[Growth Hormone treatment in children with Growth Hormone deficiency, idiopathic short stature, SHOX gene mutation, small for gestational age and Turner syndrome]. / Tratamiento con Hormona de Crecimiento en pacientes con déficit de hormona de crecimiento, talla baja idiopática, mutación gen SHOX, pequeños para edad gestacional y síndrome de Turner.

Growth hormone (GH) is effective in improving height in several conditions. OBJECTIVE: To describe the evolution of a group of children who received GH in a tertiary center between 2012-2022. PATIENTS AND METHOD: Descriptive, retrospective study. We analyzed the impact on height after GH use with Z-score according to etiology, age at onset and bone age. Patients under 15 years old at baseline and receiving GH for at least 12 months, with diagnoses of GH deficiency (GHD), idiopathic short stature (ISS), small for gestational age (SGA), SHOX Haploinsufficiency (SHOX) and Turner syndrome (TS) were included. Height was expressed as Z-score for age and sex, according to NCHS curves. RESULTS: 145 children received GH. Sixty patients were excluded due to irregular administration, incomplete data, less than 12 months of GH, change of hospital, and associated comorbidities. Seventy-three patients were analyzed, 23 GHD, 15 ISS, 20 SGA, 9 SHOX and 6 TS patients. Significant improvement in height (Z-score for age and sex) was observed in SGA (1.4 ± 0.8 gain; p < 0.001), GHD (1.1 ± 1.0; p < 0.001), ISS (1.1 ± 0.8; p < 0.001) and SHOX (0.8 ± 0.7; p = 0.007) patients. In TS, a non-statistically significant improvement was observed (0.7 ± 0.8; p = 0.085). In GHD, onset before 3 years showed a gain of 1.9 ± 1.1, vs 0.7 ± 0.6 (p = 0.083) and in ISS onset with bone age less than 9 years increased it by 1.7 ± 0.5 vs 0.5 ± 0.5 (p < 0.001). ADVERSE EVENTS: 27/73 (37%) headache, 18/73 (24%) lower extremity pain, 1/73 (1.5%) dizziness, 1/73 (1.5%) scoliosis, 1/73 (1.5%) epiphysiolysis and 1/73 (1.5%) craniopharyngioma recurrence. CONCLUSIONS: Children with GHD, ISS, SHOX mutation and SGA significantly improved their height, highlighting in GHD and ISS the importance of early treatment. Treatment was well tolerated in the 5 groups analyzed.

Effects of Modified Invasion Games on Motor Competence and Self-Assessed Physical Condition in Elementary School Students in the Physical Education Classroom.

Modified invasion games promote the development of real and perceived motor competence. Children with higher motor competence are more likely to participate in physical activity practice and to remain in it, both in adolescence and adulthood. (1) Background: The purpose of this study is to determine the effect of modified invasion games on the real motor competence and self-assessment of the physical condition fifth-grade students from a private school in Viña del Mar, Chile. (2) Methods: 40 girls and boys with an average age of 11.47 years (SD = 0.554) participated in this study during a 12-week intervention. The MOBAK 5-6 battery was used to assess actual motor competence, the SEMOK questionnaire was used to determine perceived motor competence, the International Fitness Scale (IFIS) self-assessment questionnaire was used to assess perceived physical fitness, and the weight/size ratio was used to determine BMI. A Friedman's nonparametric ANOVA analysis was applied to determine the effect of the intervention, in addition to an analysis of covariance (ANCOVA) to identify the influence of the covariates on motor competence. (3) Results: No statistically significant differences were established between weight, BMI, and waist circumference. There was a statistically significant difference after the intervention in the actual motor competence of object control (p = 0.005) and perceived motor competence of object control (p ≤ 0.001) (4) Conclusions: An intervention based on modified invasion games is effective for the improvement of actual and perceived motor competence of object control. It was not possible to identify a positive effect on the self-assessment of muscle strength after the intervention.

National mitigation potential from natural climate solutions in the tropics.

