Spironolactone reduces oxidative stress in living donor kidney transplantation: a randomized controlled trial.

Mineralocorticoid receptor antagonism prevents acute kidney injury induced by ischemia-reperfusion in rodent and pig preclinical models. In a pilot study, we showed that spironolactone (25 mg) reduced oxidative stress after 5 days of kidney transplant (KT). In the present study, we investigated the effects of higher doses (50 and 100 mg) of spironolactone on kidney function, tubular injury markers, and oxidative stress in living donor KT recipients. We included KT recipients aged 18 yr or older who received immunosuppression therapy with IL-2 receptor antagonist, mycophenolate mofetil, corticosteroids, and tacrolimus with negative cross-match, and compatible blood group. Patients were randomized to receive placebo (n = 27), spironolactone (50 mg, n = 25), or spironolactone (100 mg, n = 25). Treatment was given from 3 days before and up to 5 days after KT. Serum creatinine, K+, urine neutrophil gelatinase-associated lipocalin-2, heat shock protein 72, and 8-hydroxy-2-deoxyguanosine levels were assessed. As expected, kidney function was improved after KT. Serum K+ remained in the normal range along the study. There was no significant effect of spironolactone on urinary neutrophil gelatinase-associated lipocalin-2 levels, whereas the increase in urinary heat shock protein 72 levels tended to be less intense in the 100 mg spironolactone-treated group (P = 0.054). In the placebo-treated group, urinary 8-hydroxylated-guanosine levels increased on days 3 and 5 after transplantation. This effect was prevented in patients that received spironolactone. In conclusion, spironolactone reduces the acute increase in urinary oxidative stress in living donor KT recipients.

Human papillomavirus infections in Mexican women with normal cytology, precancerous lesions, and cervical cancer: type-specific prevalence and HPV coinfections.

The prevalence and genotype distribution of human papillomavirus (HPV) provides the basis for designing HPV prevention programs. The prevalence rates of type-specific HPV and coinfections in samples of Mexican women were investigated in 822 women aged 18-87 years. HPV detection was performed using a Linear Array™ genotyping test. HPV infection was found in 12.4% of controls, 46.3% of those with cervical intraepithelial neoplasia 1, and 100% of those with cervical intraepithelial neoplasia 3 or cervical cancer. HPV 16 was the most prevalent type in all diagnosis groups. The HPV types most frequently found in cervical cancers were 16, 18, 45, 52, 58, and 39; HPV types 16, 62, 51, 84, 18, 53, and CP6108 were the most prevalent in control women. Considering HPV-positive samples only, coinfections occurred most often in controls (63%) and were less frequent in those with cervical cancer (26%). The most frequent viral types in coinfections with HPV 16 in control women were HPV 62, 51, and 84; in women with cervical cancers, HPV 18, 39, and 70 were most common. In conclusion, in addition to HPV types 16 and 18, types 45, 39, 58, 52, and 71 were found in cervical cancers in Mexican women (78%); among them, only 65% were attributable to HPV types 16 and 18. Therefore, it is necessary to consider these viral types in the design of new vaccines, and to determine whether certain HPV types coinfecting with HPV 16 in precursor lesions determine tumor progression or regression.

Molecular Analysis by Gene Expression of Mitochondrial ATPase Subunits in Papillary Thyroid Cancer: Is ATP5E Transcript a Possible Early Tumor Marker?

BACKGROUND: Cancer development involves an "injury" to the respiratory machinery (Warburg effect) due to decreased or impaired mitochondrial function. This circumstance results in a down regulation of some of the ATPase subunits of the malignant tissue. The objective of this work was to assess and compare the relative expression of mRNA of mitochondrial ATPase subunits between samples of thyroid cancer and benign nodules. MATERIAL AND METHODS: Samples from 31 patients who had an operation for PTC at the General Hospital of Mexico were snap-frozen and stored at -70°C. Thirty-five patients who had an operation for benign tumors were also included in the study. mRNA expression levels of alpha, beta, gamma, and epsilon subunits of F1 and "c12" of subunit Fo were determined by real-time RT-PCR (by duplicate), in order to determine if abnormal expression of these genes could partially explain the Warburg effect in papillary thyroid cancer (PTC). RESULTS: ATP5E transcript alteration (down-expression) was highly associated to PTC diagnosis OR=11.76 (95% confidence interval, 1.245-237.98; p=0.04). CONCLUSIONS: Relative down-expression of ATP5E transcript was highly associated with PTC diagnosis. This transcript alteration may be used as a tumoral marker in papillary thyroid cancer.

