Strategies Used by Puerto Rican Children in the Cognitive Assessment System and Their Relationship with Planning Performance.

Studies involving the Cognitive Assessment System (CAS) planning scale typically use only the subtest and scale scores without assessing the strategies employed by the participants. This study addressed this gap and examined the planning strategies used by children in the CAS2: Spanish version and their relationship with planning performance. We conducted an exploratory cross-sectional study with 26 Puerto Rican children aged 8 to 11. Results showed that no strategies were consistently used by participants according to examinees' reports (f = 0-46%), but examiners observed consistent use of some strategies such as "coded left to right, top to bottom", f = 92%; "scanned the page for the next number or letter", f = 100%. Welch's t-tests did not show relationships between participants' performance and the strategies observed by examiners, | mean differences | = 0.05-0.81, ps ≥ 0.05, nor with the strategies reported by participants, | mean differences | = 0.05-1.69, ps ≥ 0.05. These findings suggest that although the examiners may observe the use of strategies, the examinees are unaware of the strategies they use, and the strategies used are not associated with their performance. Future studies are needed to confirm these findings.

Dental Hygiene Challenges in Children with Autism: Correlation with Parental Stress: A Scoping Review.

BACKGROUND: Children diagnosed with autism spectrum disorders are shown to have poor periodontal health and dental hygiene habits. Extensive research has revealed that parents of children with autism spectrum disorder (ASD) frequently encounter heightened levels of stress, despair, and anxiety in comparison to parents of neurotypical children. The aim was to understand the relationship between the dental hygiene of children with ASD and the stress generated in their parents. Methods: A scoping review was carried out to identify any gaps or research opportunities for clinical practice concerning oral care and stress levels in parents in the PubMed, Medline, ScienceDirect, and Scopus databases. Results: A total of 139 articles were reviewed. Of these, only 10 met the selection criteria for inclusion. Our results reveal a lack of studies presenting evidence on the topic of poor dental hygiene in children with ASD and high stress levels in their parents. Discussion: There is ample evidence that children with ASD have poor dental hygiene, as well as higher levels of stress in their parents. However, little or no evidence links these two variables. Future studies should focus on this link, which could have practical implications for improving dental care for children with ASD.

Protocolo para el tratamiento de la recesión gingival con membrana de fibrina rica en plaquetas / Protocol for the Treatment of Gingival Recession with Platelet-rich Fibrin Membrane

Introducción: Es necesario la aplicación de protocolos de actuación como herramientas que permiten homogeneizar los procedimientos plásticos periodontales regenerativos y establecer las pautas de actuación del Periodontólogo para el abordaje de las recesiones gingivales con esta modalidad terapéutica de avanzada. Objetivo: Diseñar un protocolo para el tratamiento de la recesión gingival mediante la utilización de la membrana de fibrina rica en plaquetas, asociada al colgajo de avance coronal. Métodos: Se realizó una investigación con enfoque cualitativo en la Facultad de Estomatología de Villa Clara, de julio de 2020 a diciembre de 2021. Para el diseño del protocolo se empleó una fase de preparación y una de elaboración; dentro de esta última se estructuraron tres momentos: revisión sistemática de la literatura, aplicación de técnicas grupales (grupo focal y nominal) y conclusión del documento. Se realizó una valoración por criterios de especialistas externos antes de concluir la estructura definitiva del protocolo. Resultados: Se consultaron cinco guías para la confección de protocolos, cinco protocolos de atención médica y enfermería y 10 estomatológicos. La estructura del documento quedó conformada por: portada, introducción, objetivos, profesionales a quienes va dirigido, población diana, proceso de elaboración, procedimiento, algoritmo, fecha de implementación y revisión, proceso de implantación, indicadores de evaluación, glosario y referencias bibliográficas. Conclusiones: Se diseñó un protocolo de actuación que establece las pautas para la realización del proceder terapéutico regenerativo, desde la selección de los pacientes hasta la evolución de la terapéutica. El documento se valoró por especialistas externos como positivo(AU)

Introduction: It is necessary to apply action protocols as tools to homogenize regenerative periodontal plastic procedures and to establish the guidelines for the periodontist to approach gingival recession with this advanced therapeutic modality. Objective: To design a protocol for the treatment of gingival recession using platelet-rich fibrin membrane associated with coronal advancement flap. Methods: A research with a qualitative approach was carried out in the School of Stomatology of Villa Clara, from July 2020 to December 2021. For the design of the protocol, a preparation phase and an elaboration phase were used; within the latter, three moments were structured: systematic review of the literature, application of group techniques (focal and nominal group) and conclusion of the document. An evaluation by external specialists was carried out before finalizing the definitive structure of the protocol. Results: Five guides for the preparation of protocols, five medical and nursing care protocols and 10 stomatological protocols were consulted. The structure of the document consisted of: cover page, introduction, objectives, target professionals, target population, elaboration process, procedure, algorithm, implementation and revision date, implementation process, evaluation indicators, glossary and bibliographic references. Conclusions: An action protocol was designed that establishes the guidelines for carrying out the regenerative therapeutic procedure, from the selection of patients to the evolution of the therapy. The document was positively evaluated by external specialists(AU)

Membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal tres años después

Fundamento la asociación de la membrana de fibrina rica en plaquetas con el colgajo de reposición coronal constituye una modalidad de la ingeniería de tejidos que aporta elementos regenerativos al proceso de reparación tisular. Objetivo evaluar la efectividad de la membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal en el tratamiento de la recesión periodontal tres años después. Métodos se realizó un cuasiexperimento en la facultad de Estomatología de Villa Clara, en el periodo marzo de 2017-julio de 2020, y con una población de estudio conformada por 46 pacientes portadores de recesión periodontal, quienes requerían recubrimiento radicular mediante el colgajo de reposición coronal. Se utilizó un muestreo no probabilístico intencional por criterios, y la muestra quedó conformada por 26 pacientes. Se establecieron sitios de estudio y sitios de control. Las variables estudiadas fueron: edad, sexo, largo de la recesión, clasificación de Miller, cobertura radicular, ancho y ganancia de la encía insertada, categorías de evaluación y efectividad del tratamiento. Resultados en el 88,68 % de los dientes ubicados en los sitios de estudio predominó la categoría de evaluación favorable. El porcentaje de efectividad a los tres años de la terapéutica fue superior en los sitios de estudio (54,71 %). Conclusiones se consideró más efectivo el tratamiento de la recesión periodontal con membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal a los tres años del proceder.

