Plasma cell-free DNA as a monitoring tool for high-risk pregnancies associated with antiphospholipid syndrome.

INTRODUCTION: Despite thromboprophylaxis, women with antiphospholipid syndrome (APS) face high-risk pregnancies due to proinflammatory and prothrombotic states. This highlights the need for new monitoring and prognostic tools. Recent insights into the pathophysiological role of neutrophil activation and extracellular trap (NET) formation in this syndrome led to the exploration of plasma cell-free DNA (cfDNA), a derivative of NETosis, as a promising biomarker. MATERIALS AND METHODS: cfDNA was isolated and quantified from plasma samples of healthy pregnant women (control group, HC) and women with APS (APS group). We assessed the physiological variability of cfDNA across the three trimesters in HC. Levels of cfDNA were compared between APS and HC by gestational trimester. ROC curve analysis was performed to evaluate the efficacy of cfDNA levels for classifying APS patients. Furthermore, cfDNA levels in pregnant women with APS with obstetric complications were compared to those from uncomplicated pregnancies. RESULTS: Among HC, cfDNA significantly increased in the third trimester compared to the first and second. Elevated cfDNA levels in APS compared to HC were observed in the first and second trimesters. First-trimester cfDNA levels demonstrated the highest classification ability to discriminate between APS and HC patients (AUC: 0.906). Among APS, those with complicated pregnancies (fetal growth restriction, preeclampsia, placenta accreta) exhibited significantly elevated cfDNA levels in the second trimester. CONCLUSIONS: Elevated levels of cfDNA in pregnant women with APS, particularly among those with obstetric complications, supports further investigation into the potential of cfDNA as a valuable tool in the obstetric management of women with APS.

Efficiency of Microorganisms and Effectiveness of Biodegradation Techniques on LDPE Plastics: A Systematic Review.

Introduction: The aim of the research was to demonstrate the efficiency of microorganisms and the effectiveness of biodegradation techniques on Low-density polyethylene (LDPE) plastics. The research question was: What is the efficiency of LDPE-degrading microorganisms and the effectiveness of biodegradation techniques? Methods: The systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles were obtained from Scopus, Web of Science (WOS), Embase, and Google Scholar. The DeCS/Mesh search terms were: Low-density polyethylene, efficiency, biodegradation, microbial consortia, fungi, bacteria. Inclusion criteria were: scientific articles that included bacteria, fungi, and microbial consortia reported as LDPE degraders that report the percentage of weight loss; articles published from January 2010 to October 2022, and publications in Spanish and English with open access. Exclusion criteria were: studies that do not report gravimetry, the biodegradation time of LDPE, and the genus or species of the polyethylene-degrading microorganism. Results: Out of 483 studies found, 50 were included in this Systematic Review (SR). The most frequent study techniques were scanning electron microscopy (SEM), gravimetry, and fourier transform infrared spectroscopy (FTIR), and in the case of microorganisms, the most studied belonged to the genus Pseudomonas, Bacillus, and Aspergillus. Regarding the isolation place, the most frequent mentioned in the reviewed articles were landfill soil and sanitary landfill soil. The efficiency of LDPE-degrading microorganisms was higher in bacteria such as Enterobacter spp., Pantoea spp., Pseudomonas spp., Escherichia coli, and Bacillus spp., which obtained a range of DE of 9.00-70.00%, 24.00-64%, 1.15 - 61.00%, 45.00%, and 1.5-40% with DT of 4-150, 120, 4-150, 30, and 30-120 days, respectively; in the case of fungi, the main microorganisms are Neopestalotiopsis phangngaensis, Colletotrichum fructicola, and Thyrostroma jaczewskii with efficiencies of 54.34, 48.78, and 46.34%, in 90 days, respectively; and the most efficient microbial consortia were from Enterobacter spp. and Pantoea sp. with 38.00 - 81.00%, in 120 days; and, Pseudomonas protegens, Stenotrophomonas sp., B. vallismortis and Paenibacillus sp. with 55. 00 - 75.00% in 120 days. Conclusions: The most efficient microorganisms in LDPE degradation are Enterobacter spp., Pantoea spp., Pseudomonas spp., Escherichia coli, and Bacillus spp.; in fungi Neopestalotiopsis phangngaensis, Colletotrichum fructicola, and Thyrostroma jaczewskii; and in microbial consortia, those formed by Enterobacter spp. and Pantoea sp., and that of P. protegens, Stenotrophomonas sp., B. vallismortis and Paenibacillus sp.; and the most effective techniques used in LDPE biodegradation are SEM, gravimetry, and FTIR.

