Quantification of mitral regurgitation after transcatheter edge-to-edge repair: Comparison of echocardiography and patient-specific in silico models.

BACKGROUND: Doppler echocardiographic (echo) assessment of residual mitral regurgitation (MR) after transcatheter edge-to-edge repair (TEER) is challenging and often subjective. This study aimed to evaluate the accuracy and feasibility of standardized quantitative echo methods for assessment of MR severity after MitraClip repair by comparing measurements against a reference MR severity obtained from patient-specific in silico models. METHODS: Post-procedure hemodynamics were simulated under five different MitraClip configurations in previously validated patient-specific in silico models for the treatment of functional MR. The residual regurgitant volume was calculated as in clinical practice using four quantitative virtual echo methods: pulsed Doppler, volumetric, proximal isovelocity surface area (PISA) and vena contracta area (VCA). Multiple permutations were performed for each method. Virtual echo MR results were evaluated against reference MR values directly extracted from the 5 patient-specific in silico models. RESULTS: The echo methods with the greatest accuracy were the three-dimensional (3D) volumetric method (r = 0.957, bias -0.8 ± 1.2 ml, p = 0.01), the 3D VCA method wherein velocity time integrals were evaluated for each jet assessed (r = 0.919, bias -1.5 ± 1.7 ml, p = 0.03), and the 3D PISA method integrating surface areas throughout systole (r = 0.98, bias -2.0 ± 0.9 ml, p = 0.003). The pulsed Doppler and 2D volumetric methods had technical limitations that may result in a high underestimation or overestimation of the MR severity after TEER. In the case of multiple regurgitant jets, a more accurate MR assessment was obtained when all significant jets were evaluated. CONCLUSIONS: Clinically, the 3D volumetric, 3D VCA and 3D PISA methods gave the most accurate MR quantification after TEER. Three-dimensional echo technologies harbor the potential of becoming the non-invasive imaging tool of choice for MR quantification after complex transcatheter mitral interventions.

Relación entre la anemia infantil y el desempeño intelectual en la juventud

Objetivo: Determinar la relación que entre la anemia padecida por una generación cuando eran niños y su rendimiento en la prueba PISA a los 15 años de edad. Material y métodos: Se relacionó el puntaje que los jóvenes de cada país obtuvieron en la prueba PISA 2018 con la prevalencia de anemia infantil en 2005, el Ingreso Nacional Bruto per cápita y los Años Esperados de Escolaridad del Índice de Desarrollo Humano del año 2018. Resultados: El puntaje obtenido en la prueba PISA se relaciona con la anemia cuando niños, el Ingreso Nacional Bruto per cápita y los Años Esperados de Escolaridad (Esfuerzo Educativo) con coeficientes de determinación (r2) de 0.5168, 0.1951 y 0.3536, respectivamente. Conclusión: El puntaje obtenido en la prueba PISA se asocia con más fuerza con la prevalencia de anemia que padeció esa generación cuando eran niños que con cualquier otro factor económico o social actuales.

Factors Related with Underperformance in Reading Proficiency, the Case of the Programme for International Student Assessment 2018.

Almost 217 million secondary school students (60% of the world's adolescents) do not reach minimum levels in reading proficiency at the end of secondary school, according to objective 4.1 of the UN's Sustainable Development Goals. Therefore, the early and efficient identification of this disadvantage and implementation of remedial strategies is critical for economies. In 2018, the Programme for International Student Assessment (PISA) assessed the reading skills of 15-year-old students in 80 countries and economies. This work introduces a methodology that uses PISA's data to build logistic regression models to identify the main factors contributing to students' underperforming reading skills. Results showed that socioeconomic status (SES), metacognition strategies, Information and Communication Technology (ICT) skills, and student-teacher relationships are the most important contributors to low reading abilities.

