How do we classify organ involvement in Chagas disease? A systematic review of organ involvement since 1909, Highlighting the urgent need for a universal classification system in Chronic Chagas disease.

Chagas disease (CD) is recognized as one of the 20 neglected tropical diseases by the World Health Organization (WHO), posing a significant global health challenge. The objective of this work was to conduct a systematic methodology review to explore the different classifications used to describe the presence and degree of organ involvement in patients with CD since the disease's description in 1909. We searched relevant electronic medical databases from their inception dates to July 2023. We also delved into historical variations and revisions of each classification, the necessary diagnostic methods, their prognostic value, and their uptake. Our study underscores the conspicuous absence of a universally accepted CD classification system for cardiac and digestive involvement, both in the context of clinical trials and within current clinical guidelines. This endeavour will facilitate cross-population comparisons if clinical manifestations and complementary test results are available for each patient, constituting a pivotal stride toward identifying precise prognoses and establishing a minimum data set requisite for a fitting CD classification, tailored to the test availability in both endemic and non-endemic regions.

Escape Room como Herramienta Didáctica en la Enseñanza de la Histología / Escape Room as a Didactic Tool in Histology Teaching

En el marco de un proceso de aprendizaje activo, se investigó el rendimiento académico a corto y a largo plazo de los estudiantes en dos sesiones prácticas de la asignatura de Histología a las que se incorporó un escape room. También se evaluó su impacto en la motivación y la retención del conocimiento. Los estudiantes fueron clasificados en un grupo control, que siguió una metodología de enseñanza tradicional, y un grupo experimental, que participó en la actividad del escape room. Los resultados revelaron mejoras significativas en las calificaciones posteriores a la intervención en el grupo experimental. El estudio también evaluó la percepción estudiantil de la experiencia del escape room que demostró valoraciones muy satisfactorias.

SUMMARY: In the context of an active learning process, this study investigated the short-term and long-term academic performance of students in two practical sessions of the Histology course, which included an escape room activity. The impact of this approach on motivation and knowledge retention was also assessed. Students were divided into a control group, which followed a traditional teaching methodology, and an experimental group, which participated in the escape room activity. The results revealed significant improvements in post-intervention grades in the experimental group. Additionally, the study assessed students' perceptions of the escape room experience, which showed highly satisfactory evaluations.

Cortical volume reductions in men transitioning to first-time fatherhood reflect both parenting engagement and mental health risk.

Perinatal reductions in gray matter volume have been observed in human mothers transitioning to parenthood, with preliminary evidence for similar changes in fathers. These reductions have been theorized to support adaptation to parenting, but greater investigation is needed. We scanned 38 first-time fathers during their partner's pregnancy and again after 6 months postpartum, and collected self-report data prenatally and 3, 6, and 12 months postpartum. Significant gray matter volume reductions were observed across the entire cortex but not the subcortex. Fathers who reported stronger prenatal bonding with the unborn infant, and planned to take more time off from work after birth, subsequently showed larger cortical volume decreases. Larger reductions in gray matter volume also emerged among fathers who reported stronger postpartum bonding with the infant, lower parenting stress, and more time spent with their infant. Larger volume reductions predicted more postpartum sleep problems and higher levels of postpartum depression, anxiety, and psychological distress, controlling for prenatal sleep and mental health. Volume reductions were smaller among fathers whose infants were older at the postpartum scan, indicating potential rebound. These results suggest that perinatal gray matter volume reductions might reflect not only greater parenting engagement but also increased mental health risk in new fathers.

Women's neuroplasticity during gestation, childbirth and postpartum.

Pregnancy is a unique neuroplastic period in adult life. This longitudinal study tracked brain cortical changes during the peripartum period and explored how the type of childbirth affects these changes. We collected neuroanatomic, obstetric and neuropsychological data from 110 first-time mothers during late pregnancy and early postpartum, as well as from 34 nulliparous women evaluated at similar time points. During late pregnancy, mothers showed lower cortical volume than controls across all functional networks. These cortical differences attenuated in the early postpartum session. Default mode and frontoparietal networks showed below-expected volume increases during peripartum, suggesting that their reductions may persist longer. Results also pointed to different cortical trajectories in mothers who delivered by scheduled C-section. The main findings were replicated in an independent sample of 29 mothers and 24 nulliparous women. These data suggest a dynamic trajectory of cortical decreases during pregnancy that attenuates in the postpartum period, at a different rate depending on the brain network and childbirth type.

