Executive Functions and Theory of Mind in Teachers and Non-Teachers.

Human teaching is a key behavior for the socialization of cultural knowledge. Previous studies suggest that human teaching behavior would support the development of executive and ToM skills, which in turn would refine the teaching behavior. Given this connection, it raises the question of whether subjects with professional training in teaching also have more efficient executive and ToM systems. To shed light on this issue, in the present study we compared the performance of professional teachers (N = 20, age range = 35-61 years) with a matched control group of non-teachers (N = 20, age range: 29-64 years) on tasks measuring working memory (Sternberg Task), cognitive flexibility (Wisconsin Card Sorting Test), executive control (Attention Network Test), along with online ToM skills (Frith-Happé Animations Task), emotion recognition (Reading the Mind in the Eyes Test) and first-order and second-order ToM (Yoni Task). We found that teachers were significantly more accurate on tasks involving cognitive flexibility (p = .014) and working memory (p = .040), and more efficient on tasks requiring executive control of attention (p = .046), compared to non-teachers. In ToM tasks, differences in accuracy between teachers and non-teachers were not found. But, teachers were slower to respond than non-teachers (about 2 s difference) on tasks involving emotion recognition (p = .0007) and the use of second-order affective ToM (p = .006). Collectively, our findings raise an interesting link between professional teaching and the development of cognitive skills critical for decision-making in challenging social contexts such as the classroom. Future research could explore ways to foster teachers' strengths in cognitive flexibility, working memory, and executive control of attention to enhance teaching strategies and student learning outcomes. Additionally, exploring factors behind slower response times in affective ToM tasks can guide teacher-training programs focused on interpersonal skills and improve teacher-student interactions.

Assessing Spatial User Experience for Design Guidelines: A Comparative Study of Outpatient Waiting Rooms With Conventional Versus Modern Features.

OBJECTIVES: Identify waiting room design features that are most appreciated by outpatients and their companions in conventional and modern waiting rooms. Evaluate if end users evaluate the environment differently from experts and in what aspects. Provide evidence-based design guidelines that orient designers and healthcare managers. BACKGROUND: Built environments are relevant in patients' evaluation of overall healthcare service. For outpatients, waiting frequently consumes the largest amount of time; thus, waiting room interior design has great potential to enhance their experience. METHODS: This study compares perceptions of two types of waiting rooms-conventional and modern-based on the spatial user experience (SUE) model. In the first stage of the study, we compared user evaluations of conventional waiting rooms (n = 137) and modern waiting rooms (n = 426) with respect to the eight SUE model dimensions using multigroup structural equation modeling. In the second stage, an expert ergonomist and two professional interior designers assessed both types of waiting rooms. RESULTS: Results showed that modern waiting rooms were perceived to be significantly better in all SUE dimensions. We also found experts' evaluations were overall consistent with users' perceptions. Discrepancies were only found in temperature perception, signage evaluation, and spatial appreciation. CONCLUSIONS: Participants valued modern style waiting room features such as good quality signage, use of armchairs and sofas, a controlled environment, and decoration. We suggest involving end users in the design process to respond to their needs and promote a positive experience. Finally, we provide easy-to-adopt design guidelines to improve patients' waiting room experience.

Pronación precoz en pacientes con síndrome de distrés respiratorio por neumonía COVID-19 / Early pronation in patients with respiratory distress due to COVID-19 pneumonia

Introducción: El tratamiento de los pacientes con insuficiencia respiratoria en el curso de la COVID-19 ha sido un reto en todo el mundo, debido al gran número de pacientes afectados por la agresividad del virus, el empleo de los recursos humanos y la disponibilidad de los equipos. Objetivo: Demostrar la utilidad de la pronación precoz para lograr mejoría de la oxigenación y prevenir en muchos casos la intubación endotraqueal en pacientes con distrés respiratorio por la COVID-19. Métodos: Se realizó un estudio observacional analítico, de corte transversal retrospectivo, de pacientes que ingresaron en la Unidad de Cuidados Intensivos del Hospital Cubano En Qatar, perteneciente a la Hamad Medical Corporation, en el período comprendido de marzo a mayo de 2021. Se utilizaron variables enfocadas en demostrar la respuesta ventilatoria. Se utilizó el paquete estadístico Statistical Package Social Science (Ssps) versión 21.0, según porcentaje y Chi cuadrado, y la t de Student para análisis estadístico deductivo de las muestras relacionadas. Resultados: Predominó el grupo de edades de 3-50 años en pacientes con 2 o más comorbilidades. La oxigenación con HFNC y combinada con NIV fueron las más empleadas. La mayoría de las variables en prueba de muestras relacionadas fueron altamente significativas. Conclusiones: La pronación precoz, como complemento del tratamiento intensivo en pacientes con insuficiencia respiratoria, causada por la enfermedad COVID-19, proporciona una mejor recuperación de los enfermos y una mejoría indiscutibles de los parámetros de ventilación y oxigenación(AU)

