Ferrier Glycosylation Mediated by the TEMPO Oxoammonium Cation.

The TEMPO oxoammonium cation has been proven to be both an efficient oxidizing reagent and an electrophilic substrate frequently found in organic reactions. Here, we report that this versatile chemical reagent can also be used as an efficient promoter for C- and N-glycosylation reactions through a Ferrier rearrangement with moderate to high yields. This unprecedented reactivity is explained in terms of a Lewis acid activation of glycal by TEMPO+ forming a type of glycal-TEMPO+ mesomeric structure, which occurs through an extended vinylogous hyperconjugation toward the π*(O═N+) orbital [LP(O1) → π*(C1═C2), π*(C1═C2) → σ*(C3-O3), and LP(O6) → π*(O═N+)]. This enables the formation of the respective Ferrier glycosyl cation, which is trapped by various nucleophiles. The extended hyperconjugation (or double hyperconjugation) toward the π*(O═N+) orbital, which confers the Lewis acid character of the TEMPO cation, was supported by natural bond orbital analysis at the M06-2X/6-311+G** level of theory.

Analysis of the Effect of Exams on Perceived Stress and Temporomandibular Joint Status in Physiotherapy Students: A Pilot Study.

Background and Objectives: Temporomandibular disorders or dysfunction (TMDs) encompass a range of complex conditions that impact the temporomandibular joint (TMJ), chewing muscles, teeth, and/or their supporting tissues. Stress is one of the most associated factors studied as a TMD predictor. The aim is to figure out the influence of stress on TMJ status and salivary cortisol in university students during and before exams. Materials and Methods: The study was non-experimental, employing a longitudinal, analytical, observational cohort design. The study population consisted of students enrolled in the physiotherapy degree program at the Alfonso X El Sabio University (Madrid, Spain). Data were collected during two distinct academic periods: the first period was characterized by low academic stress and no exams, and the second period coincided with the high academic stress of final course exams. The collected results included sociodemographic data, assessment of TMJ status (Fonseca Index), evaluation of muscle evaluation (masseter, upper trapezius, and sternocleidomastoid) using a MOXY Monitor (muscle oxygenation) and Neurotrac® (surface EMG, sEMG), assessment of perceived stress (PSS-14), and measurement of salivary cortisol (enzyme immunoassay with Elisa). The statistical analysis was conducted with a confidence level of 95% (p ≤ 0.05) and asymptotic or bilateral significance. Results: 70 students were analyzed during two different measurement periods. According to the Fonseca Index, initially, 37.14% of the analyzed students showed mild TMDs, 17.14% moderate TMDs, and 45.72% showed no TMDs. In general terms, stress increased with age and is related to female sex, maximum mouth opening decreased with age, oxygen saturation decreased with age and academic stress, and myoglobin concentration was related to age. Furthermore, muscle contraction decreased during higher academic stress and increased with age. For women, age was a risk factor for suffering from TMDs, and stress worsened the transition from having TMDs to having no TMDs in both sexes. Conclusions: Academic stress influences TMJ status and muscle outcomes such as oxygen saturation, myoglobin concentration, and muscle contraction, although more research is needed.

Implementation of a roadmap for the comprehensive diagnosis, follow-up, and research of childhood leukemias in vulnerable regions of Mexico: results from the PRONAII Strategy.

The main objective of the National Project for Research and Incidence of Childhood Leukemias is to reduce early mortality rates for these neoplasms in the vulnerable regions of Mexico. This project was conducted in the states of Oaxaca, Puebla, and Tlaxcala. A key strategy of the project is the implementation of an effective roadmap to ensure that leukemia patients are the target of maximum benefit of interdisciplinary collaboration between researchers, clinicians, surveyors, and laboratories. This strategy guarantees the comprehensive management of diagnosis and follow-up samples of pediatric patients with leukemia, centralizing, managing, and analyzing the information collected. Additionally, it allows for a precise diagnosis and monitoring of the disease through immunophenotype and measurable residual disease (MRD) studies, enhancing research and supporting informed clinical decisions for the first time in these regions through a population-based study. This initiative has significantly improved the diagnostic capacity of leukemia in girls, boys, and adolescents in the regions of Oaxaca, Puebla, and Tlaxcala, providing comprehensive, high-quality care with full coverage in the region. Likewise, it has strengthened collaboration between health institutions, researchers, and professionals in the sector, which contributes to reducing the impact of the disease on the community.

En Route to Furan-Fused Naphthopyrones: Formal Synthesis of the (+)-Lasionectrin and Its C12-Epimer.