[Increase S/D ratio in uterine artery as a predictor for preeclampsia in adolescent patients]. / Aumento del índice S/D en la arteria uterina como predictor de preeclampsia en adolescentes.

BACKGROUND: Pregnancy during adolescence has been rising in the past years, and it is well known that preeclampsia affects teenagers, because maternal age and primigravida are risk factors. There are different ways and methods to predict preeclampsia, for example doppler velocimetry. OBJECTIVE: Determine S/D ratio of uterine artery in pregnant teenagers between 24-28 weeks and correlation with preeclampsia. MATERIAL AND METHOD: Observational study in 50 pregnant teenagers (14-19 years) obtaining uterine artery waveform at 24-28 weeks gestation recording S/D ratio. RESULTS: Sensitivity and specificity of 90% with a positive predictive value of 69.23% and negative predictive value of 97.3%. 13 patients had S/D ratio greater than 2.6, of which 5 had gestational hypertension, 3 with preeclampsia, 1 with Fetal Growth Restriction, 4 with normal pregnancy. Relative Risk was 25.62 (3.58-183.13) with odds ratio of 81.00 (6.83-2260.88) and p value 0.00002. CONCLUSION: analysis of uterine artery flow velocity waveforms is a method to predict preeclampsia.

[Serological evidence of infection by three species of Chlamydia in pregnant women in Mexico]. / Evidencia serológica de infección por tres especies de Chlamydia en mujeres embarazadas.

UNLABELLED: Background: Chlamydiales are obligate intracellular pathogens causing a wide range of diseases in humans and animals. BACKGROUND: Chlamydiales are obligate intracellular pathogens causing a wide range of diseases in humans and animals. OBJECTIVE: To evaluate the seroprevalence of IgG antibodies to Chlamydophila psittaci, Chlamydophila pneumoniae and Chlamydia trachomatis in a group of pregnant women few hours before resolution of gestation, thus allowing for assessment of the potential effects in their pregnancy outcomes. MATERIAL AND METHODS: A cross-sectional study was done involving 110 hospitalized women for pregnancy resolution in two secondary care hospitals, one of Mexico City and other of Cuernavaca, Mor. Obstetric outcomes were followed in every case. Serum antibody measures were performed by microimmunofluorescence. Possible associations between seropositivity and pregnancy outcomes were analyzed. RESULTS: 110 pregnant women were studied, 85 were seropositive for any of the species (77.3%), of which 39 (46%) had antibodies to the three species, 27 against two (32%) and 19 (22%) against one. No associations of serologic results with obstetric complications were observed in these pregnant women. High socioeconomic status was found as a risk factor for seropositivity against C trachomatis. CONCLUSIONS: This study reveals high exposure to three species of Chlamydiaceae in Mexican pregnant women. Demonstrating complex interactions in two different places where all species are present. No correlation was found between seropositivity towards these Chlamydia species and pregnancy complications.

Cross-Neutralizing Anti-Chikungunya and Anti-Dengue 2 IgG Antibodies from Patients and BALB/c Mice against Dengue and Chikungunya Viruses.

