Reproductive aspects of Grapsus grapsus (Decapoda: Grapsidae) on islands of the southeastern Gulf of California / Aspectos reproductivos de Grapsus grapsus (Decapoda: Grapsidae) en islas del sureste del Golfo de California

ABSTRACT Objective. The sex ratio, proportion of ovigerous females, length at sexual maturity and fecundity of Grapsus grapsus crabs in the Lobos, Venados and Pajaros islands (southeastern Gulf of California) were analyzed. Materials and methods. Sampling was conducted monthly between March 2011 and February 2012, during the night at low tide. Thirty crabs were collected in a quadrant (25 m2) at each sampling site on each island. cw (mm) and w (g) were determined. The sex ratio and size at sexual maturity (cw50%) were estimated, and for ovigerous females, embryonic stages and fecundity (gravimetric method) were determined. Results. The sex ratio (M:F) was 1:1.3. The average size at sexual maturity (cw50%) was 34.9 mm. The majority of females were ovigerous (71.3%), and 48% of the embryos of ovigerous females were at the red-orange phase. Egg diameter ranged from 1.1 to 5 µm, with an average of 2.05 µm. The mean fecundity was 24339.3 eggs. The maximum and minimum weight of ovigerous females was 69.9 and 15.2 g. Conclusions. The studied characteristics of sex ratio, proportion of ovigerous females, length at sexual maturity and fecundity of G. grapsus, indicate the effective administration and management of this resource in this area.

RESUMEN Objetivo. Se analizó la proporción de sexos, hembras ovígeras, talla de primera madurez sexual y fecundidad del cangrejo roca Grapsus grapsus en islas Lobos, Venados y Pájaros (sureste del Golfo de California). Material y métodos. Los muestreos fueron mensuales entre marzo 2011 y febrero 2012, las colectas fueron nocturnas durante la bajamar, se obtuvieron en un cuadrante (25 m2) por isla 30 organismos al azar, se les determinó el AN (mm) y PT (g). Se estimó la proporción de sexos y talla de primera madurez sexual (AN50%), se analizaron en hembras grávidas, las fases embrionarias y la fecundidad (método gravimétrico). Resultados. La proporción de M:H fue 1:1.3. La talla media de primera madurez fue AN50% 34.9 mm. Es evidente la presencia de hembras ovígeras (71.3%) y todas las fases embrionarias, la fase rojo-naranja fue la mayor representada en 48%. La variación del diámetro del huevo fue 1.1 a 5 µm y el promedio de 3.05 µm. La fecundidad media fue 24339.3 cigotos. El máximo y mínimo peso de hembras ovígeras fue 69.9 y 15.2 g, respectivamente. Conclusiones. Con base a las características biológicas del recurso tales como la proporción de sexos, hembras ovígeras, talla de primera madurez sexual y fecundidad en la población de G. grapsus, representa un efecto favorable en su posterior administración y manejo de este recurso en esta zona.

Inequidades sociales en madres adolescentes y la relación con resultados perinatales adversos en poblaciones sudamericanas / Social inequities in teenage mothers and the relationship to adverse perinatal outcomes in South American populations / Iniquidades sociais em mães adolescentes e sua relação com resultados perinatais adversos em populações sul-americanas

Resumen: El objetivo fue explicar las diferencias en la frecuencia de eventos perinatales adversos entre madres adolescentes con baja y alta escolaridad. La muestra poblacional se recogió en la base de datos del Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC). Entre 2.443.747 nacimientos ocurridos en 93 hospitales, se reclutaron 66.755 recién nacidos vivos, sin defectos congénitos, durante el período 2000-2017. Las madres adolescentes se clasificaron según su escolaridad en: baja, media y alta. Se utilizó un modelo multivariado, que incluyó efectos reproductivos, acceso a servicios de salud, variables demográficas-socioeconómicas, así como de grupo étnico. El modelo de descomposición de Fairlie se aplicó para cuantificar la contribución de variables explicativas en las frecuencias de eventos perinatales adversos. De los 66.755 recién nacidos investigados, el 21,1% (n = 14.078) fue primigrávida de madres adolescentes. La distribución por escolaridad materna fue de 24,2%, 59,8% y 16% para baja, media y alta escolaridad, respectivamente. Las mayores frecuencias de eventos perinatales adversos se observaron en madres adolescentes con baja escolaridad. La variable "acceso a servicios de salud" explicó un 35%, 37% y 23% de las disparidades en el bajo peso al nacimiento, prematuridad y retardo de crecimiento intrauterino, respectivamente, entre madres adolescentes con baja y alta escolaridad. El bajo número de consultas prenatales fue el único factor de riesgo para los dos niveles de escolaridad y la variable que mejor explica las diferencias entre las frecuencias de eventos perinatales adversos. Desde el punto de vista de la salud pública, ellos representan una intervención de bajo coste, con posibilidad de que se incrementen mediante información adecuada para la población y medidas sistemáticas en los niveles de atención primaria.

