Evaluation of Multiple RNA Extraction Protocols for Chikungunya Virus Screening in Aedes aegypti Mosquitoes.

Chikungunya virus (Togaviridae, Alphavirus; CHIKV) is a mosquito-borne global health threat. The main urban vector of CHIKV is the Aedes aegypti mosquito, which is found throughout Brazil. Therefore, it is important to carry out laboratory tests to assist in the virus's diagnosis and surveillance. Most molecular biology methodologies use nucleic acid extraction as the first step and require quality RNA for their execution. In this context, four RNA extraction protocols were evaluated in Ae. aegypti experimentally infected with CHIKV. Six pools were tested in triplicates (n = 18), each containing 1, 5, 10, 20, 30, or 40 mosquitoes per pool (72 tests). Four commercial kits were compared: QIAamp®, Maxwell®, PureLink®, and PureLink® with TRIzol®. The QIAamp® and PureLink® with TRIzol® kits had greater sensitivity. Two negative correlations were observed: as the number of mosquitoes per pool increases, the Ct value decreases, with a higher viral load. Significant differences were found when comparing the purity and concentration of RNA. The QIAamp® protocol performed better when it came to lower Ct values and higher RNA purity and concentration. These results may provide help in CHIKV entomovirological surveillance planning.

Efficacy between Conventional Laparoscopy and Robotic Surgery in Mexican Patients with Endometriosis: A Comparative Study.

Background. Surgical management of endometriosis is essential, and deep endometriosis involves the invasion of endometrial tissue into other organs such as the bladder, ureters, and rectum. In Latin American countries, significant expertise has been achieved in conventional laparoscopy (CL); however, there is less experience in robot-assisted laparoscopy (RAL) because of the high cost of this technique. For this reason, studies comparing CL and RAL for the treatment of deep endometriosis in patients are scarce, making this study the first to share the experience of Mexican patients. Aim. The efficacy of CL vs. RAL in the management of deep endometriosis in Mexican patients was compared. Materials and Methods. We performed a retrospective and comparative study. We considered all patients treated with minimally invasive surgery for deep endometriosis between 2015 and 2023. Results. A total of 93 patients were included; 56 patients were treated with CL, and 37 patients were treated with RAL. A significant difference (p < 0.05) was observed in the postoperative length of stay, which was longer in patients treated with CL compared with those treated with RAL. Additionally, postoperative pain was less frequent in patients treated with RAL than in those treated with CL (p < 0.05). We did not observe a significant difference in operative time, blood loss, or perioperative complications between the two surgical techniques (p < 0.05). Conclusions. CL and RAL are effective methods for managing endometriosis in Mexican patients; however, RAL is beneficial for the treatment of deep endometriosis because patients experience postoperative pain less frequently than CL patients and have a shorter postoperative length of stay.

Characterization and efficacy of Salmonella phage cocktail PHA46 in the control of Salmonella Newport and Typhimurium internalized into cherry tomatoes.

Non-typhoid Salmonella enterica causes salmonellosis illness, and this bacterium can contaminate food throughout the production chain, including those that are consumed as raw products. Salmonella enterica can adhere to and internalize into fresh produce such as cherry tomatoes. It has been reported that lytic bacteriophages (phages) can be used as a biocontrol agent in the agricultural field, being an alternative for the control of Salmonella in red meat, fish, lettuce, and cabbage. The aim of this study was to characterize the two phages present in the PHA46 cocktail to determine their morphology, genome, host range, and resistance to different temperatures and pHs values; and later evaluate their lytic activity to reduce the adherence to and internalization of Salmonella enterica serovars Newport and Typhimurium into cherry tomatoes. In addition, in this work, we also explored the effect of the PHA46 cocktail on the virulence of S. Newport-45 and S. Typhimurium SL1344, recovered from the interior of cherry tomatoes, on the lifespan of the animal model Caenorhabditis elegans. The nematode C. elegans, recently has been used to test the virulence of Salmonella and it is easy to maintain and work with in the laboratory. The results revealed that the morphology obtained by Transmission Electron Microscopy of two phages from the PHA46 cocktail correspond to a myovirus, the analyses of their genomes sequences did not report virulence or antimicrobial resistance genes. The PHA46 sample is specific for 33 different serovars from different Salmonella strains and shows stability at 7 °C and pH 6. Also, the PHA46 cocktail was effective in reducing the adherence of S. Newport-45 and S. Typhimurium SL1344 to cherry tomatoes, at an average of 0.9 log10, respectively. Regarding internalized bacteria, the reduction was at an average of 1.2 log10, of the serovars mentioned above. The lifespan experiments in C. elegans showed by itself, that the PHA46 cocktail was harmless to the nematode, and the virulence from both Salmonella strains grown in vitro is diminished in the presence of the PHA46 cocktail. In conclusion, these results showed that the PHA46 cocktail could be a good candidate to be used as a biocontrol agent against Salmonella enterica.

Microsclerotia from Metarhizium robertsii: Production, ultrastructural analysis, robustness, and insecticidal activity.

