Comorbidity patterns and mortality among hospitalized patients with psychiatric disorders and COVID-19

Objectives: To examine the association between psychiatric and non-psychiatric comorbidity and 28-day mortality among patients with psychiatric disorders and COVID-19. Methods: Multicenter observational retrospective cohort study of adult patients with psychiatric disorders hospitalized with laboratory-confirmed COVID-19 at 36 Greater Paris university hospitals (January 2020-May 2021) (n=3,768). First, we searched for different subgroups of patients according to their psychiatric and non-psychiatric comorbidities through cluster analysis. Next, we compared 28-day all-cause mortality rates across the identified clusters, while taking into account sex, age, and the number of medical conditions. Results: We found five clusters of patients with distinct psychiatric and non-psychiatric comorbidity patterns. Twenty-eight-day mortality in the cluster of patients with mood disorders was significantly lower than in other clusters. There were no significant differences in mortality across other clusters. Conclusion: All psychiatric and non-psychiatric conditions may be associated with increased mortality in patients with psychiatric disorders and COVID-19. The lower risk of death among patients with mood disorders might be in line with the potential beneficial effect of certain antidepressants in COVID-19, but requires further research. These findings may help identify at-risk patients with psychiatric disorders who should benefit from vaccine booster prioritization and other prevention measures.

Contribution to the knowledge of cladocerans fauna (Crustacea, Branchiopoda) from La Española lagoon, Colombia

Thirty-five cladocerans species are recorded from La Española lagoon in the Orinoquia region of Colombia; all are new records for Meta Department and 10 for Colombia. With the addition of these new reports, the total number of cladocerans for Colombia and the Meta department is increased by 124 and 38 species, respectively. The cladoceran fauna from the surveyed area is represented mainly by widespread species, commonly found in the Neotropical regions, but local morphological data are scarce in the regional literature. Brief diagnostic description of 18 species of cladoceran fauna recorded of the Meta department-Colombia are provided together with illustrations of taxonomically significant appendages, morphological remarks, notes on the variability of some species, and their distribution.

Se registran treinta y cinco especies de cladóceros de la laguna La Española en la región de la Orinoquia de Colombia; todos ellos son nuevos registros para el Departamento del Meta y 10 para Colombia. Con la incorporación de estos nuevos reportes, el número total de cladóceros para Colombia y el departamento del Meta se incrementa en 124 y 38 especies respectivamente. La fauna de cladóceros del área estudiada está representada principalmente por especies de amplia distribución y que se encuentran comúnmente en las regiones Neotropicales, pero los datos morfológicos locales son escasos en la literatura regional. Se proporcionan breves descripciones diagnosticas de 18 especies registradas para la fauna de cladóceros del departamento del Meta-Colombia, junto con ilustraciones de apéndices taxonómicamente significativos, comentarios morfológicos, notas sobre la variabilidad de algunas especies y su distribución.

An application of cognitive diagnostic models in the evaluation of reading comprehension in Chilean university students

Introduction: Reading Comprehension skills are fundamental to the academic performance of university students. These abilities are not innate; therefore, systematic training is required before entering university. The main objective of this study was to evaluate the reading comprehension skills of Chilean University Students. Method: A sample of 579 students participated in the study, responding to four texts that comprise the Reading Comprehension Strategies for University Students (ELCU). An automated platform was used to apply and correct the test with immediate results and feedback. The tool allowed the use of a broad and representative sample of the various regions of Chile. The ELCU was developed using a cognitive diagnostic assessment (CDA) considering cognitive, metacognitive and linguistic strategies. The ana-lyses were performed using two different approaches: The Linear Logistic Test Model (LLTM) and the deterministic inputs, noisy "and" gate (DINA) model. Results: The rejection of the LLTM implies that the strategies do not differ in cognitive complexity (difficulty) while the adequate goodness of fit to the DINA model allows to characterise the students according to their reading abilities. Conclusion: The ELCU test provides reliable and valid information on the reading comprehension ability and metacognitive awareness of university students.

