Signos y Síntomas en 3557 Pacientes con Trastornos Temporomandibulares

Los trastornos temporomandibulares (TTM) tienen una alta frecuencia en la población y pueden presentar síntomas en la región de la cabeza, el oído y la región cervical. Este estudio evalúa la presencia de signos y síntomas en la región de la cabeza y el cuello, incluyendo: cefalea, trastornos del oído, y de la columna vertebral, en una población de 3557 pacientes con TTM. Para este estudio los datos consistieron en los registros de 3557 pacientes consecutivos de TTM referidos a una clínica privada de trastornos temporomandibulares y dolor craneofacial, en Santiago de Chile entre 1998 y 2019. El examen y los registros fueron efectuados por uno los autores (RW), en un programa computacional previamente diseñado. Los resultados fueron analizaron utilizando la distribución de la frecuencia de los datos para evaluar la prevalencia. En esta serie 72.67 % correspondieron a pacientes de sexo femenino. Los síntomas más prevalentes reportados por los 3557 pacientes estudiados fueron rigidez en el cuello 65,25 %, cefaleas 61,01 % y dolor lumbar 57,16 %. Los síntomas relacionados con el oído fueron: mareos en el 46,70 %, dolor de oídos en 32,64 % y tinnitus en el 33,60 % de los pacientes. La asimetría facial estuvo presente en el 74.08 % de los 3557 pacientes. Se observó desviación mandibular en apertura bucal, en el 74.44 % de los 3557 pacientes. Se presentó dolor a la palpación muscular en un alto porcentaje de los pacientes, en los músculos temporales, maseteros, esternocleidomastoideo y trapecio, Este estudio nos permite describir la frecuencia de los signos y síntomas que presentan los pacientes con TTM en una amplia casuística.

Temporomandibular disorders (TMD) are frequently associated with other conditions in the head, ear and neck region, including cervical spine disorders and headache. This study evaluates the presence of signs and symptoms in the head and neck region, including headache, ear disorders, cervical and spine disorders, on a population of 3557 patients with TMD. For this study data consisted of the records of 3557 consecutive TMD patients referred to a temporomandibular disorder and craniofacial pain private clinic in Santiago, Chile between 1998 and 2019. The examination and recordings were made by all the authors. The results were analyzed using the distribution of frequency of the data to asses prevalence. The most prevalent symptoms reported by the 3557 subjects were neck stiffness 65.25 %, headaches 61.01 % and low back pain 57.16 %, the most frequent ear symptom was dizziness 46.70 %. The present study analize the frecuency of signs and symptons presented in a big casuistic of patients with TMD.

Nivel de coordinación motriz de niños y niñas participantes del programa escuelas deportivas integrales del ministerio del deporte de Chile / Level of motor coordination in children participating in the integral sports schools program of chile's sports ministry

Hurtado Almonacid, J.G., Páez Herrera, J., Abusleme Allimant, R. Olate Gómez, F., Follegati Shore, S., Briones Oyanedel, V. y Mallea Díaz, V. (2023). Nivel de coordinación motriz de niños y niñas participantes del programa escuelas deportivas integrales del ministerio del deporte de Chile. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. Durante los últimos años se ha identificado que una baja coordinación motriz general incide en una baja participación en instancias de juego libre, actividades deportivas organizadas y libres. A su vez, un mejor dominio motriz se relaciona con un bajo nivel de sedentarismo. Por lo tanto, el objetivo de este artículo fue comparar el nivel de coordinación motriz general de niños y niñas participantes del componente de Iniciación Deportiva del programa ''Escuelas Deportivas Integrales'' (EDI) del Ministerio del Deporte Chile (''Crecer en Movimiento'' desde 2019), según región de procedencia. En relación con la muestra, se evaluaron 341 niños y niñas de ocho regiones del país (Antofagasta, Coquimbo, Valparaíso, O'Higgins, Metropolitana, Bío-Bío, Araucanía y Los Lagos) cuyas edades fluctuaron entre los 6 y 11 años de edad. Para recopilar información, se utilizó el instrumento 3JS, compuesto por siete tareas (3 de locomoción y 4 de control de objetos). Los resultados reflejaron que los niños poseen mejor rendimiento que las niñas en coordinación motriz general. Al agrupar las pruebas del test según el tipo de coordinación, también superan a las damas en locomoción y en control de objetos. Los niños y niñas de la región de Los Lagos obtienen mejor rendimiento en seis de las siete pruebas. Se concluye que los varones superan a las damas en las pruebas de coordinación locomotriz y control de objetos, así como también en las puntuaciones de coordinación motriz general.

Hurtado Almonacid, J.G., Páez Herrera, J., Abusleme Allimant, R. Olate Gómez, F., Follegati Shore, S., Briones Oyanedel, V. & Mallea Díaz, V. (2023). Level of motor coordination in children participating in the integral sports schools program of chile's sports ministry. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. In recent years, it has been detected that generally low motor coordination results in low participation in free play situations, organized and free sports activities. In turn, a better motor mastery is consistent with a low level of sedentary lifestyle. Therefore, the objective of this article is to compare the level of general motor coordination in children that participate in the Sports Initiation component of the ''Integral Sports Schools'' (EDI) program of Chile's Sports Ministry (since 2019, ''Growing in Movement''), according to the regions they come from. Concerning the sample, the assessment covered 341 boys and girls from eight different regions in the country (Antofagasta, Coquimbo, Valparaíso, O'Higgins, Metropolitan Region, Bío-Bío, Araucanía and Los Lagos), in ages ranging from 6 to 11. The information was gathered through the 3JS instrument, made up of seven tasks (3 in locomotion and 4 in object control). The results showed that boys have a better performance than girls in terms of general motor coordination. When the test data were grouped according to the type of coordination, boys are also above girls in terms of locomotion and object control. Boys and girls from the Los Lagos region performed better in six of seven tests. In conclusion, boys outperform girls in the tests of motor coordination and object control, as well as in the scores of general motor coordination.

