study performed in children between 8 and 18 years of age with a diagnosis of IBS. The children answered the Questionnaire for Pediatric Gastrointestinal Symptoms Roma III for Schoolchildren and Adolescents (QPGS-III) to identify functional gastrointestinal disorders. Variables such as age and sex were taken into account. The subtypes of IBS were classified in IBS with constipation (IBS-c), with diarrhea (IBS-d), mixed (IBS-m) and without subtype (IBS-ss). Statistical analysis included measures of central tendency, two-tailed student t-test, chi-square test, and Fisher's exact test, with a significant p<0.05. RESULTS: We included 79 children (54.4% female, 12.1±2.1 years) presenting IBS-ss in 55.7%, IBS-c in 15.2%, IBS-m in 15.2% and SII-d in 13.9%. Severe pain predominated most of the day and with mucous stools; possible associations for IBS-d school and sex. CONCLUSION: After IBS-ss, the IBS-e, IBS-d and IBS-m are similar, being the possible risk factors for IBS-d, the public school and the female gender.

Caracterización y subtipos del síndrome de intestino irritable en niños de Panamá, Ecuador, El Salvador, Nicaragua y México / Irritable bowel syndrome subtypes and characteristics in children from Panama, Ecuador, El Salvador, Nicaragua and Mexico

Introducción: Pocos estudios pediátricos clasifican los subtipos del síndrome de intestino irritable (SII). Objetivo: Describir las características y subtipos del SII en niños de Panamá, Ecuador, El Salvador, Nicaragua y México. Material y métodos: Estudio de prevalencia realizado en niños entre los 8 y 18 años de edad con diagnóstico de SII. Los niños respondieron el Cuestionario para Síntomas Gastrointestinales Pediátricos Roma III para Escolares y Adolescentes (QPGS-III) para identificar desordenes gastrointestinales funcionales (DGFs). Se tuvieron en cuenta variables como edad y sexo. Los subtipos de SII se clasificaron en SII con estreñimiento (SII-e), con diarrea (SII-d), mixto (SII-m) y sin subtipo (SII-ss). El análisis estadístico incluyó medidas de tendencia central, t-student a dos colas, chi cuadrado, y prueba exacta de Fisher, siendo una p<0,05 significativa. Resultados: Fueron incluidos 79 niños (54,4% femeninos; 12,1±2,1 años) presentándose SII-ss en 55,7%, SII-e en 15,2%, SII-m en 15,2% y SII-d en13,9%. Predominó el dolor severo la mayor parte del día y con heces mucosas; siendo posibles asociaciones para SII-d el colegio y el sexo. Conclusión: Luego del SII-ss, los SII-e, SII-d y SII-m son similares, siendo los posibles factores de riesgo para SII-d, el colegio público y el género femenino

Introduction: Few pediatric studies classify the irritable bowel syndrome (IBS) subtypes. Objective: To describe the characteristics and subtypes of IBS in children from Panama, Ecuador, El Salvador, Nicaragua and Mexico. Material and methods: Prevalence study performed in children between 8 and 18 years of age with a diagnosis of IBS. The children answered the Questionnaire for Pediatric Gastrointestinal Symptoms Roma III for Schoolchildren and Adolescents (QPGS-III) to identify functional gastrointestinal disorders. Variables such as age and sex were taken into account. The subtypes of IBS were classified in IBS with constipation (IBS-c), with diarrhea (IBS-d), mixed (IBS-m) and without subtype (IBS-ss). Statistical analysis included measures of central tendency, two-tailed student t-test, chi-square test, and Fisher's exact test, with a significant p<0.05. Results: We included 79 children (54.4% female, 12.1±2.1 years) presenting IBS-ss in 55.7%, IBS-c in 15.2%, IBS-m in 15.2% and SII-d in 13.9%. Severe pain predominated most of the day and with mucous stools; possible associations for IBS-d school and sex. Conclusion: After IBS-ss, the IBS-e, IBS-d and IBS-m are similar, being the possible risk factors for IBS-d, the public school and the female gender

El cuidado espiritual un camino para trascender en la razón de ser de la Enfermería / Spiritual care a way to transcend the reason of being of Nursing

Resumen

¿Cómo se relaciona la espiritualidad con el arte del cuidado?

