Perceptual reversals and time-response analyses within the scope of decoding a bistable image / Análisis de reversibilidades perceptuales y de tiempos de respuesta en el marco de la decodificación de una imagen biestable

Abstract A bistable image admits two possible interpretations, so that the observer can recognize the two percepts, but never at the same time. The alternations between percepts are called "perceptual reversals". When the observer's position is different from the upright position, the ability to make perceptual alternations may be impaired. Besides, the recognition of the percepts of a bistable image can be a complex reaction time visual task, if it involves recognizing two different conceptual units, added to the fact of having to make a subsequent report. A visual task was performed by 88 people in order to establish whether the perception of Boring's bistable image My girlfriend or my mother-in-law is associated with areas that condition its interpretation. It was assumed that decoding the image and reporting the perceived percept implied a complex reaction time. The task itself was done in front of a fixed 120 Hz eye-tracker, in two opposite body positions. Analyses were made reviewing the association of the percepts with bottom-up modulation areas of the image, and considering ocular fixations made 200 and 250 milliseconds before the time of the report. The records of these fixations were obtained so as to establish which of the two reaction times (200 ms or 250 ms) was involved in the bottom-up modulation process from the moment of ocular fixation to the reports given by the participants. It was concluded that perceptual reversals decrease significantly when head idiotropic axis points in the gravity vector direction, in comparison to the upright position. Likewise, associations between visual percepts and bottom-up modulating areas of the image were found when analyses were done by considering ocular fixations made 250 ms before the moment of the report. Interpreting Boring's bistable image implies a complex visual task in accordance with the results obtained.

Resumen Una imagen biestable admite dos interpretaciones, de modo que el observador reconoce cada percepto, pero nunca los dos al mismo tiempo. Cada alternancia entre uno y otro percepto se conoce con el nombre de "reversibilidad perceptual". Este tipo de percepción, denominada también "biestable", puede implicar dos tipos de modulación, una mediada por las características físicas del estímulo visual y por las áreas de fijación ocular, y otra por información contextual o por conocimiento almacenado en memoria. En ese sentido, las alternancias perceptuales que se manifiestan durante la observación de una imagen biestable pueden estar condicionadas por la manera en que el observador recorre con su mirada el estímulo biestable, de manera tal que es manifiesta una asociación entre específicas áreas de la imagen y el percepto que se reconoce. En efecto, para la imagen biestable de Boring Mi novia o mi suegra, se han establecido áreas de fijación ocular que favorecen los dos posibles perceptos (una mujer joven y una mujer de edad). Algunas de estas zonas elicitan más la interpretación de uno de los perceptos, otras de los dos indistintamente, como se reconoce en estudios precedentes. Por otra parte, se ha encontrado evidencia de que cuando la posición corporal del observador es distinta a la posición erguida (el tronco y la cabeza alineados con la vertical), puede dificultarse la capacidad para hacer las alternancias perceptuales. La rotación del eje idiotrópico de la cabeza con respecto al vector que apunta verticalmente hacia el cénit tiene repercusiones en los procesos perceptuales visuales y también en la manifestación de las reversibilidades perceptuales inherentes a la observación de imágenes biestables. El reconocimiento de los perceptos de un estímulo visual biestable puede suponer una tarea visual de tiempo de reacción complejo (superior a 230 milisegundos), dado que esta implica reconocer dos unidades conceptuales diferentes. A esto se suma el hecho de tener que hacer un reporte posterior que implique eferencias motoras. A los efectos de establecer si la percepción de la imagen biestable Mi novia o mi suegra está asociada a las áreas del estímulo que condicionan su interpretación cuando se asume que su decodificación más su reporte implican un tiempo de reacción complejo, se hicieron análisis de tareas visuales realizadas por 88 personas frente a un eye-tracker fijo de 120 Hz en dos posiciones corporales opuestas (una, con el tronco erguido y el eje idiotrópico de la cabeza apuntando hacia el cénit, y otra con el vector idiotrópico de la cabeza apuntando hacia el suelo en paralelo al eje gravitacional). Se revisó la asociación de los perceptos con las áreas de modulación de la imagen y considerando las fijaciones oculares realizadas 200 y 250 milisegundos antes del momento del reporte, el cual fue realizado por cada participante mediante el uso de los botones de un dispositivo conectado al registrador de datos. Los registros de fijaciones oculares, tomados en dos momentos previos al momento del reporte de los perceptos identificados, fueron considerados para establecer cuál de los dos tiempos de reacción (200 ms o 250 ms) está implicado en el proceso de modulación bottom-up desde el momento de la fijación ocular hasta el reporte dado por los participantes. Se concluyó que las reversibilidades perceptuales disminuyen significativamente cuando el eje idiotrópico de la cabeza apunta en el sentido del vector gravitacional en comparación con la posición erguida. Se encontraron asociaciones entre los perceptos y las áreas de modulación cuando en el análisis se consideran las fijaciones oculares registradas, 250 milisegundos antes de los reportes. La interpretación de la imagen analizada supone una tarea visual compleja de conformidad con los resultados, pues el análisis de asociación entre perceptos reportados y áreas moduladoras que arroja significancia es el que se hace revisando las fijaciones oculares hechas 250 ms antes del registro del reporte de cada percepto.

