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RATIONALE: The Lipidyzer platform was recently updated on a SCIEX QTRAP 6500+ mass spectrometer and offers a targeted lipidomics assay including 1150 different lipids. We evaluated this targeted approach using human plasma samples and compared the results against a global untargeted lipidomics method using a high-resolution Q Exactive HF Orbitrap mass spectrometer. METHODS: Lipids from human plasma samples (N = 5) were extracted using a modified Bligh-Dyer approach. A global untargeted analysis was performed using a Thermo Orbitrap Q Exactive HF mass spectrometer, followed by data analysis using Progenesis QI software. Multiple reaction monitoring (MRM)-based targeted analysis was performed using a QTRAP 6500+ mass spectrometer, followed by data analysis using SCIEX OS software. The samples were injected on three separate days to assess reproducibility for both approaches. RESULTS: Overall, 465 lipids were identified from 11 lipid classes in both approaches, of which 159 were similar between the methods, 168 lipids were unique to the MRM approach, and 138 lipids were unique to the untargeted approach. Phosphatidylcholine and phosphatidylethanolamine species were the most commonly identified using the untargeted approach, while triacylglycerol species were the most commonly identified using the targeted MRM approach. The targeted MRM approach had more consistent relative abundances across the three days than the untargeted approach. Overall, the coefficient of variation for inter-day comparisons across all lipid classes was â¼ 23% for the untargeted approach and â¼ 9% for the targeted MRM approach. CONCLUSIONS: The targeted MRM approach identified similar numbers of lipids to a conventional untargeted approach, but had better representation of 11 lipid classes commonly identified by both approaches. Based on the separation methods employed, the conventional untargeted approach could better detect phosphatidylcholine and sphingomyelin lipid classes. The targeted MRM approach had lower inter-day variability than the untargeted approach when tested using a small group of plasma samples. These studies highlight the advantages in using targeted MRM approaches for human plasma lipidomics analysis.
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Lipidômica/métodos , Lipídeos/sangue , Espectrometria de Massas em Tandem/métodos , Idoso , Cromatografia Líquida , Feminino , Humanos , Masculino , Fosfatidilcolinas/sangue , Reprodutibilidade dos Testes , Software , Triglicerídeos/sangueRESUMO
BACKGROUND: Suicide is the primary cause of unnatural death in Spain, and suicide re-attempts a major economic burden worldwide. The risk factors for re-attempt and suicide after an index suicide attempt are different. This study aims to investigate risk factors for re-attempt and suicide after an index suicide attempt. METHODS: This observational study is part of a one-year telephone management program. We included all first-time suicide attempters evaluated in the emergency department at Parc Taulí-University Hospital (n = 1241) recruited over a five-year period (January 2008 to December 2012). Suicide attempters were evaluated at baseline using standardized instruments. Bivariate logistic regression models were used to identify risk factors. Kaplan-Meier curves were used to compare the time to re-attempt between categorical variables. Comparisons were performed using Log-Rank and Wilcoxon tests. Variables with a p-value lower than 0.2 were included in a multivariate Cox regression model. Bivariate logistic regression models were considered to identify risk factors for suicide. The significance level was set to 0.05. RESULTS: Suicide re-attempters were more likely diagnosed with cluster B personality disorders (36.8% vs. 16.6%; p < 0.001), and alcohol use disorders (19.8 vs. 13.9; p = 0.02). Several [1.2% (15/1241)] of them died by suicide. Attempters who suicide were more likely alcohol users (33.3% vs. 17.2%; p = 0.047), and older (50.9 ± 11.9 vs. 40.7 ± 16.0; p = 0.004). CONCLUSIONS: Alcohol use, personality disorders and younger age are risk factors for re-attempting. Older age is a risk factor for suicide among suicide attempters. Current prevention programs of suicidal behaviour should be tailored to the specific profile of each group.
