¿Cómo y Cuánto se Mueven los Adultos que sufrieron un Evento Coronario un Año después de haber entrado a un Programa de Rehabilitación Cardiaca? / How and How Much Do Adults Who Suffered a Coronary Event Move One Year After Entering a Cardiac Rehabilitation Program?

Introducción. Establecer un estilo de vida activo y saludable es uno de los objetivos más importantes y desafiantes de la rehabilitación cardíaca. Comprender el comportamiento de los patrones de actividad física (AF) en adultos que han sufrido un evento coronario y que han participado en un programa de Rehabilitación Cardíaca (RC) es necesario para evaluar su impacto y proponer estrategias oportunas en esta área. Objetivo. Evaluar el cumplimiento de la recomendación global de AF 1 año después de ingresar a un programa de RC para enfermedad arterial coronaria. Métodos. Se aplicó el Cuestionario Internacional de Actividad Física a adultos con enfermedad coronaria tratada a los 6 y 12 meses de su ingreso a un programa de Rehabilitación Cardíaca en 6 hospitales de Chile, entre mayo de 2019 y febrero de 2020 en el contexto del estudio aleatorizado. Se realizó un ensayo clínico multicéntrico de no inferioridad (Hybrid Cardiac Rehabilitation Trial, HYCARET). Resultados. 117 participantes (74 hombres, edad 59,34 ±9,52 años, 83,4±27,2% de adherencia a la RC) físicamente activos al final de un programa de RC fueron evaluados a los 6 y 12 meses desde el ingreso para determinar su adherencia a la AF. La tasa de seguimiento fue del 94,01% a los 6 meses (6m) y del 78,63% a los 12 meses (12m). El 90% de los participantes seguían físicamente activos a los 6 meses y el 92,39% seguían activos a los 12 meses después del evento coronario. Un 5,98% fueron clasificados como inactivos a los 6 m pero estaban físicamente activos al año. En contraste, sólo el 0,85% se volvió inactivo a los 6 meses y permaneció inactivo hasta 1 año, mientras que el 4,27% se reportó como activo a los 6 meses, pero terminó estando inactivo al año. La AF relacionada con las tareas del hogar es responsable del 40% y más del gasto calórico total de los adultos después de un evento coronario en todo momento. El gasto calórico relacionado con actividades recreativas y transporte disminuyó a los 6 y 12 meses, mientras que el gasto calórico asociado con el trabajo y las actividades domésticas aumentó a los 6 y 12 meses después de completar un programa de RC. Conclusión. Los adultos que completan un programa de RC continúan activos 6 y 12 meses después de un evento coronario. Sin embargo, las actividades que generan mayor gasto calórico varían con el tiempo. Este hallazgo resalta la importancia de fomentar la actividad física como parte del tiempo de ocio y recreación en los adultos, ya que se sabe que su beneficio es mayor.

Background. Establishing a healthy, active lifestyle is one of the most important and challenging goals of cardiac rehabilitation. Understanding the behavior of physical activity (PA) patterns in adults who have suffered a coronary event and who have participated in a Cardiac Rehabilitation (CR) program is necessary to evaluate its impact and propose timely strategies in this area. Objetive. To evaluate compliance with the global PA recommendation 1 year after entering a CR program for coronary artery disease. Methods. The International Physical Activity Questionnaire was applied to adults with coronary heart disease treated 6 and 12 months after admission to a Cardiac Rehabilitation program in 6 hospitals in Chile, between May 2019 and February 2020 in the context of the randomized study. A multicenter non-inferiority clinical trial (Hybrid Cardiac Rehabilitation Trial, HYCARET) was conducted. Results. 117 participants (74 men, age 59.34 ± 9.52 years, 83.4 ± 27.2% adherence to CR) physically active at the end of a CR program were evaluated at 6 and 12 months from entry. to determine their adherence to PA. The follow-up rate was 94.01% at 6 months (6m) and 78.63% at 12 months (12m). 90% of participants were still physically active at 6 months and 92.39% were still active at 12 months after the coronary event. 5.98% were classified as inactive at 6 m but were physically active at one year. In contrast, only 0.85% became inactive at 6 months and remained inactive for up to 1 year, while 4.27% reported themselves as active at 6 months but ended up being inactive at one year. Housework-related PA is responsible for 40% and more of adults' total caloric expenditure after a coronary event at all times. Caloric expenditure related to recreational activities and transportation decreased at 6 and 12 months, while caloric expenditure associated with work and home activities increased at 6 and 12 months after completing a CR program. Conclusion. Adults who complete a CR program remain active 6 and 12 months after a coronary event. However, the activities that generate the greatest caloric expenditure vary over time. This finding highlights the importance of promoting physical activity as part of leisure and recreation time in adults, since it is known that its benefit is greater.

Signal mining and analysis of selinexor adverse events / 中国药房

OBJECTIVE To mine the adverse drug event （ADE） signals of selinexor， and to provide reference for its clinical safety medication. METHODS ADE data for selinexor reported from July 3rd， 2019 to March 31st， 2023 were collected from the FDA adverse event reporting system （FAERS）. Data mining was performed by using the reporting odds ratio （ROR） and proportional reporting ratio （PRR） methods， and categorization statistics were performed by using the system organ class （SOC） and preferred term （PT） from drug ADE terminology set in the MedDRA （version 26.0）. RESULTS A total of 3 084 ADE reports were obtained for selinexor， with a total of 134 ADE-positive signals. Among the reported genders， there were 127 males and 124 females， with a predominant age of ≥65 years old （4.12%）； the United States had the highest number of reports （96.53%）， with consumers being the main reporters （77.27%）； severe ADR was mainly characterized by hospitalization/prolonged hospitalization （26.26%）， followed by death （17.15%）. The top 3 ADE in the list of frequency were nausea （1 162 times）， fatigue （790 times） and anorexia （610 times）， all of which were mentioned in the selinexor’s instructions. The top 3 signals in the list of strength were device-associated bacteremia （ROR＝115.07， PRR＝114.94）， blepharospasm dysfunction （ROR＝106.70， PRR＝106.54）， and salmonella sepsis （ROR＝99.90， PRR＝99.81）， all of which were not mentioned in the selinexor’s instructions. CONCLUSIONS In addition to the ADE of nausea mentioned in the instruction manual， attention should also paid to device-associated bacteremia， blepharospasm dysfunction， salmonella sepsis， and other ADE not mentioned in the instruction manual when using selinexor in clinical practice； weekly rechecking of the patient’s blood routine should be done to monitor the patient’s blood indexes， symptoms of infection， and so on， to ensure that the safety of 1661962346@qq.com drug use.

