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Visceral Leishmaniasis (VL) is the most severe of the three forms of Leishmaniasis. In the Americas, Brazil and Colombia present more than 90 % of the cases in the region. Our aim in this research was to estimate the association of the incidence rate of Visceral Leishmaniasis with the following environmental variables: the percentage of area suitable for the vector Lutzomyia longipalpis, the episodes of La Niña and El Niño, the Brazilian and Colombian biomes. Epidemiological data were obtained from the Brazilian Notifiable Diseases Information System and the Colombian National Public Health Surveillance System. Environmental data were downloaded from the NASA Giovanni web app, the Modis Sensor database, and the meteorological agencies of Australia, Japan, and the United States of America. Records of the presence of Lu. longipalpis were obtained from public databases and previous studies. As a result, the incidence per 10,000 inhabitants with LEBS for each El Niño-Southern Oscillation (ENSO) episode showed the largest values during El Niño 2015-2016, mainly in Brazil's Northeast and Central regions and the Northeast region of Colombia. Compared with the Neutral 2012-2014 episode, the episodes of El Niño 2015-2016 and La Niña 2010-2011 showed an average increase in the monthly incidence rate of VL, and the average increase was higher during El Niño 2015-2016 (aIRR = 2.304 vs.1.453) We found a positive association between the incidence rate of VL and the El Niño 2015-2016 episode and an impressive% of area suitable for the vector Lu. longipalpis in the Amazon region.An increase of 1 % in the area suitable for the vector Lu. longipalpis leads to an average rise of 0.8 % in the monthly incidence rate of VL. Our study shows a possible association between VL incidence and ENSO, with the most considerable incidence rates observed during El Niño 2015-2016 in Brazil's Northeast and Central regions and the Northeast region of Colombia. The present study is very important to better understand the Visceral Leishmaniasis transmission dynamics.

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Visceral Leishmaniasis (VL) is the most severe of the three forms of Leishmaniasis. In the Americas, Brazil and Colombia present more than 90 % of the cases in the region. Our aim in this research was to estimate the association of the incidence rate of Visceral Leishmaniasis with the following environmental variables: the percentage of area suitable for the vector Lutzomyia longipalpis, the episodes of La Niña and El Niño, the Brazilian and Colombian biomes. Epidemiological data were obtained from the Brazilian Notifiable Diseases Information System and the Colombian National Public Health Surveillance System. Environmental data were downloaded from the NASA Giovanni web app, the Modis Sensor database, and the meteorological agencies of Australia, Japan, and the United States of America. Records of the presence of Lu. longipalpis were obtained from public databases and previous studies. As a result, the incidence per 10,000 inhabitants with LEBS for each El Niño-Southern Oscillation (ENSO) episode showed the largest values during El Niño 2015–2016, mainly in Brazil's Northeast and Central regions and the Northeast region of Colombia. Compared with the Neutral 2012–2014 episode, the episodes of El Niño 2015–2016 and La Niña 2010–2011 showed an average increase in the monthly incidence rate of VL, and the average increase was higher during El Niño 2015–2016 (aIRR = 2.304 vs.1.453) We found a positive association between the incidence rate of VL and the El Niño 2015–2016 episode and an impressive% of area suitable for the vector Lu. longipalpis in the Amazon region.An increase of 1 % in the area suitable for the vector Lu. longipalpis leads to an average rise of 0.8 % in the monthly incidence rate of VL. Our study shows a possible association between VL incidence and ENSO, with the most considerable incidence rates observed during El Niño 2015–2016 in Brazil's Northeast and Central regions and the Northeast region of Colombia. The present study is very important to better understand the Visceral Leishmaniasis transmission dynamics.

