Pre-contact and post-colonial ecological legacies shape Surinamese rainforests.

Disturbances in tropical forests can have long-lasting ecological impacts, but their manifestations (ecological legacies) in modern forests are uncertain. Many Amazonian forests bear the mark of past soil modifications, species enrichments, and fire events, but the trajectories of ecological legacies from the pre-contact or post-colonial period remain relatively unexplored. We assessed the fire and vegetation history from 15 soil cores ranging from 0 to 10 km from a post-colonial Surinamese archaeological site. We show that (1) fires occurred from 96 bc to recent times and induced significant vegetation change, (2) persistent ecological legacies from pre-contact and post-colonial fire and deforestation practices were mainly within 1 km of the archaeological site, and (3) palm enrichment of Attalea, Oenocarpus and Astrocaryum occurred within 0, 1, and 8 km of the archaeological site, respectively. Our results challenge the notion of spatially extensive and persistent ecological legacies. Instead, our data indicate that the persistence and extent of ecological legacies are dependent on their timing, frequency, type, and intensity. Examining the mechanisms and manifestations of ecological legacies is crucial in assessing forest resilience and Indigenous and local land rights in the highly threatened Amazonian forests.

Phytolith assemblages reflect variability in human land use and the modern environment.

Phytoliths preserved in soils and sediments can be used to provide unique insights into past vegetation dynamics in response to human and climate change. Phytoliths can reconstruct local vegetation in terrestrial soils where pollen grains typically decay, providing a range of markers (or lack thereof) that document past human activities. The ca. 6 million km2 of Amazonian forests have relatively few baseline datasets documenting changes in phytolith representation across gradients of human disturbances. Here we show that phytolith assemblages vary on local scales across a gradient of (modern) human disturbance in tropical rainforests of Suriname. Detrended correspondence analysis showed that the phytolith assemblages found in managed landscapes (shifting cultivation and a garden), unmanaged forests, and abandoned reforesting sites were clearly distinguishable from intact forests and from each other. Our results highlight the sensitivity and potential of phytoliths to be used in reconstructing successional trajectories after site usage and abandonment. Percentages of specific phytolith morphotypes were also positively correlated with local palm abundances derived from UAV data, and with biomass estimated from MODIS satellite imagery. This baseline dataset provides an index of likely changes that can be observed at other sites that indicate past human activities and long-term forest recovery in Amazonia. Supplementary Information: The online version contains supplementary material available at 10.1007/s00334-023-00932-2.

Interlayer charge transfer in supported and suspended MoS2/Graphene/MoS2 vertical heterostructures.

In this letter, we report on the optical and structural properties of supported and suspended MoS2/Graphene/MoS2 vertical heterostructures using Raman and photoluminescence (PL) spectroscopies. Vertical heterostructures (VH) are formed by multiple wet transfers on micro-sized holes in SiO2/Si substrates, resulting in VH with different configurations. The strong interlayer coupling is confirmed by Raman spectroscopy. Additionally, we observe an enhancement of the PL emission in the three-layer VH (either support or suspended) compared with bare MoS2 or MoS2/Graphene. This suggests the formation of a spatial type-II band alignment assisted by the graphene layer and thus, the operation of the VH as a n++/metal/n junction.

Evolución histórica del tratamiento en dientes permanentes inmaduros necróticos / Historical evolution of treatment in necrotic immature permanent teeth i: en

El tratamiento de dientes permanentes inmaduros necróticos constituye un desafío en la odontopediatría, y son múltiples las opciones terapéuticas propuestas para solucionar esta problemática. A tales efectos se realizó el presente estudio con el objetivo de exponer la evolución histórica de dicho tratamiento, para lo cual se efectuó una exhaustiva búsqueda bibliográfica. Se consideró como método general de la investigación el dialéctico-materialista y, de manera particular, los métodos de revisión documental histórico-lógico, de análisis-síntesis e inductivo-deductivo. A partir de determinados hitos históricos se establecieron 3 etapas, cada una de ellas con sus aportes y limitaciones; asimismo, se identificaron las regularidades y tendencias, así como los fundamentos que sustentan la necesidad de continuar investigando sobre nuevos enfoques terapéuticos.

