ABSTRACT Purpose: To evaluate the predictive value of initial intraocular pressure difference of the detached and fellow eyes of patients with complex rhegmatogenous retinal detachment on postoperative persistent ocular hypotony. Methods: This retrospective observational study included 538 eyes of 538 unilateral complex rhegmatogenous retinal detachment patients with a proliferative vitreoretinopathy grade of C-1 or higher, treated with silicone oil endotamponade following pars plana vitrectomy. The patients were divided into Group A (patients having silicone oil removal without ocular hypotony; n=504) and Group B (patients with persistent ocular hypotony following silicone oil removal [n=8, 23.5%] and with retained silicone oil [n=26, 76.5%] due to the risk of persistent ocular hypotony; total n=34). Ocular hypotony was defined as an intraocular pressure of <6 mmHg on two or more occasions. Patients’ demographics, including age, sex, and follow-up time, and ocular characteristics, including ocular surgical and trauma history, initial and final best-corrected visual acuity, intraocular pressure and initial intraocular pressure difference of the detached and fellow eyes, and anatomical success rates and postoperative complications, were retrospectively collected from the electronic patient files. Results: The initial intraocular pressure was significantly lower in the detached eyes of Group B than in Group A (8.3 ± 3.5 vs. 12.9 ± 3.3, p<0.001). Also, the initial intraocular pressure difference was significantly higher in Group B than in Group A (8.9 ± 3.2 vs. 2.2 ± 2.7mmHg, p<0.001). The receiver operating characteristic curve analysis showed that the cutoff value of the initial intraocular pressure difference was 7.5mmHg for the risk of persistent ocular hypotony. The most influential factors on postoperative persistent ocular hypotony in the binary logistic regression analysis were the initial intraocular pressure difference and the need for a retinectomy. Conclusion: In eyes with complex rhegmatogenous retinal detachment treated with pars plana vitrectomy and silicone oil tamponade, the initial intraocular pressure difference could be of value in predicting postoperative persistent ocular hypotony and could guide surgeons on the decision of silicone oil removal. Purpose Methods 53 C1 C 1 C- n=504 n504 n 504 n=8, n8 8 [n=8 23.5% 235 23 5 n=26, n26 26 [n=26 76.5% 765 76 n=34. n34 n=34 . 34 n=34) 6 < occasions Patients demographics age sex followup follow up time characteristics history bestcorrected best corrected acuity complications files Results 8.3 83 3 (8. 35 3. vs 129 12 9 12. 33 3.3 p<0.001. p0001 p p<0.001 0 001 p<0.001) Also 8.9 89 32 2 22 2. 27mmHg 7mmHg 2.7mmHg 75mmHg 7 5mmHg retinectomy Conclusion tamponade n=50 n50 50 n=8 [n= 23.5 n=26 n2 [n=2 76.5 n3 n=3 8. (8 p000 p<0.00 00 n=5 n5 n= [n 23. n=2 76. ( p00 p<0.0 p0 p<0. p<0 p<

To discover new bisamide compounds with insecticidal and fungicidal activities, 19 novel cyproflanilide derivatives containing 1,2,4-oxadiazole group were designed and synthesized according to the principle of biologically active factor splicing. Preliminary biological assay data indicated that the majority of target compounds demonstrated significant insecticidal activity against Lepidopteran pests. Meanwhile, compounds 5p and 5q showed 97.22 and 100% lethality against Tetranychus cinnabarinus at 400 mg L-1, which were better than cyproflanilide (41.11% at 400 mg L-1). In addition, it is exciting that we have achieved our initial goals as some of the target compounds exhibited both insecticidal and fungicidal activities. For instance, compounds 5b and 5c showed 59.26 and 74.07% fungicidal activities against Cucumber downy mildew at 400 mg L-1, as well as 100% insecticidal activity against Plutella xylostella and armyworm at 100 mg L-1. Compound 5h showed 100% insecticidal activity against armyworm at 10 mg L-1, and also displayed 66.67% fungicidal activity against Cucumber downy mildew at 400 mg L-1. The inhibition rate of compounds 5l and 5s against Cucumber downy mildew reached 88.89 and 96.30% at 400 mg L-1. This work showed the effectively fungicidal application of 1,2,4-oxadiazole group in bisamide compounds and provides insights for optimal structural design. 1 1,2,4oxadiazole 124oxadiazole oxadiazole 1,2,4 2 4 splicing pests Meanwhile p q 9722 97 22 97.2 40 L1, L1 L 1, L-1 41.11% 4111 41 11 (41.11 L1. . L-1) addition instance b c 5926 59 26 59.2 7407 74 07 74.07 1. h 6667 66 67 66.67 l s 8889 88 89 88.8 9630 96 30 96.30 design 4oxadiazole 124 1,2, 972 9 97. L- 41.11 411 (41.1 592 5 59. 740 7 0 74.0 666 6 66.6 888 8 88. 963 3 96.3 12 1,2 41.1 (41. 74. 66. 96. 41. (41 (4 (

