Características psicométricas del Test de Anillos para la evaluación atencional en niños. Resultados preliminares / Psychometric characteristics of the Ring Test to assess attention in children. Preliminary results

Resumen Los modelos neurocognitivos actuales definen a la atención como un sistema de control cognitivo responsable de la activación y organización jerárquica de los procesos encargados de elaborar la información. La atención juega un rol clave en el desempeño cognitivo infantil y en el aprendizaje escolar. Por ello, resulta importante disponer de instrumentos de evaluación, válidos y confiables, que permitan valorar con mayor precisión el desempeño atencional en niños y niñas. El propósito de este trabajo es analizar las propiedades psicométricas del Test de Anillos (TA), un nuevo instrumento diseñado para evaluar atención visual en niños. El TA se ha construido utilizando el optotipo C de Landolt y sigue la estructura triestímulo propuesta por la prueba de percepción de similitudes y diferencias (CARAS). Es una prueba de papel y lápiz que se compone de 60 bloques de estímulos. La muestra estuvo conformada por 86 escolares entre 8 y 10 años de edad. Para el estudio de las propiedades psicométricas se analizó la validez convergente entre el TA y el Test CARAS y se examinó la estabilidad temporal para analizar la confiabilidad del TA. Los resultados indicaron que el TA es un instrumento válido y confiable para la medición de la atención visual en niños y niñas. Presentó adecuados valores en validez convergente y una satisfactoria estabilidad temporal entre la primera y la segunda evaluación. Se concluye que el TA constituye un aporte a los instrumentos neuropsicológicos existentes para la evaluación de la atención visual en población infantil.

Abstract Current neurocognitive models define attention as a cognitive control system responsible for activation and hierarchical organization of the processes to elaborate information. It plays a key role in child cognitive performance and in school learning. It has been documented that children with greater attention capabilities show better performance in tasks that require cognitive control and better school performance. Therefore, it is important to have valid and reliable assessment instruments, which allow evaluating attentional performance in children with greater precision, and that are adapted to the sociocultural context of the target population. In line with these postulates, this paper presents a new instrument designed to evaluate visual attention in children called the Ring Test. The Ring Test is a visual discrimination test that has been constructed using Landolt's C optotype and following the tristimulus structure proposed by the Perception of Similarities and Differences (FACES) Test. Ring Test is a pencil and paper test that is made up of 60 blocks of stimuli each with triads of optotypes, where two optotypes are the same and one different. Subject's task is to find the different optotype in each stimulus triad and cross it out. This instrument brings into play focused and sustained attention and makes it possible to assess attentional effectiveness (AE), attentional efficiency (AF) and attentional performance (AP). Also, the Ring Test measures impulsivity (ICI) and net correct answers (NCA). The purpose of the study is to analyze psychometric properties for the Ring Test. Study's specific objectives were: (1) analyze the convergent validity between the Ring Test and the FACES Test, and (2) analyze the reliability of the Ring Test through the temporal stability. This study is framed in an instrumental design. The sample was composed of 86 schoolchildren, between 8 to 10 years. The results indicated that the Ring Test presented accurate values of convergent validity with the FACES test. The indicators of the Ring Test (AE, AF, AP, ICI and NCA) weighted for the complete execution of the test, showed the highest convergent validity indexes with the FACES Test (rho: from .55 to .62). AR and NCA for the complete execution of the test were the indicators that presented the highest validity (rho > .58), within the analyzed indicators. Also, the Ring Test presented a satisfactory temporal stability between the first and second measurement. It was observed that the most stable indicators are those that are calculated for the complete performance of the test (rho: from .56 to .76), and not for the partial times. AR and NCA calculated for the complete execution of the test were the indicators that denoted the greatest temporal stability (rho > .65). Another interesting aspect to highlight is that the Ring Test proved to be a valid and reliable instrument to measure attentional efficacy and impulsivity. AE evaluates the accuracy with which a child discriminates targeted stimuli within a set of similar stimuli and, consequently, can be considered a good indicator of attentional control. The ICI assesses the reflexivity or impulsiveness with which a subject performs a visual discrimination task. In sum, the results indicated that the Ring Test is a valid and reliable instrument for measuring visual attention in children. It is recommended to apply the complete test, not in time fractions, because the indicators calculated for the complete execution of the test showed greater convergent validity with the FACES test and greater temporal stability than the part-time indicators. It is concluded that the Ring Test is a contribution to the neuropsychological instruments available for the proper evaluation of visual attention in children.

Assessment of Knowledge, Attitude & Perception towards COVID-19 Vaccine among the rural and urban population of Navi Mumbai: An Alarming Scenario

Objective: To assess the knowledge, attitude, and perception towards COVID-19 vaccination among rural and urban areas. To study and analyze any socio-demographic barriers and economic factors affecting the immunization program. Methodology: A cross-sectional comparative study was conducted between the urban and rural populations with the help of pre-designed and pre-structured questionnaires. Data were collected from 205 subjects from the urban population with the help of Google form and 242 subjects from the rural population through an interview. Results: 97.1% of the urban population were aware of the Arogya Setu app of which 80% were using it while 87.6% of the rural population were not aware of the Arogya Setu app. 60.3% of the rural population had the perception that the Covid-19 vaccine can be eradicated without the vaccine whereas 77.1% of the urban population had the opposite perception. Conclusion: Most of the urban population had good knowledge about the Covid 19 vaccine with a positive attitude of accepting the vaccine as the most important preventive measure of prevention and control of the Covid 19 pandemic as compared to the rural population.

