Mesialización del sector posterior por la ausencia del primer molar mediante el uso de microimplantes / Mesialization of the posterior sector due to the absence of the first molar through the use of micro-implants

Se presenta un caso clínico de paciente femenina de 16 años, la cual reportó haber perdido su primer molar superior izquierdo por caries dos años atrás. Es una paciente con maloclusión clase II esquelética, mesofacial, perfil recto, clase I molar derecho, ausencia del diente 26, clase I canina derecha y tendencia a clase II canina izquierda, con apiñamiento leve superior e inferior y línea media dental inferior desviada a la izquierda. Se trató mediante el uso de microimplante, con el objetivo de mesializar los dientes 27 y 28 así como mejorar el asentamiento de la clase canina izquierda. Se finalizó de manera exitosa la mesialización de los dientes posteriores superiores izquierdos, estableciendo una adecuada oclusión, eliminando el apiñamiento, logrando una buena guía anterior con líneas medias dentales coincidentes, proporcionando una sonrisa funcional y armoniosa. El propósito de este caso es demostrar que con las herramientas y mecánicas adecuadas además de una buena planificación, se puede lograr el control del anclaje en el movimiento de cierre posterior a falta de un molar ausente, y así lograr establecer una adecuada oclusión.

A clinical case of a 16-year-old female patient is presented, who reported having lost her upper left first molar due to caries two years ago is presented. She is a patient with class II skeletal, mesofacial malocclusion, straight profile, class I right molar, absence of tooth 26, class I right canine and tendency to class II left canine, with mild upper and lower crowding and lower dental midline deviated to the left. It was treated through the use of a microimplant, with the objective of mesializing teeth 27 and 28 as well as improving the settlement of the left canine class. The mesialization of the upper left posterior teeth was successfully completed, establishing adequate occlusion, eliminating crowding, achieving good anterior guidance with coincident dental midlines, providing a functional and harmonious smile. The purpose of this case is to demonstrate that with the appropriate tools and mechanics in addition to good planning, control of the anchorage in the posterior closing movement can be achieved in the absence of an absent molar, and thus achieve adequate occlusion.

Serous maculopathy with absence of retinal pigment epithelium (SMARPE) associated with large drusen.

PURPOSE: To describe the association of serous maculopathy with absence of retinal pigment epithelium (SMARPE) and large drusen in patients with non-neovascular age-related macular degeneration (AMD). METHODS: A retrospective study of ophthalmic examination and multimodal imaging data of individuals with SMARPE and large drusen observed over a period of 12-month was accomplished. SMARPE was defined as subretinal accumulation of fluid within the macular area due to retinal pigment epithelium (RPE) aperture. Large drusen were identified by the presence of sub-RPE deposits using multimodal imaging analysis (color fundus photography, fundus autofluorescence, and spectral-domain optical coherence tomography). RESULTS: Twelve eyes of 7 white patients with a mean age of 77 years were observed to have SMARPE associated with large drusen. The median visual acuity was 20/100. Bilateral SMARPE lesions were observed in 71% of study patients. All SMARPE lesions were hypoautofluorescent, located in the subretinal space between the RPE and the ellipsoid zone, and presented as complete or incomplete RPE apertures associated with subretinal fluid. The SMARPE in this study had coincident multimodal imaging features as the SMARPE described in other reports in the literature. CONCLUSIONS: Bilateral SMARPE can occur in association with typical AMD large drusen. Anomalisms resulting in drusen biogenesis or mechanisms that act alongside to these may be related to SMARPE development.

A experiência do distanciamento social: entre presenças, ausências e sentidos / The experience of social distancing: between presences, absences and senses / La experiencia del distanciamento social: entre presencias, ausencias y sentidos

O presente ensaio teórico buscou discutir as transformações que a experiência de distanciamento social, em decorrência da pandemia do novo coronavírus, tem operado nas formas de produção compartilhada de sentidos. Para tal, utilizamos as contribuições da abordagem enativa da cognição sobre o conceito de produção de sentidos. As noções de presença e ausência, como dimensões coproduzidas e relevantes nas vivências coletivas do último período permearam toda a reflexão. Compreendemos o sentido como uma realização incorporada que movimenta e mantém a vida e sua rede de relações, de modo que não é produzido apenas individualmente, mas também participativamente. Avançamos na discussão sobre a experiência corporal de ausências, destacando a solidão no aspecto que compreendemos aqui como ausência de produção compartilhada de sentidos. Como resposta à ausência do outro, as interações por internet ganharam relevância. Discutimos as presenças mediadas tecnologicamente, dando ênfase ao papel das redes sociais no cotidiano, às formas de produzir sentidos participativamente neste contexto, atenuando as emoções de ausência, mas por outro lado intensificando sofrimentos específicos gerados por esse modo de se relacionar e produzir subjetividade. Concluímos apontando para a diversidade de formas de experienciar os efeitos da pandemia, inclusive ressalvando que não apenas as ausências provocaram sofrimento neste período, mas também algumas presenças, causando sobrecarga pelas demandas de cuidado.(AU)

This theoretical essay sought to discuss the transformations that the experience of social distancing due to the pandemic of the new coronavirus has operated in the forms of participatory sense-making. To this end, we use contributions from the enactive approach to cognition on the concept of sense-making. The notions of presence and absence, as coproduced and relevant dimensions in the collective experiences of the last period, permeated all reflection. We understand the sense as an embodied realization that moves and maintains life and its network of relationships, so that it is produced not only individually, but also participatively. We advanced in the discussion about the bodily experience of absences, highlighting loneliness in the aspect that we understand here as the absence of participatory sense-making. In response to the absence of the other, internet interactions have gained relevance. We discussed the presences technologically mediated, emphasizing the role of social media in everyday life, the ways of participatory sensemaking in this context, attenuating the emotions of absence, but on the other hand intensifying specific sufferings generated by this way of relationship and producing subjectivity. We conclude by pointing to the diversity of ways of experiencing the effects of the pandemic, including that not only the absences caused suffering in this period, but also some presences, causing overload by care demands.(AU)