Pressupostos e Procedimentos da Investigação às Margens da Filosofia e da Psicanálise: Questões Acerca de Método / Presuppositions and the Procedures of Investigation on the Margins in Psychoanalysis and Philosophy: Questions About Method

Neste este artigo focalizamos a modalidade de relação que o pesquisador engendra com o seu campo de investigação ­ o campo das experiências humanas ­ a fim de delinear um pensamento que possa funcionar como horizonte dos procedimentos metodológicos utilizados nas pesquisas stricto sensu conduzidas em nosso grupo. Trata-se de pôr em questão o par sujeito-objeto, de modo a transpassar o realismo científico e os meros construtivimos. Trazemos para nossa argumentação um panorama genealógico da noção de sujeito para chegar ao deslocamento de sua posição perante os objetos produzido por Kant (1787/1974). Em solo kantiano ­ e permitindo-nos arriscar além dele ­ parece-nos legítimo semear a ideia de que as investigações por nós conduzidas, do recorte das experiências humanas considerado, podem ter como alvo a circunscrição da potência da coisa (do material, da exterioridade, do objeto, como quer que a designemos) de afetar o pesquisador. E, com certo atrevimento, apostamos na noção de campo transferencial como referência ao que precede e acompanha a captura e o registro da potência de afetar da coisa, esta necessariamente pertencente à esfera do não-antecipável, porquanto da ordem do acontecimento. Propomos como condição e consequência de nossa posição epistemológica a construção de cenas-acontecimento como forma de apresentação dos resultados da pesquisa.

In this article, we focus on the modality of relationship that the researcher establishes with their investigation field­the field of human experience­to delineate a thought that could serve as a horizon for the methodological procedures used in the stricto sensu research conducted by the group. It brings to question the subject-object pair in the way to transcend the scientific realism and the mere constructionism. We bring forth to our argumentation a genealogical panorama of the notion of the subject to reach the displacement of its position towards the objects produced by Kant (1787/1974). On Kantian soil­and allowing ourselves to venture beyond it­it seems legitimate to sow the idea that the investigations conducted by us may have as targets the circumscription of the potency of the thing (of the material, of the exteriority, of the object, however it is that we designate it) to affect the researcher. And, with a degree of boldness, we bet on the notion of transference field as reference to what precedes and follows the capture and registry of potency to affect the thing it necessarily belongs to the sphere of the unpredictable, whilst the order of the event. We propose, as condition and consequence of our epistemological position, the construction of event-scenes as a way of presenting the results of research.

Marcadores Neurales como Indicadores de Funciones Predictivas en Pacientes con Traumatismo Cerebral Moderado a Severo / Neural Markers as Indicators of Predictive Functions in Patients with Moderate to Severe Brain Trauma

Introducción. El traumatismo encéfalo craneano moderado a severo (TEC-MS) es una condición compleja que cambia la estructura y función del cerebro, afectando a personas de distintas edades. Los problemas cognitivos y motores son la mayor causa de discapacidad en individuos con TEC-MS crónico. Sin embargo, muchas de estas dificultades no son visibles de inmediato clasificándose como una "Epidemia silenciosa". Las principales alteraciones reportadas por los pacientes tienen relación con problemas de la memoria, atención y lentitud psicomotora, los cuales tienen un impacto en su independencia y funcionalidad. Objetivo. Este estudio tiene por objetivo discutir y revisar la evidencia disponible acerca de la capacidad de los pacientes crónicos con TEC-MS para generar predicciones en diferentes niveles de procesamiento cerebral. Métodos. Para esto, utilizamos desde las neurociencias el modelo teórico del código predictivo para explicar las respuestas neurofisiológicas adquiridas bajo un paradigma de predicción auditiva. Esta información es complementada con el reporte de datos preliminares de sujetos con TEC-MS y sujetos control, con el fin de ilustrar los aspectos teóricos discutidos. Conclusiones. Esto podría contribuir a una mejor comprensión de los mecanismos neurales detrás de los déficits cognitivos en esta población, aportando una perspectiva que nos oriente al desarrollo de nuestras estrategias terapéuticas.

Background. Moderate to severe traumatic brain injury (TBI-MS) is a complex condition that changes the structure and function of the brain, affecting people of different ages. Cognitive and motor problems are the major cause of disability in individuals with chronic ECT-MS. However, many of these difficulties are not immediately visible, classifying them as a "Silent Epidemic." The main alterations reported by patients are related to problems with memory, attention and psychomotor slowness, which have an impact on their independence and functionality. Objetive. This study aims to discuss and review the available evidence about the ability of chronic ECT-MS patients to generate predictions at different levels of brain processing. Methods. For this, we use the theoretical model of the predictive code from neuroscience to explain the neurophysiological responses acquired under an auditory prediction paradigm. This information is complemented with the report of preliminary data from subjects with ECT-MS and control subjects, in order to illustrate the theoretical aspects discussed. Conclusions. This could contribute to a better understanding of the neural mechanisms behind cognitive deficits in this population, providing a perspective that guides us in the development of our therapeutic strategies.