ABSTRACT Introduction: Burnout results from chronic exposure to work-related stress and it is characterized by a reduction in professional efficacy, feelings of lack of energy/exhaustion, and negativity related to work activities. It has a higher incidence in professions with significant interpersonal contact and among caregivers, making doctors a vulnerable population. The Maslach Burnout Inventory questionnaire is considered the gold standard for measuring this disease. In 2014, quinquennial prevention was described, aiming to prevent harm to patients through strategies that reduce Burnout in doctors. Clinical Case: The case describes a 29-year-old woman, a physician in her final year of Residency in General and Family Medicine, who sought an urgent consultation due to feelings of physical and mental exhaustion, hopelessness, irritability, initial and middle insomnia, for the last three months, and hyperphagia, two months ago. She has requested a sick leave from work because “I can't stand working anymore. I need to sleep for a week”. She identified excessive workload at the Clinic, stemming from the demands of her medical residency, as the main cause. She feels unsupported by her colleagues and Training Supervisor and feels pressured to manage the medical agenda without adequate preparation. She reports occasional errors in prescriptions, leading her to feel the need to repeatedly review records and decisions she has made. She denies any appointment with her designated Work physician ever since she started her internship. Upon physical examination, she appeared slaughtered, with a depressed mood, tearful, restless, and with fleeting eye contact. Applying the Maslach Burnout Inventory: Section A- 34 points- high level; Section B- 28 points- high level; Section C- 25 points- high level. A work leave from work was issued, laboratory studies were requested, and fluoxetine 20 mg and trazodone 50 mg were initiated, along with psychotherapy. So far, the patient has been re-evaluated in three consultations, with organic causes ruled out, and in the last re-evaluation, her scores were: Section A- 20 points- moderate level; Section B- 5 points- low level; Section C- 39 points- moderate level. She reports a decrease in medical errors. She maintained the prescribed medication and psychotherapy. She declined to join a Balint group. A new re-evaluation was scheduled in six months. Discussion/Conclusion: This is a case of a General and Family Medicine Resident Physician, diagnosed with Burnout, who has managed to substantially improve her quality of life and job satisfaction, as well as her personal life, following the implementation of both pharmacological and non-pharmacological measures, along with workplace adjustments and the setting of boundaries. She has successfully reduced her perception of making medical errors, thereby improving the quality of healthcare provided to the patients. The long journey of recovery from Burnout makes the monitoring of this illness imperative not only by the patients Family Doctor and Psychologist, but also by the Occupational physician, targeting the improvement of the quality of life of the healthcare professionals in their occupational activity. This clinical case’s purpose is to address and raise awareness among professionals to the prevention of Burnout, particularly in Residents, promoting quinquennial prevention. It is important to note that only professionals who are fulfilled in their biopsychosocial sphere can provide quality care and significantly reduce medical errors.

RESUMO Introdução: O Burnout resulta da exposição crónica ao stress laboral e caracteriza-se por redução da eficácia a nível profissional, sentimentos de falta de energia/exaustão e negatividade relacionados com a atividade laboral. Tem maior incidência em profissões de elevado contacto com pessoas e em prestadores de cuidados, tornando os médicos uma população vulnerável. O questionário Maslach Burnout Inventory é considerado gold standard para a medição desta patologia. Em 2014 foi descrita a prevenção quinquenária, que pretende evitar o dano para o paciente, atuando no médico através de estratégias que visem a diminuição do Burnout. Caso Clínico: Descreve-se uma mulher de 29 anos, médica, no último ano da especialização em Medicina Geral e Familiar, que recorreu a consulta aberta por sensação de exaustão física e mental, sentimentos de desesperança, irritabilidade, insónia inicial e intermédia, com três meses de evolução e hiperfagia há dois meses. Solicitou certificado de incapacidade temporária para o trabalho, porque “já não aguento mais trabalhar. Preciso de dormir uma semana”. Aponta como principal etiologia o trabalho excessivo no Centro de Saúde, decorrente da exigência do internato médico. Sente-se pouco apoiada pelos colegas de equipa e orientador de formação e considera-se pressionada a gerir a agenda médica sem ter preparação para tal. Relata erros pontuais na prescrição médica, pelo que sente necessidade de rever várias vezes os registos efetuados e as atitudes tomadas. Nega ter sido convocada para qualquer consulta de Medicina do Trabalho desde que ingressou na especialidade. Ao exame objetivo, apresentava-se cabisbaixa, com humor deprimido, chorosa, inquieta e com contacto ocular fugaz. Aplicando o questionário atrás mencionado: Secção A - 34 pontos - nível elevado; Secção B - 28 pontos - nível elevado; Secção C - 25 pontos - nível elevado. Foi emitido o certificado de incapacidade temporária para o trabalho, solicitado estudo analítico e iniciada fluoxetina 20mg e trazodona 50mg, bem como psicoterapia. Até à data, a doente foi reavaliada em três consultas, foi excluída patologia orgânica e na última reavaliação apresentava os seguintes valores: Secção A- 20 pontos- nível moderado; Secção B- 5 pontos- nível baixo; Secção C- 39 pontos- nível moderado. Refere diminuição dos erros médicos. Manteve a medicação instituída, bem como a psicoterapia. Recusou o grupo Balint. Foi programada nova reavaliação em seis meses. Discussão/Conclusão: Trata-se de uma doente, Médica Interna em Medicina Geral e Familiar com o diagnóstico de Burnout, que conseguiu melhorar substancialmente a sua qualidade de vida e satisfação no trabalho e vida pessoal, após a implementação de medidas farmacológicas e não farmacológicas e também após alterações a nível laboral e imposição de limites. Conseguiu diminuir a perceção de erro médico, melhorando assim os cuidados de saúde prestados aos utentes. O longo percurso de recuperação desta doença torna fulcral o acompanhamento destes utentes pela equipa de Medicina do Trabalho, e não só pelo Médico de Família e Psicólogo, visando melhorar a qualidade de vida e saúde dos profissionais no âmbito da sua atividade laboral. Com este caso clínico pretende-se abordar e sensibilizar os profissionais para a prevenção do Burnout, em particular nos médicos internos, fomentando a prevenção quinquenária. De ressalvar que apenas profissionais realizados na sua esfera biopsicossocial conseguem proporcionar cuidados de qualidade e reduzir de forma importante o erro médico.

