A digital study on predictive factors for Instagram users' engagement with amber necklace-related posts.

AIM: This study aimed to assess the engagement of Instagram users with Brazilian Portuguese posts related to amber necklaces for teething symptoms relief, identifying predictive factors that can increase users' engagement with information and misinformation. METHODS: This digital study analysed Brazilian Portuguese amber necklace-related posts on Instagram. The posts were collected using specific search strategies on CrowdTangleTM. Subsequently, two independent investigators were trained and calibrated to categorise the posts concerning the proposed outcomes. The posts were categorised according to their facticity (information or misinformation), type of media (album/photo or video/Instagram TV), sentiment (positive, neutral, or negative), author's occupation (dentist or non-dentist), and type of profile (commercial or personal). Additionally, investigators compiled information about the time of publication (days) and interaction metrics (total interaction and overperforming score). The statistical analysis assessed the inter-examiner reliability, group comparisons, and the factors associated with interaction and misinformation. P values <0.05 were considered significant. CONCLUSION: Videos and personal profiles were predictive factors for higher user engagement with amber necklace posts on teething symptoms relief on Instagram, even with the warnings of health organisations and the lack of scientific evidence to confirm its efficacy.

Decoding early childhood caries: an in-depth analysis of YouTube videos for effective parental education.

PURPOSE: To assess the coverage of information about early childhood caries (ECC) available on YouTube videos in three different languages, regarding technical characteristics of videos and interaction metrics. METHODS: Search strategies were developed in English, Spanish, and Portuguese to make a comprehensive collection of videos from YouTube, encompassing 60 samples for each language, regarding all video types. The videos were assessed by a thematic checklist regarding 17 items on ECC. Videos were dichotomized according to the median of the thematic score and the nature of their authorship (health and non-health authors) to compare groups. The statistical analysis was performed using the Statistical Package for Social Science (version 25.0), applying Spearman's rank correlation coefficient and Mann-Whitney U test. P < 0.05 values were considered significant. RESULTS: Among 120 videos meeting inclusion criteria, ECC aetiology and prevention information proved incomplete, with a median score of 5 (Q1-Q3 = 3-7). No correlation emerged between this score and other video characteristics. However, interaction metrics like views, likes, dislikes, and viewing rates displayed significant correlations. Health authors primarily created these videos, yet non-health author channels had more subscribers. Surprisingly, videos focused on the impact of regular sugary food and beverage consumption on ECC progression received the most attention. CONCLUSIONS: Videos that presented information about the aetiology and prevention of ECC invariably focused on partial aspects of the disease. This highlights the need for better-quality educational videos and the importance of dental professionals in guiding patients toward reliable sources of information.

Actualización en clasificación y manejo de anomalías vasculares laríngeas en adultos / Update on classification and management of laryngeal vascular anomalies in adults

Introducción: Las anomalías vasculares (AV) de cabeza y cuello son una patología prevalente en niños, pero son poco frecuentes en adultos. La última clasificación descrita por la International Society for the Study of Vascular Anomalies (ISSVA) en 2018, propone dividirlas en tumores vasculares (TV) y malformaciones vasculares (MV) con una aproximación basada en la etiopatogenia, comportamiento biológico e inmunohistoquímico (IHQ). Objetivo: Describir la experiencia en el manejo de AV laríngeas (AVL) en adultos operados en los últimos 5 años en el Servicio de Otorrinolaringología (ORL) del Hospital Barros Luco Trudeau (HBLT) y realizar una revisión actualizada en cuanto a diagnóstico y manejo. Material y Método: Revisión retrospectiva y descriptiva de los casos de AVL en adultos operados del servicio de ORL del HBLT informadas por biopsia en el servicio de anatomía patológica del mismo hospital entre los años 2015 a 2020. Resultados: Se encontraron cinco casos de AVL. Los síntomas descritos fueron disfonía, odinofagia y disfagia. La sospecha diagnóstica se fundó en historia clínica, nasofibroscopia y estudio imagenológico, y se confirmó con biopsia posoperatoria. Todos los pacientes fueron resueltos de manera quirúrgica con leve preferencia por el láser CO2. No se registraron complicaciones ni signos de recidiva durante el seguimiento. Conclusión: Recomendamos el manejo quirúrgico de las AVL en adultos, realizando una resección completa de la lesión y su clasificación, según las recomendaciones de la ISSVA, con biopsia posoperatoria e inmunohistoquímica debido a la heterogeneidad de las clasificaciones previas.

