Oscillatory activity underlying cognitive performance in children and adolescents with autism: a systematic review.

Autism spectrum disorder (ASD) is a neurodevelopmental condition that exhibits a widely heterogeneous range of social and cognitive symptoms. This feature has challenged a broad comprehension of this neurodevelopmental disorder and therapeutic efforts to address its difficulties. Current therapeutic strategies have focused primarily on treating behavioral symptoms rather than on brain psychophysiology. During the past years, the emergence of non-invasive brain stimulation techniques (NIBS) has opened alternatives to the design of potential combined treatments focused on the neurophysiopathology of neuropsychiatric disorders like ASD. Such interventions require identifying the key brain mechanisms underlying the symptomatology and cognitive features. Evidence has shown alterations in oscillatory features of the neural ensembles associated with cognitive functions in ASD. In this line, we elaborated a systematic revision of the evidence of alterations in brain oscillations that underlie key cognitive processes that have been shown to be affected in ASD during childhood and adolescence, namely, social cognition, attention, working memory, inhibitory control, and cognitive flexibility. This knowledge could contribute to developing therapies based on NIBS to improve these processes in populations with ASD.

[Experience in COVID-19 in hospitalized patients in pediatric critical units during pandemic period]. / Experiencia en COVID-19 en pacientes hospitalizados en unidades de paciente crítico pediátrico durante el periodo pandémico.

OBJECTIVES: To characterize the COVID-19 disease profile in Chilean children hospitalized in pediatric intensive care units (PICU) and to evaluate risk factors associated with severe COVID-19. PATIENTS AND METHOD: A multicenter prospective cohort study with patients 0-18 years of age with confirmed SARS-CoV-2 hospitalized in PICU. Clinical, laboratory, imaging, and therapeutic variables were recorded. We compared "mild/moderate COVID-19" with ''severe COVID-19" using median with interquartile range (IQR), Mann-Whitney U test, two-tailed Fisher's test, and forward binary multivariate analysis to adjust variables for "severe COVID-19". A p < 0.05 was considered significant. RESULTS: From 16 PICUs, 219 patients were recruited, 55.3% were male, with a median age of 86 months (IQR: 13.5-156). The most frequent comorbidities were obesity and respiratory diseases. Overall mortality was 3.6%. "Severe COVID-19" (26.5%) showed more leukopenia, lymphopenia, increased inflammatory parameters, and altered organ function (p < 0.05). It also developed more sepsis/shock, ARDS, and organ dysfunction, requiring more hemodynamic, anti-inflammatory, anticoagulation, and antibiotic therapy, with a longer stay in the PICU/hospital (p < 0.05), and 13.8% of mortality. Risk factors associated with "severe COVID-19" were shock on admission to the PICU [aOR 28.44 (95%CI 10.45-77.4)], obesity [aOR 3.55 (95%CI 1.3-9.6)], consolidation [aOR 3.1 (95%CI 1.1 -8.7)], atelectasis [aOR: 8.7 (95%CI 1.17-64.3)], stress dose of corticosteroids [aOR 7.7 (95%CI 1.9-30.6)], early antibiotic therapy [aOR: 12.02 (95%CI 1.11-130.02)], acquired/congenital immunodeficiency [aOR: 19.2 (95%CI: 1.19-321)], and oncological pathology [aOR 10.7 (95%CI 2.14-47.8)]. CONCLUSION: In this Chilean pediatric cohort, most patients with COVID-19 admitted to de PICU were male, of school age, with associated comorbidity. Risk factors for developing severe COVID-19 were the presence of comorbidities such as acquired/congenital immunodeficiency, oncological pathology, and obesity, in addition to shock on admission and consolidations on X-rays.

Sunlight-Driven Photocatalytic Degradation of Methylene Blue with Facile One-Step Synthesized Cu-Cu2O-Cu3N Nanoparticle Mixtures.

Sunlight-driven photocatalytic degradation is an effective and eco-friendly technology for the removal of organic pollutants from contaminated water. Herein, we describe the one-step synthesis of Cu-Cu2O-Cu3N nanoparticle mixtures using a novel non-aqueous, sol-gel route and their application in the solar-driven photocatalytic degradation of methylene blue. The crystalline structure and morphology were investigated with XRD, SEM and TEM. The optical properties of the as-prepared photocatalysts were investigated with Raman, FTIR, UV-Vis and photoluminescence spectroscopies. The influence of the phase proportions of Cu, Cu2O and Cu3N in the nanoparticle mixtures on the photocatalytic activity was also investigated. Overall, the sample containing the highest quantity of Cu3N exhibits the highest photocatalytic degradation efficiency (95%). This enhancement is attributed to factors such as absorption range broadening, increased specific surface of the photocatalysts and the downward band bending in the p-type semiconductors, i.e., Cu3N and Cu2O. Two different catalytic dosages were studied, i.e., 5 mg and 10 mg. The higher catalytic dosage exhibited lower photocatalytic degradation efficiency owing to the increase in the turbidity of the solution.