Microsclerotia (MS) are considered one of the most promising propagules for use as active ingredients in biopesticides due to their tolerance to abiotic factors and ability to produce infective conidia for the control of pests. Therefore, the objective of this research was to establish the conditions required to induce the formation of microsclerotia in Metarhizium robertsii Mt004 and to study its development process, tolerance to abiotic factors and insecticidal activity of MS-derived conidia. M. robertsii started to form hyphal aggregates after 2 days and looked more compact after 8 days. MS were mature and pigmented after 20 days. The final yield was 2.0 × 103 MS/mL and MS size varied between 356.9 and 1348.4 µm. Ultrastructure analysis revealed that mature MS contained only a few live cells embedded in an extracellular matrix. Mature MS were more tolerance to UV-B radiation, heat and storage trials than conidia from Solid State Fermentation. MS-derived conidia were as virulent as conidia against Diatraea saccharalis larvae. These results showed that MS are promising propagules for the development of more persistent and efficient biopesticides for harsh environmental conditions. Our findings provide a baseline for production and a better understanding of microsclerotia development in M. robertsii strains.

Los principios bioéticos de los médicos generales integrales en la prescripción de medicamentos

Introducción: Durante el acto de la prescripción se deben relacionar los conocimientos de la terapéutica con los principios de la bioética para contribuir al uso racional de medicamentos. En el artículo se analiza el cumplimiento de los principios bioéticos relacionados con las prescripciones de medicamentos por los médicos generales integrales del municipio Santiago de Cuba. Métodos: Se realizó un estudio descriptivo transversal con una muestra de médicos generales integrales en el que se emplearon métodos teóricos, empíricos y matemáticos estadísticos, así como la triangulación metodológica. Se consideró como variable el cumplimiento de los principios bioéticos relacionados con las prescripciones de medicamentos y cinco indicadores que fueron valorados mediante encuesta, entrevista y observación del desempeño. Resultados: Se encontró que los médicos generales integrales alcanzaron un nivel alto de cumplimiento de los principios bioéticos relacionados con las prescripciones de medicamentos con un valor de media ponderada de 2,94. La valoración de la frecuencia de realización de los indicadores evidenció que tres de ellos fueron considerados del nivel alto, dos de nivel medio y ninguno de nivel bajo. Discusión: los resultados fueron confrontados con otros estudios y se confirma que los médicos generales integrales en Cuba por su formación humanista cumplen con la mayoría de los principios bioéticos en su desempeño profesional.

Introduction: During the act of prescription, therapeutic knowledge must be related to the principles of bioethics to contribute to the rational use of medications. The article analyzes compliance with bioethical principles related to medication prescriptions by comprehensive general practitioners of the Santiago de Cuba municipality. Methods: A cross-sectional descriptive study was carried out with a sample of comprehensive general practitioners in which theoretical, empirical and mathematical statistical methods were used, as well as methodological triangulation. Compliance with bioethical principles related to medication prescriptions and five indicators that were assessed through a survey, interview and performance observation were considered as variables. Results: It was found that comprehensive general practitioners reached a high level of compliance with bioethical principles related to medication prescriptions with a weighted mean value of 2.94. The assessment of the frequency of carrying out the indicators showed that three of them were considered high level, two medium level and none low level. Discussion: the results were compared with con studies and it is confirmed that comprehensive general practitioners in Cuba, due to their humanistic training, comply with most of the bioethical principles in their professional performance.

Detection of a Multiple Circulation Event of Dengue Virus 2 Strains in the Northern Region of Brazil.

Dengue virus serotype 2 (DENV-2) is responsible for dengue epidemics on a global scale and is associated with severe cases of the disease. This study conducted a phylogenetic investigation of DENV-2 isolates from 2017 to 2021 originating from the northern states of Brazil. A total of 32 samples from DENV-2 isolates were analyzed, including 12 from Acre, 19 from Roraima, and one from Tocantins. Only one lineage of the Asian-American genotype and one lineage of the cosmopolitan genotype were observed: Lineage 1, Asian-American genotype (connection to Puerto Rico); Lineage 5, cosmopolitan genotype (connection to Peru). Our results provide important data regarding the study of DENV genotypes and lineage distribution and open up possibilities for probable introduction and dissemination routes.

Incidence of major cardiovascular events at 1, 2, and 5 years and mortality in incident patients on peritoneal dialysis regarding their nutritional status by bioimpedanciometry: A multicenter study in Colombia.

BACKGROUND: The nutritional status of incident patients on peritoneal dialysis (PD) has been associated with survival outcomes. Bioimpedanciometry (BCM) enables to establish a nutritional diagnosis, the volume status, and correlates these findings with survival. METHODS: This study used a retrospective multicenter historical cohort. RESULTS: In this study, which included 420 incident patients on peritoneal dialysis with a 5-year follow-up, a cumulative incidence of major adverse cardiovascular events (MACE) of 28.8% was found, being higher in the diabetic population at 36.8%. In regard to the nutritional status in this population, it was found that approximately 44% had altered nutritional status; 34% were found to be in sarcopenia; 6.7% sarcopenic obesity; and 2.8% in obesity (p < 0.001). In the survival analysis, a lower probability of survival was found in patients with overhydration (OH) greater than 3 L (p < 0.001) and in patients with altered nutritional status due to sarcopenia, sarcopenic obesity, and obesity (p 0.016). According to survival in the subgroup of the diabetic population, a lower probability of survival was found in this group of patients (p: 0.011). The overall mortality of the study population was 18%, being higher in the first 2 years, with the most important causes of mortality being cardiovascular. Of the deceased population, 51% were diabetic patients (p: 0.012). CONCLUSION: In incident patients on peritoneal dialysis, sarcopenic obesity, sarcopenia, overhydration status determined by BCM, and having a diagnosis of diabetes are related to a lower probability of survival; MACE outcomes are more frequent in the diabetic population.