Para além dos limites da saúde: cuidado em perspectiva interdisciplinar / Beyond the limits of health: care from an interdisciplinary perspectivea / Más allá de los límites de la salud: cuidado desde una perspectiva interdisciplinaria

Este relato apresenta reflexões sobre uma experiência interdisciplinar que envolveu idealização, planejamento, organização, realização e divulgação de um evento científico virtual como requisito da disciplina Seminários Avançados de Pesquisa 1, oferecida pelo Programa de Pós-graduação em Informação e Comunicação em Saúde desenvolvido pelo Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, uma das unidades técnico-científicas da Fundação Oswaldo Cruz. Os doutorandos da turma de 2020 promoveram o webinário "Para além dos limites da saúde: cuidado em perspectiva interdisciplinar", como parte da formação acadêmica, e este relato é produto científico daquele evento. Além do desenvolvimento de habilidades e atitudes, essa experiência representou um aprendizado pessoal, intangível e emocional do cuidado para além dos limites da saúde, e também ético sobre as "coisas negligenciadas" e acerca da força dos consensos diante de um cenário complexo marcado por uma pandemia causada pelo vírus SARS-CoV-2, a pandemia de covid-19

This report presents reflections about an interdisciplinary experience that involved the idealization, planning, organization, implementation and dissemination of a virtual scientific event as requisite for the Seminários Avançados de Pesquisa 1 (Advanced Research Seminars 1), one of the disciplines offered by the Programa de Pós-graduação em Informação e Comunicação em Saúde (Postgraduate Program in Health Information and Communication) developed by the Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Institute of Communication and Scientific and Technological Information in Health), one of the technical-scientific units of the Fundação Oswaldo Cruz (Oswaldo Cruz Foundation). The students who began in 2020 their classes to obtain the PhD Degree promoted the webinar "Beyond the limits of health: care from an interdisciplinary perspective" as part of the academic education, and this report is a scientific product of that event. In addition to the development of skills and attitudes, that experience represented a personal, intangible and emotional learning of the care beyond the limits of health as well as an important ethical learning about the "neglected things" and the strength of consensus in the face of a complex scenario marked by a pandemic caused by the SARS-CoV-2, the Covid-19 pandemic

Este relato presenta reflexiones sobre una experiencia interdisciplinar que implicó la idealización, planificación, organización, realización y difusión de un evento científico virtual como requisito de la disciplina Seminários Avançados de Pesquisa 1 (Seminarios Avanzados de Investigación 1), ofrecida por el Programa de Pós-graduação em Informação e Comunicação em Saúde (Programa de Posgrado en Información y Comunicación en Salud) desarrollado por el Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Instituto de Comunicación y Información Científica y Tecnológica en Salud), una de las unidades técnicas y científicas de la Fundação Oswaldo Cruz (Fundación Oswaldo Cruz). Los doctorandos del curso de 2020 promovieron el webinario "Más allá de los límites de la salud: cuidado desde una perspectiva interdisciplinaria" como parte de la formación académica, y este relatoes producto científico de aquel evento. Además del desarrollo de habilidades y actitudes, esa experiencia representó un aprendizaje personal, intangible y emocional del cuidado más allá de los límites de la salud, y también un importante aprendizaje ético sobre las "cosas tratadas con negligencia" y aún acerca de la fuerza de los consensos ante un escenario complejo marcado por una pandemia provocada por el virus SARS-CoV-2, la pandemia de Covid-19

Hepatotoxicidad inducida por clozapina: reporte de caso y revisión breve de la literatura

Introducción: Los antipsicóticos son medicamentos que pueden producir elevaciones transitorias de las enzimas hepáticas. La clozapina es un antipsicótico atípico usado en el tratamiento de la esquizofrenia refractaria a los antipsicóticos convencionales y existe evidencia que puede producir elevaciones de las transaminasas hepáticas, expresión de dafño hepático con patrón hepatocelular. Métodos: Reporte de caso y revisión no sistemática de la literatura relevante. Presentación del caso: Una mujer de 39 años con diagnóstico de esquizofrenia paranoide acudió a un servicio de urgencias de un hospital general por náuseas, vómitos e ictericia que apareció tras el inicio de clozapina. No hubo mejoría clínica de la paciente durante la hospitalización, que falleció a los 44 días de su ingreso. Revisión de la literatura: La clozapina puede elevar las cifras de función hepática de manera transitoria y asintomática. Hay criterios clínicos para recomendar la suspensión de este antipsicótico. Conclusiones: Este caso es el tercero en la literatura que registra un desenlace fatal tras un cuadro de hepatotoxicidad inducido por clozapina. © 2021 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L.U. Todos los derechos reservados.

Introduction: Antipsychotics are drugs that can produce transient elevations of hepatic enzymes. Clozapine is an atypical antipsychotic used in treatment-resistant schizophrenia and there is evidence that it can produce elevations of hepatic transaminases, expression of liver damage in a hepatocellular pattern. Methods: Case report and non-systematic review of the relevant literature. Case presentation: A 39-year-old woman with a diagnosis of paranoid schizophrenia attended the emergency department of a general hospital for nausea, vomiting and jaundice that appeared after the initiation of clozapine. There was no clinical improvement during hospitalization, and death occurred after 44 days. Literature review: Clozapine can increase the liver enzyme levels transiently and asymptomatically; however, there are clinical criteria that recommend the withdrawal of the antipsychotic. Conclusions: This is the third case reported in the literature of a fatal outcome of clozapine-induced hepatotoxicity.