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This research provides new evidence regarding the different kinds of air quality episodes, and their underlying mechanisms, that frequently impact the urban area of Quintero Bay in Central Chile, which is located along complex coastal terrain and is surrounded by industries. The monitoring campaign was carried out in January 2022 and encompassed two distinctive meteorological regimes. The first part of the month was dominated by a coastal low centered to the south of Quintero, which resulted in prevailing northerly flow (or weak southerlies) and a deep cloud-topped marine boundary layer. After a 2-3-day transition, the latter collapsed, and a clear-sky regime ensued, which was characterized by a shallow boundary layer and strong southerly winds during the daytime that lasted until the end of the campaign. By using proton transfer reaction time of flight mass spectrometry (PTR-TOF-MS) at a high temporal resolution (1 s), we measured high levels of volatile organic compounds (VOCs) during air quality episodes in real time. The episodes detected were associated with different prevailing meteorological regimes, suggesting that different point sources were involved. In the first episode, propene/cyclopropane, butenes, benzene, toluene and ethylbenzene/xylenes were associated with north and northwesterly weak winds. Complaints associated with hydrocarbon odor were reported. The pollution originated from industrial and petrochemical units located to the north of Quintero, which transport and store natural gas, liquified petroleum gas and oil. The second episode was linked to an oil refinery located south of our measurement site. In this case, high levels of phenol, furan and cresols occurred under strong southwesterly winds. During this event, headaches and dizziness were reported. By contrast, the levels of other aromatic compounds (benzene, toluene, ethylbenzene/xylenes) were lower than in the first air pollution episode.

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Oxidative potential (OP) has gained attention as a parameter that can reveal the ability of different properties of particulate matter (PM) to generate reactive oxygen species (ROS) as one single value. Moreover, OP is also believed to be a predictor of toxicity and hence the health effects of PM. This study evaluated the OP of PM10, PM2.5,and PM1.0samples using dithiothreitol assays in two cities of Chile (Santiago and Chillán). The results showed that the OP was different between cities, PM size fractions, and seasons. Additionally, OP was strongly correlated with certain metals and meteorological variables. Higher mass-normalized OP was observed during cold periods in Chillán and warm periods in Santiago and was associated with PM2.5 and PM1. On the other hand, volume-normalized OP was higher during winter in both cities and for PM10. Additionally, we compared the OP values to the Air Quality Index (AQI) scale and found cases of days that were classified as having "good" air quality (supposed to be less harmful to health) showing extremely high OP values that were similar to those on days that were classified as "unhealthy". Based on these results,we suggest using the OP as a complementary measure to the PM mass concentration because it includes important new information related to PM properties and compositions that could help improvecurrent air quality management tools.

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This paper analyzes the spatio-temporal variations, and exceedances of the PM2.5 concentrations in Northwestern South America at different scales to assess the implemented policies and identify the involved phenomena. Through reanalysis and ground-based data, we found that high PM2.5 levels in most cities of the region are caused by wildfires and local emissions, including the capital cities of Venezuela, Ecuador, Colombia, and Panamá. In-situ measurements suggest that the majority of the cities comply with the local but not with the WHO guidelines, indicating that local annual limits should be more restrictive. Two peaks in the daily variations of PM2.5 (related to vehicle emissions) and also a steeper decrease around noon (associated with an increase in wind speed and in the boundary layer height) were identified. The trend-analysis shows that Bogotá and Medellín have a decreasing PM2.5 annual-trend (between -0.8µgm-3 and -1.7µgm-3) that corresponds to effective policies. In contrast, Cali has a positive annual-trend (0.8µgm-3) most likely because of Short-Range Transport produced by a northerly-flow from a highly polluted neighboring city, which also affects Cali's PM2.5 diurnal cycle, or by local-dynamics. The exceedances show that the policies are working on an annual but not at a daily time-scale. These results serve as a first input for additional studies, with the aim of gaining a better understanding of the contaminant before adapting current policies or implementing new policies and measures that need to include a joint international, regional, and inter-city efforts regarding pollution transport.