Hurtado Almonacid, J.G., Páez Herrera, J., Abusleme Allimant, R. Olate Gómez, F., Follegati Shore, S., Briones Oyanedel, V. e Mallea Díaz, V. (2023). Nível de coordenação motora das crianças que participam do programa escolas esportivas integrais do ministério do esporte do Chile. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. Nos últimos anos, identificou-se que a baixa coordenação motora geral tem um impacto na baixa participação em atividades de jogos livres, atividades esportistas organizadas e livres. Por sua vez, uma melhor dominância motora está relacionada com um baixo nível de sedentarismo. Portanto, o objetivo deste artigo foi comparar o nível de coordenação motora geral das crianças participantes do componente de Iniciação Esportiva do programa "Escolas Esportivas Integrais" (EEI) do Ministério do Esporte do Chile ("Crescendo em Movimento" desde 2019), segundo a região de origem. Em relação à amostra, foram avaliadas 341 crianças de oito regiões do país (Antofagasta, Coquimbo, Valparaíso, O'Higgins, Metropolitana, Bío-Bío, Araucanía e Los Lagos) com idades entre 6 e 11 anos. Para a coleta de informações, foi utilizado o instrumento 3JS, composto por sete tarefas (3 de locomoção e 4 de controle de objetos). Os resultados mostraram que os meninos têm melhor desempenho do que as meninas na coordenação motora geral. Ao agrupar os testes de acordo com o tipo de coordenação, eles também superam as meninas em locomoção e controle de objetos. As crianças da região de Los Lagos tiveram melhor desempenho em seis dos sete testes. Conclui-se que os meninos superam as meninas nos testes de coordenação locomotora e controle de objetos, bem como nos escores gerais de coordenação motora.

Aflatoxin Occurrence, Food Regulations, Dietary Exposure, and Risk Assessment: A Mini Review from the Malaysian Perspective

@#Aflatoxins are ubiquitous and occur in food. Exposure to aflatoxins seriously impact the health of human and animal. It is concerning especially when aflatoxins are odourless, colourless, and tasteless that hardly be detected through naked eyes. Ingestion of aflatoxin-contaminated food contributes the major route of exposure. The present review is an update on the aflatoxin occurrence in food, aflatoxin regulations in food, and recent risk assessment of aflatoxin exposure in Malaysia. Peanuts and chili were more prone to aflatoxin contamination in Malaysia. The extreme weather experienced in Malaysia and global climatic change may worsen the aflatoxin contamination in food. The regulatory standards for aflatoxins imposed by Malaysia are less stringent than developed countries. The dietary exposure of aflatoxins among Malaysian was relatively high as compared with other Asia countries, ranging from 0.002 to 34.00 ng/kg body weight/day. Nonetheless, Malaysian population had low risk of aflatoxin-related liver cancer, with an estimated liver cancer risk of <1 cancer case/100,000 population/year.

Caracterización de la displasia broncopulmonar según dos definiciones en prematuros chilenos / Characterization of bronchopulmonary dysplasia in relation with two definitions in chilean preterm infants

Existen controversias en la definición de la displasia broncopulmonar, siendo las más utilizadas el requerimiento de O2 durante 28 días o a las 36 semanas de edad gestacional corregida (EGC). Nuestro objetivo fue determinar la incidencia y características clínicas de los prematuros nacidos antes de las 32 semanas (RNP≤ 32s) con requerimiento de O2 a los 28 días de vida (DBP28d) y a las 36 semanas de EGC (DBP36s) en una unidad neonatal de Santiago, Chile, entre los años 2012 y 2019. Es un estudio descriptivo, retrospectivo con componente analítico. La población estudiada incluyó 535 RNP≤ 32s, vivos a las 36 semanas o dados de alta después de las 34 semanas de EGC. De los 242 prematuros DBP28d, 203 (83,88%) fueron DBP36s; 16 de los 242 (6%) requirió O2 durante menos de 28 días consecutivos, de los cuales 7, aún lo requerían a las 36 semanas. Los predictores de DBP36s fueron: sexo masculino (OR 2,42, IC del 95%: 1,24-4,69), peso al nacer (OR 1, IC del 95%: 0,99-1), edad gestacional (OR 0,75, IC del 95%: 0,57-0,97), APGAR a los 5 min, (OR 0,01, IC del 95%: 0,003-0,05), el requerimiento de presión positiva continua o cánula nasal de alto flujo (OR 1,1, IC del 95%: 1,04-1,17) y días de ventilación mecánica invasiva (OR 1,1,95% IC: 1-1,2). Conclusiones: No encontramos una diferencia significativa en la incidencia de DBP entre las definiciones de DBP28d y DBP36s; y la mayoría de los RNP< 32s con diagnóstico de DBP36s se pudieron identificar a los 28 días de vida.

Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in premature newborns. It is commonly defined as a need for supplemental O2 for 28 days or at 36 weeks postmenstrual age (PMA) (BPD36w). Our objective was to determine the incidence and clinical characteristics of premature neonates born at less than 32 weeks (PNB< 32w) with O2 requirement at 28 days of life (DBP28d) and DBP36w in a neonatal unit of Santiago, Chile, between 2012 and 2019. This is a descriptive, retrospective study with an analytical component. The study population included 535 PNB< 32w, alive at 36 weeks or discharged after 34 PMA. Of the 242 premature BPD28d, 203 (83,88%) were BPD36w; 16 (6%) required O2 for less than 28 consecutive days, of which 7 still required it at 36 weeks. The predictors of BPD36w were: male (OR 2.42, 95% CI: 1.24-4.69), birth weight (OR 1, 95% CI: 0.99-1), gestational age (OR 0.75, 95% CI: 0.57-0.97), APGAR at 5 min, (OR 0.01, 95% CI: 0.003-0.05), continuous positive pressure or high-flow nasal cannula requirement (OR 1.1, 95% CI: 1.04-1.17) and days of invasive mechanical ventilation (OR 1.1, 95% CI: 1-1.2). Conclusions: We did not find a significant difference in the incidence of BPD between the definitions of BPD28d and BPD36s; and the majority of PNB < 32w diagnosed with BPD36w can be identified at 28 days of life.

