Consolidation of the Journal Investigación y Educación en Enfermería as a Publication with Impact on the Dissemination of Nursing Knowledge

Almost 14 years ago, Dean Beatriz Elena Ospina Rave entrusted me with the direction of the IEE Journal, given the leave of absence taken by the then director, María del Pilar Pastor, who had been named Secretary of Health of the Municipality of Medellín. Meeting this responsibility represented a great academic and professional challenge because it was a scientific publication of the highest quality in the area of Nursing, recognized in Colombia and Latin America. I received a journal with 26 years of uninterrupted edition and which already had three years in category A2 in the PUBLINDEX by COLCIENCIAS, hence, I had the commitment to lead the preparation of the publication to ascend to the long-awaited maximum A1 category, for which it was "only" necessary to meet the most complex criterion to obtain: achieve indexing in Medline, or in at Consolidation of the Journal Investigación y Educación en Enfermería as a Publication with Impact on the Dissemination of Nursing Knowledge*Invest Educ Enferm. 2023; 41(3): e01least one of the bibliographic citational bases, like Elsevier's Scopus or in the Web of Science, now Clarivate.

Effect of Human Adenovirus 36 on Response to Metformin Monotherapy in Obese Mexican Patients with Type 2 Diabetes: A Prospective Cohort Study.

Human adenovirus 36 (HAdV-36) has been associated with obesity and changes in glucose and lipid metabolism. The virus has been reported to increase insulin sensitivity and paradoxically promote weight gain. Because of its effects on metabolism, infection with the virus could alter the response to several drugs used to treat type 2 diabetes (DM2), such as metformin. The aim of this study was to test whether HAdV-36 affects the response to metformin in a group of obese patients with DM2. METHODS: In a prospective cohort study, 103 obese patients with newly diagnosed DM2 were divided into two groups based on their HAdV-36 seropositivity (+HAdV-36 and -HAdV-36). Weight, glucose, cholesterol, triglycerides, body mass index, body fat percentage, and waist and hip circumference were measured and compared in both groups at baseline and after 45 days of metformin treatment. RESULTS: Only glucose was significantly lower in the +HAdV-36 group at baseline, while all other variables were similar between the two study groups. After 45 days of follow-up, it was observed that the effect of metformin did not differ between the groups, but the variables improved significantly after treatment. CONCLUSIONS: In this study, we did not find that HAdV-36 had an effect on the response to metformin in obese patients with DM2.

Accommodation Response Variations in University Students under High Demand for Near-Vision Activity.

The objective of this study was to investigate accommodation changes and visual discomfort in a university student population after a period of high demand for near-vision activity. A total of 50 university students aged between 20 and 22 years were recruited. The tests performed involved positive relative accommodation (PRA), negative relative accommodation (NRA), accommodation amplitude (AA), and monocular and binocular accommodative facility (MAF and BAF). Visual discomfort was measured on a scale involving a visual discomfort questionnaire (VDQ). All accommodative variables underwent changes during the exam period; specifically, regarding NRA and PRA, 30.4% and 15.1% of the studied population, respectively, appeared to be below average. Moreover, 42.3% of the population exhibited values below average in the second measure of AA. On the other hand, a small percentage of the population was below average in MAF and BAF measurements: 3% in the monocular right eye test, 6% in the left eye test, and 9.1% in the binocular facility test. Finally, the VDQ score did not reveal a statistically significant difference between the two measurements. Prolonged near-distance work, such as a university exams period, changed all accommodation systems (amplitude of accommodation, relative accommodation, and accommodation facility). These changes influence an accommodation excess that results in blurred vision, headache, and problems with focusing.

Differentiation of subclinical and clinical electrographic events in long-term electroencephalographic recordings.

OBJECTIVE: With the advent of ultra-long-term recordings for monitoring of epilepsies, the interpretation of results of isolated electroencephalographic (EEG) recordings covering only selected brain regions attracts considerable interest. In this context, the question arises of whether detected ictal EEG patterns correspond to clinically manifest seizures or rather to purely electrographic events, that is, subclinical events. METHODS: EEG patterns from 268 clinical seizures and 252 subclinical electrographic events from 50 patients undergoing video-EEG monitoring were analyzed. Features extracted included predominant frequency band, duration, association with rhythmic muscle artifacts, spatial extent, and propagation patterns. Classification using logistic regression was performed based on data from the whole dataset of 10-20 system EEG recordings and from a subset of two temporal electrode contacts. RESULTS: Correct separation of clinically manifest and purely electrographic events based on 10-20 system EEG recordings was possible in up to 83.8% of events, depending on the combination of features included. Correct classification based on two-channel recordings was only slightly inferior, achieving 78.6% accuracy; 74.4% and 74.8%, respectively, of events could be correctly classified when using duration alone with either electrode set, although classification accuracies were lower for some subgroups of seizures, particularly focal aware seizures and epileptic arousals. SIGNIFICANCE: A correct classification of subclinical versus clinical EEG events was possible in 74%-83% of events based on full EEG recordings, and in 74%-78% when considering only a subset of two electrodes, matching the channel number available from new implantable diagnostic devices. This is a promising outcome, suggesting that ultra-long-term low-channel EEG recordings may provide sufficient information for objective seizure diaries. Intraindividual optimization using high numbers of ictal events may further improve separation, provided that supervised learning with external validation is feasible.