Clinical Profile and Effects of Ductal Size on Anthropometry of Children with Patent Ductus Arteriosus (PDA)

It is not known at which size a congenital Patent ductus arteriosus (PDA) in children becomes associated with a resultant severe malnutrition in children. Furthermore, the effect of ductal size on anthropometry of children with PDA is yet to be determined. Objectives This study was aimed to asses if the ductal size had any effect on anthropometry of children with PDA and at which size evidence of severe malnutrition ensues Methods This was a five-year observational cross-sectional study of children who presented at three tertiary institutions with PDA. Results There was a negative non-significant correlation between the size of PDA and the weight of patients, (Pearson correlation coefficient = -0.1, p = 0.7). There was also a negative non-significant correlation between the size of PDA and patient’s height/length, (correlation coefficient = -0.1, p = 0.5). The association between the size of PDA and the severity of malnutrition revealed greater proportion of 35.3% (6/17) for wasting and stunting in patients who had large PDA sizes of >7mm, when compared with fewer proportions in those with PDA sizes of 3- 6mm (26.1% (6/23) and those with tiny PDA of <3mm (33.3% (10/30); (?2 = 10.21, p = 0.8). There was a positive correlation between ductal size and nutritional status of patients, and severe malnutrition ensued from ductal size of 3.2mm; with ETA square of 0.072. The majority of children with PDA presented with severe forms of malnutrition (wasting and stunting). Conclusion: Severe malnutrition ensues when ductal size is 3.2mm. The size of PDA has no effect on weight and height of children with PDA.

The present status, distribution, demography, and diet of the Dahls Jird

Abstract Meriones dahli (Shidlovsky, 1962) was previously accepted to be a subspecies of M. meridianus (Pallas, 1773). However, it was later suggested that they are geographically isolated from each other. Although hybridological studies and differences in certain external characteristics support the idea that M. dahli is a separate species, there are still doubts on its species status, and the exact range of its distribution is not known. In this paper, we provide some taxonomic information about the species, and compare these with the information given in previous studies. We argue that some differences exist among Armenian population regarding external measurements. Recent studies indicate that M. dahli is currently only distributed in Turkey, as an endemic mammal species. We provide predictions about the distribution of M. dahli, and report the estimated population size to its maximum value. Food preference studies for this species, conducted under laboratory conditions, are also introduced for the first time. We discuss the ecological data obtained from field studies, and emphasize that the habitat of M. dahli is about to disappear. Consequently, the protection status of this species should urgently be changed to the CR category and conservation studies must be carried out immediately.

Resumo Meriones dahli (Shidlovsky, 1962) foi previamente aceito como uma subespécie de M. meridianus (Pallas, 1773). No entanto, mais tarde, foi sugerido que eles estão geograficamente isolados um do outro. Embora estudos hibridológicos e diferenças em certas características externas apoiem a ideia de que M. dahli é uma espécie separada, ainda há dúvidas sobre o status de sua espécie, e a extensão exata de sua distribuição não é conhecida. Neste artigo, fornecemos algumas informações taxonômicas sobre as espécies e as comparamos com as informações fornecidas em estudos anteriores. Argumentamos que existem algumas diferenças entre a espécie armênia em relação às medidas externas. Estudos recentes indicam que M. dahli está atualmente distribuído apenas na Turquia como uma espécie endêmica de mamífero. Fornecemos previsões sobre a distribuição de M. dahli e relatamos o tamanho estimado da população em seu valor máximo. Estudos de preferência alimentar para essa espécie, conduzidos em condições de laboratório, também são introduzidos pela primeira vez. Discutimos sobre os dados ecológicos obtidos em estudos de campo e enfatizamos que o habitat de M. dahli está prestes a desaparecer. Consequentemente, o status de proteção dessa espécie deve ser alterado com urgência para a categoria CR, e estudos de conservação devem ser realizados imediatamente.

Biochemical parameters and antioxidant property of three Salvia L. taxa endemic in Turkey

Abstract The aim of the present study was to determine and compare the fatty acids, lipid soluble vitamins, sterols, phenolics, and antioxidant capacities of three endemic Salvia L. taxa (S. euphratica var. Montbret & Aucher ex Bentham leiocalycina (Rech. Fil.) Hedge, S. euphratica var. Montbret & Aucher ex Bentham euphratica (Rech. Fil.) Hedge and S. pseudoeuphratica Rech.Fil.) and to evaluate these results systematically. The fatty acid compositions were determined by using gas chromatography, while the lipid soluble vitamins, sterols, and phenolics were determined by using HPLC. Also, the antioxidant capacities of three Salvia taxa were measured in vitro. Palmitic acid was found as major saturated fatty acid while oleic acid, linoleic acid, -linolenic acid, and erucic acid were found as major unsaturated fatty acids in the present study. It was found that S. euphratica var. euphratica had lower palmitic acid (8.94 ± 0.71%), total saturated fatty acid (19.16 ± 0.15%), and higher unsaturated fatty acid content (82.08 ± 0.52%) than other studied taxa. Furthermore, it was shown that S. euphratica var. euphratica had different 18.3/18:2 (0.36) unsaturated/saturated fatty acid (4.28) ratios. However, this study demonstrated that Salvia taxa had low lipid soluble vitamins, sterol contents. On the other hand, it was shown that Salvia taxa had similar catechin (509.2 ± 4.21 µg/g and 552.2 ± 9.21 µg/g) and vanillic acid amounts (351.2 ± 2.17 µg/g and 396.8 ± 4.1 µg/g) in this study. And also, it was found that Salvia taxa had high rosmarinic acid content while S. euphratica var. leiocalycina had the highest rosmarinic acid content (1480 ± 7.57 µg/g). On the other hand, it was shown that the two ferulic acid contents of S. euphratica varieties were higher (1175 ±/5.21 µgmg-1740.2 ± 4.82 µg/mg) than the ferulic acid content of S. pseudoeuphratica of which was the lowest (19.2 ± 0.97 µg/mg). The present results suggested that the biochemical results guided the morphological studies, and Salvia taxa have a potent antioxidant capacity.