Better land stewardship is needed to achieve the Paris Agreement's temperature goal, particularly in the tropics, where greenhouse gas emissions from the destruction of ecosystems are largest, and where the potential for additional land carbon storage is greatest. As countries enhance their nationally determined contributions (NDCs) to the Paris Agreement, confusion persists about the potential contribution of better land stewardship to meeting the Agreement's goal to hold global warming below 2°C. We assess cost-effective tropical country-level potential of natural climate solutions (NCS)-protection, improved management and restoration of ecosystems-to deliver climate mitigation linked with sustainable development goals (SDGs). We identify groups of countries with distinctive NCS portfolios, and we explore factors (governance, financial capacity) influencing the feasibility of unlocking national NCS potential. Cost-effective tropical NCS offers globally significant climate mitigation in the coming decades (6.56 Pg CO2e yr-1 at less than 100 US$ per Mg CO2e). In half of the tropical countries, cost-effective NCS could mitigate over half of national emissions. In more than a quarter of tropical countries, cost-effective NCS potential is greater than national emissions. We identify countries where, with international financing and political will, NCS can cost-effectively deliver the majority of enhanced NDCs while transforming national economies and contributing to SDGs. This article is part of the theme issue 'Climate change and ecosystems: threats, opportunities and solutions'.

Conversion from forests to pastures in the Colombian Amazon leads to contrasting soil carbon dynamics depending on land management practices.

Strategies to mitigate climate change by reducing deforestation and forest degradation (e.g. REDD+) require country- or region-specific information on temporal changes in forest carbon (C) pools to develop accurate emission factors. The soil C pool is one of the most important C reservoirs, but is rarely included in national forest reference emission levels due to a lack of data. Here, we present the soil organic C (SOC) dynamics along 20 years of forest-to-pasture conversion in two subregions with different management practices during pasture establishment in the Colombian Amazon: high-grazing intensity (HG) and low-grazing intensity (LG) subregions. We determined the pattern of SOC change resulting from the conversion from forest (C3 plants) to pasture (C4 plants) by analysing total SOC stocks and the natural abundance of the stable isotopes (13) C along two 20-year chronosequences identified in each subregion. We also analysed soil N stocks and the natural abundance of (15) N during pasture establishment. In general, total SOC stocks at 30 cm depth in the forest were similar for both subregions, with an average of 47.1 ± 1.8 Mg C ha(-1) in HG and 48.7 ± 3.1 Mg C ha(-1) in LG. However, 20 years after forest-to-pasture conversion SOC in HG decreased by 20%, whereas in LG SOC increased by 41%. This net SOC decrease in HG was due to a larger reduction in C3-derived input and to a comparatively smaller increase in C4-derived C input. In LG both C3- and C4-derived C input increased along the chronosequence. N stocks were generally similar in both subregions and soil N stock changes during pasture establishment were correlated with SOC changes. These results emphasize the importance of management practices involving low-grazing intensity in cattle activities to preserve SOC stocks and to reduce C emissions after land-cover change from forest to pasture in the Colombian Amazon.

Conversion from forests to pastures in the Colombian Amazon leads to differences in dead wood dynamics depending on land management practices.

Dead wood, composed of coarse standing and fallen woody debris (CWD), is an important carbon (C) pool in tropical forests and its accounting is needed to reduce uncertainties within the strategies to mitigate climate change by reducing deforestation and forest degradation (REDD+). To date, information on CWD stocks in tropical forests is scarce and effects of land-cover conversion and land management practices on CWD dynamics remain largely unexplored. Here we present estimates on CWD stocks in primary forests in the Colombian Amazon and their dynamics along 20 years of forest-to-pasture conversion in two sub-regions with different management practices during pasture establishment: high-grazing intensity (HG) and low-grazing intensity (LG) sub-regions. Two 20-year-old chronosequences describing the forest-to-pasture conversion were identified in both sub-regions. The line-intersect and the plot-based methods were used to estimate fallen and standing CWD stocks, respectively. Total necromass in primary forests was similar between both sub-regions (35.6 ± 5.8 Mg ha(-1) in HG and 37.0 ± 7.4 Mg ha(-1) in LG). An increase of ∼124% in CWD stocks followed by a reduction to values close to those at the intact forests were registered after slash-and-burn practice was implemented in both sub-regions during the first two years of forest-to-pasture conversion. Implementation of machinery after using fire in HG pastures led to a reduction of 82% in CWD stocks during the second and fifth years of pasture establishment, compared to a decrease of 41% during the same period in LG where mechanization is not implemented. Finally, average necromass 20 years after forest-to-pasture conversion decreased to 3.5 ± 1.4 Mg ha(-1) in HG and 9.3 ± 3.5 Mg ha(-1) in LG, representing a total reduction of between 90% and 75% in each sub-region, respectively. These results highlight the importance of low-grazing intensity management practices during ranching activities in the Colombian Amazon to reduce C emissions associated with land-cover change from forest to pasture.