Introducción: Las habilidades de comprensión lectora son fundamentales para el rendimiento académico de los estudiantes universitarios. Estas habilidades no son innatas; por tanto, se requiere una formación sistemática antes de ingresar a la universidad. El objetivo principal de este artículo fue evaluar las habilidades de comprensión lectora de estudiantes universitarios chilenos. Método: En el estudio participó una muestra de 579 estudiantes que respondieron cuatro textos que componen las Estrategias de Comprensión Lectora para Estudiantes Universitarios (ELCU). Se utilizó una plataforma automatizada para aplicar y corregir la prueba con resultados y retroalimentación inmediatos. La herramienta permitió utilizar una muestra amplia y representativa de las distintas regiones de Chile. ELCU fue desarrollado mediante evaluación diagnóstica cognitiva (CDA) considerando estrategias cognitivas, metacognitivas y lingüísticas. Los análisis se realizaron mediante dos aproximaciones diferentes: The Linear Logistic Test Model (LLTM) y the Deterministic Inputs, Noisy "and" Gate (DINA) model. Resultados: El rechazo al modelo LLTM implica que las estrategias no difieren en complejidad cognitiva mientras que la adecuada bondad de ajuste al modelo DINA permiten caracterizar a los estudiantes según sus habilidades lectoras. Conclusión: La prueba ELCU permite obtener información confiable y válida sobre la capacidad de comprensión lectora y la conciencia metacognitiva de los estudiantes universitarios.

Importance of Confirmatory Tests for Sars-Cov-2 Infection in Hemodialysis Patients: A Multicenter Mexican Registry

Abstract Background: Since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, patients with chronic kidney disease vulnerable to suffering more severe COVID-19 disease and worse outcomes have been identified Objectives: Our study's aim was to determine the incidence, characteristics, and outcomes of SARS-CoV-2 infection in patients of hemodialysis (HD) units in Mexico and to describe the availability of confirmatory testing Methods: This study was multicentric study of 19 HD units, conducted between March 2020 and March 2021 Results: From a total of 5779 patients, 955 (16.5%) cases of suspicious COVID-19 were detected; a SARS-CoV-2 reverse transcription polymerase chain reaction test was done in only 50.6% of patients. Forty-five percentages were hospitalized and 6% required invasive mechanical ventilation (IMV). There was no significant difference in mortality between confirmed (131/483) and suspicious (124/472) cases (p = 0.74). The percentage of patients in need of hospitalization, IMV, and deceased was greater than in the rest of the study population Conclusions: The study revealed that 49.4% of the cases were not confirmed, a worrisome observation given that this is a highly vulnerable population (higher probability of contagion and worse outcomes), in which 100% of patients should have a confirmatory test

Do Dipteryx alata Vogel seedlings recover the quality and the photosynthetic and antioxidant responses in the post-flooding? / Mudas de Dipteryx alata Vogel recuperam a qualidade e as respostas fotossintéticas e antioxidantes no pós-alagamento?

Dipteryx alata Vogel is a tree species widely found in Cerrado, settling preferentially in well drained soils. Studies related to ecophysiology of D. alata may contribute to the decision making about using seedlings of this species in projects aimed at the recovery of degraded areas where seasonal flooding happens. This study aimed to assess the effects of flooding on photosynthetic and antioxidant metabolism and quality of D. alata seedlings cultivated or not under flooding during four assessment periods (0, 20, 40, and 60 days), followed by 100 days after the end of each assessment period (0+100, 20+100, 40+100, and 60+100 days), allowing verifying the potential for post-flooding recovery. Flooded plants showed lower photosynthetic efficiency than non-flooded plants, regardless of the periods of exposure. However, this efficiency was recovered in the post-flooding, with values similar to that of the non-flooded seedlings. Moreover, the damage to FV/FM was evidenced by an increase in the period of exposure to flooding, but recovery was also observed at this stage of the photosynthetic metabolism. Seedling quality decreased under flooding, not varying between periods of exposure, but remained lower although the increase observed in the post-flooding period, with no recovery after flooding. The occurrence of hypertrophied lenticels associated with physiological changes and an efficient antioxidant enzyme system might have contributed to the survival and recovery of these seedlings. Thus, this species is sensitive to flooding stress but capable of adjusting and recovering metabolic characteristics at 100 days after the suspension of the water stress, but with no recovery in seedling quality. Thus, we suggested plasticity under the cultivation condition and determined that the time of 100 days is not enough for the complete resumption of growth.