Introduction: Head and neck vascular abnormalities (AV) are common alterations found in children, but rare in adults. The latest classification described by the International Society for the Study of Vascular Anomalies (ISSVA) in 2018, proposes dividing them into vascular tumors (TV) and vascular malformations (MV), based on their etiopathogenesis, biological and immunohistochemical behavior (IHC). Aim: To describe the experience in the management of laryngeal AV (AVL) of adults treated surgically on in the last 5 years in the Otolaryngology Service (ORL) of the Hospital Barros Luco Trudeau (HBLT). Material and Method: Retrospective and descriptive review of cases with histologically confirmed AVL in adults treated surgically in the ORL service of the same hospital between the years 2015 and 2020. Results: Five cases of AVL were found. The symptoms described were dysphonia, pharyngodine, and dysphagia. The diagnostic suspicion was based on clinical history, nasofibroscopy and imaging study, confirmed with post-operative biopsy. All patients were resolved surgically with a slight preference for the CO2 laser. No complications or signs of recurrence were recorded during the follow-up. Conclusion: We recommend surgical management of AVL in adults with a complete resection and their classification according to the recommendations of the ISSVA with postoperative and immunohistochemical biopsy, due to heterogeneity of previous classifications systems.

Online quality and readability assessment of Early childhood caries information available on websites from distinct countries: A cross-sectional study.

AIM: To assess the quality and readability of ECC-related Web information available in English, Spanish, and Brazilian Portuguese language. METHODS: This study assessed the quality and readability of information related to ECC in three different languages found on the most popular Internet search engines worldwide. Websites were retrieved from different search engines using specific strategies. DISCERN questionnaire, JAMA benchmark criteria, and language-based readability formulas were used by two independent investigators to evaluate the quality and readability of websites. Also, contents were categorised according to aetiology, prevention, and treatment of ECC. The statistical analysis was performed using Spearman's rank correlation coefficient, hierarchical clustering analysis by Ward's minimum variance method, and Mann-Whitney U test. P values < 0.05 were considered significant. CONCLUSION: ECC-related digital contents were considered simple, accessible and of poor quality, independently of their language and authorship. These findings indicate the importance of professional counseling to empower parents in selecting and consuming adequate information towards the improvement of children's oral health.

Radioterapia en tumor de células gigantes tenosinovial (sinovitis villonodular pigmentada) / Radiation therapy in tenosynovial giant cell tumor (pigmented villonodular synovitis)

Presentar nuestra experiencia de 18 años en el tratamiento con radioterapia y evaluar cifras de control tumoral local en pacientes con diagnóstico de tumor de células gigantes tenosinovial difuso sinovitis villonodular pigmentada difusa. 33 pacientes, tratados durante el período 2000-2018. En 19 (57,6 %) se practicó sinovectomía parcial, 10 (30,3 %) fueron tratados con artroplastia y sinovectomía, 4 (12,2 %) con sinovectomía total. 32 pacientes recibieron radioterapia posoperatoria, 1 paciente preoperatoria. Técnica más empleada fue planificación 2D 51,5 % seguida de conformada con planificación 3D (RTC3D) 48,5 %. La dosis total promedio administrada 44 Gy (rango 10,5 - 50). Tiempo promedio de tratamiento radiante 28 días (8-35). Tiempo de seguimiento entre 0,7 - 240,8 meses, mediana 12 meses, promedio 52,1 meses. 26 pacientes (79 %) presentaron mejoría de la sintomatología inicial y 6 (18 %) refirieron estabilidad de los síntomas. La respuesta clínica al tratamiento en relación al tiempo de seguimiento, 12 pacientes (36,4 %) estaban asintomáticos, 10 con un seguimiento mayor a 60 meses; 14 (42,4 %) refieren respuesta clínica satisfactoria, (2 con un seguimiento mayor a 60 meses) 6 pacientes presentaban enfermedad estable, para un control local del 97 %. El 87,9 % presentaron dermatitis grado I, 1 desarrolló dermatitis grado II, 3 no presentaron efectos adversos. La radioterapia es una modalidad de tratamiento muy efectiva como adyuvante a la sinovectomía, observándose altas tasas de control local de la enfermedad con una baja morbilidad(AU)

To report our eighteen-year experience with radiation therapy in the treatment of diffuse tenosinovial giant cell tumor / diffuse pigmented villonodular synovitis and to assess local control of the disease. A review of 33 patients with treated with radiation therapy during the period 2000-2018 was done. 19 (57.6 %) partial synovectomy was performed, 10 (30.3 %) underwent arthroplasty plus synovectomy, 4 (12.2 %) total synovectomy. 32 patients received radiotherapy postoperative and 1 pre-operative. Most common technique employed was conventional (2D) in 51.5 % and 3D conformal (3DCRT) in 48.5 %. The average total dose was 44 Gy (range 10.5-50), with a mean treatment time of 28 days (8-35). Follow-up time ranged from 0.7- 240.8 months, median time and mean time of 12 and 52.1 months respectively After RT 26 (79 %) of the patients obtained improvement of the initial symptoms and 6 (18 %) were stable. 12 patients (36.4 %) were asymptomatic with follow-up time longer than 36 months (10 of 12 had follow-up time >60 months), 14 (42.4 %) had significant clinical improvement (2 of 14 had follow-up time >60 months), and 6 had stable disease, local control of 97 %. Complications were few, acute skin toxicity was grade I in 29 (87.9%) and grade II in 1 patient. There was no significant chronic toxicity. Radiation therapy is an effective adjuvant treatment modality after synovectomy in patients with high local control rates and low morbidity(AU)

Skin autofluorescence in people with type 1 diabetes and people without diabetes: An eight-decade cross-sectional study with evidence of accelerated aging and associations with complications.