Prevalence and Characterisation of Multiresistant Bacterial Strains Isolated in Pigs from the Island of Tenerife.

BACKGROUND: Antibiotic-resistant bacteria can circulate among human and animal populations through direct contact with animals, as well as via food and the environment. The purpose of this study was to examine the prevalence and characterisation of multiresistant bacteria in pig samples. METHODS: 224 samples of pig livestock were taken at the slaughterhouse on the island of Tenerife. A nasal and a rectal sample were collected from each pig. The presence of methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant Staphylococcus coagulase-negative (MRCoNS), vancomycin-resistant Enterococcus (VRE), extended-spectrum ß-lactamase-producing Enterobacteriaceae (BLEE), carbapenemase-producing Enterobacteriaceae (CPE), and colistin-resistant Enterobacteriaceae was investigated. The resistance genes of the isolated bacteria were characterised by specific PCRs depending on the microorganism to be studied, and in vitro antimicrobial resistance was determined using the broth microdilution method (Vitek®2 system bioMérieux®, Nurtingen, Germany). RESULTS: MRSA prevalence was 73.21% (164 isolates). MRCoNS prevalence was 9.8% (22 isolates), S. sciuri being the prevalent species. Six isolates presented a 2.7% prevalence of extended-spectrum ß-lactamase-producing Escherichia coli (BLEE) in the CTX-M-1 group. No vancomycin-resistant Enterococcus (VRE), carbapenemase-producing Enterobacteriaceae (CRE), or colistin-resistant Enterobacteriaceae were isolated. CONCLUSION: we found a high presence of multiresistant bacteria, suggesting the need for increased control and surveillance of this type of strains in pig livestock and a better understanding of the possible transmission routes of these microorganisms through livestock products.

Astroglial and oligodendroglial markers in the cuprizone animal model for de- and remyelination.

Myelin loss with consecutive axon degeneration and impaired remyelination are the underlying causes of progressive disease in patients with multiple sclerosis. Astrocytes are suggested to play a major role in these processes. The unmasking of distinct astrocyte identities in health and disease would help to understand the pathophysiological mechanisms in which astrocytes are involved. However, the number of specific astrocyte markers is limited. Therefore, we performed immunohistochemical studies and analyzed various markers including GFAP, vimentin, S100B, ALDH1L1, and LCN2 during de- and remyelination using the toxic murine cuprizone animal model. Applying this animal model, we were able to confirm overlapping expression of vimentin and GFAP and highlighted the potential of ALDH1L1 as a pan-astrocytic marker, in agreement with previous data. Only a small population of GFAP-positive astrocytes in the corpus callosum highly up-regulated LCN2 at the peak of demyelination and S100B expression was found in a subset of oligodendroglia as well, thus S100B turned out to have a limited use as a particular astroglial marker. Additionally, numerous GFAP-positive astrocytes in the lateral corpus callosum did not express S100B, further strengthening findings of heterogeneity in the astrocytic population. In conclusion, our results acknowledged that GFAP, vimentin, LCN2, and ALDH1L1 serve as reliable marker to identify activated astrocytes during cuprizone-induced de- and remyelination. Moreover, there were clear regional and temporal differences in protein and mRNA expression levels and patterns of the studied markers, generally between gray and white matter structures.

Intervención educativa de enfermería en pacientes con cateterismo cardiaco / Nursing educational intervention in patients with cardiac catheterization

Introducción: la intervención de enfermería en pacientes sometidos a cateterismo cardiaco constituye el eje articular de las acciones de planeación, desarrollo y evaluación; lo que permite atender el proceso de aprendizaje. Objetivo: evaluar la relación entre el nivel de conocimiento y ansiedad de los pacientes sometido a cateterismo cardiaco, antes y después de aplicar una intervención educativa. Metodología: investigación con enfoque cuantitativo, descriptivo, transversal y exploratorio a 70 pacientes sometidos a cateterismo cardiaco por primera vez, se aplicaron dos instrumentos validados para medir el nivel de conocimiento y ansiedad con un Alfa de Cronbach de 0.90; la recolección fue en dos fases, pretest y postest, la primera antes de la cirugia; la segunda posterior al procedimiento y se compararon los resultados de ambos test en búsqueda de mejores resultados. Resultados: media de edad de 60 - 79 años; 68.6% hombres y 31.4% mujeres; el nivel de conocimientos del pretest fue de 52.9% regular y postest, excelente con un 50%; en cuanto a la ansiedad el pretest el 97.1% reportó grave, mientras que en el postest, el 80% reportó moderado. Conclusiones: el aporte de conocimientos por parte del personal de enfermería a través del rol educador, favorece a los pacientes que son sometidos a un cateterismo cardiaco, que se refleja en disminución de ansiedad e incremento de calidad de vida.