Sensorless Speed Estimation of Induction Motors through Signal Analysis Based on Chaos Using Density of Maxima.

Three-phase induction motors are widely used in various industrial sectors and are responsible for a significant portion of the total electrical energy consumed. To ensure their efficient operation, it is necessary to apply control systems with specific algorithms able to estimate rotation speed accurately and with an adequate response time. However, the angular speed sensors used in induction motors are generally expensive and unreliable, and they may be unsuitable for use in hostile environments. This paper presents an algorithm for speed estimation in three-phase induction motors using the chaotic variable of maximum density. The technique used in this work analyzes the current signals from the motor power supply without invasive sensors on its structure. The results show that speed estimation is achieved with a response time lower than that obtained by classical techniques based on the Fourier Transform. This technique allows for the provision of motor shaft speed values when operated under variable load.

Guía de práctica clínica para la atención a niños y adolescentes con enfermedad renal crónica / Clinical practice guide for the care to children and adolescents with chronic renal disease

La enfermedad renal crónica constituye un problema de salud por su impacto sobre los individuos, la sociedad y la economía. Teniendo en cuenta lo anterior, y luego de una amplia búsqueda bibliográfica, se diseñó una guía de práctica clínica en el Policlínico Luis Augusto Turcios Lima de la provincia de Pinar del Río, dirigida a los profesionales de la atención primaria de salud, con el objetivo de mejorar la calidad de vida de niños y adolescentes con dicha enfermedad. Esta fue elaborada por los métodos de la medicina basada en la evidencia, según el consenso y la opinión de los expertos. Se logró generalizar esta herramienta, emitir recomendaciones y actualizarla acorde con las nuevas evidencias médicas. Finalmente, resultó evaluada por los expertos como muy recomendada.

Chronic renal disease constitutes a health problem due to its impact on individuals, society and economy. Taking into account the above-mentioned, and after a wide literature search, a clinical practice guide was designed in Luis Augusto Turcios Lima Polyclinic from Pinar del Río province, directed to primary health care professionals, aimed at improving the life quality of children and adolescents with this disease. It was elaborated by medicine methods based on the evidence, according to the consent and opinion of experts. It was possible to generalize this tool, give recommendations and up to date according to the new medical evidences. Finally, it was evaluated by experts as very recommended.

Prospective Teachers' Knowledge of Physical Activity in Children and Adolescents.

Over the past few years, organizations around the world have tried to reach different populations with recommendations about physical activity (PA), due to this subject playing an important role in the phases of intention development and in preparation for it. Thus, the knowledge of future educators in the fields of health and PA is of vital importance when improving the levels of the latter in students. The objective of this research is to determine what knowledge future teachers have about health and PA, examining possible disparities according to the gender, age, and level of physical exercise of the participants. In addition, the psychometric properties of the instrument used were explored. A total of 321 Colombian university students from the Faculty of Education between the ages of sixteen and thirty-five participated in this study, providing sociodemographic information by filling out the CUAFYS-A questionnaire. Significant differences were found in the scale items according to sex and self-perception of being physically active. Also, the findings revealed a single-factor structure with nine items that had satisfactory reliability (α = 0.71; CR = 0.72) and excellent goodness-of-fit indices (RMSEA = 0.055 (90% CI (0.3, 0.8), RMSR = 0.02, CFI = 0.935, NNFI = 0.912, CMIN/DF = 1.97). Therefore, strategies and campaigns to promote PA knowledge in prospective teachers should be tailored according to gender and PA levels. Similarly, the CUAFYS-A questionnaire can be considered a valid and reliable instrument to identify the PA knowledge of future educators.

A Reliable Method for Quantifying Plasma Cell-Free DNA Using an Internal Standard Strategy: Evaluation in a Cohort of Non-Pregnant and Pregnant Women.

The use of plasma cell-free DNA (cfDNA) as a useful biomarker in obstetric clinical practice has been delayed due to the lack of reliable quantification protocols. We developed a protocol to quantify plasma cfDNA using an internal standard strategy to overcome difficulties posed by low levels and high fragmentation of cfDNA. cfDNA was isolated from plasma samples of non-pregnant (NP, n = 26) and pregnant (P, n = 26) women using a commercial kit and several elution volumes were evaluated. qPCR parameters were optimized for cfDNA quantification, and several quantities of a recombinant standard were evaluated as internal standard. Absolute quantification was performed using a standard curve and the quality of the complete method was evaluated. cfDNA was eluted in a 50-µl volume, actin-ß (ACTB) was selected as the target gene, and qPCR parameters were optimized. The ACTB standard was constructed and 1000 copies were selected as internal standard. The standard curve showed R2 = 0.993 and E = 109.7%, and the linear dynamic range was defined between 102 and 106 ACTB copies/tube. Repeatability and reproducibility in terms of CV were 19% and up to 49.5% for ACTB copies per milliliter of plasma, respectively. The range of cfDNA levels was 428-18,851 copies/mL in NP women and 4031-2,019,363 copies/mL in P women, showing significant differences between the groups. We recommend the application of internal standard strategy for a reliable plasma cfDNA quantification. This methodology holds great potential for a future application in the obstetric field.

