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MOTIVATION: Wikipedia is a vital open educational resource in computational biology. The quality of computational biology coverage in English-language Wikipedia has improved steadily in recent years. However, there is an increasingly large 'knowledge gap' between computational biology resources in English-language Wikipedia, and Wikipedias in non-English languages. Reducing this knowledge gap by providing educational resources in non-English languages would reduce language barriers which disadvantage non-native English speaking learners across multiple dimensions in computational biology. RESULTS: Here, we provide a comprehensive assessment of computational biology coverage in Spanish-language Wikipedia, the second most accessed Wikipedia worldwide. Using Spanish-language Wikipedia as a case study, we generate quantitative and qualitative data before and after a targeted educational event, specifically, a Spanish-focused student editing competition. Our data demonstrates how such events and activities can narrow the knowledge gap between English and non-English educational resources, by improving existing articles and creating new articles. Finally, based on our analysis, we suggest ways to prioritize future initiatives to improve open educational resources in other languages. AVAILABILITY AND IMPLEMENTATION: Scripts for data analysis are available at: https://github.com/ISCBWikiTeam/spanish.

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Antimicrobial peptides (AMPs) are important mediator molecules of the innate defense mechanisms in a wide range of living organisms, including bacteria, mammals, and plants. Among them, peptide protease inhibitors (PPIs) from plants play a central role in their defense mechanisms by directly attacking pathogens or by modulating the plant's defense response. The growing prevalence of microbial resistance to currently available antibiotics has intensified the interest concerning these molecules as novel antimicrobial agents. In this scenario, PPIs isolated from a variety of plants have shown potential in inhibiting the growth of pathogenic bacteria, protozoans, and fungal strains, either by interfering with essential biochemical or physiological processes or by altering the permeability of biological membranes of invading organisms. Moreover, these molecules are active inhibitors of a range of proteases, including aspartic, serine, and cysteine types, with some showing particular efficacy as trypsin and chymotrypsin inhibitors. In this review, we provide a comprehensive analysis of the potential of plant-derived PPIs as novel antimicrobial molecules, highlighting their broad-spectrum antimicrobial efficacy, specificity, and minimal toxicity. These natural compounds exhibit diverse mechanisms of action and often multifunctionality, positioning them as promising molecular scaffolds for developing new therapeutic antibacterial agents.

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La comunicación efectiva en las intervenciones de fisioterapia/kinesiología tiene un impacto directo en los resultados y en la experiencia de los usuarios. Además, promover un lenguaje y una terminología universal en nuestra disciplina facilita la colaboración y la investigación nacional e internacional. El enfoque centrado en la Convención de las Naciones Unidas sobre los Derechos de las Personas con Discapacidad adoptado por la Confederación Mundial de Fisioterapia nos compromete a alinearnos con definiciones de conceptos acordados internacionalmente, lo que fortalece la profesión y promueve el profesionalismo en las acciones terapéuticas. Avanzar hacia reflexión y consensos en la comunidad de fisioterapia/kinesiología en torno a conceptos claves como discapacidad, rehabilitación, inclusión y desempeño, con la impronta del funcionamiento humano, optimizan la praxis profesional y su impacto en las intervenciones a lo largo del curso de vida en todos los niveles asistenciales.

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BACKGROUND: The anterior minimally invasive (AMI) approach reduces soft tissue damage, risk of dislocation and enhances recovery, but it is associated with certain complications. The aim of this study is to compare the outcomes of patients who underwent total hip arthroplasty (THA) through posterolateral (PL) and AMI approaches performed by the same surgeon, in order to determine the learning curve associated with this new approach. METHODS: This retrospective cohort study included patients who underwent THA via PL and AMI approach between 2017 and 2022, with a minimum follow-up of 1 year. Hip fracture and oncologic patients were excluded. Demographic variables, functional scores and perioperative complications were assessed. A bivariate analysis was performed to identify differences between groups. RESULTS: Data of 124 AMI and 120 PL patients were analyzed. Demographic characteristics among groups were homogeneous. Functional outcomes at 3 months were superior for AMI (Oxford: 43 vs. 38; p < 0.05), no dislocations were identified (0% vs. 4.2%; p < 0.05) and no differences in the transfusion rate were found (6.5% AMI vs. 6.7% PL; p = 0.996). Infection rate was 4% for AMI and 3.4% for PL (p = 0.572). Surgical time was shorter for the PL approach, but the median surgical time of the last 25 AMI cases was shorter. CONCLUSIONS: The AMI approach is an excellent alternative for patients requiring THA. Although surgical time and perioperative bleeding were greater during the learning curve, this approach offers improved functional outcomes and a lower dislocation rate, without significant differences in transfusion and infection outcomes, demonstrating that responsible innovation and safe implementation of new techniques is possible.