Introduction:The nursing intervention in patients undergoing cardiac catheterization constitutes the articular axis of planning, development and evaluation actions; which allows to attend the learning process. Objective: To evaluate the relationship between the level of knowledge and anxiety of the patient undergoing cardiac catheterization, before and after applying an educational intervention. Methodology: Investigation with a quantitative, descriptive, cross-sectional and exploratory approach to 70 patients undergoing cardiac catheterization for the first time. Two validated instruments were applied to measure the level of knowledge and anxiety with a Cronbach's Alpha of 0.90; the collection was in two phases, pre and post test, the first before surgery; the second after the procedure, the results of both tests were compared in search of better results. Results: Average age of 60-79 years, 68.6% men and 31.4% women; the level of knowledge of the pre-test was 52.9% regular and post-test, excellent with 50%; regarding anxiety, the pre-test 97.1% serious, post-test, 80% moderate. Conclusions: The contribution of knowledges by the nursing staff through the educator role, favors patients who undergo cardiac catheterization, which is reflected in the reduction of seniority and the increase in the quality of life.

Epilepsia y TDAH / Epilepsy and ADHD

La epilepsia engloba un conjunto de trastornos convulsivos heterogéneos, con diversas características clínicas que excluyen un mecanismo etiológico singular. Individuos con epilepsia presentan una tasa significativamente mayor de condiciones psiquiátricas y neurológicas asociadas. Niños con epilepsia tienen dos a tres veces más riesgo de desarrollar trastornos por déficit de atención e hiperactividad (TDAH) cuando son comparados con individuos sanos, mientras que uno de cada cinco adultos epilépticos presentan síntomas de TDAH. En los niños con epilepsia, la gravedad y frecuencia de las crisis y una edad más temprana de inicio de las crisis son factores de riesgo comunes para padecer TDAH. Se realizó una revisión narrativa de la literatura y se seleccionaron artículos publicados en el periodo entre el año 2003 y 2021 en bases digitales del área de la salud (LILACS, Medline, Web of Science, SciELO y PubMed). La revisión evidenció que la epilepsia puede aumentar el riesgo de desarrollar TDAH en los niños, y que la epilepsia rolándica benigna es el tipo más diagnosticado en estos niños, que incluso tiene alta tasa de trastornos neuroconductuales con síntomas de TDAH asociados. El diagnóstico temprano y un manejo apropiado, llevan a mejor pronóstico en este grupo de pacientes

Epilepsy encompasses a set of heterogeneous seizure disorders, with various clinical characteristics that exclude a unique etiological mechanism. Individuals with this disease have a significantly higher rate for the development of psychiatric and neurological conditions. Children with epilepsy have two to three times increased risk of developing ADHD when compared to healthy individuals, while one in five epileptic adults have ADHD symptoms. In children with epilepsy, the severity and frequency of seizures and an earlier age at the onset of seizures are common risk factors for ADHD. A narrative review of the literature was carried out and articles published in the period between 2003 and 2021 in digital databases of the health area (LILACS, Medline, Web of Science, SciELO and PubMed) were selected. The review showed that epilepsy can increase the risk of developing ADHD in children, and that benign rolandic epilepsy is the most diagnosed type in these children, which even has a high rate of neurobehavioral disorders with associated ADHD symptoms. Early diagnosis and appropriate management lead to a better prognosis in this group of patients.

Genotoxicity and cytotoxicity evaluation of two thallium compounds using the Drosophila wing somatic mutation and recombination test.

Thallium (Tl) is a heavy and toxic metal and a byproduct of several human activities, such as cement production, mining, and coal combustion. Thallium is found in fruits, vegetables, and animal fodder with high Tl contamination; therefore, it is an environmental pollution issue and a toxicological contamination problem for human beings and other organisms when exposed to it. The mutagenic potential of Tl and its compounds is controversial, and there are few in vivo studies on its effects. We conducted the animal bioassay Drosophila wing somatic mutation and recombination test (SMART) to test for genotoxicity and assessed the genotoxic effects of Tl acetate (TlCH3COO) and Tl sulfate (Tl2SO4) on Drosophila melanogaster. Third instar larvae from the SMART standard cross (ST) were fed Tl acetate [0.2, 2, 20, 200, 600 and 1200 µM] and Tl sulfate [0.2, 2, 20, 200, and 600 µM]. Hexavalent chromium [CrO3, 500 µM] served as the positive control, and Milli-Q water served as the negative control. Only the high Tl2SO4 [600 µM] concentration resulted in genotoxicity with 87.6% somatic recombination, and both salts disrupted cell division of wing imaginal disc cells, showing the expected cytotoxic effects. Genotoxic risks due to high metal levels by bioaccumulation of Tl+1 or its compounds require further evaluation with other in vivo and in vitro assays.