Introduction: In the course of COVID-19, the management of patients with respiratory failure has been a challenge worldwide, due to the large number of patients affected by the aggressiveness of the virus, the use of human resources and the availability of equipment. Objective: To show the usefulness of early pronation for improving oxygenation and prevent, in many cases, endotracheal intubation in patients with respiratory failure due to COVID-19. Methods: An analytical, observational, retrospective and cross-sectional study was carried out with patients hospitalized in the intensive care unit of the Cuban Hospital in Qatar, belonging to the Hamad Medical Corporation, in the period from March to May 2021. Variables focused on demonstrating the ventilatory response were used. The Statistical Package Social Science (SPSS), version 21.0, was used, according to percentage and chi-square, as well as Student's t-test for deductive statistical analysis of related samples. Results: The predominant age group was 3-50 years, in patients with two or more comorbidities. Oxygenation with high-flow nasal cannula and combined with non-invasive ventilation were the most widely used. Most of the variables in the related samples test were highly significant. Conclusions: Early pronation, as an adjunct to intensive management of patients with respiratory failure caused by COVID-19, provides better recovery for patients and an indisputable improvement of ventilation and oxygenation parameters(AU)

Platos olvidados o de consumo ocasional en la gastronomía española: Asturias / Forgotten dishes or occasional consumption in Spanish gastronomy: Asturias

El mar Cantábrico con sus pescados y mariscos, y los valles profundos de la cordillera Cantábrica que proporcionan pastos para la cría de ganado en libertad suministran los ingredientes a la cocina asturiana tradicional, con importante presencia también de verduras, hortalizas y legumbres como las fabes, sin olvidar la gran variedad de quesos artesanales. (AU)

The Cantabrian Sea with its fish and shellfish, and the deep valleys of the Cantabrian mountains that provide pasture for free-range cattle raising, supply the ingredients for traditional Asturian cuisine, with an important presence of vegetables and legumes such as fabes, without forgetting the great variety of artisanal cheeses. (AU)

Tasa de fecundidad infantil y la paulatina no declaración de los progenitores en Costa Rica (2000-2019) / Infant fertility rate and the gradual non-declaration of parents in Costa Rica (2000-2019)

Resumen Introducción: la maternidad infantil debe evidenciarse por su propia naturalización social como producto de violaciones. Es relevante su estudio luego de aprobadas algunas leyes que buscan evitarla. Objetivo: analizar el comportamiento de la tasa de fecundidad en niñas entre 10 y 14 años en Costa Rica (2000-2019) y la edad de los perpetradores o «padres» en el marco de los aparatos ideológicos de Estado, desigualdad social y dentro de un contexto social conservador. Método: la información se extrajo de las bases de datos en línea del Instituto Nacional de Estadística y Censos. El abordaje es cuantitativo, con un estudio correlacional y no experimental de la población descrita en todo el país y en áreas geográficas pequeñas. Resultados: la fecundidad infantil ha disminuido entre los años 2000 y 2019. La edad estimada de embarazo es cuando se cumplen los 13 años. Se detectaron áreas geográficas con mayores niveles de fecundidad dentro y fuera del Gran Área Metropolitana. Se evidenció estadísticamente que algunas leyes han contribuido al aumento considerable de perpetradores no declarados luego de 2016. Todo esto fue validado por instituciones religiosas y los medios de comunicación lo pregonaron como positivo, a pesar de la jurisprudencia nacional e internacional. Conclusiones: esta información es trascendental para orientar las políticas públicas educativas y de salud desde el primer nivel de atención, con miras a promover los derechos reproductivos de las niñas.

Abstract Introduction: Child motherhood must be evidenced by the naturalization of this social fact itself, since it is the product of rape. The study of this phenomenon is relevant after the approval of some laws that seek to prevent it. Objective: to analyze of the fertility rate in girls between the ages 10 and 14 in Costa Rica (2000-2019) the age of the perpetrators or "parents" within the framework of ideological State apparatuses, social inequality, and a conservative social context. Method: The information was processed from the online databases of the Instituto Nacional de Estadística y Censos. The approach is quantitative, with a correlational and non-experimental study of the population of girls between 10 and 14 years of age throughout the country, as well as for small geographic areas. Results: Infant fertility has decreased between 2000 and 2019. The estimated age of pregnancy is at the age of 13. Geographical areas with higher fertility levels are detected, inside and outside the Metropolitan Area. It is statistically evidenced that these have contributed to the increase in undeclared perpetrators considerably after 2016. All this is validated by religious institutions and the media proclaim as positive, despite national and international jurisprudence. Conclusions: This information is essential to guide public educational and health promotion policies from the first level of care, which promote the reproductive rights of girls.

