Especialización o diversificación en el desarrollo deportivo: Una revisión integrativa / Specialization or Diversification in Sports Development: An Integrative Review / Especialização ou diversificação no desenvolvimento esportivo: uma revisão integrativa

Resumen Objetivo: Explorar y discutir literatura científica teórica y práctica para comparar la diversificación y la especialización deportivas tempranas como un enfoque deportivo y educativo. Métodos: Se realizó una revisión sistemática siguiendo las pautas PRISMA, se incluyó un total de 61 estudios. Resultados: Entrenadores, padres e hijos consideran que la mejor forma de desarrollar el talento deportivo y alcanzar la élite en el deporte es participar en una sola disciplina y hacerlo lo antes posible para lograr la especialización y las máximas habilidades técnicas, físicas y psicológicas. Los caminos de especialización deportiva pueden conducir a una situación física, social y mental que comprometa su desarrollo integral. Conclusión: Se puede plantear, en primer lugar, la diversificación deportiva en edades tempranas y luego la especialización; una vez alcanzadas las bases de la fuerza, el acondicionamiento y el entrenamiento neuromuscular, así como una maduración psicomotora específica, para que su rendimiento deportivo y su salud no se vean comprometidos en el mediano o largo plazo. Es necesario considerar que pocos niños logran obtener un lugar en los deportes de élite, por lo que, para muchos de ellos, la educación en torno al deporte será la base para el ejercicio de su ciudadanía como personas activas.

Abstract Purpose: To explore and discuss theoretical and practical scientific literature to compare sports diversification and early sports specialization as a sport and educational approach. Methods: A systematic review was conducted following PRISMA guidelines, and 61 studies were included. Results: Coaches, parents, and children consider that the best way to develop sports talent and enter the elite in sports is to practice a single discipline as early as possible to achieve specialization and maximum technical skills and physical and psychological conditions. Sports specialization paths may lead to a physical, social, and mental state that compromises their integral development. Conclusion: Sports diversification should be considered first at an early age and, afterward, the specialization once the bases of strength, conditioning, neuromuscular training, and a specific psychomotor maturation have been achieved, so that sports performance and health are not compromised in the medium or long term. It is necessary to consider that few children enter elite sports, so for many of them, sports education will be the basis for exercising their citizenship as active people.

Resumo Objetivos: Explorar e discutir literatura científica teórica e prática para comparar a diversificação e especialização esportiva precoce como uma abordagem esportiva e educacional. Métodos: uma revisão sistemática foi realizada seguindo as diretrizes do PRISMA, um total de 61 estudos foram incluídos Resultados: Treinadores, pais e crianças acreditam que a melhor maneira de desenvolver talentos esportivos e ingressar na elite do esporte é participar de uma única disciplina e fazer o mais cedo possível para alcançar a especialização e o máximo de habilidades técnicas, físicas e psicológicas. Os caminhos da especialização esportiva podem levar a uma situação física, social e mental que comprometa seu desenvolvimento integral. Conclusão: Primeiro, a diversificação esportiva pode ser considerada em uma idade precoce e depois a especialização, uma vez que os princípios básicos de força, condicionamento e treinamento neuromuscular tenham sido alcançados, bem como a maturação psicomotora específica para que seu desempenho esportivo e saúde não sejam comprometidos a médio ou longo prazo. É necessário considerar que poucas crianças conseguem obter um lugar nos esportes de elite, de modo que, para muitas delas, a educação em torno do esporte será a base para o exercício de sua cidadania como pessoas ativas.

Jawline Aesthetic Definition: Enhancement with Masseteric Augmentation Using Ultrasound-Guided Fat Transfer.

Background: The rejuvenation and restoration of a well-defined jawline contour are crucial for enhancing facial aesthetics in both men and women. Within the jawline aesthetic unit (mandibular angle), the masseter muscle plays a significant role, as it is responsible for mandibular masticatory movements. We propose a new approach using ultrasound-guided intramuscular fat transfer to enhance the mandibular angle and jawline. Methods: The multicenter study included 20 patients from three countries (Peru, Brazil, and Mexico). After fat harvesting, the ultrasound-guided masseteric fat transfer was performed with a 1.5-mm Viaro cannula from an incision beneath the ear lobule. The fat was then injected intramuscularly into the masseter at each side of the mandibular angle. Results: Masseter ultrasound-guided fat transfer was performed on 10 men and 10 women between 2021 and 2022. The patients had a mean age of 34.4 ±â€…6.39 years and a mean body mass index of 22.39 ±â€…2.59 kg per m2. The mean injected volume was 5.83 mL and 5.58 mL on the right and left sides, respectively. Muscle thickness increased in patients immediately postsurgery, but decreased after 1 month. The muscle remained significantly thicker on each side than the presurgery measurements in patients regardless of gender (both P < 0.0001). Conclusions: Ultrasound-guided intramuscular fat transfer is a safe and reproducible technique for enhancing the jawline contour at the mandibular angle. We believe that it could be a more durable solution than other procedures, although further evaluation of long-term results is necessary.

Chronic Bi-Maxillary Osteomyelitis Caused by Actinomycetes in a Patient with Severe COVID-19 / Osteomyelitis bi-maxilar crónica causada por Actinomycetes en un paciente con COVID-19 severo

Abstract Osteomyelitis is defined as the inflammation of the either medullary, cortical, or cancellous bone, including nerves and blood vessels, causing necrosis and bone sequestrum formation; this condition has become a rare pathology, and odontogenic infections are considered the most frequent causal factor. This case shows a patient with bi-maxillary osteomyelitis caused by Actinomyces spp, which was worsened for severe COVID-19 infection. Patient was submitted at surgery as, amplified total bilateral maxillectomy through the surgical technique Weber-Fergusson, and prolonged use of combination of antibiotics, achieved a good recovery. Two years later follow- up, the patient no show imaging or clinical evidence of the infection of osteomyelitis. The present case shows an interesting relationship between a rare infection and its association with COVID-19.