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Depression is a common illness worldwide, affecting an estimated 3.8% of the population, including 5% of all adults, in particular, 5.7% of adults over 60 years of age. Unfortunately, at present, the ways to evaluate different mental disorders, like the Montgomery-Åsberg depression rating scale (MADRS) and observations, need a great effort, on part of specialists due to the lack of availability of patients to obtain the necessary information to know their conditions and to detect illness such as depression in an objective way. Based on data analysis and artificial intelligence techniques, like Convolutional Neural Network (CNN), it is possible to classify a person, from the mental status examination, into two classes. Moreover, it is beneficial to observe how the data of these two classes are similar in different time intervals. In this study, a motor activity database was used, from which the readings of 55 subjects of study (32 healthy and 23 with some degree of depression) were recorded with a small wrist-worn accelerometer to detect the peak amplitude of movement acceleration and generate a transient voltage signal proportional to the rate of acceleration. Motor activity data were selected per patient in time-lapses of one day for seven days (one week) in one-minute intervals. The data were pre-processed to be given to a two-dimensional convolutional network (2D-CNN), where each record of motor activity per minute was represented as a pixel of an image. The proposed model is capable of detecting depression in real-time (if this is implemented in a mobile device such as a smartwatch) with low computational cost and accuracy of 76.72% In summary, the model shows promising abilities to detect possible cases of depression, providing a helpful resource to identify the condition and be able to take the appropriate follow-up for the patient.

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Personal positions and voices of a patient diagnosed with borderline personality disorder (BPD) and the therapist during long-term psychotherapy were studied aiming to find differences in the patterns formed in these aspects of subjectivity according to the level of elaboration of the change episodes achieved by the patient. This case study considered a stage of qualitative analysis where change episodes of the patient were traced through the Change Episodes Model. Later, through the Model of Analysis of Discursive Positioning in Psychotherapy (MAPP), the voices and personal positions of the patient and her therapist were identified in each of the change episodes. In the stage of quantitative analysis, dynamic patterns in the voices and personal positions were established, accounting for hypothetical attractors using the Space State Grid (SSG) technique in each of the three different levels of subjective elaboration that constitute the change episodes. The results established differentiated dynamic patterns in the change episodes, coherent with the patient's change process, and formation of propositive/reflective specific patterns as the patient evolved in the three different levels of subjective elaboration. The above suggests that a subjective transformation process is displayed, and this is manifested in the different voices and personal positions that emerged as the change episodes evolve. The identified dynamic patterns can be considered nonlinear and emergent subjective exchanges between the patient and the therapist throughout the psychotherapy.

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Introducción: El pseudotumor hemofílico consiste en un hematoma encapsulado de crecimiento progresivo debido a repetidos episodios de hemorragia en pacientes con hemofilia. Objetivo: Evaluar la recuperación de un paciente con una lesión compleja y poco frecuente que le causaba limitaciones a su vida cotidiana. Presentación de caso: Paciente masculino de 36 años de edad, con antecedentes patológicos personales de hemofilia A grave, que presentaba aumento de volumen en la pierna derecha posterior a un trauma sufrido a ese nivel. Llevó tratamiento conservador por más de 10 años, período en que la lesión continúo aumentando de tamaño, el cual progresó considerablemente en los últimos 3 años, por lo que requirió tratamiento quirúrgico. Conclusiones: La complejidad del paciente no solo radica en la afección en la región medial de la tibia, sino por la enfermedad de base, demuestra que se requiere un diagnóstico lo más certero y precoz posible para adoptar una conducta adecuada y rápida(AU)

Introduction: Hemophilic pseudotumor consists of an encapsulated hematoma with progressive growth, due to repeated bleeding episodes in patients with hemophilia. Objective: To evaluate the recovery of a patient with a complex and rare injury that already caused limitations to his daily life. Case presentation: 36-year-old male patient with a personal pathological history of severe hemophilia A, who presented an increase in volume in the right leg after a trauma that he suffered at that level. As time went by, he began to present an increase in volume in the distal middle region of his right leg for more than 10 years, which progressed considerably in the last 3 years, requiring surgical treatment. Conclusions: The complexity of the patient is not only given by the condition in the medial region of the tibia, but by the underlying disease shows that a diagnosis as accurate and early as possible is required, to adopt an adequate and rapid behavior(AU)

