The debate on militarisation of domestic security around the world Is mostly normative and conceptual, but there are few estimates of the direct impact of the use of military forces in public security tasks. This paper assesses the impact on local homicides of the 2019 deployment of the South African National Defence Force in police station areas in Cape Town, a measure taken to stem gang violence. It uses an interrupted time-series approach to estimate the effect by comparing murder counts in relevant precincts before and during the deployment, compared to precincts with similar murder rates and socioeconomic characteristics. Results show that there was an apparent initial reduction in the month in which the measure was taken, but the presence of the army was not associated with a significant decrease in homicides over the deployment period.

RESUMO OBJETIVO Analisar o perfil sociodemográfico e as condições de saúde autorrelatadas por solicitantes de refúgio no Rio de Janeiro. MÉTODOS Estudo transversal de dados secundários, coletados de formulários de solicitação de refúgio preenchidos em 2016 e 2017, na Cáritas Arquidiocesana do Rio de Janeiro (Cáritas-RJ). Foram realizadas análises descritivas e calculadas frequências absolutas, relativas e intervalos de 95% de confiança. RESULTADOS Foram identificados formulários preenchidos por 818 solicitantes de refúgio, originários de 49 países diferentes, dos quais 126 (20,3%) eram apátridas, 510 (62,7%) do sexo masculino, 797 (97,4%) adultos, com idade média de 30,5 anos, 551 (73,5%) solteiros, 340 (44,1%) com ensino superior e 27 (4,0%) desempregados no país de origem antes da vinda para o Brasil. Entre os motivos declarados para solicitação de refúgio, destacaram-se o temor de perseguição por opinião política, violação de direitos humanos e risco de tortura. Para chegar ao Brasil, 629 (80,5%) viajaram somente de avião. Em relação às condições de saúde, 216 (29,0%) afirmaram ter algum sintoma, doença ou agravo em saúde, sendo as mais frequentes dores, problemas de visão, doenças infecciosas (incluindo HIV/aids) e hipertensão. Apenas 15 indivíduos (2,2%) relataram estar em algum tratamento médico ou psicológico; 42 (6,0%) relataram deficiências visuais, 14 (2,0%) relataram deficiências físicas e 4 (0,6%) deficiências auditivas. CONCLUSÕES Diferentemente de outros países, onde migrantes forçados de baixo grau de instrução entram por vias clandestinas marítimas ou terrestres, os solicitantes de refúgio residentes no Rio de Janeiro entre 2016 e 2017, eram, em sua maioria, adultos com ensino superior que migraram usando transporte aéreo. Apresentavam condições de saúde sensíveis à atenção primária que poderiam ser tratadas via acesso aos serviços públicos da atenção primária em saúde.

ABSTRACT OBJECTIVE To analyze the sociodemographic profile and self-reported health conditions of asylum-seekers in Rio de Janeiro. METHODS A cross-sectional study of secondary data, collected from asylum claims forms completed in 2016 and 2017, at Cáritas Arquidiocesana do Rio de Janeiro (Cáritas-RJ). Descriptive analyses were performed and absolute and relative frequencies and 95% confidence intervals were calculated. RESULTS Claims completed by 818 asylum-seekers from 49 different countries were identified, of whom 126 (20.3%) were stateless, 510 (62.7%) were male, 797 (97.4%) were adults, with a mean age of 30.5 years, 551 (73.5%) were single, 340 (44.1%) had higher education, and 27 (4.0%) were unemployed in their country of origin before coming to Brazil. Fear of persecution for political opinion, violation of human rights, and risk of torture stood out among the reasons stated for requesting asylum. To reach Brazil, 629 (80.5%) traveled only by plane. Regarding health conditions, 216 (29.0%) reported having some symptom, disease or health problem, the most frequent being pain, vision problems, infectious diseases (including HIV/AIDS), and hypertension. Only 15 individuals (2.2%) reported being in some medical or psychological treatment; 42 (6.0%) reported visual impairments, 14 (2.0%) reported physical impairments and 4 (0.6%) hearing impairments. CONCLUSIONS Unlike other countries, where forced migrants with a low level of education enter clandestinely by sea or land, asylum-seekers residing in Rio de Janeiro between 2016 and 2017 were mostly adults with higher education who migrated using air transport. They had primary care-sensitive health conditions that could be treated via access to public primary health care services.