Cognitive Abilities, Debt, Roads and their Impact on Deaths in Traffic in Brazil / Habilidades Cognitivas, Endividamento, Rodovias e seus Impactos nos Óbitos no Trânsito

Abstract Deaths in traffic represent a global and multicausal problem. We verified, through a linear regression model, that cognitive abilities (CA) and population indebtedness (PI) predict, together, 56% of the variation of death rates in the traffic (DT) of the twenty-seven states of Brazil. CA's are related to a greater control of the attention and, possibly, to a greater compliance with norms for preventing traffic accidents, has a greater impact than PI on DT, since PI associates to only one deficit of people's attention resources. The decrease of PI and the improvement of CA can decrease DT.

Resumo Os óbitos no trânsito representam um problema global e multicausal. Verificamos, por meio de um modelo de regressão linear, que as habilidades cognitivas (HC) e o endividamento populacional (ENDP), predizem, juntos, 56% da variação das taxas de óbitos no trânsito (TOT) das 27 unidades federativas (UF) do Brasil. As HC, por estarem relacionadas a um maior controle da atenção e, possivelmente, a um maior cumprimento de normas de prevenção contra acidentes de trânsito, possuem um impacto maior que o ENDP sobre as TOT, já que o ENDP associa somente a um deficit dos recursos de atenção das pessoas. A diminuição do ENDP e a melhoria das HC podem reduzir as TOT.

Brasil no pisa 2003 e 2012: os estudantes e a matemática / Brazil in pisa 2003 and 2012: students and mathematics / Le brésil au pisa 2003 et 2012: les élèves et les mathématiques / Brasil en el pisa 2003 y 2012: los estudiantes y la matemática

Resumo Este trabalho apresenta uma investigação sobre o desempenho dos estudantes brasileiros em Matemática no Pisa de 2003 e 2012. O objetivo foi verificar em qual conteúdo avaliado os estudantes apresentaram melhor desempenho e dispersão positiva na escala de níveis da avaliação. A estratégia empírica adotada foi descritiva e comparativa. Foram analisados relatórios do Inep (Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira) e da OCDE/Pisa para compor a base de dados para análise comparativa das duas aplicações da prova. Os resultados apontam que os estudantes brasileiros apresentaram melhor desempenho e a mais significativa distribuição na escala Pisa em Indeterminação e Dados ou Probabilidade. Contudo o desempenho dos estudantes brasileiros, influenciado por uma multiplicidade de fatores, ainda está longe de atingir os níveis da OCDE.

Abstract This study presents an investigation on the performance of Brazilian students in Mathematics in Pisa 2003 and 2012. Our goal was to identify the assessed content in which the students had their best performance and most significant dispersion in the scale of assessment levels. Our empirical study consisted of descriptive and comparative analyses. Reports from Inep (Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira) and OECD/Pisa were analyzed to make up the database for comparing the two editions of the test. The results show that Brazilian students had their best performance and most significant distribution on the Pisa scale in Indetermination and Data or Probability. However, the performance of Brazilian students, influenced by innumerous factors, is still far below OECD levels.

Résumé Cet article présente une recherche sur la performance des élèves brésiliens en mathématiques dans au Pisa 2003 et 2012. L'objectif était de vérifier quels étaient les contenus évalués dans lesquels les élèves avaient obtenu une meilleure performance et dispersion positive sur l'échelle des niveaux d'évaluation. La stratégie empirique adoptée a été d'ordre descriptif et comparatif. Des rapports de l'Inep (Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira) et de l' OCDE/Pisa ont été analysés pour composer la base de données de l'analyse comparative des deux épreuves du test. Les résultats indiquent que, sur l'échelle Pisa, les élèves brésiliens ont présenté une meilleure performance et la distribution la plus marquée en Indétermination et en Données et Probabilité. Cependant, dû à une multitude de facteurs, le score des élèves brésiliens est encore loin d'atteindre les niveaux de l'OCDE.

