Levels of Small Extracellular Vesicles Containing hERG-1 and Hsp47 as Potential Biomarkers for Cardiovascular Diseases.

The diagnosis of cardiovascular disease (CVD) is still limited. Therefore, this study demonstrates the presence of human ether-a-go-go-related gene 1 (hERG1) and heat shock protein 47 (Hsp47) on the surface of small extracellular vesicles (sEVs) in human peripheral blood and their association with CVD. In this research, 20 individuals with heart failure and 26 participants subjected to cardiac stress tests were enrolled. The associations between hERG1 and/or Hsp47 in sEVs and CVD were established using Western blot, flow cytometry, electron microscopy, ELISA, and nanoparticle tracking analysis. The results show that hERG1 and Hsp47 were present in sEV membranes, extravesicularly exposing the sequences 430AFLLKETEEGPPATE445 for hERG1 and 169ALQSINEWAAQTT- DGKLPEVTKDVERTD196 for Hsp47. In addition, upon exposure to hypoxia, rat primary cardiomyocytes released sEVs into the media, and human cardiomyocytes in culture also released sEVs containing hERG1 (EV-hERG1) and/or Hsp47 (EV-Hsp47). Moreover, the levels of sEVs increased in the blood when cardiac ischemia was induced during the stress test, as well as the concentrations of EV-hERG1 and EV-Hsp47. Additionally, the plasma levels of EV-hERG1 and EV-Hsp47 decreased in patients with decompensated heart failure (DHF). Our data provide the first evidence that hERG1 and Hsp47 are present in the membranes of sEVs derived from the human cardiomyocyte cell line, and also in those isolated from human peripheral blood. Total sEVs, EV-hERG1, and EV-Hsp47 may be explored as biomarkers for heart diseases such as heart failure and cardiac ischemia.

Standardizing an Experimental Murine Model of Extraparenchymal Neurocysticercosis That Immunologically Resembles Human Infection.

BACKGROUND: Neurocysticercosis (NCC) is endemic in non-developed regions of the world. Two forms of NCC have been described, for which neurological morbidity depends on the location of the lesion, which can be either within the cerebral parenchyma or in extraparenchymal spaces. The extraparenchymal form (EXP-NCC) is considered the most severe form of NCC. EXP-NCC often requires several cycles of cysticidal treatment and the concomitant use of glucocorticoids to prevent increased inflammation, which could lead to intracranial hypertension and, in rare cases, to death. Thus, the improvement of EXP-NCC treatment is greatly needed. METHODS: An experimental murine model of EXP-NCC, as an adequate model to evaluate new therapeutic approaches, and the parameters that support it are described. EXP-NCC was established by injecting 30 Taenia crassiceps cysticerci, which are less than 0.5 mm in diameter, into the cisterna magna of male and female Wistar rats. RESULTS: Cyst implantation and infection progression were monitored by detecting the HP10 antigen and anti-cysticercal antibodies in the serum and cerebral spinal fluid (CSF) of infected rats and by magnetic resonance imaging. Higher HP10 levels were observed in CSF than in the sera, as in the case of human EXP-NCC. Low cell recruitment levels were observed surrounding established cysticerci in histological analysis, with a modest increase in GFAP and Iba1 expression in the parenchyma of female animals. Low cellularity in CSF and low levels of C-reactive protein are consistent with a weak inflammatory response to this infection. After 150 days of infection, EXP-NCC is accompanied by reduced levels of mononuclear cell proliferation, resembling the human disease. EXP-NCC does not affect the behavior or general status of the rats. CONCLUSIONS: This model will allow the evaluation of new approaches to control neuroinflammation and immunomodulatory treatments to restore and improve the specific anti-cysticercal immunity in EXP-NCC.

Strategies for Hypothermia Compensation in Altricial and Precocial Newborn Mammals and Their Monitoring by Infrared Thermography.