Despite the vast presence of the furan-fused naphthopyrone (FFN) skeleton in many bioactive natural products, such as lasionectrin, at present, a general approach to FFNs has not been developed yet. For that reason, a simple and straightforward synthetic approach consisting of a sequential procedure of a Diels-Alder reaction between 1,3-dimethoxy-benzocyclobutenol I and furan-fused-α,ß-unsaturated-δ-lactones II (via an ο-quinodimethane intermediate III) followed by an oxidative aromatization of the corresponding Diels-Alder adduct IV is reported. Subsequently, the formal synthesis of the (+)-lasionectrin and its C12-epimer was achieved, the latter in only six steps.

Prevalence of anxiety and depression in patients with acute coronary syndrome: systematic review and meta-analysis.

Depression and anxiety are common in patients experiencing acute coronary syndrome (ACS), occurring at significantly elevated rates. Together, these depressive symptoms and anxiety have a substantial negative impact on individuals with ACS. Therefore, the aim of the present study was to determine the prevalence of anxiety and depression among patients with ACS. A systematic review and meta-analysis of cross-sectional studies were carried out. A comprehensive search of five databases (PubMed, Scopus, Embase, Web of Science, and ScienceDirect) was performed until August 2, 2023. The quality of the included studies was assessed using the Joanna Briggs Institute statistical meta-analysis review instrument. The collected data were entered into a Microsoft Excel spreadsheet and analyzed with the R program version 4.2.3. A total of 3103 articles were evaluated, and, after the evaluation process, eight studies were included, for a total sample of 1642 participants. The pooled prevalence of mild depression was 14% (95% CI: 06%-23%; I2= 95%), moderate was 12% (95% CI: 06%-19%; I2= 92%), and high/severe was 15% (95% CI: 05%-30%; I2= 97%). The joint prevalence of mild anxiety was 38% (95% CI: 12%-68%; I2= 98%), moderate anxiety was 17% (95% CI: 08%-29%; I2= 89%), and high/severe anxiety was 10% (95% CI: 01%-25%; I2=95%). Therefore, it is concluded that there is a significant prevalence of anxiety and depressive symptoms in patients with ACS. However, more research focused on this area is required to obtain more robust and substantial evidence.

High Retention and Purification of Bromelain Enzyme (Ananas comosus L. Merrill) from Pineapple Juice Using Plain and Hollow Polymeric Membranes Techniques.

The demand for bromelian and pineapple fruit has been increasing substantially in the world because of their benefits for the human health and use in diverse areas. In this context, this work aimed to study the capacity of higher retention (concentration); bromelain activity underwent ultrafiltration from pineapple juice (Ananas comusus L. Merrill). All assays were carried out at pH 7.0 and 7.5, and at 0.05 and 0.40 bar of transmembrane pressures. Results have shown that at the best operating conditions, between 85 and 87% of bromelain activity was recovered using the plain membrane separation process at 0.05 bar. The ultrafiltration has shown the capacity to retain 100% of proteolytic activity of the bromelain extracted. The samples have kept the same physics properties after ultrafiltration, and the result was verified via electrophoresis. The bromelain enzyme obtained was characterized, and pH 7 and between 30 and 40 °C were the best conditions. Therefore, this work shows that the use of both polymeric membranes has shown high efficiency, and can be used in the purification of bromelain enzymes.

Efecto del programa SERUMS en la equidad de la distribución de recursos humanos del primer nivel de atención en Perú

Introducción. La adecuada dotación y distribución con equidad de recursos humanos son fundamentales para el desempeño del sistema de salud, especialmente en el primer nivel de atención. El Programa Servicio Rural y Urbano Marginal (SERUMS) es la principal estrategia desarrollada por el Estado peruano para este fin. Objetivo. Describir el efecto de la dotación de médicos, enfermeros y obstetras del Programa SERUMS en la equidad de la distribución de recursos humanos en el primer nivel de atención. Métodos. Estudio observacional, descriptivo y transversal, de carácter censal con base en el Registro Nacional de Personal de Salud - INFORHUS, agosto 2019. Se aplicó indicadores de dotación, se verificó si existe diferencia entre la distribución porcentual de profesionales SERUMS y no SERUMS, se calculó la densidad (profesionales/10 000 hab. a nivel departamental, quintil de pobreza y ruralidad) y coeficientes de Gini (departamental). Resultados. La población estuvo constituida por 6037 profesionales SERUMS y 27 495 no SERUMS. El Programa SERUMS incrementó de manera importante la dotación y densidad de profesionales en casi todas las regiones del país. En 5 regiones los profesionales SERUMS representaron más del 50% de la dotación. Incrementos importantes se encontraron en el análisis por quintil de pobreza y en el ámbito rural, especialmente en la dotación de médicos. El programa SERUMS evidenció una mayor desigualdad en su distribución, según los coeficientes de Gini, a favor de las poblaciones más vulnerables. Conclusiones. El Programa SERUMS incrementa de manera importante la dotación y densidad de profesionales, especialmente en los distritos más pobres del Perú.