La espiritualidad acompaña al hombre desde sus orígenes, al igual que el cuidado se reconoce como una dimensión humana; en la contemporaneidad, se explica dentro del paradigma de la Nueva Era como respuesta a las concepciones tradicionales. Se relaciona con la comunicación enfermera-persona durante el proceso de cuidado que, en esencia, se trata de recuperar el sentido de la vida-muerte, la conciencia de sí y su trascendencia.

La espiritualidad se fundamenta en procesos de vida, posee orientaciones y significados diferentes; así es como el cuidado espiritual se convierte en un proceso dinámico continuo de interacción, del estar ahí con la persona, de ayudarle en su necesidad de trascender y de vivir acorde con sus creencias y significados.

El profesional de enfermería, al apropiarse de estos conceptos y ponerlos en práctica desarrolla su propia espiritualidad, promueve en las personas preguntarse por el sentido de su existencia, elaborar proyectos de vida y comprender su historia de vida; dichas acciones, favorecen que el profesional de enfermería se identifique consigo mismo y con el otro en el momento de brindar cuidado, y convierte el acto del cuidado en una experiencia trascendente, donde convergen el crecimiento personal y profesional.

Abstract

How is spirituality related to the art of care?

Spirituality accompanies man from his origins just as care is recognized as a human dimension; in contemporaneity, it is explained within the paradigm of the New Age as a response to traditional conceptions. It is related to the nurse-person communication during the care process, which in essence, is about recovering the meaning of life-death, self-awareness and its transcendence. Spirituality is based on life processes, and it has different orientations and meanings; that is how, spiritual care becomes a continuous dynamic process of interaction, of being there with the person, of helping him in his need to transcend and live according to his beliefs and meanings.

The nursing professional, by appropriating these concepts and putting them into practice, develops his own spirituality; promotes in people, the question of the meaning of their existence, develop life projects and understand their life history; these actions favor that the nursing professional identifies himself with himself and with the other at the time of providing care, and turns the act of care into a transcendent experience, where personal and professional growth converge.

[Overlapping of functional gastrointestinal disorders in latinamerican schoolchildren and adolescents]. / Superposición de desórdenes gastrointestinales funcionales en escolares y adolescentes latinoamericanos.

INTRODUCTION: There are few studies on overlapping Functional Gastrointestinal Disorders (FGIDs). OBJECTIVE: To describe the prevalence and possible risk factors in Latin American children (Latam) to present overlapping FGIDs. PATIENTS AND METHOD: Prevalence study in Latam schoolchildren bet ween 8-18 years of age. Sociodemographic variables were included; the Rome III Criteria in Spanish were used, and overlapping FGIDs were considered when two, three or four and more FGIDs were presented in the same child. The statistical analysis included Student's T-test, chi-square test, Fisher's exact test, univariate and multivariate analysis, and calculation of ORs and 95% CI, being considered a significant p < 0.05. RESULTS: 6,193 Latam children were analyzed (11.8 ± 2.2 years, 62.2% between 8-12 years of age, 50.4% girls, 68.0% public school), and 23.4% with a diagnosis of some kind of FGIDs. There was overlap of FGIDs in the same child, in 8.4% (5.5% with 2 FGIDs, 2.1% with 3 FGIDs and 0.9% with 4 or more FGIDs), the main overlaps were irritable bowel syndrome (IBS) + functional abdominal pain (FAP) (2.6%), and IBS + FAP + functional constipation (1.1%). There was predominance of the female gender. CONCLUSION: There is a low prevalence of overlapping FGIDs in Latam schoolchildren and adolescents, with a predominance in females and of very variable pre sentation.