Thermoregulation in newborn mammals is an essential species-specific mechanism of the nervous system that contributes to their survival during the first hours and days of their life. When exposed to cold weather, which is a risk factor associated with mortality in neonates, pathways such as the hypothalamic-pituitary-adrenal axis (HPA) are activated to achieve temperature control, increasing the circulating levels of catecholamine and cortisol. Consequently, alterations in blood circulation and mechanisms to produce or to retain heat (e.g., vasoconstriction, piloerection, shivering, brown adipocyte tissue activation, and huddling) begin to prevent hypothermia. This study aimed to discuss the mechanisms of thermoregulation in newborn domestic mammals, highlighting the differences between altricial and precocial species. The processes that employ brown adipocyte tissue, shivering, thermoregulatory behaviors, and dermal vasomotor control will be analyzed to understand the physiology and the importance of implementing techniques to promote thermoregulation and survival in the critical post-birth period of mammals. Also, infrared thermography as a helpful method to perform thermal measurements without animal interactions does not affect these parameters.

Endogenous pannexin1 channels form functional intercellular cell-cell channels with characteristic voltage-dependent properties.

The occurrence of intercellular channels formed by pannexin1 has been challenged for more than a decade. Here, we provide an electrophysiological characterization of exogenous human pannexin1 (hPanx1) cell­cell channels expressed in HeLa cells knocked out for connexin45. The observed hPanx1 cell­cell channels show two phenotypes: O-state and S-state. The former displayed low transjunctional voltage (Vj) sensitivity and single-channel conductance of ∼175 pS, with a substate of ∼35 pS; the latter showed a peculiar dynamic asymmetry in Vj dependence and single-channel conductance identical to the substate conductance of the O-state. S-state hPanx1 cell­cell channels were also identified between TC620 cells, a human oligodendroglioma cell line that endogenously expresses hPanx1. In these cells, dye and electrical coupling increased with temperature and were strongly reduced after hPanx1 expression was knocked down by small interfering RNA or inhibited with Panx1 mimetic inhibitory peptide. Moreover, cell­cell coupling was augmented when hPanx1 levels were increased with a doxycycline-inducible expression system. Application of octanol, a connexin gap junction (GJ) channel inhibitor, was not sufficient to block electrical coupling between HeLa KO Cx45-hPanx1 or TC620 cell pairs. In silico studies suggest that several arginine residues inside the channel pore may be neutralized by hydrophobic interactions, allowing the passage of DAPI, consistent with dye coupling observed between TC620 cells. These findings demonstrate that endogenously expressed hPanx1 forms intercellular cell­cell channels and their unique properties resemble those described in innexin-based GJ channels. Since Panx1 is ubiquitously expressed, finding conditions to recognize Panx1 cell­cell channels in different cell types might require special attention.

ATARI: A Graph Convolutional Neural Network Approach for Performance Prediction in Next-Generation WLANs.

IEEE 802.11 (Wi-Fi) is one of the technologies that provides high performance with a high density of connected devices to support emerging demanding services, such as virtual and augmented reality. However, in highly dense deployments, Wi-Fi performance is severely affected by interference. This problem is even worse in new standards, such as 802.11n/ac, where new features such as Channel Bonding (CB) are introduced to increase network capacity but at the cost of using wider spectrum channels. Finding the best channel assignment in dense deployments under dynamic environments with CB is challenging, given its combinatorial nature. Therefore, the use of analytical or system models to predict Wi-Fi performance after potential changes (e.g., dynamic channel selection with CB, and the deployment of new devices) are not suitable, due to either low accuracy or high computational cost. This paper presents a novel, data-driven approach to speed up this process, using a Graph Neural Network (GNN) model that exploits the information carried in the deployment's topology and the intricate wireless interactions to predict Wi-Fi performance with high accuracy. The evaluation results show that preserving the graph structure in the learning process obtains a 64% increase versus a naive approach, and around 55% compared to other Machine Learning (ML) approaches when using all training features.

Function of P2X4 Receptors Is Directly Modulated by a 1:1 Stoichiometric Interaction With 5-HT3A Receptors.