Increase in Beta Power Reflects Attentional Top-Down Modulation After Psychosocial Stress Induction.

Selective attention depends on goal-directed and stimulus-driven modulatory factors, each relayed by different brain rhythms. Under certain circumstances, stress-related states can change the balance between goal-directed and stimulus-driven factors. However, the neuronal mechanisms underlying these changes remain unclear. In this study, we explored how psychosocial stress can modulate brain rhythms during an attentional task and a task-free period. We recorded the EEG and ECG activity of 42 healthy participants subjected to either the Trier Social Stress Test (TSST), a controlled procedure to induce stress, or a comparable control protocol (same physical and cognitive effort but without the stress component), flanked by an attentional task, a 90 s of task-free period and a state of anxiety questionnaire. We observed that psychosocial stress induced an increase in heart rate (HR), self-reported anxiety, and alpha power synchronization. Also, psychosocial stress evoked a relative beta power increase during correct trials of the attentional task, which correlates positively with anxiety and heart rate increase, and inversely with attentional accuracy. These results suggest that psychosocial stress affects performance by redirecting attentional resources toward internal threat-related thoughts. An increment of endogenous top-down modulation reflected an increased beta-band activity that may serve as a compensatory mechanism to redirect attentional resources toward the ongoing task. The data obtained here may contribute to designing new ways of clinical management of the human stress response in the future and could help to minimize the damaging effects of persistent stressful experiences.

Bi-Stable Perception: Self-Coordinating Brain Regions to Make-Up the Mind.

Bi-stable perception is a strong instance of cognitive self-organization, providing a research model for how 'the brain makes up its mind.' The complexity of perceptual bistability prevents a simple attribution of functions to areas, because many cognitive processes, recruiting multiple brain regions, are simultaneously involved. The functional magnetic resonance imaging (fMRI) evidence suggests the activation of a large network of distant brain areas. Concurrently, electroencephalographic and magnetoencephalographic (MEEG) literature shows sub second oscillatory activity and phase synchrony on several frequency bands. Strongly represented are beta and gamma bands, often associated with neural/cognitive integration processes. The spatial extension and short duration of brain activities suggests the need for a fast, large-scale neural coordination mechanism. To address the range of temporo-spatial scales involved, we systematize the current knowledge from mathematical models, cognitive sciences and neuroscience at large, from single-cell- to system-level research, including evidence from human and non-human primates. Surprisingly, despite evidence spanning through different organization levels, models, and experimental approaches, the scarcity of integrative studies is evident. In a final section of the review we dwell on the reasons behind such scarcity and on the need of integration in order to achieve a real understanding of the complexities underlying bi-stable perception processes.

Surgical Stabilization of Rib Fractures: Indications, Techniques, and Pitfalls.

Rib fractures are a common thoracic injury that is encountered in 20% to 39% of patients with blunt chest trauma and is associated with substantial morbidity and mortality1,2. Traditionally, the majority of patient with rib fractures have been managed nonoperatively. Recently, the utilization of surgical stabilization of rib fractures has increased considerably because the procedure has shown improved outcomes3-5. DESCRIPTION: Surgical stabilization should be considered in cases of multiple bicortically displaced rib fractures, especially in those with a flail chest and/or a concomitant ipsilateral displaced midshaft clavicular fracture or sternal fracture, as such cases may result in thoracic wall instability. For surgical stabilization of rib fractures, we classify rib fractures by location, type of fracture, and degree of displacement after obtaining thin-sliced chest computed tomography (CT) scans. The incision is selected depending on the fracture location, and the surgical technique is chosen relevant to the type of fracture. Single-lung intubation is preferred if there is no severe contralateral pulmonary contusion. We favor performing video-assisted thoracoscopy if possible to control bleeding, evacuate hematomas, repair a lung, and perform cryoablation of the intercostal nerves. A lateral approach is considered to be the main surgical approach because it allows access to the majority of rib fractures. A curvilinear skin incision is made overlying the fractured ribs. Posterior rib fractures are exposed through a vertical incision within the triangle of auscultation, and anterior fractures, through a transverse inframammary incision. The muscle-sparing technique, splitting alongside fibers without transection, should be utilized if possible and supplemented by muscle retraction. For surgical stabilization of rib fractures, we currently prefer precontoured side and rib-specific plates with threaded holes and self-tapping locking screws. Polymer cable cerclage is used to enhance plating of longitudinal fractures, rib fractures near the spine, osteoporotic ribs, and injuries of rib cartilage. The third to eighth ribs are plated most often. Intercostal muscle deficit, if present, is repaired with a xenograft patch. In comminuted rib fractures, the bone gap is bridged with bone graft. Surgical stabilization of rib fractures is recommended within the first 7 days after trauma, preferably within the first 3 days6-8. ALTERNATIVES: Nonoperative treatment alternatives include (1) epidural analgesia when not contraindicated because of anticoagulant venous thromboembolism prophylaxis9,10; (2) thoracic paravertebral blockage, e.g., serratus anterior or erector spinae plane nerve block11,12; (3) intercostal nerve block; (4) intravenous or enteral analgesics, e.g., opioids, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs); (5) intrapleural analgesia, e.g., bupivacaine infusion; and (6) multimodal analgesia that incorporates regional techniques, systemic analgesics, and analgesic adjuncts9. RATIONALE: Surgical stabilization of rib fractures is a safe and effective method to treat displaced rib fractures. The procedure provides definitive stabilization of fractures, improves pulmonary function, lessens pain medication requirements, prevents deformity formation, and results in reduced morbidity and mortality.