Foundation the association of the platelet-rich fibrin membrane with the coronal replacement flap constitutes a modality of tissue engineering that provides regenerative elements to the tissue repair process. Objective to evaluate the effectiveness of the platelet-rich fibrin membrane associated with the coronal repositioning flap in the treatment of periodontal recession three years later. Methods a quasi-experiment was carried out at the Villa Clara Dentistry Faculty, from March 2017 to July 2020, a study population of 46 patients with periodontal recession, who required root coverage using the replacement flap coronal. Intentional non-probabilistic sampling by criteria was used, and the sample of 26 patients. Study sites and control sites were established. The studied variables were: age, sex, recession length, Miller classification, root coverage, width and gain of the attached gingiva, evaluation categories and treatment effectiveness. Results in 88.68% of the teeth located in the study sites, the favorable evaluation category predominated. The effectiveness percentage three years after treatment was higher in the study sites (54.71%). Conclusions the treatment of periodontal recession with platelet-rich fibrin membrane associated with the coronal replacement flap was considered more effective three years after the procedure.

Virological evidence of the impact of non-pharmaceutical interventions against COVID-19 in Ecuador, a resource-limited setting.

Ecuador had substantial COVID-19-mortality during 2020 despite early implementation of non-pharmaceutical interventions (NPIs). Resource-limited settings like Ecuador have high proportions of informal labour which entail high human mobility, questioning efficacy of NPIs. We performed a retrospective observational study in Ecuador's national reference laboratory for viral respiratory infections during March 2020-February 2021 using stored respiratory specimens from 1950 patients, corresponding to 2.3% of all samples analysed within the Ecuadorian national surveillance system per week. During 2020, detection of SARS-CoV-2 (Pearson correlation; r = -0.74; p = 0.01) and other respiratory viruses (Pearson correlation; r = -0.68; p = 0.02) by real-time RT-PCR correlated negatively with NPIs stringency. Among respiratory viruses, adenoviruses (Fisher's exact-test; p = 0.026), parainfluenzaviruses (p = 0.04), enteroviruses (p < 0.0001) and metapneumoviruses (p < 0.0001) occurred significantly more frequently during months of absent or non-stringent NPIs (characterized by <55% stringency according to the Oxford stringency index data for Ecuador). Phylogenomic analyses of 632 newly characterized SARS-CoV-2 genomes revealed 100 near-parallel SARS-CoV-2 introductions during early 2020 in the absence of NPIs. NPI stringency correlated negatively with the number of circulating SARS-CoV-2 lineages during 2020 (r = -0.69; p = 0.02). Phylogeographic reconstructions showed differential SARS-CoV-2 dispersion patterns during 2020, with more short-distance transitions potentially associated with recreational activity during non-stringent NPIs. There were also fewer geographic transitions during strict NPIs (n = 450) than during non-stringent or absent NPIs (n = 580). Virological evidence supports that NPIs had an effect on virus spread and distribution in Ecuador, providing a template for future epidemics in resource-limited settings and contributing to a balanced assessment of societal costs entailed by strict NPIs.

Exposure to Trypanosoma cruzi and Leishmania parasites in dogs from a rural locality of Yucatan, Mexico. A serological survey.

Trypanosoma cruzi, the causal agent of American trypanosomiasis, and Leishmania spp., the causal agents of Leishmaniasis, are prevalent in more than 20 American countries, including Mexico. Dogs have been reported as incidental hosts for both parasites and may be helpful as transmission sentinels. We surveyed the dog population in a rural locality of the Merida municipality in Yucatan, Mexico, to evaluate the seroreactivity against T. cruzi and Leishmania spp. using two antigens, parasite homogenate (H) and iron superoxide dismutase extract (FeSODe), with two serological techniques (ELISA and Western Blot). Our study found that 3.33% of the tested dogs were seroreactive to T. cruzi using ELISA-H, and 29.5% were seroreactive to FeSODe antigen, with a 94.4% consistency between the two tests. Similarly, for L. mexicana, 1.6% were seroreactive using ELISA-H, and 9.8% were seroreactive using ELISA-FeSODe, with an 83.3% consistency between tests. For L. braziliensis, no dogs were seroreactive using ELISA-H, but 16.4% were seroreactive using ELISA-FeSODe, with a 90% consistency between tests. Finally, for L. infantum, 4.9% were seropositive using ELISA-H, and 6.6% were seropositive using ELISA-FeSODe, with a 75% consistency between tests. These results show noticeable evidence of exposure of dogs to trypanosomatid parasites and highlight the potential disease risk for the people and their companion animals in the region.

Effect of receiving a customizable brochure on breast cancer patients' knowledge about their diagnosis and treatment: A randomized clinical trial.

