Ecoepidemiology of Chagas Disease in a Biological Corridor in Southeastern Mexico: A Promising Approach to Understand the Risk of Chagas Disease.

Ecoepidemiology is an emerging field that attempts to explain how biotic, environmental, and even social factors influence the dynamics of infectious diseases. Particularly in vector-borne diseases, the study under this approach offers us an overview of the pathogens, vectors, and hosts that coexist in a given region and their ecological determinants. As a result of this, risk predictions can be established in a changing environment and how it may impact human populations. This paper is aimed at evaluating some ecoepidemiological characteristics of Chagas disease in a natural reserve in southeastern Mexico that borders human settlements. We carry out a cross-sectional study in 2022 where we search insects manually and with light traps. We set traps for small mammals and bats and conducted interviews with the inhabitants living around the study site. We identified the presence of Triatoma dimidiata and T. huehuetenanguensis species with a percentage of TcI T. cruzi infection of 68.4% (95% CI: 66.9-69.9). Temperature and humidity were not determining factors for the probability of insect capture. Of the 108 wild mammals (Chiroptera, Rodentia, and Didelphimorphia), none was infected with T. cruzi. Knowledge about Chagas disease in nearby inhabitants is poor, and some characteristics were found on the periphery of dwellings that could offer a refuge for insect vectors. With this information, surveillance strategies can be generated in the study area that reduce the risk of transmission of T. cruzi parasite to humans, and it is expected to motivate the use of this field in future research.

Identification of Discrete Typing Units of Trypanosoma cruzi Isolated from Domestic Environments in Southeastern Mexico.

Background: The Trypanosoma cruzi parasite is the causal agent of Chagas disease, recognized by the World Health Organization as a neglected tropical disease. Currently there are seven discrete typing units (DTUs) of T. cruzi distributed in America, but there are still gaps about its distribution in some endemic regions. Materials and Methods: Seventeen units isolated from Chiapas and Oaxaca in Mexico were identified by amplification of the C-5 sterol desaturase gene. Results: Three DTUs of T. cruzi, TcI (6), TcII (10), and TcIV (1) were detected by comparing polymorphic sites in specific regions. Conclusions: New DTUs are reported for both states, where TcII was the most common DTU. The genetic characterization of the isolates can help to understand the epidemiology of Chagas disease.

What Do You Need to Know before Studying Chagas Disease? A Beginner's Guide.

Chagas disease is one of the most important tropical infections in the world and mainly affects poor people. The causative agent is the hemoflagellate protozoan Trypanosoma cruzi, which circulates among insect vectors and mammals throughout the Americas. A large body of research on Chagas disease has shown the complexity of this zoonosis, and controlling it remains a challenge for public health systems. Although knowledge of Chagas disease has advanced greatly, there are still many gaps, and it is necessary to continue generating basic and applied research to create more effective control strategies. The aim of this review is to provide up-to-date information on the components of Chagas disease and highlight current trends in research. We hope that this review will be a starting point for beginners and facilitate the search for more specific information.

Assessing the Larvicidal Properties of Endemic Campeche, Mexico Plant Piper cordoncillo var. apazoteanum (Piperaceae) against Aedes aegypti (Diptera: Culicidae) Mosquitoes.

The research aims to investigate the mortality effect of essential oil from Piper cordoncillo var. apazoteanum, an endemic plant from Campeche, Mexico, on early second-instar Aedes aegypti larvae; it also aims to identify the volatile compounds present in the fresh leaves of the plant. To test the effectiveness of the essential oil, we followed World Health Organization Standard Procedures. Larvae were observed for 17 consecutive days after treatment to determine the mortality and growth-inhibitory effect exerted by the essential oil. The results showed that the essential oil was effective in controlling mosquito populations. At a concentration of 800 ppm, the oil achieved an effectiveness rate of 70.00 ± 8.16% after 24 h, increasing to 100.00 ± 0.01% mortality after 72 h. With a concentration of 400 ppm, the effectiveness was 98.33 ± 0.17% by the end of the experiment. Furthermore, the obtained results demonstrated that the LC50 value was 61.84 ± 6.79 ppm, while the LC90 value was 167.20 ± 11.49 ppm. Essential oil concentrations inhibited the growth of immature insect stages, with concentrations between 800-100 ppm demonstrating very high inhibitory activity, and the lowest concentration of 50 ppm showing high inhibitory activity. The study also identified 24 chemical compounds representing 86.71% of the volatile compound composition of the fresh leaves of P. cordoncillo; the most abundant compounds were Safrole, Caryophyllene oxide, E-Nerolidol, and Calarene epoxide. The method used to extract the volatile compounds, solvent-free microwave extraction (SFME), is a promising alternative to traditional methods that avoids the use of potentially harmful solvents, making it more ecologically friendly and potentially safer for professionals handling the extracted compounds. Overall, the study demonstrates the potential of P. cordoncillo essential oil as an effective means of controlling mosquito populations, and provides valuable information on the chemical composition of the plant.Moreover, our study is the first to report on the biological activity and chemical composition of P. cordoncillo worldwide.