Interacting receptors at the neuronal plasma membrane represent an additional regulatory mode for intracellular transduction pathways. P2X4 receptor triggers fast neurotransmission responses via a transient increase in intracellular Ca2+ levels. It has been proposed that the P2X4 receptor interacts with the 5-HT3A receptor in hippocampal neurons, but their binding stoichiometry and the role of P2X4 receptor activation by ATP on this crosstalking system remains unknown. Via pull-down assays, total internal reflection fluorescence (TIRF) microscopy measurements of the receptors colocalization and expression at the plasma membrane, and atomic force microscopy (AFM) imaging, we have demonstrated that P2X4/5-HT3A receptor complexes can interact with each other in a 1:1 stoichiometric manner that is preserved after ATP binding. Also, macromolecular docking followed by 100 ns molecular dynamics (MD) simulations suggested that the interaction energy of the P2X4 receptor with 5-HT3A receptor is similar at the holo and the apo state of the P2X4 receptor, and the interacting 5-HT3A receptor decreased the ATP binding energy of P2X4 receptor. Finally, the P2X4 receptor-dependent Ca2+ mobilization is inhibited by the 5-HT3A interacting receptor. Altogether, these findings provide novel molecular insights into the allosteric regulation of P2X4/5-HT3A receptor complex in lipid bilayers of living cells via stoichiometric association, rather than accumulation or unspecific clustering of complexes.

Is clinical simulation an effective learning tool in teaching clinical ethics? / ¿Es la simulación clínica una herramienta de aprendizaje efectiva en la enseñanza de la ética clínica?

INTRODUCTION: In the teaching of clinical ethics, many traditional methods have been used that aim to develop competencies in the face of ethical challenges. Situations that can be reproduced in a standardized way through clinical simulation can be presented and evaluated in the training process of health professionals; however, its use requires evidence of effectiveness. OBJECTIVE: To identify and synthesize the available evidence on the effectiveness of teaching clinical ethics using simulation as a learning tool. METHODS: We conducted a bibliographic review, with searches in PubMed, LILACS and Cochrane databases using English and Spanish: "Ethics, Clinical/education" [Mesh]) AND "Simulation Training" [Mesh], without methodological filters, published from inception of each database until July 2019, without language, geographical or temporal restrictions. We considered as a primary outcome the identification, resolution or reflection on ethical problems. RESULTS: One hundred sixteen studies were retrieved. Fifteen studies met the selection criteria. Narrative reviews and opinion articles were excluded. The population to whom the intervention was applied were mainly students in nursing, medicine, and dentistry. A study in a multidisciplinary ethics committee was also included. The intervention was the use of the simulation technique with a standardized patient. Only two studies compared with traditional methods. Sixty percent considered the intervention to have favorable results on the primary outcome. CONCLUSIONS: To date, there are few studies with very low quality of evidence that evaluate the effectiveness of clinical simulation in teaching clinical ethics. The studies found that, in the short term, this methodology allows participants to identify, solve or reflect on ethical problems by using standardized patients and it seems to be advisable to incorporate simulation techniques as part of the teaching and evaluation curriculum of clinical ethics, to the extent that resources are available.

INTRODUCCIÓN: En la enseñanza de la ética clínica se han utilizado numerosos métodos tradicionales que persiguen el desarrollo de competencias frente a los desafíos éticos actuales. Estas situaciones pueden ser reproducidas en forma estandarizadas mediante la simulación clínica para ser presentadas y evaluadas en el proceso de formación de los profesionales de salud. Sin embargo, se requiere disponer de evidencias sobre su efectividad. OBJETIVO: Identificar y sintetizar la evidencia disponible sobre la efectividad de la enseñanza de la ética clínica usando la simulación como herramienta de aprendizaje. MÉTODOS: Revisión bibliográfica, con búsqueda en bases de datos PubMed, LILACS y Cochrane usando palabras clave en idiomas inglés y español: "Ethics, Clinical/education" [Mesh]) AND "Simulation Training" [Mesh], sin filtros metodológicos, publicados desde el inicio de cada base de datos hasta julio de 2019, sin restricciones idiomáticas, geográficas o temporales, considerando como desenlace primario: la identificación, resolución o reflexión de problemas éticos. RESULTADOS: Se encontraron 116 estudios, de los que 15 cumplieron los criterios de selección; el resto se trataba de revisiones narrativas y artículos de opinión. La población a la cual se le aplicó la intervención era de enfermería, medicina, odontología y un estudio a un comité de ética multidisciplinario. La intervención se ejecutó usando simulación con paciente estandarizado. Sólo dos estudios realizaron comparación con métodos tradicionales y el 60% consideró el desenlace primario de interés con resultados favorables. CONCLUSIONES: Hasta la fecha existen pocos estudios y con muy baja calidad de evidencia, que evalúen la efectividad de la simulación clínica en la enseñanza de la ética clínica. Los estudios encontrados demuestran que a corto plazo esta metodología logra que los participantes puedan identificar, resolver o reflexionar sobre los problemas éticos con el uso de pacientes estandarizados. Es aconsejable su incorporación como método de enseñanza y evaluación de la ética clínica, considerando los recursos disponibles.