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Suicídio/psicologia , Adulto , Fatores Etários , Alcoolismo , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Espanha/epidemiologia , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Análise de Sobrevida , Adulto Jovem , Prevenção do SuicídioRESUMO
The scorpion toxin tamapin displays the most potent and selective blockage against KCa2.2 channels known to date. In this work, we report the biosynthesis, three-dimensional structure, and cytotoxicity on cancer cell lines (Jurkat E6-1 and human mammary breast cancer MDA-MB-231) of recombinant tamapin and five related peptides bearing mutations on residues (R6A,R7A, R13A, R6A-R7A, and GS-tamapin) that were previously suggested to be important for tamapin's activity. The indicated cell lines were used as they constitutively express KCa2.2 channels. The studied toxin-like peptides displayed lethal responses on Jurkat T cells and breast cancer cells; their effect is dose- and time-dependent with IC50 values in the nanomolar range. The order of potency is r-tamapin>GS-tamapin>R6A>R13A>R6A-R7A>R7A for Jurkat T cells and r-tamapin>R7A for MDA-MB-231 breast cancer cells. Our structural determination by NMR demonstrated that r-tamapin preserves the folding of the αKTx5 subfamily and that neither single nor double alanine mutations affect the three-dimensional structure of the wild-type peptide. In contrast, our activity assays show that changes in cytotoxicity are related to the chemical nature of certain residues. Our results suggest that the toxic activity of r-tamapin on Jurkat and breast cancer cells could be mediated by the interaction of charged residues in tamapin with KCa2.2 channels via the apoptotic cell death pathway.
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Neurotoxinas/toxicidade , Peptídeos/toxicidade , Proteínas Recombinantes/toxicidade , Venenos de Escorpião/toxicidade , Morte Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Células Jurkat , Linfócitos/citologia , Linfócitos/efeitos dos fármacos , Modelos Moleculares , Neurotoxinas/química , Neurotoxinas/isolamento & purificação , Peptídeos/química , Peptídeos/isolamento & purificação , Proteínas Recombinantes/química , Proteínas Recombinantes/isolamento & purificação , Venenos de Escorpião/química , Venenos de Escorpião/isolamento & purificação , Relação Estrutura-Atividade , Células Tumorais CultivadasRESUMO
PARP1 (ARTD1) and Tankyrases (TNKS1/TNKS2; PARP5a/5b) are poly-ADP-ribose polymerases (PARPs) with catalytic and non-catalytic functions that regulate both the genome and proteome during zygotic genome activation (ZGA), totipotent, and pluripotent embryonic stages. Here, we show that primed, conventional human pluripotent stem cells (hPSC) cultured continuously under non-specific TNKS1/TNKS2/PARP1-inhibited chemical naive reversion conditions underwent epigenetic reprogramming to clonal blastomere-like stem cells. TIRN stem cells concurrently expressed hundreds of gene targets of the ZGA-priming pioneer factor DUX4, as well as a panoply of four-cell (4C)-specific (e.g., TPRXL, HOX clusters), eight-cell (8C)-specific (e.g., DUXA, GSC, GATA6), primitive endoderm-specific (e.g., GATA4, SOX17), trophectoderm-specific (e.g., CDX2, TFAP2C), and naive epiblast-specific (e.g., DNMT3L, NANOG, POU5F1(OCT4)) factors; all in a hybrid, combinatorial single-cell manner. Mapping of proteomic and single-cell expressions of TIRN cells against human preimplantation embryo references identified them as relatively homogenous 4C-8C stage populations. Injection of TIRN cells into murine 8C-16C-staged embryos resulted in efficient totipotent-like single cell contributions of human cells to both extra-embryonic (trophectoderm, placenta) and embryonic (neural, fetal liver, hematopoietic) lineages in human-murine blastocyst and fetal chimeras. Pairing of proteome with ubiquitinome analyses of TIRN cells revealed a global shutdown of ADP-ribosylation, and a perturbed TNKS/PARP1 equilibrium which not only impacted the protein levels of hundreds of TNKS/PARP1 substrates via a rewiring of the ubiquitin-proteosome system (UPS), but also de-repressed expression of hundreds of developmental genes associated with PARP1 suppression. ChIP-Seq analysis of core NANOG-SOX2-OCT4 (NSO) pluripotency factors in TIRN cells identified reprogrammed DUX4-accessible distal and cis-regulatory enhancer regions that were co-bound by PARP1 (NSOP). These NSOP enhancer regions possessed co-binding motifs for hundreds of the same ZGA-associated, embryonic, and extraembryonic lineage-specifying pioneer factors (e.g., HOX, FOX, GATA, SOX, TBX, CDX families) that were concurrently co-expressed in TIRN cells; suggesting that PARP1 and DUX4 cooperate with NSO pluripotency core factors to regulate the epigenetic plasticity of a human totipotency program. These findings provide the first demonstration that global, proteome-wide perturbations of post-translational modifications (i.e., ADP-ribosylation, ubiquitination) can regulate epigenetic reprogramming during human embryogenesis. Totipotent TIRN stem cells will provide a valuable cell culture model for studying the proteogenomic regulation of lineage specification from human blastomere stages and may facilitate the efficient generation of human organs in interspecies chimeras.