Dipteryx alata Vogel é uma arbórea de ampla ocorrência no Cerrado, se estabelecendo preferencialmente em solos bem drenados. Estudos referentes à ecofisiologia de D. alata em podem contribuir para a tomada de decisão sobre o uso de mudas dessa espécie em programas de recuperação de áreas degradadas sujeitas a alagamento temporário. Objetivamos com essa pesquisa avaliar os efeitos do alagamento no metabolismo fotossintético e antioxidante, além da qualidade de mudas dessa espécie, cultivadas ou não sob alagamento durante quatro períodos de avaliação (0, 20, 40 e 60 dias) seguidos de 100 dias após o término de cada período (0+100, 20+100, 40+100, 60+100 dias), possibilitando verificar o potencial de recuperação pós-alagamento. Observamos que as plantas alagadas apresentaram menor eficiência fotossintética e danos em FV/FM entretanto houve recuperação dessas características no pós alagamento. A qualidade das mudas reduziu sob alagamento não variando entre os períodos de exposição e embora tenha aumentado no pós-alagamento manteve-se menor não se recuperando. A ocorrência de lenticelas hipertrofiadas associadas a alterações fisiológicas e um eficiente sistema enzimático antioxidante devem ter contribuído para a sobrevivência e recuperação metabólica dessas mudas. Diante disso, sugerimos que a espécie é sensível ao estresse por alagamento, mas capaz de se ajustar e recuperar as características metabólicas 100 dias após a suspensão deste estresse hídrico, no entanto a qualidade da mudas não apresentou recuperação, assim, sugerimos plasticidade diante da condição de cultivo e ressaltamos que o tempo de 100 dias não é suficiente para a completa retomada do crescimento.

Do Dipteryx alata Vogel seedlings recover the quality and the photosynthetic and antioxidant responses in the post-flooding?

Abstract Dipteryx alata Vogel is a tree species widely found in Cerrado, settling preferentially in well drained soils. Studies related to ecophysiology of D. alata may contribute to the decision making about using seedlings of this species in projects aimed at the recovery of degraded areas where seasonal flooding happens. This study aimed to assess the effects of flooding on photosynthetic and antioxidant metabolism and quality of D. alata seedlings cultivated or not under flooding during four assessment periods (0, 20, 40, and 60 days), followed by 100 days after the end of each assessment period (0+100, 20+100, 40+100, and 60+100 days), allowing verifying the potential for post-flooding recovery. Flooded plants showed lower photosynthetic efficiency than non-flooded plants, regardless of the periods of exposure. However, this efficiency was recovered in the post-flooding, with values similar to that of the non-flooded seedlings. Moreover, the damage to FV/FM was evidenced by an increase in the period of exposure to flooding, but recovery was also observed at this stage of the photosynthetic metabolism. Seedling quality decreased under flooding, not varying between periods of exposure, but remained lower although the increase observed in the post-flooding period, with no recovery after flooding. The occurrence of hypertrophied lenticels associated with physiological changes and an efficient antioxidant enzyme system might have contributed to the survival and recovery of these seedlings. Thus, this species is sensitive to flooding stress but capable of adjusting and recovering metabolic characteristics at 100 days after the suspension of the water stress, but with no recovery in seedling quality. Thus, we suggested plasticity under the cultivation condition and determined that the time of 100 days is not enough for the complete resumption of growth.

Resumo Dipteryx alata Vogel é uma arbórea de ampla ocorrência no Cerrado, se estabelecendo preferencialmente em solos bem drenados. Estudos referentes à ecofisiologia de D. alata em podem contribuir para a tomada de decisão sobre o uso de mudas dessa espécie em programas de recuperação de áreas degradadas sujeitas a alagamento temporário. Objetivamos com essa pesquisa avaliar os efeitos do alagamento no metabolismo fotossintético e antioxidante, além da qualidade de mudas dessa espécie, cultivadas ou não sob alagamento durante quatro períodos de avaliação (0, 20, 40 e 60 dias) seguidos de 100 dias após o término de cada período (0+100, 20+100, 40+100, 60+100 dias), possibilitando verificar o potencial de recuperação pós-alagamento. Observamos que as plantas alagadas apresentaram menor eficiência fotossintética e danos em FV/FM entretanto houve recuperação dessas características no pós alagamento. A qualidade das mudas reduziu sob alagamento não variando entre os períodos de exposição e embora tenha aumentado no pós-alagamento manteve-se menor não se recuperando. A ocorrência de lenticelas hipertrofiadas associadas a alterações fisiológicas e um eficiente sistema enzimático antioxidante devem ter contribuído para a sobrevivência e recuperação metabólica dessas mudas. Diante disso, sugerimos que a espécie é sensível ao estresse por alagamento, mas capaz de se ajustar e recuperar as características metabólicas 100 dias após a suspensão deste estresse hídrico, no entanto a qualidade da mudas não apresentou recuperação, assim, sugerimos plasticidade diante da condição de cultivo e ressaltamos que o tempo de 100 dias não é suficiente para a completa retomada do crescimento.

Do Dipteryx alata Vogel seedlings recover the quality and the photosynthetic and antioxidant responses in the post-flooding? / Mudas de Dipteryx alata Vogel recuperam a qualidade e as respostas fotossintéticas e antioxidantes no pós-alagamento?