Abstract: The aim was to explain differences in the rates of adverse perinatal events in teenage mothers with low and high schooling. The sample was collected from the Latin American Colaborative Study of Congenital Malformations (ECLAMC) database. From a total of 2,443,747 births in 93 hospitals, 66,755 live newborns without congenital malformations were recruited from 2000 to 2017. Teenage mothers were classified according to low, medium, and high schooling. A multivariate model was used that included reproductive history, access to health services, demographic and socioeconomic variables, and ethnic group. The Fairlie decomposition model was applied to quantify the contribution of explanatory variables to the adverse perinatal event rates. Of the 66,755 newborns analyzed, 21.1% (n = 14,078) were born to teenage mothers. Distribution of maternal schooling was 24.2%, 59.8%, and 16% for low, medium, and high schooling, respectively. The highest rates of adverse perinatal events were seen in teenage mothers with low schooling. The variable "access to health services" explained 35%, 37%, and 23% of the disparities in low birthweight, prematurity, and intrauterine growth restriction, respectively, among teenage mother with low and high schooling. Low number of prenatal visits was the only risk factor for the two levels of schooling and the variable that best explained the differences between the rates of adverse perinatal events. From the public health perspective, prenatal care represents a low-cost intervention with the possibility of increased implementation through adequate information for the population and systematic measures in primary care.

Resumo: O objetivo foi explicar as diferenças na frequência de eventos perinatais adversos entre mães adolescentes com baixa e alta escolaridade. A amostra populacional foi coletada na base de dados do Estudo Colaborativo Latino-Americano de Malformações Congênitas (ECLAMC). Entre 2.443.747 nascimentos ocorridos em 93 hospitais, 66.755 recém-nascidos vivos sem defeitos congênitos foram recrutados no período 2000-2017. As mães adolescentes foram classificadas segundo sua escolaridade em: baixa, média e alta. Foi utilizado um modelo multivariado que incluiu efeitos reprodutivos, acesso a serviços de saúde, variáveis demográficas-socioeconômicas e de grupo étnico. O modelo de decomposição de Fairlie foi aplicado para quantificar a contribuição de variáveis explicativas nas frequências de eventos perinatais adversos. Dos 66.755 recém-nascidos pesquisados, o 21,1% (n = 14.078) foi a mãe adolescente. A distribuição por escolaridade materna foi de 24,2%, 59,8% e 16% para baixa escolaridade, média escolaridade e alta escolaridade, respectivamente. As maiores frequências de eventos perinatais adversos foram observadas em mães adolescentes com baixa escolaridade. A variável "acesso a serviços de saúde"; explicou 35%, 37% e 23% das disparidades no baixo peso ao nascer, prematuridade e retardo de crescimento intrauterino, respectivamente, entre mães adolescentes com baixa e alta escolaridades. O baixo número de consultas pré-natais foi o único fator de risco para os dois níveis de escolaridade e a variável que melhor explica as diferenças entre as frequências de eventos perinatais adversos. Do ponto de vista da saúde pública, eles representam uma intervenção de baixo custo, com possibilidade de ser incrementadas por meio de informações adequadas à população e medidas sistemáticas nos níveis de atenção primária.

