A Systematic Review and Meta-Analysis on the Prevalence of Mild Cognitive Impairment and Dementia in Mexico.

INTRODUCTION: Age remains one of the major risk factors for the onset of mild cognitive impairment (MCI) and dementia. Studies on the prevalence of these conditions in Mexico used different methods, tools, and populations with different health statuses. All these heterogeneous results may be a problem in identifying the true prevalence of MCI and dementia in Mexico. To our knowledge, there is not a systematic review available that presents essential figures on the prevalence of these conditions in Mexico. Therefore, we intend to access the maximum number of reports published on the topic and determine the prevalence of MCI and dementia in older Mexican adults. METHODS: A systematic review using PubMed, Cochrane, Research Gate, Lilacs, and Scielo databases was performed. Meta-analysis of the prevalence of MCI and dementia was performed using a random-effects model and presented in a forest plot among cross-sectional, epidemiological, and pooled studies. RESULTS: Sixteen articles were included. The overall prevalence of MCI of 18% (95% CI 0.10-0.27) was estimated from pooled information from 12 selected studies, in women 21% (95% CI 0.08-0.38) and in men 18% (95% CI 0.06-0.33). The overall prevalence of dementia of 10% (95% CI 0.06-0.14) was estimated from pooled information from 9 selected studies, in women 14% (95% CI 0.05-0.25) and in men 10% (95% CI 0.04-0.17). CONCLUSION: Mexican older individuals have a similar prevalence of dementia and MCI as reported by international data; nevertheless, the prevalence is higher than in some Latin American countries. Mexico has particular issues that must be resolved, such as a lack of research in the southern regions of the country and the high incidence of comorbidities.

The Livestock Frontier in the Paraguayan Chaco: A Local Agent-based Perspective.

Deforestation is one of the most relevant transformations characterizing global environmental change in the tropics at present. There is wide consensus in pointing the context-dependent nature of tropical deforestation. In this sense, a better characterization of the phenomenon considering the social context could provide a more accurate picture of tropical deforestation. With this aim, a Q-methodology discourse analysis was conducted to characterise the different discourses that coexist in the particular region of the Paraguayan Chaco concerning the development of cattle ranching and derived deforestation. Four different discourses were identified as making sense the wide range of interests and values coexisting and clashing in the Paraguayan Chaco, namely: the Environmentalist discourse, the Business discourse, the Resigned discourse, and the Possibilist discourse. The results point that the fundamental differences between the discourses are largely explained by the different positions on three specific domains: (i) the socio-economic benefits the expansion of cattle ranching brings about; (ii) the environmental impacts the expansion of cattle ranching and the derived deforestation brings on; and, finally (iii) the degree to which an active intervention from the side of policy making to regulate the expansion of cattle ranching and to minimize possible detrimental effects is seen as necessary. The position of the different discourses in relation to these domains could help policy makers to make measures and regulations more widely accepted and followed.

Nontuberculous Mycobacteria, Mucociliary Clearance, and Bronchiectasis.

Nontuberculous mycobacteria (NTM) are environmental and ubiquitous, but only a few species are associated with disease, often presented as nodular/bronchiectatic or cavitary pulmonary forms. Bronchiectasis, airways dilatations characterized by chronic productive cough, is the main presentation of NTM pulmonary disease. The current Cole's vicious circle model for bronchiectasis proposes that it progresses from a damaging insult, such as pneumonia, that affects the respiratory epithelium and compromises mucociliary clearance mechanisms, allowing microorganisms to colonize the airways. An important bronchiectasis risk factor is primary ciliary dyskinesia, but other ciliopathies, such as those associated with connective tissue diseases, also seem to facilitate bronchiectasis, as may occur in Lady Windermere syndrome, caused by M. avium infection. Inhaled NTM may become part of the lung microbiome. If the dose is too large, they may grow excessively as a biofilm and lead to disease. The incidence of NTM pulmonary disease has increased in the last two decades, which may have influenced the parallel increase in bronchiectasis incidence. We propose that ciliary dyskinesia is the main promoter of bronchiectasis, and that the bacteria most frequently involved are NTM. Restoration of ciliary function and impairment of mycobacterial biofilm formation may provide effective therapeutic alternatives to antibiotics.

NeuroTri2-VISDOT: An open-access tool to harness the power of second trimester human single cell data to inform models of Mendelian neurodevelopmental disorders.

Whole exome and genome sequencing, coupled with refined bioinformatic pipelines, have enabled improved diagnostic yields for individuals with Mendelian conditions and have led to the rapid identification of novel syndromes. For many Mendelian neurodevelopmental disorders (NDDs), there is a lack of pre-existing model systems for mechanistic work. Thus, it is critical for translational researchers to have an accessible phenotype- and genotype-informed approach for model system selection. Single-cell RNA sequencing data can be informative in such an approach, as it can indicate which cell types express a gene of interest at the highest levels across time. For Mendelian NDDs, such data for the developing human brain is especially useful. A valuable single-cell RNA sequencing dataset of the second trimester developing human brain was produced by Bhaduri et al in 2021, but access to these data can be limited by computing power and the learning curve of single-cell data analysis. To reduce these barriers for translational research on Mendelian NDDs, we have built the web-based tool, Neurodevelopment in Trimester 2 - VIsualization of Single cell Data Online Tool (NeuroTri2-VISDOT), for exploring this single-cell dataset, and we have employed it in several different settings to demonstrate its utility for the translational research community.