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SUMMARY: There are many reports on anatomical variations of the vertebral arteries, which may be related to origin, trajectory, caliber, and side. Bilateral variations are less frequent, however, and less common are bilateral variants that differ from each other. The aim of this work was to report the presence of a bilateral variation of the vertebral artery and its functional and clinical implications. Dissection of a female cadaver, fixed in 10 % buffered formaldehyde, which had not undergone any previous surgeries in the study area and had anatomical variations in both vertebral arteries. In each one, follow-up was done from its origin to its end, determining its trajectory, diameters, branching, and anatomical relations. A left vertebral artery was found, starting in the aortic arch and making a sinuous trajectory of 4 curvatures to enter the transverse foramen of C4. The right vertebral artery began as the first branch of the subclavian artery. Its initial trajectory was rectilinear, followed by a right concave curve, a 360° loop that included a second ascending curve, and ended straight before entering the transverse foramen of C6. The coexistence of bilateral variations in the vertebral arteries is possible. This atypical situation can potentially generate vascular and neurological pathologies, but with different symptoms and causes. Knowing these variations and deliberately searching for them will enable the specialist to make a suitable differential diagnosis.

Existen múltiples reportes sobre variaciones anatómicas de las arterias vertebrales, las que se pueden relacionar con origen, trayecto, calibre y lateralidad. Sin embargo, las variaciones bilaterales son menos frecuentes, y menos común es que las variantes bilaterales sean diferentes entre ellas. El objetivo de este trabajo fue reportar la presencia de una variación bilateral de la arteria vertebral y su implicancia funcional y clínica. Disección en un cadáver de sexo femenino, fijado en formaldehido tamponado al 10 %, el cual no presentaba intervenciones quirúrgicas previas en la región de estudio y que tenía variaciones anatómicas en ambas arterias vertebrales. En cada una se realizó seguimiento desde su origen hasta su terminación, pudiendo determinar su trayecto, diámetros, ramificaciones y relaciones anatómicas. Se encontró una arteria vertebral izquierda originada en el arco aórtico, que realizaba un trayecto sinuoso de 4 curvaturas e ingresaba al foramen transverso de C4. La arteria vertebral derecha se originaba como primera rama de la arteria subclavia. Su trayecto inicial era rectilíneo seguido por una curva de concavidad derecha, un loop (giro) de 360° que incluía una segunda curva ascendente y terminaba en dirección recta antes de ingresar al foramen transverso de C6. La coexistencia de variaciones bilaterales en las arterias vertebrales es posible. Esta situación atípica, potencialmente puede generar en la persona patologías neurológicas de origen vascular, pero con sintomatología y causas diferentes. Conocer estas variaciones y realizar una búsqueda intencionada de ellas permitirá el especialista realizar un adecuado diagnóstico diferencial.