AIM: To measure skin autofluorescence in youth (<18 y.o.) and adults (≥18 y.o.) and to assess its relationship with type 1 diabetes, chronic complications and smoking. METHODS: In a cross-sectional study (n = 383) skin autofluorescence was measured in 269 people with type 1 diabetes (67 with vascular complications) and 114 people without diabetes, covering eight decades of age. Associations of skin autofluorescence with demographics and traditional risk factors were assessed. RESULTS: Skin autofluorescence increased with age in people with diabetes: for those with complications it increased by a mean ± se of 0.029 ± 0.003 arbitrary units per year (r = 0.76) and, for those without complications, it increased by 0.028 ± 0.002 arbitrary units (r = 0.77). These increases were higher than for people without diabetes, whose skin autofluorescence increased by 0.022 ± 0.002 arbitrary units (r = 0.78) per year (p = 0.004). Mean ±se age-adjusted skin autofluorescence was higher in people with diabetes complications vs people without diabetes complications (1.85 ± 0.04 vs 1.66 ± 0.02 arbitrary units) and people without diabetes (1.48 ± 0.03 arbitrary units; all P < 0.0001). Age-adjusted skin autofluorescence was higher in current smokers and recent ex-smokers vs non-smokers and longer-term ex-smokers (1.86 ± 0.06 vs 1.63 ± 0.02 arbitrary units; P = 0.0005). Skin autofluorescence area under the receiver-operating characteristic curve was 0.89 (95% CI 0.85-0.94) for retinopathy and 0.56 (95% CI 0.47-0.65) for nephropathy. CONCLUSIONS: Skin autofluorescence increases with age, but faster in people with diabetes, particularly in those with complications and in smokers, consistent with accelerated aging. Skin autofluorescence may facilitate complication screening and prediction. Longitudinal studies are merited.

¿Igualdad de género en otorrinolaringología? / Gender equality in otolaryngology?

RESUMEN Introducción: Cada día son más las mujeres que ingresan a las escuelas de medicina y a los programas de especialización tradicionalmente considerados como de "predominancia masculina" (especialidades quirúrgicas y médico-quirúrgicas). Internacionalmente se han hecho esfuerzos por conocer la realidad de igualdad de género en otorrinolaringología, pero poco se sabe del escenario chileno. Objetivo Evaluar la percepción de igualdad de género en otorrinolaringología en residentes y médicos de la especialidad en Chile. Además evaluar la asociación entre género y aspectos de vida laboral y personal. Material y método Elaboración y distribución de encuesta que recopila información epidemiológica, de formación, de vida personal y laboral, además de preguntas relacionadas con percepción de acoso y/o discriminación de género. Resultados 139 encuestados (55% hombres, 75% ≥40 años, 72% especialistas). Se obtuvo una diferencia estadísticamente significativa en percepción de discriminación negativa de género hacia mujeres tanto durante la residencia como en el lugar de trabajo, mayor reporte de cuestionamiento de habilidades quirúrgicas y de comentarios sexistas en desmedro de mujeres. Sin diferencia estadísticamente significativa en percepción de acoso sexual ni en variación de horas de trabajo luego de ser padre o madre. Conclusión En la población encuestada, la población femenina reportó mayor percepción de discriminación de género. Se deben aumentar los esfuerzos por estudiar la situación de igualdad de género en nuestro medio y generar ambientes amigables para el desarrollo profesional indiferente del género.

ABSTRACT Introduction: Everyday more women enter medicine schools and to traditionally known as "male predominant" specialization programs (surgical and medical-surgical specialties). Internationally, efforts have been made to understand the reality regarding gender equality in otolaryngology, but little is known about the Chilean scene. Aim: To evaluate the perception on gender equality in otolaryngology of residents and physicians of the specialty in Chile. Also, to evaluate the association between gender and aspects of labor and personal life. Material and methods: Elaboration and distribution of a survey that collects epidemiologic, schooling, personal and labor life information, additionally questions related to perception of harassment and/or gender discrimination. Results: 139 people surveyed (55% men, 75% ≤40 years old, 72% specialists). Statistically significant difference was found in the perception of negative discrimination against women during residency and in work places, greater report of questioning of surgical abilities and sexist comments against women. No statistical difference was found in the perception of sexual harassment nor variation of work hours after mother or fatherhood. Conclusion: The female population surveyed reported a greater perception of gender discrimination. Efforts to study gender equality situation should be increased and friendly environments for professional development independent of gender should be generated.

