Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19.

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09-1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3-7.9; p=0.001) were independently associated with composite adverse fetal outcome. Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.

Convergent evolution in floral morphology in a plant ring species, the Caribbean Euphorbia tithymaloides.

PREMISE: Ring species have long fascinated evolutionary biologists for their potential insights into lineage divergence and speciation across space. Few studies have investigated the potential for convergent or parallel evolution along the diverging fronts of ring species. We investigated a potential case of parallel floral variation in the Caribbean spurge Euphorbia tithymaloides, the only plant system with molecular support as a ring species. The terminal populations of each front, despite being the most divergent, exhibit such similar floral traits that they were originally considered each other's closest relative. METHODS: We evaluated convergence in floral and leaf traits in relation to geography across 95 populations spanning the distribution of E. tithymaloides. We also reanalyzed available genetic data (from previous phylogenetic analyses) in an explicitly spatial framework. RESULTS: Floral morphology appears to have shifted in a convergent fashion along both geographic fronts of E. tithymaloides, resulting in shorter and more compact inflorescences in Antillean populations compared to the typical elongate "slipper-like" cyathia characteristic of the area of origin. Patterns of spatial genetic variation were more consistent with a two-fronted invasion of the Caribbean than with a simpler model of isolation-by-distance. CONCLUSIONS: Floral divergence in E. tithymaloides is consistent with convergent evolution along the two fronts of a ring species. We outline several (not mutually exclusive) mechanisms that could be driving patterns in morphology, including shifts toward generalized pollination with reduced reliance on hummingbirds, shifts in floral structure closely matching available hummingbird bill traits, and shifts toward increased selfing.

Potential fat-lowering and prebiotic effects of enzymatically treated okara in high-cholesterol-fed Wistar rats.

This study evaluates the effect of the lipid profile on serum, liver and faeces, and the potential prebiotic effect of diets supplemented with enzymatically treated okara (okara(ET)) in high-cholesterol fed Wistar rats. Triglyceride levels were significantly reduced in the serum (p < 0.01) and liver (p < 0.01) of okara(ET) treated rats. Total lipids, triglycerides and bile acids were significantly higher (p < 0.001) in the faeces of rats fed the okara(ET) diet. The pH of faecal contents from treated okara(ET) rats was lower (p < 0.001), probably due to the significantly higher (p < 0.001) production of short-chain fatty acids (SCFA). Okara(ET), therefore, reduced triglycerides in serum and liver, and increased the excretion of total lipids, triglycerides and bile acids, improving the lipid profile in rats fed with high-cholesterol diets. Okara(ET) fibre can improve intestinal transit by increasing faecal bulk. The decreased pH and increased SCFA production indicated that okara(ET) fibre fermentation occurred, suggesting a potential prebiotic effect.

First Human Case of Fungal Keratitis Caused by a Putatively Novel Species of Lophotrichus.

We report an aggressive fungal keratitis caused by a putatively novel species of Lophotrichus in a patient with traumatic injury to the cornea from a dog paw. The organism was isolated from the patient's necrotic cornea, which perforated despite coverage with hourly fortified broad-spectrum topical antibiotic therapy. This report represents the first case of human infection caused by this species.

Mental health problems and resilience in adolescents during the COVID-19 pandemic in a post-armed conflict area in Colombia.

The impact of COVID-19 pandemic on mental health of adolescents are emerging and require particular attention in settings where challenges like armed conflict, poverty and internal displacement have previously affected their mental wellbeing. This study aimed to determine the prevalence of anxiety symptoms, depressive symptomatology, probable post-traumatic stress disorder and resilience in school-attending adolescents in a post-conflict area of Tolima, Colombia during the COVID-19. A cross-sectional study was carried out with 657 adolescents from 12 to 18 years old, recruited by convenience sampling in 8 public schools in the south of Tolima, Colombia, who completed a self-administered questionnaire. Mental health information was obtained through screening scales for anxiety symptoms (GAD-7), depressive symptomatology (PHQ-8), probable post-traumatic stress disorder (PCL-5) and resilience (CD-RISC-25). The prevalence observed for moderate to severe anxiety symptoms was 18.9% (95% CI 16.0-22.1) and for moderate to severe depressive symptomatology was 30.0% (95% CI 26.5-33.7). A prevalence of probable post-traumatic stress disorder (PTSD) of 22.3% (95% CI 18.1-27.2) was found. The CD-RISC-25 results for resilience had a median score of 54 [IQR 30]. These results suggest that approximately two-thirds of school-attending adolescents in this post-conflict area experienced at least one mental health problem such as anxiety symptoms, depressive symptomatology or probable PTSD during the COVID-19 pandemic. Future studies are of interest to establish the causal relationship between these findings and the impact of the pandemic. These findings highlight the challenge that schools have after pandemic to address the mental health of their students in order to promoting adequate coping strategies and implement prompt multidisciplinary interventions to reduce the burden of mental health problems in adolescents.