Factores de riesgo en la Bulimia Nerviosa (BN): elementos claves de seguridad en el cuidado de la salud. Una revisión de la literatura / Bulimia nervosa risk factors (BN): key elements of health care security. A review of the literature

Resumen Se realizó una revisión de literatura con el objetivo de identificar los factores de riesgo de la BN, utiles para que el equipo de salud proteja la seguridad de sus intervenciones y atención a las personas que padecen este trastorno en el ciclo de vida adolescente y joven. Se hizo una búsqueda en bases de datos y repositorios, con uso de términos libres como: BN, adolescente, factor de riesgo, trastorno de conducta alimentaria, en español e inglés, combinados con operadores boleanos (AND, OR, NOT) y de posición (WTH y NEAR). Se incluyeron 72 documentos tras la selección por criterios de inclusión, se hizo depuración de ellos según sus datos bibliográficos, objetivo, tipo de estudio, resultados y conclusión. Los resultados muestran que hay aún factores biológicos por rastrear y analizar, dentro de los sociodemográficos, la edad de afectación principalmente reportada es la adolescencia y adultez joven, no hubo diferencias por raza o nivel socioeconómico. Factores comportamentales como preocupación por la imagen corporal, dietas y ejercicio son documentados. Desde el área psicosocial, la disfuncionalidad individual y los antecedentes de trastornos psicológicos, la familia y el entorno cultural condicionan para que el cuerpo logre su delgadez. La conclusión general sugiere que la seguridad de la atención en la BN está en explorar los antecedentes individuales, biológicos, psicológicos y comportamentales; reconocer dinámicas familiares y la influencia del entorno social. Asimismo, es útil, el trabajo interdisciplinar e integración de red de apoyo familiar para lograr atención segura en la BN.

Abstract Review of literature aimed at recognizing risk factors of BN, useful for the health team to protect the safety of their interventions and care for people suffering from this disorder in the adolescent and young life cycle. It consists of a narrative review, carried out by means of search in databases and repositories, with use of free terms such as: BN, adolescent, risk factor, food behavior disorders, in Spanish and English, combined with bolean operators (AND, OR, NOT) and position (WTH and NEAR). Seventy-two sources were incorporated, documents were selected by inclusion criteria, review according to bibliographic data, objective, type of study, results, and conclusion. The results show that there are still biological factors to be traced and analyzed, within the sociodemographic the age of involvement is adolescence and youth, it does not have differences by race or socioeconomic level. Behavioral factors such as concern for body image, diets and exercise are documented. From the psychosocial area, individual dysfunction and backgrounds of psychological disorders, the family and the cultural environment influence to achieve the thinness of the body. The general conclusion suggests that the safety of care in the BN lies in exploring the individual, biological, psychological and behavioral backgrounds, recognizing family dynamics and the influence of the social environment. It is useful, interdisciplinary work and integration of family support network to achieve safe health care in the BN.

De lo no-velado a la capacidad de novelar. La virtualidad en la clínica con adolescentes durante la pandemia / From the unveiled to de capacity to novelize. Virtuality in clinic with adolecent during the pandemic / Du non voilé à la capacité de romancier. La clinique avec les adolescents pendant la pandémie / Do ñao-velar á capacidade de novelar. A clínica com adolescentes durante a pandemia

El presente artículo aborda las consecuencias psíquicas en los adolescentes, del aislamiento social obligatorio durante la pandemia de Covid19. Un acontecimiento social que dio lugar a procesos creativos y patológicos. La virtualidad como herramienta tecnológica ha transformado las formas del lazo social y de la subjetividad, pero también ha permitido sostener una continuidad en los dispositivos de salud y de educación. En el caso de los tratamientos se modificaron los encuadres dando lugar a nuevas formas de atención, con sus particularidades en el trabajo clínico con adolescentes AU

This article is about the psychological consequences in Atdolescents of mandatory social isolation during the Covid19 pandemic. A social event that gave rise to creative and pathological processes. Virtuality as a technological tool has transformed the forms of social bond and subjectivity, but it has also made it possible to sustain continuity in health and education devices. In the case of treatments, the frames were modified, giving rise to new forms of care, with their particularities in clinical work with adolescents AU

Cet article aborde les conséquences psychologiques chez les adolescents de l'isolement social obligatoire pendant la pandémie de Covid19. Un événement social qui a donné lieu à des processus créatifs et pathologiques. Levirtualité comme outil technologique a transformé les formes de lien social et de subjectivité, mais elle a aussi permis de pérenniser les dispositifs de santé et d'éducation. Dans le cas des traitements, les cadres ont été modifiés, donnant lieu à de nouvelles formes de soins, avec leurs particularités dans le travail clinique avec les adolescents AU

Este artigo aborda as consequências psicológicas em adolescentes do isolamento social obrigatório durante a pandemia de Covid19. Um acontecimento social que deu origem a processos criativos e patológicos. A virtualidade como ferramenta tecnológica transformou as formas de vínculo social e subjetividade, mastambém possibilitou sustentar a continuidade dos dispositivos de saúde e educação. No caso dos tratamentos, os quadros foram modificados, dando origem a novas formas de cuidado, com suas particularidades no trabalho clínico com adolescentes AU

Acute abducens nerve palsy with acute disseminated encephalomyelitis-like presentation following COVID-19 vaccination

We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated systemic symptoms. Post-vaccination demyelination typically known as acute disseminated encephalomyelitis (ADEM) associated with several vaccines is more common in children. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to the post-vaccine neuroinflammatory syndrome. Cranial nerve palsies and ADEM-like presentations may represent part of the neurologic spectrum following COVID-vaccination in adults, and ophthalmologists should be aware of these sequelae. Although cases of sixth nerve palsy following COVID vaccination are already reported, associated MRI changes have not been reported from India.