Aneurismas micóticos popliteos bilaterales asociados con endocarditis bacteriana / Bilateral Mycotic Popliteal Aneurysms Associated with Infective Endocarditis

En la era posantibiótica, los aneurismas micóticos en arterias periféricas son una complicación poco frecuente de endocarditis infecciosa. El compromiso de la arteria poplítea es excepcional y más frecuente en hombres. El diagnóstico temprano, utilizando los métodos de imágenes ante una elevada sospecha clínica, tiene implicaciones pronósticas. El tamaño del aneurisma, la presencia de trombosis y el estado general del paciente son factores importantes para decidir un tratamiento oportuno. En esta presentación se describe el caso de un paciente de 48 años con aneurismas poplíteos bilaterales con punto de partida en una endocarditis mitroaórtica por Staphylococcus aureus meticilinorresistente, con embolias sépticas múltiples.

Mycotic aneurysms are a rare complication of infective endocarditis in the post-antibiotic era. The involvement of the popliteal artery is an exception and is more common in men. When the clinical suspicion is high, early diagnosis using image tests has prognostic implications. The aneurysm size, the presence of thrombosis and the patient's general condition are important factors to decide the adequate treatment. We describe the case of a 48-year old male patient with bilateral aneurysms of the popliteal arteries originating from endocarditis of the mitral and aortic valves caused by methicillin-resistant Staphylococcus aureus with multiple septic emboli.

Aneurismas micóticos popliteos bilaterales asociados con endocarditis bacteriana / Bilateral Mycotic Popliteal Aneurysms Associated with Infective Endocarditis

En la era posantibiótica, los aneurismas micóticos en arterias periféricas son una complicación poco frecuente de endocarditis infecciosa. El compromiso de la arteria poplítea es excepcional y más frecuente en hombres. El diagnóstico temprano, utilizando los métodos de imágenes ante una elevada sospecha clínica, tiene implicaciones pronósticas. El tamaño del aneurisma, la presencia de trombosis y el estado general del paciente son factores importantes para decidir un tratamiento oportuno. En esta presentación se describe el caso de un paciente de 48 años con aneurismas poplíteos bilaterales con punto de partida en una endocarditis mitroaórtica por Staphylococcus aureus meticilinorresistente, con embolias sépticas múltiples.(AU)

Mycotic aneurysms are a rare complication of infective endocarditis in the post-antibiotic era. The involvement of the popliteal artery is an exception and is more common in men. When the clinical suspicion is high, early diagnosis using image tests has prognostic implications. The aneurysm size, the presence of thrombosis and the patients general condition are important factors to decide the adequate treatment. We describe the case of a 48-year old male patient with bilateral aneurysms of the popliteal arteries originating from endocarditis of the mitral and aortic valves caused by methicillin-resistant Staphylococcus aureus with multiple septic emboli.(AU)

Photoperiodic induction of synchronous flowering near the Equator.

In tropical rainforests, 30-65% of tree species grow at densities of less than one individual per hectare. At these low population densities, successful cross-pollination relies on synchronous flowering. In rainforests with low climatic seasonality, photoperiodic control is the only reliable mechanism for inducing synchronous flowering. This poses a problem because there is no variation in day length at the Equator. Here we propose a new mechanism of photoperiodic timekeeping based on the perception of variation in sunrise or sunset time, which explains and predicts the annually repeated, staggered, synchronous and bimodal flowering of many tree species in Amazonian rainforests near the Equator.

Determinación de los Signos y Síntomas de los Trastornos Temporomandibulares, en Estudiantes de 13 a 18 Años de un Colegio de la Comuna de Temuco, Chile / Temporomandibular disorders signs and symtoms determination of 13 to 18 years old students from a school in Temuco, Chile