ABSTRACT Chondracanthus chamissoi is a commercially important algae used as raw material in direct human consumption and carrageenan extraction. This species is cultivated via vegetative propagation and through the production of spores; however, there is a lack of information on techniques for early-stage secondary attachment discs (SAD) formation under laboratory conditions. The present work aimed to determine the formation of DFS in function of different initial cultivation conditions, using Argopecten purpuratus shells as natural substrate for the SAD fixation, factorially varying the inoculum (washed algae and unwashed), the type of substrate (biologized; unbiologized) and the water (treated, untreated). Our results showed significant SAD formation of C. chamissoi in the treatments where the algae were washed and average of 1 - 21 SAD / shell was accounted. On the other hand, a significant increase in SAD is observed in the interaction of the treatments where the water was treated and untreated water or biologized and unbiologized. Therefore, we consider that cleaning protocols in the initial stages is essential for this type of cultivation by vegetative propagation.

RESUMEN Chondracanthus chamissoi es un alga de importancia comercial usada como materia prima en el consumo humano directo y en la extracción de carragenina. Esta especie es cultivada vía propagación vegetativa y/o mediante la producción de esporas; sin embargo, hay una falta de información sobre las técnicas para el manejo en etapas iniciales en la formación de discos de fijación secundaria (DFS) en laboratorio. El presente trabajo tuvo como objetivo determinar la formación de DFS en función de distintos tratamientos de cultivo inicial, empleando como sustrato natural valvas de Argopecten purpuratus para la fijación de los DFS, variando factorialmente el inóculo (alga lavada y sin lavar), el manejo del sustrato (biologizado y sin biologizar) y el agua (tratada y sin tratar). Los resultados mostraron una mayor formación de DFS de C. chamissoi en los tratamientos donde el alga era lavada y se contabilizaron un rango de 1 a 21 DFS / valva en promedio. Por otro lado, se observó un aumento significativo de DFS en la interacción de los tratamientos donde el agua era clorada y sin clorar o con sustrato biologizado y sin biologizar. Por lo tanto, se considera que realizar protocolos de limpieza en etapas iniciales es primordial para este tipo de cultivo por propagación vegetativa.

SUMMARY: The aim of this study was to determine the effects 12 weeks Step aerobics program on anthropometric characteristics and body composition in young females. A total of 94 female participants were randomly divided in two groups. The E group subsample consisted of 44 participants (20±0.4 years), who had three Step aerobics program trainings per week and the C group subsample consisted of 50 participants (20±0.6 years), who did not take part in any organized exercise program and only conducted their regular daily activities. The following measurements were used: Body height, body weight, waist size, abdomen skinfold, back skinfold, upper arm skinfold, upper leg skinfold, body fat percentage and muscle mass percentage. Upon the Step aerobics program implementation, there was a body fat reduction by 4.9 % and waist size by 7.7 %, while the muscle mass was increased by 9.4 %. Above mentioned skinfolds showed a reduction (p>0.05) at the final measurement compared to the initial one - abdomen by 25 %, upper leg by 23.7 %, back by 15.7 % and upper arm by 3.5 %. Likewise, there was a body fat percentage reduction by 2.1 % and BMI by 6.4 %. Based on the obtained results, we can conclude that the Step aerobics training is efficient in reducing subcutaneous fat tissue and viscelar fat, as well as in increasing muscle mass.