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INTRODUCTION: We compared the association of glomerular filtration rate (GFR) estimated with the Cockcroft-Gault, Modification of Diet in Renal Disease study (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), or the new CKD-EPI without race (CKD-EPI-NR) equations, with 4-year all-cause mortality in patients with diabetes. RESEARCH DESIGN AND METHODS: We analyzed a nationwide, centralized database of all adults diagnosed with diabetes assisted by the Colombian Health System between July 1, 2015, and June 30, 2019. Plasma creatinine was used to calculate baseline estimated glomerular filtration rate (eGFR) and classify each patient in a chronic kidney disease (CKD) stage, by each of the four equations. We used multivariate logistic regression to compare the association between CKD stage and mortality, and receiver operating characteristic (ROC) analyses to assess the overall association of eGFR by each equation and mortality. RESULTS: The study included 758,219 patients (58% female, 7.2% black race, mean age 62.3, Glycated hemoglobin A1c [HbA1c] 7.4%). There were 35,296 deaths over the study follow-up. Considering eGFR by each equation as a continuous variable, the odds of death decreased by 1.1%-1.5% for each additional mL/min. Compared with CKD stage 1 of each equation, being placed in CKD stages 3a, 3b, or 4 by MDRD or CKD-EPI-NR was associated with greater odds of death than being categorized in the same stages by CKD-EPI. Among patients of black race, the adjusted OR of mortality for CKD stage 4 relative to stage 1 was 4.63 (95% CI 3.39 to 6.35) for MDRD, 3.66 (2.85 to 4.69) for CKD-EPI-NR, 3.01 (2.38 to 3.81) for CKD-EPI, and 2.82 (2.29 to 3.49) for Cockcroft-Gault. The area under the ROC curve to discriminate by survival status was greatest for MDRD, followed by CKD-EPI-NR, CKD-EPI, and Cockcroft-Gault, in that order (p<0.001 for all differences). CONCLUSIONS: Compared with other eGFR equations, MDRD showed the strongest association with all-cause mortality in a sample of Latin-American patients with diabetes. This difference was most pronounced among patients of black race.

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BACKGROUND: Difficulties in cancer services access increase the burden of disease and mortality in rural areas, and telehealth can be a useful tool to address these inequalities. OBJECTIVE: We aimed to describe the outcomes of patients in rural and urban areas with solid tumors managed by oncologists through telemedicine. METHODS: We conducted a retrospective cohort study of patients with solid tumors from March to December 2020. A total of 1270 subjects with solid tumors were included, 704 living in urban areas and 566 in rural areas. RESULTS: The most frequent tumors were breast (51.8%) and prostate (12.4%). The trend of telemedicine care was similar for both populations; in-person care was more frequent in the urban population. There were no differences in referral to the emergency room, need for hospitalization, and mortality for both groups. CONCLUSION: Telemedicine is a care modality that reduces barriers in the care of patients with solid tumors, evidencing similar outcomes regardless of living in rural or urban areas.

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Context: The relative importance of the control of different metabolic risk factors for the prevention of chronic kidney disease among patients with diabetes in real life conditions is insufficiently understood. Objective: We evaluated the effect of the achievement of glycated hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDLc) or non-high-density lipoprotein cholesterol (non-HDLc) goals (ABC goals) on the development of incident chronic kidney disease (iCKD) among patients with diabetes. Methods: In a nationwide registry of all individuals diagnosed with diabetes assisted by the health system in Colombia, we analyzed the association between baseline or sustained goal achievement and development of iCKD over a 4-year follow-up. iCKD was defined as a new occurrence of an estimated glomerular filtration rate less than 60 mL/min/1.73 m2, hemodialysis, peritoneal dialysis, or kidney transplant. Results: The study included 998 790 adults with diabetes (56% female, mean age 59). There were 125 626 cases of iCKD. After adjustment for multiple confounders, a baseline SBP less than 130 mm Hg (odds ratio [OR] 0.79 [0.78-0.80]) and a baseline HbA1c less than 7.0% (OR 0.86 [0.85-0.87]) were negatively associated with iCKD. Sustained achievement showed stronger negative associations with iCKD than just baseline achievement. Considering each goal separately, sustained non-HDLc less than 130 mg/dL had the strongest negative association with iCKD (OR 0.67 [0.65-0.69]). Patients who maintained the triple ABC goal over the entire follow-up had 32% (29-34) lower odds of developing CKD, 38% (34-42) if they additionally kept a normal body mass index (BMI). Sustained ABC control including a normal BMI was more strongly associated with a lower incidence of CKD in patients of Black race (OR 0.72 vs 0.89; P for interaction = .002). Conclusion: At the country level, sustained achievement of ABC goals and most especially non-HDLc were associated with substantial reductions in iCKD.

