Sonographic and Anatomical Evaluation of the Liver and Portal Vein Reference Values / Evaluación Ecográfica y Anatómica de los Valores de Referencia del Hígado y la Vena Porta

SUMMARY: This paper's aim is a morphometric evaluation of liver and portal vein morphometry using ultrasonography in healthy Turkish population. This study was carried out with 189 subjects (107 females, 82 males). The demographic data and the body surface area were calculated. The longitudinal axis of the liver for two lobes, diagonal axis or liver span, anteroposterior diameter of the liver and portal vein, portal vein transverse diameter, caudate lobe anteroposterior diameter, and portal vein internal diameters as well as longitudinal liver scans in an aortic plane, sagittal plane, transverse plane, and kidney axis were measured. All measurements were analyzed according to age, sex, body mass index, obesity and alcohol consumption. The mean values of the age, height, weight and body mass index were calculated as 44.39 years, 167.05 cm, 74.23 kg, and 27.06kg/m2 in females, respectively. The same values were 44.13 years, 167.70 cm, 75.93 kg and 26.71 kg/m2 in males, respectively. There was significant difference between demographic characteristics, gender, and alcohol consumption in terms of anteroposterior diameter of the liver, portal vein transverse diameter of the right side and liver transverse scan. Also, some measurements including portal vein transverse diameter, liver transverse scan and at kidney axis longitudinal scan of liver showed significant difference between the age groups. There was significant difference in diagonal axis and anteroposterior diameter of liver, portal vein internal diameter, and longitudinal liver scans of the aortic plane parameters between obesity situation. The findings obtained will provide important and useful reference values as it may determine some abnormalities related liver diseases. Also, age, sex, obesity and body mass index values can be effective in the liver and portal vein morphometry related parameters.

El objetivo de este artículo fue realizar una evaluación de la morfometría del hígado y la vena porta mediante ecografía en una población turca sana. Este estudio se llevó a cabo en 189 sujetos (107 mujeres, 82 hombres). Se calcularon los datos demográficos y la superficie corporal. Se midió eleje longitudinal del de dos lóbulos del hígado, el eje diagonal o la extensión del hígado, los diámetros anteroposterior del hígado y de la vena porta, el diámetro transversal de la vena porta, anteroposterior del lóbulo caudado y los diámetros internos de la vena porta, así como las exploraciones longitudinales del hígado en un plano aórtico. Se midieron el plano sagital, el plano transversal y el eje del riñón. Todas las mediciones se analizaron según edad, sexo, índice de masa corporal, obesidad y consumo de alcohol. Los valores medios de edad, talla, peso e índice de masa corporal se calcularon como 44,39 años, 167,05 cm, 74,23 kg y 27,06 kg/m2 en las mujeres, respectivamente. Las mismas variable fueron 44,13 años, 167,70 cm, 75,93 kg y 26,71 kg/m2. Hubo diferencias significativas entre las características demográficas, el sexo y el consumo de alcohol en términos de diámetro anteroposterior del hígado, diámetro transversal de la vena porta del lado derecho y exploración transversal del hígado. Además, algunas mediciones, incluido el diámetro transversal de la vena porta, la exploración transversal del hígado y la exploración longitudinal del hígado en el eje del riñón, mostraron diferencias significativas entre los grupos de edad. Hubo diferencias significativas en el eje diagonal y el diámetro anteroposterior del hígado, el diámetro interno de la vena porta y los parámetros de las exploraciones hepáticas longitudinales del plano aórtico entre situaciones de obesidad. Los hallazgos obtenidos proporcionarán valores de referencia importantes y útiles ya que pueden determinar algunas anomalías relacionadas con enfermedades hepáticas. Además, los valores de edad, sexo, obesidad e índice de masa corporal pueden ser eficaces en los parámetros relacionados con la morfometría del hígado y la vena porta.

Angle Evaluation of Possible Routes that Can Be Used to Reach the Foramen Ovale in the Anterior Approach / Evaluación Angular de Posibles Rutas que se Pueden Utilizar para Alcanzar el Foramen Oval en el Abordaje Anterior

SUMMARY: For the treatment of trigeminal neuralgia, the foramen ovale is reached by entering the cheek with a needle. Thermocoagulation is performed with balloon compression, administration of alcohol or radiofrequency. Apart from the classical method, it is theoretically possible to reach the foramen ovale through the mouth with the anterior approach. In our study, it was aimed to examine horizontally and vertically the angular values that must be given to the needle to reach the foramen ovale in the anterior approach. Three landmark points were determined on both right and left sides of 25 dry skulls. A rod was inserted starting from these landmark points and passing through the center of the foramen ovale. The vertical and horizontal angular values of this bar were measured. For each foramen ovale, 3 vertical angles, 3 horizontal angles and 4 distance measurements were made. There was a significant difference between the right and left sides in terms of horizontal angular values. Average values of horizontal angles (in degrees); on the right, 7.29 for H1, 12.15 for H2, 32.29 for H3; 1.26 for H1, 9.46 for H2, and 30.56 for H3 on the left side (p<0.005). The angle value was measured as 0 or negative value in 5 (20 %) of the H1 angle measurements made on the right side and 14 (56 %) on the left side. The H2 angle value was found to be smaller than the H1 angle in the skull 2 (8 %) on the right and 3 (12 %) on the left. There was no difference between the right and left sides in terms of vertical angular values. A significant difference was found between the right and left sides in the D1, D2, D4 distances (p<0.005). Six important anatomical features affecting angular values were encountered.

Para el tratamiento de la neuralgia del trigémino, se alcanza el foramen oval introduciendo una aguja en la mejilla. La termocoagulación se realiza con compresión con balón, administración de alcohol o radiofrecuencia. Aparte del método clásico, en teoría es posible alcanzar el foramen oval a través de la cavidad oral mediante el abordaje anterior. En nuestro estudio se tuvo como objetivo examinar horizontal y verticalmente los valores angulares que se deben dar a la aguja para alcanzar el foramen oval en el abordaje anterior. Se determinaron tres puntos de referencia en los lados derecho e izquierdo de 25 cráneos secos. Se insertó una varilla comenzando desde estos puntos de referencia y pasando por el centro del foramen oval. Se midieron los valores angulares verticales y horizontales de esta barra. Para cada foramen oval se realizaron mediciones de 3 ángulos verticales, 3 ángulos horizontales y 4 distancias. Hubo una diferencia significativa entre los lados derecho e izquierdo en términos de valores angulares horizontales. Valores medios de ángulos horizontales (en grados); a la derecha, 7,29 para H1, 12,15 para H2, 32,29 para H3; 1,26 para H1, 9,46 para H2 y 30,56 para H3 en el lado izquierdo (p<0,005). El valor del ángulo se midió como 0 o valor negativo en 5 (20 %) de las mediciones del ángulo H1 realizadas en el lado derecho y 14 (56 %) en el lado izquierdo. Se encontró que el valor del ángulo H2 era menor que el ángulo H1 en el cráneo 2 (8 %) a la derecha y 3 (12 %) a la izquierda. No hubo diferencia entre los lados derecho e izquierdo en términos de valores angulares verticales. Se encontró diferencia significativa entre el lado derecho e izquierdo en las distancias D1, D2, D4 (p<0,005). Se encontraron seis características anatómicas importantes que afectan los valores angulares.