Genetic Mapping of prod E.3.3 , a New Lethal Allele of prod.

The E.3.3 mutation was generated in a Flp/FRT EMS screen for conditional mutations that cause growth and developmental defects in a genetic background that blocks apoptosis. The mutations were conditional, based on the Dark 82 allele being present on the starting chromosome, and blocking canonical apoptosis in a homozygous state. The E.3.3 mosaic eyes exhibit defects in eye development including patches of rough eye and irregular surface structure. Whole Genome Sequencing and complementation mapping revealed E.3.3 as an allele of prod . Prod is a DNA-binding protein that binds satellite repeats and is involved in chromocenter formation during mitosis. Here we present a novel allele of prod , prod E.3.3 , that disrupts the functional region of the Prod protein resulting in disruption of typical eye structure, likely due to disruption of chromatid separation during development.

Expanded phenotypic spectrum of neurodevelopmental and neurodegenerative disorder Bryant-Li-Bhoj syndrome with 38 additional individuals.

Bryant-Li-Bhoj syndrome (BLBS), which became OMIM-classified in 2022 (OMIM: 619720, 619721), is caused by germline variants in the two genes that encode histone H3.3 (H3-3A/H3F3A and H3-3B/H3F3B) [1-4]. This syndrome is characterized by developmental delay/intellectual disability, craniofacial anomalies, hyper/hypotonia, and abnormal neuroimaging [1, 5]. BLBS was initially categorized as a progressive neurodegenerative syndrome caused by de novo heterozygous variants in either H3-3A or H3-3B [1-4]. Here, we analyze the data of the 58 previously published individuals along 38 unpublished, unrelated individuals. In this larger cohort of 96 people, we identify causative missense, synonymous, and stop-loss variants. We also expand upon the phenotypic characterization by elaborating on the neurodevelopmental component of BLBS. Notably, phenotypic heterogeneity was present even amongst individuals harboring the same variant. To explore the complex phenotypic variation in this expanded cohort, the relationships between syndromic phenotypes with three variables of interest were interrogated: sex, gene containing the causative variant, and variant location in the H3.3 protein. While specific genotype-phenotype correlations have not been conclusively delineated, the results presented here suggest that the location of the variants within the H3.3 protein and the affected gene (H3-3A or H3-3B) contribute more to the severity of distinct phenotypes than sex. Since these variables do not account for all BLBS phenotypic variability, these findings suggest that additional factors may play a role in modifying the phenotypes of affected individuals. Histones are poised at the interface of genetics and epigenetics, highlighting the potential role for gene-environment interactions and the importance of future research.

Factores de riesgo maternos asociados con la muerte fetal tardía en el contexto santaclareño / Maternal risk factors associated with late fetal death in the Santa Clara context

Introducción: La muerte fetal es uno de los accidentes obstétricos más difíciles de enfrentar, tanto para la paciente y su familia como para el personal de salud que atiende a la gestante. Objetivo: Identificar los factores de riesgo maternos asociados con la muerte fetal tardía en el contexto santaclareño. Métodos: Se realizó un estudio descriptivo, longitudinal y retrospectivo en el municipio Santa Clara, provincia Villa Clara, en el período comprendido de enero de 2015 a diciembre de 2019. La población estuvo conformada por 71 gestantes con fetos muertos en una etapa tardía y sus productos; en el análisis y procesamiento de los datos, se usó el software SPSS versión 20 para Windows. Resultados: Existió predominio de gestantes multíparas (56,3 %), en edad reproductiva óptima (69 %) y con uno a tres factores de riesgo (71,8 %). Conclusiones: Los factores maternos asociados con mayor frecuencia a la muerte fetal tardía pueden agruparse en: los vinculados a las enfermedades crónicas, en primer lugar la hipertensión arterial y en segundo el hipotiroidismo, y los relacionados con las afecciones del tracto genital, entre las que prevalece la vaginitis.

Introduction: fetal death is one of the most difficult obstetric accidents to face, both for patients and their families as well as for the health personnel who take care of the pregnant women. Objective: to identify the maternal risk factors associated with late fetal death in the Santa Clara context. Methods: a descriptive, longitudinal and retrospective study was carried out in Santa Clara municipality, Villa Clara province, from January 2015 to December 2019. The population consisted of 71 pregnant women with late fetal demise and their products; the SPSS software version 20.0 for Windows was used in the data processing and analysis. Results: multiparous pregnant women predominated (56.3%), in optimal reproductive age (69%) and from one to three risk factors (71.8%). Conclusions: the most frequently maternal factors associated with late fetal death can be grouped into those that were linked to chronic diseases, firstly arterial hypertension and secondly hypothyroidism, and those related to disorders of the genital tract, among which vaginitis prevails.