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Diabetic retinopathy is a devastating and frequent complication of poorly controlled diabetes, whose pathogenesis is still only partially understood. Advances in basic research over the last two decades have led to the discovery of angiopoietins, proteins that strongly influence the growth and integrity of blood vessels in many vascular beds, with particular importance in the retina. Angiopoietin 1 (Ang1), produced mostly by pericytes and platelets, and angiopoietin 2 (Ang2), produced mainly by endothelial cells, bind to the same receptor (Tie2), but exert opposing effects on target cells. Ang1 maintains the stability of the mature vasculature, while Ang2 promotes vessel wall destabilization and disruption of the connections between endothelial cells and pericytes. Human retinal endothelial cells exposed to Ang2 show reduced membrane expression of the adhesion molecule VE-cadherin, and patients with proliferative diabetic retinopathy or diabetic macular edema have markedly increased vitreal concentrations of Ang2. Faricimab, a bi-specific antibody simultaneously directed against Ang2 and VEGF, has shown promising results in clinical trials among patients with diabetic retinopathy, and other agents targeting the angiopoietin system are currently in development.

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Some studies based on bone biopsy have demonstrated that in patients with tumor-induced osteomalacia (TIO) the mineralization process of the bone matrix is profoundly disturbed. However, the interrelationship between clinical and biochemical features and bone microarchitecture in this disease needs further analysis. With this purpose in mind, we set out three objectives: (i) to determine bone microarchitecture and estimated bone strength in a group of patients with tumor-induced osteomalacia using high-resolution peripheral quantitative computed tomography (HR-pQCT) and finite element analysis (FEA), (ii) to investigate correlations between duration of disease, biochemical features, bone density, HR-pQCT and FEA parameters, and (iii) to compare HR-pQCT and FEA parameters with a healthy control group. Ten patients with TIO were included. All patients had non-resolved disease. At the distal radius, all bone microarchitecture parameters were significantly affected in patients with TIO in comparison with healthy controls. At the distal tibia, all parameters were significantly impaired, except for trabecular thickness. All the parameters were more affected in the distal tibia than in the distal radius. Women with TIO (n = 7) had significantly lower bone strength parameters than healthy controls. In men (n = 3), bone strength parameters were significantly lower than in the control group at the distal tibia. Alkaline phosphatase levels exhibited a negative correlation with microarchitecture parameters, failure load, and stiffness. Higher levels of parathyroid hormone correlated with poorer microarchitecture parameters. We believe that in TIO, hormonal disturbances and the lack of mechanical stimulus specially converge to generate an extremely harmful combination for bone health. © 2021 American Society for Bone and Mineral Research (ASBMR).

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The introduction of alien species represents one of the greatest threats to biodiversity worldwide. Highway construction increases the dispersal and invasion of exotic plant species. This study examined the assembly process of the plant communities to determine whether the roadsides of the Patagonian steppe represent a reservoir and dispersal source of invasive exotic species. We analyzed the composition of exotic and native species and functional groups present in the established vegetation and seed banks of roadsides and reference areas nearby. The type of dispersal of exotic and native species at the roadsides was also evaluated. Total cover and that of exotic and native species was lower at the roadsides than in the reference areas; however, at the roadsides the cover and seed abundance of exotic species was higher than that of native species. In the roadsides vegetation, native shrubs such as Acaena splendens predominated, along with exotic perennial herbs and grasses which were mainly represented by Rumex acetosella. In the seed bank the predominant species were exotic perennial herbs, also represented by R. acetosella, annual exotic species such as Epilobium brachycarpum and Verbascum thapsus, and annual native species such as Heliotropium paronychioides. No exotic shrubs were found either at the roadsides or in the reference areas. The species at the roadsides did not present a dominant type of dispersal. The abundance of exotic species at the roadsides, both in the aboveground vegetation and the seed bank, may be due to the stressful environment and the characteristics of the species themselves, such as the ability to form seed banks. This work revealed that the roadsides of the Patagonian steppe constitute reservoirs of invasive exotic species, highlighting the importance of identifying them and controlling their spread, with a view to generating ecosystem management programs.