Abstract Dipteryx alata Vogel is a tree species widely found in Cerrado, settling preferentially in well drained soils. Studies related to ecophysiology of D. alata may contribute to the decision making about using seedlings of this species in projects aimed at the recovery of degraded areas where seasonal flooding happens. This study aimed to assess the effects of flooding on photosynthetic and antioxidant metabolism and quality of D. alata seedlings cultivated or not under flooding during four assessment periods (0, 20, 40, and 60 days), followed by 100 days after the end of each assessment period (0+100, 20+100, 40+100, and 60+100 days), allowing verifying the potential for post-flooding recovery. Flooded plants showed lower photosynthetic efficiency than non-flooded plants, regardless of the periods of exposure. However, this efficiency was recovered in the post-flooding, with values similar to that of the non-flooded seedlings. Moreover, the damage to FV/FM was evidenced by an increase in the period of exposure to flooding, but recovery was also observed at this stage of the photosynthetic metabolism. Seedling quality decreased under flooding, not varying between periods of exposure, but remained lower although the increase observed in the post-flooding period, with no recovery after flooding. The occurrence of hypertrophied lenticels associated with physiological changes and an efficient antioxidant enzyme system might have contributed to the survival and recovery of these seedlings. Thus, this species is sensitive to flooding stress but capable of adjusting and recovering metabolic characteristics at 100 days after the suspension of the water stress, but with no recovery in seedling quality. Thus, we suggested plasticity under the cultivation condition and determined that the time of 100 days is not enough for the complete resumption of growth.

Resumo Dipteryx alata Vogel é uma arbórea de ampla ocorrência no Cerrado, se estabelecendo preferencialmente em solos bem drenados. Estudos referentes à ecofisiologia de D. alata em podem contribuir para a tomada de decisão sobre o uso de mudas dessa espécie em programas de recuperação de áreas degradadas sujeitas a alagamento temporário. Objetivamos com essa pesquisa avaliar os efeitos do alagamento no metabolismo fotossintético e antioxidante, além da qualidade de mudas dessa espécie, cultivadas ou não sob alagamento durante quatro períodos de avaliação (0, 20, 40 e 60 dias) seguidos de 100 dias após o término de cada período (0+100, 20+100, 40+100, 60+100 dias), possibilitando verificar o potencial de recuperação pós-alagamento. Observamos que as plantas alagadas apresentaram menor eficiência fotossintética e danos em FV/FM entretanto houve recuperação dessas características no pós alagamento. A qualidade das mudas reduziu sob alagamento não variando entre os períodos de exposição e embora tenha aumentado no pós-alagamento manteve-se menor não se recuperando. A ocorrência de lenticelas hipertrofiadas associadas a alterações fisiológicas e um eficiente sistema enzimático antioxidante devem ter contribuído para a sobrevivência e recuperação metabólica dessas mudas. Diante disso, sugerimos que a espécie é sensível ao estresse por alagamento, mas capaz de se ajustar e recuperar as características metabólicas 100 dias após a suspensão deste estresse hídrico, no entanto a qualidade da mudas não apresentou recuperação, assim, sugerimos plasticidade diante da condição de cultivo e ressaltamos que o tempo de 100 dias não é suficiente para a completa retomada do crescimento.

Subclavian-Brachial Bypass for Chronic Limb Threatening Ischemia Associated with an Old Motorcycle Accident

Chronic limb-threatening ischemia is rarely associated with previous traumatic injury. We present a case of a 28-year-old male with progressive digit ulcers, a weak pulse, cyanosis, and a cold limb. Eight months prior, he had a motorcycle accident resulting in a right clavicle fracture and brachial plexus injury. Computed tomography angiography revealed occlusion of the right subclavian artery near a surgically implanted reduction plate. The patient underwent an open subclavianbrachial bypass with a reversed saphenous vein graft. His postoperative recovery was uneventful. After 3 months, he had a euthermic right hand with a palpable pulse and his ulcers had completely healed. This case reinforces the need for patients with a neurological deficit in the upper extremity caused by blunt trauma to undergo thorough vascular examination to identify potential arterial injury and compromised perfusion.

Root resorption pattern in panoramic radiographs of pediatric patients with unilateral posterior crossbite: a cross-sectional and retrospective study / Patrón de reabsorción radicular en radiografías panorámicas de pacientes pediátricos con mordida cruzada posterior unilateral: estudio transversal y retrospectivo

SUMMARY: temporary mandibular molars in panoramic radiographs of pediatric patients with unilateral posterior crossbite (UPCB). This cross-sectional and retrospective study analyzed 114 orthopantomograms of patients between 6 - 9 years of age with unilateral posterior crossbite diagnosis. The first and second mandibular molars were analyzed. Their root resorption stage was typified, and the root lengths were measured; to later compare the data obtained depending on the malocclusion side. 86.4 % of molars showed a linear resorption pattern, and atypical resorption prevalence in patients with UPCB was 13.5 %. The total length average of the first molars on the side of the malocclusion was 8.20 mm, while the contralateral exhibited a mean of 9.29 mm. Lastly, the second molars had a mean length of 11.12 mm in crossbite side and 12.30 mm in the normal occlusion side. UPCB could affect physiological resorption by observing a resorption alteration in those mandibular molars located on the malocclusion side.