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Diarrhea following bariatric surgery may be secondary to multiple causes. The aim of the present study is to report a significant reduction in episodes of diarrhea with the stimulation of the lymphatic system in a patient with post-bariatric diarrhea usingthe Godoy method for the treatment for lymphedema. Case Report: A 40-year-old female patient with obesity was submitted to bariatric surgery, type Gastric bypass (roo-en-wy), 13 years ago. Beginning immediately after surgery, the patient began to have around 12 episodes of diarrhea per day for approximately 11 years. The patient also had lower limb lymphedema and was sent to the Clínica Godoy-Brazil for treatment. The patient underwent the Godoy Method® of intensive treatment for lymphedema. However, the most important finding was the immediate reduction in the number of episodes of diarrhea per day, which went from 12-13 to 2-3 after only one day of treatment. This result regarding diarrhea has been maintained for two years, with the maximum number of seven episodes on some days, which subsequently returned to two to three episodes. The Godoy intensive lymphedema treatment method was effective at reducing the number of episodes of post-bariatric diarrhea, offering a novel treatment option for these patients

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Mentalizing, conceived as the capacity to attribute intentional mental states as implicit or underlying behavior of an individual or others, has gained interest within psychodynamic clinical research due to its potential as a change mechanism. Variations and qualities of mentalization have been studied through reflective functioning (RF). But only few studies are analyzing it throughout the psychotherapeutic interaction, identifying its level for therapists and patients. In contrast, brief psychodynamic therapy has a long tradition for establishing a focus to be worked upon. Lately, a multischematic focus has arisen, considering both conflict and personality functioning focuses as key elements on successful psychotherapies. This study aimed to identify mentalizing manifestations of patients and therapists through change episodes of one successful brief psychodynamic therapy and establish the relationship between these mentalizing manifestations and the type and depth of the therapeutic focus being worked on (conflict or personality functioning). Only 37.5% of speaking turns were able to be coded with RF; 77% of these had moderate to high RF and 22% had low or failure RF. The patient had 91% of low or failure RF, while the therapist only had 9% of low or failure RF. As for moderate to high RF, patients had 39%, while therapists had 61%. The patient showed a similar number of low or failure RF interventions and moderate to high RF interventions in conflict episodes. Meanwhile, the therapist only performs moderate to high-level RF interventions. In episodes in which personality functioning is worked on, both patient and therapist show a greater presence of interventions of moderate to high levels of RF. Finally, mentalizing interactions and non-mentalizing interactions were found on segments with conflict, and only mentalizing interactions were found on personality functioning segments.

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INTRODUCCIÓN: La hipotonía-hiporrespuesta (HHR) es uno de los efectos adversos supuestamente atribuibles a la vacunación e inmunización de tipo neurológico más notificados. El impacto a largo plazo a nivel del neurodesarrollo no es completamente conocida. OBJETIVO: Caracterizar los eventos de HHR post vacuna pentavalente notificados entre 2014 y 2018 al Ministerio de Salud Pública (MSP) de Uruguay. Realizar el tamizaje del neurodesarrollo de los que al momento de la evaluación tenían menos de 6 años de edad. METODOLOGÍA: Estudio descriptivo de las notificaciones al Sistema Nacional de Farmacovigilancia del MSP. Se realizó el tamizaje del neurodesarrollo con la Guía Nacional para la Vigilancia del Desarrollo. RESULTADOS: 30 casos, la mayoría de breve duración, en las primeras horas post primera dosis y con recuperación espontánea. Requirieron hospitalización 29. Se realizó el tamizaje del neurodesarrollo en 16. La media de tiempo entre el evento y esta evaluación fue 2 años y 2 meses. Fue normal la prueba de tamizaje en 15. En uno se detectó un retraso del lenguaje. CONCLUSIONES: Los episodios de HHR se presentaron con características similares a las descritas en la bibliografía. A pesar de las limitaciones del estudio, no se encontraron retrasos ni desvíos del desarrollo en los niños evaluados.