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Online streaming series 'Thirteen Reasons Why' (13RW), released in March 2017, was criticized for its sensationalist portrayal of the main character's suicide, leading some people to voice fears of a global contagion of self-harm behaviors. The current investigation provides a systematic review of original studies analyzing the role of 13RW as an influencing factor for suicide. Articles were identified through a systematic search of Medline, Web of Science, Scopus, PsycInfo, and a manual search of reference lists from inception until the 16 January 2023. Twenty-seven published articles were identified from an initial search of 496 studies. The positive effects of watching 13RW included a reduction in suicide stigma and a greater likelihood to discuss mental health concerns and seek for help. However, several studies reported negative outcomes, including significant increases in the rate of deaths by suicide in adolescents, the number of admissions for suicidal reasons, and the prevalence and severity of suicidal ideation and self-harm behaviors in vulnerable viewers. Still, due to methodological limitations, no causal relationship could be established. Preventive measures are required to alert of the risk and should be particularly addressed to susceptible subjects. Psychoeducational programs should be focused on this kind of phenomena in vulnerable populations.
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Comportamento Autodestrutivo , Suicídio , Adolescente , Humanos , Ideação Suicida , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Medo , RegistrosRESUMO
PARP13/ZAP (zinc-finger antiviral protein) acts against multiple viruses by promoting degradation of viral mRNA. PARP13 has four N-terminal zinc (Zn) fingers that bind CG-rich nucleotide sequences, a C-terminal ADP ribosyltransferase fold, and a central region with a fifth Zn finger and tandem WWE domains. The central PARP13 region, ZnF5-WWE1-WWE2, is implicated in binding poly(ADP-ribose); however, there are limited insights into its structure and function. We present crystal structures of ZnF5-WWE1-WWE2 from mouse PARP13 in complex with ADP-ribose and in complex with ATP. The crystal structures and binding studies demonstrate that WWE2 interacts with ADP-ribose and ATP, whereas WWE1 does not have a functional binding site. Binding studies with poly(ADP-ribose) ligands indicate that WWE2 serves as an anchor for preferential binding to the terminal end of poly(ADP-ribose) chains. The composite ZnF5-WWE1-WWE2 structure forms an extended surface to engage ADP-ribose chains, representing a distinctive mode of recognition that provides a framework for investigating the impact of poly(ADP-ribose) on PARP13 function.
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Adenosina Difosfato Ribose , Poli Adenosina Difosfato Ribose , Camundongos , Animais , Adenosina Difosfato Ribose/metabolismo , Dedos de Zinco , ADP Ribose Transferases/metabolismo , RNA Mensageiro/genética , Antivirais , Zinco , Trifosfato de AdenosinaRESUMO
The coronavirus disease of 2019 (COVID-19) has been a cause of significant morbidity and mortality worldwide. Among the short- and long-term consequences of COVID-19, myocarditis is a disease to be taken into consideration. Myocarditis, in general, is related to a poor prognosis. However, the epidemiology and prognosis of myocarditis related to COVID-19 are currently unknown. While vaccination against COVID-19 is of great benefit at a public health level, the risk of myocarditis should be considered in the context of the global benefits of vaccination. In this narrative review, we will summarize the etiopathogenic bases, the epidemiology, the clinical manifestations, the course, diagnosis, prognosis, and the treatment of myocarditis related to SARS-CoV-2, as well as myocarditis secondary to mRNA vaccines.