Waist-to-height ratio and sedentary lifestyle as predictors of metabolic syndrome in children in Ecuador / Índice cintura-altura y estilo de vida sedentario como factores predictivos del síndrome metabólico en niños de Ecuador

Objective: To determine the predictors and prevalence of metabolic syndrome (MS) and the presence of vascular inflammation in apparently-normal children (10-15 years) of both sexes in Guayaquil, Ecuador. Study design and methods: We included 395 apparently-healthy students from a middle-income school in a cross-sectional survey. Informed consent was obtained from students and parents. Anthropometric measurements including blood pressure (BP), body mass index (BMI) and waist-to-height ratio (WHtR), and blood tests were recorded. Vascular inflammation parameters were assessed. Percentiles of the different parameters were used, and MS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria (NCEP-ATPIII). Waist circumference > P 75, blood pressure > P 90, glucose > 100 mg/dl, triglycerides > 100 mg/dl, HDL < 45 mg/dl. If 3 of the 5 criteria were present, this was considered MS. Results: The mean age was 12 years (186 boys, 209 girls). The overall prevalence of MS was 9.37% (6.33% in girls, 3.04% in boys). Sustained hypertension was detected in 6.6% of children and pre-hypertension in 7.1%. Obesity was found in 1.8% of subjects, and overweight in 15.2%. Triglycerides has a RR 2.34 (1.97-2.76); HOMA index has a RR 1.97(1.62-2.40); HDL cholesterol has a RR 1.84(1.58-2.13); Insulin level has a RR 1.53(1.40-1.67) and interleukin 6 has RR 1.83(1.20-2.79). Serum glucose, total cholesterol and LDL-Cholesterol had no association with the metabolic syndrome. HDL-Cholesterol<45mg/dl and triglyceride >100 mg/dl were present in 70% of subjects with MS. The WHtR threshold≥ 0.5 was 100% sensitive in both sexes (67% specificity in boys and 69% in girls). There were significant associations between the WHtR and pre-hypertension and sedentary lifestyle (P < 0.001 and P < 0.003 respectively). A WHtR value of ≥0.50 indicated a 2.2-fold increased risk of MS compared with normal WHtR, and normal weight. Conclusions: A WHtR≥ 0.5 was 100% sensitive in detecting MS in 10-15 year-old boys and girls in the normal or overweight range of the BMI. This assessment is a simple and practical tool for use in population-based studies of cardiovascular risk. When combined with pre-hypertension and a sedentary lifestyle, the WHtR is highly sensitive in predicting MS

Objetivo: Determinar los factores predictivos y la prevalencia del síndrome metabólico (SM), así como la presencia de inflamación vascular en niños aparentemente normales (10-15 años) de ambos sexos en Guayaquil, Ecuador. Diseño del estudio y métodos: Incluimos en una encuesta transversal a 395 estudiantes aparentemente sanos de una escuela de renta media. Se obtuvo consentimiento informado de los estudiantes y padres. Se registraron las medidas antropométricas que incluyeron presión arterial (PA), índice de masa corporal (IMC), índice cintura-altura (ICA), y hemogramas. Se valoraron los parámetros de inflamación vascular. Se utilizaron los percentiles de los diferentes parámetros, definiéndose el SM con arreglo a los criterios del National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII): valores de perímetro de cintura > 75, presión arterial > 90, glucosa > 100 mg/dl, triglicéridos > 10 mg/dl, HDL < 45 mg/dl. En caso de presentar 3 de estos 5 criterios se consideró la presencia de SM. Resultados: La edad media fue de 12 años (186 chicos, 209 chicas). La presencia general de SM fue del 9,37% (el 6,33% en chicas y el 3,04% en chicos). Se detectó hipertensión sostenida en el 6,6% de los niños, y pre-hipertensión en el 7,1%. Se encontró obesidad en el 1,8% de los sujetos, y sobrepeso en el 15,2%. Los valores de RR fueron: para triglicéridos, 2,34 (1,97-2,76); índice HOMA, 1,97 (1,62-2,4); HDL colesterol, 1,84 (1,58-2,13); nivel de insulina 1,53 (1,4-1,67) e interleucina 6, 1,83 (1,2-2,79). Los valores de glucosa sérica, colesterol total y LDL-colesterol no guardaron asociación con el síndrome metabólico. Los valores de HDL-colesterol < 45 mg/dl y triglicéridos > 100 mg/dl se encontraron en el 70% de los sujetos con SM. El límite de ICA > 0,5 reflejó una sensibilidad del 100% en ambos sexos (67% de especificidad en chicos y del 69% en chicas). Se encontraron asociaciones significativas entre ICA y pre-hipertensión y el estilo de vida sedentario (p < 0,001 y p < 0,003, respectivamente). El valor de ICA > 0,5 indicó un incremento de 2,2 del riesgo de SM en comparación al valor normal de ICA y peso normal. Conclusiones: El valor de ICA>0,5 reflejó un 100% de sensibilidad a la hora de detectar el SM en chicos y chicas de 10 a 15 años dentro del rango normal de IMC. Esta medida es una herramienta simple y práctica de utilizar para valorar el riesgo cardiovascular en estudios basados en la población. Al combinarse con la pre-hipertensión y el estilo de vida sedentario, el ICA es altamente sensible a la hora de predecir el SM