RESUMEN: El objetivo de este estudio fue determinar los efectos de un programa aeróbico Step de 12 semanas sobre las características antropométricas y la composición corporal en mujeres jóvenes. Un total de 94 mujeres participantes fueron divididas aleatoriamente en dos grupos. La submuestra del grupo E estuvo compuesta por 44 participantes (20 ± 0,4 años), que realizaron tres entrenamientos del programa aeróbico Step por semana y la submuestra del grupo C estuvo compuesta por 50 participantes (20 ± 0,6 años), que no participaron en ningún programa de ejercicio organizado y sólo realizaron sus actividades diarias habituales. Se utilizaron las siguientes mediciones: altura corporal, peso corporal, tamaño de cintura, pliegue cutáneo del abdomen, pliegue cutáneo de la espalda, pliegue cutáneo de la parte superior del brazo, pliegue cutáneo de la parte superior de la pierna, porcentaje de grasa corporal y porcentaje de masa muscular. Al implementar el programa aeróbico Step, hubo una reducción de la grasa corporal de un 4,9 % y del tamaño de la cintura de un 7,7 %, mientras que la masa muscular aumentó un 9,4 %. Los pliegues cutáneos mencionados anteriormente mostraron una reducción (p>0,05) en la medición final en comparación con la inicial: abdomen en un 25 %, parte superior de la pierna en un 23,7 %, espalda en un 15,7 % y parte superior del brazo en un 3,5 %. Asimismo, hubo una reducción del porcentaje de grasa corporal del 2,1 % y del IMC del 6,4 %. Con base en los resultados obtenidos, podemos concluir que el entrenamiento aeróbico Step es eficaz para reducir el tejido adiposo subcutáneo y la grasa visceral, así como para aumentar la masa muscular.

ABSTRACT. This study aimed to assess the impact of microalgal concentrations in diets on the settlement and metamorphosis stages of pediveliger larvae and spat of Crassostrea gigas oysters. Diets containing microalgal concentrations of 8, 12, and 16×104 cells mL-1 were administered for seven days during the larval settlement phase of pediveliger larvae. In the metamorphosis and postlarval cultivation phases, diets with microalgal concentrations of 8, 16, 24, and 32×104 cells mL-1 and a control group without food were tested for 14 and 21 days, respectively. Growth, yield, and survival were assessed every seven days. The diet comprised 30% Isochrysis galbana and 70% Chaetoceros muelleri microalgae. In the metamorphosis phase, the results revealed no significant differences in larval metamorphosis rate and survival across the tested diets. The concentrations exhibited similar survival in the spat with an initial average shell height of 0.657 ± 0.05 mm, with a significant difference only in growth. In the spat with an initial average shell height of 0.830 ± 0.12 mm, no differences in survival were observed among the tested concentrations. We concluded that diets of 12 and 16×104 cells mL-1 provide high rates of larval metamorphosis and spat yield during the larval settlement and metamorphosis phases. During the spat cultivation phases, diets of 32 and 24×104 cells mL-1 could optimize the cultivation time and yield of C. gigas spat in the laboratory. However, when considering survival alone, no advantage was found in providing a diet with a microalgal concentration above 8×104 cells mL-1 across all C. gigas oyster cultivation phases.

ABSTRACT During 2022, an investigation was conducted on 16 farms to evaluate management of pressurized irrigation systems in Portoviejo City. Factors that affected management were identified, such as; A) Presence of leaks or breaks in the irrigation system deployed on the field, B) Modifications done to the initial project constructions, C) Lack of knowledge regarding managing, operating and maintaining (AOM) irrigation system, D) Absence of a filtering system, E) Absence of a hydraulic design of the system or implementation of a hydraulic project, F) Absence of water collectors. Factor D) was the most frequent troubling issue, identified in 14 out of 16 evaluations. Quality of the system was tested based on hydraulic evaluation and calculations to determine the uniformity of the output following the established hydraulic system norms. As a result, Localized irrigation systems displayed the highest rating, with a maximum efficiency of 93.90%. Sprinkler systems had a wider range, from 29.90% to 73.10%, with an average of 52.33%, which was considered unacceptable. Factor A showed little variation in uniformity evaluations, while factor D, C and E showed greater disparity in uniformity values.