Parâmetros de referência espaço-temporais de um sensor inercial para sujeitos brasileiros sadios / Spatial-temporal gait parameters based on a wearable inertial sensor of healthy Brazilian subjects

Gait analysis in a laboratory may be expensive, time-consuming, and restricted to a controlled environment. Validated wearable technology may be an alternative to such analysis. However, wearable technologies should demonstrate reference values of a healthy population. Objective: To establish spatio-temporal gait reference values of an accelerometer (G-Walk) in a healthy Brazilian population. Methods: This is a cross-sectional study with 124 healthy subjects evaluated with G-Walk in the 6-minute and 10-meter walk tests (6MWT and 10MWT). Gait parameters of Velocity, Cadence, Distance, and gait symmetry variables were retrieved for analysis. Clinical and demographical characteristics were also collected and tested with simple linear regression as covariables of the gait characteristics. The bootstrapped 5th percentile of the gait parameter established the reference values. If a covariable influence was found, the reference values were established by subgroup analysis according to the covariable. Results: The study analyzed 114 subjects, mostly women (67.74%), aged 39.36 (SD 12.18). Height was a covariable of cadence for the 10MWT and cadence and stride length for the 6MWT. Age and sex combined were covariables of 6MWT velocity, and sex alone was a covariable of 6MWT. All reference values for symmetry were above 89%, velocity at the 10MWT was above 1.0m/s, and distance at the 6MWT was 354m and 359.5 for females and males, respectively. Conclusions: Our study generated reference values for spatio-temporal gait analysis with G-Walk of a population of a major urban area, considering the covariables of age, height, and sex.

Análises da marcha em laboratório tem custo elevado, demandando tempo e ambiente controlado. Wearables são equipamentos portáteis que podem ser alternativas aos laboratórios. Valores de referência podem determinar parâmetros para análises de marcha de pessoas com patologias. Objetivo: Estabelecer valores de referência espaço-temporais de um acelerômetro (G-Walk) em uma população saudável. Métodos: Trata-se de um estudo transversal com indivíduos saudáveis avaliados com G-Walk nos testes de caminhada de 6 minutos e de 10 metros (TC6 e TC10). Velocidade, cadência, distância e de simetria da marcha foram analisados. Características clínicas e demográficas também foram testadas com regressão linear simples como covariáveis das características da marcha. Os valores de referência foram estabelecidos pelo quinto percentil dos parâmetros por bootstrap e na presença de covariáveis demográficas, os valores foram estabelecidos por análise de subgrupos, de acordo com a covariável. Resultados: O estudo analisou 114 sujeitos, em sua maioria mulheres (67,74%), com idade de 39,36 (DP 12,18). A altura foi uma covariável da cadência do TC10 e da cadência e comprimento da passada do TC6. Idade e sexo combinados foram covariáveis da velocidade do TC6, e o sexo foi uma covariável do TC6. Todos os valores de referência para simetria foram superiores a 89%, a velocidade no TC10 foi superior a 1,0m/s e a distância no TC6 foi de 354m e 359,5m para mulheres e homens, respectivamente. Conclusões: Nosso estudo gerou valores de referência para análise espaço-temporal da marcha com o equipamento G-Walk em uma população de uma grande área urbana, considerando as covariáveis idade, altura e sexo.

El trasfondo romántico del concepto de religión de Max Scheler

En la modernidad, la reflexión moral ha estado influida por orientaciones fundamentadas en la razón y en el sentimiento. Dos ejemplares de estas orientaciones son la Ilustración y el Romanticismo, respectivamente. El desarrollo de estos movimientos culturales e intelectuales está asociado a las demandas por los derechos políticos y sociales, junto a la insistencia en la importancia de la solidaridad y la hermandad en el desarrollo de las comunidades. Este artículo de reflexión presenta una perspectiva interpretativa del concepto de religión de Max Scheler La reflexión está enfocada en las raíces románticas de la propuesta Scheleriana, derivadas de la discusión moderna entre el Racionalismo y el Romanticismo. Adicionalmente, se presenta el contexto político y social al que responde la conceptualización de Scheler: Como resultado de esta reflexión, se concluye que el concepto de religión de Scheler reivindica la importancia de los valores y el compromiso moral frente a las crisis políticas que sufrió Europa a inicios del siglo XX.

In modernity moral reflection has been influenced by orientations grounded in reason and in feeling. Two exemplars of these orientations are the Enlightenment and Romanticism, respectively The development of these cultural and intellectual movements is associated with demands for social and political rights, together with the insistence in the importance of solidarity and brotherhood in the development of communities. This reflection paper presents an interpretative perspective of Max Scheler's concept of religion. The reflection is focused on the romantic roots of the Schelerian proposal, derived from the modern discussion between Rationalism and Romanticism. Additionally the political and social context to which Scheler's conceptualization responds is presented. As a result of this reflection, it is concluded that Scheler's concept of religion claims the importance of values and moral commitment against Europe's political crises at the beginning of the 20th century.

Na modernidade, a reflexão moral foi influenciada por orientações baseadas na razão e no sentimento. Dois exemplos dessas orientações são o Iluminismo e o Romantismo, respectivamente. O desenvolvimento desses movimentos culturais e intelectuais está associado a demandas por direitos políticos e sociais, juntamente com a insistência na importância da solidariedade e da fraternidade no desenvolvimento das comunidades. Este artigo de reflexão apresenta uma perspectiva interpretativa sobre o conceito de religião de Max Scheler O foco da reflexão são as raízes românticas da abordagem scheleriana, derivadas da discussão moderna entre racionalismo e romantismo. Além disso, é apresentado o contexto político e social ao qual a conceitualização de Scheler responde. Como resultado dessa reflexão, conclui-se que o conceito de religião de Scheler reivindica a importância dos valores e do compromisso moral diante das crises políticas sofridas pela Europa no início do século XX.