Proceso enseñanza aprendizaje del pregrado en Atención Primaria de Salud durante el primer enfrentamiento a la COVID-19 / Teaching learning process in first health care attention during the first attempt to face covid-19

RESUMEN Introducción: Las universidades médicas cubanas enfrentan el desafío, en medio de la pandemia de COVID-19, de mantener la formación de recursos humanos y apoyar directamente las acciones para evitar el contagio de la población. Objetivo: describir el desarrollo del proceso enseñanza aprendizaje durante la integración de estudiantes de las carreras de la Salud a la Atención Primaria en la lucha contra la COVID-19 Método: Se desarrolló un estudio descriptivo transversal de marzo a julio del 2020 en el municipio Santo Domingo, provincia Villa Clara. Además se recopiló información de archivos del Departamento Docente y de Higiene Municipal. Fueron insertados 305 estudiantes y 15 profesores en 44 consultorios, previo análisis contextual se implementó modificaciones en las estrategias didácticas para la educación a distancia a través de uso de datos en telefonía móvil empleando aplicación whatsapp. Resultados: Con predominio de métodos asincrónicos, se logró mantener un flujo informativo y actualizado de las estadísticas necesarias para los partes diarios, la información sobre diferentes asignaturas, estado de salud de los alumnos y profesores, se fortaleció el trabajo político ideológico al contrarrestar la infodemia y otras campañas de desinformación al establecer vínculos con otros grupos administrados por la FEU y el grupo de comunicadores de la Universidad. Conclusiones: La respuesta dinámica del claustro con inserción de las Tecnologías de la Información y las Comunicaciones durante la labor de pesquisa permitió dar continuidad al proceso enseñanza aprendizaje y la obtención de resultados exitosos en el primer enfrentamiento a la pandemia en el municipio.

ABSTRACT Introduction: In Cuban Medical Universities, 2019-2020 course faces the challenge that, through the COVID-19 pandemic, the formation of human resources had to be maintained as well as to support directly actions to avoid the population contagious. Objective: To describe the teaching learning process development during the integration of health careers students to the primary health care attention in the battle against COVID-19. Method: In Santo Domingo, from March to July 2020it was developed a transversal descriptive study, information was collected from archives of the teaching and the municipal hygiene departments. In 44medical offices were inserted 305 students and 15 professors, previous contextual analysis it were implemented modifications on the didactics strategies for distance learning education by means of data on mobile phones using in this case the whatsapp application. Results: With the predominance of asynchrony methods, it was maintain the information process and the updating of the necessary statistics for the daily reports, different subjects orientations, students and professors health status, was strengthen the ideological and political work facing Infodemia and other fake information campaigns, helped by other groups too administered by FEU and the group of communicators from the university. Conclusions: The dynamic answer from the group of teachers with the insertion of communication and information technologies during the searching procedure made possible to continue the teaching learning process getting sucessful results during the first attempt to face COVID-19 in Santo Domingo municipality.

Sistema de actividades para desarrollar habilidades comunicativas en idioma Inglés en los residentes de Estomatología / System of activities for developing communication skills in the English language in dental residents

RESUMEN Fundamento: la preparación idiomática, según lo establecido por el Marco Común Europeo de Referencia (MCER), constituye una necesidad de primer orden en el proceso de formación y superación de los futuros profesionales de las ciencias médicas. Objetivo: diseñar un sistema de actividades para desarrollar habilidades comunicativas en idioma Inglés en los residentes de Estomatología. Métodos: se realizó un estudio descriptivo de corte transversal en la Facultad de Estomatología entre enero 2018-diciembre 2019. Se emplearon métodos teóricos: histórico-lógico, analítico-sintético, inductivo-deductivo y sistémico-estructural; empíricos: análisis documental, encuesta en forma de cuestionario a estudiantes y entrevista a informantes clave. Resultados: el diagnóstico realizado demostró la necesidad de diseñar un sistema de actividades que incluye tres folletos: el primero, con actividades para la impartición de clases dirigido a profesores y estudiantes; el segundo, con respuestas a interrogantes y orientaciones metodológicas generales y un set de audiciones auténticas con sus transcripciones; y el tercero, ofrece ayuda a los estudiantes en su estudio individual. Conclusiones: el sistema de actividades diseñado se caracteriza por su flexibilidad y enfoque interdisciplinar, tiene en cuenta el desarrollo de las cuatro habilidades del idioma, las subhabilidades y sus funciones. Fue valorado de forma satisfactoria por los especialistas quienes reconocieron sus adecuadas pertinencia social y pedagógica, estructura lógica, factibilidad, originalidad y valor científico-pedagógico.

ABSTRACT Background: language preparation, as established by the Common European Framework of Reference (CEFR), constitutes a first order need in the process of training and updating future professionals in the medical sciences. Objective: to design a system of activities to develop communication skills in the English language in Dentistry residents. Methods: a descriptive cross-sectional study was carried out at the Dentistry Faculty from January 2018 to December 2019. Theoretical methods were used: historical-logical, analytical-synthetic, inductive-deductive and systemic-structural; empirical ones: documentary analysis, survey in the form of a questionnaire to students and interview with key informants. Results: the diagnosis showed the need to design a system of activities that includes three booklets: the first, with activities for teaching classes aimed at teachers and students; the second, with answers to questions and general methodological guidelines and a set of authentic auditions with their transcripts; and the third, offers help to students in their individual study. Conclusions: the designed activity system is characterized by its flexibility and interdisciplinary approach; it takes into account the development of the four language skills, sub skills and their functions. It was satisfactorily evaluated by specialists who recognized its adequate social and pedagogical relevance, logical structure, feasibility, originality and pedagogical-scientific value.

