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INTRODUCTION: Parkinson's disease is characterised by the presence of motor symptoms including hypomimia, and by non-motor symptoms including alterations in facial recognition of basic emotions. Few studies have investigated this alteration and its relationship to the severity of hypomimia. OBJECTIVE: The objective is to study the relationship between hypomimia and the facial recognition of basic emotions in subjects with Parkinson's disease. SUBJECTS AND METHODS: Twenty-three patients and 29 controls were evaluated with the test battery for basic emotion facial recognition. The patients were divided into two subgroups according to the intensity of their hypomimia. RESULTS: The comparison in battery test performance between the minimal/mild hypomimia and moderate/severe hypomimia groups was statistically significant in favour of the former group. CONCLUSIONS: This finding shows a close relationship between expression and facial recognition of emotions, which could be explained through the mechanism of motor simulation.

TITLE: Relación entre la gravedad de la hipomimia y el reconocimiento de emociones básicas en la enfermedad de Parkinson.Introducción. La enfermedad de Parkinson se caracteriza por la presencia de síntomas motores, entre los que es significativa la presencia de hipomimia, y por síntomas no motores, en los que se destaca la alteración en el reconocimiento facial de emociones básicas. Son pocos los estudios que investiguen dicha alteración relacionada con la gravedad de la hipomimia. Objetivo. El objetivo es estudiar la relación entre la hipomimia y el reconocimiento facial de emociones básicas en sujetos con enfermedad de Parkinson. Sujetos y métodos. Se evaluó a 23 pacientes y 29 controles con la batería de reconocimiento facial de emociones básicas. El grupo de pacientes se dividió en dos subgrupos según la intensidad de la hipomimia. Resultados. La comparación en el rendimiento de las pruebas de la batería entre el grupo de hipomimia mínima/leve e hipomimia moderada/grave resultó estadísticamente significativa a favor del primer grupo. Conclusiones. Este hallazgo evidencia una estrecha relación entre la expresión y el reconocimiento facial de emociones, que podría explicarse a través del mecanismo de simulación motora.

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INTRODUCTION: An alteration in the recognition of basic emotions is usually observed in Alzheimer's type dementia. Although there is some consensus that basic emotions are six, more recent studies conclude that there may be a combination between fear/ surprise and disgust/anger. This pattern has not yet been investigated in the Alzheimer's type dementia. AIMS: To evaluate if the main confusers are significant as to determine the amount of basic emotions, and to study which are the main confusers, between emotions, that are manifested in patients with Alzheimer's type dementia. PATIENTS AND METHODS: Twenty-eight patients were evaluated with the Battery of Facial Recognition of Basic Emotions. RESULTS: The highest percentages of choice for each emotion, proceeding those of correct answers, correspond to the main confusers (fear x surprise, surprise x fear, and disgust x anger). Significant differences were found between fear correct/surprise x fear, surprise correct/fear x surprise, anger correct/disgust x anger, and disgust correct/anger x disgust. CONCLUSIONS: These results support the classical theory raised on the existence of six basic emotions. As regard as emotional confusers, our results coincide partially with studies which found that the main errors are between anger/disgust and surprise/fear. As an exception, we found in our sample that when the correct answer is anger, the most common response by patients is fear.

TITLE: Reconocimiento de emociones básicas y sus principales confusores en la demencia tipo Alzheimer.Introducción. En la demencia tipo Alzheimer se suele observar alteración en el reconocimiento de las emociones básicas. Aunque existe cierto consenso en que las emociones básicas son seis, trabajos más recientes concluyen que puede haber una combinación entre miedo/sorpresa y asco/enojo. Este patrón no está investigado en la demencia tipo Alzheimer. Objetivos. Evaluar si los principales confusores son significativos para determinar la cantidad de emociones básicas y estudiar cuáles son los principales confusores entre emociones que se manifiestan en los pacientes con demencia tipo Alzheimer. Pacientes y métodos. Se evaluó a 28 pacientes con la batería de reconocimiento facial de emociones básicas. Resultados. Los porcentajes más elevados de elección para cada emoción, que proceden de las respuestas correctas, corresponden a los principales factores de confusión (miedo × sorpresa, sorpresa × miedo y asco × enojo). Se encontraron diferencias significativas entre miedo correcto/sorpresa × miedo, sorpresa correcta/miedo × sorpresa, enojo correcto/asco × enojo y asco correcto/enojo × asco. Conclusiones. Estos resultados estarían apoyando la teoría clásica planteada sobre la existencia de seis emociones básicas. Respecto a los confusores emocionales, nuestros resultados coinciden parcialmente con estudios que encontraron que los principales errores se presentan entre enojo/asco y sorpresa/miedo. Como excepción, en nuestra muestra encontramos que cuando la respuesta correcta es enojo, la respuesta más común de los pacientes es miedo.