IMÁGENES CLÍNICAS: TATTOO EN NIÑO

En este espacio o sección se reportan o describen diagnósticos interesantes o novedosos que hacen a la práctica clínica alergológica en general

Advertencias / Trastornos de retina inducidos por fármacos / Excipientes: ¿sustancias inertes?

En este espacio se informa sobre advertencias y comunicaciones recientes, de fármacos preferentemente relacionados con la especialidad

Advertencias: Fármacos que pueden incrementar el riesgo de neumonía

En este espacio se informa sobre advertencias y comunicaciones recientes de fármacos, preferentemente relacionadas con la especialidad.

Objective evaluation of vision quality in pseudophakic patients with posterior capsular opacification using double-pass retinal imaging / Avaliação objetiva da qualidade da visão em pacientes pseudofácicos com opacificação capsular posterior pelo método de dupla passagem de luz

ABSTRACT Purpose: The purpose of this study was to objectively assess the optical vision quality of patients before and after Nd:YAG capsulotomy for posterior capsular opacification using a double-pass retinal imaging system. Methods: We retrospectively analyzed the data from 26 pseudophakic eyes with posterior capsular opacification that underwent Nd:YAG capsulotomy. The objective scatter indices, modulation transfer function cutoff frequencies, Strehl ratios, and logMAR corrected distance visual acuities were assessed before and after YAG capsulotomy with a double-pass retinal imaging system (OQAS II, Visiometrics, Spain). We also analyzed data from a subgroup of 10 patients with pre-YAG corrected distance visual acuity of 0.10 logMAR (20/25) or better. Results: Vision quality indices improved in all 26 eyes, resulting in a statistically significant improvement in the corrected distance visual acuity (p=0.007), objective scatter index (p=0.001), modulation transfer function cutoff frequency (p=0.001), and Strehl ratio (p=0.020). The overall mean improvements included 0.12 ± 0.04 logMAR for corrected distance visual acuity, 2.84 ± 0.76 for objective scatter index, 12.29 ± 2.77 for modulation transfer function cutoff frequency, and 0.06 ± 0.03 for Strehl ratio. Our sub-analysis of 10 eyes with 0.10 logMAR (20/25) corrected distance visual acuity or better also showed a statistically significant improvement in the mean objective scatter index (0.76 ± 16; p=0.001), resulting in approximately 35% decrease in intraocular light scatter. Conclusions: The objective vision quality measurements as assessed by the double-pass retinal imaging system showed a significant improvement after YAG capsulotomy. This suggests that the objective scatter index improves after YAG capsulotomy, even in eyes with pre-YAG 0.10 logMAR (Snellen 20/25) corrected distance visual acuity or better.

RESUMO Objetivo: Avaliar objetivamente a qualidade da visão óptica antes e depois da capsulotomia com Nd: YAG, obtida por imagem pelo metodo de dupla passagem de luz em pacientes com opacificação capsular posterior. Método: Análise retrospectiva de 26 olhos pseudofácicos com opacificação capsular posterior visualmente significativa, que foram submetidos à capsulotomia de Nd: YAG. O índice de dispersão objetiva, a função de transferência de modulação, a relação de Strehl e a acuidade visual à distância corrigida foram avaliados antes e após a capsulotomia com YAG usando o dupla passagem de luz (OQAS II, Visiometrics, Espanha). Também foi analisado um subgrupo de pacientes com acuidade visual à distância corrigida pré-YAG de 0,10 logMAR (20/25) ou melhor. Resultados: Os índices de qualidade da visão melhoraram em todos os 26 olhos, resultando em uma melhora estatisticamente significativa na acuidade visual à distância corrigida (p=0,007), índice de dispersão objetiva (p=0,001), função de transferência de modulação (p=0,001) e relação de Strehl (p=0,020). A melhora média na acuidade visual à distância corrigida foi de 0,12 ± 0,04 logMAR, no índice de dispersão objetiva foi de 2,84 ± 0,76, no função de transferência de modulação foi de 12,29 ± 2,77 e na razão de Strehl foi de 0,06 ± 0,03 em todos os olhos. Sub-análise de 10 olhos com 0.10 logMAR (20/25) acuidade visual à distância corrigida ou melhor também mostrou uma melhora estatisticamente significativa no índice de dispersão objetiva (p=0,001). A melhora média no OSI foi de 0,76 ± 16, uma diminuição de 35% na dispersão da luz intraocular. Conclusões: A qualidade da visão avaliada pelo dupla passagem de luz mostra uma melhora significativa nas medidas objetivas da qualidade da visão após a capsulotomia do YAG. O índice de dispersão objetiva melhora após a capsulotomia YAG, mesmo em olhos com acuidade visual à distância corrigida pré-YAG de 0,10 logMAR (Snellen 20/25) ou melhor.

