Chest CT Scan Findings in Children with COVID-19: A Systematic Review.

Objectives: To gather, summarize, and appraise the available evidence on: 1) the accuracy of chest CT scan in diagnosing COVID-19 among children, and 2) the characteristic chest CT scan findings associated with COVID-19 pneumonia in children. Methods: We comprehensively searched databases (MEDLINE, COCHRANE), clinical trial registries, bibliographic lists of selected studies, and unpublished data for relevant studies. Guide questions from the Painless Evidence Based Medicine and the National Institutes of Health Quality Assessment Tools were used to assess study quality. Results: A poor quality study showed 86.0% (95% CI 73.8, 93.0) sensitivity and 75.9% (95% CI 67.1, 83.0) specificity of chest CT scan in diagnosing COVID-19 in children. Thirty-nine observational studies describing chest CT scan in children with COVID-19 showed abnormal findings in 717 of 1028 study subjects. Common chest CT scan findings in this population include: 1) ground glass opacities, patchy shadows, and consolidation, 2) lower lobe involvement, and 3) unilateral lung lesions. Conclusion: Studies which investigate the accuracy of chest CT scan in the diagnosis of COVID-19 in children are limited by heterogeneous populations and small sample sizes. While chest CT scan findings such as patchy shadows, ground glass opacities, and consolidation are common in children with COVID-19, these may be similar to the imaging findings of other respiratory viral illnesses.

Anticipatory regulation for pandemic responses: are we there yet?

Can drug and vaccine regulatory agencies leverage their experience during the coronavirus disease 2019 (COVID-19) pandemic to advance from reactive regulation to adaptive regulation and beyond to anticipatory regulation to prevent or curb future pandemics?

A genome-wide atlas of human cell morphology.

A key challenge of the modern genomics era is developing data-driven representations of gene function. Here, we present the first unbiased morphology-based genome-wide perturbation atlas in human cells, containing three genome-scale genotype-phenotype maps comprising >20,000 single-gene CRISPR-Cas9-based knockout experiments in >30 million cells. Our optical pooled cell profiling approach (PERISCOPE) combines a de-stainable high-dimensional phenotyping panel (based on Cell Painting1,2) with optical sequencing of molecular barcodes and a scalable open-source analysis pipeline to facilitate massively parallel screening of pooled perturbation libraries. This approach provides high-dimensional phenotypic profiles of individual cells, while simultaneously enabling interrogation of subcellular processes. Our atlas reconstructs known pathways and protein-protein interaction networks, identifies culture media-specific responses to gene knockout, and clusters thousands of human genes by phenotypic similarity. Using this atlas, we identify the poorly-characterized disease-associated transmembrane protein TMEM251/LYSET as a Golgi-resident protein essential for mannose-6-phosphate-dependent trafficking of lysosomal enzymes, showing the power of these representations. In sum, our atlas and screening technology represent a rich and accessible resource for connecting genes to cellular functions at scale.

CS-iCCA, A New Clinically Based Staging System for Intrahepatic Cholangiocarcinoma: Establishment and External Validation.

INTRODUCTION: Intrahepatic cholangiocarcinoma (iCCA) is a primary liver malignancy with poor prognosis. Current prognostic methods are most accurate for patients with surgically resectable disease. However, a significant proportion of patients with iCCA are not surgical candidates. We aimed to develop a generalizable staging system based on clinical variables to determine prognosis of all patients with iCCA. METHODS: The derivation cohort included 436 patients with iCCA seen between 2000 and 2011. For external validation, 249 patients with iCCA seen from 2000 to 2014 were enrolled. Survival analysis was performed to identify prognostic predictors. All-cause mortality was the primary end point. RESULTS: Eastern Cooperative Oncology Group status, tumor number, tumor size, metastasis, albumin, and carbohydrate antigen 19-9 were incorporated into a 4-stage algorithm. Kaplan-Meier estimates for 1-year survival were 87.1% (95% confidence interval [CI] 76.1-99.7), 72.7% (95% CI 63.4-83.4), 48.0% (95% CI 41.2-56.0), and 16% (95% CI 11-23.5), respectively, for stages I, II, III, and IV. Univariate analysis yielded significant differences in risk of death for stages II (hazard ratio [HR] 1.71; 95% CI 1.0-2.8), III (HR 3.32; 95% CI 2.07-5.31), and IV (HR 7.44; 95% CI 4.61-12.01) compared with stage I (reference). Concordance indices showed the new staging system was superior to the TNM staging for predicting mortality in the derivation cohort, P < 0.0001. In the validation cohort, however, the difference between the 2 staging systems was not significant. DISCUSSION: The proposed independently validated staging system uses nonhistopathologic data to successfully stratify patients into 4 stages. This staging system has better prognostic accuracy compared with the TNM staging and can assist physicians and patients in treatment of iCCA.