Actividades de superación profesional de médicos generales integrales sobre el uso racional de medicamentos / Professional training activities of comprehensive general doctors on the rational use of medications i: en

Introducción: El uso irracional de medicamentos se debe, entre otros elementos, a la falta de superación profesional; situación con mayor repercusión en la atención primaria de salud, donde generalmente laboran los médicos generales integrales. Objetivo: Caracterizar las actividades de superación profesional de médicos generales integrales sobre el uso racional de medicamentos. Métodos: Se realizó un estudio descriptivo y transversal de 269 médicos generales integrales que laboraban en los consultorios del médico de la familia o en los servicios de urgencia de las 17 áreas de salud del municipio de Santiago de Cuba en el período comprendido desde enero hasta julio de 2022, quienes fueron seleccionados mediante muestreo probabilístico por conglomerado bietápico. Se consideró como variable las actividades de superación profesional relacionadas con el uso racional de medicamentos, las cuales fueron valoradas a través de 5 indicadores. Resultados: La triangulación metodológica de los resultados evidenció que el nivel alcanzado en cuanto a la frecuencia de realización de dichas actividades fue bajo (índice de 1,18), al igual que lo obtenido en los indicadores analizados, excepto en el referido a la autopreparación que mostró un nivel medio. Conclusiones: Las actividades de superación profesional de los médicos generales integrales relacionadas con el uso racional de medicamentos en el municipio de Santiago de Cuba se caracterizaron por un nivel bajo de frecuencia de realización.

Introduction: Irrational use of medications is, among other elements, due to the lack of professional training; situation with more repercussion in primary health care, where comprehensive general doctors generally work. Objective: To characterize the professional training activities of comprehensive general doctors on the rational use of medications. Methods: A descriptive and cross-sectional study of 269 comprehensive general doctors who worked in the family doctor offices or in the emergency services of the 17 health areas of Santiago de Cuba municipality was carried out from January to July, 2022, who were selected by means of a probabilistic sampling by biphase conglomerate. The activities of professional training related to the rational use of medications were considered as variable, which were valued through 5 indicators. Results: The methodological triangulation of the results evidenced that the level reached as for the frequency of realization of this activities was low (index of 1.18), as well as what was obtained in the analyzed indicators, except the one referred to the self-preparation which showed a mean level. Conclusions: Professional training activities of comprehensive general doctors related to the rational use of medications in Santiago de Cuba municipality were characterized by a low level of realization frequency.

Análisis del programa de Farmacología Clínica en el plan de estudio E para la carrera de Medicina / Analysis of the program of Clinical Pharmacology in the E plan study for the Medicine career i: en

Introducción: En Cuba han existido varias concepciones sobre planes de estudio. La necesidad de revisar y proponer cambios que aseguren los niveles de calidad deseados en el proceso de formación integral de los futuros profesionales motivó a investigar los elementos teóricos y metodológicos que regulan y orientan el proceso de enseñanza-aprendizaje en la asignatura Farmacología Clínica. Objetivo: Analizar el programa de Farmacología Clínica del plan de estudio E para la carrera de Medicina desde un enfoque crítico y sistematizado. Métodos: Se realizó un estudio cualitativo del programa de estudio de la asignatura Farmacología Clínica según el plan E, vigente en la Universidad de Ciencias Médicas de Santiago de Cuba, durante el 2022, para lo cual se utilizaron los métodos de revisión documental, los documentos rectores del proceso docente en la educación superior y la metodología propuesta por algunos autores. Resultados: Varios temas enunciaban un número excesivo de objetivos específicos sin tener en cuenta el nivel de asimilación; la forma de organización de la enseñanza más utilizada fue la conferencia. En las evaluaciones frecuentes no se tuvo en cuenta el trabajo investigativo independiente; en tanto, la bibliografía básica correspondió a una edición del 2002. Conclusiones: El programa no requirió trasformaciones temáticas, pero desde el punto de vista didáctico deben modificarse componentes del proceso de enseñanza-aprendizaje y, además, se debe actualizar la bibliografía básica pertinente.

Introduction: In Cuba several conceptions have existed on the study plans. The necessity to revise and propose changes that assure the levels of quality wanted in the process of integral formation of the future professionals motivated to investigate the theoretical and methodological elements that regulate and guide the teaching-learning process in the Clinical Pharmacology subject. Objective: To analyze the program of Clinical Pharmacology of the E plan study for the medicine career, from a critical and systematized approach. Methods: A qualitative study of the study program in the Clinical Pharmacology subject was carried out according to the E plan, effective in the University of Medical Sciences in Santiago de Cuba, during 2022, for which the methods of documental review, the rector documents of the teaching process in higher education and the methodology proposed by some authors were used. Results: Several topics enunciated an excessive number of specific objectives without taking into account the level of assimilation; the form of organization most used in teaching was the conference. Independent investigative work was not taken into account in frequent evaluations; meanwhile, the basic bibliography corresponded to an edition from 2002. Conclusions: The program did not require of thematic transformations, but from the didactic point of view components of the teaching-learning process should be modified, besides updating the pertinent basic literature.