Resumen La osteomielitis se define como la inflamación del hueso medular, cortical o esponjoso, incluyendo nervios y vasos sanguíneos, causando necrosis y formación de secuestro óseo; esta condición es una patología rara, y las infecciones odontogénicas son consideradas como el factor causal más frecuente. En este caso, se muestra un paciente con osteomielitis bi-maxilar causada por Actinomyces spp, la cual empeoró por la infección de COVID-19 severo. El paciente fue sometido a una cirugía, maxilectomía bilateral total amplificada, a través de la técnica quirúrgica de Weber- Fergusson, y el uso prolongado de una combinación de antibióticos, logrando una buena recuperación. A los 2 años de seguimiento, el paciente no mostró evidencia clínica o imagenológica de la infección de osteomielitis. El presente caso muestra una interesante relación entre una infección rara y su asociación con COVID-19.

Actividad física en el recreo escolar: mediciones de actividad física y la perspectiva de personas menores de edad pertenecientes a centros educativos de zona urbana y rural / Physical Activity in School Recess: Measurements of Physical Activity and the Perspective of School Children from Educational Centers in Urban and Rural Areas / Atividade física no recreio escolar: Medições da atividade física e a perspectiva das crianças de escolas urbanas e rurais

Resumen: Objetivo: El propósito del estudio fue examinar la cantidad de estudiantes que realizan actividad física durante el recreo escolar y los que mantienen una actitud sedentaria durante el recreo escolar, así como sus percepciones de motivación y barreras que impiden la práctica de la actividad física, tanto en escuelas rurales como urbanas de la provincia de Heredia. Metodología: Se llevó a cabo una investigación mixta, empleando el instrumento SOPLAY, para observar y clasificar el tipo de actividad física realizada en recreos. Además, se efectuaron grupos focales en los que participaron algunos niños y niñas que fueron seleccionados previamente, a quienes se les preguntó acerca de su percepción de las barreras y la motivación para realizar actividad física. La población estudiada en esta investigación corresponde a escolares entre 7 y 12 años, estos niños y niñas estaban inscritos en escuelas públicas urbanas y rurales de la provincia de Heredia. Resultados: En los niños y niñas de escuelas urbanas se observó más actividad física moderada (AFM) que en los niños y niñas que asisten a las escuelas rurales. En cuanto a la actividad física vigorosa (AFV), las diferencias estadísticamente significativas fueron únicamente entre sexo (mayor en los niños que en las niñas). En cuanto a la motivación para hacer actividad física, lo más mencionado por los niños y las niñas fue aprender, jugar y socializar; mientras que las principales barreras mencionadas fueron los espacios, la infraestructura peligrosa y la violencia o matonismo. Discusión: Se recomienda invertir en el mejoramiento de la infraestructura de las escuelas: eliminar materiales de desecho que ponen en riesgo la seguridad de las personas menores de edad y les limitan el área de juego; además, adquirir materiales para brindar más opciones y promover la realización de actividad física durante el recreo, con oportunidades para todas y todos.

Abstract: Objective: The purpose of this research was to examine the number of active and sedentary students during recess, as well as their perceptions of motivation and barriers that prevent the practice of physical activity in this space, in rural and urban schools in the province of Heredia. Methodology: For this, a mixed investigation was carried out, using the SOPLAY instrument to measure and classify the type of physical activity. In addition, focus groups were held with selected schoolchildren, who were asked about their perception of barriers and motivation to engage in physical activity. The population studied in this research was schoolchildren between 7 and 12 years old, who were enrolled in urban and rural public schools in the province of Heredia. Results: Among the results obtained, statistically significant differences were found between moderate physical activity (AFM) performed in urban schools with respect to rural ones, with urban school students being more active than minors enrolled in rural schools. Regarding vigorous physical activity (VFA), the statistically significant differences were only between sex, being greater in boys than in girls; as for the motivation to do physical activity, among the main reasons for this are learning, playing and socializing. The main barriers mentioned by the children were space, the dangers of infrastructure and violence or bullying. Discussion: It is recommended to invest in improving the infrastructure of schools, eliminating waste materials that put the safety of minors at risk so that they have more space to play, in addition to the acquisition of materials to provide more options and promote the realization of physical activity during recess.

Resumo: Objetivo: O objetivo do estudo era examinar o número de alunos ativos e atitudes sedentárias durante o recreio escolar, bem como suas percepções de motivação e barreiras à atividade física tanto nas escolas rurais quanto urbanas da província de Heredia. Metodologia: foi realizada uma pesquisa mista, utilizando o instrumento SOPLAY para observar e classificar o tipo de atividade física realizada durante os recreios. Além disso, grupos de foco foram conduzidos com alunos selecionados; eles foram questionados sobre sua percepção de barreiras e motivação para se envolverem em atividade física. A população estudada nesta pesquisa era de alunos entre 7 e 12 anos, que estavam matriculados em escolas públicas urbanas e rurais na província de Heredia. Resultados: Os alunos das escolas urbanas apresentaram uma atividade física (MPA) mais moderada do que os alunos matriculados em escolas rurais. Em termos de atividade física vigorosa (VPA), as diferenças estatisticamente significativas foram apenas entre os sexos, sendo maiores nos meninos do que nas meninas. Em termos de motivação para ter uma atividade física, os mais mencionados pelos alunos foram o aprendizado, a brincadeira e a socialização; enquanto as principais barreiras mencionadas, foram o espaço, a infraestrutura perigosa e a violência ou o bullying. Discussão: Recomenda-se investir na melhoria da infraestrutura das escolas, eliminando materiais residuais que colocam em risco a segurança das crianças e limitam sua área de jogos, além da aquisição de materiais para oferecer mais opções e promover a atividade física durante o recreio, com oportunidades para todos.

