Systematic literature review and bibliometric analysis on virtual reality and education.

The objective of this study is to identify and analyze the scientific literature with a bibliometric analysis to find the main topics, authors, sources, most cited articles, and countries in the literature on virtual reality in education. Another aim is to understand the conceptual, intellectual, and social structure of the literature on the subject and identify the knowledge base of the use of VR in education and whether it is commonly used and integrated into teaching-learning processes. To do this, articles indexed in the Main Collections of the Web of Science, Scopus and Lens were analyzed for the period 2010 to 2021. The research results are presented in two parts: the first is a quantitative analysis that provides an overview of virtual reality (VR) technology used in the educational field, with tables, graphs, and maps, highlighting the main performance indicators for the production of articles and their citation. The results obtained found a total of 718 articles of which the following were analyzed 273 published articles. The second stage consisted of an inductive type of analysis that found six major groups in the cited articles, which are instruction and learning using VR, VR learning environments, use of VR in different fields of knowledge, learning processes using VR applications or games, learning processes employing simulation, and topics published during the Covid-19 pandemic. Another important aspect to mention is that VR is used in many different areas of education, but until the beginning of the pandemic the use of this so-called "disruptive process" came mainly from students, Institutions were reluctant and slow to accept and include VR in the teaching-learning processes.

Myasthenic Crisis in an Elderly Patient with Positive Antibodies against Acetylcholine and Anti-MuSK, Successfully Treated with Noninvasive Mechanical Ventilation.

Myasthenia gravis is an autoimmune disease characterized by muscle weakness. Subjects with antibodies against acetylcholine usually have greater ocular symptoms, lower bulbar weakness, and fewer respiratory complications, compared to individuals with anti-MuSK antibodies. The presence of positivity to both types of antibodies in the same patient is uncommon, and the clinical behavior of these individuals is uncertain. A myasthenic crisis is characterized by respiratory and bulbar muscle weakness, causing acute respiratory failure which requires mechanical ventilatory support. We present the case of a 73-year-old man with a medical history of myasthenia gravis and positive antibody titers against acetylcholine and anti-MuSK, who sought for medical assessment because of respiratory tract infection symptoms, dysphagia, and generalized weakness. Initially, no respiratory distress was found. After 24 hours the patient showed respiratory deterioration and neurological impairment. Endotracheal intubation was rejected, so ventilatory support with noninvasive ventilation was started. The patient was supported by intense respiratory therapy, and infusion of immunoglobulin was initiated. The individual responded favorably, improving his general condition. Weaning from noninvasive mechanical ventilation was possible after six days. Our case illustrates that noninvasive ventilation, properly supported by intense respiratory therapy, can be a great option to avoid intubation in the myasthenic patient.

Unplanned pregnancy in adolescents: association with family structure, employed mother, and female friends with health-risk habits and behaviors.

Previous publications have suggested that living in a nonintact family household and socializing with girlfriends who smoke or who consume alcoholic beverages favor the development of health-risk habits and customs in adolescents. However, their relationship with unplanned pregnancy in adolescents has not been determined. We investigated the association between family structure, employed mother, and female friends with health-risk habits and behaviors with unplanned pregnancy in adolescents (n = 3,130). After adjusting for low maternal educational level and low family income, logistic regression analyses showed that having an employed mother and socializing with girlfriends who have health-risk habits or behaviors, rather than living in a nonintact family household, appear to be the most important health-risk factors for unplanned pregnancy in adolescents. It is important for health-care programs for adolescents to be revised and for their strategies be strengthened in order to reach the objectives for which they were created.

Effect of ACTN3 gene on strength and endurance in soccer players.

Sports efficiency in activities in which strength and speed are the determining factors has been associated to the ACTN3 gene, which is responsible for the expression of α-actinin-3. Soccer is a mainly aerobic sport because of its long duration, but the acute actions that define the game demand a lot of strength and speed. The purpose of the present study was to compare the performance capacity of soccer players with different genotype groups of ACTN3 (XX, RX, and RR) in strength, speed, and endurance tests. Two hundred professional players of Brazilian soccer first division teams participated in this study. Speed, jump, and endurance test results were compared with the polymorphisms of the ACTN3 gene. It was noticed that RR individuals spent less time to run a 10-m path, compared with XX individuals (p < 0.05). The RR individuals also presented lower time rates at the 20- and 30-m path, compared with RX and XX individuals (p < 0.05). In jump tests, RR individuals presented higher rates, compared with RX and XX individuals (p < 0.05). As for aerobic tests, the XX individuals presented higher rates of V[Combining Dot Above]O2 max, compared with the RR group (p < 0.05), and did not differ from the RX group. The main conclusion of this study is that soccer players of genotype ACTN3/RR are the fastest in short distances and present higher jump potential. ACTN3/XX individuals presented the highest aerobic capacity. These findings can be used in training load adjustment and can influence the development of tactical schemes in soccer matches.