Development and Implementation of DIALOG+S in the School Setting as a Tool for Promoting Adolescent Mental Well-Being and Resilience in a Post-Armed Conflict Area in Colombia: Exploratory Cluster Randomized Controlled Trial.

BACKGROUND: Educational settings are ideal for promoting mental well-being and resilience in children. The challenges of the COVID-19 pandemic made evident the important role that teachers and school counselors play in the mental health of their students. Therefore, it is imperative to develop and implement cost-effective interventions that allow them to identify and address mental health problems early, especially in post-armed conflict areas, to reduce the burden of mental disorders in this population. OBJECTIVE: This study aimed to adapt an existing patient-focused digital intervention called DIALOG+ from an adult clinical setting to an adolescent educational setting and to assess the feasibility, acceptability, and estimated effect of implementing this intervention as a tool for promoting quality of life, mental well-being, and resilience. METHODS: We conducted an exploratory mixed methods study in 2 public schools in postconflict areas in Tolima, Colombia. This study was conducted in 3 phases. In the adaptation phase, focus groups were conducted with students and teachers to identify changes required in DIALOG+ for it to be used in the school setting. The exploration phase consisted of an exploratory cluster randomized controlled trial. A total of 14 clusters, each with 1 teacher and 5 students, were randomly allocated to either the experimental (DIALOG+S) group or to an active control group (counseling as usual). Teachers in both groups delivered the intervention once a month for 6 months. Through screening scales, information was collected on mental health symptoms, quality of life, self-esteem, resilience, and family functionality before and after the intervention. Finally, the consolidation phase explored the experiences of teachers and students with DIALOG+S using focus group discussions. RESULTS: The changes suggested by participants in the adaptation phase highlighted the central importance of the school setting in the mental health of adolescents. In the exploratory phase, 70 participants with a mean age of 14.69 (SD 2.13) years were included. Changes observed in the screening scale scores of the intervention group suggest that the DIALOG+S intervention has the potential to improve aspects of mental health, especially quality of life, resilience, and emotional symptoms. The consolidation phase showed that stakeholders felt that using this intervention in the school setting was feasible, acceptable, and an enriching experience that generated changes in the perceived mental health and behavior of participants. CONCLUSIONS: Our results are encouraging and show that the DIALOG+S intervention is feasible and acceptable as a promising opportunity to promote well-being and prevent and identify mental health problems in the school context in a postconflict area in Colombia. Larger, fully powered studies are warranted to properly assess the efficacy and potential impact of the intervention and to refine implementation plans. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN) registry ISRCTN14396374; https://www.isrctn.com/ISRCTN14396374. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/40286.

Broad bean and pea by-products as sources of fibre-rich ingredients: potential antioxidant activity measured in vitro.

BACKGROUND: By-products generated during the processing of plant food can be considered a promising source of dietary fibre as a functional compound. The dietary fibre composition, soluble sugars and antioxidant activity of the extractable polyphenols of pea and broad bean by-products have been analysed in this study. RESULTS: Total dietary fibre using AOAC methods plus hydrolysis (broad bean pod: 337.3 g kg⁻¹; pea pod: 472.6 g kg⁻¹) is higher (P < 0.05) in both by-products than with the Englyst method (broad bean pod: 309.7 g kg⁻¹; pea pod: 434.6 g kg⁻¹). The main monomers are uronic acids, glucose, arabinose and galactose in broad bean pods. However, pea pods are very rich in glucose and xylose. The soluble sugars analysed by high-performance liquid chromatography in both by-products have glucose as the most important component, followed by sucrose and fructose. The ferric reducing antioxidant power (broad bean pod: 406.4 µmol Trolox equivalents g⁻¹; pea pod: 25.9 µmol Trolox equivalents g⁻¹) and scavenging effect on 2,2-diphenyl-1-picrylhydrazyl radical (EC50 of broad bean pod: 0.4 mg mL⁻¹; EC50 of pea pod: 16.0 mg mL⁻¹) were also measured. CONCLUSIONS: Broad bean and pea by-products are very rich in dietary fibre, particularly insoluble dietary fibre and their extractable polyphenols demonstrate antioxidant activity. Therefore they might be regarded as functional ingredients.