Este ensayo teórico buscó discutir las transformaciones que ha operado la experiencia de distanciamiento social debido a la pandemia del nuevo coronavirus en las formas de creación de sentido participativo. Con este fin, utilizamos contribuciones del enfoque enactivo de la cognición sobre el concepto de producción de sentido. Las nociones de presencia y ausencia, como dimensiones coproducidas y relevantes en las vivencias colectivas del último período, permearon toda reflexión. Entendemos el sentido como una realización encarnada que mueve y mantiene la vida y su red de relaciones, de modo que se produce no sólo de forma individual, sino también participativa. Avanzamos en la discusión sobre la vivencia corporal de las ausencias, destacando la soledad en el aspecto que aquí entendemos como ausencia de producción de sentidos participativos. En respuesta a la ausencia del otro, las interacciones por Internet han ganado relevancia. Discutimos las presencias mediadas tecnológicamente, enfatizando el papel de las redes sociales en la vida cotidiana, las formas de crear sentidos participativamente en este contexto, atenuando las emociones de ausencia, pero por otro lado intensificando los sufrimientos específicos generados por esta forma de relacionarse y producir subjetividad. Concluimos señalando la diversidad de formas de vivir los efectos de la pandemia, incluyendo que no solo las ausencias causaron sufrimiento en este período, sino también algunas presencias, provocando sobrecarga por las demandas de cuidado.(AU)

Quantitative EEG analysis in typical absence seizures: unveiling spectral dynamics and entropy patterns.

A typical absence seizure is a generalized epileptic event characterized by a sudden, brief alteration of consciousness that serves as a hallmark for various generalized epilepsy syndromes. Distinguishing between similar interictal and ictal electroencephalographic (EEG) epileptiform patterns poses a challenge. However, quantitative EEG, particularly spectral analysis focused on EEG rhythms, shows potential for differentiation. This study was designed to investigate discernible differences in EEG spectral dynamics and entropy patterns during the pre-ictal and post-ictal periods compared to the interictal state. We analyzed 20 EEG ictal patterns from 11 patients with confirmed typical absence seizures, and assessed recordings made during the pre-ictal, post-ictal, and interictal intervals. Power spectral density (PSD) was used for the quantitative analysis that focused on the delta, theta, alpha, and beta bands. In addition, we measured EEG signal regularity using approximate (ApEn) and multi-scale sample entropy (MSE). Findings demonstrate a significant increase in delta and theta power in the pre-ictal and post-ictal intervals compared to the interictal interval, especially in the posterior brain region. We also observed a notable decrease in entropy in the pre-ictal and post-ictal intervals, with a more pronounced effect in anterior brain regions. These results provide valuable information that can potentially aid in differentiating epileptiform patterns in typical absence seizures. The implications of our findings are promising for precision medicine approaches to epilepsy diagnoses and patient management. In conclusion, our quantitative analysis of EEG data suggests that PSD and entropy measures hold promise as potential biomarkers for distinguishing ictal from interictal epileptiform patterns in patients with confirmed or suspected typical absence seizures.

Lack of spontaneous typical seizures during intracranial monitoring with stereo-electroencephalography.

OBJECTIVE: In the presurgical evaluation of patients with drug-resistant epilepsy (DRE), occasionally, patients do not experience spontaneous typical seizures (STS) during a stereo-electroencephalography (SEEG) study, which limits its effectiveness. We sought to identify risk factors for patients who did not have STS during SEEG and to analyze the clinical outcomes for this particular set of patients. METHODS: We conducted a retrospective analysis of all patients with DRE who underwent depth electrode implantation and SEEG recordings between January 2013 and December 2018. RESULTS: SEEG was performed in 155 cases during this period. 11 (7.2%) did not experience any clinical seizures (non-STS group), while 143 experienced at least one patient-typical seizure during admission (STS group). No significant differences were found between STS and non-STS groups in terms of patient demographics, lesional/non-lesional epilepsy ratio, pre-SEEG seizure frequency, number of ASMs used, electrographic seizures or postoperative seizure outcome in those who underwent resective surgery. Statistically significant differences were found in the average number of electrodes implanted (7.0 in the non-STS group vs. 10.2 in STS), days in Epilepsy Monitoring Unit (21.8 vs. 12.8 days) and the number of cases that underwent resective surgery following SEEG (27.3% vs. 60.8%), respectively. The three non-STS patients (30%) who underwent surgery, all had their typical seizures triggered during ECS studies. Three cases were found to have psychogenic non-epileptic seizures. None of the patients in the non-STS group were offered neurostimulation devices. Five of the non-STS patients experienced transient seizure improvement following SEEG. SIGNIFICANCE: We were unable to identify any factors that predicted lack of seizures during SEEG recordings. Resective surgery was only offered in cases where ECS studies replicated patient-typical seizures. Larger datasets are required to be able to identify factors that predict which patients will fail to develop seizures during SEEG.

