Second generation of pyrimidin-quinolone hybrids obtained from virtual screening acting as sphingosine kinase 1 inhibitors and potential anticancer agents.

We report here the virtual screening design, synthesis and activity of eight new inhibitors of SphK1. For this study we used a pre-trained Graph Convolutional Network (GCN) combined with docking calculations. This exploratory analysis proposed nine compounds from which eight displayed significant inhibitory effect against sphingosine kinase 1 (SphK1) demonstrating a high level of efficacy for this approach. Four of these compounds also displayed anticancer activity against different tumor cell lines, and three of them (5), (6) and (7) have shown a wide inhibitory action against many of the cancer cell line tested, with GI50 below 5 µM, being (5) the most promising with TGI below 10 µM for the half of cell lines. Our results suggest that the three most promising compounds reported here are the pyrimidine-quinolone hybrids (1) and (6) linked by p-aminophenylsulfanyl and o-aminophenol fragments respectively, and (8) without such aryl linker. We also performed an exhaustive study about the molecular interactions that stabilize the different ligands at the binding site of SphK1. This molecular modeling analysis was carried out by using combined techniques: docking calculations, MD simulations and QTAIM analysis. In this study we also included PF543, as reference compound, in order to better understand the molecular behavior of these ligands at the binding site of SphK1.These results provide useful information for the design of new inhibitors of SphK1 possessing these structural scaffolds.

What's in a name? Political and economic concepts differ in social media references to harmful algae blooms.

Policies and management decisions in the marine environment are driven in part by public sentiment which can grow more intense during hazard events like Harmful Algae Blooms (HABs). The public conversations on social media sites like Twitter (before X) reveal the polarized nature of HABs through nuanced language and sentiment. This article uses mixed methods of machine learned topic modeling and inductive qualitative coding to describe the ways the long-term 2017-2019 Karenia brevis "red tide" bloom were politicized across Florida's South West coast. It finds that there are topical differences in keywords related to place (e.g. beach, Florida, coast), agent (individual or organization), and epistemic values (reliance on scientific and/or media reports). These topical differences demonstrate different levels of politicization and partisanship in qualitative analysis. Conceptually, this research demonstrates the ways different dimensions of a long-duration marine hazard can be polarized. Regarding management, this research provides insights to political and organizational stakeholders and the gaps in the discourse shaping marine hazards which can be used to strategically guide future social media engagement to manage politicization. What if all the careful work that resource and environmental managers do can be undone by simple, seemingly uncontroversial words? In an era of increased environmental and marine distress-coupled with short format communication-the ways environmental managers choose their words is crucial, even between ostensibly inconsequential nouns like "red tide" or "algae bloom." Policies and management decisions in the marine environment are driven in part by public sentiment which can grow more intense during hazard events like Harmful Algae Blooms (HABs). The public conversations on social media sites like Twitter (before X) reveal the polarized nature of HABs through nuanced language and sentiment. This article relies on mining social media posts, and uses mixed methods of machine-learned topic modeling and human-driven inductive qualitative coding to describe the ways the long-term 2017-2019 Karenia brevis "red tide" blooms were politicized across Florida's South West coast. It finds that there are topical differences in keywords related to place (e.g. beach, Florida, coast), agent (individual or organization), and epistemic values (reliance on scientific and/or media reports). These topical differences demonstrate different levels of politicization and partisanship in qualitative analysis. Conceptually, this research demonstrates the ways different dimensions of a long-duration marine hazard can be polarized. Regarding management, this research provides insights to political and organizational stakeholders and the gaps in the discourse shaping marine hazards which can be used to strategically guide future social media engagement to manage politicization.

Non-linear impacts of harmful algae blooms on the coastal tourism economy.

Harmful algae blooms (HABs) occur in water bodies throughout the globe and can have multi-faceted impacts on tourism. However, little is known of the magnitude of economic losses to the tourism sector as a result of HABs. There is limited understanding of the empirical relationships between HAB intensity and duration, and the effects of this phenomenon on the tourism sector. This study is based in the state of Florida, USA, a notable sun, sand, and sea destination in the western hemisphere, where blooms of a marine harmful algae are a recurrent threat to coastal tourism. The empirical framework is based on a month and county-level panel database that combines sales by tourism-related businesses with observations from the official HAB surveillance system of the state of Florida. We use time and space fixed-effects regressions to estimate the loss in tourism revenue associated with one additional day of red tide. Results indicate that impacts of HABs on tourism do not follow a linear pattern with increasing HAB concentrations, but rather appear to follow an inverted-U pattern. In other words, higher concentrations of the HAB organism do not necessarily imply higher economic losses, suggesting that the impacts of HABs on tourism are not driven solely by the biophysical element of cell density. Rather, these impacts appear to be mediated and amplified by human dimensions. The loss to tourism-related businesses due to the 2018 Florida red tide bloom was estimated to be $2.7 billion USD, which implies that HABs and their impact on tourism can be considered as a potential 'billion-dollar' disaster.