Producción científica sobre Ortodoncia publicada en revistas biomédicas pertenecientes a universidades médicas cubanas / Scientific production on Orthodontics published in biomedical journals belonging to Cuban medical universities

La necesidad de impulsar la investigación en Ortodoncia y realizar un análisis de los artículos publicados en la web cubana, con la finalidad de conocer sus características bibliométricas, es cada vez mayor. El presente estudio tuvo como objetivo caracterizar la producción científica sobre Ortodoncia, publicada en revistas biomédicas profesionales patrocinadas por las universidades médicas cubanas entre enero del 2015 y agosto del 2021. Se realizó un estudio bibliométrico, observacional, descriptivo, longitudinal de la productividad científica acerca de Ortodoncia publicada en dichas revistas. Se empleó el gestor de referencias Zotero para procesar los metadatos y VOSviewer para analizar las redes de coautoría. Se constataron 158 artículos; el 15,19 por ciento se publicó en Medisan y el año más productivo fue el 2015. Predominaron los artículos originales (67,72 por ciento), con autoría múltiple (cinco autores), el sexo femenino (76,41 por ciento), los autores de nacionalidad cubana (98,38 por ciento) y procedentes de Santiago de Cuba/Cuba (15,19 por ciento). Se emplearon 2665 referencias con un índice de Price de 0,53. El área temática más abordada fue la Ortodoncia interceptiva (33,54 por ciento). Los artículos recibieron un total de 1041 citas en el Google Académico. El análisis de la red de coautoría permitió establecer 13 clústeres, donde fueron visualizados 106 autores, con 282 links y una fuerza de atracción total entre ellos de 97. Se concluye que la producción científica sobre Ortodoncia, por lo general, es baja. Es necesario lograr la indexación de estas revistas en las grandes bases de datos para así aumentar la visibilidad e impacto de los artículos(AU)

The need to promote research in orthodontics and to carry out an analysis of the articles published in the Cuban web, with the purpose of knowing their bibliometric characteristics, is increasing. The present study aimed at characterizing the scientific production on orthodontics, published in professional biomedical journals sponsored by Cuban medical universities between January 2015 and August 2021. A bibliometric, observational, descriptive, longitudinal, descriptive study of the scientific productivity about Orthodontics published in these journals was carried out. The reference manager Zotero was used to process the metadata and VOSviewer to analyze the co-authorship networks. A total of 158 articles were ascertained; 15.19percent ere published in Medisan and the most productive year was 2015. Original articles predominated (67.72percent), with multiple authorship (five authors), female gender (76.41percent), authors of Cuban nationality (98.38percent) and from Santiago de Cuba/Cuba (15.19percent). A total of 2665 references were used with a Price index of 0.53. Interceptive orthodontics (33.54percent) was the most common subject area. The articles received a total of 1041 citations in Google Scholar. The analysis of the co-authorship network made it possible to establish 13 clusters, where 106 authors were visualized, with 282 links and a total strength of attraction among them of 97. It is necessary to achieve the indexing of these journals in large databases in order to increase the visibility and impact of the articles(AU)

Factores de riesgos heredofamiliares, prenatales y perinatales en niños cubanos con autismo primario / Family inherited, prenatal and perinatal risk factors in Cuban children with primary autism

Introducción: El autismo primario es una heterogénea alteración neuroconductual, de causa no precisa, en la que tanto los genes como el ambiente contribuyen a la patogenia del trastorno. Objetivo: Identificar factores de riesgos heredofamiliares, prenatales y perinatales en niños cubanos con autismo primario. Material y Métodos: Se realizó una investigación observacional tipo casos y controles (1:1) en niños con autismo primario, atendidos en el Hospital Pediátrico "Juan Manuel Márquez", La Habana; en el período de octubre de 2014 a septiembre de 2019. La muestra quedó conformada por 126 casos y 126 controles. Se recolectaron los datos sobre la historia de enfermedades neuropsiquiátricas de tres generaciones, antecedentes prenatales y perinatales. Se realizó una regresión logística multivariada para identificar factores de riesgos relacionados con el autismo primario. Resultados: El odds de presentar autismo primario fue aproximadamente siete y cuatro veces superior en hijos de madres y padres con edad avanzada, respectivamente. Los antecedentes de trastornos del lenguaje y epilepsia en familiares de primer grado, confirió un odds de presentar autismo 27 y 24 veces mayor, respectivamente. El odds de presentar autismo fue aproximadamente diez veces mayor en los hijos de gestantes con anemia, ocho veces en hijos de gestantes que tuvieron gestorragias y 18 veces para los nacidos de madres con antecedentes de diabetes mellitus pregestacional. Conclusiones: Los antecedentes de enfermedades heredofamiliares neuropsiquiátricas y de factores ambientales prenatales y perinatales relacionados con eventos hipoxémicos constituyen factores de riesgo para el autismo primario en la muestra de niños cubanos estudiados(AU)

