Metacognitive Awareness among Middle School Adolescents: Development and Validation of a Shortened Version of the MAI, Jr / Conciencia metacognitiva entre adolescentes de secundaria: Desarrollo y validación de una versión abreviada del MAI, Jr

Abstract Precise and accurate measurement of metacognitive phenomena has never been more necessary than in today's fast-paced world in which vast quantities of information are readily available to the learner. The MAI, Jr. (see Sperling et al., 2002) is a widely used, 18-question, self-report measure of metacognitive awareness. However, this measure has not been re-examined for construct validity and internal consistency since its inception in 2002. In this manuscript we report on our findings of a 2-year study in which we worked to validate a shortened version of the MAI, Jr. Over the course of 2 years, 601 students in grades 6-8 participated in our study. In each year, data was examined using exploratory factor analysis with common factor extractions (principal axis factoring [PAF]) and oblique rotations (promax). The results of this study support the validation of a shortened, 7-item, scale. We discuss why shorter measures with appropriate construct validity and internal consistency are preferred.

Resumen La medición precisa y exacta de los fenómenos metacognitivos nunca ha sido más necesaria que en el acelerado mundo actual, en el que el alumno dispone de grandes cantidades de información. El MAI, Jr. (ver Sperling et al., 2002) es una medida de autoinforme de conciencia metacognitiva de 18 preguntas ampliamente utilizada. Sin embargo, esta medida no ha sido reexaminada en cuanto a validez de constructo y consistencia interna desde su inicio en 2002. En este documento se informa sobre los hallazgos de un estudio de 2 años en el que trabajamos para validar una versión abreviada del MAI, Jr. En el transcurso de 2 años, 601 estudiantes de 6.º a 8.º grado participaron en nuestro estudio. En cada año, los datos se examinaron mediante análisis factorial exploratorio con extracciones de factores comunes (factorización del eje principal [PAF]) y rotaciones oblicuas (promax). Los resultados de este estudio respaldan la validación de una escala abreviada de 7 ítems. Se discute por qué se prefieren medidas más cortas con validez de constructo y consistencia interna apropiadas.

Parto humanizado: O papel da enfermagem na prevenção da violência obstétrica / Humanized birth: The role of nursing in preventing obstetric violence

Introdução: As altas taxas de violência obstétrica (VO) no Brasil suscitam a discussão acerca de medidas de prevenção e combate às práticas abusivas e degradantes no atendimento à pessoa gestante no país. Nesse cenário, entender o papel dos profissionais de saúde é decisivo para efetivar políticas públicas já existentes no cotidiano da práxis obstétrica. Objetivos: Compreender a relevância da atuação do profissional de Enfermagem na prevenção e combate à VO e definir estratégias de intervenção práticas. Métodos: Trata-se de revisão de literatura coletada a partir de pesquisas em bases de dados virtuais, como PubMed e Biblioteca Virtual em Saúde (BVS), a partir de critérios estabelecidos previamente. Resultados: A atuação do enfermeiro obstetra é primordial para prevenir e conter a VO no atendimento à pessoa gestante em todos os momentos do atendimento pré-natal, trabalho de parto, intraparto, pós-parto e puerpério. Entretanto, a existência de importante déficit na compreensão técnica da VO entre esses profissionais dificulta o exercício de sua função plena e corrobora para a perpetuação do ciclo de violência. Conclusão: Destaca-se o potencial impacto da atuação de enfermeiros na contenção de situações de VO e possíveis práticas de humanização do atendimento a serem adotadas, bem como identifica lacunas que dificultam a redução dos índices de abusos ocorridos durante o cuidado materno-fetal.(AU)

Introducción: Los altos índices de Violencia Obstétrica (VO) en Brasil incentivan discusiones sobre medios de prevención y combate a las prácticas abusivas y vejatorias durante la atención a gestantes en el país. En ese sentido, comprender el papel de los profesionales de salud es decisivo para actualizar las medidas públicas ya existentes en el cotidiano de la práctica de la partera. Objetivos: Comprender la relevancia de la actuación de los profesionales de enfermería en la prevención y combate a la VO y definir estrategias prácticas de intervención. Métodos: Se trata de una revisión de la literatura recogida a través de la investigación en bases de datos virtuales como PubMed y Biblioteca Virtual em Saúde (BVS), a partir de criterios previamente establecidos. Resultados: La actuación de las enfermeras obstétricas es primordial para prevenir y contener la VO sobre la gestante durante el prenatal, parto, intraparto, postparto y puerperio. Sin embargo, la existencia de un importante déficit sobre la comprensión técnica de la VO en medio de esos profesionales dificulta el desempeño de su papel y favorece la permanencia de ese ciclo de violencia. Conclusiones: Se destaca el impacto potencial de la actuación de las enfermeras en la contención de los casos de VO, así como las posibles prácticas humanizadoras del cuidado a ser implementa-das, además de identificar lagunas que dificultan la disminución de los índices de maltrato ocurridos durante la atención materno-fetal.(AU)

Introduction: The high Obstetrical Violence (OV) rates in Brazil encourage discussions about means of prevention and combat of abusive and abusive practices during the care for pregnant people in the country. On that note, understanding the role of healthcare workers is decisive to actualize already existing public measures in the midwife practice's daily routine. Objectives: Comprehend the relevancy of nursing professional's actions on the prevention and combat of OV and define practical intervention strategies. Methods: It is a review of literature collected through research in virtual databases such as PubMed and Biblioteca Virtual em Saúde (BVS), based on previously established criteria. Results: The actions of obstetric nurses are primordial to prevent and contain OV upon the pregnant person during prenatal care, labor, intrapartum, post childbirth and postpartum. Nonetheless, the existence of an important deficit about the technical comprehension of OV midst these professionals makes it difficult to perform their proper role and endorses the stay of this cycle of violence. Conclusion: The potential impact of nurse's actions to contain cases of OV as well as possible humanizing care practices to be implemented stand out, as well as how it identifies gaps that hamper the decrease of abuse rates occurred during maternal-fetal care.(AU)