Resumen Este trabajo presenta una investigación sobre el desempeño de los estudiantes brasileños en Matemática en el Pisa de 2003 y 2012. El objetivo fue verificar en cuál contenido evaluado los estudiantes presentaron mejor desempeño y dispersión positiva en la escala de niveles de evaluación. La estrategia empírica adoptada fue descriptiva y comparativa. Fueron analizados informes del Inep (Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira) y de la OCDE/Pisa para componer la base de datos para análisis comparativa de las dos aplicaciones de la prueba. Los resultados apuntan que los estudiantes brasileños presentaron mejor desempeño y la más significativa distribución en la escala Pisa en Indeterminación y Datos o Probabilidad. Aun considerando esto, el desempeño de los estudiantes brasileños, influenciado por una multiplicidad de factores, todavía esta lejos de alcanzar los niveles de la OCDE.

PISA 2012: Inmigración y etapa de llegada al Sistema Educativo Español / PISA 2012: Age at Immigration and the Spanish Education System

Resumen Introducción. Las evidencias empíricas muestran que hay diferencias en el rendimiento entre es colares inmigrantes que puede ser atribuido a diferentes variables, entre ellas la etapa de llegada al Sistema Educativo Español. Objetivo. Analizar el riesgo y/o probabilidad que escolares inmi grantes de la muestra española tienen de tener bajo rendimiento en las competencias evaluadas en PISA 2012, considerando la etapa de llegada al Sistema Educativo como variable predictora del riesgo. Metodología. No experimental o ex-post facto, diseño comparativo - causal. Análisis de datos. Análisis de regresión logística binaria. Resultados. En relación a la etapa de llegada al Sistema Educativo Español, es en la etapa de Educación Infantil donde se registra mayor riesgo de bajo de rendimiento en comparación con Educación Infantil: Lectura, Matemáticas y Ciencias. Respecto a las competencias, es en la competencia matemática donde se registra mayor riesgo en comparación con el resto de competencias evaluadas (Lectura y Ciencias). Conclusiones. El riesgo de tener bajo rendimiento varía según la etapa de llegada al Sistema Educativo. La llega da de escolares inmigrantes en Educación Infantil es un factor de riesgo. Es necesario desarro llar políticas educativas (programas lingüísticos, programas de acogida, por ejemplo) que mini micen el impacto y reduzcan el riesgo con el abandono y fracaso escolar en etapas posteriores.

Abstract Introduction. Immigrants arriving at school at younger ages have lower educational achievement than those who arrive at adolescence. Aims. Analyze risk and / or probability of immigrant students having low performance in skills assessed in PISA 2012, considering their age of arrival into the Education System. Methodology. Non- experimental or ex post facto, comparative design - cau sal. Data Analysis: Binary logistic regression analysis. Outcomes. In relation to the age at entrance into the Spanish Education System, the stage of Early Childhood Education increases the risk of a diminished performance in Reading, Mathematics and Science. With respect to PISA 2012 skills as sessment, it varies in stages: Kindergarten, Primary Education y Secondary Education. Conclusions. The risk of low performance varies with the educational stage at arrival. The arrival of immigrant students at Primary Education is a risk factor. We need to develop educational policies (e.g., language programs, host programs) that minimize the impact and reduce the risk of subsequent abandonment.

Measuring affective temperaments: a systematic review of validation studies of the Temperament Evaluation in Memphis Pisa and San Diego (TEMPS) instruments.

BACKGROUND: The assessment of affective temperaments has provided useful insights for the psychopathological understanding of affective disorders and for the conceptualization of bipolar spectrum disorders. The Temperament in Memphis Pisa and San Diego (TEMPS) instrument has been widely used in research, yet its psychometric properties and optimal factor structure are unclear. METHODS: The PubMed/MEDLINE, PsycINFO, and EMBASE electronic databases were searched from inception until March 15th, 2016. Validation peer-reviewed studies of different versions of the TEMPS performed in adult samples were considered for inclusion. RESULTS: Twenty-seven studies (N=20,787) met inclusion criteria. Several versions of the TEMPS have been validated in 14 languages across 15 countries. The 110-item self-reported version of the TEMPS has been the most studied version. Most studies (50%) supported a five factor solution although few studies performed confirmatory factor analyses. A five-factor solution has consistently been reported for the 39-item version of the TEMPS-A. Overall, evidence indicates that different versions of the TEMPS have adequate internal consistency reliability, while the TEMPS-A-110 version has acceptable test-retest reliability. The methodological quality of included studies varied. LIMITATIONS: A meta-analysis could not be performed due to the heterogeneity of settings and versions of the TEMPS utilized. CONCLUSIONS: Different versions of the TEMPS have been validated across different cultures. The short 39-item version of the TEMPS-A holds promise and merits further investigation. Culture-bound factors may influence the expression and/or assessment of affective temperaments with the TEMPS.