Resumo O objetivo do presente estudo foi determinar e comparar os ácidos graxos, vitaminas lipossolúveis, esteróis, fenóis e capacidades antioxidantes de três espécies endêmicas de Salvia L. (S. euphratica var. Montbret & Aucher ex Bentham leiocalycina (Rech. Fil.) Hedge, S. euphratica var. Montbret & Aucher ex Bentham euphratica (Rech. Fil.) Hedge e S. pseudoeuphratica Rech.Fil.) e avaliar esses resultados sistematicamente. As composições de ácidos graxos foram determinadas por cromatografia gasosa, enquanto as vitaminas lipossolúveis, esteróis e fenóis foram determinadas por HPLC. Além disso, as capacidades antioxidantes das três espécies de Salvia foram medidas in vitro. O ácido palmítico foi encontrado como ácido graxo saturado principal, enquanto o ácido oleico, ácido linoleico, ácido -linolênico e ácido erúcico foram encontrados como principais ácidos graxos insaturados no presente estudo. Verificou-se que S. euphratica var. euphratica tem menor teor de ácido palmítico (8.94 ± 0.71%) e ácido graxo saturado total (19.16 ± 0.15%) e maior teor de ácidos graxos insaturados (82.08 ± 0.52%) do que as outras espécies estudadas. Além disso, foi demonstrado que a S. euphratica var. euphratica apresentou diferentes proporções 18:3/18:2 (0.36) de ácidos graxos insaturados/saturados (4.28). No entanto, este estudo demonstrou que o gênero Salvia tinha baixo teor de vitaminas lipossolúveis e baixo conteúdo de esteróis. Por outro lado, foi demonstrado que as espécies do gênero Salvia contém quantidades de catequinas (509.2 ± 4,21 µg/mg-552.2 ± 9.21 µg/mg) e ácido vanílico semelhantes (351.2 ± 2.17 µg/mg 396,8 ± 4,1 µg/mg). Descobriu-se também que o gênero Salvia tinha alto conteúdo de ácido rosmarínico enquanto a espécie S. euphratica var. leiocalycina apresentou o maior teor desse ácido (1.480 ± 7.57 µg/g). Por outro lado, foi demonstrado que os teores de ácido ferúlico da espécie S. eupratica foram maiores (1.175 ± 5.21 µg/mg-1740.2 ± 4.82 µg/mg) do que o conteúdo de ácido ferúlico da espécie S. pseudoeuphratica dos quais foi o mais baixo (19.2 ± 0.97 µg/mg). Os resultados atuais sugerem que os resultados bioquímicos orientaram os estudos morfológicos e as espécies de Salvia têm uma potente capacidade antioxidante.

Estudio comparativo de una asociación de diclofenac, betametasona y vitamina b12 (blokium b12®) con diclofenac (sin asociar) en el tratamiento de patología dolorosa de columna con compromiso neural / COMPARATIVE STUDY OF AN ASSOCIATION OF DICLOFENAC, BETAMETASONE AND VITAMIN B12 (BLOKIUM B12®) WITH DICLOFENAC (WITHOUT ASSOCIATION) IN THE TREATMENT OF PAINFUL SPINE PATHOLOGY WITH NEURAL COMMITMENT

El dolor lumbar bajo y el dolor cervical con o sin irradiación son causas muy comunes de consulta a los médicos generalistas en los países desarrollados. La discopatía aguda y el dolor por estenosis del canal espinal son los diagnósticos más frecuentes. La postura tradicional ha sido la de administrar antiinflamatorios no esteroideos (AINES) para estas lumbalgias o cervicalgias agudas. Cuando existe irradiación neural por compresión radicular es usual asociar al AINE un corticoide a baja dosis, así como un antineurítico, para lograr un mejor resultado. Con el objeto de documentar la utilidad de esta práctica habitual, efectuamos en 142 pacientes ambulatorios un estudio multicéntrico randomizado que compara la efectividad y la tolerancia de una asociación a dosis fija de diclofenac, betametasona y cianocobalamina administrada por vía oral versus la administración de diclofenac como monofármaco en el tratamiento de la patología dolorosa de la columna lumbar y cervical asociada a compresión neural. La asociación demostró ser más eficaz en controlar el dolor y mejorar la funcionalidad de los pacientes que la administración de diclofenac en forma aislada y se asoció a escasos efectos colaterales, principalmente digestivos

Low back pain and neck pain with or without radiation are very common causes of consultation with general practitioners in developed countries. Acute discopathy and pain due to spinal canal stenosis are the most frequent diagnoses. The traditional approach has been to administer non-steroidal antiinflammatory drugs (NSAIDs) for these acute low back or cervical pain. When there is neural radiation due to root compression, it is usual to associate a low-dose corticosteroid with the NSAID, as well as an antineuritic, to achieve a better result. In order to document the usefulness of this routine practice, we conducted a randomized multicenter study in 142 outpatients that compared the effectiveness and tolerance of a fixed-dose combination of diclofenac, betamethasone, and cyanocobalamin administered orally versus the administration of diclofenac as Monopharmaceutical in the treatment of painful pathology of the lumbar and cervical spine associated with neural compression. The association proved to be more effective in controlling pain and improving the functionality of patients than the administration of diclofenac in isolation and was associated with few side effects, mainly digestive