[Association between unplanned pregnancy and adolescence onset asthma]. / Asociación entre embarazo no planeado y asma de inicio en la adolescencia.

BACKGROUND: The association between asthma and pregnancy has been documented previously. The relationship between unplanned pregnancy and onset asthma in adolescence has not been studied. OBJECTIVE: To determine the association between unplanned pregnancy and adolescence onset asthma. MATERIAL AND METHODS: A cross-sectional study was done gathering information about asthma, unplanned pregnancy, family atopy and active or passive smoking in 3,130 adolescents aged 13-19 years. Asthma diagnosis was established through a selfquestionnaire based on the International Study of Asthma and Allergy in Childhood. Odds ratios for asthma were determined using logistic regression model and chi-squared test. RESULTS: Mean age of the participants was 16.37 ± 1.93 years. The prevalence of active smoking was 16.1%, of passive smoking 40% and of family atopy 9.8%. From the pregnant adolescents (785), 59.5% reported had planned not to have a child before pregnancy. Prevalence of wheezing during the year prior to the study was 9.3% and of wheezing during the pregnancy 2%. The prevalence of adolescence onset asthma was 5.4%. The age of initiation of asthma in the adolescence was 14.75 ± 1.60 years. The analysis showed that unplanned pregnancy has a slight risk for the development of asthma during adolescence. (Crude OR=1.03; CI 95% 1.02-1.05; p=0.000). CONCLUSION: Unplanned pregnancy, family atopy, active smoking and smoking friends are associated with the onset-asthma in the adolescence.

ANTECEDENTES: la asociación entre embarazo y asma se ha documentado previamente. La relación entre embarazo no planeado y asma de inicio en la adolescencia no se ha estudiado. OBJETIVO: determinar la asociación entre embarazo no planeado y asma de inicio en la adolescencia. MATERIAL Y MÉTODOS: estudio transversal en el que se recogió información de asma, embarazo no planeado, atopia familiar y tabaquismo activo o pasivo en 3,130 adolescentes de 13-19 años de edad. El asma se diagnosticó mediante un cuestionario autoadministrado basado en el utilizado en el Estudio Internacional de Asma y Alergia en Niños (ISAAC por sus siglas en inglés). Se determinó la razón de momios para asma mediante regresión logística y chi cuadrada. RESULTADOS: la edad media de las participantes fue 16.37 ± 1.93 años. La prevalencia del tabaquismo activo fue 16.1%, del pasivo 40% y la atopia familiar 9.8%. De las adolescentes embarazadas (785), 59.5% anotó que no había planeado tener un hijo antes del embarazo. La prevalencia de sibilancias durante el último año fue 9.3% y de sibilancias durante el embarazo 2%. La prevalencia de asma de inicio en la adolescencia fue 5.4%. La edad de inicio de asma en la adolescencia fue 14.75 ± 1.60 años. El análisis muestra que el embarazo no planeado tiene un ligero riesgo de padecer asma de inicio en la adolescencia (RM cruda=1.03; IC 95% 1.02-1.05). CONCLUSIONES: el embarazo no planeado, la atopia familiar, el tabaquismo activo y el tabaquismo de las amigas se asocian con el asma de inicio en la adolescencia.

[Metabolic syndrome prevalence and clinical features in blood donors]. / Prevalencia de síndrome metabólico y características clínicas en donadores de sangre.