Is reduction necessary in overriding metaphyseal distal radius fractures in children under 11 years: a systematic review and meta-analysis of comparative studies.

OBJECTIVE: To determine the necessity of reduction in the treatment of overriding metaphyseal distal radius fractures (DRF) in children under 11 years. METHODS: In this systematic review and meta-analysis, PubMed, Embase, and Cochrane databases were searched to retrieve studies published from inception to 2023. Two reviewers independently screened for studies with observational or randomized control design comparing two treatments for overriding metaphyseal DRF in patients under 11 years: simple casting without reduction (SC group) versus closed reduction plus casting or pin fixation (CRC/F group); with varying outcomes reported (CRD471761). The risk of bias was assessed using the ROBINS-I tool. RESULTS: Out of 3,024 screened studies, three met the inclusion criteria, 180 children (mean age 7.1 ± 0.9 years) with overriding metaphyseal DRF: SC-group (n = 79) versus CRC/F-group (n = 101). Both treatment groups achieved 100% fracture consolidation without requiring further manipulation. The SC-group showed significantly fewer complications (mean difference [MD] 0.08; 95% CI [0.01, 0.53]; I2 = 22%; P < 0.009) and trends towards better sagittal alignment (MD 5.11; 95% CI [11.92, 1.71]; I2 = 94%; P < 0.14), less reinterventions (MD 0.31; 95% CI [0.01, 8.31]; P < 0.48), and fewer patients with motion limitation at the end of follow-up (MD 0.23; 95% CI [0.03,  1.98]; P < 0.18), although these findings were not statistically significant. CONCLUSIONS: Despite a limited number of studies comparing SC versus CRC/F in overriding DRF in children under 11 years, this study suggests that anatomical reduction is not necessary. Treating these fractures with SC, even when presenting with an overriding position, leads to reduced complications, shows a trend towards fewer reinterventions, improved sagittal alignment, and less limitation in patient motion. LEVEL OF EVIDENCE: Level III, Systematic review of Level-III studies.

Effects of Parity and Somatic Cell Count Threshold on Udder Morphology, Milkability Traits, and Milk Quality in Canarian Goats.

The effects of parity and somatic cell count in milk (SCC) threshold on the udder morphology, milkability traits, and milk composition was evaluated in 41 Canarian goats in mid-lactation. The animals were divided according to parity (1st, 2nd, and 3rd), and a SCC threshold of 2000 × 103 cells/mL in milk was set to evaluate the effect of this factor on the different measured parameters. Results showed that primiparous goats had the udder smaller and less distended than multiparous goats, but no differences were detected on milk flow parameters. Furthermore, SCC and total bacterial count (TBC) tended to be higher when the parity increased. On the other hand, goats with SCC ≤ 2000 × 103 had higher cistern-floor distance (CF) and lower TBC values compared with those goats with a count above the predetermined threshold. The results suggest that a reduction in SCC can be achieved by a selection of udder morphological traits. Moreover, milk flow parameters do not seem to be a tool to determine the udder health status in Canarian goats, but long-term studies are needed to verify it.

Carbon footprint and employment generation produced by ICT networks for Internet deployment: A multi-regional input-output analysis.

Internet is widely regarded as a necessary resource for economic and social development. The availability of this technology requires the deployment of ICT networks which have implications not only on the natural surroundings but also on the human environment. Understanding the impact generated on key areas of socio-ecological concern such as carbon footprint and employment generation is essential to ensure well-informed decision-making. This investigation utilized multiregional environmentally extended input-output (MRIO) methodology to evaluate the carbon footprint and the employment generation associated with providing internet to six geo-demographic scenarios, from urban to remote rural, using Peru as a reference site. The results showed that most of the carbon emissions (289-340 kg CO2 eq./subs./yr.) and employment (7-8 jobs/subs./yr.) associated with larger ICT networks intended for urban and suburban areas was attributable to the manufacturing of end-user devices. The sustainability of smaller ICT networks for rural areas was dominated by the construction of shared infrastructures (mainly 4G LTE equipment), while the contribution of the energy consumed was in all cases limited. Although the analysis considered ICT networks deployed in Peru, most impacts were generated in China, where the manufacturing of the electronic components was assumed to take place. This analysis highlights the value of econometric methods for sustainability assessment such as MR-EEIO, which are complementary to the more conventional process-based E-LCA.

Ray resection in pediatric population after trauma injuries.