Resultados de la estrategia de código rojo en la atención a pacientes con hemorragia posparto / Results of the red code strategy in the care of patients with postpartum hemorrhage

Introducción: La estrategia de código rojo permite la atención inmediata, sistematizada y coordinada de la hemorragia posparto. Es un esquema de trabajo organizado que contribuye a un tratamiento oportuno y pertinente de la hemorragia obstétrica. Con esta herramienta, el equipo asistencial puede seguir los pasos indicados sin desviarse del objetivo, trabajar de manera ordenada y aplicarlo en cada situación específica, para disminuir la morbilidad y mortalidad materna. Objetivo: Caracterizar los resultados de la estrategia de código rojo en la atención a pacientes con hemorragia posparto en Villa Clara. Métodos: Se realizó un estudio de desarrollo, observacional, de corte transversal y retrospectivo de las pacientes con hemorragia posparto en Villa Clara, durante el período de enero 2018 a junio de 2021. La muestra no probabilística quedó conformada por 127 pacientes. Se utilizaron medidas de resumen para la descripción de las variables. En las cuantitativas se emplearon medidas de tendencia central y de dispersión (media y desviación estándar), para las variables cualitativas se mostraron frecuencias absolutas y relativas. Para establecer las relaciones entre variables se aplicó la prueba de independencia basada en la distribución Ji cuadrado. Resultados: En la evaluación del cumplimiento del protocolo de código rojo resultaron incorrectos algunos parámetros como: el diagnóstico de las etapas del choque y el tiempo de accionar. Conclusiones: Cada institución debe contar con protocolos y guías de atención de pacientes obstétricas con bases científicas que se correspondan a las posibilidades de cada país; estos protocolos deben facilitar y perfeccionar las acciones del médico.

Introduction: the red code strategy allows immediate, systematized and coordinated care of postpartum hemorrhage. It is an organized work scheme that contributes to timely and relevant treatment of obstetric hemorrhage. The healthcare team can follow with this tool the indicated steps without deviating from the objective, work in an orderly manner and apply it in each specific situation to reduce maternal morbidity and mortality. Objective: to characterize the results of the red code strategy in the care of patients with postpartum hemorrhage in Villa Clara. Methods: a retrospective, cross-sectional, observational and developmental study was carried out in patients with postpartum hemorrhage in Villa Clara from January 2018 to June 2021. The non-probabilistic sample consisted of 127 patients. Summary measures were used to describe the variables. Measures of central tendency and dispersion (mean and standard deviation) were used in the quantitative variables as well as absolute and relative frequencies were shown for the qualitative ones. The independence test based on the Chi-square distribution was applied to establish the relationships between variables. Results: some parameters were incorrect in the evaluation of compliance with the red code protocol such as the diagnosis of the stages of shock and the time to act. Conclusions: each institution must have protocols and guidelines for the care of obstetric patients with scientific bases that correspond to the possibilities of each country; these protocols should facilitate and improve the doctor's actions.

Riesgo aterogénico en la preeclampsia agravada lejos del termino y de aparición tardía

Introducción: La preeclampsia-eclampsia es una de las principales causas de morbimortalidad materna y perinatal. Objetivos: Determinar el riesgo aterogénico en la preeclampsia precoz y tardía. Método: Estudio descriptivo de corte transversal en gestantes que ingresaron en el hospital materno con diagnóstico de preeclampsia agravada entre los años 2010 ­ 2019. La muestra quedó constituida por 506 mujeres, que se subdividieron en precoz (menos de 34 semanas) y tardía (con 34 y más). Se determinó riesgo aterogénico en el momento del diagnóstico de preeclampsia grave y se clasificó a las gestantes según riesgo cardio metabólico usando el método multivariante de clasificación: técnica de conglomerados en dos fases. Las variables utilizadas para el riesgo aterogénico fueron los índices de Castelli y proaterogénico a partir del cociente CT/cHDL. Resultados: Con predominio en edad fértil, con una media de 27,3 años, en la preeclampsia precoz la media resulto 30,6 semanas y en la preeclampsia tardía 37,6 semanas. En los antecedentes patológicos se encontró la multiparidad en 211 gestantes, seguido de la Hipertensión arterial crónica en 207. Del total de las 506 pacientes, 488 tienen un riesgo moderado y máximo (419 (82,8%) máximo riesgo aterogénico y 69(13,6%) riesgo moderado) con un marcado predominio en el grupo de preeclampsia de aparición tardía. Conclusiones: Pertenecen generalmente al grupo de edades reproductivas, la mayoría son multíparas, y la hipertensión arterial crónica es uno de los antecedentes más frecuentes encontrados. El riesgo aterogénico máximo y moderado predomino en la mayoría de las mujeres con preeclampsia agravada sobre todo en la aparición tardía. (provisto por Infomedic International)

Introduction: Preeclampsia-eclampsia is one of the main causes of maternal and perinatal morbidity and mortality. Objectives: To determine the atherogenic risk in early and late preeclampsia. Methods: Descriptive cross-sectional study of pregnant women admitted to the maternity hospital with a diagnosis of aggravated preeclampsia between 2010 and 2019. The sample consisted of 506 women, who were subdivided into early (less than 34 weeks) and late (34 weeks and older). Atherogenic risk was determined at the time of diagnosis of severe preeclampsia and the pregnant women were classified according to cardio-metabolic risk using the multivariate method of classification: two-stage clustering technique. The variables used for atherogenic risk were the Castelli and proatherogenic indices based on the TC/cHDL ratio. Results: Predominantly in fertile age, with a mean of 27.3 years, in early preeclampsia the mean was 30.6 weeks and in late preeclampsia 37.6 weeks. In the pathological history, multiparity was found in 211 pregnant women, followed by chronic arterial hypertension in 207. Of the total 506 patients, 488 had moderate and maximum risk (419 (82.8%) maximum atherogenic risk and 69 (13.6%) moderate risk) with a marked predominance in the group of late onset preeclampsia. Conclusions: They generally belong to the reproductive age group, most are multiparous, and chronic arterial hypertension is one of the most frequent antecedents found. Maximum and moderate atherogenic risk predominated in most of the women with aggravated preeclampsia, especially in late onset. (provided by Infomedic International)