Synthesis of thieno[2,3-h]-/[3,2-h]quinolines and thieno[2,3-f] quinolines by Brønsted acid mediated cycloisomerisation.

Several thieno[2,3-h]-/[3,2-h]- and [2,3-f]quinolines have been synthesised from 2,3-dihalogenated pyridines or -quinolines by site-selective Pd catalysed cross-coupling reactions and Brønsted acid mediated cycloisomerisations as the final key step. This newly developed synthetic strategy is used in a modular way to synthesize diverse regioisomeric derivatives, tolerates various functional groups, and proceeds with high selectivity, and the desired final products have been isolated in high overall yields.

Brain-to-Brain Coupling in the Gamma-Band as a Marker of Shared Intentionality.

Cooperation and competition are two ways of social interaction keys to life in society. Recent EEG-based hyperscanning studies reveal that cooperative and competitive interactions induce an increase in interbrain coupling. However, whether this interbrain coupling effect is just a reflection of inter-subject motor coordination or can also signal the type of social interaction is unknown. Here, we show that behavioral coordination and social interaction type can be distinguished according to the frequency of oscillation in which the brains are coupled. We use EEG to simultaneously measure the brain activity of pairs of subjects, while they were performing a visual cue-target task in a cooperative and competitive manner. Behavioral responses were quasi-simultaneous between subject pairs for both competitive and cooperative conditions, with faster average response times for the competitive condition. Concerning brain activity, we found increased interbrain coupling in theta band (3-7 Hz) during cooperation and competition, with stronger coupling during competitive interactions. This increase of interbrain theta coupling correlated with a decrease in reaction times of the dyads. Interestingly, we also found an increase in brain-to-brain coupling in gamma band (38-42 Hz) only during cooperative interactions. Unlike the theta coupling effect, the gamma interbrain coupling did not correlate with dyads' reaction times. Taken together, these results suggest that theta interbrain coupling could be linked to motor coordination processes common to cooperative and competitive interactions, while gamma brain-to-brain coupling emerges as an electrophysiological marker of shared intentionality during cooperative interactions.

Humor Improves Women's but Impairs Men's Iowa Gambling Task Performance.

The Iowa Gambling Task (IGT) is a popular method for examining real-life decision-making. Research has shown gender related differences in performance, in that men consistently outperform women. It has been suggested that these performance differences are related to decreased emotional control in women compared to men. Given the likely role of emotion in these gender differences, in the present study, we examine the effect of a humor induction on IGT performance and whether the effect of humor is moderated by gender. IGT performance and parameters from the Expectancy Valence Model (EVM) were measured in 68 university students (34 men; mean age 22.02, SD = 4.3 and 34 women; mean age 22.3, SD = 4.1) during a 100 trial-IGT task. Participants were exposed to a brief video before each of the IGT decisions available; one half of the samples (17 men and 17 women) was exposed to 100 humor videos, while the other half was exposed to 100 non-humor videos during the task. We observed a significant interaction between gender and humor, such that under humor, women's performance during the last block (trials 80-100) improved (compared to women under non-humor), whereas men's performance during the last block was worse (compared to men under non-humor). Consistent with previous work, under non-humor, men outperformed women in the last block. Lastly, our EVM results show that humor impacts the learning mechanisms of decision-making differently in men and women. Humor impaired men's ability to acquire knowledge about the payoff structure of the decks, and as a consequence, they were stuck in suboptimal performance. On the other hand, humor facilitated women's ability to explore and to learn from experience, improving performance. These findings deepen our understanding of the mechanisms underlying IGT decision-making and differential effects of humor in men and women.