Valor nutritivo da Coastcross-1 inoculada com Azospirillum brasilense / Nutritive value of Coastcross-1 inoculated with Azospirillum brasilense

Objetivou-se com este trabalho avaliar a taxa de produção de forragem e o valor nutritivo da Coastcross-1, inoculada com Azospirillum brasilense, fertilizada com diferentes doses de N e submetida ao regime de corte. O delineamento experimental foi o de blocos ao acaso, com três repetições, em esquema fatorial. Os fatores foram o uso da inoculação (não inoculada, inoculada somente no plantio e reinoculada no segundo ano), níveis de N (0, 100 e 200kg/ha/ano de N) e os períodos do ano. Avaliaram-se a taxa de produção e a composição botânica da forragem, a composição morfológica, o teor de proteína bruta, a digestibilidade in situ da matéria orgânica e os nutrientes digestíveis totais da Coastcross-1. A inoculação, quando não associada ao adubo nitrogenado, ocasionou aumento na taxa de produção de forragem, na participação da Coastcross-1 e na produção de nutrientes digestíveis totais. Houve redução nos teores de proteína bruta da Coastcross-1, quando a gramínea adubada com 200kg/ha/ano de N foi inoculada. A inoculação tem efeito positivo na Coastcross-1 não submetida à adubação nitrogenada.(AU)

The objective of this study was to evaluate the forage yield rate and nutritive value of Coastcross-1 inoculated with Azospirillum brasilense and fertilized with different levels of nitrogen subjected to cut. The experimental design was randomized blocks with three replications, in a factorial scheme. The factors were the inoculation (without inoculation, inoculated just in the implantation and reinoculated in the second year), levels of nitrogen (0, 100 and 200kg/ha/year of N) and periods of the year. Forage yield rate and botanical composition; morphological composition, crude protein content, in situ digestibility of organic matter and the total digestible nutrients of Coastcross-1 were evaluated. Inoculation increased the forage yield rate, Coastcross-1 contribution and production of total digestible nutrients, when the pasture was not fertilized with N. There was reduction in Coastcross-1 crude protein content when fertilized with 200kg/ha/yr of N. The inoculation has a positive effect on Coastcross-1 not submitted to nitrogen fertilization.(AU)

Reactividad vascular in vitro y estudio morfométrico de venas safenas utilizadas como bypass coronario: técnica "no-touch" versus convencional / In vitro vascular reactivity and morphometric study of saphenous veins graft used as coronary bypass: "no-touch" versus conventional technique

Resumen Introducción: Prolongar la permeabilidad de los injertos utilizados en bypass coronario es un desafío constante. Objetivo: Comparar anatomofuncionalmente venas safenas humanas (VSH) extraídas con técnica convencional (TC) vs técnica "no-touch" (NT). Material y Método: Estudio experimental. Se diseccionó VSH con TC y NT en el pabellón de cirugía cardiaca del Hospital Regional de Antofagasta. Las muestras de VSH fueron seccionadas en anillos de 3 mm y conservados en cámaras de órganos aislados con solución Ringer-Krebs. Para evaluar la vasomotilidad se administró norepinefrina (10-6M), papaverina (10-4M), acetilcolina (10-6M) y nitroprusiato de sodio (10-5M). Un segmento de las muestras fue fijado en formalina al 10%, procesado con técnica histológica y analizado bajo microscopía óptica. Las muestras fueron teñidas con hematoxilina-eosina, Verhoeff y orceína. El análisis estadístico fue realizado mediante el software Prism Graphad. Resultados: Reactividad vascular: La vasoconstricción inducida por noradrenalina fue significativamente superior en anillos del grupo NT vs TC (p < 0,0001). La vasodilatación producida por papaverina y acetilcolina fue superior en el grupo NT (p < 0,004) y (p < 0,0003), respectivamente. Estudio morfométrico: El grupo NT presentó túnica muscular (0,755 vs 0,680 mm), adventicia (0,5600 vs 0,4663 mm) y pared total (1,344 vs 0,962 mm) más gruesa que el grupo TC. No hubo diferencias significativas respecto el número de vasa vasorum. Conclusión: El grupo NT responde significativamente mejor a estímulos vasoconstrictores y vasodilatadores. Los resultados se asocian con las diferencias morfométricas.