Análisis de los polimorfismos ECA y ACTN3 con la agilidad en seleccionados nacionales de deportes de conjunto de Costa Rica. Estudio piloto / ACE and ACTN3 polymorphisms analysis on agility test in national players in team sports of Costa Rica. Pilot study / Análise dos polimorfismos ECA e ACTN3 com agilidade em jogadores esportivos selecionados da seleção costarriquenha. Estudo piloto

Resumen: Objetivo: Analizar las diferencias de los polimorfismos de los genes ECA y ACTN3 en el rendimiento de una prueba de agilidad en jugadores élite de deportes colectivos pertenecientes a selecciones nacionales de Costa Rica. Metodología: Se contó con una muestra de 33 jugadores hombres, de deportes colectivos (fútbol sala, rugby, voleibol y balonmano). Para la evaluación de la agilidad se utilizó el test de Illinois. Se realizaron dos visitas, en la primera se obtuvo muestras de células por medio de un enjuague y en la segunda se aplicó la prueba de agilidad. Se utilizó la prueba de Chi-cuadrado (X2) para conocer las diferencias entre las frecuencias de los polimorfismos de los genes ECA y ACTN3 y el tipo de deporte. Resultados: La mayor distribución de los polimorfismos del gen ECA, de jugadores de selecciones nacionales de deportes de conjunto, se encuentra en el ID (X2= 6.87, p= .334) y en ACTN3 el RX (X2= 6.33, p= .388). Además, tampoco se encontraron diferencias significativas entre el tiempo efectuado en el test de Illinois y los polimorfismos del gen ECA (F= 2.150, p= .134), de igual forma para los polimorfismos del gen ACTN3 (F= .950, p= .339). Conclusiones: Los polimorfismos de los genes ECA y ACTN3 no se relacionaron estadísticamente con el tipo de deporte colectivo. La agilidad no se ve asociada por un tipo de polimorfismo, lo que indica que, de forma independiente al gen, esta cualidad física se puede entrenar y generar buenos resultados en la población en general.

Abstract: Objective: To analyze the differences in the polymorphisms of the ACE and ACTN3 genes on agility test performance in elite players of collective sports from National teams of Costa Rica. Methods: a sample of 33 male team sports players (futsal, rugby, volleyball, and handball). All subjects were tested with the Illinois Agility Test. Two days of measurements were made; on the first day, cell samples were obtained and on the second day, the agility test was applied. The Chi-square test (x2) was used to determine the differences between the frequencies of the polymorphisms of the ACE and ACTN3 genes and the type of sport. Results: The highest distribution of polymorphisms of the ECA gene of players from national teams of collective sports was found in the ACE ID (X2 = 6.87, p = .334), and in ACTN3 the RX (X2 = 6.33, p =. 388). Furthermore, no significant relationship was found between the Illinois test performance and the polymorphisms of the ECA gene (F = 2,150, p = .134). Conclusions: The ACE and ACTN3 genes polymorphisms were not statistically related to the type of team sport. Agility is not associated with the type of polymorphism, which indicates that regardless of the gene, this physical quality can be trained and generate good results in the general population.

Resumo: Objetivo: analisar as diferenças dos polimorfismos dos genes ECA e ACTN3 na realização de um teste de agilidade em jogadores de elite de equipes esportivas pertencentes a equipes nacionais costarriquenhas. Metodologia: foi utilizada uma amostra de 33 jogadores de futebol masculino (futsal, rúgbi, vôlei e handebol). O teste de Illinois foi usado para avaliar a agilidade. Foram feitas duas visitas; na primeira foram obtidas amostras de uma célula por lavagem e na segunda foi aplicado o teste de agilidade. O teste qui-quadrado (X2) foi usado para determinar as diferenças entre as frequências dos polimorfismos dos genes ECA e ACTN3 e o tipo de esporte. Resultados: A maior distribuição de polimorfismos do gene ECA em jogadores de equipes nacionais de esportes coletivos é encontrada no ID (X2= 6,87, p= 0,334) e no ACTN3 no RX (X2= 6,33, p= 0,388). Além disso, não foram encontradas diferenças significativas entre o tempo gasto no teste de Illinois e os polimorfismos do gene ECA (F= 2,150, p= 0,134), assim como para os polimorfismos do gene ACTN3 (F= 0,950, p= 0,339). Conclusões: Os polimorfismos dos genes ECA e ACTN3 não estavam estatisticamente relacionados com o tipo de esporte coletivo. A agilidade não está associada pelo tipo de polimorfismo, indicando que, independentemente do gene, essa qualidade física pode ser treinada e gerar bons resultados na população em geral.

Trends in incidence rates of head and neck squamous cell carcinomas overall and by potential relatedness to human papillomavirus, Costa Rica 2006 to 2015.