BACKGROUND: Metabolic syndrome (MS) including obesity, diabetes mellitus, hypertension, dyslipidemia, etc.. is a major cause of morbidity and mortality worldwide. It was reported that 15.9% of blood donors showed changes in fasting plasma glucose. OBJECTIVE: To determine the prevalence of MS in a population of healthy donors in a secondary hospital. MATERIAL AND METHODS: A cross-sectional study, included 726 healthy donors who attended the blood bank HGZ36. The SM was identified with at least 3 of 5 criteria of the NCEP ATPIII, we applied a structured questionnaire. We determined HDL cholesterol, triglycerides, glucose Abnormal Fasting (GAA), hypertension (SAH), body mass index (BMI), waist circumference (WC), hip circumference (NCC). Plan Analysis: prevalence, t student, Chi2. RESULTS: Of the 726 donors, 85.1% were male, according to the ATPIII criteria, 54.8% (398) had a GAA, 63.2% (458) had hypertriglyceridemia, almost 17% (121) presented HDL hypocholesterolemia, 44.1% (320) were overweight by BMI, the prevalence of metabolic syndrome was 54.4%, in comparison by gender, men had a statistically significant difference compared to women, showing an OR = 2.27 (p = 0.0001, 95% CI 1.44-3.60). CONCLUSIONS: MS is highly prevalent in this population, which involves implementing preventive measures, changes in lifestyles and identify risk factors to be free from diseases like diabetes, hypertension, obesity and MS itself.

Association between obesity and asthma in preschool Mexican children.

The elevated prevalence of obesity as well as of asthma in preschool children has prompted investigators to speculate that obesity in childhood might be a causal factor in the development of asthma. The results obtained to date are debatable. We investigated the association between obesity and asthma in 1,160 preschool Mexican children. Diagnosis of asthma was performed using the International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire. The body mass index (BMI) in units of kg/m2 was determined, and children were categorized according to age- and gender-specific criteria, such as normal weight (5th-85th percentile), overweight (> or =85th and <95th percentile), and obesity (> or =95th percentile). Power test for logistic regression model was calculated. We found no association between overweight (adjusted OR = 1.02; 95% CI = 0.66-1.58), obesity (adjusted OR = 0.94; 95% CI = 0.68-1.30), and wheezing during the last year as determined by logistic regression model adjusted. We did not find an association between overweight, obesity, and asthma-associated hospitalizations. Further longitudinal studies are required to provide a better understanding of the relationship between obesity and asthma in preschool children.

Association between family structure, parental smoking, friends who smoke, and smoking behavior in adolescents with asthma.

Recent investigations show that the smoking prevalence among asthmatic adolescents is higher than among healthy adolescents, and the causes that lead these asthmatic adolescents to smoke are unclear. We investigated the association between family structure, parental smoking, smoking friends, and smoking in asthmatic adolescents (n = 6,487). After adjusting for sex and age, logistic regression analyses showed that nonintact family structure, parental smoking, and smoking friends are associated with smoking in adolescents with and without asthma. Asthmatic adolescents who reside in the household of a nonintact family have a 1.90 times greater risk of smoking compared with those who live with both biological parents. It is important that parents who have children with asthma be made aware that the presence of smokers in the home and adolescent fraternization with smoking friends not only favor the worsening of asthma, but also induce the habit of smoking.

Cuban medical education: aiming for the six-star doctor.

Profound changes are under way in Cuban medical education. Some aspects of this transformation represent radical shifts, others a deepening of processes already in motion. Together, these changes reflect a progressive sense of urgency over the last four decades to: 1) scale up physician training to meet the needs of the whole population; 2) recruit and train scientifically prepared and socially committed students; and 3) match competencies, knowledge base, and scope of responsibilities to the concrete health needs of people in Cuba and other countries where these future physicians may serve. These three goals have guided successive innovations in Cuban medical education since the early 1960s, when the University of Havana Medical School was left with only 23 of its 161 professors - the rest either emigrating or in disagreement with academic and health care reforms designed to guarantee the right to health care. From a fee-for-service model catering mainly to individual patients, health care was being transformed into a universal public health system. This required decentralization of medical services - first to the rural areas of the country, which had essentially gone without - followed by development of a nationwide primary health care network. Thus, from the beginning, there was an urgent need to train many more physicians and to train physicians prepared for, and committed to, this new vision.