Introduction: Prolonging of the grafts permeability used in coronary bypass is a constant challenge. Objective: To compare anatomical and functional human saphenous veins (VSH) extracted "No touch" (NT) technique vs conventional technique (TC). Materials and Methods: Experimental study. VSH dissected with CT and NT in the Regional Hospital of Antofagasta cardiac surgery ward. VSH samples were sectioned into 3 mm rings and preserved in isolated organs chambers with Krebs-Ringer solution. To evaluate the vasomotor activity, norepinephrine (10-6M), papaverine (10-4M), acetylcholine (10-6M) and sodium nitroprusside (10-5M) was administered. A segment of samples was fixed in 10% formalin, processed and histological analyzed under light microscopy technique with hematoxylin-eosin, Verhoeff and orceína. Statistical analysis was performed using the Prism software Graphad. Results: Vascular Reactivity: norepinephrine-induced vasoconstriction was significantly higher in the group rings NT vs TC (p < 0.0001). Vasodilation was higher with papaverine and acetylcholine in the NT group (p < 0.004) and (p < 0.0003), respectively. Morphometric study: The NT group presented muscularis (0.755 vs 0.680 mm), adventitious (0.5600 vs 0.4663 mm), and total wall (1.344 vs 0.962 mm) thicker than the TC group. No significant differences in vasa vasorum number identified. Conclusion: The NT group vasoconstrictor and vasodilator responds significantly better. Results correlate with morphometric differences.

Produtividade de genótipos de trigo duplo propósito submetidos ao pastejo com vacas em lactação / Productivity of dual-purpose wheat genotypes under grazing with lactating cows

Esta pesquisa foi conduzida com o objetivo de avaliar a produtividade de dois genótipos de trigo de duplo propósito, BRS Tarumã e BRS Umbu, submetidos ao pastejo com vacas em lactação. O delineamento experimental foi o inteiramente ao acaso, com dois tratamentos (genótipos), três repetições (piquetes) e medidas repetidas no tempo (pastejos). Avaliaram-se a precocidade, a composição estrutural dos trigos, as produções de forragem e de biomassa de lâminas foliares, as taxas de acúmulo diário de forragem e de lâminas foliares, a taxa de lotação, as ofertas de forragem e de lâminas foliares, a eficiência de pastejo, o consumo aparente e a produção de grãos. O trigo mais precoce para produção de forragem foi o BRS Umbu. Houve diferença para a produção de forragem (3196 vs. 4143kg MS/ha) e de lâminas foliares (2281 vs. 3205kg MS/ha) para os genótipos BRS Umbu e BRS Tarumã, respectivamente. Valores similares foram encontrados para taxa de lotação (2,26UA/ha); eficiência de pastejo (52,26%), consumo aparente (2,91%) e produção de grãos (1716kg/ha). O genótipo BRS Tarumã é o mais indicado para o manejo de duplo propósito em condições de pastejo com vacas em lactação.(AU)

The objective of this research was to evaluate the productivity of two dual-purpose wheat genotypes BRS Tarumã and BRS Umbu under grazing with lactating cows. The experimental design was completely randomized, with two treatments, three replications (paddocks) and repeated measures (grazing cycles). Studied variables were early growth, the structural composition of wheat, forage production, leaf blade biomass, the stocking rate, the herbage and leaf blade allowance, the grazing efficiency, the herbage intake and grain yield. The earliest genotype for forage production was the BRS Umbu. Differences in herbage yield between BRS Umbu and BRS Tarumã genotypes (3196 vs. 4143kg DM/ha) and leaf blade production (2281 vs. 3205kg DM/ha), respectively, were detected. Similar values between cultivars were found in stocking rate (2,26AU/ha); grazing efficiency (52,26%), herbage intake (2,91 %) and grain yield (1716kg/ha). The BRS Tarumã genotype is the most suitable for dual-purpose under grazing with dairy cows.(AU)

Waist-to-height ratio and sedentary lifestyle as predictors of metabolic syndrome in children in Ecuador.