In Costa Rica (CR), only one report on head and neck cancer (HNC) incidence trends (1985-2007) has been published and no investigations on the epidemiology of potentially human papillomavirus (HPV)-related and HPV-unrelated HNCs have been done. We examined the age-standardized incidence rates (IRs) and trends of head and neck squamous cell carcinomas (HNSCC) and compared incidence trends of potentially HPV-related and HPV-unrelated HNSCCs. We obtained all available HNC cases for the period 2006-2015 from the Costa Rican National Cancer Registry of Tumors and the population estimates from the Costa Rican National Institute of Statistics and Census. The analysis was restricted to invasive HNSCCs (n = 1577). IRs and incidence rate ratios were calculated using SEER*Stat software and were age-standardized for the 2010 Costa Rican population. Joinpoint regression analysis program was used to calculate trends and annual percent changes (APCs) in rates. For all HNSCCs, the age-standardized IR was 34.0/million person-years; 95% CI 32.4, 35.8. There was a significant decline in the incidence of nasopharyngeal cancer (APC: -5.9% per year; 95% CI -10.8, -0.7) and laryngeal cancer (APC: -5.4% per year; -9.2, 1.5). The incidence trends for hypopharyngeal, oropharyngeal and oral cavity cancers each remained stable over time. HNSCCs were categorized by their potential relatedness to HPV infection. Though the APCs were not statistically significant, IRs of potentially HPV-related HNSCCs trended upward, while HPV-unrelated HNSCCs trended downward. HNSCCs are uncommon in CR and decreased over time. We observed a divergent pattern of decreasing HPV-unrelated with increasing HPV-related HNSCCs that should be further informed by HPV genotyping tumor samples.

Human milk microbial species are associated with infant head-circumference during early and late lactation in Guatemalan mother-infant dyads.

Human milk contains abundant commensal bacteria that colonize and establish the infant's gut microbiome but the association between the milk microbiome and head circumference during infancy has not been explored. For this cross-sectional study, head-circumference-for-age-z-scores (HCAZ) of vaginally delivered breastfed infants were collected from 62 unrelated Mam-Mayan mothers living in eight remote rural communities in the Western Highlands of Guatemala during two stages of lactation, 'early' (6-46 days postpartum, n = 29) or 'late' (109-184 days postpartum, n = 33). At each stage of lactation, infants were divided into HCAZ ≥ -1 SD (early: n = 18; late: n = 14) and HCAZ < -1 SD (early: n = 11; late: n = 19). Milk microbiome communities were assessed using 16S ribosomal RNA gene sequencing and DESeq2 was used to compare the differential abundance (DA) of human milk microbiota with infant HCAZ subgroups at both stages of lactations. A total of 503 ESVs annotated 256 putative species across the 64 human milk samples. Alpha-diversity using Chao index uncovered a difference in microbial community richness between HCAZ ≥ -1 SD and HCAZ < -1 SD groups at late lactation (p = 0.045) but not at early lactation. In contrast, Canonical Analysis of Principal Coordinates identified significant differences between HCAZ ≥ -1 SD and HCAZ < -1 SD at both stages of lactation (p = 0.003); moreover, 26 milk microbial taxa differed in relative abundance (FDR < 0.05) between HCAZ ≥ -1 SD and HCAZ < -1 SD, with 13 differentially abundant at each lactation stage. Most species in the HCAZ ≥ -1 SD group were Streptococcus species from the Firmicutes phylum which are considered human colonizers associated with human milk whereas the HCAZ < -1 SD group at late lactation had more differentially abundant taxa associated with environmentally and 'potentially opportunistic' species belonging to the Actinobacteria genus. These findings suggest possible associations between brain growth of breastfed infants and the milk microbiome during lactation. Importantly, these data provide the first evidence of cross talk between the human milk microbiome and the infant brain that requires further investigation.

Incorporation of the UGRAFT Technique to High-definition Liposuction.

High-definition liposuction is now a reliable procedure that provides more athletic results. It is a trend among plastic surgeons and patients. The ultrasound-guided rectus abdominis fat transfer (UGRAFT) technique has expanded the range of patients who can benefit from rectus abdominis fat grafting, including those without skin laxity. Its advantage over isolated high-definition liposuction is a more natural-looking result because it increases muscle volume and provides a contoured abdomen even during movement, regardless of the patient's position. In this article, we describe one patient undergoing the UGRAFT technique after high-definition liposuction, versus one patient undergoing only high-definition liposuction. We determined that the use of the UGRAFT technique provides greater muscle definition over those in which this technique has not been performed. The UGRAFT technique opens the possibility of developing more complete body structures regarding definition, providing volume to muscular areas. The more muscle mass and less body fat, the greater the body definition in a liposuction. The less muscle mass and more body fat, the less definition a patient will have in a liposuction. Under these principles, we improve the result by increasing the volume of muscle mass.

Highlights from the 7th Oncological Pathology Conference 'Pathological Anatomy in the context of the National Cancer Law: An overview of the Latin American experience', 15, 22 and 23 July 2022, Trujillo, Peru.

The seventh session of the Oncological Pathology Conference (JoPaO) entitled 'Pathological Anatomy in the context of the National Cancer Law: An overview of the Latin American experience', was held virtually on July 15, 22 and 23. Peru was the headquarters for this event, where 17 national and international professors of high academic standing participated. They interacted in a multidisciplinary context through talks with national panellists and the general public. The recent promulgation of the 'National Cancer Law' fosters the development of discussion forums to analyse the national realities and uphold continuous learning about experiences in other Latin American countries with successful cancer programmes, in which pathology holds a principal role. The topics addressed during this JoPaO included the exchange of Latin American cancer management experiences, an emphasis on investments in and the development of strategic plans to improve care, the use of new technologies, laboratory quality control, and the need to advance scientific research.