Estrategias metodológicas interactivas de la educación virtual en medicina: una revisión sistemática

Introducción: La pandemia ocasionada por la COVID - 19, ha provocado un cambio radical en la educación, siendo una de las más afectadas la educación médica. Los programas de esta carrera han realizado cambios para mantener el plan de estudios, surgiendo la necesidad de implementar nuevas estrategias metodológicas que permitan el mejor desempeño del estudiante. Objetivo: Describir estrategias metodológicas interactivas para la mejora de la práctica docente en el programa de medicina humana, teniendo en cuenta el contexto actual, a partir de evidencia publicada como resultado de investigaciones. Métodos: Esta revisión sistemática está basada en evidencia publicada como resultado de investigaciones en las bases de datos SCOPUS, Scielo, Latindex y DOAJ. Se eligieron artículos que hayan sido publicados entre los años 2017 y 2021 de acceso gratuito y que estén escritos en inglés o español. El estudio permitirá de manera importante mejorar la práctica docente en los programas de medicina humana. Desarrollo: En las tablas 1 y 2, son mostradas algunas estrategias metodológicas interactivas de la educación virtual (29,8%), que satisface las exigentes necesidades de la industria de la educación y con ayuda de la tecnología han transformado el sistema educativo en un modo en línea. De los resultados encontrados en la revisión de los artículos (tabla 3), se puede inferir que aplicar estrategias metodológicas donde exista una interacción activa entre el docente y alumno resultan beneficiosas en el aprendizaje. Conclusiones: Se determinó que implementar las estrategias metodológicas interactivas como la simulación virtual, trabajo colaborativo, aula invertida y ambientes virtuales de aprendizaje en la formación del programa de medicina colabora de manera importante en el aprendizaje y estimulación del estudiante.

Introduction: The pandemic caused by COVID - 19 has caused a radical change in education, one of the most affected being medical education. The programs of this career have made changes to maintain the study plan, arising the need to implement new methodological strategies that allow the best performance of the student. Objective: Describe interactive methodological strategies for the improvement of teaching practice in the human medicine program, taking into account the current context, based on evidence published as a result of research. Methods: This systematic review is based on evidence published as a result of research in the SCOPUS, Scielo, Latindex and DOAJ databases. Articles that have been published between the years 2017 and 2021 with free access and that are written in English or Spanish were chosen. The study will significantly improve teaching practice in human medicine programs. Development: In tables 1,2, some interactive methodological strategies of virtual education (29.8%) are shown, which satisfy the demanding needs of the education industry and with the help of technology have transformed the educational system into a mode in line. From the results found in the review of the articles (table 3), it can be inferred that applying methodological strategies where there is an active interaction between the teacher and student are beneficial in learning. Conclusions: It was determined that implementing interactive methodological strategies such as virtual simulation, collaborative work, flipped classroom and virtual learning environments in the training of the medicine program contributes significantly to student learning and stimulation.

Effect of oral hygiene in infants before dental eruption on Candida spp. colonization and the occurrence of oral candidiasis: A randomized clinical trial.

Background: To assess the influence of oral hygiene in infants before the primary tooth eruption on colonization by Candida spp. and the occurrence of oral candidiasis. Material and Methods: Fifty-six infants were randomly selected in their first 48 hours of life and allocated into 2 groups: Group I (Mothers were instructed to sanitize the oral cavity of the infant with gauze and filtered water once a day) and Group II (Mothers were instructed not to sanitize the oral cavity of the infant before the dental eruption). Data collection was performed one month after the birth of the infant, in their residence, including saliva collection for identification and quantification of Candida spp. Results: Colonization by Candida spp. species was found in 49.1% of the infants evaluated. There was no statistically significant difference between colonization by Candida spp. and intervention groups (p=0.947). 13.2% of the participants presented oral candidiasis during the first month of life, this prevalence was 15.4% in the control group and 11.1% in the intervention group, however, this difference was not significant (p=0.704). Conclusions: The Candida spp. colonization and the oral candidiasis occurrence, in the first month of the life of the infant, were not influenced by oral hygiene. Key words:Infants, oral hygiene, oral health, oral candidiasis.