Current state of cannabis use, policies, and research across sixteen countries: cross-country comparisons and international perspectives

Abstract Introduction Varying public views on cannabis use across countries may explain the variation in the prevalence of use, policies, and research in individual countries, and global regulation of cannabis. This paper aims to describe the current state of cannabis use, policies, and research across sixteen countries. Methods PubMed and Google Scholar were searched for studies published from 2010 to 2020. Searches were conducted using the relevant country of interest as a search term (e.g., "Iran"), as well as relevant predefined keywords such as "cannabis," "marijuana," "hashish," "bhang "dual diagnosis," "use," "addiction," "prevalence," "co-morbidity," "substance use disorder," "legalization" or "policy" (in English and non-English languages). These keywords were used in multiple combinations to create the search string for studies' titles and abstracts. Official websites of respective governments and international organizations were also searched in English and non-English languages (using countries national languages) to identify the current state of cannabis use, policies, and research in each of those countries. Results The main findings were inconsistent and heterogeneous reporting of cannabis use, variation in policies (e.g., legalization), and variation in intervention strategies across the countries reviewed. European countries dominate the cannabis research output indexed on PubMed, in contrast to Asian countries (Thailand, Malaysia, India, Iran, and Nepal). Conclusions Although global cannabis regulation is ongoing, the existing heterogeneities across countries in terms of policies and epidemiology can increase the burden of cannabis use disorders disproportionately and unpredictably. There is an urgent need to develop global strategies to address these cross-country barriers to improve early detection, prevention, and interventions for cannabis use and related disorders.

Ocular fixations modulate audiovisual semantic congruency when standing in an upright position / Las fijaciones oculares modulan la congruencia semántica audiovisual cuando el cuerpo está en una posición erguida

Abstract Introduction: Multisensory audiovisual semantic congruency is the process by which visual information is perceived as integrated to auditory stimuli, because both coincide in terms of simultaneity and semantic correspondence. This study was aimed at establishing whether visual percepts, which semantically correspond to auditory stimuli, are associated with ocular fixations in modulating bottom-up areas while keeping a body posture alignment between the up-direction and the idiotropic axes, as well as in another orientation corresponding to a vectorial opposition between the up-direction and the head idiotropic axis. Method: Two groups (one for each position) were selected from a sample of 88 people. A bistable image was presented on a screen of a fixed 120 Hz eye-tracker device, providing background auditory stimuli so as to establish semantic congruencies and their relations to ocular fixations. Results: It was found that audiovisual semantic congruency is associated with fixations when idiotropic vectors are aligned with the up direction. Fixations manifested in bottom-up modulating areas are not associated with multisensory audiovisual semantic congruency when the head idiotropic vector is parallel with the gravity vector. Eye fixations decrease significantly if the head idiotropic axis is aligned with the gravity vector. Conclusion: It is concluded that body position can affect visual perceptual processes involved in the occurrence of semantic congruency.