BACKGROUND: Hypotonic-hyporesponsive episodes (HHE) is one frequently reported neurologic adverse effect supposedly attributable to vaccination and immunization. Its long-term impact on neurodevelopment is not completely known. AIM: To characterize the post-pentavalent vaccine HHE events reported to the Uruguayan Ministry of Health (M of H) between 2014 and 2018. To perform neurodevelopment screening of those who were under 6 years of age at the time of evaluation. METHODS: Descriptive study of the reports made to the National Farmacosurveillance System of the M of H. Neurodevelopment screening was performed using the National Guidelines for Developmental Surveillance. RESULTS: 30 cases were studied. Most cases occurred after the first doses, were of short duration and during the first hours after vaccination, with spontaneous recovery. Median time between the event and this evaluation was 2 years and 2 months. Screening tests were normal in 15. Delay in the language area was detected in one case. CONCLUSIONS: HHE events had similar characteristics to those described in the literature, with no severe short-term complications. Despite the limitations of the present study, no delays nor deviations were found in the development of the children who were evaluated.

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Suicide associated with severe psychiatric illnesses is considered the leading cause of maternal deaths. We aimed to assess the suicide risk in women who experienced depressive or mixed episodes of mood change during the postpartum period and to determine which disorder is more related to suicide risk in the same period. We conducted a longitudinal study with 706 women whose children were born from April 2007 to May 2008 in a southern city in Brazil, and received prenatal care by the Brazilian National System of Public Health. The first assessment occurred during the prenatal period and the second within 30 to 60 days postpartum. The incidence of suicide risk was 10.9%. The odds of postpartum suicide risk were 6.50 (95% CI: 2.73; 15.48) higher in mothers with postpartum depression and 41.50 (95% CI: 12.11; 142.16) higher in those with mixed episodes than those who did not suffer from any mood disorder. Women with chronic episodes (who had depressive or mixed episodes during pregnancy and postpartum) were at increased odds of 4.94 (95% CI: 1.46; 16.69) of a postpartum suicide risk. The postpartum seems to be a critical period in the women's mental health. The impact of mental disorders in this period, especially mixed episodes, can increase the odds of a suicide risk onset. A good psychiatric evaluation and support during the prenatal and postpartum care may prevent the subsequent risk of suicide.

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This study aims to assess moments of meeting in psychotherapy -understood as moments of intense connectedness and intimacy, shared between patient and therapist during any therapeutic encounter that enable a spin in the therapy process- using a qualitative interview with patients who were undergoing or had finished psychological treatment. Micro-pehenomenological interviews were conducted with nine patients who were undergoing or had finished psychological treatment. Transcriptions of the interviews were subject to micro-phenomenological analysis. A general structure of episodes of meeting showing their temporal evolution was identified and divided into six consecutive phases. These findings suggest that episodes of meeting in psychotherapy are lived and remembered by patients in a significant way; they are emotionally charged and have a meaning for each participant. Also, emotional and nonverbal cues seem to be highly relevant features. Moments of meeting could be understood as implicit mechanisms that allow changes in the implicit relational domain.

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OBJECTIVE: The aim of this study was to estimate whether neurocognitive deficits are predictors of the long-term clinical course of patients with bipolar disorder. METHODS: A total of 76 outpatients with bipolar disorder performed a neurocognitive assessment at baseline and were followed for a period of at least 48 months. The clinical course during the follow-up period was documented by two measures: (1) number of affective episodes and (2) time spent ill. RESULTS: Patients had lower performance than controls in the domains of verbal memory and executive functions, and they were followed-up for a mean period of 70.73 months. Global cognitive deficits (performance 1.5 standard deviations below the mean in two or more cognitive domain) were independent predictors of both hypo/manic episode density and time spent with hypo/manic symptoms during follow-up. On the contrary, no neurocognitive measure showed a relationship with depressive morbidity during follow-up. CONCLUSION: Our findings suggest that cognitive deficits could be useful for predicting hypo/manic morbidity in the long-term clinical course. Theoretical and clinical implications of these findings are discussed.

