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BACKGROUND: Major depressive disorder (MDD) in older adults is a serious public health concern. Repetitive transcranial magnetic stimulation (rTMS) is a nonpharmacological intervention approved for MDD treatment in adults, but its value in older adults remains unknown. This study aims to systematically review and meta-analyze evidence of rTMS efficacy in MDD treatment among older adults. METHODS: We systematically reviewed the literature for randomized controlled trials (RCTs) and open-label studies assessing rTMS for the treatment of MDD in patients older than 50 years, published until June 2020. Random-effects meta-analyses using standardized mean differences (SMDs) were conducted to assess change in depression severity score (primary outcome), while odds ratios (ORs) were used to assess secondary categorical outcomes (response and remission). Additionally, univariate meta-regression analyses were performed to identify potential predictors of change in depression severity scores. RESULTS: Fourteen RCTs were included in meta-analyses and 26 studies (10 RCTs and 16 open-label studies) in meta-regression. Active rTMS was significantly superior to sham treatment for reduction of severity (SMD = 0.36; 95% CI = 0.13-0.60), as well as response (OR = 3.26; 95% CI = 2.11-5.04) and remission (OR = 4.63; 95% CI = 2.24-9.55). Studies were of moderate to high quality, with funnel plots and Egger's regression test not suggestive of publication bias. In meta-regressions, higher mean age and number of sessions were significantly associated with greater improvement. CONCLUSIONS: Our results support that rTMS is an effective, safe, and well-tolerated treatment for MDD in older adults and that it should be considered in the treatment of this vulnerable population.

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Indigenous populations around the world experience a disproportionate burden in terms of oral diseases and conditions. These inequalities are likely due to a complex web of social determinants that includes poverty, historical consequences of colonialism, social exclusion, government policies of assimilation, cultural annihilation, and racism in all its forms (societal, institutional). Despite documented oral health disparities, prevention interventions have been scarce in Indigenous communities. This review describes oral health interventions and their outcomes conducted for Indigenous populations of the United States, Canada, Brazil, Australia, and New Zealand. The review includes research published since 2006 that are available in English in electronic databases, including MEDLINE. A total of 13 studies were included from the United States, Canada, Brazil, and Australia. The studies reviewed provide a wide range of initiatives, including interventions for prevention and treatment of dental disease, as well as interventions that improve oral health knowledge, behaviors, and other psychosocial factors. Overall, 6 studies resulted in improved oral health in the study participants, including improvements in periodontal health, caries reduction, and oral health literacy. Preferred intervention methodologies included community-based research approaches, culturally tailored strategies, and use of community workers to deliver the initiative. Although these studies were conducted with discrete Indigenous populations, investigators reported similar challenges in research implementation. Recommendations for future work in reducing oral health disparities include addressing social determinants of health in various Indigenous populations, training future generations of dental providers in cultural competency, and making Indigenous communities true partners in research.

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A new record, Coprotiella venezuelensis was isolate on rhinoce-rosdung collected at south park Maracaibo zoo in Zulia State, Venezuela. The genus is compared with Coprotus and C.gongylospora having ascospores possessing De Bary bubbles.

Un nuevo registro, Coprotiella venezuelensis, fue aislado en heces de rinocerontes, colectados en el Parque Sur Zoológico en el estado Zulia, Venezuela. El género es comparado con Coprotus y C. gongylospora presentando ascósporas con burbujas de Bary.

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Basado en un estudio de hongos coprofílicos en el estado Zulia, Venezuela, una especie de la familia Coniochaetaceae, la cual presenta un ascocarpo tipo cleistotecio y ascósporas con poro germinativo, fue aislada de heces de paloma. Ésta fue identificada como una especie del género Coniochaetidium Malloch and Cain., la cual difiere de las otras cinco (5) especies descritas, en sus características morfológicas, presenta 8 esporas, ascas globosas y ascósporas elipsoidales. Además difiere de las otras porque las ascósporas desarrolladas en medios de cultivo son más largas, casi el doble de largo. La especie fue identificada como Coniochaetidium zulianensis Delgado, Urdaneta y Piñeiro, la cual representa un nuevo registro en el mundo.

On the basis of a study of coprophilous fungi from Zulia state, Venezuela, one specie of the family Coniochaetaceae, with cleistothecial ascocarp and ascospores with germ pore was isolated from dove dung. It was identified as species of Coniochaetidium Malloch and Cain. The species described in this paper differs from the other five (5) species in its morphological characteristic, globose asci, 8 spored and ellipsoidal ascospores, also this species differs from another by having larger ascopores, which are nearly double its length in culture. The species was identified as Coniochaetidium zulianensis Delgado, Urdaneta and Piñeiro, which represents a new record in the world.