Hidatidosis esplénica gigante primaria en una gestante: reporte de caso / Primary giant splenic hydatid disease in a pregnant woman: case report

La hidatidosis es considerada en la actualidad como un problema de salud pública en el Perú. Es una infección parasitaria trasmitida por la ingesta de huevos de Echinococcus granulosus y los órganos más comprometidos son el hígado y los pulmones, siendo rara la afectación del bazo. Presentamos el caso de una gestante joven con dolor abdominal y sensación de masa en hipocondrio izquierdo. El estudio ecográfico reveló imagen quística multitabicada en hemiabdomen izquierdo, con feto viable. Se le realizó cesárea, seguido de laparotomía exploratoria y se halló una tumoración gigante de bazo que, según el estudio anatomopatológico corresponde a una hidatidosis esplénica multiquística. Asimismo, como complicación fetal ocurrió restricción del crecimiento intrauterino. La paciente evolucionó favorablemente sin recurrencia de focos hidatídicos, mientras que el neonato mostró un patrón de crecimiento adecuado.

Hydatidosis is currently considered a public health problem in Peru. It is a parasitic infection transmitted by the ingestion of eggs of Echinococcus granulosus. The most involved organs are the liver and lungs, with spleen involvement being rare. We present the case of a young pregnant woman with abdominal pain and a sensation of mass in the left hypochondrium. The ultrasound study revealed a multiloculated cystic image in the left hemiabdomen, and a viable fetus. She underwent cesarean section, followed by exploratory laparotomy, which revealed a giant spleen tumor that, according to the anatomopathological study, corresponded to multicystic splenic hydatid disease. Likewise, intrauterine growth restriction was found as a fetal complication. The patient progressed favorably without recurrence of hydatid foci and the neonate had an adequate growth pattern.

Performance evaluation of standard™ Q Covid-19 Ag saliva test in detection of Covid-19 among patients in tertiary hospital

@#Newer diagnostic tests for COVI D-19 such as antigen tests are being used for rapid identification of cases. Compared to reverse transcriptase polymerase chain reaction (RT-PCR), these tests offer simpler collection and processing. This study aims to determine the accuracy of a SARS-CoV-2 antigen-detecting rapid diagnostic test (Ag-ROT) using saliva compared to nasopharyngeal and oropharyngeal swab (NPS/OPS) RT- PCR among patients tested in the Emergency Room at Makati Medical Center. Patients who underwent NPS/OPS RT-PCR and who consented to participate in the study were asked to submit salivary sample to be analyzed using the Standard™ Q Covid-19 Ag Saliva Test kit. A total of 366 samples were collected . The overall accuracy was 81 .69% with a sensitivity of 63.58% and a specificity of 97.93%. Subgroup analyses as to processing time, number of days from symptom onset, and presence or absence of symptoms had no effect the overall accuracy. The Standard™ Q Covid-19 Ag Saliva Test kit was able to satisfy the ~97% specificity recommended by the WHO for SARS-CoV-2 Ag-RDTs but did not meet the minimum performance requirements of ~80% sensitivity. A positive test results can help in the initiation of early treatment and isolation of cases, but a negative test should still be confirmed by NPS/OPS RT-PCR test.

An outcomes-based evaluation of the mindfulness for safe schools program

Objectives@#The objective of this evaluation was to assess the effectiveness of Mindfulness for Safe Schools, a mindfulness-based intervention adapted for sexual abuse prevention during peer-to-peer dating among Filipino public school children in Grades 7 and 8. It was hoped that through the intervention, children would be able to regulate their emotions so that they do not react impulsively to emotionally stimulating events, especially during peer dating. The study consists of four levels of evaluation: reaction, learnings, and behaviors of teachers toward the program, as well as effect of the intervention on emotion regulation and peer conformity among students. @*Methods@#This study utilized a mixed methods design using a concurrent embedded method. For teachers, quantitative surveys and focused group discussions were conducted to determine their reactions to the training, their learnings, and behaviors after the program, as well as their observations of students’ responses to the intervention. Focused group discussions were analyzed through thematic analysis. Effect of the program on emotion regulation and peer conformity among students were determined mainly through a pre and post-test survey and analyzed through paired samples t-test. Video content analysis of the classroom delivery was also conducted to determine student engagement during the program. @*Results@#Teachers reacted favorably to the training workshops and were able to use what they learned from the workshops to increase their patience and understanding towards themselves, their job, and their students. Students also reacted favorably to the Mindfulness for Safe Schools modules and were observed to use the skills taught in the modules to regulate their emotions. Emotion regulation improved (t=3.47, significant with p=0.00) and susceptibility to peer pressure decreased (t=8.94, significant with p=0.00) for Grade 8 students (n=950) after the modules were delivered. However, teachers reported implementation issues, such as conflicting requirements of the program with their official workload, which may have affected program effects. @*Conclusion@#Our findings indicate that Mindfulness for Safe Schools was associated with improvements in emotional awareness, management of negative emotions, and showing care and respect for student peers. It also suggests that integrating mindfulness interventions in schools requires close coordination with all stakeholders: teachers, schools, and appropriate government divisions to ensure fidelity and reaching desired effects.

