Search

La vertiginosa expansión de la pandemia COVID-19 ha concebido efectos significativos, tanto en el entorno social, económico, psicológico y educativo; en primera instancia, el cierre de las entidades de educación como escuelas, institutos y universidades no fue una opción, más bien una necesidad transcendental para continuar con el desarrollo académico sin comprometer con la salud de docentes y estudiantes; por lo antes argumentado, los objetivos del estudio son: analizar sí la pandemia Covid-19 incidió en el estado emocional de los docentes, por lo consiguiente, valorar sí las variables explicativas del estado emocional presentan correlación y relación en conjunto al desempeño laboral. La metodología se dividirá en secciones, la primera denominada revisión preliminar mediante al Alfa de Cronbach, evaluación descriptiva por componentes y correlacional realizado con el Análisis de Componentes Principales y la Correlación de Pearson, finalmente, evaluación lineal con la Regresión Lineal Simple. Los resultados obtenidos condescienden un nivel de fiabilidad acorde, la regresión ratifica que el estado emocional adjudica significancia en el desempeño laboral con un P-valor (0,0000).

With the objective of evaluating the quality parameters of raw milk in Ecuador between 2010 and 2020, a systematic review and meta-analysis of 73 studies on raw milk produced in different regions of Ecuador was performed. Under the random effects model, effect size and heterogeneity were determined vs. climatic region both among analyses and studies, with Cochran’s Q, I2 and Tau (π) statistics. For all the variables, it was observed that there was great heterogeneity (I2 > 90%) among the studies; additionally, it was found that climatic region had an influence only among the variables arsenic, mercury, pH and total solids, and it was greater in the coastal region than the Inter-Andean region. The mean values of the physicochemical characteristics of the milk (titratable acidity, ash, cryoscopy, fat, lactose, pH, protein, non-fat solids and total solids) in the great majority of these studies were within the range allowed by Ecuadorian regulations. As for the hygienic quality of raw milk (total bacterial count, somatic cell count and presence of reductase), although the mean values were within those determined by local legislation, it should be noted that the range established by Ecuadorian regulations is relatively much higher compared to other regulations, which possibly means that there is a high presence of bacteria and somatic cells in raw milk. Finally, the presence of several adulterants (added water) and contaminants (AFM1, antibiotics and heavy metals) was confirmed in the milk, in addition to other substances such as eprinomectin, zearalenone and ptaquilosides, whose presence can be very dangerous, because they can be hepatotoxic, immunotoxic and even carcinogenic. In conclusion, there is great variability among the studies reviewed, with the physicochemical characteristics being the most compliant with Ecuadorian legislation; the hygienic characteristics, adulterants and contaminants of raw milk require greater attention by producers and local authorities, so that they do not harm the health of consumers and the profitability of producers in Ecuador.

Primary cardiac tumours are uncommon in the paediatric population, accounting for fewer than 0.5% of paediatric cases of cardiac disease. Right ventricular tumours, including myxomas, are particularly rare and may be asymptomatic or demonstrate varying degrees of cardiac dysfunction based on the location and size of the tumour, inducing conduction abnormalities, syncope, embolism, and potentially, sudden death. We report a rare case of right ventricular myxoma causing severe right ventricular outflow tract obstruction and surgical intervention in a paediatric patient.

Introdução: As neoplasias de pele têm crescido em todo o mundo, porém, cerca de 50% dos casos podem ser prevenidos. Os trabalhadores rurais apresentam grande risco de desenvolver o câncer de pele, pois passam um longo período exposto às radiações solares. Objetivo: Elaborar um material educativo de abordagem ao câncer de pele. Método: Estudo relato de experiência descritivo. Para elaboração do material educativo foi realizada uma revisão sobre o tema na literatura científica e o documento elaborado pelo Consenso Brasileiro de Fotoproteção, produzido pela Sociedade Brasileira de Dermatologia. Foram realizadas atividades de intervenção educativas para a prevenção do câncer de pele em trabalhadores rurais em um município do Estado de Minas Gerais, Brasil. Resultados: Realizado orientação com o material educativo ilustrativo abordando a temática do câncer de pele, material intitulado “Câncer de Pele: Plantando Proteção, Colhendo Saúde” sendo disponibilizado aos trabalhadores. Estes demonstraram ter compreendido as orientações do folheto informativo. Conclusões: Atividades de intervenção educativas são importantes para a prevenção do câncer de pele em trabalhadores rurais, porém devem ser moldadas para a sua realidade.