El método de clasificación de mortinatos "Condición Obstétrica Relevante de la Muerte Fetal" (CORM) reduce la frecuencia de muerte fetal de causa inexplicable / The stillbirth classification method "Relevant Obstetric Condition of Stillbirth" (CORM) reduces the frequency of unexplained fetal death

RESUMEN Introducción: La muerte fetal (MF) es el principal contribuyente de la mortalidad perinatal. Objetivo: Analizar la eficiencia del método de clasificación de mortinatos, condición obstétrica relevante de la MF (CORM). Métodos: Estudio cohorte retrospectivo, de las MF ocurridas en la Maternidad del Hospital San Borja Arriarán durante 10 años. Los datos provienen de los informes de las auditorías de mortinatos. Se aplicó el método de clasificación CORM, que usa la biopsia placentaria, los datos clínicos y de laboratorio analizados por un obstetra y un patólogo. Resultados: Ocurrieron 56.130 nacimientos y 479 MFs. Tasa de MF, 8.5 por 1000 nacimientos. Se identificaron el 93.5% de las condiciones obstétricas de MF y 6.5% fueron inexplicables. Las más frecuentes fueron: infección bacteriana ascendente (IBA) 24.9%, anomalía congénita 18.0%, y patología placentaria 14.0%. La restricción del crecimiento fetal intrauterino (RCIU) se presentó en el 49.7% de los mortinatos, la mayoría 93.7%, fue secundaria a condición obstétrica primaria. La asfixia durante el parto fue el 0.8% de los mortinatos y se presentó en embarazos de término. El parto prematuro (PP) representó el 80% de los casos de MF. La condición más frecuente asociada con PP fue IBA (38.5% y 38.2% de las MF menores de 30 semanas y menores de 1000 gramos respectivamente). Conclusiones: El método clasificación de mortinatos CORM, es más eficiente que los métodos convencionales en detectar la causa de MF porque identifica la mayoría de las condiciones obstétricas responsables de la MF. Es reproducible, requiere estudio histopatológico de la placenta y no de autopsia fetal. Permite elaborar guías de prevención por causa.

SUMMARY Introduction: Stillbirth is the main contributor to perinatal mortality. Aim: To analyze the efficiency of the method for classification of fetal death (FD), "obstetric condition relevant to the death (OCRD). Methods: Retrospective cohort study of the FD that occurred in the Maternity Hospital of San Borja Arriarán for ten years. The data comes from the reports of the stillborn audits. We applied the classification method OCRD, which uses placental biopsy, clinical and laboratory data analyzed by a single obstetrician and a single pathologist. Results: 56,130 births and 479 FD occurred. FD rate, 8.5 per 1000 births. We identified 93.5% of the obstetric conditions of FD and 6.5% were unexplained. The most frequent were: ascending bacterial infection (ABI) 24.9%, congenital anomaly 18.0%, and placental pathology 14.0%. The intrauterine fetal growth restriction (IUGR) was present in 49.7% of the stillbirths, the majority 93.7%, was secondary to primary obstetric condition. Asphyxia during delivery was 0.8% of the stillbirths and occurred in term pregnancies. Preterm birth (PB) represented 80% of FD cases. The most frequent condition associated with PB was ABI (38.5% and 38.2% of the FD less than 30 weeks and less than 1000 grams respectively). Conclusions: The OCRD stillbirth classification method is more efficient than conventional methods in detecting the cause of MF because it identifies most of the obstetric conditions responsible for FD. It is reproducible, requires histopathological study of the placenta and not fetal autopsy. It allows developing guidelines of prevention for cause.