Distributed compact plasma reactor decontamination for planetary protection in space missions.

This paper presents a proof-of-concept study establishing effectiveness of the Active Plasma Sterilizer (APS) for decontamination in planetary protection. The APS uses Compact Portable Plasma Reactors (CPPRs) to produce surface dielectric barrier discharge, a type of cold plasma, using ambient air to generate and distribute reactive species like ozone used for decontamination. Decontamination tests were performed with pathogenic bacteria (Escherichia coli and Bacillus subtilis) on materials (Aluminum, Polycarbonate, Kevlar and Orthofabric) relevant to space missions. Results show that the APS can achieve 4 to 5 log reductions of pathogenic bacteria on four selected materials, simultaneously at 11 points within 30 min, using power of 13.2 ± 2.22 W. Spatial decontamination data shows the APS can uniformly sterilize several areas of a contaminated surface within 30 min. Ozone penetration through Kevlar and Orthofabric layers was achieved using the CPPR with no external agent assisting penetration. Preliminary material compatibility tests with SEM analysis of the APS exposed materials showed no significant material damage. Thus, this study shows the potential of the APS as a light-weight sustainable decontamination technology for planetary protection with advantages of uniform spatial decontamination, low processing temperatures, low exposure times, material compatibility and the ability to disinfect porous surfaces.

Adaptive robustness through incoherent signaling mechanisms in a regenerative brain.

Animal behavior emerges from collective dynamics of interconnected neurons, making it vulnerable to connectome damage. Paradoxically, many organisms maintain significant behavioral output after large-scale neural injury. Molecular underpinnings of this extreme robustness remain largely unknown. Here, we develop a quantitative behavioral analysis pipeline to measure previously uncharacterized long-lasting latent memory states in planarian flatworms during whole-brain regeneration. By combining >20,000 animal trials with neural population dynamic modeling, we show that long-range volumetric peptidergic signals allow the planarian to rapidly reestablish latent states and restore coarse behavior after large structural perturbations to the nervous system, while small-molecule neuromodulators gradually refine the precision. The different time and length scales of neuropeptide and small-molecule transmission generate incoherent patterns of neural activity which competitively regulate behavior and memory. Controlling behavior through opposing communication mechanisms creates a more robust system than either alone and may serve as a generic approach to construct robust neural networks.

Enteropathogen Changes After Rotavirus Vaccine Scale-up.

OBJECTIVES: To inform next steps in pediatric diarrhea burden reduction by understanding the shifting enteropathogen landscape after rotavirus vaccine implementation. METHODS: We conducted a case-control study of 1788 medically attended children younger than 5 years, with and without gastroenteritis, after universal rotavirus vaccine implementation in Peru. We tested case and control stools for 5 viruses, 19 bacteria, and parasites; calculated coinfection-adjusted attributable fractions (AFs) to determine pathogen-specific burdens; and evaluated pathogen-specific gastroenteritis severity using Clark and Vesikari scales. RESULTS: Six pathogens were independently positively associated with gastroenteritis: norovirus genogroup II (GII) (AF 29.1, 95% confidence interval [CI]: 28.0-32.3), rotavirus (AF 8.9, 95% CI: 6.8-9.7), sapovirus (AF 6.3, 95% CI: 4.3-7.4), astrovirus (AF 2.8, 95% CI: 0.0-4.0); enterotoxigenic Escherichia coli heat stable and/or heat labile and heat stable (AF 2.4, 95% CI: 0.6-3.1), and Shigella spp. (AF 2.0, 95% CI: 0.4-2.2). Among typeable rotavirus cases, we most frequently identified partially heterotypic strain G12P[8] (54 of 81, 67%). Mean severity was significantly higher for norovirus GII-positive cases relative to norovirus GII-negative cases (Vesikari [12.7 vs 11.8; P < .001] and Clark [11.7 vs 11.4; P = .016]), and cases in the 6- to 12-month age range relative to cases in other age groups (Vesikari [12.7 vs 12.0; P = .0002] and Clark [12.0 vs 11.4; P = .0016]). CONCLUSIONS: Norovirus is well recognized as the leading cause of pediatric gastroenteritis in settings with universal rotavirus vaccination. However, sapovirus is often overlooked. Both norovirus and sapovirus contribute significantly to the severe pediatric disease burden in this setting. Decision-makers should consider multivalent vaccine acquisition strategies to target multiple caliciviruses in similar countries after successful rotavirus vaccine implementation.

