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OBJECTIVE: To evaluate students' qualification after a six-month basic course of Neonatal Performed Echocardiography (NPEcho), adjusted by the motivational profile. STUDY DESIGN: Prospective cohort of 16 neonatologists/neonatal fellows who underwent the basic NPEcho course in 2019 (18 h face-to-face theoretical classes; 36 h hands-on training) and 12 in 2020 (18 h online theoretical classes; 36 h hands-on training). Students' qualification was defined as ≥70% in post-test, video test, and practical evaluation in neonates. Academic Motivation Scale was applied. RESULTS: Scores in 2019 vs. 2020 were: pre-test -32% vs. 40% (p = 0.029), final theoretical score -78% vs. 69% (p = 0.007), and practical evaluation -88% vs. 65% (p = 0.003), resulting in 68.8% in 2019 vs. 33.3% in 2020 qualified students. Students' motivational profile were similar in 2019 and 2020. CONCLUSION: The NPEcho was successful in qualifying students with face-to-face theoretical classes, but the online format was inadequate to achieve the learning goals.

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Coping is defined as a set of cognitive and behavioral efforts made to master stressful specific demands. Adaptation to chronic diseases, such as Multiple Sclerosis (MS), depends on the effectiveness of coping. Objective: To assess the psychometric properties of the Coping Responses Inventory (CRI-A) in persons with MS (PwMS), verifying the transferability of the measure, already validated in the Argentine general population, and to describe the types of coping strategies available for PwMS. Methods: 90 PwMS were included. Outcome measures: CRI-A Inventory, Expanded Disability Status Scale (EDSS), Beck Depression Inventory, Fatigue Severity Scale and MS International Quality of Life questionnaire. Results: Descriptive data is as follows: mean age (years): 40.97 ± 12.85; years of education: 13.46 ± 3.93; EDSS: 2.48 ± 1.79; disease evolution (years): 10.76 ± 9.72; depression: 13.92 ± 10.45; fatigue 3.77 ± 1.72. The psychometric properties of the CRI-A Inventory observed in the Argentine general population are present in the MS sample as well, with adequate validity and reliability. The respondents most frequently utilized a problem-focused coping style. Conclusions: Results showed the CRI-A has good transferability properties from the Argentine general population to the MS population.

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La presente investigación se propone analizar los estilos y estrategias de afrontamiento utilizados por los pacientes con Esclerosis Múltiple (EM) mediante el Inventario de Respuestas de afrontamiento (CRI-A), ya validado en Argentina. El afrontamiento es concebido como los esfuerzos cognitivos y conductuales que se utilizan para controlar las demandas externas y/o internas generadoras de estrés. Existen dos estilos de afrontamiento, el Afrontamiento Centrado en el Problema (ACP) y el Afrontamiento Centrado en la Emoción (ACE). Investigaciones exponen que los pacientes con EM tienden a utilizar más estrategias centradas en la emoción que estrategias centradas en el problema, sosteniendo un afrontamiento ineficaz y desadaptativo ante las situaciones de estrés. El diseño de investigación es de corte transversal, de tipo descriptivo-correlacional. Población/muestra; 90 pacientes atendidos desde el 1 de junio del 2018 al 28 de febrero del 2019 en el Hospital General de Agudos J. M. Ramos Mejía. INSTRUMENTOS Inventario de Respuestas de Afrontamiento, Expanded Disability Status Scale, Fatigue Severity Scale, Inventario de Depresión de Beck y Multiple Sclerosis International Quality of Life questionnaire. Para el análisis descriptivo se utilizaron porcentajes y correlación de Pearson (CP). Se evaluó el mantenimiento de las propiedades psicométricas del instrumento (CRI-A) en la población específica de personas con EM (transferabilidad), evaluando la validez de constructo (con Análisis Factorial), la validez de criterio (CP con otros instrumentos) y la confiabilidad (con Cronbach). Se utilizó el programa SPSS. RESULTADOS Se evidenció que el estilo de ACP es el más utilizado por los pacientes con una media de 1,81 ± 0,52. El mismo se asocia significativamente con la escolaridad (r=,305) y el nivel de discapacidad (r=-,230). Mientras que el estilo de ACE es menos utilizado con una media de 1,38 ± 0,49 y se asocia con las variables de depresión (r=,427), fatiga (r=,211) y la Calidad de vida relacionada con la salud (r=,-228). Se demostró además que el Inventario de Respuestas de afrontamiento (CRI-A), mantiene sus propiedades psicométricas en la subpoblación de EM. DISCUSIÓN El estilo de afrontamiento varía según factores demográficos y clínicos, como ser el nivel de escolaridad, la discapacidad, la depresión y la fatiga. Algunas de estas variables, facilitan el manejo de la EM de manera adaptativa, mientras que otros interfieren con la capacidad para adoptar un afrontamiento eficaz ante la enfermedad