The treatment of necrotic immature permanent teeth constitutes a challenge in the pediatric dentistry, and there are multiple therapeutic options to solve this problem. To such effects the present investigation was carried out with the objective of exposing the historical evolution of this treatment, reason why an exhaustive literature review was carried out. The dialectical-materialistic method was assumed as the general one of the investigation and in a particular way, the historical-logical, analysis-synthesis and inductive-deductive methods of documental review. Three stages were established based on certain historical landmarks, each one with its contributions and limitations; also, regularities and tendencies were identified, as well as the foundations that sustain the necessity to continue investigating on new therapeutic approaches.

Phytoremediation of CdS/Te quantum dots by Ocimum basilicum in the presence of EDTA.

Purpose: The use of nanomaterials like quantum dots (QDs) with optical properties has increased in the last decade because of their electronics, medicine, and environmental applications. The lack of recycling and appropriate disposal causes these materials to be considered new emerging contaminants. In this research, the extraction and translocation (phytoextraction) of cadmium as QDs by Ocimum basilicum "basil" in the presence of EDTA (chelating agent) was studied. For edible plants are essential to know where the contaminants are located to minimize human consumption. Methods: In this work, the phytoextraction, distribution, and translocation of cadmium (under ionic solution-CdIS and CdS/Te QDs) at 25 and 50 mg/kg-soil and in the presence of 1,000 mg/kg-soil EDTA was studied in O. basilicum (a commercialized culinary herb) for three and six weeks. Basil seedlings were grown in an environmentally controlled chamber at 24-28o C and 12/12 hours periods of light and darkness. Results: The highest cadmium concentration was found in the roots from where it is translocated to stems and leaves. CdS/Te QDs at low concentration (25 mg/kg and 3 weeks of exposure) had the highest translocation factor, indicating that cadmium's nanocrystal (QDs) forms can affect the phytoextraction mechanism. The highest bioconcentration of cadmium was reached at a high contaminant concentration. Conclusion: The bioconcentration factors confirm that O. basilicum phytoextracts cadmium from soils contaminated with CdS/Te QDs and CdIS. The bioconcentration factors of cadmium (under both species CdS/Te QDs and CdIS) increase in the presence of EDTA. The bioconcentration and translocation factors suggest that consuming "basil" from contaminated soils with CdS/Te QDs at low concentrations increases the exposition to this metal.

Necesidad de actualización de los conocimientos sobre laserterapia en profesionales de estomatología / Necessity of updating knowledge on laser therapy in stomatology professionals

Introducción: El conocimiento sobre laserterapia es necesario en los profesionales de las especialidades médicas y estomatológicas, a fin de emplearla apropiadamente en los pacientes. Objetivo: Identificar la necesidad de conocimientos sobre laserterapia en profesionales de estomatología. Métodos: Se realizó un estudio descriptivo y transversal, desde marzo de 2020 hasta abril de 2021, en 60 profesionales del Servicio de Estomatología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, en quienes se aplicó una encuesta cuyas respuestas fueron catalogadas en adecuadas e inadecuadas. Asimismo, se utilizaron métodos empíricos y estadísticos para el análisis de los resultados. Resultados: La mayoría de los encuestados habían obtenido los conocimientos en la formación de pregrado; asimismo, se obtuvo un porcentaje superior de respuestas adecuadas en cuanto a las propiedades de la terapia con láser, las precauciones para su aplicación y las contraindicaciones relacionadas con el tratamiento quirúrgico. Al analizar el conocimiento según categoría profesional, se pudo comprobar que los especialistas poseían una noción más adecuada acerca del tema que el resto de los participantes en la investigación. Conclusiones: Los profesionales mostraron conocimientos insuficientes para aplicar la laserterapia; por ende, se requiere trazar una estrategia de superación que posibilite capacitarles en tan importante tema.