Epilepsias generalizadas idiopáticas / Idiopathic generalized epilepsies

Resumen Las epilepsias generalizadas idiopáticas (EGI) son un grupo de epilepsias generalizadas edad de pendientes, subgrupo de las Epilepsias genéticas generalizadas(EGG), con hallazgos electro-clínicos característicos y herencia poligénica. Las EGI inclu yen las cuatro epilepsias generalizadas clásicas más comunes de las EGG: la epilepsia de ausencias de la infancia (EAI), epilepsia de ausencias juveniles (EAJ), epilepsia mioclónica juvenil (EMJ) y la epilepsia con crisis tónico clónicas generalizadas. Clínicamente caracterizadas por la presencia de una o una com binación de crisis de ausencias, mioclonías, tónica-clónicas omioclónica-tónica-clónicas con patrón elec troencefalográfico de punta onda lenta de 2.5 a 6cps y activación con la hiperventilación y fotoestimula ción, Sobresalen de las EGG por compartir atributos particulares como el buen pronóstico con control frecuente de las crisis, la no evolución a encefalopa tías epilépticas, frecuente superposición clínica entre las tres primeras, pudiendo evolucionar entre ellas; la probabilidad y edad de remisión varía en cada una.Más del 80% se controlan adecuadamente con medicamentos anticrisis de amplio espectro como el ácido valproico y pueden empeorar con bloqueadores de sodio o gabaérgicos. Si bien los pacientes son previamente sanos con neurodesarrollo normal, frecuentemente se asocian con trastornos del ánimo, déficit de atención e hiperactividad (TDAH) y problemas del aprendizaje pero no presentan déficit cognitivo. El reconocimiento de este grupo de EGI es importan te para el uso adecuado del recurso, evitando estudios innecesarios, adecuada orientación del pronóstico y un tratamiento óptimo.

Abstract Idiopathic generalized epilepsies (IGE) is a group of epilepsies age-dependent, a subgroup of EGG genetic generalized epilepsies, with electro-clinical features and polygenic inheritance. Four syndromes comprising the IGEs: childhood absence epilepsy (CAD), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), and generalized tonic-clonic seizures epilepsy. Clinically characterized by the presence of one or a combination of absence seizures, myoclonus, tonic-clonic, or myoclonic-tonic-clonic with common electroencephalographic pat terns of 2.5-5.5 Hz generalized spike-wave and activated by hyperventilation or photic stimulation. They generally have a good prognosis for seizure control, not evolve to an epileptic encephalopathy. Frequent clinical overlap between the first three, being able to evolve between them; the probability and age of remission varies in each one. About 80% responding to broad-spectrum anti-seizure drugs such as valproic acid, may worsen with sodium or GABAergic blockers. Development is typically normal; however, they are frequently associated with mood disorders, attention-deficit/hyperactivity disorder (ADHD), and learning dis abilities, but do not have cognitive deficits. The recognition of this group of EGI is important for the adequate use of the resources, avoiding unnecessary studies, adequate orientation of the prognosis and an optimal treatment.

[Idiopathic generalized epilepsies]. / Epilepsias generalizadas idiopáticas.

Idiopathic generalized epilepsies (IGE) is a group of epilepsies age-dependent, a subgroup of EGG genetic generalized epilepsies, with electro-clinical features and polygenic inheritance. Four syndromes comprising the IGEs: childhood absence epilepsy (CAD), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), and generalized tonic-clonic seizures epilepsy. Clinically characterized by the presence of one or a combination of absence seizures, myoclonus, tonic-clonic, or myoclonictonic- clonic with common electroencephalographic patterns of 2.5-5.5 Hz generalized spike-wave and activated by hyperventilation or photic stimulation. They generally have a good prognosis for seizure control, not evolve to an epileptic encephalopathy. Frequent clinical overlap between the first three, being able to evolve between them; the probability and age of remission varies in each one. About 80% responding to broad-spectrum anti-seizure drugs such as valproic acid, may worsen with sodium or GABAergic blockers. Development is typically normal; however, they are frequently associated with mood disorders, attentiondeficit/ hyperactivity disorder (ADHD), and learning disabilities, but do not have cognitive deficits. The recognition of this group of EGI is important for the adequate use of the resources, avoiding unnecessary studies, adequate orientation of the prognosis and an optimal treatment.

Las epilepsias generalizadas idiopáticas (EGI) son un grupo de epilepsias generalizadas edad dependientes, subgrupo de las Epilepsias genéticas generalizadas(EGG), con hallazgos electro-clínicos característicos y herencia poligénica. Las EGI incluyen las cuatro epilepsias generalizadas clásicas más comunes de las EGG: la epilepsia de ausencias de la infancia (EAI), epilepsia de ausencias juveniles (EAJ), epilepsia mioclónica juvenil (EMJ) y la epilepsia con crisis tónico clónicas generalizadas. Clínicamente caracterizadas por la presencia de una o una combinación de crisis de ausencias, mioclonías, tónicaclónicas omioclónica-tónica-clónicas con patrón electroencefalográfico de punta onda lenta de 2.5 a 6cps y activación con la hiperventilación y fotoestimulación, Sobresalen de las EGG por compartir atributos particulares como el buen pronóstico con control frecuente de las crisis, la no evolución a encefalopatías epilépticas, frecuente superposición clínica entre las tres primeras, pudiendo evolucionar entre ellas; la probabilidad y edad de remisión varía en cada una. Más del 80% se controlan adecuadamente con medicamentos anticrisis de amplio espectro como el ácido valproico y pueden empeorar con bloqueadores de sodio o gabaérgicos. Si bien los pacientes son previamente sanos con neurodesarrollo normal, frecuentemente se asocian con trastornos del ánimo, déficit de atención e hiperactividad (TDAH) y problemas del aprendizaje pero no presentan déficit cognitivo. El reconocimiento de este grupo de EGI es importante para el uso adecuado del recurso, evitando estudios innecesarios, adecuada orientación del pronóstico y un tratamiento óptimo.

Impacts of phosphorus and nitrogen absence on microbial diversity and sulfate removal in anaerobic batch reactors.