Púrpura fulminante postinfecciosa: a propósito de un caso / Postinfectious purpura fulminans: A case report

La púrpura fulminante adquirida postinfecciosa es una entidad aguda y grave, poco frecuente, caracterizada por necrosis cutánea asociada a coagulopatía intravascular diseminada (CID), en ausencia de infección activa o alteraciones previas de la coagulación. Afecta fundamentalmente a la población pediátrica y, en el 90 % de los casos, está precedida por un proceso infeccioso. El mecanismo fisiopatológico es un déficit transitorio de proteína S mediado por autoanticuerpos que favorece un estado de hipercoagulabilidad. Se presenta el caso de un varón de 8 años previamente sano, con lesiones cutáneas purpúricas características de púrpura fulminante asociada a CID en ausencia de sepsis. Se constató deficiencia plasmática transitoria de proteína S. Requirió tratamiento sustitutivo con plasma fresco congelado y anticoagulación; la evolución fue favorable. La actividad de la proteína S permaneció disminuida durante 2 meses.

Acquired postinfectious purpura fulminans is a rare, acute, and severe disease characterized by skin necrosis associated with disseminated intravascular coagulation (DIC) in the absence of active infection or previous coagulation disorders. It mainly affects the pediatric population and, in 90% of cases, it is preceded by an infectious process. The pathophysiological mechanism is a transient autoantibodymediated protein S deficiency that favors a hypercoagulable state. Here we describe the case of a previously healthy 8-year-old boy with purpuric skin lesions typical of purpura fulminans associated with DIC in the absence of sepsis. A transient plasma protein S deficiency was confirmed. He required replacement therapy with fresh frozen plasma and anticoagulation; he had a favorable course. Protein S activity remained decreased for 2 months.

Experimental Model Exposed to Bisphenol and Submitted to a High-Fat Diet and Related Morphologic Testicular Parameters Alterations Analysis

ABSTRACT Purpose To evaluate the morphological and stereological parameters of the testicles in mice exposed to bisphenol S and/or high-fat diet-induced obesity. Material and Methods Forty adult male C57BL/6 mice were fed a standard diet (SC) or high-fat diet (HF) for a total of 12 weeks. The sample was randomly divided into 4 experimental groups with 10 mices as follows: a) SC - animals fed a standard diet; b) SC-B - animals fed a standard diet and administration of BPS (25 μg/kg of body mass/day) in drinking water; c) HF: animals fed a high-fat diet; d) HF-B - animals fed a high-fat diet and administration of BPS (25 μg/Kg of body mass/day) in drinking water. BPS administration lasted 12 weeks, following exposure to the SC and HF diets. BPS was diluted in absolute ethanol (0.1%) and added to drinking water (concentration of 25 μg/kg body weight/day). The animals were euthanized, and the testes were processed and stained with hematoxylin and eosin (H&E) for morphometric and stereological parameters, including density of seminiferous tubules per area, length density and total length of seminiferous tubules, height of the tunica albuginea and the diameter of the seminiferous tubules. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done with the Image Pro and Image J programs. Means were statistically compared using ANOVA and the Holm-Sidak post-test (p<0.05). Results The seminiferous tubule density per area reduced in all groups when compared with SC samples (p<0.001): HF (40%), SC-B 3(2%), and HF-B (36%). Length density was reduced significantly (p<0.001) in all groups when compared with SC group: HF (40%), SC-B (32%), and HF-B (36%). The seminiferous tubule total length was reduced (p<0.001) when compared to f HF (28%) and SC-B (26%) groups. The tubule diameter increased significantly (p<0.001) only when we compared the SC group with SC (54%) an SC-B (25%) groups and the tunica thickness increased significantly only in HF group (117%) when compared with SC-B (20%) and HF-B 31%. Conclusion Animals exposed to bisphenol S and/or high-fat diet-induced obesity presented important structural alterations in testicular morphology.

Sialolitotomía submandibular / Submandibular Sialolithotomy

Los sialolitos son masas calcificadas que se encuentran dentro de los conductos salivales, siendo más frecuente su localización en el conducto de la glándula submandibular, asociado a su configuración anatómica, así como a la alta concentración de fosfatos de calcio y mucina en la saliva. Su patogenia no está bien identificada ni establecida. La sintomatología está asociada a dolores prandiales, así como inflamación de la glándula afectada y en ocasiones se presenta sintomatología de índole infecciosa. El diagnóstico es realizado mediante una palpación bimanual extraoral e intraoral de la glándula, así como el apoyo de estudios imagenológicos. El tratamiento depende de la localización y del tamaño del sialolito, con base en estos criterios se opta por una intervención conservadora o bien su remoción quirúrgica. El presente artículo describe una sialolitotomía submandibular con abordaje intraoral (AU)

Sialoliths are calcified masses found within the salivary ducts, most frequently located in the submandibular gland duct, associated with their anatomical configuration as well as the high concentration of calcium phosphates and mucin in saliva. Its pathogenesis is not well identified or established. The symptoms are associated with prandial pain, as well as inflammation of the affected gland and occasionally symptoms of an infectious nature are present. Diagnosis is made by extraoral and intraoral bimanual palpation of the glands, as well as the support of imaging studies. Treatment depends on the location and size of the sialolith. Based on these criteria, a conservative intervention or surgical removal is chosen. This paper describes a submandibular sialolithotomy with an intraoral approach (AU)

Streptococcus gallolyticus subspecies pasteurianus causing late onset neonatal sepsis and meningitis: a case report

Streptococcus gallolyticus is a gram-positive microbe rarely isolated from cases of neonatal sepsis. Prompt identification, management and monitoring is necessary in such cases due to potential complications like meningitis and endocarditis. We report a preterm baby referred to us on day 18 of life with fever, respiratory distress and lethargy with seizure. Blood culture revealed S. gallolyticus subspecies pasteurianus with meningitis on cerebrospinal fluid examination. He was treated with 21 days of injectable vancomycin and teicoplanin. Baby had no neurological sequelae or other end organ complications. To the best of our knowledge, this is the first case report from eastern India describing sepsis secondary to this rare organism.