Introduction: Knowledge on lasertherapy is necessary in professionals of medical and stomatological specialities, so as to use them properly in patients. Objective: To identify the scarce knowledge on lasertherapy in stomatology professionals. Methods: A descriptive and crossed-sectional study was carried out from March 2020 to April, 2021, in 60 professionals in the stomatological service from Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, in whom a survey was applied and their answers were classified as adequate or inadequate. Likewise, empiric and statistics methods were used for the analysis of results. Results: Most of the surveyed professionals had acquired knowlegde during their pre-degree training, in the same way, a higher percentage of adequate answers was obtained regarding the properties of therapy with laser, meassures for its use, and contraindications related to surgical treatment. When analizing knowledge according to professional categories, it could be proven that specialists had a more adequate notion on the topic than the rest of participants in the study. Conclusions: Professional showed scarce knowledge on to use lasertherapy; so, it is required to elaborate a training estrategy to prepare them in such an important topic.

Broadband, Ultra-High-Responsive Monolayer MoS2/SnS2 Quantum-Dot-Based Mixed-Dimensional Photodetector.

Atomically thin two-dimensional (2D) materials have gained significant attention from the research community in the fabrication of high-performance optoelectronic devices. Even though there are various techniques to improve the responsivity of the photodetector, the key factor limiting the performance of the photodetectors is constrained photodetection spectral range in the electromagnetic spectrum. In this work, a mixed-dimensional 0D/2D SnS2-QDs/monolayer MoS2 hybrid is fabricated for high-performance and broadband (UV-visible-near-infrared (NIR)) photodetector. Monolayer MoS2 is deposited on SiO2/Si using chemical vapor deposition (CVD), and SnS2-QDs are prepared using a low-cost solution-processing method. The high performance of the fabricated 0D/2D photodetector is ascribed to the band bending and built-in potential created at the junction of SnS2-QDs and MoS2, which enhances the injection and separation efficiency of the photoexcited charge carriers. The mixed-dimensional structure also suppresses the dark current of the photodetector. The decorated SnS2-QDs on monolayer MoS2 not only improve the performance of the device but also extends the spectral range to the UV region. Photoresponsivity of the device for UV, visible, and NIR region is found to be ∼278, ∼ 435, and ∼189 A/W, respectively. Fabricated devices showed maximum responsivity under the visible region attributed to the high absorbance of monolayer MoS2. The response time of the fabricated device is measured as ∼100 ms. These results reveal that the development of a mixed-dimensional (0D/2D) SnS2-QDs/MoS2-based high-performance and broadband photodetector is technologically promising for next-generation optoelectronic applications.

Conceptual validation of an innovative remote pulmonary rehabilitation solution for Chronic Obstructive Pulmonary Disease.

INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in the world. Pulmonary rehabilitation (PR) reduces COPD hospitalisations, although its use is low. Telerehabilitation is effective; however, in Chile the development of remote PR technology is incipient. Therefore, the aim of the study was to validate conceptual aspects of an innovative remote PR solution for COPD. METHODS: This mixed study used a nonprobabilistic sample of PR professionals and people with COPD (PwCOPD) from Santiago. The perception of a conceptual solution for PR through a semi-structured interview was determined. Professionals were also asked about willingness to use technology using a questionnaire designed and validated in 75 professionals in this study. The study was approved by the Ethics Committee and data were collected after informed consent. RESULTS: Twenty-two participants were recruited, of which 14 were professionals and eight were PwCOPD. Among professionals and patients, the willingness to use the solution is positive because it would reduce visits and improve self-management, although it should include a remote/in-person combination, training, and user-friendly interface. Most of the professionals were willing to use technology for pulmonary rehabilitation. CONCLUSIONS: The development of telehealth technologies should consider the expectations of patients and professionals and may incorporate elements of persuasive technologies in the design. The results could contribute to the development of digital solutions for remote PR in PwCOPD.