Introduction: Primary autism is a heterogeneous neurobehavioral disorder of uncertain etiology in which both genes and the environment contribute to the pathogenesis of the disorder. Objective: To identify family inherited, prenatal and perinatal risk factors in Cuban children with primary autism. Material and Methods: An observational case-control study (1:1) was carried out in children with primary autism, treated at "Juan Manuel Márquez" Pediatric Hospital, Havana, in the period from October of 2014 to September of 2019. The sample was made up of 126 cases and 126 controls. Data on neuropsychiatric diseases, prenatal and perinatal history of three generations were collected. Multivariate logistic regression was performed to identify risk factors related to primary autism. Results: The odds of presenting primary autism were approximately seven and four times higher in children of mothers and fathers of advanced ages, respectively. A history of language disorders and epilepsy in first-degree relatives conferred 27- and 24-fold higher odds of presenting with autism, respectively. The odds of presenting autism were approximately ten times greater in children born to pregnant women with anemia, eight times in children born to pregnant women who had bleeding during pregnancy, and 18 times in those born to mothers with a history of pregestational diabetes mellitus. Conclusions: The history of inherited neuropsychiatric diseases and prenatal and perinatal environmental factors related to hypoxemic events are risk factors for primary autism in the sample of Cuban children studied(AU)

Atención estomatológica integral a niños con trastorno del espectro autista / Comprehensive dental care for children with autism spectrum disorder

RESUMEN Introducción: los trastornos del espectro autista consisten en un grupo de discapacidades del desarrollo nervioso que afecta la interacción social. El niño autista se considera un paciente especial en Estomatología. Objetivo: evaluar la efectividad de una intervención estomatológica en niños autistas, de la escuela especial "Héroes del Moncada" del municipio Camagüey, de septiembre 2018 a junio 2019. Métodos: se realizó un estudio cuasi experimental, antes-después sin grupo control, de septiembre 2018 a junio 2019. El universo y la muestra coincidieron con 26 pacientes, matrícula total de la escuela especial. Se estudiaron variables: tipos de enfermedades bucodentales, factores de riesgo, clasificación epidemiológica, índice COP-D. Se diseñó un protocolo de actuación escalonada, reforzado por técnicas de modificación de la conducta para la familiarización, el acondicionamiento y las posteriores acciones curativas. Resultados: se observó la prevalencia de enfermedad periodontal (80,8 %) y caries dental (57,7 %), cifras que disminuyeron a 15,4 % y 7,7 % después de la intervención. Existió una frecuencia elevada de anomalías dento-maxilo-faciales (61,5 %), tributarias al segundo nivel de atención. El 96,2 % de los pacientes presentaron una mala higiene bucal y presencia de placa dentobacteriana (PDB), lo cual disminuyó notablemente (26,9 % para ambas variables) una vez tratados. Conclusiones: la intervención estomatológica desarrollada fue efectiva y aplicable, con un aporte educativo, preventivo-curativo y social. Desarrolló en los niños con TEA, hábitos correctos y conocimientos básicos de higiene bucal. Se redujeron las afecciones bucales, se garantizó el seguimiento y evolución a través de nexos afectivos que se establecieron.