Eventos adversos del nimotuzumab en pacientes con tumor cerebral primario / Adverse events to the nimotuzumab in patients with primary cerebral tumor

Introducción: El nimotuzumab es un anticuerpo monoclonal empleado en el tratamiento de pacientes con tumor cerebral. Dada su novedad se justifica la realización de estudios de farmacovigilancia que avalen su seguridad. Objetivo: Caracterizar los eventos adversos relacionados con este medicamento en la práctica médica habitual. Métodos: Se realizó un estudio descriptivo y transversal de 41 pacientes con tumor cerebral primario tratados con nimotuzumab en el Departamento de Ensayos Clínicos del Hospital Provincial Docente Saturnino Lora Torres de Santiago de Cuba, desde mayo de 2017 hasta abril de 2019. Resultados: En la serie se identificaron 31 eventos adversos, de los cuales 17 eran conocidos y 14 desconocidos. Predominaron la cefalea (80,5 %), la debilidad en miembros inferiores (48,8 %) y la fosfatasa alcalina elevada (41,5 %). Cabe destacar que el total de los efectos no deseados se consideraron ligeros, según su intensidad; reversibles, según sus resultados y sin cambios, según la actitud respecto al medicamento. Conclusiones: Las características de los eventos adversos encontrados se asemejan a las descritas en otros estudios que también avalan la seguridad del fármaco.

Introduction: The nimotuzumab is a monoclonal antibody used in the treatment of patients with cerebral tumor. The realization of pharmaco surveillance studies that guaranteed its security is justified given its new features. Objective: To characterize the adverse events related to this medicine in the habitual medical practice. Methods: A descriptive and cross-sectional study of 41 patients with primary cerebral tumor treated with nimotuzumab in the Clinical Trial Department of Saturnino Lora Torres Teaching Provincial Hospital was carried out in Santiago de Cuba, from May, 2017 to April, 2019. Results: In the series 31 adverse events were identified, of which 17 were known and 14 were unknown. There was a prevalence of the headache (80.5 %), weakness in lower members (48.8 %) and the high alcaline phosphatase (41.5 %). It is necessary to highlight that all the non wanted effects were considered light according to the intensity; reversible, according to the results and without changes, according to the attitude regarding the medicine. Conclusions: The characteristics of the adverse events that were found resemble to those described in other studies that also guarantee the security of the drug.

Superación profesional sobre uso racional de medicamentos dirigida a los médicos generales integrales / Professional improvement on the rational use of medications intended comprehensive general practitioners

RESUMEN Fundamento: el vertiginoso avance de la industria farmacéutica exige al médico general integral un proceso de superación continuo que favorezca el uso racional de los medicamentos. Objetivo: caracterizar la superación de estos profesionales relacionada con el uso racional de medicamentos en la Facultad de Medicina 1 de Santiago de Cuba. Métodos: se realizó un estudio descriptivo transversal en el que se analizaron las actividades de superación profesional de cinco cursos académicos desde el 2014 al 2019 a través de la revisión documental de los planes de superación profesional, así como los programas correspondientes. Resultados: las actividades relacionadas con el uso racional de medicamentos eran insuficientes y con tendencia a la disminución de un curso a otro; la forma de organización del posgrado más empleada fueron los cursos, seguidas de los talleres. Para incorporar los contenidos de uso racional de medicamentos se utilizaron, con más frecuencia, elementos de terapéutica de una enfermedad o grupo de estas así como la introducción de la medicina natural y tradicional. En las actividades se abordaron aspectos novedosos, pero no se hizo referencia a la terapéutica razonada. Conclusiones: se caracterizó la superación profesional para los médicos generales integrales relacionada con el uso racional de medicamentos la cual fue valorada como insuficiente por lo que urge retomar los aspectos que resultaron deficitarios en esta caracterización.

ABSTRACT Background: the vertiginous advance of the pharmaceutical industry demands from the comprehensive general practitioner a continuous improvement process that favors the rational use of medications. Objective: to characterize the improvement of these professionals related to the rational use of medications in the Faculty of Medicine 1 of Santiago de Cuba. Methods: a cross-sectional descriptive study was carried out in which the professional improvement activities of five academic courses from 2014 to 2019 were analyzed through the documentary review of the professional improvement plans, as well as the corresponding programs. Results: the activities related to the rational use of medications were insufficient and tended to decrease from one course to another; the most used form of postgraduate organization were courses, followed by workshops. To incorporate the contents of rational use of medications, therapeutic elements of a disease or group of diseases were used, as well as the introduction of Herbal and Folk medicine. In the activities, novel aspects were addressed, but no reference was made to reasoned therapy. Conclusions: professional improvement for comprehensive general practitioners related to the rational use of medications was characterized, which was assessed as insufficient, so it is urgent to retake the aspects that were deficient in this characterization.