Dengue (DENV) and Chikungunya (CHIKV) viruses can be transmitted simultaneously by Aedes mosquitoes, and there may be co-infections in humans. However, how the adaptive immune response is modified in the host has yet to be known entirely. In this study, we analyzed the cross-reactivity and neutralizing activity of IgG antibodies against DENV and CHIKV in sera of patients from the Mexican Institute of Social Security in Veracruz, Mexico, collected in 2013 and 2015 and using IgG antibodies of BALB/c mice inoculated with DENV and/or CHIKV. Mice first inoculated with DENV and then with CHIKV produced IgG antibodies that neutralized both viruses. Mice were inoculated with CHIKV, and then with DENV; they had IgG antibodies with more significant anti-CHIKV IgG antibody neutralizing activity. However, the inoculation only with CHIKV resulted in better neutralization of DENV2. In sera obtained from patients in 2013, significant cross-reactivity and low anti-CHIKV IgG antibody neutralizing activity were observed. In CHIKV-positive 2015 sera, the anti-DENV IgG antibody neutralizing activity was high. These results suggest that CHIKV stimulates DENV2-induced memory responses and vice versa. Furthermore, cross-reactivity between the two viruses generated neutralizing antibodies, but exchanging CHIKV for DENV2 generated a better anti-CHIKV neutralizing response.

Parameters to Predict the Outcome of Severe and Critical COVID-19 Patients when Admitted to the Hospital.

Manifestations of COVID-19 are diverse and range from asymptomatic to severe, critical illness and death. Cases requiring hospital care (in severe and critical illnesses) are associated with comorbidities and hyperactivation of the immune system. Therefore, in this exploratory observational study, we analyzed which parameters are associated with mortality. We evaluated: demographic characteristics (age, sex and comorbidities), laboratory data (albumin, leukocytes, lymphocytes, platelets, ferritin), days of hospital stay, interleukins (IL-2, IL-6, IL-7, IL-10, IL-17) and sP-selectin in 40 Mexican patients admitted to medical emergencies with a confirmed diagnosis of COVID-19, a complete clinical record, and who signed the informed consent. Twenty severe (they required intermediate care with non-invasive ventilation) and twenty critically ill patients (they required mechanical ventilation) were classified, and these were subsequently compared with healthy and recovered subjects. A significant difference was found between the hospitalized groups in the parameters of age, ferritin, days of hospital stay and death with p values = 0.0145, p = 0.0441, p = 0.0001 and p = 0.0001, respectively. In the determination of cytokines and P-selectin, a significant difference was found between the following groups: recovered patients and healthy volunteers compared with hospitalized patients in severe and critical condition. Importantly, IL-7 remained elevated one year later in recovered patients. Taken together, these values determined at the time of hospital admission could be useful to monitor patients closely and evaluate in-hospital progress, hospital discharge, and out-of-hospital progress.

Comparative effects of levamisole, Staphylococcus, and Freund's adjuvant on rat immunization with excretory and secretory antigens of Trichinella spiralis muscle larvae.

A comparison was made of the effects of levamisole, the bacterial fractions of Staphylococcus, and Freund's adjuvant on the immunization of rats with the excretory and secretory antigens of Trichinella spiralis muscle larvae. Wistar rats were immunized with the antigen and a saline solution, levamisole (LV), Staphylococcus (ST), or Freund's adjuvant (FA). After immunization, rats were infected, and the parasite burden at muscular phase was calculated for each group. Levels of IgG1 and IgG2 antibodies, as well as levels of two cytokines, IL-4 and IFN-γ, were evaluated during the immunization and postinfection periods. Differences were found in the kinetics of antibody production between groups (p < 0.01). In all cases, there was reactivity with the main 45-, 50-, and 55-kDa antigens of Trichinella muscle larvae. Immunization with FA and ST enhanced the production of IgG1, but only FA showed a significant increase in the production of IFN-γ (p < 0.01), resulting in 86% protection against the infection. In contrast, only 60-70% protection was attained in the ST and LV groups (p < 0.01). These data support the idea that levamisole and Staphylococcus can be used as adjuvant to enhance the humoral response and, at the same time, demonstrate that IFN-γ could be involved in protection against Trichinella.

Perception and Knowledge of Mercury by Occupationally Exposed Health Care Personnel.