Niveles de referencia diagnósticos en equipos de radiografía dental en Bogotá, Colombia

Introducción: Las radiografías dentales son una de las exposiciones médicas más frecuentes a la radiación ionizante. El uso de radiación ionizante está asociado a un riesgo probable de desencadenar efectos biológicos adversos y posibles daños a la salud del paciente. Para evitar que los pacientes reciban dosis innecesariamente altas durante estas exposiciones, la Comisión Internacional de Protección Radiológica recomienda la utilización de los niveles de referencia para diagnóstico, como una herramienta efectiva de ayuda a la optimización de la protección radiológica de los pacientes. Objetivo: Estimar los niveles de referencia para diagnóstico en radiografía dental intraoral y panorámica en la ciudad de Bogotá, D. C. Metodología: Se evaluaron los parámetros de exposición radiográficos de los equipos y la calidad de imagen en 68 equipos de radiografía dental periapical y 23 equipos de radiografía panorámica. Se estimaron las magnitudes dosimétricas de kerma incidente en aire (Kai) en equipos intraorales para la radiografía de un maxilar molar de un adulto y el producto kerma aire-área (PKA) en equipos de radiografía panorámica en un examen de un adulto estándar. Resultados: El tercer cuartil de la distribución de kerma incidente en aire para radiografía intraoral fue de 3,3 mGy y del producto kerma aire-área para radiografía panorámica fue de 103,9 mGycm2. En la distribución de frecuencias de kerma incidente en aire para radiografía intraoral, el porcentaje más alto de equipos estuvo en el rango de 2,0-3,0 mGy. En la distribución de frecuencias del producto kerma aire-área para los equipos de radiografía panorámica, el porcentaje más alto de equipos estuvo en el rango de 60 a 80 mGycm2. Discusión: Las instituciones consideradas para establecer los Niveles de Referencia para Diagnóstico en este estudio contaron con una adecuada calidad de la imagen evaluada con un maniquí dental, pero las variaciones en las dosis de radiación entre instituciones señalan la necesidad de implementar herramientas que contribuyan a la optimización de las prácticas. Conclusiones: Se recomienda usar los valores de los niveles de referencia para diagnóstico encontrados en esta investigación para optimizar la protección radiológica en las exposiciones radiológicas dentales, y se espera que este estudio sirva de base para nuevas investigaciones en las demás ciudades del país.

Introduction: Dental X-rays are one of the most frequent medical exposures to ionizing radiation. The use of ionizing radiation is associated with a probable risk of triggering adverse biological effects and possible damage to the patient's health. To prevent patients from receiving unnecessarily high doses during these exposures, the International Commission on Radiological Protection recommends the use of diagnostic reference levels as an effective tool to help optimize radiological protection for patients. Objective: To estimate diagnostic reference levels in intraoral and panoramic dental radiography in the city of Bogotá, D.C. Methodology: In 68 periapical dental radiography equipment and 23 panoramic radiography equipment, the radiographic exposure parameters of the equipment and image quality were evaluated. The dosimetric magnitudes of incident air kerma (Ka,i) in intraoral equipment for the radiography of a maxillary molar of an adult and the air kerma-area product (PKA) in panoramic radiography equipment in a standard adult examination were estimated. Results: The third quartile of the incident air kerma distribution for intraoral radiography was 3,3 mGy and the air kerma-area product for panoramic radiography was 103,9 mGycm2. In the frequency distribution of incident air kerma for intraoral radiography, the highest percentage of equipment was in the range of 2,0-3,0 mGy, and in the frequency distribution of the air kerma-area product for equipment of panoramic radiography, the highest percentage of the equipment was in the range of 60 to 80 mGy cm2. Discussion: The institutions considered to establish the diagnostic reference levels in this study had an adequate quality of the image evaluated with a dental phantom, but the variations in radiation doses between institutions indicate the need to implement tools that contribute to the optimization of the practices. Conclusions: It is recommended to use the values of the diagnostic reference levels found in this research to optimize radiological protection in dental radiological exposures, and it is expected that this study will serve as a basis for further research in other cities of the country.

Valores de referencia de espirometría forzada de adultos residentes sobre o bajo 1500 m s. n. m.: revisión sistemática

Introducción: La espirometría es una prueba de función pulmonar usada en la valoración de programas de rehabilitación para evaluar exposiciones a tóxicos y alérgenos, en estudios epidemiológicos y en el desarrollo de ecuaciones de referencia en poblaciones específicas; estos valores pueden variar de acuerdo con la altura. Objetivo: Establecer las diferencias entre los valores de referencia de espirometría forzada en población adulta residentes en alturas mayores y menores a 1500 metros sobre el nivel del mar. Métodos: Revisión sistemática, se encontraron 536 estudios, se evaluaron 66 en texto completo, 33 en calidad metodológica con las listas de chequeo Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies y Quality Assessment of Case-Control Studies; 21 estudios fueron seleccionados para la revisión y 12 surtieron metanálisis. Resultados: Se contó con 48 923 participantes de alturas entre 2,4 y 4440 m s. n. m. Hay diferencias iniciales al relacionar la altura (+/-1500 m s. n. m) con el VEF1 (hombres: DM 0,29; IC: 0,03-0,55; mujeres: DM 0,27; IC: -0,07-0,60) y los valores de referencia con el sexo: CVF (DM 1,31; IC: 1,24-1,37) y VEF1 (DM: 1,03; IC: 0,95-1,11). Se reportó alta heterogeneidad y riesgo de sesgo de publicación. Discusión: Estas diferencias se dan en función de aspectos antropométricos y fisiológicos como la aclimatación y el envejecimiento pulmonar. Los mecanismos que influyen en estos cambios son la adaptación genética, molecular, fisiológica y anatómica, que permiten compensar los efectos de la hipoxia aguda o crónica, lo cual aumenta la ventilación alveolar y los valores espirométricos. Conclusiones: Los valores de referencia de espirometría varían de acuerdo con la altura (mayores en alturas > 1500 m s. n. m) y el sexo (más elevados en hombres). Es necesario contar con evidencias más amplias y contundentes en la temática.

Introduction: Spirometry is a lung function test used in the evaluation of rehabilitation programs to evaluate exposures to toxics and allergens in epidemiological studies and in the development of reference equations in specific populations; these values may vary according to height. Objective: To establish the differences between the reference values of forced spirometry in the adult population living at altitudes greater than and less than 1,500 meters above sea level. Methods: Systematic review a total of 536 studies were found; 66 were assessed in full text and 33 were assessed for methodological quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and Quality Assessment of Case-Control Studies checklists; 21 studies were selected for the review and 12 provided meta-analyses. Results: There were 48,923 participants from heights between 2.4 and 4,440 m.a.s.l. There are initial differences when relating height (+/-1,500 m.a.s.l.) with FEV1 (men: MD 0.29; CI: 0.03-0.55; women: MD 0.27; CI: -0.07-0 .60); and the reference values with gender: FVC (MD 1.31, CI: 1.24-1.37) and FEV1 (MD: 1.03, CI: 0.95-1.11). High heterogeneity and risk of publication bias are reported. Discussion: These differences occur based on anthropometric and physiological aspects such as acclimatization and lung aging. The mechanisms that influence these changes are genetic, molecular, physiological and anatomical adaptations that allow compensation for the effects of acute or chronic hypoxia, which increases alveolar ventilation and spirometric values. Conclusions: The spirometry reference values vary according to height (higher at heights >1,500 m.a.s.l.) and sex (higher in men). It is necessary to have broader and more convincing evidence on the subject.