Tendencias históricas en el proceso de dirección académica de la Facultad de Medicina No. 1 de Santiago de Cuba / Historical tendencies in the academic direction process of the Medicine Faculty No. 1 from Santiago de Cuba

El proceso de dirección académica de la Facultad de Medicina No. 1 de Santiago de Cuba, tuvo sus cimientos en el contexto de la Universidad de Oriente en 1962. Desde su fundación se ha concebido para redimensionar la academia, a tono con los problemas de salud de la población. Lo anterior posibilitó constatar, mediante la revisión de distintas publicaciones relacionadas con historia de la medicina, la carencia de estudios que analicen la dirección académica en la estructura de la facultad, como proceso integral e integrado, por lo cual se realizó el presente estudio con el objetivo de caracterizar las tendencias que distinguen el desarrollo de la dirección académica en el contexto educativo enunciado. Al respecto, se determinan los fundamentos que sustentan la necesidad de su perfeccionamiento. Se concluye, que se requiere de una gestión científico-metodológica pertinente, que impacte el entorno santiaguero, para satisfacer los problemáticas esenciales de salud, climáticas y sociales.

The process of academic direction of the Medicine Faculty No. 1 from Santiago de Cuba, had its foundations in the context of Oriente University in 1962. Since its foundation it has been conceived to resize the academy, according to the population health problems. The above-mentioned facilitated to verify, by means of the revision of different publications related to the history of medicine, the lack of studies that analyze the academic direction in the faculty structure, as integral and integrated process, reason why the present study was carried out aimed at characterizing the tendencies that distinguish the development of the academic direction in the enunciated educational context. In this respect, the foundations that sustain the necessity of its improvement are determined. It was concluded that a pertinent scientific-methodological administration that impacts the Santiago environment is required to satisfy the essential health, climatic and social problems.

La actualización sobre el uso racional de medicamentos en el proceso de superación del médico general integral en Cuba: aspectos históricos / Upgrading on the rational use of medications in the training process of the comprehensive general doctor in Cuba: historical aspects

La relevancia y el alcance del uso racional de medicamentos y su contribución al mejoramiento de la salud poblacional constituyen suficientes argumentos para que el médico general integral en Cuba lo adopte como modalidad de superación que cualifica su desempeño profesional. Al respecto, se han desarrollado varios estudios históricos sobre la superación de este especialista; sin embargo, se requiere profundizar en determinados temas que pueden aportarle un sentido renovador como prescriptor de medicamentos. A tal efecto, en este artículo se exponen los antecedentes del proceso de educación de posgrado de este galeno, con énfasis en la actualización sobre el uso racional de medicamentos. Pudo concluirse que existen vacíos importantes en el diseño de superación profesional en cuanto al uso racional de medicamentos en la atención primaria de salud; no obstante, se reconoce la trascendencia social de esa problemática por parte de los niveles directivos correspondientes.

The relevance and reach of the rational use of medications and their contribution to the improvement of the populational health constitute enough arguments so that the comprehensive general doctor in Cuba adopts it as training modality that qualifies his professional performance. In this respect, several historical studies have been developed on the training of these specialists; however, it is required to deepen in certain topics that can contribute a renovating sense to them as drugs prescribers. To such an effect, the history of the postdegree educational process of this doctor is exposed in this work, with emphasis in upgrading on the rational use of medications. It could be concluded that there are important gaps in the training design as for the rational use of medications in the primary health care; nevertheless, the social transcendency of that problem is recognized on the part of the corresponding directive levels.

Evaluación de la prescripción de medicamentos en niños y adolescentes con hipertensión arterial / Evaluation of the medications prescription in children and adolescents with hypertension

Introducción: El tema de la tensión arterial en niños y adolescentes ha cobrado un marcado interés en los últimos años, debido al incremento de su prevalencia en este grupo poblacional Objetivo: Evaluar la prescripción de medicamentos en niños y adolescentes con hipertensión arterial atendidos en el Hospital Infantil Norte Dr. Juan de la Cruz Martínez Maceira de Santiago de Cuba. Métodos: Se realizó una investigación observacional, descriptiva y transversal, que se corresponde con un estudio de utilización de medicamentos, del tipo indicación-prescripción, esquemas terapéuticos y consecuencias prácticas, de 39 pacientes con diagnóstico de hipertensión arterial atendidos en el Servicio de Cardiología del mencionado centro hospitalario, desde enero hasta diciembre de 2018, quienes cumplieron los criterios de selección establecidos. Se utilizaron variables principales (prescripción y reacciones adversas) y de control (edad, color de la piel, sexo y factores de riesgo). Resultados: Predominaron el sexo masculino (79,4 %), el grupo etario de 15-18 años (66,6 %), la hipertensión arterial primaria (estadio 1), los pacientes de piel negra y la obesidad como factor de riesgo mayormente identificado (58,9 %). Conclusiones: Las prescripciones fueron evaluadas en su mayoría como adecuadas, lo que demuestra el enfoque preventivo y el uso racional de los medicamentos.

Introduction: The topic of blood pressure in children and adolescents has taken a marked interest in the last years, due to the increment of its prevalence in this population group Objective: To evaluate the prescription of medications in children and adolescents with hypertension assisted in Dr. Juan de la Cruz Martínez Maceira Northern Children Hospital in Santiago de Cuba. Methods: An observational, descriptive and cross-sectional investigation that squared with a medications use study, of indication-prescription type, therapeutic outlines and practical consequences, of 39 patients with diagnosis of hypertension assisted in the Cardiology Service of the hospital abovementioned, was carried out from January to December, 2018, who fulfilled the established selection approaches. Main variables (prescription and adverse reactions) and control variables (age, skin colour, sex and risk factors) were used. Results: There was a prevalence of the male sex (79.4 %), 15-18 age group (66.6% ), primary hypertension (stage 1), black skin patients and obesity as the risk factor mostly identified (58.9 %). Conclusions: The prescriptions were evaluated in their majority as appropriate, what demonstrates the preventive approach and the rational use of medications.