Prevalencia del bajo peso al nacer en un escenario de depresión económica en Argentina / Prevalence of low birth weight in a scenario of economic depression in Argentina

Introducción. El bajo peso al nacer (BPN) es considerado un indicador general de salud por su relación con complicaciones en la vida del recién nacido y por ser una de las primeras causas de mortalidad infantil. Es multifactorial y, entre sus determinantes, se incluyen los socioeconómicos. Objetivo. Evaluar el impacto de la desigualdad económica sobre la prevalencia del BPN, cuantificando el efecto diferencial según edad y educación materna y nivel de atención. Población y métodos. Estudio epidemiológico de diseño transversal, en el cual se analizaron los nacimientos ocurridos en Argentina desde 2001 a 2013 con datos obtenidos del Registro Nacional de los nacimientos, perteneciente a la Dirección de Estadísticas e Información en Salud (DEIS). Se estudió la variación temporal de la prevalencia de recién nacidos con BPN (< 2500 gramos) y su relación con indicadores demográficos y socioeconómicos. Se evaluó su asociación a través de modelos de regresión logística. Resultados. Se incluyeron 9 001 960 nacimientos. Se observó un incremento en la prevalencia de recién nacidos con BPN durante la crisis económica de 2001 -de un 6% en 2002 y un 7% en 2003-. Fue heterogéneo y tuvo mayor impacto en hospitales públicos (razón de prevalencia -RP-= 1,03) y madres adolescentes (RP= 1,07) y ningún impacto sobre la educación materna baja (RP= 0,99). Conclusiones. El impacto de la desigualdad socioeconómica sobre la prevalencia de bajo peso fue significativo y heterogéneo, más importante en hospitales públicos y madres en edades extremas.

Introduction. Low birth weight (LBW) is considered a general indicator of health because it is related to complications in the life of a newborn infant and is one of the leading causes of infant mortality. It is a multifactorial indicator, and its determinants include socioeconomic factors. Objective. To assess the impact of economic inequality on the prevalence of LBW by quantifying its differential effect by maternal age, level of maternal education, and level of care. Population and methods. Epidemiological, cross-sectional study that analyzed all births occurred in Argentina between 2001 and 2013 based on data provided by the National Registry of births, corresponding to the Health Statistics and Information Department. The temporal variation in the prevalence of LBW newborn infants (< 2500 grams) and its relation to demographic and socioeconomic indicators were studied. Its association was assessed using logistic regression models. Results. A total of 9 001 960births were included. The prevalence of LBW newborn infants during the 2001 economic crisis increased -6% in 2002 and 7% in 2003- The impact was heterogeneous and higher on public hospitals (--1;PR--3; = 1.03) and adolescent mothers (PR=1.07), but no impact was observed on a low level of maternal education (PR= 0.99). Conclusions. The impact of socioeconomic inequality on the prevalence of LBW was significant and heterogeneous, especially on public hospitals and mothers at the extremes of maternal age.

Accuracy of linear measurements performed with two imaging software in cone-beam computed tomography scans of dry human mandibles

ABSTRACT The present study aimed to assess the accuracy of linear measurements performed with two software packages in multislice (MSCT) and cone beam (CBCT) computed tomography (CT) images. The sample consisted of 10 human mandibles marked standardly 8 times with metallic orthodontic wires. The mandibles underwent both MSCT and CBCT scanning and were measured linearly and digitally with two software packages, namely Studio 3.1® (Anne Solutions®, SP, Brazil) (ST) and Implant Viewer 2.817® (Anne Solutions®, SP, Brazil) (IV). The linear measurements were the mandibular height (MH) and width (MW), and the distance from the alveolar ridge to the mandibular canal (AC). To validate the measurements, the mandibles were sectioned in the marked regions and measured with a digital caliper. Statistically significant differences were not observed between the measurements (MH, MW, and AC) taken digitally with the two software packages from images obtained from the two scanning modalities (MSCT and CBCT) and the measurements taken manually with a digital caliper (p>0.05). MSCT and CBCT images measured digitally with ST and IV software packages resulted in reliable outcomes when compared to measurements obtained manually. Both software and imaging modalities are reliably useful for planning surgical procedure in the dental practice.