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In the present paper, we explore the temporal dynamics of the flanker effect in the tactile modality and compare it with findings in the visual modality. We created a tactile version of the flanker task in which we presented groups of dots oriented either vertically or horizontally to a participant's fingertips. The target stimulus was presented to the middle finger, while the flanker stimuli were presented to the index and the ring fingers. Distributional analyses of the latency data show a tactile flanker effect: an overall facilitation for congruent target-flanker trials relative to incongruent trials, and a higher effect size for slower correct responses (higher quantiles) than for faster correct responses (lower quantiles). While this congruency effect may resemble the one typically reported in the visual modality, there are differences between these two modalities as well, mainly related to the relative speed of error and correct responses. These differences suggest that some of the mechanisms responsible for the flanker effect differ across sensory modalities.
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Atenção , Tato , Dedos , Humanos , Tempo de ReaçãoAssuntos
Serviços de Saúde Mental/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Ideação Suicida , Prevenção do Suicídio , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/prevenção & controle , Comportamento Autodestrutivo/psicologia , Suicídio/psicologia , Tentativa de Suicídio/psicologiaRESUMO
Plasticity of thalamocortical (TC) synapses is robust during early development and becomes limited in the adult brain. We previously reported that a short duration of deafening strengthens TC synapses in the primary visual cortex (V1) of adult mice. Here, we demonstrate that deafening restores NMDA receptor (NMDAR)-dependent long-term potentiation (LTP) of TC synapses onto principal neurons in V1 layer 4 (L4), which is accompanied by an increase in NMDAR function. In contrast, deafening did not recover long-term depression (LTD) at TC synapses. Potentiation of TC synapses by deafening is absent in parvalbumin-positive (PV+) interneurons, resulting in an increase in feedforward excitation to inhibition (E/I) ratio. Furthermore, we found that a brief duration of deafening adult mice recovers rapid ocular dominance plasticity (ODP) mainly by accelerating potentiation of the open-eye responses. Our results suggest that cross-modal sensory deprivation promotes adult cortical plasticity by specifically recovering TC-LTP and increasing the E/I ratio.
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Percepção Auditiva , Potenciação de Longa Duração , Tálamo/fisiologia , Córtex Visual/fisiologia , Percepção Visual , Animais , Potenciais Pós-Sinápticos Excitadores , Feminino , Potenciais Pós-Sinápticos Inibidores , Interneurônios/metabolismo , Interneurônios/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Receptores de N-Metil-D-Aspartato/metabolismo , Privação Sensorial , Tálamo/citologia , Córtex Visual/citologiaRESUMO
RESUMEN Este estudio describe los cambios emocionales que viven las personas que durante su niñez quedaron huérfanas a causa del conflicto armado en Colombia. Se desarrolló una investigación de tipo cualitativa, en la que, por medio de cuatro entrevistas a profundidad, realizadas a las víctimas, se evidenció que los NNA deben asumir roles que no les corresponden, como la carga económica de su casa, la crianza de los hermanos menores y el abandono de los estudios y sus sueños de infancia. Los entrevistados narraron cómo enfrentaron el desplazamiento y reclutamiento forzado y cómo debieron habituarse a nuevos núcleos familiares e instituciones. Sus descripciones reflejan que han asumido el desarrollo de una infancia, juventud y edad adulta lidiando con duelos y pérdidas no resueltas, como vivir mutilados emocionalmente durante el resto de su vida, así lo mencionaron. Otros hallazgos relevantes del estudio son las conductas de aislamiento social y secuelas físicas que desarrollan las víctimas aún en la etapa adulta como consecuencia del impacto emocional por la pérdida violenta de sus padres a causa del conflicto. Esta investigación resalta la importancia de reconocer a los menores huérfanos por el conflicto como víctimas y acompañarlos en el proceso de duelo por la muerte de sus familiares, en tiempos más cercanos al evento traumático, al igual que entregar herramientas, basadas en experiencias reales, que les permitan adaptarse a sus nuevas dinámicas familiares y de vida con el apoyo de profesionales de la salud mental y asesores familiares.