Estudio cualitativo sobre sujetos de vida violenta en Venezuela desde la perspectiva generacional / Estudo qualitativo sobre sujeitos de vida violenta na Venezuela a partir de uma perspectiva geracional / Qualitative Study on Subjects with Violent Lives in Venezuela from a Generational Perspective

Con base en la premisa teórica de que tanto el aumento de la inseguridad ciudadana, y de la violencia en general, como la ineficiente reacción institucional formal para regular las conductas sociales, tuvieron un efecto en la estructura de socialización e interacción individual del venezolano, el presente estudio hace un análisis comparativo generacional entre sujetos de vida violenta. Se expone la manera como la violencia se ha convertido en un valor de socialización y moralización para estos sujetos, quienes han centralizado la misma como un valor de vida para la interacción cotidiana con los demás individuos e instituciones. Al emplear una metodología cualitativa, a través de historias de vida, entrevistas a profundidad y revisión documental, los hallazgos permiten concluir que, como consecuencia de una socialización primaria y secundaria precaria (caracterizada por el establecimiento de vínculos débiles, en el plano afectivo y moral, con figuras como los padres, la familia, la sociedad, las instituciones y la autoridad), para el sujeto de vida violenta de la nueva generación la violencia pasó a ser un valor central, moralizado y legitimado. Estos sujetos tienen una mayor propensión a la violencia, la cual se configura no solo como su modo de vida, sino también como su rol principal para las relaciones con los demás y con las estructuras sociales.

Based on the theoretical premise that both an increase in citizen insecurity and general violence, as well as inefficient formal reactions by institutions regulating social conducts, affected Venezuelans' social and individual interaction structures, this study performs a generational comparative analysis between subjects with violent lives. The study shows how violence has become a value of social interaction and moralization for these subjects, who have centralized violence as a life value for daily interactions with other individuals and institutions. By using a qualitative methodology through life stories, in-depth interviews and documentary review, the findings allow concluding that, as a consequence of primary and secondary unstable social interaction (characterized by establishing weak emotional and moral bonds with figures, such as parents, family, society, institutions and authorities), violence became a central, moralized and legitimized value for subjects with violent lives in the new generation. These subjects are more likely to have a violent behavior, which is demonstrated not just by their ways of life, but in the main role violence plays in their relationships with others and social structures.

Partindo da premissa teórica de que tanto o aumento da insegurança cidadã e da violência em geral, quanto a ineficiente atuação institucional formal para regular os comportamentos sociais, tiveram um efeito na estrutura de socialização e interação individual dos sujeitos venezuelanos, este estudo faz uma análise comparativa geracional entre sujeitos de vida violenta. Expõe-se a forma como a violência se tornou um valor de socialização e moralização para esses sujeitos, que a centralizaram como um valor de vida para a interação cotidiana com outros indivíduos e instituições. Adotando uma metodologia qualitativa, por meio de histórias de vida, entrevistas em profundidade e revisão documental, os resultados permitem concluir que, em decorrência de uma precária socialização primária e secundária (caracterizada pelo estabelecimento de laços fracos, no plano afetivo e moral, com figuras como pais, família, sociedade, instituições e autoridade), para o sujeito da vida violenta da nova geração, a violência tornou-se um valor central, moralizado e legitimado. Esses sujeitos apresentam maior propensão à violência, que se configura não apenas como seu modo de vida, mas também como seu principal papel nas relações com os outros e com as estruturas sociais.

Saúde Brasil 2020/2021: anomalias congênitas prioritárias para a vigilância ao nascimento / Saúde Brasil 2020/2021: priority congenital anomalies for birth surveillance

O principal objetivo deste livro é fornecer informações teóricas, epidemiológicas e práticas sobre as anomalias congênitas no Brasil, de modo a fortalecer o registro delas no Sistema de Informações Sobre Nascidos Vivos (Sinasc) e possibilitar a qualificação das políticas de saúde. Esta é a primeira edição do livro Saúde Brasil: anomalias congênitas prioritárias para a vigilância ao nascimento, elaborado pela Coordenação-Geral de Informações e Análises Epidemiológicas (Cgiae), do Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis (DASNT), da Secretaria de Vigilância em Saúde (SVS) do Ministério da Saúde, em parceria com a Universidade Federal do Rio Grande do Sul (UFRGS) e o Hospital das Clínicas de Porto Alegre (HCPA), e que também contou com a participação de um grupo de especialistas na temática

Comparative Analysis of Serum Lipoprotein (a) in Hypothyroid and Healthy Subjects

This study is taken up to estimate and compare the level of serum Lp(a) in hypothyroid patients and in healthy controls. A total of 50 hypothyroidpatients within aged group 20-60 years and total of 50 healthy controls within 20-60 years were enrolled in the study after taking written consent. Thyroid profile and Lp(a) were measured by CLIA and immune turbidemetric method respectively. Data collected was analysed using Stata version 14.1 software. Result shows an increased level of Lp(a) among hypothyroid patients when compared to healthy controls

Evaluation of Free Radical Scavenging Potential of Different Bioactive Fractions Present in Boerhavia diffusa Linn. Root Extract: An in-vitro Approach