The aim of this study is to assess the functional, emotional, and social adaptation of pediatric patients submitted to a hand ray resection to treat a traumatic hand injury. Retrospective study of pediatric patients undergoing hand ray resection, in the period 2013-2022, performed in two hospital institutions. Inclusion criteria: age less than 18 years, primary/secondary resection due to traumatic etiology and follow-up time of more than 1 year. Data concerning demographic information, lesion location, traumatic mechanism and surgical description were collected. Functional outcomes (QuickDASH Score), social and emotional integration (PEDSQL) and satisfaction were evaluated. Seven patients were included, with male predominance (n = 4) and the right side was the most affected (n = 5). Median age at the time of surgery was 10 years (2-15). Primary ray resection, without previous revascularization, was performed in three patients. Secondary ray resection was performed in four patients. Three patients with an unsuccessful revascularization procedure attempt another patient with a sequela with severe deformity. All patients presented a good adaptation to daily living activities, with good pinch and grip function. The median follow-up was 4 years (min:1; max:9). The scores were collected on six out of seven patients. Median QuickDASH score of 14 (min:11; max:22), and PEDSQL[physical] of 95.31 (min:78.13; max:100) and PEDSQL[social] of 93.47 (min:66.3; max:100). Hand ray resection is a rare procedure in pediatric age and usually difficult for patients and parents to accept. However, it is a useful and safe technique that allows for an improvement in overall hand function and psychosocial readaptation in specific and selected cases. Level of evidence: Level of evidence IV - case series.

Real-world persistence with dolutegravir/lamivudine versus bictegravir/emtricitabina/tenofovir-alafenamide among people with HIV. / Persistencia de los tratamientos con dolutegravir/lamivudina y bictegravir/emtricitabina/tenofovir-alafenamida en personas con VIH en la práctica real.

OBJETIVES: The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS: We conducted a retrospective, non-interventional, descriptive and longitudinal study. All human immunodeficiency virus (HIV) patients over 18 years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS: Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (p = 0.001). Persistence with DGT/3TC was 1,237 days (IC95% 1,216-1,258) and persistence with BIC/FTC/TAF was 986 days ([IC95% 950-1,021]; p < 0.001). The difference was remained after adjusting for covariates with the cox regression model (HR= 8.2 [IC95% 1.03-64.9], p = 0.047). The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION: In our study patients had a high persistence. Patients on DTG/3TC treatment were more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF was tolerability/toxicity.

[Translated article] Real-world persistence with dolutegravir/lamivudine versus bictegravir/emtricitabine/tenofovir-alafenamide among persons with HIV.

OBJETIVES: The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS: We conducted a retrospective, non-interventional, descriptive, and longitudinal study. All human immunodeficiency virus (HIV) patients over 18 years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS: Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (p=.001). Persistence with DGT/3TC was 1237 days (IC95% 1216-1258) and persistence with BIC/FTC/TAF was 986 days [(IC95% 950-1021); p<.001]. The difference was remained after adjusting for covariates with the cox regression model [HR=8.2 (IC95% 1.03-64.9), p=.047]. The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION: In our study, patients have a high persistence. Patients on DTG/3TC treatment are more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF is tolerability/toxicity.

Parálisis del nervio radial neonatal: relato de un caso / Isolated radial nerve palsy in a newborn: case report

La parálisis radial neonatal aislada (PRNA) es un cuadro clínico infrecuente que debe distinguirse de otras entidades más frecuentes, como la parálisis braquial obstétrica (PBO). Debemos sospechar una PRNA en neonatos que presentan incapacidad para la extensión de muñeca y de dedos, pero mantienen intacta la función del deltoides, del bíceps, y del tríceps, así como la flexión de muñeca y de dedos. Mientras la PBO tiene una evolución clínica variable dependiendo de la extensión de la lesión neurológica, la PRNA presenta una resolución espontánea, independientemente del grado de afectación inicial. Presentamos el caso de un recién nacido con PRNA cuyo diagnóstico inicial fue de PBO.

Isolated radial nerve palsy (IRNP) in the newborn is a rare clinical condition that must be distinguished from entities that are more common, such brachial plexus birth palsy (BPBP). It should be suspected in newborns presenting with absent wrist and digital extension but intact deltoid, biceps, and triceps function, as well as wrist and digital flexor function. Whereas BPBP is highly variable depending on the extent of the neurological involvement, IRNP resolves spontaneously, regardless of the severity of the initial presentation. We herein present a case of newborn with IRNP whose initial diagnosis was of BPBP.

Osteosintesis asistida con navegación 2D con tornillos iliacosacros percutáneos en lesiones del anillo pélvico posterior / Assisted osteosynthesis with 2D navigation with percutaneous iliacosacral screws in posterior pelvic ring injuries