Manejo quirúrgico del mixoma cardíaco / (Surgical management of cardiac myxoma)

ResumenSe presenta el caso de una paciente de 32 años, con trastorno psiquiátrico, con historia de un mes de evolución de disnea y tos no productiva, tratada inicialmente como bronconeumonía, con amplia cobertura antibiótica sin mejoría de síntomas; se maneja luego como síndrome de dificultad respiratoria aguda. Debido a franco ataque al estado general y datos incongruentes con historia clínica, se realiza ecocardiograma que incidentalmente reporta mixoma en aurícula izquierda. Los mixomas cardíacos son el tipo más común de tumores primarios benignos cardíacos, una patología poco frecuente y con mortalidad asociada a muerte súbita en un 15%. La mayoría de casos son encuentros incidentales, esporádicos y su etiología no es conocida. Los síntomas pueden asociarse a embolismo del tumor, insuficiencia cardiaca, obstrucción mecánica valvular y síntomas constitucionales varios.

AbstractWe present the case of a 32 year old patient known to have a psychiatric disorder, who presented with a history of one month of dyspnoea and nonproductive cough, which was treated initially as bronchopneumonia, with wide spectrum antibiotics without clinical improvement. Later is treated as an acute pulmonary distress syndrome, but because of poor general condition and incongruent data in the clinical history an echocardiogram was performed in the Emergency Room that incidentally founds a myxoma in the left atrium. Cardiac myxomas are the most common primary heart benign tumors, and have a mortality rate associated with sudden death of 15%. In the majority of the cases the diagnosis is incidental, sporadic and the etiology is unknown.The symptoms may be associated with tumor embolism, heart failure, valvular disease and nonspecific symptoms.

Association of a characteristic membrane pattern of annexin A2 with high invasiveness and nodal status in colon adenocarcinoma.

The identification of tumor cells in lymph nodes is essential for the correct classification of patients with colorectal cancer who may benefit from adjuvant treatments. Proper classification of tumor stage becomes entangled by variables such as an insufficient number of lymph nodes examined, which can result in erroneous or missed diagnosis. The determination of pathologic factors in the primary tumor associated with positive lymph nodes is an area of research that has attempted to provide variables to solve this problem. In the present study, we observed that the localization of annexin A2 (AnxA2) in a cell membrane is the characteristic that distinguishes tumor cells with high invasiveness. Localization of AnxA2 expression was also studied in tissue specimens from 58 patients with invasive colorectal carcinoma (T3-T4), who had undergone colectomy with radical lymph node dissection. Interestingly, the membrane pattern observed in tumor cell lines was also identified in patient's tissue samples and allowed us to distinguish among different cell populations with the tumor. Univariate analysis showed that tumor deposits in pericolic fat, extramural vascular invasion, and amount of cells with AnxA2 membrane pattern in the tumor invasive edge had a significant influence on lymph node metastasis. On the contrary, multivariate analysis revealed that the number of cells with AnxA2 membrane pattern (P < 0.05) and tumor deposits (P < 0.05) was significantly associated with lymph node metastasis. Furthermore, AnxA2 cellular localization was observed in cell clusters that define tumor budding, and a significant association between both variables was detected.

Description of a new species of Neoparaphytoseius Chant and McMurtry (Acari: Mesostigmata: Phytoseiidae) from Peru, with a redefinition of the genus.

Neoparaphytoseius charapa n. sp. is described, based on the morphology of adult females and males collected on Inga edulis (Mart.) (Fabaceae) in northeastern Peru. Neoparaphytoseius Chant & McMurtry is redefined on the basis of the new species and re-examination of its type species N. sooretamus Chant & McMurtry. 