Factores de riesgo relacionados con el síndrome poscovid-19 en pobladores pinareños / Risk factors related to postcovid­19 syndrome in residents from Pinar del Río i: en

Introducción: Las posibilidades de padecer el síndrome poscovid-19 crecen en la medida en que se expande la pandemia. Objetivo: Identificar los factores de riesgo relacionados con el síndrome poscovid-19 en pobladores pinareños. Métodos: Se realizó un estudio de casos y controles, que incluyó a convalecientes de covid-19, atendidos en la consulta multidisciplinaria del Policlínico Luis Augusto Turcios Lima de la provincia de Pinar del Río durante el 2022, quienes fueron incluidos de forma aleatoria en 2 grupos, a razón de 1:2 (100 casos y 200 controles). El análisis estadístico se basó en una estrategia univariada, que consistió en la determinación del odds ratio para cada factor de riesgo, así como en la estimación de los intervalos de confianza al 95 % y la prueba de la Χ2, con un nivel de significación de p<0,05. Resultados: En el estudio predominaron el sexo femenino, la diabetes mellitus, el tratamiento farmacológico, el soporte ventilatorio, la presencia de secuelas establecidas y las complicaciones. Conclusiones: A pesar de identificar los factores de riesgo más frecuentes relacionados con el síndrome poscovid-19, este continúa siendo un desafío para los profesionales de la salud.

Introduction: The possibilities to suffer from the postcovid-19 syndrome grow as the pandemic expands. Objective: To identify the risk factors related to the postcovid-19 syndrome in residents from Pinar del Río. Methods: A cases and controls study that included covid-19 convalescents was carried out. They were assisted in the multidisciplinary service of Luis Augusto Turcios Lima Polyclinic of Pinar del Rio province during 2022 that were included in 2 groups at random, at a ratio of 1:2 (100 cases and 200 controls). The statistical analysis was based on an univaried strategy, for which the odds ratio was determined for each risk factor and the confidence intervals were considered at 95 %, as well as the chi-square test, with a significance level of p<0,05. Results: In the study there was a prevalence of the female sex, diabetes mellitus, pharmacological treatment, ventilation support, the presence of established sequels and complications. Conclusions: In spite of identifying the most frequent risk factors related to the postcovid-19 syndrome, it is still a challenge for health professionals.

Psychometric assessment of oral health-related quality of life questionnaires cross-culturally adapted for use in Brazilian adults - a systematic review.

OBJECTIVE: This study aimed to review the psychometric properties of oral health-related quality of life (OHRQoL) questionnaires for the Brazilian adult population. METHODS: A systematic review was performed based on the COSMIN guidelines (PROSPERO CRD42022300018). The studies were obtained through electronic searches in the PubMed/MEDLINE, Web of Science, Lilacs, VHL (BIREME), SciELO, and Embase databases. RESULTS: The search was performed in December 2022. Articles on OHRQoL that reported the cross-cultural adaptation of instruments into Portuguese (Brazil) and evaluated the psychometric properties of measuring instruments in adult patients were included. Those about the development of a novel instrument and participants under 18 years of age were excluded. Information was collected on the country, type of instrument validated, psychometric tests, and adaptation process. The certainty of the evidence was assessed using GRADEpro program. The search returned 6,556 articles, and 14 were considered for this review. However, two studies did not report the cross-cultural adaptation process. Content validity, internal consistency, criterion validity, construct validity, reliability, general discriminant validity, Cronbach's alpha value, and general intraclass correlation coefficient value were confirmed in 12 studies. Cronbach's alpha ranged from 0.69 to 0.96. The certainty of the evidence was considered moderate and low. This study has some limitations, such as the lack of information in some reviewed studies, the unavailability of Brazilian instruments, and absence of longitudinal validation of some instruments. CONCLUSIONS: In conclusion, there are 14 OHRQoL instruments adapted for Brazilian adults that can be used with caution by researchers and clinicians, since they presented moderate to low certainty of the evidence.

Neonatal overfeeding alters the functioning of the mesolimbic dopaminergic circuitry involving changes in DNA methylation and effects on feeding behavior.