Working restrictions and disability benefits eligibility in patients with functional (psychogenic) seizures: An international survey of physicians' opinions.

OBJECTIVES: In this international study, we aimed to investigate the opinions of physicians dealing with patients with functional seizures (FS) worldwide on working restrictions and disability benefits eligibility. METHODS: International online survey of neurologists/mental health professionals from Argentina, Venezuela, Colombia, Italy, France, Iran, Iraq, United Arab Emirates (UAE), Qatar, Saudi Arabia, Georgia, and Russia. RESULTS: Six hundred and twenty-seven physicians from 12 countries participated in the study. Working as a neurologist was a predictor to think that patients with FS should not be counseled to avoid performing all jobs or professions as long as they have active disease (OR: 0.46; 95% CI: 0.30 to 0.68; p < 0.001). Having managed more than 200 patients was associated with the opinion that patients should not be counseled to avoid performing any type of work (OR: 2.17; 95% CI: 1.02 to 4.59; p = 0.043). Working as a psychiatrist/psychologist was associated with the idea that patients with FS should be qualified for disability benefits (OR: 1.97; 95% CI: 1.21-3.21; p = 0.006), and receive these benefits lifelong (OR: 0.43; 95% CI: 0.22-0.84; p = 0.014). CONCLUSION: Neurologists and mental health professionals have different attitudes and opinions toward working restrictions and disability benefits for patients with FS. Further studies should investigate the reasons for these differences, and propose solutions to avoid discrimination and unequal access to employment and disability benefits.

Physicochemical characterization and nano-emulsification of three species of pumpkin seed oils with focus on their physical stability.

We present the chemical composition, quality parameters and antioxidant capacity of pumpkin seed oils (PSO) from Cucurbita pepo, Cucurbita maxima, and Cucurbita moschata cultivated in Brazil. In addition, PSO nanoemulsions (nanopepo, nanomax and nanomosc) were developed and their physical stabilities were assessed under long-term storage at two temperatures. Among the PSO, C. pepo presented the highest contents of polyunsaturated fatty acids, total carotenoids, and chlorophylls, but the lowest oxidative stability. Conversely, C. maxima PSO showed highest oxidative stability and total tocopherol content but the lowest chlorophyll content. Nanomax and nanopepo were more stable to droplet growth at 4 °C, while nanomosc was more stable at 25 °C. Nanopepo was the most stable formulation after the heating-cooling cycles, whereas nanomax was the most stable under centrifugation regardless the temperature. Overall, all nanoemulsions presented droplet diameter lower than 200 nm and ζ-potential approaching -30 mV until the end of storage.

Working Hard or Hardly Working? Regulatory Bottlenecks in Developing a COVID-19 Vaccine.

Vaccine solutions rarely reach the public until after an outbreak abates; an Ebola vaccine was approved 5 years after peak outbreak and SARS, MERS, and Zika vaccines are still in clinical development. Despite massive leaps forward in rapid science, other regulatory bottlenecks are hamstringing the global effort for pandemic vaccines.

Pasteurization of passion fruit Passiflora setacea pulp to optimize bioactive compounds retention.