Valor pronóstico del PET/CT interino en Linfoma no Hodgkin en comparación con factores pronósticos clásicos (IPI) y de composición corporal (sarcopenia/lipopenia)

Background: The prognosis of Non-Hodgkin Lymphoma (NHL) depends on the type of lymphoma, the extension of the disease and the response to therapy. Aim: To evaluate the prognostic value of pretreatment and interim PET/CT compared to classic prognosis factors and body composition measurement (sarcopenia, adipopenia) in patients with recently diagnosed NHL. Material and Methods: Patients with recently diagnosed NHL who had staging 18F-FDG PET/CT performed between December 2008 and August 2018 were selected. Age, gender, weight, height, B symptoms, laboratory tests, pathology, staging PET/CT findings (Ann Arbor, number of nodal groups and extranodal sites involved, Bulky, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis), Computed Tomography findings (psoas muscle mass index, psoas area, psoas density, subcutaneous fat index (all of them at L3 level), and Deauville score (Lugano Criteria) were recorded. The prognostic value of each of these factors was assessed using Cox multivariable regressions. Results: Of 138 NHL studied patients (median 61 y, 15-87 y, 60.4% men), 31 of them died due to the disease. The median follow-up was 39 months (1-115 months). The strongest prognostic factors were: B symptoms (p < 0.01), anemia (p < 0.01), hypoalbuminemia (p: 0.01), sarcopenia (p < 0.01), adipopenia (p < 0.01), number of node groups involved (p < 0.01), MTV (p < 0.01), and a bad response in interim PET/CT (p < 0.01). In a comparative Cox multivariable analysis, interim PET/CT was the independent variable with the highest significance (p < 0.01). Conclusions: Early treatment response assessed by interim PET/CT is the strongest prognostic factor in NHL patients.

[Prognostic value of interim PET/CT in non-hodgkin lymphoma]. / Valor pronóstico del PET/CT interino en Linfoma no Hodgkin en comparación con factores pronósticos clásicos (IPI) y de composición corporal (sarcopenia/lipopenia).

BACKGROUND: The prognosis of Non-Hodgkin Lymphoma (NHL) depends on the type of lymphoma, the extension of the disease and the response to therapy. AIM: To evaluate the prognostic value of pretreatment and interim PET/CT compared to classic prognosis factors and body composition measurement (sarcopenia, adipopenia) in patients with recently diagnosed NHL. MATERIAL AND METHODS: Patients with recently diagnosed NHL who had staging 18F-FDG PET/CT performed between December 2008 and August 2018 were selected. Age, gender, weight, height, B symptoms, laboratory tests, pathology, staging PET/CT findings (Ann Arbor, number of nodal groups and extranodal sites involved, Bulky, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis), Computed Tomography findings (psoas muscle mass index, psoas area, psoas density, subcutaneous fat index (all of them at L3 level), and Deauville score (Lugano Criteria) were recorded. The prognostic value of each of these factors was assessed using Cox multivariable regressions. RESULTS: Of 138 NHL studied patients (median 61 y, 15-87 y, 60.4% men), 31 of them died due to the disease. The median follow-up was 39 months (1-115 months). The strongest prognostic factors were: B symptoms (p < 0.01), anemia (p < 0.01), hypoalbuminemia (p: 0.01), sarcopenia (p < 0.01), adipopenia (p < 0.01), number of node groups involved (p < 0.01), MTV (p < 0.01), and a bad response in interim PET/CT (p < 0.01). In a comparative Cox multivariable analysis, interim PET/CT was the independent variable with the highest significance (p < 0.01). CONCLUSIONS: Early treatment response assessed by interim PET/CT is the strongest prognostic factor in NHL patients.

Impacto de la universalización en la formación y desempeño de profesionales de la salud / Impact of universalization on the training and performance of health professionals

RESUMEN Fundamento: el proceso de universalización de la enseñanza en la formación de profesionales de la salud posibilitó la educación médica en escenarios diversos donde antes solo se realizaba la atención primaria. Objetivo: valorar el impacto de la universalización en la formación y desempeño de los profesionales de la salud en la sede universitaria del municipio de Santo Domingo en Villa Clara. Métodos: se realizó un estudio de intervención en el proceso de universalización del período 2009-2017, las unidades de observación fueron el total de profesores activos categorizados para impartir la docencia y los estudiantes de la carrera de Medicina matriculados en los dos primeros cursos. Se utilizaron métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; y empíricos: el análisis documental de informes que ofrecieron los datos de comparación. Resultados: las cifras encontradas posibilitaron apreciar avances en los educadores en cuanto al tránsito de categorías docentes inferiores hasta profesores auxiliares, aumento de grados académicos y científicos concretados en mayor número de másteres, especialistas de segundo grado e investigadores agregados, y se incrementaron las publicaciones y la participación en eventos científicos nacionales e internacionales. La mayoría de los estudiantes se graduaron, y se mantienen en el sistema de salud aportando buenos resultados en la atención a la población, incluso algunos han cumplido misiones internacionalistas. Conclusiones: el proceso de universalización se valoró de forma positiva porque elevó de forma considerable las competencias en los profesionales del territorio y el desempeño de los graduados formados en esa modalidad de estudios universitarios.