RESUMEN Durante 2022, se realizó una investigación en los sistemas de riego presurizados de 16 fincas del cantón Portoviejo para evaluar su gestión desde la etapa de proyección hasta la operación de los Sistemas. Los Factores limitantes más relevantes que afectaron la gestión fueron: A) Presencia de fugas o roturas en campo presentes en el sistema, B) Modificaciones constructivas al proyecto inicial, C) Desconocimiento de procedimiento de Administración, Operación y Mantenimiento (AOM) del sistema de riego, D) Ausencia de sistema de filtrado, E) Ausencia de proyecto o diseño hidráulico del sistema, F) Ausencia de obras de captación. El factor D) fue el problema más frecuente, identificado en 14 de 16 evaluaciones. La Calidad del Riego se evaluó a partir de evaluaciones hidráulicas y cálculo de los Coeficientes de Uniformidad establecidos en las Normas para estos sistemas. Se evidenció una mayor Uniformidad en los sistemas de riego localizado con un máximo del 93.90%. La Uniformidad en los sistemas de aspersión tuvo un rango amplio, de 29.90% a 73.10%, con una media de 52.33%, lo cual categoriza como inaceptable. El factor A mostró poca influencia en la Uniformidad, mientras que los factores limitantes D, C y E fueron los que mayor incidencia tuvieron en la calidad del Riego.

Abstract Introduction: the cultural dimension of health, now clearly acknowledged (WHO, 2017), remains insufficiently explored. Particularly, investigating the cultural influence on the effectiveness of health interventions is relevant since, insofar as when such interventions lack meaning from the target population's cosmovision or are not practical in their context, the effectiveness of those interventions may have a limited scope (Bautista-Gómez et al, 2022), creating the need for culturally adapted health interventions. Aim: tto understand how cultural adaptations have been designed and implemented, and how they have contributed to improving health outcomes in low and middle-income countries. Methods: the guiding question was designed following the PICo methodology. PubMED, Scopus, and Web of Science databases were reviewed, the descriptors were established based on the MeSH/DeSC registry, and inclusion and exclusion criteria were defined. The initial articles were selected based on the appearance of the descriptors in their title and abstract, and then a filtering process was carried out based on the full reading of the texts that led to 14 articles that met the established criteria, on which a thematic analysis was carried out. Results: it was evidenced that: a) interventions are designed based on 3 components: community participation, adjustment of content, and changes in the service delivery; b) aspects related to poverty, vulnerability, and deficiencies in the health system are the main barriers, whilst the inclusion of the community’s beliefs and customs, adaptation to their context, and articulation with the communities and local health institutions are the main facilitators; c) main outcomes are feasibility, effectiveness, improvement of disease’s knowledge and acceptability. Conclusions: cultural adaptation with ethnic groups in vulnerable settings is useful to ensure comprehensive health education and to promote behavioural change to improve mainly the effectiveness and acceptability of health interventions.

ABSTRACT Introduction: In patients with acute viral hepatitis A, cholestasis is intrahepatic and extrahepatic manifestations are infrequent. Objective: To present a patient with acute viral hepatitis A with extrahepatic manifestations, and rare neurological complications. Clinical case: A 21-year-old male patient with no epidemiological history of interest was admitted with acute abdominal pain in the right hypochondrium, vomiting and obstructive icterus. Initial results of hemochemical and imaging examinations suggested acute cholecystitis. Choledochal lithiasis was suspected in his clinical evolution. The patient presented with non-encephalopathic neurological symptoms, which resulted in pontine central myelinolysis, confirmed by magnetic resonance imaging. Endoscopic retrograde cholangiopancreatography was performed, which excluded an obstructive cause in the bile ducts. With the results of the viral markers for hepatitis A, B and C viruses, acute viral hepatitis type A (with cholestatic presentation) was diagnosed. The patient was treated with ursodeoxycholic acid with a favorable response to treatment and clinical evolution towards convalescence. Conclusions: Cholestatic acute viral hepatitis A may present with infrequent extrahepatic manifestations, such as acute alithiasic cholecystitis and neurological complications unrelated to liver disorders.

RESUMEN Introducción: En pacientes con hepatitis viral aguda tipo A, la colestasis es intrahepática y las manifestaciones extrahepáticas son infrecuentes. Objetivo: Presentar un paciente con hepatitis viral aguda tipo A colestásica, con manifestaciones extrahepáticas y complicaciones neurológicas, poco frecuentes. Caso clínico: Paciente masculino de 21 años de edad, sin antecedentes epidemiológicos de interés, que ingresó por un cuadro de dolor abdominal agudo en hipocondrio derecho, vómitos e ictericia obstructiva. Los resultados iniciales de exámenes hemoquímicos e imagenológicos sugerían una colecistitis aguda. En la evolución clínica se sospechó litiasis coledociana. Presentó un cuadro neurológico no encefalopático, que resultó mielinolisis central pontina, confirmada por resonancia magnética nuclear. Se realizó colangiopancreatografía retrógrada endoscópica, que descartó causa obstructiva en las vías biliares. Con los resultados de los marcadores virales para virus de hepatitis A, B y C, se diagnosticó hepatitis viral aguda tipo A (con presentación colestásica). Se trató con ácido ursodesoxicólico, hubo respuesta favorable al tratamiento y evolución clínica hacia la convalecencia. Conclusiones: La hepatitis viral aguda tipo A colestásica, es infrecuente que se presente con manifestaciones extrahepáticas, como la colecistitis aguda y complicaciones neurológicas no relacionadas con las alteraciones hepáticas.