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Piperine (PIP) is an alkaloid which is potent as a therapeutic agent. However, its applications are restricted by its poor water solubility. Nanosponges (NS) derived from polymers are versatile carriers for poor water-soluble substances. The aim of this work was to synthesize ß-cyclodextrin NS, by microwave-assisted fusion, for the encapsulation of PIP. Different formulations of NS were synthesized by varying the molar ratio of ß-cyclodextrin:diphenyl carbonate (ß-CD:DPC; 1:2, 1:6 and 1:10). NS specimens derived from 1:2, 1:6 and 1:10 ß-CD:DPC molar ratios exhibited degree of substitution values of 0.345, 0.629 and 0.878, respectively. The crystallinity of NS was enhanced by increasing diphenyl carbonate concentration. A high degree of crosslinking in the NS increased the loading efficiency due to increased surface area available for bioactive inclusion. This study demonstrated the feasibility of synthesizing NS derived from ß-cyclodextrin of high crystallinity for the encapsulation of PIP at high loading capacity.

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Background: Depressive disorder is one of the main health problems worldwide. Many risk factors have been associated with this pathology. However, while the association between risks factors and adult depression is well established, the mechanisms behind its impact remains poorly understood. A possible, yet untested explanation is the mediating impact of levels of personality functioning, i.e., impairments with regard to self and interpersonal. Method: Around 162 patients were assessed at the beginning of their therapy, with regard to risk factors, such as sociodemographic, physical, hereditary (Information Form), and adverse childhood experiences (ACE; CTQ). Depressive symptoms (Beck Depression Inventory, BDI) and personality functioning (OPD-SQ) were also measured. Associations between the related variables as well as other possible covariates were examined by means of zero-order correlations and bootstrapping-based mediation analysis. Results: Of all the risk factors taken into account, level of education and physical illness were associated with depression. On the other hand, the most significant predictor of depressive symptomatology was ACE, and this relationship was mediated by personality functioning. This indicates that patients presenting adverse childhood experiences are more likely to develop deficiencies in personality functioning, which in turn increases their likelihood of developing depressive symptomatology. Conclusion: These results reaffirm the importance of incorporating risk and vulnerability factors such as personality functioning in understanding depression.

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Krüppel-like factor 6 (KLF6) is a transcription factor involved in the regulation of several cellular processes. Regarding its role in tumorigenesis, KLF6 is considered a tumor suppressor. Numerous reports demonstrate its frequent genomic loss or down-regulation, implying a functional inactivation in a broad range of human cancers. Previous work from our laboratory showed that the down-regulation of KLF6 expression in normal fibroblasts leads to cellular transformation, while its ectopic expression interferes with the oncogenic transformation triggered by activated Ras through a cell cycle arrest. We hypothesize that the growth suppressor activity of KLF6 may involve the induction of cellular senescence thereby helping to prevent the proliferation of cells at risk of neoplastic transformation. Here, we explored the association of KLF6 up-regulation in two different cellular senescence scenarios. We found that KLF6 silencing bypasses both oxidative and oncogene-induced senescence. In this context, KLF6 expression per se was capable to trigger cellular senescence in both normal and tumoral contexts. As such, the findings presented in this report provide insights into a potential mechanism by which KLF6 may play a suppressing role of uncontrolled or damaged cell proliferation.

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El objetivo fue evaluar los requerimientos de germinación de Phacelia secunda J.F. Gmel. y Eryngium paniculatum Cav. y Dombey ex F. Delaroche, herbáceas perennes colonizadoras de ambientes degradados del noroeste patagónico argentino y de interés para la restauración ecológica. Se evaluó el porcentaje, tiempo medio e inicio de germinación en un control (C) y dos tratamientos pre-germinativos: escarificación mecánica con bisturí (EM) y estratificación húmeda fría durante 45 días (EHF). En P. secunda, el porcentaje de germinación en el tratamiento EHF (2%) fue menor que en el C (24%) y el tratamiento EM (16%). En E. paniculatum se encontraron diferencias entre el C (94%) y el tratamiento EHF (82%), pero no entre el C y EM (91%). El tratamiento EHF aceleró el inicio de la geminación en ambas especies. Las semillas de P. secunda mostraron baja capacidad de germinación siendo necesario evaluar nuevos tratamientos. Eryngium paniculatum mostró alta capacidad germinativa aún en el control, lo que evidencia que no requiere tratamientos pregerminativos específicos.