Introduction. The adequate allocation and equitable distribution of human resources are essential for the health system›s performance, especially at the first level of care. The Rural and Urban Marginal Service Program (SERUMS) is the primary strategy developed by the Peruvian State for this purpose. Objective. To describe the effect of the number of doctors, nurses, and midwives of the SERUMS Program on the equity of the distribution of human resources at the primary care level. Methods. Observational, descriptive, and cross-sectional study of a census nature based on the National Registry of Health Personnel - INFORHUS, August 2019. Staffing indicators were applied, it was verified if there is a difference between the percentage distribution of SERUMS and non-SERUMS professionals, density (professionals per 10 000 inhabitants at the departmental level, poverty quintile, and rurality), and Gini coefficients (departmental) were calculated. Results. The population consisted of 6037 SERUMS professionals and 27 495 non-SERUMS professionals. The SERUMS Program significantly increased the number and density of professionals in almost all departments. In 5 regions, SERUMS professionals represented more than 50% of the workforce. Significant increases in the number of doctors were found in the poverty quintile and rural areas analysis. According to the Gini coefficients, the SERUMS program showed greater inequality in its distribution in favor of the most vulnerable populations. Conclusions. The SERUMS Program significantly increases the number and density of healthcare professionals, especially in the poorest districts of Peru.

A Case Report of Leptomeningeal Carcinomatosis Secondary to Recurrent Merkel Cell Carcinoma after Avelumab.

INTRODUCTION: Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine cancer with a high mortality rate of 33% to 46%. Merkel cell is a type of epidermis cell receptor responsible for contact sensitivity and is known to have neuroendocrine properties. Treatment of Merkel cell carcinoma with avelumab has been prominsing, but its rarity and poor prognosis necessitates close follow up. CASE PRESENTATION: A 71-year-old woman presented with a left forearm mass that was initially suspected to be a sebaceous cyst. After surgical excision and biopsy, she was diagnosed with Merkel cell carcinoma. The patient underwent avelumab treatment for 2 years, with remission of cancer for 24 months. A positron emission tomographic scan at 24 months of treatment noted uptake in the left axilla and portocaval regions. Despite receiving different combinations of immunotherapy, chemotherapy, and radiation, the patient's cancer metastasized to the leptomeninges. She was transitioned to hospice and passed away 3 months after diagnosis of leptomeningeal carcinoma. CONCLUSION: This case highlights the efficacy of avelumab in keeping patients in remission, which can offer increased quality of life. However, it also highlights the aggressive nature of Merkel cell carcinoma and the importance of surveillance for early detection of recurrence.

Combination of Computational Techniques to Obtain High-Quality Gelatin-Base Gels from Chicken Feet.

With the increasing global population, it has become necessary to explore new alternative food sources to meet the increasing demand. However, these alternatives sources should not only be nutritive and suitable for large scale production at low cost, but also present good sensory characteristics. Therefore, this situation has influenced some industries to develop new food sources with competitive advantages, which require continuous innovation by generating and utilising new technologies and tools to create opportunities for new products, services, and industrial processes. Thus, this study aimed to optimise the production of gelatin-base gels from chicken feet by response surface methodology (RSM) and facilitate its sensorial classification by Kohonen's self-organising maps (SOM). Herein, a 22 experimental design was developed by varying sugar and powdered collagen contents to obtain grape flavoured gelatin from chicken feet. The colour, flavour, aroma, and texture attributes of gelatines were evaluated by consumers according to a hedonic scale of 1-9 points. Least squares method was used to develop models relating the gelatin attributes with the sugar content and collagen mass, and their sensorial qualities were analysed and classified using the SOM algorithm. Results showed that all gelatin samples had an average above six hedonic points, implying that they had good consumer acceptance and can be marketed. Furthermore, gelatin D, with 3.65-3.80% (w/w) powdered collagen and 26.5-28.6% (w/w) sugar, was determined as the best. Thus, the SOM algorithm proved to be a useful computational tool for comparing sensory samples and identifying the best gelatin product.

Vaccination with cathepsin L mimotopes of Fasciola hepatica in goats reduces worm burden, morphometric measurements, and reproductive structures.