Clinicopathologic and Proteomic Analysis of Amyloidomas Involving the Ocular Surface and Adnexa.

OBJECTIVES: Ocular amyloidoma is a rare disorder characterized by deposition of insoluble proteinaceous fibrils in the extracellular space of the ocular adnexa. This study details the clinicopathologic features and proteomic characteristics of periocular amyloid deposition. METHODS: Specimens (1991-2020) were retrieved and reviewed. All available H&E slides and special stains were reviewed. Proteomic analysis was performed using immunohistochemistry (IHC) for IgG, IgG4, IgA, IgD, IgM, CD20, CD3, CD138, and κ/λ, as well as chromatography-electrospray tandem mass spectrometry on formalin-fixed, paraffin-embedded tissue. RESULTS: There were 14 patients (7 men, 7 women). The depositions involved eyelid (n = 3), conjunctiva (n = 8), and orbit (n = 3). All patients were adults with a median age at diagnosis of 56 (range, 39-88) years. The deposits were predominantly λ light chain restricted (n = 6) and mixed light chains (n = 2), and one case was κ predominant. Two of the cases with a mixture of κ and λ light chains had an excess of transthyretin by mass spectrometry. Four of the cases did not have adequate material for proteomic subtyping. CONCLUSIONS: Amyloidomas involving ocular adnexa contain a variety of amyloid-related and immunoglobulin-associated peptides. The λ light chain predominates as in other body sites, but mixed patterns and rarely κ light chain restriction may be encountered.

Pasteurization Modifies the Sensorial Attributes and Nutritional Profile of Orange Pulp By-Product.

After orange processing, different by-products are generated, i.e., peels, seeds and pulps. The pulp is highly perishable, being an unstable food matrix that needs a preservation process to be stored and used again in the food production chain. Pasteurization is the technique of choice before aseptically packaging and storing under refrigerated conditions. In this study, the effect of pasteurization has been evaluated on the chemical, functional and sensorial profiles. Ash content decreased (p < 0.05) after the thermal treatment. Indeed, magnesium, calcium and zinc diminished, although copper was found to be higher (p < 0.05) in the pasteurized product. Total dietary fiber decreased (p < 0.05), but soluble dietary fiber raised (p < 0.05) due to hydrolysis caused by pasteurization. SDF:IDF ratio, hydration properties, and fat binding capacity were improved. Total soluble phenolic compounds remained similar but FRAP and DPPH scavenging activity decreased (p < 0.05) in the pasteurized by-product. Regarding the sensorial profile, pasteurization produced darkening, appearance of a cooked smell and an increase in bitterness. Therefore, pasteurization deteriorates the sensorial profile being able to change the attributes of an added-pasteurized-pulp juice; however, it is a good choice to preserve the orange pulp by-product to formulate food products different from juices or other beverages.

Adapting DIALOG+ in a School Setting-A Tool to Support Well-being and Resilience in Adolescents Living in Postconflict Areas During the COVID-19 Pandemic: Protocol for a Cluster Randomized Exploratory Study.

BACKGROUND: Colombia has a long history of an armed conflict that has severely affected communities with forced internal displacement and violence. Victims of violence and armed conflicts have higher rates of mental health disorders, and children and adolescents are particularly affected. However, the mental health needs of this population are often overlooked, especially in low- and middle-Income countries, where scarcity of resources exacerbates the problem that has been further compounded by the global COVID-19 pandemic. Thus, special attention should be paid to the development of interventions that target this population. OBJECTIVE: Our research aims to adapt an existing patient-centered digital intervention called DIALOG+ from a clinical setting to an educational setting using stakeholders' (teachers' and students') perspectives. We aim to evaluate the feasibility, acceptability, and estimated effect of implementing this intervention as a tool for the identification and mobilization of personal and social resources to mitigate the impact of social difficulties and to promote mental well-being. METHODS: We will conduct an exploratory mixed methods study in public schools of postconflict areas in Tolima, Colombia. The study consists of 3 phases: adaptation, exploration, and consolidation of the DIALOG+ tool. The adaptation phase will identify possible changes that the intervention requires on the basis of data from focus groups with teachers and students. The exploration phase will be an exploratory cluster randomized trial with teachers and school counselors to assess the acceptability, feasibility, and estimated effect of DIALOG+ for adolescents in school settings. Adolescents' data about mental health symptoms and wellness will be collected before and after DIALOG+ implementation. During this phase, teachers or counselors who were part of the intervention group will share their opinions through the think-aloud method. Lastly, the consolidation phase will consist of 2 focus groups with teachers and students to discuss their experiences and to understand acceptability. RESULTS: Study recruitment was completed in March 2022, and follow-up is anticipated to last through November 2022. CONCLUSIONS: This exploratory study will evaluate the acceptability, feasibility, and estimated effect of DIALOG+ for adolescents in postconflict school settings in Colombia. The use of this technology-supported tool aims to support interactions between teachers or counselors and students and to provide an effective student-centered communication guide. This is an innovative approach in both the school and the postconflict contexts that could help improve the mental health and wellness of adolescents in vulnerable zones in Colombia. Subsequent studies will be needed to evaluate the effectiveness of DIALOG+ in an educational context as a viable option to reduce the gap and inequities of mental health care access. TRIAL REGISTRATION: ISRCTN Registry ISRCTN14396374; https://www.isrctn.com/ISRCTN14396374?q=ISRCTN14396374. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40286.