ABSTRACT The following study describes the emotional changes experienced by people who were orphaned during their childhood due to the armed conflict in Colombia. A research with a qualitative methodology was carried out, in which, through four in-depth interviews carried out with the victims, it was shown that children and adolescents must assume roles that do not correspond to them, such as the financial burden of their home, raising their siblings, and the abandonment of their education and childhood dreams. The interviewees narrated how they faced displacement and forced recruitment and how they had to get used to new family nuclei and institutions. Their descriptions reflect that they have assumed the development of a childhood, youth, and adulthood dealing with grief and unresolved losses, such as living emotionally mutilated for the rest of their lives, as they mentioned. Other relevant findings of the study are the behaviors of social isolation and physical consequences that the victims develop, even in adulthood, because of the emotional impact of the violent loss of their parents due to the conflict. This research highlights the importance of recognizing minors orphaned by the conflict as victims, and accompanying them in the process of mourning the death of their relatives, in times closer to the traumatic event, as well as providing tools, based on real experiences, that allow them to adapt to their new family and life dynamics with the support of mental health professionals and family counselors.
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Humanos , Família , Criança , Conflitos Armados , Isolamento Social , AdultoRESUMO
RESUMEN ANTECEDENTES: La obesidad es una epidemia mundial que provoca una alta frecuencia de factores de riesgo cardiovascular (FRCV). Se ha observado que la aculturación está incidiendo en los pueblos originarios, como consecuencia de una dieta occidentalizada, lo cual predispone la obesidad, desarrollo de enfermedades cardiovasculares (ECV) y diabetes. En general la población aymara adulta presenta un bajo riesgo cardiovascular innato, lo cual lleva a una baja incidencia de ECV. Objetivos: Conocer la influencia de la occidentalización de la nutrición y evaluar riesgo cardiovascular de la población adolescente aymara de la comuna de Camiña. Método: Estudio descriptivo de corte transversal, en población aymara entre 11 y 18 años de la comuna de Camiña. Muestra probabilística aleatoria simple constituida por 94 individuos. Se aplica una encuesta alimentaria de tendencia de consumo cuantificada, medición antropométrica y exámenes de glicemia y perfil lipídico. Resultados: Se evaluaron 94 participantes 57,4 % mujeres. Malnutrición por exceso presenta 41%; riesgo cardiovascular según medición de perímetro de cintura (PC) 55,2%; colesterol total alterado 52,6% y triglicéridos alterados 89,5%. Mediante encuesta alimentaria se pudo conocer que 71,7% mantenían una dieta hipercalórica, 69,8 % una dieta hiperglucídica, 45% una dieta hiperlipídica. Conclusión: En la población adolescente aymara estudiada se encontraron factores de riesgo cardiovascular alterados, como malnutrición por exceso, PC aumentado, Colesterol total y Triglicéridos elevados. Su alimentación era "de tipo occidental", consumiendo alimentos procesados y elaborados con dietas hipercalóricas, hiperglucídicas e hiperlipídicas.