Resumen Introducción: La congruencia semántica audiovisual es el proceso por el cual información de una modalidad sensorial visual se percibe como integrada a estímulos auditivos, porque coinciden en términos de simultaneidad y correspondencia semántica. Este estudio tuvo por objeto establecer si los perceptos visuales que se corresponden semánticamente a estímulos auditivos están asociados con las fijaciones oculares realizadas en áreas de modulación bottom-up, tanto en una postura corporal definida por la alineación entre la dirección vertical hacia arriba y los ejes vectoriales idiotrópicos, como en otra orientación definida por una oposición vectorial entre la vertical hacia arriba y el eje idiotrópico de la cabeza. Método: Dos grupos fueron seleccionados (uno por cada posición), tomados de una muestra de 88 personas. Los datos se obtuvieron por medio de un dispositivo fijo de registro de movimientos oculares de 120 Hz. Una imagen biestable se presentó, proporcionando estímulos auditivos de fondo para producir congruencias semánticas y establecer su relación con las fijaciones oculares. Resultados: Se encontró que la congruencia semántica audiovisual está asociada con áreas de fijación ocular cuando los vectores idiotrópicos están alineados con la dirección vertical ascendente. Las fijaciones oculares en áreas de modulación bottom-up no están asociadas con la congruencia semántica audiovisual cuando el vector idiotrópico de la cabeza está alineado con el vector gravitacional. En esta última posición, la cantidad de fijaciones oculares es significativamente menor. Conclusión: La posición del cuerpo puede afectar procesos perceptuales visuales que, a su vez, inciden en el efecto de congruencia semántica.

Psychiatric neuroimaging research in Brazil: historical overview, current challenges, and future opportunities

The last four decades have witnessed tremendous growth in research studies applying neuroimaging methods to evaluate pathophysiological and treatment aspects of psychiatric disorders around the world. This article provides a brief history of psychiatric neuroimaging research in Brazil, including quantitative information about the growth of this field in the country over the past 20 years. Also described are the various methodologies used, the wealth of scientific questions investigated, and the strength of international collaborations established. Finally, examples of the many methodological advances that have emerged in the field of in vivo neuroimaging are provided, with discussion of the challenges faced by psychiatric research groups in Brazil, a country of limited resources, to continue incorporating such innovations to generate novel scientific data of local and global relevance.

Electroencephalogram patterns with the presence of an unknown musical stimulus

The cerebral activity presents different behaviors in different situations and levels of consciousness, especially under musical stimulation. Signals of the central nervous system may disclose bioelectrical patterns, since listening to rhythmic sequences activates specific brain areas. In this paper, we analyze 42 neurologically normal Brazilian individuals, submitted to musical stimulation based on a procedure consisting of three different steps, during which the volunteer is kept with closed eyes. The first step is associated with the preliminary control silence period, without any stimulus, as the volunteer remains at rest. The second step consisted of unknown music stimulation. Finally, the third step involves post-music rest. Quantitative signal analysis computes the power spectrum time variations. Results point out stronger changes in gamma and high gamma waves (30 ­ 100 Hz). Even though the clinical rhythms (0 ­ 30 Hz) change throughout the whole period of the experiment, quantitative differences at gamma and high gamma bands are remarkably greater. Particularly, when comparing the initial silent period and the final post-stimulation silent one, bioelectrical differences are only highlighted by gamma and high gamma rhythms. In consequence, this paper points out that the EEG analysis of cognitive issues related to musical perception cannot disregard gamma and high gamma waves.

Condicionantes de la Educación Física para la carrera de Educación Prescolar / Determinantes da Educação Física para a carreira de Educação Pré-Escolar / Physical Education Conditions for the Preschool Education career

Resumen La Educación Física constituye una de las disciplinas del currículo que mayor nivel de confusión genera en estudiantes de la carrera de Educación Prescolar de la Universidad de Pinar del Río, dado que esta carrera tiene como objeto de su profesión, al culminar sus estudios, la atención educativa integral a la primera infancia, por lo que imparten todas las áreas del currículo en las instituciones infantiles; tal es el caso de la Educación Física. Esta disciplina pertenece al ciclo de formación general, es ubicada en el primer y segundo año de la carrera y, posteriormente, en el tercer y cuarto año, dentro de las didácticas particulares, reciben la Educación Física y su didáctica. Los responsables de su dirección, dada las imprecisiones existentes en la actualidad que contribuyen a su inadecuada concepción en la práctica pedagógica, necesitan lograr una nueva cultura del aprendizaje de la Educación Física, con la finalidad de brindar al futuro educador una visión panorámica de su propio quehacer en su desempeño laboral, de modo que satisfaga las exigencias sociales. La situación antes expuesta revela la necesidad de desarrollar el presente trabajo que tiene como objetivo: proponer condicionantes para la Educación Física, en la carrera de Educación Prescolar. Sustentado en el método dialéctico-materialista, se emplean métodos teóricos: el histórico-lógico, la modelación, el sistémico-estructural-funcional, así como los métodos empíricos: la encuesta, la entrevista y la observación a clases. Como resultado se logra incorporar un grupo de condicionantes para mejorar la Educación Física.