ABSTRACT Introduction: autism spectrum disorders consist of a group of neuro-developmental disabilities that affect social interaction. The autistic child is considered a special patient in dentistry. Objective: to evaluate the effectiveness of a dentistry intervention in autistic children, from Heroes del Moncada Special School in Camagüey municipality, September 2018 to June 2019. Methods: a quasi-experimental study was conducted, before-after without control group from September 2018 to June 2019.The target group and the sample matched (26 patients), the total registration of the special school. The variables studied were: types of oral diseases, risk factors, epidemiological classification, and DMFT index. A stepwise action protocol was designed, reinforced by behavior modification techniques for familiarization, conditioning and subsequent healing actions. Results: the prevalence of periodontal disease (80,8 %) and dental caries (57,7 %) was observed, figures that decreased to 15,4 % and 7,7 % respectively after the intervention. There was a high frequency of dento-maxillofacial anomalies (61,5 %), responding to the second level of care. The 96,2 % of patients presented poor oral hygiene and presence of dentobacterial plaque (DBP), which decreased significantly (26,9 % for both variables) after treatment. Conclusions: the dentistry intervention developed was effective and applicable, with an educational, preventive-healing and social contribution. It developed correct habits and basic knowledge of oral hygiene in children with ASD. Oral disorders were reduced and follow-up along with evolution were guaranteed all through the affective bonds developed.

Growth of the Black Soldier Fly Hermetia illucens (Diptera: Stratiomyidae) on Organic-Waste Residues and Its Application as Supplementary Diet for Nile Tilapia Oreochromis niloticus (Perciformes: Cichlidae).

The black soldier fly, Hermetia illucens (BSF, Diptera: Stratiomyidae) is an insect with high protein value and a potential feed agent for animals aimed for human consumption. The growth parameters of BSF larvae reared on four substrates-restaurant-waste, fruit-waste, fish-waste, and commercial tilapia food-for 41 days before processing for inclusion into Oreochromis niloticus (Perciformes: Cichlidae, Nile tilapia) commercial fry diets at 30% (70:30) were determined. On fly larvae, the food substrate based on restaurant waste yielded the greatest larval weight and length. BSF larvae fed a fish-waste diet showed the shortest developmental time. The fruit-waste diet induced the lowest weight and length in the fly larvae/pre-pupae (immature stage). The pre-pupal protein values were similar to commercial food. On fry-fish, the diets with pre-pupae grown on fish waste showed the greatest yields regarding weight (biomass), length, and nutritional content. These results suggest the BSF has the potential to be used in fish feed and provides an alternative for commercial cultivation.

Mini-exon gene reveals circulation of TcI Trypanosomacruzi (Chagas, 1909) (Kinetoplastida, Trypanosomatidae) in bats and small mammals in an ecological reserve in southeastern Mexico.

A wide variety of mammals are involved in the sylvatic cycle of Trypanosomacruzi, the causative agent of Chagas disease. In many areas in Latin America where T.cruzi is endemic, this cycle is poorly known, and its main reservoirs have not been identified. In this study we analyzed T.cruzi infection in bats and other small mammals from an Ecological Reserve in southeastern Mexico. From January through March 2021, we captured wild individuals to extract cardiac and peripheral blood, and infection was detected by PCR of the mini-exon gene. In bats, the prevalence of infection was 16.36%, while in small mammals the prevalence was 28.57%. All of the samples that were positive for T.cruzi were identified as the TCI genotype. Our findings suggest that this zone, situated at the periphery of urban zones might have epidemiological relevance in the sylvatic cycle of T.cruzi and needs to be monitored. The infection of bats in this area is particularly concerning since the flight pattern of this populations overlaps with human settlements. Despite being subject to conservation protections, there continue to be anthropogenic actions that disturb the study area, which could exacerbate risks to public health.

Uso del yo como herramienta terapéutica: una experiencia formativa de terapia ocupacional en pregrado / Uso de si como ferramenta terapêutica: uma experiência formativa na graduação em terapia ocupacional / Use of the self as a therapeutic tool: a formative experience of occupational therapy in an undergraduate course

Resumen Introducción El uso del yo como herramienta terapéutica es una práctica centrada en el cliente y el pilar disciplinar con menor evidencia pedagógica en terapia ocupacional. En Chile, surgen asignaturas vivenciales, ligadas a métodos artísticos/lúdicos que buscan incidir en competencias del estudiante de pregrado para su desarrollo. Objetivo Analizar la experiencia de las estudiantes en relación a los aprendizajes, características y contribuciones de las asignaturas que aportan a la formación del uso del yo como herramienta terapéutica, en carreras de terapia ocupacional de universidades al sur de Chile. Método Investigación cualitativa, con diseño en teoría fundamentada de alcance exploratorio. El muestreo fue no probabilístico, intencionado, por criterio, conformado por quince estudiantes en etapa de internado profesional. La recolección de datos fue mediante dos grupos focales, previa firma de consentimiento informado. El análisis se realizó por método de comparación constante de Glaser y Strauss, utilizando el programa Atlas Ti para sistematizar la información. La rigurosidad científica fue cautelada por los criterios de Guba y Lincoln. Resultados Se identifican 530 unidades de significado, 30 códigos abiertos descriptivos, agrupados en ocho categorías axiales, emergiendo dos núcleos temáticos que abordan el "Proceso de enseñanza aprendizaje en la formación del Uso del Yo" y el "Desarrollo profesional para el Uso del Yo". Conclusión Para los estudiantes las metodologías utilizadas contribuyen de manera relevante al desarrollo del autoconocimiento y competencias genéricas clave para el "Uso del Yo". Esta pedagogía se podría complementar con otras estrategias activas para asegurar la centralidad del usuario en la terapia ocupacional.