ABSTRACT BACKGROUND. Obesity is widely known to lead to increased cardiovascular risk factors (RF). Cultural changes observed in native populations, including the adoption of a western type nutrition, leads to obesity, increased levels of RF ,cardiovascular diseases and diabetes. Aim: To determine the influence of a western type nutrition on RF among adolescent Aymaras in northern Chile. Methods: A cross sectional descriptive study was performed in Camiña (northern Chile), including Aymaras aged 11 to 18 years-old. A quantified alimentary consumption questionnaire, anthropometric measurements, blood glucose levels and lipid profile were obtained. Results: 94 subjects (57% women) were studied. Excess malnutrition (obesity) was present in 41%, abnormally high waist circumference in 55%, high cholesterol levels in 53%, and high triglycerides in 90% of subjects. The contents of the diet being consumed was high in calories in 72%, high in sugar in 70% and high in lipids in 45%. Conclusion: A high prevalence of cardiovascular RF was present in adolescent Aymaras of northern Chile. This finding was related to the consumption of a western type diet, rich in calories, lipids and sugar, leading to obesity
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Humanos , Masculino , Feminino , Criança , Adolescente , Etnicidade , Hipernutrição/epidemiologia , Fatores de Risco de Doenças Cardíacas , Obesidade , Indígenas Sul-Americanos , Índice de Massa Corporal , Chile/epidemiologia , Antropometria , Prevalência , Estudos Transversais , Inquéritos e Questionários , DietaRESUMO
INTRODUCTION: Inter-rater agreement is a crucial aspect in the planning and performance of a clinical trial in which the main assessment tool is the clinical interview. The main objectives of this study are to study the inter-rater agreement of a tool for the assessment of suicidal behavior (Brief Suicide Questionnaire) and to examine whether the inter-examiner agreement when multiple ratings are made on a single subject is an efficient method to assess the reliability of an instrument. METHOD: In the context of designing a multicenter clinical trial, 32 psychiatrists assessed a videotaped clinical interview of a patient with suicidal behavior. In order to identify those items in which a greater level of discordance existed and detect the examiners whose ratings differed significantly from the average ratings, we used the DOMENIC method (Detecion of Multiple Examiners Not in Consensus). RESULTS: Inter-rater agreement was between poor (<70%) to excelent (90-100%. Inter-rater agreement in Brugha's list of threatening experiences ranged from 75.5 and 100%; in the Global Assessment of Functioning (GAF) Scale was 82.58%; in the Beck's Suicidal Intent Scale, ranged from 67.5 and 97%; in the Beck's Scale for Suicide Ideation, ranged from 63.5 and 100%; and in the Lethality Rating Scale was 88.39%. On the whole, the level of agreement among raters, both in general scores and in particular items, was appropriate. CONCLUSION: The proposed design allows the assessment of the inter-rater agreement in an efficient way (only in one session). In addition, regarding the Brief Suicide Questionnaire, inter-raters agreement was appropriate.
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Ideação Suicida , Inquéritos e Questionários , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos TestesRESUMO
No disponible
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Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Transtorno do Espectro Autista/epidemiologia , Saúde do Idoso , Estudos Retrospectivos , Transtorno do Espectro Autista/diagnósticoRESUMO
The cavitation phenomenon is caused by the local pressure depression that occurrs during the closure and/or opening of prosthetic valve leaflets. Occasionally, peculiar features of echocardiographic images generated by cavitation can simulate a mass or vegetation, and are a potential source of diagnostic error. A clinical case that illustrates this phenomenon is described.