Surveying the Synthesis, Optical Properties and Photocatalytic Activity of Cu3N Nanomaterials.

This review addresses the most recent advances in the synthesis approaches, fundamental properties and photocatalytic activity of Cu3N nanostructures. Herein, the effect of synthesis conditions, such as solvent, temperature, time and precursor on the precipitation of Cu3N and the formation of secondary phases of Cu and Cu2O are surveyed, with emphasis on shape and size control. Furthermore, Cu3N nanostructures possess excellent optical properties, including a narrow bandgap in the range of 0.2 eV-2 eV for visible light absorption. In that regard, understanding the effect of the electronic structure on the bandgap and on the optical properties of Cu3N is therefore of interest. In fact, the density of states in the d-band of Cu has an influence on the band gap of Cu3N. Moreover, the potential of Cu3N nanomaterials for photocatalytic dye-degradation originates from the presence of active sites, i.e., Cu and N vacancies on the surface of the nanoparticles. Plasmonic nanoparticles tend to enhance the efficiency of photocatalytic dye degradation of Cu3N. Nevertheless, combining them with other potent photocatalysts, such as TiO2 and MoS2, augments the efficiency to 99%. Finally, the review concludes with perspectives and future research opportunities for Cu3N-based nanostructures.

Outcome of patients with primary glioblastoma in Chile: single centre series.

BACKGROUND: Glioblastoma (GBM) is the most common and most aggressive primary malignant brain tumour. The standard of care is surgical resection, followed by radiotherapy with concurrent and adjuvant temozolomide. In Latin America, there is scarcity of information about the incidence of GBM and even less data regarding outcomes. In this study, we describe the clinicopathologic features, management and outcomes of GBM patients. METHODS: We describe a single-centre multidisciplinary team experience in managing GBM patients over an 11-year period (Jan 2005 to Dec 2016). Pathology was reviewed by the pathology collaborator and retrospective chart review performed for treatment and clinical outcomes. RESULTS: We identified 74 patients (50 males) with diagnosis of GBM. Median age at diagnosis was 58 years (range 24-79 years), and median Karnofsky performance status was 80%. Forty-three (58.1%) went to gross total resection, 20 (27%) partial resection and 11 (14.9%) biopsy. Sixty-four (87%) patients received Stupp regimen. The median overall survival (OS) was 13.9 months (standard error (SE) 1.71; 95% confidence interval (CI), 10.56-17.23). In patients treated according to Stupp regimen, the progression-free survival (PFS) was 10 months (SE 1.8; 95% CI, 6.481-13.519), the selfcare survival was 11.8 months (SE 1.61; 95% CI, 8.632-14.968) and the OS was 16.1 months (SE 1.53; 95% CI, 13.01-19.099). CONCLUSIONS: This study reports the most complete analysis of epidemiology, clinical management and outcomes of patients with diagnosis of GBM in Chile treated with Stupp regimen. The PFS and OS are consistent with reports of US and Europe.

[Differential diagnosis from hyperglycemic ketoacidosis: pesticide poisoning. Clinical case]. / Diagnóstico diferencial de cetoacidosis hiperglicémica: intoxicación por plaguicidas. Caso clínico.

Diabetic ketoacidosis in children causes serious morbidity and mortality, especially if it is not recognized on time in the initial diagnosis. However, there are other diseases that can appear to be a metabolic disorder of this kind and be ignored if it is not suspected. We present a clinical case with hyperglycemic ketoacidosis due to the contact with organophosphate; we had to use a continuous infusion of insulin to control the metabolic disorder without repercussions after the girl came home.

La cetoacidosis diabética en niños puede ser una causa de morbilidad grave y mortalidad, especialmente si no se reconoce en el momento del primer diagnóstico. Sin embargo, existen otras patologías que pueden aparentar una alteración metabólica de este tipo y pasarse por alto si no se tiene sospecha clínica. A continuación, se describe un caso clínico que presenta cetoacidosis hiperglicémica debido al contacto con organofosforado, en el cual fue necesario el uso de insulina en infusión continua para el control del trastorno metabólico, sin repercusiones después del alta.

Diagnóstico diferencial de cetoacidosis hiperglicémica: Intoxicación por plaguicidas. Caso clínico / Differential diagnosis from hyperglycemic ketoacidosis: Pesticide poisoning. Clinical case

La cetoacidosis diabética en niños puede ser una causa de morbilidad grave y mortalidad, especialmente si no se reconoce en el momento del primer diagnóstico. Sin embargo, existen otras patologías que pueden aparentar una alteración metabólica de este tipo y pasarse por alto si no se tiene sospecha clínica. A continuación, se describe un caso clínico que presenta cetoacidosis hiperglicémica debido al contacto con organofosforado, en el cual fue necesario el uso de insulina en infusión continua para el control del trastorno metabólico, sin repercusiones después del alta.