Prevalencia de Toxoplasma gondii en mujeres embarazadas asintomáticas en Quito, Ecuador 2020 / Prevalence of Toxoplasma gondii in asymptomatic pregnant women in Quito, Ecuador 2020

La toxoplasmosis es causada por un protozoo intracelular, Toxoplasma gondii, que tiene una amplia distribución geográfica. La forma congénita resulta en una forma gestacional que puede presentar una parasitemia temporal que infectará al feto. Es adquirido por consumo de carne cruda o poco cocida, alimentos o agua contaminada e infección congénita a través de la placenta. El objetivo de este estudio fue determinar la prevalencia de infección por toxoplasmosis y sus posibles factores de riesgo asociados con mujeres embarazadas que asistieron al servicio de control prenatal en el Hospital Gineco Obstétrico "Isidro Ayora", Ecuador. Las muestras de sangre se analizaron para detectar la presencia de anticuerpos IgG e IgM contra T. gondii utilizando una prueba de hemoaglutinación. Se probó la significación de los factores de riesgo mediante análisis bivariado. Se consideró un valor de p <0,05 como estadísticamente significativo. La prevalencia de anticuerpos IgG e IgM fue de 16,32%. Se observó una asociación significativa entre la seroprevalencia y antecedentes de aborto (p=0,00804), contacto con gatos domésticos (p<0,0001) y hábitos higiénicos incorrectos (p<0.0001). Los hallazgos demostraron que el contacto con gatos, antecedentes de abortos y hábitos higiénicos incorrectos se identificaron como factores de riesgo de infección por T. gondii(AU)

Toxoplasmosis is caused by an intracellular protozoan, Toxoplasma gondii, which has a wide geographical distribution. The congenital form results in a gestational form that can present a temporary parasiteamia that will infect the fetus. It is acquired by consumption of raw or undercooked meat, food or water contaminated and congenital infection through the placenta. Tthe objective of this study was to determine the prevalence of toxoplasmosis infection and its possible risk factors associated with pregnant women who attended the prenatal control service at the Gyneco-Obstetric Hospital "Isidro Ayora", Ecuador. Blood samples were tested for presence of IgG and IgM antibodies against T. gondii using a hemagglutination test. The risk factors were tested for significance using bivariate analysis. P-value <0.05 was considered statistically significant. The prevalence of IgG and IgM antibodies was 16.32%. A significant association was observed between seroprevalence and history of abortion (p=0,00804), contact with domestic cats (p<0,0001) and incorrect hygiene habits (p<0,0001). The findings demonstrated that contact with cats, a history of miscarriages, and poor hygiene habits were identified as risk factors for T. gondii infection(AU)

Diseño y validación de cuestionario de conocimientos, actitudes y prácticas de la enfermedad de Chagas / Design and validation of the survey of knowledge, attitudes and practices of Chagas disease

La enfermedad de Chagas es considerada una afección desatendida a nivel mundial que afecta principalmente a la población de escasos recursos en Latinoamérica, con aproximadamente 10 millones de personas afectadas. Se estima que en Ecuador más de 200000 personas son seropositivas para T. cruzi y 4.400 adquieren la infección anualmente. Se han realizado estudios en zonas endémicas como Loja, Manabí, Guayas y El Oro, las cuales constituyen el hábitat de cinco especies de triatómicos, responsables de la transmisión vectorial de la enfermedad, no obstante, se requiere información epidemiológica actualizada en áreas consideradas prioritarias. Es por ello, que se realizó un estudio descriptivo transversal para diseñar y validar un cuestionario de conocimientos, actitudes y prácticas de la enfermedad de Chagas en las 5 áreas prioritarias en Ecuador. Se diseñó un cuestionario inicial de 36 ítems, empleado para un estudio piloto con 5 expertos claves que validaron dicho instrumento, Para evaluar la validez de contenido se empleó la V de Aiken (0,82) y la validez del constructo fue evaluada a través del análisis factorial exploratorio, del cual se obtuvieron 3 dimensiones; ´ mientras que la prueba de alfa de Cronbach (>0,7) demostró la consistencia interna del instrumento. La versión final del cuestionario contentiva de 31 ítems fue aplicada a 20 participantes con características epidemiológicas diferentes de cada área prioritaria, demostrando que el mismo reúne todas las condiciones de validación y confiabilidad y puede ser aplicado en otros estudios epidemiológicos relacionados con la enfermedad de Chagas(AU)

Chagas disease is considered a neglected condition worldwide which mainly affects the poor population in Latin America, with approximately 10 million people affected. It is estimated that in Ecuador more than 200,000 people are seropositive for T. cruzi and 4,400 acquire the infection annually. Studies have been carried out in endemic areas such as Loja, Manabí, Guayas and El Oro, which constitute the habitat of five species of triatomics, responsible for the vector transmission of the disease, however, updated epidemiological information is required in areas considered priority. For this reason, a cross-sectional descriptive study was carried out to design and validate a questionnaire on knowledge, attitudes and practices of Chagas disease in the 5 priority areas in Ecuador. An initial questionnaire of 36 items was designed, used for a pilot study with 5 key experts who validated said instrument. To evaluate the content validity, Aiken's V (0.82) was used and the validity of the construct was evaluated through the exploratory factor analysis, from which 3 dimensions were obtained; While the Cronbach's alpha test (> 0.7) demonstrated the internal consistency of the instrument. The final version of the questionnaire containing 31 items was applied to 20 participants with different epidemiological characteristics from each priority area, showing that it meets all the validation and reliability conditions and can be applied in other epidemiological studies related to Chagas disease(AU)

Prevalence of dental anxiety in patients attending the dental service of two hospitals managed by the Ministry of Health of Peru / Prevalencia de ansiedad dental en pacientes del servicio de odontología de dos hospitales del Ministerio de Salud del Perú

Objective: To determine the level of dental anxiety in dental patients from two hospitals managed by the Ministry of Health of Peru, between August-September 2015. Material and Methods: Cross-sectional, comparative, and observational study, carried out between August and September 2015, including a total of 660 adult patients from the Dental Service of the Hospitals Regional Docente de Trujillo and Belén de Trujillo, Peru. A questionnaire based on the Modified Dental Anxiety Scale (MDAS) (Cronbach's Alpha=0.77) was applied to the participating subjects. Student's t test for independent groups and the Mann-Whitney U test were used for the analysis of the results, considering a significance level of 5%. Results: The mean total anxiety score for the population was 12.05 (SD=3.76). Females (mean=12.56) presented greater anxiety than males (mean=11.53) (p<0.001), young adults (Me=12.60) presented greater anxiety than subjects in mid-adulthood (Me=11.10) (p<0.001). No difference was found in terms of hospitals (p=0.386); 96.06% of the patients evaluated presented dental anxiety, 4.09% had extreme anxiety. Conclusion: The mean dental anxiety of the studied population coincides with the level of moderate anxiety. Females and young adults presented greater anxiety. No difference was found with respect to hospitals. Likewise, 96.06% of the evaluated patients presented dental anxiety, 4.09% had extreme anxiety.