ABSTRACT Background: the process of universalization of education in the training of health professionals enabled medical education in diverse settings where primary care was only performed before. Objective: to assess the impact of universalization in the training and performance of health professionals in Santo Domingo Municipality University branch in Villa Clara. Methods: an intervention study was carried out in the universalization process from 2009 to 2017, the observation units were the total number of active ranked teaching professors and the students of the medical degree enrolled in the first two courses. Theoretical methods were used: analysis-synthesis, induction-deduction and historical-logical; and empirical ones: the documentary analysis of reports that offered the comparison data. Results: the figures found made it possible to appreciate advances in educators in terms of the transition from lower teaching ranks to associate professors, increase in academic and scientific degrees specified in a greater number of masters, second degree specialists and assistant researchers, and publications and Participation in national and international scientific events. Most of the students graduated, they remain in the health system providing good results in the care of the population, and even some of them have completed internationalist missions. Conclusions: the universalization process was valued in a positive way because it significantly increased the competencies in the professionals of the territory and the performance of graduates trained in this modality of university studies.

Apego materno-fetal: un análisis de concepto / Maternal-fetal bonding: a concept analysis

Introducción: El apego materno-fetal es un proceso relacional que construye la mujer gestante. Objetivo: Identificar los atributos del concepto de apego materno-fetal. Material y métodos: Se utilizó la metodología de análisis de concepto propuesta por Walker y Avant. Se realizó búsqueda de artículos en las bases de datos Lilacs/BIREME, CUIDEN, EBSCO, Science Direct, Ovid, EMBASE, Pubmed/Medline y Google Scholar. Se diseñó una base de datos para consolidar la información proveniente de los artículos. La integración de la información se hizo a través de los pasos propuestos para el análisis de concepto de Walker y Avant. Desarrollo: El apego materno-fetal es un proceso que requiere la representación mental del feto como persona, puede ser manifestado en comportamientos de interacción con el feto y cuidado hacia sí misma y requiere de una red de apoyo. Son antecedentes del apego materno-fetal, las formas de vinculación de la mujer gestante con su madre y su pareja, y, como consecuencias, la intención de lactar, la sensación de competencia materna y el vínculo materno-infantil. Los atributos de este concepto se pueden agrupar en cuatro dimensiones: cognitiva, afectiva, altruista y personal/relacional. Son varios los instrumentos que se han desarrollado para medirlas, entre los que se cuentan el de Cranley, Muller y el de Condon. Conclusiones: Se concluye que el apego materno-fetal es un concepto de trascedencia para la teoría y la práctica de la enfermería materno-infantil y el cuidado prenatal, pues es pilar fundamental en la transición hacia la maternidad(AU)

Introduction: Maternal-fetal bonding is a relational process built by the pregnant woman. Objective: To identify the attributes of the concept of maternal-fetal bonding. Material and methods: The conceptual analysis approached by Walker and Avant´s was used. A detailed searched for articles in several databases such as Lilacs/BIREME, CUIDEN, EBSCO, Science Direct, Ovid, EMBASE, PubMed/Medline y Google Scholar was carried out. A database was designed to gather information from different articles. The integration of information was carried out following the steps proposed for the concept analysis outlined by Walker and Avant. Development: Maternal-fetal bonding is a process that requires the mental representation of the fetus as a person. It can be expressed as interactions with the fetus and self-care behavior, and it requires network support. Some antecedents of maternal-fetal bonding are the relation of the pregnant woman with her mother and her partner and consequently, the intention to breastfeed, the sensation of maternal competence, and maternal-infant attachment. The attributes of this concept can be grouped into four dimensions: cognitive, affective, altruistic, and personal/relational. Several instruments have been developed to carry out its measurement, including Cranley´s, Muller´s and Condon´s. Conclusions: It is concluded that maternal-fetal bonding is a concept of transcendence combining theory and practice of maternal and child nursing care and prenatal care; as it is a fundamental pillar in the transition to motherhood(AU)

Atención sanitaria trans competente, situación actual y retos futuros. Revisión de la literatura / Competent trans health care, current situation and future challenges. A review