BACKGROUND: Patients' lack of knowledge about their own disease may function as a barrier to shared decision-making and well-being. This study aimed to evaluate the impact of written educational materials on breast cancer patients. METHODS: This multicenter, parallel, unblinded, randomized trial included Latin American women aged ≥18 years with a recent breast cancer diagnosis yet to start systemic therapy. Participants underwent randomization in a 1:1 ratio to receive a customizable or standard educational brochure. The primary objective was accurate identification of molecular subtype. Secondary objectives included identification of clinical stage, treatment options, participation in decision-making, perceived quality of information received, and illness uncertainty. Follow-up occurred at 7-21 and 30-51 days post-randomization. CLINICALTRIALS: gov identifier: NCT05798312. RESULTS: One hundred sixty-five breast cancer patients with a median age of 53 years and 61 days from diagnosis were included (customizable: 82; standard: 83). At first available assessment, 52%, 48%, and 30% identified their molecular subtype, disease stage, and guideline-endorsed systemic treatment strategy, respectively. Accurate molecular subtype and stage identification were similar between groups. Per multivariate analysis, customizable brochure recipients were more likely to identify their guideline-recommended treatment modalities (OR: 4.20,p = 0.001). There were no differences between groups in the perceived quality of information received or illness uncertainty. Customizable brochure recipients reported increased participation in decision-making (p = 0.042). CONCLUSIONS: Over one third of recently diagnosed breast cancer patients are incognizant of their disease characteristics and treatment options. This study demonstrates a need to improve patient education and shows that customizable educational materials increase patients' understanding of recommended systemic therapies according to individual breast cancer characteristics.

Risk of Developing Insulin Resistance in Adult Subjects with Phenylketonuria: Machine Learning Model Reveals an Association with Phenylalanine Concentrations in Dried Blood Spots.

Phenylketonuria (PKU) is an autosomal recessive inborn error of metabolism where high phenylalanine (Phe) concentrations cause irreversible intellectual disability that can be prevented by newborn screening and early treatment. Evidence suggests that PKU subjects not adherent to treatment could be at risk of insulin resistance (IR). We studied how Phe concentrations (PheCs) relate to IR using machine learning (ML) and derived potential biomarkers. In our cross-sectional study, we analyzed subjects with neonatal diagnoses of PKU, grouped as follows: 10 subjects who adhered to treatment (G1); 14 subjects who suspended treatment (G2); and 24 control subjects (G3). We analyzed plasma biochemical variables, as well as profiles of amino acids and acylcarnitines in dried blood spots (DBSs). Higher PheCs and plasma insulin levels were observed in the G2 group compared to the other groups. Additionally, a positive correlation between the PheCs and homeostatic measurement assessments (HOMA-IRs) was found, as well as a negative correlation between the HOMA-Sensitivity (%) and quantitative insulin sensitivity check index (QUICKI) scores. An ML model was then trained to predict abnormal HOMA-IRs using the panel of metabolites measured from DBSs. Notably, ranking the features' importance placed PheCs as the second most important feature after BMI for predicting abnormal HOMA-IRs. Our results indicate that low adherence to PKU treatment could affect insulin signaling, decrease glucose utilization, and lead to IR.

Dolor y edema posquirúrgico en la regeneración cutánea nasal con fibrina rica en plaquetas y leucocitos / Post-surgical pain and edema in nasal skin regeneration with fibrin rich in platelets and leukocytes

Introducción: La reconstrucción de defectos cutáneos nasales requiere del uso de procedimientos orientados a obtener la menor probabilidad de complicaciones posoperatorias en el menor período de tiempo posible. Novedosas técnicas utilizan los concentrados plaquetarios por sus propiedades moduladoras del dolor y el edema posoperatorio. Objetivo: Determinar el comportamiento del dolor y el edema posquirúrgico en la regeneración de defectos cutáneos nasales con el uso de la membrana de fibrina autóloga, rica en plaquetas y leucocitos. Método: Se realizó una investigación cuasiexperimental, con diseño antes-después, sin grupo control en el Servicio de Cirugía Maxilofacial del Hospital Universitario "Arnaldo Milián Castro" de la ciudad de Santa Clara, Villa Clara, Cuba, desde septiembre de 2015 a junio de 2019. La muestra seleccionada aleatoriamente fue de 46 pacientes. A partir de una autodonación de sangre del paciente se obtuvo una membrana de fibrina rica en plaquetas y leucocitos, la cual fue suturada en el defecto quirúrgico nasal. Resultados: La edad media fue 62,71 años y el 60,87 por ciento de la muestra correspondió al sexo masculino. Se presentaron el dolor en el 23,91 por ciento y el edema en el 28,26 por ciento de la muestra estudiada. Conclusiones: Se encontraron escasas complicaciones posoperatorias como el dolor y el edema, las que se manifestaron predominantemente de intensidad leve. Existió asociación entre estas complicaciones y la edad, la cantidad de subunidades anatómicas afectadas, la diabetes mellitus y el tabaquismo(AU)

Introduction: The reconstruction of nasal skin defects requires the use of procedures aimed at obtaining the lowest probability of postoperative complications in the shortest period of time possible. Novel techniques use platelet concentrates for their modulating properties of pain and postoperative edema. Objective: To determine the behavior of pain and post-surgical edema in the regeneration of nasal skin defects with the use of autologous platelet- and leukocyte-rich fibrin membrane. Method: A quasi-experimental research was carried out, with a before-after design, without a control group, in the Maxillofacial Surgery Service at Arnaldo Milián Castro University Hospital in Santa Clara, Villa Clara, Cuba, from September 2015 to June 2015. 2019. The randomly selected sample was 46 patients. A fibrin membrane rich in platelets and leukocytes was obtained from a patient's blood self-donation, which was sutured in the nasal surgical defect. Results: The mean age was 62.71 years and 60.87 por ciento f the sample was male. Pain was present in 23.91 por ciento and edema in 28.26 por ciento of the studied sample. Conclusions: Few postoperative complications such as pain and edema were found, showing to be mild predominantly. There was association between these complications and age, the number of affected anatomical subunits, diabetes mellitus and smoking habit(AU)

Validación de la Escala de Bienestar Psicológico de Carol Ryff, en adultos mayores cubanos / Validation of Carol Ryff's Psychological Well-Being Scale in Cuban older adults