Mesolimbic dopaminergic circuit is essential for food reward and motivational behaviors and can contribute to weight gain and obesity. Litter reduction is a classical model for studying the effects of neonatal overfeeding and overweight. Litters of Wistar rats were reduced to 4 pups/dam for small litter (SL) and 10 pups/dam for normal litter at postnatal day (PND) 4. Immediately after performing the feeding behavior tests, the animals were sacrificed in PND21 and PND90. The ventral tegmental area (VTA), Nucleus Accumbens Core (NAcC) and Shell (NAcSh) were isolated from frozen brain sections using the Palkovits micropunch technique. RNA and DNA were extracted from these areas, gene expression was measured by RT-qPCR and DNA methylation levels were measured by MSRM-qPCR technique. SL-PND21 animals presented increased expression levels of Tyrosine Hydroxylase and Dopamine Receptor D2 in VTA, decreased expression levels of dopamine active transporter (DAT) in VTA, and higher expression levels of DAT in NAcC. On the other hand, SL-PND90 animals showed decreased expression levels of Dopamine Receptor D1 and higher expression of DAT in NAcSh. These animals also evidenced impaired sensory-specific satiety. In addition, altered promoter methylation was observed at weaning, and remained in adulthood. This work demonstrates that neonatal overfeeding induces disruptions in the mesolimbic dopaminergic circuitry and causes alterations in feeding behavior from weaning to adulthood, suggesting that the neonatal period is critical for the normal development of dopaminergic circuit that impact on feeding behavior.

Tissue and subcellular localization of CycD2 and KRPs are dissimilarly distributed by glucose and sucrose during early maize germination.

In maize, immunoprecipitation assays have shown that CycD2;2 interacts with KRPs. However, evidence on CycD2;2 or KRPs localization and their possible interaction in specific tissues is lacking and its physiological consequence is still unknown. This work explores the spatiotemporal presence of CyclinD2s and KRPs, cell cycle regulators, during maize seed germination (18 and 36 h) after soaking on glucose or sucrose (120 mM). CyclinD2s are positive actors driving proliferation; KRPs are inhibitors of the main kinase controlling proliferation (a negative signal that slows down the cell cycle). Cell cycle proteins were analyzed by immunolocalization on longitudinal sections of maize embryo axis in seven different tissues or zones (with different proliferation or differentiation potential) and in the nucleus of their cells. Results showed a prevalence of these cell cycle proteins on embryo axes from dry seeds, particularly, their accumulation in nuclei of radicle cells. The absence of sugar caused the accumulation of these regulators in different proliferating zones. CyclinD2 abundance was reduced during germination in the presence of sucrose along the embryo axis, while there was an increase at 36 h on glucose. KRP proteins showed a slight increase at 18 h and a decrease at 36 h on both sugars. There was no correlation between cell cycle regulators/DNA co-localization on both sugars. Results suggest glucose induced a specific accumulation of each cell cycle regulator depending on the proliferation zone as well as nuclear localization which may reflect the differential morphogenetic program regarding the proliferation potential in each zone, while sucrose has a mild influence on both cell cycle proteins accumulation during germination. Whenever CycD2s were present in the nucleus, KRPs were absent after treatment with either sugar and at the two imbibition times analyzed, along the different embryo axe zones.

The glycolytic enzymes glyceraldehyde-3-phosphate dehydrogenase and hexokinase interact with cell cycle proteins in maize.

Cyclin/cyclin-dependent kinase (CDK) heterodimers have multiple phosphorylation targets and may alter the activity of these targets. Proteins from different metabolic processes are among the phosphorylation targets, that is, enzymes of central carbon metabolism. This work explores the interaction of Cyc/CDK complex members with the glycolytic enzymes hexokinase 7 (HXK7) and glyceraldehyde-3-phosphate dehydrogenase (GAP). Both enzymes interacted steadily with CycD2;2, CycB2;1 and CDKA;1 but not with CDKB1;1. However, Cyc/CDKB1;1 complexes phosphorylated both enzymes, decreasing their activities. Treatment with a CDK-specific inhibitor (RO-3306) or with lambda phosphatase after kinase assay restored total HXK7 activity, but not GAP activity. In enzymatic assays, increasing concentrations of CDKB1;1, but not of CycD2;2, CycB2;1 or CycD2;2/CDKB1;1 complex, decreased GAP activity. Cell cycle regulators may modulate carbon channeling in glycolysis by two different mechanisms: Cyc/CDK-mediated phosphorylation of targets (e.g., HXK7; canonical mechanism) or by direct and transient interaction of the metabolic enzyme (e.g., GAP) with CDKB1;1 without a Cyc partner (alternative mechanism).

