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OBJECTIVES: Studies exploring variations in peripheral muscle oxygenation and pressure pain thresholds (PPT) of masticatory muscles in individuals with Temporomandibular Disorders (TMDs) are limited. The purpose of this study was to compare variations in peripheral oxygenation of the masseter muscle; PPT of the masseter and temporal muscles and correlate peripheral muscle oxygenation and PPT of the masseter muscle in individuals with different types of TMDs. MATERIALS AND METHODS: Cross-sectional study involving 116 participants classified into three groups: muscle group (MG, n = 32), joint group (JG, n = 30) and muscle-joint group (MJG, n = 54). Individuals aged 26.97 ± 6.93, 68.97% female, 31,03% males were included. All participants were evaluated using the Diagnostic Criteria for Temporomandibular Disorders, Near-infrared spectroscopy (NIRS) for peripheral muscle oxygenation and pressure algometer for PPT. RESULTS: There was no difference in masseter muscle oxygenation among groups. In the masseter muscle, a weakly positive correlation was observed between PPT and variation in tissue saturation index in the MG (rho = 0.365) and JG (rho = 0.317). In addition, the MJG expressed lower PPT (p = 0.004) than JG, demonstrating that MJG had more pain in this muscle. CONCLUSIONS: MJG have lower PPT in the masseter muscle. Although the PPT is dependent on the type of TMDs, the correlation between PPT and oxygenation is weak. All TMDs groups evaluated (MG, JG, MJG) showed hemodynamic similarities of the masseter muscle. CLINICAL RELEVANCE: Understanding pain thresholds and the hemodynamic behavior of the masticatory muscles contributes to a more assertive physiotherapeutic assessment in TMDs, serving as a basis for careful and individualized interventions.

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Anemia is a pathological condition in which the hemoglobin and red blood cell mass decrease; it is mainly defined by the concentration of hemoglobin in the blood. The World Health Organization guidelines establish specific values to define anemia in different population groups. Early detection of anemia can also be a valuable indicator of underlying medical conditions. Clinical studies have explored the relationship between perioperative anemia and morbidity, highlighting the need for more judicious therapeutic strategies, such as the use of Patient Blood Management, which aims to prevent and treat anemia in a personalized and effective way. Patient Blood Management emerges as a promising approach to dealing with anemia, recognizing that its correction through transfusion always carries risks and that personalized prevention and treatment can offer better outcomes for patients.

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The study of rainfall thresholds is vital in understanding the factors that trigger landslides, being one of the criteria applied to landslide early warning systems that aim to mitigate their consequences. These thresholds enable the prediction of landslide occurrences as a function of rainfall measurements. This work presents an overview of the parameters involved in defining rainfall thresholds based on scientific articles published between 2008 and 2021 that discuss the subject through statistical or physical methods. These articles provided data such as publication information, threshold types, details on the data used in the works, methodology, and application of the threshold in early warning systems. There was a significant increase in research papers on this theme during this period, possibly due to the strategies advocated by the Sendai Framework. However, some regions of the world severely affected by landslides are barely mentioned in these studies. The results indicate specific trends, such as those found in the methods used to define rainfall thresholds and the parameters relating to the database when a statistical approach was used. Certain deficiencies were found, such as those concerning geological-geotechnical conditions for categorizing thresholds, the time scales of rainfall data, rain gauge density, and the criteria to define the accumulated rainfall period to be considered.

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Workers' task specialization and division of labor are critical features of social insects' ecological success. It has been proposed that the division of labor relies on response threshold models: individuals varying their sensitivity (and responsiveness) to biologically relevant stimuli and performing a specific task when a stimulus exceeds an internal threshold. In this work, we study carbohydrate and protein responsiveness and their relation to worker task specialization in Vespula germanica, an invasive social wasp. The sucrose and peptone responsiveness of two different subcastes, preforagers and foragers, was determined by stimulating the antenna of the wasps with increasing concentrations of the solution and quantifying whether each concentration elicited a licking response. We studied responsiveness in five different ways: (1) response threshold, (2) concentration 50 (concentration to which at least 50% of wasps responded), (3) maximum response, (4) mean scores and (5) median scores. Our results suggest that V. germanica foragers are more sensitive to sucrose (lower thresholds) than preforager workers. However, we found no differences for peptone thresholds (i.e., a protein resource). Nonetheless, this is the first study to investigate response thresholds for protein resources. The intercaste variation in sucrose responsiveness shown in our work contributes to the existing knowledge about response threshold theory as a mechanism for task specialization observed in V. germanica.