RESUMO OBJETIVO Analisar o perfil sociodemográfico e as condições de saúde autorrelatadas por solicitantes de refúgio no Rio de Janeiro. MÉTODOS Estudo transversal de dados secundários, coletados de formulários de solicitação de refúgio preenchidos em 2016 e 2017, na Cáritas Arquidiocesana do Rio de Janeiro (Cáritas-RJ). Foram realizadas análises descritivas e calculadas frequências absolutas, relativas e intervalos de 95% de confiança. RESULTADOS Foram identificados formulários preenchidos por 818 solicitantes de refúgio, originários de 49 países diferentes, dos quais 126 (20,3%) eram apátridas, 510 (62,7%) do sexo masculino, 797 (97,4%) adultos, com idade média de 30,5 anos, 551 (73,5%) solteiros, 340 (44,1%) com ensino superior e 27 (4,0%) desempregados no país de origem antes da vinda para o Brasil. Entre os motivos declarados para solicitação de refúgio, destacaram-se o temor de perseguição por opinião política, violação de direitos humanos e risco de tortura. Para chegar ao Brasil, 629 (80,5%) viajaram somente de avião. Em relação às condições de saúde, 216 (29,0%) afirmaram ter algum sintoma, doença ou agravo em saúde, sendo as mais frequentes dores, problemas de visão, doenças infecciosas (incluindo HIV/aids) e hipertensão. Apenas 15 indivíduos (2,2%) relataram estar em algum tratamento médico ou psicológico; 42 (6,0%) relataram deficiências visuais, 14 (2,0%) relataram deficiências físicas e 4 (0,6%) deficiências auditivas. CONCLUSÕES Diferentemente de outros países, onde migrantes forçados de baixo grau de instrução entram por vias clandestinas marítimas ou terrestres, os solicitantes de refúgio residentes no Rio de Janeiro entre 2016 e 2017, eram, em sua maioria, adultos com ensino superior que migraram usando transporte aéreo. Apresentavam condições de saúde sensíveis à atenção primária que poderiam ser tratadas via acesso aos serviços públicos da atenção primária em saúde.

ABSTRACT OBJECTIVE To analyze the sociodemographic profile and self-reported health conditions of asylum-seekers in Rio de Janeiro. METHODS A cross-sectional study of secondary data, collected from asylum claims forms completed in 2016 and 2017, at Cáritas Arquidiocesana do Rio de Janeiro (Cáritas-RJ). Descriptive analyses were performed and absolute and relative frequencies and 95% confidence intervals were calculated. RESULTS Claims completed by 818 asylum-seekers from 49 different countries were identified, of whom 126 (20.3%) were stateless, 510 (62.7%) were male, 797 (97.4%) were adults, with a mean age of 30.5 years, 551 (73.5%) were single, 340 (44.1%) had higher education, and 27 (4.0%) were unemployed in their country of origin before coming to Brazil. Fear of persecution for political opinion, violation of human rights, and risk of torture stood out among the reasons stated for requesting asylum. To reach Brazil, 629 (80.5%) traveled only by plane. Regarding health conditions, 216 (29.0%) reported having some symptom, disease or health problem, the most frequent being pain, vision problems, infectious diseases (including HIV/AIDS), and hypertension. Only 15 individuals (2.2%) reported being in some medical or psychological treatment; 42 (6.0%) reported visual impairments, 14 (2.0%) reported physical impairments and 4 (0.6%) hearing impairments. CONCLUSIONS Unlike other countries, where forced migrants with a low level of education enter clandestinely by sea or land, asylum-seekers residing in Rio de Janeiro between 2016 and 2017 were mostly adults with higher education who migrated using air transport. They had primary care-sensitive health conditions that could be treated via access to public primary health care services.

Resumo: Embora alguns estudos sugiram que a natureza das interações com a comunidade influencie o risco percebido de vitimização criminal, apenas algumas pesquisas têm testado essa associação no Brasil. Utilizando quatro pesquisas brasileiras de vitimização, realizamos modelos logísticos para examinar se os laços sociais e a coesão social estão associados à percepção de risco e medo do crime. Os resultados mostraram que apenas em alguns contextos a coesão social manifestou associação com o medo do crime. Especificamente, dois componentes da coesão social podem ser relevantes para esse fim: confiar nos vizinhos e obter ajuda; e a capacidade de distinguir vizinhos de estranhos nas ruas.

Abstract: While some studies suggest that the nature of one's interactions with the community influences one's perceived risk of criminal victimization, only a few pieces of research have tested this association in Brazil. Using four previously existing Brazilian victimization surveys, we conducted logistic models to examine whether social ties and social cohesion are associated with perceived risk and fear of crime. The results showed that only in some contexts did social cohesion manifest an association with fear of crime. Specifically, two components of social cohesion may be relevant for this purpose: trusting neighbours and getting help; and the ability to distinguish neighbours from strangers in the street.