Aimand Objectives:Boerhavia diffusa(B. diffusa) frequently known as punarnava is specifically used to replenish the body. The present work was designed to evaluate the scavenging potentialof its bioactive constituents. Materials and Methods:The different fractions ofB. diffusaroot methanolic extractwere examined for phenolic, flavonoids contents, DPPH free radical and Nitric oxide scavenging activities. Further antioxidant activity wasevaluated by ABTS free radical scavenging method and also from the reducing potential scavenging activity. The total phenolic content in different fractions by using various solvent like ethanol, diethyl ether, chloroform, ethyl acetate, and n-butanol were carried out to find the antioxidant activities. Results:The phenolic content was highest in ethanolic fraction that was significantly comparable with ascorbic acid. The flavonoid content was highest in ethanol fraction (41.93 ± 3.92 μg/mL) followed by n-butanol fraction (31.68 ± 1.72 μg/mL), then ethyl acetate fraction (29.67 ± 2.83 μg/mL) and least in chloroform fraction (16.91 ± 2.74 μg/mL). The ethanolic fraction of B. diffusaalso showed highest DPPH radical scavenging activity (101.29 ± 3.78) when compared with other fractions of same extract using different solvent phases. Moreover the nitric oxide scavenging activity of ethanolic fraction was maximum (82.31 ± 2.83) than different fractions. The ethanolic fraction also showed improved ABTS radical scavenging activity (81.73 ± 2.73 mg/mL) while chloroform fraction showed poor ABTS radical cation scavenging activity (29.51 ± 2.79 mg/mL). Conclusions:The study concludes that Boerhavia diffusa has rich and ample source of phenolic acid and flavonoids. Among all fractions the ethanolic has potent antioxidant activity, which shows its significance for a better novel approach.

Correction systems of the Bender Visual-Motor Gestalt Test: A systematic mapping of the literature / Sistemas de corrección de la prueba de Gestalt Visual-Motor de Bender: un mapeo sistemático de la literatura

Abstract Background the Bender test, developed by Lauretta Bender, is intended to evaluate children's perceptual maturity. Because the instrument lacks a standardized correction system, other researchers have designed different systems for this purpose at distinct periods. Objective: for the present research, we reviewed articles that included the Bender test to identify the most widely used correction systems. Method: eligibility criteria included the instrument application in children up to 10 years of age, focusing on evaluating cognitive aspects. Searches were carried out through the CAPES periodicals portal, which covers both Brazilian and international databases. Results: at the end of the search, 72 published articles were selected and analyzed in their entirety. The four most widely used correction systems were the Koppitz System, Gradual Scoring System, Qualitative Classification System, and Global Classification System. Brazil, Peru and the United States were the countries with the highest number of studies. The predominant objectives were the evaluation of the psychometric properties of correction systems and the use of the Bender test to predict possible learning difficulties, especially in reading and writing. Conclusion: suggested prospects for future Bender test studies are reviews of studies developed with an emotional focus, and the addition of other research databases.

Resumen Antecedentes la prueba de Bender, desarrollada por Lauretta Bender, está destinada a evaluar la madurez perceptiva de los niños. Dado que el instrumento no tiene un sistema de corrección estandarizado, en diferentes períodos, otros investigadores han diseñado diversos sistemas para este propósito. Objetivos: para la presente investigación, los artículos que incluyeron la prueba de Bender fueron revisados para identificar cuáles eran los sistemas de corrección más utilizados. Método: los criterios de elegibilidad incluyeron la aplicación del instrumento en niños de hasta 10 años, con un enfoque en la evaluación de aspectos cognitivos. La búsqueda fue realizada en el portal de revistas CAPES que cubre bases de datos nacionales e internacionales. Resultados: al final de la investigación, 72 artículos publicados fueron seleccionados y analizados en su totalidad. Los cuatro sistemas de corrección más utilizados fueron Koppitz, Sistema de Calificación Gradual, Sistema de Calificación Cualitativa y Sistema de Calificación Global. Brasil, Perú y Estados Unidos fueron los países con el mayor número de estudios, siendo los objetivos predominantes la evaluación de las propiedades psicométricas de los sistemas de corrección y el uso de la prueba de Bender para predecir posibles dificultades de aprendizaje, especialmente en la lectura y la escritura. Conclusión: las perspectivas sugeridas para futuros estudios de prueba de Bender son revisiones de estudios desarrollados con un enfoque emocional, además de la adición de otras bases de datos de investigación.

Diseño de Sonrisa Digital / Digital Smile Desinge

Nowadays, a lot of people need in reconstruction of the teeth in connection with their loss. Before prosthetics or any other manipulations, a person wants to quickly see the aesthetic appearance of his future tooth. At the moment, many dentists use the option of verbal explanation to the patient, what will look like a smile or a front row of teeth after treatment, but the visual representation of the person remains aside. But now this can be achieved with the help of "Digital smile design", which shows the person the final result of the dentition. This technology has a number of advantages. Some of them are the rapid creation of a prototype model and high accuracy in the manufacture of work. Thanks to these technologies, communication between the specialist and the patient has been facilitated. The digital smile design has simplified the doctor's work process and reduced patient data processing time. From now on, achieving aesthetic results in the reconstruction of teeth for the dentist is not a problem.