Sulfate-rich effluents have been successfully treated in anaerobic reactors using sulfate-reducing bacteria (SRB). Many authors have demonstrated that these systems require nitrogen and phosphorous supplementation to achieve high sulfate removal rates. However, the resource ratio theory assumes that some species can be dominant according to the nutritional relations used or even without external nutrient supplementation. Thus, this study evaluated the SRB communities in batch reactors without external nitrogen and phosphorus sources based on most probable number (MPN) quantification, denaturing gradient gel electrophoresis (DGGE) analyses and sequencing. The sulfate and chemical oxygen demand (COD) removal and kinetic parameters were also determined. After 100 days of operation, the sulfate and COD removal achieved 71.8 ± 10% and 86.5 ± 10%, respectively. The SRB population increased from 8.106 to 4 × 1012 MPN 100 mL-1, and the richness of SRB bands was much higher at the end of the experiment compared to the inoculum. In addition, the sequenced bands from SRB-DGGE showed similarities to Desulfacinum infernum, Desulfobulbus sp, Syntrophobacter and Desulfomicrobium aestuarii-related sequences. Therefore, biological treatment of acid mine drainage wastewater was effective in the absence of nutrients, lowering costs and providing high sulfate removal efficiency.

Occurrence Prediction of Riffle Beetles (Coleoptera: Elmidae) in a Tropical Andean Basin of Ecuador Using Species Distribution Models.

Genera and species of Elmidae (riffle beetles) are sensitive to water pollution; however, in tropical freshwater ecosystems, their requirements regarding environmental factors need to be investigated. Species distribution models (SDMs) were established for five elmid genera in the Paute river basin (southern Ecuador) using the Random Forest (RF) algorithm considering environmental variables, i.e., meteorology, land use, hydrology, and topography. Each RF-based model was trained and optimised using cross-validation. Environmental variables that explained most of the Elmidae spatial variability were land use (i.e., riparian vegetation alteration and presence/absence of canopy), precipitation, and topography, mainly elevation and slope. The highest probability of occurrence for elmids genera was predicted in streams located within well-preserved zones. Moreover, specific ecological niches were spatially predicted for each genus. Macrelmis was predicted in the lower and forested areas, with high precipitation levels, towards the Amazon basin. Austrelmis was predicted to be in the upper parts of the basin, i.e., páramo ecosystems, with an excellent level of conservation of their riparian ecosystems. Austrolimnius and Heterelmis were also predicted in the upper parts of the basin but in more widespread elevation ranges, in the Heterelmis case, and even in some areas with a medium level of anthropisation. Neoelmis was predicted to be in the mid-region of the study basin in high altitudinal streams with a high degree of meandering. The main findings of this research are likely to contribute significantly to local conservation and restoration efforts being implemented in the study basin and could be extrapolated to similar eco-hydrological systems.

Bird species occupancy trends in Southeast Mexico over 1900-2020: Accounting for sighting record absences.

Long-term land-use change impacts tropical bird communities through population-level and functional diversity effects from habitat loss, degradation and fragmentation, leading to land management and conservation challenges. Assessing the temporal impacts of land-use change on occupancy patterns, population change and functional traits of bird species in tropical areas is limited by the treatment of nondetections as true absences or artefacts of low sampling effort during and throughout years. With this in mind, we developed a novel Bayesian species occupancy framework to account for species absences to evaluate bird community changes in Palenque, Chiapas, Mexico, where there is opportunity for study given exceptional records of change across habitats from rainforest to urban centres. We created a novel dataset of population trends for 244 bird species over the years 1900 to 2020 from published short-term field studies, expert field notes and community science pages. Our results show that open area species had higher population increases than forest specialists over time, represented most evidently by the turnover of rainforest specialists for urban species. Modelled influence of functional traits displayed the importance of main habitat types, body mass and habitat and dietary breadth as factors that associated with bird population trends. On average, species with body masses <6.6 and > 948.4 g showed decreasing trends, while all other species showed increasing or stable trends. Our findings illuminate the value of accounting for species absences from several data sources to discover long-term species population trends and affiliated functional traits whose preservation requires conservation and land management action to protect bird ecosystem services. Primary forest conservation is key to maintaining populations of habitat and dietary specialists, such as small understorey insectivorous and large frugivorous species. Protecting rare natural savanna patches from conversion to cattle pasture is vital to prevent further extirpation of native granivores and to slow colonization by exotic and invasive species.

El cambio a largo plazo en el uso de la tierra impacta a las comunidades de aves tropicales a través de los efectos de la diversidad funcional y a nivel de la población debido a la pérdida, degradación y fragmentación del hábitat, lo que lleva a desafíos de gestión y conservación de la tierra. La evaluación de los impactos temporales del cambio de uso de la tierra en los patrones de ocupación, el cambio de población y los rasgos funcionales de las especies de aves en áreas tropicales enfrenta limitaciones al considerar el tratamiento de las no detecciones como ausencias verdaderas o artefactos de bajo esfuerzo de muestreo durante el año y los años. La evaluación de los impactos temporales del cambio de uso de la tierra en los patrones de ocupación, el cambio de población y las características funcionales de las especies de aves en áreas tropicales está limitada por el tratamiento de las no detecciones como verdaderas ausencias o artefactos de bajo esfuerzo de muestreo durante y a lo largo de los años. Con esto en mente, desarrollamos un marco bayesiano novedoso de ocupación de especies para dar cuenta de las ausencias de especies para evaluar los cambios en la comunidad de aves en Palenque, Chiapas, México, donde existe la oportunidad de estudiar dados los registros excepcionales de cambios en los hábitats, desde la selva tropical hasta los centros urbanos. Creamos un nuevo conjunto de datos de tendencias de población para 244 especies de aves durante los años 1900 a 2020 a partir de estudios de campo a corto plazo publicados, notas de campo de expertos y páginas de ciencia comunitaria. Nuestros resultados muestran que las especies de áreas abiertas tuvieron aumentos de población más altos que los especialistas forestales a lo largo del tiempo, representado más evidentemente por la rotación de especialistas de bosques tropicales por especies urbanas. La influencia modelada de los rasgos funcionales mostró la importancia de los principales tipos de hábitat, la masa corporal y el hábitat y la amplitud de la dieta como factores asociados con las tendencias de la población de aves. En promedio, las especies con masas corporales <6,6 g y >948,4 g mostraron tendencias decrecientes, mientras que todas las demás especies mostraron tendencias crecientes o estables. Nuestros hallazgos iluminan el valor de contabilizar las ausencias de especies de varias fuentes de datos para descubrir tendencias de población de especies a largo plazo y rasgos funcionales afiliados cuya preservación requiere acción de conservación y manejo de la tierra para proteger los servicios ecosistémicos de las aves. La conservación de los bosques primarios es clave para mantener las poblaciones de especialistas en hábitat y dieta, como las especies insectívoras pequeñas del sotobosque y las especies frugívoras grandes. Proteger los raros parches naturales de sabana de la conversión en pastos para ganado es vital para evitar una mayor extirpación de los granívoros nativos y para retrasar la colonización por especies invasoras.