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Background: The 6-minute rowing ergometer test (6-minRT) is valid and reliable for establishing maximal aerobic power (MAP) in amateur male rowers. However, ventilatory thresholds (VTs) have not yet been established with their mechanical correspondence in this test. Objective: The primary objective was to determine the VTs in the 6-minRT achieved by amateur male rowers, while the secondary objective was to determine the correspondence between ventilatory, mechanical, and heart rate (HR) outcomes of the 6-minRT. Methods: Sixteen amateur male rowers were part of the study. All participants were instructed to perform an incremental test (IT) and a 6-minRT. Determination of the ventilatory parameters for the first ventilatory threshold (VT1), the second ventilatory threshold (VT2), and 6minRTVO2max were performed by correlating the outcomes of VT1, VT2, and VO2max obtained in the IT, with the outcomes of 6-minRT. For these purposes, Pearson's test was used, with the following criteria: trivial, <0.1; small, 0.1-0.3; moderate, 0.3-0.5; high, 0.5-0.7; very high, 0.7-0.9; or practically perfect, >0.9. The significance level was p < 0.05. Results: The IT analysis determined that VT1 and VT2 correspond to 55 and 80% of VO2max, respectively. A high correlation was observed between IT outcomes in VT1, VT2, and VO2max, with the outcomes of 6-minRT (r > 0.6). Conclusion: Based on IT ventilatory parameters and concordance analysis, VT1 and VT2 of 6-minRT are determined at 55 and 80%, respectively, of both ventilatory parameters and their corresponding mechanical outcomes and HR.

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Measurements of ecosystem carbon (C) fluxes in temperate forests are concentrated in the Northern Hemisphere, leaving the functionally diverse temperate forests in the Southern Hemisphere underrepresented. Here, we report three years (February 2018-January 2021) of C fluxes, studied with eddy-covariance and closed chamber techniques, in an endangered temperate evergreen rainforest of the long-lived paleoendemic South American conifer Fitzroya cupressoides. Using classification and regression trees we analyzed the most relevant drivers and thresholds of daily net ecosystem exchange (NEE) and soil respiration. The annual NEE showed that the forest was a moderate C sink during the period analyzed (-287±38 g C m-2 year -1). We found that the capacity to capture C of the Fitzroya rainforests in the Coastal Range of southern Chile is optimal under cool and rainy conditions in the early austral spring (October-November) and decreases rapidly towards the summer dry season (January-February) and autumn. Although the studied forest type has a narrow geographical coverage, the gross primary productivity measured at the tower was highly representative of Fitzroya and other rainforests in the region. Our results suggest that C fluxes in paleoendemic cool F. cupressoides forests may be negatively affected by the warming and drying predicted by climate change models, reinforcing the importance of maintaining this and other long-term ecological research sites in the Southern Hemisphere.

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Introducción: Pese a que el uso de corticoides transtimpánicos en pacientes con enfermedad de Méniere es habitual en muchos centros, la evidencia respecto de su efecto sobre los umbrales auditivos es aún controversial. Objetivo: Estudiar los umbrales auditivos de pacientes con enfermedad de Méniere que recibieron corticoides transtimpánicos en el Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile. Material y Método: Estudio retrospectivo de pacientes con enfermedad de Méniere que consultaron entre los años 2015 y 2021. Se estudiaron los umbrales auditivos, antes y después de 3 inyecciones de dexametasona transtimpánica. Resultados: Se obtuvieron datos completos de 27 pacientes. Al comparar el promedio tonal puro antes y después del tratamiento, no se observaron diferencias significativas. A nivel individual, la variación de cambio de los umbrales auditivos con dexametasona se correlaciona en forma significativa con los umbrales auditivos previos a las inyecciones y con el tiempo transcurrido desde la última inyección, pero no con la edad. Conclusión: La terapia con dexametasona transtimpánica en pacientes con enfermedad de Méniere no altera los umbrales auditivos. Sin embargo, se requieren más estudios, para comprobar, si existe un efecto transitorio en los umbrales auditivos de los primeros días posterior al procedimiento.