Passiflora setacea is a wild species of passion fruit with interesting functional properties. Fruit seasonality demands conservation methods to enable its consumption throughout the year. We evaluated High Temperature Short Time (HTST) and Low Temperature Long Time (LTLT) binomials on physical, chemical, antioxidant and sensory characteristics of Passiflora setacea pulps. In natura (IN) and pasteurized pulps were analysed for DPPH, FRAP, ORAC, total phenolic content (TPC), vitamin C, bioactive amines, flavonoids, color, remaining enzymatic activity (REA), microbiological analyzes, sensory evaluation and physical stability. All binomials reached microbiological standards. Binomials 82 °C/20 s and 82 °C/40 s were selected for providing higher total antioxidant activity (TAA), TPC and lower REA. The highest levels of antioxidant activity, flavonoids, vitamin C were kept by 82 °C/20 s, without difference from IN pulp. LTLT binomial showed higher retention of bioactive amines, but also higher REA. Sensory acceptance was not affected by the binomials but pasteurized-cooked flavor was more checked for 82 °C 40 s than IN pulp.

Efectos de adopción y crianza homoparental* / Effects of adoption and homoparental breeding

La adopción y crianza de niños por padres del mismo sexo es un tema de reciente discusión en Colombia, aunque ha sido investigado por más de 4 décadas en el resto del mundo. Existen dudas de que crecer en este tipo de familias produzca efectos adversos. Éste trabajo pretende responder a través de una revisión de la literatura, si existen diferencias en el ajuste psicológico, desarrollo de la sexualidad, estigmatización y desempeño cognitivo, de los niños biológicos o adoptados por padres homosexuales. A través de la búsqueda en la base de datos PubMed se encontraron 204 artículos en total; aplicando criterios de inclusión se seleccionaron 18 que incluyen niños que viven en diferentes tipos de familias. En conclusión, de acuerdo a la revisión realizada y para responder a la pregunta de sí el bienestar de estos niños es igual, mejor o peor que el de los que son criados por padres heterosexuales, existe cierta tendencia y consistencia en los estudios analizados, en mostrar que no hay diferencia en el bienestar psicológico ni el desarrollo de la sexualidad entre los niños de este tipo de familias; por otro lado, si hay mayor posibilidad de estigmatización, pero es una variable que no depende en sí misma de la conformación de la familia o la orientación sexual de los padres, sino de factores externos como el entorno social y de educación del niño y sus pares..(AU)

The adoption and upbringing of children by parents of the same sex is a subject recently discussed in Colombia, even though it has been investigated for more than four decades in the rest of the world. There are concerns that growing up in this kind of family produces adverse effects. This document aims to respond through a review of the literature if there are differences between biological children or children adopted by homosexual parents in psychological adjustment, development of sexuality, stigmatization and cognitive performance. Through the search in the PubMed database, 204 articles were found in total, 18 articles were selected that fulfilled the inclusion criteria, which include approximately 1700 children with different types of families. In conclusion, the quality of the studies does not allow to generate degrees of recommendation for answering whether the welfare of these children is equal, better or worse than the children raised by heterosexual parents. However, a certain tendency and consistency among the studies shows that there is no difference in the psychological well-being or the development of sexuality between these two groups of families. In contrast, there is a greater possibility of stigmatization, a variable that does not depend itself on the conformation of the family or the sexual orientation of the parents, but depends on external factors such as the social and educational environment of the child and his peers..(AU)

First retrospective studies with etiological confirmation of porcine transmissible gastroenteritis virus infection in Argentina.

BACKGROUND: In 2014, a notification of porcine transmissible gastroenteritis virus (TGEV) was made by the National Services of Animal Health of Argentina (SENASA) to the World Organization of Animal Health (OIE). The notification was based on a serological diagnosis in a small farm with a morbidity rate of 2.3% without enteric clinical signs. In order to determine if TGEV was circulating before the official report, a retrospective study on cases of neonatal diarrhea was performed. The selection criteria was a sudden increase in mortality in 1- to 21-day-old piglets with watery diarrhea that did not respond to antibiotics. Based on these criteria, three clinical cases were identified during 2010-2015. RESULTS: All animals that were evaluated presented histological lesions consistent with enteric viral infection. The feces and ultrathin sections of intestine that were evaluated by electron microscopy confirmed the presence of round particles of approximately 80 nm in size and characterized by finely granular electrodense nucleoids consistent with complete particles of coronavirus. The presence of the TGEV antigen was confirmed by monoclonal specific immunohistochemistry, and final confirmation of a metabolically-active virus was performed by in situ hybridization to detect a TGE mRNA encoding spike protein. All sections evaluated in this case were negative for PEDV and rotavirus A. CONCLUSIONS: This is the first case series describing neonatal mortality with etiological confirmation of TGEV in Argentina. The clinical diagnosis of TGEV infections in endemic regions is challenging due to the epidemiological distribution and coinfection with other enteric pathogens that mask the clinical presentation.