Thermometers and baumanometers frequently contain mercury, a toxic heavy metal. Inadequate management of this substance can constitute an occupational hazard by exposing health care professionals to health risks including memory loss, psychosomatic symptoms, fatigue, and other signs of cognitive dysfunction as reported in several studies. PURPOSE: To assess Mexico's health care professionals' health and mercury-related knowledge and risk perception and to explore the measurement properties of a questionnaire assessing that level of knowledge. MATERIALS AND METHODS: Mixed methodology. A quantitative, cross-sectional study was conducted to measure health care professionals' knowledge of mercury and to validate an instrument using a Rasch analysis in 160 professionals. A qualitative study involving in-depth interviews was conducted to identify participants' risk perception for mercury exposure. RESULTS: The total knowledge of mercury was 19.0 ± 2.0 on a scale of 0 to 28 points. The scores for medical specialists were significantly (P < .001) higher, ranging between 20.0 ± 2.05 and 23.0 ± 1.63. In general, the level of risk perception for mercury exposure was low. The questionnaire presented a reasonable fit to the Rasch model (good item fit with a Bonferroni-adjusted P = .000714). The response categories of three items were collapsed, and two pairs of items were bundled into two super items. CONCLUSION: The levels of the knowledge of the health and safety risks and risk perception for mercury exposure in the Mexican health care professionals evaluated were low. Health care professionals should receive comprehensive training in the safe use and health risks of mercury.

Improved HUMARA for the Detection of X-Linked Agammaglobulinemia Carriers.

Background: Fragment analysis of exon 1 of the human androgen receptor, known as HUMARA, is a polymerase chain reaction (PCR)-based method for detecting X-linked agammaglobulinemia (XLA) carriers. This method takes advantage of X-chromosome inactivation (XCI) in female cells. XLA is caused by mutations in the Bruton tyrosine kinase (BTK) gene, located in Xq22.1. In this study, XCI is nonrandom or skewed in B-cells. B-cells with an active X-chromosome carrying a BTK mutation do not mature. Peripheral B-cells in XLA carriers inactivate the mutated X-chromosome. Methods: HUMARA was performed using DNA from purified B-cells and total leukocytes. DNA was digested using methylation-sensitive HhaI. The PCR of the HUMARA polymorphic marker was performed with the HhaI digested samples. The lengths of the PCR products were determined. If a suspected carrier showed skewed XCI in their B-cells, the marker length that corresponded with the length determined in the index patient indicated their carrier status. Results: HUMARA was conducted on purified B-cells; this allowed easier identification of the mutated or inactive allele, as the active allele was enzymatically digested. Analysis of 30 possible carriers using modified HUMARA corroborated that the carrier status in all samples that were heterozygous for the marker using XCI calculation for leukocytes showed a Gaussian distribution, while the carrier B-cell DNA showed a skewed XCI. Conclusion: Carrier status was successfully determined for most of the analyzed samples. B-cell enrichment resulted in precise carrier determination data, reduced the sample size, and facilitated inactive and active allele identification.

Human T-Lymphotropic Virus (HTLV) Type I in vivo Integration in Oral Keratinocytes.

Although the infection of HTLV-1 to cell components of the mouth have been previously reported, there was not until this report, a detailed study to show the characteristics of such infection. From 14 Tropical Spastic Paraparesis/HTLV-1-Associated Myelopathy (HAM/TSP) patients and 11 asymptomatic carrier individuals (AC) coming from HTLV-1 endemic areas of southwest Pacific of Colombia, infected oral mucosa cells were primary cultured during five days. These cell cultures were immunophenotyped by dual color fluorescence cell assortment using different lymphocyte CD markers and also were immunohistochemically processed using a polyclonal anti-keratin antibody. Five days old primary cultures were characterized as oral keratinocytes, whose phenotype was CD3- /CD4-/CD8-/CD19-/CD14-/CD45-/A575-keratin+. From DNA extracted of primary cultures LTR, pol, env and tax HTLV-1 proviral DNA regions were differentially amplified by PCR showing proviral integration. Using poly A+ RNA obtained of these primary cultures, we amplify by RT-PCR cDNA of tax and pol in 57.14% (8/14) HAM/TSP patients and 27.28% (3/11) AC. Tax and pol poly A+ RNA were expressed only in those sIgA positive subjects. Our results showed that proviral integration and viral gene expression in oral keratinocytes are associated with a HTLV-1 specific local mucosal immune response only in those HTLV-1 infected individuals with detectable levels of sIgA in their oral fluids. Altogether the results gave strong evidence that oral mucosa infection would be parte of the systemic spreading of HTLV-1 infection.