COVID-19 vaccination in children: a public health priority

Abstract Objective: Covid-19 had a direct impact on children's health. The aim of this review was to analyze epidemiological and clinical data, the consequences of the pandemic, and vaccination aspects in this group. Sources of data: The searches were carried out from January 2020 to November 2022, in the MEDLINE databases (PubMed) and publications of the Brazilian Ministry of Health and the Brazilian Society of Pediatrics. Summary of findings: Covid-19 has a mild presentation in most children; however, the infection can progress to the severe form and, in some cases, to MIS-C. The prevalence of the so-called long Covid in children was 25.24%. Moreover, several indirect impacts occurred on the health of children and adolescents. Vaccination played a crucial role in enabling the reduction of severe disease and mortality rates. Children and adolescents, as a special population, were excluded from the initial clinical trials and, therefore, vaccination was introduced later in this group. Despite its importance, there have been difficulties in the efficient implementation of vaccination in the pediatric population. The CoronaVac vaccines are authorized in Brazil for children over three years of age and the pediatric presentations of the Pfizer vaccine have shown significant effectiveness and safety. Conclusions: Covid-19 in the pediatric age group was responsible for the illness and deaths of a significant number of children. For successful immunization, major barriers have to be overcome. Real-world data on the safety and efficacy of several pediatric vaccines is emphasized, and the authors need a uniform message about the importance of immunization for all children.

Estudios neurofisiológicos en los trastornos del neurodesarrollo: potenciales evocados cognitivos / Neurophysiological studies in neurodevelopmental disorders: event related potentials

Resumen El trastorno por déficit de atención con hiperactividad (TDAH) y el trastorno del espectro autista (TEA) son trastornos del neurodesarrollo cuyo diagnóstico es clínico y con gran variabilidad en la presentación clínica. La posibilidad de identificar y validar biomarcadores en estos trastornos del neurodesarrollo ayudaría no sólo en su diagnóstico sino también a la hora de implementar tratamientos personalizados y mo nitorizar la respuesta al tratamiento. Exploraciones neurofisiológicas como los potenciales evocados cognitivos (PEC), son una de las herramientas más utilizadas para evaluar de forma objetiva y con una alta resolución temporal las funciones cognitivas y proporcionan información sobre los mecanismos neurobiológicos subyacen tes, por lo que constituyen una herramienta de gran utilidad para valorar las alteraciones cognitivas asociadas a los trastornos del neurodesarrollo. Se han utilizado diferentes componentes de los PEC para el estudio de los trastornos del neurodesarrollo, como el componente P300, N400 o el componente N170 como biomarcador de la disfunción social en TEA. Revisamos los principales componentes de los PEC que se han estudiado como herramientas complementarias en el diagnóstico y en la monitorización de los tratamientos en los trastornos del neurodesarrollo.

Abstract Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are neurodevel opmental disorders whose diagnosis is clinical and with great variability in clinical presentation. The possibility of identifying and validating biomarkers in these neurodevelopmental disorders would help not only in their diagnosis, but also when implementing personalized treatments and monitori ng the response to treatment. Neurophysiologi cal examinations such as event related potentials (ERP) are one of the most widely used tools to objectively assess cognitive functions with high temporal resolution and provide information on the underlying neurobiological mechanisms, making them a very useful tool to assess cognitive alterations associated with neurodevelopmental disorders. Different components of the ERP have been used for the study of neurodevelopmental disorders, such as the P300, N400 component or the N170 component as a biomarker of social dysfunction in ASD. We review the main components of ERP that have been studied as complementary tools in the diagnosis and monitoring of treatments in neurodevelopmental disorders.

Ocorrência de pneumotórax como evento adverso relacionado assistência à saúde / Ocorrência de pneumotórax como evento adverso relacionado assistência à saúde / Presence of pneumorax as an adverse event related to health care

Introdução: O acesso venoso central é definido como a colocação de um cateter com sua extremidade posicionada na veia cava ou no átrio direito, tendo diversas funções no manejo do paciente em estado crítico. Pneumotórax causado durante a inserção do cateter é um incidente que resulta em dano ao paciente, sendo assim considerado um evento adverso relacionado à assistência médica. Objetivo: Analisar a ocorrência de pneumotórax como evento adverso relacionado à assistência à saúde após a inserção de um cateter venoso central. Método: Trata-se de um estudo quantitativo, transversal e analítico. Depois de realizar o cálculo amostral para obtenção da amostra, pacientes submetidos à inserção de cateter venoso central na instituição pesquisada no período de abril até setembro de 2022 foram incluídos na pesquisa, a coleta de dados utilizou dados secundários. Resultados: Uma amostra de 103 pacientes foi obtido, dos quais 10 (9,7%) dos pacientes apresentaram pneumotórax relacionado à inserção de cateter venoso central. de pneumotórax. A ocorrência de pneumotórax e o fato de o profissional que inseriu o cateter ser residente. A ocorrência de pneumotórax teve associação significativa (p 0,03) levando ao aumento do tempo de internação. Conclusão: O os resultados encontrados demonstram uma significativa ocorrência do evento adverso relacionado à assistência à saúde pneumotórax, após a inserção do Cateter Venoso Central (CVC). Estratégias voltadas para a segurança do paciente são fundamentais e devem ser perseguidas constantemente.