Diabetic ketoacidosis in children causes serious morbidity and mortality, especially if it is not recognized on time in the initial diagnosis. However, there are other diseases that can appear to be a metabolic disorder of this kind and be ignored if it is not suspected. We present a clinical case with hyperglycemic ketoacidosis due to the contact with organophosphate; we had to use a continuous infusion of insulin to control the metabolic disorder without repercussions after the girl came home.

Ventilación de alta frecuencia: experiencia inicial en la Unidad de Cuidados Intensivos del Hospital Pediátrico Baca Ortíz de Quito-Ecuador / High frequency ventilation: initial experience in the Unit of Intensive Care of the Hospital Pediatric Baca Ortíz of Quito-Ecuador

La ventilación mecánica es necesaria para asegurar un adecuado intercambio gaseoso en la insufciencia respiratoria, especialmente en el Síndrome de Distress Respiratorio Agudo (SDRA), pero puede inducir daño pulmonar y contribuir al desarrollo de disfunción multiorgánica. Los cambios cíclicos de volumen pulmonar generan mayor distensión y/o colapso de áreas pulmonares, lo que sería un factor determinante para un eventual daño [1­3]. Es por ello que las estrategias ventilatorias protectoras buscan el empleo de bajos volúmenes corrientes, generalmente asociado a PEEP elevado e hipercapnia permisiva, perflándose en forma promisoria en pacientes que padecen dicha patología [4, 5]. Pero en ocasiones, ante el fracaso de esta modalidad terapéutica, cada vez más se ha desarrollado en las Unidades de Cuidados Intensivos Pediátricos el uso de la ventilación de alta frecuencia oscilatoria (VAFO). Así, ventilando por medio de la VAFO en una zona de seguridad situada entre los puntos de inflexión superior e inferior de la curva de presión volumen estática, se evitan los ciclos de colapso pulmonar seguidos de sobredistensión pulmonar

Mechanical ventilation is necessary to ensure adequate gaseous exchange in respiratory insufficiency, especially in Acute Respiratory Distress Syndrome (ARDS), but it can induce lung damage and contribute to the development of multi-organ dysfunction. Cyclic changes in lung volume generate more distension and / or collapse of pulmonary areas, which would be a determining factor for eventual damage [1-3]. That is why the ventilatory strategies Protectors seek the use of low running volumes, generally associated with elevated PEEP and permissive hypercapnia, profiling itself in a promising way in patients suffering from this pathology [4, 5]. But sometimes, given the failure of this modality therapeutic, has increasingly been developed in Units of Pediatric Intensive Care the use of high ventilation oscillatory frequency (HFOV). Thus, ventilating through HFOV in a safety zone located between the points of superior in fl ection and lower of the static volume pressure curve, cycle cycles are avoided Pulmonary collapse followed by pulmonary overdistension

Staphylococcus aureus meticilino resistente comunitario, Hospital de Niños Baca Ortiz / Community methicilin-resistant Staphylococcus aureus; Baca Ortiz Children´s Hospital

Introducción: las infecciones debidas a Staphylococcus aureus adquiridos en la comunidad (MRSA-AC) están aumentando significativamente a nivel mundial. Su virulencia se caracteriza principalmente por la presencia de la leucocidina Panton- Valentine. Caso: en la siguiente revisión presentamos dos casos clínicos en niños ecuatorianos que tuvieron cuadros infecciosos con las características de MRSA-AC con el objetivo de analizar la importancia del estudio de sensibilidad de los antibióticos para S. aureus adquiridas en la comunidad, lo que determina un manejo adecuado y temprano en la terapéutica de estas infecciones.

Introduction: infections due to community-acquired Staphylococcus aureus (MRSA -AC) are increasing signifcantly worldwide. Its virulence is mainly characterized by the presence of Panton- Valentine Leukocidin. This study pretends to analyze the importance of studying antibiotic sensitivity of community- acquired S. aureus, which determines appropriate management and early treatment of these infections. Case study: we present two cases in Ecuadorian children who had the characteristics of MRSA-AC.

[Comparison of MRI and arthroscopic images for the diagnosis of knee disorders]. / Comparación de las imágenes de resonancia y artroscopía para el diagnóstico de las afecciones de la rodilla.