Introducción: El bienestar del adulto mayor constituye una prioridad del Sistema Sanitario, por lo que es necesario contar con instrumentos válidos y confiables para su evaluación. Objetivo: Validar la Escala de Bienestar Psicológico de Carol Ryff, en una muestra de adultos mayores con diagnóstico presuntivo de osteoartrosis de rodilla, de la provincia de Villa Clara, Cuba. Métodos: Se asumió el paradigma de investigación cuantitativo y un tipo de estudio instrumental. La selección muestral fue probabilística, conformada por 170 adultos mayores. Se aplicó el instrumento Escala de Bienestar Psicológico de Carol Ryff (42 aspectos); para el procesamiento de la información se emplearon las pruebas estadísticas: coeficiente alpha de Cronbach y el Análisis Factorial Exploratorio. Resultados: Se determinó una estructura coherente de 5 factores: autoaceptación, propósito en la vida, dominio del entorno, autonomía y relaciones positivas con los demás. Se apreció una elevada consistencia interna de la escala global y sus dimensiones, así como adecuadas correlaciones entre los diversos aspectos. Conclusión: El instrumento posee adecuadas propiedades psicométricas y permite evaluar el constructo en esta población.

Introduction: the well-being of the elderly is a priority of the health system, that is why valid and reliable instruments are necessary for its evaluation. Objective: to validate the Carol Ryff's Psychological Well-Being Scale in a sample of older adults from Villa Clara province, Cuba with a presumptive diagnosis of knee osteoarthritis. Methods: a quantitative and instrumental research was assumed. The sample selection was probabilistic, made up of 170 older adults with this condition. The Carol Ryff's Psychological Well-Being Scale was applied (42 items); statistical tests were used for information processing such as Cronbach's alpha coefficient and Exploratory Factor Analysis. Results: a coherent factorial structure of 5 factors was determined: self-acceptance, purpose in life, environmental mastery, autonomy, and positive relationships with others. A high internal consistency of the global scale and its dimensions were observed, as well as adequate inter-item correlations. Conclusion: the instrument has adequate psychometric properties and allows us to evaluate the construct in this population.

Survey on the association between Toxoplasma gondii infection and violent behavior in inmates.

We evaluated the association between T. gondii seropositivity and violent behavior in a sample of inmates in Durango, Mexico. Through a cross-sectional study design, we studied 128 inmates (mean age: 35.89 ± 10.51; range: 19-65 years). Sera of participants were analyzed for anti-T. gondii IgG antibodies using a commercially available enzyme-linked immunosorbent assay. Violence was assessed by 1) the Historical, Clinical and Risk Management-20 (HCR-20) tool; 2) the type of the crime for which inmates were convicted; and 3) the Buss-Perry Aggression Questionnaire (AGQ). Of the 128 inmates, 17 (13.3%) had high risk of violence by the HCR-20 criteria, 72 (56.3%) were considered violent by the type of the crime committed, and 59 (46.1%) were considered violent by the AGQ. Depending on the evaluation method of violence, the seroprevalence of T. gondii infection in violent inmates varied from 0% to 6.9%. No statistically significant difference in anti-T. gondii IgG seroprevalence between violent and non-violent inmates was found (for instance by AGQ, OR: 1.17; 95% CI: 0.22-6.07; P = 1.00). Mean scores of the AGQ in T. gondii seropositive inmates (73.67 ± 29.09; 95% CI: 50.00-99.31) were similar to those (79.84 ± 25.00; 95% CI: 75.46-84.27) found in T. gondii seronegative inmates (P = 0.55). Mean scores of anger, psychical aggression, verbal aggression, and hostility in T. gondii seropositive inmates were similar to those found in T. gondii seronegative inmates. Results of this study suggest that infection with T. gondii is not associated with violence in inmates in Durango, Mexico. Further studies with larger sample sizes and in several correctional facilities to determine the association between T. gondii infection and violence in inmates are needed.

Cardiometabolic risk factors and antithrombotic treatment in a Mexican population with atrial fibrillation and heart failure with reduced ejection fraction.

INTRODUCTION: Heart failure in patients with non-valvular atrial fibrillation (NVAF) is two to three times more common than in individuals without NVAF. OBJECTIVE: To identify cardiometabolic risk factors (CMRF) and antithrombotic treatment in patients with NVAF and heart failure with reduced ejection fraction (HFrEF), and to determine if there were differences according to gender. METHODS: CMRF, pro-thrombotic risk, bleeding risk, and antithrombotic therapy were globally analyzed and according to gender. RESULTS: Out of 1,423 patients with NVAF, 336 had HFrEF. On average, females were older than males. There was no difference between genders with regard to the type of NVAF or direct oral anticoagulants use. Hypertension was more common in women. History of transient ischemic attack was reported in 3.6% of the patients and cerebrovascular event in 10%, without differences in terms of gender. The percentage of men with elevated embolic risk was higher, but without antithrombotic treatment, in comparison with women. CONCLUSIONS: Significant differences were found according to gender in patients with NVAF and HFrEF, both in CMRF and some comorbidities, as well as in antithrombotic treatment according to embolic and bleeding risk.

INTRODUCCIÓN: La insuficiencia cardiaca en pacientes con fibrilación auricular no valvular (FANV) es de dos a tres veces más frecuente que en individuos sin FANV. OBJETIVO: Identificar los factores de riesgo cardiometabólico (FRCM) y el tratamiento antitrombótico de pacientes con FANV e insuficiencia cardiaca con fracción de expulsión reducida (IC-FEr), y determinar si existen diferencias conforme al sexo. MÉTODOS: En forma global y de acuerdo con el sexo se analizaron FRCM, riesgo protrombótico, riesgo de sangrado y terapia antitrombótica. RESULTADOS: De 1423 pacientes con FANV, 336 tuvieron IC-FEr. Las mujeres promediaron mayor edad que los hombres. No hubo diferencia entre los sexos respecto al tipo de FANV o uso de anticoagulantes orales directos. La hipertensión arterial sistémica fue más frecuente en mujeres. Un 3.6 % de los pacientes reportó antecedente de ataque isquémico transitorio y 10 % de evento vascular cerebral, sin diferencias en cuanto al sexo. El porcentaje de hombres con riesgo embólico elevado fue mayor, pero sin tratamiento antitrombótico, en comparación con las mujeres. CONCLUSIONES: Se encontraron diferencias significativas de acuerdo con el sexo en pacientes con FANV e IC-FEr, tanto en FRCM y algunas comorbilidades, como en el tratamiento antitrombótico de acuerdo con el riesgo embólico y de sangrado.

