Reproducibility of pop sensation, Thompson sign in achillotomy, and final Pirani score to predict clubfoot relapse: Achillotomy clinical signs and Pirani predictive ability.

Ultrasound (US) can guide and confirm percutaneous release of the achilles tendon in the clubfoot. However, this technique may not always be available; therefore, surgeons' reported feelings of tendon release ("click" or "pop") and the Thompson sign could demonstrate that they are sensitive and reliable for confirming complete tendon release. The purpose of this study was to compare the reproducibility of clinical maneuvers that aim to detect the reported "click" or "pop" sensation by the surgeon and the Thompson sign after surgical release in percutaneous achilles tenotomy compare with US in patients with clubfoot. A cross-sectional reproducibility study of consecutive patients with idiopathic clubfoot was conducted. All the patients were scheduled to undergo tenotomy in the operating room using the standard percutaneous achilles tenotomy technique under sedation. The surgeon's reported surgical sensation ("click" or "pop") and Thompson signs were compared to the US assessment of the cut. The final Pirani score was used to predict recurrence risk and was correlated with the number of plaster casts and age. Forty-five feet were affected in 30 patients. Eighteen (60%) men. Age range: 1 to 60 months. The sensation of "click" or "pop" was recorded in 38 patients, and complete release was confirmed by US in 37 patients, for a sensitivity (Se) of 0.95 and specificity (Sp) of 0.63. Thompson signs were positive in 33 and 36 patients at 2 evaluations, with Se values of 0.87 and 0.92 and Sp values of 0.88 and 0.75, respectively. The Pirani final score, a predictor of recurrence risk, had an area under the curve of 0.80 (95% CI = 0.63-0.97; P = .005), Se = 0.78, and Sp = 0.56, with a cutoff point of 2.75. The feeling of achilles tendon release and Thompson sign had high sensitivity, prevalence, accuracy, and posttest probability. The confirmation of tendon release based on clinical signs could prevent the use of US.

Toxoplasma gondii infection of the central nervous system and suicide: A case-control study of decedents.

We sought to determine the association between Toxoplasma gondii (T. gondii) infection of the central nervous system and suicide in a sample of decedents in Mexico City. One hundred and forty-seven decedents (87 who committed suicide and 60 who did not commit suicide) were studied. Brain tissues (amygdala and prefrontal cortex) of decedents were examined for the detection of T. gondii using immunohistochemistry. Detection of T. gondii was positive in 7 (8.0%) of the 87 cases (6 found in prefrontal cortex and one in amygdala), and in one (1.7%) of the 60 controls (found in prefrontal cortex) (OR: 5.16; 95% CI: 0.61-43.10; P = 0.14). Results suggest that T. gondii infection in brain is not associated with suicide. Further studies to confirm this finding are needed.

Association between Toxoplasma gondii Infection in Brain and a History of Depression in Suicide Decedents: A Cross-Sectional Study.

We assessed the association between Toxoplasma gondii (T. gondii) infection of the central nervous system and suicide correlates in suicide decedents. Eighty-seven decedents who died by suicide received in a forensic setting for medico-legal autopsies in Mexico City were studied. Two samples of brain (amygdala and prefrontal cortex) from each decedent were examined for detection of T. gondii using immunohistochemistry. Correlates of suicide including a history of previous suicide attempts, co-morbid mental disorder, consumption of alcohol or tobacco, irritability and aggression, economic problems, presence of drugs or alcohol in blood and suicide method were obtained and analyzed for their association with T. gondii infection. T. gondii immunohistochemistry was positive in prefrontal cortex sections in 6 decedents and in an amygdala section in one decedent. Thus, the prevalence of T. gondii infection in brain in suicide victims was 8.0% (7/87). Bivariate and logistic regression analysis of suicide correlates showed that only a history of depression was associated with T. gondii infection of the brain in suicide victims (OR: 12.00; 95% CI: 2.26-63.46; p = 0.003). Our results provide evidence that T. gondii infection in brain is associated with a history of depression in suicide decedents.

A Distributed Framework for the Construction of Transport Maps.

