Evaluation of adverse drug reactions in patients of schizophrenia in tertiary care teaching hospitals in Central India

Background: For decades, it has been observed that mental health is shrouded in stigma and discrimination. The scope, severity, and expense of impairment and costs to people, families, and societies are staggering. Mental illnesses are among the most frequent illnesses, affecting over a quarter of the population in any given year. According to national institute of mental health and neurosciences, Bangalore, the prevalence of schizophrenia has been considered as 4/1000 for all ages and both sexes. Aim and Objectives: The objectives of this study were to as follows: (1) To evaluate adverse drug reactions (ADRs) in patients with schizophrenia who received antipsychotic treatment and (2) to compare ADRs in typical versus atypical antipsychotic agents in schizophrenic patients. Materials and Methods: A total of 50 schizophrenic patients were enrolled for evaluating adverse effects to antipsychotic drugs. During the research, all ethical precautions were taken. All patients were followed up by medical history, history of drugs, and any severity of adverse drug reaction. Causality assessment was graded by Naranjo scale. Result: Among all of the antipsychotic drugs, risperidone (05%), quetiapine (04%), and aripiprazole (04%) have shown lowest propensity to cause serious adverse event. These drugs are most commonly prescribed drugs and are least likely to affect quality of life of patient. However, the risk of extrapyramidal symptoms is lower with olanzapine (05%) than haloperidol (34%) and even in case with risperidone at higher dose (20%). Although atypical antipsychotics such as olanzapine (46%) have shown maximum potential to produce metabolic side effect such as dyslipidemia and hyperglycemia compared to that of other antipsychotics. Conclusion: The most common adverse effects were found with typical and atypical antipsychotics such as weight gain, drowsiness, constipation, sedation, dyslipidemia, and hypotension.

Relationship between affective temperament and the severity of depressive symptoms on medical college students / 中华行为医学与脑科学杂志

Objective:To explore the relationship between affective temperament and the severity of depressive symptoms in medical college students.Methods:From October to November 2021, a questionnaire survey was conducted among 1 780 medical undergraduates from two medical colleges in Anhui Province.The Chinese version of temperament scale of Memphis, Pisa, Paris and San Diego autoquestionnaire (TEMPS-A) and the Chinese version of the Beck depression inventory (BDI-Ⅱ) were used to evaluate the affective temperament and depressive symptoms of medical college students, respectively.SPSS 23.0 software was used for statistical analysis of the data.Ordinal Logistic regression model was used to analyze the impact of affective temperament characteristics on the severity of depressive symptoms.Results:The detection of depressive symptoms among medical college students was 6.4% with mild depression, 7.4% with moderate and severe depression and 86.2% without depression.The scores of cyclothymic, depressive, irritable, hyperthymia and anxious temperaments in TEMPS-A were significantly different among medical college students with different levels of depressive symptoms (all P<0.05). There were statistically significant differences in the detection rates of depression symptoms among medical college students with different typical affective temperament characteristics(all P<0.05). Ordinal Logistic regression model analysis showed that typical cyclothymic temperament ( OR=5.05, 95% CI: 3.68-6.94), typical depressive temperament ( OR=7.69, 95% CI: 4.64-12.86), typical hyperthymia temperament ( OR=0.30, 95% CI: 0.15-0.58), and typical anxious temperament ( OR=2.41, 95% CI: 1.75-3.32) were influencing factors for the severity of depressive symptoms in medical college students. Conclusion:Affective temperament, especially typical depressive temperament, typical cyclothymic temperament and typical anxious temperament can affect the severity of depressive symptoms in medical college students.