Objetivo: Determinar la ansiedad dental en pacientes odontológicos de dos hospitales del Ministerio de Salud del Perú, agosto-septiembre, 2015.Material y Métodos: El presente estudio de corte transversal, comparativo y observacional, se desarrolló entre agosto y septiembre del 2015 e incluyó un total de 660 pacientes adultos del Servicio de Odontología de los hospitales Regional Docente de Trujillo y Belén de Trujillo. Se les aplicó un cuestionario basado en la Escala de Ansiedad Dental Modificada (Alfa de Cronbach=0.77). Para el análisis de resultados se empleó la prueba t de Student para grupos independientes y la prueba U de Mann-Whitney, considerando un nivel de significancia del 5%. Resultados: La puntuación media total de ansiedad para la población fue de 12.05 (DE=3.76), el sexo femenino (Me=12.56) presentó mayor ansiedad que el masculino (Me=11.53) (p<0.001), la adultez joven (Me=12.60) presentó mayor ansiedad que la adultez media (Me=11.10) (p<0.001). No se encontró diferencia en cuanto a hospital (p=0.386). El 96.06% de los pacientes evaluados presentaron ansiedad dental, siendo el 4.09% de ansiedad extrema. Conclusión: La ansiedad dental media de la población estudiada coincide en el nivel de ansiedad moderada. El sexo femenino y los adultos jóvenes presentaron mayor ansiedad. No se encontró diferencia con respecto a los hospitales. Asimismo, el 96.06% de los pacientes evaluados presentaron ansiedad dental, siendo el 4.09% de ansiedad extrema.

Next-generation sequencing: toward an increase in the diagnostic yield in patients with apparently idiopathic spermatogenic failure / 亚洲男科学杂志(英文版)

A large proportion of patients with idiopathic spermatogenic failure (SPGF; oligozoospermia or nonobstructive azoospermia [NOA]) do not receive a diagnosis despite an extensive diagnostic workup. Recent evidence has shown that the etiology remains undefined in up to 75% of these patients. A number of genes involved in germ-cell proliferation, spermatocyte meiotic divisions, and spermatid development have been called into play in the pathogenesis of idiopathic oligozoospermia or NOA. However, this evidence mainly comes from case reports. Therefore, this study was undertaken to identify the molecular causes of SPGF. To accomplish this, 15 genes (USP9Y, NR5A1, KLHL10, ZMYND15, PLK4, TEX15, TEX11, MEIOB, SOHLH1, HSF2, SYCP3, TAF4B, NANOS1, SYCE1, and RHOXF2) involved in idiopathic SPGF were simultaneously analyzed in a cohort of 25 patients with idiopathic oligozoospermia or NOA, accurately selected after a thorough diagnostic workup. After next-generation sequencing (NGS) analysis, we identified the presence of rare variants in the NR5A1 and TEX11 genes with a pathogenic role in 3/25 (12.0%) patients. Seventeen other different variants were identified, and among them, 13 have never been reported before. Eleven out of 17 variants were likely pathogenic and deserve functional or segregation studies. The genes most frequently mutated were MEIOB, followed by USP9Y, KLHL10, NR5A1, and SOHLH1. No alterations were found in the SYCP3, TAF4B, NANOS1, SYCE1, or RHOXF2 genes. In conclusion, NGS technology, by screening a specific custom-made panel of genes, could help increase the diagnostic rate in patients with idiopathic oligozoospermia or NOA.

Factors contributing to urinary aflatoxin M1 occurrence among residents in Hulu Langat district, Malaysia

@#Introduction: Chronic exposure to aflatoxin can lead to complications such as liver failure and cancer. There are many factors that affect aflatoxin occurrence. This study aimed to assess the association between sociodemographic factors and the knowledge, attitude and practice towards aflatoxin with urinary aflatoxin M1 occurrence among residents in Hulu Langat district, Malaysia. Methods: This was a cross-sectional study conducted among healthy Malaysian adults aged 18 to 60 years residing in Hulu Langat district, Malaysia. Socio-demographic background and the knowledge, attitude and practice of respondents towards aflatoxin were assessed through questionnaires. Non-fasting urine sample (15 ml) was collected in the morning and urinary aflatoxin M1 level was quantified. Results: Of the 444 healthy Malaysian adults, 199 urine samples were detected with aflatoxin M1. From 37 positive samples with aflatoxin M1 level above detection limit (0.64 ng/ml), mean value was 1.23±0.91 ng/ml (range = 0.65-5.34 ng/ml). Urinary aflatoxin M1 occurrence was significantly different across ethnicity, age group, monthly household income, attitude and practice towards aflatoxin. Binomial logistic regression confirmed ethnicity and monthly household income as factors contributing to urinary aflatoxin M1 occurrence. Chinese were 3.20 times more likely to have aflatoxin exposure than non-Chinese. Detected urinary aflatoxin M1 was more common among household with a monthly income above RM1,500. Conclusion: The results provided an insight to explain the variation in aflatoxin occurrence among the population.