The need to reason about uncertainty in large, complex, and multimodal data sets has become increasingly common across modern scientific environments. The ability to transform samples from one distribution P to another distribution Q enables the solution to many problems in machine learning (e.g., Bayesian inference, generative modeling) and has been actively pursued from theoretical, computational, and application perspectives across the fields of information theory, computer science, and biology. Performing such transformations in general still leads to computational difficulties, especially in high dimensions. Here, we consider the problem of computing such "measure transport maps" with efficient and parallelizable methods. Under the mild assumptions that P need not be known but can be sampled from and that the density of Q is known up to a proportionality constant, and that Q is log-concave, we provide in this work a convex optimization problem pertaining to relative entropy minimization. We show how an empirical minimization formulation and polynomial chaos map parameterization can allow for learning a transport map between P and Q with distributed and scalable methods. We also leverage findings from nonequilibrium thermodynamics to represent the transport map as a composition of simpler maps, each of which is learned sequentially with a transport cost regularized version of the aforementioned problem formulation. We provide examples of our framework within the context of Bayesian inference for the Boston housing data set and generative modeling for handwritten digit images from the MNIST data set.

Coalitional Play Fighting and the Evolution of Coalitional Intergroup Aggression.

Dyadic play fighting occurs in many species, but only humans are known to engage in coalitional play fighting. Dyadic play fighting is hypothesized to build motor skills involved in actual dyadic fighting; thus, coalitional play fighting may build skills involved in actual coalitional fighting, operationalized as forager lethal raiding. If human psychology includes a motivational component that encourages engagement in this type of play, evidence of this play in forager societies is necessary to determine that it is not an artifact of agricultural or industrial conditions. We examine whether coalitional play fighting appears in the hunter-gatherer record and includes motor skills used in lethal raiding. Using the ethnographic record, we generated a list of motor patterns regularly used in forager warfare. Then, using Murdock's Ethnographic Atlas, we identified 100 culture clusters containing forager societies and searched the ethnographic records of these societies for descriptions of coalitional play fighting, operationalized as contact games played in teams. Resulting games were coded for the presence of eight motor patterns regularly used in forager lethal raiding. Although play does not tend to be systematically documented in the hunter-gatherer literature, sufficiently detailed descriptions of coalitional play were found for 46 of the 100 culture clusters: all 46 exhibited coalitional play using at least one of the predicted motor patterns; 39 exhibited coalitional play using four or more of the eight predicted motor patterns. These results provide evidence that coalitional play fighting (a) occurs across a diverse range of hunter-gatherer cultures and habitats, (b) regularly recruits motor patterns used in lethal raiding, and (c) is not an artifact of agricultural or industrial life. This is a first step in a new line of research on whether human male psychology includes motivations to engage in play that develops the deployment of coordinated coalitional action involving key motor patterns used in lethal raiding.

Hypocholesterolemia is an independent risk factor for depression disorder and suicide attempt in Northern Mexican population.

BACKGROUND: Cholesterol has been associated as a risk factor for cardiovascular disease. Recently, however, there is growing evidence about crucial requirement of neuron membrane cholesterol in the organization and function of the 5-HT1A serotonin receptor. For this, low cholesterol level has been reported to be associated with depression and suicidality. However there have been inconsistent reports about this finding and the exact relationship between these factors remains controversial. Therefore, we investigated the link between serum cholesterol and its fractions with depression disorder and suicide attempt in 467 adult subjects in Mexican mestizo population. METHODS: Plasma levels of total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c) were determined in 261 MDD patients meeting the DSM-5 criteria for major depressive disorder (MDD), 59 of whom had undergone an episode of suicide attempt, and 206 healthy controls. RESULTS: A significant decrease in total cholesterol, LDL-cholesterol, VLDL-cholesterol and triglyceride serum levels was observed in the groups of MDD patients and suicide attempt compared to those without suicidal behavior (p < 0.05). After adjusting for covariates, lower cholesterol levels were significantly associated with MDD (OR 4.229 CI 95% 2.555 - 7.000, p<.001) and suicide attempt (OR 5.540 CI 95% 2.825 - 10.866, p<.001) CONCLUSIONS: These results support the hypothesis that lower levels of cholesterol are associated with mood disorders like MDD and suicidal behavior. More mechanistic studies are needed to further explain this association.