Application of typical tasks-based mind mapping in nursing teaching for children with autism spectrum disorder / 中华医学教育探索杂志

Objective:To explore the application of typical tasks-based mind mapping in nursing teaching for children with autism spectrum disorder (ASD).Methods:A total of 102 nursing students who were involved in the nursing of children with ASD in Hunan Children's Hospital were selected and divided into control group and observation group according to the teaching methods. Fifty-one students in the control group were provided with conventional teaching, while 51 students in the observation group were provided with typical tasks-based mind mapping teaching. The students in the two groups were assessed for performance, self-directed learning ability score, and overall literacy at completion of the nursing course. SPSS 22.0 was used for the t test. Results:The scores of theoretical examination[(92.34±4.07) vs. (89.92±3.61)], nursing note writing[(91.07±3.84) vs. (88.60±3.59)], and operational examination[(90.47±2.98) vs. (88.52±2.73)] were significantly higher among students in the observation group than among those in the control group ( P<0.05); after the internship, students in the two groups had significantly increased scores in interpersonal relationships, learning awareness, learning strategies, learning behaviors, and learning evaluation, and the observation group had better performance than the control group in the above indices ( P<0.05); after the internship, students in the two groups had significantly increased scores in problem solving, interpersonal communication, critical thinking, and self-leadership, and the observation group had better performance than the control group in the above indices ( P<0.05). Conclusion:The application of typical tasks-based mind mapping in nursing teaching for children with ASD can improve nursing students' academic performance, enhance their self-directed learning, and improve their overall literacy.

Analysis of causes for dental implant failure / 口腔医学

@#The implant-supported prosthesis has gradually become the preferred treatment for patients with partial edentulous or complete edentulous. Causes for the implant failure have been discussed in the majority of studies conducted in recent years, while their risk factors are still controversial. Patient factors (gender, age, smoking, osteoporosis, diabetes, medication, periodontitis and bruxism), clinical parameters (implant area, bone quality, implant size) and doctor factors (surgical-related factors, prosthesis-related factors) will all affect implant failure. This article presents typical clinical cases and reviews the potential risk factors for dental implant failure, in order to provide guidance for clinical practice.

Typical behavior analysis of children with autism in symbolic play / 中国康复理论与实践

ObjectiveTo explore the typical behavior characteristics of children with autism in symbolic play and the value of Symbolic Play Test (SPT) in the early identification of autism. MethodsFrom November, 2021 to September, 2022, a total of 260 children with language problems were collected from Department of Children's Health Care of Binzhou Medical University Hospital. A total of 193 children with autism were as observation group and 67 normal children were as control group. All children played symbolic games. The typical behavioral characteristics of children with autism in SPT were explored, and a reliability and validity analysis based on the results of SPT was conducted. They were assessed with the adaptive and personal social scores of Gesell Development Scale, and the correlation of the scores of Gesell Development Scale and the score of SPT was analyzed. ResultsThe Cronbach's α coefficient of SPT of children with autism was 0.835 to 0.935, and the total score of SPT, the scores of surrogate object, fictional attribute and fictional object were positively correlated with each other (r > 0.607, P < 0.001). The SPT scores decreased in the observation group (t > 9.615, P < 0.001), and SPT score positively correlated with adaptability and personal-social development quotient (r > 0.609, P < 0.001). ConclusionTypical behavior of children with autism can be reflected in symbolic play, and SPT can provide clues for early identification of autism.

A semi-automated microscopic image analysis method for scoring Ki-67 nuclear immunostaining

Nuclear proliferation marker MIB-1 (Ki-67) immunohistochemistry (IHC) is used to examine tumor cell proliferation. However, the diagnostic or prognostic value of the Ki-67 nuclear staining intensity and location, defined as nuclear gradient (NG), has not been assessed. This study examined the potential association between Ki-67 NG and cell cycle phases and its effect on the prognosis of pulmonary typical carcinoid (PTC) tumors. We propose a method for classifying the NG of Ki-67 during the cell cycle and compare the results between PTC, pulmonary adenocarcinoma (PAD), and breast ductal carcinoma (BDC). A literature review and objective analysis of IHC-stained paraffin sections were used to determine the Ki-67 labeling index and composed a stratification of the NG into NG1, NG2, and NG3/4 categories. A semi-automated image analysis protocol was established to determine the Ki-67 NG in PTC, PAD, and BDC. High intraobserver consistency and moderate interobserver agreement were achieved in the determination of Ki-67 NG in tumor specimens. NG1 and NG2 were lower in PTC than in PAD and BDC. Cox multivariate analysis of PTC after adjusting for age and number of metastatic lymph nodes showed that Ki-67 NG1 and NG2 significantly predicted clinical outcomes. The semi-automated method for quantification of Ki-67 nuclear immunostaining proposed in this study could become a valuable diagnostic and prognostic tool in PTC.