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Introducción. El acuerdo entre-examinadores es un aspecto fundamental en la planificación de cualquier trabajo de investigación donde la principal herramienta diagnóstica es la entrevista clínica. El objetivo de este estudio es valorar el acuerdo entre-examinadores de un instrumento de evaluación de la conducta suicida (Protocolo breve de evaluación del suicidio) utilizando las valoraciones de múltiples observadores en una sola sesión. Método. Durante la fase piloto de un estudio clínico multicéntrico centrado en la monitorización de intentos de suicidio, 32 examinadores evaluaron el vídeo de la entrevista clínica a un paciente simulado con conducta suicida. Para identificar los ítems en los que existía una mayor discordancia y a los examinadores cuyo criterio se alejaba más del acuerdo general, se utilizó el método Detection Of Multiple Examiners Not In Consensus (DOMENIC). Resultado. El acuerdo interexaminadores osciló entre pobre (<70%) y excelente (90-100%). En la escala de acontecimientos vitales estresantes el nivel de acuerdo osciló entre 48,4 y 97%; en la escala problemas psicosociales del DSM-IV, entre 75,5 y 100%; en la escala de evaluación de la actividad global fue de 82,58%; en la escala de intencionalidad suicida, osciló entre 67,5 y 97%; en la escala de ideación suicida, entre 63,5 y 100% y en la escala de letalidad del intento de suicidio fue de 88,39%. En general, los examinadores mostraron un nivel de acuerdo adecuado tanto en las puntuaciones globales de cada escala como en cada ítem en particular. Conclusiones. El diseño propuesto permite evaluar el acuerdo entre-examinadores de una forma eficiente (en una única sesión). Además, con respecto al Protocolo breve de evaluación del suicidio, el acuerdo entre-examinadores fue apropiado(AU)
Introduction. Inter-rater agreement is a crucial aspect in the planning and performance of a clinical trial in which the main assessment tool is the clinical interview. The main objectives of this study are to study the inter-rater agreement of a tool for the assessment of suicidal behaviour (Brief Suicide Questionnaire) and to examine whether the inter-examiner agreement when multiple ratings are made on a single subject is an efficient method to assess the reliability of an instrument. Method. In the context of designing a multicenter clinical trial, 32 psychiatrists assessed a videotaped clinical interview of a patient with suicidal behaviour. In order to identify those items in which a greater level of discordance existed and detect the examiners whose ratings differed significantly from the average ratings, we used the DOMENIC method (Detecion of Multiple Examiners Not in Consensus). Results. Inter-rater agreement was between poor (<70%) to excellent (90-100%. Inter-rater agreement in Brugha's list of threatening experiences ranged from 75.5% to 100%; in the Global Assessment of Functioning (GAF) Scale was 82.58%; in Beck's Suicidal Intent Scale, ranged from 67.5% to 97%; in Beck's Scale for Suicide Ideation, ranged from 63.5% to 100%; and in the Lethality Rating Scale was 88.39%. On the whole, the level of agreement among raters, both in general scores and in particular items, was appropriate. Conclusion. The proposed design allows the assessment of the inter-rater agreement in an efficient way (only in one session). In addition, regarding the Brief Suicide Questionnaire, inter-raters agreement was appropriate(AU)
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Humanos , Masculino , Feminino , Protocolos Clínicos/normas , Suicídio/estatística & dados numéricos , Suicídio/tendências , Tentativa de Suicídio/estatística & dados numéricos , Ideação Suicida , Estudos de Avaliação como Assunto , Psiquiatria , Pesquisa/métodos , Escalas de Graduação Psiquiátrica Breve/estatística & dados numéricos , Escalas de Graduação Psiquiátrica Breve/normas , 35170/métodos , Tentativa de Suicídio/prevenção & controle , Suicídio/prevenção & controle , Psiquiatria Preventiva , PsicologiaRESUMO
El propósito principal de este proyecto es brindar otra forma de consulta de fácil manejo y movilidad, reduciendo la demanda de recursos centralizados y facilitando la difusión de información. Por supuesto que hacia futuro podrá ser mejorado adicionando otras imágenes u otra tecnología más avanzada, siempre tratando de mejorar el proceso de enseñanza aprendizaje...
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CD-Interativo , Histologia , SoftwareRESUMO
La artritis reumatoidea juvenil (ARJ) es una enfermedad inflamatoria crónica de la niñez, que afecta las articulaciones sinoviales incluyendo la articulación temporomandibular (AEM). De esta manera, aquellos individuos con ARJ en la ATM presentan frecuentemente aberraciones en el desarrollo mandibular. La presente es una aproximación a las generalidades de la ARJ y a la forma como a ella se compromete la ATM, mencionando las diferentes modalidades de tratamiento. El objetivo primordial de esta revisión es informar acerca de los trastornos en el desarrollo mandibular de los niños que sufren la patología, pues aunque poco prevalerte, genera alteraciones marcadas que desde la niñez temprana van a permanecer hasta la edad adulta, con sus consecuentes implicaciones morfológicas, funcionales y psicosociales, demostrando así la enorme competencia de la enfermedad en el área de la odontopediatría y sin olvidar que ella requiere un manejo interdisciplinario.