Manejo de pacientes con tumores de células germinales en primera recaída / Management of patients with germinal cell tumors in first relapse

Resumen Los tumores de células germinales (TCG) son las neoplasias malignas más comunes y afectan especialmente a hombres jóvenes de 15 a 35 años de edad. Los pacientes con estadios 2 y 3 que recaen ofrecen un gran reto para el tratamiento inicial de la primera recaída. La terapia óptima para estos pacientes depende de su tratamiento inicial y está pobremente definida. Las opciones incluyen regímenes de segunda línea de quimioterapia a dosis convencionales que combinan cisplatino e ifosfamida, con vinblastina, etopósido o paclitaxel, o quimioterapia de altas dosis con soporte de células madre. En vista de que todavía no hay evidencia concluyente en los ensayos clínicos, las indicaciones para el uso de quimioterapia de altas dosis permanecen poco claras y se basan en estudios fundamentalmente retrospectivos. El tratamiento en la segunda recaída debe individualizarse según el paciente y el tratamiento previo. La resección quirúrgica de masas residuales luego de la quimioterapia es un elemento clave para una terapia exitosa en pacientes con marcadores tumorales negativos. Actualmente, en Venezuela los pacientes que presentan recaídas deben recibir tratamiento con cualquiera de los regímenes establecidos que se utilizan a dosis convencionales en segunda línea. En algunos casos, los pacientes deben recibir tratamiento en centros de oncología con un manejo multidisciplinario que permita el acceso a tratamiento con altas dosis de quimioterapia y a cirujanos oncólogos expertos en esta patología.

Abstract Germ cell tumors (GCT) are the most common malignant neoplasms affecting young men aged 15 to 35 years. Patients with previous stage 2 and 3 who relapse offer a great challenge to the Medical team. The optimal therapy for these patients with recurrent disease is still poorly defined. Options include second-line chemotherapy regimens at conventional doses which combine cisplatin and ifosfamide, with vinblastine, etoposide or paclitaxel, or alternatively high-dose chemotherapy with stem cell support. As there is still no conclusive evidence from clinical trials, the indications for the use of high-dose chemotherapy remain unclear. Most of the present literature is based in retrospective studies. Second relapse treatment options should be individualized according to the patient and his previous treatment. Surgical resection of residual masses in patients with negative markers after chemotherapy is a key element for successful therapy. Currently, patients in Venezuela who have relapses should receive treatment with any of the established regimens that are used at conventional doses in the second line, however in some cases they should receive treatment in an oncology center with a multidisciplinary team having access to treatment with high dose chemotherapy and to oncologist surgeons who are experts in this area.

Validity, reliability, and sensitivity to motor impairment severity of a multi-touch app designed to assess hand mobility, coordination, and function after stroke.

BACKGROUND: The assessment of upper-limb motor impairments after stroke is usually performed using clinical scales and tests, which may lack accuracy and specificity and be biased. Although some instruments exist that are capable of evaluating hand functions and grasping during functional tasks, hand mobility and dexterity are generally either not specifically considered during clinical assessments or these examinations lack accuracy. This study aimed to determine the convergent validity, reliability, and sensitivity to impairment severity after a stroke of a dedicated, multi-touch app, named the Hand Assessment Test. METHODS: The hand mobility, coordination, and function of 88 individuals with stroke were assessed using the app, and their upper-limb functions were assessed using the Fugl-Meyer Assessment for Upper Extremity, the Jebsen-Taylor Hand Function Test, the Box and Block Test, and the Nine Hole Peg Test. Twenty-three participants were further considered to investigate inter- and intra-rater reliability, standard error of measurement, and the minimal detectable change threshold of the app. Finally, participants were categorized according to motor impairment severity and the sensitivity of the app relative to these classifications was investigated. RESULTS: Significant correlations, of variable strengths, were found between the measurements performed by the app and the clinical scales and tests. Variable reliability, ranging from moderate to excellent, was found for all app measurements. Exercises that involved tapping and maximum finger-pincer grasp were sensitive to motor impairment severity. CONCLUSIONS: The convergent validity, reliability, and sensitivity to motor impairment severity of the app, especially of those exercises that involved tapping and the maximum extension of the fingers, together with the widespread availability of the app, could support the use of this and similar apps to complement conventional clinical assessments of hand function after stroke.