Variações quantitativas em carreiras de Estado do Poder Executivo federal / Variaciones cuantitativas en carreras del Estado del Poder Ejecutivo federal / Quantitative variations in federal Executive Career Paths

Resumo Este trabalho pretende analisar mudanças quantitativas no número de servidores de algumas carreiras de Estado do Poder Executivo federal entre 2012 e 2022. Para tal, dividiram-se quatro grupos de carreiras civis da administração direta que exercem atividades afins e costumam ser classificadas como típicas de Estado: segurança pública, jurídicas, fiscalização e gestão pública. A escolha por esses grupos se deveu ao fato de que tais carreiras estratégicas com frequência se articulam em conjunto na defesa de seus interesses. Baseando-se em levantamentos realizados pelo Painel Estatístico de Pessoal do Governo Federal, concluiu-se que, durante o período, as carreiras do grupo de segurança pública selecionadas cresceram fortemente (+24%) e ultrapassaram, em número de servidores, as carreiras de fiscalização selecionadas (-27%), que foram reduzidas em proporção semelhante. Individualmente, as carreiras que mais cresceram foram a de policial rodoviário federal (34%) e de analista de comércio exterior (78%). Já as carreiras de auditor-fiscal da Receita Federal e de auditor-fiscal do trabalho foram as que mais diminuíram, perdendo quase um terço de seus servidores ativos cada uma (33% e 33%).

Resumen Este trabajo pretende analizar los cambios cuantitativos en el número de servidores de algunas carreras del Estado del Ejecutivo federal entre 2012 y 2022. Para ello, las carreras civiles de la administración directa que desarrollan actividades similares y son comúnmente catalogadas como propias del Estado se dividieron en cuatro grupos: Seguridad Pública, Jurídica, Inspección y Gestión Pública. La elección de estos grupos de debió a que tales carreras estratégicas frecuentemente se articulan en la defensa de sus intereses. Con base en las encuestas realizadas por el Panel Estadístico del Personal del Gobierno Federal, se concluyó que, durante el período, las carreras del grupo de Seguridad Pública seleccionadas crecieron fuertemente (+24%) y superaron a las carreras de Inspección seleccionadas en número de empleados (-27%), que se redujeron en una proporción similar. De manera individual, las carreras que más crecieron fueron policía federal de caminos (34%) y analista de comercio exterior (78%). Las carreras de inspector fiscal del Ministerio de Hacienda e inspector fiscal del Ministerio de Trabajo fueron las que más declinaron, perdiendo casi un tercio de sus servidores activos cada una (33% y 33%).

Abstract This paper analyzes the quantitative changes in the number of servers of some State Careers of the federal executive branch between 2012 and 2022. Thus, they were divided into four groups of direct administration civil careers that carry out similar activities and are commonly classified as typical of the state: Public Security, Legal, Inspection, and Public Management. Based on surveys carried out by the Statistical Panel of Federal Government Personnel, it was concluded that, during the period, the careers of the selected Public Security group grew strongly (+24%) and surpassed the selected Inspection careers in number of employees (-27%), which were reduced in a similar proportion. Individually, the careers that grew the most were Federal Highway Police (34%) and Foreign Trade Analyst (78%). The careers of Tax Auditor of the Federal Revenue and Labour Tax Auditor were the ones that declined the most, losing almost a third of their active servants each (33% and 33%).

