Arousal and Executive Alterations in Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in childhood and can significantly affect a child’s personal and social development and academic achievement. Taking into account the model of attentional networks proposed by Posner et al., the aim of the present study was to review the literature regarding two main explicative models of ADHD, i.e., the inhibition model and the cognitive-energetic model, by discussing behavioral and neurological evidence of both models and the limitations of each model. The review highlights evidence that favors the energetic model and points to an unstable arousal as a potential pathogenetic factor in ADHD

Gestión de deportistas extremos

Se diseñó y desarrolló un sistema de localización de deportistas de montaña para abreviar la relación espacio-temporal en caso de accidentes, búsqueda, acciones de control, entre otras situaciones. Es una herramienta innovadora factible de implementarse utilizando la interconexión de redes inalámbricas e Internet. Consiste en un dispositivo portable con un GPS y un módulo Zigbee, que transmite la posición a través de una red de nodos a la estación receptora en la base de operaciones. Alli se interconecta la red de radio con Internet a traves de un gateway, que se encarga de reenviar los datos a una plataforma integral de gestión alojada en un servidor web. El aspecto global del sistema está dado por la plataforma, ya que al estar “en la nube”, permite el acceso virtual desde cualquier dispositivo que tenga conexión a Internet, para poder visualizar la información disponible asignada a cada usuario de la plataforma

Evaluation of SYBR Green real time PCR for detecting SARS-CoV-2 from clinical samples

The pandemic caused by SARS-CoV-2 has triggered an extraordinary collapse of healthcare systems and hundred thousand of deaths worldwide. Following the declaration of the outbreak as a Public Health Emergency of International Concern by the World Health Organization (WHO) on January 30th, 2020, it has become imperative to develop diagnostic tools to reliably detect the virus in infected patients. Several methods based on real time reverse transcription polymerase chain reaction (RT-qPCR) for the detection of SARS-CoV-2 genomic RNA have been developed. In addition, these methods have been recommended by the WHO for laboratory diagnosis. Since most of these protocols are based on the use of fluorogenic probes and one-step reagents (cDNA synthesis followed by PCR amplification in the same tube), these techniques can be difficult to perform given the limited supply of reagents in low- and middle-income countries. In order to develop an inexpensive SARS-CoV-2 detection protocol using available resources we evaluated the SYBR Green based detection of SARS-CoV-2 to establish a suitable assay. To do so, we adapted one of the WHO recommended TaqMan-based one-step real time PCR protocols (from the University of Hong Kong) to SYBR Green. Our results indicate that SYBR-Green detection of ORF1b-nsp14 target represents a reliable cost-effective alternative to increase the testing capacity.ANII: FCE_1_2019_1_156157ANII: FCE_1_2019_1_15593

Antimicrobial consumption at the hospital level in latin america. Similarities and differences according to each country

One of the main problems for health service around the world is the antimicrobial resistance (AMR). Objective: to describe the antimicrobial consumption (AMC) at hospital level in Latin American countries and compare the amount and type of antibiotics usage among them in order to guide local public health actions towards AMR prevention.Design: A descriptive study of antimicrobial consumption at hospital level among six health institution in Latin America with an analytical comparative stage. Antimicrobials included corresponded to the WHO Anatomical Therapeutic Chemical (ATC) classification system subgroups: J01, A07A and P01AB. Methods: WHO GLASS methodology was applied for surveillance of AMC, using the ATC classification based on Defined Daily Dose (DDD) and DDD/100 hospital discharges as standard unit of measurement. Antimicrobials consumed were also classified according to the WHO AccessWatch-Reserve (AWaRe) classification. Results: The quantitative data, measured in DDD/100 hospital discharges, showed a wide range of consumption (182.48 - 2260.95). Qualitative analysis according to the AWaRe classification also showed a wide range in terms of consumption of Access (38.14% - 73.64%), Watch (24.93% - 60 .53%) and Reserve (0.31% - 3.55%) groups expressed as a percentage of the total consumption.Conclusion: Great heterogeneity and arbitrariness exist in the selection of antimicrobials for hospital use. Although this situation might be explained on local antimicrobial resistance, the history of prescription, local pharmaceutical promotion, and pharmacological education of health professional in each country, particular habits and distinctive culture may justify the differential consumption patterns observed in each institution in this study.Fil: Marin, Gustavo Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Giangreco, Luis. Universidad Nacional de La Plata; ArgentinaFil: Hernández, Yago. Universidad Nacional de La Plata; ArgentinaFil: Dorati, Cristian. Universidad Nacional de La Plata; ArgentinaFil: Mordujovich Buschiazzo, Perla. Universidad Nacional de La Plata; ArgentinaFil: Bay, María Rosa. Hospital Interzonal General de Agudos San Roque - Mb Gonnet ; Gobierno de la Provincia de Buenos Aires;Fil: Gonzalez, Gladys María Adriana. Hospital Interzonal General de Agudos San Roque - Mb Gonnet ; Gobierno de la Provincia de Buenos Aires;Fil: Aldunate, Francisca. Pontificia Universidad Católica de Chile; ChileFil: López Peña, Mónica. Ministerio de Salud y Protección Social; ColombiaFil: Martínez Parra, Adriana. Ministerio de Salud y Protección Social; ColombiaFil: Ching Fung, Shing Mi. Costa Rican social security; Costa RicaFil: Alfonso Arvez, María José. Ministry of Public Health and Social Welfare; ParaguayFil: Mantilla Ponte, Hilda. General Directorate of Medicines, Supplies and Drugs; PerúFil: Marin, Danini. General Directorate of Medicines, Supplies and Drugs; PerúFil: Rojas, Robin. General Directorate of Medicines, Supplies and Drugs; PerúFil: Castro, José Luis. Pan-American Health Organization; Estados Unido