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INTRODUCTION: Multiple sclerosis (MS) and neuromyelitis optica (NMO) are demyelinating diseases of the central nervous system. Autoimmunity in patients with demyelinating disease and in their families has been broadly investigated and discussed. Recent studies show a higher incidence of rheumatic autoimmune diseases among adult patients with MS or NMO and their families, but there are no studies in the pediatric population. OBJECTIVE: To evaluate an association of MS and NMO with autoimmune rheumatic diseases in pediatric patients. METHOD: 22 patients younger than 21 years old with MS or NMO diagnosed before the age of 18 years were evaluated regarding epidemiological data, clinical presentation, association with autoimmune diseases, family history of autoimmune diseases, laboratory findings, imaging studies and presence of auto-antibodies. RESULTS: Among the patients studied, there was a prevalence of females (68.1%). The mean age of symptoms onset was 8 years and 9 months and the mean current age was 16 years and 4 months. Two patients (9%) had a history of associated autoimmune rheumatic disease: one case of juvenile dermatomyositis in a patient with NMO and another of systemic lupus erythematosus in a patient with MS. Three patients (13%) had a family history of autoimmunity in first-degree relatives. Antinuclear antibody was found positive in 80% of patients with NMO and 52% of patients with MS. About 15% of antinuclear antibody-positive patients were diagnosed with rheumatologic autoimmune diseases. CONCLUSION: Among patients with demyelinating diseases diagnosed in childhood included in this study there was a high frequency of antinuclear antibody positivity but a lower association with rheumatologic autoimmune diseases than that observed in studies conducted in adults.

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ABSTRACT Introduction: Multiple sclerosis (MS) and neuromyelitis optica (NMO) are demyelinating diseases of the central nervous system. Autoimmunity in patients with demyelinating disease and in their families has been broadly investigated and discussed. Recent studies show a higher incidence of rheumatic autoimmune diseases among adult patients with MS or NMO and their families, but there are no studies in the pediatric population. Objective: To evaluate an association of MS and NMO with autoimmune rheumatic diseases in pediatric patients. Method: 22 patients younger than 21 years old with MS or NMO diagnosed before the age of 18 years were evaluated regarding epidemiological data, clinical presentation, association with autoimmune diseases, family history of autoimmune diseases, laboratory findings, imaging studies and presence of auto-antibodies. Results: Among the patients studied, there was a prevalence of females (68.1%). The mean age of symptoms onset was 8 years and 9 months and the mean current age was 16 years and 4 months. Two patients (9%) had a history of associated autoimmune rheumatic disease: one case of juvenile dermatomyositis in a patient with NMO and another of systemic lupus erythematosus in a patient with MS. Three patients (13%) had a family history of autoimmunity in first-degree relatives. Antinuclear antibody was found positive in 80% of patients with NMO and 52% of patients with MS. About 15% of antinuclear antibody-positive patients were diagnosed with rheumatologic autoimmune diseases. Conclusion: Among patients with demyelinating diseases diagnosed in childhood included in this study there was a high frequency of antinuclear antibody positivity but a lower association with rheumatologic autoimmune diseases than that observed in studies conducted in adults.