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OBJECTIVE: To determine the relationship of interpregnancy interval with maternal and offspring outcomes. DESIGN: Retrospective study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Uruguay. SETTING: Latin America, 1990-2009. POPULATION: A cohort of 894 476 women delivering singleton infants. METHODS: During 1990-2009 the Perinatal Information System database of the Latin American Centre for Perinatology identified 894 476 women with defined interpregnancy intervals: i.e. the time elapsed between the date of the previous delivery and the first day of the last normal menstrual period for the index pregnancy. Using the interval 12-23 months as the reference category, multiple logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) of the association between various interval lengths and maternal and offspring outcomes. MAIN OUTCOME MEASURES: Maternal death, pre-eclampsia, eclampsia, puerperal infection, fetal death, neonatal death, preterm birth, and low birthweight. RESULTS: In the reference interval there was 0.05% maternal death, 1.00% postpartum haemorrhage, 2.80% pre-eclampsia, 0.15% eclampsia, 0.28% puerperal infection, 3.45% fetal death, 0.68% neonatal death, 12.33% preterm birth, and 9.73% low birthweight. Longer intervals had increased odds of pre-eclampsia (>72 months), fetal death (>108-119 months), and low birthweight (96-107 months). Short intervals of <12 months had increased odds of pre-eclampsia (aOR 0.80; 95% CI 0.76-0.85), neonatal death (aOR 1.18; 95% CI 1.08-1.28), and preterm birth (aOR 1.16; 95% CI 1.11-1.21). Statistically, the interval had no relationship with maternal death, eclampsia, and puerperal infection. CONCLUSIONS: A short interpregnancy interval of <12 months is associated with pre-eclampsia, neonatal mortality, and preterm birth, but not with other maternal or offspring outcomes. Longer intervals of >72 months are associated with pre-eclampsia, fetal death, and low birthweight, but not with other maternal or offspring outcomes. TWEETABLE ABSTRACT: A short interpregnancy interval of <12 months is associated with neonatal mortality and preterm birth.

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OBJECTIVE: To generate a global reference for caesarean section (CS) rates at health facilities. DESIGN: Cross-sectional study. SETTING: Health facilities from 43 countries. POPULATION/SAMPLE: Thirty eight thousand three hundred and twenty-four women giving birth from 22 countries for model building and 10,045,875 women giving birth from 43 countries for model testing. METHODS: We hypothesised that mathematical models could determine the relationship between clinical-obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three-step approach to generate the global benchmark of CS rates at health facilities: creation of a multi-country reference population, building mathematical models, and testing these models. MAIN OUTCOME MEASURES: Area under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate. RESULTS: According to the different versions of the model, areas under the ROC curves suggested a good discriminatory capacity of C-Model, with summary estimates ranging from 0.832 to 0.844. The C-Model was able to generate expected CS rates adjusted for the case-mix of the obstetric population. We have also prepared an e-calculator to facilitate use of C-Model (www.who.int/reproductivehealth/publications/maternal_perinatal_health/c-model/en/). CONCLUSIONS: This article describes the development of a global reference for CS rates. Based on maternal characteristics, this tool was able to generate an individualised expected CS rate for health facilities or groups of health facilities. With C-Model, obstetric teams, health system managers, health facilities, health insurance companies, and governments can produce a customised reference CS rate for assessing use (and overuse) of CS. TWEETABLE ABSTRACT: The C-Model provides a customized benchmark for caesarean section rates in health facilities and systems.