Immunomodulation as a Treatment for Parkinson´s Disease in Current Trials: A Systematic Review and Meta-Analysis

ABSTRACT Background: Immunomodulatory drugs and immunotherapies are being evaluated in clinical trials for the treatment of neuroinflammation, as the latter is an essential mechanism for the development and progression of Parkinson´s disease. Objective: The objective of the study is to review recent evidence on the evaluation of immunomodulators in randomized controlled clinical trials measuring improvement of motor symptoms. Methods: A meta-analysis of Movement Disorder Society-Unified Parkinson´s disease Rating Scale (MDS-UPDRS III) scores extracted from seven articles selected after an online search of PubMed, Cochrane Library, and Clarivate's Web of Science for randomized controlled clinical trials published between 2000 and July 2023 was performed. The selected articles reported clinical trials evaluating the effects of specific immunomodulators or treatments with known effects on the immune system and inflammation. MDS-UPDRS III scores were reported in these studies, and the results of the placebo groups were compared with those of the treatment groups. Results: A total of 590 patients treated with immunomodulators and 622 patients treated with placebo were included. A test for heterogeneity yielded an I2 value > 50%. The mean standard difference for change in MDS-UPDR III score was −0.46 (CI [95%] = −0.90 - −0.02, p < 0.01). No significant differences were found in the change in mean MDS-UPDR III score between the treatment and placebo groups; however, two studies showed a trend toward separation from the mean. Conclusion: The immunomodulatory treatments included in this study showed no efficacy in improving motor symptoms in Parkinson´s disease patients. Further clinical trials with larger patient populations are needed.

Transición en enfermedades inflamatorias intestinales: de la pediatría a la adultez / Transition in inflammatory bowel diseases: from childhood to adulthood

El 25% de los pacientes con Enfermedades Inflamatorias Intestinales (EII) se diagnostican antes de los 20 años. En la mayor parte de los centros del país se lleva a cabo la "transferencia" del paciente desde un centro de atención pediátrico a uno de adultos. La "transición" es un criterio de calidad con beneficios en el control de la EII reduciendo el número de recaídas, de hospitalizaciones y de cirugías. Por tal motivo hemos desarrollado un Programa Interdisciplinario de Transición entre dos hospitales de referencia nacional e internacional en EII. Materiales y métodos: Entre 1/2021 y 12/ 2022 se incorporaron 24 pacientes que ingresaron en 3 fases: Fase 1 Pacientes entre 14 y 16 años asistidos en el Hospital Garrahan (HG) con un abordaje interdisciplinario. Fase 2. A partir de los 17 años se realizaron 2 (dos) encuentros en el HG en conjunto con gastroenterólogos de adultos evaluando adherencia y autonomía y la Fase 3 llevada a cabo en el Hospital B. Udaondo (HBU) sólo con el equipo de adultos luego de 6 meses de realizada la transferencia evaluando adherencia al tratamiento, consultas a emergencias, internación y/o cirugías Resultados: Al inicio del Programa el 66% de los pacientes presentaban una actividad moderada a severa vs el 8% al finalizar la fase 3. Luego de la transferencia el 12,5% necesito ingreso a guardia e internación y un 8% tratamiento quirúrgico. El 83% de los pacientes continúan en seguimiento luego de 6 meses de haber sido transferidos (AU)

Twenty-five percent of patients with inflammatory bowel diseases (IBD) are diagnosed before the age of 20 years. In most centers in the country, the "transfer" of the patient from a pediatric to an adult care center is done. However, "transition" is a quality criterion with benefits in the control of IBD by reducing the number of relapses, hospitalizations, and surgeries. For this reason, we developed an Interdisciplinary Transition Program between two national and international reference hospitals in IBD. Materials and Methods: Between January 2021 and December 2022, we incorporated 24 patients into a three-phase program. Phase 1 involved patients between 14 and 16 years of age seen at Garrahan Hospital (HG) with an interdisciplinary approach. Phase 2 began from 17 years of age, with two meetings held at HG involving adult gastroenterologists to evaluate adherence and autonomy. Phase 3 was conducted at Hospital B. Udaondo (HBU) only with the adult team, six months after the transfer, evaluating adherence to treatment, emergency consultations, hospitalizations, and/or surgeries. Results: At the beginning of the program, 66% of the patients presented with moderate to severe disease activity, compared to 8% at the end of Phase 3. After the transfer, 12.5% of the patients required emergency department visits and hospitalization, and 8% required surgical treatment. Eighty-three percent of the patients continue in the program and are still being followed up six months after the transfer (AU)

Investigações sobre a visibilidade dada ao usuário de drogas durante a ditadura militar brasileira no acervo da Folha de S. Paulo / Research on the visibility given to drug users during the Brazilian military dictatorship in the Folha de S. Paulo archive / Investigación sobre la visibilidad dada a los usuarios de drogas durante la dictadura militar brasileña en lo acervo de la Folha de S. Paulo

Este artigo traz reflexões com base no acervo virtual da Folha de S.Paulo, identificando representações do usuário de substâncias psicoativas veiculadas pelo jornal no período da Ditadura Militar brasileira, anos notáveis por aspectos políticos, culturais, jurídico-legais e médicos diretamente associados às drogas. Nesse contexto, foram selecionadas notícias sobre o assunto veiculadas pela Folha, dada a sua ascensão nacional, na década de 1960, pela fusão da Folha da Manhã e da Folha da Noite, e como empresa de mídia aliada do governo ditatorial. Para isso, foram feitas consultas ao repositório virtual do jornal usando adjetivos que referenciam quem utiliza substâncias psicoativas: "drogado", "toxicômano", "usuário de drogas", "usuário de entorpecentes", "viciado em drogas" e "dependente químico"). Surgiram duas categorias: saúde e crime. Delas derivam as representações do usuário de drogas. Ao longo do texto, reflete-se sobre os processos de sua visibilidade e estigmatização e a maneira como isso impacta atualmente. Reflete-se ainda sobre o caráter democrático do acesso ao repositório digital do jornal, bem como sobre os atuais movimentos nostálgicos do ufanismo existente no período ditatorial e seus impactos nas políticas de drogas.