Persistent leukocytosis in polycythemia vera is associated with disease evolution but not thrombosis.

There are unresolved questions regarding the association between persistent leukocytosis and risk of thrombosis and disease evolution in polycythemia vera (PV), as much of the published literature on the topic does not appropriately use repeated-measures data or time-dependent modeling to answer these questions. To address this knowledge gap, we analyzed a retrospective database of 520 PV patients seen at 10 academic institutions across the United States. Taking hematologic laboratory data at ∼3-month intervals (or as available) for all patients for duration of follow-up, we used group-based trajectory modeling to identify latent clusters of patients who follow distinct trajectories with regard to their leukocyte, hematocrit, and platelet counts over time. We then tested the association between trajectory membership and hazard of 2 major outcomes: thrombosis and disease evolution to myelofibrosis, myelodysplastic syndrome, or acute myeloid leukemia. Controlling for relevant covariates, we found that persistently elevated leukocyte trajectories were not associated with the hazard of a thrombotic event (P = .4163), but were significantly associated with increased hazard of disease evolution in an ascending stepwise manner (overall P = .0002). In addition, we found that neither hematocrit nor platelet count was significantly associated with the hazard of thrombosis or disease evolution.

¿Es la simulación clínica una herramienta de aprendizaje efectiva en la enseñanza de la ética clínica? / Is clinical simulation an effective learning tool in teaching clinical ethics?

Introducción En la enseñanza de la ética clínica se han utilizado numerosos métodos tradicionales que persiguen el desarrollo de competencias frente a los desafíos éticos actuales. Estas situaciones pueden ser reproducidas en forma estandarizadas mediante la simulación clínica para ser presentadas y evaluadas en el proceso de formación de los profesionales de salud. Sin embargo, se requiere disponer de evidencias sobre su efectividad. Objetivo Identificar y sintetizar la evidencia disponible sobre la efectividad de la enseñanza de la ética clínica usando la simulación como herramienta de aprendizaje. Métodos Revisión bibliográfica, con búsqueda en bases de datos PubMed, LILACS y Cochrane usando palabras clave en idiomas inglés y español: "Ethics, Clinical/education" [Mesh]) AND "Simulation Training" [Mesh], sin filtros metodológicos, publicados desde el inicio de cada base de datos hasta julio de 2019, sin restricciones idiomáticas, geográficas o temporales, considerando como desenlace primario: la identificación, resolución o reflexión de problemas éticos. Resultados Se encontraron 116 estudios, de los que 15 cumplieron los criterios de selección; el resto se trataba de revisiones narrativas y artículos de opinión. La población a la cual se le aplicó la intervención era de enfermería, medicina, odontología y un estudio a un comité de ética multidisciplinario. La intervención se ejecutó usando simulación con paciente estandarizado. Sólo dos estudios realizaron comparación con métodos tradicionales y el 60% consideró el desenlace primario de interés con resultados favorables. Conclusiones Hasta la fecha existen pocos estudios y con muy baja calidad de evidencia, que evalúen la efectividad de la simulación clínica en la enseñanza de la ética clínica. Los estudios encontrados demuestran que a corto plazo esta metodología logra que los participantes puedan identificar, resolver o reflexionar sobre los problemas éticos con el uso de pacientes estandarizados. Es aconsejable su incorporación como método de enseñanza y evaluación de la ética clínica, considerando los recursos disponibles.