Valores humanos e crença em informações enganosas a respeito da COVID-19 / Human values and belief in misleading information about COVID-19 / Valores humanos y creencia en información engañosa sobre la COVID-19

Valores são aspectos fundamentais da psicologia humana, sendo permeados pela forma como os indivíduos se veem e aspiram ser. Este estudo objetivou avaliar associações entre valores humanos e crença em informações enganosas sobre a COVID-19 no Brasil. Participaram 238 sujeitos, que responderam a três instrumentos de autorrelato: Questionário de Atitudes Frente ao Coronavírus, Questionário de Consumo de Informações e a Escala de Valores Pessoais - PQV-21. Evidenciou-se correlações estatisticamente significativas entre os valores de Tradição e crença em informações enganosas. Assim, quando as prioridades axiológicas envolvem a manutenção do status quo, as informações consumidas tendem a ser aquelas que negam ou minimizam a gravidade da doença. Aqueles que priorizam valores coletivistas, por outro lado, tendem a maior adesão a medidas preventivas e de controle. Ressalta-se a importância do desenvolvimento de estratégias assertivas na comunicação e orientação em saúde pública alinhadas ao estudo dos valores humanos.(AU)

Values are fundamental aspects of human psychology, permeated by the way individuals see themselves and aspire to be. This study aimed to evaluate the associations between human values and the belief in misleading information about COVID-19 in Brazil. A total of 238 participants completed three self-reporting questionnaires: one on Attitudes towards Coronavirus, another on Information Consumption, and the Portrait Values Questionnaire (PQV-21). The study revealed statistically significant correlations between the value of Tradition and the tendency to believe in misleading information. This suggests that individuals who prioritize maintaining the status quo are more likely to consume information that denies or mitigates the severity of the disease. Conversely, those who prioritize collectivist values tend to be more inclined to follow preventive and control measures. The study highlights the importance of developing assertive public health communication and guidance strategies, taking into account the influence of human values.(AU)

Los valores son aspectos fundamentales de la psicología humana, moldeados por la forma en que los individuos se ven a sí mismos y aspiran a ser. Este estudio pretendió evaluar las asociaciones entre valores humanos y creencia en información engaños sobre la COVID-19 en Brasil. Participaron 238 sujetos, que respondieron a tres instrumentos de autorregistro: el Cuestionario de Actitudes Frente al Coronavirus, el Cuestionario de Consumo de Informaciones y Escala de Valores Personales (PQV-21). Se evidenciaron correlaciones estadísticamente significativas entre los valores de Tradición y creencia en información engaños. Así, cuando las prioridades axiológicas involucran la preservación del status quo, la información consumida tiende a ser aquella que niega o minimiza la gravedad de la enfermedad. Por otro lado, aquellos que priorizan valores colectivistas tienden a mayor adhesión a medidas preventivas y de control. Se resalta la importancia del desarrollo de estrategias asertivas en la comunicación y orientación en salud pública, en consonancia con el estudio de los valores humanos.(AU)

Evidências de validade da Escala RASH - Relação, Autonomia, Separação e Heteronomia em uma amostra de brasileiros e norte americanos / Evidenced of validity of the RASH Scale - Relation, Autonomy, Separation and Heteronomy in a sample of brazilians and north americans / Evidencias de validez de la Escala RASH - Relación, Autonomía, Separación y Heteronomía en una muestra de brasileños y norteamericanos

A Escala RASH (relação, autonomia, separação e heteronomia) foi desenvolvida para investigar padrões de self em estudos transculturais. No presente estudo, foi realizada uma análise fatorial da escala RASH em amostras brasileiras e norte-americanas, com o objetivo de fornecer uma medida de quatro fatores com bons índices de ajuste. Buscou-se confirmar o padrão de self autônomo-relacionado nas duas amostras e também a relação entre o nível de escolaridade dos pais e tipos de valores que desejam para seus filhos. Coletou-se dados de 756 participantes (EUA, n = 519, Brasil, n = 237), pais ou responsáveis por alunos de 7 a 14 anos. Foram realizadas análise fatorial exploratória e confirmatória, medidas de invariância e estatísticas básicas como média, desvio padrão e correlação. Os resultados corroboram uma estrutura de quatro fatores do instrumento e os padrões autorrelatados nas duas culturas. O instrumento pode auxiliar em pesquisas transculturais sobre o desenvolvimento de valores e captar diferenças entre culturas.(AU)

The RASH scale (which stands for relation, autonomy, separation, and heteronomy) was developed to investigate patterns of self in cross-cultural studies. In the present study, a factor analysis of the RASH scale was conducted in Brazilian and North American samples, with the aim of providing a four-factor measure with good fit indices. The aim was to confirm the pattern of autonomous-relational self in the two samples and also the relationship among the parents' level of education and the types of values they want for their children. We collected data from 756 participants (n = 519, USA; n = 237, Brazil), parents or guardians of students aged 7 to 14 years. Exploratory and confirmatory factor analyses, invariance measures and basic statistics such as mean, standard deviation, and correlation were performed. The results confirmed the four-factor structure of the instrument and self-reported patterns in the two cultures. The instrument can help in cross-cultural research on the development of values and capture differences between cultures.(AU)

La escala RASH (relación, autonomía, separación y heteronomía) se desarrolló para investigar patrones del self en estudios transculturales. En el presente estudio, se realizó una validación de la escala RASH en muestras brasileñas y norteamericanas, con el objetivo de proporcionar una medida de cuatro factores con buenos índices de ajuste. Se buscó confirmar el patrón de self autónomo-relacionado en ambas muestras, así como la relación entre el nivel educativo de los padres y los tipos de valores que desean para sus hijos. Se recopilaron datos de 756 participantes (n = 519 en EE. UU.; N = 237 en Brasil), padres o tutores de estudiantes de 7 a 14 años. Se llevaron a cabo análisis factoriales exploratorios y confirmatorios, seguidos de medidas de invarianza y cálculos de estadísticas básicas como media, desviación estándar y correlación. Los resultados respaldaron la estructura de cuatro factores del instrumento y los patrones autoinformados en ambas culturas. El instrumento puede ser útil para investigaciones interculturales sobre el desarrollo de valores y para capturar las diferencias entre culturas.(AU)

Pruebas funcionales en esclerosis múltiple y su comparabilidad con los valores de administración autónoma: estudio piloto / Multiple sclerosis functional tests and their comparability with self-administered values: A pilot study