Introduction: Central venous access is defined as the placement of a catheter with its end positioned in the superior vena cava or in the right atrium, having several functions in the management of the patient in critical condition. Pneumothorax caused during catheter insertion is an incident that results in harm to the patient, thus considered an adverse event related to health care. Objective: To analyze the occurrence of pneumothorax as adverse events related to health care after insertion of a central venous catheter. Method: This is a quantitative, cross-sectional, analytical study. After performing the sample calculation to obtain the sample, patients who underwent insertion of a central venous catheter at the researched institution from April to September 2022 were included in the research, data collection used secondary data. Results: A sample of 103 patients was obtained, of which 10 (9.7%) of the patients had pneumothorax related to the insertion of a central venous catheter. of pneumothorax. The occurrence of pneumothorax and the fact that the professional who inserted the catheter was a resident. The occurrence of pneumothorax had a significant association (p 0.03) leading to increased length of stay. Conclusion: The results found demonstrate a significant occurrence of the adverse event related to pneumothorax health care, after the insertion of the Central Venous Catheter (CVC). Strategies aimed at patient safety are fundamental and must be pursued constantly.(AU)

Introducción: El acceso venoso central se define como la colocación de un catéter con su extremo posicionado en la vena cava superior o en la aurícula derecha, teniendo varias funciones en el manejo del paciente en estado crítico. El neumotórax causado durante la inserción del catéter es un incidente que resulta en daño para el paciente, por lo que se considera un evento adverso relacionado con la atención a la salud. Objetivo: Analizar la ocurrencia de neumotórax como eventos adversos relacionados con la atención a la salud después de la inserción de un catéter venoso central. Método: Se trata de un estudio cuantitativo, transversal, analítico. Después de realizar el cálculo de la muestra para la obtención de la muestra, se incluyeron en la investigación los pacientes que se sometieron a la inserción de un catéter venoso central en la institución investigada de abril a septiembre de 2022, la recolección de datos utilizó datos secundarios. Resultados: Se obtuvo una muestra de 103 pacientes, de los cuales 10 (9,7%) de los pacientes presentaron neumotórax relacionado con la inserción de un catéter venoso central. La ocurrencia de neumotórax y el hecho de que el profesional que insertó el catéter fuera residente. La ocurrencia de neumotórax tuvo una asociación significativa (p 0,03) que condujo a una mayor duración de la estancia. Conclusión: Los resultados encontrados demuestran una ocurrencia significativa del evento adverso relacionado con la atención de salud del neumotórax, después de la inserción del Catéter Venoso Central (CVC). Las estrategias dirigidas a la seguridad del paciente son fundamentales y deben ser seguidas constantemente.(AU)

Elderly people with human T-cell leukemia virus type 1-associated myelopathy present an early impairment in cognitive skills / Idosos com mielopatia associada ao vírus da leucemia de células T humanas tipo 1apresentam comprometimento precoce em habilidades cognitivas

Abstract Background Cerebral changes occur in individuals with human T-cell leukemia virus type 1 (HTLV-1 )-associated myelopathy (HAM) and seem to predominate in subcortical areas. Little is known about the cognitive decline in the elderly living with HTLV-1. Objective To evaluate the cognitive aging of individuals infected with HTLV-1 aged ≥ 50 years. Methods This is a cross-sectional study of former blood donors infected with HTLV-1 who have been followed in the cohort of the Interdisciplinary Research Group on HTLV-1 since 1997. The groups of study consisted of 79 HTLV-1 infected individuals aged ≥ 50 years, with 41 of them presenting symptomatic HAM and 38 being asymptomatic carriers, and 59 seronegative individuals (controls) aged ≥ 60 years. All were submitted to the P300 electrophysiological test and neuropsychological tests. Results Individuals with HAM presented delayed P300 latency in relation to the other groups, and this latency delay increased progressively with aging. The performance of this group in the neuropsychological tests was also the worst. The HTLV-1- asymptomatic group performance was similar to that of the control group. Conclusions Individuals with HAM presented cognitive decline that progressed with aging and, although HTLV-1-asymptomatic carriers appear to present cognitive aging similar to that of healthy elderly people, concern about a subclinical cognitive impairment is warranted in this population.

Resumo Antecedentes Alterações cerebrais ocorrem em indivíduos com mielopatia associada ao vírus da leucemia de células T humanas tipo 1 (HTLV-1) (HAM) e parecem predominar em áreas subcorticais. Pouco se sabe sobre o declínio cognitivo em idosos vivendo com HTLV-1. Objetivo Avaliar o envelhecimento cognitivo de indivíduos infectados pelo HTLV-1 com idade ≥ 50 anos. Métodos Trata-se de um estudo transversal com ex-doadores de sangue infectados pelo HTLV-1 acompanhados na coorte do Grupo Interdisciplinar de Pesquisa em HTLV-1 há 20 anos. Os grupos de estudo foram compostos por 79 indivíduos infectados pelo HTLV-1 com idade ≥ 50 anos, sendo que 41 apresentavam HAM e 38 eram portadores assintomáticos, e 59 indivíduos soronegativos (controles) com idade ≥ 60 anos. Todos foram submetidos ao teste eletrofisiológico P300 e testes neuropsicológicos. Resultados Indivíduos com HAM apresentaram atraso na latência do P300 em relação aos demais grupos, e esse atraso de latência aumentou progressivamente com o envelhecimento. O desempenho desse grupo nos testes neuropsicológicos também foi o pior. O desempenho do grupo HTLV-1- assintomático foi semelhante ao do grupo controle. Conclusão Indivíduos com HAM apresentaram declínio cognitivo que progrediu com o envelhecimento e, embora os portadores assintomáticos do HTLV-1 pareçam apresentar envelhecimento cognitivo semelhante ao dos idosos saudáveis, justificase a preocupação com um comprometimento cognitivo subclínico nessa população.