Resumen: Aunque algunos estudios sugieren que la naturaleza de las interacciones comunitarias influye en el riesgo percibido de victimización criminal, solo unos pocos estudios han probado esta asociación en Brasil. Utilizando cuatro encuestas brasileñas de victimización, realizamos modelos logísticos para examinar si los lazos sociales y la cohesión social están asociados con el riesgo percibido y el miedo al crimen. Los resultados mostraron que solo en algunos contextos se asociaba la cohesión social con el miedo al crimen. Específicamente, dos componentes de la cohesión social pueden ser relevantes para este propósito: confiar en los vecinos y obtener ayuda; y la capacidad de distinguir vecinos de extraños en las calles.

Resumen El triaje permite la priorización de pacientes según su urgencia médica, y de ahí que este artículo se proponga realizar un modelo estadístico correlacionado con la mortalidad para generar alertas desde el triaje con una cohorte prospectiva de 6438 adultos que ingresaron a urgencias del Hospital Universitario San Ignacio del 1/3/2018 al 28/2/2019. Se dividieron aleatoriamente los datos en entrenamiento y prueba. Sobre los datos de entrenamiento se ejecutó una regresión logística bivariada entre triaje y mortalidad y, luego, una regresión logística multivariada. Después, el modelo se redujo mediante pruebas de razón de verosimilitud. En los datos de prueba se realizaron áreas bajo la curva (ROC, por sus siglas en inglés) para el cálculo de punto de corte, que se evaluó con medidas de asociación. Hubo ROC para los modelos realizados y se halló el modelo triaje con una ROC de 0,82; “reducido”, con una ROC de 0,90, y “Edad + sistólica”, con una ROC de 0,87, sin diferencia significativa. Se seleccionó el “reducido” con una sensibilidad de 0,869; una especificidad de 0,842; una VPP de 0,066, y una VPN de 0,998. El punto de corte se seleccionó con un árbol de decisiones según las variables significativas, que encontró una mayor mortalidad en pacientes triaje 1-2, con TAS menor de 117 mmHg y mayores de 58 años. El modelo final podría funcionar como tamización para generar alarmas de mortalidad en triaje iguales.

Abstract Triage allows priorization of patients according to their medical urgency. Multiple triage systems have been developed in the world. We propose a statistical model using triage to create an alert system related to mortality rates that could be used as a screening tool during triage. A prospective cohort of 6438 adults who were admitted to the emergency room of Hospital Universitario San Ignacio between 03/01/2018 and /02/28/2019 was used. The data was divided into “training” and “testing”. A bivariate logistic regression between triage and mortality using “training” data was done. Afterwards, a multivariate logistic regression was downgraded using the previous information. In order to find the set point, an Area Under the Curve (ROC) was calculated using the “testing data”. The efficiency was evaluated using measures of association. Three different ROC models were created: “triage” which showed an ROC-0.82, “reduced” with an ROC-0.90 and “age+systolic” with an ROC-0.87, thereby not exhibiting significant difference. The reduced model was chosen, presenting sensitivity of 0.869, specificity of 0.842, PPV 0.062, and NPV 0.998. A set point was chosen according to significant variables, demonstrating a higher mortality rate in those classified as triage 1-2, those over 58 years old, and those presenting with SBP below 117mmHg. Our final model could be useful as an additional screening measure for patients within the same triage classification as an alert system for mortality.

SUMMARY: Introduction: Since 1972, the Joint Committee on Infant Hearing (JCIH) in the USA has proposed the early audiological evaluation of every children born with certain risk factors (RF), because of these RF have been associated frequently with hearing loss. After universal hearing screening became a reality, it was also indicated that newborns with permanent postnatal or delayed-onset hearing loss (DH) RF should be followed. Methods: The results obtained after 25 years of application of a neonatal auditory screening program at the HCU in Valladolid (Spain) are analyzed, looking for the performance obtained with the follow-up of children with RF of DH. Results: We evaluated 27,649 newborns and detected 0.25 per thousand with DH. This represents 8% of congenital hearing loss and 0.65% of newborns with RF. The family history of hearing loss and the presence of malformations or syndromes that associate hearing loss are in our environment the RF with higher prevalence of DH. DH usually is bilateral and neurosensorial, with a high percentage (23%) of mild degree. Discussion/Conclusions: The monitoring of risk factors proposed by the JCIH as DH indicators is neither effective nor economically profitable. Given the importance of DH, we consider that the follow-up of children with high prevalence of RF should be maintained, in addition to this, we realized that half of them have not associate RF, for this reason, we think that a neonatal study of genetic tests for hearing loss should be carried out together with citomegalovirus screening.:

RESUMEN: Introducción: En 1972 el Joint Committee on Infant Hearing (JCIH) de EE. UU., propone la evaluación audiológica precoz de los niños que nacen con determinados factores de riesgo (FR), al comprobarse que asocian hipoacusia con mayor frecuencia. Tras hacerse realidad el cribado auditivo universal, se sigue indicando la conveniencia de un seguimiento de los recién nacidos (RN) con FR de hipoacusia permanente posnatal o de inicio tardío (HPP). Material y métodos: Tras aplicar durante 25 años un programa de cribado auditivo neonatal, en el Hospital Clínico Universitario (HCU) de Valladolid (España), hemos analizado la incidencia de los FR y el rendimiento obtenido con el seguimiento de los niños que presentaban FR de hipoacusia tardía al nacimiento. Resultados: De los 27.649 RN evaluados, detectamos un 0,25 por mil de HPP, que representa el 8% de las hipoacusias congénitas y el 0,65% de los RN con FR. En nuestro medio, los FR con mayor prevalencia de HPP son, los antecedentes familiares de hipoacusia y la presencia de malformaciones o síndromes que asocian hipoacusia. La HPP es fundamentalmente bilateral, de tipo neurosensorial y en un elevado porcentaje (23%) de grado leve. Discusión y Conclusiones: El seguimiento de los factores de riesgo propuestos por el JCIH como indicadores de HPP, no resulta ni eficaz ni económicamente rentable; sin embargo, dada la importancia de la HPP, consideramos que en el momento actual debería mantenerse el de aquellos FR que tengan una prevalencia elevada de hipoacusia y dado que, la mitad de las hipoacusias posnatales no asocian FR, añadir a este seguimiento, la realización de un estudio neonatal de pruebas genéticas de hipoacusia junto al análisis de la presencia de citomegalovirus.

Resumo Investiga-se a capacidade institucional das cortes de contas, como formadoras e aplicadoras de precedentes e súmulas, para responder: é possível uma aproximação profícua com o regime de padrões decisórios do Código de Processo Civil-CPC, assim como um diálogo produtivo com a Lei de Introdução às Normas de Direito Brasileiro-LINDB? O objetivo do trabalho é analisar, a partir das capacidades institucionais abstrata e concreta dos tribunais de contas, a aptidão para formação e aplicação de padrões decisórios. Para tanto, elegeu-se a teoria interpretativista de Ronald Dworkin, especialmente porque acredita-se que os precedentes se entrelaçam em uma trama discursiva, na qual cada intérprete se coloca no compromisso de analisar as decisões passadas, de forma reflexiva, para decidir no presente e, ao mesmo tempo, antecipando também os sentidos para o futuro da decisão, que se faz no aqui e agora. A hipótese é de que os tribunais de contas têm aptidão potencial para formar e aplicar precedentes e súmulas, decorrente do exercício de suas competências constitucionais. Observou-se, que o desenvolvimento da capacidade institucional concreta, para formar e aplicar padrões decisórios controladores, permite uma melhor compreensão da relação entre as decisões dos tribunais de contas e as judiciais. Trata-se de trabalho teórico, de análise jurídica do tema, valendo-se do método dedutivo, partindo-se de uma análise geral para se chegar à capacidade institucional dos tribunais de contas para formação e aplicação de padrões decisórios.

Abstract The institutional capacity of the courts of audit as makers and applicants of precedents and summulas (restatement of case law) is investigated to answer the following: is it possible a mutually beneficial approach to the decision standards regimen from the Civil Procedure Code-CPC, as well as a productive dialogue with the Law of Introduction to the Brazilian Legal Statutes (Lei de Introdução às normas do Direito Brasileiro-LINDB)?. The objective of the work is to analyze, from the abstract and concrete institutional capacities of the audit courts, the aptitude for the formation and application of decision-making standards. To do so, Ronald Dworkin’s interpretive theory was chosen, especially because it is believed that precedents are intertwined in a discursive plot, when every single interpreter commits to analyzing past decisions, in a reflexive way, to decide in the present and, at the same time, anticipating the directions for the future of the decision, which is made in the here and now. The hypothesis is that the audit courts have the potential ability to form and apply precedents and summulas, arising from the exercise of their constitutional powers, but that it is also necessary to develop a concrete capacity to form and apply controlling decision patterns. In this way, it allows for a better understanding of the relationship between the decisions of the audit courts and the judicial ones. It is a theoretical work, of legal analysis of the subject, using the deductive method, starting from a general analysis to reach the institutional capacity of audit courts for the formation and application of decision-making standards.