Investigation of Variables that Determine Levels of Self-Esteem in Central American Schoolchildren: A Binary Logistic Regression Model / Investigación de las variables que determinan los niveles de autoestima en los escolares centroamericanos: Un modelo de regresión logística binaria

Resumen El propósito de esta investigación fue examinar el enlace entre los hábitos de actividad física de los niños centroamericanos, su nivel de autoestima, edad y país de origen. Este fue un estudio correlacional de muestras probabilísticas aleatorias por conglomerados, que evaluó 5291 estudiantes matriculados en cuarto, quinto y sexto grado, de los cuales el 52.3 % corresponde a niñas y el 47.7 % a niños, pertenecientes a 74 escuelas en Guatemala, Honduras, El Salvador, Costa Rica, Nicaragua y Panamá, con una edad media de 10.90 ± 1.13. En todas las naciones, se utilizó el cuestionario LAWSEQ para medir el nivel de autoestima y se aplicó el de actividad física para la niñez (PAQ-C). Un análisis de regresión logística binaria fue ejecutado para estimar si las variables independientes podrían predecir el nivel de autoestima de los infantes. Los resultados mostraron que el 47 % de los estudiantes se percibió con un bajo nivel de actividad física y, con respecto a la autoestima, quienes poseen de 9 a 10 años tuvieron porcentajes más bajos, con 51.6 % y 47.7 %, respectivamente. En cuanto al país de origen, los niños de Costa Rica y Guatemala tienen un mejor nivel de autoestima que aquellos habitantes de El Salvador, Nicaragua, Honduras y Panamá. Además, se determinó que la edad, el nivel de actividad física y el país de origen predecían el 58 % del nivel de autoestima infantil centroamericana. Esto demuestra la importancia de promover la actividad física en dicho sector poblacional, para contribuir al desarrollo de su autoestima.

Abstract This research aimed to examine the relationships between the levels of self-esteem of Central American schoolchildren and their physical activity habits, ages, and countries of origin. This was a correlational study of random cluster probabilistic samples, which evaluated 5,291 students enrolled in fourth, fifth, and sixth grades, 52.3% of whom were girls and 47.7% boys, from 74 schools in Guatemala, Honduras, El Salvador, Costa Rica, Nicaragua, and Panama, with an average age of 10.90 ± 1.13 years. Lawrence's Self-Esteem Questionnaire (LAWSEQ) was used to measure levels of self-esteem, and the physical activity questionnaire for boys and girls (PAQ-C) was applied in all the countries. A binary logistic regression analysis was conducted to estimate the statistical probability that the independent variables (age, level of activity, and country of origin) could predict the level of self-esteem. The results of this investigation showed that 47% of the children under study perceive themselves to have a low level of physical activity and that children from 9 to 10 years had lower percentages of self-esteem with 51.6% and 47.7%, respectively. In terms of country of origin, children from Costa Rica and Guatemala have a better level of self-esteem than those living in El Salvador, Nicaragua, Honduras, and Panama. In addition, it was determined that age, level of physical activity, and country of origin predicted 58% of the level of self-esteem of Central American children. This situation shows the importance of promoting physical activity in childhood to contribute to the development of self-esteem.

Resumo O objetivo desta pesquisa foi examinar a ligação entre os hábitos de atividade física de crianças da América Central, seu nível de autoestima, idade e país de origem. Este foi um estudo correlacional de amostras probabilísticas aleatórias por conglomerados, que avaliou 5.291 estudantes matriculados na quarta, quinta e sexta séries do ensino fundamental, dos quais 52,3% correspondem a meninas e 47,7% a meninos, pertencentes a 74 escolas na Guatemala, Honduras, El Salvador, Costa Rica, Nicarágua e Panamá, com média de idade de 10,90 ± 1,13. Nesses países, o questionário LAWSEQ foi utilizado para medir o nível de autoestima e o questionário de atividade física para a infância (PAQ-C) foi aplicado. Uma análise de regressão logística binária foi realizada para estimar se as variáveis independentes poderiam predizer o nível de autoestima das crianças. Os resultados mostraram que 47% dos estudantes se perceberam com baixo nível de atividade física e, no que se refere à autoestima, aqueles com 9 a 10 anos apresentaram percentuais menores, com 51,6% e 47,7%, respectivamente. Quanto ao país de origem, as crianças da Costa Rica e da Guatemala apresentam um nível de autoestima superior as de El Salvador, Nicarágua, Honduras e Panamá. Além disso, determinou-se que a idade, o nível de atividade física e o país de origem previam os 58% do nível de autoestima da criança centro-americana. Isso mostra a importância da promoção da atividade física nesse setor populacional, de forma a contribuir para o desenvolvimento de sua autoestima.