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OBJECTIVE: To assess the incidence of hypertensive disorders of pregnancy and related severe complications, identify other associated factors and compare maternal and perinatal outcomes in women with and without these conditions. DESIGN: Secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health (WHOMCS) database. SETTING: Cross-sectional study implemented at 357 health facilities conducting 1000 or more deliveries annually in 29 countries from Africa, Asia, Latin America and the Middle East. POPULATION: All women suffering from any hypertensive disorder during pregnancy, the intrapartum or early postpartum period in the participating hospitals during the study period. METHODS: We calculated the proportion of the pre-specified outcomes in the study population and their distribution according to hypertensive disorders' severity. We estimated the association between them and maternal deaths, near-miss cases, and severe maternal complications using a multilevel logit model. MAIN OUTCOME MEASURES: Hypertensive disorders of pregnancy. Potentially life-threatening conditions among maternal near-miss cases, maternal deaths and cases without severe maternal outcomes. RESULTS: Overall, 8542 (2.73%) women suffered from hypertensive disorders. Incidences of pre-eclampsia, eclampsia and chronic hypertension were 2.16%, 0.28% and 0.29%, respectively. Maternal near-miss cases were eight times more frequent in women with pre-eclampsia, and increased to up to 60 times more frequent in women with eclampsia, when compared with women without these conditions. CONCLUSIONS: The analysis of this large database provides estimates of the global distribution of the incidence of hypertensive disorders of pregnancy. The information on the most frequent complications related to pre-eclampsia and eclampsia could be of interest to inform policies for health systems organisation.

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Findings from a qualitative research study of the context of adolescent pregnancy are presented. Participants were 21 pregnant adolescents from Medellín, Colombia, and nearby villages in the region. Data were collected by means of 21 qualitative interviews, and analysis followed grounded theory procedures. The study reveals that adolescent pregnancy occurs in the context of a "genuine love affair" in which ideas of romantic love and gender rules guide young women's behaviour. Regarding an adolescent as immature or in a process of becoming might hinder adolescents' distinctive culture and circumstances. Ideas of romantic love and gender rules were powerful influences on those who unintentionally got pregnant.

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Yeast adherence to epithelial cells is a very important step in colonization and infection caused by these opportunistic pathogens. This phenomenon may be modified in vitro by many factors. The aim of this work was to find out how variations in pH and temperature modify the in vitro adherence of Candida albicans to epithelial cells. We worked with epithelial buccal cells and a yeast strain according to Gibbons and Van Houte technique with slight modifications. In the first assay, adherence at 28 degrees C and 37 degrees C, and three pH values, 6, 7.2 and 8.4 were simultaneously studied. We did not find significant variations in adherente capacity, but a slight increase was detected at pH 7.2 and 37 degrees C. In the second assay, temperature was fixed at 37 degrees C and four pH values were studied: 3, 4, 5, and 7.2. We find a highly significant difference (p < 0.001) between adherente at pH = 7.2 with respect to the other pH values. According to these results C. albicans adherence to epithelial buccal cells, in vitro, is produced at 37 degrees C and pH 7.2 in optimal conditions.

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Qualitative investigation in the health care field is faced with the relative problems of scientific knowledge production or epistemological questions, methodological procedures in qualitative investigations, and the utility and use of qualitative findings. These questions and others are discussed, in a general manner, in this article.

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One approach to analyse geographic variations of a disease within a country is through mortality rates in administrative areas. In some geographical areas the rates can be unstable due to their low population. Thus, the statistical analysis of the rate could be not significant due to low population, not because of the real value. An alternative approach to this problem is to set a minimum level of population that enables valid statistical comparisons with the national rate to be made. It is decided to apply an algorithm that groups neighbouring geographical units that reach the minimum population. In the resulting regions, mortality rates are calculated, and the geographic patterns are analysed through the Moran's I coefficient of spatial clustering. This paper presents an application of this approach to mortality rates from breast cancer by Argentine departments, political administrative units into which a province is divided. Applying this procedure, 217 regions were obtained. In two of the regions the rates were significantly higher than the national rate, while in 40 regions they were significantly lower. Significant spatial grouping, reflected by a Moran I coefficient of O-47, was observed.

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En el presente trabajo se estudian los efectos producidos por la procaína sobre el sistema de conducción intracardíaco con el método de registro directo del haz de His en perros, observándose a pesar de lo pequeño de la muestra valores altamente significativos de daño al sistema de conducción. Los valores observados se hacen evidentes a partir de la segunda dosis terapéutica lo que refleja el estrecho margen con el cual se trabaja con esta droga en anestesia general quirúrgica

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