Fasciolosis is a worldwide emergent zoonotic disease that significantly constrains the productivity of livestock. We conducted an experimental trial with four groups of five goats each, vaccinated with 1 × 1013 phage particles of cathepsin L1 (CLI: DPWWLKQ), CL1 (SGTFLFS), and CL2 (PPIRNGK) mimotopes combined with Quil A adjuvant. Animals received a booster four weeks later. The control group received phosphate-buffered saline. All animals were infected with 200 Fasciola hepatica metacercariae at week six and euthanised 16 weeks later. The percentage of significant worm reduction in CL1 (DPWWLKQ), CL1 (SGTFLFS), and CL2 (PPIRNGK) compared to the control group were 55.40%, 70.42% (P < 0.05), and 32.39%, respectively. Vaccinated animals showed a significant reduction in faecal egg production and egg viability. A significant reduction in the total biomass of parasites recovered was observed in the CL1 (DPWWLKQ) and CL1 (SGTFLFS) groups. In goats vaccinated with CL2 (PPIRNGK), fluke length and width were smaller than those in the control group. Furthermore, animals receiving CL mimotopes showed a significant reduction in the total area of reproductive structures. Goats immunised with phage-displayed mimotopes produced significantly high titres of specific IgG1 and IgG2 isotypes, indicating a mixed Th1/Th2 response. The liver fluke burdens in goats vaccinated with CL1 (DPWWLKQ) and CL1 (SGTFLFS) were significantly correlated with IgG and IgG1 levels.

Prevalence and risk factors of gastrointestinal nematode infestation of horses, donkeys and mules in tropical, dry and temperate regions in Mexico.

The aims of this study were to determine the prevalence of gastrointestinal nematodes (GIN) in horses, donkeys and mules and its associations with age, sex and climatic factors (derived from satellite data) to identify the potential risk factors of different climate regions in four Mexican states. From May 2017 to April 2018, a total of 560 farm owners or managers answered the questionnaire, and the data were used to establish three Köppen climate classes (tropical, dry, temperate). The overall prevalence of GIN parasites in equines was 77.9% (436 out of 560). The highest percentage of GIN was detected in mules (87.5%). In addition, the highest prevalence among the climate regions was found in the temperate climate (79.9%). The identified nematodes were strongyle type (77.9%), Parascaris equorum (5.7%), Strongyloides (0.7%) and Oxyuris equi (2.9%). The highest mean value of strongylid eggs per g faeces was found in the dry climate (632.6 ± 96.8), followed by that in the tropical climate (518.3 ± 49.7) and temperate climate (383.8 ± 30.2); however, a similar prevalence was observed between different climate regions. Age and sex were identified as risk factors for high shedding of strongyle eggs: the odds ratios for higher shedding intensities were 3.858 for geldings compared to mares, 2.602 for 6-10-year-old equines and 3.597 for ≤16-year-olds compared to young equines (≤5 years old).

MTHFR rs1801133 Polymorphism Is Associated With Liver Fibrosis Progression in Chronic Hepatitis C: A Retrospective Study.

Background: The MTHFR (methylenetetrahydrofolate reductase) rs1801133 polymorphism leads to higher circulating levels of homocysteine, which is related to several liver diseases. We aimed to evaluate the relationship between MTHFR rs1801133 polymorphism and liver fibrosis progression in HCV-infected patients. Methods: We conducted a preliminary retrospective cohort study in 208 non-cirrhotic HCV-infected patients. These subjects had at least two liver stiffness measurements (LSM), which were assessed using transient elastography, and no patient had cirrhosis at baseline. We analyzed the association between MTHFR rs1801133 and outcome variables using Generalized Linear Models. Results: HCV-infected patients were 47 years old, around 54% were males, a low frequency of high alcohol intake (13.5%) or prior use of intravenous drugs (10.1%). A total of 26 patients developed cirrhosis (LSM1 ≥ 12.5) during a median follow-up of 46.6 months. The presence of the rs1801133 C allele showed an inverse association with the LSM2/LSM1 ratio (adjusted AMR = 0.90; 95%CI = 0.83-0.98; p = 0.020) and the cirrhosis progression (adjusted OR = 0.43; 95%CI = 0.19-0.95; p = 0.038). Besides, rs1801133 CT/CC genotype had an inverse association with the LSM2/LSM1 ratio (adjusted AMR = 0.80; 95%CI = 0.68-0.95; p = 0.009) and the cirrhosis progression (adjusted OR= 0.21; 95%CI = 0.06-0.74; p = 0.015). Conclusions: MTHFR rs1801133 C allele carriers presented a diminished risk of liver fibrosis progression and development of cirrhosis than rs1801133 T allele carriers. This statement supports the hypothesis that MTHFR rs1801133 polymorphism appears to play a crucial role in chronic hepatitis C immunopathogenesis.

Photocatalytic xanthate-based radical addition/cyclization reaction sequence toward 2-biphenyl isocyanides: synthesis of 6-alkylated phenanthridines.