Resumen Introducción: La administración del calostro a través de su absorción a nivel orofaríngeo estimula el tejido linfoide asociado a mucosas, proporcionando una barrera de protección local e inmunológica. Conocer la asociación de la administración de calostro orofaríngeo con la disminución de los índices inflamatorios. Material y métodos: Observacional, ambispectivo, analítico, recién nacidos < 32 semanas de gestación con riesgo de sepsis, se administró calostro orofaríngeo 0.2 ml cada 4 horas durante 5 días. se analizó índices inflamatorios, evolución clínica. Análisis estadístico: frecuencias, porcentajes, media y DS, coeficiente de contingencia y prueba de Kolmogorov Smirnov para la curva de distribución de los datos numéricos. Resultados: Fueron 50 pacientes, 33 (66%) femenino, 17 (34%) masculino, edad gestacional mediana 30-31 semanas (IC 95%), 19 pacientes cursaron con sepsis encontrando menor índice de positividad en la PCR, mediana de 0.5-0.6 (IC 95%) a los 5 días de administración de calostro vs 0.5-1.1 (IC 95%) como PCR inicial, analizando con Chi cuadrada con valor p = 0.13, mediante coeficiente de contingencia con p = 0.196, traduciendo asociación. Conclusión: La calostroterapia se asoció con menor índice de positividad en la PCR; clínicamente hacia la mejoría, en recién nacidos prematuros con riesgo de sepsis.

Abstract Background: The administration of colostrum through its absorption at the oropharyngeal level stimulates the mucosa-associated lymphoid tissue, providing a local immunological protection barrier. The study aimed to investigate the association of oropharyngeal colostrum administration with the reduction of inflammatory indices. Materials and methods: This was an observational, ambispective, analytical study of newborns < 32 weeks of gestation at risk of sepsis. Oropharyngeal colostrum was administered at 0.2 mL every 4 h for 5 days. Inflammatory indices were analyzed. Statistical analysis included frequencies, percentages, mean and Standard deviation, contingency coefficient, and Kolmogorov–Smirnov test for the distribution curve of the numerical data. Results: There were 50 patients, 33 (66%) female and 17 (34%) male, with a median gestational age of 30-31 weeks (95% confidence interval [CI]). Nineteen patients had sepsis. A lower positivity rate in C-reactive protein was found, with a median of 0.5-0.6 (95% CI) at 5 days of colostrum administration versus 0.5-1.1 (95% CI) as the initial C-reactive protein. Analysis with χ2 yielded a p = 0.13, and the contingency coefficient showed a p = 0.196, indicating an association. Conclusion: Oropharyngeal colostrum administration was associated with a lower C-reactive protein positivity rate and clinical improvement in premature newborns at risk of sepsis.

Abstract Background: Thermography is a tool for obtaining images by capturing different temperatures emitted by a body. Thermographic patterns are the result of obtaining images of different temperature ranges. Objective: To analyze thermographic patterns in the diagnosis and monitoring of chronic venous disease. Method: An observational, descriptive, longitudinal, and prospective study was carried out on 98 patients with chronic venous disease with thermography recording. Results: The initial average temperature was: 31.6 oC in C1, 33.2 oC in C2, 32.7 oC in C3, 32.4 oC in C4A, 32.1 oC in C4B, 32.9 oC in C4C, 32.6 oC in C5, and 34.2 oC in C6. Patients with conservative treatment classified as CEAP C1 recorded a decrease in temperature between 0.3 and 0.5 oC at four weeks, patients with surgical treatment recorded a decrease between 0.8 and 1 oC in 24 hours and four weeks later, a decrease between 1.4 and 1.6 oC. Patients treated with EVLA recorded a decrease between 0.8 and 1.4 oC in 24 hours and four weeks later a decrease between 1.8 and 2.6 oC. Conclusion: Patients in whom a drop in temperature between 31 and 32.6 oC was recorded, this was associated with improvement in symptoms after four weeks.