Síndrome de West criptogénico: perfil clínico, respuesta al tratamiento y factores pronósticos / Cryptogenic West syndrome: Clinical profile, response to treatment and prognostic factors

INTRODUCCIÓN: El síndrome de West (SW) es una encefalopatía epiléptica dependiente de la edad con pronóstico variable según la etiología subyacente, no siempre identificada. OBJETIVOS: Definir el perfil del SW criptogénico en nuestro medio, subgrupo menos estudiado de forma aislada. Estudiar su evolución, respuesta a los distintos tratamientos y establecer factores pronósticos. PACIENTES Y MÉTODOS: Revisión de historias clínicas de 16 pacientes diagnosticados de SW criptogénico durante el período 2000-2015. El tiempo de seguimiento medio fue 6,6 años y mínimo de 2 años. RESULTADOS: 11 de 16 fueron varones, la edad media de inicio fue de 6 meses y 6/16 presentaban antecedente familiar de epilepsia idiopática. El tratamiento de primera línea con vigabatrina tuvo respuesta electroclínica en 5/16 pacientes, respondiendo los casos restantes a hormona adrenocorticotropa (ACTH). El 44% de los pacientes evolucionaron a otras epilepsias, sin diferencia entre los tratados con vigabatrina o ACTH. Se obtuvo un mayor número de efectos adversos con la ACTH, no se evidenció afectación retiniana con la vigabatrina. Durante el seguimiento se llegó a la causa etiológica en 2/16. El sexo femenino, el comienzo tardío y el control precoz de la hipsarritmia resultaron factores de buen pronóstico. CONCLUSIONES: El pronóstico global del SW criptogénico resultó más grave de los esperado. Aunque la incidencia de síndrome de Lennox-Gastaut fue baja, la epilepsia focal resultó la evolución más frecuente apareciendo en los 2 primeros años del diagnóstico. La respuesta inicial a vigabatrina fue menor a la esperada, pero el resultado a largo plazo resultó superponible a la ACTH

INTRODUCTION: West syndrome (WS) is an age-dependent epileptic encephalopathy in which the prognosis varies according to the, not always identified, underlying origin. OBJECTIVES: To define the profile of cryptogenic (a least studied isolated sub-group) WS, in Spain. To study its outcome, response to different treatments, and to establish prognostic factors. PATIENTS AND METHODS: The study included a review of the medical records of 16 patients diagnosed with cryptogenic WS during the period, 2000-2015. The mean follow-up time was 6.6 years, with a minimum of 2 years. RESULTS: The large majority (11/16) were male. The mean age at onset was 6 months, and 6/16 had a family history of idiopathic epilepsy. The first line treatment with vigabatrin had an electrical-clinical response in 5/16 patients, with the remaining cases responding to adrenocorticotropic hormone (ACTH). Almost half (44%) of the patients progressed to other types of epilepsy, with no difference between those treated with vigabatrin or ACTH. A greater number of adverse effects were obtained with ACTH, with no retinal involvement being observed with vigabatrin. The aetiological cause was found in 2/16. Being female, late onset, and early control of the hypsarrhythmia, were factors of a good prognosis. CONCLUSIONS: The overall prognosis of cryptogenic WS was more serious than expected. Although the incidence of Lennox-Gastaut syndrome was low, the progression to focal epilepsy was the most common, with it appearing within the first 2 years of the diagnosis. The initial response to vigabatrin was lower than expected, but the long-term result was comparable to ACTH

Componentes y determinantes del estado de salud bucal en pacientes de un consultorio médico de la familia / Components and determining factors of the oral health state in patients from a family doctor´s office

Se llevó a cabo un estudio epidemiológico, descriptivo y transversal de 1660 pacientes, quienes pertenecían al Consultorio Médico de la Familia No 1 del Policlínico Universitario Julián Grimau de Santiago de Cuba, desde marzo del 2015 hasta igual periodo del 2016, con vistas a determinar el estado de salud bucal de esta población. Se realizó el examen bucal con el depresor lingual y la ayuda de la luz natural o artificial. También se desarrolló la lluvia de ideas como técnica cualitativa. La higiene bucal deficiente y la dieta cariogénica fueron los factores de riesgo que más incidieron en el aumento de la morbilidad bucal, lo cual demostró la necesidad de tratamiento de estos pacientes(AU)

An epidemiologic, descriptive and cross-sectional study of 1660 patients who belonged to the Family Doctor´s Office No 1 of Julián Grimau University Polyclinic in Santiago de Cuba, was carried out from March, 2015 to the same period in 2016, aimed at determining the oral health state of this population. The oral exam with the lingual depressor and the help of natural or artificial light was carried out. The brainstorm as qualitative technique was also developed. The poor oral hygiene and the cariogenic diet were the risk factors that impacted the most in the increase of oral morbidity, which demonstrated the necessity of treatment for these patients(AU)