A photocatalytic xanthate-based radical addition/cyclization reaction cascade toward 2-biphenylisocyanides is described as a practical and modular approach to 6-alkylated phenanthridines. The use of xanthates as radical precursors allowed the synthesis of diversely 6-substituted phenanthridines. Electrophilic radicals derived from nitriles, aromatic and aliphatic ketones, malonates, and amide derivatives, as well as radicals derived from phthalimidomethyl and benzylic derivatives were successfully introduced. The reaction proceeds under mild conditions without a stoichiometric amount of oxidant. Thirty novel phenanthridine scaffolds were synthesized with yields ranging from 24 to 76%.

Prevalencia de hábitos de succión no nutritiva y su relación con maloclusión y anomalías dentomaxilares en preescolares de Cnel. Oviedo, Paraguay / Prevalence of non-nutritive sucking habits and their relationship with malocclusion and dentomaxillary abnormalities in preschoolers of Cnel. Oviedo, Paraguay

El objetivo fue determinar la prevalencia de hábitos de succión no nutritiva y su relación con maloclusiones y anomalías dentomaxilares en preescolares de Coronel Oviedo - Paraguay, durante el año 2015. Se realizó un estudio observacional, descriptivo de corte transversal con componente analítico, con muestreo probabilístico estratificado bietápico. La población de estudio estuvo constituida por niños del sexo masculino y femenino de la Educación Inicial (maternal, jardín y pre-escolar). Las variables del estudio fueron la succión no nutritiva (succión digital y succión del chupete, edad, sexo, onicofagia y el uso del biberón. Los datos fueron recabados mediante una encuesta dirigida a los padres; acompañada de la inspección bucodental. Fueron incluidos 344 escolares, el 48,84% (168) tenía una edad de 5 años y el 52,91% (182) era del sexo masculino. El 13,08% (45) realizaba succión digital, el 9,59% (33) succión de chupete y el 38,95% (134) otros hábitos. Al diferenciar la presencia de hábitos con las características demográficas se pudo apreciar como la presencia de succión digital estaba relacionada con la mordida abierta (p=0.000), la mordida cruzada (p=0.049), con la orientación de los incisivos (p=0.000), la forma de la arcada (p=0.000), y la oclusión de vista transversal (p=0.046) y sagitalmente (p=0.000). La prevalencia de hábitos de succión no nutritiva en estos escolares fue alta y estaba relacionada con la maloclusión y la aparición de anomalías dentomaxilares, por lo que la educación de padres para la prevención de dichas condiciones es fundamental(AU)

The objective was to determine the prevalence of non-nutritive suction habits and their relationship with malocclusions and dentomaxillary anomalies in preschool children of Coronel Oviedo - Paraguay, during 2015. An observational, descriptive cross-sectional study with analytical component was carried out, with two-stage stratified probabilistic sampling. The study population consisted of boys and girls of the Pre-Primary Education (nursery, kindergarten and pre-school). The variables of the study were the non-nutritive suction (digital suction and suction of the pacifier, age, sex, onychophagia and the use of the feeding bottle). The data were collected through a survey addressed to the parents, accompanied by an oral inspection. Three hundred forty-four schoolchildren were included, 48.84% (168) was 5 years old and 52.91% (182) was male. Of the total, 13.08% (45) performed digital suction, 9.59% (33) pacifier suction and 38.95% (134) other habits. By differentiating the presence of habits with demographic characteristics, it was seen how the presence of digital suction was related to the open bite (p=0.000), the crossbite (p = 0.049), and the orientation of the incisors (p=0.000). ), the shape of the arch (p = 0.000), the cross sectional occlusion (p=0.046) and the sagittal occlusion (p = 0.000). The prevalence of non-nutritive suction habits in these school children was high and related to malocclusion and the appearance of dentomaxillary anomalies, so the education of parents for the prevention of these conditions is fundamental(AU)

Sincronización del estro en ovejas de pelo mediante protocolo basado en prostaglandinas + GnRH / Estrous synchronization in hair sheep using a protocol based on prostaglandin + GnRH