Introduction: Although transtympanic corticosteroids are proposed in Méniere's disease patients refractory to standard medical therapy, the evidence regarding the effect of transtympanic corticosteroids on hearing thresholds is still controversial. Aim: To study the hearing thresholds of patients with Méniere's disease who were administrated with transtympanic corticosteroids at the Otorhinolaryngology Service of the University of Chile's Clinical Hospital. Material and Method: Retrospective study of Méniere's disease patients who consulted between 2015 and 2021. Demographic variables and hearing thresholds were studied before and after three transtympanic injections of dexamethasone. Results: A total of 27 patients were studied. There were non-significant differences in pure-tone hearing threshold averages before and after the injections. Individual variation in hearing thresholds correlates significantly with the pre-injection hearing thresholds and the period since the last injection, but not with age. Conclusion: Transtympanic dexamethasone therapy in patients with Meniere's disease does not alter hearing thresholds. However, more studies are needed to verify whether there is a transitory effect on hearing thresholds in the first days after the procedure.

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A green screening method to determine cashew nut adulteration with Brazilian nut, pecan nut, macadamia nut and peanut was proposed. The method was based on the development of a one-class soft independent modelling of class analogy (SIMCA) model for non-adulterated cashew nuts using near-infrared (NIR) spectra obtained with portable equipment. Once the model is established, the assignment of unknown samples depends on the threshold established for the authentic class, which is a key aspect in any screening approach. The authors propose innovatively to define two thresholds: lower model distance limit and upper model distance limit. Samples with distances below the lower threshold are assigned as non-adulterated with a 100% probability; samples with distance values greater than the upper threshold are assigned as adulterated with a 100% probability; and samples with distances within these two thresholds will be considered uncertain and should be submitted to a confirmatory analysis. Thus, the possibility of error in the sample assignment significantly decreases. In the present study, when just one threshold was defined, values greater than 95% for the optimized threshold were obtained for both selectivity and specificity. When two class thresholds were defined, the percentage of samples with uncertain assignment changes according to the adulterant considered, highlighting the case of peanuts, in which 0% of uncertain samples was obtained. Considering all adulterants, the number of samples that were submitted to a confirmatory analysis was quite low, 5 of 224 adulterated samples and 3 of 56 non-adulterated samples.

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Maximal oxygen consumption (V̇O2max), physiological thresholds, and hemoglobin mass are strong predictors of endurance performance. High values of V̇O2max, maximal aerobic power (MAP), and power output at anaerobic thresholds are key variables in elite rowers. Endurance athletes often use altitude training as a strategy to improve performance. However, no clear evidence exists that training at natural altitude enhances sea-level performance in elite rowers. This study aimed to evaluate the effect of altitude training on rowing-performance parameters at sea level. The study was conducted on eleven rowers (Six females, five males) from the Chilean National Team during a 3-week moderate altitude training (∼2,900 m. a.s.l.) under the live high-train high (LHTH) model. It included a rowing ergometer maximal incremental test and blood analysis (pre and post-altitude). Gas exchange analysis was performed to measure V̇O2max, ventilatory thresholds (VTs) and rowing economy/efficiency (ECR/GE%). LHTL training improves performance-related variables at sea level (V̇Emax: 3.3% (95% CI, 1.2-5.5); hemoglobin concentration ([Hb]): 4.3% (95% CI, 1.7-6.9); hematocrit (%): 4.5% (95% CI, 0.9-8.2); RBC (red blood cells) count: 5.3% (95% CI, 2.3-8.2); power at VT2: 6.9% (95% CI, 1.7-12.1), V̇EVT2: 6.4% (95% CI, 0.4-12.4); power at VT1: 7.3% (95% CI, 1.3-13.3), V̇EVT1: 8.7% (95% CI, 1.6-15.8)) and economy/efficiency-related variables (ECRVT2: 5.3% (95% CI, -0.6 to -10.0); GE(%): 5.8% (95% CI, 0.8-10.7)). The LHTH training decreased breathing economy at MAP (-2.8% (95% CI, 0.1-5.6)), pVT2 (-9.3% (95% CI, -5.9 to -12.7)), and pVT1 (-9.3% (95% CI, -4.1 to -14.4)). Non-significant changes were found for V̇O2max and MAP. This study describes the effects of a 3-week moderate altitude (LHTH training) on performance and economy/efficiency-related variables in elite rowers, suggesting that it is an excellent option to induce positive adaptations related to endurance performance.