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A pesar de los ocasionales intentos de eliminarla, la venta de alimentos en la vía pública en América Latina parece estar aumentando, estimulada por las crecientes poblaciones urbanas marginales, el desempleo que crea innumerables vendedores callejeros potenciales, las grandes distancias recorridas cotidianamente entre el lugar de trabajo y el hogar, la demanda de alimentos baratos y culturalmente apropiados cerca de los lugares de trabajo y la escasez o ausencia de establecimientos permanentes que sirvan ese tipo de alimentos. Además de representar una carga oculta para los servicios públicos, la industria de los alimentos de venta callejera, por lo general no reglamentada y casi clandestina, tiende a no observar normas adecuadas de higiene y a plantear considerables problemas de salud pública. En este contexto, las epidemias de cólera en América Latina han atraído la atención hacia el potencial de transmisión de enfermedades que tienen los alimentos vendidos en la calle y han estimulado el apoyo a los intentos de resolver ese problema. En este momento, más que fútiles intentos de abolir esa venta, aparentemente se requiere un criterio nuevo y más positivo mediante el cual los países modifiquen sus reglamentaciones para permitir la adaptación constructiva y pacífica de la venta callejera de alimentos a un nuevo estilo de vida de las sociedades latinoamericanas. Esto implica una reorganización jurídica orientada a establecer estructuras para la venta de alimentos en la vía pública y permitir la aplicación de medidas -especialmente el suministro y la utilización de agua inocua- que fomenten las normas adecuadas de higiene y el consumo de alimentos no peligrosos. También implica crear programas para proporcionar adiestramiento apropiado a los inspectores y educación sanitaria tanto a los vendedores como a los consumidores de esos alimentos; esto significa que hay que promover y adoptar métodos mejores para preparar y vender alimentos. No hay motivos para suponer que estas medidas constituirán una panacea inmediata para el problema de la venta de callejera de alimentos; sin embargo, hay buenas razones para pensar que pueden mejorar notablemente la situación actual

Version revisada de un documento presentado en la Conferencia "Street Foods: Epidemiology, Management and Practical Approaches" celebrada en Beijing, China, del 19 al 21 de octubre de 1993. Se publica en inglés en el Bull. PAHO. Vol. 28(4), 1994

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A pesar de los avances espectaculares en la tecnología médica y veterinaria en lo referente a la producción de vacunas antirrábicas y en los métodos de vigilancia y control de rabia, esta enfermedad sigue siendo un importante problema de salud pública en la mayoria de los países del mundo y unalimitante a la población animal, especialmente en America Latina

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We studied the effect of preoperative preparation on stress reduction in children hospitalized for dental surgery under general anesthesia. Participants were 45 children, 3 and 4 years of age, with no previous hospital-surgery experience and no history of medical or psychological conditions requiring special care. Subjects were randomly assigned to one of three experimental groups: control, receiving no preoperative preparation; unrelated play therapy, receiving a preoperative play session unrelated to hospital or surgical procedures; and related play therapy, receiving a preoperative play session focusing on hospital and surgical procedures. Subjects' behavior was assessed using behavior observation scales for cooperation and upset at seven stress points: admission, nurse's examination, pediatric medical examination, blood test, preoperative injection, transfer to surgery, and induction. The related play therapy group was more cooperative and less upset than either the unrelated play therapy group or the control group across stress points. No significant heart rate differences were found among the three groups. The results suggest that play therapy related to hospital and surgical procedures can alleviate stress and anxiety in 3- and 4-year-old children.

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Despite occasional attempts to repress it, street food vending in Latin America appears to be on the rise- encouraged by growing marginal urban populations, the unemployed status of innumerable potential street vendors, lengthening commutes for workers, public demand for cheap and culturally appropriate food near workplaces, and a shortage or absence of regular establishments serving such food. Besides placing a hidden burden on public services, the generally unregulated and quasi clandestine street food industry tends to observe poor hygienic practices and to pose significant public health problems. Within this context, Latin America's cholera epidemics have drawn increasing attention to street food's potential for disease transmission and have created growing support for attempts to resolve these troubles. What appears needed at this point, rather than futile attempts at abolition, is a new and more positive approach wherein countries change their regulations so as to permit peaceful and constructive adaptation of street food vending to a new style of Latin American social life. This implies legal reorganization directed at structurally developing street food vending and permitting application of measures- especially provision and use of safe water- that will foster good hygiene and safe foods. It also implies creating programs to provide appropriate training for inspectors as well as health education for both vendors and consumers of street food; and it implies promoting and adopting improved methods for preparing and selling such food. There is no reason to suppose these measures will provide and immediate panacea for the street food vending problem; but there is good reason to think they can immensely improve the situation that exists today

Revised version of a paper presented at the Conference "Street Foods: Epidemiology, Management, and Practical Approaches" help in Beijing, China on 19-21 October 1993. This article will also be published in Spanish in the BOSP. 118(3), 1995

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