Factores de riesgo cardiometabólico y tratamiento antitrombótico en población mexicana con fibrilación auricular e insuficiencia cardiaca con fracción de expulsión reducida / Cardiometabolic risk factors and antithrombotic treatment in a Mexican population with atrial fibrillation and heart failure with reduced ejection fraction

Resumen Introducción: La insuficiencia cardiaca en pacientes con fibrilación auricular no valvular (FANV) es de dos a tres veces más frecuente que en individuos sin FANV. Objetivo: Identificar los factores de riesgo cardiometabólico (FRCM) y el tratamiento antitrombótico de pacientes con FANV e insuficiencia cardiaca con fracción de expulsión reducida (IC-FEr), y determinar si existen diferencias conforme al sexo. Métodos: En forma global y de acuerdo con el sexo se analizaron FRCM, riesgo protrombótico, riesgo de sangrado y terapia antitrombótica. Resultados: De 1423 pacientes con FANV, 336 tuvieron IC-FEr. Las mujeres promediaron mayor edad que los hombres. No hubo diferencia entre los sexos respecto al tipo de FANV o uso de anticoagulantes orales directos. La hipertensión arterial sistémica fue más frecuente en mujeres. Un 3.6 % de los pacientes reportó antecedente de ataque isquémico transitorio y 10 % de evento vascular cerebral, sin diferencias en cuanto al sexo. El porcentaje de hombres con riesgo embólico elevado fue mayor, pero sin tratamiento antitrombótico, en comparación con las mujeres. Conclusiones: Se encontraron diferencias significativas de acuerdo con el sexo en pacientes con FANV e IC-FEr, tanto en FRCM y algunas comorbilidades, como en el tratamiento antitrombótico de acuerdo con el riesgo embólico y de sangrado.

Abstract Introduction: Heart failure in patients with non-valvular atrial fibrillation (NVAF) is two to three times more common than in individuals without NVAF. Objective: To identify cardiometabolic risk factors (CMRF) and antithrombotic treatment in patients with NVAF and heart failure with reduced ejection fraction (HFrEF), and to determine if there were differences according to gender. Methods: CMRF, pro-thrombotic risk, bleeding risk, and antithrombotic therapy were globally analyzed and according to gender. Results: Out of 1,423 patients with NVAF, 336 had HFrEF. On average, females were older than males. There was no difference between genders with regard to the type of NVAF or direct oral anticoagulants use. Hypertension was more common in women. History of transient ischemic attack was reported in 3.6% of the patients and cerebrovascular event in 10%, without differences in terms of gender. The percentage of men with elevated embolic risk was higher, but without antithrombotic treatment, in comparison with women. Conclusions: Significant differences were found according to gender in patients with NVAF and HFrEF, both in CMRF and some comorbidities, as well as in antithrombotic treatment according to embolic and bleeding risk.

El Modelo Bidimensional de Salud Mental: una aproximación empírica en una muestra de la población general

Introducción: La regulación de las emociones implica modular las experiencias de las emociones para facilitar el logro de los objetivos, por el contrario, las dificultades en las mismas son un patrón de experiencias emocionales que interfieren con el comportamiento dirigido a un objetivo. Objetivos: Presentamos una aproximación al Modelo Bidimensional de Salud Mental (BDSM) que consideran la angustia psicológica y el bienestar subjetivo como dos dimensiones separadas pero relacionadas. Método: En una muestra es de 290 personas adultas de la comunidad, con un 55,2% mujeres y una media de edad de 28,6 (Dt = 12.0). Resultados: Los resultados confirman una estructura bidimensional de psicopatología (PS) y bienestar subjetivo (BS), negativamente relacionados. El modelo propone la clasificación en cuatro grupos atendiendo al resultado anterior, a saber, salud mental completa (BS alto, PS baja, 62,2%), vulnerable (BS bajo, PS baja, 11,4%), sintomático pero contento (BS alto, PS alta, 11,4%) y con problemas (BS bajo, PS alta, 15%). Los resultados señalan que los grupos con problemas y sintomáticos obtienen puntuaciones medias más elevadas en la preocupación rasgo, la evitación experiencial y conductual, y a su vez, el grupo sintomático puntúa más elevado en resistencia al malestar y en las estrategias de regulación emocional cognitivas más adaptativas. El grupo vulnerable obtiene medias más bajas en estas últimas. Los resultados de los grupos vulnerables y sintomáticos confirman la coexistencia del bienestar y la psicopatología. Conclusiones: Los resultados se discuten atendiendo a los estudios revisados, y dada la relevancia de las estrategias de regulación emocional en la satisfacción con la vida y la resistencia al malestar, se proponen tratamientos transdiagnósticos de la regulación de las emociones.

Background: Comprehensive mental health research is proposed as an important resource for individual well-being, as opposed to indicators of psychopathology. Objectives: We present an approach to the Bidimensional Model of Mental Health (BDSM) that considers psychological distress and subjective well-being as two separate but related dimensions. Methods: In a sample of 290 adults from the community, with 55.2% women and a mean age of 28.6 (Dt = 12.0). Results: The continuous results confirm a two-dimensional structure of psychopathology (PS) and subjective well-being (BS). The proposed model proposes classification into four groups according to the above result, namely, complete mental health (high BS, low PS, 62.2%), vulnerable (low BS, low PS, 11.4%), symptomatic but content (high BS, high PS, 11.4%) and troubled (low BS, high PS, 15%). The categorical results indicate that the problem and symptomatic groups obtained higher mean scores in trait worry, experiential and behavioral avoidance, and in turn, the symptomatic group scored higher in resistance to distress and in the more adaptive cognitive emotional regulation strategies; on the contrary, the vulnerable group obtained lower means in the latter. The results of the vulnerable and symptomatic groups confirm the coexistence of well-being and psychopathology. Conclusions: The promotion of subjective well-being is proposed when considering health in a more comprehensive way, because of its potential to generate profound and lasting benefits for individuals and the community in general.