Resultados tras la rehabilitación vestibular y terapia Wii ® en pacientes con hipofunción vestibular unilateral crónica / Outcomes after vestibular rehabilitation and Wii ® therapy in patients with chronic unilateral vestibular hypofunction

Introducción y objetivos: La rehabilitación vestibular está destinada a maximizar la compensación central de la enfermedad vestibular periférica. El objetivo del presente estudio fue analizar las diferencias de la percepción de discapacidad, el riesgo de caídas y la estabilidad de la mirada antes y después de un tratamiento de rehabilitación vestibular con el uso complementario de terapia Wii® en pacientes con diagnóstico de hipofunción vestibular unilateral crónica. Materiales y métodos: Se revisaron registros de pacientes entre abril de 2009 y mayo de 2011 del área de rehabilitación vestibular de un hospital universitario. Las variables estudiadas fueron el Dizziness Handicap Inventory, el índice dinámico de la marcha y la agudeza visual dinámica. Todos los sujetos usaron Wii® como complemento. Resultados: Sesenta y nueve casos (41 mujeres y 28 hombres). La mediana de edad fue 64 años. La mediana de Dizziness Handicap Inventory inicial fue de 40 puntos (rango 0-84, percentil 25-75 = 20-59) y final de 24 (rango 0-76, percentil 25-75 = 10-40) p < 0,0001. La mediana del índice dinámico de la marcha inicial fue 21 puntos (rango 8-24, percentil 25-75 = 17,5-23) y final de 23 (rango 12-24, percentil 25-75 = 21-23) p < 0,0001. La mediana de la agudeza visual dinámica inicial fue 2 (rango 0-6, percentil 25-75 = 1-4) y final de 1 (rango 0-3, percentil 25-75 = 0-2) p < 0,0001. Conclusión: Se observó una disminución de los valores del Dizziness Handicap Inventory, un aumento de los valores del índice dinámico de la marcha y una mejoría en la agudeza visual dinámica; todas estas variaciones fueron estadísticamente significativas (AU)

Introduction and objectives: Vestibular rehabilitation therapy is an exercise-based programme designed to promote central nervous system compensation for inner ear deficit. The objective of the present study was to analyse the differences in the perception of handicap, the risk of falls, and gaze stability in patients diagnosed with chronic unilateral vestibular hypofunction before and after vestibular rehabilitation treatment with complementary Wii® therapy. Materials and methods: A review was performed on the clinical histories of patients in the vestibular rehabilitation area of a university hospital between April 2009 and May 2011. The variables studied were the Dizziness Handicap Inventory, the Dynamic Gait Index and dynamic visual acuity. All subjects received complementary Wii® therapy. Results: There were 69 cases (41 woman and 28 men), with a median age of 64 years. The initial median Dizziness Handicap Inventory score was 40 points (range 0-84, percentile 25-75 = 20-59) and the final, 24 points (range 0-76, percentile 25-75 = 10.40), P < .0001. The initial median for the Dynamic Gait Index score was 21 points (range 8-24, percentile 25-75 = 17.5-2.3) and the final, 23 (range 12-24, percentile 25-75 = 21-23), P < .0001. The initial median for dynamic visual acuity was 2 (range 0-6, percentile 25-75 = 1-4) and the final, 1 (range 0-3, percentile 25-75 = 0-2), P < .0001. Conclusion: A reduction was observed in the Dizziness Handicap Inventory Values. Values for the Dynamic Gait Index increased and dynamic visual acuity improved. All these variations were statistically significant (AU)

Outcomes after vestibular rehabilitation and Wii® therapy in patients with chronic unilateral vestibular hypofunction.