Antipsychotics as a probable cause of Leukocytoclastic Vasculitis: A Systematic Review

Abstract: Leukocytoclastic vasculitis (LCV) is a skin condition that is a result of unregulated immune activation. The exact causes have to date not been established. The studied causes tend to have a higher probability of causing LCV. This raises concerns about a deep-seated causal relationship and the tendency of an individual for the development of LCV. Antipsychotics are a class of drug mainly used for psychiatric disorders including schizophrenia, schizophreniform disorder, or even depressive disorder with psychotic features. These drugs target the dopamine receptors in the central nervous system to exert their effects. They are classified as typical or the older antipsychotics and atypical or the newer antipsychotics. Prevalent in the current literature are the reported cases of LCV with antipsychotic medications. We carried out a systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) protocol to find out previously reported cases on LCV due to antipsychotic medication administration from inception till current date. Our study aims to check and in turn, discuss the causal relationship of antipsychotics with LCV.

Clinico-epidemiologic characteristics of optic neuritis in a tertiary eye centre in Eastern India based on the status of serum aquaporin-4 antibody

Purpose: To elucidate the clinico?epidemiologic characteristics of optic neuritis based on the status of serum aquaporin?4 antibody (AQP4?Ab) in patients with optic neuritis (ON). Methods: Medical records of 106 patients with ON and a follow?up of 3 years were reviewed. For each patient, the following data were extracted: medical history, findings of the ocular examination, brain, orbital or spinal MRI, and serological tests for AQP4. The ON was classified as typical or atypical based on disc examination and improvement in vision after intravenous methylprednisolone (IVMP). The clinical findings (typical or atypical), disease course, and outcomes were analyzed according to the serostatus of the ON. Results: 10 patients ((9.4%) were seropositive for AQP4?Ab; all had atypical ON. 96 patients (91%) were seronegative for AQP4?Ab: 36 atypical ON and 60 typical ON. Profound visual impairment at presentation was seen in all patients. However, at the end of the study period, seropositive and seronegative atypical ON had poor visual outcomes as compared to seronegative typical ON (P = 0.002). Five seropositive and four seronegative patients with atypical ON developed transverse myelitis. Bilateral disease with relapse was more in seropositive patients (80%); however, seronegative with atypical ON also had bilateral presentation and relapse in 42% and 41%, respectively. Conclusion: AQP4?Ab seropositive patients mostly present with atypical features such as bilateral recurrent ON, poor visual outcome, and increased incidence of transverse myelitis. However, atypical clinical features can also be seen in seronegative ON with a poor visual outcome and a recalcitrant course.

Application of typical case combined with practice teaching in pediatric clinical teaching / 中华医学教育探索杂志

Objective:To explore the application of typical case combined with practice teaching in the pediatric clinical teaching.Methods:A total of 80 clinical interns majoring in pediatrics who practiced in the Affiliated Hospital of Jining Medical University between September 2019 and January 2020 were selected as the research subjects, and they were randomly divided into observation group ( n=41) and control group ( n=39). The control group adopted conventional teaching while the observation group were given typical case combined with practice teaching model. After 16 weeks of training, the theoretical knowledge, practical operation [direct observation of procedural skill (DOPS) evaluation, and mini-clinical evaluation exercise (Mini-CEX)] and overall performance were analyzed in the two groups of students. SPSS 19.0 was used for t test, chi-square test and rank sum test. Results:After the internship, the theoretical scores of common pediatric diseases, clinical disease characteristics, etiopathogenesis, treatment regimen and complications were enhanced in the two groups, and the above scores in observation group were higher than those in control group ( P<0.05). Besides, the DOPS scores and Mini-CEX scores of the two groups were increased, and the scores were higher in observation group than in control group ( P<0.05). Furthermore, the overall excellent rate of the observation group was 87.80% (36/41), which was higher than 69.23% in control group (27/39). Survey found that the number of interns who believed that the teaching regimen could deepen the knowledge mastery degree, increase the internship interest and improve the comprehensive ability, internship efficiency and clinical thinking ability was more in observation group than in control group. Conclusion:Typical case combined with practice teaching can effectively deepen the interns' understanding of theoretical knowledge of clinical pediatrics, improve the practical operation ability and arouse the interest in learning.