Introducción. El deterioro neurológico en la esclerosis múltiple es variable para cada paciente y su cuantificación se dificulta con el tiempo. El Multiple Sclerosis Outcome Assessment Consortium estableció medidas clínicas sensibles, costo-efectivas y reproducibles para medir los resultados de los estudios clínicos. Sin embargo, sus valores de referencia se desconocen y, en la atención habitual, su uso no está extendido por limitaciones de tiempo y entrenamiento. Objetivo. Establecer la factibilidad de la administración autónoma de las pruebas de marcha de 25 pies, símbolos y dígitos, y clavijas y nueve hoyos en individuos sanos. Materiales y métodos. Se realizó un estudio piloto descriptivo. Se incluyeron individuos sanos entre los 18 y los 80 años. Las pruebas de Timed 25-Foot Walking Test (T25-FWT) [caminata cronometrada de 25 pies], Symbol Digit Modality Test (SDMT) [símbolos y dígitos] y Nine-Hole Peg Test (9-HPT) [clavijas y nueve agujeros] fueron administradas por un médico capacitado, quien también instruyó a los sujetos sobre la administración autónoma de las pruebas. La correlación y la concordancia entre la prueba guiada y la autónoma se evaluaron con los coeficientes de Pearson y Spearman, y el análisis gráfico de Bland-Altman. Resultados. Se incluyeron 38 voluntarios sanos. La mediana de edad fue de 36 (rango: 23-55 años) y el 55,26 % eran mujeres. El coeficiente de correlación entre la prueba de administración guiada y la autónoma fue de 0,37 para la T25-FWT (p=0,01), de 0,54 para la SDMT (p<0,001) y de 0,64 y 0,65 para la 9-HPT, en las manos dominante y no dominante, respectivamente (p<0,001). Ambas formas de administración fueron concordantes para las pruebas T25-FWT (IC95%: -1,49 a 1,43), 9-HPT con la mano dominante (IC95%: -5,23 a 4,09), 9-HPT con la mano no dominante (IC95%: -7,75 a 7,14) y SDMT (IC95%: -20,94 a 24,10). Conclusiones. Los resultados de este estudio ayudan a determinar los valores de normalidad poblacional obtenidos con las pruebas T25-FWT, 9-HPT y SDMT; además, establecen la posibilidad de practicarlas de forma autónoma.

Introduction. Neurological impairment in multiple sclerosis is highly variable among patients and over time it is difficult to quantify. The Multiple Sclerosis Outcome Assessment Consortium established sensitive, cost-effective, clinically significant, and reproducible measures of different functional systems to measure outcomes in clinical trials. However, their use in clinical care routines is not widespread due to time and training constraints. Objective. To evaluate the self-administration feasibility of the timed 25-foot walking, symbol-digit-modality, and 9-peg hole tests in healthy individuals. Materials and methods. We performed a descriptive pilot study. Healthy individuals between 18 and 80 years of age were included. The Timed 25-Foot Walking Test (T25- FWT), the Symbol Digit Modality Test (SDMT), and the Nine-Hole Peg Test (9-HPT) (using the dominant and non-dominant hand) were administered by a trained physician, who also instructed the subjects about test self-administration. The correlation and agreement, between the guided and self-administered tests were assessed with Pearson and Spearman coefficients and the Bland-Altman method. Results. Thirty-eight healthy volunteers were included. The median age was 36 (range: 23-55) years old, and 55.26% were female. The correlation coefficient between guided and selfadministered tests was 0.37 for the T25-FWT (p=0.01), 0.54 for the SDMT (p<0.001), and 0.64 and 0.65 for the 9-HPT, in the dominant and non-dominant hands, respectively (p<0,001). Both forms of administration were concordant for the T25-FWT (95%CI: -1,49 to 1,43), the 9-HPT with dominant hand (95%CI: -5,23 to 4,09), the 9-HPT with non-dominant hand (95%CI: -7,75 to 7,14) and the SDMT (95% CI: -20,94 to 24,10). Conclusions. We provide a proof of concept related to the feasibility of the selfadministration of the T25-FWT, the 9-HPT, and the SDMT, as a tool to improve monitoring in routine clinical practice.

Conductas prosostenibilidad y percepciones del estudiantado adolescente sobre prácticas parentales y valores familiares / Pro-sustainability behaviors and perceptions of adolescent students about parenting practices and family values

Resumen La familia juega un papel fundamental tanto en la socialización como en la configuración de valores en menores y adolescentes. Esta investigación estudia las percepciones del estudiantado adolescente sobre prácticas parentales y valores familiares e identifica las conductas prosostenibilidad de dicho estudiantado en una triple perspectiva: reducir, reutilizar y reciclar (3R). La población diana es el estudiantado de bachillerato de la ciudad de Cuenca (Ecuador). El análisis de datos incluye: comparación de medias, coeficiente de correlación r de Pearson y regresión lineal simple. Los resultados señalan que las mujeres y los varones adolescentes del estudio perciben un elevado apoyo parental a su autonomía y que las madres conceden mayor importancia al valor de ayuda a los demás. Adicionalmente, un alto porcentaje de los sujetos realizan al menos una acción de las 3R. Se concluye que la muestra percibe a la familia como un agente impulsor de su desarrollo como sujetos autónomos, un factor prometedor para la integración de valores y el desarrollo de competencias para la sostenibilidad; sin embargo, reconoce que la escuela es donde se fragua su compromiso con un futuro sostenible con más intensidad.

Abstract The family plays a fundamental role both in socialization and in the configuration of values in minors and adolescents; including those related to environmental care. In keeping with this premise, Unicef (2018) announced that the sustainable development of the planet requires counting on families; it pointed them out as essential collaborators of governments for the quality of life of future generations. Considered a natural and elemental unit of all modern societies and an educational agent of the first order for the development and psychosocial adjustment of its members, the family is also a primary socialization agent (Fontana-Abad, Gil y Reyero, 2013). It plays a key role in the internalization of prosocial values, such as self-transcendence (care and universalism) and conservation (conformity, safety, and tradition); values ​​closely related to pro-environmental behaviors (Barrera-Hernández, Sotelo, Echeverría y Tapia, 2020). Following this line, this research studies the perceptions that adolescents have about family values, parental support for autonomy, and environmental care practices, according to the 3R rule, in a triple perspective: reduce, reuse, and recycle. It uses a quantitative, descriptive, and relational methodology. The target population was high school adolescents from the city of Cuenca (Ecuador). The sample was made up of 122 adolescents which attended three schools: one private educational unit (36.1 %) and two public (27.9 % and 36.1 %). Of the respondents, 38.8 % were female and 61.2 % were male, and they all were between 15 and 19 years old (M = 16.4; SD = 1.2); 27 % were in their first year of high school (15-17 years), 44.3 % were in their second year of high school (16-18 years) and the 28.7 % were in their third year (17-19 years). Data analysis includes comparison of means, Pearson's r correlation coefficient and simple linear regression. The results indicate that a high percentage of the adolescents in the study carry out at least one of the following environmental care actions (these are organized from highest to lowest frequency): saving water and electricity consumption, using garbage cans, reusing bottles, separating garbage, and participating in actions in favor of environment. Likewise, it is detected that they perceive family as a driving agent for their development as autonomous subjects, and a promising factor for the process of integration of values ​​and the development of competencies for caring for the environment; however, they still recognize the school as the place where their commitment to a sustainable future is most intensely forged. Additionally, the adolescents in the study perceive a high parental support for their autonomy and, likewise, that mothers attach greater importance to the value of helping others, a central axis in the ethics of care that characterizes the paradigm of sustainability. This research corroborated, once again, the ONU's (2015) position when it indicates that the family is a main agent of change for sustainability, with a decisive influence on the preservation of life and ecosystems. It endorses the relevance of promoting educational strategies that promote family-school relations in order to enhance the role of the former in the acquisition of pro-environmental values ​​and, ultimately, its collaboration in the quality of formal education aimed at sustainability. With these results, a path is opened to improve the knowledge on the parental role in relation to the promotion of behaviors of environmental care (pro-sustainability), within the framework of adolescents' and young people's formal education.