OBJECTIVE: The purpose of this study was to compare the diagnostic performance of magnetic resonance imaging with arthroscopy for intra-articular knee conditions. MATERIAL AND METHOD: Between January 2000 and February 2007, 93 patients with medial meniscal tear, lateral meniscal tear, anterior cruciate ligament rupture, and articular cartilage pathology were prospectively assessed. After the physical exam, magnetic resonance imaging studies and arthroscopic surgery of the knee were performed. The sensitivity, specificity, positive and negative predictive values and the diagnostic odds ratio were estimated to compare the magnetic resonance imaging diagnoses with the arthroscopic findings. RESULTS: Fifty-two patients were males and 41 females; mean patient age was 42.6 years (16-68 years). The diagnostic odds ratio was significant for medial meniscal tear, anterior cruciate ligament rupture and the coexistence of both meniscal and ligament lesions. CONCLUSION: The strength of the diagnostic association confirms the usefulness of magnetic resonance imaging for medial meniscal tears, anterior cruciate ligament rupture and the coexistence of both lesions. We do not recommend ordering a routine preoperative magnetic resonance imaging study as a condition for performing knee arthroscopy.

Hipercalcemia por intoxicación con vitamina d / Hypercalcemia by poisoning with vitamin d

La hipercalcemia es una entidad poco frecuente, que a nivel mundial no se han reportado un número significativo de casos. A nivel nacional no se encuentran casos reportados según las estadísticas dellNEC en el último reporte. En el Hospital Baca Ortiz revisando los datos estadísticos del hospital tampoco hay reporte de casos por lo que este sería el primero reportado en los últimos 5 años. A continuación presentamos el caso de un paciente de 9 meses de edad que al ingreso presenta un cuadro respiratorio acompañado de importante sintomatología abdominal con antecedente de recibir 17 días antes del ingreso una ampolla diaria de Raquiferol D por nueve días (600.000Ulc/amp de vitamina D) lo que equivale decir que el paciente recibe 1.500 veces las dosis recomendada, a las 44 horas de hospitalización presenta un claro deterioro clínico seguido de paro cardiorrespiratorio por 2 ocasiones, a las 56 horas de ingreso a UCIP el paciente fallece.

[Intestinal parasites in dogs and cats with gastrointestinal symptoms in Santiago, Chile]. / Parásitos intestinales en caninos y felinos con cuadros digestivos en Santiago, Chile. Consideraciones en Salud Pública.

BACKGROUND: There is an increasing importance of pet-transmitted infections, some of those are considered emerging infections. AIM: To determine the species and frequency of intestinal parasites in pets with diarrhea (hemorrhagic gastroenteritis excluded). MATERIAL AND METHODS: A descriptive retrospective study. Fecal samples from 972 dogs and 230 cats consulting in two veterinary practices in Santiago, between 1996 and 2003, were studied using Burrows' technique. RESULTS: Protozoa were found in 64.8% of dogs and in 66.5% of cats; helminthes in 24% of dogs and 45.2% of cats. The species found in dogs were Blastocystis sp. in 36%, Ameba sp. in 31%, Giardia intestinalis in 22%, Toxocara canis in 11%, Chilomastix sp. in 10%, Isospora sp. in 9%, Trichuris vulpis in 9%, Trichomonas sp. in 5%, Sarcocystis sp. in 4%, Dipylidium caninum in 2%, Ancylostomideos in 2%, Toxascaris leonina in 1%, Physaloptera sp. in 1%, Taenia sp. in 0.4%. Species found in cats were Blastocystis sp. in 37%, Ameba sp. in 30%, G intestinalis in 19%, Chilomastix sp. in 12%, Isospora sp. in 12%, Toxocara cati in 10%, D caninum in 7%, Sarcocystis sp. in 5%, Trichomona sp. in 5%, Toxoplasma gondii in 4%, Taenia sp. in 2% and Physaloptera sp. in 1%. Forty eight percent of parasites found in dogs and 49% found in cats have zoonotic potential. In dogs younger than six months Blastocystis sp., Ameba sp., G intestinalis, Chilomastix sp., Isospora sp. and T canis were significantly more common; the same was observed for Isospora in young cats. Approximately 60% of infected animals bore more than one parasite. CONCLUSIONS: A high rate of intestinal parasitism in pets with diarrhea was found; an important proportion of them have zoonotic potential.

Complicaciones hemorrágicas de los accesos venosos centrales / Hemorrágicas complications of central venous accesses

Se trata de un estudio de tipo prospectivo, en el que se analiza las complicaciones henorrágicas en los pacientes en quienes se canaliza una vía venosa central aún cuando estos tienen trastornos de coagulación. Se realizó en 25 pacientes hospitalizados en la Unidad de Cuidados Intensivos del Hospital Baca Ortíz, cuyas edades fluctúan entre 1 mes hasta 72 meses que ingresaron por diferentes diagnósticos, a los cuales se les colocó una vía vemnosa central siguiendo todas las normas técnicas. Se realizó por tres vías, la yugular interna, subclavia y la femoral. Se presentó complicación hemorrágica en un solo caso (hemotórax( )4 por ciento), el mismo que fue comprobado por una radiografía de tórax e inmediantamente solucionado con tubo toráxico.