This article reflects on the virtual archive of Folha de S.Paulo, identifying representations of psychoactive substance users published by that newspaper during the Brazilian Military Dictatorship, years notable for the political, cultural, legal and medical aspects directly associated with drugs. In this context, news on the subject published by Folha was selected, given its national rise in the 1960s through the merger of Folha da Manhã and Folha da Noite, and as a media company allied with the dictatorial government. To do this, the newspaper's virtual repository was searched using adjectives that refer to those who use psychoactive substances: "drugged", "drug addict", "drug user", "illegal narcotics user", "hooked on drugs" and "chemical dependent"). Two categories emerged: health and crime. The representations of drug users derive from these. Throughout this text, we reflect on the processes of their visibility and stigmatisation and the way in which this has an impact today. We also reflect on the democratic nature of access to the newspaper's digital repository, as well as the current nostalgic movements for chauvinism that existed during the dictatorial period and their impact on drug policies.

Este artículo aporta reflexiones basadas en el acervo virtual de la Folha de S.Paulo, identificando las re-presentaciones de los usuarios de sustancias psicoactivas publicadas por el periódico durante la Dictadura Militar brasileña, años destacados por los aspectos políticos, culturales, jurídicos y médicos directamente asociados a las drogas. En este contexto, fueron seleccionadas noticias sobre el tema publicadas por la Folha, dada su proeminencia nacional en la década de 1960 a través de la fusión de Folha da Manhã y Folha da Noite, y como medio de comunicación aliado del gobierno dictatorial. Para hacerlo, se realizó una búsqueda en el repositorio virtual del periódico utilizando adjetivos que hacen referencia a quien consume sustancias psicoactivas: "yonqui", "toxicómano", "usuario de drogas", "usuario de estupefacientes", "dro-gadicto" y "químicamente dependiente"). Surgieron dos categorías: salud y crimen. De ellas se derivan las representaciones de los usuarios de drogas. A lo largo del texto, reflexionamos sobre los procesos de su visibilidad y estigmatización y la forma como esto repercute en la actualidad. También reflexionamos sobre el carácter democrático del acceso al repositorio digital del periódico, así como sobre los actuales movi-mientos nostálgicos del ufanismo que existió durante la dictadura y su impacto en las políticas de drogas.

Staphylococcus aureus: changes in antimicrobial sensitivity profile and its relationship with SCCmec among clinical isolates / Staphylococcus aureus: alterações no perfil de sensibilidade antimicrobiana e sua relação com SCCmec entre isolados clínicos / Staphylococcus aureus: cambios en el perfil de sensibilidad antimicrobiana y su relación con SCCmec entre aislados clínicos

Background and Objectives: Staphylococcus aureus is a pathogen of great clinical relevance, especially those resistant to methicillin, called MRSA. Over the years, S. aureus antimicrobial resistance patterns have changed. Understanding such changes is essential to update protocols and propose efficient therapeutic approaches. This study aimed to characterize the temporal distribution of S. aureus antimicrobial resistance in patients admitted to the hospital as well as to assess its relationship with SCCmec typing. Methods: a total of 9,949 cultures of clinical materials were analyzed, between January 2000 and October 2019, from patients admitted to a university hospital in southern Brazil. All isolates had their identification and antimicrobial sensitivity profile analyzed using manual and automated techniques. Furthermore, 86 isolates were selected for mecA gene research and SCCmec typing using conventional and multiplex PCR techniques, respectively. Results: when assessing the temporal distribution of S. aureus over 20 years, it was possible to observe a drop in the proportion of MRSA compared to methicillin-sensitive S. aureus (MSSA). Between 2000 and 2002, the frequency of MRSA was 58.5%, whereas that of MSSA was 36.7%. However, from 2003 onwards, there was a reversal of these percentages. At the end of the analyzed period, 55.2% of infections were caused by MSSA, whereas 36.2% contained MRSA isolates. Furthermore, in the period analyzed, the highest prevalence was of SCCmec type II. Conclusion: these data suggest an epidemiological change in S. aureus from clinical materials, with a change in the prevalent type of SCCmec and changes in the antimicrobial sensitivity profile exhibited by the isolates. Such facts must be considered by the clinical staff with a focus on effective patient management, the choice of appropriate antimicrobial therapy so that effective infection control measures are implemented.(AU)

Justificativa e Objetivos: Staphylococcus aureus é um patógeno de grande relevância clínica, especialmente aqueles resistentes à meticilina, denominados MRSA. Ao longo dos anos, os padrões de resistência antimicrobiana dos S. aureus têm apresentado modificações. Compreender tais mudanças é fundamental para atualizar protocolos e propor abordagens terapêuticas eficientes. O objetivo do estudo foi caracterizar a distribuição temporal da resistência antimicrobiana de S. aureus proveniente de pacientes internados no hospital, bem como avaliar sua relação com a tipagem SCCmec. Métodos: foram analisadas 9.949 culturas de materiais clínicos, entre janeiro de 2000 e outubro de 2019, de pacientes internados em um hospital universitário no sul do Brasil. Todos os isolados tiveram sua identificação e perfil de sensibilidade aos antimicrobianos analisados por técnicas manuais e automatizadas. Ainda, 86 isolados foram selecionados para a realização da pesquisa do gene mecA e tipagem SCCmec, utilizando a técnica de PCR convencional e multiplex, respectivamente. Resultados: avaliando a distribuição temporal dos S. aureus ao longo de 20 anos, foi possível observar queda na proporção de MRSA em comparação com o S. aureus sensível à meticilina (MSSA). Entre 2000 e 2002, a frequência de MRSA foi de 58,5%, enquanto que a de MSSA foi de 36,7%. No entanto, a partir de 2003, houve uma inversão desses percentuais. Ao final do período analisado, 55,2% das infecções foram ocasionadas por MSSA, enquanto que 36,2% continham isolados de MRSA. Ainda, no período analisado, a prevalência maior foi do SCCmec tipo II. Conclusão: esses dados sugerem uma alteração epidemiológica em S. aureus provenientes de materiais clínicos, com alteração do tipo SCCmec prevalente e modificações do perfil de sensibilidade aos antimicrobianos exibidos pelos isolados. Tais fatos devem ser considerados pelo corpo clínico, focando para que haja um manejo efetivo dos pacientes, escolha da terapia antimicrobiana adequada e para que medidas de efetivas de controle de infecção sejam implementadas.(AU)