Tumores óseos en edad pediátrica / Bone tumor in the pediatric age

RESUMEN Fundamento: los tumores óseos algunas veces son difíciles de diagnosticar, estos se dividen en benignos y malignos, los benignos son lo más frecuente y entre de ellos el osteocondroma es el principal. Los malignos a pesar de su baja frecuencia tienen importancia por su alta mortalidad, que varía entre 80 a 95 %, y las graves secuelas físicas y emocionales que acarrea su tratamiento en los pacientes. Los tipos de tumor óseo maligno más frecuente son el sarcoma de Ewing y el sarcoma osteogénico. Objetivo: profundizar los conocimientos de los tumores óseos en edad pediátrica. Métodos: la búsqueda de la información se realizó en un periodo de cinco meses (primero de agosto de 2017 al 31 de diciembre de 2017) y se emplearon las siguientes palabras claves: bone neoplasms y Childhood, a partir de la información obtenida se realizó una revisión bibliográfica de un total de 246 artículos publicados en las bases de datos PubMed, Hinari, Medline y SciELO y mediante el gestor de búsqueda y administrador de referencias EndNote, de ellos se utilizaron 50 citas seleccionadas para realizar la revisión, 40 de ellas de los últimos cinco años, donde se incluyeron dos libros. Resultados: se abordan formas de presentación clínica de los tumores óseos y los estudios de tipo imagenológicos, de laboratorio e histológicos. Se describen modalidades de tratamiento tanto conservador como quirúrgico. Conclusiones: los tumores óseos benignos en edad pediátrica son más frecuente y en ellos predomina los osteocondroma y entre los malignos el tumor de Ewing y el sarcoma osteogénico.

ABSTRACT Background: bone tumors are sometimes difficult to diagnose, they are divided into benign and malignant, benign tumors are the most frequent and among them the Osteochondroma is the main one. The malignant ones in spite of their low frequency are important for their high mortality, which varies between 80 to 95%, and the serious physical and emotional consequences that their treatment brings to patients. The most common malignant bone tumor types are Ewing's sarcoma and osteogenic sarcoma. Objective: to deepen the knowledge of bone tumors in pediatric age. Methods: the search of the information was made in a period of five months (from August 1st, 2017 to December 31st, 2017) and the following key words were used: bone neoplasms and Childhood, from the information obtained a bibliographical review of a total of 246 articles published in PubMed, Hinari, Medline, and SciELO databases was made through the EndNote search manager and reference manager, of which 50 selected citations were used to perform the review, 40 of them from the last five years, where two books were included. Results: forms of clinical presentation of bone tumors and imaging, laboratory and histological studies are addressed. Both conservative and surgical treatment modalities are described. Conclusions: benign osseous tumors in the pediatric age are more frequent and osteochondroma predominates in them and malignant tumors include Ewing tumor and osteogenic sarcoma.

Tumores óseos en edad pediátrica / Bone tumor in the pediatric age

Fundamento: los tumores óseos algunas veces son difíciles de diagnosticar, estos se dividen en benignos y malignos, los benignos son lo más frecuente y entre de ellos el osteocondroma es el principal. Los malignos a pesar de su baja frecuencia tienen importancia por su alta mortalidad, que varía entre 80 a 95 porciento, y las graves secuelas físicas y emocionales que acarrea su tratamiento en los pacientes. Los tipos de tumor óseo maligno más frecuente son el sarcoma de Ewing y el sarcoma osteogénico. Objetivo: profundizar los conocimientos de los tumores óseos en edad pediátrica.Métodos: la búsqueda de la información se realizó en un periodo de cinco meses (primero de agosto de 2017 al 31 de diciembre de 2017) y se emplearon las siguientes palabras claves: bone neoplasms y Childhood, a partir de la información obtenida se realizó una revisión bibliográfica de un total de 246 artículos publicados en las bases de datos PubMed, Hinari, Medline y SciELO y mediante el gestor de búsqueda y administrador de referencias EndNote, de ellos se utilizaron 50 citas seleccionadas para realizar la revisión, 40 de ellas de los últimos cinco años, donde se incluyeron dos libros. Resultados: se abordan formas de presentación clínica de los tumores óseos y los estudios de tipo imagenológicos, de laboratorio e histológicos. Se describen modalidades de tratamiento tanto conservador como quirúrgico. Conclusiones: los tumores óseos benignos en edad pediátrica son más frecuente y en ellos predomina los osteocondroma y entre los malignos el tumor de Ewing y el sarcoma osteogénico (AU)