Hipotensión ortostática en el adulto mayor: Frecuencia y factores asociados / Orthostatic hypotension in the elder: Frequency and associated factors

No existen descripciones locales de hipotensión ortostática (HO). Los criterios diagnósticos no están uniformizados ni basados en evidencias. La presencia de hipotensión ortostática es un factor de riesgo independiente de mortalidadcardiovascular. Objetivos: Determinar la frecuencia de hipotensión ortostática en el adulto mayor, el tiempo en el que ocurre y describir sus características clínicas y demográficas. Material y métodos: Fueron incluidos 280 adultos mayores sin enfermedad aterosclerótica, metabólica o inmunológica clínicamente evidente. La presión arterial fue medida con un monitor ambulatorio OMRON serie HEM 705-CP con calibración vigente. Tras reposo de 5 minutos en decúbito dorsal, se determinó la presión arterial basal y luego de pararse se midió la presión en cada minuto durante 5 minutos. Se consignaron los síntomas asociados al cambio de postura.Resultados: Cuarenta y siete(16,79%) pacientes presentaron HO. La hipotensión ortostática fue sistólica en 74,7%, diastólica en 8,51% y sisto-diastólica en 17,02% de los casos. No se encontró asociación entre HO y edad, género, índice de masa corporal, ser hipertenso y recibir medicación antihipertensiva. La HO fue más frecuente en los que tenían PAS basal ≥180mmHg (p<0,001). En 61,7% la HO ocurrió en el primer minuto.Conclusiones: La hipotensión ortostática es una condición frecuente en el adulto mayor, es más frecuentecon PAS basal ≥ 180 mmHg y más del 80% ocurre en los primeros3 minutos

There is no local data on orthostatic hypotension (OH). The diagnostic criteria of OH are not standardized and are not based on good evidence. OH is an independent risk factor for cardio-vascular mortality. Objectives: To determine the frequency of OH in the elder, and to describe its clinical and demographic features. Methods: 280-elder patients without clinical evidence of atherosclerotic, metabolic or immunologic diseases were included. Blood pressure measurements were performed with an ambulatory monitor OMRON-HEM 705-CP recently callibrated. Baseline blood pressure was measured after resting the patient in the supine position for five minutes. Then, the blood pressure was measured every minute with the patient in the standing position. Symptoms associated with change in position were recorded. Results: 47 patients (16.79%) presented OH. OH was systolic in 74.7%; diastolic in 8.51%, and systo-diastolic in 17.02%. No association was found between age, gender, body mass index, blood hypertension and receiving medication for blood hypertension and OH. OH was more frequent in patients with baseline systolic pressure greater than or equal to 180mmHg (p<0.001). OH occurred in the first minute measurement in 61.7% of cases. Conclusions: OH is frequent among elder patients, it is more frequent among those with baseline blood pressures greater than or equal to 180 mmHg, and it happens in more than 80% of cases in the first 3 minute measurements.

Differences in talker recognition by preschoolers and adults.

Talker variability in speech influences language processing from infancy through adulthood and is inextricably embedded in the very cues that identify speech sounds. Yet little is known about developmental changes in the processing of talker information. On one account, children have not yet learned to separate speech sound variability from talker-varying cues in speech, making them more sensitive than adults to talker variation. A different account is that children are less developed than adults at recognizing speech sounds and at recognizing talkers, and development involves protracted tuning of both recognition systems. The current research presented preschoolers and adults (N=180) with voices linked to two distinct cartoon characters. After exposure, participants heard each talker and selected which character was speaking. Consistent with the protracted tuning hypothesis, children were much less accurate than adults when talkers were matched on age, gender, and dialect (Experiments 1-3), even when prosody differed (Experiment 5). Children were highly accurate when voices differed in gender (Experiment 2) or age (mother vs. daughter; Experiment 6), suggesting that greater acoustic dissimilarity facilitated encoding. Implications for speech sound processing are discussed, as are the roles of language knowledge and the nature of talker perceptual space in talker encoding.

[Acute necrotizing pancreatitis by a foreign body. First worldwide report secondary to a match impactation]. / Pancreatitis Aguda Necrotizante por Cuerpo Extraño. Primer caso Reportado SecundariO a un Palillo de Fósforos.

