Consistency between POLARS and LARS scores regarding the incidence of low anterior resection syndrome in a Chilean population undergoing rectal surgery secondary to cancer in a high-volume hospital.

AIM: The aim of this work was to evaluate the concordance between the low anterior resection syndrome (LARS) and preoperative LARS (POLARS) scores regarding the incidence of LARS in a Chilean population undergoing rectal surgery for cancer in a high-volume hospital. METHOD: The LARS score questionnaire, following telephone requests, was used to determine the presence and severity of LARS. The POLARS score was calculated based on variables described previously. Correlations and qualitative and quantitative concordance were evaluated using Spearman's correlation coefficient, the kappa coefficient and the Bland-Altman plot with Lin's concordance correlation coefficient. RESULTS: A total of 120 patients met the inclusion criteria: 37.5% underwent neoadjuvant radiotherapy, 61% underwent total mesorectal excision (TME) and 51.6% underwent ostomy. A total of 49% of patients did not present with LARS, whereas 28% had major LARS. The correlation between scales was poor, with a fair qualitative concordance to determine the presence/absence of LARS and a slight qualitative concordance to determine the degree of the intensity. The quantitative concordance was poor. CONCLUSION: In the Chilean population, concordance between the LARS and POLARS scores was qualitatively fair to determine the presence/absence of the disease and qualitatively slight to determine the degree of intensity. We do not suggest using the POLARS score in the perioperative period in the Chilean population deliberately, as the score may help to determine the presence/absence of LARS but cannot determine its degree of intensity. Additional evaluations are required to determine the factors contributing to the degree of agreement between the scales.

Resultados estandarizados del Montreal Cognitive Assessment (MoCA) para cribado neurocognitivo en población chilena / Standardized results of the Montreal Cognitive Assessment (MoCA) for neurocognitive screening in a Chilean population

Introducción: El envejecimiento poblacional implica un desafío para los países respecto a prevenir y detectar trastornos neurodegenerativos. El Montreal Cognitive Assessment (MoCA), test de cribado breve, de simple aplicación, válido y confiable, evalúa el estado cognitivo general, siendo útil en contextos de salud pública. El estudio busca normalizar y estandarizar el test MoCA para población chilena. Método: Se presenta estudio de validación para prueba diagnóstica de tipo descriptivo y correlacional, se evaluó a 526 sujetos, hombres y mujeres, de entre 18 y 90 años, sanos, del norte, centro y sur de Chile, analizando: el efecto de la edad, nivel educativo y sexo, para rendimiento de MoCA. Resultados: Se demuestra un efecto significativo de la edad y el nivel educativo sobre el rendimiento cognitivo general según MoCA. La edad, educación y sexo explican 1-7% de la varianza. El rendimiento cognitivo medio del total de la muestra fue de 24,04 ± 3,22, para un rango definido originalmente por el instrumento de 26 puntos sobre 30. Los adultos mayores con menor educación formal presentaron bajos resultados y menor rendimiento cognitivo. Se propone protocolo de evaluación de resultados en percentiles y puntuaciones por rango de edad y puntuación escalar normalizada individual. Discusión: Se presentan datos normativos de MoCA según las características sociodemográficas chilenas y puntos de corte propuestos para discriminar el rendimiento cognitivo normal de trastornos neurocognitivos según rangos de edad, ajustando los resultados al nivel educacional, la propuesta permitiría facilitar el uso del instrumento y disminuir la aparición de falsos positivos.(AU)

Introduction: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. Method: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. Results: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. Discussion: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.(AU)

Standardised results of the Montreal Cognitive Assessment (MoCA) for neurocognitive screening in a Chilean population.

INTRODUCTION: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. METHOD: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. RESULTS: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1%-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. DISCUSSION: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.

Standardized results of the Montreal Cognitive Assessment (MoCA) for neurocognitive screening in a Chilean population. / Resultados estandarizados del Montreal Cognitive Assessment (MoCA) para cribado neurocognitivo en población chilena.

INTRODUCTION: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. METHOD: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. RESULTS: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. DISCUSSION: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.