Complete atrioventricular block secondary to the BBIBP-CorV vaccine The report of a rare adverse event; the first description in Colombia

Introduction: cardiovascular complications due to COVID-19 infection are very frequent. However, these complications are rarely reported as a vaccine reaction. Case presentation: a female patient with no significant cardiovascular history developed functional class deterioration 14 days after her third dose of the BBIBP-CorV vaccine, along with three syncopal episodes. She was seen at a primary care level and an electrocardiogram was ordered which showed Mobitz 2 atrioventricular block which progressed to a complete block. Molecular tests for COVID-19 infection were negative, as were immunological studies for collagen disease, Chagas, and viral myocarditis. A transthoracic echocardiogram showed no regional kinetic disturbances, and the ejection fraction was preserved at 60%. Cardiac magnetic resonance imaging showed edema in the T2-STIR sequences, and subepicardial enhancement in the medial distal lateral region was compatible with acute myocarditis. The patient required a permanent pacemaker. Discussion: electrical or mechanical dysfunction secondary to a COVID-19 vaccine is anecdotal, with few reports in the literature. In a review of both the 2021 European Society of Cardiology and the 2018 American Heart Association Guidelines on cardiac pacing and cardiac resynchronization therapy, no recommendation was found for these types of events associated with COVID-19 or following vaccination. An international network should be created to report these events and thus determine general management guidelines. For now, the recommendations must be individualized for these patients. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2602).

Safety profile of CoviShield (ChAdOx1nCoV-19) vaccine among healthcare workers in a tertiary care hospital

Background: Coronavirus 2019 was declared as a pandemic by the World Health Organization in March 2020. Bereft of specific treatment for the disease, vaccinations and COVID appropriate behavior have come to be the main approaches to combat the pandemic. A number of vaccines have been approved after clearing clinical trials. Hence, it is essential to evaluate the safety profile of each vaccine for ensuring optimum health of the general population. This study was conducted to evaluate the adverse events following CoviShield vaccination in a tertiary care center. Aims and Objectives: The aim of the study was to describe the pattern of adverse effects, treatment given, and comorbidities seen in healthcare workers (HCW) who reported to the adverse drug reaction (ADR) monitoring center in the department of pharmacology Government T.D. Medical College, Alappuzha, following CoviShield vaccination from January 2021 to October 2021. Materials and Methods: A retrospective and descriptive study was carried out at Department of Pharmacology, GTDMCA involving all HCW who reported side effects following CoviShield vaccination in the ADR monitoring centre (AMC) in the Department of Pharmacology, GTDMCA from January 2021 to Oct 2021. Results: Out of 620 HCWs who reported adverse event following vaccination, majority (45%) were from the age group 21–30 years. About 83% of HCWs who reported adverse effect were women. Majority of the respondents (96%) experienced the adverse effects within 24 h. About 88% of respondents experienced these adverse effects after the initial dose alone. Commonly encountered adverse effects were fever (57%), headache (43%), myalgia (38%) etc. Hypertension (7%) was the most common comorbidity seen. Majority of the beneficiaries (70%) took paracetamol for the treatment of the adverse effect. Conclusion: Majority of the vaccinated HCWs experienced minor and self-limiting adverse event following immunization (AEFI) with Chimpanzee Adenovirus Oxford novel CoronaVirus-19. No serious AEFI were reported to the AMC. Despite the record speed at which the vaccine has been developed, it has shown to have a good safety profile considering the millions of doses that have been administered.

Adverse drug reaction profile of patients taking amantadine for traumatic brain injury in a tertiary care hospital

Background: Amantadine is found to be effective for the treatment of complications associated with traumatic brain injury. Drug-related side effects are common with Amantadine especially when combined with other drugs. Comprehensive information about the incidence and severity of these adverse effects is not available. Aim and Objectives: The aim of the study was to analyze the pattern of occurrence of adverse drug reactions (ADRs) in patients receiving Amantadine for traumatic brain injury in a tertiary care hospital. We also assessed the causality, severity and preventability of ADRs. Materials and Methods: This prospective cohort study was conducted among patients taking Amantadine for a continuous period of 1 month for traumatic brain injury in neurosurgery department between June 2020 and December 2020. Tools used were ADR Reporting form of National Pharmacovigilance Centre, WHO causality scale, Hartwig and Siegel scale, and Schumock and Thornton scale. Descriptive statistics were used and the values were expressed in numbers and percentages. Results: ADRs were experienced in 55 patients (36.7%) out of 150 patients and all the patients were on combination therapy. ADR was present more in male patients (63.6%) compared to females (36.4%). The most common ADRs were headache, ankle edema and dry mouth. Majority of ADRs belonged to the possible category according to the WHO causality assessment scale. Majority of the ADRs (61.9%) were mild level 1 according to severity scale. All the ADRs came under the definitely or probably preventable category. Conclusion: ADRs with Amantadine are common but mild and preventable.

Medical planning for mass gathering sports events in brazil / Planificación médica para eventos deportivos masivos en brasil / Planejamento médico para eventos esportivos de massa no brasil

ABSTRACT Introduction: Medical planning for mass gathering events is founded on the structuring of assistance to the population involved and the preservation of the response capacities of the local healthcare system. Large sporting events attended by crowds are increasingly common in society. These events have been shown to be dangerous, generating higher incidences of injuries and illnesses than usual. Thus, planning and the interaction among various public and private sectors are required for the prevention of and response to emergencies and incidents involving multiple victims. Methods: Recently published studies on medical planning for large sports events and current federal agency legislation were selected to conduct an updated review on the subject. Results: After reading titles and abstracts, 159 papers were chosen for a full reading, 50 of which met the eligibility criteria and were included as the basis for this review. The size of the audience, the weather, and the behavior of the crowd seem to contribute significantly to the estimated need for resources in sporting events. Conclusion: Mass events require planning for prevention and to strengthen the resilience of host communities. There is a still a lack of evidence that these events increase the risk of the mass spreading of disease. Level of Evidence: V; Expert opinion .