Relación entre biometría fetal, producto de acumulación de los lípidos y condición trófica al nacer / Relationship between fetal biometry, lipid accumulation product and the trophic condition at birth

Fundamento: Las alteraciones del estado nutricional materno generalmente se relacionan con desviaciones del crecimiento fetal, que pueden detectarse por los parámetros biofísicos fetales e identifican la posible condición trófica al nacer. Objetivo: Determinar la posible relación entre los parámetros biométricos fetales, la condición trófica al nacer y el producto de acumulación de los lípidos. Metodología: Se realizó un estudio transversal en el Policlínico Chiqui Gómez Lubian del municipio Santa Clara, durante el año 2019, en una población de 253 gestantes normopeso supuestamente sanas al inicio de la gestación. La muestra no probabilística fue de 144 gestantes. Las variables de estudio fueron: producto de acumulación de los lípidos, biometría fetal y condición trófica al nacer. Se utilizaron métodos teóricos, empíricos y estadísticos. Resultados: En el segundo trimestre ningún parámetro biométrico coincidió con la condición al nacer de pequeño, mientras que para el grande coincidieron las circunferencias cefálica y abdominal. En el tercer trimestre la longitud del fémur y la circunferencia abdominal coinciden en la identificación del pequeño y del grande. El PAL se correlacionó con la circunferencia abdominal del tercer trimestre y con el peso al nacer; presentando mayor frecuencia de valores en el tercer tertil para los nacimientos grandes. Conclusiones: La circunferencia abdominal fue el parámetro biométrico con mayor coincidencia con la condición trófica al nacer, la que se asoció con valores en el tercer tertil del PAL para la detección de nacimientos grandes, relacionándose el fenotipo normopeso metabólicamente obeso con el crecimiento fetal por exceso.

Background: Maternal nutritional status disorders are usually related to fetal growth deviations, which can be detected by fetal biophysical parameters and identify the possible trophic condition at birth. Objective: To determine the possible relationship between fetal biometric parameters, the birth trophic state and lipid accumulation product. Methodology: A cross-sectional study was conducted at the Chiqui Gómez Lubian Polyclinic in Santa Clara municipality, during 2019, in a population of 253 normal-weight pregnant women who were apparently healthy at the beginning of their gestation. The non-probability sample was made up of 144 pregnant women. Study variables were: lipid accumulation product, fetal biometry and trophic condition at birth. Theoretical, empirical and statistical methods were used. Results: In the second trimester, none of the biometric parameters matched the condition at birth as a small child, while in the large one the head and abdominal circumferences matched. In the third trimester, femoral length and abdominal circumference coincide in identifying the small one and the large one. LAP correlated with third trimester abdominal circumference and birth weight, presenting higher frequency of values in the third tertile for large births. Conclusions: Abdominal circumference was the biometric parameter with the highest coincidence with trophic condition at birth, associated with values in the third tertile of the LAP for detecting large births, relating the metabolically obese normal weight phenotype with excessive fetal growth.

Velocidad de procesamiento en escolares chilenos con y sin Trastorno por Déficit de Atención con Hiperactividad (TDAH) / Processing Speed in Chilean Schoolchildren With and Without Attention Deficit Hyperactivity Disorder (ADHD) / Velocidade de processamento em estudantes chilenos com e sem Transtorno de Déficit de Atenção e Hiperatividade (TDAH)

El TDAH es el trastorno del neurodesarrollo más diagnosticado en escolares. La evidencia indica que las funciones ejecutivas, como es el caso de la velocidad de procesamiento y la memoria de trabajo, están afectadas en estudiantes con TDAH, aunque no existe un acuerdo definitivo sobre su presencia sistemática en este trastorno. Esta investigación pretende determinar si la velocidad de procesamiento y la memoria de trabajo corresponden a variables cognitivas en el TDAH. Participaron 138 estudiantes de 10 a 17 años. Se determinó TDAH con la escala VADTRS; se evaluó velocidad de procesamiento con una tarea de rapidez grafomotora y memoria de trabajo con una tarea de dígitos. Se utilizó un diseño transversal, univariante e intersujeto para el análisis de los datos. El VADTRS detectó un grupo con TDAH (N = 97) y otro sin TDAH (N = 41). A ambos grupos se aplicaron tareas de velocidad de procesamiento y memoria de trabajo; los análisis permitieron detectar diferencias significativas en estas variables entre los grupos con y sin TDAH. El grupo con TDAH fue dividido según su presentación; no se detectaron diferencias significativas en velocidad de procesamiento; la memoria de trabajo mostró un rendimiento significativa- mente menor en las presentaciones de TDAH inatenta y combinada. La velocidad de procesamiento y la memoria de trabajo parecen distinguir entre sujetos con y sin TDAH, la velocidad de procesamiento no parece distinguir entre presentaciones y la memoria de trabajo aparece alterada en aquellas presentaciones en que el componente atencional es definitorio