Relations between mental workload and decision-making in an organizational setting

Asbtract Background The complexity of current organizations implies a potential overload for workers. For this reason, it is of interest to study the effects that mental workload has on the performance of complex tasks in professional settings. Objective The objective of this study is to empirically analyze the relation between the quality of decision-making, on the one hand, and the expected and real mental workload, on the other. Methods The study uses an ex post facto prospective design with a sample of 176 professionals from a higher education organization. Expected mental workload (Pre-Task WL) and real mental workload (Post-Task WL) were measured with the unweighted NASA-Task Load Index (NASA-TLX) questionnaire; difference between real WL and expected WL (Differential WL) was also calculated; quality of decision-making was measured by means of the Decision-Making Questionnaire. Results General quality of decision-making and Pre-Task WL relation is compatible with an inverted U pattern, with slight variations depending on the specific dimension of decision-making that is considered. There were no verifiable relations between Post-Task WL and decision-making. The subjects whose expected WL matched the real WL showed worse quality in decision-making than subjects with high or low Differential WL. Conclusions The relations between mental workload and decision-making reveal a complex pattern, with evidence of nonlinear relations.

Morphometry and Vascularization of the Rabbit Kidneys (Oryctolagus cuniculus) / Morfometría y Vascularización del Riñón de Conejo (Oryctolagus cuniculus)

Rabbits have been used as urologic models in many studies. The aim of this study was to characterize the renal morphology and anatomical variations of the renal pedicle in rabbit. The research ethics committee of Rio de Janeiro Federal Rural University approved this study. The animals were obtained from the university's necropsy unit. Dissections were performed in 50 adult rabbits, male and females, without macroscopic renal pathology. Kidney measurements were made with a digital caliper: length, width, and thickness. The length and origin of the renal arteries and main branches and length of the renal veins were also determined. The terminology of Nomina Anatomica Veterinaria was followed. The mean and standard deviation of the length of the right kidney was 3.150±0.2588 cm in males and 3.127±0.3769 cm in females and in the left kidney was 3.083±0.0818 cm in males and 3.162±0.0848 cm in females. The width of the right kidney was 1.933±0.0848 cm in males and 1.996±0.0680 cm in females and in the left kidney was 1.850±0.0659 cm in males and 2.004±0.0940 cm in females. There was no significant difference in the measurements between the two sexes and antimeres and in the measures of renal vessels in relation to sex, but the left artery and renal vein were always larger than the right in both sexes. The results of the present study are expected to contribute to the body of knowledge in the field of comparative and applied anatomy.

Los conejos se han utilizado como modelos urológicos en muchas investigaciones. El objetivo de este estudio fue caracterizar la morfología renal y variaciones anatómicas del pedículo renal en el conejo. El comité de ética de la investigación de Río de Janeiro Universidad Federal Rural aprobó este estudio. Los animales se obtuvieron de unidad de necropsia de la universidad. Las disecciones se realizaron en 50 conejos adultos, machos y hembras, sin patología renal macroscópica. Se realizaron con un calibrador digital las siguientes mediciones en el riñón : longitud, ancho y grosor. También se determinaron la longitud y el origen de las arterias renales y ramas principales y longitud de las venas renales. Se siguió la terminología de Nomina Anatomica Veterinaria. La Media y DE de la longitud del riñón derecho fue 3,150±0,2588 cm en machos y 3,127±0,3769 cm en hembras y en el riñón izquierdo fue 3,083±0,0818 cm en machos y 3,162±0,0848 cm en hembras. El ancho del riñón derecho fue 1,933±0,0848 cm en machos y 1,996±0,0680 cm en las hembras y en el riñón izquierdo fue 1,850±0,0659 cm en machos y 2,004±0,0940 cm en hembras. No hubo diferencias significativas en las mediciones entre los dos sexos y los antímeros, así como en las medidas de los vasos renales en relación con el sexo; pero la arteria y vena renal izquierda fueron siempre mayores que las del lado derecho en ambos sexos. Se espera con los resultados del presente estudio contribuir al conocimientos en el campo de la anatomía comparada y aplicada.