Justificación y Objetivos: Staphylococcus aureus es un patógeno de gran relevancia clínica, especialmente los resistentes a meticilina, denominado MRSA. Con el paso de los años, los patrones de resistencia a los antimicrobianos de S. aureus han cambiado. Comprender tales cambios es esencial para actualizar los protocolos y proponer enfoques terapéuticos eficientes. El objetivo del estudio fue caracterizar la distribución temporal de la resistencia antimicrobiana de S. aureus en pacientes ingresados en el hospital, así como evaluar su relación con la tipificación de SCCmec. Métodos: se analizaron 9.949 cultivos de materiales clínicos, entre enero de 2000 y octubre de 2019, de pacientes ingresados en un hospital universitario del sur de Brasil. Se analizó la identificación y el perfil de sensibilidad antimicrobiana de todos los aislados mediante técnicas manuales y automatizadas. Además, se seleccionaron 86 aislados para la investigación del gen mecA y la tipificación de SCCmec, utilizando técnicas de PCR convencional y múltiple, respectivamente. Resultados: al evaluar la distribución temporal de S. aureus durante 20 años, fue posible observar una caída en la proporción de MRSA en comparación con S. aureus sensible a meticilina (MSSA). Entre 2000 y 2002, la frecuencia de MRSA fue del 58,5%, mientras que la de MSSA fue del 36,7%. Sin embargo, a partir de 2003, se produjo una reversión de estos porcentajes. Al final del período analizado, el 55,2% de las infecciones fueron causadas por MSSA, mientras que el 36,2% contenía aislados de MRSA. Además, en el período analizado, la mayor prevalencia fue de SCCmec tipo II. Conclusión: estos datos sugieren un cambio epidemiológico en S. aureus a partir de materiales clínicos, con un cambio en el tipo prevalente de SCCmec y cambios en el perfil de sensibilidad antimicrobiana exhibido por los aislados. El personal clínico debe considerar estos hechos, centrándose en el tratamiento eficaz del paciente, la elección del tratamiento antimicrobiano adecuado y la implementación de medidas eficaces de control de infecciones.(AU)

Orogenital ulcers and the Behcet’s disease

Behcet’s’s disease is a systemic vasculitis involving small to large veins and arteries. It is a sporadic disease, mostly prevalent among the ancestors of the silk route. It is characterized by recurrent oral ulcers, genital ulcers, and uveitis. It also can manifest as skin, vascular, gastrointestinal, neurological, cardiac, and renal involvement. Though overall mortality is around 5%, delay in diagnosis and treatment may lead to significant morbidity. Cardiovascular and pulmonary arterial aneurysms are dreadful complications of this disease. Being uncommon in south India it is liable to be wrongly diagnosed and treated. Delay in the diagnosis and treatment may lead to severe complications. Here we present a case of Behcet’s disease which was managed at primary health care inadequately. We also demonstrated a quick response to steroids which are the mainstay of treatment. In this case presentation we illustrated pre and post treatment scrotal and oral Behcet’s’s lesions for clinicians to memorize. We also discussed international criteria to diagnose Behcet’s disease (ICBD) in concurrence with our case. In this presentation, we briefly described the involvement of other systems and their treatment. This article also elaborated on the latest developments in the treatment of Behcet’s disease.

Aspectos relacionados às preferências e vivências das mulheres perante as vias de parto / Aspects related to women's preferences and experiences with birth routes / Aspectos relacionados con las preferencias y experiencias de las mujeres respecto a las vías de parto

Objetivo: Analisar as preferências e vivências das mulheres perante as vias de parto. Métodos: Trata-se de uma pesquisa qualitativa do tipo exploratória, através de relatos de experiências de um total de 19 mulheres, as quais tiveram seus filhos por via de parto normal ou cesariana, nos anos de 2020 ou 2021. Resultados: A cesariana e o parto normal possuem divergências perante as experiências vivenciadas pelas mulheres. O procedimento da cesárea vem se tornando uma conduta rotineira, dificultando a autonomia da parturiente nas tomadas de decisões. Diferente do parto normal, o qual segundo relatos observados nas entrevistas, é um processo que envolve e depende mais da mulher. O parto normal ainda é temido pelas mulheres pelo medo da dor, enfatizando a necessidade de um acompanhamento de qualidade durante todo o processo de pré-natal, trabalho de parto e parto. Conclusão: Percebeu-se através do estudo que a preferência pelo parto normal vem crescendo ao longo dos últimos anos, mesmo a cesariana ainda sendo a via de parto com maiores índices. Os sentimentos e experiências das mulheres durante o parto são relativos conforme suas vivências e preferências, sendo considerado também a influência das condutas dos profissionais. (AU)

Objective: To analyze the preferences and experiences of women regarding birth routes. Methods: This is an exploratory qualitative research, through the experience reports of a total of 19 women, who had their children by normal birth or cesarean section, in the years 2020 or 2021. Results: Cesarean and normal birth have divergences in the experiences of women. The cesarean procedure has become a routine conduct, hindering the autonomy of the mother in decision-making. Unlike normal birth, which according to reports observed in the interviews, is a process that involves and depends more on the woman. Normal birth is still feared by women for fear of pain, emphasizing the need for quality monitoring throughout the prenatal process, labor and delivery. Conclusion: The study showed that the preference for normal birth has been growing over the past few years, even though the cesarean section is still the most commonly used method of delivery. The feelings and experiences of women during childbirth are relative according to their experiences and preferences, being also considered the influence of the professionals' behaviors. (AU)