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INTRODUCTION: Mixed-specifier mood disorders are probably a different subgroup in terms of response to treatment, socio-demographic parameters, course, and family history. Here we describe the rationale and design of a clinical trial aimed to test the efficacy, safety, and tolerability of a non-pharmacological treatment known as theta-burst stimulation (TBS) for treating the mixed depressive episodes of both bipolar (I or II), and unipolar depression. METHODS: The study is designed as a randomized, sham-controlled, double-blinded clinical trial evaluating TBS for the treatment of moderate or severe major depressive episodes with mixed features of patients receiving at least one first or second-line pharmacological treatment for depressive episodes without adequate response. Ninety adult (18 to 65 years old) patients will be enrolled and submitted to 6-week (comprising 5 consecutive days a week sessions for the first 3 weeks and then 2 days a week for a further 3 week) of inhibitory followed by excitatory TBS in dorsolateral prefrontal cortex. Participants will be assessed using clinical and neuropsychological tests before and after the intervention. The primary outcome is change in Montgomery-Åsberg Depression Scale (MADRS) score over time and across groups. Cognitive parameters will also be assessed with neuropsychological tests. RESULTS: The clinical results will provide evidence about TBS as an adjunctive treatment for mixed depression treatment and neuropsychological parameters will contribute toward an improved understanding the effects of TBS in cognition. CONCLUSION: Our results could introduce a novel therapeutic technique for mixed depressive episodes of both bipolar and unipolar disorders. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier NCT04123301; date of registration: 10/10/2019; URL: https://clinicaltrials.gov/ct2/show/NCT04123301?term=NCT04123301&rank=1.

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OBJECTIVE: To investigate the features of cardiorespiratory events in infants born preterm during the transitional period, and to evaluate whether different neonatal characteristics may correlate with event type, duration, and severity. STUDY DESIGN: Infants with gestational age (GA) <32 weeks and/or birth weight <1500 g were enrolled in this observational prospective study. Heart rate (HR) and peripheral oxygen saturation (SpO2) were recorded continuously over the first 72 hours. Cardiorespiratory events of ≥10 seconds were clustered into isolated desaturation (SpO2 <85%), isolated bradycardia (HR <100 bpm or <70% of baseline), or combined desaturation/bradycardia and classified as mild, moderate, or severe. The daily incidences of isolated desaturation, isolated bradycardia, and combined desaturation and bradycardia were analyzed. The effects of relevant clinical variables on cardiorespiratory event type and severity were assessed using generalized estimating equations. RESULTS: Among the 1050 events analyzed, isolated desaturations were the most frequent (n = 625) and isolated bradycardias the least common (n = 171). The number of cardiorespiratory events increased significantly from day 1 to day 2 (P = .028). One in 5 events had severe characteristics; event severity was highest for combined desaturation and bradycardia (P < .001). Compared with other event types, the incidence of combined desaturation and bradycardia was inversely correlated with GA (P = .029) and was higher with the use of continuous positive airway pressure (P = .002). The presence of a hemodynamically significant patent ductus arteriosus was associated with the occurrence of isolated desaturations (P = .001) and with a longer duration of cardiorespiratory events (P = .003). CONCLUSIONS: Cardiorespiratory events during transition exhibit distinct types, duration, and severity. Neonatal characteristics are associated with the clinical features of these events, indicating that a tailored clinical approach may reduce the hypoxic burden in preterm infants aged 0-72 hours.

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Major Depression Disease has been increasing in the last few years, affecting around 7 percent of the world population, but nowadays techniques to diagnose it are outdated and inefficient. Motor activity data in the last decade is presented as a better way to diagnose, treat and monitor patients suffering from this illness, this is achieved through the use of machine learning algorithms. Disturbances in the circadian rhythm of mental illness patients increase the effectiveness of the data mining process. In this paper, a comparison of motor activity data from the night, day and full day is carried out through a data mining process using the Random Forest classifier to identified depressive and non-depressive episodes. Data from Depressjon dataset is split into three different subsets and 24 features in time and frequency domain are extracted to select the best model to be used in the classification of depression episodes. The results showed that the best dataset and model to realize the classification of depressive episodes is the night motor activity data with 99.37% of sensitivity and 99.91% of specificity.