ADHD is the most commonly diagnosed neurodevelopmental disorder in schoolchildren. Evidence indicates that executive functions, such as processing speed and working memory, are affected in students with ADHD, although there is no definitive agreement on their sys- tematic presence in this disorder. This research aims to determine whether processing speed and working memory correspond to cognitive variables in ADHD. A total of 138 students aged 10 to 17 years participated. ADHD was determined with the VADTRS scale; processing speed was assessed with a graphomotor speed task and working memory with a digit task. A cross-sectional, univariate, intersubject design was used for data analy- sis. The VADTRS detected one group with ADHD (N = 97) and one without ADHD (N = 41). Processing speed and working memory tasks were applied to both groups; analyses detected significant differences in these variables between the ADHD and non- ADHD groups. The ADHD group was divided according to presentation; no significant differences were detected in processing speed; working memory showed significantly lower performance in the inattentive and combined ADHD presentations. Processing speed and working memory appear to distinguish between subjects with and without ADHD, processing speed does not appear to distinguish between presentations, and working memory appears impaired in those presentations in which the attentional component is defining.

O TDAH é o distúrbio de desenvolvimento neurológico mais frequentemente diagnosticado em crianças em idade escolar. As provas indicam que as funções executivas, tais como a velocidade de processamento e a memória de trabalho, são afectadas nos estudantes com TDAH, embora não haja um acordo definitivo sobre a sua presença sistemática nesta doença. Esta investiga- ção visa determinar se a velocidade de processamento e a memória de trabalho correspondem a variáveis cognitivas na TDAH. Um total de 138 estudantes com idades compreendidas entre os 10 e os 17 anos participaram. A TDAH foi determinada com a escala VADTRS; a velocidade de processamento foi avaliada com uma tarefa de velocidade grafomotora e a memória de trabalho com uma tarefa de dígitos. Foi utilizado um desenho transversal, univariado e intersubjecto para análise de dados. O VADTRS detectou um grupo com ADHD (N = 97) e um grupo sem ADHD (N = 41). Ambos os grupos foram administrados com velocidade de processamento e tarefas de memória de trabalho; as análises detectaram diferenças significativas nestas variáveis entre os grupos com ADHD e sem ADHD. O grupo TDAH foi dividido de acordo com a apresentação; não foram detectadas diferenças significativas na velocidade de processamento; a memória de trabalho mostrou um desempenho significativamente inferior nas apresentações de TDAH desatenta e combinada. A velocidade de processamento e a memória de trabalho parecem distinguir entre assuntos com e sem TDAH; a velocidade de processamento não parece distinguir entre apresentações e memória de trabalho parece prejudicada nas apresentações em que a componente atencional está a definir

Biometría fetal en la confirmación de restricciones del crecimiento intrauterino / Fetal Biometrics in Confirming Restrictions of Intrauterine Growth

Introducción: El crecimiento y el desarrollo son fenómenos biológicos que implican aumento de masa celular y diferenciación de forma o función, respectivamente. En beneficio del diagnóstico, se utilizan las bondades del ultrasonido en la evolución biométrica del crecimiento fetal. Objetivo: Determinar mensuraciones biométricas fetales más asociadas a la restricción del crecimiento fetal en infantes que sufrieron restricción del crecimiento intrauterino. Métodos: Se realizó un estudio longitudinal descriptivo y retrospectivo de gestantes captadas en dos áreas de salud del municipio Santa Clara, que terminaron su embarazo entre septiembre del 2013 y octubre del 2018 y cuyos recién nacidos experimentaron restricción del crecimiento. La muestra se clasificó al nacimiento en pequeños y adecuados, según condición trófica y en cada grupo se estudió relación con valores percentilares de variables biométricas en los dos últimos trimestres. Resultados: Predominaron en todas las biometrías y en los dos trimestres los valores por debajo del décimo percentil. En la totalidad de los infantes y durante todo el período fetal, la circunferencia abdominal estuvo por debajo del percentil 10. En las variables largo del fémur y circunferencia cefálica los percentiles más altos se encontraron en el tercer trimestre y desde el segundo en la variable diámetro biparietal, posiblemente relacionado con restricciones asimétricas del crecimiento. Conclusiones: La variable biométrica circunferencia abdominal desde el segundo trimestre es fiable en la detección de restricciones del crecimiento intrauterino y su existencia por debajo del décimo percentil debe servir como certeza de su existencia, aun cuando la condición trófica del recién nacido parezca revelar otra realidad(AU)

Introduction: Growth and development are biological phenomenons involving cell mass increase and differentiation of form or function, respectively. For diagnostic purposes, the benefits of ultrasound are used for the biometric evolution of fetal growth. Objective: To determine fetal biometric measurements mostly associated with fetal growth restriction in infants who suffered intrauterine growth restriction. Methods: A descriptive and retrospective longitudinal study was carried out with pregnant women from two health areas of Santa Clara Municipality, who finished their pregnancy between September 2013 and October 2018 and whose newborns experienced growth restriction. The sample was classified at birth into small and adequate, according to trophic condition; and, in each group, the relationship with percentile values of biometric variables in the last two trimesters was studied. Results: Values below the tenth percentile predominated in all biometrics and in the two trimesters. In all infants and during the whole fetal period, abdominal circumference was below the tenth percentile. In the variables femur length and cephalic circumference, the highest percentiles were found in the third trimester; while, from the second trimester on, the same occurred in the variable biparietal diameter, possibly related to asymmetric growth restrictions. Conclusions: The biometric variable abdominal circumference is, from the second trimester on, reliable in the detection of intrauterine growth restrictions; its existence below the tenth percentile should serve as certainty of its existence, even when the trophic condition of the newborn seems to reveal another reality(AU)