Resumo A Educação Física é uma das disciplinas do currículo que gera o maior nível de confusão entre os estudantes na carreira da Educação Pré-Escolar na Universidade de Pinar del Río, uma vez que o objetivo desta carreira é proporcionar uma educação infantil abrangente no final dos seus estudos, pelo que ensinam todas as áreas do currículo nas instituições infantis; este é o caso da Educação Física. Esta disciplina faz parte do ciclo educativo geral, e é ensinada no primeiro e segundo anos do curso. Os responsáveis pela sua gestão, dadas as imprecisões que existem atualmente e que contribuem para a sua concepção inadequada na prática pedagógica, necessitam de alcançar uma nova cultura de aprendizagem da Educação Física, a fim de proporcionar ao futuro educador uma visão panorâmica do seu próprio desempenho no trabalho, de modo a satisfazer as exigências sociais. A situação descrita acima revela a necessidade de desenvolver o presente trabalho, que visa propor condições para a Educação Física na carreira da Educação Pré-Escolar. Com base no método dialético-materialista, são utilizados métodos teóricos: o histórico-lógico, a modelação, sistémico-estrutural-funcional, bem como métodos empíricos: o inquérito, a entrevista e a observação de aulas. Como resultado, é possível incorporar um grupo de fatores condicionantes para melhorar a Educação Física.

Abstract Physical Education is one of the disciplines of the curriculum that generates more confusion in students of the Preschool Education career of the University of Pinar del Río, because this career has as its objective the integral educational attention to early childhood, so they teach all the areas of the curriculum in children's institutions, such is the case of Physical Education. This discipline belongs to the general formation cycle, it is located in the first and second year of the career and later in the third and fourth year within the particular didactics, they receive the Physical Education and its didactics, those responsible for its direction, given the existing imprecision at present, which contributes to its inadequate conception in the pedagogic practice needs to achieve a new culture of learning of the Physical Education with the purpose of offering to the future educator a panoramic vision of his own task in his work performance, so that it satisfies the social demands. The situation previously exposed reveals the need to develop the present work that has as objective to propose conditioners for the Physical Education in the Preschool Education career. Based on the dialectical materialist method, theoretical methods are used: the historical-logical, the modeling, the systemic-structural-functional; as well as the empirical methods, the survey, the interview and the observation to classes. As a result, it is possible to incorporate a group of conditioning factors to improve Physical Education.

Severe cardiac insufficiency secondary to cardiotoxicity with clinical and morpho-functional improvement after optimised clinical treatment: case report / Insuficiência cardíaca grave secundária a cardiotoxicidade com melhora clínica e morfo-funcional após tratamento clínico otimizado: relato de caso

Many therapies used for cancer (pathology whose cases are progressively increasing in the world) such as chemotherapy and radiotherapy have numerous adverse effects, with cardiotoxicity being one of the most important. This can be defined from the detection, by an imaging method, of a reduction of at least 10% in the left ventricular ejection fraction (LVEF), bringing it to a value below 53%. Anthracyclines (such as Doxorubicin), Trastuzumab, and Taxanes (Docetaxel) are among the most associated chemotherapeutics. To emphasize the importance of optimized treatment for heart failure and to review the main updates on the theme of cardiotoxicity. Case report and bibliographic review on the latest updates to the management of cardiotoxicity and associated heart failure. When correctly identifying the main risk factors associated with chemotherapy and the individual to develop myocardial injury, it is possible to perform the monitoring by means of two main predictors: the myocardial tension strength and the biomarkers. In this sense, changes associated with these predictors may allow early intervention through appropriate treatment and, with the advancement of research, even prevention, mainly using the association of Carvedilol with Enalapril. Continuous monitoring and early initiation of drug therapy for heart failure are clearly associated with a lower degree of myocardial injury and a lower rate of complications. In addition, there is still an increasingly promising possibility in relation to preventive drug therapy, however, there is still a lack of studies on this topic.