Resumo Introdução O uso de si como ferramenta terapêutica é uma prática centrada no cliente e o pilar disciplinar com menor evidência pedagógica em terapia ocupacional. No Chile, surgem disciplinas vivenciais, vinculadas a métodos artísticos/lúdicos que buscam contribuir as habilidades do aluno de graduação para seu desenvolvimento. Objetivo Analisar a experiência dos alunos em relação à aprendizagem, características e contribuições das disciplinas que auxiliam para a formação do uso de si como ferramenta terapêutica, nos cursos de terapia ocupacional em universidades ao sul do Chile. Método Pesquisa qualitativa, com delineamento da teoria fundamentada de alcance exploratório. A amostragem foi não probabilística, intencional, por critério, composta por quinze alunos em etapa de estágio profissional. A coleta de dados se deu por meio de dois grupos focais, após assinatura do consentimento informado. A análise foi realizada pelo método de comparação constante de Glaser e Strauss, utilizando o programa Atlas Ti para sistematizar as informações. O rigor científico foi resguardado pelos critérios de Guba e Lincoln. Resultados Foram identificadas 530 unidades de sentido, 30 códigos abertos descritivos, agrupados em oito categorias axiais, emergindo dois núcleos temáticos que abordam o "Processo de ensino-aprendizagem na formação do Uso de Si" e o "Desenvolvimento profissional para o uso de Si". Conclusão Para os alunos, as metodologias utilizadas contribuem de forma relevante para o desenvolvimento do autoconhecimento e das competências genéricas chave para o "Uso de Si". Essa pedagogia poderia ser complementada com outras estratégias ativas para garantir a centralidade do usuário na terapia ocupacional.

Abstract Introduction The use of the self as a therapeutic tool is a client-centered practice with the least evidence in the pedagogy of occupational therapy. In Chile, experiential subjects arise, linked to artistic/playful methods that seek to influence the skills of the undergraduate student for their development. Objective To analyze the experience of the students in relation to the learning, characteristics, and contributions of the subjects that contribute to the development of the use of the self as a therapeutic tool, in occupational therapy careers at universities in the south of Chile. Method Qualitative research, exploratory with a grounded theory design. The sampling was non-probabilistic, intentional, by criteria, of fifteen students in the professional internship stage. Data collection was through two focus groups, after signing informed consent. The analysis was carried out using the constant comparison method of Glaser and Strauss, using the Atlas Ti program to systematize the information. Scientific rigor was guarded by the criteria of Guba and Lincoln. Results 530 units of meaning are identified, 30 descriptive open codes, grouped into eight axial categories, emerging two thematic nuclei that address the "Teaching-learning process in the formation of the Use of the Self" and the "Professional Development for the Use of the Self". Conclusion For the students, the methodologies used to contribute in a relevant way to the development of self-knowledge and key generic competences for the "Use of the Self". This pedagogy could be complemented with other active strategies to ensure the centrality of the user in occupational therapy.

Knowledge and perceptions about Covid-19 in the marginalized population of southeastern Mexico.

Not available.

Formación clínica en carreras de la salud: ¿dónde se incluye la diversidad? / The inclusion of diversity in clinical training

Background Educational inclusion, a concept that has changed over time, is becoming relevant. It initially considered only disability and now contemplates education for all people. Educational inclusion has special relevance in health care workers' training, who will have direct contact with heterogeneous populations, where diversity-oriented treatments are required. Aim To describe how diversity is integrated into health care training in a clinical context. Material and Methods qualitative study, based on Grounded Theory. Two group interviews and thirteen semi-structured interviews were conducted among 11 teachers and 25 students of health careers. Data was analyzed using Atlas-ti 7.5.2. A constant comparison method, reaching an axial coding level, was used. Results The category of training in health careers in the context of diversity emerged. It is a process that operates in cognitive, affective and behavioral dimensions. It accounts for the diversity of system actors and the model of a health professional and teacher facing diversity. Conclusions These dimensions should be understood during clinical training. Socio-cultural diversity encompassing gender, sex, ethnicity, religion and disability should be considered. Therefore, educational inclusion is an important issue to be considered by universities.