Indicadores antropométricos y descontrol glucémico en diabetes tipo 2 con enfermedad renal / Anthropometric indicators and poor glycemic control in type 2 diabetes with kidney disease

Introducción: la relación de los indicadores antropométricos y de composición corporal, con la evolución de la enfermedad renal en pacientes con diabetes tipo 2 sigue siendo controversial. Objetivo: identificar la asociación de los indicadores de la enfermedad renal con indicadores de control metabólico y antropométricos en pacientes con diabetes tipo 2. Material y métodos: se realizó un estudio transversal analítico en 395 pacientes del primer nivel de atención. La glucosa, hemoglobina glucosilada (HbA1c), perfil de lípidos y creatina se midió en ayuno. La enfermedad renal crónica (ERC) se consideró cuando la excreción de albumina urina- ria (EAU) > 30 mg/g y con la reducción del nivel de la tasa de filtrado glomerular < 60 mL/min/1.73 m2, utilizando la ecuación CKD-EPI. Se midió el peso y circunferencia de cintura, así como la composición corporal a través de bioimpedancia. Resultados: un 17% de la población presentó ERC con alteración de la EAU y 6.6% con una TFG reducida. Un mayor tiempo de diagnóstico de la enfermedad, mayor nivel de HbA1c y menor nivel grasa corporal se asoció a una EAU > 30 mg/g, (p < 0.05). La disminución de la TFG (< 60 mL/ min/1.73 m2) se asoció con mayor edad, ser mujer, tener mayor circunferencia de cintura y menor porcentaje de grasa corporal (p < 0.05). Conclusiones: un mayor nivel de circunferencia de cintura y menor porcentaje de grasa corporal se asocian a mayor evolución de la ERC en pacientes con diabetes tipo 2. El descontrol glucémico se identificó en pacientes con mayor excreción de albumina urinaria.

Background: The relationship of anthropometric and body composition indicators with the evolution of kidney disease in patients with type 2 diabetes, is still inconsistent. Objective: To identify the association of indicators of kid- ney disease with indicators of metabolic and anthropometric control in patients with type 2 diabetes. Material and methods: An analytical cross-sectional study was carried out in 395 patients of the first level of care. The glucose, glycosylated hemoglobin (HbA1c), creatinine and lipid profile were measured. The kidney disease (CKD) was made when urinary albumin excretion (UAE) > 30 mg/g and with a reduction in the level of glomerular filtration rate < 60 mL/min/1.73 m2, using the CKD-formula. Weight and waist circumference were measured, as well as the body composition through bioimpedance. Results: Seventeen percent of the population has a diagnosed with CKD with alteration of the UAE and 6.6% had a reduced GFR. A longer time of diagnosis of the diabetes, hig- her HbA1c level and body fat were associated with an UAE > 30 mg/g, (p < 0.05). The decline in GFR (< 60 mL/min/ 1.73 m2) was associated with older age, being a woman, greater waist circumference, and a higher percentage of body fat (p < 0.05). Conclusions: A higher level of waist circumference and a lower percentage of body fat are associated with a greater evolution of chronic kidney disease in patients with type 2 diabetes. Glycemic uncontrol is identified in patients with high urinary albumin excretion.

Neural therapy approach in a hospitalized patient with acute stress disorder. case report

ABSTRACT Introduction: Acute stress disorder is a picture of rapid onset that follows a traumatic event. It is characterized by dissociative, intrusive, avoidance and activation symptoms that affect the quality of life of the patient. To date, there is no evidence of a relationship between altered organ function and this disorder, and there is no literature on its treatment with neural therapy on an inpatient basis. Case presentation: 53-year-old woman, who developed symptoms compatible with acute stress disorder after the resection of an intra-abdominal mass diagnosed as lymphoma. The patient was assessed by the neural therapy department, which applied procaine into specific skin zones -determined by the clinical history and physical examination-, with improvement of dissociated symptoms. Discussion: The neural therapy approach allowed identifying the relationship between the dissociative symptoms of the patient and the associated alteration in organ function, as well as applying a therapy that led to the resolution of the symptoms. Conclusions: The neural therapy approach allows for a comprehensive perspective and treatment of the patient, taking into account the close functional relationship between mind-emotions-body. This type of treatment also offers therapeutic strategies to hospitals, which can accompany the treatment established by other health specialists.