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Climate change, particularly global warming, is disturbing biological processes in unexpected ways and forcing us to re-study/reanalyze the effects of varying temperatures, among them extreme ones, on insect functional traits such as lifespan and fecundity/fertility. Here we experimentally tested, under both laboratory and field conditions, the effects of an extreme range of temperatures (5, 10, 15, 20, 30, 40, and 45 °C, and the naturally varying conditions experienced in the field), on survivorship/lifespan, fecundity, and fertility of four pestiferous fruit fly species exhibiting contrasting life histories and belonging to two phylogenetic groups within the genus Anastrepha: A. ludens, A. obliqua, A. striata, and A. serpentina. In the field, we also measured the length of the entire life cycle (egg to adult), and in one species (A. ludens), the effect on the latter of the host plant (mango and grapefruit). Under laboratory conditions, none of the adults, independent of species, could survive a single day when exposed to a constant temperature of 45 °C, but A. striata and A. serpentina females/males survived at the highly contrasting temperatures of 5 and 40 °C at least 7 days. Maximum longevity was achieved in all species at 15 °C (375, 225, 175 and 160 days in A. ludens, A. serpentina, A. striata and A. obliqua females, respectively). Anastrepha ludens layed many eggs until late in life (368 days) at 15 °C, but none eclosed. Eclosion was only observed in all species at 20 and 30 °C. Under natural conditions, flies lived ca. 100 days less than in the laboratory at 15 °C, likely due to the physiological cost of dealing with the highly varying environmental patterns over 24 h (minimum and maximum temperatures and relative humidity of ca. 10-40 °C, and 22-100%, respectively). In the case of A. ludens, the immature's developmental time was shorter in mango, but adult survival was longer than in grapefruit. We discuss our results considering the physiological processes regulating the traits measured and tie them to the increasing problem of global warming and its hidden effects on the physiology of insects, as well as the ecological and pest management implications.

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To propose a new Cardiopulmonary Exercise Test with Elastic Resistance (CPxEL) and compare the physiological responses to conventional cardiopulmonary exercise test (CPx) performed on a treadmill. In addition, we tested the reproducibility of the CPxEL. Twenty-four physically active participants completed the CPx (first session) and CPxEL twice (second and third sessions) interspersed by seven days. A treadmill protocol with increments of 1km·h-1 every minute until exhaustion was used in CPx. The CPxEL consisted of performing alternating steps back-and-forth against an elastic resistance attached to a belt and an incremental protocol with 1 stage (S) per minute following a cadence of 200 bpm controlled by a metronome in an 8-stage rubber mat. First analysis: first ventilatory threshold (VT1) occurred at 69.7% and 75.3% of maximal heart rate (HRmax) and 53.5% and 65.7% of maximal oxygen consumption (V̇O2max). Second VT (VT2) occurred at 93.3% and 96.8% of the HRmax and 87.0% and 96.9% of V̇O2max for CPx and CPxEL, respectively. At exhaustion, V̇O2max, perceived exertion (BORG-CR10 and OMNI-RES EB), and test duration presented lower values for CPxEL (P < 0.05). Second analysis: VT1 occurred at warm-up (S0) (P = 0.731), VT2 occurred at S5 (P = 0.912), and the exhaustion occurred at S6 and S7 (P = 0.271) for CPxEL and retest, respectively. The intraclass correlation coefficient (ICC) for V̇O2max was 0.921 and for HRmax was 0.930. The CPxEL has good test-retest reproducibility and represents a possible and interesting add-on to determine maximal oxygen consumption, maximal heart rate, and second ventilatory threshold without using traditional ergometers.

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OBJECTIVE: To evaluate the effect of layering strategy and substrate color on the masking ability of resin composites. MATERIALS AND METHODS: A1-shaded specimens from Charisma Diamond and Filtek Z350XT were produced using different layering strategies. Color measurements were made by a reflectance spectrophotometer over A2, C2, A3.5, C3, C4 substrates. Color differences were calculated and interpreted by the 50%:50% perceptibility and acceptability visual thresholds. Data was analyzed by Kruskal-Wallis and Dunn post hoc test. Chi-square test was used to determine the association between masking ability, and independent variables. RESULTS: Color differences were significantly lower on A2 and C2 in comparison with C4 for the majority of the layering strategies. Acceptable matches were observed on most of the combinations over A2. Moderately unacceptable mismatches were observed in most of the combinations over C2 and A3.5. Clearly unacceptable mismatches were observed on the C3 and C4. The ΔE00 color shifts were predominantly influenced by ΔL00 for all layering strategies and substrate colors. CONCLUSION: Masking ability was affected by the layering strategy and substrate color. Acceptable masking was associated with A2 and C2, and with layering strategy composed of 0.5 mm enamel opacity and 1.0 mm dentin opacity thicknesses, using the Filtek Z350XT. CLINICAL SIGNIFICANCE: Resin composites-shade A1-applied by different layering strategies with a final thickness of 1.5 mm were able to mask mild and moderately discolored substrates. Severely discolored substrates were not masked effectively.