Resumen Antecedentes: La termografía es una herramienta para la obtención de imágenes por medio de la captación de diferentes temperaturas que emite un cuerpo. Los patrones termográficos son el resultado de la obtención de imágenes de los diferentes rangos de temperatura. Objetivo: Analizar patrones termográficos en el diagnóstico y seguimiento de la enfermedad venosa crónica. Método: Se realizó un estudio observacional, descriptivo, longitudinal y prospectivo de 98 pacientes con enfermedad venosa crónica con registro de termografía. Resultados: La temperatura inicial promedio fue: 31.6 oC en C1, 33.2 oC en C2, 32.7 oC en C3, 32.4 oC en C4A, 32.1 oC en C4B, 32.9 oC en C4C, 32.6 oC en C5 y 34.2 oC en C6. Los pacientes con tratamiento conservador clasificados como CEAP C1 registraron un descenso de temperatura entre 0.3 y 0.5 oC a las cuatro semanas, los pacientes con tratamiento quirúrgico registraron un descenso entre 0.8 y 1 oC en 24 horas y cuatro semanas posteriores un descenso entre 1.4 y 1.6 oC. Los pacientes tratados con EVLA registraron un descenso entre 0.8 y 1.4 oC en 24 horas y cuatro semanas posterior un descenso entre 1.8 y 2.6 oC. Conclusión: En los pacientes en quienes se registró un descenso de temperatura entre 31 y 32.6 oC, esto se asoció con mejoría de la sintomatología a las cuatro semanas.

School readiness assessments in South Africa still predominantly focus on the assessment of cognitive skills. The Emotional Social Screening Tool for School Readiness (E3SR) was developed to bridge the perceived gap in assessing emotional-social skills as a domain of school readiness. An emerging body of research reports exists on the psychometric properties and factor structure of the E3SR. An initial validation study recommended a 6-factor solution instead of the theoretical 9-factor model that was proposed in the development of the E3SR. The E3SR (Revised) was also reduced in length. We report here on a pilot study of which the aim was to establish the reliability and construct validity of the E3SR (Revised). A cross-sectional survey design was used to gather data from 9 pre-schools in Cape Town, South Africa. Pre-school teachers (n = 24) constituted the respondent group who completed the E3SR (Revised) screening questionnaires on Grade R learners (n = 394). Analysis was conducted on 321 completed screening questionnaires. With the data analysis we aimed to: a) summarise sample characteristics of teachers and children; b) establish reliability estimates; and c) establish construct validity and confirming the factor structure. Ethics clearance was given by the Humanities and Social Science Research Ethics Committee (HSSREC) of the University of the Western Cape. The study adhered to stipulated ethics requirements. Data failed to show multivariate normality; however, this violation of normality was expected and was theoretically supported. The sample size (n = 321) was sufficient for factor analysis of a 36-item scale. All subscales showed excellent reliability: Cronbach's alphas ranged between .939 and .971. CFA results demonstrated a good model fit. The E3SR (Revised) was found to be reliable and valid for use. The use of a rigorous methodological process including the decision-making matrix represent good research practice that can be used in instrument development across cultures.

BACKGROUND: Predicting severe Crohn's disease (SCD) can assist in planning risk reduction therapy for SCD, thereby improving disease outcomes OBJECTIVE: To determine the prevalence and predictors of SCD in a sample of South African (SA) patients METHODS: This was a retrospective chart review of patients with Crohn's disease (CD) attending the gastroenterology unit at a tertiary hospital in Durban, SA. Demographic and clinical variables at diagnosis of CD were collected and analysed for statistical associations with SCD (defined as the presence of >1 of the following over the course of CD: complex perianal disease, colonic resection, >2 small-bowel resections, a single small-bowel resection >50cm, or construction of a definitive stoma). The prognostic utility of statistically significant variables was investigated by establishing their sensitivity, specificity and predictive values for SCD RESULTS: The study sample consisted of 93 patients. The rate of SCD was 64.5%, with 63.3% of patients developing SCD within 1 year of CD diagnosis. Ileocolonic location (p=0.046) and penetrating disease at initial diagnosis of CD (p=0.021) were statistically associated with SCD. The sensitivity, specificity, positive predictive value and negative predictive value of ileocolonic location for SCD were 72.7%, 47.4%, 66.7% and 54.6%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of penetrating disease for SCD were 85.7%, 41.7%, 30.0% and 91.0%, respectively CONCLUSION: Most patients with CD developed SCD within 1 year of their CD diagnosis. CD with a penetrating phenotype at diagnosis is a good predictor for the development of SCD and should be further investigate

Abstract Pastures that include annual and perennial grasses can play a strategic role in increasing the sustainability of temperate livestock systems. However, the impacts of the competition between annual and perennial genetically improved forage species on pastures has scarcely been studied. We evaluated the early dynamics of tillering, carbon partitioning and both intra- and interspecific competition in – or between – an annual (Bromus willdenowii; prairie grass; Bw) and a perennial (Dactylis glomerata; orchard grass; Dg) C3 grass species. We sowed 24 0.18 m2 microplots in May 2008. Each microplot constituted an experimental unit and contained five sowing lines spaced 0.175 m apart. On three of the lines, we sowed different combinations of the mentioned grasses, while on the two lines between them, we sowed red clover (Trifolium pratense). We randomly applied a factorial array of eight treatments—2 species (Dg vs. Bw) × 2 types of competition (intra vs. interspecific) × 2 levels of winter nitrogen fertilization (0 vs. 170 kg of N ha-1)—designed in three complete random blocks. Fertilization did not have any significant effect on any species. The evaluation period lasted 109 days after sowing (das), separated into three phases (0-53 das, 59-90 das and 90-109 das). The variables recorded were aerial biomass (leaves, sheets and senescent material), root biomass and tiller density per species. As expected, annual Bw inhibited the growth of perennial Dg at the latest stage of establishment but surprisingly promoted it at the earliest stage. This work suggested that a low initial density of an annual species should optimize the initial facilitating effect of the annual species on the perennial species with its subsequent inhibitory effect.