Background During the severe acute respiratory syndrome Coronavirus 2 pandemic, there has been an increase in hyperinflammatory presentation in previously healthy children with a variety of cardiac manifestations. Our objective is to describe the cardiac manifestations found in an international cohort of 55 pediatric cases with multi‐system inflammatory syndrome during the severe acute respiratory syndrome Coronavirus 2 pandemic. Methods and Results We reviewed data on previously healthy pediatric patients (≤18 years) with structurally normal hearts who presented at hospitals in the United States, United Kingdom, Spain, and Pakistan with multi‐system inflammatory syndrome in children and had consultation with a pediatric cardiologist. Data collected included demographics, clinical presentation, laboratory values, electrocardiographic abnormalities, echocardiographic findings, and initial therapies. A total of 55 patients presented with multi‐system inflammatory syndrome in children. Thirty‐five patients (64%) had evidence of decreased left ventricular function, 17 (31%) had valvulitis, 12 (22%) with pericardial effusion, and 11 (20%) with coronary abnormalities. Twenty‐seven (49%) required intensive care unit admission and 24 (44%) had evidence of shock. Eleven patients (20%) fulfilled complete Kawasaki disease criteria and had lower NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), D‐dimer, and ferritin levels compared with those who did not fulfill criteria. Electrophysiologic abnormalities occurred in 6 patients and included complete atrioventricular block, transient atrioventricular block, and ventricular tachycardia. Conclusions To our knowledge, we describe the first international cohort of pediatric patients with multi‐system inflammatory syndrome in children during the severe acute respiratory syndrome Coronavirus 2 pandemic with a range of cardiac manifestations. This article brings awareness and alertness to the global medical community to recognize these children during the pandemic and understand the need for early cardiology evaluation and follow‐up.

Background During the SARS‐CoV2 pandemic, there has been increase in hyperinflammatory presentation in previously healthy children with a variety of cardiac manifestations. Our objective is to describe the cardiac manifestations found in an international cohort of 55 pediatric cases with multi‐system inflammatory syndrome (MIS‐C) during the SARS‐CoV2 pandemic. Methods and Results We reviewed data on previously healthy pediatric patients (≤18 years) with structurally normal hearts who presented at hospitals in the United States, United Kingdom, Spain and Pakistan with MIS‐C and had consultation with a pediatric cardiologist. Data collected included demographics, clinical presentation, laboratory values, electrocardiographic abnormalities, echocardiographic findings and initial therapies. A total of 55 patients presented with MIS‐C. Thirty‐five patients (64%) had evidence of decreased left ventricular function, 17 (31%) had valvulitis, 12 (22%) with pericardial effusion and 11 (20%) with coronary abnormalities. Twenty‐seven (49%) required ICU admission and 24 (44%) had evidence of shock. Eleven patients (20%) fulfilled complete Kawasaki disease criteria and had lower NT pro‐BNP, D‐dimer and ferritin levels compared with those who did not fulfill criteria. Electrophysiologic abnormalities occurred in 6 patients and included complete atrioventricular (AV) block, transient AV block and ventricular tachycardia. Conclusions We describe the first international cohort of pediatric patients with MIS‐C during the SARS‐CoV2 pandemic with a range of cardiac manifestations. This paper brings awareness and alertness to the global medical community to recognize these children during the pandemic and understand the need for early cardiology evaluation and follow‐up.

