Greater Predisposition Research Articles

Social perception on the integration of children with special educational needs in mainstream education

The inclusion of students with Special Educational Needs (SEN) within the general education system is a complex and persistent issue, considering that although educational policies and national legislation affirm support for the principle of inclusion, it is often implemented only at a declarative level. In the theoretical part, the evolution and progress of inclusive education at the international level was addressed, emphasizing the significant contribution of the United Nations Organization and various international conferences in promoting the individual rights of people with special needs. Another aspect considered the integration of students with special educational needs into the mainstream educational system, highlighting the crucial role and support offered to them. It is also emphasized the importance of the continuous professional development of teachers and the active involvement of parents in the educational process, as central pillars in the promotion of effective inclusive education. The methodology applied in the study regarding the integration of students with SEN in the Romanian educational system has as its main objectives the identification and analysis of teachers' perceptions and attitudes towards the integration process, the differences found between teaching staff from urban and rural environments, as well as examining the correlation between teachers' optimism and their perspectives on inclusion. Another important goal of the research is to identify barriers to the effective implementation of current and future public policies related to inclusive education. The research instruments used include an original questionnaire, entitled „Teachers' Beliefs and Attitudes about the Integration of Students with SEN”, intended to assess teachers' perceptions of inclusion, and an optimism measuring instrument, composed of 48 items, used to assess the level of optimism of the respondents. The sample of the study was made up of 60 teaching staff, aged between 25 and 45, divided into two groups, depending on the environment of origin (rural/urban). The analysis of the collected data indicates a greater predisposition towards acceptance and positive attitudes towards inclusion on the part of teachers from the urban environment, compared to their counterparts from the rural environment. Also, the results emphasize the existence of a positive correlation between the level of teachers' optimism and their attitude towards the inclusion of students with SEN. In conclusion, the findings of this research emphasize the significance of increasing the professionalism of teachers in supporting inclusive education and reveal notable disparities between rural and urban teachers in terms of the integration of students with special educational needs.

Identifying psychosis subtypes use individualized covariance structural differential networks and multi-site clustering

BackgroundSimilarities among schizophrenia (SZ), schizoaffective disorder (SAD) and bipolar disorder (BP) including clinical phenotypes, brain alterations and risk genes, make it challenging to perform reliable separation among them. However, previous subtype identification that transcend traditional diagnostic boundaries were based on group-level neuroimaging features, ignoring individual-level inferences. Methods455 psychoses (178 SZs, 134 SADs and 143 BPs), their first-degree relatives (N = 453) and healthy controls (HCs, N = 220) were collected from Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP I) consortium. Individualized covariance structural differential networks (ICSDNs) were constructed for each patient and multi-site clustering was used to identify psychosis subtypes. Group differences between subtypes in clinical phenotypes and voxel-wise fractional amplitude of low frequency fluctuation (fALFF) were calculated, as well as between the corresponding relatives. ResultsTwo psychosis subtypes were identified with increased whole brain structural covariance, with decreased connectivity between amygdala-hippocampus and temporal-occipital cortex in subtype I (S-I) compared to subtype II (S-II), which was replicated under different clustering methods, number of edges and across datasets (B-SNIP II) and different brain atlases. S-I had higher emotional-related symptoms than S-II and showed significant fALFF decrease in temporal and occipital cortex, while S-II was more similar to HC. This pattern was consistently validated on relatives of S-I and S-II in both fALFF and clinical symptoms. ConclusionsThese findings reconcile categorical and dimensional perspectives of psychosis neurobiological heterogeneity, indicating that relatives of S-I might have greater predisposition in developing psychosis, while relatives of S-II are more likely to be healthy. This study contributes to the development of neuroimaging informed diagnostic classifications within psychosis spectrum.

Co-VAN study: COVID-19 vaccine associated neurological diseases- an experience from an apex neurosciences centre and review of the literature