The aim was to evaluate the seed germination requirements of Phacelia secunda J.F. Gmel. and Eryngium paniculatum Cav. y Dombey ex F. Delaroche, perennial herbaceous colonizers of degraded environments of northwest Argentinian Patagonia and of interest for ecological restoration. The germination percentage, mean germination time and time until initiation of germination of a control (C) and two pre-germination treatments: mechanical scarification with a scalpel (EM) and 45 days cold moist stratification (EHF) were evaluated. In P. secunda, the germination percentage in EHF treatment (2%) was lower than in C (24%) and EM (16%) treatment. In E. paniculatum, differences between C (94%) and EHF (82%) were found, but not between C and EM (91%). EHF treatment accelerated the germination initiation in both species. Seeds of P. secunda showed low germination capacity being necessary to evaluate new treatments. Eryngium paniculatum showed high germination capacity in the control. Thus this species does not require specific pre-germination treatments.

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The facilitation mechanism maintains ecosystem richness by increasing seedling recruitment. Overgrazed grasslands of northwestern Patagonia are invaded by shrubs that could promote the seedling recruitment of forage species. We investigated the role of Acaena splendens shrubs on the maintenance of diversity and its usefulness as a nurse shrub in the recruitment of Festuca pallescens, a grass of high forage value present with a low cover in degraded grasslands. To test the performance of A.splendens as a nurse plant in non-degraded grassland, we recorded the species richness four years inside of A. splendens senescent shrubs and in gaps among dominant tussock grasses. Species were grouped in four functional groups: annual and biannual herbs and grasses, perennial herbs, perennial grasses and shrubs. To test the usefulness of A. splendens in the restoration of degraded grassland, we monitored the seedling emergence and survival of F. pallescens inside A. splendens and in gaps. We related seedling survival to meteorological and microenvironmental conditions. Species richness was higher in Acaena nurse plants than in gaps. The frequency of functional groups, with exception of annual and biannual herbs and grasses, were higher in Acaena than in gaps. Seedling emergence and survival of F. pallescens were higher in Acaena, but the seedlings died in summer in both microsites. Mean maximum temperature was higher and mean minimum humidity lower in gaps than in Acaena during spring. However, the spring-summer season in which we monitored F. pallescens survival, was exceptionally dry and hot, affecting the survival of F. pallescens seedlings. Our results show that A. splendens act as a nurse species increasing the richness in the non-degraded grassland and facilitating the seedling recruitment of an important forage species in the degraded grassland. Nevertheless, the facilitation mechanism will fail in drought conditions, indicating that this restoration tool is limited by climate.

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La Aplasia Cutis Congénita es una afección in-frecuente caracterizada por la ausencia de piel al nacer. Su localización más frecuente es en vértex, siendo rara en miembros inferiores como es el caso de nuestra paciente. La misma puede presentarse de forma aislada o asociada a otras anomalías o alteraciones genéticas. Analizamos el caso de una paciente de sexo femenino, con antecedente de consumo de marihuana materno durante la gestación, que presenta una aplasia cutis congénita extensa de miembro inferior derecho con acorta-miento del mismo a expensas de partes blandas, sin otras anomalías asociadas a la que se le realizó tratamiento tópico con gel antiséptico y apósitos glicerinados estériles con buena evolución y sin complicaciones.

Aplasia Cutis Congenita is an infrequent condi-tion characterized by the absence of skin at birth. The most frequent location is the scalp, being rare in lower limbs as is the case of our patient. It can be an isolated condition or be associated with other anomalies or genetic disorders. We analyzed the case of a female patient, with a history maternal use of marijuana during pregnancy, who presented a congenital extensive aplasia cutis of the right lower limb, with shortening at the expense of soft parts, without other abnormalities associated, who received topical treatment with antiseptic gel and sterile glycerinated dressings with good evolution and without complications.

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This study examined the association between body composition, somatotype and socioeconomic status (SES) in Chilean children and adolescents by sex and school level (grade). The cross-sectional study was conducted on 1168 schoolchildren aged 6-18 years (572 males) from Valparaíso, Chile. Body composition, as assessed by percentage body fat (BF%) and somatotype, was evaluated using Ellis equations and the Heath-Carter method, respectively. The socioeconomic status of respondents was assessed using the ESOMAR survey. Obesity was defined as BF% ≥25 for boys and ≥30 for girls; 'high endomorph' somatotype was defined as a somatotype endomorph component (EC) of at least 5.5. Logistic regression analysis was used to assess the relationship between high adiposity and SES, potential confounding factors and school level. In females, the results indicated that the groups with lower SES had higher EC. At the 1st (youngest) school level (1-4th grades), males exhibited similar trends in their BF% and EC. High adiposity was associated with the female sex (BF%: OR=3.39; 95% CI 2.60, 4.41; high EC: OR=2.31; 95% CI 1.80, 2.98). In addition, low SES increased the risk of high adiposity compared with high SES (BF%: OR=2.25; 95% CI 1.40, 3.61; high EC: OR=2.19; 95% CI 1.37, 3.47). An association was observed between increased adiposity and lower SES, mainly in females, which indicates that females with low SES might be at greater risk of obesity.