Introducción: Conocemos como una persona trans a aquella que no se identifica con el sexo de nacimiento, este hecho aún recogido como patología por el actual manual diagnóstico y estadístico de enfermedades mentales (DSM-V) va a provocar que existan desigualdades y barreras significativas a la hora de la atención sanitaria. Objetivo: Explorar las dificultades para la asistencia sanitaria percibidas por las personas trans y por los profesionales que los atienden en centros sanitarios. Material y método: Revisión de la literatura. Resultados: Tanto los profesionales como las personas trans perciben barreras significativas. Se podrían agrupar en diversos temas: desigualdades en la atención sanitaria percibidas por los pacientes trans, prejuicios y discriminación sentida, riesgos específicos de salud, déficit de conocimientos de los profesionales y déficit de formación en los planes de estudio actuales. Por otro lado, enfermería ante los pacientes trans puede resultar un facilitador. Conclusiones: Existen numerosos factores que pueden ser modificables y que provocan que las personas trans no perciban una asistencia adecuada. La adecuada formación de los profesionales sanitarios es uno de los que adquiere mayor relevancia Los resultados encontrados aportan una información clave para el futuro diseño de intervenciones dirigidas a mejorar la calidad de la asistencia en este colectivo

Introduction: We know as a transgender person who is not identified with the sex of birth, this fact still collected as pathology by the current Diagnostic and Statistical Manual of Mental Illness (DSM-V) will cause inequalities and barriers At the time of health care. Objective: To explore the difficulties for health care perceived by trans people and by the professionals who assist them in health centres. Material and method: Literature review. Results: Both professionals and trans people perceive significant barriers. They could be grouped by diverse topics: healthcare inequalities noticed by trans patients, prejudices and felt discrimination, specific health risks, lack of professional knowledge and deficit of training in current curricula. On the other hand, nursing with trans patients may result in a facilitator. Conclusions: There are multiple factors which can be modified and which produce that trans people do not notice appropriate care. Appropriate training of health professionals is the one which acquires more relevance. The results found provide key information for the future design of interventions aimed at improving the quality of the assistance in this group

Satisfacción de estudiantes y docentes con la educación en el trabajo desde la Atención Primaria / Student and teacher satisfaction with on-the-job training in primary health care

Introducción: La formación del estudiante de Medicina se basa en los principios de la vinculación del estudio con el trabajo. La educación en el trabajo, como forma organizativa del proceso docente, lleva el protagonismo para cumplir con esta misión, por lo que los escenarios de la Atención Primaria de Salud deben ganar cada vez mayor espacio en la formación de estos profesionales. Objetivo: Valorar la satisfacción de estudiantes y profesores de la carrera de Medicina con la educación en el trabajo desde los escenarios de la Atención Primaria de Salud. Métodos: Se realizó un estudio descriptivo de corte longitudinal durante el curso 2016-2017 en Santo Domingo, provincia Villa Clara. La muestra estuvo constituida por 26 estudiantes de Medicina de tercer año del Policlínico Universitario "Manuel Piti Fajardo", 24 alumnos de sexto año que hicieron su rotación de Medicina General Integral en este municipio, y 20 profesores que participaron activamente en la formación de estos educandos. La información se obtuvo mediante revisión documental y encuestas realizadas a estudiantes y profesores. Resultados: Predominó el buen desempeño de los estudiantes, al adquirir sus habilidades en los dos años de la carrera, así como la promoción en la convocatoria ordinaria. Los profesores, en su mayoría, eran asistentes y estaban preparados metodológicamente para desarrollar la educación el trabajo. Conclusiones: La mayoría de los educandos y profesores del estudio se consideraron satisfechos con desarrollar la educación en el trabajo desde estos escenarios(AU)

Introduction: Medical education is based on the principles of on-the-job training. As a form of organization of the teaching process, on-the-job training plays a leading role in fulfilling such a mission. Primary health care settings should therefore permanently expand their involvement in the training of these professionals. Objective: Determine medical student and teacher satisfaction with on-the-job training in primary health care settings. Methods: A longitudinal descriptive study was conducted in Santo Domingo, Villa Clara province, during the school year 2016-2017. The sample was 26 third-year medical students from Manuel Piti Fajardo University Polyclinic, 24 sixth-year students rotating in Comprehensive General Medicine in this municipality, and 20 teachers actively involved in the training of these students. Data were obtained from document review and surveys applied to students and teachers. Results: Good performance prevailed. Students acquired their skills in the two years assigned to them, and all passed their end-of-term exams in the ordinary call. Most teachers were Assistant Professors methodologically trained to lead on-the-job training tasks. Conclusions: Most of the students and teachers in the study reported being satisfied with participating in on-the-job training activities in these environments(AU)

Costumbres y prácticas ancestrales en el cuidado de la mujer tseltal embarazada / Ancient customs and practices for the care of pregnant tseltal women