Introduction In the teaching of clinical ethics, many traditional methods have been used that aim to develop competencies in the face of ethical challenges. Situations that can be reproduced in a standardized way through clinical simulation can be presented and evaluated in the training process of health professionals; however, its use requires evidence of effectiveness. Objective To identify and synthesize the available evidence on the effectiveness of teaching clinical ethics using simulation as a learning tool. Methods We conducted a bibliographic review, with searches in PubMed, LILACS and Cochrane databases using English and Spanish: "Ethics, Clinical/education" [Mesh]) AND "Simulation Training" [Mesh], without methodological filters, published from inception of each database until July 2019, without language, geographical or temporal restrictions. We considered as a primary outcome the identification, resolution or reflection on ethical problems. Results One hundred sixteen studies were retrieved. Fifteen studies met the selection criteria. Narrative reviews and opinion articles were excluded. The population to whom the intervention was applied were mainly students in nursing, medicine, and dentistry. A study in a multidisciplinary ethics committee was also included. The intervention was the use of the simulation technique with a standardized patient. Only two studies compared with traditional methods. Sixty percent considered the intervention to have favorable results on the primary outcome. Conclusions To date, there are few studies with very low quality of evidence that evaluate the effectiveness of clinical simulation in teaching clinical ethics. The studies found that, in the short term, this methodology allows participants to identify, solve or reflect on ethical problems by using standardized patients and it seems to be advisable to incorporate simulation techniques as part of the teaching and evaluation curriculum of clinical ethics, to the extent that resources are available.

A stoichio-kinetic model for a DPPH∙ -ferulic acid reaction.

Estimates of the activity of antioxidants in the literature often appear inconsistent. In the specific case of the DPPH∙ test, the diversity of measurements may arise from variations in the protocols followed. This paper proposes an unbiased method which models the reduction mechanism. This method is applied to the reduction of DPPH∙ by ferulic acid. A scheme with eight coupled reactions is proposed and has been validated on different solvents and using a wide range of DPPH ̇, ferulic acid, and 5,5'-diferulic acid concentrations, and verified using data from the literature on ferulic acid activity. This modeling approach permits a correction to the bias of the 8th reaction (spontaneous reduction of DPPH ̇), because of its sensitivity to solvent, which in most cases is not taken into account. The best experimental strategy to determine the Efficient Concentration of ferulic acid to reduce 20% (EC20) and 50% (EC50) of DPPH∙ is then detailed in terms of initial DPPH∙ concentrations and the duration of the experiment.

Draft genome sequence of Janthinobacterium lividum strain MTR reveals its mechanism of capnophilic behavior.

Janthinobacterium lividum is a Gram-negative bacterium able to produce violacein, a pigment with antimicrobial and antitumor properties. Janthinobacterium lividum colonizes the skin of some amphibians and confers protection against fungal pathogens. The mechanisms underlying this association are not well understood. In order to identify the advantages for the bacterium to colonize amphibian skin we sequenced Janthinobacterium lividum strain MTR, a strain isolated from Cajón del Maipo, Chile. The strain has capnophilic behavior, with growth favored by high concentrations (5 %) of carbon dioxide. Its genome is 6,535,606 bp in size, with 5,362 coding sequences and a G + C content of 62.37 %. The presence of genes encoding for products that participate in the carbon fixation pathways (dark CAM pathways), and the entire set of genes encoding for the enzymes of the glyoxylate cycle may explain the capnophilic behavior and allow us to propose that the CO2 secreted by the skin of amphibians is the signal molecule that guides colonization by Janthinobacterium lividum.

Use of food and packaging model matrices to investigate the antioxidant properties of biorefinery grass lignins.

The antioxidant properties of grass lignins recovered from an alkaline industrial process and from different ethanol organosolv pretreatment processes were compared using two types of tests: (i) classical radical 2,2'-diphenyl-1-picrylhydrazyl (DPPH(•)) scavenging tests in dioxane/water or ethanol and (ii) tests involving multiphasic systems (lipid dispersion in water or cellulose film suspended in ethanol). These multiphasic systems were representative of food and packaging matrices in view of high-value applications. All lignins, in solution or in the film, effectively scavenged radicals. Moreover, they were competitive with a food commercial rosemary extract to protect linoleic acid against oxidation. Whereas the DPPH(•) test in dioxane was not discriminant, differences appeared between lignins when the test was performed in ethanol or with the multiphasic systems. Moreover, radical scavenging activity was preserved in the film even after its immersion in ethanol. Structural analysis of lignins revealed that low-molar-mass phenolics, namely p-hydroxycinnamic acids and lignin depolymerization products, governed lignin antioxidant properties in the multiphasic systems.