Sick Leave in Colombia in the 2016-2018 period: A Retrospective Cross-Sectional Observational Study / Licencia por enfermedad en Colombia en el período 2016-2018: Estudio observacional transversal retrospectivo

Introduction: To understand the sick leave situation and the causes and effects of a temporary loss of capacity to work allows for the strengthening of policies and management in the provision of health services. Objective: To analyze sick leave in Colombia in the 2016-2018 period. Materials and methods: A retrospective cross-sectional observational study and the relative risk was calculated. Sick leave reports were provided by the Ministry of Health and Social Protection. 12,410,837 reports from formal workers between the ages of 18-70 years and had at least one temporary disability were processed. Results: The average age of people with sick leave was 37.11 years, 53% corresponding to females. On average, sick leave was 90.6% and 5.6% for dependent and independent workers, respectively. The principal causes of disability were musculoskeletal diseases and were more likely in men and adults according to RR. Men in comparison to females and adults in comparison to youths are less likely to have sick leave due to respiratory disease. Conclusions: In Colombia, females presented more temporary sick leave, even if males had more days of disability, even though the median was three days in both genders. Youth and adults had more sick leave days.

Introducción: Comprender la situación de incapacidad por enfermedad, causas y efectos de una pérdida temporal de la capacidad de trabajo fortalece las políticas y la gestión en la prestación de servicios de salud. Objetivo: Analizar las incapacidades por enfermedad en Colombia en el período 2016-2018. Materiales y métodos: Estudio observacional transversal retrospectivo, con cálculo del riesgo relativo. Se procesaron 12.410.837 registros de trabajadores formales entre 18 y 70 años de edad y con al menos una incapacidad temporal, según los informes del Ministerio de Salud y Protección Social. Resultados: La edad promedio de las personas fue de 37,11 años, 53% fueron mujeres. En promedio, el 90,6% de las incapacidades fue para trabajadores dependientes y el 5,6% trabajadores independientes. Las principales causas de incapacidad fueron las enfermedades del sistema musculoesquelético más frecuentes en hombres adultos según RR. Los hombres en comparación con las mujeres y los adultos en comparación con los jóvenes tienen menos probabilidades de tener licencia por enfermedad respiratoria. Conclusiones: Las mujeres presentaron más incapacidades temporales por enfermedad, aunque los hombres tuvieron más días de incapacidad, la mediana fue de tres días en ambos géneros. Los jóvenes y los adultos tenían más días de baja por enfermedad.

Riesgos ergonómicos y sus efectos sobre la salud en el personal de Enfermería

RESUMEN Introducción: El trabajo en instituciones hospitalarias de varios países es realizado en condiciones laborales inadecuadas. En el caso de las ergonómicas esta situación acarrea enfermedades en los trabajadores, como son las lesiones osteomusculares, con su consiguiente ausentismo por licencias médicas. Objetivo: Describir la ocurrencia de lesiones osteomusculares y de ausentismo-enfermedad y las condiciones laborales que ocasionó la solicitud de licencias prolongadas en el personal de salud. Método: Se realizó un estudio observacional, descriptivo, de corte transversal en 23 profesionales de Enfermería con licencia de larga duración, de una institución pública en la Ciudad Autónoma de Buenos Aires, Argentina, en el periodo septiembre-octubre de 2021. Se utilizó el Cuestionario Nórdico Estandarizado y el Cuestionario de Situación Ergonómica del Ambiente de Trabajo. Fueron analizadas las variables: condiciones del entorno laboral, riesgos ergonómicos y riesgos laborales, síntomas osteomusculares, ausentismo, postura corporal según posición de columna vertebral y brazos. Resultados: El 60,9 % de los encuestados perteneció al sexo femenino. La edad promedio fue de 35,9 años, moda de 39 y la desviación estándar de 9,2 años. Prevalecieron las lesiones en espalda alta y baja, cuello y ambos hombros. En cuanto a la satisfacción respecto a la postura corporal adoptada y las condiciones ergonómicas del mobiliario, el 73,9 % refirió que era poco satisfactorio. Conclusiones: Los riesgos ergonómicos que influyen en el personal de Enfermería de esta institución ocasionan daños físicos y mentales al personal debido a la sobrecarga del aparato músculo-esquelético y la función cognitiva que tienen que desempeñar para realizar sus actividades diarias.