Objetivo: analizar las costumbres y prácticas ancestrales en el cuidado de la mujer tseltal embarazada de tres comunidades de Chilón (Chiapas, México). Método: estudio cualitativo, etnográfico, descriptivo. Esta investigación se realizó en el sureste de México, en el estado de Chiapas, con un grupo de mujeres embarazadas tseltales, pertenecientes a tres comunidades de la región (Tulijá, Tseltal y Chol). Son comunidades indígenas en donde aún se rigen por usos y costumbres, por ello la figura de las matronas fue fundamental, ya que a través del consentimiento y aprobación de ellas como líderes de las comunidades se logró el acercamiento a las mujeres embarazadas. La técnica utilizada para la recogida de información fue la entrevista semiestructurada. El análisis del discurso permitió señalar conceptos y asignar códigos para generar categorías y subcategorías. Resultados: se reclutaron siete mujeres embarazadas entre las 20 y 38 semanas de gestación. Edad entre 17-42 años. El 100% pertenecía a la etnia tseltal. En el análisis del discurso emergieron dos categorías: "Creencias y prácticas durante el embarazo" y "La matrona, mujer sabia en el cuidado de la embarazada". Conclusiones: las mujeres gestantes tseltales tienen sus propias prácticas ancestrales de cuidado, no solo cuidan el cuerpo físico, sino tratan de guardar un equilibrio con la naturaleza, las emociones y el espíritu. El cuidado se basa en prácticas preventivas. De acuerdo a su cosmovisión, el estudio de estos saberes y prácticas integradas en la mujer embarazada tseltal, sensibiliza sobre la actuación enfermera para mejorar las competencias culturales

Objective: to analyze the ancient customs and practices regarding the care of tseltal pregnant women, from three Chilon communities (Chiapas, Mexico). Method: a qualitative, ethnographic, descriptive study. This research was conducted in South East Mexico, in the state of Chiapas, with a group of pregnant tseltal women, from three communities in the Tulija, Tseltal and Chol regions. These are native communities still ruled by uses and practices; therefore, the profile of midwives was essential, because an approach to pregnant women was possible through their consent and approval as community leaders. The technique used for collecting information was semi-structured interviews. Discourse analysis allowed to highlight concepts and assign codes in order to generate categories and subcategories. Results: seven pregnant women were recruited, within the 17-to-42 age range and on their 20th to 38th week of pregnancy; 100% of them belonged to the tseltal ethnic group. Two categories emerged within the discourse analysis: "Beliefs and practices during pregnancy", and "The midwife, a wise woman in pregnancy care". Conclusions: pregnant tseltal women have their own ancient practices of care: they won't only look after the physical body, but also try to keep in balance with nature, emotions and spirit. Care is based upon preventive practices. According to their worldview, the study of this knowledge and practices integrated in the pregnant tseltal woman creates awareness about the action of the nursing staff in order to improve cultural skills

[Lung infection by lophomonas spp. in a female patient with acute myeloid leukemia]. / Infección pulmonar por Lophomonas sp en una paciente con leucemia mieloide aguda.

Protozoic infections are prevalent worldwide, particularly in immunosuppressed patients. We reported the case of a patient from the city of Viña del Mar, Chile, a carrier of acute myeloid leukemia in whom an infection by Lophomonas sp. was confirmed by bronchoalveolar lavage. She was treated with antibiotics but died of complications of the underlying disease. There is little literature available on this microorganism. We conclude that Lophomonas sp. should be considered as a diagnostic possibility if protozoa are found in bronchoalveolar lavage of immunosuppressed patients.

Las infecciones por protozoos son prevalentes a nivel mundial, en particular en pacientes inmunosuprimidos. Comunicamos el caso de una paciente procedente de la ciudad de Viña del Mar, Chile, portadora de leucemia mieloide aguda en quiense confirmó una infección por Lophomonas sp. en lavado bronquioalveolar. Se manejó con antibióticos, pero falleció decomplicaciones de su enfermedad de base. Existe poca literatura disponible respecto a este microorganismo. Concluimos que debe considerarse a Lophomonas sp. como posibilidad diagnóstica si se encuentran protozoos en lavados bronquioalveolares de pacientes inmunosuprimidos.

Infección pulmonar por Lophomonas sp en una paciente con leucemia mieloide aguda / Lung infection by lophomonas spp. in a female patient with acute myeloid leukemia

RESUMEN Las infecciones por protozoos son prevalentes a nivel mundial, en particular en pacientes inmunosuprimidos. Comunicamos el caso de una paciente procedente de la ciudad de Viña del Mar, Chile, portadora de leucemia mieloide aguda en quiense confirmó una infección por Lophomonas sp. en lavado bronquioalveolar. Se manejó con antibióticos, pero falleció decomplicaciones de su enfermedad de base. Existe poca literatura disponible respecto a este microorganismo. Concluimos que debe considerarse a Lophomonas sp. como posibilidad diagnóstica si se encuentran protozoos en lavados bronquioalveolares de pacientes inmunosuprimidos.

ABSTRACT Protozoic infections are prevalent worldwide, particularly in immunosuppressed patients. We reported the case of a patient from the city of Viña del Mar, Chile, a carrier of acute myeloid leukemia in whom an infection by Lophomonas sp. was confirmed by bronchoalveolar lavage. She was treated with antibiotics but died of complications of the underlying disease. There is little literature available on this microorganism. We conclude that Lophomonas sp. should be considered as a diagnostic possibility if protozoa are found in bronchoalveolar lavage of immunosuppressed patients.