INTRODUCTION AND OBJECTIVES: Vestibular rehabilitation therapy is an exercise-based programme designed to promote central nervous system compensation for inner ear deficit. The objective of the present study was to analyse the differences in the perception of handicap, the risk of falls, and gaze stability in patients diagnosed with chronic unilateral vestibular hypofunction before and after vestibular rehabilitation treatment with complementary Wii® therapy. MATERIALS AND METHODS: A review was performed on the clinical histories of patients in the vestibular rehabilitation area of a university hospital between April 2009 and May 2011. The variables studied were the Dizziness Handicap Inventory, the Dynamic Gait Index and dynamic visual acuity. All subjects received complementary Wii® therapy. RESULTS: There were 69 cases (41 woman and 28 men), with a median age of 64 years. The initial median Dizziness Handicap Inventory score was 40 points (range 0-84, percentile 25-75=20-59) and the final, 24 points (range 0-76, percentile 25-75=10.40), P<.0001. The initial median for the Dynamic Gait Index score was 21 points (range 8-24, percentile 25-75=17.5-2.3) and the final, 23 (range 12-24, percentile 25-75=21-23), P<.0001. The initial median for dynamic visual acuity was 2 (range 0-6, percentile 25-75=1-4) and the final, 1 (range 0-3, percentile 25-75=0-2), P<.0001. CONCLUSION: A reduction was observed in the Dizziness Handicap Inventory Values. Values for the Dynamic Gait Index increased and dynamic visual acuity improved. All these variations were statistically significant.

Regulación emocional en niños y adolescentes: artículo de revisión: nociones evolutivas y clínica psicopatológica / Emotional regulation in children and adolescents: review: developmental concepts and clinical psychopathology

El presente artículo revisa los principales conocimientos que se han generado en los últimos años a nivel internacional y nacional respecto a la regulación emocional. Se define el concepto y las principales estrategias de regulación emocional en niños y adolescentes, los factores involucrados en la regulación emocional, así como su desarrollo a través de las distintas etapas evolutivas. Se revisan las investigaciones que han estudiado la relación entre regulación emocional, salud mental y psicopatología. Las conclusiones destacan la relevancia de estos conocimientos como marco para la evaluación y tratamiento de dificultades de regulación emocional en niños y adolescentes.

This article is a review of the knowledge about emotion regulation developed in the last years internationally and in our country. The concept and main strategies of emotion regulation in children and adolescents are defined, as well as the factors involved in emotion regulation, and it`s evolution in the different developmental stages. Research about the relation between emotion regulation, mental health and psychopathology are reviewed. Conclusions highlight the importance of this knowledge as a framework for the assessment and treatment of emotion regulation difficulties in children and adolescents.

Obesity is related to increased menopausal symptoms among Spanish women.

OBJECTIVE: To assess the metabolic syndrome (METS) and its components in postmenopausal women using updated diagnostic criteria and explore their relation to menopausal symptom severity. METHOD: Medical records of the first visit of 574 postmenopausal Caucasian Spanish women attending a menopause clinic were retrospectively reviewed. Recorded information included general demographic data, type of menopause, menopausal symptom intensity (Kupperman index) and baseline hormonal and metabolic parameters. METS was established if three or more of the following criteria were met: body mass index (BMI) >28.8 kg/m(2), fasting glycaemia ≥100 mg/dL, high-density lipoprotein cholesterol (HDL-C) <50 mg/dL, triglycerides ≥150 mg/dL and blood pressure ≥130/85 mmHg. RESULTS: Mean ± SD age of the whole cohort was 49.9 ± 6.1 years, 66% had natural menopause and 38.9% were obese. In all, 23.1% met diagnostic criteria for METS who were significantly older and displayed higher rates of being married, obesity and abnormal glucose, triglyceride, HDL-C, low-density lipoprotein cholesterol and blood pressure values, when compared with those without the syndrome. The mean Kupperman index score for the whole sample was 26.4±10.6, with 73.8% displaying moderate to severe scores (20 or more). Logistic regression analysis determined that obesity and marriage status were independent risk factors related to more severe menopausal symptoms (Kupperman index scores of 20 or more). CONCLUSION: Although METS was observed in a lower frequency than previous reports, obesity was associated with more severe menopausal symptoms among postmenopausal Spanish women.

Perceived control over menopausal hot flushes in mid-aged women.