High Hydrostatic Pressure Assisted by Celluclast® Releases Oligosaccharides from Apple By-Product.

A novel and green procedure consisting of high hydrostatic pressure (HHP) aided by a commercial cellulase (Celluclast®) has been applied to valorise the apple by-product, a valuable source of dietary fibre but mainly composed by insoluble fibre. Optimal conditions for solubilisation of dietary fibre were first determined at atmospheric pressure as 2% (w/v) of substrate concentration and 20 Endo-Glucanase Units of cellulase. Monitoring of polysaccharides and oligosaccharides released from apple by-product was carried out by means of a newly validated HPLC method with refractive index detector. A synergistic effect was observed when the combined HHP plus cellulase treatment was used. Thus, the application of 200 MPa at 50 °C for 15 min enabled a significant increase in the release of water-soluble polysaccharides (1.8-fold) and oligosaccharides (3.8-fold), as well as a considerable decrease in the time required (up to 120-fold), compared to control at 0.1 MPa. Therefore, this technology could be a promising alternative approach to transform an industrial by-product into a novel rich-in-oligosaccharide food ingredient and a step forward into shaping the world of prebiotics.

[Social perception of biomedicine in Spain]. / Percepción social de la biomedicina en España.

BACKGROUND AND OBJECTIVES: There is increasing concern that studies of public understanding of science, especially biomedicine, should be expected to bring shared frameworks to European and national policies. The present article aims to provide a critical overview of the most recent studies of public understanding of biomedicine in Spain. Specifically, this essay reviews the similarities and differences in the latest European and Spanish surveys. MATERIAL AND METHOD: Throughout this article we compare the Third National Survey of Social Perception of Science and Technology produced by the Spanish National Science and Technology Foundation, focusing on issues related to biomedicine, and the Medical and Health Research. A special Eurobarometer Public Survey published by the European Commission. RESULTS: The two surveys were compared attending to the three main common items of science, technology and biomedicine: the level of interest, the level of information and political attitudes. Some discrepancies in the results of the two studies, such as public interest in these subjects, may partly be due to the different methodologies used in the survey designs. CONCLUSIONS: Further national studies exploring public understanding of science, technology and biomedicine at the national level, as well as the use of European standards, would be of great help in other cross-national studies and policies. Improving qualitative studies would also be useful to strengthen relations among science, technology and society.

[Staphylococcus aureus enterotoxin A detection using the polymerase chain reaction (PCR) and its correlation with coagulase and thermonuclease tests]. / Deteccion de la enterotoxina A de Staphylococcus aureus mediante la reaccion en cadena de la polimerasa (PCR) y su correlacion con las pruebas de coagulasa y termonucleasa.

Staphylococcus aureus is a pathogenic bacterium, widely distributed on nature and associated to general infection and food borne outbreaks. The relationship between this bacterium and food borne outbreaks has been done, historically, using several tests, including coagulase, thermonuclease and actually, PCR for the genes codifying for the enterotoxin responsible of clinical symptoms. The objective of this work is to detect enterotoxin A codifying gene through PCR in a group of S. aureus strains isolated from food samples, and also to correlate the presence of this gene with the production of coagulase and thermonuclease enzymes. A total of 69 staphylococcal strains were analyzed, 58 obtained from non pasteurized milk samples from the Estación Experimental Alfredo Volio Mata and 11 from the Food and Water Microbiology Laboratory collection, Universidad de Costa Rica. Coagulase, thermonuclease and enterotoxin A were analyzed in all the strains, and a statistical correlation was performed in order to verify possible associations. Results show that there is no correlation between the three variables, nevertheless, all coagulase positive strains were thermonuclease positive, and all enterotoxin positive strains were coagulase and thermonuclease positive, but not inversely. These results show that the use of presumptive or indirect tests for establishing entorotoxigenity of S. aureus strains is not truthful, more sensible and specific analysis, as PCR, shall be performed.