Enfermeros y agentes sanitarios como impulsores de la adherencia terapéutica: una investigación etnográfica en Catamarca, Argentina / Nurses and Paramedic Staff as Drivers of Therapy Adherence: An Ethnographic Research in Catamarca, Argentina / Enfermeiros e agentes sanitários como impulsores da aderência terapêutica: uma pesquisa etnográfica em Catamarca, Argentina

Resumen Objetivos: el objetivo central de este artículo es analizar el rol del enfermero y del agente sanitario locales en el área del Valle del Cajón, Catamarca, Argentina, estudio que está focalizado en su intervención en la adherencia terapéutica de los pacientes. Desarrollo: a partir de la utilización de una metodología cualitativa de carácter etnográfico, se exponen los resultados obtenidos mediante entrevistas abiertas de sesiones múltiples, observación participante, registros fílmicos y diarios de campo. La investigación muestra que las siguientes son intancias que sostienen la adherencia terapéutica: la alta valoración que los enfermeros y los agentes sanitarios poseen para la gente local y los demás trabajadores de la salud; su intervención con resultado favorable en los itinerarios terapéuticos; el conocimiento que poseen de las formas de concebir el proceso de salud y enfermedades nativas; su pertenencia a la organización social local; su intervención como mediadores culturales entre los pobladores y los médicos; su pericia en el manejo de la farmacopea local y su activa participación en funciones que exceden el sistema de salud, entre otras. Conclusiones: se postula que los enfermeros y agentes sanitarios son engranajes centrales de la APS y su práctica cotidiana en el Valle del Cajón constituye un soporte decisivo en lo referido al seguimiento de los tratamientos terapéuticos.

Abstract Objectives: The main objective of this article is to analyze the role of the local nurses and paramedics in the Valle del Cajon region, Catamarca, Argentina, focusing on their intervention in the patients' theraphy adherence. Content: Arising from the use of a qualitative methodology with an ethnographic approach, the results stated are obtained from open interviews in multiple sessions, participant observation, film recording and field logbooks. The research shows that the high value that local people bestow on nurses and paramedics, as well as other health workers, their successful intervention in therapeutic itineraries, their knowledge about the ways to conceive the process of health and native diseases, their attachment to the local social organization, their intervention as cultural mediators between local people and doctors, their expertise in handling the local pharmacopoeia and their active participation in issues beyond the health system, among others, constitute instances that sustain therapy adherence. Conclusions: The research results show that nurses and paramedics are key actors in APS and their everyday practice in Valle del Cajón, which constitutes a decisive support as to the monitoring of therapeutic treatments.

Resumo Objetivos: o objetivo central deste artigo é analisar o papel do enfermeiro e do agente sanitário locais na área de Valle del Cajón, Catamarca, Argentina, estudo que está focalizado em sua intervenção na aderência terapêutica dos pacientes. Desenvolvimento: a partir da utilização de uma metodologia qualitativa de carácter etnográfico, expõem-se os resultados obtidos mediante entrevistas abertas de sessões múltiplas, observação participante, registros fílmicos e diários de campo. A pesquisa mostra que a alta valoração que os enfermeiros e os agentes sanitários possuem para o pessoal local e os demais trabalhadores da saúde; a sua intervenção com resultado favorável nos itinerários terapêuticos; o conhecimento que possuem das formas de conceber o processo de saúde e doenças nativas; a sua pertença à organização social local; a sua intervenção como mediadores culturais entre os povoadores e os médicos; a sua perícia na gestão da farmacopeia local e a sua ativa participação em funções que excedem o sistema de saúde, entre outras, constituem instâncias que sustentam a aderência terapêutica. Conclusões: se apresenta que os enfermeiros e agentes sanitários são engrenagens centrais da APS e a sua prática cotidiana no Valle del Cajón constitui um suporte decisivo no referido ao seguimento dos tratamentos terapêuticos.