BACKGROUND: Hot flushes (HFs) and night sweats are frequent complaints among both peri- and postmenopausal women. Perceived control of this complaint may vary from one population to another. OBJECTIVE: To assess perceived control over menopausal HFs and determinant factors among mid-aged Ecuadorian women. METHODS: In this cross-sectional study healthy women aged 40-59 years, seeking healthcare centres of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the Menopause Rating Scale (MRS) and those presenting HFs were requested to fill out the Perceived Control Index (PCI) and a questionnaire containing socio-demographic data (female and partner). RESULTS: A total of 1154 women participated in this study of which 56% presented HFs (n = 646). According to the MRS, 29.1% and 9.1% of these HFs were graded as severe and very severe, respectively. Mean age of women presenting HFs was 49.5 +/- 5.2 years, with 51.9% having 12 years or less of education, 61.5% being postmenopausal and 47.2% living in high altitude. At the moment of the survey 13.9% were on hormone therapy, 12.8% on phytoestrogens and 7.1% on psychotropic drugs. There was a significant decreasing trend for PCI scores (total and difficulty in control items) from one menopausal stage to the next, with no differences observed for time since menopause onset. Despite this, logistic regression analysis determined that HF severity, as determined with the MRS, was the only single predictive factor related to lower HF perceived control (total PCI score <38) (OR: 1.83 CI 95% [1.15-2.90], p < 0.01). CONCLUSION: As determined with the PCI, HF severity was related to a lower perceived control among mid-aged women.

Beliefs regarding menopausal hot flushes among climacteric women as assessed with the Hot Flush Beliefs Scale.

BACKGROUND: Hot flushes (HFs) and night sweats are frequent complaints among both peri- and postmenopausal women. Beliefs regarding these complaints may vary from one population to another. OBJECTIVE: To assess HF beliefs and factors related to negative beliefs in a climacteric Hispanic population using the Hot Flush Beliefs Scale (HFBS). METHODS: A total of 1154 healthy women (40-59 years) were assessed with the Menopause Rating Scale (MRS), those presenting HFs were requested to fill out the HFBS and a questionnaire containing socio-demographic data (female and partner). RESULTS: A total of 646 presented HFs (56%) graded according to the first item of the MRS as mild (28.6%), moderate (33.2%), severe (29.1%) and very severe (9.1%). Mean age of these women was 49.5+/-5.2 years, with 51.9% having 12 or less years of education, 61.5% being postmenopausal and 47.2% living in high altitude. At the moment of the survey 13.9% were on HT, 12.8% on phytoestrogens and 7.1% on psychotropic drugs. Women strongly disagreed in more negatively oriented items of those contained in subscale one (beliefs about self in social context). Contrary to this, women strongly agreed in more negative oriented items contained in subscale two which assesses beliefs about coping with HFs. Women presenting with severe-very severe HFs displayed higher HFBS total and subscale scores indicating a more negative belief regarding HFs. Logistic regression analysis determined that HF severity was related to higher HFBS scores for the total and subscales one and two. Current smoking, higher parity, lower female education, female psychiatric consultation, time since menopause and partner unhealthiness and alcohol consumption were also related to higher HFBS scorings. Postmenopausal status and church attendance were related to lower scores. CONCLUSION: In this mid-aged Ecuadorian female series negative beliefs regarding HFs were related to the severity of HFs and individual female or partner characteristics. Data provided from clinical research using this tool, alone or in combination with other tests, is warranted.

Assessment of self-esteem in mid-aged women.

OBJECTIVE: To assess self-esteem and affecting factors in a middle-aged Ecuadorian female population using the Rosenberg Self-Esteem Scale (RSES). STUDY DESIGN: This was a cross-sectional study in which 149 women (40-59 years) were requested to fill out the RSES and a general socio-demographic form containing personal and partner data. RESULTS: Mean age of sample was 47.6+/-5.5 years, a 67.8% had less than 12 years of schooling and 33.6% were postmenopausal. At the moment of the survey 2.7% were on hormone therapy, and 2% were taking psychotropic drugs. Mean total RSES score was 26.6+/-3.1 (median 26, range 17-35). A 35.6% and 18.1% of women respectively presented total RSES scores below 26 (median) and 25 (25th percentile) suggesting lower self-esteem. Total scores did not differ when comparing older age, menopausal phases or time since the menopause. Logistic regression analysis determined that women with lower parity and an unhealthy partner were related to lower total RSES scores (below the 25th percentile) suggesting lower self-esteem. CONCLUSIONS: In this mid-aged series lower self-esteem was not related to the aging process per se yet to socio-demographic female/male aspects. More research is needed in this regard that incorporates other sociological aspects.

Factors related to increased daytime sleepiness during the menopausal transition as evaluated by the Epworth sleepiness scale.