RESUMO Introdução: Esclerose múltipla (EM) e neuromielite óptica (NMO) são doenças desmielinizantes do sistema nervoso central. A autoimunidade entre pacientes com doenças desmielinizantes e seus parentes tem sido amplamente investigada e discutida. Estudos recentes demonstram maior incidência de doenças reumáticas autoimunes entre pacientes adultos com EM e NMO e seus parentes, mas não há estudos na população pediátrica. Objetivo: Avaliar a associação de EM e NMO com doenças reumáticas autoimunes em pacientes pediátricos. Método: Foram incluídos 22 pacientes menores de 21 anos com diagnóstico de EM ou NMO antes dos 18 anos e avaliados dados epidemiológicos, clínicos, associação com doenças autoimunes, história familiar de doenças autoimunes, exames laboratoriais, exames de imagem e presença de autoanticorpos. Resultados: Entre os pacientes estudados, houve prevalência do sexo feminino (68,1%). A média de idade de início dos sintomas foi de oito anos e nove meses e a média de idade dos pacientes na avaliação foi 16 anos e quatro meses. Dois pacientes (9%) apresentaram doença reumática autoimune associada, um caso de dermatomiosite juvenil em paciente com NMO e outro de lúpus eritematoso sistêmico juvenil em paciente com EM. Três pacientes (13%) apresentaram história familiar de autoimunidade em parentes de primeiro grau. Anticorpo antinuclear (ANA) positivo foi encontrado em 80% dos pacientes com NMO e em 52% dos pacientes com EM. Cerca de 15% dos pacientes com ANA positivo apresentaram diagnóstico definitivo de doença autoimune reumática associada. Conclusão: Entre os pacientes com doenças desmielinizantes diagnosticadas durante a infância incluídos nesta pesquisa houve uma alta frequência de ANA positivo, mas uma menor taxa de associação com doenças reumáticas autoimunes do que a encontrada em trabalhos conduzidos em adultos.

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BACKGROUND: Acne is an inflammatory disease of the pilosebaceous follicles. Oral isotretinoin is the treatment of choice for severe acne. Exaggerated cicatrization related to oral isotretinoin was reported in the 1980s and 1990s. Currently, dermabrasion for acne scar revision is only recommended 6 to 12 months after the completion of oral isotretinoin treatment. OBJECTIVE: To evaluate the evolution of healing from manual chemabrasion of depressed scars resulting from acne conducted within 1 to 3 months after oral isotretinoin treatment. METHODS AND MATERIALS: This was an interventional, prospective study involving 10 patients with depressed facial scars. A medium-depth chemical peel was applied to the entire face. Manual sandpaper dermabrasion was performed to areas of scarring until the appearance of bloody dew. A 6-month reepithelization follow-up was conducted. RESULTS: All of the patients presented with normal cicatrization, and neither hypertrophic scars nor keloids were observed. Depressed acne scar revision was satisfactory. CONCLUSION: Our observations may contribute to the discussion of the negative influence of oral isotretinoin on wound healing. Other studies are necessary to reevaluate the current recommendation of a 6- to 12-month waiting period after oral isotretinoin treatment before performing dermabrasion or fractional ablative laser for acne scar revision.

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The triphenylmethyl (Tr) group undergoes a transfer (transetherification or disproportionation) between the molecules of 5'-O-Tr-2'-deoxynucleosides in a process mediated by anhydrous sulfates of Cu(+2), Fe(+2), or Ni(+2) to yield mixtures of 3',5'-bis-O-Tr and 3'-O-Tr products. If phenylmethanol is present in a reaction medium, detritylation results with concomitant formation of phenylmethyl triphenylmethyl ether. The behavior of t-butyldimethylsilyl (TBDMS) group in 5'-O-TBDMS-2'-deoxynucleosides is exactly the same. Such type of transetherifications was not observed before for the O-Tr and O-TBDMS groups.

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