BackgroundRecent studies have shown various neurological adverse events associated with COVID-19 vaccine. ObjectiveWe aimed to retrospectively review and report the neurological diseases temporally associated with COVID-19 vaccine. MethodsWe performed a retrospective chart review of admitted patients from 1st February 2021 to 30th June 2022. A total of 4672 medical records were reviewed of which 51 cases were identified to have neurological illness temporally associated with COVID-19 vaccination. ResultsOut of 51 cases, 48 had probable association with COVID-19 vaccination while three had possible association. Neurological spectrum included CNS demyelination (n = 39, 76.5 %), Guillain-Barré-syndrome (n = 3, 5.9 %), stroke (n = 6, 11.8 %), encephalitis (n = 2, 3.9 %) and myositis (n = 1, 2.0 %). Female gender had a greater predisposition (F:M, 1.13:1). Neurological events were more commonly encountered after the first-dose (n = 37, 72.5%). The mean latency to onset of symptoms was 13.2 ± 10.7 days after the last dose of vaccination. COVIShield (ChAdOx1) was the most commonly administered vaccine (n = 43, 84.3 %). Majority of the cases with demyelination were seronegative (n = 23, 59.0 %) which was followed by anti-Myelin oligodendrocyte-glycoprotein associated demyelination (MOGAD) (n = 11, 28.2 %) and Neuromyelitis optica (NMOSD) (n = 5, 12.8 %). Out of 6 Stroke cases, 2 cases (33.3 %) had thrombocytopenia and coagulopathy. At discharge, 25/51 (49.0 %) of the cases had favourable outcome (mRS 0 to 1). Among six patients of stroke, only one of them had favourable outcome. ConclusionIn this series, we describe the wide variety of neurological syndromes temporally associated with COVID-19 vaccination. Further studies with larger sample size and longer duration of follow-up are needed to prove or disprove causality association of these syndromes with COVID-19 vaccination.

Effect of Combined Antiretroviral Therapy on the Levels of Selected Parameters Reflecting Metabolic and Inflammatory Disturbances in HIV-Infected Patients.

Subjects infected with human immunodeficiency virus (HIV) treated with combined antiretroviral therapy (cART) show a greater predisposition to metabolic disturbances compared to the general population. The aim of the study was to assess the effect of cART on the level of selected parameters related to carbohydrate and lipid metabolism, cardiovascular diseases and inflammation in the plasma of HIV-infected patients against the uninfected. The levels of irisin (IRS), myostatin (MSTN), peptide YY (PYY), glucagon-like peptide-1 (GLP-1), dipeptidyl peptidase IV (DPP-4), fetuin A (FETU-A), pentraxin 3 (PTX 3), chemokine stromal cell-derived factor 1 (SDF-1), and regulated on activation normal T cell expressed and secreted (RANTES) in the plasma of HIV-infected patients and the control group were measured by immunoassay methods. HIV-infected patients were analyzed in terms of CD4+ T cells and CD8+ T cell count, HIV RNA viral load, and the type of therapeutic regimen containing either protease inhibitors (PIs) or integrase transfer inhibitors (INSTIs). The analysis of HIV-infected patients before and after cART against the control group showed statistically significant differences for the following parameters: IRS (p = 0.02), MSTN (p = 0.03), PYY (p = 0.03), GLP-1 (p = 0.03), PTX3 (p = 0.03), and RANTES (p = 0.02), but no significant differences were found for DPP-4, FETU-A, and SDF-1. Comparing the two applied therapeutic regimens, higher levels of all tested parameters were shown in HIV-infected patients treated with INSTIs compared to HIV-infected patients treated with PIs, but the differences were not statistically significant. The obtained results indicated significant changes in the expression of selected parameters in the course of HIV infection and cART. There is need for further research on the clinical usefulness of the selected parameters and for new information on the pathogenesis of HIV-related comorbidities to be provided. The obtained data may allow for better monitoring of the course of HIV infection and optimization of therapy in order to prevent the development of comorbidities as a result of long-term use of cART.

A Retrospective Study of Non-Communicable Diseases amongst Blue-Collar Migrant Workers in Qatar.

Background: South Asian workers have a greater predisposition to non-communicable diseases (NCDs) that is exacerbated by migration and length of residence in host countries. Aims: To examine the association between length of residence in Qatar with diagnosis of NCDs in male blue-collar workers. Methods: A retrospective investigation of the electronic health records (EHRs) of 119,581 clinical visits by 58,342 patients was conducted. Data included age, nationality and confirmed ICD-10 diagnosis. Based on duration of residence, the population was divided into groups: ≤6 months, 6–12 months, 1–≤2 years, 2–≤5 years, 5–≤6 years, >6 years. It was assumed that the group that had been resident in Qatar for ≤6 months represented diseases that had been acquired in their countries of origin. Results: South Asian (90%) patients presented with NCDs at a younger (mean ± SD age of 34.8 ± 9.0 years) age. Diabetes and hypertension were higher in those who had just arrived (<6 months’ group), compared to the other durations of residence groups. Conversely, acute respiratory infections, as well as dermatitis and eczema, all increased, perhaps a consequence of shared living/working facilities. Only patients with diabetes and hypertension visited the clinic multiple times, and the cost of medication for these NCDs was affordable, relative to earnings. Discussion/Conclusions: Blue-collar workers were predominantly South Asian, from lower socioeconomic classes, with early onset chronic NCDs. Notably, residence in Qatar gave them better access to affordable, significantly subsidized healthcare, leading to effective management of these chronic conditions.