Caracterización clínico quirúrgica de la colecistitis aguda en pacientes tratados en el Servicio de Cirugía General. Cienfuegos, 2017- 2019

Fundamento la colecistitis aguda es una enfermedad inflamatoria, caracterizada por alteraciones agudas de la pared vesicular que pueden ir desde el edema y la congestión hasta la gangrena y perforación. Es una enfermedad con alta incidencia en urgencia quirúrgica. Objetivo: caracterizar clínica y quirúrgicamente la colecistitis aguda en pacientes del Servicio de Cirugía General. Métodos: se realizó un estudio descriptivo y prospectivo de pacientes atendidos por colecistitis aguda en el Servicio de Cirugía durante el período del primero de enero de 2017 al treinta y uno de diciembre de 2019. Los datos se obtuvieron de las historias clínicas y los informes operatorios, utilizando un modelo de recolección de datos. Se analizaron las variables edad, sexo, enfermedades asociadas, manifestaciones clínicas, confirmación diagnóstica, tipo de tratamiento, modalidad de tratamiento quirúrgico, evolución, complicaciones, uso de antibiótico, lugar de ingreso y estadía hospitalaria Resultados: predominaron los pacientes de 60 años y más del sexo femenino; el dolor abdominal prevaleció en la mayoría de los pacientes, acompañado de vómitos y taquicardia; el diagnóstico se confirmó mediante la clínica; predominó el tratamiento quirúrgico, la colecistectomía convencional abierta fue la técnica de elección; la mayoría evolucionó de forma satisfactoria. La sepsis de la herida quirúrgica fue la complicación más frecuente. Conclusiones: la colecistitis aguda es más frecuente en ancianos, el diagnóstico precoz y tratamiento oportuno pueden disminuir el porcentaje de complicaciones; el tratamiento quirúrgico es el de elección, combinado con antibióticoterapia.

Background: acute cholecystitis is an inflammatory disease, characterized by acute changes in the gallbladder wall that can range from edema and congestion to gangrene and perforation. It is a disease with a high incidence in surgical urgency. Objective: to clinically and surgically characterize acute cholecystitis in patients of the General Surgery Service. Methods: a descriptive and prospective study of patients treated for acute cholecystitis in the Surgery Service was carried out from January the 1st, 2017 to December the 31st, 2019. Data were obtained from medical records and operative reports, using a data collection model. The variables age, sex, associated diseases, clinical manifestations, diagnostic confirmation, type of treatment, modality of surgical treatment, evolution, complications, use of antibiotics, place of admission and hospital stay were analyzed. Results: female patients aged 60 years and over predominated; abdominal pain prevailed in most of the patients, accompanied by vomiting and tachycardia; the diagnosis was confirmed through the clinic; surgical treatment predominated, conventional open cholecystectomy was the technique of choice; most progress satisfactorily. Surgical wound sepsis was the most frequent complication. Conclusions: acute cholecystitis is more frequent in the elderly, early diagnosis and timely treatment can reduce the percentage of complications; surgical treatment is the treatment of choice, combined with antibiotic therapy.

Factores de riesgo relacionados con la COVID-19. Policlínico Turcios Lima. Pinar del Río, 2020-2021

Fundamento el reconocimiento oportuno de determinados factores de riesgo contribuye a identificar la infección por COVID-19 en una etapa temprana, lo cual, unido a la participación interdisciplinaria e intersectorial, permite implementar mejores estrategias y reducir la morbimortalidad. Objetivo determinar los factores de riesgo relacionados con la aparición de COVID-19. Métodos se realizó un estudio de casos y controles, que incluyó a pacientes atendidos en el Policlínico Comunitario Turcios Lima, de Pinar del Río, en los años 2020 y 2021. La selección de la muestra fue aleatoria 3:6 (3000 casos positivos de COVID-19/6000 controles sin la enfermedad), pareados por edad y sexo. El análisis estadístico se basó en una estrategia multivariada, cálculo de Odds Ratio (OR) con intervalos de confianza al 95 % (IC 95 %), y la prueba de Chi Cuadrado, con nivel de significación estadística de p<0,05. Resultados los factores de riesgo más frecuentes fueron: el sexo masculino (X2=8,5900; p<0,001), la residencia urbana (X2=509,03; p<0,001) y la ocupación como estudiante o trabajador (X2=199,93; p<0,001); así como los antecedentes patológicos personales de diabetes mellitus, hipertensión arterial, cardiopatía isquémica, asma bronquial, insuficiencia cardiaca y enfermedad pulmonar obstructiva crónica. Conclusiones aunque se identificaron el sexo, el lugar de residencia, la ocupación y los antecedentes patológicos personales, como factores de riesgo relacionados con la COVID-19, la información acerca del impacto de otros factores es todavía limitada y requiere de estudio.