Successive Oral Immunizations Against Piscirickettsia Salmonis and Infectious Salmon Anemia Virus are Required to Maintain a Long-Term Protection in Farmed Salmonids.

Currently, there is a growing demand to determine the protective status of vaccinated fish in order to prevent diseases outbreaks. A set of different parameters that include the infectious and immunological status of vaccinated salmonids from 622 Chilean farms were analyzed during 2011-2014. The aim of this study was to optimize the vaccination program of these centers through the determination of the protective state of vaccinated fish using oral immunizations. This state was determined from the association of the concentration of the immunoglobulin M (IgM) in the serum and the mortality rate of vaccinated fish. Salmonids were vaccinated with different commercial mono- or polyvalent vaccines against salmonid rickettsial septicemia (SRS) and infectious salmon anemia (ISA), first by the intraperitoneal injection of oil-adjuvanted antigens and then by the stimulation of mucosal immunity using oral vaccines as a booster vaccination. The results showed that high levels of specific IgM antibodies were observed after injectable vaccination, reaching a maximum concentration at 600-800 degree-days. Similar levels of antibodies were observed when oral immunizations were administrated. The high concentration of antibodies [above 2750 ng/mL for ISA virus (ISAv) and 3500 ng/mL for SRS] was maintained for a period of 800 degree-days after each vaccination procedure. In this regard, oral immunizations maintained a long-term high concentration of anti-SRS and anti-ISAv specific IgM antibodies. When the concentration of antibodies decreased below 2000 pg/mL, a window of susceptibility to SRS infection was observed in the farm, suggesting a close association between antibody levels and fish protective status. These results demonstrated that, in the field, several oral immunizations are essential to uphold a high level of specific anti-pathogens antibodies and, therefore, the protective status during the whole productive cycle.

Connexin43 hemichannels mediate secondary cellular damage spread from the trauma zone to distal zones in astrocyte monolayers.

The mechanism of secondary damage spread after brain trauma remains unsolved. In this work, we redirected the attention to astrocytic communication pathways. Using an in vitro trauma model that consists of a scratch injury applied to an astrocyte monolayer, we found a significant and transient induction of connexin43 (Cx43) hemichannel activity in regions distal from the injury, which was maximal ∼1 h after scratch. Two connexin hemichannel blockers, La(3+) and the peptide Gap26, abolished the increased activity, which was also absent in Cx43 KO astrocytes. In addition, the scratch-induced increase of hemichannel activity was prevented by inhibition of P2 purinergic receptors. Changes in hemichannel activity took place with a particular spatial distribution, with cells located at ∼17 mm away from the scratch presenting the highest activity (dye uptake). In contrast, the functional state of gap junction channels (dye coupling) was not significantly affected. Cx43 hemichannel activity was also enhanced by the acute extracellular application of 60 mM K(+) . The increase in hemichannel activity was associated with an increment in apoptotic cells at 24 h after scratch that was totally prevented by Gap26 peptide. These findings suggest that Cx43 hemichannels could be a new approach to prevent or reduce the secondary cell damage of brain trauma.

Lipid oxidation in baked products: impact of formula and process on the generation of volatile compounds.

This paper investigates the effect of ingredients on the reactions occurring during the making of sponge cake and leading to the generation of volatile compounds related to flavour quality. To obtain systems sensitive to lipid oxidation (LO), a formulation design was applied varying the composition of fatty matter and eggs. Oxidation of polyunsaturated fatty acids (PUFA) and formation of related volatile compounds were followed at the different steps of cake-making. Optimised dynamic Solid Phase Micro Extraction was applied to selectively extract either volatile or semi-volatile compounds directly from the baking vapours. We show for the first time that in the case of alveolar baked products, lipid oxidation occurs very early during the step of dough preparation and to a minor extent during the baking process. The generation of lipid oxidation compounds depends on PUFA content and on the presence of endogenous antioxidants in the raw matter. Egg yolk seemed to play a double role on reactivity: protecting unsaturated lipids from oxidation and being necessary to generate a broad class of compounds of the Maillard reaction during baking and linked to the typical flavour of sponge cake.