Las relaciones de la regulación de las emociones con la procastinación, la satisfacción con la vida y la resistencia al malestar

Introducción: La regulación de las emociones implica la modulación de las experiencias de las emociones para facilitar la consecución de los objetivos, por el contrario, las dificultades emocionales son un patrón de experiencias y/o expresiones emocionales que interfieren con el comportamiento dirigido a objetivos. Objetivos: Nuestro objetivo fue determinar la relación entre las dificultades en la regulación emocional con la postergación, la satisfacción con la vida y la resiliencia a la angustia. Método: La muestra consistió en 366 personas de la población general, con una media de edad de 33 años (DE=15) y un 62.1% de mujeres. Resultados: La postergación se relaciona positivamente con las seis estrategias de dificultades en la regulación de las emociones y el afecto negativo (AN), y negativamente con el afecto positivo (AP), la satisfacción con la vida y la resistencia a la angustia. La satisfacción con la vida y la resistencia a la angustia se relacionan negativamente con las estrategias de regulación identificadas y con el afecto negativo, y positivamente con el afecto positivo. La postergación, una vez controlado el AN y el AP se predice por la falta de claridad y la falta de objetivos. La satisfacción con la vida y la resistencia a la angustia son predichas por menos falta de estrategias. Conclusiones: Se concluye que de las variables sociodemográficas solo la edad es relevante en la postergación, dado que las personas menores de 21 años puntúan más elevado en este constructo. La postergación se relaciona positivamente con las seis dimensiones de las dificultades en la regulación de las emociones, en las que es predicha por la falta de objetivos y la falta de claridad, sin embargo, la satisfacción con la vida y la resistencia al malestar por menos falta de estrategias.

Background: Emotion regulation involves the modulation of emotional experiences to facilitate goal attainment. Conversely, emotional difficulties are a pattern of emotional experiences and expressions that interfere with goal-directed behavior. Objectives: Our aim was to determine the relationship between emotional regulation difficulties with procrastination, life satisfaction, and resilience to distress. Methods: The sample consisted of 366 individuals from the general population, with a mean age of 33 years (SD=15) and 62.1% female. Results: Procrastination was positively related to the six emotional distress regulation strategies and negative affect (NA), and negatively related to positive affect (PA). Life satisfaction and distress endurance are negatively related to the identified regulation strategies and NA, and positively related to PA. Procrastination, once NA and PA are controlled is predicted by lack of clarity and lack of goals. Satisfaction with life and resistance to distress are predicted by less lack of strategies. Conclusions: It is concluded that of the sociodemographic variables only age is relevant to procrastination, given that people younger than 21 years score higher on this construct. Procrastination is positively related to the six dimensions of difficulties in emotion regulation, where it is predicted by lack of goals and lack of clarity, however, satisfaction with life and resistance to discomfort by less lack of strategies.

The Bidimensional Model of Mental Health: an empirical approach in a general population sample / El Modelo Bidimensional de Salud Mental: una aproximación empírica en una muestra de la población general

Background: Comprehensive mental health research is proposed as an important resource for individual well-being, as opposed to indicators of psychopathology. Objectives: We present an approach to the Bidimensional Model of Mental Health (BDSM) that considers psychological distress and subjective well-being as two separate but related dimensions. Methods: In a sample of 290 adults from the community, with 55.2% women and a mean age of 28.6 (Dt = 12.0). Results: The continuous results confirm a two-dimensional structure of psychopathology (PS) and subjective well-being (BS). The proposed model proposes classification into four groups according to the above result, namely, complete mental health (high BS, low PS, 62.2%), vulnerable (low BS, low PS, 11.4%), symptomatic but content (high BS, high PS, 11.4%) and troubled (low BS, high PS, 15%). The categorical results indicate that the problem and symptomatic groups obtained higher mean scores in trait worry, experiential and behavioral avoidance, and in turn, the symptomatic group scored higher in resistance to distress and in the more adaptive cognitive emotional regulation strategies; on the contrary, the vulnerable group obtained lower means in the latter. The results of the vulnerable and symptomatic groups confirm the coexistence of well-being and psychopathology. Conclusions: The promotion of subjective well-being is proposed when considering health in a more comprehensive way, because of its potential to generate profound and lasting benefits for individuals and the community in general.

Introducción: La regulación de las emociones implica modular las experiencias de las emociones para facilitar el logro de los objetivos, por el contrario, las dificultades en las mismas son un patrón de experiencias emocionales que interfieren con el comportamiento dirigido a un objetivo. Objetivos: Presentamos una aproximación al Modelo Bidimensional de Salud Mental (BDSM) que consideran la angustia psicológica y el bienestar subjetivo como dos dimensiones separadas pero relacionadas. Método: En una muestra es de 290 personas adultas de la comunidad, con un 55,2% mujeres y una media de edad de 28,6 (Dt = 12.0). Resultados: Los resultados confirman una estructura bidimensional de psicopatología (PS) y bienestar subjetivo (BS), negativamente relacionados. El modelo propone la clasificación en cuatro grupos atendiendo al resultado anterior, a saber, salud mental completa (BS alto, PS baja, 62,2%), vulnerable (BS bajo, PS baja, 11,4%), sintomático pero contento (BS alto, PS alta, 11,4%) y con problemas (BS bajo, PS alta, 15%). Los resultados señalan que los grupos con problemas y sintomáticos obtienen puntuaciones medias más elevadas en la preocupación rasgo, la evitación experiencial y conductual, y a su vez, el grupo sintomático puntúa más elevado en resistencia al malestar y en las estrategias de regulación emocional cognitivas más adaptativas. El grupo vulnerable obtiene medias más bajas en estas últimas. Los resultados de los grupos vulnerables y sintomáticos confirman la coexistencia del bienestar y la psicopatología. Conclusiones: Los resultados se discuten atendiendo a los estudios revisados, y dada la relevancia de las estrategias de regulación emocional en la satisfacción con la vida y la resistencia al malestar, se proponen tratamientos transdiagnósticos de la regulación de las emociones.