Background timely recognition of certain risk factors helps to identify COVID-19 infection at an early stage, which, together with interdisciplinary and intersectoral participation, allows for the implementation of better strategies and reduction of morbidity and mortality. Objective to determine the risk factors related to the appearance of COVID-19. Methods: a case-control study was carried out, which included patients treated at the Turcios Lima Community Polyclinic, in Pinar del Río, from 2020 to 2021. The sample selection was random 3:6 (3000 positive cases of COVID-19/6000 controls without the disease), matched by age and sex. Statistical analysis was based on a multivariate strategy, calculation of the Odds Ratio (OR) with 95% confidence intervals (95% CI), and the Chi Square test, with a statistical significance level of p<0.05. Results the most frequent risk factors were: male sex (X2=8.5900; p<0.001), urban residence (X2=509.03; p<0.001) and occupation as a student or worker (X2=199 .93, p<0.001); as well as personal medical history of diabetes mellitus, arterial hypertension, ischemic heart disease, bronchial asthma, heart failure, and chronic obstructive pulmonary disease. Conclusions although sex, place of residence, occupation, and personal medical history were identified as risk factors related to COVID-19, information about the impact of other factors is still limited and requires further study.

The Impact of Socio-Environmental, Individual, and Biological Factors on Oral Health-Related Quality of Life among Preschool Children: A Cohort Study with 3-Year Follow-Up.

This study assessed impact of socio-environmental, individual, and biological factors on the worsening and severe worsening of oral health-related quality of life (OHRQoL) among preschoolers and their families. A cohort study was conducted in Diamantina, Brazil, with 151 children between 1 and 3 years of age and their mothers, who were evaluated at baseline (2014) and re-evaluated after 3 years (2017). The children were clinically examined to assess the presence of dental caries, malocclusion, dental trauma, and enamel defects. The mothers answered the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire addressing individual characteristics of the child and socio-environmental factors. Extensive caries found in the follow-up (relative risk [RR] = 1.91; 95% confidence interval [CI] = 1.26-2.91) and failure to undergo the dental treatment recommended at baseline (RR = 2.49; 95% CI = 1.62-3.81) were associated with worsening of OHRQoL over 3 years. An increase in the number of children in the household (RR = 2.95; 95% CI = 1.06-8.25), occurrence of extensive caries in the follow-up (RR = 2.06; 95% CI = 1.05-4.07), and failure to undergo the dental treatment recommended at baseline (RR = 3.68; 95% CI = 1.96-6.89) were associated with a severe worsening of OHRQoL. In conclusion, the risk of worsening and severe worsening of OHRQoL was higher in preschoolers with extensive caries at follow-up and among those who did not undergo dental treatment. Furthermore, severe worsening of OHRQoL was also impacted by an increase in the number of children in the household.

Estimation of body weight using body measurements in female water buffaloes reared in southeastern Mexico.

Buffalo farming is an important livestock activity in Mexico. However, the low technological level of the farms makes it difficult to monitor the growth rates of the animals. The objectives of this study were to analyse the body measurements of 107 adult female Murrah buffaloes, to estimate the interrelationships between those measurements and body weight, and to develop equations to predict body weight (BW) using body measurements including withers at height (WH), rump height (RH), body height (BH), heart girth (HG), abdominal girth (AG), pelvic girth (PG), body length (BL), girth circumference (GC), diagonal body length (DBL), pelvic circumference (PC), and abdomen circumference (AC). The study was conducted on two commercial farms in southern Mexico. Pearson correlation and stepwise regression techniques were used for the data analysis. To find out the best regression models, we used model quality criteria such as coefficient of determination (R2), adjusted R2 (Adj.R2), root mean square error (RMSE), Mallow's Cp, Akaike's information criteria (AIC), Bayesian information criteria (BIC), and coefficient of variation (CV). Correlation results indicated that BW had a positive high correlation (P < 0.01) of all the measured traits. Model 4 (-780.56 + 311.76GC + 383.51DBL + 51.82PC + 47.65AC-106.78BL) was the best regression model with a higher R2 (0.87), Adj. R2 (0.86) smaller Cp (4.24), AIC (749.19), BIC (752.16), and RMSE (36.91). The current study suggests that GC, DBL, PC, AC, and BL might be used in combination to estimate BW of adult female Murrah buffaloes.

Mothers' sense of coherence and oral health-related quality of life of preschoolers: a 3-year cohort study.