Monitoring Countries in a Changing World: A New Look at DIF in International Surveys.

This paper discusses the issue of differential item functioning (DIF) in international surveys. DIF is likely to occur in international surveys. What is needed is a statistical approach that takes DIF into account, while at the same time allowing for meaningful comparisons between countries. Some existing approaches are discussed and an alternative is provided. The core of this alternative approach is to define the construct as a large set of items, and to report in terms of summary statistics. Since the data are incomplete, measurement models are used to complete the incomplete data. For that purpose, different models can be used across countries. The method is illustrated with PISA's reading literacy data. The results indicate that this approach fits the data better than the current PISA methodology; however, the league tables are nearly identical. The implications for monitoring changes over time are discussed.

Risk low math performance PISA 2012: Impact of assistance to Early Childhood Education and other possible cognitive variables / Rendimiento bajo en matemáticas PISA 2012: impacto de la asistencia en educación infantil temprana y otras posibles variables cognitivas

Abstract: Mathematics competencies are critical in the development of the individual. There are several variables that can predict poor performance in this competition. These variables may be related to self-learner and teacher who instructs. Objective: Analyse the risk of poor performance depending on several variables: attending early childhood education, learning strategies and strategies used by the teacher uses. Method: No experimental or ex post facto. Data: We used the database PISA 2012 for Spain provided by the Ministry of Education, Culture and Sport. The generated data sample consists of 25,313 young Spaniards of both sexes, aged 15 years, belonging to 902 schools that are distributed throughout the national territory of Spain. Dependent or endogenous variable: Performance in mathematics. Independent or exogenous variables: Different variables were considered: attendance and duration of Early Childhood Education, student learning strategies and teaching strategies. Analysis of data: Binary logistic regression. Results: It shows that the factor that has greater predictive capability of risk of underperformance is attending Early Childhood Education [β = −.595; ρ < .001]. It is the variable that has more predictive capability of risk of all analysed. Discussion: There are variables that increase the risk and others that reduce this risk. It is possible to prevent low performance in Mathematics competencies, for example, we need to pursue a teaching of quality Early Childhood Education knowing their long-term benefits and not only ensure access to it for all children.

Resumen: Las competencias matemáticas son críticas en el desarrollo del individuo. Existen diversas variables que pueden predecir el bajo rendimiento en este tipo de competencias. Dichas variables pueden estar relacionadas con el auto-aprendiz o con el maestro que imparte instrucción. Objetivo: Analizar el riesgo de rendimiento bajo según diferentes variables: educación formal desde edad temprana, estrategias de aprendizaje y estrategias que utiliza el maestro. Método: No experimental o ex post facto. Datos: Se utilizó la base de datos PISA 2012 para España, otorgada por el Ministerio de Educación, Cultura y Deporte. La muestra de datos generada consiste en 25313 jóvenes españoles de ambos sexos, de 15 años, pertenecientes a las 902 escuelas distribuidas a lo largo del territorio nacional de España. Variable dependiente: Rendimiento en matemáticas. Variable independiente: Diferentes variables fueron consideradas: asistencia y duración de la educación en edades tempranas, estrategias de aprendizaje del estudiante y estrategias de enseñanza. Análisis de datos: Regresión binaria logística. Resultados: Estos indican que el factor con mayor capacidad predictiva de rendimiento bajo es la educación formal en edades tempranas (B=-.595; p<.001). Es la variable que tiene mayor capacidad predictiva de todas las que se analizaron. Discusión: Existen variables que aumentan el riesgo y otras que lo disminuyen. Es posible prevenir el bajo rendimiento en competencias asociadas a las matemáticas; por ejemplo, se necesita hacer énfasis en la enseñanza de calidad en la educación en edades tempranas sabiendo los beneficios de esto a largo plazo y no solo garantizar el acceso a esta para todos los niños.