RESUMEN: El trabajo de este estudio se realizó en molares mandibulares temporales en radiografías panorámicas de pacientes pediátricos con mordida cruzada posterior unilateral (MCPU). Este estudio transversal y retrospectivo analizó 114 ortopantomografías de pacientes entre 6 - 9 años de edad con diagnóstico de mordida cruzada posterior unilateral. Se analizaron los primeros y segundos molares mandibulares. Se tipificó su estado de reabsorción radicular y se midió la longitud de las raíces; para luego comparar los datos obtenidos según el lado de la maloclusión. El 86,4 % de los molares mostró un patrón de reabsorción lineal y la prevalencia de reabsorción atípica en pacientes con MCPU fue del 13,5 %. El promedio de longitud total de los primeros molares del lado de la maloclusión fue de 8,20 mm, mientras que el contralateral exhibió una media de 9,29 mm. Por último, los segundos molares tenían una longitud media de 11,12 mm en el lado de mordida cruzada y de 12,30 mm en el lado de oclusión normal. La MCPU podría afectar la reabsorción fisiológica al observar una alteración de la reabsorción en aquellos molares mandibulares ubicados en el lado de la maloclusión.

Co-relationship between Escherichia coli in broiler cellulitis and liver lesions / Correlação entre a presença de Escherichia coli em lesões de celulite e fígados de frango

Abstract Pathogenic strains of Escherichia coli may invade the subcutaneous tissue of poultry and cause cellulitis, whilst the pathogen may also cause lesions in internal organs such as the liver. Current paper co-relates Escherichia coli and virulence genes characteristic of Avian Pathogenic Escherichia coli (APEC) in broilers´ cellulitis and liver lesions. One hundred carcasses were retrieved from the production chain in an avian abattoir in the state of Bahia, Brazil, between August 2013 and January 2014, due to detection of cellulitis lesions. Cellulitis and liver samples were retrieved aseptically to quantify E. coli by Petrifilm™ count fast method (3M Company) (AOAC 998.8). Virulent genes iss and iutA were removed from E. coli isolates by Polymerase Chain Reaction (PCR). Escherichia coli was isolated from 82.0% of broilers removed from the production chain and the bacterium was concomitantly detected in cellulitis and liver lesions in 40.0% of broilers. E. coli counts ranged between 1.00 and 4.73 log CFU/g in liver lesions and between 2.00 and 9.00 log UFC/g in cellulitis lesions. Virulent genes iutA and iss were detected in 97.56% and 89.02% of E. coli isolates, respectively. Genotype analysis demonstrated the concomitant amplification of genes iutA and iss in 60.0% (n=40) of samples of cellulitis and liver lesions in which the simultaneous isolation of E. coli occurred. There was a positive and significant co-relationship (r=0.22; p<0.05) between the variables occurrence of E. coli isolated from liver samples and the occurrence of E. coli isolated from cellulitis lesions. There were also positive and significant co-relationships between populations of E. coli from liver isolates and cellulitis lesions (r=0.46; p<0.05) when E. coli isolated in the liver and in cellulitis lesions was detected. Since results showed a relationship between E. coli in cellulitis and liver lesions and possible systemic infection, the occurrence of cellulitis lesions as a criterion for total discarding of carcass may be suggested.