Plasmaféresis, experiencia del Hospital Regional de Talca en pacientes con indicaciones nefrológicas / Plasmapheresis, experience of the Regional Hospital of Talca, in patients with nephrological indications

INTRODUCTION: Plasmapheresis is an extracorporeal procedure that allows the plasma to be separated from the figurative elements of the blood, removing specific elements involved in pathological processes. OBJECTIVE: To show the experience of the Regional Hospital of Talca (HRT) in the use of Plasmapheresis from 2017 to March 2019. METHODS: Corresponds to a retrospective study of all patients undergoing plasmapheresis from January 2017 to March 2019 (27 months). The clinical profile of this group of patients is analyzed, emphasizing in the nephrological etiologies and showing the clinical evolution of the diseases submitted to this procedure and aspects such as number of sessions, complications and associated therapies. RESULTS: In this period 14 patients have required plasmapheresis in our center, 9 cases for renal causes (64.2%) and 5 for non-renal causes (35.7%). A deceased was recorded during the acute stage of the disease (7.14%), in the context of a negative antineutrophil cytoplasmic antibody (ANCA) in patient with pulmonary-renal syndrome. 78% of those who needed plasmapheresis for renal etiologies are on hemodialysis at the end of the work. The clinical improvement experienced in the majority of the cases studied allows us to attribute a beneficial effect of plasmapheresis.

Percepción del proceso evaluativo en la práctica clínica durante el internado de estudiantes de Medicina / Medical Students' Perception of the Evaluation Process of Clinical Practice in the Internship

Introducción: La evaluación es un eje rector del proceso enseñanza-aprendizaje, que permite coadyuvar a la formación y valorar la adquisición en los educandos de las competencias profesionales. Objetivo: Indagar en las características del docente clínico y en los factores que intervienen en el proceso evaluativo en los estudiantes de 6to año de Medicina. Métodos: Estudio cualitativo e intrínseco de casos de una muestra no probabilística de 29 estudiantes, intencionada por conveniencia y con previa firma del consentimiento informado. Los datos se obtuvieron mediante los grupos focales y el análisis se hizo a través de reducción de datos con el programa Atlas Ti. La rigurosidad científica fue cautelada por criterios de credibilidad, transferibilidad, dependencia y confirmabilidad. Resultados: Se identificaron 467 unidades de significado. Se originaron 42 categorías descriptivas y emergieron seis macrocategorías: "Características docente clínico", "Factores que dificultan evaluación clínica", "Evaluación de competencias genéricas", "Factores que facilitan evaluación clínica", "Evaluación de competencias disciplinares", "Utilización de instrumentos de evaluación" y dos dominios cualitativos: 1) Aportes del estudiantado al proceso evaluativo de la docencia clínica y 2) Significado del proceso evaluativo de la práctica clínica. Conclusiones: Los estudiantes valoraron que los docentes clínicos debían tener formación docente, motivación y experiencia clínica, además utilizar instrumentos de evaluación objetivos que permitieran la retroalimentación e interacción(AU)

Introduction: Evaluation is a key factor within the teaching-learning process, also contributing to the training and the assessment of student acquisition of professional competences. Objective: To characterize the clinical professor and the factors involved in the evaluation process of medical students from the sixth academic year. Methods: Qualitative and intrinsic case study with a non-probabilistic sample of 29 students, intended by convenience and with prior signature of informed consent. The data were obtained through focus groups and the analysis was obtained through data reduction with the program Atlas Ti. Scientific rigor was protected by credibility, transferability, dependence and confirmability criteria. Results: We identified 467 units of meaning. Fourty-two descriptive categories appeared and six macrocategories emerged ("clinical teaching characteristics", "factors that obstruct clinical evaluation", "evaluation of generic competences", "factors that facilitate clinical evaluation", "evaluation of disciplinary competences", "usage of tools for the evaluation"), as well as two qualitative domains (students' contributions to the evaluation process of clinical teaching and meaning of the evaluation process of clinical practice). Conclusions: The students considered that clinical professors should have teaching training, motivation and clinical experience, in addition to using objective evaluation tools that allow feedback and interaction(AU)

Tratamiento de úlcera posflebítica con plasma rico en plaquetas y autoinjerto de piel. Presentación de un caso / Postphlebitic ulcer treatment with platelet-rich plasma and autograft of skin. Case Presentation