Resumen El uso de progestágenos puede contaminar el medio ambiente y el tejido animal, por lo que el uso de prostaglandinas F2α (PGF2α) y hormona liberadora de gonadotropinas (GnRH) pueden representar una alternativa viable. El objetivo del presente trabajo fue evaluar el efecto de aplicar una dosis de GnRH en el intervalo de aplicación de dos dosis de PGF2α, y compararlo con protocolos basados en progestágenos y PGF2α, comúnmente utilizados en la sincronización de estros, con respecto al pico pre-ovulatorio de la hormona luteinizante (LH), concentraciones de progesterona post-estro, tasa de preñez, pariciones y prolificidad. Después de una pre-sincronización con doble aplicación de PGF2α, 30 ovejas adultas multíparas (peso vivo = 45 ± 3.1 kg, condición corporal= 3.2 ± 0.5 unidades y tiempo post-parto = 60 d a 90 d) fueron asignadas aleatoriamente a uno de tres tratamientos (n = 10). Grupo 1: P (Testigo), recibieron dosis única de 125 μg de cloprostenol por vía IM (intramuscular); Grupo 2: FP, recibieron esponjas intravaginales que contenían 20 mg de acetato de fluorgestona por 5 d, y al retiro de la esponja fueron inyectadas con 125 μg de cloprostenol vía IM; Grupo 3: GP, recibieron 50 μg de GnRH IM, y 7 d después fueron inyectadas con 125 μg de cloprostenol. El inicio del estro fue más rápido (P ≤ 0.05) en el grupo P comparado con el grupo FP. El grupo GP (P ≤ 0.05) tuvo mayores concentraciones de progesterona después de 5 d postestro, comparado con los grupos P y FP. La tasa de preñez no fue diferente (P > 0.05) entre grupos. Los protocolos de sincronización evaluados fueron semejantes en su efectividad para mejorar el comportamiento reproductivo en ovejas de pelo. Se recomienda usar protocolos basados en su aplicación de PGF2α, debido a su facilidad de aplicación.

Abstract The use of progestogens can contaminate the environment and animal tissue. Therefore, the use of prostaglandins F2α (PGF2α) and gonadotropin-releasing hormone (GnRH) may represent a viable alternative. The aim of the present work was to evaluate the effect of applying a dose of GnRH within the range of application of two doses of PGF2α, and compare it with protocols based on progestogens and PGF2α, commonly used in the synchronization of estrus, with respect to the pre-ovulatory peak of luteinizing hormone (LH), post-estrus progesterone concentrations, pregnancy rate, calving and prolificacy. After a pre-synchronization with a double application of PGF2α, 30 multiparous adult ewes (live weight = 45 ± 3.1 kg, body condition = 3.2 ± 0.5 units and postpartum time = 60 d to 90 d, were randomly assigned to one of three treatments (n = 10). The ewes in Group 1: P (Control) received a single dose of 125 μg of cloprostenol via IM (intramuscular); the ewes in Group 2: FP received intravaginal sponges containing 20 mg of fluorogestone acetate for 5 d; and upon removal of the sponge, they were injected with 125 μg of cloprostenol via IM; the ewes in Group 3: GP received 50 μg of GnRH IM, and 7 d later they were injected with 125 μg of cloprostenol. The onset of estrus was detected faster (P ≤ 0.05) in P and GP groups than in the FP group. The GP group (P ≤ 0.05) had higher concentrations of progesterone after 5 d post-estrus, compared to the P and FP groups. The pregnancy rate was not different (P > 0.05) between groups. All the synchronization protocols evaluated were similar in the effectiveness to improve the reproductive behavior in hair sheep. Therefore, the use of protocols based on the application of PGF2α is recommended, due to their its ease of application.

Tiempo de espera y calidad de atención en pacientes de odontoestomatología intervenidos en sala de operaciones / Waiting time and quality of care in operated odontostomatology patients

Introducción. Los tiempos de espera para cirugía electiva son indicadores que legitiman socialmente los servicios sanitarios públicos, si su situación es la adecuada. Objetivo. Determinar la relación entre el tiempo de espera y la percepción de la calidad de atención, en pacientes de odontoestomatologia de un hospital de la seguridad social. Métodos. Los niveles de satisfacción e insatisfacción se determinaron por medio del instrumento SERVQUAL modificado. Los resultados se correlacionaron con el tiempo de espera superior a 180 días y con la afectación de la calidad de vida; además, se evaluaron los factores con mayor influencia sobre el grado de insatisfacción. Resultados. El grado de satisfacción fue del 44%. Los pacientes que esperaron más de 180 días presentaron 2,6 veces más posibilidad de insatisfacción, los pacientes afectados presentaron 3,4 veces más posibilidad de insatisfacción. Finalmente, los pacientes afectados presentaron 3,3 más posibilidad de insatisfacción, en relación con que esperaron más de 180 días, los cuales presentaron 2.5 más posibilidad de insatisfacción. Conclusión: Existe relación inversa entre el tiempo de espera y la percepción de la calidad de atención; además, el grado de insatisfacción está asociado, sobre todo, a la afectación de la calidad de vida más que al propio tiempo de espera.

Introduction: Waiting times for elective surgery are indicators that legitimize socially public health services, if their situation is appropriate. Objective: To determine the relationship between the waiting time and the perception of the quality of care in Odontostomatology patients of a Social Security hospital. Methods: Satisfaction and dissatisfaction levels were determined by means of the modified SERVQUAL instrument, the results were correlated with the waiting time of more than 180 days and the quality of life; was affected, as well as which of these factors was most influenced about the degree of dissatisfaction. Results: The degree of satisfaction was 44%. The patients who waited more than 180 days presented 2.6 times more possibility of dissatisfaction, the affected patients presented 3.4 times more possibility of dissatisfaction. Finally, the affected patients presented 3.3 more possibilities of dissatisfaction, in relation to those who waited more than 180 days, which presented 2.5 more possibilities of dissatisfaction. Conclusion: There is an inverse relationship between waiting time and the perception of quality of care; In addition, the degree of dissatisfaction is associated, above all, with the impact of the quality of life rather than the waiting time itself.