'Método de evaluación dinámica automatizado' de competencias lectoras para educación secundaria (EdiLEC) / Method of Automated Dynamic Assessment of reading literacy for Secondary Education (EdilLEC)

Se presenta un nuevo método de evaluación dinámica de la competencia lectora automatizado para educación secundaria (EdiLEC). Su diseño se ajusta al marco teórico propuesto por el Informe PISA-2009 (OCDE, 2010) y los principios de la evaluación dinámica (Sternberg & Grigorenko, 2002). Esta herramienta electrónica proporciona automáticamente mensajes de retroalimentación adaptados a cada individuo sobre el proceso y ejecución a lo largo de la prueba, añadiendo a los resultados de la evaluación tradicional de la competencia lectora la posibilidad de explorar las potencialidades de aprendizaje del estudiante. El método ha sido baremado con una muestra de 1008 estudiantes de entre 11 y 14 años. Los resultados muestran que consta de propiedades psicométricas de fiabilidad, homogeneidad y validez satisfactorias.

A new method to evaluate students' reading literacy, the Method of Dynamic Assessment for Secondary Education (EdilLEC) is presented. EdilLEC is based on PISA assessment framework and the principles of dynamic assessment. In a computer-based environment, automatically provides adaptive intervention elements (feedback and user's aids), in order to add to the reading literacy traditional assessment the possibility to explore the potential of student's learning. The method has been standarized with a sample of 1008 students between 11 and 14 years of aged. Conclusions: The results show satisfactory psychometric properties of reliability, validity and homogeneity.

La prueba PISA: una mirada alternativa desde la Teoría del Actor-Red / The PISA test: an Actor-Network Theory alternative approach

En el marco de la proliferación de las evaluaciones estandarizadas, inscritas en lo que ha sido conceptualizado por la literatura como políticas de accountability o de rendición de cuentas, se ofrece por medio de este artículo una línea de pensamiento y discusión alternativa sobre la prueba PISA2. Utilizando como enfoque la Teoría del Actor-Red (TAR) de Bruno Latour, se presentan ejercicios de traslación epistémica de la prueba PISA desde un modelo de pensamiento positivista moderno, a uno materialista pragmático en el que se privilegia una descripción constructivista y analítica de los componentes que la constituyen. En base al seguimiento y análisis de noticias sobre la prueba PISA desplegadas en diarios electrónicos en Chile y Argentina, más la revisión de fuentes secundarias, se exponen algunas de las controversias suscitadas en torno a la evaluación y se discute sobre su posible impacto en nuestras percepciones sobre educación y calidad. También se problematiza el carácter neutral y objetivo de la prueba, y se levanta la pregunta acerca de su posible agencia en la cristalización de las relaciones de centro-periferia entre países que, en el marco del enfoque de la TAR, tiene sentido explorar...

In the context of the proliferation of standardized testing, circumscribed by what has been conceptualized in the literature as “accountability policies”, the aim of this paper is to offer an alternative line of thought and discussion on the PISA test. Using the approach of Bruno Latour’s actor-network theory (ANT), I present exercises on epistemic translation of the PISA test from a modern-positivist model of thought to a materialistic-pragmatic one, in which a constructivist and analytical description of its constituent components is preferred. Based on the monitoring and analysis of news reports about PISA in electronic newspapers in Chile and Argentina, plus the review of secondary sources, I describe some of the controversies surrounding the test and discuss its potential impact on our perceptions of education and quality. Additionally, the allegedly neutral and objective character of the test is problematized, and it is raised the question of its possible agency in the crystallization of centerperiphery relations between countries which, in the framework of the ANT approach, makes sense to explore...