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Cedrela odorata is a native tree of economic importance, as its wood is highly demanded in the international market. In this work, the current and future distributions of C. odorata in Mexico under climate change scenarios were analyzed according to their optimal temperature ranges for seed germination. For the present distribution, 256 localities of the species' presence were obtained from the Global Biodiversity Information Facility (GBIF) database and modelled with MaxEnt. For the potential distribution, the National Center for Atmospheric Research model (CCSM4) was used under conservative and drastic scenarios (RCP2.6 and RCP8.5 Watts/m2, respectively) for the intermediate future (2050) and far future (2070). Potential distribution models were built from occurrence data within the optimum germination temperature range of the species. The potential distribution expanded by 5 and 7.8% in the intermediate and far future, respectively, compared with the current distribution. With the increase in temperature, adequate environmental conditions for the species distribution should be met in the central Mexican state of Guanajuato. The states of Chihuahua, Mexico, Morelos, Guerrero, and Durango presented a negative trend in potential distribution. Additionally, in the far future, the state of Chihuahua it is likely to not have adequate conditions for the presence of the species. For the prediction of the models, the precipitation variable during the driest month presented the greatest contribution. When the humidity is not limiting, the thermal climatic variables are the most important ones. Models based on its thermal niche for seed germination allowed for the identification of areas where temperature will positively affect seed germination, which will help maximize the establishment of plant populations and adaptation to different climate change scenarios.

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OBJECTIVE: Evaluate the effectiveness and color stability of bleaching techniques on blood-stained teeth. MATERIAL AND METHODS: The teeth were stained by blood and allocated to groups: walking bleach, inside/outside, and in-office bleaching. L*, a*, b*, C*, h° color coordinates were measured using a clinical spectrophotometer at baseline, weekly (T1-T2-T3), and at 1-week (T4), 6-months (T5), and 1-year (T6) follow-up evaluations. ΔEab* , ΔE00 , and ΔWID were calculated between sequential evaluation timepoints and between baseline and each evaluation timepoint. Color coordinates and WID differences in each timepoint and technique were analyzed by Wilcoxon Signed Rank, Kruskal-Wallis and Mann-Whitney U test, respectively. ΔEab* , ΔE00 , and ΔWID were interpreted by color visual thresholds. RESULTS: The techniques presented a significant increase in L* and WID and, a significant decrease in a* and b* until the completion of treatments. Statistical differences between the techniques for a*, b* and WID were observed from T1 until T3. All techniques demonstrated excellent effectiveness for ΔEab* , ΔE00 , and ΔWID between baseline and each evaluation and follow-up timepoints. However, at T6, it was possible to identify a rebound effect for all techniques. CONCLUSIONS: All bleaching techniques presented excellent effectiveness. The stability of the whitening produced was maintained for 6 months. CLINICAL SIGNIFICANCE: Effective whitening of blood-stained teeth was achieved using walking bleach (sodium perborate), inside/outside (hydrogen peroxide - 7.5%) and in-office techniques (hydrogen peroxide - 35%). The bleaching techniques were effective after the completion of the treatments. A slight rebound was observed at 1 year follow-up.