Fases típicas del voleibol de playa en el sexo masculino. Valores de referencia en la iniciación / Fases típicas do vôlei de praia masculino. Valores de referência na iniciação / Typical phases of beach volleyball male sex. Reference values at the initiation

RESUMEN Actualmente, es cada vez más importante estudiar la actividad competitiva en los procesos de preparación deportiva. En voleibol de playa, desde las categorías de iniciación, los entrenadores deben centrar la preparación en aspectos de rendimiento propios y determinantes para obtener el máximo resultado competitivo. Para ello, es importante modelar el entrenamiento en un contexto lo más cercano posible a la realidad del juego en cada categoría. Sin embargo, apenas se conocen los valores de referencia de la categoría de iniciación de base en Cuba. Los estudios actuales se dirigen fundamentalmente al más alto nivel de competición. En tal sentido, el conocimiento de los valores de rendimiento relativos a las fases típicas del juego y las situaciones especiales en esta modalidad, resultan vitales para un entrenamiento preciso desde la etapa de iniciación. La presente investigación tuvo como objetivo determinar el comportamiento de las Fases Típicas del Juego (FTJ) del voleibol de playa, categoría 11-12 años, sexo masculino, en el campeonato provincial de Villa Clara en 2019, como valores de referencia de la etapa de iniciación. Se utilizaron métodos como la observación estructurada, revisión documental, estadístico-matemático y talleres metodológicos como técnicas de investigación. Se determinó la frecuencia de aparición de dichas fases, su incidencia y efectividad en el juego, importantes elementos que constituyen valores referenciales para los entrenadores en su proceso de planificación y modelación del entrenamiento en este nivel de competición.

RESUMO Hoje em dia, é cada vez mais importante estudar a atividade competitiva nos processos de preparação esportiva. No vôlei de praia, a partir das categorias de iniciação, os treinadores devem concentrar a preparação nos aspectos de desempenho que são determinantes para obter o máximo resultado competitivo. Para isso, é importante modelar o treinamento em um contexto o mais próximo possível da realidade do jogo em cada categoria. No entanto, os valores de referência para a categoria de iniciação básica em Cuba são pouco conhecidos. Os estudos atuais são destinados principalmente ao mais alto nível de competição. Neste sentido, o conhecimento dos valores de desempenho relacionados com as fases típicas do jogo e as situações especiais nesta modalidade são vitais para um treinamento preciso desde a fase de iniciação. O objetivo desta pesquisa foi determinar o comportamento das Fases Típicas do Jogo (FTJ) do vôlei de praia, 11-12 anos, categoria masculina, no campeonato provincial de Villa Clara em 2019, como valores de referência da fase de iniciação. Métodos como observação estruturada, revisão documental, oficinas de matemática estatística e metodológica foram utilizados como técnicas de pesquisa. A frequência da ocorrência dessas fases, sua incidência e eficácia no jogo foram determinadas, elementos importantes que constituem valores de referência para os treinadores em seu processo de planejamento e modelagem de treinamentos neste nível de competição.

ABSTRACT Currently, the study of competitive activity is becoming increasingly important in the sport preparation process. Since the initiation categories in the beach volleyball, coaches should focus their preparation on the performance of own and decisive aspects to obtain the maximum competitive result. For this, it is important to model the training in a context as close as possible to the reality of the game in each category. However, hardly they known the reference values of the initiation category in Cuba. Studies primarily aimed at the highest level of competition. In this sense, the knowledge of the performance values related to the typical phases of the game and the special situations in this modality are vital for a precise training since the initiation phase. This research aimed to determine the behavior of the Game Typical Phases (FTJ in Spanish) in the beach volleyball, category 11-12 years old, male sex in the Provincial championship of Villa Clara in 2019, as reference values in the initiation stage. There were used methods such as structured observation, documentary review, the statistical - mathematical, and methodological workshops as research technique. It was determined the frequency of appearance of these phases, their incidence and effectiveness in the game, important elements that constitute referential values for the coaches in their planning and modeling process of the training of the players at this competition level.

Research on the typical modes of medical alliances in China / 中华医院管理杂志

By means of analysis of related national policies on medical alliances, and investigation of their current development in China, the authors summarized the conceptual category of existing medical alliances. Typical cases were selected for comparative analysis in terms of urban medical groups, medical communities, specialized alliances and telemedicine collaboration networks. In view of such setbacks found as lack of health services, ambiguity of power and duties of stakeholders, and low penetration rate of composite medical insurance payment, as well as lack of effective incentives and poor online diagnosis and treatment mechanism, the authors recommended on development of medical alliances in respect of framework improvement and mechanism optimization among others.