Gamificación educativa en el laboratorio de biología celular / Educational gamification in the cell biology laboratory

La incorporación de estrategias de gamificación en la docencia se ha descrito como una herramienta para aumentar la motivación y el compromiso de los alumnos con la materia. Bajo esta premisa, se ha desarrollado una experiencia de innovación educativa mediante la plataforma Kahoot! en la primera y última práctica de laboratorio de la asignatura de Biología Celular del Grado en Biología. Los participantes fueron 135 alumnos repartidos en 12 grupos de laboratorio, que se dividieron entre experimentales y controles. Todos los grupos resolvieron un cuestionario en papel acerca de los conceptos explicados en clase, al finalizar ambas prácticas (post-test), pero sólo aquellos grupos experimentales resolvían un cuestionario antes de la clase (pre-test). Antes de la primera práctica, los alumnos de los grupos experimentales respondieron al pre-test mediante el Kahoot! Sin embargo, para la última práctica algunos grupos lo resolvieron jugando al Kahoot! y otros, con papel y bolígrafo. Los resultados mostraron que aquellos alumnos que fueron seleccionados para jugar a Kahoot!, obtuvieron un mayor número de aciertos en el test realizado tras la sesión práctica (post-test) con respecto a aquellos que no resolvieron ningún pre-test o, que lo hicieron de un modo clásico. Por lo tanto, nuestros resultados sugieren que implementar la jugabilidad en la docencia incrementa considerablemente la motivación del alumnado debido, probablemente, a cambios fisiológicos experimentados por el cerebro durante el juego y a la creación de un clima positivo, que facilitan el proceso de aprendizaje.

SUMMARY: The incorporation of gamification strategies in teaching has been described as a tool to increase the motivation and engagement of students with the subject. Under this premise, an educational innovation experience has been developed using the Kahoot! platform in the first and last laboratory practice of the Cell Biology course of the Biology degree. The participants were 135 students divided into 12 laboratory groups, which were divided into experimental and control groups. All groups solved a questionnaire on paper about the concepts explained in class, at the end of both practices (post-test), but only the experimental groups solved a questionnaire before the class (pre-test). Before the first practice, students in the experimental groups answered the pre-test using Kahoot! However, for the last practice, some groups solved it by playing Kahoot! and others with pen and paper. The results showed that those students who were selected to play Kahoot! obtained a higher number of correct answers in the test performed after the practical session (post-test) than those who did not solve any pre- test or who did it in a classical way. Therefore, our results suggest that implementing gamification in teaching considerably increases student motivation, probably due to physiological changes experienced by the brain during the game and the creation of a positive climate, which facilitates the learning process.

Fibroxantoma atípico en un anciano / Atypical fibroxanthoma in an elderly

Se describe el caso clínico de un anciano de 72 años de edad, quien presentaba un tumor cutáneo dorsal maligno, por lo cual fue atendido de forma multidisciplinaria en 2 hospitales de la provincia de Santiago de Cuba. Dado el diagnóstico preoperatorio de epitelioma basocelular de piel se procedió a la extirpación del tumor de forma ambulatoria. El resultado del estudio anatomopatológico no confirmó dicho diagnóstico, pero sí corroboró que se trataba de un fibroxantoma atípico. Con los márgenes quirúrgicos de seguridad amplios se logró la curación del paciente.

The case report of a 72 years old man who presented a dorsal cutaneous neoplasm is described, reason why he was assisted in a multidisciplinary way in 2 hospitals from Santiago de Cuba. Given the preoperative diagnosis of skin basal cell epithelioma the tumor was removed in an ambulatory way. The result of the pathologic study didn't confirm this diagnosis, but it corroborated that it was an atypical fibroxanthoma. With the wide surgical margins of security the patient's cure was achieved.

Capacidad aeróbica, dieta mediterránea y riesgo cardiometabólico en adultos / Aerobic fitness, Mediterranean diet and cardiometabolic risk factors in adults

Introducción: Un estilo de vida poco activo y una dieta inadecuada podrían influir en el desarrollo de futuras enfermedades cardiometabólicas. El objetivo principal fue determinar la asociación entre capacidad aeróbica y factores de riesgo cardiometabólicos y si dicha posible asociación es independiente de la dieta mediterránea (DM). A su vez, se plantea como objetivo secundario estudiar el efecto combinado de la capacidad aeróbica y la adherencia a la DM sobre el índice de riesgo cardiometabólico global (IRCM) en adultos. Métodos: Se evaluó a 79 adultos (38% mujeres) entre 18 y 40 años en Cádiz. Se midieron indicadores de adiposidad, presión arterial, triglicéridos, glucosa y perfil inflamatorio (interleucina-6 y factor de necrosis tumoral) y se desarrolló un IRCM. Se midió la capacidad aeróbica mediante el consumo máximo de oxígeno a través de una prueba de esfuerzo incremental en cicloergómetro. La adherencia a la DM se evaluó mediante cuestionario. Se utilizó un modelo de regresión lineal para estudiar la asociación entre capacidad aeróbica y factores de riesgo cardiometabólicos con diferentes modelos de ajuste. Se analizó el efecto combinado de la capacidad aeróbica y la adherencia a la DM sobre el IRCM mediante el test de ANOVA, con nivel de significación de p < 0,05 en Bonferroni. Resultados: Se observó asociación negativa entre la capacidad aeróbica y los factores de riesgo cardiometabólicos (todas p ≤ 0,05) en el modelo sin ajustar. La presión arterial y los triglicéridos perdieron la asociación tras ajustar el modelo por sexo, edad y adherencia a la DM. Los participantes con alta capacidad aeróbica y alta adherencia a la DM mostraron un menor IRCM (-1,083 ± 2,325 vs. 2,802 ± 1,759). Conclusiones: La capacidad aeróbica se asocia de forma inversa con factores de riesgo cardiometabólicos relacionados con la adiposidad, independientemente de la adherencia a la DM. Una alta adherencia a la DM podría influir en la modulación de la presión arterial. Una alta capacidad aeróbica podría reducir las consecuencias adversas de una baja adherencia a la DM