Objetivo: Analizar las preferencias y vivencias de las mujeres ante las vías de parto. Métodos: Se trata de una investigación cualitativa de tipo exploratorio, a través de los relatos de experiencias de un total de 19 mujeres, que tienen sus hijos por vía de parto normal o cesárea, en los años 2020 o 2021. Resultados: La cesárea y el parto normal tienen divergencias ante las experiencias vividas por las mujeres. El procedimiento de cesárea se ha convertido en una conducta rutinaria, dificultando la autonomía de la parturienta en la toma de decisiones. A diferencia del parto normal, que según los informes observados en las entrevistas, es un proceso que implica y depende más de la mujer. El parto normal aún es temido por las mujeres por el dolor, enfatizando la necesidad de un acompañamiento de calidad durante todo el proceso prenatal, el trabajo de parto y el parto. Conclusión: Se percibe a través del estudio que la preferencia por el parto normal está creciendo a lo largo de los últimos años, aunque la cesárea sigue siendo la vía de parto con mayores índices. Los sentimientos y las experiencias de las mujeres durante el parto son relativos a sus vidas y preferencias, considerando también la influencia de las conductas de los profesionales. (AU)

Screening of essential oils against oxacillin - resistant Staphylococcus aureus strains isolated from bovine mastitis / Screening de aceites esenciales frente a Staphylococcus aureus oxacilino - resistentes extraidos de aislados de mastitis bovina

Bovine mastitis is a disease wi th far - reaching consequences for the dairy industry. Staphylococcus aureus is a pathogen that is especially resistant to antibiotics. The objective of this study was to evaluate the antimicrobial activity of the essential oils Lippia citriodora (Lam.), Thy mus vulgaris (L), and a mixture of the essential oils Lippia citriodora and Thymus vulgaris (50/50 v/v), against isolates of oxacillin - resistant Staphylococcus aureus (n=15) of positive cases of bovine mastitis. For the statistical analysis, the IBM SPSS s tatistical package was used. The mixture of essential oils ( Lippia citriodora and Thymus vulgaris (50/50 v/v)) obtained the most significant antimicrobial activity in relation to pure essential oils. It is therefore concluded that the mixture of these oils boosts their antimicrobial activity ( p <0.05). The minimum inhibitory and bactericidal concentration of this mixture for the total isolations was 12 µL/L and 25 µL/mL, respectively.

La mastitis bovina es una enfermedad de gran impacto para la industria lechera. El Staphylococcus aureus es uno de los principales patógenos, especialmente aquellos resistentes a los antibióticos. El objetivo de este estudio fue evaluar la actividad antimicrobiana de los aceites esenciales de Lippia citriodora (Lam.), Thymus vulgaris (L), y una mezcla de aceites esenciales de Lippia citriodora y Thymus vulgaris (50/50 v/v), frente a aislamientos clínicos de Staph ylococcus aureus oxacilino - resistentes (n=15) de mastitis bovina. Se utilizó p rograma estadístico IBM SPSS y se concluyó la diferencia significativa a un p <0.05. La mezcla de aceites esenciales ( Lippia citriodora y Thymus vulgaris (50/50 v/v)), obtuvo la m ayor actividad antimicrobiana en relación a los aceites esenciales puros, se concluye que la mezcla de estos aceites potencia su actividad antimicrobiana ( p <0.019). La concentración mínima inhibitoria y bactericida de esta mezcla fue del 12 µL/mL y 25 µL/m L, respectivamente, y puede ser una alternativa terapéutica.

Unveiling complex interaction of sickle cell hemoglobin with another hemoglobinopathy - A Rare Entity

ABSTRACT Hemoglobinopathies constitute one of the most common inherited hematological disorders in the world with an increasing global disease burden each year. One among them is sickle cell disease with diverse genotypes and wide phenotypic heterogenity. Many subgroups exist within the umbrella of sickle cell disease. Hb S/DPunjab, a rare hemoglobinopathy, is one of them, mimics sickle cell disease, and is discussed in the present study. We describe one such unusual clinical case of a young child who presented with intermittent fever and joint problems. The study case was found to have Hb S/DPunjab by high performance liquid chromatography. Clinical and hematological details of this rare condition is only briefly discussed in the literature. Precise diagnosis can be made using high performance liquid chromatography in conjunction with family studies.

A MOLECULAR MODELLING APPROACH FOR STRUCTURE-BASED VIRTUAL SCREENING AND IDENTIFICATION OF NOVEL ISOXAZOLES AS POTENTIAL ANTIMICROBIAL AGENTS AGAINST S. AUREUS

Objective: Universal use of antibacterial agents and swift development of resistance by the microorganisms pose a major threat to public health. Hence, there is a pressing need to develop novel antimicrobials. Isoxazole derivatives exhibiting versatile biological activities have been widely used as important scaffolds in the field of drug designing.Methods: Twenty isoxazole derivatives were virtually screened by means of the molecular docking approach in order to identify potential antimicrobials against the most common disease-causing bacteria, S. aureus. In silico studies were done to detect the selectivity of the novel isoxazole derivatives for the selected bacterial protein targets using ‘Glide’. In silico docking was carried out on few essential enzymes of S. aureus; Dihydrofolate reductase (DHFR), DNA gyrase, Dihydropteroate Synthetase (DHPS), Pyuvate kinase (PK). The compounds were subjected to energy minimization, followed by optimization and minimization of protein and generation of 3D grid at its active site. The ligands were subjected to molecular docking the Standard Precision and Extra Precision modes.Results: Docking of the compounds with Pyruvate Kinase and dihydrofolate reductase are quite encouraging.2C (4-hydroxy) and 2D (4-hydroxy) analogues gavea G Score of-8.33 and-8.64 with DHFR and Pyruvate Kinase respectively. However, the dock scores for the other target proteins indicate that the scaffolds have not bound with those bacterial targets. Moreover, ADME studies indicate that the derivatives do not show any violations in the rules for the requirements of orally active drugs.Conclusion: Study suggests that the derivatives 2C (4-hydroxy) and 2D(2-hydroxy) specifically bind to the active site of PK and DHFR. In silico ADME studies predicted the compounds to be “drug-like.” Hence the hydroxy derivatives may be considered as leads for further structural modifications to arrive at potential anti-bacterial agents.