Enfermería transcultural como método para la gestión del cuidado / Transcultural nursing as an approach to care management

El objetivo general de la investigación fue describir la enfermería transcultural como método para la gestión del cuidado. Método: El planteamiento formulado por los investigadores se basó en el enfoque cuantitativo, con una metodología descriptiva con diseño no experimental. Se apoyó en el análisis documental­bibliográfico. Se organizó un proceso investigativo en donde la población de estudio se basó primordialmente en tesis y artículos científicos arbitrados. Resultados: Las desigualdades en la atención médica, causadas por las diferencias culturales en el acceso a la calidad de la atención, se manifiestan principalmente en edad, género, raza, etnia, educación, ingresos y discapacidad. En conclusión: La promoción de la enfermería transcultural se fortalece facilitando las herramientas, la formación y actualización de los profesionales existentes y las nuevas generaciones desde una preparación integral desde el conocimiento. Se deben desarrollar modelos para la gestión del cuidado, enfatizando en el respeto de los valores, creencias y patrones.

The overall objective of the research was to describe transcultural nursing as a method for care management. Method: The approach formulated by the researchers was based on the quantitative approach with a descriptive methodology with a non-experimental design, which was supported by documentary-bibliographic analysis. A research process was organized in which the study population was based primarily on theses and peer-reviewed scientific articles. Results: Inequalities in health care caused by cultural differences in access to quality of care and are manifested primarily in age, gender, race, ethnicity, education, income, disability. In conclusion: The promotion of transcultural nursing is strengthened by facilitating the tools, training and updating of existing professionals and new generations from a comprehensive preparation from knowledge, developing models for care management emphasizing respect for values, beliefs, patterns.

Ecuación de referencia espirométrica en varones de 2 regiones del norte peruano ubicadas entre 0 a 100 metros sobre el nivel del mar: Estudio transversal

Objetivo: Determinar los valores de referencia de espirometría y formular una ecuación de predicción de valores espirométricos en población económicamente activa (PEA) de regiones con altitud 0-100 m.s.n.m. Métodos: Se seleccionaron a los participantes del estudio considerando los criterios de selección del estudio. Se recogió la información sobre las variables consideradas en el estudio: Capacidad Vital Forzada (CVF) y Volumen Espiratorio Forzado en el primer Segundo (VEF1), datos sociodemográficos y medidas antropométricas. Se dividió a la muestra en dos grupos para poder formular la ecuación de referencia y para evaluar su confiabilidad en un subgrupo de validación mediante las pruebas de correlación intraclase, T de Student para muestras pareadas y los gráficos de Bland-Altman. Resultados: Se seleccionaron 1052 participantes varones. Los rangos normales de CVF y VEF1 calculados fueron de CVF de 3.48 -5.47 y VEF1 de 2.83 - 4.41. Mediante una regresión lineal múltiple, se obtuvieron las siguientes fórmulas: CVF = 2.206 - 0.131 (Altitud Geográfica) - 0.014 (Edad) + 0.045 (Talla) y VEF1 = 1.589 - 0.08 (Altitud Geográfica) - 0.015 (Edad) + 0.033 (Talla). En los análisis de confiabilidad, se encontró una diferencia estadísticamente significativa en las medias entre los valores predichos por la ecuación y los valores reales, aunque en los gráficos de Bland-Altman no se evidenció un sesgo significativo y los coeficientes de correlación intraclase (CVF-ICC: 0.69; VEF1-ICC: 0.70) se encontraban dentro de un rango adecuado. Conclusiones: Las ecuaciones de CVF y VEF1 desarrolladas permiten predecir adecuadamente los valores espirométricos en PEA masculina de las regiones incluidas en el estudio.

Objective: Determine the spirometry reference values and formulate an equation to predict spirometric values in the economically active population (EAP) in regions with an altitude of 0-100 m.a.s.l. Materials and Methods: Study participants were selected considering the study selection criteria. Information was collected on the variables considered in the study: Forced Vital Capacity (FVC) and Forced Expiratory Volume in the first second (FEV1), sociodemographic data and anthropometric measurements. The sample was divided into 2 groups to be able to formulate the reference equation and to assess its reliability in a validation subgroup using intraclass correlation tests, Student's t-test for paired samples, and Bland-Altman plots. Results: 1052 male participants were selected. The normal ranges for FVC and FEV1 calculated were FVC 3.48 - 5.47 and FEV1 2.83 - 4.41. Using multiple linear regression, the following formulas were obtained: FVC = 2.206 - 0.131 (Geographic Altitude) - 0.014 (Age) + 0.045 (Height) and FEV1 = 1.589 - 0.08 (Geographic Altitude) - 0.015 (Age) + 0.033 (Height). In the reliability analyses, a statistically significant difference was found in the means between the values predicted by the equation and the real values, although the Bland-Altman plots did not show a significant bias and the intraclass correlation coefficients (FVC- ICC: 0.69; FEV1-ICC: 0.70) were within an adequate range. Conclusions: The developed FVC and FEV1 equations allow adequate prediction of spirometric values in male PEA of the regions included in the study.

Método indirecto para la verificación del intervalo de referencia del perfil lipídico / Indirect method for the verification of the lipid profile reference range

Introducción: La dislipidemia es uno de los problemas más frecuentes en los niños y adolescentes y su estudio es importante debido a su fuerte correlación con la enfermedad cardiovascular aterosclerótica en adultos. Muchos países desarrollaron valores de referencia nacionales investigando los lípidos séricos utilizando datos basados en la población nacional propia. Nuestro objetivo fue verificar el intervalo de referencia del perfil lipídico calculando las curvas de percentiles a través del método indirecto en nuestra población pediátrica. Materiales y métodos: Se analizaron los resultados de nuestra base de datos utilizando el método indirecto. Luego de aplicar filtros y criterios de exclusión se calcularon los percentiles 25, 50, 75, 95 y 99 para colesterol total (CT), colesterol HDL (C-HDL), colesterol no HDL (C-no-HDL), triglicéridos (TG) y colesterol LDL (C-LDL) y para el C-HDL además se calculó el percentil 10. El valor de referencia para el cambio (RCV) se utilizó para determinar si existía diferencia clínicamente significativa entre los valores de percentiles obtenidos y los utilizados en el consenso de la SAP. Resultados: No se evidenció diferencia clínicamente significativa contra los valores propuesto por la SAP, excepto para los TG para las edades 1,5,7 años en el percentil 95 y para la edad de 8 años en el percentil 75 y 95; para el C-HDL en el percentil 10 para las edades 1,16 y 17 años. Discusión: Se obtuvieron los percentiles de los lípidos y se compararon con los valores de referencia utilizados por el consenso en el que están basados las guías (AU)