Arterial tortuosity syndrome causing recurrent transient ischemic attacks in young adult: a case report

BackgroundArterial Tortuosity Syndrome (ATS) is a rare autosomal recessive disorder characterized by elongated and tortuous arteries. Although ATS showed a significant clinical and pathophysiological overlap with other syndromes involving connective tissues, only few cases of cerebrovascular events related to this syndrome have been described so far.Case presentationWe report the case of a 33-years-old male diagnosed with ATS since childhood, that experienced three sudden episodes of expressive aphasia and right hemiparesis with spontaneous resolution. He was treated with recombinant tissue plasminogen activator (r-TPA) at a dosage of 0.9 mg/kg with a complete recovery. Brain Magnetic Resonance Imaging (MRI) showed the absence of acute ischemic lesions and the patient was diagnosed with recurrent transient ischemic attacks (TIA).Intracranial and supra-aortic trunks Magnetic Resonance Angiography (MRA) and Angio-CT scan of the thoracic and abdominal aorta showed marked vessel tortuosity without stenosis.To our knowledge, this is the first reported case of an ATS patient with TIA in young age that was treated with intravenous thrombolysis with recombinant plasminogen activator.ConclusionOur report strengthens the relationship between ATS and juvenile cerebrovascular events, suggesting that an extensive study of body vessels in order to detect potential stenoses or occlusions in these cases is needed.The greater predisposition to cerebrovascular events in ATS could benefit from a more aggressive primary and secondary prevention therapy.

Genomic predictors of testosterone levels are associated with muscle fiber size and strength

PurposeCirculating testosterone levels are a heritable trait with anabolic properties in various tissues, including skeletal muscle. So far, hundreds of single nucleotide polymorphisms (SNPs) associated with testosterone levels have been identified in nonathletic populations. The aim of the present study was to test the association of 822 testosterone-increasing SNPs with muscle-related traits (muscle fiber size, fat-free mass and handgrip strength) and to validate the identified SNPs in independent cohorts of strength and power athletes.MethodsOne hundred and forty-eight physically active individuals (47 females, 101 males) were assessed for cross-sectional area (CSA) of fast-twitch muscle fibers. Significant SNPs were further assessed for fat-free mass and handgrip strength in > 354,000 participants from the UK Biobank cohort. The validation cohorts included Russian elite athletes.ResultsFrom an initial panel of 822 SNPs, we identified five testosterone-increasing alleles (DOCK3 rs77031559 G, ESR1 rs190930099 G, GLIS3 rs34706136 TG, GRAMD1B rs850294 T, TRAIP rs62260729 C) nominally associated (P < 0.05) with CSA of fast-twitch muscle fibers, fat-free mass and handgrip strength. Based on these five SNPs, the number of testosterone-increasing alleles was positively associated with testosterone levels in male athletes (P = 0.048) and greater strength performance in weightlifters (P = 0.017). Moreover, the proportion of participants with ≥ 2 testosterone-increasing alleles was higher in power athletes compared to controls (68.9 vs. 55.6%; P = 0.012).ConclusionTestosterone-related SNPs are associated with muscle fiber size, fat-free mass and strength, which combined can partially contribute to a greater predisposition to strength/power sports.