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Decisions made by foraging animals conform a complex process based on the integration of information from multiple external environmental stimuli and internal physiological signals, which in turn are modulated by individual experience and a detection threshold of each individual. For social insects in which foraging is limited to given age subcastes, individual foraging decisions may also be affected by ontogenetic shifts and colony requirements. We studied the short-term changes in foraging preferences of the generalist wasp Vespula germanica, focusing on whether the individual response to different resources could be influenced by the ontogenetic shifts and/or by social interaction with nestmates. We carried both laboratory and field experiments to confront worker wasps to a short-term resource switch between either protein or carbohydrate-based foods. We tested the response of (1) Preforager workers (no foraging experience nor interaction with other wasps), (2) Forager workers (experience in foraging and no colony feedback), and (3) Wild forager workers (foraging naturally and exposed to free interactions with nestmates). We evaluated the maxilla-labium extension response (MaLER) for laboratory assays or the landing response for field assays. We observed that for wasps deprived of colony feedback (either preforagers or foragers), the protein-rich foods acceptance threshold increased (and thus a lower level of foraging on that item was observed) if they had foraged on carbohydrates previously, whereas carbohydrates were accepted in all assays. However, wasps immersed in a natural foraging context did accept protein foods regardless of their first foraging experience and reduced the carbohydrates collected when trained on protein foods. We provide evidence that short-term changes in foraging preferences depend on the type of resource foraged and on the social interactions, but not on ontogenetic shifts.

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Excessive sodium consumption is a worldwide public health concern. The substitution of sodium chloride (NaCl) for potassium chloride (KCl) has been adopted to reduce the sodium concentration in processed foods. The challenge is to make this substitution without affecting the sensory acceptance of foods. In this context, the objective was to determine from which concentrations the replacement of NaCl by KCl results in reduced acceptance (compromised acceptance threshold - CAT) and begins the sensory rejection (hedonic rejection threshold - HRT) of cracker-type biscuits. Using the hedonic thresholds methodology (HTM) by varying a stimulus, CAT and HRT were determined for the concentration of NaCl in crackers and, by varying two stimuli, CAT and HRT, for replacing NaCl with KCl in crackers were determined. Without the addition of KCl, the reduction in acceptance started to occur by reducing the NaCl content by around 60% (from 1.81% to 0.73%); and sensory rejection began to appear by reducing the NaCl content by approximately 93% (1.81% to 0.13%). Reduction in the acceptance started to occur by lowering the NaCl content by around 78% (from 1.81% to 0.397%), with the addition of 0.896% KCl. In addition, by adding KCl, it was possible to reduce 100% NaCl without sensory rejection of the crackers. With these results, cracker industries can reduce the sodium content of their products, contributing to the reduction of population salt intake.

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Resumen La coledocolitiasis secundaria es una entidad de alta prevalencia que involucra desafíos de diagnóstico y tratamiento; asimismo, genera un elevado uso de recursos y costo económico. Existen múltiples vacíos de conocimiento con respecto a los modelos de predicción clínica para el diagnóstico, estratificación en grupos de riesgo y manejo de pacientes con coledocolitiasis secundaria. Los principales vacíos recaen sobre su rendimiento diagnóstico, variables incluidas y umbrales de riesgo, así como sobre su costo-efectividad para el uso de recursos no invasivos e invasivos, y aplicación en grupos poblacionales especiales. Este artículo ahonda estos vacíos de conocimiento y propone una agenda que puede orientar la investigación futura.

Abstract Secondary choledocholithiasis is a disease of high prevalence that involves diagnostic and treatment challenges; it implies a high use of resources and economic costs. There are significant knowledge gaps related to clinical prediction models, risk group classification, and patient treatment in secondary choledocholithiasis cases. Those gaps include diagnostic performance, variables, and risk thresholds, as well as cost-effectiveness for the use of non-invasive and invasive resources, and their application in special population groups. This study analyzes those knowledge gaps and outlines a guideline that could lead future research.

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Atualmente o autismo tem sido classificado como Transtorno do Espectro Autista (TEA), podendo apresentar como critério diagnóstico os atrasos no desenvolvimento psicomotor e alterações sensoriais, além das características típicas. Objetivo: Identificar as características psicomotoras e sensoriais de crianças com diagnóstico de TEA atendidas no setor de Terapia Ocupacional na Unidade Saúde Escola da Universidade Federal de São Carlos (USE-UFSCar). Método: Trata-se de uma pesquisa exploratória e descritiva, de abordagem quantitativa. Participaram nove crianças de quatro a dez anos de idade com diagnóstico de TEA, e seus responsáveis. Os instrumentos utilizados para coleta de dados foram um Questionário de dados gerais da criança; Perfil sensorial e Bateria Psicomotora. A coleta dos dados ocorreu na própria Unidade,sendo que os dados dos instrumentos padronizados foram analisados a partir das instruções pré-existentes, e os dados do Questionário de forma descritiva. Resultados: Identificou-se que as crianças participantes apresentam déficits psicomotores nos seguintes aspectos: noção do corpo, estruturação espaço-tempo, praxia global e fina. Em relação ao sistema sensorial, as alterações identificadas no presente estudo foram na audição, sistema vestibular e multissensorial, constante procura sensorial, inatenção e na motricidade fina. Conclusão: Aponta-se para a importância de maiores investimentos nesse campo, uma vez que pode favorecer as intervenções voltadas a esse público.