Observation of Short-term and Long-term Efficacy of Bronchoscopic Interventional Therapy in the Treatment of Typical Carcinoid / 中国肺癌杂志

BACKGROUND@#The curative potential of various bronchoscopic treatments such as electric snare, carbon dioxide freezing, argon plasma coagulation (APC), Neudymium-dopted Yttrium Aluminium Garnet (Nd:YAG) laser and photodynamic therapy (PDT) for the treatment of intraluminal tumor has been administered previously, but this regimen is not common in the treatment of typical carcinoid. The aim of this study is to investigate the curative effects both in short-term and long-term of interventional bronchoscopy in the treatment of typical carcinoid.@*METHODS@#We retrospectively reviewed the clinical data of typical carcinoid patients who were treated with interventional bronchoscopy for tumor suppression and they were hospitalized in the Emergency General Hospital from December 2010 to December 2020, and Wilcoxon rank sum test and chi-square test were used for analysis.@*RESULTS@#A total of 32 patients were included, including 18 cases of preoperative bronchial artery embolization (embolization rate 56%, 95%CI: 31%-79%). The grade score of dyspnea decreased from before treatment to after treatment, and the difference was statistically significant [(1.44±1.03) score vs (0.25±0.58) score, P=0.003]; The degree of bronchial stenosis decreased from pre-treatment to post-treatment, and the difference was statistically significant [(87.50%±13.90%) vs (17.50%±6.83%), P<0.001]; There was significant difference in bronchial diameter before and after treatment [(0.14±0.18) cm vs (0.84±0.29) cm, P<0.001].@*CONCLUSIONS@#Bronchoscopic interventional therapy has significant short-term and long-term effects in the treatment of typical carcinoid.

Construction of the curriculum for developing the ability to solving complex engineering problems in the field of biotechnology industry / 生物工程学报

Accurately understanding the features and connotations of complex engineering problems is an important prerequisite for setting graduation requirements, constructing curriculum and designing teaching contents. By discussing the characteristics of complex engineering problems in the biological industry, this paper explored the demands for undergraduates in Yangtze river delta region, summarized the typical jobs and their requirements, and expounded the connotation of complex engineering problems contained in various typical tasks. On this basis, a gradual curriculum system was constructed, which included multiple stages of conceiving, formation and application, to cultivate the ability to solve complex engineering problems in the major of bioengineering. The curriculum coordinated the implementation of deep integration of industry and education, research feed back course construction, course team and advanced courses building up, professional associations covered all crews and students, supporting the ability training of solving complex engineering problems.

Current status and future perspectives of metabolic network models of industrial microorganisms / 生物工程学报

Genome-scale metabolic network model (GSMM) is an extremely important guiding tool in the targeted modification of industrial microbial strains, which helps researchers to quickly obtain industrial microbes with specific traits and has attracted increasing attention. Here we reviewe the development history of GSMM and summarized the construction method of GSMM. Furthermore, the development and application of GSMM in industrial microorganisms are elaborated by using four typical industrial microorganisms (Bacillus subtilis, Escherichia coli, Corynebacterium glutamicum, and Saccharomyces cerevisiae) as examples. In addition, prospects in the development trend of GSMM are proposed.