Introducción: La osteosíntesis percutánea sacroiliaca guiada por radioscopia en lesiones del anillo pélvico posterior sigue siendo la técnica de referencia. Sin embargo, el desarrollo de técnicas como la cirugía asistida por navegación 2D/3D o por tomografía han mejorado la facilidad y seguridad en la colocación de los tornillos. Objetivo: Presentar la técnica de fijación asistida por navegación en 2D y los resultados clínicos y radiológicos obtenidos. Materiales y métodos: Se revisaron 23 pacientes con disrupción del anillo pélvico posterior (luxación y/o fractura sacroiliaca) intervenidos mediante fijación percutánea asistida por navegación 2D (Sistema Synergy de Medtronic®) en el hospital desde 2017 hasta la actualidad. Se recogieron variables demográficas, de clasificación, terapéuticas y las complicaciones derivadas. Se utilizó la escala modificada de valoración POS (Multicenter Study Group Pelvis Outcome Scale) para evaluar el resultado clínico, radiológico y social. Resultados: Ocho pacientes presentaban luxación sacro-iliaca y 15 tenían fractura a través del sacro. Se implantaron 40 tornillos iliacosacros. El tiempo quirúrgico medio fue de 20 minutos para cada tornillo. Fueron necesarios ocho pulsos de radioscopia de media por intervención. Hubo tres tornillos (7.5%) mal posicionados. 15 pacientes obtuvieron un resultado bueno o excelente en el formulario POS. Conclusiones: La técnica asistida por navegación es una alternativa con buenos resultados. Facilita al cirujano la colocación correcta de los tornillos en el corredor óseo sacro, acortando el tiempo quirúrgico y con una menor exposición a radiaciones ionizantes. Es útil para todo tipo de lesiones del anillo y cuando son necesarias maniobras de reducción.

Introduction: Radioscopy-guided percutaneous sacroiliac osteosynthesis in posterior pelvic ring lesions continues to be the reference technique. However, the development of techniques such as surgery assisted by 2D/3D navigation or tomography have improved the ease and safety in screw placement. Objective: To present the 2D navigation-assisted fixation technique and the clinical and radiological results obtained. Materials and methods: 23 patients with disruption of the posterior pelvic ring (dislocation and/or sacroiliac fracture) who underwent percutaneous fixation assisted by 2D navigation (Medtronic® Synergy System) at the hospital from 2017 to the present were reviewed. Demographic, classification, therapeutic variables and resulting complications were collected. The modified POS (Multicenter Study Group Pelvis Outcome Scale) assessment scale was used to evaluate the clinical, radiological and social outcome. Results: Eight patients had sacro-iliac dislocation and 15 had a fracture through the sacrum. 40 iliacosacral screws were implanted. The average surgical time was 20 minutes for each screw. An average of eight fluoroscopy pulses were necessary per intervention. There were three screws (7.5%) incorrectly positioned. 15 patients had a good or excellent result on the POS form. Conclusions: The navigation-assisted technique is an alternative with good results. It makes it easier for the surgeon to correctly place the screws in the sacral bone corridor, shortening surgical time and with less exposure to ionizing radiation. It is useful for all types of ring injuries and when reduction maneuvers are necessary.

Miositis osificante progresiva: reporte de un caso / Progressive myositis ossificans: Case report

Introducción: la miositis osificante progresiva (MOP) es una enfermedad hereditaria del tejido conectivo de baja prevalencia (1:2,000,000 habitantes). Se caracteriza por osificación heterotópica con un comportamiento incierto que excepcionalmente se ha relacionado con neoplasias. Se buscó conocer la coexistencia de la MOP con neoplasias de origen mesodérmico, para que sean consideradas en el diagnóstico de otros pacientes, así como formular hipótesis para esclarecer su asociación. Caso clínico: mujer de 27 años con dolor de músculo isquitiobial y glúteo derecho que incrementaba con el ejercicio, sin remisión con analgésicos hasta limitar la movilidad de ambas extremidades. Se solicitó una serie ósea donde se evidenciaron zonas de radiolucidez heterogénea en la región de ambos muslos y pelvis de manera irregular, semejante a densidad ósea, que fue compatible con los hallazgos ecográficos y tomográficos; se concluyó que eran imágenes relacionadas con miositis osificante de cadera. La paciente refirió sintomatología gástrica y se solicitó una endoscopía que histopatológicamente reportó carcinoma gástrico difuso con células en anillo de sello; las imágenes de gabinete mostraron tumoración ovárica. Conclusión: la MOP es una patología de baja prevalencia, por lo que su conocimiento y sospecha son fundamentales para el diagnóstico. Hay poca literatura que involucre a las tres entidades; por ende, su fisiopatología y comprensión es limitada. En cuanto a la MOP, aún no hay un tratamiento curativo; sin embargo, el diagnóstico certero permite iniciar rehabilitación de manera oportuna con mejoría de la calidad de vida.

Background: Myositis ossificans progressiva (MOP) is a low prevalence hereditary connective tissue disease (1:2,000,000 habitants). It is characterized by heterotopic ossification with an uncertain behavior that has been exceptionally related to neoplasms. The objective was to know the coexistence of MOP with neoplasms of mesodermal origin, so that they can be considered in the diagnosis of other patients, as well as formulate hypotheses to clarify their association. Clinical case: 27-year-old female with right gluteal and ischitiobial muscle pain that increased with exercise, without remission with analgesics until limiting the mobility of both extremities. A bone series was requested where areas of heterogeneous radiolucency were evidenced in the region of, both, thighs and pelvis in an irregular manner, similar to bone density, which was compatible with the ultrasound and tomographic findings; we concluded that they were images of myositis ossificans of the hip. The patient reported gastric symptoms and an endoscopy was requested, which histopathologically reported diffuse gastric carcinoma with signet ring cells; cabinet images showed an ovarian tumor. Conclusion: MOP is a low prevalence disease, which is why its knowledge and suspicion are essential for the diagnosis. We found little literature that involves the three entities; therefore, their pathophysiology and understanding is limited. Regarding MOP, at this moment there is no curative treatment; however, an accurate diagnosis allows to start rehabilitation in a timely manner with an improvement in the quality of life.