Resumo Cepas patogênicas de Escherichia coli podem invadir o tecido subcutâneo das aves e provocar celulite aviária e este patógeno pode provocar lesões nos órgãos internos, como o fígado. Desta forma, objetivou-se correlacionar a presença de Escherichia coli e os genes de virulência característicos de Escherichia coli Patogênica para Aves (APEC) nas lesões de celulite e nos fígados dos frangos. Entre agosto de 2013 a janeiro de 2014, foram retiradas 100 carcaças da linha de produção por apresentarem lesões de celulite em um matadouro avícola da Bahia (Brasil). Foram coletadas amostras de celulite e fígados de frango assepticamente para quantificação de E. coli pelo método rápido de contagem Petrifilm™ (3M Company) (AOAC 998.8). Em seguida foi realizada a pesquisa dos genes de virulência iss e iutA nos isolados de E. coli utilizando a Reação em Cadeia da Polimerase (PCR). Escherichia coli foi isolada em 82,00% das aves retiradas da linha de produção e a bactéria foi detectada concomitantemente nas lesões de celulite e fígado em 40,00% das aves. As contagens de E. coli variaram de 1,00 a 4,73 log UFC/g nos fígados e de 2,00 a 9,00 log UFC/g nas lesões de celulite. Os genes de virulência iutA e iss foram encontrados em 97,56% e 89,02% dos isolados de E. coli, respectivamente. A análise genotípica revelou a amplificação concomitante dos genes iutA e iss em 60,00% (n=40) das amostras de lesões de celulite e fígado nas quais houve o isolamento simultâneo de E. coli. Foi observada correlação positiva e significativa (r=0,22; p<0,05) entre as variáveis ocorrência de E. coli isolada das amostras dos fígados e ocorrência E. coli isolada das lesões de celulite e, nos casos em que foi detectada a ocorrência de E. coli isolada em fígado e lesões de celulite, correlações positivas e significativas também foram evidenciadas entre as populações de E. coli dos isolados dos fígados e das lesões de celulite, (r=0,46; p<0,05). Assim ficou evidenciada a relação entre E. coli presente nas lesões de celulite e no fígado e uma possível infecção sistêmica, desta forma, sugere-se que a presença de lesões de celulite seja utilizada como critério para o descarte total da carcaça.

Incidence of thyroid diseases: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

ABSTRACT Objective: To evaluate incidence of subclinical and overt hyperthyroidism and hypothyroidism. Subjects and methods: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study of 15,105 civil servants, examined at baseline and over a 4-year follow-up. This analysis included 9,705 participants with normal thyroid function at baseline, follow-up information about thyroid function and with no report of using drugs that may interfere in the thyroid function. Thyroid function was defined by TSH/FT4 levels or routine use of thyroid hormones/anti-thyroid medications. Annual and cumulative (over 4-year) incidence rates were presented as percentages (95% Confidence Intervals). Results: The incidence of all overt and subclinical thyroid disease was 6.7% (1.73%/year): 0.19% for overt hyperthyroidism (0.048%/year), 0.54% for subclinical hyperthyroidism (0.14%/year), 1.98% for overt hypothyroidism (0.51%/year), and 3.99% for subclinical hypothyroidism (1.03%/year). The incidence of all thyroid diseases was higher in women, when compared to men, with a low women:men ratio (1.36). For Blacks the highest incidence was for overt hyperthyroidism, while for Whites, the highest incidence was for overt hypothyroidism. However, the highest incidence of overt hyperthyroidism was detected in Asian descendants. The presence of antithyroperoxidase antibodies at baseline was associated with higher incidence of overt thyroid diseases. Conclusion: These results showed a high incidence of hypothyroidism, which is compatible with a country with a more-than-adequate iodine intake. The low women:men ratio of the incidence of thyroid dysfunction highlights the importance of the diagnosis of thyroid diseases among men in Brazil.

Actitudes y conocimientos sobre la pandemia por la COVID-19 en docentes de Canarias / Teachers' attitudes and knowledge about the COVID-19 pandemic in the Canary Islands

RESUMEN Con el objetivo de estudiar las actitudes y conocimientos sobre la pandemia por la COVID-19 en el personal docente de la región de Canarias en España, se realizó un estudio transversal entre el 14 y el 18 de mayo de 2020, mediante la aplicación de un cuestionario virtual basado en un instrumento validado. Se incluyeron 1503 encuestas, en donde se describe que el personal docente no está dispuesto a trabajar si existe riesgo de infectarse en el centro educativo (76,6%). No obstante, afirman que acudiría a trabajar si dispusieran de las medidas higiénicas (69,2%) y de protección adecuadas (67,0%). En conclusión, resulta pertinente garantizar las medidas preventivas necesarias para evitar el contagio en los centros educativos, propiciando la formación específica de los docentes en prevención primaria.

ABSTRACT A cross-sectional study was carried out to determine the teachers' attitudes and knowledge about the COVID-19 pandemic in the Canary Islands region in Spain, between May 14 - 18, 2020. A virtual questionnaire based on a validated instrument was applied. We included 1,503 surveys, which showed that teachers are unwilling to work if there is risk of infection at the school (76.6%). However, they state that they would go to work if they had the appropriate hygiene (69.2%) and protection (67.0%) measures. In conclusion, it is important to guarantee the necessary preventive measures to avoid contagion in educational centers, promoting specific training of teachers in primary prevention.