Sistematización de la creación del modelo escuelas en movimiento: Intervención en salud escolar / Systematization of the Creation of the Moving Schools Model: Intervention In School Health

Resumen El objetivo de esta sistematización es mostrar el proceso que dio origen al modelo escuelas en movimiento", conceptualmente anclado al modelo ecológico, cuyo propósito es contrarrestar los efectos del sedentarismo, el sobrepeso y la obesidad infantil desde el ámbito escolar. El trabajo se gestó valiéndose de estructuras ya existentes e instaladas en instituciones públicas, que contemplaban, dentro de sus acciones, la creación de espacios de promoción de la salud y actividad física; desde esta perspectiva, se utilizó la RECAFIS (Red Costarricense de Actividad Física para la Salud) del sector Belén-Flores, de la provincia de Heredia, Costa Rica, que sirvió de plataforma para implementar este modelo de intervención llamado escuelas en movimiento. Dicho modelo se llevó a cabo en tres escuelas públicas en la provincia de Heredia. La metodología consistió en observar las actividades que realizaban los niños y las niñas durante el tiempo escolar (recreos, clases de educación física, comportamiento en las aulas). Posteriormente se ejecutó un plan de actividades dirigido a la promoción de estilos activos en los niveles interpersonal, intrapersonal y organizativo. Esta estrategia de trabajo estuvo respaldada con el modelo ecológico. Se sistematizaron las experiencias vividas con el fin de orientar la construcción de intervenciones en la promoción de estilos de vida activos en la niñez dentro del ámbito escolar, mediante la estimulación de destrezas motoras básicas como brincar, saltar y correr. Se incluyen las intervenciones en las que participaron las familias, con los niños y niñas e instituciones. Conclusiones: La intervención multinivel, interinstitucional basada en la teoría ecológica demostró su idoneidad para promocionar estilos de vida activos en los espacios de los niveles académicos y desde clases de Educación Física, mediante intervenciones novedosas, que contemplen sus gustos e intereses para ser sujetos más activos y saludables sin segregar a escolares con sobrepeso y obesidad, por los efectos de estigmatización y obstáculos que generó esta práctica.

Abstract This systematization aims to show the process that originated the schools in the movement model, conceptually anchored to the ecological model whose purpose is to counteract the effects of a sedentary lifestyle, overweight, and childhood obesity at school. The work was conceived using existing structures installed in public institutions; this included, among the actions, the creation of spaces to promote health and physical activity. Under this perspective, RECAFIS (Costa Rican Network of Physical Activity for Health) from the Belen-Flores sector, in the province of Heredia, Costa Rica, was used; it served as a platform to implement this intervention model called schools in movement. This model was implemented in three public schools in the province of Heredia. The methodology consisted of observing the activities that boys and girls carried out during school time (breaks, physical education classes, classroom behavior). Subsequently, an activity plan was implemented to promote active styles at the interpersonal, intrapersonal, and organizational levels. The ecological model supported this work strategy. The experiences lived were systematized to guide the construction of interventions to promote active lifestyles in childhood within the school environment by stimulating basic motor skills such as skipping, jumping, and running. The interventions in which families, children, and institutions participated are included. Conclusions: The multi-level, inter-institutional intervention, based on the ecological theory, demonstrated its suitability to promote active lifestyles in the spaces of the academic levels and from Physical Education classes, through original interventions, which contemplate students' tastes and interests to let them be more active and healthy without segregating overweight and obese schoolchildren due to the stigmatization effects and obstacles that this practice generated.

Resumo O objetivo desta sistematização é mostrar o processo que deu origem ao modelo das Escolas em Movimento, conceitualmente ancorado no Modelo Ecológico; que tem como finalidade, contrariar os efeitos do sedentarismo, do excesso de peso e da obesidade infantil a partir do ambiente escolar. O trabalho foi realizado utilizando estruturas existentes instaladas em instituições públicas, o que incluiu a criação de espaços de promoção da saúde e da atividade física em suas ações. Sob esta perspectiva, a RECAFIS (Rede Costarriquenha de Atividade Física para a Saúde) do setor Belén-Flores, na província de Heredia, Costa Rica, foi utilizada como plataforma para implementar este modelo de intervenção denominado Escolas em Movimento. Este modelo foi realizado em três escolas públicas na província de Heredia. A metodologia consistia em observar as atividades que as crianças realizavam durante o horário escolar (intervalos, aulas de educação física, comportamento em sala de aula). Posteriormente, foi implementado um plano de atividades destinado a promover estilos ativos nos níveis interpessoal, intrapessoal e organizacional. Esta estratégia de trabalho foi apoiada pelo Modelo Ecológico. As experiências foram sistematizadas a fim de orientar a construção de intervenções na promoção de estilos de vida ativos em crianças dentro do ambiente escolar, através do estímulo de habilidades motoras básicas como pular, saltar e correr. Isto inclui intervenções envolvendo famílias, crianças e instituições. Conclusões: A intervenção interinstitucional multinivel baseada na Teoria Ecológica demonstrou sua aptidão para promover estilos de vida ativos nos espaços das matérias acadêmicas e das aulas de Educação Física, através de intervenções inovadoras, que contemplam seus gostos e interesses a fim de serem mais ativos e saudáveis, sem segregar o excesso de peso e as crianças obesas em idade escolar, devido aos efeitos de estigmatização e obstáculos gerados por esta prática.

A New Surgical Approach to Body Contouring.

BACKGROUND: The success of body contouring surgery will largely depend on the correct choice and performance of the technique, and utilization of the necessary scientific measures. Thus, this study sought to highlight the combination and evolution of the abdominoplasty-assisted liposuction technique, while individualizing each case for the patient's benefit. METHOD: We present a series of 188 cases from the past 3 years (2017-2019), using our modification to the surgical technique: performing 360-degree liposuction first, and then abdominoplasty in the same surgical time. We show our aesthetic results, surgical time, and complications, so as to compare them with the literature. RESULTS: Of the 188 cases, 184 were women (97.9%) and 4 were men (2.1%). In 11 cases (5.8%), we recorded 4 hours as a minimum surgical time and 8 hours in 16 cases (8.5%) as a maximum time. Regarding complications, hematomas were recorded in 1 case (0.5%) as the least frequent complication and seromas in 18 cases (9.6%) as the most frequent complication. The aesthetic results, although not objectively measurable, are flattering for both the patient and the surgeon, as shown by documented evidence (photographs) before and after surgery. CONCLUSIONS: Our study supports favorable results. Modification of this technique has resulted in outstanding body contouring surgery. We hope this procedure can be reproduced because of its few complications and the pleasant results it yields.