Multiple eruptive and vulvar syringomas and the incipient role of dermoscopy in diagnosis / Siringomas eruptivos múltiples y vulvares y el papel incipiente de la dermatoscopia en el diagnóstico

INTRODUCCIÓN: Los siringomas son tumores benignos derivados de la porción intraepidérmica de los conductos sudoríparos ecrinos. Ocasionalmente pueden iniciar de forma súbita como siringomas eruptivos o localizarse en sitios atípicos que retrasan el diagnóstico por años. La dermatoscopía tiene un rol incipiente en diferenciar siringomas de su extenso diagnóstico diferencial. MÉTODOS: Estudio retrospectivo descriptivo de serie de casos de siringomas de localización atípica. Los datos fueron extraídos de fichas clínicas electrónicas. Todos incluyen dermatoscopía y correlación histopatológica. RESULTADOS: Cinco pacientes. Cuatro hombres y una mujer entre 40 y 79 años de edad con siringomas atípicos: cuatro casos eruptivos y un caso de siringomas vulvares. DISCUSIÓN: Proponemos la dermatoscopía basada en nuestros hallazgos como una herramienta útil con estructuras ovales amarillas y una pseudo-red café clara difusa en su superficie. Estas estructuras amarillas se pueden correlacionar con la proliferación ductal ecrina y el denso estroma en la histopatología. CONCLUSIÓN: Enfatizamos que se debe considerar esta entidad en el diagnóstico diferencial de dermatosis papulares y conocer sus manifestaciones clínicas para optimizar la sospecha diagnóstica.

INTRODUCCTION: Syringomas are common benign tumors, probably of origin derived from the intraepidermal portion of the eccrine sweat ducts. Occasionally they may develop suddenly and extensively as eruptive syringomas or be located in atypical sites delaying the diagnosis for years. Dermoscopy has an incipient role in differentiating syringomas from their extensive differential diagnosis. METHODS: Retrospective descriptive case-series study of atypical location syringomas. Data extraction from clinical history from electronic files. They all include dermoscopy and histopathological correlation. RESULTS: Five patients: Four men and one woman between 40 and 79 years old, with atypical syringomas diagnosis: four eruptive and one vulvar syringomas. DISCUSSION: We propose dermoscopy, based on our findings, as a useful tool to this entity, with its oval yellow structures and a diffuse light-brown network-like structure on its surface. These yellow enlargements may be correlated with the ductal eccrine proliferation and the dense stroma seen in the histopathology. CONCLUSION: We emphasize that they should be considered in the differential diagnosis of papular dermatosis, as they tend to be underdiagnosed, and to know their clinical manifestations to optimize the diagnostic suspicion.

Software educativo sobre el desarrollo histórico de la especialidad Prótesis Estomatológica en Camagüey / Educational software on the historical development of Dental Prosthetics specialty in Camagüey

RESUMEN Fundamento: la especialidad Prótesis Estomatológica es una rama de la Estomatología destinada a la rehabilitación de los pacientes con ausencias dentarias, así como a la prevención, diagnóstico y tratamiento de las alteraciones del sistema estomatognático. Objetivo: elaborar un software educativo utilizando una base de datos sobre el desarrollo histórico de la formación de especialistas en Prótesis Estomatológica en Camagüey. Método: se realizó un estudio de innovación tecnológica para la creación de un software con la herramienta de autoría orientada a la creación de multimedias Mediator v9.0 en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Camagüey. Se utilizaron métodos teóricos para la interpretación y procesamiento de la información; empíricos: análisis documental de archivos personales de autores y colaboradores y del Departamento de Cuadros y Secretaría General de la Universidad de Ciencias Médicas de Camagüey y se valoró el producto por especialistas y usuarios a través de una encuesta en su modalidad de cuestionario. Resultados: se elaboró un software educativo sobre el desarrollo histórico de la docencia y formación de especialistas en Prótesis Estomatológica en Camagüey que permitió complementar la carencia de la literatura existente sobre el tema. Conclusiones: el producto fue valorado por los especialistas y usuarios como necesario y útil, de gran aplicabilidad, con calidad en los contenidos tratados.