Actualmente, el autismo se ha clasificado como trastorno del espectro autista (TEA), y puede presentarse como criterio de diagnóstico de retrasos en el desarrollo psicomotor y cambios sensoriales, además de las características típicas. Objetivo: identificar las características psicomotoras y sensoriales de los niños diagnosticados con TEA tratados en el sector de terapia ocupacional en la Unidad de la Escuela de Salud de la Universidad Federal de São Carlos (USE-UFSCar). Método: Esta es una investigación exploratoria y descriptiva, con un enfoque cuantitativo. Participaron nueve niños de cuatro a diez años diagnosticados con TEA y sus padres. Los instrumentos utilizados para la recopilación de datos fueron un cuestionario de datos generales del niño; Perfil sensorial y batería psicomotora. La recopilación de datos tuvo lugar en la propia Unidad, y los datos de los instrumentos estandarizados se analizaron utilizando instrucciones preexistentes y los datos del Cuestionario de manera descriptiva. Resultados: Se identificó que los niños participantes tienen déficits psicomotores en los siguientes aspectos: noción del cuerpo, estructuración espacio-tiempo, praxis global y fina. Con respecto al sistema sensorial, los cambios identificados en el presente estudio fueron en el sistema auditivo, vestibular y multisensorial, búsqueda sensorial constante, falta de atención y en el motricidad fina. Conclusión: señala la importancia de mayores inversiones en este campo, ya que puede favorecer intervenciones dirigidas a esta audiencia.

Currently, autism has been classified as Autism Spectrum Disorder (ASD), and may present as a diagnostic criterion delays in psychomotor development and sensory changes, in addition to the typical characteristics. Objective: To identify the psychomotor and sensory profile of children diagnosed with ASD. Method: This is a survey study, exploratory and descriptive, with a qualitative and quantitative approach. Nine children from four to ten years old diagnosed with a diagnosis of ASD participated, linked to the School Health Unit (uSE)­UFSCar and their guardians. The instruments used for data collection were a questionnaire of general data of the child; Sensory profile and Psychomotor Battery. Data collection took place at the Unit itself, and data from standardized instruments were analyzed based on pre-existing instructions, and data from the Questionnaire were analyzed descriptively. Results: Children with ASD have psychomotor deficits in the following aspects: body notion, space-time structuring, global and global and fine praxis. Regarding the sensory system, the changes identified were in hearing, vestibular and multisensory system, constant sensory search, inattention and fine motor. Conclusion: It points to the importance of greater investments in this field, since it can favor interventions aimed at this audience.

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RESUMEN INTRODUCCIÓN: La enfermedad de Fabry (EF) es una enfermedad genética, causada por el déficit de la enzima alfa galactosidasa A (α-Gal A), lo que provoca la acumulación de glicoesfingolípidos en los tejidos. Sus manifestaciones clínicas son variables. Estudios en mujeres heterocigotas reportan la existencia de dolor neuropático como manifestación de neuropatía de fibra pequeña. OBJETIVO: Determinar la presencia de neuropatía de fibra pequeña en mujeres heterocigotas para la EF, mediante la prueba cuantitativa sensorial. MATERIALES Y MÉTODOS: Se evaluaron 33 mujeres heterocigotas para EF y 33 mujeres sanas, con características demográficas similares. A todas se les aplicó la prueba cuantitativa sensorial (Quantitative Sensory Testing por medio de la detección de umbrales de frío (Colà Detection Threshold), calor (Warm Detection Threshold), dolor inducido por calor (Heat-pain Detection Thresholds) y vibración (Vibratory Detection Threshold) en los miembros superior e inferior, utilizando un sistema asistido por computador versión IV (CASE IV, WR Medical Electronics Co., Stillwater, MN). Adicionalmente, al grupo de mujeres heterocigotas para EF, se le evaluó la percepción subjetiva de dolor neuropàtico mediante el cuestionario de síntomas sensitivos neuropáticos positivos (Positive Neuropathic Sensory Symptom). Los resultados de la prueba cuantitativa sensorial se compararon entre los grupos. También se estableció la correlación entre la prueba cuantitativa sensorial y los resultados del cuestionario de síntomas sensitivos neuropáticos positivos. RESULTADOS: Se encontró una diferencia estadísticamente significativa en las pruebas de vibración (p = 0,008), calor (p = 0,017) y dolor inducido por calor (p = 0,04) en el miembro inferior en las mujeres heterocigotas para EF, comparado con el grupo control. Se encontró una correlación inversa estadísticamente significativa entre la intensidad del dolor quemante y el dolor inducido por calor en el miembro inferior (p = 0,018, r = -0,48) y entre la intensidad del dolor al ser rozado o tocado y el dolor inducido por calor en el miembro inferior (p = 0,006, r = -0,49). CONCLUSIÓN: En las mujeres heterocigotas para EF, las pruebas objetivas para establecer la presencia de neuropatía de fibra pequeña son anormales en miembros inferiores y se correlacionan con los síntomas sensitivos.