Factors associated with the need of parenteral nutrition in critically ill patients after the initiation of enteral nutrition therapy

Background and aimsDespite enteral nutrition (EN) is the preferred route of nutrition in patients with critical illness, EN is not always able to provide optimal nutrient provision and parenteral nutrition (PN) is needed. This is strongly associated with gastrointestinal (GI) complications, a feature of gastrointestinal dysfunction and disease severity. The aim of the present study was to investigate factors associated with the need of PN after start of EN, together with the use and complications associated with EN.MethodsAdult patients admitted to 38 Spanish intensive care units (ICUs) between April and July 2018, who needed EN therapy were included in a prospective observational study. The characteristics of EN-treated patients and those who required PN after start EN were analyzed (i.e., clinical, laboratory and scores).ResultsOf a total of 443 patients, 43 (9.7%) received PN. One-third (29.3%) of patients presented GI complications, which were more frequent among those needing PN (26% vs. 60%, p = 0.001). No differences regarding mean energy and protein delivery were found between patients treated only with EN (n = 400) and those needing supplementary or total PN (n = 43). Abnormalities in lipid profile, blood proteins, and inflammatory markers, such as C-Reactive Protein, were shown in those patients needing PN. Sequential Organ Failure Assessment (SOFA) on ICU admission (Hazard ratio [HR]:1.161, 95% confidence interval [CI]:1.053–1.281, p = 0.003) and modified Nutrition Risk in Critically Ill (mNUTRIC) score (HR:1.311, 95% CI:1.098–1.565, p = 0.003) were higher among those who needed PN. In the multivariate analysis, higher SOFA score (HR:1.221, 95% CI:1.057–1.410, p = 0.007) and higher triglyceride levels on ICU admission (HR:1.004, 95% CI:1.001–1.007, p = 0.003) were associated with an increased risk for the need of PN, whereas higher albumin levels on ICU admission (HR:0.424, 95% CI:0.210–0.687, p = 0.016) was associated with lower need of PN.ConclusionA higher SOFA and nutrition-related laboratory parameters on ICU admission may be associated with the need of PN after starting EN therapy. This may be related with a higher occurrence of GI complications, a feature of GI dysfunction.Clinical trial registrationClinicalTrials.gov: NCT03634943

Antimicrobial Consumption in Latin American Countries: First Steps of a Long Road Ahead

Background: Irrational antimicrobial consumption (AMC) became one of the main global health problems in recent decades. Objective: In order to understand AMC in Latin-American Region, we performed the present research in 6 countries. Methods: Antimicrobial consumption (J01, A07A, P01AB groups) was registered in Argentina, Chile, Colombia, Costa Rica, Paraguay, and Peru. Source of information, AMC type, DDD (Defined Daily Doses), DID (DDD/1000 inhabitants/day), population were variables explored. Data was analyzed using the Global Antimicrobial Resistance and Use Surveillance System (GLASS) tool. Results: Source of information included data from global, public, and private sectors. Total AMC was highly variable (range 1.91-36.26 DID). Penicillin was the most consumed group in all countries except in Paraguay, while macrolides and lincosamides were ranked second. In terms of type of AMC according to the WHO-AWaRe classification, it was found that for certain groups like “Reserve,” there are similarities among all countries. Conclusion and Relevance: This paper shows the progress that 6 Latin-American countries made toward AMC surveillance. The study provides a standardized approach for building a national surveillance system for AMC data analysis. These steps will contribute to the inclusion of Latin-America among the regions of the world that have periodic, regular, and quality data of AMC.Facultad de Ciencias Médica

Jurisprudencia. Observaciones a la lei de 15 de octubre de 1856 sobre procedimiento judicial en asuntos de menor cuantía, comparandola con la misma lei que rije en España i con otras análogas.

Observaciones a la lei de 15 de octubre de 1856 sobre procedimiento judicial en asuntos de menor cuantía, comparandola con la misma lei que rije en España i con otras análogas. Memoria de prueba de don Luis Aldunate en su exámen para optar el grado de Licenciado en Leyes, leída el 12 de Diciembre de 1863