Muitas terapias utilizadas para o câncer (patologia cujos casos estão aumentando progressivamente no mundo) como a quimioterapia e a radioterapia possuem inúmeros efeitos adversos, sendo a cardiotoxicidade um dos mais importantes. Esta pode ser definida a partir da detecção, por um método de imagem, de uma redução de, pelo menos, 10% na fração de ejeção do ventrículo esquerdo (FEVE), levando a mesma para um valor inferior a 53%. As Antraciclinas (como a Doxorrubicina), o Trastuzumab, e os Taxanos (Docetaxel) estão entre os quimioterápicos mais associados. Enfatizar a importância do tratamento otimizado para insuficiência cardíaca e revisar sobre as principais atualizações do tema cardiotoxicidade. Relato de caso e revisão bibliográfica sobre últimas atualizações de condutas referentes ao manejo da cardiotoxicidade e insuficiência cardíaca associada. Ao se identificar corretamente os principais fatores de risco associados à quimioterapia e ao indivíduo para desenvolver a injúria miocárdica, é possível realizar o monitoramento por meio de dois preditores principais: a força de tensão miocárdica e os biomarcadores. Nesse sentido, alterações associadas a esses preditores podem permitir a intervenção precoce por meio do tratamento adequado e, com o avanço das pesquisas, até mesmo a realização da prevenção, principalmente utilizando-se a associação de Carvedilol com Enalapril. Monitorização contínua e início precoce da terapia medicamentosa para insuficiência cardíaca estão claramente associadas com um menor grau de injúria miocárdica e um menor índice de complicações. Além disso, ainda há a possibilidade cada vez mais promissora em relação à terapia medicamentosa preventiva, porém, ainda há carência de estudos em relação a este tema.

Differences in total brain volume between sexes in a cognitively unimpaired elderly population

OBJECTIVES: Although a large number of studies have shown brain volumetric differences between men and women, only a few investigations have analyzed brain tissue volumes in representative samples of the general elderly population. We investigated differences in gray matter (GM) volumes, white matter (WM) volumes, and intracranial volumes (ICVs) between the sexes in individuals older than 66 years using structural magnetic resonance imaging (MRI). METHODS: Using FreeSurfer version 5.3, we obtained the ICVs and GM and WM volumes from the MRI datasets of 84 men and 92 women. To correct for interindividual variations in ICV, GM and WM volumes were adjusted with a method using the residuals of a least-square-derived linear regression between raw volumes and ICVs. We then performed an analysis of covariance comparing men and women, including age and years of schooling as confounding factors. RESULTS: Women had a lower socioeconomic status overall and fewer years of schooling than men. The comparison of unadjusted brain volumes showed larger GM and WM volumes in men. After the ICV correction, the adjusted volumes of GM and WM were larger in women. CONCLUSION: After the ICV correction and taking into account differences in socioeconomic status and years of schooling, our results confirm previous findings of proportionally larger GM in women, as well as larger WM volumes. These results in an elderly population indicate that brain volumetric differences between sexes persist throughout the aging process. Additional studies combining MRI and other biomarkers to identify the hormonal and molecular bases influencing such differences are warranted.

Validation of a new tool for evaluating subjects' satisfaction with medicine package leaflets: a cross-sectional descriptive study