Unobserved heterogeneity in work absence.

Labour absenteeism may be detrimental to firms and society because of the economic costs, organizational problems and production cuts that it involves. Although involuntary absenteeism due to accident or illness that prevents workers from performing their work is unavoidable, avoidable voluntary absenteeism may also emerge due to asymmetric information given that neither employers nor doctors have perfect information about workers' health status. Assuming that there is heterogeneity in individual's behaviour and thus some workers are more likely to take sick leave than others due to differences in observable and unobservable characteristics, we specify a Finite Mixture Model to analyse sick leave days per year using a sample of employees from the 2014 European Health Survey in Spain. This specification accounts for unobserved heterogeneity in a discrete way assuming that there are two types of workers even though the data do not allow us to identify which group any individual belongs to. Our results reveal that, although health indicators have the greatest impact on the proportional change in days of absenteeism, there is heterogeneity in sick leave decisions and individual and job characteristics have different effect on the absenteeism of each group.

Validez diagnóstica de cinco escalas de predicción clínica para la trombosis venosa profunda (TVP)

Introducción: la trombosis venosa profunda (TVP) es una entidad común que afecta principalmente el sistema venoso profundo de los miembros inferiores, para el cual se han desarrollado múltiples escalas de predicción clínica, las cuales han sido construidas y validadas en pacientes ambulatorios y hospitalizados. Objetivos: validar cinco escalas de predicción clínica para TVP en pacientes atendidos en un centro de tercer nivel en la sabana de Bogotá, Colombia. Métodos: se llevó a cabo un estudio de corte transversal con análisis de prueba diagnóstica en sujetos con sospecha de TVP, incluyendo aquellos que contaran con la realización de ecografía Doppler venosa de miembros inferiores. Se calculó el rendimiento de cinco escalas de predicción clínica para TVP (Wells clásico y modificado, Oudega, CEBI y Constans) para pacientes ambulatorios u hospitalizados, individualizando la población en la que fueron validadas. Resultados: ingresaron al análisis 974 pacientes, de estos 485 (49,7 %) presentaron TVP. La escala de Constans tuvo un mejor rendimiento diagnóstico entre los pacientes hospitalizados y ambulatorios, con un área bajo la curva ROC de 0,73 (95 % 0,70-0,78) al compararla con Wells clásico, Wells modificado, Oudega y CEBI. Al comparar el rendimiento de Constans en ambos grupos de pacientes por separado, también se observó un mejor rendimiento con respecto a las demás escalas. Conclusión: la escala de Constans presenta un mejor rendimiento diagnóstico comparado con las demás escalas al ser aplicada en paciente hospitalizados y ambulatorios.

Summary Introduction: The deep vein thrombosis (DVT) is a common entity that mainly affects the deep venous system of the lower limbs, for which multiple clinical prediction scales have been developed, which have been constructed and validated in outpatients and inpatients. Objetives: We aimed to validated five clinical prediction scores for the diagnosis of lower limb DVT in patients from La Sabana de Bogota, Colombia. Methods: A cross-sectional study with analysis of a diagnostic test was carried out in patiens with suspected deep vein thrombosis, including those who had venous Doppler ultrasound of the lower limbs for suspected DVT. The performance of five clinical prediction scales for DVT (classic and modified Wells, Oudega, CEBI and Constans) for outpatients and inpatients was calculated in those scores who are validated in both populations and only in ambulatory or hospitalized patients for those that are specific scores. Results: Nine hundred seventy-four patients were entered into the analysis, of which 485 (49.7%) presented DVT. The Constans scale had a better diagnostic performance among inpatients and outpatients with an area under the ROC curve of 0.73 (95% 0.70-0.78) when compared with classic Wells, modified Wells, Oudega and CEBI. When we compared Constans performance in both groups of patients separately, we observed better performance with respect to the other scores. Conclusion: The Constans scale presents a better diagnostic performance compared to the other scales when applied to inpatients and outpatients.