National Registry of Cardiac Rehabilitation Programs in Mexico II (RENAPREC II) / Registro Nacional de Programas de Rehabilitación Cardiaca en México II (RENAPREC II)

Abstract: Objective: The aim of this paper is to compare the state of Cardiac Rehabilitation Programs (CRP) in 2009 with 2015. Focus is directed on health care, training of health-providers, research, and the barriers to their implementation. Methods: All authors of RENAPREC-2009, and other cardiac rehabilitation leaders in Mexico were requested to participate. These centres were distributed into two groups: RENAPREC-2009 centres that participated in 2015, and the new CRP units. Results: In 2009 there were 14 centres, two of which disappeared and another two did not respond. CRP-units increased by 71% (n = 24), and their geographic distribution shows a centripetal pattern. The coverage of CRP-units was 0.02 centres per 100,000 inhabitants. Only 4.4% of eligible patients were referred to CRP, with a rate of 10.4 patients/100,000 inhabitants in 2015. The ratio of Clinical Cardiologists to Cardiac Rehabilitation Specialists was 94:1, and the ratio of Intervention Specialists to cardiac rehabilitation experts was 16:1. Cardiac rehabilitation activities and costs varied widely. Patient dropout rate in phase II was 12%. Several barriers were identified: financial crisis (83%), lack of skilled personnel (67%), deficient equipment (46%), inadequate areas (42%), and a reduced number of operating centres (38%). Conclusions: CRPs in Mexico are still in the process of maturing. Mexican CRP-centres have several strengths, like the quality of the education of the professionals and the multidisciplinary programs. However, the lack of referral of patients and the heterogeneity of procedures are still their main weaknesses.

Resumen: Objetivo: El propósito de este trabajo es comparar el estado actual de los programas de rehabilitación cardiaca (PRC) en México con el RENAPREC-2009, dirigido a la asistencia, docencia, investigación y barreras. Métodos: Se convocó a participar a todos los autores de RENAPREC-2009 y a otros líderes en rehabilitación cardiaca de México. Los centros fueron distribuidos en 2 grupos: los que participaron en el 2015 y las nuevas unidades de PRC. Resultados: En 2009 había 14 centros operativos, de los cuales 2 cerraron y 2 no respondieron. En 2015 se registraron 24 centros en total, representando un aumento neto del 71%. La distribución geográfica fue centrípeta. La cobertura fue de 0.02 centros/100,000 habitantes y de solamente un 4.4% de los pacientes elegibles (10.4 pacientes/100,000 habitantes). La relación cardiólogo clínico-rehabilitador cardiaco es de 94:1 y la de intervencionista-rehabilitador cardiaco es de 16:1. Las actividades realizadas y los costos de los PRC varían de forma importante de centro a centro. En promedio, el 12% de los pacientes en fase ii abandonaron el programa. Las principales barreras para el desarrollo de PRC fueron: económicas (83%), falta de personal capacitado (67%), falta de equipo (46%), áreas inadecuadas (42%) y un insuficiente número de centros operativos (38%). Conclusiones: Los PRC en nuestro país continúan en crecimiento. Se observan fortalezas como el nivel de docencia y el enfoque multidisciplinario, así como deficiencias en la homogeneidad de las actividades y la falta de referencia de la población elegible.

Relación entre gestión del director y satisfacción del usuario externo en centros de salud de un distrito del Ecuador / Relationship between director management and the external user satisfaction in health centers in a district of Ecuador

La gestión sanitaria, su competencia y conducción directiva, se ha ejercitado con protagonismo médico. Cambios en su enfoque evolucionaron a centrar las acciones en el usuario externo al logro de su satisfacción. Estudios independientes de gestión y satisfacción visualizaron diferentes efectos de resultados ante organizaciones, gestores y usuarios. Es relevante priorizar nodos críticos entre sus dimensiones para elaborar proyectos de mejora continua. Objetivo. Establecer la relación entre la gestión del director y la satisfacción del usuario externo. Diseño. Estudio transversal, de correlación. Lugar. Distrito 17D09 del Ecuador. Participantes. Nueve directores de centros de salud y 652 usuarios externos. Intervención. Muestreo aleatorio simple, juicio de expertos, formularios válidos: SERVQUAL modificado de satisfacción y EVAL O1-MRL de gestión, consentimiento informado, análisis en sistemas SPSS V20, Excel. Principal medida de resultado. Índice de gestión del director. Resultados. La gestión del director fue 56% de nivel regular y 44% satisfactoria. La insatisfacción del usuario externo fue 89% de nivel moderada y 11% leve. La mala calidad de atención institucional fue 100%. El nivel de correlación dimensional fue variado entre gestión e insatisfacción tipo: negativa débil (-0,28 y -016); positiva débil (0,31) y negativa fuerte (-0,52 y -070). Conclusiones. Existió correlación directa significativa entre una gestión inadecuada y la insatisfacción del usuario.