Validity of the patient health questionnaire 9-item in autistic youths: a pilot study

BackgroundAutistic adolescents have greater predisposition to depression and suicidality than neurotypical adolescents. Early detection is essential for timely treatment. The Patient Health Questionnaire 9-item (PHQ-9) is a brief screen for depression. The study examines the validity of the PHQ-9 for detecting major depressive disorder (MDD) in autistic youths.MethodsEnglish speaking youths aged 10–18 years, with DSM-IV/DSM-5/ICD-10 diagnosis of Autism Spectrum Disorder (ASD), and their parents presenting to a child psychiatric service were invited to participate between May 2018 to August 2020. Participants completed the respective self- and parent-rated PHQ-9 independently. MDD was verified using the MINI-Kid (Mini-International Neuropsychiatric Interview, Kid version).ResultsOne hundred one youth, mean (SD) age 14.6 (2.3), were enrolled. 27 (27%) met criteria for current MDD. Mean total PHQ-9 scores, percentage ratings for severity of symptoms of depression, functional impairment, dysthymia and suicidality were compared. Areas under the ROC curve and statistically optimal cutoffs were determined. Parents rated depressive symptoms severity lower than their children. The PHQ-9 displayed low sensitivity with high false negative rates at conventional, adjusted and proposed cutoffs.ConclusionsFuture studies should improve on the validity and reliability of existing depression screening tools, or develop more appropriate screening methods of depression, for autistic youths.

Perfil renal e excreção fracionada urinária de cálcio, fósforo e magnésio de cordeiros alimentados com teores diferentes de fósforo

Obstructive urolithiasis is common in confined sheep, and a predominant factor predisposing animals to this condition is nutritional management. The objective of this study was to evaluate the effect of different concentrations of phosphorus (P) on urinalysis, serum urea and creatinine, and serum and urine concentrations of calcium (Ca), P, and magnesium (Mg), as well as to establish the fractional excretion (FE) of these elements in confined lambs. Thirty male Santa Inês x Ile de France sheep at four months of age were divided into two groups according to the diet: Group 1 (G1, n = 15), with 0.43% P in their feed; and Group 2 (G2, n = 15) with 0.65% P. The diets consisting of 10% Coast-cross hay and 90% of a concentrate of soybean meal, wheat, and crushed corn were provided for 90 consecutive days, with water ad libitum. The time points (M) of blood and urine collection were determined as M0, immediately before the beginning of the diet, and at 15-day intervals: M1, M2, M3, M4, M5, and M6. Phosphorous-rich diets favored the appearance of triple phosphate crystals in both groups, causing calculogenesis in more than one third of the animals (11/30), emphasizing the relevance of conducting laboratory tests to aid in urolithiasis diagnosis. In addition, FE revealed an increased renal excretion of excess minerals in the diet, and therefore a greater predisposition for stone formation in relation to nutritional management.

Coping Strategies by University Students in Response to COVID-19: Differences between Community and Clinical Groups

Last year, the COVID-19 pandemic had severe consequences on the health and well-being of millions of people. Different studies try to identify the main effects that the crisis and several lockdowns have had on the citizens’ mental health. This research analyses the coping strategies generated by students from a community group and a clinical group in response to this crisis, using the Coping Responses Inventory—Adult Form (CRI-A) by Moos with a sample of 1074 students of Universidad de Extremadura. Multivariate analysis and receiver operating characteristic curve analysis have been carried out, revealing, amongst other things, a greater predisposition of the clinical sample towards factors such as seeking guidance and support, cognitive avoidance or emotional discharge. Results show that students with prior mental health problems perform an unhealthy coping response based on avoidance strategies. This group of students suffers a double source of distress and anxiety, one derived from their prior psychopathologic problems and the stress of the lockdown and another one originating from an inefficient coping response, which makes coping strategies raise levels of distress and anxiety.

Cross-sectional observational study – Investigation of vitamin D concentration in Caucasian cancer patients. what is the adequate dose of vitamin D for these patients?

Vitamin D impairs tumour-related transformation and supports the anticancer function of the immune system. Currently, there are no guidelines on vitamin D supplementation devoted solely to cancer patients. The primary objective of the study was to evaluate the frequency of vitamin D deficiency in Caucasian cancer patients and to characterize the clinical factors that predispose individuals to decreased vitamin D concentration. Secondly, the study aimed to estimate the dose of vitamin D supplementation that would prevent deficiencies in patients with cancer. In the presented cross-sectional study the population consisted of 500 consecutive Caucasian patients with a diagnosis of neoplastic disease, some of which declared long-term vitamin D supplementation in various doses. Serum vitamin D concentration was measured once in all patients and clinical data were obtained from the hospital database. The frequencies of vitamin D deficiency were compared to certain clinical variables by appropriate statistical tests. The dose of vitamin D substitution in cancer patients was estimated using the receiver operating characteristic (ROC) curve. Vitamin D deficiency was diagnosed in 66.8% of patients with cancer and even in 31.6% who declared vitamin D supplementation. Older age, male gender, diagnosis of head and neck cancer or squamous cell carcinoma and body mass loss were identified as factors that predispose to vitamin D deficiency. The dose of vitamin D that would prevent deficiency in Caucasian patients with cancer was set at 2250 IU daily. Vitamin D deficiency was very common in Caucasian patients with cancer, even in terms of vitamin D supplementation. The greatest predisposition was related to elder age, male gender, diagnosis of head and neck or squamous cell carcinoma and body mass loss. The dose of vitamin D supplementation in cancer patients should probably be higher than in the general population.