Factores relacionados con la comprensión materna de indicaciones al alta de lactantes hospitalizados / Factors related to maternal comprehension of indications at discharge in hospitalized infants

Objetivos. Determinar el grado de comprensión materna de las indicaciones entregadas por la enfermera al momento del alta y evaluar algunos factores que determinan diferencias en su comprensión. Método. Diseño de corte transversal en una muestra de 61 madres de lactantes que consintieron para el estudio. Se aplicó una pauta de observación del procedimiento de alta y luego un cuestionario a las madres, y se evaluó la comprensión global y por indicaciones farmacológicas, de alimentación y asistencia a control. Resultados. Las madres asignaron alta calificación al lenguaje y actitud de la enfermera. El tiempo empleado en el alta se consideró, en la mayoría de los casos, como suficiente. El 59% de las madres demostró comprensión total de indicaciones, grado que alcanzó el 96,7% en indicaciones de alimentación, el 93,4% en indicación de asistencia a control y el 64,4% en indicaciones farmacológicas. Hubo asociación significativa del grado de comprensión total con la mayor duración del alta, menos días de hospitalización del lactante e indicaciones entregadas en la misma sala de hospitalización. Igualmente, si bien no fue estadísticamente significativa, hubo una mayor proporción de comprensión total cuando las madres no describieron factores interferentes. No se observó asociación con edad materna ni nivel de escolaridad. Conclusiones. Manteniendo un correcto lenguaje y actitud, se requiere adicionalmente de preocupación por el entorno físico y el tiempo destinado al alta para alcanzar una correcta comprensión de las indicaciones y con ello el cumplimiento del plan de cuidados en el hogar

Objectives. To determine maternal comprehension of indications provided at discharge by nurses in hospitalized infants and to evaluate factors related to comprehension. Method. A cross-sectional study was performed in a sample of 61 mothers of hospitalized infants who agreed to participate. Discharges were observed and the mothers were given a questionnaire evaluating overall understanding and understanding of indications for drugs, feeding, and attendance at follow-up visits. Results. The mothers assigned a high score to nurses' language and attitude. Most mothers considered the time taken for discharge to be sufficient. Fifty-nine percent of the mothers showed complete understanding of the indications; complete understanding was shown by 96.7% of mothers in indications for feeding, by 93.4% for indication for attendance at follow-up visits and by 64.4% for drug indications. Complete understanding was significantly associated with greater length of time taken for discharge, fewer days of infant hospitalization and providing indications on the ward. Complete understanding was also associated with a lack of environmental factors interfering with comprehension, although this association was not statistically significant. No association was found between the degree of comprehension and maternal age or educational level. Conclusions. To achieve adequate understanding of indications at discharge and compliance with the care plan in the home, appropriate language and attitude, as well as concern for the physical environment and the time taken for discharge are required

Esquizofrenia de inicio en la niñez, revisión de conceptos actuales y dificultades en el diagnóstico / Child schizophrenia: A Review of Current Concepts and Diagnostic Difficulties

La esquizofrenia en niños es una patología cuyodiagnóstico es difícil. La mayoría de los estudioshablan de síntomas en niños escolares yadolescentes y la continuidad en la que se presentaen los adultos. Sin embargo, siguen existiendovacíos diagnósticos en los niños menoresy se busca encontrar mejores marcadores clínicospara detener o retrasar el deterioro propiode esta patología.

Enuresis y encopresis en adolescente de 12 años / Enuresis and Encopresis in a 12-year old Adolescent

Se discute el caso de una niña que presentó enuresis y encopresis de manera crónica y como hallazgo principal, las causas de estrés psicosociales derivadas de estas condiciones, así como depresión mayor. El tratamiento aplicado confirma la comorbilidad entre estas patologías y su superposición.