Introduction: Health management, competence and policy conduction, has exercised with medical prominence. The change in approach evolved to focus their actions on the external user to achieve their satisfaction. Independent studies on management and satisfaction visualized different effects of organizations, managers and users results. It is relevant to prioritize critical nodes between its dimensions in order to develop projects of continuous improvement. Objective: To establish the relationship between the director management and the external user satisfaction. Design: Cross-sectional, correlation study. Setting: District 17D09, Ecuador. Participants: Nine directors of health centers and 652 external users. Interventions: Simple random sampling, expert judgment, validated forms: satisfaction modified SERVQUAL, and management EVAL O1-MRL, informed consent, SPSS V20 analysis, Excel software. Main outcome measure: Director´s Management Index. Results: Director's management was of regular level in 56% and satisfactory in 44%. External user dissatisfaction was moderate in 89% and mild in 11%. The institutional care was of poor quality in 100%. The level of dimensional correlation was varied between management and dissatisfaction: weak negative (-0.28and -016), weak positive (0.31) and strong negative (-0.52 and -070). Conclusions: There was a direct and significant correlation between poor management and patient dissatisfaction.

National Registry of Cardiac Rehabilitation Programs in Mexico II (RENAPREC II).

OBJECTIVE: The aim of this paper is to compare the state of Cardiac Rehabilitation Programs (CRP) in 2009 with 2015. Focus is directed on health care, training of health-providers, research, and the barriers to their implementation. METHODS: All authors of RENAPREC-2009, and other cardiac rehabilitation leaders in Mexico were requested to participate. These centres were distributed into two groups: RENAPREC-2009 centres that participated in 2015, and the new CRP units. RESULTS: In 2009 there were 14 centres, two of which disappeared and another two did not respond. CRP-units increased by 71% (n=24), and their geographic distribution shows a centripetal pattern. The coverage of CRP-units was 0.02 centres per 100,000 inhabitants. Only 4.4% of eligible patients were referred to CRP, with a rate of 10.4 patients/100,000 inhabitants in 2015. The ratio of Clinical Cardiologists to Cardiac Rehabilitation Specialists was 94:1, and the ratio of Intervention Specialists to cardiac rehabilitation experts was 16:1. Cardiac rehabilitation activities and costs varied widely. Patient dropout rate in phase II was 12%. Several barriers were identified: financial crisis (83%), lack of skilled personnel (67%), deficient equipment (46%), inadequate areas (42%), and a reduced number of operating centres (38%). CONCLUSIONS: CRPs in Mexico are still in the process of maturing. Mexican CRP-centres have several strengths, like the quality of the education of the professionals and the multidisciplinary programs. However, the lack of referral of patients and the heterogeneity of procedures are still their main weaknesses.

Comparative Diagnosis of Serum IgG1 and Coproantigen ELISA for Fasciolosis Detection of Goats in Mexico.

The objective of present study was to determine the prevalence of natural caprine fasciolosis in the Mixteca region of Mexico using coproantigen and serum IgG1 ELISA tests for comparative purposes. A total of 1070 serum and faecal samples were analyzed for IgG1 antibodies and coproantigens, using ELISA with E/S products as antigen and a monoclonal antibody-based sandwich ELISA. Prevalence of 73.46% was found using the serological ELISA and a percentage of 77.20 was found for coproantigen ELISA. The diagnostic sensitivity and specificity for serum ELISA were 86.7% and 96.4%, and for the coproantigen ELISA they were 93.1% and 97.8%, respectively. The seropositive samples were further categorized as low, medium, or high positivity. Results show a great proportion of low and medium positive goats when the serum ELISA test was used. Correlation coefficients between coproantigens and seropositivity were statistically significant (P < 0.01) for low seropositivity (r = 0.93) and medium seropositivity (r = 0.84). The accuracy of faecal antigen ELISA was higher compared to indirect ELISA serological test. Two ELISAs were shown to be useful for demonstrating the current status of F. hepatica infection in the endemic areas and can be employed in studies on epidemiology as well as anthelmintics treatment for preventing economic loss and the risk of transmission to humans.