Tuberculosis Infection and Incidence of Loss to Follow Up among HIV Patients at Saiful Anwar General Hospital, Indonesia: A Retrospective Study

@#Introduction: Tuberculosis (TB) is the most common opportunistic infection experienced by HIV patients that can affect the success of antiretroviral (ARV) therapy. This study aimed to determine the association between tuberculosis infection and loss to follow-up (LTFU) among HIV patients after ARV therapy initiation. Methods: This retrospective cohort study was conducted by observing HIV patients in Saiful Anwar General Hospital, Indonesia who were diagnosed in 2015 for 39 months based on medical records data. The number of samples that met the inclusion and exclusion criteria was 170 patients. Kaplan Meier and Cox Regression were the statistical tests used to analyze data in this study. Results: The probability of HIV patients to retain in ARV therapy for 39 months was 90% among HIV co-infected TB patients and 84% among HIV without TB co-infection. However, no significant difference was found (p-value = 0.41). Most of the incidence of LTFU in both groups occurred in the first year after ARV initiation. Cox Regression analysis showed that TB infection did not have a significant relationship with the incidence of LTFU ARV therapy (HR 0.62; 95% CI 0.18 – 2.08; p-value = 0.44). Conclusion: This study found that TB infection did not have a significant association with LTFU after ARV initiation. However, most of LTFU in both groups (the co-infection group and without TB co-infection) occurred in the first year of ARV therapy. Providing intensive counseling in the initial phase could increase the commitment of HIV patients for staying in ARV therapy.

Comparative study of cold compress and liniment treatment as an adjunct to massage therapy for Exercise-Associated Muscle Cramps (EAMC) among young athletes in the Philippine setting

@#Exercise-associated muscle cramps (EAMC) is prevalent among athletes during training or competitions where they are subjected to strenuous activities for a prolonged period. To manage this painful condition, health practitioners have used numerous treatment modalities having massage done with adjunct application such as cold compress or liniment. Studies show that it is debatable which combination of treatment modalities is more effective on people affected by EAMC. Hence, this study aimed to present evidence-based data to show if there is a difference in the effectiviteness of the two modalities in treating EAMC. A total of thirty-two (32) athletic participants were enrolled in this study and a total of 40 treatment trials were included in the analysis of data. Each participant performed strenuous exercises meant to induce muscle cramps. The onset of muscle cramps was identified using a set criteria. After which, treatment was applied and the length of time that the cramp was resolved was recorded. Determining relief from muscle cramps was based on the characteristic of muscle hardness and the level of pain by using a numerical rating scale. Results showed that though majority of the participants verbalized preference for the ice treatment, analysis of data using one-way ANOVA revealed that there is no evidence to prove that there is a difference in the effectivity among the treatment modalities performed. In conclusion, though all modalities performed were able to relieve the EAMC, the use of adjunct treatment in addition to massage and stretching may have a placebo effect component, which improves the patient's perception of greater efficacy.

Política terapéutica de la coinfección por M. tuberculosis y el VIH / Therapeutic policy of coinfection by M. tuberculosis and HIV

La tuberculosis (TB) es la infección oportunista más frecuente en pacientes infectados por el VIH, con impactos bidireccionales en el paciente: al aumentar la carga viral, la TB acelera la progresión de la infección por VIH a SIDA y, con ello, a la muerte. A su vez, El VIH dificulta el diagnóstico y tratamiento de la TB y favorece el desarrollo de diversas complicaciones clínicas. Al considerar que (1) sólo las dos terceras partes de la población seropositiva en el mundo tienen acceso a terapia antiretroviral; que (2) la tercera parte de fallecidos por SIDA en 2019 estaban también diagnosticados con TB; que (3) a nivel global el riesgo de morir por TB se duplica en el individuo con diagnóstivo de VIH positivo; y que (4) en las Américas, únicamente el 61% de las personas con TB-VIH reciben tratamiento antiretroviral, dejando tres veces más muertes y dos veces más pérdida en el seguimiento en los coinfectados, se evidencia una realidad preocupante sobre los resultados de las actuales políticas de tratamiento para la coinfección TB-VIH, haciendo necesario explorar sus bases, alcance, y metodologías en América y en Ecuador(AU)

Tuberculosis (TB) is the most frequent opportunistic infection in HIV-infected patients, with two-way impacts on the patient: by increasing the viral load, TB accelerates the progression from HIV infection to AIDS and, with it, to the death. In turn, HIV makes the diagnosis and treatment of TB difficult and favors the development of various clinical complications. Considering that (1) only two thirds of the HIV-positive population in the world have access to antiretroviral therapy; that (2) a third of those who died from AIDS in 2019 were also diagnosed with TB; that (3) globally, the risk of dying from TB is doubled in the individual with a positive HIV diagnosis; and that (4) in the Americas, only 61% of people with TB-HIV receive antiretroviral treatment, leaving three times more deaths and two times more loss to follow-up in those who are coinfected, there is a worrying reality about the results of current treatment policies for TB-HIV coinfection, making it necessary to explore its bases, scope, and methodologies in America and Ecuador(AU)

Características y factores asociados a trastornos de la esfera mental en estudiantes de medicina de la costa, sierra y selva peruana / Characteristics and factors associated with disorders of the mental sphere in medical students of the coast, mountains and Peruvian jungle

Resumen Introducción: Los trastornos de la esfera mental son cada vez más frecuentes, estos deben ser medidos en los estudiantes que están sometidos a gran presión y según el lugar de influencia. Objetivos: Determinar las características y factores asociados a trastornos de la esfera mental en estudiantes de medicina de la costa, sierra y selva peruana. Metodología: Se realizó un estudio transversal analítico preliminar, a través de la aplicación del Inventario Clínico Multiaxial de Millon (MCMI-II), a 105 estudiantes, dicha encuesta midió los distintos trastornos de la esfera mental; a los cuales se les asoció con variables socio-educativas. Resultados: Grandes porcentajes de encuestados tuvieron compulsividad (29%) y narcisismo elevado (28%). En el análisis multivariado se encontró que las mujeres tuvieron menor frecuencia de trastorno esquizoide (p=0,027); conforme aumentó la edad también hubo mayor frecuencia de trastornos evitativo (p=0,049) y ansiedad (p= 0,043); a mayor año académico se encontró menor frecuencia de trastorno dilusional (p=0,010); los estudiantes de la universidad de la sierra tuvieron más narcisismo (p=0,011), compulsividad (p=0,018) y paranoide (p=0,041); los estudiantes de la universidad de la selva tuvieron más agresividad-sádica (p=0,021), narcisismo (p=0,020) y compulsividad (p=0,005); estas dos últimas fueron comparados versus los que estudiaban en la costa. Conclusión: Se encontró gran frecuencia de algunos trastornos, así como algunos factores asociados, lo que puede ser útil como análisis situacional, lo que debería generar mayores trabajos en la materia.