Resumen Las gramíneas anuales y perennes pueden desempeñar un papel estratégico en el aumento de la sostenibilidad de los sistemas ganaderos de zonas templadas. Sin embargo, el impacto de la competencia entre especies forrajeras genéticamente mejoradas anuales y perennes en los pastos apenas ha sido estudiado. En este trabajo evaluamos la dinámica temprana del macollaje y la partición de carbono y la competencia intraespecífica e interespecífica en, o entre, una especie de pasto C3 anual (Bromus willdenowii; pasto de la pradera; Bw) y perenne (Dactylis glomerata; pasto de huerto; Dg). Sembramos 24 microparcelas de 0,18 m2 en mayo de 2008. Cada microparcela constituyó una unidad experimental y contenía cinco líneas de siembra espaciadas 0,175 m entre sí. En tres de las líneas sembramos diferentes combinaciones de las gramíneas mencionadas, mientras que en las dos líneas intermedias sembramos trébol rojo (Trifolium pratense). Aplicamos aleatoriamente un conjunto factorial de ocho tratamientos: 2 especies (Dg vs. Bw) × 2 tipos de competencia (intra vs. interespecífica) × 2 niveles de fertilización con nitrógeno invernal (0 vs. 170 kg de N ha-1), diseñado en tres bloques completos al azar. La fertilización no tuvo ningún efecto significativo en ninguna especie. El período de evaluación tuvo una duración de 109 días después de la siembra (dds), separados en tres fases (0-53 dds, 59-90 dds y 90-109 dds). Las variables registradas fueron biomasa aérea (hojas, láminas y material senescente), biomasa de raíces y densidad de macollos por especie. Como se esperaba, Bw inhibió el crecimiento de Dg en la última etapa de establecimiento, pero sorprendentemente lo promovió en la etapa más temprana. Este trabajo sugirió que una baja densidad inicial de una especie anual debería optimizar el efecto facilitador inicial de la especie anual sobre la especie perenne con su posterior efecto inhibidor.

Resumo O linfoma anaplásico de grandes células cutâneo primário (C-ALCL) é um linfoma não-Hodgkin raro com expressão do antígeno CD30 e que não possui manifestações extracutâneas no momento do diagnóstico. O surgimento de pápulas ou nódulos solitários, localizados principalmente no tronco e nas extremidades, são característicos da doença. Neste relato de caso, discorre-se sobre paciente do sexo feminino, 58 anos, com lesão em panturrilha direita de aspecto nodular com crescimento acelerado. Na biópsia, anatomopatológico evidenciou neoplasia maligna de células linfoides/epitelioides. Os aspectos morfológicos, associados ao perfil imunoistoquímico, revelaram desordem linfoproliferativa CD30 positiva em pele, compatível com C-ALCL. Após primeira exérese, surgimento de novas lesões dolorosas em placa de coloração violácea, com realização de nova biópsia. Foi realizada radioterapia durante quatro semanas e as lesões regrediram, porém, recidivaram cerca de um ano após o tratamento. Houve indicação de um novo ciclo de radioterapia para a paciente. A excepcionalidade do C-ALCL justifica o desenvolvimento desse relato de caso, a fim de salientar a importância de se considerar este diagnóstico como uma possibilidade nos linfomas cutâneos de grandes células.

Abstract Primary cutaneous anaplastic large-cell lymphoma (C-ALCL) is a rare subtype of non-Hodgkin lymphoma, CD30 positive that does not exhibit extracutaneous manifestations at the time of diagnosis. The emergence of solitary papules or nodules, on the trunk and extremities, characterizes the disease. This case reports a 58-year-old female who presented with a rapidly enlarging nodule on her right calf. The biopsy revealed a malignant neoplasm of large cells. The morphological features, combined with the immunohistochemical profile, revealed a CD30-positive and anaplastic lymphoma kinase-negative lymphoproliferative disorder, consistent with C-ALCL. Shortly after the first excision, new lesions manifested in violaceous papules and nodules, and a new biopsy was performed, confirming the initial diagnosis. The patient underwent radiotherapy for 4 weeks and the lesions regressed but recurred about a year after. The patient is currently under treatment. The main goal is to emphasize the importance of considering this diagnosis as a possibility in large-cell cutaneous lymphomas.