Expresión de citoquinas Th17 y su correlación con periodontopatógenos y el área periodontal inflamada en pacientes con periodontitis crónica / Th17 cytokines expression and its correlation with periodontopathogens and periodontal inflammed surface area (PISA) in patients with chronic periodontitis

Antecedentes: La periodontitis es una enfermedad inflamatoria infecciosa que involucra una respuesta inmune del hospedero y se caracteriza por destrucción del hueso alveolar, el objetivo del estudio es analizar la expresión de citoquinas Th17 y su correlación con periodontopatógenos y el área periodontal inflamada en pacientes con periodontitis crónica. Método: Se realizó un estudio descriptivo exploratorio en el que se reclutaron 23 pacientes con diagnóstico de periodontitis crónica y un grupo control de 10 individuos sano/gingivitis. A todos los sujetos se les realizó un examen periodontal completo. Además, se utilizó el método PISA (Periodontal Inflamed Surface Area) para cuantificar el tamaño de la herida periodontal. Se recolectaron muestras de FGC, plasma y placa bacteriana para su análisis mediante técnica de ELISA de IL-17 A, IL-6, IL-23 y IL-10 y PCR para la determinación de la presencia de: P. gingivalis, T. denticola, T. forsythensis, A. actinomycetemcomitans, F. nucleatum y P. intermedia. Los datos fueron analizados utilizando estadística descriptiva y la asociación entre variables se estimó a través de modelos de regresión logística. Resultados: Se observó una tendencia al aumento, no significativa, de los niveles de IL-17A, IL-6 y IL-23 a nivel de FGC en los sujetos con periodontitis crónica (p=0.716, 0.784, 0.421, respectivamente). Los pacientes con periodontitis crónica presentaron una disminución de la IL-10 (p=0.012) y los niveles de IL-17A se correlacionaron positivamente con el área periodontal inflamada (p=0.004). A nivel de los patógenos periodontales, se observó una asociación entre la presencia de: P. gingivalis, T. denticola, T. forsythensis y los niveles de IL-6 plasmática (p=0.017, 0.033, 0.024, respectivamente).

Objective: Periodontitis is an infectious and inflammatory disease that involves a host immune response and is characterized by alveolar bone destruction. Aim: Analyze the expression of Th17 cytokines and their correlation with periodontopathogens and periodontal inflamed area in patients with chronic periodontitis. Method: A case control study was performed. At the time of delivery, 23 cases of patients with periodontal diagnosis were enrolled in the study and 10 controls with gingivitis. The diagnosis involved a complete periodontal examination with periodontal Florida probe. Also we used the PISA (Periodontal Inflamed Surface Area) index to classify the groups. Plasma and GCF samples were collected and studied for protein expression by ELISA assays for IL17A, Il6, IL23 and IL10. Plaque was analyzed by PCR for the determination of the presence of: P. gingivalis, T. denticola, T. forsythensis, F. nucleatum, P. intermedia and A. actinomycetemcomitans. Data was analyzed using descriptive statistics and the association between variables was estimated through logistic regression models. Results: There is a trend of increased GCF levels of IL17A, IL6, and IL23 with no significance. However there was an association between gingivitis and IL10 plasma and GCF levels (p=0.012). In relation to the periodontal wound size, a correlation was observed between the levels of IL6 and IL10 in GCF. Analysis of periodontal pathogens, showed an association between the presence of: P. gingivalis, T. denticola, T. forsythensis and plasma levels of IL-6 (p=0.017, 0.033 and 0.024, respectively).

Early adversity, socioemotional development, and stress in urban 1-year-old children.