Introduction: The disorders of the mental sphere are increasingly frequent, these should be measured in students who are under great pressure and according to the place of influence. Objectives: To determine the characteristics and factors associated with disorders of the mental sphere in medical students of the coast, mountains and Peruvian jungle. Methodology: A preliminary analytical cross-sectional study was carried out, through the application of the Millon Multiaxial Clinical Inventory (MCMI-II), to 105 students, said survey measured the different disorders of the mental sphere; to which they were associated with socio-educational variables. Results: Large percentages of respondents had compulsivity (29%) and high narcissism (28%). In the multivariate analysis it was found that women had a lower frequency of schizoid disorder (p = 0.027); as age increased there was also a higher frequency of avoidance disorders (p = 0.049) and anxiety (p = 0.043); the higher the academic year, the lower the frequency of dilution disorder (p = 0.010); the students of the Universidad de la Sierra had more narcissism (p = 0.011), compulsivity (p = 0.018) and paranoid (p = 0.041); the students of the jungle university had more aggressive-sadistic (p = 0.021), narcissism (p = 0.020) and compulsivity (p = 0.005); These last two were compared versus those studying on the coast. Conclussion: We found a high frequency of some disorders, as well as some associated factors, which can be useful as a situational analysis, which should generate more work in the field.

Establishment of reference interval for thyroid-stimulating hormone using electrochemiluminescence assay in a healthy adult population from Fortaleza, Brazil

ABSTRACT Objective This study aimed to determine the thyroid-stimulating hormone (TSH) reference interval (RI) and to assess the influence of the use of thyroid ultrasonography (TUS) on reference individual selection from a healthy adult population in Fortaleza, Brazil. Subjects and methods This cross-sectional study recruited patients (N = 272; age = 18-50 years) with normal thyroid function (NTF) and placed them in three groups according to their test results: NTF (n = 272; all participants), TUS (n = 170; participants who underwent thyroid US), RI (n = 124; reference individuals with normal TSH levels). TSH, FT4, TT3, TgAb, and TPOAb concentrations were determined by electrochemiluminescence assay. TUS was performed using a 7-12 MHz multifrequency linear transducer by two radiologists. The 2.5th and 97.5th percentiles of the distribution curve corresponded to lower and upper TSH RI levels, respectively. Results The mean TSH level was 1.74 ± 0.96 mIU/L, and TSH range was 0.56-4.45 mIU/L. There was no difference in the TSH concentrations between men and women nor between the groups. TUS did not appear to be an essential tool for the reference group selection. Conclusion The upper limit of TSH was comparable to the reference interval provided by the assay manufacturer (4.45 vs. 4.20 mIU/L) but the lower limit was not (0.56 vs. 0.27 mIU/L). This finding may have a clinical impact since these values may lead to the misdiagnosis of euthyroid patients with subclinical hyperthyroidism.

Ascaris lumbricoides, causa de la colecistitis aguda en el servicio de emergencia del Hospital "Alfredo Noboa Montenegro", 2018 / Ascaris lumbricoides, cause of acute cholecystitis in the emergency service of the "Alfredo Noboa Montenegro" Hospital, 2018

Ascaris lumbricoides provoca una de las helmintiasis más frecuentes en los países tropicales, pudiendo producir efectos patológicos en cualquier parte del organismo, siendo los conductos biliales uno de los sitios recurrentes provocando una colecistitis aguda. La CA es una de las principales causas de ingreso al servicio de Emergencia, es una inflamación de la vesícula cuyo diagnóstico oportuno es de vital importancia para la prevención de complicaciones. Por tal razón, determinar la frecuencia de las variables clínicas, de laboratorio y ecográficas, su relación con las comorbilidades asociadas a las características demográficas de los pacientes y el nivel de severidad de la colecistitis aguda causada por la A. lumbricoides de las Guías de Tokio 2018 del Servicio de Emergencia del Hospital Alfredo Noboa Montenegro durante el periodo junio - diciembre 2018, para la elaboración de un esquema diagnóstico. La metodología de investigación fue cuantitativa descriptiva de corte transversal. Dentro de los principales hallazgos, el CA aparece con prevalencia en el género femenino en un 69,41%, promedio de edad de 32 a 45 años, el 10% de 170 pacientes presentaron en su ecografía una forma parasitaria compatible con A. Lumbricoides, los resultados clínicos arrojaron presencia de dolor (67,34%), fiebre (68,65%), náuseas (45,93%); en los laboratorio la Proteína C Reactiva estuvo aumenta en el 94,18% de los casos, en imagenología se refleja presencia de líquido pericolecistico en un 78,82% y un engrosamiento de pared vesicular en un 34,12%. El nivel de severidad registrado según los criterios de las guías de Tokio 2018 fue grado I 35,3%, grado II 47,1% y grado III 17,6%. Se recomienda la estructuración de un esquema diagnóstico oportuno de colecistitis aguda causada por A. Lumbricoides(AU)