OBJECTIVE: To determine the predictors and prevalence of metabolic syndrome (MS) and the presence of vascular inflammation in apparently-normal children (10-15 years) of both sexes in Guayaquil, Ecuador. STUDY DESIGN AND METHODS: We included 395 apparently-healthy students from a middle-income school in a cross-sectional survey. Informed consent was obtained from students and parents. Anthropometric measurements including blood pressure (BP), body mass index (BMI) and waist-to-height ratio (WHtR), and blood tests were recorded. Vascular inflammation parameters were assessed. Percentiles of the different parameters were used, and MS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria (NCEP-ATPIII). Waist circumference>P 75, blood pressure>P 90, glucose>100mg/dl, triglycerides>100mg/dl, HDL<45mg/dl. If 3 of the 5 criteria were present, this was considered MS. RESULTS: The mean age was 12 years (186 boys, 209 girls). The overall prevalence of MS was 9.37% (6.33% in girls, 3.04% in boys). Sustained hypertension was detected in 6.6% of children and pre-hypertension in 7.1%. Obesity was found in 1.8% of subjects, and overweight in 15.2%. Triglycerides has a RR 2.34 (1.97-2.76); HOMA index has a RR 1.97(1.62-2.40); HDL cholesterol has a RR 1.84(1.58-2.13); Insulin level has a RR 1.53(1.40-1.67) and interleukin 6 has RR 1.83(1.20-2.79). Serum glucose, total cholesterol and LDL-Cholesterol had no association with the metabolic syndrome. HDL-Cholesterol<45mg/dl and triglyceride>100mg/dl were present in 70% of subjects with MS. The WHtR threshold≥0.5 was 100% sensitive in both sexes (67% specificity in boys and 69% in girls). There were significant associations between the WHtR and pre-hypertension and sedentary lifestyle (P<0.001 and P<0.003 respectively). A WHtR value of ≥0.50 indicated a 2.2-fold increased risk of MS compared with normal WHtR, and normal weight. CONCLUSIONS: A WHtR≥0.5 was 100% sensitive in detecting MS in 10-15 year-old boys and girls in the normal or overweight range of the BMI. This assessment is a simple and practical tool for use in population-based studies of cardiovascular risk. When combined with pre-hypertension and a sedentary lifestyle, the WHtR is highly sensitive in predicting MS.

Early changes of arterial elasticity in Type 1 diabetes with microvascular complications - A cross-sectional study from childhood to adulthood.

AIM: To examine the trajectory of small artery elasticity (SAE) and pulse pressure (PP) in people with Type 1 diabetes and non-diabetic controls across the lifespan, and explore associations with microvascular complications (CX+). METHODS: This cross-sectional study included 477 Type 1 diabetes patients (188 with CX+, 289 without CX-) and 515 controls. Relationships between SAE and PP and age were evaluated using segmented linear regression. Logistic regression was used to assess the associations between microvascular complications (retinopathy and/or nephropathy) and SAE and PP. RESULTS: SAE peaked significantly later among controls than diabetic patients CX- vs. CX+ (21.2 vs. 20.4 vs. 17.6 years respectively, p < 0.001). In adults, mean SAE was significantly lower in CX+ vs. CX- vs. controls (6.8 vs. 7.8 vs. 8.0 ml/mm Hg × 10; p < 0.0001), and mean PP was significantly higher in CX+ vs CX- and controls (60 vs. 55 vs. 53 mm Hg; p < 0.0001). CONCLUSION: Type 1 diabetes CX+ subjects have an earlier peak and decline in SAE relative to CX- and controls, who did not differ. Lower SAE and higher PP were associated with increased odds of Type 1 diabetes complications in adults. These clinically applicable techniques demonstrate an association between accelerated vascular aging and vascular complications in diabetes.

Higher skin autofluorescence in young people with Type 1 diabetes and microvascular complications.

AIM: To test the hypothesis that non-invasive skin autofluorescence, a measure of advanced glycation end products, would provide a surrogate measure of long-term glycaemia and be associated with early markers of microvascular complications in adolescents with Type 1 diabetes. METHODS: Forearm skin autofluorescence (arbitrary units) was measured in a cross-sectional study of 135 adolescents with Type 1 diabetes [mean ± sd age 15.6 ± 2.1 years, diabetes duration 8.7 ± 3.5 years, HbA1c 72 ± 16 mmol/mol (8.7 ± 1.5%)]. Retinopathy, assessed using seven-field stereoscopic fundal photography, was defined as ≥1 microaneurysm or haemorrhage. Cardiac autonomic function was measured by standard deviation of consecutive RR intervals on a 10-min continuous electrocardiogram recording, as a measure of heart rate variability. RESULTS: Skin autofluorescence was significantly associated with age (R2 = 0.15; P < 0.001). Age- and gender-adjusted skin autofluorescence was associated with concurrent HbA1c (R2 = 0.32; P < 0.001) and HbA1c over the previous 2.5-10 years (R2 = 0.34-0.43; P < 0.002). Age- and gender-adjusted mean skin autofluorescence was higher in adolescents with retinopathy vs those without retinopathy [mean 1.38 (95% CI 1.29, 1.48) vs 1.22 (95% CI 1.17, 1.26) arbitrary units; P = 0.002]. In multivariable analysis, retinopathy was significantly associated with skin autofluorescence, adjusted for duration (R2 = 0.19; P = 0.03). Cardiac autonomic dysfunction was also independently associated with skin autofluorescence (R2 = 0.11; P = 0.006). CONCLUSIONS: Higher skin autofluorescence is associated with retinopathy and cardiac autonomic dysfunction in adolescents with Type 1 diabetes. The relationship between skin autofluorescence and previous glycaemia may provide insight into metabolic memory. Longitudinal studies will determine the utility of skin autofluorescence as a non-invasive screening tool to predict future microvascular complications.