Introduction: Dyslipidemia is one of the most common problems in children and adolescents and its study is important because of its strong correlation with atherosclerotic cardiovascular disease in adulthood. Many countries have developed national reference values investigating serum lipids using data based on their own national population. Our aim was to verify the lipid profile reference range by calculating percentile curves through the indirect method in our pediatric population. Materials and methods: The results of our database were analyzed using the indirect method. After applying filters and exclusion criteria, the 25th, 50th, 75th, 95th, and 99th percentiles were calculated for total cholesterol (TC), HDL cholesterol (HDL-C), non-HDL cholesterol (non-HDL-C), triglycerides (TG), and LDL cholesterol (LDL-C); for HDL-C, the 10th percentile was also calculated. The reference change values (RCV) were used to determine whether there was a clinically significant difference between the percentile values obtained and those used in the consensus of the Argentine Association of Pediatrics (SAP). Results: There was no clinically significant difference with the values proposed by the SAP, except for TG for ages 1, 5, and 7 years at the 95th percentile and for age 8 years at the 75th and 95th percentile; and for HDL-C at the 10th percentile for ages 1, 16, and 17 years. Discussion: Lipid percentiles were obtained and compared with the reference values used by the consensus on which the guidelines are based (AU)

Análisis clínicos en pediatría: la necesidad de minimizar las horas de ayuno / Clinical analysis in pediatrics: the need to minimize fasting hours

Los informes de laboratorio tienen impacto en las decisiones médicas. El ayuno es un factor preanalítico "controlable" que influye en los distintos parámetros bioquímicos. El objetivo del presente trabajo es poner en discusión la realización en pediatría de análisis clínicos con la indicación de un ayuno fisiológico , analizando resultados obtenidos por diferentes autores y evaluando las diferencias clínicas encontradas según los criterios de calidad establecidos por el laboratorio de Química Clínica. La mayoría de los individuos durante el día se encuentran en estado postprandial. Los resultados del perfil lipídico en ayunas no representan las concentraciones reales promedios de los lípidos plasmáticos de un paciente. El ayuno no sería crítico en la etapa de pesquisa , pero puede ser relevante para establecer un diagnóstico certero o inicio de tratamiento. En el caso de la glucemia si se indica en el control rutinario del paciente, y no hay sospecha de alteraciones en el metabolismo de los hidratos de carbono la glucemia sin ayuno puede ser solicitada comparando la misma con valores de corte adecuado. Las diferentes guías nacionales e internacionales recomiendan que la elección de la métrica para la evaluación, control y seguimiento de pacientes con diagnóstico de diabetes se realicen según el objetivo terapéutico. En los trabajos analizados, observamos que varios parámetros bioquímicos presentaron diferencias estadísticas, aunque las diferencias clínicas no fueron relevantes y permanecieron dentro de los intervalos de referencia. El factor limitante para evaluar parámetros bioquímicos sin ayuno es la falta de valores de referencia adecuados. Hay evidencia suficiente para que tanto el perfil lipídico, la glucemia como el resto de los parámetros bioquímicos del laboratorio de química clínica, sean solicitados con la indicación de un ayuno fisiológico de 2, 4 o 6 horas, dependiendo siempre del motivo de consulta y/o la edad del paciente. Es esencial extender la evaluación a otros analitos en población pediátrica, así como evaluar nuevos puntos de corte para parámetros bioquímicos sin ayuno (AU)

Laboratory reports have an impact on medical decision-making. Fasting is a "controllable" preanalytical factor that influences the different biochemical parameters. The aim of this study is to discuss the performance of clinical analyses in pediatrics with the indication of physiological fasting, analyzing results obtained in different disciplines, and evaluating the clinical differences found according to the quality criteria established by the clinical chemistry laboratory. During the day, most patients are in a postprandial state. Fasting lipid profile results do not represent the actual average plasma lipid concentrations of a patient. Fasting would not be critical in the screening stage, but it may be relevant to establish an accurate diagnosis or initiate treatment. Regarding glycemia, if it is indicated in the routine control of the patient and there is no suspicion of alterations in carbohydrate metabolism, non-fasting glycemia can be requested, comparing it with adequate cut-off values. Different national and international guidelines recommend that the choice of metrics for the evaluation, control, and follow-up of patients with diabetes should be made according to the therapeutic objective. In the studies analyzed, we found that several biochemical parameters presented statistical differences, although the clinical differences were not relevant and remained within the reference range. The limiting factor in the evaluation of biochemical parameters without fasting is the lack of adequate reference values. There is sufficient evidence that the lipid profile, glycemia, and the remaining biochemical parameters of the clinical chemistry laboratory should be requested with the indication of a physiological fast of 2, 4, or 6 hours, always depending on the reason for consultation and/or the patient's age. It is essential to extend the evaluation to other analytes in the pediatric population, as well as to evaluate new cut-off points for biochemical parameters without fasting (AU)

Propuesta de Valores de Referencia para el Cuestionario de Evaluación del Apego Adulto: Experiences in Close Relationships (ECR-12), en población adulta chilena / Reference values for the Adult Attachment Assessment Questionnaire: Experiences in Close Relationships (ECR-12) in the Chilean Adult Population

El cuestionario de Experiencias en Relaciones Cercanas (ECR) es un instrumento de auto-reporte ampliamente utilizado para evaluar el apego en la adultez, a partir de dos dimensiones: la ansiedad y la evitación asociadas al apego. Este instrumento ha sido adaptado en múltiples contextos, incluyendo el chileno, del cual existe una versión abreviada (ECR-12), objeto de análisis del presente estudio. Si bien existe consenso en que la seguridad en el apego es mejor descrita en términos dimensionales, hay ámbitos, como en la práctica clínica donde contar con valores de referencia podría ser de utilidad. El objetivo de este estudio es proveer valores de referencia para la interpretación de los valores del ECR-12 en el contexto chileno. Para ello, una muestra de 6779 participantes respondió el ECR-12. Se utilizó el método de puntuación z con normalización para obtener los valores de referencia. Los análisis realizados evidenciaron la necesidad de construir baremos diferenciados por edad. Así, para el grupo de 29 años o menos, el punto de corte en la dimensión de ansiedad es de un promedio igual o superior a 4.4 puntos, y para la evitación, el punto de corte es de un promedio igual o superior a 2.5. En cambio, para el grupo de 30 años o más, el punto de corte en la dimensión de ansiedad es de un promedio igual o superior a 4.2, y para la evitación, es de un promedio igual o superior a 2.9. Estos hallazgos pueden ser relevantes no sólo para identificar a personas que puedan presentar niveles sustancialmente altos de ansiedad y/o evitación en el apego, sino, también puede constituirse como una herramienta clínica complementaria en contextos terapéuticos.