Asociación entre polimorfismos del gen NAT2 y fisura labiopalatina no sindrómica en Argentina / Association between NAT2 polymorphisms with non-syndromic cleft lip with or without cleft palate in Argentina

Background: NAT genes are considered candidate genes for the genetic predisposition to non-syndromic Cleft lip with or without cleft palate (NSCLP), since they codify for N-acetyltransferases, enzymes responsible for the biotransformation of arylamines, hydrazine drugs, and a great number of toxins and carcinogens present in diet, cigarette smoke, and environment. Aim: To determine the association between alleles determining slow acetylator phenotype and the risk of NSCLP. Material and Methods: We analyzed *5 (481C>T), *6 (590G>A) and *7 (857G>A) alleles which determine the slow acetylator phenotype and *4 (wild type) allele by polymerase chain reaction/restriction fragment length polymorphism in 97 progenitor-case trios of NSCLP in Argentinian Obstetric Wards. We evaluated the transmission disequilibrium (TDT). Results: TDT showed a positive association between allele *5 and NSCLP (odds ratio = 1,6; p = 0,03). Conclusions: The presence of *5 allele is significantly higher in cases with congenital NSCLP.

Epidermal growth factor receptor (EGFR) mutations in lung cancer: preclinical and clinical data

Lung cancer leads cancer-related mortality worldwide. Non-small-cell lung cancer (NSCLC), the most prevalent subtype of this recalcitrant cancer, is usually diagnosed at advanced stages, and available systemic therapies are mostly palliative. The probing of the NSCLC kinome has identified numerous nonoverlapping driver genomic events, including epidermal growth factor receptor (EGFR) gene mutations. This review provides a synopsis of preclinical and clinical data on EGFR mutated NSCLC and EGFR tyrosine kinase inhibitors (TKIs). Classic somatic EGFR kinase domain mutations (such as L858R and exon 19 deletions) make tumors addicted to their signaling cascades and generate a therapeutic window for the use of ATP-mimetic EGFR TKIs. The latter inhibit these kinases and their downstream effectors, and induce apoptosis in preclinical models. The aforementioned EGFR mutations are stout predictors of response and augmentation of progression-free survival when gefitinib, erlotinib, and afatinib are used for patients with advanced NSCLC. The benefits associated with these EGFR TKIs are limited by the mechanisms of tumor resistance, such as the gatekeeper EGFR-T790M mutation, and bypass activation of signaling cascades. Ongoing preclinical efforts for treating resistance have started to translate into patient care (including clinical trials of the covalent EGFR-T790M TKIs AZD9291 and CO-1686) and hold promise to further boost the median survival of patients with EGFR mutated NSCLC.

Determinantes sociales adversos y riesgo para anomalías congénitas seleccionadas / Adverse social determinants and risk for congenital anomalies

Introducción. Diferentes trabajos han relacionando condiciones sociales adversas a nivel familiar y regional con resultados perinatales (mortalidad neonatal, bajo peso y prematuridad), sin embargo, pocos estudiaron el efecto de la pobreza sobre anomalías congénitas. Objetivo. Evaluar el riesgo de ocurrencia de 25 anomalías congénitas y determinantes sociales adversos según el nivel socioeconómico de la familia y de la región. Población y métodos. Estudio caso-control exploratorio, en el que se utilizaron datos del Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC). La muestra consistió en 3786 recién nacidos vivos con una única malformación y 13 344 controles, seleccionados entre 546 129 nacimientos, ocurridos en 39 hospitales de Argentina durante el período 1992-2001. Se estimaron los riesgos (OR) directos, indirectos (a través de la región de residencia) y la interacción entre el nivel socioeconómico individual y residencial para cada uno de los 25 defectos congénitos. Resultados. Los defectos labio leporino con/sin paladar hendido (OR= 1,43) y comunicación interventricular (OR= 1,38) mostraron un riesgo significativamente mayor en el nivel socioeconómico más bajo. Los niveles socioeconómicos bajos se asociaron de manera significativa con una mayor frecuencia de consanguinidad parental, ancestros nativos, edad materna menor de 19 años, más de 4 embarazos, bajo número de visitas prenatales y residencia en regiones desfavorables. Conclusión. La fisura labial con o sin paladar hendido y los defectos del tabique interventricular estuvieron asociados significativamente con un nivel socioeconómico más bajo. La falta de planificación familiar, de control prenatal y la exposición a agentes ambientales o teratógenos pueden explicar estos hallazgos.