[Cryptogenic West syndrome: Clinical profile, response to treatment and prognostic factors]. / Síndrome de West criptogénico: perfil clínico, respuesta al tratamiento y factores pronósticos.

INTRODUCTION: West syndrome (WS) is an age-dependent epileptic encephalopathy in which the prognosis varies according to the, not always identified, underlying origin. OBJECTIVES: To define the profile of cryptogenic (a least studied isolated sub-group) WS, in Spain. To study its outcome, response to different treatments, and to establish prognostic factors. PATIENTS AND METHODS: The study included a review of the medical records of 16 patients diagnosed with cryptogenic WS during the period, 2000-2015. The mean follow-up time was 6.6 years, with a minimum of 2 years. RESULTS: The large majority (11/16) were male. The mean age at onset was 6 months, and 6/16 had a family history of idiopathic epilepsy. The first line treatment with vigabatrin had an electrical-clinical response in 5/16 patients, with the remaining cases responding to adrenocorticotropic hormone (ACTH). Almost half (44%) of the patients progressed to other types of epilepsy, with no difference between those treated with vigabatrin or ACTH. A greater number of adverse effects were obtained with ACTH, with no retinal involvement being observed with vigabatrin. The aetiological cause was found in 2/16. Being female, late onset, and early control of the hypsarrhythmia, were factors of a good prognosis. CONCLUSIONS: The overall prognosis of cryptogenic WS was more serious than expected. Although the incidence of Lennox-Gastaut syndrome was low, the progression to focal epilepsy was the most common, with it appearing within the first 2 years of the diagnosis. The initial response to vigabatrin was lower than expected, but the long-term result was comparable to ACTH.

Early maladaptive schemas associated with dimensional and categorical psychopathology in patients with borderline personality disorder.

OBJECTIVE: To ascertain the foundations for a schema-focused therapy model for the treatment of borderline personality disorder. METHODS: The sample consisted of 102 borderline personality disorder outpatients. Dimensional psychopathology was assessed using the Scale for Suicidal Ideation, the Aggression Questionnaire, and the Symptom CheckList Revised. Categorical psychopathology was measured using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders, Patient Edition. Stepwise linear/logistic multiple regression analyses were used to determine the predictive role of the schema domains tested by the Young Schema Questionnaire on both types of psychopathology. Receiver operating characteristic curves were calculated for those binary outcomes. RESULTS: Regarding dimensional psychopathology, disconnection/rejection predicted greater suicidal ideation (ß = .39, p = .002), physical/overt aggressiveness (ß = .27, p = .05), and psychotic-like symptoms, such as paranoid ideation (ß = .35, p = .003). Other-directedness predicted greater anger/inner aggressiveness (ß = .22, p = .05) and internalizing symptoms, such as phobic anxiety (ß = .39, p = .001). Regarding categorical psychopathology, disconnection/rejection significantly predicted the presence of lifetime comorbidities with eating disorders (adjusted odds ratio [AOR] = 1.12, 95% CI = 0.99-1.24) and posttraumatic stress disorder (AOR = 1.2, 95% CI = 1.04-1.3), resulting in a good balance of sensitivity/specificity, respectively (.97/.96 and .88/.89). Other-directedness significantly predicted the absence of lifetime comorbidity with substance-use disorders (AOR = .74, 95% CI = 0.57-0.95). These relationships remained significant after controlling for confounders (e.g., comorbidity with other personality disorders, clinical global severity). CONCLUSIONS: Two schema domains, disconnection/rejection and other-directedness, were directly associated with dimensional and categorical psychopathology among borderline personality disorder patients. These findings provide further information about the foundations and target interventions when implementing schema-focused therapy on this population.