BACKGROUND: Sleep disorders and sleep-apnea/hypopnea syndromes are very frequent in women, being misdiagnosed in many cases. The menopause, regardless of age, is associated to poor sleep quality and daytime sleepiness that can lead to impaired quality of life, and reduced productivity and functioning. OBJECTIVE: To assess daytime sleepiness and related risk factors among middle aged Ecuadorian women using the Epworth Sleepiness Scale (ESS). METHODS: In this cross-sectional study 149 women aged 40-59 years were assessed for hot flush presence and intensity using the Menopause Rating Scale (MRS) and requested to fill out the ESS and a questionnaire containing personal and partner data. RESULTS: Mean age of surveyed women was 47.6+/-5.5 years, with 67.8% having less than 12 years of schooling, 33.6% being postmenopausal, and 2.7% on hormone therapy. A 10.1% were current smokers and 20.8% were sedentary. According to the MRS (item 1) 51.7% presented hot flushes, which were graded as severe-very severe in 42.8% of cases. Regarding the partner (n=132), erectile dysfunction was present in 10.6%, premature ejaculation 6.1% and 17.4% abused alcohol. Mean total ESS score was 8+/-4.4 (median 8), with 33.6% considered having some degree of daytime sleepiness (ESS score >or=10). Logistic regression analysis determined that postmenopausal status (OR 6.58, CI 95% [2.51-17.23], p=0.001), sedentarism (OR 3.43, CI 95% [1.14-10.26], p=0.02) and hot flush presence (OR 2.61, CI 95% [1.02-6.65], p=0.04) among women were risk factors for increased daytime sleepiness (ESS total score >or=10) whereas partner faithfulness decreased this risk (OR 0.47, CI 95% [0.24-0.90], p=0.02). CONCLUSION: Increased daytime sleepiness in this middle aged series was related to female (hormonal status and sedentarism) and partner factors; several which are susceptible of intervention.

Risk factors related to the presence and severity of hot flushes in mid-aged Ecuadorian women.

BACKGROUND: Several studies drawn from the Ecuadorian population have previously reported that more than half of mid-aged women present hot flushes, which can impair their quality of life. However up-to-date risk factors for their presence and severity have not been assessed. OBJECTIVE: To assess hot flush frequency and intensity and related risk factors among middle-aged Ecuadorian women. METHODS: In this cross-sectional study, 1154 healthy women aged 40-59 years, visiting healthcare centers of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the first item of the Menopause Rating Scale (MRS) and a questionnaire containing female and partner socio-demographic data. RESULTS: Mean age of the entire sample was 48.8+/-5.6 years (median 48), a 48.7% had 12 or less years of schooling, 52.8% were postmenopausal, 43.6% lived at high altitude, 56.8% were married and 10% were on hormonal therapy (HT). Hot flushes accounted for 56% (n=646) of the whole sample, of which 29.1% and 9.1% were respectively graded as severe and very severe. Logistic regression determined that female sedentarism (OR: 2.42, CI 95% [1.63-3.59]), accessing a free healthcare system (OR: 1.96, CI 95% [1.30-2.96]), living at high altitude (OR: 1.82, CI 95% [1.14-2.90]) and having a partner abusing alcohol (OR: 1.92, CI 95% [1.09-3.35]) were significant risk factors related to the presence of hot flushes. The regression model also determined that among women with hot flushes (n=646), sedentarism (OR: 1.73, CI 95% [1.14-2.62]) and having a partner with erectile dysfunction (OR: 2.57, CI 95% [1.44-4.59]) were significant risk factors related to severe/very severe hot flushes whereas married status (OR: 0.53, CI 95% [0.32-0.86]), living at high altitude (OR: 0.46, CI 95% [0.26-0.78]) and partner healthiness (OR: 0.59, CI 95% [0.36-0.95]) were not. CONCLUSION: To the best of our knowledge this is the first and largest study assessing hot flushes in a mid-aged Ecuadorian population. We found that the presence and severity were not significantly related to age and hormonal status yet to other individual female/male characteristics and the demography of the studied population.

Severe menopausal symptoms in middle-aged women are associated to female and male factors.

