Clinical Study Hearing and Neurological Impairment in Children with History of Exchange Transfusion for Neonatal Hyperbilirubinemia

The objective was to determine frequency of sensorineural hearing loss (SNHL), identified by abnormal threshold in evoked potentials, absence of otoacoustic emissions and behavioral responses, auditory neuropathy (AN) (absence of evoked potentials, with preservation of otoacoustic emissions), and neurological comorbidity in infants with hyperbilirubinemia (HB) treated with exchange-transfusion (ET). From a total of 7,219 infants, ET was performed on 336 (4.6%). Inclusion criteria were fulfilled in 102; 234 children did not meet criteria (182 outside of the study period, 34 did not have complete audiological evaluation, and 18 rejected the followup). Thirty-five children (34%) were born at-term and 67 (66%) were preterm. Children had a mean age of 5.5 ± 3.9 years. Main causes of ET were Rh isoimmunization in 48 (47%), ABO incompatibility in 28 (27.5%), and multifactorial causes in 26 (25.5%). Fifteen (15%) children presented with SNHL. Preterm newborns presented more often with SNHL. Indirect bilirubin level was higher in children with SNHL (22.2 versus 18.7 mg/dL, = 0.02). No cases of AN were documented. An increased risk of neurologic sequelae was observed in children with SNHL. In conclusion, we disclosed a high frequency of SNHL in children with neonatal HB and ET and neurological alterations. No cases of AN were observed

DISEÑO DE ESTRUCTURAS CELULARES BASE ACERO INOXIDABLE CON PROPIEDADES SIMILARES A LAS DEL HUESO HUMANO (CELLULAR STRUCTURE DESIGN BASE STAINLESS STEEL WITH SIMILAR PROPERTIES LIKE THE HUMAN BONE)

Se presentan propuestas de diseño y fabricación de estructuras celulares triplemente periódicas (TPMS), sobre giróides tipo Schoen simple y doble. El objetivo de este trabajo es poder fabricar estructuras auto-soportadas con características similares al hueso humano. Las estructuras celulares tipo giroide se pueden diseñar a voluntad para dar características de densidad y resistencia en los niveles del hueso trabecular humano. En el presente trabajo se fabricaron estructuras TPMS empleando la tecnología de sinterización de metales por láser (DMLS), empleando polvo de acero inoxidable 17-4. El diseño se realizó mediante Matlab. Se realizaron pruebas de compresión obteniendo resultados en módulo elástico (400 – 850 MPa) similares a los del hueso trabecular. Modificando desde la ecuación el parámetro t y el número de celdas, gracias a esto, fue posible controlar la densidad (1.17 - 1.99 g/cm3) y el módulo de Young resultantes de las piezas fabricadas.Palabras Clave: Prótesis, estructuras celulares, giroide, biocompatibilidad, impresión 3D. AbstractDesign and manufacturing proposals are presented for the triple periodical minimal surfaces (TPMS), mostly about Schoen’s gyroid simple and double. The goal of this paper is to can create auto-supported structures with similar characteristics to the human bone and in a personalized way. The gyroid cellular structures can be design to desire to give the density and resistant characteristics in the levels of the the trabecular bone. In this paper TPMS were built with DMLS technology, using stainless steel powder 17-4. The design was done in Matlab and some other programs. Compression test were done obtaining results in yield strength (400-850 MPa) similar to the trabecular bone. Modifiying the parameter “t” and the number of cells in the equation that describe both kinds of gyroids, it was possible to control the density (1.17 – 1.99 g/ cm3) and the young modulus in the manufactured samples.Keywords: Prosthesis, cellular structures, gyroid, biocompatibility, 3D printing

Acute Stress in Health Workers during Two Consecutive EpidemicWaves of COVID-19

The COVID-19 pandemic has provoked generalized uncertainty around the world, with health workers experiencing anxiety, depression, burnout, insomnia, and stress. Although the effects of the pandemic on mental health may change as it evolves, the majority of reports have been web-based, cross-sectional studies. We performed a study assessing acute stress in frontline healthworkers during two consecutive epidemic waves. After screening for trait anxiety/depression and dissociative experiences, we evaluated changes in acute stress, considering resilience, state anxiety, burnout, depersonalization/derealization symptoms, and quality of sleep as cofactors. During the first epidemic wave (April 2020), health workers reported acute stress related to COVID-19, which was related to state anxiety. After the first epidemic wave, acute stress decreased, with no increase during the second epidemic wave (December 2020), and further decreased when vaccination started.During the follow-up (April 2020 to February 2021), the acute stress score was related to bad quality of sleep. However, acute stress, state anxiety, and burnout were all related to trait anxiety/depression, while the resilience score was invariant through time. Overall, the results emphasize the relevance of mental health screening before, during