Postcolonial Bonds? Latin American Origins, Discrimination, and Sense of Belonging to Spain

The present study examines the costs of discrimination and cultural-linguistic differences for the development of migrants’ sense of belonging to the receiving society. Focusing on Latin Americans in Spain allows shedding light on the cultural and linguistic mechanisms involved in this process. Migration scholars have long recognized the importance of belonging as a key indicator of integration. An analysis of belonging has clear relevance to settlement policies and programs to prevent social fragmentation or isolation of immigrants. This article takes a fresh approach to explore the development of migrants’ sense of belonging to the receiving society by drawing on an original survey data set collected in 25 highly diverse territories in Spain ( N = 2,648). The results show that cultural and linguistic affinity matter: There is a greater predisposition among immigrants born in Latin America to identify themselves as Spaniards, compared with other immigrant groups. However, self-reported discrimination and deficient residential settings seem to be hindering the development of a significant feeling of belonging to Spain, also among Latin Americans. Public policies aimed at decreasing discrimination against migrants, as well as improving migrant neighborhoods, will favor the integration of these immigrants and their descendants.

Reduced brown adipose tissue activity during cold exposure is a metabolic feature of the human thrifty phenotype

BackgroundWe recently demonstrated that thrifty subjects, characterized by a greater decrease in 24 h energy expenditure (24hEE) during short-term fasting, have less capacity for cold-induced thermogenesis (CIT) during 24 h of mild cold exposure. ObjectiveAs cold-induced brown adipose tissue activation (CIBA) is a determinant of CIT, we sought to investigate whether thrifty individuals also have reduced CIBA. MethodsTwenty-four healthy subjects (age: 29.8 ± 9.5y, body fat: 27.3 ± 12.4%, 63% male) were admitted to our clinical research unit and underwent two 24hEE assessments in a whole-room indirect calorimeter during energy balance and fasting conditions at thermoneutrality to quantify their degree of thriftiness. Positron emission tomography/computed tomography scans were performed after exposure to 16 °C for 2 h to quantify peak CIBA. ResultsA greater decrease in 24hEE during fasting was associated with lower peak CIBA (r = 0.50, p = 0.01), such that a 100 kcal/day greater reduction in 24hEE related to an average 3.2 g/mL lower peak CIBA. ConclusionOur results indicate that reduced CIBA is a metabolic trait of the thrifty phenotype which might explain reduced CIT capacity and greater predisposition towards weight gain in individuals with a thrifty metabolism.

Reserpine-Induced Progressive Parkinsonism in Mice Predisposed and Non-Predisposed to Depressive-Like Behavior

Parkinson’s disease (PD) is a progressive degenerative condition that mainly affects the elderly. The disease comprises motor symptoms such as tremors at rest, loss of voluntary movement, decreased muscle strength, propensity to lean forward and acceleration of the walking pace. These signs are related to the degeneration of the nigrostriatal dopaminergic pathway. Patients also have non-motor symptoms, among which sleep alterations, cognitive deficits, fatigue, pain and depression stand out. Although depression has been described as the most prevalent non-motor symptom, it is not clear whether this mood disorder is due to PD or patients would already have a greater predisposition. The present study evaluated the relationship between the predisposition to depressive-like behavior and the development of motor alterations in a progressive pharmacological model of PD in mice. Mice were classified into groups of depressive-like propensities and submitted to the pharmacological model. Reserpine was administrated at 0.1 mg/kg on alternate days for 40 days. The catalepsy and oral movement tests were used to evaluate motor alterations, the sucrose preference test was used to evaluate anhedonia, and the open field test was applied to evaluate general activity. Reserpine promoted parkinsonian motor impairments, and there were no differences between animals from different depressive-like behavior profiles. Thus, it was not possible to find a relationship between parkinsonism and the propensity to depression based on the basal sucrose preference test. More studies with other evaluations of depressive-like behavior are needed to confirm the results found in our study.