Distinct Changes Occur in the Human Breast Milk Microbiome Between Early and Established Lactation in Breastfeeding Guatemalan Mothers.

Human breast milk contains a diverse community of bacteria, but as breast milk microbiome studies have largely focused on mothers from high income countries where few women breastfeed to 6 months, the temporal changes in the breast milk microbiome that occur during later lactation stages have not been explored. For this cross-sectional study, microbiota from breast milk samples of Mam-Mayan mothers living in eight remote rural communities in the Western Highlands of Guatemala were analyzed. All mothers delivered vaginally and breastfed their infants for 6 months. Breast milk from 76 unrelated mothers was used to compare two lactation stages, either "early" (6-46 days post-partum, n = 33) or "late" (109-184 days post-partum, n = 43). Breast milk microbial communities were assessed using 16S ribosomal RNA gene sequencing and lactation stages were compared using DESeq2 differential abundance analysis. A total of 1,505 OTUs were identified, including 287 which could be annotated as putative species. Among several maternal factors, lactation stage explained microbiome variance and inertia in ordination with the most significance (p < 0.001). Differential abundance analysis identified 137 OTUs as significantly higher in either early or late lactation. These included a general shift from Staphylococcus and Streptococcus species in early lactation to Sphingobium and Pseudomonas species in late lactation. Species enriched in early lactation included putative commensal bacteria known to colonize the infant oral and intestinal tracts whereas species enriched in late lactation had a uniform functional trait associated with aromatic compound degradation. Differentially abundant species also included several species which have not previously been reported within breast milk, such as Janthinobacterium agaricidamnosum, Novosphingobium clariflavum, Ottowia beijingensis, and Flavobacterium cucumis. These discoveries describe temporal changes to the breast milk microbiome of healthy Guatemalan mothers from early to late lactation. Collectively, these findings illustrate how studying under-represented human populations might advance our understanding of factors that modulate the human milk microbiome in low and middle income countries (LMIC).

Root canal microorganisms and their antibiotic susceptibility in patients with persistent endodontic infections, with and without clinical symptoms.

Secondary/persistent infections are present in teeth with previous root canal treatment, and a great variety of anaerobic microorganisms has been observed in these infections. The antibiotics prescription is occasional; however, in some cases, it is essential, particularly when the general health condition of the patient is compromised. The aims of this study were to identify the associated microorganisms in diagnosis of persistent or secondary apical periodontitis and to evaluate the susceptibility level to the antibiotics most used. Fifteen patients with persistent or secondary apical periodontitis requiring endodontic re-treatment were included. Microbiological samples were taken from the root canals and incubated in thioglycollate under anaerobic conditions. Anaerobic CDC agar (formulated by the Center for Disease Control and Prevention) was employed as a culture medium and the microorganisms were identified using the API system. The microorganisms were subjected to antibiograms with three different antibiotics. Twenty-six microorganisms were identified, the most common genus was Enterococcus (26.8%), Streptococcus (19.22%), Aerococcus (19.1%), and Clostridium (11.4%). 48% of them were susceptible to amoxicillin, with 28% of resistance. For clavulanic acid/amoxicillin, the susceptibility occurred in 32%, with 28% of resistance; and for clindamycin, the susceptibility was present in 40%, with 52% of resistance. The most frequently detected associated microorganism for secondary infections was genus Enterococcus, which exhibited high resistance to the studied antibiotics.

TRPV1: Structure, Endogenous Agonists, and Mechanisms.

The Transient Receptor Potential Vanilloid 1 (TRPV1) channel is a polymodal protein with functions widely linked to the generation of pain. Several agonists of exogenous and endogenous nature have been described for this ion channel. Nonetheless, detailed mechanisms and description of binding sites have been resolved only for a few endogenous agonists. This review focuses on summarizing discoveries made in this particular field of study and highlighting the fact that studying the molecular details of activation of the channel by different agonists can shed light on biophysical traits that had not been previously demonstrated.

The Perception of the Ideal Body Contouring in Mexico.

Over the centuries, our appreciation of beauty has changed, as has the social environment that influences our perspective. Currently we are trying to use measurable instruments to achieve a better aesthetic result in each patient, using as a reference the "golden ratio," which is found in harmonies of all kinds-in art, nature, architecture, and today, in medicine-to aspire to the ideal proportion. METHODS: We conducted a survey in which we showed participants 4 digitally modified images of a model with different body proportions, 1 with the golden ratio and 3 with other variable proportions. In total, 900 people were surveyed, of which 131 had attended cosmetic surgery consultation, and 769 respondents were recruited on our social networks. RESULTS: Of the 900 respondents, 607 were women and 293 were men. Fifty-nine percent of the surveyed women chose image C (shown in Fig. 3) and similarly, so did 59.4% of surveyed men, which was not statistically significant; however, when considering age, we found the groups of 21-30, 31-40, and 41-50 chose image C at 46%, 65%, and 67%, respectively, whereas 44% of those over 51 years preferred image B, which is statistically significant. CONCLUSIONS: The image whose waist-hip harmony meets the golden ratio (1.61) is most often chosen as "the most beautiful," by both men and women. It is also the preferred image for all age groups under 50.