Review of Paediatric Typhoid Perforation Cases Managed at a Tertiary Care Centre

Background: Any criteria (clinical, pathologic, microbiological or histo-pathologic) attributing a case of Paediatric gastrointestinal perforation to Typhoid would be of help in reaching a proper diagnosis to guide appropriate management.Aims and Objectives: To review all cases of Typhoid perforation for their clinical, pathologic and intra-operative findings.Materials and Methods: A retrospective study was conducted on all cases of typhoid perforation (gastrointestinal perforation with positive Widal test) operated at a tertiary care centre from September 2015 to September 2018. Data regarding their clinical findings, investigation results, intraoperative findings, nature of thesurgical intervention, postoperative results and histopathological findings were collected from their records and analysed.Results: A total of 13 patients were operated during this period with positive Widal’s test at presentation. 6/13 had single ileal perforation; two patients had multiple ileal perforations; perforation at atypical sites were found in four patients (one each at gastric, duodenal, caecal and rectal); one patient presented with Meckel’s band obstruction with multiple ulcers –this patient was sick and died despite a diverting ileostomy in the postoperative period. While 8/13 patients had primary closure of the perforation site, diversion through ileostomy was performed in five patients. All patients did well in the post-operative period except one patient of multiple ulcers and obstructing Meckel’s band who died in the post-operative period. Conclusion: On encountering a gastrointestinal perforation, no definite symptomatology or its pattern, no clinical examination findings, no intraoperative characteristics of the perforation and no biopsy can definitively point towards Typhoid as the cause. Therefore, we still have to depend on serological tests in correlation with clinical features to reach a conclusive diagnosis. Cultures and PCR, although sensitive are either time-taking or expensive to guide management. Typhoid perforation can have vivid and atypical presentation depending on the number and site of perforation

Privilegiar la dignidad durante la muerte en unidades de cuidados intensivos. Perspectivas del personal de salud / Perspectives of the healthcare staff to privilige dignity in dying in the ICU

Los pacientes que ingresan a las Unidades de Cuidados Intensivos (UCI) no siempre evolucionan hacia la recuperación, lo que implica que el personal de la UCI tenga una visión holística para favorecer una "buena muerte" centrada en el acompañamiento familiar y la mitigación del sufrimiento. Objetivo: comprender el sentido otorgado por los profesionales de la salud de la UCI respecto a los cuidados del paciente al final de la vida y el apoyo a sus familiares. Metodología: estudio cualitativo descriptivo en dos UCI de Bogotá. La información se obtuvo con la técnica de grupos focales y se analizó siguiendo la propuesta de Taylor y Bogdan, adaptada por Amezcua y Hueso. Resultados: emergieron cuatro categorías: sentidos y significados del equipo interdisciplinario respecto a la muerte, comunicación al final de vida en la UCI, percepciones sobre muerte digna en la UCI y dilemas éticos respecto al manejo terapéutico al final de vida. Conclusiones: Para la atención del paciente crítico al final de la vida se debe garantizar comodidad, ausencia de dolor, acompañamiento familiar, bienestar espiritual, respeto por la voluntad del paciente y una buena comunicación que facilite la inclusión de los familiares en la toma de decisiones. Para mitigar la sobrecarga y el sufrimiento del personal de salud generado por la muerte y la toma de decisiones al final de vida, se sugiere formación y diseño de protocolos multidisciplinarios.

Patients admitted to the intensive care units (ICUs) do not always progress toward recovery. This implies that the ICU staff has a holistic vision centered in family reassurance and mitigation of suffering to favor a "good death". Objective: to understand the sense given to ICU healthcare professionals regarding end-of-life care to patients while providing emotional support to their relatives. Methodology: a qualitative descriptive study was conducted in two ICUs in Bogotá. Data capturing was based on focus group sessions and the Taylor and Bogdan methods adapted by Amezcua and Hueso were used for data analysis. Results: the following four analysis categories were identified: senses and meanings of the interdisciplinary team regarding death; communication at the end of life in the ICU; perceptions about dignity in dying in the ICU; and ethical dilemmas regarding therapeutic management at the end of life. Conclusions: critically ill patient care at the end of life includes ensuring comfort, absence of pain and family reassurance, spiritual well-being, respect for the will of patients and good communication facilitating involvement of relatives in end-of-life care decision making. We suggest training heath care staff and designing multidisciplinary protocols as a means to mitigate the overburden and suffering generated by death and end-of-life decision making.

Assessment of magnitude of physical activity among rural high school children of Nelamangala taluk, Bengaluru: a cross sectional study

Background: In India, more than two thirds of adolescents aged 11-17 years have insufficient physical activity. Though data on prevalence of physical activity among adolescents with reference to WHO criteria are available, very few studies have assessed the magnitude of physical activity. Hence, the study was conducted to assess the magnitude of physical activity among rural high school children of Nelamangala Taluk, Bengaluru.Methods: A cross sectional study was conducted among 200 high school students from 6 co-education schools. Magnitude of physical activity was assessed using physical activity questionnaire for adolescents (PAQ-A), a self-reported, validated questionnaire.Results: Mean age of the study participants was 14.35 years. 112 (56%) of them were female and 123 (61.5%) of them were studying in 10th standard. 100 (50%) of them were from government or aided school. Final Physical activity score of study participants was 2.39±0.64. There was a statistically significant difference (p<0.05) in the final physical activity score between males and females. Government or aided school participants had a better final score than those of private school and the difference was statistically significant. Final physical activity score decreased with their promotion to higher class. There was no significant difference between activity levels during physical education class across variables like sex, class studying and type of school.Conclusions: Physical activity was better among males, government school participants and those studying in lower class in comparison to their counterparts. Majority of this difference can be attributed to activities happening beyond the school hou

Dimensiones aórticas en deportistas de elite / Aortic Diameters in Elite Athletes