Los trastornos temporomandibulares (TTM) han sido descritos como "término colectivo que encierra muchos problemas clínicos que comprometen la musculatura masticatoria, articulaciones y estructuras asociadas". Estudios epidemiológicos han reportado que éstos son comunes en niños y adolescentes, con prevalencias de 6% a 68% y, en población adulta el 75% presenta algún tipo de alteración funcional. Los propósitos de este estudio fueron conocer la prevalencia de signos y síntomas de TTM, en un grupo de escolares de Temuco, Chile y determinar tanto el efecto de diseño para un posterior estudio poblacional, como la estabilidad de los tests. Es un estudio de corte transversal, con muestra no probabilística por conveniencia y consentimiento informado, de 116 alumnos del Colegio Bautista de Temuco, quienes respondieron un test sobre síntomas subjetivos de TTM, y fueron examinados clínicamente evaluando: alteraciones, limitaciones o desviación de los movimientos mandibulares, dolor a la palpación muscular y articular, ruidos y bruxismo. El test autorreporte arrojó que: el 77.6% mostró uno o más síntomas; el 37.9% presentó ruido articular; 23.3% sintió la mandíbula rígida y un 35.3% refirió dolor de cabeza, nuca y sien. Clínicamente, el 85.3%% presentó uno o más signos de TTM. Un 50% presentó ruido articular, el 8.6% alteración apertura bucal, 18.1% disminución del movimiento en lateralidad, 8.6% sensibilidad a la palpación articular y el 4.3% y 6% a la palpación de los músculos temporal y masetero, respectivamente y el 46.6% alguna manifestación de bruxismo. Al comparar estos signos con edad y sexo, sólo hubo diferencias significativas de la edad con apertura y bruxismo (p<0.05). En conclusión, el ruido fue el signo de mayor frecuencia en esta población. Hay concordancia entre lo percibido por los adolescentes y lo observado clínicamente en cuanto a: apertura, dificultad al masticar, ruido y sensibilidad articular. En los análisis del test y retest, ...

Temporomandibular disorders (TMD) has been descrited as "Collective terms that involucre several clinical problems that compromise masticatory musculature, joints and associated structures". Epidemiologic studies have reported that there are common in children and adolescents. Showing prevalences ranging from 6% to 68% and 75% of adult population show some kind of functional alteration. The purpose of this study was to determine the prevalence of TMD signs and symptoms non existent in this commune, stablish the design effect for grade to calculate sample size for populational study and to determine stability of the test. Cross sectinal study with non probabilistic (by convenience) sample and informed consent, taken from 116 students from the Baptist School of Temuco, who answered a test inquiring about subjective symptoms and then they were clinically examinations looking for signs, like: alterations, limitations or desviations of mandibular motion; pain to joint and muscular palpation; noises and bruxism. Autoreport Test: 77.6% repot one or more symptoms, articular noise 37.9%; to feel jaw rigid 23.1% and headache, nape and temple, 35.3% Clinically: 85.3% showed one or more TMD signs; 50% joint noise; 8.6% mouth opening alteration; 18.1% diminished lateral motion; 8.6% tenderness to joint palpation; 4.3% tenderness to palpation an temporalis muscleand 6% masseterus; 46:6% showed any bruxism manifestation. Correlation between this signs with gender and age showed only significant differences for age with mouth opening and Bruxism (p<0.05) There is agreement between what was perceived by the adolescents and what was clinically obsrved in maximun opening, chewing difficulty, noise and tendernees to joint palpation. In the analysis of the test and retest, great correlations was found between the answers. No statistically significant differences were found between signs and symptoms with gender. Desing effect: 1.23.

Temas de sexualidad que preguntan adolescentes a través de la prensa / Subjects of sexuality that adolescents through the press ask

Estudio descriptivo de 870 preguntas de adolescentes, sobre sexualidad y reproducción recibidas en el suplemento dominical Vida Afectiva y Sexual, del Diario la Cuarta de Santiago y reagrupadas en 10 grandes temas. Fueron 57,8 por ciento mujeres y 42,2 por ciento varones, sin diferencias por edad. Para el análisis se aplico el test de Chi cuadrado y análisis multinominal. Los temas más consultados: Relaciones Sexuales, Anatomía relacionada al sexo, Homosexualidad e ITS, Embarazo en Adolescentes y Masturbación. Los/las adolescentes menores preguntan más sobre Masturbación y Desarrollo Puberal y los/las adolescentes mayores en Anticoncepción. No hubo tendencia por edad en los temas de Relaciones Sexuales, Embarazo, Relaciones Afectivas y Familiares y Homosexualidad e ITS. Los varones preguntan significativamente más sobre Masturbación, Anatomía relacionada al Sexo y Homosexualidad e ITS. Las mujeres preguntan más de Relaciones sexuales, Embarazo y Relaciones Afectivas y Familiares. No hubo diferencias por Regiones. De los Subtemas de Relaciones Sexuales los más consultados fueron: Inicio Sexual relacionado con el Desarrollo Puberal, Dispareunia y Anorgasmia. Hubo tendencia a mayor edad por la inquietud acerca de Dispareunia y Anorgasmia. En conclusión se confirma la urgencia de desarrollar programas de educación sexual en el Sector Público y capacitar a los docentes, padres y apoderados para satisfacer las necesidades de las/los adolescentes. La educación debe ser impartida por igual a hombres y mujeres, considerando algunos temas en complejidad creciente en relación a la edad.