ABSTRACT Introduction: Works in hospital institutions in several countries is performed under inadequate working conditions. Concerning the ergonomic risk, this situation leads to illnesses in workers, such as musculoskeletal injuries, causing absenteeism in workers due to medical exemption certificates. Objective: To describe the arising musculoskeletal injuries and absenteeism-illness, also the working conditions that caused on the health personnel request for extended medical exemption certificates. Method: An observational, descriptive, and cross-sectional study was carried out, during the period September throughout October 2021, on 23 nursing professionals with extended medical exemption certificates, all of them associated to a public institution at the Autonomous City of Buenos Aires, Argentina. The Standardized Nordic Questionnaire and the Questionnaire of Ergonomic Situation for working environment were used. The following variables were analyzed: working environment conditions, ergonomic risks and occupational hazards, musculoskeletal symptoms, absenteeism, body posture according to the spine and arms position. Results: The 60.9% of personnel surveyed were female. The mean age was 35.9 years, mode ≈39 and standard deviation 9.2 years. Injuries at the upper and lower back, neck and both shoulders prevailed. Concerning satisfaction on the ergonomic conditions of the furniture and the adopted body posture, 73.9% reported that it was not very satisfactory. Conclusions: The ergonomic risks that impact the nursing staff at this institution cause physical and mental damage due to the overload of the musculoskeletal apparatus and the cognitive function they have to perform in order to carry out their daily activities.

RESUMO Introdução: O trabalho em instituições hospitalares em vários países é realizado em condições inadequadas de trabalho. No caso da ergonomia, essa situação leva a doenças nos trabalhadores, como lesões musculoesqueléticas, com consequente absenteísmo por licença médica. Objetivo: Descrever a ocorrência de lesões musculoesqueléticas e absenteísmo-doença e as condições de trabalho que levaram ao pedido de afastamento prolongado do pessoal de saúde. Método: Estudo observacional, descritivo, transversal, realizado em 23 profissionais de Enfermagem com licença de longa duração, de uma instituição pública da Cidade Autônoma de Buenos Aires, Argentina, no período de setembro a outubro de 2021. O Questionário Nórdico Padronizado e o Questionário de Situação Ergonômica do Ambiente de Trabalho. As variáveis analisadas foram: condições do ambiente de trabalho, riscos ergonômicos e ocupacionais, sintomas osteomusculares, absenteísmo, postura corporal de acordo com a posição da coluna e dos braços. Resultados: 60,9% dos entrevistados eram do sexo feminino. A média de idade foi de 35,9 anos, a moda de 39 e o desvio padrão de 9,2 anos. Lesões na parte superior e inferior das costas, pescoço e ambos os ombros prevaleceram. Em relação à satisfação com a postura corporal adotada e as condições ergonômicas do mobiliário, 73,9% relataram que era insatisfatória. Conclusões: Os riscos ergonômicos que influenciam a equipe de Enfermagem desta instituição causam danos físicos e mentais à equipe devido à sobrecarga do aparelho musculoesquelético e da função cognitiva que têm que desempenhar para realizar suas atividades diárias.

Artrogriposis múltiple congénita. Caso clínico / Congenital multiple arthrogryposis. Clinical case

RESUMEN La artrogriposis múltiple congénita es una enfermedad de baja frecuencia, esporádica, no progresiva, que aparece en el período prenatal y se caracteriza por varias contracturas articulares presentes al nacimiento en los cuatro miembros. Se estima una incidencia de 1/10 000 nacidos vivos. El diagnóstico es posible al realizar los ultrasonidos en un feto que tiene posiciones viciosas y que no se mueve. La prevalencia de la artrogriposis múltiple congénita es variable, resultando la más frecuente la artrogriposis múltiple clásica (amioplasia), presente entre el 40 y el 50 % de los afectados. La búsqueda ultrasonográfica en el tercer trimestre del embarazo es fundamental con fines diagnósticos, para brindar asesoramiento genético y preparar un equipo para el nacimiento. Es importante tener sospecha diagnóstica para sugerir la vía alta por cesárea, para bienestar fetal. Un grupo multidisciplinario debe llevar a cabo el manejo y tratamiento de estos enfermos. Se presenta el caso de un neonato nacido a las 39 semanas por parto eutócico prolongado por presentación de cara, con sufrimiento fetal agudo, meconio ++++, apgar 5-7, con peso de 3 300 g, que presentó luxación y contractura generalizada de hombros, codos, así como de caderas, rodillas y tobillos, con dedos de manos y pies en flexión.

ABSTRACT Congenital multiple arthrogryposis is a low-frequency, sporadic, non-progressive disease that appears in the prenatal period, and is characterized by several contractures present at birth in the four limbs. The estimated incidence is 1/10 000 born alive. The diagnosis is possible performing ultrasounds on a fetus that has vicious positions and does not move. The prevalence of congenital multiple arthrogryposis is variable, being classical multiple arthrogryposis (amyoplasia) the most frequent one, present in between 40 and 50 % of the affected persons. Ultrasonographic search in the third semester of pregnancy is essential for diagnostic purposes to provide genetic counseling and to prepare a ream for birth. It is important to have diagnostic suspicion to suggest the high cesarean way for fetal well-being. A multidisciplinary group should carry out the management and treatment of these patients. The case of a newborn is presented, who was born at 39 weeks by prolonged eutocic delivery due to presenting face, with acute fetal suffering, meconium ++++, apgar 5-7, weighing 3 300 g, that presented luxation and general contracture of shoulders, elbows, and also hips, knees and ankles, with fingers and toes in flexion.

Costs of sickness absence in a service company in Colombia: case analysis by gender and occupation.

Introduction: Sickness absence is a phenomenon that has an impact on productivity, costs, and the working environment. Objectives: To understand the patterns of sickness absence by gender, age, and occupation, as well as its association with cost in a service company. Methods: We conducted a cross-sectional study based on the sick leave data for 889 employees in one service company. The total number of sick leave notifications registered was 156. We performed a t-test for gender and a non-parametric test for the mean differences related to cost. Results: We found that women registered more sick days than men, accounting for 68.59% of all sick days recorded. Absence due to sickness was more common in the age range of 35-50 years for both men and women. The mean number of days lost was 6, and the average cost was 313 U.S. dollars. Chronic disease was the main cause of sick leave, representing 66.02% of all absent days. There were no differences in the mean number of days of sick leave between men and women. Conclusions: There is no statistical difference in the number of days of sick leave between men and women. The costs of absence related to chronic disease are higher than those for other causes, so it is good practice to try developing health promotion programs in the workplace to prevent chronic disease in the working age population and reduce its associated costs.