Las úlceras cutáneas no solo constituyen un serio problema físico, sino también psicológico, pues merman considerablemente la calidad de vida de los enfermos. Se presenta el caso de una mujer de 76 años, con antecedentes de insuficiencia venosa periférica y cirugía vascular por várices, aquejada de una gran úlcera posflebítica (14 x 9 cm) de larga evolución, en región maleolotibial derecha. Se aplicó tratamiento con gel plasmático autólogo rico en plaquetas y posteriormente autoinjerto libre de piel, de grosor mediano. Luego de curar el área injertada y de realizar curas de forma ambulatoria durante tres semanas, se obtuvo la cicatrización en más del 70 % del área afectada inicialmente. La presentación de este caso tiene como objetivo mostrar los beneficios del plasma rico en plaquetas como adyuvante en la cicatrización.

Cutaneous ulcers not only constitute a serious physical problem, but also a psychological one, as they considerably reduce the patient's quality of life. The case of a 76 - year - old woman with a history of peripheral venous insufficiency and variceal vascular surgery is presented. She was suffering from a large post - phlebitic ulcer (14 x 9 cm) with a long evolution in the right maleolotibial region. It was applied a treatment with autologous plasma gel rich in platelets and then autografting skin free, of medium thickness. After curing the grafted area and performing cures on an outpatient basis for three weeks, healing was achieved in more than 70% of the initially affected area. The case presentation is aimed at showing the benefits of platelet-rich plasma as healing adjuvant.

Factores que facilitan u obstaculizan el aprendizaje basado en problemas en grupo pequeño, vistos por los estudiantes de la Facultad de Medicina de la Universidad de La Frontera, Temuco, Chile / Fatores que facilitam ou dificultam a aprendizagem baseada em problema no pequeno grupo, visto pelos alunos da Faculdade de Medicina da Universidad de la Frontera, Temuco, Chile / Factors that facilitate or make difficult the problembased learning in small groups, as seen by students at the Faculty of Medicine, University of La Frontera, Temuco, Chile

El objetivo del presente estudio fue develar factores que facilitan u obstaculizan el proceso tutorial del aprendizaje basado en problemas (ABP) en grupo pequeño, según los destacan los estudiantes de la Facultad de Medicina de la Universidad de La Frontera. Se desarrolló la investigación bajo el paradigma cualitativo mediante un estudio de caso. La muestra estuvo constituida por 15 estudiantes informantes claves de los dos últimos niveles curriculares. La información se obtuvo mediante seis entrevistas y un grupo focal. Se hizo triangulación por investigador, juicio de experto y comprobación con participantes en el estudio. Se identificaron 574 unidades de significado, de las cuales 542 se agruparon en 22 categorías. Se destacan entre ellas: Desarrollo del tutorial, Tutor experto en la metodología, Manejo del grupo, Características personales del estudiante y Responsabilidad del estudiante. Emergieron cuatro macro categorías: Competencias propias del tutor, Relaciones humanas y ambiente de aprendizaje, Características y participación de los estudiantes y Aspectos organizacionales. Los estudiantes consideraron relevantes en el proceso tutorial las características del tutor y su experiencia y responsabilidad; también le dieron importancia a las características personales, la experiencia en la metodología, el trabajo colaborativo, las relaciones interpersonales y el ambiente de aprendizaje. Asimismo, a los aspectos administrativos y de gestión que influyen en el desarrollo del ABP...

The objective of the study was to explore factors that facilitate or make difficult the tutorial process in problem-based learning (PBL) in small groups, atthe Faculty of Medicine, University of La Frontera. Research was done under the qualitative paradigm through a case study. The sample consisted of 15 key informant students of the last two curricular levels. Information was collected through six interviews and a focus group. Triangulation was conducted by researcher, expert judgment and verification with study participants. We identified 574 meaning units, out of which 542 were grouped in 22 categories, among them: Tutorial group development, Tutor as an expert in methodology, Group management, Personal characteristics of the student, and Student responsibility. Four macro-categories emerged, namely: Competences of the tutor, Human relationships and learning environment, Characteristics and participation of the students and Organizational aspects. Students considered that the characteristics of the tutor and his/her experience and responsibility are relevant in the tutorial process. They also emphasized on collaborative work, interpersonal relationships, learning environment, and the administrative aspects that may influence the development of PBL...