Actividad antiviral de la lactoferrina de calostro humano contra el virus Herpes simple tipo 1 / Antiviral activity of human colostral lactoferrin against herpes simplex virus type 1

En el presente trabajo se evaluan la citotoxidad y actividad de una preparación local de lactoferrina de calostro humano para determinar su inocuidad y la actividad bilógica. en el modelo VHS-1 /células Vero, sta preparación de lactoferrina mostró una actividad antiviral significativa contra VHS-1 con parámetros (CC50-54,3uM, ED50 1,4uM, SI-39) Similares a los reportados para otras preparaciones comerciales de lactoferrina humana. Esta preparación de lactoferrina inhibió la actividad hemaglutinante del VHS-1 en eritrocitos de ratón. Se muestra por primera vez, que la actividad antiviral de la lactoferrina y la heparina contra VHS-1 se anulan, si ambas sustancias se mezclan antes de la infección viral(AU)

Patología y cirugía de tórax en el Hospital Juárez de México, SSA / Pathology and thoracic surgery at the Hospital Juaréz de México, SSA

La patología tumoral y no tumoral estudiada y tratada quirúrgicamente en el Hospital Juárez de México, SSA, es multiforme, tanto por su variedad etiológica como por la modalidad quirúrgica a la que tiene que recurrirse para su solución. Es una patología problemática porque a unos pasos del tercer milenio aún tenemos casos que constituyen hoy en día un problema de salud pública como el empiema postneumónico (36.63 por ciento). Otros generados hace una década y que van en aumento en proporción geométrica, como el tórax traumático (.9 por ciento) y la patologia tumoral (9 por ciento) en que bien poco se puede actuar médica o quirúrgicamente, por el grado tan avanzado en que los pacientes llegan a los hospitales del Sector Salud. Se analiza el grado de yatrogenia, (14 por ciento) de nuestro propio hospital. La cirugía de urgencía se realizó en el 26 por ciento de los casos. Se obtuvieron buenos resultados en el 97 por ciento de los pacientes

Estudio comparativo de eficacia y seguridad de 2 contraceptivos inyectables mensuales (Cycloprovera y HRP-102) / Coparative study of 2 injectable contraceptives administered in monthly doses: cycloprovera and HRP-102

Se realiza un estudio comparativo sobre la eficacia y seguridad de 2 contraceptivos inyectables administrados mensualmente por vía intramuscular (cycloprovera y HRP-102). Se estudian 70 mujeres sanas en edad reproductiva (18-35 años) que utilizaron dichos compuestos durante un año como máximo (35 mujeres en cada ggrupo). La efectividad del método fue del 100 por ciento en ambos grupos. No hubo variaciones significativas del peso, tensión arterial sistólica y diastólica durante el uso del método, así como se mantuvo sin variaciones el smear vaginal orgánico. Concluyeron el estudio 57 mujeres, mientras 7 lo suspendieron por trastornos del sangrado vaginal, 1 por galactorrea y 5 no regresaron a la consulta. Las manifestaciones secundarias más frecuentes, por orden, fueron: alteraciones del sangrado menstrual, dolor abdominal bajo y galactorrea. se comparan estos resultados con los encontrados en el estudio multicéntrico de la OMS, del cual formó parte (AU)

Estudio comparativo de eficacia y seguridad de 2 contraceptivos inyectables mensuales (Cycloprovera y HRP-102) / Comparative study of 2 injectable contraceptives administered in monthly doses: cycloprovera and HRP-102

Se realiza un estudio comparativo sobre la eficacia y seguridad de 2 contraceptivos inyectables administrados mensualmente por vía intramuscular (cycloprovera y HRP-102). Se estudian 70 mujeres sanas en edad reproductiva (18-35 años) que utilizaron dichos compuestos durante un año como máximo (35 mujeres en cada ggrupo). La efectividad del método fue del 100 por ciento en ambos grupos. No hubo variaciones significativas del peso, tensión arterial sistólica y diastólica durante el uso del método, así como se mantuvo sin variaciones el smear vaginal orgánico. Concluyeron el estudio 57 mujeres, mientras 7 lo suspendieron por trastornos del sangrado vaginal, 1 por galactorrea y 5 no regresaron a la consulta. Las manifestaciones secundarias más frecuentes, por orden, fueron: alteraciones del sangrado menstrual, dolor abdominal bajo y galactorrea. se comparan estos resultados con los encontrados en el estudio multicéntrico de la OMS, del cual formó parte

Importancia de la labor de enfermería en el tratamiento de la diabética embarazada / Iportance of nurse's work in the treatment of diabetic pregnant women