La rehabilitación integral en pacientes post COVID-19

Introducción: El equipo de rehabilitación asume un papel importante en el manejo de secuelas que pueden derivarse de la COVID-19 por el virus SARS-CoV-2. Objetivo: Caracterizar a pacientes que han padecido la COVID-19 y relacionar las pautas terapéuticas en rehabilitación con variables de interés. Métodos: Se realizó un estudio descriptivo en el Policlínico Universitario Santa Clara, de enero a septiembre del año 2021. En la totalidad de pacientes 322 con diagnóstico confirmado de COVID-19, por la prueba de reacción en cadena de la polimerasa en tiempo real con examen negativo al egreso. Se estudiaron las variables: edad, sexo, comorbilidades, síntomas y presencia de complicaciones en el curso de la enfermedad, síntomas post COVID-19, pautas rehabilitadoras. Se mostraron distribuciones de frecuencias absolutas y relativas. En el análisis estadístico se utilizó la prueba de independencia basada en la distribución chi cuadrado. Se tuvo en cuenta consideraciones éticas. Resultados: Prevaleció el sexo masculino y el grupo de edad entre 18 a 59 años; la comorbilidad más frecuente fue la hipertensión arterial. En el curso de la enfermedad fue la tos el síntoma más frecuente y en la valoración post COVID-19 la debilidad muscular. Un porcentaje elevado de casos necesitó rehabilitación, ya sea domiciliaria o institucional. La necesidad de rehabilitación domiciliaria o institucional alcanzó mayor frecuencia ante la presencia de comorbilidades y complicaciones. Conclusiones: Las comorbilidades y complicaciones mostraron una relación estadísticamente significativa con las pautas terapéuticas.

Introduction: The rehabilitation team assumes an important role in the management of sequelae that may result from COVID-19 due to the SARS-CoV-2 virus. Objectives: To characterize patients who have suffered from COVID-19 and relate therapeutic guidelines in rehabilitation with variables of interest. Methods: A descriptive study at the Santa Clara University Polyclinic, from January to September 2021. In all patients (322) with a confirmed diagnosis for SARS-CoV-2, by the polymerase chain reaction test in time real with negative exam at discharge. The variables were studied: age, sex, comorbidities, symptoms and presence of complications in the course of the disease, post-COVID-19 symptoms, rehabilitation guidelines. Absolute and relative frequency distributions were shown. In the statistical analysis, the test of independence based on the chi-square distribution was used. Ethical considerations were taken into account. Results: The male sex and the age group between 18 to 59 years prevailed; the most frequent comorbidity was high blood pressure. During the course of the disease, cough was the most frequent symptom and in the post-COVID-19 assessment, muscle weakness. A high percentage of cases required rehabilitation, either home or institutional. The need for home or institutional rehabilitation was more frequent in the presence of comorbidities and complications. Conclusions: Comorbidities and complications showed a statistically significant relationship with therapeutic guidelines.

Beneficios del ejercicio físico en niños y niñas con sobrepeso y obesidad en Neiva -Huila, Colombia / Benefits of physical exercise in overweight and obese children in Neiva -Huila, Colombia

Resumen El sobrepeso y la obesidad infantil son un problema mundial, de estadísticas alarmantes, tales patologías afectan el crecimiento y desarrollo de los niños y las niñas. Se considera que estas condiciones pueden prevenirse mediante la promoción del ejercicio físico y el cambio hacia una alimentación sana en la infancia, etapa fundamental donde se sientan las bases esenciales de los estilos de vida saludable que incidirán de manera directa e indirecta en el bienestar físico, social y emocional por el resto de la vida.

Abstract Childhood overweight and obesity are global problems that affect the growth and development of children. The statistics are alarming due to their growth in different countries. It is considered that these conditions can be prevented through the promotion of physical activity and healthy diets in childhood, which is a fundamental stage for establishing the essential foundations of healthy lifestyles that will directly and indirectly affect physical, and social and emotional well-being for life.

Vinculación de una línea de investigación doctoral a la especialización médica / Linking a line of doctoral research to medical specialization

RESUMEN Fundamento: la educación médica cubana no ha logrado, en la formación académica, suficientes resultados en la escalera certificativa de la especialidad al doctorado. Se ha considerado que la solución estaría en encontrar temas de tesis de especialidad con la calidad requerida, con la esperanza de lograr continuidad hacia una maestría afÍn que concluya en tesis doctorales. Objetivo: promover oportunidades en las líneas de investigación doctoral para la formación de especialistas de primer grado en el territorio. Métodos: se realizó un estudio observacional descriptivo del proceso de formación investigativa en 29 residentes que constituyeron el universo de estudio, en la Universidad de Ciencias Médicas de Villa Clara, en vías de formación como especialistas de primer grado, a partir de las oportunidades que ofreció una línea de investigación doctoral entre los años 2014 y 2021. Se utilizaron como métodos teóricos: análisis-síntesis, inducción-deducción y como métodos empíricos: revisión documental y observación participativa. Resultados: se desarrollaron 16 tesis en la especialidad de Anatomía Humana, 6 en Embriología Humana, 6 en Bioestadística y una en Medicina General Integral que abordaron temáticas afines a la antropometría materna y la biometría fetal, con énfasis en el crecimiento fetal y la condición trófica del recién nacido. Conclusiones: se redujo la dispersión temática en las tesis de residentes, así como la repetición de objetivos y variables con posibles impactos en el perfeccionamiento del Programa Nacional de Atención Materno-Infantil.