Background: bone tumors are sometimes difficult to diagnose, they are divided into benign and malignant, benign tumors are the most frequent and among them the Osteochondroma is the main one. The malignant ones in spite of their low frequency are important for their high mortality, which varies between 80 to 95 percent, and the serious physical and emotional consequences that their treatment brings to patients. The most common malignant bone tumor types are Ewing's sarcoma and osteogenic sarcoma. Objective: to deepen the knowledge of bone tumors in pediatric age. Methods: the search of the information was made in a period of five months (from August 1st, 2017 to December 31st, 2017) and the following key words were used: bone neoplasms and Childhood, from the information obtained a bibliographical review of a total of 246 articles published in PubMed, Hinari, Medline, and SciELO databases was made through the EndNote search manager and reference manager, of which 50 selected citations were used to perform the review, 40 of them from the last five years, where two books were included. Results: forms of clinical presentation of bone tumors and imaging, laboratory and histological studies are addressed. Both conservative and surgical treatment modalities are described. Conclusions: benign osseous tumors in the pediatric age are more frequent and osteochondroma predominates in them and malignant tumors include Ewing tumor and osteogenic sarcoma (AU)

Beta Oscillations Distinguish Between Two Forms of Mental Imagery While Gamma and Theta Activity Reflects Auditory Attention.

Visual sensory processing of external events decreases when attention is internally oriented toward self-generated thoughts and also differences in attenuation have been shown depending on the thought's modality (visual or auditory thought). The present study aims to assess whether such modulations occurs also in auditory modality. In order to investigate auditory sensory modulations, we compared a passive listening condition with two conditions in which attention was internally oriented as a part of a task; a visual imagery condition and an inner speech condition. EEG signal was recorded from 20 participants while they were exposed to auditory probes during these three conditions. ERP results showed no differences in N1 auditory response comparing the three conditions reflecting maintenance of evoked electrophysiological reactivity for auditory modality. Nonetheless, time-frequency analyses showed that gamma and theta power in frontal regions was higher for passive listening than for internal attentional conditions. Specifically, the reduced amplitude in early gamma and theta band during both inward attention conditions may reflect reduced conscious attention of the current auditory stimulation. Finally, different pattern of beta band activity was observed only during visual imagery which can reflect cross-modal integration between visual and auditory modalities and it can distinguish this form of mental imagery from the inner speech. Taken together, these results showed that attentional suppression mechanisms in auditory modality are different from visual modality during mental imagery processes. Our results about oscillatory activity also confirm the important role of gamma oscillations in auditory processing and the differential neural dynamics underlying the visual and auditory/verbal imagery.

Osteocondroma del segundo metatarsiano: presentación de un caso / Osteochondroma of second metatarsal: a case report

RESUMEN Fundamento: los tumores óseos benignos son los más frecuentes en la edad pediátrica, entre ellos, el osteocondroma es el principal. Objetivo: presentar un caso de osteocondroma del pie el cual fue diagnosticado en consulta externa por medio del cuadro clínico y radiografías. Caso clínico: paciente femenina de 10 años de edad, blanca la cual fue llevada a consulta externa por presentar aumento de volumen en la parte anterior del pie y molestia cuando se le ponía zapato cerrado, a la exploración física se palpó una tumoración dura, no movible, en región distal del segundo metatarsiano Se indicó radiografía del pie anteroposterior y lateral y al observar aumento de volumen en región distal del segundo metatarsiano, se decide ingresar con el diagnóstico de osteocondroma, para tratamiento quirúrgico mediante resección ósea y biopsia. Conclusiones: el Osteocondroma del pie se considera un diagnóstico poco frecuente en el medio, el tratamiento de elección es el quirúrgico para mejorar las manifestaciones clínicas.

ABSTRACT Background: benign bone tumors are the most frequent in the pediatric age, among them; the Osteochondroma is the main one. Objective: to present a case of Osteochondroma of the foot that it was diagnosed in the outpatient clinic by means of the clinical symptoms and radiographs. Clinical case: 10-years-old female white patient. The mother says that the girl reported pain when wearing a shoe and she noticed an increase in volume when touching the anterior part of the foot, for which she was brought to the outpatient clinic where a physical examination revealed a hard, non-movable mass in the distal region of the second metatarsal. Radiography of the anteroposterior and lateral foot was indicated and when an increase in volume was observed in the distal region of the second metatarsal, it was decided to enter with the diagnosis of Osteochondroma, for surgical treatment by means of bone resection and biopsy. Conclusions: Osteochondroma of the foot is considered a rare diagnosis in our environment, the treatment of choice is surgery to improve clinical manifestations.