Vegfa promoter gene hypermethylation at HIF1α binding site is an early contributor to CKD progression after renal ischemia.

Chronic hypoxia is a major contributor to Chronic Kidney Disease (CKD) after Acute Kidney Injury (AKI). However, the temporal relation between the acute insult and maladaptive renal response to hypoxia remains unclear. In this study, we analyzed the time-course of renal hemodynamics, oxidative stress, inflammation, and fibrosis, as well as epigenetic modifications, with focus on HIF1α/VEGF signaling, in the AKI to CKD transition. Sham-operated, right nephrectomy (UNx), and UNx plus renal ischemia (IR + UNx) groups of rats were included and studied at 1, 2, 3, or 4 months. The IR + UNx group developed CKD characterized by progressive proteinuria, renal dysfunction, tubular proliferation, and fibrosis. At first month post-ischemia, there was a twofold significant increase in oxidative stress and reduction in global DNA methylation that was maintained throughout the study. Hif1α and Vegfa expression were depressed in the first and second-months post-ischemia, and then Hif1α but not Vegfa expression was recovered. Interestingly, hypermethylation of the Vegfa promoter gene at the HIF1α binding site was found, since early stages of the CKD progression. Our findings suggest that renal hypoperfusion, inefficient hypoxic response, increased oxidative stress, DNA hypomethylation, and, Vegfa promoter gene hypermethylation at HIF1α binding site, are early determinants of AKI-to-CKD transition.

In silico analysis of the association of hsa-miR-16 expression and cell survival in MDA-MB-231 breast cancer cells subjected to photodynamic therapy.

BACKGROUND: Breast cancer is the most common malignancy effecting women, and the triple-negative breast cancer (TNBC) subtype is particularly aggressive. This study aimed to evaluate the differential expression pattern of microRNAs (miRNAs) between untreated MDA-MB-231 cells (TNBC cell model) and those that survived photodynamic therapy (PDT) to gain insights into cell survival mechanisms. METHODS: Two PDT cycles were applied to MDA-MB-231 cells, using δ-aminolevulinic acid (ALA) followed by laser light at 635 nm. RNA was obtained from cells surviving PDT and untreated cells. The miRNAs expression profile was analyzed to detect the differences between the two groups. The potential target network of hsa-miR-16 was examined in silico with the integrative database Ingenuity® Pathway Analysis software. RESULTS: After the first and second PDT cycles, 17.8% and 49.6% of the MDA-MB-231 cells were viable. Microarray profiling of miRNAs showed decreased hsa-miR-16 expression (p < 0.05) in MDA-MB-231 cells surviving PDT when compared to the control cells. The predicted downstream targets of hsa-miR-16 were: 1) tumor suppressor protein 53; 2) molecules related to the cell cycle, such as cyclin D1, D3, and E1, and checkpoint kinase 1; 3) cell proliferation molecules, including fibroblast growth factor 1, 2 and 7 and fibroblast growth factor receptor 1; and 4) apoptosis-related molecules, consisting of BCL-2, B-cell leukemia/lymphoma 2, caspase 3, and cytochrome c. CONCLUSIONS: The differential expression of hsa-miR-16 between untreated MDA-MB-231 cells and those surviving PDT has not been previously reported. There was a lower expression of hsa-miR-16 in treated cells, which probably altered its downstream target network. In silico analysis predicted, a network related to the cell cycle, proliferation and apoptosis. These results are congruent with previous descriptions of hsa-miR-16 as a tumor suppressor and suggest that the treated population has increased their capacity to survive.

Implementation of control measures against an outbreak due to Clostridioides difficile producing toxin B in a tertiary hospital in Mexico.