ABSTRACT Background: Cuban medical education has not achieved, in academic training, sufficient results in the certification ladder from specialty to doctorate. It has been considered that the solution would be to find specialty thesis topics with the required quality, with the hope of achieving continuity towards a related master's degree that concludes in doctoral theses. Objective: to promote opportunities in the lines of doctoral research for the training of first-degree specialists in the territory. Methods: a descriptive observational study of the researching training process was carried out in 29 residents who constituted the universe of study, at Villa Clara University of Medical Sciences, in the process of training as first-degree specialists, based on the opportunities offered a line of doctoral research from the 2014 to 2021. Theoretical methods were used: analysis - synthesis, induction - deduction and as empirical methods: documentary review and participatory observation. Results: 16 theses were developed in the specialty of Human Anatomy, 6 in Human Embryology, 6 in Biostatistics and one in Comprehensive General Medicine that addressed topics related to maternal anthropometry and fetal biometry, with emphasis on fetal growth and atrophic condition of the newborn. Conclusions: topic dispersion in the resident theses was reduced, as well as the repetition of objectives and variables; with possible impacts on the improvement of the National Maternal and Child Care Program.

Experiencias en la productividad científica de una línea de investigación doctoral / Experiences in the scientific productivity of a line of doctoral research

RESUMEN Fundamento: las políticas científicas, las líneas de investigación doctoral y la productividad científica forman un todo que requiere control y atención sistemática por parte de las instituciones de educación superior. Objetivo: promover desde una experiencia local, el control sistemático de la productividad científica en los programas de doctorado según sus líneas de investigación. Métodos: se realizó un estudio observacional descriptivo de la productividad científica según las evidencias encontradas en revistas científicas y memorias de eventos nacionales e internacionales registradas en diferentes plataformas, vinculadas a una línea de investigación doctoral en el período enero 2016 / noviembre 2021. Resultados: se identificó elevada productividad científica con 32 artículos publicados en revistas de los grupos I y II; además de la presentación de 57 trabajos científicos en ocho eventos de alcance nacional e internacional, con la participación de 296 autorías, entre ellas 118 (39,8 %) de doctorandos. Se identificaron debilidades que servirán de orientación para el perfeccionamiento del trabajo. Conclusiones: el control sistemático de la productividad científica de la línea de investigación doctoral estudiada, aportó evidencias de calidad en la formación investigativa de sus doctorandos con una visibilidad adecuada de sus resultados, además de condiciones suficientes para la sistematización del conocimiento científico.

ABSTRACT Background: scientific policies, doctoral research lines and scientific productivity comprise a whole that requires control and systematic attention from higher education institutions. Objective: to promote, from a local experience, the systematic control of scientific productivity in doctoral programs according to their lines of research. Methods: a descriptive observational study of scientific productivity was carried out according to the evidence found in scientific journals and memories of national and international events registered on different platforms, linked to a line of doctoral research from January 2016 to November 2021. Results: high scientific productivity was identified with 32 articles published in journals of groups I and II; in addition to the presentation of 57 scientific papers in eight national and international events, with the participation of 296 authors, including 118 (39.8%) doctoral students. Weaknesses were identified that will serve as a guide for the improvement of the work. Conclusions: the systematic control of the scientific productivity of the doctoral research line studied, provided evidence of quality in the research training of its doctoral students with adequate visibility of their results, as well as sufficient conditions for the systematization of scientific knowledge.

Resiliencia, estrés y ansiedad de cuidadores formales durante la pandemia por COVID-19 / Resilience, anxiety and stress among formal caregivers for institutionalized older people

BACKGROUND: Caregiver stress is a common problem observed in nursing homes. AIM: To determine the association between the level of resilience and stress, anxiety and depression in formal caregivers of older people institutionalized in long-stay establishments during the COVID-19 pandemic. MATERIAL AND METHOD: One hundred ninety eight formal caregivers working at 11 long term residences for older people in southern Chile were invited to answer the SV-RES resilience and the DASS-21 anxiety and depression scales and 102 agreed to participate. RESULTS: We observed a significant association between the resilience scale score and variables such as weekly working hours (p < 0.01), current hours of sleep (p < 0.01), self-perception of sleep (p < 0.01), anxiety level (p < 0.01) and stress level (p < 0.01). Conclusions: A higher score on the Resilience Scale was associated with the absence of anxiety and stress, working between 22 and 43 hours per week, sleeping between 7 and 8 hours of sleep and a satisfactory self-perception of sleep. Studying the factors associated with resilience in formal caregivers of the elderly allows healthcare personnel to focus preventive actions, intervening promptly in risk areas associated with the work context, and strengthening the personal resources of caregivers.