The aim of the present study was to assess whether mothers' sense of coherence (SOC) was a predictor of decline in oral health-related quality of life (OHRQoL) of preschoolers. A 3-year cohort study was conducted in Diamantina, Brazil. At baseline, 162 preschoolers aged one to three years were randomly selected from among children registered in local Primary Healthcare Units. In the first stage, mothers completed a sociodemographic questionnaire, the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS), and the Brazilian short version of the Sense of Coherence Scale (SOC-13). The total score obtained from the SOC-13 was used to select exposed and unexposed children. Clinical examinations were performed to detect the presence of dental caries, traumatic dental injury, and malocclusion. At follow-up, mothers completed the sociodemographic questionnaire and the B-ECOHIS again. The incidence of severe dental caries and adherence to the proposed treatment at baseline were evaluated. A decline in OHRQoL was considered if there was an increase in the B-ECOHIS score of at least one unit. The chi-square test and Poisson regression were performed. A total of 151 preschoolers participated in the study, among whom 37.7% showed a decline in OHRQoL. Mothers' SOC was not associated with a negative impact on OHRQoL (RR = 1.24; 95%CI = 0.81-1.88), while the incidence of severe dental caries had a greater impact on the decline in OHRQoL (RR = 2.02; 95%CI = 1.29-3.16). Mothers' low SOC was not a predictor of decline in the OHRQoL of preschoolers after a 3-year follow-up period.

Propuesta de guía de práctica clínica corta para el manejo de la enfermedad renal crónica

La enfermedad renal crónica constituye un problema de salud debido su impacto sobre los individuos, la sociedad y la economía. Se propone una guía de práctica clínica para atención de la enfermedad renal crónica en la Atención Primaria de Salud. Se realizó una investigación clínica epidemiológica entre los años 2017-2019, en el Policlínico Luis Augusto Turcios Lima, del municipio de Pinar del Río. La guía fue elaborada siguiendo criterios de la medicina basada en la evidencia, por consenso y por opinión de expertos. La evaluación de calidad se realizó con el Instrumento Appraisal of Guidelines, Research and Evaluation for Europe. Se elaboraron recomendaciones, se generalizó y actualizó permanentemente con las nuevas evidencias médicas. Se sistematizaron las prácticas preventivas y de detección precoz de la enfermedad. La guía propuesta provee a los profesionales que laboran en la Atención Primaria de Salud, las herramientas apropiadas para la detección y manejo de la enfermedad renal crónica; además de facilitar la coordinación entre los ámbitos de los niveles primario y secundario de Salud. Se concluye que permite mejorar la atención de los pacientes con esta enfermedad, particularmente en la Atención Primaria de Salud.

Chronic kidney disease constitutes a health problem due to its impact on individuals, society and the economy. A clinical practice guide for chronic kidney disease care in Primary Health Care is proposed. A clinical epidemiological investigation was carried out from 2017 to 2019, at the Luis Augusto Turcios Lima Polyclinic, in the Pinar del Río municipality. The guideline was prepared following evidence-based medicine criteria, by consensus and by expert opinion. The quality evaluation was carried out with the Appraisal of Guidelines, Research and Evaluation for Europe Instrument. Recommendations were elaborated; it was generalized and permanently updated with the new medical evidence. Preventive practices and early detection of the disease were systematized. The proposed guide provides professionals working in Primary Health Care with the appropriate tools for the detection and management of chronic kidney disease; also facilitating coordination between the primary and secondary levels of Health. It is concluded that it allows improving the care of patients with this disease, especially in Primary Health Care.

Family income modifies the association between frequent sugar intake and dental caries.

AIM: The aim of this cross-sectional study was to investigate whether family income modifies associations between dental caries and sex, age, mother's education, type of preschool, sugar intake, and toothbrushing. BACKGROUND: Dental caries is a multifactorial dyanamic disease primarily mediated by biofilm and sugar. DESIGN: A randomly selected sample of 308 Brazilian preschool children aged 1-3 years underwent a clinical oral examination for the assessment of moderate/extensive dental caries using codes 3-6 of the International Caries Detection and Assessment System. Mothers were asked to fill out a form addressing the child's demographic and socioeconomic characteristics as well as the frequency of sugar intake. Statistical analysis involved descriptive statistics, the chi-squared test, and Poisson regression models. RESULTS: The prevalence of moderate/extensive dental caries was 42.5%. The adjusted model revealed that within low-income families (<2 times the monthly minimum wage), the prevalence of dental caries was higher among children with a high frequency of sugar intake (≥ twice per day) than in those with a low frequency of sugar intake (< twice a day) (RR = 1.79; CI: 1.38-2.33). In families with higher income (≥2 times the monthly wage), no significant association between sugar intake and dental caries was, however, found. CONCLUSIONS: In conclusion, monthly family income can modify the association between the high frequency of sugar intake and dental caries.