Relationships of emotion regulation to procrastination, life satisfaction and resilience to discomfort / Las relaciones de la regulación de las emociones con la procastinación, la satisfacción con la vida y la resistencia al malestar

Background: Emotion regulation involves the modulation of emotional experiences to facilitate goal attainment. Conversely, emotional difficulties are a pattern of emotional experiences and expressions that interfere with goal-directed behavior. Objectives: Our aim was to determine the relationship between emotional regulation difficulties with procrastination, life satisfaction, and resilience to distress. Methods: The sample consisted of 366 individuals from the general population, with a mean age of 33 years (SD=15) and 62.1% female. Results: Procrastination was positively related to the six emotional distress regulation strategies and negative affect (NA), and negatively related to positive affect (PA). Life satisfaction and distress endurance are negatively related to the identified regulation strategies and NA, and positively related to PA. Procrastination, once NA and PA are controlled is predicted by lack of clarity and lack of goals. Satisfaction with life and resistance to distress are predicted by less lack of strategies. Conclusions: It is concluded that of the sociodemographic variables only age is relevant to procrastination, given that people younger than 21 years score higher on this construct. Procrastination is positively related to the six dimensions of difficulties in emotion regulation, where it is predicted by lack of goals and lack of clarity, however, satisfaction with life and resistance to discomfort by less lack of strategies.

Introducción: La regulación de las emociones implica la modulación de las experiencias de las emociones para facilitar la consecución de los objetivos, por el contrario, las dificultades emocionales son un patrón de experiencias y/o expresiones emocionales que interfieren con el comportamiento dirigido a objetivos. Objetivos: Nuestro objetivo fue determinar la relación entre las dificultades en la regulación emocional con la postergación, la satisfacción con la vida y la resiliencia a la angustia. Método: La muestra consistió en 366 personas de la población general, con una media de edad de 33 años (DE=15) y un 62.1% de mujeres. Resultados: La postergación se relaciona positivamente con las seis estrategias de dificultades en la regulación de las emociones y el afecto negativo (AN), y negativamente con el afecto positivo (AP), la satisfacción con la vida y la resistencia a la angustia. La satisfacción con la vida y la resistencia a la angustia se relacionan negativamente con las estrategias de regulación identificadas y con el afecto negativo, y positivamente con el afecto positivo. La postergación, una vez controlado el AN y el AP se predice por la falta de claridad y la falta de objetivos. La satisfacción con la vida y la resistencia a la angustia son predichas por menos falta de estrategias. Conclusiones: Se concluye que de las variables sociodemográficas solo la edad es relevante en la postergación, dado que las personas menores de 21 años puntúan más elevado en este constructo. La postergación se relaciona positivamente con las seis dimensiones de las dificultades en la regulación de las emociones, en las que es predicha por la falta de objetivos y la falta de claridad, sin embargo, la satisfacción con la vida y la resistencia al malestar por menos falta de estrategias.

Bienestar psicológico y ansiedad en adultos mayores con osteoartrosis de rodilla / Psychological well-being and anxiety in older adults with knee osteoarthritis

Introducción: El envejecimiento poblacional en Cuba ha incrementado los casos de osteoartrosis de rodilla. Como alternativa terapéutica se utiliza el plasma rico en plaquetas autólogo, en aras de potenciar el bienestar físico y psicológico de los pacientes. Objetivo: Caracterizar la relación entre el bienestar psicológico y la ansiedad de los adultos mayores con osteoartrosis de rodilla tratados con plasma rico en plaquetas autólogo. Métodos: Se utilizó un enfoque cuantitativo, con un alcance descriptivo-correlacional, y un diseño expost-facto retrospectivo simple. El muestreo fue intencional, no probabilístico, y quedó conformado por 300 pacientes. Se aplicó la Adaptación de la Escala de Bienestar Psicológico de Ryff y el Inventario de Ansiedad Rasgo-Estado. Para el análisis de los datos se realizaron tres cortes: antes del tratamiento regenerativo y a los tres y seis meses de evolución. Resultados: Hubo cambios de niveles medio-bajo a niveles altos de bienestar psicológico. Disminuyeron los niveles de ansiedad estado, pero no los de ansiedad rasgo. El bienestar psicológico no se correlacionó con la ansiedad rasgo y la relación estadística positiva fue muy débil con la ansiedad estado. Conclusiones: Se identificaron cambios favorables del bienestar psicológico y de la ansiedad estado, con persistencia de niveles altos de ansiedad rasgo(AU)

Introduction: The population aging in Cuba has caused the increase of osteoarthrosis of the knee in the elderly. As a therapeutic alternative, it was used the clinical use of autologous platelet-rich plasma, in order to promote well-being, not only physical, but also psychological. Objective: To characterize the relationship between psychological well-being and anxiety state and feature of elderly adults with osteoarthrosis of the knee, who are subjected to regenerative treatment with autologous platelet-rich plasma. Methods: A quantitative research approach was used, with a descriptive-correlational scope, and a simple retrospective expost-fact design. Sampling was intentional, non-probabilistic and consisted of 300 older adults. The Adaptation of the Ryff Psychological Well-Being Scale and the Trait-State Anxiety Inventory were applied. For the analysis of the data, three cuts were made: before the regenerative treatment, and after three and six months of evolution. Results: There were changes from medium-low levels to high levels of psychological well-being. Levels of state anxiety decreased, but trait anxiety did not. Psychological well-being did not correlate with trait anxiety and there was a weak positive statistical relationship with state anxiety. Conclusions: Changes were identified that favor psychological well-being and trait anxiety, with persistent high levels of trait anxiety(AU)