ABSTRACT BACKGROUND: Package leaflets of medicines need to be intelligible, but tools for their evaluation are scarce. OBJECTIVE: To validate a new tool for assessing subjects' satisfaction with medicine package leaflets (LiS-RPL). DESIGN AND SETTING: Cross-sectional descriptive study conducted in two regions of Portugal (Lisbon and Centre). METHODS: 503 participants (53.1% male) were selected according to convenience and homogenously distributed into three groups: 1 to 6; 7 to 12; and > 12 years of schooling. LiS-RPL was developed based on international regulation guidelines and was initially composed of 14 items. Twelve package leaflets were tested. Dimensionality calculations included: exploratory factor analysis and minimum rank factor analysis; Kaiser-Meyer-Olkin index and Bartlett's sphericity test to assess matrix adequacy for exploratory factor analysis; exploratory bifactor analysis with Schmid-Leiman solution to detect possible existence of a broad second-order factor; and Bentler's Simplicity Index and Loading Simplicity Index to assess factor simplicity. Diverse coefficients were calculated to assess reliability. RESULTS: Minimum rank factor analysis detected a two-factor or single-factor structure. Exploratory factor analysis with 12 items showed a two-factor structure, explaining 69.11% of the variance. These items were strongly correlated with each other (r = 0.80). Schmid-Leiman: all items seemed to represent the general factor (loadings above 0.50), which was 76.4% of the extracted variance. Simplicity indices were good (percentile 99): Bentler's Simplicity Index of 0.99 and Loading Simplicity Index of 0.48. Internal consistency indexes indicated good reliability. LiS-RPL was shown to be homogenous. CONCLUSION: LiS-RPL is a validated tool for evaluating subjects' satisfaction with medicine package leaflets.

Alice in Wonderland syndrome: "Who in the world am I?" / Síndrome de Alice no País das Maravilhas: "Quem sou eu no mundo?"

ABSTRACT Alice in Wonderland syndrome (AIWS) is a paroxysmal, perceptual, visual and somesthetic disorder that can be found in patients with migraine, epilepsy, cerebrovascular disease or infections. The condition is relatively rare and unique in its hallucinatory characteristics. Objective: To discuss the potential pathways involved in AIWS. Interest in this subject arose from a patient seen at our service, in which dysmetropsia of body image was reported by the patient, when she saw it in her son. Methods: We reviewed and discussed the medical literature on reported patients with AIWS, possible anatomical pathways involved and functional imaging studies. Results: A complex neural network including the right temporoparietal junction, secondary somatosensory cortex, premotor cortex, right posterior insula, and primary and extrastriate visual cortical regions seem to be involved in AIWS to varying degrees. Conclusions: AIWS is a very complex condition that typically has been described as isolated cases or series of cases.

RESUMO Síndrome de Alice no País das Maravilhas (SAPM) é uma condição paroxística visual perceptiva e somestésica que pode ser encontrada em pacientes com enxaqueca, epilepsia, doença cerebrovascular ou infecções. A condição é relativamente rara e tem características alucinatórias peculiares. Objetivo: Discutir as potenciais vias envolvidas na SAPM. O interesse pelo assunto surgiu com um caso de nosso serviço, onde a distropsia da imagem corporal foi relatada pela paciente, que via isto em seu filho. Métodos: Os autores revisaram e discutiram a literatura médica de casos relatados de SAPM, possíveis vias anatômicas envolvidas e estudos de imagem funcional. Resultados: Uma complexa rede neural incluindo junção temporoparietal direita, córtex somatossensitivo secundário, córtex pré-motor, região posterior da ínsula direita, e regiões do córtex visual primário e extra-estriatal têm diferentes graus de envolvimento na SAPM. Conclusão: SAPM é uma condição complexa que tipicamente foi descrita apenas com casos isolados ou séries de casos.

O papel mediador da autorrevelação sexual na relação entre a expressão de sentimentos e a satisfação sexual em adultos heterossexuais / The mediating role of sexual self-disclosure satisfaction in the association between expression of feelings and sexual satisfaction in heterosexual adults

Resumo O objetivo de deste estudo foi testar um modelo de mediação da expressão de sentimentos e a satisfação sexual via autorrevelação, enquanto processo, é uma variável mediadora significativa da associação entre a expressão de sentimentos e a satisfação sexual. A amostra deste estudo foi constituída por 564 participantes (370 mulheres, 65,60%), cisgénero, heterossexuais, numa relação diádica de exclusividade e compromisso. Foram testados dois modelos: um modelo de mediação simples e um modelo de mediação moderada, sendo este último usado para testa a influência do género no modelo de mediação. Os resultados demonstraram que, globalmente, homens e mulheres apresentaram valores médios idênticos na autorrevelação sexual e satisfação sexual; se contudo, na expressão de sentimentos, as mulheres apresentaram valores significativamente superiores. A expressão de sentimentos revelou-se uma variável preditora significativa da satisfação sexual e a autorrevelação sexual como uma variável parcialmente mediadora do modelo. No entanto, o género não modera a expressão de sentimentos e a autorrevelação. O presente estudo demonstra que a expressão de sentimentos e a autorrevelação sexual são importantes aspetos da satisfação sexual de ambos os géneros.