Introduction: Unhealthy lifestyle and inadequate diet could influence the development of future cardiometabolic disease. The main aim of this study was to determine the association between aerobic fitness and cardiometabolic risk factors in adults, whether this relation is depends of adherence to Mediterranean diet (MD). A secondary aim was to study the combined effect of aerobic capacity and adherence to MD on global cardiometabolic risk score (CMRS). Method: A total of 79 adults (38% women) enrolled between 18-40 year from Cádiz. We measured adiposity indicators, blood pressure, triglycerides, glucose and inflammatory profile (interleukin-6 and tumor necrosis factor) and was computed (CMRS). Aerobic fitness was measured by maximal oxygen comsuption through an incremental stress test by cycleergometer. The MD patterns was measured using the questionnaire of adherence to MD. The association between aerobic fitness and cardiometabolic risk factors was examined using a lineal regression and it was adjusted for different confounders. CMRS on the lifestyle was analyzed using the ANOVA test, with statistical significance level of P < 0.05 in Bonferroni. Results: Linear regression showed inverse association between aerobic fitness and cardiometabolic risk factors (all P ≤ 0.05) in the model without adjustment. Blood pressure and triglycerides lost the association after adjust model for sex, age, and adherence to MD. Participants with high aerobic fitness and high adherence to MD show a lowest CMRS (-1.083 ± 2.325 vs. 2.802 ± 1.759). Conclusions: Aerobic fitness was inversely associated with fatness risk factors, that relationship is independent to adherence to MD. A high adherence to MD could modulate blood pressure. A combination of high aerobic capacity and high adherence to MD could reduce the adverse consecuence of a low adherencie to MD

Etnobotánica y territorio en el pastal de Mulluri (Norte de Chile): las enseñanzas del pastoreo aymara / Ethnobotany and territory in Mulluri ́s pasture (Northern Chile): the teachings of aymara pastoralism

A partir de un trabajo etnográfico centrado en las memorias territoriales de la comunidad aymara de Mulluri (Región de Arica y Parinacota, Norte de Chile) se propone que el pastoreo, un modo de vida tradicional de origen prehispánico, tiñe fuertemente la percepción del espacio de sus habitantes y la clasificación que elaboran en relación al mundo de las plantas. Se realizaron entrevistas y observación participante guiadas por un enfoque etnobotánico y espacial orientado a relevar sistemas clasificatorios y manejos ganaderos. Se analizaron las categorías "cordillera", "costa" y "valle" usadas por los comuneros para nombrar las distintas regiones geográficas o pisos ecológicos de la gradiente occidental andina, definidas por ellos a partir de variables climáticas, ecológicas, simbólicas y prácticas. Simultáneamente, al interior de estas macro regiones los comuneros reconocen zonas específicas según las asociaciones botánicas existentes. Éstas fueron conceptualizadas por los comuneros como "etapas de pasto", coincidiendo con los pisos vegetacionales definidos por la botánica. En relación a las plantas, se registraron categorías genéricas de acuerdo a sus formas de crecimiento ("pastos del champeal", "pajas" o wichu, t ́olas, "montes", "pastos de lluvia" y otros) así como nomenclaturas específicas por especie.

From an ethnographic work focused on the territorial memories of the Aymara community of Mulluri (Region of Arica and Parinacota, Northern Chile) it is proposed that pastoralism, as a traditional way of life of prehispanic origin, strongly colors the perception and systematic of space and of the world of plants. Interviews and participant observation were conducted guided by an ethnobotanical and spatial approach aimed at relieving classification systems and livestock management. The categories "cordillera", "costa" and "valle" used by the comuneros were analyzed to name the different geographical regions or ecological zones of the western Andean gradient, which are defined by them from climatic, ecological, symbolic and practice variables. Simultaneously, within these macro-regions the comuneros recognize specific zones according to the existing botanical associations. These were conceptualized by the comuneros as "pasture stages", coinciding fully with the vegetational areas defined by botany. In relation to the plants, generic categories were registered according to their growth forms ("pastos del champeal", "pajas" o wichu, t ́olas, "montes", "pastos de lluvia", among others) as well as specific nomenclatures by species.