[Cecal tuberculosis: the importance of a high diagnostic suspicion]. / Tuberculosis cecal: la importancia de una alta sospecha diagnóstica.

Intestinal tuberculosis is less common than pulmonary tuberculosis. Its clinical and endoscopic features are nonspe-cific, so diagnostic suspicion must be high in order to make an early diagnosis and prevent iatrogenia. Pharmacotherapy is often effective, with an excellent clinical and endoscopic evolution. Surgical treatment is reserved for complications. We present the case of cecal tuberculosis diagnosed endoscopically; this is the second case diagnosed in a few months in our center. In this case there were no risk factors, such as recent travel, risk of contacts or inmunosupression.

[Lymphoplasmacytic inflammatory pseudotumor of the liver]. / Pseudotumor inflamatorio hepático linfoplasmocítico.

We present the case of a middle-aged woman with antecedents of cholecystectomy and several episodes of resi-dual coledocolitiasis resolved endoscopically. She attended Emergency Services due to a new clinical picture of abdo-minal pain and alteration of hepatic enzymes. Image tests showed lesions that suggested hepatic abscesses without ruling out a malign origin. Given this doubt it was decided to carry out a thick needle biopsy obtaining a diagnosis of an inflammatory pseudotumour of the liver related to IgG4-related disease. This is an infrequent entity but must be taken into consideration because - unlike malign pathology, which is the main differential diagnosis - its behaviour is benign, with a good evolution with medical treatment. That is why a suitable diagnosis is vital to avoid aggressive, diagnostic-therapeutic procedures.

Pseudotumor inflamatorio hepático linfoplasmocítico / Lymphoplasmacytic inflammatory pseudotumor of the liver

Presentamos el caso de una mujer de mediana edad con antecedentes de colecistectomía y varios episodios de coledocolitiasis residual resueltos endoscópicamente. Acude al servicio de Urgencias por un nuevo cuadro de dolor abdominal y alteración de enzimas hepáticas, apreciándose en las pruebas de imagen lesiones sugestivas de abscesos hepáticos sin poder descartarse un origen maligno. Dada esta duda se decide realizar una biopsia con aguja gruesa llegando al diagnóstico de pseudotumor inflamatorio hepático relacionada con la enfermedad por IgG4. Ésta es una entidad infrecuente pero que debe ser tenida en cuenta debido a que, a diferencia de la patología maligna, que es el principal diagnóstico diferencial, su comportamiento es benigno, con buena evolución con tratamiento médico. Por ello es vital un adecuado diagnóstico para evitar procedimientos diagnóstico-terapéuticos agresivos (AU)

We present the case of a middle-aged woman with antecedents of cholecystectomy and several episodes of residual coledocolitiasis resolved endoscopically. She attended Emergency Services due to a new clinical picture of abdominal pain and alteration of hepatic enzymes. Image tests showed lesions that suggested hepatic abscesses without ruling out a malign origin. Given this doubt it was decided to carry out a thick needle biopsy obtaining a diagnosis of an inflammatory pseudotumour of the liver related to IgG4-related disease. This is an infrequent entity but must be taken into consideration because - unlike malign pathology, which is the main differential diagnosis - its behaviour is benign, with a good evolution with medical treatment. That is why a suitable diagnosis is vital to avoid aggressive, diagnostic-therapeutic procedures (AU)

Dietary patterns are associated with bone mineral density in an urban Mexican adult population.

UNLABELLED: Several types of nutrients and foods affect bone mineral density (BMD). However, these nutrients occur together in food groups and dietary patterns, and the overall effects of dietary patterns are not yet well known. INTRODUCTION: We evaluated the associations between dietary patterns and BMD among adults participating in the Health Workers Cohort Study. METHODS: In a cross-sectional analysis, we examined 6915 Mexican adults aged 20-80 years. All participants completed a validated self-administered food frequency questionnaire (FFQ) and had total, hip, and spine BMD measurements assessed by dual-energy X-ray absorptiometry (DXA). The FFQ included 116 foods, which were grouped into 22 categories and entered into a factor analysis to derive dietary patterns. RESULTS: Three dietary patterns emerged-a Prudent, a Refined foods, and a Dairy and fish pattern. After adjustment for potential confounders, those in the highest quintile of the Prudent pattern had lower odds (OR) of low spine BMD (OR = 0.80; 95 % CI 0.68, 0.94; P for trend = 0.031) compared to those in the lowest quintile. In contrast, participants in the highest quintile of the Refined foods pattern had greater odds of low total BMD (OR = 1.74; 95 % CI 1.10, 2.76; P for trend = 0.016) than those in the lowest quintile. Finally, participants in the highest quintile of the Dairy and fish dietary pattern had significantly lower likelihood of having low BMD. CONCLUSION: This study identified specific dietary patterns associated with BMD among a Mexican adult population and highlights the importance of promoting food-based prevention strategies for maintaining bone health.