Interactions of the tooth and bone during development.

The tooth works as a functional unit with its surrounding bony socket, the alveolar bone. The growth of the tooth and alveolar bone is co-ordinated so that a studied distance always separates the 2, known as the tooth-bone interface (TBI). Lack of mineralization, a crucial feature of the TBI, creates the space for the developing tooth to grow and the soft tissues of the periodontium to develop. We have investigated the interactions between the tooth and its surrounding bone during development, focusing on the impact of the developing alveolar bone on the development of the mouse first molar (M1). During development, TRAP-positive osteoclasts are found to line the TBI as bone starts to be deposited around the tooth, removing the bone as the tooth expands. An enhancement of osteoclastogenesis through RANK-RANKL signaling results in an expansion of the TBI, showing that osteoclasts are essential for defining the size of this region. Isolation of the M1 from the surrounding mesenchyme and alveolar bone leads to an expansion of the tooth germ, driven by increased proliferation, indicating that, during normal development, the growth of the tooth germ is constrained by the surrounding tissues.

Hidranencefalia en un recién nacido por toxoplasmosis congénita / Hydroanencephalia in a newborn due to congenital toxoplasmosis

A case is described of a full-term newborn with hydroanencephalia due to congenital toxoplasmosis. Prenatal diagnosis had been made. The infection was supposedly acquired in the early stages of the pregnancy, the mother presented positive serology for active infection. The newborn presented elevated specific IgM. Fetal and newborn MRI was compatible with hydrancencephalia. The newborn presented macrocephalia, cataracts, abnormal archaic reflexes, hypotonia, thermoregulation abnormalities, and altered spinal fluid. Due to the severity and rarity of this clinical picture, and an absence of a national detection program, the possibility of offering mothers the possibility of detecting this illness is highlighted.

Se presenta el caso de un recién nacido de término con hidranencefalia por toxoplasmosis congénita con diagnóstico prenatal, el cual habría adquirido su infección en forma precoz durante el embarazo. Destaca madre con serología positiva para infección activa. Recién Nacido (RN) con IgM específica elevada. Resonancia Magnética fetal y del neonato compatible con hidranencefalia. RN con macrocefalia, catarata, reflejos arcaicos anormales, hipotonía, alteración del la termorregulación y LCR alterado. Frente a la gravedad y lo inusual del cuadro clínico y considerando la ausencia de un programa nacional de tamizaje se destaca la importancia de ofrecer a la madre embarazada la posibilidad de detección precoz y prevención de esta enfermedad frente a las severas complicaciones neurológicas de esta infección congénita.

[Epidemiologic and nutritional characteristics of the elderly]. / Características epidemiológicas y nutricionales del adulto mayor.

A sample of 1365 elders of both sexes from rural and urban populations was studied. Thirty four percent of the subjects were older that 80 years. 21.6% lived alone, 25% were illiterate and 50% did not finish elementary school. Mental impairment was found in 5.6% and body mass index was normal in 41.4% of subjects. Eighty seven percent did not smoke and 80% were teetotalers. Medical services were requested at least every one year by 15.4% and twice a year by 11.9% of subjects. These numbers will help to design preventive and interventional policies directed to this segment of the population.

Efecto antihipertensivo del acebutolol en pacientes con restriccion de sodio. / Antihypertensive effect of acebutolol in patients with low sodium diet

Se tratan 22 pacientes ambulatorios con hipertensiones esenciales leves o moderadas, con acebutolol, en dosis unica de 400 mg/dia mas regimen hiposodico (4 grs. Na Cl al dia), y con placebo mas regimen hiposodico, en ensayo de doble ciego. Se analizan los efectos por separado y se comparan los resultados obtenidos en el grupo de enfermos con placebo y regimen hiposodico, con los del grupo que recibio la droga mas regimen hiposodico. Se comprueba que baja la presion arterial con el regimen hiposodico y placebo, pero significativamente mas con acebutolol y regimen hiposodico. Se comprobo clinicamente la cardioselectividad y el efecto simpaticomimetico intrinseco de Acebutolol. No hubo efectos adversos