Osteocondroma del segundo metatarsiano: presentación de un caso / Osteochondroma of second metatarsal: a case report

Fundamento: los tumores óseos benignos son los más frecuentes en la edad pediátrica, entre ellos, el osteocondroma es el principal. Objetivo: presentar un caso de osteocondroma del pie el cual fue diagnosticado en consulta externa por medio del cuadro clínico y radiografías. Caso clínico: paciente femenina de 10 años de edad, blanca la cual fue llevada a consulta externa por presentar aumento de volumen en la parte anterior del pie y molestia cuando se le ponía zapato cerrado, a la exploración física se palpó una tumoración dura, no movible, en región distal del segundo metatarsiano Se indicó radiografía del pie anteroposterior y lateral y al observar aumento de volumen en región distal del segundo metatarsiano, se decide ingresar con el diagnóstico de osteocondroma, para tratamiento quirúrgico mediante resección ósea y biopsia. Conclusiones: el Osteocondroma del pie se considera un diagnóstico poco frecuente en el medio, el tratamiento de elección es el quirúrgico para mejorar las manifestaciones clínicas(AU)

Background: benign bone tumors are the most frequent in the pediatric age, among them; the Osteochondroma is the main one.Objective: to present a case of Osteochondroma of the foot that it was diagnosed in the outpatient clinic by means of the clinical symptoms and radiographs. Clinical case: 10-years-old female white patient. The mother says that the girl reported pain when wearing a shoe and she noticed an increase in volume when touching the anterior part of the foot, for which she was brought to the outpatient clinic where a physical examination revealed a hard, non-movable mass in the distal region of the second metatarsal. Radiography of the anteroposterior and lateral foot was indicated and when an increase in volume was observed in the distal region of the second metatarsal, it was decided to enter with the diagnosis of Osteochondroma, for surgical treatment by means of bone resection and biopsy. Conclusions: Osteochondroma of the foot is considered a rare diagnosis in our environment, the treatment of choice is surgery to improve clinical manifestations(AU)

Extracellular Matrix Applications in the Treatment of Open Fractures With Complex Wounds and Large Soft Tissue Defects.

Use of biologic scaffolds such as extracellular matrix (ECM) is a promising trend in the treatment of complex wounds in orthopedic trauma patients. In this clinical series we describe the technique of the successful application of porcine urinary bladder ECM products in the treatment of open fractures of the extremities with complex wounds and large soft tissue defects. The clinical outcomes demonstrated that even in challenging cases where local flap coverage of bone or neurovascular structures is not possible, sequential xenograft implantation allowed us to achieve a stable soft tissue envelope. Different forms of ECM products are easy to apply in the presence of orthopedic hardware. In certain wounds, complete closure can be achieved even without subsequent skin grafting. We recommend relatively earlier application of xenograft.

Técnica de Ghali modificada: estudio de 12 años / Modified Ghali technique: a twelve-year-study

Fundamento: entre las limitaciones físicas provocadas por deformidades de los pies en el niño, el metatarso varo es la enfermedad más frecuente.Objetivo: evaluar los resultados de la técnica de Ghali modificada en el tratamiento del metatarso varo del niño.Métodos: se realizó un estudio cuasi experimental con dos momentos observacionales, antes y después de la intervención, que incluyó 122 pacientes menores de 15 años intervenidos de forma quirúrgica, desde el 1 de enero de 2002 hasta el 31 de diciembre de 2014, en el Hospital Pediátrico Universitario Eduardo Agramonte Piña.Resultados: se estudiaron 122 niños con 244 pies con metatarso varo congénito, la edad que ocupó el primer lugar fue de cinco a nueve años con 68 pacientes. En la comparación de la modificación posoperatoria del grado de afección clínica y radiográfica de los pacientes con metatarso varo congénito en lo estático, los 122 niños se les corrigió la deformidad y en lo dinámico un mínimo quedó con desviación interna al caminar. La evaluación clínica se realizó de una manera objetiva y subjetiva en los 244 pies operados, se tuvo en cuenta los siguientes parámetros: apariencia estética del pie, calidad de la marcha, complicaciones, satisfacción del resultado por parte de los padres. La radiológica mediante el ángulo metatarso escafoides. Se obtuvo un resultado bueno en la mayoría de los pacientes, las complicaciones fueron mínimas.Conclusiones: los resultados de la serie fueron adecuados y el seguimiento realizado fue a largo plazo por lo que se debe considerar como una probabilidad terapéutica, en el tratamiento del metatarso varo congénito(AU)