Infección osteoarticular neumocócica en un hospital terciario durante un período de 11 años / Osteoarticular pneumococcal infections observed in a tertiary hospital over a period of 11 years

INTRODUCCIÓN: La infección osteoarticular neumocócica es una complicación poco frecuente de la bacteriemia neumocócica, debido a los avances en la terapia antibiótica y en el patrón de inmunización. MÉTODOS: Estudio retrospectivo de los pacientes con infección osteoarticular por neumococo entre enero de 2003 y diciembre de 2013 en un hospital tercer nivel. RESULTADOS: Cinco de los 321 pacientes con bacteriemia neumocócica presentaron infección osteoarticular. Todos padecían al menos una enfermedad crónica de base y habían sido inmunizados de acuerdo con el calendario vacunal habitual. La cadera y las vértebras fueron las más frecuentemente afectadas. La evolución fue favorable en todos los casos. CONCLUSIONES: Es necesario tener en cuenta las características clínicas de la infección osteoarticular neumocócica. Su prevención óptima en los pacientes de alto riesgo debe incluir la vacuna conjugada 13V

INTRODUCTION: Osteoarticular pneumococcal infection is an infrequent complication of pneumococcal bacteremia, due to the advances in antibiotic therapy and in the pattern of immunization. METHODS: A retrospective study was conducted on patients diagnosed with osteoarticular pneumococcal infection between January 2003 and December 2013 in the University Hospital Marqués de Valdecilla in Santander. RESULTS: Five out of 321 patients diagnosed with pneumococcal bacteremia had osteoarticular infection. All of them had at least one chronic underlying disease and had been immunized according to the standard vaccination schedule. Hip and vertebra were the most common joints involved. Outcome was favorable in all cases. CONCLUSIONS: The clinical findings of pneumococcal osteoarticular infection should be borne in mind. Its optimal prevention in high-risk patients should include the 13V conjugate vaccine

Síndrome calcio-alcalinos: actualización de un antiguo problema clínico / Calcium-alkali syndrome: Update of an old clinical problem

No disponible

Diagnóstico, manejo y tratamiento de la afectación digestiva en la fase crónica de la enfermedad de Chagas en países no endémicos / Diagnosis, management and treatment of chronic Chagas' gastrointestinal disease in areas where Trypanosoma cruzi infection is not endemic

La infección por Trypanosoma cruzi (T. cruzi), agente responsable de la enfermedad de Chagas, ha estado tradicionalmente ligada a las zonas rurales de América Latina, donde es transmitido por diversas especies de chinches. Esta situación epidemiológica ha ido cambiando en el transcurso de las últimas décadas, de forma que en la actualidad la enfermedad de Chagas es una patología importada diagnosticada a nivel urbano y un problema de salud pública en países no endémicos con gran número de población inmigrante, dónde la transmisión se puede producir durante el embarazo/parto, por transfusión sanguínea o por transplante de órganos. Se estima que hasta un 20% de los pacientes con infección por T. cruzi presentan afectación del aparato digestivo, que causa importante morbilidad y que requiere un manejo y tratamiento adecuado. En el presente documento se aborda el diagnóstico, manejo y tratamiento de las manifestaciones digestivas de pacientes con infección por T. cruzi en nuestro medio (AU)

Trypanosoma cruzi (T. cruzi) infection, causal agent of Chagas’ disease, has been traditionally limited to rural areas of Latinamerica, where it is transmitted by insects belonging to different species of bugs. Due to recent trends in migration, Chagas disease is now a public health problem in urban areas of endemic countries and in non endemic countries as well, where the transmission via blood products, transplantation of infected organs, or vertical transmission is possible. It is estimated that 20% of individuals infected with T. cruzi might develop symptomatic gastrointestinal disease, which causes important morbidity and needs an adequate management and treatment. The aim of this document is to improve patient care by increasing understanding among physicians and other healthcare professionals who may be involved in the management of patients infected by T. cruzi who present with gastrointestinal symptoms (AU)

Gengivite de origem inflamatória e terapêutica homeopática / Inflammatory gingivitis and homeopathic therapy

Foram estudados 40 pacientes com periodontopatias de origem inflamatória (gengivite) tipo crônicas com agudizaçäo. Aplicou-se o índice de análise de higiene bucal de Love (IAHB), o índice de sangramento e o índice gengival de Loe (IG) para medir a efetividade do medicamento homeopático (Calendula). Os resultados foram animadores.