Pancreatitis caused by foreign bodies is exceptionally rare. It has been described: needles, surgical clips, sutures, belt buckles, toothpicks, spines of fish, chicken feathers and bezoars. This is the first case reported in world literature caused by a match ("cerillo"). A 73-year-old women, admitted with the diagnostic of severe necrotizing pancreatitis, APACHE score 12, during 36 hours following the admission she developed refractory hypotension, acute renal failure and finally died. The necropsy showed: extensive necrosis that compromise the whole pancreas and a match impacted in the duct of Wirsung. Microscopic evaluation revealed coagulative parenchymal necrosis, micro abscesses and a dense accumulation of acute inflammatory cells surrounding the match.

Pancreatitis aguda necrotizante por cuerpo extraño. Primer caso reportado secundario a un palillo de fósforos / Acute necrotizing pancreatitis by a foreign body. First reported case secondary to a match stick

Cuadros de pancreatitis causada por cuerpo extraño son excepcionalmente raros. Se han descrito: agujas, clips quirúrgicos, suturas, hebillas de cinturón, mondadientes, espinas de pescado, plumas de pollo y bezoares. Este es el primer caso reportado en la literatura mundial causado de un palito de fósforo (cerillo). Se trata de una mujer de 73 años con diagnóstico de pancreatitis aguda necrotizante, puntaje Apache en 12, que desarrollo en las siguientes 36 horas de la admisión, hipotensión refractaria, falla renal aguda y muerte. La autopsia mostró necrosis extensa que comprometía todo el páncreas y un cerillo impactado en el conducto de Wirsung. Microscópicamente se evidenció necrosis coagulativa parenquimal, micro_abscesos y un denso infiltrado inflamatorio agudo rodeando al cerillo.

Pancreatitis caused by foreign bodies is exceptionally rare. It has been described: needles, surgical clips, sutures, belt buckles, toothpicks, spines of fish, chicken feathers and bezoars. This is the first case reported in world literature caused by a match ("cerillo"). A 73-year-old women, admitted with the diagnostic of severe necrotizing pancreatitis, APACHE score 12, during 36 hours following the admission she developed refractory hypotension, acute renal failure and finally died. The necropsy showed: extensive necrosis that compromise the whole pancreas and a match impacted in the duct of Wirsung. Microscopic evaluation revealed coagulative parenchymal necrosis, micro abscesses and a dense accumulation of acute inflammatory cells surrounding the match.

Anatomic double-bundle ACL reconstruction with femoral cortical bone bridge support using hamstrings.

While ACL reconstruction using single-tunnel and single-bundle techniques generally yields good clinical results, more and more studies are now reporting results that are not entirely satisfactory, as this type of reconstruction only exerts control over forward tibial shifting, not tibial rotation, when activities that exert high functional demands are undertaken. As a result, recent years have seen the appearance of numerous techniques for anatomic ACL reconstruction that reproduce both the anteromedial and posterolateral bundles of the ligament and therefore offer potentially improved rotational control. This article outlines a technique for anatomic ACL reconstruction. Said technique uses central and anteromedial portals, which afford a better perspective of the intercondylar notch. The main features of this technique are: (1) Double bone tunnels in the femur and tibia. The femoral tunnels are created using the out-in technique. (2) Double bundles with hamstring tendon grafts. (3) Tibial fixation by means of interference screws. (4) Femoral fixation in which the graft is supported by a cortical bone bridge and an interference screw in one of the tunnels. We feel that the main advantage of this technique is precisely that it introduces a new feature (a cortical femoral bone bridge) and is not necessarily dependent on specific double-bundle instrumentation, using only regular drill guides to create out-in femoral tunnels. This enables said tunnels to be located with ease and precision. The femoral fixation model itself, with the support provided by the cortical bone bridge, potentially guarantees a level of resistance that can be further increased with the aid of one or two interference screws, thus avoiding the need for post fixation techniques that require the use of screws or buttons.