Resumen Objetivo: Describir las características de la atención de los pacientes menores de 16 años con apendicitis aguda llevados a apendicectomía entre enero del 2014 y mayo del 2019. Metodología: Estudio observacional descriptivo retrospectivo de los registros de pacientes con apendicitis aguda durante 5 años. Resultados: 257 registros cumplieron los criterios de inclusión. El promedio de edad de los pacientes fue 9,5 años; el tiempo promedio de diagnóstico fue 7 horas desde el ingreso y fueron llevados a cirugía en las primeras 6 horas desde el diagnóstico. La mayoría fueron apendicitis no complicadas con un bajo porcentaje de complicaciones posoperatorias. Al 6 % de los pacientes se les realizó cultivo de líquido peritoneal intraoperatorio sin que esto implicara cambios significativos en la conducta. Conclusiones: El éxito en el manejo de la apendicitis aguda en los pacientes pediátricos del hospital del estudio refleja una atención de alta calidad. El uso de ampicilina sulbactam como manejo empírico muestra resultados favorables con una baja de tasa de complicaciones. El cultivo de líquido peritoneal no generó cambios en la conducta médica o quirúrgica. Dado lo anterior, es viable un uso razonable de los recursos, a fin de brindar una atención de alta calidad con resultados óptimos y menor costo para el sistema de salud.

Abstract Objective: To describe the characteristics of the care of patients under 16 years old with acute appendicitis taken to appendectomy between January 2014 and May 2019. Methodology: Retrospective descriptive observational study of the records of patients with acute appendicitis over 5 years. Results: 257 records met the inclusion criteria. The average age of the patients was 9.5 years. The average diagnosis time from admission was 7 hours and they were taken to surgery in the first 6 hours after diagnosis. The majority were uncomplicated appendicitis with a low percentage of postoperative complications. Six percent of patients underwent intraoperative peritoneal fluid culture without this involving significant changes in medical behavior. Conclusions: The success in the management of acute appendicitis in pediatric patients of hospital reflects high quality care. The use of ampicillin sulbactam as an empirical management shows favorable results with a low complication rate. Peritoneal fluid culture did not generate changes in medical or surgical behavior. Given the above, it is feasible to make reasonable use of resources, providing high quality care with optimal results and a lower cost to the health system.

Resumen Introducción: El sugammadex permite revertir cualquier tipo de bloqueo inducido por rocuronio de forma rápida y segura. El bloqueo neuromuscular más frecuente es el moderado, en el cual dosis inferiores a las recomendadas por la industria podrían revertirlo completamente. Objetivo: Evaluar la efectividad de la mitad de la dosis de sugammadex recomendada por la industria para revertir un bloqueo neuromuscular moderado. Métodos: Ensayo clínico de fase IV en un unico centro que incluyó a 34 pacientes intervenidos de colecistectomía laparoscópica. Se realizó anestesia general intravenosa con monitoreo aceleromiográfico del bloqueo neuromuscular. Tras la intervención, el bloqueo se revirtió con la totalidad o con la mitad de la dosis de sugammadex recomendada para bloqueos moderados, utilizando una jeringa ciega. Resultados: Las características de los pacientes de los dos grupos fueron similares. La media de tiempo de recuperación fue de 3,6 ± 1,7 minutos para el grupo de estudio y de 3,1 ± 1,7 minutos para el grupo de control (p = 0,42). La reversión del bloqueo se completó con una dosis única de sugammadex en todos los pacientes. Hubo una correlación lineal importante entre la profundidad del bloqueo y el tiempo de recuperación. Conclusión: El monitoreo transquirúrgico es esencial para individualizar la dosis del agente de bloqueo neuromuscular. Para revertir un bloqueo moderado bajo monitoreo neuromuscular, una dosis de 1mg/kg es suficiente e igualmente segura y efectiva.