Background: among the physical limitations caused by deformities of the feet in the child, the metatarsus varus is the most frequent disease.Objective: to evaluate the results of the modified Ghali technique in the treatment of the varus metatarsus of the child.Methods: a quasi-experimental study was performed with two observational moments, before and after the intervention, including 122 patients under the age of 15 who underwent surgery from January 1, 2002 to December 31, 2014 at the Eduardo Agramonte Piña Hospital.Results: 122 children with 244 feet with congenital metatarsus varus were studied, the leading age was 5 to 9 years old with 68 patients (55,7 percent), in the comparison of the postoperative modification of the degree of clinical affection and radiographic examination of patients with metatarsal varus congenital in the static, the 122 children were corrected the deformity and in the dynamic a minimum remained with internal deviation when walking. The clinical evaluation was done in an objective and subjective way in the 244 operated feet. The following parameters were taken into account: aesthetic appearance of the foot, gait quality, complications, satisfaction of the result by the parents, radiology by means of the scaphoid metatarsal angle. A good outcome was obtained in the majority of patients, and complications were minimal.Conclusions: the results of the series were adequate and the follow-up was performed in the long term and should therefore be considered as a therapeutic probability in the treatment of varicella metatarsus varus(AU)

Incidencia de tumores óseos malignos en niños: estudio de cinco años / Malignant incidence of osseous tumors in children: a five-year study

Fundamento: los tumores óseos malignos en el niño son bastante raros. Comparado con el resto de los tumores infantiles ocupa solo un 3 a 4 %. A pesar de su baja frecuencia tienen importancia por su alta mortalidad, que varía entre 80 a 95 %, y las graves secuelas físicas y emocionales que acarrea su tratamiento en los pacientes. Los tipos de tumor óseo maligno más frecuente a esta edad son el sarcoma de Ewing y el Sarcoma osteogénico. Objetivo: determinar cuáles son los tumores óseas malignos más frecuentes con un estudio de cinco años de los casos ingresados en el Hospital Pediátrico Universitario Eduardo Agramonte Piña de Camagüey en menores de 19 años. Métodos: se realizó un estudio observacional, descriptivo, longitudinal y retrospectivo a través de la revisión del archivo de anatomía patología del Hospital Pediátrico Universitario Eduardo Agramonte Piña de Camagüey. Se estudiaron todos los casos con diagnóstico histopatológico de tumor óseo maligno desde el 1ro de enero 2012 a 31 de diciembre de 2016, con edades inferiores a los 19 años. La fuente de información fue el libro de registro de biopsias del departamento de Anatomía Patológica, los datos obtenidos se compilaron en un formulario elaborado para los mismos. El análisis estadístico se realizó con el paquete estándar profesional S.P.S.S versión 21 2012. Los resultados se presentaron en tablas. Resultados: los tumores óseos malignos de mayor incidencia fueron el sarcoma de Ewing y el Sarcoma osteogénico. El grupo de edad más frecuente de tumores óseos fue entre 10 a 14 años. Conclusiones: el resultado del estudio es comparable con lo reportado en la bibliografía médica donde los tumores óseos malignos, el sarcoma de Ewing y el sarcoma osteogénico son los másfrecuentes.

Background: malignant bone tumors in children are quite rare. When compared to the rest of the childhood tumors it occupies only 3 to 4%. Despite their low frequency, they are important because of their high mortality, ranging from 80 to 95%, and the serious physical and emotional sequelae that their treatment entails in patients. The most frequent types of malignant bone tumor at that age are Ewing's sarcoma and osteogenic sarcoma. Objective: to determine the most frequent malignant bone tumors with a five-year study of the cases admitted to the Eduardo Agramonte Piña University Pediatric Hospital in Camagüey under the age of 19 years. Methods: an observational, descriptive, longitudinal and retrospective study was carried out through a review of the anatomy pathology file of the Eduardo Agramonte Piña University Pediatric Hospital in Camagüey. We studied all cases with histopathological diagnosis of malignant bone tumor from January 1, 2012 to December 31, 2016, with ages below 19 years. The source of information was the biopsy record book of the Department of Pathology. The data obtained were compiled in a form prepared for them. Statistical analysis was performed using the standard professional package S.P.S.S version 21 2012. The results were presented in tables. Results: Ewing’s sarcoma and osteogenic sarcoma were the most frequent malignant tumors. The most frequent age group of bone tumors was between 10 and 14 years. Conclusions: the results of the study are comparable to those reported in the medical literature where malignant bone tumors, Ewing's sarcoma and osteogenic sarcoma are the most common.