Who Is Pulling the Leash? Effects of Human Gender and Dog Sex on Human-Dog Dyads When Walking On-Leash.

Simple SummaryThe gender of humans and the sex of dogs influence human–dog interactions. This study investigated human–dog interactions when volunteers take shelter dogs for an on-leash walk, using video recording and a canine leash tension meter. Male dogs tended to pull more frequently and created higher leash tensions than female dogs. Dogs displayed more stress related behaviours when interacting with men than women, with the signs including spending less time holding the tail in a high position, and more frequent gazing and lip-licking behaviours. Finally, during the walk, there was a greater pre-disposition in women to use verbal commands and language typically associated with talking to babies, while men were more inclined to have physical contact with the dogs. These results may be used to match shelter dogs with appropriate men and women volunteers for dog walking exercise, and to improve potential socialisation of the dogs before rehoming.Previous studies have indicated that human gender and canine sex influences human–dog interactions. However, the majority of studies have considered the interaction when dogs were off-leash and the behavioural interactions when dogs are walked on a leash have not been addressed. This study investigated human–dog interactions when shelter volunteers take shelter dogs for an on-leash walk. Video records were made of 370 walks, involving 74 volunteers and 111 shelter dogs, and a leash tension meter was used to determine the pull strength of dogs and walkers. Human gender and canine sex had dyadic effects during the walk. Male dogs tended to pull more frequently and created increased leash tensions. Dogs displayed more stress related behaviours when interacting with men than women, with the signs being spending less time holding the tail in the high position, and more frequent gazing and lip-licking behaviours. Finally, there was a greater pre-disposition in women to use verbal commands, and language typically used with babies, while men were more inclined to have physical contact with dogs. This study’s results may be used to match shelter dogs with appropriate men and women volunteers for walking exercise of the dog, and to improve potential dog socialisation efforts by shelters.

Genetic Features of Cerebral Stroke

Recent years have seen an increase in interest in the identification of additional genetic factors for cerebral stroke. A large number of studies have been run with the aim of verifying genetic influences on the risk of developing both ischemic and hemorrhagic stroke. This article discusses the main genes for susceptibility and genetic polymorphisms associated with the development of this disease. An important role in the occurrence of stroke is played by genetic factors controlling the processes of inflammation, blood clotting, lipid metabolism, nitric oxide formation, the functioning of the renin–angiotensin–aldosterone system, and homeostasis. Complex analysis of a number of genes allows patients with the greatest predisposition to developing the disease to be identified with the aims of providing state-of-the-art prophylaxis and reducing the burden of stroke.

Reflexões sobre a associação entre o tabagismo e COVID – 19: revisão de literatura

A patogênese do COVID-19 é amplamente desconhecida, e os dados são limitados sobre as características clínicas dos pacientes e seus fatores prognósticos, presumindo -se que o tabagismo esteja possivelmente associado ao prognóstico adverso da doença. Este trabalho tem como objetivo descrever baseando-se na literatura científica a associação entre o consumo de tabaco e a progressão da COVID-19. Trata-se de uma revisão de literatura do tipo integrativa, e realizaram-se buscas na base de dados PUBMED e BIREME, utilizando os descritores “tobacco” and “COVID-19”, de artigos completos e gratuitos publicados no ano de 2020. A amostra final desta revisão foi constituída por 8 (oito) artigos científicos. As principais alterações relacionadas com a progressão da COVID-19 em indivíduos tabagistas nos estudos analisados foram: maior expressão do gene do receptor ACE2 em fumantes, contribuindo com a progressão dos sintomas, o aumento da resposta inflamatória em fumantes subcrônicos de cigarros eletrônicos, o enriquecimento da via androgênica e à regulação positiva específica dos genes reguladores da via central e a realização de campanhas de combate ao tabagismo. Enquanto os processos fisiopatológicos relacionados não forem totalmente elucidados, é importante reforçar as campanhas de manutenção de hábitos de vida saudáveis, dentre os quais a não utilização de tabaco, mesmo em formas alternativas, como por exemplo, cigarros eletrônicos, pois o uso está associado à maior predisposição às manifestações clínicas mais severas da doença.