ABSTRACT Background: the Dentistry Prosthesis specialty is a branch of Dentistry aimed at the rehabilitation of patients with dental absences, as well as the prevention, diagnosis and treatment of alterations of the stomatognathic system. Objective: to develop the educational software using a database on the historical development of the training of the Dental Prosthesis specialists in Camagüey. Method: a technological innovation study was carried out for the creation of software with the authoring tool oriented to the creation of Mediator v9.0 multimedia in the Faculty of Dentistry of Camagüey Medical Sciences University. Theoretical methods were used for the interpretation and processing of information; empirical ones: documentary analysis of personal files of authors and collaborators and of the management Department and General Secretariat of Camagüey University of Medical Sciences and the product was evaluated by specialists and users through a questionnaire survey. Results: the educational software was developed on the historical development of the teaching and training of specialists in dental Prosthesis in Camagüey that allowed complementing the lack of existing literature on the subject. Conclusions: the product was valued by specialists and users as necessary and useful, of great applicability, with quality in the content treated.

Revascularización de arteria poplítea con arteria ciática persistente bilateral: presentación de un caso / Popliteal Revascularization in Bilateral Persistent Sciatic Artery: Case Report

La arteria ciática persistente (ACP) es una anomalía vascular congénita, poco frecuente, secundaria a una alteración en el desarrollo embriológico. La mayoría de los casos son asintomáticos y se detectan cuando se asocian con aneurismas o embolias. Se presenta el caso de una mujer de 81 años con factores de riesgo cardiovascular quien consulta por isquemia del miembro inferior

The persistent sciatic artery is a rare congenital vascular anomaly secondary to an alteration in embryological development. Most cases are asymptomatic and they are detected when they are associated with the presence of aneurysms or embolisms. We present the case of an 81-year-old woman with cardiovascular risk factors who consulted for ischemia of the lower limb.

Mielofibrosis primaria manifestada como fiebre de origen desconocido / Primary myelofibrosis manifested as fever of unknown origin

Resumen Se comunica el caso de un paciente de 55 años de edad que inició con fiebre como síntoma principal de su padecimiento. Después de un protocolo de estudio sistematizado y orientado se llegó al diagnóstico de fiebre de origen desconocido como síndrome, cuyo diagnóstico etiológico fue mielofibrosis primaria, enfermedad hematológica poco frecuente que se distingue por fibrosis de la médula ósea, esplenomegalia y anemia. Se revisa el abordaje de la fiebre y sus etapas de estudio siguiendo las recomendaciones actuales, técnicas y científicas, pero adaptadas a nuestro medio y recursos.

Abstract This paper reports the case of a 55 year-old man who presented with fever as a primary symptom of his condition. A systematic protocol oriented study led to the diagnosis of fever of unknown origin as a syndrome whose etiologic diagnosis was primary myelofibrosis; rare hematologic disease characterized by fibrosis of the bone marrow, anemia and splenomegaly. A review of the approach of fever and stages of study is done according to current recommendations, technical and scientific, but adapted to our environment and resources.

Influencia de la temperatura, densidad, oxígeno y alimento en la formación de marcas en las escamas de tilapia / The influence of temperature, density, oxygen and food in the mark formation on the scales of tilapia

ResumenO. niloticus se ha introducido en todo el mundo en reservorios de agua dulce y actualmente representa un alimento alternativo para las poblaciones. Dos marcas anuales en las escamas de tilapias se producen en estos ambientes, una de ellas se da por la época de reproducción mientras que la segunda se sugiere que se forma debido a bajas temperaturas, reducción en la oxigenación del agua y altas densidades entre otros estresores. Con el fin de explorar las causas de esta segunda marca se llevó a cabo un estudio experimental que analiza la influencia de cuatro factores en el crecimiento y en consecuencia en la producción de marcas del crecimiento en escamas: reducción de la cantidad de alimento, aumento en la densidad, disminución de la concentración de oxígeno y reducción de la temperatura. El experimento se realizó usando 5 tinas plásticas con 215 L de capacidad, cada una se subdividió en dos secciones para obtener una réplica por tratamiento. Se usaron 20 juveniles por réplica. Las condiciones control fueron las óptimas para la especie: 5 % del peso corporal como alimento, densidad de 3 peces /L, saturación de oxígeno de 4.98 ± 0.5 mg/L y temperatura de 25.0 ± 1.0 oC, mientras que los tratamiento variaron como sigue: Alimento (2.5 % del peso corporal como alimento); densidad (6 peces/L); oxígeno (2.8 ± 1.2 mg/L) y temperatura (19.6 ± 1.0 oC), donde la respuesta se estimó a través de las variaciones en longitud, peso y distancias inter-circulli. Cada tercer día se midió la concentración de fosfatos, amonio y nitratos con un fotómetro Hanna® HI8203. El experimento se dividió en tres etapas de mediciones de talla, peso y toma de escamas. 1) Etapa inicial: Antes de someter los organismos a experimentación. 2) Etapa final: al final del experimento y 3) Etapa compensatoria: donde todos las condiciones experimentales fueron llevadas a las condiciones del control. Todos los tratamientos causaron reducción en longitud, peso y distancias inter-circuli con respecto al control (6.7 ± 0.5 cm; 5.2 ± 1.2 g; 5.4 ± 0.5 mm), pero solo la temperatura y alimento fueron significativos (5.6 ± 0.4 y 5.8 ± 0.5 cm; 3.4 ± 0.7 y 3.3 ± 0.9 g; 3.4 ± 0.3 y 4.1 ± 0.6 mm para los tratamientos de temperatura y alimento, respectivamente) (P < 0.05). La experimentación tuvo una duración de tres semanas, y posteriormente los tratamientos fueron revertidos a condiciones control durante otras tres semanas donde se observó crecimiento compensatorio en los tratamientos de oxígeno y la densidad pero no de la misma manera para los estresores: temperatura y alimento. Las distancias inter-circuli fueron un buen indicador de períodos de estrés.