Algunas consideraciones sobre las afecciones dermatológicas en pacientes con virus de inmunodeficiencia humana/sida / Some considerations on dermatological disorders in patients with human immunodeficiency virus/AIDS

La infección por el virus de la inmunodeficiencia humana/sida es uno de los problemas de salud pública más importante en todo el mundo. Se estima que hasta 95 por ciento de los afectados presentan manifestaciones cutáneas durante el curso de la infección, entre las cuales se encuentran las producidas por hongos. A tales efectos, se describen algunas de ellas, las cuales deben ser reconocidas por los médicos y el personal de salud a cargo del tratamiento y control de los pacientes con esta enfermedad(AU)

Human immunodeficiency virus/AIDS infection is one of the most important public health problems worldwide. It is considered that up to 95 percent of the affected patients present cutaneous manifestations during the course of the infection, among which we can mention those caused by fungus. To such effects, some of these are described, which should be recognized by doctors and health staff in charge of the treatment and control of patients with this diseasase(AU)

Algunas consideraciones sobre las afecciones dermatológicas en pacientes con virus de inmunodeficiencia humana/sida / Some considerations on dermatological disorders in patients with human immunodeficiency virus/AIDS

La infección por el virus de la inmunodeficiencia humana/sida es uno de los problemas de salud pública más importante en todo el mundo. Se estima que hasta 95 por ciento de los afectados presentan manifestaciones cutáneas durante el curso de la infección, entre las cuales se encuentran las producidas por hongos. A tales efectos, se describen algunas de ellas, las cuales deben ser reconocidas por los médicos y el personal de salud a cargo del tratamiento y control de los pacientes con esta enfermedad.

Human immunodeficiency virus/AIDS infection is one of the most important public health problems worldwide. It is considered that up to 95 percent of the affected patients present cutaneous manifestations during the course of the infection, among which we can mention those caused by fungus. To such effects, some of these are described, which should be recognized by doctors and health staff in charge of the treatment and control of patients with this disease

Differential symptomatology and functioning in borderline personality disorder across age groups.

There is increasing research aimed at addressing whether patients with borderline personality disorder (BPD) may exhibit variations in symptomatology and functioning according to their chronological age. The current study consisted of 169 outpatients diagnosed with BPD, who were divided into four age groups as follows: 16-25 years (n = 41), 26-35 years (n = 43), 36-45 years (n = 45), and 46 and more years (n = 40). Age groups were compared for symptomatology, normal personality traits, psychiatric comorbidities, functioning, and treatment-related features. The younger group had significantly higher levels of physical/verbal aggression and suicide attempts relative to the older group. Conversely, the older group had significantly greater severity of somatization, depression, and anxiety symptoms. In addition, the older group showed significantly greater functional impairment overall and across physical/psychological domains, specifically when compared to the younger group. Overall, these findings may suggest that age-related symptoms should be considered when diagnosing BPD. Also, functional impairments should be the target interventions for older BPD patients.

Caracterización clinicoepidemiológica de pacientes especiales con gingivitis crónica / Clinical and epidemiological characterization of special patients with chronic gingivitis

Se realizó un estudio descriptivo y transversal de 59 pacientes especiales con gingivitis crónica, atendidos en el Policlínico Docente Julián Grimau García de Santiago de Cuba, desde marzo de 2016 hasta enero de 2017, con vistas a caracterizarles según variables clínicas y epidemiológicas de interés. Entre los resultados principales prevalecieron el sexo masculino (72,9 por ciento), el grupo etario de 10-14 años (64,4 por ciento), la primaria terminada como nivel escolar (40,7 por ciento), así como la higiene bucal deficiente (81,3 por ciento) como factor de riesgo; entre estos últimos, la mayoría presentaron gingivitis crónica edematosa (79,2 por ciento) e inflamación severa (76,2 por ciento). La práctica inadecuada del cepillado dental, dada por la incapacidad intelectual de este tipo de paciente, favoreció la aparición de esta enfermedad(AU)

A descriptive and cross-sectional study of 59 special patients with chronic gingivitis, assisted in Julián Grimau García Teaching Polyclinic was carried out in Santiago de Cuba, from March, 2016 to January, 2017, aimed at characterizing them according to clinical and epidemiologic variables of interest. Among the main results, there was a prevalence of the male sex (72.9 percent), 10-14 age group (64.4 percent), primary school level (40.7 percent), as well as the inadequate oral hygiene (81.3 percent) as risk factor; among the latter, most of them presented chronic edematous gingivitis (79.2 percent) and severe inflammation (76.2 percent). The inadequate practice of dental brushing, due to the intellectual incapacity of this type of patient, favored the emergence of this disease(AU)