Introdução: A licença médica é um fenômeno que afeta a produtividade, os custos e o ambiente de trabalho. Objetivos: O objetivo deste estudo é compreender os padrões de licença médica por sexo, idade, ocupação e sua relação com os custos de uma empresa de serviços. Métodos: Realizamos um estudo transversal com base nos dados de licença médica de 889 funcionários de uma empresa de serviços. Registraram-se 156 notificações de licença médica. Realizamos um teste t por sexo e um teste não paramétrico para testar as diferenças médias relacionadas aos custos. Resultados: Verificamos que as mulheres registraram mais dias de licença médica (68,59%) do que os homens. A licença médica foi mais comum na faixa etária de 35-50 anos, tanto para homens quanto para mulheres. O número médio de faltas foi de 6 dias e os custos médios foram de 313 dólares americanos. As doenças crônicas foram a principal causa de licença médica (66,02%). Não houve diferença da média de dias de licença médica entre homens e mulheres. Conclusões: Não houve diferença estatística de dias de licença médica entre homens e mulheres. Os custos de licença médica relacionados a doenças crônicas são mais altos do que os de outras causas, portanto constitui boa prática tentar desenvolver programas de promoção da saúde no ambiente de trabalho, para prevenir doenças crônicas na população economicamente ativa e reduzir seus custos associados.

Teste de Progresso: ausência de alunos de Medicina é sugestiva de mau desempenho acadêmico / Progress Test: medical student absenteeism is suggestive of poor academic performance

Resumo: Introdução: Não se sabe se a ausência de estudantes de Medicina ao Teste de Progresso (TP) se dá de forma aleatória ou por alguma característica sistemática deles, o que poderia influenciar a representatividade dos resultados obtidos pelos participantes. Objetivo: Este estudo teve como objetivos comparar os índices de desempenho acadêmico, no curso de Medicina da UFSC, dos alunos presentes e ausentes ao TP em 2019; propor uma maneira de estimar, a partir desses índices, quais seriam as notas dos faltantes se tivessem participado do TP; e identificar fatores associados à ausência ao TP. Método: Foram comparadas as médias dos índices de desempenho acadêmico, globais e nas diferentes fases (semestres) dos grupos de alunos presentes e ausentes ao TP, utilizando teste t de Student para amostras independentes. Por meio de uma técnica de regressão linear, foram imputadas as prováveis notas no TP ao grupo de alunos ausentes. Resultado: As médias globais dos três indicadores acadêmicos foram significativamente menores nos alunos ausentes ao TP (p variando de < 0,03 a < 0,0001); em dez das 11 fases (semestres) analisadas do curso, os indicadores acadêmicos dos faltosos foram piores do que dos presentes. A imputação de notas no TP aos ausentes permitiu verificar que existe correlação (R = 0,62) entre a porcentagem destes e a diferença de notas entre os grupos que realizaram e os que faltaram ao TP. Entre os alunos do gênero masculino, 25,8% não fizeram o TP, enquanto no gênero feminino foram 16,6% (diferença com p < 0,01). Conclusão: A ausência de alunos ao TP não se dá de forma aleatória. Entre os faltosos, há uma tendência sistemática de existirem alunos com piores índices de desempenho acadêmico. O uso de imputação múltipla de dados evidencia uma correlação entre a porcentagem de faltosos e a diferença na média da nota no TP, desse grupo, comparada à média da nota dos participantes. A proporção de homens que faltaram ao TP foi significativamente maior do que a de mulheres.

Abstract: Introduction: It is not known whether the absence of medical students at the Progress Test (PT) is random event or if it due to some systematic characteristic of the students, which could influence the representativeness of the results obtained by the participants. Objectives: 1) to compare the academic performance indexes, in UFSC Medical School, of students who were present and absent from the PT in 2019; 2) to propose a way to estimate, based on these indexes, what the absentee's grades would be if they had participated in the PT; 3) to identify factors associated with absence from the PT. Method: The averages of academic performance indexes, overall and in the different phases (semesters) in the groups of students who were present and absent from the PT, were compared using Student's t test for independent samples. Using a linear regression technique, the probable PT scores were assigned to the group of absent students. Results: The global averages of the three academic indicators were significantly lower in students absent from the PT (p ranging from < 0.03 to < 0.0001); in 10 of the 11 analyzed course phases (semesters), the academic indicators of absentees were worse than those present at the test. The attribution of PT grades to the absentees allowed us to verify that there is a correlation (R=0.62) between the percentage of these students and the difference in grades between the groups that took and those that did not take the PT. Among male students, 25.8% did not attend the PT, while among female students the number of absentees was 16.6% (difference with p <0.01). Conclusions: The absence of students at the PT does not occur randomly. Among the absentees, there is a systematic tendency to have students with worse academic performance. The use of multiple imputation of data demonstrate a correlation between the percentage of absentees and the difference in the average of grades in the PT of this group, compared to the average of the participants' grades. The proportion of male students who missed the PT was significantly higher than that of female students.

Agenesis of maxillary lateral incisors: diagnosis and treatment options

ABSTRACT Introduction: There are different possibilities of orthodontic planning for cases with congenital absence of maxillary lateral incisors. This subject divides the opinion of orthodontists and oral rehabilitation clinicians, due to the advantages and disadvantages of each treatment option, which may involve opening spaces for future implants and/or prosthetic restorations, or closing the spaces by positioning the maxillary canines in the place of lateral incisors. The correct diagnosis and careful evaluation of each patient allow to determine the best therapeutic approach. This paper discusses the main topics to be considered when planning these cases. Objectives: To evaluate the main aspects related to orthodontic treatment planning in cases of congenital absence of maxillary lateral incisors, to aid the decision-making, with clinical and scientific basis.