MATERNAL RISK FACTORS IN ADOLESCENTS WITH THREAT OF PRETERMINE BIRTH IN ENRIQUE SOTOMAYOR HOSPITAL

It is vitally important to understand that premature birth at the Latin American level and in Ecuador is a Public Health problem is considered as one of the main causes of perinatal morbidity and mortality, determined by certain obstetric gynecological aspects such as newborn weight, gestational age is important when there is an irregularity of gestational development when not being found within 32 weeks they produce a greater rate of neonatal morbidity and mortality as a consequence a greater percentage of sequelae; Therefore, it is important that through the present study it is understood that the incidence of premature births should be reduced, which not only affects the pregnant woman but also the newborn. This research is quantitative, non-experimental, cross-sectional with a descriptive level of research, based on the medical records of patients between the ages of 10 and 19 treated at the Enrique C. Sotomayor hospital in Guayaquil in the period 2015 When the present study is carried out, it is concluded that since there is no consistent prenatal control on the part of pregnant women, it directly influences the pre-term delivery leading to this problem to establish a high predisposition to produce maternal-neonatal morbidity and mortality; a greater awareness campaign should be carried out regarding the prenatal controls necessary to reduce the incidence of preterm birth. The age group with the greatest predisposition is established in adolescents whose age range is from 17 to 19 years.

Heart rate variabilit y during epileptic seizures as a factor in the development of sudden unexpected death in epilepsy (literat ure review)

Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in patients with epilepsy and occurs at least 20 times more often in patients with fore mentioned condition compared with healthy people. During epileptic seizures, a significant proportion of patients develop heart rate variability and respiratory depression. It is assumed that these cardiorespiratory complications are the most probable risk factor for the development of SUDEP. Asystole and ventricular fibrillation, developing immediately after the seizure, are the most significant arrhythmias in the pathophysiology of SUDEP. Discoordination of the autonomic nervous system activity in connection with the involvement of autonomous control centers in epileptic activity leads to the emerging cardiopulmonary pathology. In patients with long-term resistant epilepsy, chronic dysfunction of the autonomic nervous system is formed and, as a consequence, a greater predisposition to the disturbances of heart rhythm. A detailed study of cardiac disorders during epileptic seizures will provide the key for understanding the risks of developing SUDEP and developing some approaches to its prevention.

A prospective, observational study on conversion of clinically isolated syndrome to multiple sclerosis during 4-year period (MS NEO study) in Taiwan.

ImportanceCIS to MS conversion rates vary depending on population cohorts, initial manifestations, and durations of follow-up.ObjectiveTo investigate conversion rate of patients from CIS to MS and the prognostic significance of demographic and clinical variables in Taiwanese population.DesignNationwide, prospective, multi-centric, observational study from November 2008 to November 2014 with 4 years follow-up.SettingMulti-centre setting at 5 institutions in Taiwan.Participants152 patients having single clinical event potentially suggestive of MS in last 2 years were enrolled as consecutive sample. 33 patients were lost to follow-up and 16 patients did not complete the study.103 patients completed the study.Intervention(s) (for clinical trials) or exposure(s) (for observational studies)Natural progression from first episode of CIS to MS or NMO was observed.Main outcome(s) and measure(s)Variables analysed were ‘proportion of patients converting to MS or NMO after first episode of CIS’, ‘duration between first episode of neurological event and diagnosis of MS’, ‘status of anti-AQP4 IgG’ and ‘length of longest contiguous spinal cord lesion in MS patients’. Association between baseline characteristics and progression to MS from CIS was analyzed using multiple logistic regression. Multivariate time dependent effect of baseline characteristics on progression to MS was plotted.Results14.5% patients with CIS converted to MS after 1.1 ± 1.0 years with greater predisposition (18.8%) in those having syndromes referable to the cerebral hemispheres. Conversion rate from ON to MS was 9.7%. 90.9% patients had mild disease course. 46.7% patients had abnormal MRIs at baseline, with 0.6±0.5 contrast enhanced lesions. ‘Below normal BMI’ and ‘MRI lesion load (≥ 4 lesions)’ were identified as risk indicators for the development of MS. Amongst the patients who developed NMO as diagnosed by modern criteria, 80% were positive for anti-AQP4 IgG antibody.Conclusions and relevance‘Below normal BMI’ and ‘number of demyelinating lesions (≥4)’ are significant predictors of conversion from CIS to MS. A low conversion rate to MS in Taiwanese CIS patients and majority of them having a mild course and minimal disability suggest the roles of geographic, genetic and ethnic factors.Trial registrationNon-trial observational study.