Adiposidad abdominal y resistencia a la insulina al finalizar el primer trimestre de la gestación / Abdominal Adiposity and Insulin Resistance at the End of the First Trimester of Gestation

Introducción: La adiposidad central como factor desencadenante de resistencia a la insulina precoz constituye una amenaza potencial de riesgo metabólico y cardiovascular en el embarazo. Objetivo: Determinar la capacidad discriminante de las grasas abdominales sobre la resistencia a la insulina, diagnosticada por el índice triglicéridos/glucosa-IMC al finalizar el primer trimestre del embarazo. Métodos: Se realizó un estudio observacional analítico de 526 gestantes con embarazo simple y edad gestacional entre 12 y 13 semanas, entre los años 2016 y 2020. Se estudió el test de triglicéridos/glucosa-IMC y las grasas abdominales por ultrasonido. Se utilizaron las curvas ROC (Receiver operating characteristic Curve) para discriminar la resistencia a la insulina al finalizar el primer trimestre de la gestación, cuando aumentan las grasas abdominales. Resultados: La grasa subcutánea fue la que presentó mayor área bajo la curva en la discriminación de la resistencia a la insulina, con un nivel de sensibilidad y especificidad aceptable. Conclusiones: La grasa subcutánea, aunque con bajo valor discriminativo, puede considerarse como augurio de resistencia a la insulina y de diabetes gestacional. Se requiere profundizar en el estudio de las grasas abdominales dado el conocimiento de su impacto en los desórdenes metabólicos en el curso avanzado de la gestación(AU)

Introduction: Central adiposity as a triggering factor for early insulin resistance is a potential threat of metabolic and cardiovascular risk in pregnancy. Objective: To determine the discriminating capacity of abdominal fat over insulin resistance, diagnosed by the triglyceride/glucose-BMI index at the end of the first trimester of pregnancy. Methods: An analytical and observational study was carried out with 526 pregnant women of singleton pregnancy and gestational age between twelve and thirteen weeks, between 2016 and 2020. The triglyceride/glucose-BMI test was studied, together with abdominal fats by ultrasound. ROC (receiver operating characteristic) curves were used to discriminate insulin resistance at the end of the first trimester of gestation, when abdominal fats increase. Results: Subcutaneous fat presented the highest area under the curve in the discrimination of insulin resistance, with an acceptable level of sensitivity and specificity. Conclusions: Subcutaneous fat, although with low discriminative value, can be considered as a harbinger of insulin resistance and gestational diabetes. Further study of abdominal fat is required, given the knowledge of its impact on metabolic disorders in late gestation(AU)

Cambios de adiposidad corporal entre la captación del embarazo y el posparto a corto plazo / Changes in Body Adiposity between the First Antenatal Visit and the Short-Term Postpartum

Introducción: Las acumulaciones excesivas de tejido adiposo, general o regional, constituyen hallazgos de valor clínico en el seguimiento nutricional y cardiometabólico durante la gestación y en el período posparto. Objetivo: Describir los cambios en la adiposidad corporal trascurridos 18 meses después del parto. Método: Se realizó un estudio observacional descriptivo de la adiposidad corporal, entre enero 2017 y agosto 2018, en 119 mujeres en el posparto a corto plazo, cuya adiposidad corporal se había estudiado al momento de la captación en el policlínico Chiqui Gómez Lubián. Resultados: En el posparto con respecto al momento de la captación, se observó una disminución de las mujeres sin adiposidad general de 28,6 por ciento a 21,8 por ciento y de las mujeres con adiposidad general intermedia de 62,2 por ciento a 53,8 por ciento; con un aumento marcado de aquellas con adiposidad general alta de 9,2 por ciento a 24,4 por cdiento. Aumentó la cantidad de mujeres con adiposidad central alta de 35,3 por ciento a 43,7 por ciento y disminuyeron las mujeres sin adiposidad central de 64,7 por ciento a 56,3 por ciento. Conclusiones: Evaluar los cambios de la adiposidad corporal por técnicas antropométricas sencillas y de fácil acceso, durante el embarazo y en el posparto a corto plazo, puede ofrecer información de utilidad para una mejor orientación del seguimiento de la salud cardiometabólica de la mujer(AU)

Introduction: Excessive accumulations of adipose tissue, whether general or regional, are findings of clinical value in nutritional and cardiometabolic follow-up during pregnancy and in the postpartum period. Objective: To describe the changes in body adiposity at eighteenth months after delivery. Methods: A descriptive and observational study of body adiposity was carried from January 2017 to August 2018 in 119 women in the short-term postpartum period, whose body adiposity had been studied during the first antenatal visit at Chiqui Gómez Lubián Polyclinic. Results: In the postpartum period, with respect to the first antenatal visit, a decrease was observed in the number of women without general adiposity (from 28.6 percent to 21.8 percent) and of women with intermediate general adiposity (from 62.2 percent to 53.8 percent), with a marked increase in the number of women with high general adiposity (from 9.2 percent to 24.4 percent). The number of women with high central adiposity increased (from 35.3 percent to 43.7 percent), while the number of women without central adiposity decreased (from 64.7 percent to 56.3 percent). Conclusions: To evaluate the changes in body adiposity by simple and easily accessible anthropometric techniques, during pregnancy and in the short-term postpartum period, may provide useful information for designing better the follow-up of cardiometabolic health of women(AU)