Neural and Neural Crest-Derived Stem Cell Distribution in the Adult Human Dental Pulp / Distribución de Células Madre Neurales y Derivadas de la Cresta Neural en la Pulpa Dental Humana Adulta

SUMMARY: Despite comprehensive studies and reports about the properties of dental pulp stem cells (DPSCs) in vitro, we still need to confirm whether these in vitro characteristics coincide with the nature of DPSCs in situ. The anatomical location of DPSCs populations in the dental pulp has yet to be investigated. Moreover, the mesenchymal DPSCs have been much more studied than the neural crest-derived DPSCs. In this study, well-recognized neural/neural crest stem cell markers NCAM1, Nestin, SNAIL/SLUG, SOX9, and S100 are being investigated by immunohistochemistry to localize the precise location of these populations of DPSCs within the human adult dental pulp.All previously mentioned markers were expressed in the dental pulp, and their intensity and location of expression were reported.

A pesar de estudios e informes exhaustivos sobre las propiedades de las células madre de la pulpa dental (DPSC) in vitro, todavía necesitamos confirmar si estas características in vitro coinciden con la naturaleza de las DPSC in situ. La ubicación anatómica de las poblaciones de DPSC en la pulpa dental aún no se ha investigado. Además, las DPSC mesenquimales han sido mucho más estudiadas que las DPSC derivadas de la cresta neural. En este estudio, se están investigando mediante inmunohisto química marcadores de células madre de la cresta neural/ neural NCAM1, Nestin, SNAIL/SLUG, SOX9 y S100 para localizar la ubicación precisa de estas poblaciones de DPSC dentro de la pulpa dental humana adulta. Todos los marcadores mencionados anteriormente se expresaron en la pulpa dental y se informó su intensidad y ubicación de expresión.

Association between the RTS,S/AS01 malaria vaccine and under-nutrition in children aged 10 to 59 months in Siaya County, Kenya

Background: Under-nutrition is a global problem associated with infectious diseases including malaria. In this study, we explored the association between the newly introduced malaria vaccine, RTS,S/AS01 and measles vaccine with under-nutrition in children. Methods: We conducted a case-control study using anthropometric data for children aged between 10 and 59 months in Siaya County, Kenya collected from September to December 2021. Malaria and measles vaccines were the exposure variables, and under-nutrition, which is a composite variable including stunting and/or underweight was the outcome. Chi-square was used to test association between under-nutrition and the two vaccines. Further, a binary logistic regression was used to assess association between the vaccines, and independent variables with a confidence interval set at 95%. Results: From a total of 1,701 children, 185 (16.8%) were undernourished. Among the undernourished children, 121 (11.0%) were stunted and 64 (5.81%) were underweight. The undernourished children were matched with children of normal nutritional status at a ratio of 1:1 giving a total of 370. Malaria vaccine coverage was low at 21.1% (39/370) and 17.3% (32/370) among undernourished and children with normal nutritional status respectively. Similarly, the measles vaccine coverage was 30.8% (57/370) and 36.2% (67/370) among cases and controls respectively. Neither exposure to malaria nor measles vaccines showed a statistically significant difference between the cases and controls. Conclusions: We found no statistically significant association between malaria vaccine and under-nutrition in children. While malaria vaccine is important in protecting children from the malaria disease effects, it is not a proxy intervention for under-nutrition.

Tumor neuroectodérmico maligno del tracto gastrointestinal: a propósito de un caso / Malignant neuroectodermal tumor of the gastrointestinal tract: case report

El tumor neuroectodérmico maligno del tracto gastrointestinal es una neoplasia rara con pocos casos reportados en la literatura, especialmente en América Latina. Descrito por primera vez en 2003, se trata de una entidad sin tratamiento estandarizado y de pobre pronóstico. Se presenta el caso de una paciente de 22 años de edad que acude a la consulta por dolor abdominal, anemia y masa abdominal palpable. Luego de estudios pertinentes se decide la conducta resectiva y el posterior tratamiento oncológico. (AU)

Malignant gastrointestinal neuroectodermal tumor (GNET), formerly known as clear cell sarcoma of the gastrointestinal tract, is an extremely rare tumor of mesenchymal origin, which presents great microscopic and molecular similarity to clear cell sarcoma found in other parts of the body, such as tendons and aponeurosis. It is characterized by its rapid evolution, high recurrence rate and frequent diagnosis as metastatic disease.1,2 (AU)

Control de la biopelícula con materiales bioactivos en pacientes adolescentes: reporte de caso / Biofilm control with bioactive materials in adolescents' patients: case report

El objetivo del artículo es reportar el desempeño clínico en el control y disminución de la placa bacteriana en pacientes adolescentes mediante un gel y barniz con partículas S-PRG. Se realizaron tratamientos con materiales bioactivos con tecnología GIOMER en 2 pacientes. En el primer caso se realizó una profilaxis con Pro Care Gel (S-PRG) en un paciente de 15 años con problemas neuromotores para eliminar la placa y posteriormente, se aplicó un barniz con partículas de S-PRG para prevenir la formación de biofilm. En el segundo caso, un adolescente de 15 años normoreactivo con inflamación gingival recibió el tratamiento profilaxis con PRG Pro Care Gel.Se observó una disminución de placa bacteriana tras la profilaxis con el gel Pro Care y la aplicación del barniz en el primer caso. Además, existió una baja incidencia de biofilm incluso después de 11 meses de la aplicación del barniz. En el segundo caso, a las 2 horas de aplicación, se observó una disminución total de la placa. Clínicamente se observó el bueno desempeño clínico de los materiales con partículas de S-PRG, como lo demuestra la literatura científica en cuanto a la reducción de la formación de placa bacteriana en las estructuras dentarias, la desinflamación gingival, proporciona bienestar a los pacientes y restaura la salud bucal de forma menos invasiva.