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Los Trastornos Paroxísticos No Epilépticos (TPNE), son diagnóstico diferencial de crisis epilépticas. En Chile no existen reportes de frecuencia. OBJETIVO: Determinar frecuencia de TPNE en pacientes derivados por sospecha de epilepsia a Unidad de Electroencefalografía, Hospital Roberto del Río. METODOLOGÍA: Estudio observacional, transversal. Se revisó registros clínicos de pacientes derivados por sospecha de epilepsia(2012- 2014). Inclusión: paciente con TPNE, >1 mes, sin epilepsia previa. Caracterización: sexo, edad, tipo/subtipo TPNE, comorbilidades, electroencefalograma (EEG), uso fármaco antiepiléptico (FAE). Aprobado por comité de ética. RESULTADOS: Derivados 913 pacientes por sospecha de epilepsia. 36% TPNE (2,3% con epilepsia concomitante), 22% epilepsia aislada. TPNE más frecuente: escolares (31%), adolescentes (29%), femenino (52%). 30,1% hipoxia cerebral (síncope, Espasmo Sollozo); 22,4% trastornos del comportamiento (Descontrol Episódico, Crisis Psicógena no Epiléptica). 32,8% con comorbilidades no epilépticas (Trastornos psiquiátricos/neurodesarrollo). 4,3 % recibieron FAE. CONCLUSIONES: La frecuencia de TPNE en niños/adolescentes supera a la de epilepsia. Es fundamental evaluación multidisciplinaria.

Paroxysmal non-epileptic events (PNE) are differential diagnosis of epileptic seizures. In Chile, there are no reports on its frequency. OBJECTIVE: To determine the frequency of PNE in patients referred for suspicion of epilepsy to the Electroencephalography Unit of Roberto del Río Hospital. METHODOLOGY: Observational, cross-sectional study. Clinical records of patients referred for suspicion of epilepsy (2012-2014) were reviewed. Inclusion: Patient with PNE, >1 month, without previous epilepsy. Characterization: gender, age, PNE type/subtype, comorbidities, electroencephalogram, use of antiepileptic drug (AED). Approved by the ethics committee. RESULTS: 913 patients were referred for suspected epilepsy: 36% PNE (2,3% with concomitant epilepsy), 22% isolated epilepsy. PNE were more frequent in children (31%) adolescents (29%), and in females (52%). 30.1% Cerebral hypoxia (syncope, breathholding-spells); 22,4% Behavioral disorders (Episodic loss of control, Non-Epileptic Psychogenic Seizures). 32.8% non-epileptic comorbidities (Psychiatric/ neurodevelopmental disorders). 4.3% received AEDs. CONCLUSIONS: The frequency of PNE in children and adolescents exceeds that of epilepsy. A multidisciplinary medical evaluation is of the outmost importance. Keywords: Paroxysmal Non-Epileptic Disorder, Non-epileptic episodes, Epilepsy.

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In the city of Rio de Janeiro (Brazil), the districts located in the northern area are considered the most critical regarding ozone levels year-round. In this study, the potential factors that contribute to high levels of ozone in the district of Irajá were investigated. The obtained results clearly showed that, in spite of the high correlation of ozone concentrations with wind speed and temperature, ozone episodes depend on the ratios of volatile organic compounds (VOCs) to nitrogen oxides (NOx) rather than on the individual VOC and NOx levels, as expected for the VOC-controlled condition typical of the urban area of Rio de Janeiro. Moreover, high VOCs/NOx ratios are highly dependent on the transport of air masses. When pollutants are transported from urban areas with heavy vehicular flux and high NOx concentrations, ozone levels are reduced. When air masses are transported from the industrial petrochemical area, NOx levels are relatively low, and ozone episodes are frequent.

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