Actitudes y conocimientos sobre la pandemia por la COVID-19 en docentes de Canarias / Teachers' attitudes and knowledge about the COVID-19 pandemic in the Canary Islands

RESUMEN Con el objetivo de estudiar las actitudes y conocimientos sobre la pandemia por la COVID-19 en el personal docente de la región de Canarias en España, se realizó un estudio transversal entre el 14 y el 18 de mayo de 2020, mediante la aplicación de un cuestionario virtual basado en un instrumento validado. Se incluyeron 1503 encuestas, en donde se describe que el personal docente no está dispuesto a trabajar si existe riesgo de infectarse en el centro educativo (76,6%). No obstante, afirman que acudiría a trabajar si dispusieran de las medidas higiénicas (69,2%) y de protección adecuadas (67,0%). En conclusión, resulta pertinente garantizar las medidas preventivas necesarias para evitar el contagio en los centros educativos, propiciando la formación específica de los docentes en prevención primaria.

ABSTRACT A cross-sectional study was carried out to determine the teachers' attitudes and knowledge about the COVID-19 pandemic in the Canary Islands region in Spain, between May 14 - 18, 2020. A virtual questionnaire based on a validated instrument was applied. We included 1,503 surveys, which showed that teachers are unwilling to work if there is risk of infection at the school (76.6%). However, they state that they would go to work if they had the appropriate hygiene (69.2%) and protection (67.0%) measures. In conclusion, it is important to guarantee the necessary preventive measures to avoid contagion in educational centers, promoting specific training of teachers in primary prevention.

Síndrome de hipertermia maligna: una patología infrecuente / Malignant hyperthermia syndrome: A rare entity

Resumen Introducción: El síndrome de hipertermia maligna es un trastorno farmacogenético del músculo esquelético de carácter hereditario, que se caracteriza por un estado hipermetabólico relacionado con la exposición a anestésicos inhalatorios o relajantes musculares despolarizantes. Se trata de una afección infrecuente en individuos genéticamente predispuestos, con una incidencia muy baja en pediatría (1 de cada 10,000-15,000 procedimientos anestésicos). Caso clínico: Se presenta un caso de hipertermia maligna relacionado con la exposición a sevoflurano durante una cirugía de adenoidectomía en un paciente de sexo femenino de 6 años de edad. La paciente presentó taquicardia, hipercapnia e hipertermia, que precisaron la administración de dos dosis sucesivas de dantroleno sódico. La evolución posterior fue buena. Conclusiones: El síndrome de hipertermia maligna es un cuadro poco frecuente en la edad pediátrica. Se debe sospechar de forma precoz, ya que es fundamental su detección temprana para iniciar el tratamiento.

Abstract Background: Malignant hyperthermia syndrome is a hereditary pharmacogenetic disorder of skeletal muscle characterized by hypermetabolic state related to the exposure of volatile anesthetic gases or depolarizing muscle relaxants. It is an infrequent entity that occurs in genetically predisposed individuals, with a very low incidence in pediatrics (1 in 10,000-15,000 anesthetic procedures). Case report: We report a case of malignant hyperthermia related to exposure to sevoflurane during adenoidectomy surgery in a 6-year-old female. The patient presented with tachycardia, hypercapnia, and hyperthermia, requiring two successive doses of dantrolene sodium administration, with an adequate response to the treatment. Conclusions: Malignant hyperthermia syndrome is a rare condition in pediatric patients that should be detected in early stages since it is essential to initiate the treatment as soon as possible.

Infusão de morfina e cetamina, associada ou não à lidocaína, em gatas submetidas à ovariossalpingo-histerectomia / Infusion of morphine and ketamine, with or without lidocaine, in cats undergoing ovariohysterectomy