Introduction. Different studies have related familiar and regional adverse social conditions to perinatal outcome (neonatal mortality, low birth weight and prematurity); however, few studies have studied the effect of poverty on congenital anomalies. Objective. To assess the hazard ratio of 25 congenital anomalies and adverse social determinants as per the socioeconomic level of families and regions. Population and methods. Exploratory, case-control study using data from the Latin-American Collaborative Study of Congenital Malformations (Estudio Colaborativo Latinoamericano deMalformaciones Congenitas, ECLAMC). The sample consisted of 3786live newborninfantswitha singlemalformation and 13 344 controls selected among 546 129 births occurred in 39 hospitals from Argentina in the 19922001 period. Both direct and indirect (residence) risks (OR) were estimated, together with the interaction between the individual and residential socioeconomic levels for each of the 25 congenital anomalies. Results.Cleft lip with/without cleft palate (OR= 1.43) and ventricular septal defect (OR= 1.38) showed a significantly higher risk in the lower socioeconomic level. Low socioeconomic levels were significantly associated with a higher frequency of parental sibship (blood relationship); native descent; maternal age younger than 19 years old; more than four pregnancies; a low number of antenatal care visits; and residence in deprived regions. Conclusion. Cleft lip with/without cleft palate and ventricular septal defects were significantly associated with a lower socioeconomic level. Lack of family planning and antenatal care; and exposure to environmental or teratogenic agents may account for these findings.

Sentinel phenotype for rubella embryopathy: time-space distribution in Brazil / Fenótipo sentinela para embriopatia rubéolica: distribuição em tempo e espaço no Brasil

The dyad comprising eye anomalies and congenital heart defects in the same newborn has been proposed as the best sentinel phenotype for the early detection of rubella embryopathy. Time-space birth prevalence distributions of the eye-heart dyad were described in 36 Brazilian hospitals from the Latin-American Collaborative Study of Congenital Anomalies - ECLAMC network, for the period 1994-2008. Seventy dyad cases observed among 554,531 births showed seasonal variation (Χ2 = 5.84; p < 0.05), suggesting an environmental etiology, with an increase in cases in October-March and acrophase in December. The secular distribution of dyad prevalence rates was consistent with the distribution of rubella cases in Brazil, showing a decrease from 1994 to 2004, followed by an increase until 2008. Two geographic clusters were identified, one with high and the other with low dyad prevalence. In the high prevalence cluster, a secular increase was observed, starting in 1999, matching the rubella epidemic waves observed in Brazil in 1998-2000 and 2006.

A díade óculo-cardíaca havia sido proposta como o melhor fenótipo sentinela para detecção precoce da embriopatia rubéolica. Descrevem-se as distribuições têmporo-espaciais das prevalências ao nascimento dessa díade com material do Estudo Colaborativo Latino Americano de Malformações Congênitas (ECLAMC) em 36 hospitais brasileiros no período 1994-2008. Os 70 casos em 554.531 nascimentos mostraram uma variação sazonal significativa (Χ2 = 5,84; p < 0,05), o que sugere uma etiologia ambiental, com um aumento de casos de outubro a março com acrofase em dezembro. A variação secular das prevalências da díade foi compatível com o padrão observado para a distribuição da rubéola no país, com diminuição entre 1994-2004, e ulterior aumento até 2008. Identificaram-se dois conglomerados de alta e de baixa prevalência para a díade. Dentro do conglomerado de alta prevalência, observou-se significativo acréscimo secular a partir do ano 1999, não verificado no conglomerado de baixa prevalência, nem no resto dos hospitais em estudo, compatível com a série de surtos epidêmicos registrados para a infecção rubeólica no Brasil em 1998-2000 e em 2006.