Abstract Background: Sugammadex has made it possible to reverse any type of rocuronium-induced block quickly and safely. The most frequent neuromuscular blockade is the moderate one where doses smaller than those recommended by the industry could get a full reversal. Objective: We aimed to evaluate the effectiveness of half the industry recommended dose of sugammadex to reverse a moderate neuromuscular block. Methods: Unicenter phase IV clinical trial that included 34 patients undergoing laparoscopic cholecystectomy. Intravenous general anesthesia was induced, with acceleromyographic monitoring of the neuromuscular block. After the intervention, the block was reversed with all or half the dose of sugammadex recommended for moderate blocks, using a blinded syringe. Results: Patient characteristics of the 2 groups were similar. Mean time to recovery was 3.6± 1.7minutes for the study group and 3.1 ± 1.7minutes for the control group (P=0.42). Reversal of the block was complete with a single dose of sugammadex in all patients. There was an important linear correlation between depth of block and time to recovery. Conclusion: Intraoperative monitoring is essential to allow us to individualize the dose of the neuromuscular blocking agent. To reverse a moderate block under neuromuscular monitoring, a dose of 1 mg/kg is sufficient in most cases and is equally safe and effective.

RESUMEN OBJETIVO: Describir y analizar las características clínicas, funcionales, nutricionales y sociales de pacientes con demencia avanzada (DA), hospitalizados a cargo del servicio de geriatría del Hospital Universitario San Ignacio (HUSI) y su relación con desenlaces hospitalarios, comparando con demencia no avanzada. MÉTODOS: Se realizó un estudio observacional, descriptivo en pacientes ancianos hospitalizados por el servicio de geriatría del HUSI, con revisión retrospectiva de historias clínicas en el perioro de tiempo entre enero del 2016 y diciembre del 2017. La variable dependiente fue DA. Se realizó análisis univariado, bivariado y multivariado. RESULTADOS: De 1091 pacientes con demencia, 606 tenían diagnóstico de DA. La mediana de edad fue de 86 años y la prevalencia de mujeres fue mayor (57,3 %). En los sujetos con DA, comparados con el grupo de demencia, se encontró mayor porcentaje de malnutrición (91,1 %), úlceras por presión (26,2 %), delirium (67,2 %%), polifarmacia (68,3 %%), estancia hospitalaria (5 días), complicaciones (10,6 %%) y mortalidad (16,9 %%). Se encontró una mayor asociación de malnutrición con DA (OR = 2,80, IC = 1,94-4,06, p < 0,00), así mismo con polifarmacia (OR = 1,41, IC = 1,07-1,86, p = 0,012), delirium (OR = 2,24, IC = 1,72-2,92, p < 0,00), úlceras por presión (OR = 3,75, IC = 2,45-5,73, p < 0,00) y mortalidad (OR = 2,21, IC = 1,42-3,44, p < 0,00). DISCUSIÓN: La avanzada edad de nuestros pacientes puede ser determinante en el alto porcentaje de demencia encontrada. La DA condiciona a mayor compromiso en el curso de diferentes desenlaces hospitalarios como malnutrición, polifarmacia, delirium, úlceras y mortalidad. Lo anterior hace necesaria una valoración geriátrica integral del paciente anciano con demencia para mejorar el curso clínico de la hospitalización.

SUMMARY OBJECTIVE: To describe and analyze the clinical characteristics, functionality, nutritional, and social aspects in patients with Advance Dementia (AD), and to hospitalized in the geriatric unit in the Hospital Universitario San Ignacio (HUSI) and it how it is related with hospital outcomes, compare with no advanced dementia. METHODS: A cross-sectional study was conduct, in patient hospitalized in the geriatric unit in the HUSI, with a retrospective review of electronic medical charts from January of 2016 to December 2017. The dependent variable was AD, a univariate, bivariate and multivariate analysis was made. RESULTS: 1091 patients had dementia, 606 with AD, the median age was 86 years and the women prevalence were (57.3 %) higher than men. In the AD group, compared with those with dementia, had high percentage of malnutrition (91.1 %%), pressure ulcers (26.2 %%), delirium (67.2 %%), polypharmacy (68.3 %%), longer hospital admission (median of 5 days vs 4 days), medical complication (10.6 %%), and mortality (16.9 %%). We found a higher association with malnutrition with AD (OR = 2.80, CI = 1.94-4.06, p < 0.00), polypharmacy (OR = 1.41, CI = 1.07-1.86, p = 0.012), delirium (OR = 2.24, CI = 1.72-2.92, p < 0.00), pressure ulcers (OR = 3.75, CI = 2.455.73, p < 0.00) and mortality (OR = 2.21,CI = 1.42-3.44, p < 0.00). DISCUSSION: The advance aged in our patients, might be a determinant in the high percentage of dementia that we found. AD is an entity that predispose to higher clinical outcomes as malnutrition, polypharmacy, delirium, pressure ulcers and mortality. As previously shown there is a need for a comprenhensive geriatric assessment in elderly with dementia, to improve hospital outcomes.