O objetivo deste estudo foi avaliar os efeitos analgésicos transoperatórios da infusão contínua de morfina e cetamina, associada ou não à lidocaína, em gatas submetidas à OSH eletiva. Foram utilizadas 16 fêmeas adultas, hígidas, pré-medicadas com acepromazina (0,1mg/kg) e morfina (0,5mg/kg), ambas pela via intramuscular, induzidas com cetamina (1mg/kg) e propofol (4mg/kg), pela via intravenosa, e mantidas sob anestesia geral inalatória com isoflurano a 1,4 V%. Os animais foram alocados aleatoriamente em dois grupos: grupo morfina, lidocaína e cetamina (MLK, n=8), que recebeu bolus de lidocaína (1mg/kg), pela via IV, seguido de infusão de morfina, lidocaína e cetamina (0,26mg/kg/h, 3mg/kg/h e 0,6mg/kg/h, respectivamente); e grupo morfina e cetamina (MK, n=8), que recebeu bolus de solução salina, seguido de infusão de morfina e cetamina, nas mesmas doses do MLK. Os momentos avaliados foram: M0, basal, cinco minutos após a indução; M1, imediatamente após a aplicação do bolus de lidocaína ou solução salina; M2, M3, M4 e M5, a cada cinco minutos, até completar 20 minutos do início da infusão; M6, após a incisão da musculatura; M7, após pinçamento do primeiro pedículo ovariano; M8, após pinçamento do segundo pedículo ovariano; M9, após pinçamento da cérvix; M10, após sutura da musculatura; M11, ao final da cirurgia; e M12, M13 e M14, intervalos de cinco minutos, até completar uma hora de infusão. A FP no M0 foi maior no MLK quando comparado ao MK. Em ambos os grupos, a PAS foi maior no M7 e no M8 em relação ao M0, porém no MK, além da PAS, a FP foi maior do M7 ao M13, assim como a f. Os animais do MK necessitaram de um número maior de resgates transoperatorios, total de 23, do que o MLK, total de sete. Conclui-se que a adição de lidocaína incrementou a analgesia oferecida, reduzindo o número de resgates analgésicos transoperatórios, a dose total de fentanil, bem como a probabilidade de os animais necessitarem dese tipo de resgate.(AU)

The aim of this study was to evaluate the trans-operative analgesics, continuous infusion of morphine and ketamine, with or without lidocaine in cats undergoing elective OSH. Sixteen adult cats were used, otherwise healthy, pre-medicated with acepromazine (0.1mg/kg) and morphine (0.5mg/kg), both intramuscularly, induced with ketamine (1mg/kg) and propofol (4mg/kg), intravenous, maintained under general inhalation anesthesia with isoflurane 1.4 V%. The animals were randomly allocated into two groups: morphine, lidocaine and ketamine (MLK, n= 8), which received intravenous bolus of lidocaine (1mg/kg) followed by infusion of morphine, lidocaine and ketamine (0.26mg / kg/h, 3mg / kg/h and 0.6mg / kg/h, respectively); Morphine and ketamine (MK, n= 8), who received bolus of saline followed by infusion of morphine and ketamine at the same doses of MLK. The evaluated moments were: M0, basal, 5 minutes after induction; M1 immediately after the application of lidocaine bolus injection or saline; M2, M3, M4 and M5, every 5 minutes to complete 20 minutes after the start of infusion; M6, after the incision of the musculature; M7, after clamping of the first ovarian pedicle; M8, after clamping of the second ovarian pedicle; M9, after clamping of the cervix; M10, after suturing of the musculature; M11, at the end of surgery; And M12, M13 and M14, 5 minute intervals until completing one hour of infusion. The time to extubating and full recovery of animals, and the need for rescue analgesic fentanyl intraoperatively were also evaluated. HR in M0 was higher in MLK when compared to MK. In both groups the SBP was higher in M7 and M8 compared to M0, but the MK, addition of SAP, HR was greater M7 to M13, as well as f. MK animals required a greater number of trans-operative rescues than the MLK. It was concluded that the addition of lidocaine to the protocol using morphine and ketamine increased its analgesia.(AU)

Patrón de «de Winter¼ en paciente con síndrome coronario agudo sin elevación del segmento ST / "De Winter" pattern in patients with non-ST-segment elevation acute coronary syndrome

RESUMEN El patrón de «de Winter¼ fue descrito por Robbert J. de Winter en 2008. Es un signo electrocardiográfico caracterizado por infradesnivel del segmento ST de 1-3 mm, en derivaciones precordiales (V1-V4), con una onda T alta y simétrica en las mismas derivaciones, asociado con supradesnivel del segmento ST en aVR, lo que se corresponde con una lesión grave de la arteria descendente anterior de localización proximal. Se presenta el caso clínico de un hombre de 22 años de edad que acudió a urgencias con las alteraciones electrocardiográficas descritas, y en la coronariografia se corroboró la presencia de una lesión grave, oclusiva (100%), de localización ostial, en la arteria descendente anterior, sobre la que se realizó angioplastia coronaria transluminal percutánea satisfactoriamente.

ABSTRACT "De Winter" pattern was first described by Robbert J. de Winter in 2008. It is an electrocardiographic sign characterized by ST-segment depression of 1-3 mm, in precordial leads (V1-V4), with a high and symmetrical T wave in the same leads, associated with ST-segment elevation in aVR, which represents a severe lesion of the proximal left anterior descending artery. The case report presented corresponds to 22-year-old man who came to the emergency department with the mentioned electrocardiographic changes; in the coronary angiography is confirmed the presence of a severe, occlusive lesion (100%), of ostial location, in the left anterior descending artery, on which a percutaneous transluminal coronary angioplasty was successfully performed.