AbstractOreochromis niloticus has been introduced worldwide into freshwater reservoirs and represents an alternative food for local populations. Two annual marks on fish scales have been reported for fish in these environments, one of them is allocated to reproduction, while the other is thought to be formed following low temperatures, a reduction in oxygen concentration and/or high densities, among others. In order to explore the causes of this second ring, we designed an experimental study to analyze the influence of four factors: a reduction in food amount, an increase in density, a decrease in oxygen concentration and temperature. The experiment was carried out using five 215 L plastic tanks, each one divided into two sections, so as to have treatment replicates (each with 20 juveniles). The control conditions were optimal for the species: 5 % of body weight in food, a density of 3 fish/L, a total oxygen saturation of 4.98 ± 0.5 mg/L, and a temperature of 25.0 ± 1.0 oC; the treatments varied as follows: food of 2.5 % of body weight, density of 6 fish/L, oxygen of 2.8 ± 1.2 mg/L and a temperature of 19.6 ± 1.0 oC. Fish responses to stressors were estimated through variations in length, weight and inter-circuli spaces or circuli spacing in fish scales. Every third day it was measured the concentrations of ammonium, phosphates and nitrates with a photometer. Three stages for length/weight fish measurements and scales sampling were considered: 1) Initial stage: before experiment started, 2) Final stage: at the end of the experiment, and 3) Compensatory stage: when all the experimental treatments were adjusted to the Control conditions; the experiments lasted for three weeks. The results indicated that all the treatments caused a reduction in length, weight and inter-circuli spaces when compared to the controls (6.7 ± 0.5 cm; 5.2 ± 1.2 g; 5.4 ± 0.5 mm, respectively), but only the variables of temperature and food resulted significant (5.6 ± 0.4 and 5.8 ± 0.5 cm; 3.4 ± 0.7 and 3.3 ± 0.9 g; 3.4 ± 0.3 and 4.1 ± 0.6 mm for temperature and food treatments, respectively) (P < 0.05). When treatments were reversed to the control conditions for another three weeks compensatory growth was observed in the oxygen and density treatments, but not in the same way for the temperature and food treatments. We concluded that inter-circuli distances are a good indicator to stress periods in this species.

Infección por virus herpes humano 6 en un paciente inmunocompetente con síndrome DRESS secundario a carbamazepina / Human herpes virus 6 infection in an inmunocompetent patient with carbamazepine-induced DRESS syndrome

El síndrome DRESS (drug reaction with eosinophilia and systemic symptoms) constituye una reacción adversa a fármacos, potencialmente mortal, caracterizada por una erupción cutánea polimorfa asociada a fiebre, linfadeno-patías y compromiso multiorgánico con eosinofilia. Presentamos el caso clínico de un hombre inmunocompetente con un síndrome DRESS secundario a carbamazepina que cursó concomitantemente con una meningoencefalitis por virus herpes humano 6 (VHH-6). El rol patogénico del VHH-6 en el síndrome DRESS sigue siendo controversial; sin embargo, dada la importancia diagnóstica y eventualmente pronóstica de la infección por VHH-6, su tamizaje sería recomendable dentro del estudio de estos pacientes.

DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is an adverse life-threatening drug reaction characterized by a polymorphous rash associated with fever, lymphadenopathy and multiorgan involvement with eosinophilia. We present the case of an immunocompetent man with DRESS syndrome secondary to carbamazepine, that developed concomitantly meningoencephalitis caused by human herpes virus 6 (HHV-6), and a review of literature. The pathogenic role of HHV-6 in DRESS syndrome remains controversial. Given the diagnostic and possibly prognostic significance of HHV-6, the screening seems to be a good measure to use in the clinical management of these patients.