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El liquen escleroso es una dermatosis inflamatoria crónica de piel y semimucosas que afecta princi-palmente vulva y región perianal, la localización extragenital vista sólo en 15 a 20% de los casos es rara en la infancia. La presentación más frecuente es la anogenital con pápulo-placas blanco marfil, atrofia, erosiones, púrpura y esclerosis. En mujeres afecta simétricamente zona interna de vulva, pe-rianal y periné adquiriendo forma típica en ocho, sin afectar vagina o himen. El liquen escleroso ex-tragenital se localiza principalmente en el dorso, cuello, periumbilical, muñecas y axilas con lesiones similares a las descriptas. Presentamos el caso clínico de una escolar de 11 años, sin patologías previas, que consulta por der-matosis situada en piel y mucosas topografiada en tronco y genitales. En piel, zona escapular bilate-ral, se observan placas blanco-nacaradas de cen-tro atrófico, sin esclerosis palpable. En mucosas, afectaba labios mayores, menores y zona perianal en forma de ocho, con atrofia y coloración blanco-brillosa. Refiere un año de evolución, con prurito vulvar y constipación. Se realiza diagnóstico de li-quen escleroso genital y extragenital y tratamiento con buena evolución.La importancia de conocer su diagnóstico radica en que es una patología que afecta la calidad de vida de los pacientes, por su sintomatología, su po-sible repercusión sexual y urinaria, y su potencial riesgo de carcinoma espinocelular. Es importante tener un alto índice de sospecha, ya que, debido a su baja frecuencia en la edad pediátrica, muchas veces el diagnóstico es tardío.

Lichen sclerosus is a chronic inflammatory der-matosis of skin and semi-mucosae, important for its sexual and urinary repercussion, and its poten-tial risk of squamous cell carcinoma.Mainly affects vulva and perianal region, extrage-nital localization seen only in 15 to 20% of cases is rare in childhood. The most frequent presenta-tion is anogenital with white ivory papule-plates, atrophy, erosions, purpura and sclerosis. In women it affects the inner area of the vulva, peria-nal and perineum, acquiring a typical shape in eight, without affecting the vagina or hymen. The extragenital sclerosus lichen is located mainly on the back, neck, periumbilical, wrists and armpits with lesions similar to those described.We present the case of a schoolgirl of 11 years, without previous pathologies, who consulted for dermatosis located on the skin and mucous mem-branes on the trunk and genitals. In skin, bilateral scapular area, white-nacreous plates of atrophic center are observed, without palpable sclerosis. In mucous membranes, it affected the labia mi-nora, majora and perianal zone in eight form, with atrophy and white-shiny coloration. She referred a year of evolution, with vulvar pruritus and constipation. Genital and extragenital lichen sclerosus diagnosis was made and had a good evolution with treatment.

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Se presenta el caso de un lactante de 24 meses de edad diagnosticado de púrpura trombopénica corticodependiente, en el que se confirmó infección activa por citomegalovirus mediante serología y aislamiento del virus en orina. Ante la mala evolución de la enfermedad y sospechando relación causal con el virus, se inició valganciclovir vía oral hasta un total de 5 meses, obteniendo excelente respuesta con resolución simultánea de ambos procesos y sin efectos secundarios reseñables.

We report a case of a 24 months old child, diagnosed with corticodependent thrombocytopenia in which active cytomegalovirus infection was confirmed sustituir resaltado por: by means of serology and viris isolation in urine.. Due to the patient's worsening, we suspected a link between both processes and started oral valganciclovir, given for a total of 5 months. We documented excellent simultaneous response in both pathologies, and without relevant side effects.