Neuropsychological assessement of 5 to 12 year-old children with bilingual schoolar education

Como parte de un proyecto más amplio, en el que se pretende obtener datos normativos de diferentes muestras de niños con diferentes tipos de instrucción y de diferente nivel socioeconómico, se evaluaron 176 niños de ambos sexos con edades de entre cinco y doce años y del nivel socioeconómico medio. Los niños recibían instrucción escolar bilingüe. Se formaron cuatro grupos de edad (5-6, 7-8, 9-10 y 11-12) y se dividieron por sexo. Se les aplicaron las siguientes pruebas: Prueba de Denominación de Boston, Prueba de Memoria Verbal Secuencial, Prueba de Fichas, Prueba de Figuras Superpuestas, Prueba de Fluidez Verbal (FAS) en las categorías fonológica y semántica. También se hizo una revisión ortográfica de la ejecución de los niños en la categoría fonológica. Se encontraron diferencias entre los grupos de edad en todas las pruebas, pero no se encontraron diferencias entre los sexos en ninguna de las pruebas. Se comparan los resultados con los reportados por Ardila y Rosselli (1994). Se continuarán las siguientes fases del proyecto en las que se evaluarán niños de diferente nivel socioeconómico y con instrucción escolar monolingüe.Palavras-chave: evaluación neuropsicológica; neuropsicología infantil; datos normativos. As a part of a wider study, 176 children were evaluated through a neuropsychological battery. Children were 5 to 12 year-old (both sex), they were in medium socio-economic level and they were in a bilingual school. Children were divided by sex, and by age group (5-6, 7-8, 9-10 and 11-12 yearold). Neuropsychological battery included the Boston Naming Test, Token Test, Superimposed Figures (Poppelreuter type), a Verbal Fluency Test (FAS Test) and a Sequential Verbal Memory Test. No differences were found between sex in any of the applied tests. There was a significative difference among age groups for all the tests that were applied. Results are compared with some other reported (Ardila & Rosselli, 1994). This study will continue in evaluation of another socioeconomic levels and scholar education.Keywords: neuropsychological assessment; children neuropsychology; normative data

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Evaluación neuropsicológica de una muestra de niños de 5 a 12 años con instrucción escolar bilingüe

Como parte de un proyecto más amplio, en el que se pretende obtener datos normativos de diferentes muestras de niños con diferentes tipos de instrucción y de diferente nivel socioeconómico, se evaluaron 176 niños de ambos sexos con edades de entre cinco y doce años y del nivel socioeconómico medio. Los niños recibían instrucción escolar bilingüe. Se formaron cuatro grupos de edad (5-6, 7-8, 9-10 y 11-12) y se dividieron por sexo. Se les aplicaron las siguientes pruebas: Prueba de Denominación de Boston, Prueba de Memoria Verbal Secuencial, Prueba de Fichas, Prueba de Figuras Superpuestas, Prueba de Fluidez Verbal (FAS) en las categorías fonológica y semántica. También se hizo una revisión ortográfica de la ejecución de los niños en la categoría fonológica. Se encontraron diferencias entre los grupos de edad en todas las pruebas, pero no se encontraron diferencias entre los sexos en ninguna de las pruebas. Se comparan los resultados con los reportados por Ardila y Rosselli (1994). Se continuarán las siguientes fases del proyecto en las que se evaluarán niños de diferente nivel socioeconómico y con instrucción escolar monolingüe. Palavras-chave: evaluación neuropsicológica; neuropsicología infantil; datos normativos

Especificidades de la reacción emocional en adolescentes y adultos jóvenes: un estudio psicofisiológico

El paso de una edad a otra depende de múltiples cambios en el desarrollo de procesos cognitivos y neurológicos; en el caso de habilidades afectivas y sociales, se ha demostrado que la adolescencia es una edad crítica para tomar decisiones, auto-monitorearse y realizar análisis social afectivo-emocional. El objetivo del estudio fue comparar la reacción emocional entre adolescentes y adultos jóvenes. El estudio se llevó a cabo en dos muestras, constituidas de un grupo control de adultos jóvenes y un grupo experimental de adolescentes, a los que se les solicitó responder el Manikí de Auto-Evaluación (SAM), en cinco opciones, medidas en escala Likert. Se les solicitó elegir entre tres pares de variables: agradable vs desagradable, activado vs anhedónico y controlado vs en-control. Se midió la reactividad autónoma en derivaciones: frecuencia cardiaca, conductancia de la piel, temperatura y la respuesta muscular abdominal. No se observaron diferencias estadísticamente significativas en la reacción autonómica entre grupos de edad. El análisis del Modelo Lineal General de Respuesta Conductual (GLM) mostró diferencias significativas en las respuestas entre los diferentes tipos de estímulos, observadas en la reactividad autónoma y las respuestas asignadas; sin embargo, no se encontraron diferencias significativas. Los datos indican un nivel similar en la reacción de reconocimiento y respuesta autónoma de valencia emocional entre adolescentes y adultos jóvenes. Estos hallazgos pueden indicar la misma reacción de autónoma para ambos grupos estudiados, lo cual conduce a la hipótesis sobre el desarrollo posterior en el procesamiento de afectividad en las estructuras principales nerviosas superiores, pero no en la reacción de dispositivo periféric

Modified Wisconsin Card Sorting Test (M-WCST): Normative data for Spanish-speaking pediatric population

OBJECTIVE: To generate normative data for the Modified Wisconsin Card Sorting Test (M-WCST) in Spanish-speaking pediatric populations. METHOD: The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the M-WCST as part of a larger neuropsychological battery. Number of categories, perseverative errors, and total error scores were normed using multiple linear regressions and standard deviations of residual values. Age, age 2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. RESULTS: The final multiple linear regression models indicated main effects for age on all scores, such that the number of categories correct increased and total number of perseverative errors and total number of errors decrease linearly as a function of age. Age 2 had a significant effect in Chile, Cuba, Ecuador, and Spain for numbers of categories; a significant effect for number of perseverative errors in Chile, Cuba, Mexico, and Spain; and a significant effect for number of total errors in Chile, Cuba, Peru, and Spain. Models showed an effect for MLPE in Cuba (total errors), Ecuador (categories and total errors), Mexico (all scores), Paraguay (perseverative errors and total error), and Spain (categories and total errors). Sex affected number of total errors for Ecuador. CONCLUSIONS: This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate way to interpret the M-WCST with pediatric populations. © 2017 - IOS Press and the authors. All rights reserved.Trabajo de investigació

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave : the global UNITE-COVID study

Purpose To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%-50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care