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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).

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. With treatment for breast cancer, women treated may present significant sensory abnormalities in the upper extremity. However, there are no conclusive studies that have evaluated pressure pain thresholds (PPT) in the shoulder of postoperated women for breast cancer. The aim of this study was to compare PPT in the shoulder, stress, anxiety, depression symptoms, and quality of sleep among postoperated women for breast cancer (PO group) and asymptomatic women of shoulder pain (control group). Methods. 40 women participated ( n = 20 , PO group, age: average ± standard deviation , 49.2 ± 8.3 years; body mass index (BMI): 27.5 ± 3.0 kg/cm2; surgery time: 22.2 ± 34.4 months; n = 20 , control group, 46.9 ± 8.1 years; BMI: 26.8 ± 3.5 kg/cm2). The PPT was evaluated with a digital algometer at 32 points in the shoulder region and one control point in the tibialis anterior. Stress, anxiety, and depression were evaluated with the Depression, Anxiety and Stress Scale 21 (DASS-21) and the quality of sleep by the Pittsburgh Sleep Quality Index. Results. Significant differences were observed over 1.5 kgf/cm2 in 33 points evaluated ( p < 0.01 ) with a small to high effect size (Cliff’s delta range = 0.16 ; 0.92) and higher levels of anxiety and stress in the PO group (anxiety: median [first; third quartile], 5[3; 12.5]; stress: 9.7 ± 4.7 (7.8; 11.8)) in comparison with the control group (anxiety: 2.5[1; 4.8]; stress: 6.7 ± 3.31 (5.2; 8.3), ( p < 0.05 )). No significant differences were found between the groups in depression and sleep quality ( p > 0.05 ). Conclusion. Postoperated women for breast cancer present hyperalgesia in the shoulder anterior and posterior region, low PPT in the tibialis anterior, and higher levels of stress and anxiety compared to the control group.

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.

Resumen Las medidas corporales en ovinos son útiles como indicador de tipo y función, permiten mejorar la selección. Se conocen estudios biométricos en ovinos que, relacionan la importancia de estas medidas con algunas variables productivas. El objetivo del presente estudio fue evaluar el desarrollo testicular y su relación con los parámetros morfométricos en ovinos de pelo colombiano, en el municipio de Sampués, Sucre, Colombia. Se utilizaron doce ovinos machos (destetados) nacidos entre febrero y abril del 2014, sobre los cuales se tomaron las siguientes medidas: circunferencia escrotal (CE), peso corporal (PC), altura a la grupa (AG), alzada a la cruz (AC) y longitud testicular derecha e izquierda (LTD y LTI), cada veintiocho días hasta los doce meses de edad. Para CE se efectuó análisis de regresión múltiple (RM) del PC; AG; AC; LT. Para describir la variación del LT, el modelo incluyó solo las variables PC; AG; AC. El grado de asociación entre las variables estudiadas, se realizó por medio de correlación Pearson. La circunferencia escrotal mostró una correlación alta con los parámetros morfométricos evaluados. Dentro del análisis de RM, el PC influyó en la variable CE (p

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.