Se revisan los aspectos teoricoprácticos que debe dominar la enfermera que atiende a gestantes diabéticas como parte del equipo multidisciplinario de seguimiento. Se resalta la importancia del papel que desempeña la misma en la evolución de estos casos y los resultados positivos sobre el curso del embarazo y la natalidad, debido al entrenamiento adecuado de este personal técnico

Importancia de la labor de enfermería en el tratamiento de la diabética embarazada / Importance of nurse's work in the treatment of diabetic pregnant women

Se revisan los aspectos teoricoprácticos que debe dominar la enfermera que atiende a gestantes diabéticas como parte del equipo multidisciplinario de seguimiento. Se resalta la importancia del papel que desempeña la misma en la evolución de estos casos y los resultados positivos sobre el curso del embarazo y la natalidad, debido al entrenamiento adecuado de este personal técnico

Evaluación e identificación de la extensión del infarto agudo al miocardio y sus complicaciones mediante la ecocardiografía bidimensional / Evaluation and identification of the extension of acute myocardial infarction and its complications by means of two-dimensional echocardiography

Se estudió en forma consecutiva un grupo de 53 pacientes con infarto agudo al miocardio, mediante ecocardiografía bidimensional, 1 a 3 días después de su ingreso, buscando la siguiente información: 1) determinar si el método puede detectar asinergia ventricular regional; 2) determinar si el procedimiento puede detectar pacientes de alto riesgo para desarrollar choque cardiogénico antes de que presenten deterioro hemodinámico; 3) identificar las complicaciones inmediatas del infarto agudo al miocardio. Para los propósitos del presente estudio, utilizamos la nomeclatura del grupo de Tajik de la Clínica Mayo, en la cual los ventrículos se dividen en un sistema de paredes, segmentos y niveles con un sistema resultante de 22 regiones potencialmente visualizables por ecocardiográficos bidimensional. Los estudios ecocardiográficos bidimensionales pudieron realizarse en forma técnicamente satisfactoria en 48 pacientes (90.56%). De los 1056 posibles segmentos en los 48 pacientes incluídos, todos fueron perfectamente visualizables. Se detectó acinesia en 2 segmentos (0.18%), discinesia en 45 segmentos (4.26%), hipocinesia en 170 segmentos (16.09%), hipercinesia en 15 (1.42%) y se registraron 824 segmentos como normales (78.03%). Existió una correlación directamente proporcional entre el número de segmentos dañados que se identificaron por ecocardiografía bidimensional y el estado clínico y hemodinámico del paciente. Las complicaciones inmediatas fueron: Derrame pericárdico en 20 casos (45.45%), discinesia ventricular en 14(31.81%), trombosis ventricular en 6(13.63%), disfunción de músculos papilares en 3(6.81%), ruptura septal en 1 caso (2.27%). La ecocardiografía bidimensional realizada en las primeras horas después de su ingreso a la Unidad Coronaria, aporta una información útil respecto a la función, ventricular tanto global como regional y ofrece, además, información predictiva importante sobre pacientes en la etapa inmediata al infarto agudo. Se obtuvo una sensibilidad del 99.57%, especificidad del 99.75% y valor predictivo del 99.14%

Manejo de la paciente hipertiroidea embarazada con propranolol. Presentación de 7 casos / Management of a hypertyroid pregnant patient with propanolol. Presentation of seven cases

Se presentan 7 casos de pacientes embarazadas con bocio difuso tóxico, tratadas en la consulta de endocrinopatías y embarazo del hospital provincial docente "Saturnino Lora" de Santiago de Cuba, a las cuales se les impuso tratamiento con propanolol. Se establecen consideraciones sobre la utilización del medicamento en esta enfermedad, así como sus posibles efectos secundarios. Se señalan los resultados obtenidos desde el punto de vista obstétrico, asícomo en el control de la sintomatología del paciente. Se enfatiza en la posibilidad con que cuenta el médico que trate estas pacientes, de incrementar el arsenal terapéutico para las mismas. Se destaca la gran ventaja que representa el poder permitir la lactancia materna (AU)

Litoquelifopedion. Presentación de un caso / Lithokelyphopedion. Presentation of a case

Se presenta el caso de una paciente intervenida quirúrgicamente por un tumor sólido anexial, que resultó ser un litoquelifopedión. Se realiza breve reseña de la entidad y sus características clínicas y anatomopatológicas (AU)