Abstract The present study had the main goal of testing a mediation model of expression of feelings and sexual satisfaction via sexual self-disclosure, trying to understand if the process of sexual self-disclosure is a significant mediator variable of the association between expression of feelings and sexual satisfaction. The sample of this study comprised by 564 cisgender, heterosexual participants (370 women, 65.60%), who were in a dyadic and exclusive relationship of commitment. Two models were tested: a simple mediation model and a moderate mediation model in which the objective is to test the influence of gender on the of mediation. Overall, results showed that men and women had similar mean values for sexual self-disclosure and sexual satisfaction, however, a significantly higher expression of feelings was found in women compared to men. The results demonstrated that expression of feelings was a significant predictor variable of sexual satisfaction and that sexual self-disclosure is partially a mediator variable of the tested model. Gender did not moderate the association between expression of feelings and sexual self-disclosure. The present study shows that expression of feelings and sexual self-disclosure are important aspects of sexual satisfaction in both genders.

Los movimientos oculares como medida de control ejecutivo en niños con trastorno por déficit de atención con hiperactividad / Eye movements as a measure of executive control in children with Attention Deficit Hyperactivity Disorder

El Trastorno por Déficit de Atención con Hiperactividad (TDAH) está relacionado con dificultades a nivel de control ejecutivo. Nuevas formas de explorar este constructo contribuyen a la precisión diagnóstica, disminuir la prevalencia y la construcción de un consenso objetivo sobre los criterios del TDAH. El objetivo fue establecer las diferencias en el control ejecutivo de un grupo de niños con TDAH (N=22), con respecto al grupo control (N=15), de ambos géneros y de entre 7 y 12 años de edad, escolarizados de la ciudad de Medellín, Colombia. Se implementaron tres parámetros oculares: fijaciones, antisacadas y prosacadas, los cuales fueron registrados continuamente en un equipo de rastreo visual (Tobii T120). Los resultados indicaron un menor tiempo para el grupo con TDAH en fijaciones oculares (p<,001) que miden control de la interferencia. Un mayor número de errores de dirección en el parámetro antisacadas relacionados con el control inhibitorio. Respecto a las prosacadas, que miden la capacidad para iniciar una respuesta motora, no se encontraron diferencias significativas. Se concluyó que la población con TDAH presenta alteración en el control ejecutivo al utilizar el paradigma de rastreo ocular. Se propusieron, además, los movimientos oculares como posible marcador biológico para detectar una población en riesgo de padecer dicho trastorno.

Attention Deficit Hyperactivity Disorder (ADHD) is related to difficulties at the level of the executive control. New ways of exploring this construct contribute to diagnostic accuracy, decrease the prevalence and build an objective consensus on ADHD criteria. The aim of the study was to establish the differences in the executive control of a group of children with ADHD (N=22), with respect to the control group (N=15), of both genders and between 7 and 12 years old, attending school in the city of Medellin, Colombia. Three ocular parameters were implemented: fixings, antisaccade, and prosaccades, which were recorded continuously in a visual tracking equipment (Tobii T120). The results indicated a shorter time for the group with ADHD in ocular fixations (p<0.001) that measure interference control. A greater number of address errors in the antisaccade parameter related to inhibitory control. Regarding the prosaccades, which measure the capacity to initiate a motor response, no significant differences were found. It was concluded that the population with ADHD presents alteration in the executive control when using the eye tracking paradigm. Eye movements were also proposed as a possible biological marker to detect a population at risk of suffering from this disorder.

Adenocarcinoma de cólon: tratamento cirúrgico e quimioterápico / Colon adenocarcinoma: surgical and chemotherapic treatment

Introdução: Esta revisão bibliográfica buscou analisar a literatura pertinente à abordagem cirúrgica e clínica do adenocarcinoma de cólon. Métodos: Foram revisados artigos em bases de dados ­ Pudmed, Medscape e UptoDate ­ e excluídos aqueles com pouca relevância clínica ou baixo de grau de evidência. Resultados: O tratamento do adenocarcinoma de cólon visando a cura é baseado na abordagem cirúrgica. Em estádio iniciais (I e II, sem acometimento linfonodal) o tratamento cirúrgico exclusivo é a indicação atual, sendo restrito o tratamento quimioterápico adjuvante para estádios mais avançados ou pacientes estádio II de alto risco. Devem-se individualizar os casos, às vezes recorrendo-se ao tratamento paliativo. Conclusão: A principal abordagem curativa para adenocarcinoma de cólon é cirúrgica, porém pode-se recorrer à terapia adjuvante quando necessário. No momento não parecem haver dados suficientes para formulação de diretriz com tratamento neoadjuvante.