Abstract Introduction: as we face the worrisome burden of disease resulting from the increase in sedentary habits and excess weight in children, multidisciplinary interventions are recommended to promote healthy dietary and physical activity habits in the entire family. The Bicisalud programme has been developed in accordance with these recommendations. The main objective of this article was to present the outcomes of this programme. Methods: we conducted a quasi-experimental study where we analysed the variables at three time points: before, right after, and three months after the intervention. Between 2016 and 2017, a total of 47 children with overweight or obesity participated in a complex programme revolving around group bicycle rides in the countryside led by sports and health specialists. The programme also included educational activities on nutrition and exercising, among other topics. The primary outcome variable was physical fitness in its three main dimensions. The secondary outcome variables included anthropometric values, habits and physical self-perception. Results: the programme achieved a statistically significant improvement in the three dimensions of physical fitness and in waist circumference in the assessment made immediately after completion of the programme. This effect was only sustained in the assessment after the three months of summer holidays in flexibility. The changes in the remaining variables were not statistically significant at any time point. Conclusions: Bicisalud achieved a moderate but short-lived improvement in the primary outcome variables. There is evidence suggesting that longer programmes promoting the regular use of bicycles may be more effective in preventing and managing sedentary lifestyles, excess weight and their consequences.

Resumen Introducción: ante la preocupante carga de enfermedad, debida al aumento del sedentarismo y exceso de peso infantil, se recomiendan afrontamientos multidisciplinares inductores de hábitos saludables de alimentación y ejercicio en toda la familia. Siguiendo estas recomendaciones se ha desarrollado el programa Bicisalud. La presentación de sus resultados es el principal objetivo de este trabajo. Metodología: diseño cuasi experimental con análisis de variables en tres momentos: antes, tras la intervención y tres meses después. Entre 2016 y 2017 un total de 47 niños con sobrepeso u obesidad participaron en un programa complejo basado en salidas grupales en bicicleta, guiados por especialistas del deporte y salud, por entornos rurales. Se incluían actividades educativas sobre alimentación y ejercicio, entre otras. La variable principal fue la aptitud física a través de tres de sus principales factores. Las secundarias incluían aspectos somatométricos, de hábitos y autoconcepto. Resultados: se consiguió una mejora estadísticamente significativa de los tres factores de la variable aptitud física y del perímetro abdominal en la evaluación inmediata al final de las actividades. Dicho efecto solo permaneció para la flexibilidad en la valoración realizada tras los tres meses de vacaciones. Los cambios en el resto de las variables no resultaron estadísticamente significativos en ningún momento. Conclusiones: Bicisalud produjo una mejora moderada pero no mantenida en las principales variables de estudio. Programas más prolongados, que incluyan la promoción del uso habitual de la bicicleta, tienen indicios de mayor efectividad para la prevención y tratamiento del sedentarismo, el exceso de peso y sus consecuencias.

ABSTRACT The magnetic response, coercive force and magnetic induction, in Fe-10at.% Si, Fe-6at.% Al-9at.% Si and Fe-4at.% Al-8at.% Ge alloys as a function of the annealing temperature was determined and correlated to the microstructural state. The microstructural characterization was made through differential thermal analysis, mechanical spectroscopy and neutron thermodiffraction studies. It has been determined that the increase in the order degree and the decrease in the mobility of structural defects lead to a deterioration of the magnetic quality of the alloys above detailed.

Abstract: The deterioration of the ecosystem forest puts rain water storage and flow at risk. The State of Coahuila comprises 450 000 hectares of forests that serve as a rainwater catchment area. Continuous monitoring of the hydrological variables of the watershed is essential for make a better use of this resource, particularly where there is climatic uncertainty. The objective of this study was to document the hydrological behavior of a small experimental forest and rangeland watershed by monitoring the variables and through the use of a hydrological model with spatially semi-distributed parameters of the Experimental Watershed of INIFAP in Saltillo, Coahuila. The hydrological response of the watershed was analyzed based on the historical precipitation records quantified for 2016. The WIN TR-55 model was used to explain the absence of runoff in terms of the semi-distributed parameters of the watershed. The precipitation data for 2016 showed that source areas of surface runoff are the mountainsides, and that the bottom (the valley) acts as a buffer area that restricts its flow towards the runoff gauging station. According to the model simulations, a daily precipitation of over 65 mm is required in order to record surface flow at the runoff gauging station.