The majority of patients with coronavirus disease 2019 (COVID-19) display pulmonary disease; however, a significant portion of patients have cardiac injury as well, with a high incidence of myocarditis documented in the adult population. Pediatric disease from COVID-19 has been relatively rare, and no cases of virus-related cardiac disease have been published. We present a case of an adolescent girl with fulminant myocarditis with complete heart block, elevated troponin I levels, and severely depressed systolic function in the setting of COVID-19 infection.

Background Repeated exposure to pediatric emergency scenarios improves technical skills, but it is unclear whether repeated exposure to specific cases affects medical decision making in varied cases. Objective We sought to determine whether repeated exposure to 1 scenario would translate to improved performance and decision making in varied scenarios. Methods Senior pediatrics residents participated in 3 scenarios with scripted debriefing. Residents were randomized to repeated practice (RP) scenarios or mixed (MIX) scenarios. RP residents completed pulseless electrical activity (PEA) with different stems (Case 1, 2, 3). MIX residents completed PEA (Case 1), seizure (Case 2), and ventricular tachycardia (Case 3) scenarios. Four months later, participants returned to complete 3 more cases: PEA (Case 4), seizure (Case 5), and critical coarctation (Case 6). Results Twenty-three residents participated in the study and were randomized to either the RP or the MIX group. The RP group showed statistically significant improvement in time to start chest compressions, whereas the MIX group showed no improvement. Use of a backboard improved significantly in Case 4 for the RP group but not for the MIX group. Similarly, time to check glucose in the seizure scenario was significantly better in the MIX group that had previous exposure to a seizure scenario. No differences in performance were noted between groups in Case 6, which was new to both groups. Conclusions Results of this study indicate that whereas repeated exposure may improve decision-making skills in similar scenarios, it may not translate to improved medical decision making in other scenarios.

We describe the coexistence of Asperger and Tourette syndromes (AS and TS) caused by discrete hypoxic-ischaemic necrosis of the midbrain, infrathalamic and thalamic nuclei, and striatum in an adolescent male with positive family history for tics and obsessive-compulsive disorder. Behavioural ratings, cognitive tests, and volumetric measurements of the basal ganglia were performed in the patient and five other individuals with AS-TS unassociated with MRI lesions. Cognitive deficits in attentional, executive, and visual-spatial domains were found both in the patient and control AS-TS group, though deficits were more severe in the former. MRI showed reduction of the left basal ganglia volume compared with the right in the patient, whereas the control group showed reduction of right basal ganglia volume compared with the left. It is suggested that individuals with a genetic predisposition to TS may develop AS and TS after involvement of midbrain and related components of basal ganglia-thalamocortical circuits normally implicated in the integration of emotional, cognitive, and motor functions.

We discuss an unsupervised technique for determining morpheme structure of words in an inflective language, with Spanish as a case study. For this, we use a global optimization (implemented with a genetic algorithm), while most of the previous works are based on heuristics calculated using conditional probabilities of word parts. Thus, we deal with complete space of solutions and do not reduce it with the risk to eliminate some correct solutions beforehand. Also, we are working at the derivative level as contrasted with the more traditional grammatical level interested only in flexions. The algorithm works as follows. The input data is a wordlist built on the base of a large dictionary or corpus in the given language and the output data is the same wordlist with each word divided into morphemes. First, we build a redundant list of all strings that might possibly be prefixes, suffixes, and stems of the words in the wordlist. Then, we detect possible paradigms in this set and filter out all items from the lists of possible prefixes and suffixes (though not stems) that do not participate in such paradigms. Finally, a subset of those lists of possible prefixes, stems, and suffixes is chosen using the genetic algorithm. The fitness function is based on the ideas of minimum length description, i.e. we choose the minimum number of elements that are necessary for covering all the words. The obtained subset is used for dividing the words from the wordlist. Algorithm parameters are presented. Preliminary evaluation of the experimental results for a dictionary of Spanish is given.