Avaliação de controle restrito de estímulos em tarefas de discriminação simples em pré-escolares / Assessing restricted stimulus control in simple discrimination tasks in preschool children

O controle de estímulos exercido por algumas propriedades ou aspectos de um estímulo antecedente contingente ao reforço é definido como controle restrito de estímulos. O objetivo do estudo foi investigar o controle discriminativo por elementos de estímulos visuais compostos em tarefas de discriminação simples. Participaram catorze pré-escolares (seis com autismo e oito com desenvolvimento típico) entre quatro e seis anos de idade. O procedimento envolveu o ensino de discriminação simples entre um par de estímulos visuais compostos por dois elementos. Em seguida, foram realizadas sondas para avaliar o controle discriminativo por cada elemento do estímulo composto (S+ e S-). Todas as crianças responderam aos dois elementos do S+ e não responderam, ou responderam com baixa frequência, aos elementos do S- dos três pares de estímulos treinados e avaliados separadamente. Os resultados demonstraram que os pré-escolares com autismo e desenvolvimento típico responderam sob controle dos elementos dos estímulos S+. O investimento no estudo do controle restrito de estímulos pode contribuir na compreensão desse fenômeno como um processo comportamental básico.

The control of stimuli exercised by some of the properties or aspects of an antecedent stimulus contingent upon reinforcement is defined as restricted control of stimuli. The aim of this study was to investigate discriminative control by the elements of a composite visual stimuli in simple discrimination tasks. Fourteen preschool children (six with autism and eight typical development) between four and six years old participated. The procedure involved the simple discrimination learning between a pair of visual stimuli composed of two elements. Then, probes were carried out to evaluate the discriminatory control for each element of stimulus compound (S+ and S-). All children responded to both elements of S+ and did not respond or responded with low frequency to the elements of S- for the three pairs of stimuli trained and evaluated separately. The results showed that preschool children with autism and typical development responded under control of all the elements S+ stimuli. The investment in the study of the restricted control of stimuli can contribute to the understanding of this phenomenon as a basic behavioral process.

A psicanálise dos sonhos durante a pandemia / The psychoanalysis of dreams during the pandemic / El psicoanálisis de los sueños durante la pandemia / La psychanalyse des rêves pendant la pandémie

RESUMO O artigo traz relatos de sonhos de pacientes em análise, ou não, durante a pandemia. Apresenta a interpretação de sonhos da pandemia de covid-19, segundo o modelo clássico da interpretação psicanalítica de sonhos, e destaca a simbolização como recurso desse tipo de interpretação.

ABSTRACT Dreams reports of patients being analyzed, or not, during the pandemic. Dreams interpretation of the covid-19 pandemic, according to the classic model of psychoanalytic dreams interpretation. Symbolization as a resource for psychoanalytic interpretation of dreams.

RESUMEN Informes de los sueños de los pacientes analizados o no durante la pandemia. Interpretación de los sueños de la pandemia de covid-19, según el modelo clásico de interpretación de los sueños psicoanalíticos. Simbolización, como recurso para la interpretación psicoanalítica de los sueños.

RÉSUMÉ Rapports de rêves de patients analysés ou non pendant la pandémie. Interprétation onirique de la pandémie de covid-19, selon le modèle classique de l'interprétation psychanalytique des rêves. Symbolisation comme ressource pour l'interprétation des rêves.

Use of MRI Apparent Diffusion Coefficient to Noninvasively Differentiate between the Histologic Grades of Meningioma.

It is well known in the literature that Apparent Diffusion Coefficient (ADC) obtained during diffusion-weighted MRI of brain is sensitive in detecting and differentiating low-grade and aggressive meningiomas. However, other studies establish no correlation between mean-ADC and ultimate classification as benign, atypical or malignant. We wanted to assess the correlation between, A. mean of MRI Apparent Diffusion Coefficient (mean-ADC) and B. meningioma biomarker Ki-67 proliferation index, in cases of both low-grade and aggressive meningioma. We also wanted to assess the sensitivity of mean-ADC for diagnosing an aggressive meningioma.METHODSWe analysed 66 surgically treated meningioma patients with complete histopathology report (HPR) in Government Medical College, Kozhikode during the period of study (Nov-2017-Oct-2018), also having a pre-operative mean-ADC value during Diffusion Weighted Imaging (DWI) investigation at the same centre. For the latter, a standard MRI brain protocol including diffusion imaging was conducted and ADC map was generated. Regions of interest (ROIs) were manually drawn within the tumour on ADC map and mean-ADC values were measured.RESULTSUsing Pearson correlation coefficient, we found a significant negative correlation between Ki-67 proliferation index and mean-ADC in meningioma cases. We also calculate 0.79 x 10-3 mm2/s being a reasonable mean-ADC cut-off value due to its sensitivity of 84% and specificity of 77% in differentiating between typical and atypical meningiomas.CONCLUSIONSThe non-invasive calculation of mean-ADC is a valid diagnostic tool. Further, mean ADC can be used as a good test to differentiate typical and atypical meningiomas. The latter is a particularly valid conclusion, since there were few results from conventional MRI studies to differentiate between various typical and atypical meningiomas.