RESUMEN Introducción: Algunos autores sugieren que la dilatación aórtica forma parte del corazón de atleta. Las guías recientes proponen indexar los diámetros aórticos por superficie corporal (SC). En deportistas esta variable puede aumentar solo a expensas de la masa muscular y la indexación podría subestimar las dimensiones. El objetivo del estudio fue comparar los diámetros aórticos en jugadores de rugby de elite vs controles, evaluando distintas formas de cuantificación. Material y métodos: Se cuantificó mediante ecocardiografía el diámetro aórtico máximo (AoMax) y el diámetro máximo indexado a SC (AoSC). Se calculó en forma adicional el peso ideal esperado para cada individuo y se estableció el diámetro aórtico indexado por SC esperada (AoSCe). Se definió como dilatación un AoMax mayor que 40 mm o un AoSC/AoSCe mayor que 21 mm/m². Resultados: El AoMax fue mayor en deportistas (34,9 ± 2,6 vs 32,4 ± 2,9 mm; p < 0,01). Los atletas tuvieron una SC significativamente mayor y, en este contexto, presentaron menor AoSC (15,6 ± 1,2 vs 16,2 ± 1,6 mm/m2; p = 0,02). Al realizar el cálculo del peso ideal y comparar el AoSCe, no se observaron diferencias (16,6 ± 1,3 vs 16,3 ± 1,3 mm/m2; p = 0,2). El porcentaje de pacientes con AoMax mayor que 40 mm fue similar en controles y deportistas (2,3% y 1,7%; p = NS). Ningún paciente presentó diámetros indexados en rango patológico. Conclusiones: Los deportistas presentan mayores diámetros aórticos en términos absolutos, en contexto de una mayor SC. Debido al desarrollo muscular, la indexación por SC podría subestimar las dimensiones. El cálculo del AoSCe podría ser un parámetro útil. Las dimensiones aórticas en rango patológico deben ser consideradas anormales.

ABSTRACT Background: Some authors suggest that aortic dilatation is part of the athlete's heart. The recent guidelines recommend indexing aortic diameters by body surface area (BSA). This variable can be greater in athletes due to increased muscle mass, and indexing for this parameter might underestimate the measurements. Objective: The aim of this study was to compare aortic dimensions between elite rugby athletes and controls, evaluating different methods of quantification. Methods: Maximum aortic diameter (MAD) and maximum diameter indexed by BSA (MAD-BSA) were quantified by echocardiography. The expected ideal weight was calculated for each individual and MAD was indexed by the expected body surface area (eBSA). Aortic dilatation was defined as MAD >40 mm or MAD-BSA to MAD-eBSA ratio >21 mm/m2. Results: Maximum aortic diameter was greater in athletes (34.9±2.6 mm vs.32.4±2.9 mm; p <0.01). Body surface area was significantly increased in athletes and, in this setting, MAD-BSA was lower (15.6±1.2 mm/m2 vs. 16.2±1.6 mm/m2; p=0.02). After estimating the ideal weight, MAD-eBSA was not significantly different in both populations (16.3±1.3 mm/m2 vs. 16.6±1.3 mm/m2; p=0.2) The percentage of patients with MAD >40 mm was similar in controls and athletes (2.3% vs. 1.7%, respectively; p=NS). None of the patients presented indexed diameters above the normal ranges. Conclusions: Elite rugby players present larger maximum aortic diameters in absolute values in the context of greater BSA. Due to increased muscle mass, indexing by BSA could underestimate the measurements. The MAD-eBSA ratio could be a useful parameter. Aortic diameters above reference values should be considered abnormal.

Características clínicas y epidemiológicas de pacientes con paracoccidioidomicosis diagnosticados en un hospital de Resistencia, Chaco / Clinical and epidemiological characteristics of patients with paracoccidioidomycosis diagnosed in a hospital of Resistencia, Chaco

Con el objetivo de describir las características clínico-epidemiológicas de la paracoccidioidomicosis, se realizó un estudio descriptivo de los casos diagnosticados por el Servicio de Microbiología Clínica del hospital de adultos Dr. Julio C. Perrando, de la ciudad de Resistencia (Chaco, Argentina). Entre 2011 y 2014 se detectaron 46 casos. En 2013 y 2014 se constató un incremento de la tasa de incidencia de alrededor de 4 veces con respecto a los anos anteriores. La forma crónica fue la predominante, con una media de edad de los pacientes de 53 anos. Del total de ellos, a 39 se les realizaron pruebas serológicas. En 15 de 39 casos, las pruebas serológicas fueron la única herramienta diagnóstica, mientras que en 4 de estos casos con diagnóstico microbiológico, la prueba resultó no reactiva. La inclusión de la paracoccidioidomicosis en el diagnóstico diferencial de pacientes de áreas endémicas que presentan un síndrome infeccioso inespecífico y la aplicación de las herramientas diagnósticas disponibles contribuyen al diagnóstico oportuno, así como a disminuir las secuelas de esta afección y su impacto socioeconómico.

In order to describe the clinical and epidemiological characteristics of paracoccidioidomycosis, a descriptive study of all the cases diagnosed by the Clinical Microbiology Service at Dr. Julio C. Perrando hospital in the city of Resistencia (Chaco Province, Argentina) was conducted. Between 2011 and 2014, 46 cases were detected. In the period 2013-2014, an almost 4-fold increase in the incidence rate was detected. The chronic form of the disease was predominant with an average age of 53 years. Serological tests in 39 out of 46 patients were performed. In 15 of 39 patients, serological tests were the only diagnostic tool while in 4 patients with a microbiological diagnosis serological tests were non-reactive. In patients from endemic areas with non-specific infectious syndrome it is important to include paracoccidioidomycosis in the differential diagnosis and to apply all available diagnostic tools to reach a timely diagnosis and to reduce the long-term sequelae and their socio-economic impact.