Liquen plano, estudio retrospectivo en un hospital pediátrico / Lichen planus, retrospective study in a pediatric hospital

Introducción: El liquen plano (LP) es una enfermedad inflamatoria crónica, de etiología desconocida, que puede afectar la piel, los anexos y las mucosas. Objetivo: Describir las características epidemiológicas y clínicas y el tratamiento realizado en los pacientes con diagnóstico clínico e histopatológico de LP, valorados en el Servicio de Dermatología del Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" en los últimos 33 años. Diseño:Estudio descriptivo, retrospectivo y transversal. Materiales y métodos: Se revisaron las historias clínicas de los pacientes con diagnóstico histopatológico de LP atendidos en el Hospital desde agosto de 1987 hasta febrero de 2020 y se analizaron las variables epidemiológicas, clínicas y de tratamiento. Resultados: Se incluyeron datos de 26 pacientes, 18 de los cuales eran varones (69,3%). La media de edad en el momento del diagnóstico fue de 9,6 años. Presentaron la variedad de LP clásico 24 pacienes (93%). El compromiso ungueal y de la mucosa bucal se observó en 2 pacientes (7,7%). Ninguno tuvo asociación a fármacos ni a infecciones. En cuanto al tratamiento recibido, 4 pacientes (15,4%) tuvieron pérdida del seguimiento; 13 (50%) realizaron tratamiento tópico; 6 (23%), tratamiento sistémico y 3 (11,5%), tratamiento combinado. El promedio de seguimiento fue de 6 meses y se obtuvo una respuesta favorable en el 68% de los pacientes. Conclusiones: El LP es una patología de baja frecuencia en la infancia. No se encontró asociación a medicamentos ni a enfermedades infecciosas como se describe en la población adulta. Su curso es crónico y, en los pacientes que tuvieron un adecuado seguimiento, se obtuvo una buena respuesta al tratamiento indicado.

Introduction: Lichen planus (LP) is a chronic, inflammatory disease of unknown etiology, which can affect skin, adnexal tissues and mucosa. Objective: to describe the clinical, epidemiological characteristics and the treatment received by patients with clinical and histopathological diagnosis of LP, seen at the Dermatology Service of Pediatric Hospital "Prof. Dr. Juan P. Garrahan" in the last 33 years. Design: Descriptive, retrospective and cross-sectional study. Materials y methods: We reviewed the clinical history of patients with histopathological diagnosis of LP that were treated at our hospital from August 1987 to February 2020 and analysed the epidemiological, clinical and treatment variables. Results: Data of 26 patients were included in this study 18 of which are males (69.3%). The mean age of diagnosis was 9.6 years. 24 patients (93%) presented the classical type of LP. Ungual and mucosal compromise were observed in 2 patients (7.7%) and none had associations with infections or drugs. Regarding treatment, 4 patients (15.4%) did not continue follow-ups, 13 patients (50%) had topical treatment, 6 (23%) had systemic treatment and 3 patients (11.5%) received combined treatment. The average follow-up time was 6 months and 68% of patients had favorable outcome. Conclusions: LP is an uncommon pathology in children. During this study we did not find any etiologic relations with use of drugs or infectious diseases as is described in de adult population. Its course is chronic and in the patients that had a proper follow-up a good response to the indicated treatment was obtained.

SALUD MENTAL Y DESARROLLO / Mental Health and Development

La relación entre salud mental y desarrollo es tan estrecha como ignorada. Aunque ambas buscan potenciar las capacidades de los individuos para lograr un bienestar individual que redunde en la comunidad, la salud mental ha sido sistemáticamente excluida de los planes de desarrollo. Los problemas de salud mental afectan a millones de personas en el mundo quienes, al no recibir un tratamiento adecuado y oportuno, pueden desarrollar un trastorno. Se calcula que una de cada cuatro personas desarrolla algún tipo de enfermedad mental a lo largo de su vida. En tanto se cree que no es posible recuperarse de estas enfermedades, los recursos no están dirigidos a intervenir sobre ellas. Siendo absolutamente transversal a todos los aspectos de nuestras vidas, y por tanto un pilar fundamental en el desarrollo sostenible, el gasto global en salud mental es de menos de dos dólares por persona por día. Situación que no sólo impacta directamente sobre las tres dimensiones del Índice de Desarrollo Humano (IDH) - salud, educación y estándares de vida - sino que perpetúa la condición de desigualdad estructural en que viven las personas con trastornos mentales. Mientras los problemas de salud mental afectan la esperanza de vida, los años de instrucción esperados y el Ingreso Nacional Bruto per cápita, siendo a su vez causa y consecuencia de la pobreza, las personas con trastornos mentales deben enfrentar numerosas barreras para el acceso a la educación, a las oportunidades de empleo y otras fuentes de generación de ingresos, debido a la estigmatización, discriminación y marginación que históricamente han vivido. Por tanto, si queremos que todos sean partícipes de las oportunidades de desarrollo, es necesario un cambio estructural donde desaparezca el estigma frente a los trastornos mentales, que permita posicionar la salud mental como eje de los planes de desarrollo y aumentar la inversión en la promoción de la salud mental y la prevención e intervención de estas problemáticas, para alcanzar un desarrollo equitativo y sostenible.