Análisis de sobrepeso y obesidad, niveles de actividad física y autoestima en la niñez del II ciclo escolar del cantón central de Heredia, Costa Rica / Analysis of overweight and obesity, levels of physical activity and self-esteem in childhood of the II school cycle of the central canton of Heredia, Costa Rica

Resumen Objetivo: analizar la prevalencia de sobrepeso y obesidad, el nivel de actividad física y autoestima de la población escolar de II Ciclo del cantón central de Heredia Método: este fue un estudio descriptivo-comparativo transversal en el que se analizaron 442 niños, de cuarto, quinto y sexto grado escolar, de los cuales 234 fueron niños y 208 niñas con una edad entre los 9 y 13 años. Se realizó la medición del peso y la talla para el cálculo del índice de masa corporal, se aplicó el cuestionario de actividad física para niños mayores (PAQ-C) y el cuestionario LAWSEQ para la medición del nivel de autoestima. Resultados: los resultados mostraron un 20.6 % de infantes poseen sobrepeso y 13.6 % presentaron obesidad, en el nivel de actividad física un 29.4 % mostraron un nivel bajo y un 26.7 % baja autoestima. Además, los niños presentaron un nivel de actividad física más alto en comparación con las niñas (F (9) = 2.55; p=0.007). Conclusiones: en función del objetivo, la prevalencia de sobrepeso y obesidad en las niñas y en los niños fue de un 34.2 %. Un 30% presentó altos niveles de sedentarismo y un 27 % bajos niveles de autoestima. Estos datos indican la necesidad de generar opciones de intervención en los diferentes niveles educativos, fundamentalmente, trabajando en equipo con entes gubernamentales del país.

Abstract Objetive: analyze the prevalence of overweight and obesity, the level of physical activity and self-esteem of the school population of fourth, fifth and sixth grades of the Central District of Heredia. Method: The descriptive-comparative and transversal study analyzed 442 children, 234 boys and 208 girls between 9 and 13 years old. It was measured the weight and height to calculate the body mass index, the Physical Activity Questionnaire for Children (PAQ-C) and Lawrence's Self-Esteem Questionnaire (LAWSEQ). Results: the results suggest 20.6 % of infants with overweight and 13.6 % with obesity, 29.4 % indicated a low level of physical activity and 26.7 % with low self-esteem. In addition, boys report a higher level of physical activity compared to girls (F (9) =2.55; p=0.007). Conclusions: According to the objective, the prevalence of overweight and obesity in girls and boys was 34.2 %, 30 % presented high levels of sedentary lifestyle and 27 % low self-esteem. These information indicate the importance of generating intervention options is demonstrated in the different levels of education with the aim of palliate the results of this research, working as a team with government organization in the country.

Activation of the Extrinsic and Intrinsic Apoptotic Pathways in Cerebellum of Kindled Rats.

The purpose of this study is to determine the activation of the extrinsic and intrinsic apoptotic pathways in the cerebellum of rats exposed to amygdaloid electrical kindling. Western blot analyses were carried out for caspase-8 and caspase-9, Bid, Bax, and Bcl-2 in the cerebellum and immunohistochemistry of Bid, Bax, cytochrome C, and VDAC (voltage-dependent anion channels) in the cerebellar cortex of Wistar male rats with 0, 15, and 45 kindling stimulations. In the experimental group of 45 stimuli, we observed an increase in protein activation of caspase-9 and truncated Bid and Bax, in addition to a decrease in expression of pro-caspase-8 and the anti-apoptotic protein Bcl-2, determined by Western blot. Moreover, we observed a cytosolic immunopositivity for cytochrome C and a mitochondrial immunolocalization for truncated Bid and Bax in the group of 45 stimuli. In this work, we found an increase of caspase-8, a cysteine-protease that can activate caspase-3 triggering extrinsic apoptosis by signaling of death receptors. However, it also can activate the intrinsic pathway releasing Bid, which performs mitochondrial translocation of Bax, inactivating Bcl-2 and allowing the release of cytochrome C through the opening of the mitochondrial permeability transition pore, promoting the activation of caspase-9 which activates caspase-3, the main executor caspase of apoptosis. Therefore, it is concluded that there is an activation of the intrinsic and extrinsic apoptotic pathways in the cerebellum of rats exposed to the kindling model. Apoptosis signaling pathways can be analyzed as an important developing object of research about the epileptic activity. Graphical Abstract.

Aerobic and anaerobic microorganisms and antibiotic sensitivity of odontogenic maxillofacial infections.

This study aimed to identify the aerobic and anaerobic causal microorganisms of odontogenic infections and their antibiotic sensitivity. Purulent exudates were taken from patients with odontogenic infections by transdermal puncture, and aerobic and anaerobic microorganisms were identified using biochemical tests. Susceptibility to antibiotics was tested using the Kirby-Bauer method; the inhibition halos were measured according to NCCLS, and based on the results, the microorganisms were classified as susceptible, intermediate or resistant to each antibiotic. Frequencies of species and percentages of resistance were calculated. The microorganisms associated with odontogenic infections were principally anaerobic (65.3% anaerobic vs. 35.7% aerobic), and the susceptibility to antibiotics was higher in anaerobic than in aerobic microorganisms. The majority of isolated microorganisms (82%) showed susceptibility to amoxicillin/clavulanic acid. The causal agents of odontogenic infections were anaerobic microorganisms, which exhibited high resistance to antibiotics.