OBJECTIVE: To determine demographic, maternal, and child factors associated with socioemotional (SE) problems and chronic stress in 1-year-old children. STUDY DESIGN: This was a prospective, longitudinal, community-based study, which followed mother-infant dyads (n = 1070; representative of race, education, and income status of Memphis/Shelby County, Tennessee) from midgestation into early childhood. Child SE development was measured using the Brief Infant-Toddler Social and Emotional Assessment in all 1097 1-year-olds. Chronic stress was assessed by hair cortisol in a subsample of 1-year-olds (n = 297). Multivariate regression models were developed to predict SE problems and hair cortisol levels. RESULTS: More black mothers than white mothers reported SE problems in their 1-year-olds (32.9% vs 10.2%; P < .001). In multivariate regression, SE problems in blacks were predicted by lower maternal education, greater parenting stress and maternal psychological distress, and higher cyclothymic personality score. In whites, predictors of SE problems were Medicaid insurance, higher maternal depression score at 1 year, greater parenting stress and maternal psychological distress, higher dysthymic personality score, and male sex. SE problem scores were associated with higher hair cortisol levels (P = .01). Blacks had higher hair cortisol levels than whites (P < .001). In the entire subsample, increased hair cortisol levels were associated with higher parenting stress (P = .001), lower maternal depression score (P = .01), lower birth length (P < .001), and greater length at 1 year of age (P = .003). CONCLUSION: Differences in maternal education, insurance, mental health, and early stress may disrupt SE development in children. Complex relationships between hair cortisol level in 1-year-olds and maternal parenting stress and depression symptoms suggest dysregulation of the child's hypothalamic-pituitary-adrenal axis.

Dilación, dilatación e inclinación en hidrocefalia de presión normal / Delay, Dilation, and Bending in Normal Pressure Hydrocephalus

Introducción: La hidrocefalia idiopática de presión normal es una entidad conformada por una triada de signos clínicos que incluyen alteraciones de la marcha, de la cognición y del control de esfínteres urinarios, concomitantes con un aumento de líquido cefalorraquídeo con presión normal, hidrocefalia y atrofia cortical, sin causa identificable. Métodos y resultados: Reporte de caso. Paciente colombiano, de género masculino y 26 años de edad, con un cuadro clínico de tres años de evolución: presentaba los criterios clínicos descritos anteriormente, además de una notoria afectación extrapiramidal, caracterizada por distonía focal, incluyendo pleurotonos. Sumado a lo anterior, presentó labilidad emocional, alteraciones de memoria, personalidad que pasó de introvertida a compulsiva, trastornos del sueño, aislamiento y disminución de la reacción al peligro. Inicialmente se diagnosticó depresión, y luego, esquizofrenia paranoide. Recibió olanzapina sin mejoría de su cuadro neuropsiquiátrico. Algunos de estos signos y síntomas mejoraron luego de punción lumbar, la cual tuvo una presión normal, confirmándose así el diagnóstico clínico, con posibilidades terapéuticas promisorias. Conclusión: La hidrocefalia de presión normal se debe considerar en personas jóvenes, cuya sintomatología y exámenes de neurolaboratorio no cumplan con los fundamentos de la psiquiatría basada en la evidencia.

Introduction: Normal pressure hydrocephalus is a clinical entity characterized by a triad of clinical signs including gait abnormalities, cognitive disorders and sphincter dysfunction. It parallels an increased cerebrospinal fluid pressure, hydrocephalus and brain cortical atrophy. No detectable cause is a must. Methods and results: Case report. This is a Colombian male patient, 26 years-old, who had the clinical findings commented above starting three years before our evaluation. He also presented notorious extrapyramidal involvement, mostly focal dystonia including pleorotonus. Besides this, mood lability, memory disorders, personality changes turning from introverted to compulsive, sleep disorders, isolation and fearlessness were also present. Initially, depression was diagnosed and then paranoid schizophrenia was considered. Olanzapine was given with no benefits on his neuropsychiatric disorder. Some of these signs and symptoms improved after a lumbar puncture which had a normal pressure. It confirmed the diagnosis and offered very promising therapeutic possibilities. Conclusion: Normal pressure hydrocephalus must be considered in young people who have clinical symptoms and neurolaboratory findings out of the range of those commonly considered to be part of evidence-based psychiatry.