The objective of the article is to report the clinical performance in the control and reduction of bacterial plaque in adolescent patients using a gel and varnish with S-PRG particles. Treatments with bioactive materials with GIOMER technology were performed in two patients. In the first case, prophylaxis was performed with Pro Care Gel (S-PRG) in a 15-year-old patient with neuromotor problems to eliminate plaque and subsequently, a varnish with S-PRG particles was applied to prevent biofilm formation. In the second case, a normal 15-year-old adolescent with gingival inflammation received prophylaxis treatment with PRG Pro Care Gel. A decrease in bacterial plaque was observed after prophylaxis with the Pro Care gel and the application of the varnish in the first case. Furthermore, there was a low incidence of biofilm even after 11 months of varnish application. In the second case, after 2 hours of application, a total decrease in plaque was observed. The good clinical performance of materials with S-PRG particles was clinically perceived, as demonstrated by the scientific literature in terms of reducing the formation of bacterial plaque in dental structures, gingival disinflammation, providing well-being to patients and restoring oral health in a less invasive way.

Recent molecular techniques to strengthen ecological studies in echinoderms / Técnicas moleculares recientes que fortalecen los estudios ecológicos de equinodermos

Abstract Introduction: Echinoderms, an integral component of marine ecosystems worldwide, have captivated scientific interest for centuries. Despite this longstanding attention, comprehending key facets such as trophic relationships, diet composition, and host-microbiota relationships still represents a challenge using traditional techniques. Recent years, however, have witnessed a transformative shift, thanks to the emergence of advanced molecular techniques, offering new approaches to strengthen ecological studies in echinoderms. Objective: Explore how recent advancements in molecular tools have impacted ecological research on echinoderms. Specifically, we aim to investigate the potential of these tools to shed light on trophic interactions, diet composition, and the characterization of gut microbial communities in these organisms. Methods: Available literature was used to clarify how novel molecular techniques can improve ecological studies. The focus is diet, trophic relationships, and gut microbiota. Results: Traditionally, studies of stomach contents using compound microscopy have provided an idea of ingested material; nevertheless, sometimes a simple magnified visualization of dietary content does not allow exhaustive identification of the entire food spectrum, as it is limited due to the rapid digestion and maceration of food items within the echinoderm's digestive tract. The use of DNA-metabarcoding, targeting specific DNA regions, such as the mitochondrial COI gene, has allowed us to enhance the accuracy and precision of diet characterization by enabling the identification of prey items down to the species or even genetic variant level, providing valuable insights into specific dietary preferences. Another approach is the use of stable isotopes, particularly carbon and nitrogen, which provide a powerful tool to trace the origin and flow of nutrients through food webs. By analyzing the isotopic signatures in muscular tissues and food items, we can discern the sources of their primary food items and gain insights into their trophic position within the ecosystem. Lastly, a third new technique used to elucidate the characterization of the prokaryotic community is 16S rRNA sequencing. This method allows us to explore the composition and dynamics of the digestive tract microbial communities. Conclusions: This is a promising era for ecological research on echinoderms, where advances of molecular tools have enabled an unprecedented level of detail, resolving longstanding challenges in comprehending their trophic interactions, diet composition, and host-microbiota relationships, and opening new avenues of investigation in ecological studies.

Resumen Introducción: Los equinodermos, un componente integral de los ecosistemas marinos en todo el mundo, han captado el interés científico durante siglos. A pesar de esta prolongada atención, el comprender facetas clave como las relaciones tróficas, la composición de la dieta y las relaciones huésped-microbiota todavía representa un desafío utilizando técnicas tradicionales. Sin embargo, los últimos años han sido testigos de un cambio transformador, gracias a la aparición de técnicas moleculares avanzadas, que ofrecen nuevos enfoques para fortalecer los estudios ecológicos en equinodermos. Objetivo: Explorar cómo los avances recientes en herramientas moleculares han impactado la investigación ecológica sobre equinodermos. Específicamente, nuestro objetivo es investigar el potencial de estas herramientas para arrojar luz sobre las interacciones tróficas, la composición de la dieta y la caracterización de las comunidades microbianas intestinales en estos organismos. Métodos: Se utilizó la literatura disponible para aclarar cómo las nuevas técnicas moleculares pueden mejorar los estudios ecológicos. La atención se centra en la dieta, las relaciones tróficas y la microbiota intestinal. Resultados: Tradicionalmente, los estudios del contenido estomacal mediante microscopía compuesta han proporcionado una idea del material ingerido; Sin embargo, a veces una simple visualización ampliada del contenido dietético no permite una identificación exhaustiva de todo el espectro alimentario, ya que está limitado debido a la rápida digestión y maceración de los alimentos dentro del tracto digestivo del equinodermo. El uso de metabarcoding de ADN, dirigidos a regiones específicas del ADN, como el gen COI mitocondrial, nos ha permitido mejorar la exactitud y precisión de la caracterización de la dieta al permitir la identificación de presas hasta el nivel de especie o incluso de variante genética, lo que proporciona valiosos resultados sobre preferencias dietéticas específicas. Otro enfoque es el uso de isótopos estables, en particular carbono y nitrógeno, que proporcionan una poderosa herramienta para rastrear el origen y el flujo de nutrientes a través de las redes alimentarias. Al analizar las firmas isotópicas en los tejidos musculares y los alimentos, podemos discernir las fuentes de sus alimentos primarios y obtener información sobre su posición trófica dentro del ecosistema. Por último, una tercera técnica nueva utilizada para dilucidar la caracterización de la comunidad procariótica es la secuenciación del ARNr 16S. Este método nos permite explorar la composición y dinámica de las comunidades microbianas del tracto digestivo. Conclusiones: Esta es una era prometedora para la investigación ecológica sobre equinodermos, donde los avances de las herramientas moleculares han permitido un nivel de detalle sin precedentes, resolviendo desafíos de larga data en la comprensión de sus interacciones tróficas, composición de la dieta y relaciones huésped-microbiota, y abriendo nuevas vías de investigación. en estudios ecológicos.