SUMMARY INTRODUCTION: Fabry disease is a genetic condition caused by alpha-galactosidase A deficiency triggering glycosphingolipid accumulation in tissues. Clinical manifestations are variable. Studies in heterozigous females report the existence of neuropathic pain as manifestation of small fiber neuropathy. OBJECTIVE: To determine presence of small fiber neuropathy in heterozigous females with Fabry disease through Quantitative Sensory Testing (QST). MATERIALS AND METHODS: 33 heterozigous females with fabry disease and 33 healthy females with similar demographic characteristics were evaluated. QST was performed to every female evaluating Cold detection Threshold (CDT), Warm Detection Threshold (WDT), Heat-pain Detection Threshold (HPDT) and Vibratory Detection Threshold (VDT) in upper and lower limbs through Computer Assisted Sensory Examination software (CASE IV, WR Medical Electronics Co., Stillwater, MN). Subjective perception of neuropathic pain was measured through Positive Neuropathic Sensory Symptom questionnaire (P-NSS) in heterozigous females with Fabry disease. QST results were compared between groups. Correlations between QST and P-NSS were established. RESULTS: Statistically significant differences were observed in VDT (p= 0,008), WDT (p= 0,017) and HPDT (p= 0,04) in lower limbs of heterozigous females with Fabry disease compared with control group. Negative correlation was found among burning pain intensity and HPDT at lower limbs (p= 0,018, r= -0,48) and among pain intensity to light touch and HPDT in lower limbs (p= 0,006, r=-0,49). CONCLUSIONS: Objective tests to establish presence of small fiber neuropathy in heterozigous females with Fabry disease are abnormal at lower limbs and correlate with sensory symptoms.

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Abstract Introduction: Transfusion in cirrhotic patients remains a challenge due to the absence of evidence-based guidelines. Our study aimed to determine the indication of transfusion and the associated transfusion thresholds in cirrhotic patients. Methods: This retrospective observational study was conducted in the Department of Transfusion Medicine at a tertiary care liver center from October 2018 to March 2019. The blood bank and patient records of cirrhotic patients admitted during the study period were retrieved and analyzed to determine the current transfusion practice. Results: A total of 992 cirrhotic patients were included in the study. Blood components were transfused to 402 (40.5%) patients. Sixty-nine (17.2%) patients were transfused to control/treat active bleeding, while 333 (82.8%) were transfused prophylactically. Packed red blood cells (65.4%) was the most commonly transfused blood component, followed by fresh frozen plasma (35.6%), among patients receiving transfusions (therapeutic & prophylactic). The mean pre-transfusion thresholds for: (i) packed red blood cell transfusion: hemoglobin less than 7 g/dL; (ii) fresh frozen plasma transfusion: international normalized ratio over 2.6; (iii) platelet concentrate transfusion: platelet count less than 40,700/µL, and; (iv) cryoprecipitate transfusion: fibrinogen less than 110 mg/dL. The average length of stay of the study population was 5 days (3-9. Conclusion: To conclude, 40.5% of our hospitalized cirrhotic patients were transfused, with the majority of the transfusions being prophylactic (82.8%). Separate guidelines are required for this patient population, as these patients have an altered hemostasis which responds differently to the transfusion of blood components.

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