RESUMEN Introducción. El trastorno por estrés agudo es un cuadro de rápida instauración que se da luego de un evento traumático y se caracteriza por síntomas disociativos, intrusivos, de evitación y de activación que afectan la calidad de vida del paciente. A la fecha, no se ha evidenciado una relación causal orgánica de este trastorno y tampoco existe literatura sobre su intervención mediante terapia neural intrahospitalaria. Presentación del caso. Paciente femenino de 53 años quien desarrolló síntomas compatibles con un trastorno por estrés agudo posterior a la resección de una masa abdominal secundaria a un linfoma. La mujer fue valorada por el servicio de medicina neuralterapéutica, que intervino con procaína en sitios específicos de la piel -determinados por anamnesis y examen físico- con posterior mejoría de los síntomas disociativos. Discusión. El enfoque neuralterapeútico permitió, por un lado, identificar un vínculo entre los síntomas disociativos de la paciente y la alteración orgánica asociada, y, por el otro, hacer una intervención con la que se logró la resolución de tales síntomas. Conclusiones. La medicina neuralterapéutica ofrece estrategias de intervención a nivel hospitalario que pueden ir concomitantes al tratamiento instaurado por otras profesiones en el área de la salud ya que permite tener una perspectiva integral del paciente al considerar la estrecha relación funcional entre mente, emociones y cuerpo.

Fungicidal activity of volatile organic compounds from Paenibacillus bacteria against Colletotrichum gloeosporioides / Actividad fungicida de compuestos orgánicos volátiles de la bacteria Paenibacillus contra Colletotri chum gloeosporio ides / Atividade fungicida de compostos orgânicos voláteis da bactéria Paenibacillus contra Colletotrichum gloeosporioides

Abstract Some bacteria release volatile organic compounds (VOCs) that can influence the growth of other microorganisms including some pathogens. Identifying bacteria with antifungal activity makes it possible to use such bacteria in the development of biocontrol agents. Thus, the present study focuses on screening VOCs released by eight isolates from Paenibacillus genus, collected at Old Providence and Santa Catalina coral reef (Colombian Caribbean Sea), with antifungal activity against phytopathogenic fungi Colletotrichum gloeosporioides 26B. The VOCs from Paenibacillus sp (PNM-50) showed inhibition rates higher than 50% in the mycelial fungi growth accompanied by macroscopic morphological changes and a reduction in conidiation. In order to identify the VOCs responsible for this antifungal bioactivity, Headspace-Solid Phase Microextraction (HS-SPME) from the bacterial culture was conducted, followed by Gas Chromatography Mass Spectrometry (GC-MS). The chromatographic results revealed a high abundance of VOCs released just by culture media. Once, the difference between VOCs emitted by culture media and bacteria was established, it was possible to make a putative identification of 2-furanmethanol, phenylacetonitrile, and 2,4-dimethylpentanol as possible VOCs responsible for the antifungal activity.

Resumen Algunas bacterias liberan compuestos orgánicos volátiles (COVs) que pueden influir en el crecimiento de otros microorganismos incluyendo algunos patógenos. La identificación de bacterias con actividad antifúngica hace posible el uso de tales bacterias en el desarrollo de agentes de biocontrol. Así pues, en este estudio, se realizó un examen dirigido exclusivamente a los COVs emitidos por ocho aislamientos bacterianos del género Paenibacillus, recolectados en el arrecife de coral de Providencia y Santa Catalina (Mar Caribe colombiano), con actividad antifúngica contra el hongo fitopatógeno Colletotrichum gloeosporioides 26B. Los COVs del aislamiento Paenibacillus sp (PNM-50) mostraron tasas de inhibición superiores al 50% en el crecimiento micelial del hongo, acompañado de cambios morfológicos macroscópicos y una reducción en la conidiación. Para identificar los COVs responsables de esta bioactividad antifúngica, se realizó microextracción en fase sólida del espacio de cabeza (HS-SPME) del cultivo de las bacterias y posterior análisis por cromatografía de gases acoplada a espectrometría de masas (GC-MS). Los resultados cromatográficos revelaron gran abundancia de COVs emitidos por los medios de cultivo. Una vez que se estableció la diferencia entre los COVs emitidos por el medio de cultivo y las bacterias, fue posible identificar tentativamente 2-furanmetanol, fenilacetonitrilo y 2,4-dimetilpentanol como COVs posiblemente responsables de la actividad antifúngica.

Resumo Algumas bactérias liberam compostos orgânicos voláteis (COV) que podem influenciar o crescimento de outros microorganismos, incluindo alguns patógenos. A identificação de bactérias com atividade antifúngica, possibilita seu uso no desenvolvimento de agentes de biocontrole. Neste estudo, foi realizada uma triagem focada nos COV liberados por oito isolados bacterianos do gênero Paenibacillus, coletados nos recifes de coral Old Providence e Santa Catalina (mar do Caribe colombiano), com atividade antifúngica contra fungos fitopatogênicos Colletotrichum gloeosporioides 26B. Os COV de Paenibacillus sp (PNM-50) apresentaram taxas de inibição superiores à 50% sobre o crescimento de fungos miceliais, acompanhadas de alterações morfológicas macroscópicas e redução da conidiação. Para identificar os COV responsáveis por essa bioatividade antifúngica, foi conduzida uma Microextração de Fase Sólida Headspace (HS-SPME) da cultura bacteriana e, em seguida, foi analisada por Cromatografia Gasosa associada à Espectrometria de Massa (GCMS). Os resultados cromatográficos revelaram uma alta abundância de COVs liberados apenas pelos meios de cultura. Uma vez estabelecida a diferença entre os COV emitidos pelos meios de cultura e bactérias, foi possível fazer uma identificação parcial de 2-furanmetanol, fenilacetonitrila e 2,4-dimetilpentanol como possíveis COV responsáveis pela atividade antifúngica.