First isolation and molecular characterization of Suid herpesvirus type 1 from a domestic dog in Argentina.

Since Aujeszky`s disease (pseudorabies), which is caused by Suid herpesvirus type 1 (SuHV-1), was first notified in Argentina in 1978, many SuHV-1 strains have been isolated from swine. However, this disease can affect other vertebrates, such as dogs (secondary hosts), and lead to fatal neurological disease. The objective of the current work is to report the first isolation and molecular characterization of SuHV-1 from a dead domestic dog from Santa Fe Province (Argentina), which had had nervous signs compatible with pseudorabies. Samples of brain and trigeminal ganglia from this dog were obtained and fixed in formol for histopathology, and virology studies were conducted after cell disruption. Supernatants of both samples were inoculated onto RK13 cells and, after 72 h, DNA was extracted with phenol-chloroform. Purified DNA was cut with a restriction enzyme and subjected to agarose gel and an aliquot was used to amplify the gD and gC genes by PCR. The gC sequence was compared with other public sequences. The strain isolated from the dog was similar to other Argentinean swine strains.

Papel do vírus Epstein-Barr e de fatores genéticos nos perfis imunes do microambiente tumoral no linfoma de Hodgkin clássico pediátrico / [Role of the Epstein-Barr virus and genetic factors in immune profiles of tumor microenvironment in pediatric classic Hodgkin's lymphoma]

O linfoma de Hodgkin clássico (LHc) é caracterizado por apresentar 0,5-1% de células neoplásicas (Hodgkin e Reed-Sternberg) com alta dependência do microambiente tumoral (MAT) formado por células inflamatórias e estromais. Este linfoma encontra-se associado ao vírus Epstein-Barr (EBV) em ~40-50% dos casos em nossa região. No LHc pediátrico EBV+, o MAT apresenta um perfil imune pró-inflamatório (células T citotóxicas/Th1), que poderia estar sendo inibido por mecanismos supressores pró-tumorais. Nosso objetivo foi investigar o MAT do LHc, o papel potencial do EBV e o papel do background genético individual na modulação do MAT. Por isto, foi proposto avaliar perfis de expressão gênica relacionados a potenciais mecanismos supressores e variantes genéticas associadas à resposta imune local, definida pela quantificação de subpopulações imunes mediante imunohistoquímica quantitativa, em linfonodos de pacientes pediátricos com LHc EBV+ e EBV-. Análises dos polimorfismos genéticos nas posições -1082/-592 do gene IL10 e +49/CT60 do gene CTLA4. Expressão de genes associados à resposta imune por RT-qPCR [perfil pro-inflamatório: CXCL10, IFNG e STAT1; supressor: IL10 e STAT6; checkpoint imune: CTLA4 (isoformas flCTLA4, completa e sCTLA4, solúvel), PDCD1, PD1L/CD274, HAVCR2/TIM3 e BTLA e; fatores de transcrição: EOMES e TBX21/TBET] foram analisados em relação às características clínicas-epidemiológicas, composição do MAT e resposta terapêutica. Análises bioinformáticas foram desenvolvidas na procura de uma assinatura relacionada à exaustão celular associada ao EBV. No gene IL10, genótipos -1082AA+AG foram associados a altos níveis de RNAm (P=0,014) e, os genótipos -1082GG/-592CC (baixa expressão) a um menor número de células MAF+ e haplótipo ATA (alta expressão) a um incremento de células MAF+ (P<0,05) no MAT. Pior sobrevida livre de progressão (SLP) preponderou nos pacientes com genótipos -1082AA+AG vs. GG, -592AA+AC vs. CC e no haplótipo ATA (P<0,05). No gene CTLA4, genótipos +49GG e CT60GG (baixo poder inibitório) foram associados a maior número de células citotóxicas (P<0,05). Pacientes com alta expressão de HAVCR2/TIM3, sCTLA4 e razões sCTLA4/flCTLA4>1,5 e EOMES/TBX21>1,5 apresentaram pior SLP (P<0,05). Alta expressão de IFNG e STAT1 e baixa de STAT6 foram identificadas nos casos EBV+ vs. EBV- (P<0,05). In silico, a presença do EBV foi associada a maior número de células citotóxicas e a menor número de células T CD4+ totais e subpopulações T CD4+ naïve e T reguladoras (P<0,05). Na potencial assinatura de exaustão específica do LHc, genes relacionados à ativação e inibição de células inflamatórias foram identificados (CD80, CD86, KLRB1, IL1RB2), já nos LHcEBV+ uma resposta antiviral foi identificada (FASLG, SLAMF7, GRZA, GRZK, CEACAM1). Com isto, estes resultados mostram que variantes genéticas regulam os níveis de expressão e composição do MAT, impactando no desfecho terapêutico; perfis moleculares/celulares distintos são identificados nos casos EBV+ vs. EBV- , mostrando que a presença do EBV está associada a uma resposta pró-inflamatória, porém poderia mediar um estado celular de exaustão via contato célula-célula; a identificação de mediadores de supressão, como variantes genéticas e expressão de IL10 e genes do checkpoint imune, sugerem mecanismos supressores e de exaustão imune que poderia, em parte, ser responsável pela resposta inflamatória não funcional.