The Experiences in Close Relationships (ECR) questionnaire is a widely used self-report measure to assess adult attachment, based on two dimensions: attachment anxiety and attachment avoidance. This instrument has been adapted in multiple contexts, including the Chilean, for which there is an abbreviated version (ECR-12), that is the object of analysis in the present study. Although there is consensus that attachment security is best described in dimensional terms, there are areas, such as clinical practice, where having reference values could be useful. The aim of this study is to provide reference values for the interpretation of ECR-12 scores in the Chilean context. To do this, a sample of 6779 participants was evaluated using the ECR-12. The z-score normalization method was used to obtain the reference values. The analyzes carried out showed the need to build scales differentiated by age. Thus, for the group of 29 years or less, the cut-off point in the anxiety dimension is an average equal to or greater than 4.4 points, and for avoidance, the cut-off point is an average equal to or greater than 2.5. On the other hand, for the group aged 30 or older, the cut-off point in the anxiety dimension is an average equal to or greater than 4.2, and for avoidance, it is an average equal to or greater than 2.9. These findings can be relevant not only for identifying people who may present substantially high levels of anxiety and/or avoidance in attachment, but also as a complementary clinical tool in therapeutic contexts.

Percentiles de peso, talla e índice de masa corporal de escolares de Mendoza. Comparación con la referencia de la Organización Mundial de la Salud / Body mass index, weight, and height percentiles in school-aged children from Mendoza. A comparison with the WHO reference

Introducción. La Organización Mundial de la Salud (OMS) recomienda el uso de tablas de referencia para monitorear el crecimiento y estado nutricional de niños, niñas y adolescentes. El peso corporal, la talla y el índice de masa corporal (IMC) son las variables más utilizadas. El presente trabajo tiene como objetivos estimar los percentiles de peso, talla e IMC de escolares (2009-2011) residentes en el departamento San Rafael (Mendoza) y compararlos con la referencia internacional de la Organización Mundial de la Salud, a fin de establecer su pertinencia para la evaluación del crecimiento y estado nutricional de dicha población. Población y métodos. Se realizó un estudio antropométrico transversal en 3448 escolares de entre 4,00 y 13,49 años de edad. Se utilizó el programa LMS ChartMarker Pro para calcular los valores percentilares de peso/edad, talla/edad e IMC/edad, por sexo y edad, y se compararon con las curvas de la OMS. Además, se calcularon diferencias porcentuales (D%) para estimar las diferencias y su significación estadística mediante prueba de Wilcoxon. Resultados. La población de San Rafael mostró, en varones y mujeres, valores percentilares superiores de peso e IMC (D% ≈7 % y 9 %, respectivamente), y menores de talla (D% ≈0,8 %) que los de la OMS (p <0,05). Conclusión. Las diferencias encontradas alertan sobre el empleo de la referencia OMS en la población escolar de San Rafael, ya que sobreestimaría las prevalencias de sobrepeso, obesidad y desnutrición crónica, y subestimaría la de desnutrición aguda y global. Esta situación resalta la importancia de contar con una referencia local.

Introduction. The World Health Organization (WHO) recommends the use of reference tables to monitor the growth pattern and nutritional status of children and adolescents. Body mass index (BMI), weight, and height are the most commonly used variables. The objective of this study was to estimate the BMI, weight, and height percentiles for school-aged children (2009-2011) living in the department of San Rafael (Mendoza) and compare them to the international World Health Organization reference to establish their relevance for the evaluation of the growth pattern and nutritional status of this population. Population and methods. A cross-sectional anthropometric study was conducted in 3448 school-aged children aged 4.00 to 13.49 years. The LMS ChartMarker Pro software was used to estimate the BMI- for-age, weight-for-age, and height-for-age percentiles, by sex and age, and they were compared with the WHO curves. Besides, percentage differences (%D) were calculated to estimate the differences and their statistical significance using the Wilcoxon test. Results. The population of boys and girls in San Rafael showed higher weight and BMI (%D ≈ 7% and 9%, respectively) percentiles, and lower height (%D ≈ 0.8%) values than WHO reference (p < 0.05). Conclusion. The differences found warn about the use of the WHO reference in the school-aged population of San Rafael since it would overestimate the prevalence of overweight, obesity, and chronic malnutrition and underestimate the prevalence of acute and global malnutrition. This situation highlights the importance of having a local reference resource

Definición de la presión arterial normal a las 11-14 semanas de gestación según riesgo / Definition of normal blood pressure at 11 to 14 weeks' gestation according to risk

Resumen Objetivo: Definir la presión arterial normal en el primer trimestre de la gestación según el desempeño para predecir preeclampsia. Método: Estudio de cohorte en embarazos de feto único, según el modelo de riesgos en competencia para preeclampsia. La presión arterial se midió de manera estandarizada entre las 11 y 14 semanas de gestación. Resultados: En 797 embarazos incluidos hubo 40 (5.0%, intervalo de confianza del 95% [IC 95%]: 3.6-6.4) partos con preeclampsia. Las presiones arteriales sistólica, diastólica y media fueron respectivamente de 101 (9), 68 (8) y 79 (8) mmHg en las embarazadas que no desarrollaron preeclampsia, frente a 109 (10), 75 (8) y 86 (8) mmHg en las que sí (p < 0.001, prueba t de Student). Las áreas bajo la curva fueron 0.707 (0.637-0.777), 0.728 (0.661-0.795) y 0.738 (0.673-0.803). A 3% de falsos positivos, los puntos de corte fueron 119, 83 y 94 mmHg con valores predictivos negativos del 95.6%. Conclusiones: Es factible definir normalidad para la presión arterial en el embarazo con base bioestadística y clínica.

Abstract Objective: To define normal blood pressure at first trimester of pregnancy by performance for pre-eclampsia prediction. Method: A cohort study in singleton pregnancies, according to the competing risks model for pre-eclampsia. Blood pressure was measured according to a standardized method at 11 to 14 weeks' gestation. Results: Among 797 pregnancies included, there were 40 (5.0%, IC95 3.6; 6.4) deliveries with pre-eclampsia. The systolic, diastolic, and mean arterial blood pressures were respectively of 101(9), 68(8) and 79(8) mmHg in pregnant women who did not develop pre-eclampsia, against 109(10), 75(8) and 86(8) in those who did (p < 0.001, t-test). The areas under the curves were 0.707 (0.637; 0.777), 0.728 (0.661; 0.795), and 0.738 (0.673; 0.803). At a 3% of false positive rate, the cut-off points were 119, 83 and 94 mmHg with predictive values of negative of 95.6%. Conclusions: It is feasible to define the normal values for blood pressure in pregnancy on biostatistic and clinical basis.

Traditional knowledge about medicinal plant in the remote areas of Wari Tehsil, Dir Upper, Pakistan / Conhecimento tradicional sobre plantas medicinais nas áreas remotas de Wari Tehsil, Dir Upper, Paquistão

Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitant's age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of [...].

A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das [...].

Traditional knowledge about medicinal plant in the remote areas of Wari Tehsil, Dir Upper, Pakistan

Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitants age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.

Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.

Traditional knowledge about medicinal plant in the remote areas of Wari Tehsil, Dir Upper, Pakistan / Conhecimento tradicional sobre plantas medicinais nas áreas remotas de Wari Tehsil, Dir Upper, Paquistão

Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitant's age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.

Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados ​​por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.