Resumen: El deterioro de los ecosistemas forestales pone en riesgo el almacenamiento y flujo del agua de lluvia. En el estado de Coahuila, existen 450 mil hectáreas de superficie forestal, las cuales son un área de captación de agua de lluvia. Para lograr un mayor aprovechamiento de este recurso es indispensable el monitoreo continuo de variables hidrológicas en las cuencas, principalmente, donde existe incertidumbre climática. El objetivo del presente estudio fue documentar el comportamiento hidrológico de una pequeña cuenca de uso ganadero-forestal, a partir del monitoreo de variables y el empleo de un modelo hidrológico de parámetros semidistribuidos espacialmente de la Cuenca Experimental del INIFAP, ubicada en el municipio Saltillo, Coah. Con registros históricos, cuantificados durante 2016 de precipitación pluvial se realizó el análisis de la respuesta hidrológica. Se utilizó el modelo WIN TR-55 para explicar la ausencia de escurrimiento, en función de parámetros semidistribuidos. Con los datos pluviométricos de 2016, se observó que las áreas de aportación de flujo superficial son las laderas y que la parte baja de la misma (el valle) actúa como un área buffer que restringe el escurrimiento superficial hacia la estación de aforo. En función a las simulaciones con el Modelo WIN TR - 55, se requiere una lámina precipitada diaria (máxima en 24 horas) mayor a 65 mm para registrar flujo superficial en la estación de aforo.

Resumo O artigo trata da relação da violência letal com a desigualdade, sob dois pontos de vista. O primeiro é a desigualdade do risco de ser vítima de homicídio entre diversos tipos de pessoas. Nesse sentido, o perfil das vítimas preferenciais da violência letal no Brasil, confirmado pelos últimos dados disponíveis, é muito claro: jovens negros de sexo masculino. O segundo ponto de vista é a relação entre desigualdade de renda e taxa de homicídios. Esta relação depende da unidade de análise escolhida. Os dados analisados aqui, utilizando um modelo multivariado para estimar os fatores associados às taxas municipais de homicídio, mostram que é a renda dos mais pobres e não a desigualdade de renda que está diretamente relacionada à incidência da violência letal. Esses resultados, que contradizem os obtidos na literatura quando se comparam países, sublinham a importância da eleição da unidade de análise.

Abstract This paper deals with the relation between lethal violence and inequality under two approaches. The first one is the inequality in the risk of becoming a victim of homicide among various kinds of people. In this sense, the profile of victims of lethal violence in Brazil is very clear: young black males. The second approach concerns the relation between income inequality and homicide rates. This relation depends on the unit of analysis. Data analysed here, using a multivariate model to estimate factors associated to municipal homicide rates, reveal that it is the average income of the poorest sections of the population rather than income inequality that is directly related to lethal violence. These results contradict those obtained in the literature when countries are compared to each other, which underlines the importance of the choice of unit of analysis.

Abstract: Background: Multiple hereditary osteochondromatosis is characterized by the growing of benign cartilaginous tumors in form of exostosis, predominately in the metaphysis of long bones. It is described with a prevalence of 1/50,000 individuals. Case reports: This article presents the clinical information and its autosomal dominant inheritance pattern where exotoxin genes (EXT gene family) were affected in a three-member family with multiple hereditary osteochondromatosis. The three patients showed altered arcs of movement of wrists, shoulders and ankles. Clinical diagnosis was confirmed with radiology and malignancy was ruled out in all patients. Conclusions: This disease requires frequent medical evaluation, surgical bone correction when the normal function is involved, surveillance for malignant transformation, and genetic counseling.

Resumen: Introducción: La osteocondromatosis múltiple hereditaria se caracteriza por el crecimiento de múltiples tumores benignos, cartilaginosos, que crecen en forma de exostosis predominantemente en las metáfisis de los huesos largos. Se ha descrito una prevalencia de 1/50,000 individuos. Casos clínicos: Se presenta la información clínica y patrón hereditario autosómico dominante, en el que están afectados los genes de exostosina (familia de genes EXT) en tres miembros de una familia con osteocondromatosis múltiple. Los tres pacientes han presentado alteraciones en los arcos de movimiento de muñecas, hombros o tobillo. El diagnóstico clínico fue confirmado con estudios radiológicos y no hay evidencia de que las lesiones se hayan malignizado. Conclusiones: Esta entidad requiere de supervisión periódica, corrección quirúrgica de las deformaciones que limiten la función, vigilancia de la transformación maligna y consejería genética.