The usage of prior upper gastrointestinal endoscopy among symptomatic patients undergoing cholecystectomy

Background: Cholelithiasis is one of the most common problems encountered in surgery. It is an immense challenge to discriminate between signs and symptoms due to gastrointestinal lesions and gallstones diseases. The objective of this study was to evaluate the usage of pre-operative upper gastrointestinal endoscopy (UGE) as a routine in treating symptomatic gallstone patients.Methods: This prospective hospital based observational study was conducted in the Department of General Surgery at Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar from January 2018 to June 2019. 60 symptomatic gallstone patients were selected for cholecystectomy and preoperative upper gastrointestinal (GI) endoscopy evaluation was done for any associated upper gastrointestinal problems.Results: Out of the total patients, females constituted 85% of overall study patients and majority of the patients presented with atypical biliary colic symptoms (55%, group 2) whereas 45% presented with typical biliary colic symptoms (group 1) (p value=0.009). Relief rate was highest in group 1 with abnormal UGE than with group 2.Conclusions: The routine use of upper GI endoscopy in patients with symptomatic cholelithiasis prior to cholecystectomy will help reduce post-operative persistence of symptoms and thus, it is a useful investigation in the overall treatment of gallstone diseases.

Valores típicos de dosis para tomografía computada de cerebro en pacientes adultos / Typical dose values for brain computed tomography in adult patients

Resumen: Debido al aumento en el uso de la Tomografía Computada (TC), y en consecuencia, la probabilidad de generar un incremento progresivo de la dosis recibida por los paciente y su relación en el potencial riesgo de los efectos de las radiaciones ionizantes, es importante implementar el uso de niveles de referencia diagnóstico (DRLs) en TC, como herramienta fundamental dentro de un programa de control de calidad que permita la evaluación y optimización de las dosis entregadas a los pacientes según la tarea clínica deseada. Con el objetivo de establecer valores típicos de dosis en TC de cerebro en Clínica Bupa Reñaca, se estudió una muestra de 73 informes dosimétricos generados en un equipo TC Toshiba Aquilion 64, en términos de indicadores de dosis para TC: Índice de dosis en TC por volumen (CTDIvol) y Producto dosis longitud (DLP). Con los datos obtenidos, se estimó el valor del percentil 50 (p50) para cada indicador de dosis, y se determinaron los valores típicos de dosis en cada grupo estudiado según sexo, edad e indicación clínica. Se logró definir y establecer una metodología que permitió la obtención de los valores típicos de dosis para TC de cerebro, optimizando las dosis sin producir una disminución en la calidad de la imagen necesaria para nuestro propósito clínico.

Abstract: Due to the increase in the use of Computed Tomography (CT), and consequently, the probability of generating a progressive increase in the dose received by the patient and its relationship in the potential risk of the effects of ionizing radiation, it is important to implement the use of diagnostic reference levels (DRLs) in CT, as a fundamental tool within a quality control program that allows the evaluation and optimization of the doses delivered to patients according to the desired clinical task. In order to establish typical dose values in brain CT at Bupa Reñaca Clinic, a sample of 73 dosimetric reports generated on a Toshiba Aquilion 64 CT unit was studied, in terms of dose indicators for CT: Dose rate on CT by volume (CTDIvol) and Dose Length Product (DLP). With the data obtained, the value of the 50th percentile (p50) for each dose indicator was estimated, and typical dose values were determined in each group studied according to sex, age and clinical indication. It was possible to define and establish a methodology that allowed obtaining typical dose values for brain CT, optimizing the doses without producing a decrease in the image quality necessary for our clinical purpose.