BACKGROUND: The frequency and intensity of menopausal symptoms within a given population, as assessed by several tools, may vary and depend on several factors, such as age, menopausal status, chronic conditions and personal and partner socio-demographic profile. OBJECTIVE: To determine the frequency and intensity of menopausal symptoms and related risk factors among middle-aged women. METHODS: In this cross-sectional study a total of 404 women aged 40 to 59 years, visiting inpatients at the Enrique C. Sotomayor Gynecology and Obstetrics Hospital, Guayaquil, Ecuador, were requested to fill out the menopause rating scale (MRS) and a questionnaire containing personal and partner data. RESULTS: Mean age of surveyed women (n=404) was 48.2+/-5.7 years, 85.1% had 12 or less years of schooling and 44.8% were postmenopausal. None was on hormonal therapy (HT) for the menopause or psychotropic drugs. Regarding their partner, erectile dysfunction was present in 23.8%, premature ejaculation in 21.2% and 43.5% abused alcohol. The four most frequently found symptoms of those composing the MRS were muscle and joint problems (80%), depressive mood (73.5%), physical and mental exhaustion (71.3%) and irritability (68%). Mean total MRS score was 18+/-10.6 (median 17) and for subscales: 7.2+/-4.5 (somatic); 6.9+/-4.8 (psychological) and 3.9+/-3.4 (urogenital). Women presented severe scores in 53, 36.1, 48.3 and 49.8% for total MRS and somatic, psychological and urogenital subscales, respectively. After adjusting for confounding factors, logistic regression analysis determined that female higher parity and partner premature ejaculation increased the risk for presenting severe total MRS scores (impaired female quality of life), whereas women who had a positive perception of their health status were at decreased risk. CONCLUSION: In this middle-aged series psychological menopausal symptoms were the most frequent in which severity was associated to parity and partner sexual dysfunction.

A highly infective Plasmodium vivax strain adapted to Aotus monkeys: quantitative haematological and molecular determinations useful for P. vivax malaria vaccine development.

The New World primate Aotus nancymaae is susceptible to infection by the human malaria parasite Plasmodium vivax and has therefore been recommended by the World Health Organization as a model for malaria vaccine candidate evaluation. We report the isolation, adaptation, titration and genetic characterization of a P. vivax wild strain in splenectomized A. nancymaae monkeys. Parasitemia remained high after 22 passages, reaching 7.88% by Giemsa and Acridine Orange staining and Real-Time PCR determination, making this P. vivax strain a highly infective and reliable asset to be used in P. vivax biological studies and vaccine development.

Estrategias adaptativas de migrantes tobas en el gran Buenos Aires / Adaptative strategies of Toba indians migrants in the Greater Buenos Aires

Se presenta una muestra de once familias residentes en barrios pobres de la zona norte del conurbano de Buenos Aires donde los adultos son aborígenes tobas, nacidos en la Colonia Chaco (Provincia del Chaco, Rep. Argentina). Los primeros migrantes llegaron a Buenos Airers en 1969 y se instalaron en "villas miseria". El paso de la villa al barrio señala el deseo de "progresar" de estos migrantes más antiguos los que, ahora, ayudan a los recién llegados a instalarse allí. Su situación puede describirse de subocupación mal remunerada, acompañada de vivienda precaria, alimentación y vestido escasos, atención médica deficiente y educación escolar disociada del contenido de su vida cotidiana. Las estrategias de subsistencia que adoptan estos tobas en el medio urbano son semejantes a las de otros sectores maginados o subalternos

Estrategias adaptativas de migrantes tobas en el gran Buenos Aires / Adaptative strategies of Toba indians migrants in the Greater Buenos Aires

Se presenta una muestra de once familias residentes en barrios pobres de la zona norte del conurbano de Buenos Aires donde los adultos son aborígenes tobas, nacidos en la Colonia Chaco (Provincia del Chaco, Rep. Argentina). Los primeros migrantes llegaron a Buenos Airers en 1969 y se instalaron en "villas miseria". El paso de la villa al barrio señala el deseo de "progresar" de estos migrantes más antiguos los que, ahora, ayudan a los recién llegados a instalarse allí. Su situación puede describirse de subocupación mal remunerada, acompañada de vivienda precaria, alimentación y vestido escasos, atención médica deficiente y educación escolar disociada del contenido de su vida cotidiana. Las estrategias de subsistencia que adoptan estos tobas en el medio urbano son semejantes a las de otros sectores maginados o subalternos (AU)