Caracterización de los procesos de atención prenatal a las gestantes con morbilidad materna extremadamente grave / Characterization of prenatal care processes applied to pregnant women with extremely severe maternal morbidity

La identificación de la morbilidad materna extrema grave ofrece una oportunidad para la investigación de muertes maternas. El cumplimiento de los procesos de atención y determinación de los posibles riesgos asociados, es indispensable para evitarla. Objetivo: describir los procesos de atención de las gestantes con morbilidad materna extremadamente grave en la atención prenatal en el 2009. Método: se realizó un estudio descriptivo cuyo universo fueron las 63 gestantes que se diagnosticaron con morbilidad materna extremadamente grave en los servicios de ginecobstetricia de los hospitales generales y maternos de La Habana. La información se obtuvo de los registros hospitalarios y las historias clínicas de las gestantes en la atención prenatal y hospitalaria; esta se recogió a través de un instrumento creado al efecto y se introdujo en una base de datos en Access. Resultados: los principales riesgos identificados fueron la hipertensión arterial, la anemia, la infección vaginal y la pre eclampsia. La consulta de reevaluación realizada por el especialista en ginecobstetricia se reflejó en un 33 por ciento, el promedio de 10 consultas durante el embarazo se constató en el 69,8 por ciento de las gestantes. La complicación por shock hipovolémico ocupó el primer lugar, seguido del shock séptico y la eclampsia. Conclusiones: la identificación de riesgos en la atención prenatal probablemente intervenga en la evolución de la MMEG en la Habana(AU)

Identification of extremely severe maternal morbidity provides an opportunity for research into maternal death. Fulfillment of care processes and determination of potential associated risks are indispensable to prevent extremely severe maternal morbidity. Objective: describe the prenatal care processes applied to pregnant women with extremely severe maternal morbidity in 2009. Method: a descriptive study was conducted with a universe of 63 pregnant women diagnosed with extremely severe maternal morbidity at gynecobstetric services of general and maternal hospitals in Havana. A dedicated tool was used to collect data from prenatal and hospital registries and medical records of the pregnant women. The data were stored in an Access database. Results: the main risks identified were hypertension, anemia, vaginal infection and preeclampsia. Re-evaluation by a gynecobstetrician was conducted in 33 percent of the cases. The average 10 prenatal consultations were performed with 69.8 percent of the pregnant women. Hypovolemic shock ranked first among complications, followed by septic shock and eclampsia. Conclusions: risk identification during prenatal care may play a role in the evolution of extremely severe maternal morbidity in Havana(AU)

Caracterización de la morbilidad materna extremadamente grave en la provincia de Camagüey (2009) / Characterization of extremely severe maternal morbidity in Camaguey province (2009)

Introducción: a través del control y análisis de la morbilidad materna extremadamente grave se adopta una forma acertada y precisa para evaluar el nivel de salud. Se considera un indicador muy asociado a la muerte materna: constituye una alternativa válida como indicador de la calidad de los cuidados maternos. Objetivo: caracterizar la morbilidad materna extremadamente grave en Camagüey. Métodos: se realizó un estudio descriptivo transversal, desde enero hasta diciembre del año 2009, con un universo de 72 pacientes que fueron diagnosticadas como morbilidad materna extremadamente grave en los hospitales maternos de Camagüey y la Unidad de Cuidados Intensivos del Hospital Provincial, según criterios de clasificación. La información se obtuvo mediante la historia clínica de cada gestante durante su atención prenatal y hospitalaria. Resultados: el grupo etario que prevaleció fue el de más de 35 años con 26,3 por ciento. Se identificaron 72 pacientes (93,0 por ciento); como morbilidad materna extremadamente grave, de ellas, el 65,3 por ciento llegaron al parto 34,7 por ciento no lo lograron por diferentes causas (embarazos ectópicos, abortos diferidos y angina de Ludwing). Se identificaron como riesgos que se destacan la malnutrición (38,8 por ciento), la edad extrema (35,1 por ciento), la hipertensión arterial(31,4 por ciento), la anemia (25,9 por ciento), la infección vaginal (22,2 por ciento) y la preeclampsia (16,6 por ciento). Conclusiones: el diagnóstico de esta entidad se realizó fundamentalmente durante el parto, y la hemorragia obstétrica es la principal causa de morbilidad(AU)

Introduction: through the control and analysis of extremely severe maternal morbidity, it is possible to evaluate the health status in an accurate and precise way. This indicator, closely associated to maternal death, is a valid alternative as a maternal care quality indicator. Objective: to characterize extremely severe maternal morbidity in Camaguey province. Methods: a cross-sectional descriptive study was conducted from January through December 2009 in a universe of 72 patients, who were diagnosed as extremely severe maternal morbidity in the maternal hospitals of Camaguey and in the intensive care unit of the provincial hospital, according to the classification criteria. Data were collected from the medical history of each pregnant woman during her prenatal and hospital care. Results: the prevailing age group was over 35 years accounting for 26.3 percent. Seventy two patients were classified as extremely severe maternal morbidity cases; 65.3 percent of them did give birth but 34.7 percent did not because of several causes (ectopic pregnancies, delayed abortions and Ludwig angina). The identified risks were malnutrition (38.8 percent), extreme age (35.1 percent), blood hypertension (31.4 percent), anemia (25.9 percent), vaginal infection (22.2 percent) and preeclampsia (16.6 percent). Conclusions: the condition was mostly diagnosed during delivery, being the obstetric hemorrhage the main cause of morbidity(AU)