Neuropediatrics postgraduate students' learning process through hidden curriculum at Universidad Nacional de Colombia / Aprendizaje a través del currículo oculto en estudiantes del posgrado en Neuropediatría de la Universidad Nacional de Colombia

Abstract Based on the importance of a comprehensive professional training, this research aims at observing and describing the learning process achieved through the hidden curriculum of students enrolled in the Neuropediatrics Specialization Program at Universidad Nacional de Colombia in 2012 y 2013. A qualitative study to explore students' training, transmission of attitudes, values and ethical aspects was performed through the implementation of a semi-structured interview and a focal group. For this group of students, learning through the hidden curriculum is real and educational, allows having a better approach to patients and acquiring appropriate tools for a successful job performance. Nevertheless, it is still insufficient to address ethical dilemmas such as delivery of bad news and patients' deaths. Thus, complementing this type of learning with explicit training on bioethics is required.

Resumen Basándose en la importancia de la formación integral del profesional, se pretendió observar y describir el aprendizaje logrado a través del currículo oculto en los estudiantes matriculados en la especialidad en Neuropediatría de la Universidad Nacional de Colombia en 2012 y 2013. A través de la aplicación de una entrevista semiestructurada y de un grupo focal, se realizó un estudio cualitativo que exploró aspectos de la formación, la transmisión de actitudes y valores y los aspectos éticos de los estudiantes. Para este grupo de alumnas el aprendizaje a través del currículo oculto es real y formativo, les permite una mejor aproximación a sus pacientes y les da las herramientas para un desempeño profesional exitoso; sin embargo, es aún insuficiente para resolver dilemas éticos como enfrentar la explicación de malas noticias y el momento del final de la vida. Se requiere entonces complementar este aprendizaje con enseñanzas explícitas en el área de la bioética.

Type 2 diabetes mellitus and colorectal neoplasia risk in Hispanics: a case-control study.

AIMS: There is inconclusive evidence regarding the potential link between diabetes mellitus (DM) and colorectal cancer (CRC). Associations between type 2 DM and colorectal neoplasia (CRN; colorectal cancer and/or adenomas) have not been well studied in Hispanics, an ethnic minority at high risk for type 2 DM. This study aims to assess the association between type 2 DM and CRN in Hispanics. METHODS: Hispanics with incident CRN and colonoscopy-negative controls from 2005 to 2009 were evaluated. Diagnosis of type 2 DM was established by previous medical diagnosis and/or use of DM treatments. Unconditional logistic regression was performed to estimate odds ratios for the association between type 2 DM and CRN. RESULTS: A total of 451 participants (mean age 61.1±11.9years, 59.6 % men) were evaluated (218 with incident CRC, 77 with colorectal adenomas, and 156 colonoscopy-negative controls). The prevalence of type 2 DM in this study was 25.1%. After adjusting for potential confounding variables, women with type 2 DM were 2.74 (95% CI: 0.94-7.99) times more likely to have CRN and 4.83 times more likely to present with proximal colonic CRN (95% CI: 1.25-18.58) than women without type 2 DM. No statistically significant associations were found between type 2 DM and CRN among men. CONCLUSIONS: An increased odds for CRN and proximal location of CRN was observed among Hispanic women with type 2 DM. Since DM is a highly prevalent disease in this population, adherence to routine CRC screening is of outmost importance.