RESUMO Introdução: Existem diferentes possibilidades de planejamento ortodôntico para os casos que apresentam ausência congênita de incisivos laterais superiores. Esse é um assunto que divide a opinião de ortodontistas e reabilitadores orais, devido às vantagens e desvantagens de cada uma das opções de tratamento, as quais podem envolver a abertura de espaços para futuros implantes e/ou restaurações protéticas ou o fechamento dos espaços, com posicionamento dos caninos superiores no lugar dos incisivos laterais. O correto diagnóstico e uma criteriosa avaliação de cada paciente permitem determinar a melhor abordagem terapêutica. Nesse artigo, serão discutidos os principais tópicos a serem considerados no planejamento desses casos. Objetivos: Avaliar os principais aspectos relacionados ao planejamento do tratamento ortodôntico nos casos de ausência congênita de incisivos laterais superiores, de maneira a auxiliar nas tomadas de decisão, com embasamento clínico e científico.

Mutants of the Zebrafish K+ Channel Hcn2b Exhibit Epileptic-like Behaviors.

Epilepsy is a chronic neurological disorder that affects 50 million people worldwide. The most common form of epilepsy is idiopathic, where most of the genetic defects of this type of epilepsy occur in ion channels. Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are activated by membrane hyperpolarization, and are mainly expressed in the heart and central and peripheral nervous systems. In humans, four HCN genes have been described, and emergent clinical data shows that dysfunctional HCN channels are involved in epilepsy. Danio rerio has become a versatile organism to model a wide variety of diseases. In this work, we used CRISPR/Cas9 to generate hcn2b mutants in zebrafish, and characterized them molecularly and behaviorally. We obtained an hcn2b mutant allele with an 89 bp deletion that produced a premature stop codon. The mutant exhibited a high mortality rate in its life span, probably due to its sudden death. We did not detect heart malformations or important heart rate alterations. Absence seizures and moderate seizures were observed in response to light. These seizures rarely caused instant death. The results show that mutations in the Hcn2b channel are involved in epilepsy and provide evidence of the advantages of zebrafish to further our understanding of the pathogenesis of epilepsy.

Ethnic Culture as Related to Sexual and Reproductive Behavior in the Republic of Suriname: The Pervasiveness of Culture.

We examined the effects of culture and ethnicity on life history strategies in terms of sexual and reproductive behaviors. The sample included 500 adults, aged 25-50 years, from the five major ethnic groups in Suriname, i.e., the Maroons, Creoles, Hindustani, Javanese, and Mixed. First, there were strong gender differences: men reported to have had more sex partners and to have had their first sexual experience earlier than women, whereas women had their first child earlier and had more children than men. Second, in general, ethnicity affected life history substantially. The Maroons stood out by a relatively fast life history: they reported to have had more sexual partners, to have had their first sex and first child at an earlier age, and to have more children than all other groups. The Creoles were in general similar to the Maroons, whereas the Hindustani and the Javanese were characterized by a relatively slow life history: they reported to have had the lowest number of sexual partners, to have had their first sex and first child at the latest age, and to have had the lowest number of children. The differences between the ethnic groups were upheld when controlling for income, educational level, and father absence during childhood. A lower education was associated with reporting to have had one's first sex as well as one's first child at a younger age and children who grew up without a father reported to have had their first sex at a younger age.

Absence epilepsy in male and female WAG/Rij rats: A longitudinal EEG analysis of seizure expression.

The WAG/Rij strain of rats is commonly used as a preclinical model of genetic absence epilepsy. While widely utilized, the developmental trajectory of absence seizure expression has been only partially described. Moreover, sex differences in this strain have been under-explored. Here, we longitudinally monitored male and female WAG/Rij rats to quantify cortical spike-and-wave discharges (SWDs) monthly, from 4 to 10 months of age. In both male and female WAG/Rij rats, absence seizure susceptibility increased with age. In contrast to previous reports, we found a robust and consistent increase in absence epilepsy susceptibility in male WAG/Rij rats in comparison to females across months. The increased absence seizure susceptibility was characterized by increased number and duration of SWDs, and consequently increased total SWDs duration. These findings highlight a previously un-recognized sex difference in a model of absence epilepsy and narrow the knowledge gap of age-dependent expression of SWDs in the WAG/Rij strain.

Mental health: Professional rehabilitation and the return to work - A systematic review.

BACKGROUND: The problem of illnesses, sick leave and the necessary return to work and permanence at work has been determining the development of different protocols and professional rehabilitation programs in different countries. OBJECTIVE: We sought to identify articles that address programs for professional rehabilitation and the return to work of people laid off due to mental health problems, and to verify the results of professional rehabilitation programs and the follow-up processes for such return. METHOD: A systematic review was performed according to the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The serial search of the articles was carried out in the electronic databases: Web of Science, MEDLINE/PubMed and Scopus. The variations in the descriptors served to find a greater range of significant results for the research. RESULTS: In total, 2,306 articles were found. Another two articles that met the inclusion criteria were located through manual searches, adding up to a total of 2,308. Applying the exclusion criteria resulted in a final data set of 47 peer-reviewed articles. CONCLUSIONS: The issues involving return to work and permanence in work were complex and multifaceted in the research articles studied. Recovery from Common Mental Disorders (CMDs) is a major cause of long-term sick leave and the granting of disability benefits. Many people with these diagnoses remain employed; however, further studies are needed with women, workers with fragile relationships, and immigrants.