The relationship between mental health and development is as narrow as ignored. Although both seek to empower individuals to achieve individual well-being that goes back to the community, mental health has been systematically excluded from development plans. Mental health problems affect millions of people in the world who, by not receiving adequate and timely treatment, can develop a disease. It is estimated that one in four people develops some type of mental illness throughout their life. While it is believed that it is not possible to recover from these diseases, the resources are not directed at intervening on them. Being absolutely transversal to all aspects of our lives, and therefore a fundamental pillar in sustainable development, the global expenditure on mental health is less than two dollars per person per day. This situation not only directly impacts the three dimensions of the Human Development Index (HDI) ­long and healthy life, knowledge and a decent standard of living­ but perpetuates the condition of structural inequality in which people with mental illness live. While mental health problems affect life expectancy, expected years of education, and gross national income per capita, which in turn are the cause and consequence of poverty, people with mental illness must face numerous barriers to access education, employment opportunities and other sources of income generation, due to stigmatization, discrimination and marginalization that have historically lived. Therefore, if we want everyone to be involved in development opportunities, a structural change is necessary in which stigma disappears in the face of mental illness, which makes it possible to position mental health as the axis of development plans and increase investment in promotion of mental health and the prevention and intervention of these problems, in order to achieve equitable and sustainable development.

Comparación de la precisión marginal de cofias de zirconia entre los sistemas CAD/CAM Cerec InLab (Sirona ® ), CAD/CAM Zirkonzahn (Zirkonzahn ® ) y sistema pantográfico Zirkograph 025 ECO (Zirkonzahn ® ) / Comparison of marginal fit of zirconia copings manufactured with the use of two CAD/CAM systems Cerec InLab (Sirona ® ) CAD/CAM Zirkonzahn (Zirkonzahn ® ) and Zirkograph 025 ECO pantographic system (manual milling system) (Zirkonzahn ® )

Objetivo: Comparar la precisión marginal de cofias de zirconia elaboradas empleando dos sistemas CAD/CAM Cerec InLab (Sirona®) y Zirkonzahn (Zirkonzahn®) y un sistema pantográfi co Zirkograph 025 ECO (Zirkonzahn®). Material y métodos: Se elaboró un muñón maestro de Cr-Co con preparación para corona de zirconia de un premolar superior. Se fabricaron 10 cofias de zirconia por grupo siguiendo los parámetros de cada sistema. El grupo control consistió en 10 cofias metálicas. Se ejecutó una técnica de réplica, utilizando polivinilsiloxano elite HD+ (Zhermack®). Mediante observación estereomicroscópica con aumento de 50x, se determinó en micras la discrepancia marginal absoluta y el espesor marginal de un punto por cara de cada cofia. El análisis estadístico se ejecutó con el software IBM SPSS®. Para comparar los datos obtenidos se realizó el test t. Resultados: La discrepancia marginal absoluta media y el espesor marginal fue 92.14 ± 38.59 y 78.62 ± 31.33 μm para el sistema CAD/CAM Cerec InLab (Sirona®), 38.71 ± 12.62 y 36.91 ± 13.56 μm para el sistema CAD/CAM Zirkonzahn (Zirkonzahn®), 77.92 ± 38.01 y 69.42 ± 33.23 μm para el sistema pantográfico Zirkograph 025 ECO (Zirkonzahn®) y 44.11 ± 15.36 y 43.74 ± 15.70 μm para el grupo control. Existieron diferencias estadísticamente significativas entre los sistemas Cerec InLab (Sirona®) y Zirkograph 025 ECO (Zirkonzahn®) en comparación con el grupo control para la discrepancia marginal absoluta y el espesor marginal. No existieron diferencias estadísticamente significativas entre los sistemas CAD/CAM Zirkonzahn (Zirkonzahn®) y el grupo control. El nivel de significancia fue p > 0.001. Conclusiones: El sistema más preciso fue CAD/CAM Zirkonzahn (Zirkonzahn®). El sistema que mostró menor precisión marginal fue Cerec InLab (Sirona®).