Exploración de estrategias de disciplina aplicadas a los niños de una institución educativa en Bogotá / Exploring pre-school-related discipline strategies in a kindergarten in Bogotá

Antecedentes. La crianza del niño comprende todos los cuidados que se dan en las diferentes etapas de la infancia, que buscan su desarrollo y crecimiento adecuado. Esta misión es encomendada a los padres quienes, a la vez, deben iniciar su proceso de socialización. Es en este espacio donde tiene cabida la disciplina a traves de la normatividad, de manera que aseguren que los hijos acaten los principios de la sociedad. Objetivo. Describir las actitudes y prácticas de disciplina que emplean los padres de un grupo de niños de preescolar en una institución educativa de la ciudad de Bogotá. Materiales y métodos. Estudio cualitativo y cuantitativo, descriptivo de corte transversal, desarrollado con base en la realización de una entrevista semiestructurada a los padres de los niños del curso preescolar del Jardín Infantil de la Universidad Nacional de Colombia. Busca describir el perfil de la familia, consultar datos relevantes sobre conductas y antecedentes de riesgo, así como la actitud ante cuatro situaciones hipotéticas que podrían desencadenar maltrato. Resultados. Se aplicó la entrevista a 49 familias. La edad de los niños estuvo entre cuatro y cinco años 10 meses, con un promedio de cuatro años ocho meses. El 61% de las madres reconocen el antecedente de castigo físico en la infancia. Mujeres maltratadas en la actualidad: 25%. Uso de castigo físico en el 36%, de castigo psicológico en el 26%, de tiempo fuera en 44% y reparación 46% en las situaciones planteadas. Todas las familias monoparentales encabezadas por la madre usan castigo físico y fueron maltratadas en su infancia. Conclusiones. El castigo como forma de disciplina es frecuente en el grupo de estudio. En la consulta del niño debe explorarse la situación familiar de forma integral, evaluando especialmente situaciones de maltrato a la mujer. La presentación de situaciones hipotéticas es una herramienta útil para la evaluación de pautas de disciplina.

Background. Child upbringing comprehends every care which take place in the different children steps of childhood, which are intended to enhance their development and adequate growth. This mission is given to parents who, at the same time, must start the children's socialization. In this space, where children recibe discipline by means of normativity so that they assure themselves that children obey the society values. Objetive. Describing parents' attitudes and practice regarding discipline related to their pre-school children attending a kindergarten in Bogota. Materials and methods. This was a cross-sectional, descriptive, quantitative study which involved using data from semi-structured interviews with parents of pre-school children attending the Universidad Nacional de Colombia's kindergarten. The study sought to describe the families' socioeconomic profile, consult relevant information regarding risk patterns and background and the parents' attitude concerning 4 hypothetical situations which might have triggered abuse. Results. The study involved 49 families and 27 boys and 22 girls aged 4- to 5-years-old (average 4.8 years old); 49% of them were an only child. There was a 61% precedent of mothers acknowledging physical punishment during their own infancy; 25% of the women were currently being mistreated and 51% claimed that their pregnancies had not been planned. It was found that 36% of them used physical punishment in disciplining their own children, whereas 26% used psychological punishment, 44% restricted their children's freedom and 46% made them make amends. All single-parent families headed by mothers (4/5) admitted using physical punishment and had been mistreated during their infancy. Conclusions. Physical punishment was frequently used in the group being studied. A family's situation must be explored in depth during consultation, focusing on and evaluating potential events of violence against females. Presenting hypothetical situations is a useful tool for evaluating discipline guidelines in any family.