Time use in daily activities by Chilean overweight and obese adolescents / Uso del tiempo en actividades diarias por adolescentes chilenos con sobrepeso y obesidad

Abstract Introduction: Obesity is a global serious public health issue. According to the World Health Organization, insufficient physical activity and increased sedentary behaviors are the leading causes of this condition. Objective: To compare the time that overweight/obese and normal-weight adolescents spend in daily activities according to sex and the type of school they attend. Materials and methods: Quantitative and analytical research. 106 Chilean teenagers were assessed to determine their nutrition diagnosis based on their weight, height, pubertal development (Tanner stages) and body mass index. A written survey was used to collect data on how they spend their time in different activities during a typical day on weekdays. Statistical analysis was performed using the Mann-Whitney U test, in which two non-parametric samples are compared. Results: Statistically significant differences regarding the distribution of the time that adolescents devote to engaging in social participation and leisure time activities were observed: overweight/obese teenagers spend less time in these activities. Conclusion: the way that adolescents use their time could be considered as a risk factor for obesity that requires a deeper analysis. Overweight and obese adolescents have a low participation rate in social participation and leisure activities. Undoubtedly, how time is spent is increasingly regarded as a well-being indicator; therefore, further research should focus on the effectiveness of interventions based on the modification of daily routines.

Resumen Introducción. La obesidad es un problema serio de salud pública en el mundo. La Organización Mundial de la Salud señala que la actividad física insuficiente y el aumento de actividades sedentarias son sus principales causas. Objetivo. Comparar el uso del tiempo en ocupaciones diarias entre adolescentes con y sin sobrepeso/obesidad, según sexo y tipo de colegio. Materiales y métodos. Investigación de tipo cuantitativo y diseño analítico. Se evaluaron 106 adolescentes chilenos para determinar diagnóstico nutricional según peso, talla, desarrollo puberal (estadio de Tanner) e índice de masa corporal. Mediante una encuesta escrita, se recogió información sobre el tiempo que usualmente los adolescentes destinaban a distintas ocupaciones durante un día normal entre semana. Para el análisis estadístico se utilizó la prueba U de Mann-Whitney que compara dos muestras no paramétricas. Resultados. Se encontraron diferencias estadísticamente significativas en cuanto a la distribución del tiempo destinado a actividades de participación social y de tiempo libre. Los adolescentes con sobrepeso/ obesidad usan menos tiempo en estas actividades. Conclusión. El uso del tiempo podría considerarse como un factor de riesgo para el sobrepeso o la obesidad, y como tal es un tema que requiere mayor análisis. Los adolescentes con sobrepeso u obesidad no se involucran en actividades de participación social y tiempo libre. Sin duda el uso del tiempo se reconoce cada vez más como un indicador de bienestar, ante lo cual, estudios futuros deberán centrarse en evaluar la efectividad de las intervenciones basadas en el rediseño de rutinas.

La superación profesional en una Universidad Médica cubana / Professional Improvement in a Cuban Medical University

Introducción: Los análisis anuales de la actividad posgraduada permiten observar posibles cambios y planificar su futuro desarrollo para mejorar la generación de conocimientos. Objetivo: Caracterizar la superación profesional de la Facultad de Medicina No.1, Universidad de Ciencias Médicas de Santiago de Cuba. Método: Se realizó un estudio descriptivo y transversal en la Facultad de Medicina No.1, Universidad de Ciencias Médicas de Santiago de Cuba, en el período comprendido del 2012-2016. Resultados: Se cuantificaron las actividades impartidas según tipo, programas a los que respondían, la categoría docente de los profesores principales y sedes donde se ejecutaron. Se comparó además el número de actividades acreditadas con el de otras actividades capacitantes como formas diferentes de actualizar conocimientos. Entre los principales resultados se observó un predominio de la ejecución de cursos, ausencia de diferencias significativas entre las actividades impartidas por profesores Asistentes y Auxiliares, y predominio de las actividades variadas no priorizadas por el Ministerio de Salud como órgano asesor, junto con las de formación general. La superación profesional experimentó de manera general, un incremento en el quinquenio. Conclusiones: Las actividades de superación profesional experimentaron un progresivo incremento en cada curso académico, empleando como principal figura del posgrado los cursos que se relacionaron mayoritariamente con los programas priorizados de salud pública(AU)

Introduction: Yearly analyses of postgraduate activity allow observing possible changes and planning their future development to improve the generation of knowledge. Objective: To characterize the professional improvement of Medical School No.1 of Santiago de Cuba University of Medical Sciences. Method: A descriptive and cross-sectional study was carried out in the Medical School No.1 of Santiago de Cuba University of Medical Sciences, in the period 2012-2016. Results: The activities imparted were classified based on type, corresponding programs, the teaching category of the main professors and the venues where they were carried out. The number of accredited activities was compared with that of other training activities as different ways of updating knowledge. Among the main results, there was a predominance of the teaching of courses, lack of significant differences between the activities taught by assistant and auxiliary professors, and predominance of varied activities not prioritized by the Ministry of Health as an advisory body, together with those for general training. Generally speaking, professional improvement experienced an increase in the five-year period. Conclusions: Professional improvement activities experienced a progressive increase in each academic year, using as the main types of postgraduate courses those that were mostly related to the prioritized public health programs(AU)