O objetivo do presente estudo foi detectar os fatores que facilitam ou dificultam o processo tutorial de aprendizagem baseada em problemas (ABP) em pequeño grupo, de acordó com o suporte aos alunos da Faculdade de Medicina da Universidad de la Frontera. A pesquisa é desenvolvimento no âmbito do paradigma qualitativo por meio de um estudo de caso. A amostra constituiu-se de 15 alunos informanteschave no último dois níveis curriculares. As informaçõesb foram obtidas através de seis entrevistas e um focus group. Triangulação foi feita pelo pesquisador, o julgamento dos peritos e os testes com os participantes do estudo. Foram identificados 574 unidades de significado, das quais 542 foram agrupados em 22 categorias. Se destaca estre elas: Desenvolvimento do tutorial, especialista tutor da metodologia, a gestão do grupo, características pessoais do aluno e a responsabilidade do aluno. Quatro macrocategorias surgiram: competências próprias do tutor, relações humanas, e um ambiente de aprendizagem, características e a participação dos alunos e os aspectos organizacionais. Os Estudantes considerados relevantes no proceso tutor características e sua experiência eresponsabilidade; também deram importância para as características pessoais, a experiência da metodologia,trabalho colaborativo, o relacionamento interpessoal e o ambiente de aprendizagem. Além disso,aspectos administrativos e gerenciais que influenciam o desenvolvimento da ABP...

Krüppel-like factor 5 as potential molecular marker in cervical cancer and the KLF family profile expression.

Cervical cancer (CC) as other cancer types, presents molecular deregulations, such as the alterations of transcription factors. Krüppel-like factors (KLF) are a family of transcriptional regulators. They are involved in diverse cellular processes, such as proliferation, apoptosis, and angiogenesis among others. Here, we analyzed the expression of all 17 KLF members at messenger RNA (mRNA) level, and protein expression of the two most commonly altered KLF5 and KLF6 in cervical tissues. Fifty-nine cervical tissues ranging from normal tissue to CC were evaluated for KLF1-17 mRNA expression by end-point RT-PCR and KLF5 by qRT-PCR. For KLF5 and KLF6 protein analysis, a tissue microarray was constructed containing the 59 cases and subjected for immunohistochemistry assay and KLF6 IVS1-27G>A single nucleotide polymorphism by direct DNA sequencing. KLF2-16 expressions were present in normal tissue, whereas all 17 were present in Low-Grade Squamous Intraepithelial Lesion, High-Grade-SIL and CC, unrelated to presence of human papillomavirus (HPV). KLF5 mRNA expression gradually increased throughout the subgroups and overexpressed in CC (p=0.01). KLF5 and KLF6 proteins were immunodetected in all samples. For the KLF6 SNP analysis, 80% of the CC population analyzed presented GG genotype and the remaining 20% presented GA genotype (p=0.491). Our present data show that KLFs expression could not be related to HPV presence, at least at transcriptional level, and KLF5 mRNA overexpression could represent a potential molecular marker for CC; KLF6 SNP has no relation to increased risk of CC.

Altered Prion protein expression pattern in CSF as a biomarker for Creutzfeldt-Jakob disease.

Creutzfeldt-Jakob disease (CJD) is the most frequent human Prion-related disorder (PrD). The detection of 14-3-3 protein in the cerebrospinal fluid (CSF) is used as a molecular diagnostic criterion for patients clinically compatible with CJD. However, there is a pressing need for the identification of new reliable disease biomarkers. The pathological mechanisms leading to accumulation of 14-3-3 protein in CSF are not fully understood, however neuronal loss followed by cell lysis is assumed to cause the increase in 14-3-3 levels, which also occurs in conditions such as brain ischemia. Here we investigated the relation between the levels of 14-3-3 protein, Lactate dehydrogenase (LDH) activity and expression of the prion protein (PrP) in CSF of sporadic and familial CJD cases. Unexpectedly, we found normal levels of LDH activity in CJD cases with moderate levels of 14-3-3 protein. Increased LDH activity was only observed in a percentage of the CSF samples that also exhibited high 14-3-3 levels. Analysis of the PrP expression pattern in CSF revealed a reduction in PrP levels in all CJD cases, as well as marked changes in its glycosylation pattern. PrP present in CSF of CJD cases was sensitive to proteases. The alterations in PrP expression observed in CJD cases were not detected in other pathologies affecting the nervous system, including cases of dementia and tropical spastic paraparesis/HTLV-1 associated myelopathy (HAM/TSP). Time course analysis in several CJD patients revealed that 14-3-3 levels in CSF are dynamic and show a high degree of variability during the end stage of the disease. Post-mortem analysis of brain tissue also indicated that 14-3-3 protein is upregulated in neuronal cells, suggesting that its expression is modulated during the course of the disease. These results suggest that a combined analysis of 14-3-3 and PrP expression pattern in CSF is a reliable biomarker to confirm the clinical diagnosis of CJD patients and follow disease progression.