Ascaris lumbricoides causes one of the most frequent helminthiases in tropical countries, being able to produce pathological effects in any part of the body, being the bile ducts one of the recurrent sites causing acute cholecystitis. AC is one of the main causes of admission to the Emergency service, it is an inflammation of the gallbladder whose timely diagnosis is of vital importance for the prevention of complications. signs and symptoms, the timely diagnosis is of vital importance for the prevention of complications. For this reason, determine the frequency of clinical, laboratory and ultrasound variables, their relationship with the comorbidities associated with the demographic characteristics of the patients and the level of severity of acute cholecystitis cause of A. lumbricoides of the Tokyo Guidelines 2018 of the Hospital Emergency Service Alfredo Noboa Montenegro during the period June - December 2018, for the elaboration of a diagnostic scheme. The research methodology was quantitative cross-sectional descriptive. Among the main findings that were prevailed in the female gender in 69,41%, average age from 32 to 45 years, 10% of 170 patients presented in their ultrasound a parasitic form compatible with A. lumbricoides, clinical results that prevailed was presence of pain (67.34%), fever (68.65%), nausea (45.93%); in the laboratory findings the C Reactive Protein was increased in 94,18% of cases, in imaging the presence of pericolecist fluid is reflected in 78,82% and a thickening of the vesicular wall in 34,12%. The severity level recorded according to the criteria of the Tokyo 2018 guidelines was grade I 43,53%, grade II 48,24% and grade III 8,24%. The structuring of a timely diagnostic scheme for acute cholecystitis cause of A. lumbricoides is recommended(AU)

Consenso Argentino intersociedades de Infección Urinaria 2018-2019 - Parte I / Consenso Argentino Intersociedades de Infección Urinaria 2018-2019 - Parte I

La Sociedad Argentina de Infectología y otras sociedades científicas han actualizado estas recomendaciones utilizando, además de información internacional, la de un estudio multicéntrico prospectivo sobre infecciones del tracto urinario del adulto realizado en Argentina durante 2016-2017. La bacteriuria asintomática debe ser tratada solo en embarazadas, a quienes también se las debe investigar sistemáticamente; los antibióticos de elección son nitrofurantoína, amoxicilina, amoxicilina-clavulánico, cefalexina y trimetoprima-sulfametoxazol. Ante procedimientos que impliquen lesión con sangrado del tracto urinario se recomienda solicitar urocultivo para pesquisar bacteriuria asintomática, y, si resultara positivo, administrar antimicrobianos según sensibilidad desde inmediatamente antes hasta 24 horas luego de la intervención. En mujeres, la cistitis puede ser tratada con nitrofurantoina, cefalexina, o fosfomicina y no se recomienda usar trimetoprima-sulfametoxazol o fluoroquinolonas; en pielonefritis puede emplearse ciprofloxacina, cefixima o cefalexina si el tratamiento es ambulatorio o ceftriaxona, cefazolina o amikacina si es hospitalario. En los hombres, las infecciones del tracto urinario se consideran siempre complicadas. Se recomienda tratamiento con nitrofurantoina o cefalexina por 7 días, o bien monodosis con fosfomicina. Para la pielonefritis en hombres se sugiere ciprofloxacina, ceftriaxona o cefixima si el tratamiento es ambulatorio y ceftriaxona o amikacina si es hospitalario. Se sugiere tratar las prostatitis bacterianas agudas con ceftriaxona o gentamicina. En cuanto a las prostatitis bacterianas crónicas, si bien su tratamiento de elección hasta hace poco fueron las fluoroquinolonas, la creciente resistencia y ciertas dudas sobre la seguridad de estas drogas obligan a considerar el uso de alternativas como fosfomicina.

The Argentine Society of Infectious Diseases and other scientific societies have updated these recommendations based on data on urinary tract infections in adults obtained from a prospective multicenter study conducted in Argentina during 2016-2017. Asymptomatic bacteriuria should be treated only in pregnant women, who should also be systematically investigated; the antibiotics of choice are nitrofurantoin, amoxicillin, clavulanic/amoxicillin, cephalexin and trimethoprim-sulfamethoxazole. In procedures involving injury to the urinary tract with bleeding, it is recommended to request urine culture and, in the presence of bacteriuria, antimicrobial treatment according to sensitivity should be prescribed from immediately before up to 24 hours after the intervention. In women, cystitis can be treated with nitrofurantoin, cephalexin or fosfomycin, while trimethoprim-sulfamethoxazole and fluoroquinolones are not recommended; pyelonephritis can be treated with ciprofloxacin, cefixime or cephalexin in ambulatory women or ceftriaxone, cefazolin or amikacin in those who are hospitalized. In men, urinary tract infections are always considered complicated; nitrofurantoin or cephalexin are recommended for 7 days, alternatively fosfomycin should be given in a single dose. In men, ciprofloxacin, ceftriaxone or cefixime are suggested for pyelonephritis on ambulatory treatment whereas ceftriaxone or amikacin are recommended for hospitalized patients. Acute bacterial prostatitis can be treated with ceftriaxone or gentamicin. Fluoroquinolones were the choice treatment for chronic bacterial prostatitis until recently; they are no longer recommended due to the increasing resistance and recent concerns regarding the safety of these drugs; alternative antibiotics such as fosfomycin are to be considered.

Anthropometry Measurements to Determine Nutritional Status Among Cerebral Palsy Children: A Scoping Review

@#This article aimed to review the available anthropometry measurements used in the assessment of nutritional status among Cerebral Palsy (CP) children. Searched journals were from Medline, PubMed and Ovid published from 2015 to 2018. The search identified 443 articles, and eight studies met the criteria. Anthropometric measurements included weight, height, recumbent length, knee height, tibia length, Dual-energy X-ray absorptiometry (DXA), Bioelectrical impedance (BIA), Mid arm circumference (MUAC) subscapular skinfold (SFT), Triceps skinfold (TSF) and prediction equations. Body fat composition can be obtained by DXA, BIA, skinfold measurement, and also prediction equation. The predictive equation is the most reported method to determine nutritional status among CP. This review found that TSF and SFT are more accurate to determine body fat percentage when using together with the predictive equation. Besides, predictive equations using segmental length are reliable in estimating the height and can be used to evaluate the nutritional status using the specific CP growth chart.