INTRODUCTION: To describe the outbreak of Clostridioides difficile infection (CDI), and the impact of the prevention and control measures that were implemented in the "Hospital Juárez de México" (HJM) for its control. METHODS: A cross-sectional, descriptive, observational, and retrospective study was designed. All information on the hospital outbreak and on health care-associated infections (HCAI) was obtained from the files of the Hospital Epidemiological Surveillance Unit (HESU) of the HJM. RESULTS: A total of 15 cases of CDI were detected from February 20th to May 22nd, 2018, which represented 55.6% and 44.4% for the male and female gender, respectively, with an average age of 56 years and a range of 24 to 86 years old. It was possible to identify six failures and deficiencies that involved health personnel and hospital logistics through analyses based on the situational diagnosis in the services involved and through the construction of cause-effect diagrams. Additionally, through the detection of the outbreak by means of laboratory tests and timeline, the HESU team implemented measures and prospective surveillance to control and prevent the emergence of new cases. CONCLUSIONS: The implementation of basic quality tools, control measures, and the prospective epidemiological surveillance had a positive impact on the control against the outbreak of C. difficile producing toxin B.

Testing genotoxicity and cytotoxicity strategies for the evaluation of commercial radiosterilized fetal calf sera.

Effects of 18 commercial lots of fetal calf serum (FCS) after gamma-irradiation and their non-irradiated counterparts were comparatively analyzed on CHO-K1 and MDBK MDL1 cells for genotoxicity [sister chromatid exchange (SCE), micronuclei (MNi), and single cell gel electrophoresis (SCGE)], cytotoxicity [cell-cycle progression (CCP), proliferative replication index (PRI), mitotic index (MI), growth promotion (GP), and plating efficiency (PE)], and microbiological properties (mycoplasma and bovine viral diarrhea virus contamination). SCE and SCGE were the most informative end-points for genotoxicity since significant differences were found in 44.4% (P<0.05-0.001, Student's t-test) and 61.1% (P<0.05-0.001, chi(2) test) samples, respectively. MI was the cytotoxicity assay revealing the greatest variation, showing differences in 66.7% (P<0.05-0.001, chi(2) test) samples. Thus, these three end-points for screening bioproducts such as FCS were found most suitable for detecting potential geno-cytotoxicants in biological samples; their simultaneous use could be strongly recommended.

Neonatal adiposity may increase plasmatic cytokines.

Maternal health and nutritional status before and during gestation may affect neonates' immune system and energy balance as they develop. The objective of this study was to associate certain clinical markers of maternal adiposity (body mass index and gestational weight gain) and neonatal adiposity (birth weight, abdominal circumference, and waist/height index) with the levels of pro- and anti-inflammatory cytokines in umbilical cord blood at birth: IL-1ß, IL-1Rα, IL-4, IL-6, IL-10, IFN-γ, and TNF-α. An exploratory cross-sectional study was conducted with a convenience sample of women from one hospital recruited shortly before giving birth through scheduled cesarean section. Of 31 the pregnant women who agreed to participate and met the inclusion criteria, twenty-nine newborns from these women were analyzed. Three cases of tobacco smoking during pregnancy were identified as an unexpected maternal risk factor and were included in the analysis. Typical of the population treated at this hospital, ten of our participants had diabetes during pregnancy, and nine of them had a pre-pregnancy BMI> 25. Non-parametric statistical analyses and a generalized linear model with gamma scale response with a log link were performed. Results: Correlation analyses, differences in medians, and a prediction model all showed positive and significant results between cytokine levels in cord blood and neonatal abdominal circumference, birth weight, and waist-height index. For maternal variables, smoking during pregnancy showed significant associations with cytokine levels in cord blood. Conclusion: This study found a variety of associations suggesting that increased neonatal adiposity increases pro-inflammatory cytokine levels at birth.