Resistencia a los β -lactámicos en enterococos / Resistance to β-lactams in enterococci

Enterococci are intrinsically resistant to several antimicrobial classes and show a great ability to acquire new mechanisms of resistance. Resistance to β-lactam antibiotics is a major concern because these drugs either alone or in combination are commonly used for the treatment of enterococcal infections. Ampicillin resistance, which is rare in Enterococcus faecium occurs in most of the hospital-associated Enterococcus faecium isolates. High-level resistance to ampicillin in E. faecium is mainly due to the enhanced production of PBP5 and/or by polymorphisms in the beta subunit of this protein. The dissemination of high-level ampicillin resistance can be the result of both clonal spread of strains with mutated pbp5 genes and resistance horizontal gene transfer.

Los enterococos son intrínsecamente resistentes a varias clases de antimicrobianos y presentan una gran capacidad para adquirir mecanismos de resistencia. La resistencia a los antibióticos p-lactámicos es preocupante porque estos fármacos solos o combinados se usan comúnmente para el tratamiento de las infecciones enterocócicas. La mayoría de los aislamientos hospitalarios de Enterococcus faecium presentan resistencia a la ampicilina, la cual es rara en Enterococcus faecalis. El alto nivel de resistencia a la ampicilina en E. faecium se debe principalmente a la hiperproducción de PBP5 y/o a polimorfismos en la subunidad beta de esta proteína. La propagación de esta resistencia puede deberse tanto a la diseminación clonal de cepas con genes pbp5 mutados como a la transferencia horizontal de genes.

Prevalence of social anxiety disorder and its determinants among undergraduate medical students of East Delhi

Background: Social anxiety disorder (SAD) is a persistent fear of situations where a person is exposed to a possibility of being under scrutiny. This may lead to decreased academic performance which in turn can lead to depression and suicidal tendencies. Thus, medical students are more vulnerable since they are subjected to stress and academic pressure. The objective of the study was to find out the prevalence and determinants of SAD among medical undergraduate students.Methods: This was a cross-sectional descriptive study done among 404 undergraduate students of a Medical College in east Delhi. Data was collected using a questionnaire containing sociodemographic details and Social interaction anxiety scale (SIAS). Data analysis was done by MS Excel and SPSS 20.0 using frequencies, chi squared test and multiple logistic regression.Results: The mean age of the participants was 20.7 years with 75% males and two-third belonging to upper class. It was found that 12.62% of the study participants were having social phobia and 5.95% were having social anxiety. The determinants found to be significant by univariate analysis were language barrier, body image perception, facial appearance perception and academic performance satisfaction. However, after applying multiple logistic regression it was found out that language barrier (OR-4.36, 95% CI=1.567-12.165, p=0.005) and facial appearance perception (OR-2.98, 95% CI=1.206-7.375, p=0.018) were the main determinants of SAD.Conclusions: Early detection and appropriate intervention needs to be done among the students as they are the most vulnerable and most malleable.

Efeito do ômega 3 e da vitamina B12 no espermograma, na histomorfometria dos órgãos reprodutivos e nas temperaturas do corpo com termografia infravermelha em ratos Wistar / Effect of Omega 3 and Vitamin B12 on the spermogram, histomorphometry of the reproductive organs and body temperatures with infrared thermography in Wistar rats

Objetivou-se estudar o efeito do ômega 3 e da vitamina B12 no espermograma, na histomorfometria dos órgãos reprodutivos e na temperaturas do corpo com termografia infravermelha em ratos Wistar. Utilizaram-se 16 ratos, em quatro grupos (n=4), que receberam injeções diárias por 30 dias, sendo: grupo controle - solução salina; grupo ômega 3 - óleo de peixe 1g/kg; grupo B12 - vitamina B12 3µg; e grupo ômega 3 + B12 - óleo de peixe 1g/kg e vitamina B12 3µg. Imagens termográficas de áreas do corpo foram obtidas. No 30º dia, os ratos foram sacrificados e realizaram-se as análises de morfologia espermática e histomorfometria. Os dados foram submetidos à análise de variância e ao teste de Tukey a 5%. A temperatura da superfície do escroto foi superior no grupo B12 (P<0,05). Não houve diferenças entre grupos (P>0,05) para temperaturas do globo ocular. Houve correlação entre temperatura da superfície do escroto e porcentagem de gota citoplasmática distal (P=0,678). A elevação da temperatura do escroto resulta no aumento da porcentagem de gotas citoplasmáticas distais. A temperatura do globo ocular não sofre influência significativa do ômega 3 e da vitamina B12. O ômega 3 reduz o epitélio seminífero, e a vitamina B12 minimiza esse efeito.(AU)

The objective of this study was to study the effect of Omega 3 and vitamin B12 on spermogram, histomorphometry of reproductive organs and body temperature with infrared thermography in Wistar rats. Sixteen rats were used in four groups (n= 4) who received daily injections for 30 days. Control Group - saline solution; Group Omega 3 - fish oil 1g/kg; Group B12 - vitamin B12 3μg and Group Omega 3 + B12 - fish oil 1g/kg and vitamin B12 3μg. Thermographic images of body were obtained. On the 30th day the rats were sacrificed and analyzes of sperm morphology and histomorphometry were performed. Data were submitted to analysis of variance and Tukey's test at 5%. The surface temperature of the scrotum was higher in group B12 (P< 0.05). There were no differences between groups (P> 0.05) for eyeball temperatures. There was a correlation between scrotal temperature and distal cytoplasmic droplet (P= 0.678). Elevation of scrotum temperature results in an increase in the percentage of distal cytoplasmic droplets. The temperature of the eyeball is not significantly influenced by Omega 3 and vitamin B12. Omega 3 reduces the seminiferous epithelium and vitamin B12 minimizes this effect.(AU)