Objective: To compare marginal fit of zirconia copings manufactured following two different systems: CAD/CAM Cerec InLab (Sirona®) and Zirkonzahn (Zirkonzahn®) as well as a Zirkograph 025 ECO (Zirkonzahn®) pantograph system. Material and methods: A master Cr-Co model stump was manufactured; it was prepared for the zirconia crown of an upper premolar. Ten zirconia copings were manufactured for each group following manufacturer¿s instructions. Control group consisted on ten metallic copings. A replication technique was followed using elite HD+ polyvinyl siloxane (Zhermack®). Measurements were taken using a stereomicroscope at 50x magnification so as to obtain marginal width in microns and thus determine absolute marginal discrepancy of each coping. Statistical analysis was conducted using IBM SPSS® software. T-test study was conducted in order to compare obtained data. Results: Mean marginal absolute discrepancy and marginal width were as follows: 92.14 ± 38.59 and 78.62 ± 31.33 μm for Cerec InLab (Sirona®) CAD/CAM system, 38.71 ± 12.62 and 36.91 ± 13.56 μm for Zirkonzahn (Zirkonzahn®) CAD/CAM system, 77.92 ± 38.01 and 69.42 ± 33.23 μm for Zirkograph 025 ECO (Zirkonzahn®) pantograph system. Control group made of metal copings exhibited 44.11 ± 15.36 and 43.74 ± 15.70 μm. With respect to absolute marginal discrepancy and marginal width, significant differences were observed when comparing Cerec InLab (Sirona®) and Zirkograph 025 ECO (Zirkonzahn®) with control group. Nevertheless, no significant differences were observed between Zirkonzahn (Zirkonzahn®) CAD/CAM system and the control group. Overall level of statistical significance was p > 0.001. Conclusions: Zirkonzahn® CAD/CAM system was the most accurate system of all. CAD/CAM Cerec InLab system (Sirona®) proved to be the less precise system.

Análisis de alimentos de consumo habitual: parámetros relacionados con factores de riesgo de caries y desgaste erosivo / Commonly consumed foods analysis: risk factors relatedto decay and erosive wear parameters

Objetivo: analizar bebidas y alimentos de consumo frecuente para evaluar el pH, grados Brix (ºBx), efecto buffer a pH 5,5 y 7, y concentración de fosfatos, calcio y fluoruros. Materiales y métodos: en este estudio observacional, descriptivo y transversal, se evaluaron 438 alimentos, divididos en 18 grupos. Se analizó pH, capacidad Buffer a pH 5,5 y 7, grados Brix y concentración de fosfatos, de fluoruros y de calcio. Los datos fueron procesados por SPSS Statistics 20 (IBM Corp., Estados Unidos). Resultados: las gaseosas, el jugo en polvo para diluir, las aguas saborizadas y las bebidas isotónicas presntaron menor pH. El rango de sólidos solubles, expresado en grados Brix, fue de 0,05 a 15,9. El mayor valor de efecto buffer correspondió a los jugos: exprimido, en polvo, listo para consumir y para diluir. En este último, se halló mayor cantidad de fosfato. Sólo en las aguas minerales con gas se observaron fluoruros. El alimento de soja líquido natural presentó el mayor contenido de calcio. Concusiójn: las gaseosas, los jugos, las leches fermentadas y las bebidas isotónicas, resultaron ser ácidas, con bajo efecto buffer, alto valor de grados Brix y contener pocos factores protectores.

Aims: to analyze drinks and foods commonly consumedby evaluating pH, degrees Brix, buffer effect at pH 5.5 and 7.0and phosphate, calcium and fluoride concentration.Materials and methods: In this observational, descriptiveand cross-sectional study, 48 foods were evaluated,divided into 18 groups. pH, buffer capacity at 5.5 and 7, degreesBrix and phosphate, fluoride and calcium concentrationwere analyzed. The data were processed by SPSS Statistics 20(IBM Corp., USA).Results: Soda, juice powder to dilute, flavored water andsports drinks had lower pH. The range of soluble solids (degreesBrix) was from 0.05 to 15.9. The greatest value in buffereffect was in juices: squeezed, powdered, ready to consumeand to be diluted. The latter had a higher amount of phosphate.Only sparkling mineral waters showed detectable valuesfor fluorides. The liquid natural soy food had the highestcalcium content.Conclusion: Soft drinks, juices, fermentable milk, isotonicdrinks were found to be acidic, with lower buffer value,high Brix degrees and low in protective factors.