Influencia de la edad de la madre en los desenlaces perinatales y maternos / Influence of maternal age on perinatal and maternal outcomes

Resumen OBJETIVOS: Describir y comparar la influencia de la edad materna en los desenlaces maternos y perinatales. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo y unicéntrico en el que se reunieron todos los partos ocurridos en el año 2020 en un hospital español. La edad de la mujer se categorizó en tres tramos (1: menores de 35 años; 2: más o menos mayores de 35 años y menores de 40 años; 3: mayores de 40 años). RESULTADOS: Se reunió una población de estudio de 1700 mujeres y encontró una clara correlación entre la edad materna avanzada y el riesgo de cesárea y una tendencia no significativa hacia una mayor cantidad de partos instrumentados. La edad materna avanzada es un factor de riesgo de sufrir distintas enfermedades relacionadas con el embarazo y con malos desenlaces perinatales. Puesto que la tendencia actual marca un aumento de este tipo de embarazos es indispensable conocer los riesgos obstétricos a fin de informar y asesorar correctamente a las embarazadas y llevar a cabo las actuaciones pertinentes que eviten las complicaciones más frecuentes. CONCLUSIONES: Existe mayor tasa de cesárea en embarazos en edad avanzada después de ajustar los factores de confusión. Los desenlaces fetales no se ven afectados por la edad materna ni con otros eventos perinatales.

Abstract OBJETIVE: To describe and compare the influence of maternal age on maternal and perinatal outcomes. MATERIALS AND METHODS: Observational, retrospective, single-center, retrospective study in which all deliveries that occurred in the year 2020 in a Spanish hospital were collected. The age of the women was categorized into three groups (1: under 35 years; 2: more or less older than 35 years and younger than 40 years; 3: older than 40 years). RESULTS: A study population of 1700 women was assembled and found a clear correlation between advanced maternal age and risk of cesarean section and a nonsignificant trend toward a higher number of instrumented deliveries. Advanced maternal age is a risk factor for various pregnancy-related diseases and poor perinatal outcomes. Since the current trend shows an increase in this type of pregnancies, it is essential to know the obstetric risks in order to correctly inform and advise pregnant women and to carry out the pertinent actions to avoid the most frequent complications. CONCLUSIONS: There is a higher rate of caesarean section in advanced age pregnancies after the confounding factors were adjusted. Fetal outcomes are not affected by maternal age, as well as other perinatal events.

Resultados estéticos en defectos nasales posquirúrgicos regenerados con fibrina autóloga rica en plaquetas y leucocitos / Aesthetic results in post-surgical nasal defects regenerated with autologous platelet- and leukocyte-rich fibrin

Introducción: En la reconstrucción de los defectos cutáneos nasales se han utilizado varias técnicas a nivel mundial. Novedosas prácticas utilizan los concentrados plaquetarios por sus propiedades moduladoras y favorecedoras de la regeneración tisular. Objetivo: Determinar los resultados estéticos asociados al uso de la membrana de fibrina autóloga rica en plaquetas y leucocitos, para la regeneración de defectos cutáneos nasales posquirúrgicos. Métodos: Se realizó un estudio cuasiexperimental, longitudinal y prospectivo en el Servicio de Cirugía Maxilofacial del Hospital Universitario "Arnaldo Milián Castro" de la ciudad de Santa Clara, Villa Clara, Cuba, desde septiembre de 2015 hasta junio de 2019. Se efectuó un muestreo intencional, no probabilístico, de 31 pacientes. A partir de una donación de sangre del paciente, se obtuvo una membrana de fibrina rica en plaquetas y leucocitos, la que fue suturada en el defecto nasal posquirúrgico. Se estudiaron variables como el resultado estético, evaluado sobre la base de parámetros como la elasticidad, el color, el volumen y la superficie. Resultados: La edad media fue 62,71 ± 11,09 años y el 61,29 por ciento de la muestra correspondió al sexo masculino. Mostraron un buen resultado estético el 90,32 por ciento de los pacientes, lo que se asoció de forma significativa al grado de epitelización. Conclusiones: Se obtuvo un buen resultado estético en los pacientes donde se utilizó la membrana de fibrina autóloga rica en plaquetas y leucocitos, con independencia de la presencia de diabetes mellitus y hábitos tóxicos. El resultado estético estuvo asociado significativamente al grado de epitelización y a la edad(AU)

Introduction: In the reconstruction of nasal skin defects, several techniques have been used worldwide. Innovative practices use platelet concentrates for their modulating properties and favoring tissue regeneration. Objective: Determine the aesthetic results associated with the use of autologous fibrin rich in platelets and leukocytes, for the regeneration of post-surgical nasal skin defects. Methods: A quasi-experimental, longitudinal and prospective study was conducted in the Maxillofacial Surgery Service of "Arnaldo Milián Castro" University Hospital in the city of Santa Clara, Villa Clara province, Cuba, from September 2015 to June 2019. An intentional, non-probabilistic sampling of 31 patients was carried out. From a blood donation from the patient, a fibrin membrane rich in platelets and leukocytes was obtained, which was sutured in the post-surgical nasal defect. Variables such as the aesthetic result were studied, evaluated on the basis of parameters such as elasticity, color, volume and surface. Results: The mean age was 62.71 ± 11.09 years and 61.29 percent of the sample corresponded to the male sex. A good aesthetic result was shown by 90.32 percent of the patients, which was significantly associated with the degree of epithelialization. Conclusions: A good aesthetic result was obtained in patients where the fibrin membrane rich in leukocytes and autologous platelets was used, regardless of the presence of diabetes mellitus and toxic habits. The aesthetic result was significantly associated with the degree of epithelialization and age(AU)