Bedaquilina en el tratamiento de tuberculosis multirresistente en pediatría / Bedaquiline in the treatment of multidrug-resistant tuberculosis in pediatrics

RESUMEN La tuberculosis multirresistente surge de cepas de Mycobacterium tuberculosis con resistencia in vitro al menos a isoniacida y rifampicina, dos drogas de primera línea claves para el tratamiento. Anualmente, alrededor de treinta mil niños en el mundo contraen esta forma de tuberculosis, y menos del 5 % recibe tratamiento adecuado. El enfoque para estos casos debe seguir el perfil de sensibilidad del germen y tratar de lograr la curación del paciente con el menor número de complicaciones y secuelas po sibles, y prevenir la transmisión comunitaria de la enfermedad. En 2022 la Organización Mundial de la Salud recomendó la bedaquilina para el tratamiento de la tuberculosis multirresistente en adultos y niños de todas las edades. Nuestro objetivo es comunicar nuestra experiencia sobre la administración de bedaquilina en niños y adolescentes en el contexto del tratamiento de la tuberculosis multirresistente de acuerdo con las últimas recomendaciones.

ABSTRACT Multidrug-resistant tuberculosis arises from strains of Mycobacterium tuberculosis with in vitro resistance to at least isoniazid and rifampicin, two key first-line drugs for treatment. Annually, around 30 000 children worldwide contract this form of tuberculosis, and less than 5 % receive adequate treatment. The approach for these cases should follow the sensitivity profile of the germ, trying to achieve the patient's cure with the fewest pos sible complications and sequelae, and prevent community transmission of the disease. In 2022, the World Health Organization recommended bedaquiline for the treatment of multidrug-resistant tuberculosis in adults and children of all ages. Our objective is to communicate our experience on the administration of bedaquiline in children and adolescents in the context of multidrug-resistant tuberculosis treatment in accordance with the latest recommendations.

La metacognición en la enseñanza del inglés en la universidad cubana

Fundamento: el proceso enseñanza aprendizaje del idioma debe ir acompañado de estrategias de aprendizaje, entre ellas, las metacognitivas. Objetivo: identificar las carencias de conocimientos de profesores y estudiantes sobre las estrategias metacognitivas en el proceso enseñanza aprendizaje del inglés en una universidad cubana. Métodos: se realizó una investigación descriptiva transversal en la Universidad Central "Marta Abreu" de Las Villas durante el curso 2018-2019. Se emplearon métodos teóricos: análisis-síntesis e inductivo-deductivo y el enfoque sistémico; empíricos: la observación participante y un cuestionario sobre estrategias de aprendizaje; y matemático-estadísticos para los valores absolutos y relativos. Resultados: la mayoría de los estudiantes utilizan las estrategias de aprendizaje algunas veces. En la observación participante se comprobó que los profesores no aplican estrategias de aprendizaje metacognitivas en sus clases; los estudiantes tampoco las utilizan, por lo que sus conocimientos se caracterizan por un aprendizaje memorístico. Conclusiones: se identificaron carencias de conocimientos sobre las estrategias metacognitivas para lograr efectividad en el proceso enseñanza aprendizaje del inglés, por lo que resulta necesaria la capacitación en el tema por su pertinencia para la solución de la problemática; la utilidad, factibilidad y novedad de la mencionada estrategia hacen posible la solución al problema planteado.

Rationale: the language teaching-learning process should be accompanied by learning strategies, among them, metacognitive strategies. Objective: to identify the lack of knowledge of teachers and students about metacognitive strategies in the English teaching-learning process in a Cuban university. Methods: cross-sectional descriptive research was conducted at the "Marta Abreu" Central University of Las Villas during the 2018-2019 academic year. Theoretical methods were used: analysis-synthesis and inductive-deductive and the systemic approach; empirical: participant observation and a questionnaire on learning strategies; and mathematical-statistical for absolute and relative values. Results: most students use learning strategies some of the time. Participant observation showed that teachers do not apply metacognitive learning strategies in their classes; students do not use them either, so their knowledge is characterized by rote learning. Conclusions: lack of knowledge about metacognitive strategies to achieve effectiveness in the English teaching-learning process was identified; therefore, training on the subject is necessary due to its relevance for the solution of the problem; the usefulness, feasibility and novelty of the mentioned strategy make possible the solution to the problem posed.