Introduction: This review sought to analyze the literature pertinent to the surgical and clinical approaches to colon adenocarcinoma. Methods: Review of articles from databases ­ Pubmed, Medscape and UptoDate ­ those little clinical relevance or low clinical relevance or low degree of evidence. Results: The curative treatment of the colon adenocarcinoma is based on the surgical approach. In initial stages (I and II, with no lymph node involvement) the exclusive surgical treatment is the current indication, with adjuvant chemotherapy being restricted to more advanced staging or patients with high-risk stage II disease. Cases must be individualized, sometimes relying on palliative treatment. Conclusion: The main curative approach to colon adenocarcinoma is surgical, however, adjuvant therapy can be relied upon when necessary. At the moment, there do not seem to be enough data for the formulation of guidelines for neoadjuvant treatment.

ADIPOQ and adiponectin: the common ground of hyperglycemia and coronary artery disease? / ADIPOQ e adiponectina: base comum da hiperglicemia e doença arterial coronariana?

Plasma adiponectin and the coding gene for adiponectin, ADIPOQ, are thought to explain part of the interaction between obesity, insulin resistance, type 2 diabetes (T2DM) and coronary artery disease (CAD). Here, we illustrate the role that adiponectin and ADIPOQ variants might play in the modulation of CAD, especially in the occurrence of hyperglycemia. Recent evidence suggests that total and high molecular weight (HMW) adiponectin levels are apparent markers of better cardiovascular prognosis in patients with low risk of CAD. However, in subjects with established or high risk of CAD, these levels are associated with poorer prognosis. We also provide recent evidences relating to the genetic control of total and HMW adiponectin levels, especially evidence regarding ADIPOQ. Accumulated data suggest that both adiponectin levels and polymorphisms in the ADIPOQ gene are linked to the risk of CAD in patients with hyperglycemia, and that these associations seem to be independent from each other, even if adiponectin levels are partly dependent on ADIPOQ.

Os níveis plasmáticos de adiponectina e o gene codante desta proteína, ADIPOQ, parecem explicar parte da interação de doenças como obesidade, resistência à insulina, diabetes melito tipo 2 (DM2) e doença arterial coronariana (DAC). Apresentamos as evidências do papel tanto dos níveis de adiponectina quanto das variantes no ADIPOQ na modulação da DAC, sobretudo na presença de hiperglicemia. Estudos recentes sugerem que níveis de adiponectina total e de alto peso molecular (HMW) são marcadores de bom prognóstico DAC, sobretudo em pacientes de baixo risco cardiovascular, enquanto nos pacientes de alto risco ou com doença já estabelecida podem se associar com pior prognóstico. Apresentamos também as evidências em relação ao possível controle genético dos níveis circulantes de adiponectina, tanto total quanto da isoforma de alto peso molecular, sobretudo em relação ao ADIPOQ. A análise global dos dados sugere que tanto os níveis circulantes de adiponectina quanto polimorfismos no gene ADIPOQ estão implicados na evolução de DAC em pacientes com hiperglicemia e que essas associações podem existir de forma independente.

Insuficiência hepática aguda / Acute liver failure

Mediante a revisão bibliográfica apresentada a seguir, objetiva-se definir e demonstrar o quadro clínico e manejo da insuficiência hepática aguda. Dentre os demais assuntos associados à patologia, busca-se, através de dados epidemiológicos, demonstrar as etiologias do distúrbio e as complicações esperadas em sua evolução

Síndrome hepatorrenal / Hepatorenal Syndrome

Os autores fazem uma revisão bibliográfica sobre as definições, identificação e classificação da Síndrome Hepatorrenal. Através de uma base de dados atualizada, expõem-se as abordagens terapêuticas da patologia