RESUMEN Introducción: La planificación médica de eventos masivos tiene como pilares la estructuración de la atención a la población involucrada y la preservación de las capacidades de respuesta del sistema local de salud. Los grandes eventos deportivos a los que asisten multitudes son cada vez más comunes en la sociedad. Estos eventos han demostrado ser peligrosos, generando una mayor incidencia de lesiones y enfermedades de lo habitual. Por lo tanto, es necesaria la planificación y la interacción de diversos sectores, públicos y privados, para la prevención y respuesta a emergencias o incidentes con múltiples víctimas. Métodos: Se seleccionaron estudios recientes publicados sobre la planificación médica de grandes eventos deportivos y la legislación vigente en organismos federales con el objetivo de realizar una revisión actualizada sobre el tema. Resultados: Después de leer los títulos y resúmenes, se eligieron 159 artículos para lectura completa y 50 cumplieron los criterios de elegibilidad y se utilizaron como base para esta revisión. El tamaño del público, las condiciones climáticas y el comportamiento de la multitud parecen contribuir significativamente a la estimación de los requisitos de recursos en los eventos deportivos. Conclusión: Los eventos masivos requieren una planificación para la prevención y el fortalecimiento de la resiliencia de las comunidades anfitrionas. Todavía no hay pruebas de que estos eventos aumenten el riesgo de propagación masiva de enfermedades. Nivel de Evidencia: V; Opinión experta .

RESUMO Introdução: O planejamento médico para eventos de massa tem como pilares a estruturação dos atendimentos à população envolvida e a preservação da capacidade de resposta do sistema de saúde local. Grandes eventos esportivos frequentados por multidões são cada vez mais comuns na sociedade. Esses eventos têm se mostrado perigosos, gerando maiores incidências de lesões e doenças do que o habitual. Dessa forma, é necessário planejamento e interação de diversos setores, públicos e privados, para prevenção e resposta à ocorrência de emergências ou incidentes com múltiplas vítimas. Métodos: Foram selecionados trabalhos recentes publicados sobre o planejamento médico para grandes eventos esportivos e a legislação vigente em órgãos federais com o objetivo de realizar uma revisão atualizada sobre o assunto. Resultados: Após a leitura de títulos e resumos, 159 trabalhos foram escolhidos para leitura integral e 50 preencheram os critérios de elegibilidade e foram usados como base para esta revisão. O tamanho do público, as condições climáticas e o comportamento da multidão parecem contribuir significativamente para a estimativa da necessidade de recursos em eventos esportivos. Conclusão: Eventos de massa exigem planejamento para prevenção e fortalecimento da resiliência das comunidades anfitriãs. Ainda faltam evidências de que esses eventos aumentem o risco de propagação maciça de doenças. Nível de evidência: V; Opinião do especialista .

Research progress on cognitive impairment and intervention in patients with depression / 中华行为医学与脑科学杂志

Depression is one of the most common mental disorders, which can be accompanied by cognitive symptoms in addition to core symptoms.With the improvement of the awareness of the disease, people pay more attention to the cognitive symptoms of depression. The cognitive impairment of patients not only appears in the onset of the disease, but also persists during the remission of the disease, which has a negative impact on the patients’ social function. Some cognitive assessment tools such as cognitive tests, event-related potential(ERP) and eye movement tracking technology have been used to assess cognitive impairment in patients with depression, which show that there are multidimensional cognitive impairments. Some therapeutic methods such as exercise therapy, repetitive transcranial magnetic stimulation(rTMS) and drug therapy have shown the potential to improve the cognitive function of patients with depression. This article reviews related researches in recent years to explore the cognitive impairment and therapeutic methods of patients with depression.

Applications of neurofeedback training in cognitive rehabilitation / 中华行为医学与脑科学杂志

Cognitive impairment is a common dysfunction after central nervous system disease or injury, which seriously affects the daily life of patients and brings heavy economic burdens to the family and society. Neurofeedback training (NFT) based on electroencephalography (EEG) is a non-invasive method of neuroregulation, which can improve cognitive function and behavior by autonomously adjusting brain function through feedback. This paper reviews the application of EEG signal-based neurofeedback training in cognitive rehabilitation, and discusses the current problems and future development trends in this field, so as to provide new ideas for clinical research and treatment of cognitive disorders.

The mediating effect of impact of event and thought suppression between childhood abuse experience and suicide attitude among male prisoners / 中华行为医学与脑科学杂志

Objective:To investigate the relationship between childhood abuse experience and suicide attitude among male prisoners, and the mediating effect of impact of event and thought suppression.Methods:Totally 370 male prisoners were tested by personal report of childhood abuse(PRCA), impact of event scale(IES), white bear suppression inventory(WBSI) and suicide attitude inventory(SAI). SPSS 22.0 was used for correlation analysis, regression analysis and other statistical analysis.Results:The scores of PRCA, IES, WBSI and SAI were (2.60±0.62), (2.69±0.62), (2.83±0.79), (3.06±0.61), respectively.There were significant differences in the scores of PRCA, IES and WBSI among different suicide attitude groups( F=42.69, 51.06, 78.76, all P<0.01). After controlling age variables, positive correlation was observed between PRCA, IES, WBSI and SAI ( r=0.38-0.76, all P<0.01). Impact of event and thought suppression played a mediating role in the relationship between childhood abuse experience and suicide attitude among male prisoners.The mediating effect included three paths: one was the single mediating effect of impact of event, the other was the single mediating effect of thought suppression and the third was the chain mediating effect of impact of event and thought suppression, and the effect values were 0.29, 0.23 and 0.05, respectively. Conclusion:Childhood abuse experience not only directly influences male prisoners' suicide attitude, but also indirectly influences their suicide attitude through the mediating effects of impact of event and thought suppression.