Interleukin-33 and liver natural killer cells: A novel perspective on antitumor activity in liver fibrosis.

AIM: Liver fibrosis, heralding the potential progression to cirrhosis and hepatocellular carcinoma (HCC), compromises patient survival and augments post-hepatectomy recurrence. This study examined the detrimental effects of liver fibrosis on the antitumor functions of liver natural killer (NK) cells and the interleukin-33 (IL-33) signaling pathway. METHODS: Our investigation, anchored in both human physiologies using living and deceased donor livers and the carbon tetrachloride (CCl4)-induced mouse fibrosis model, aimed to show a troubling interface between liver fibrosis and weakened hepatic immunity. RESULTS: The Fibrosis-4 (FIB-4) index emerged as a salient, non-invasive prognostic marker, and its elevation correlated with reduced survival and heightened recurrence after HCC surgery even after propensity matching (n = 385). We established a strong correlation between liver fibrosis and liver NK cell dysfunction by developing a method for extracting liver NK cells from the liver graft perfusate. Furthermore, liver fibrosis ostensibly disrupted chemokines and promoted IL-33 expression, impeding liver NK cell antitumor activities, as evidenced in mouse models. Intriguingly, our results implicated IL-33 in diminishing the antitumor responses of NK cells. This interrelation, consistent across both mouse and human studies, coincides with clinical data suggesting that liver fibrosis predisposes patients to an increased risk of HCC recurrence. CONCLUSION: Our study revealed a critical relationship between liver fibrosis and compromised tumor immunity, emphasizing the potential interference of IL-33 with NK cell function. These insights advocate for advanced immunostimulatory therapies targeting cytokines, such as IL-33, aiming to bolster the hepatic immune response against HCC in the context of liver fibrosis.

Indicators of verbal creative thinking: results of a Delphi panel.

Introduction: Creativity is a fundamental competence that manifests itself in various domains of knowledge, including verbal creativity. The main aim of this study was to identify indicators of verbal creativity for the assessment of three writing tasks. Methods: Sixteen multidisciplinary and international creativity experts participated in a two-stage Delphi panel. The administered questionnaire asked about the measurement or non-measurement of eight indicators of verbal creative thinking in three tasks: problem posing, creative idea generation, and idea improvement. Originality is the most important indicator of creativity. The indicators identified in the first task were fluency, flexibility, originality, elaboration, and sensitivity to problems. The second task measures flexibility, originality, elaboration, opacity, and dynamic integration. In the third task, fluency, flexibility, originality, elaboration, dynamic integration, and refinement of ideas are considered. Results: The results of this study are key to progress in the field of measuring verbal creative thinking. Discussion: The identification of indicators of the construct called verbal creativity allows the determination of its components in order to be able to estimate the creative potential in this specific domain.

The IPTA Nashville consensus conference on post-transplant lymphoproliferative disorders after solid organ transplantation in children: IV-consensus guidelines for the management of post-transplant lymphoproliferative disorders in children and adolescents.

The International Pediatric Transplant Association convened an expert consensus conference to assess current evidence and develop recommendations for various aspects of care relating to post-transplant lymphoproliferative disorders (PTLD) after pediatric solid organ transplantation. This report addresses the outcomes of deliberations by the PTLD Management Working Group. A strong recommendation was made for reduction in immunosuppression as the first step in management. Similarly, strong recommendations were made for the use of the anti-CD20 monoclonal antibody (rituximab) as was the case for chemotherapy in selected scenarios. In some scenarios, there is uncoupling of the strength of the recommendations from the available evidence in situations where such evidence is lacking but collective clinical experiences drive decision-making. Of note, there are no large, randomized phase III trials of any treatment for PTLD in the pediatric age group. Current gaps and future research priorities are highlighted.

Epstein-Barr virus-associated post-transplant lymphoproliferative disorders in pediatric transplantation: A prospective multicenter study in the United States.

BACKGROUND: Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorders (PTLD) is the most common malignancy in children after transplant; however, difficulties for early detection may worsen the prognosis. METHODS: The prospective, multicenter, study enrolled 944 children (≤21 years of age). Of these, 872 received liver, heart, kidney, intestinal, or multivisceral transplants in seven US centers between 2014 and 2019 (NCT02182986). In total, 34 pediatric EBV+ PTLD (3.9%) were identified by biopsy. Variables included sex, age, race, ethnicity, transplanted organ, EBV viral load, pre-transplant EBV serology, immunosuppression, response to chemotherapy and rituximab, and histopathological diagnosis. RESULTS: The uni-/multivariable competing risk analyses revealed the combination of EBV-seropositive donor and EBV-naïve recipient (D+R-) was a significant risk factor for PTLD development (sub-hazard ratio: 2.79 [1.34-5.78], p = .006) and EBV DNAemia (2.65 [1.72-4.09], p < .001). Patients with D+R- were significantly more associated with monomorphic/polymorphic PTLD than those with the other combinations (p = .02). Patients with monomorphic/polymorphic PTLD (n = 21) had significantly more EBV DNAemia than non-PTLD patients (p < .001) and an earlier clinical presentation of PTLD than patients with hyperplasias (p < .001), within 6-month post-transplant. Among non-liver transplant recipients, monomorphic/polymorphic PTLD were significantly more frequent than hyperplasias in patients ≥5 years of age at transplant (p = .01). CONCLUSIONS: D+R- is a risk factor for PTLD and EBV DNAemia and associated with the incidence of monomorphic/polymorphic PTLD. Intensive follow-up of EBV viral load within 6-month post-transplant, especially for patients with D+R- and/or non-liver transplant recipients ≥5 years of age at transplant, may help detect monomorphic/polymorphic PTLD early in pediatric transplant.

Application of Mass Cytometry Platforms to Solid Organ Transplantation.

Transplantation serves as the cornerstone of treatment for patients with end-stage organ disease. The prevalence of complications, such as allograft rejection, infection, and malignancies, underscores the need to dissect the complex interactions of the immune system at the single-cell level. In this review, we discuss studies using mass cytometry or cytometry by time-of-flight, a cutting-edge technology enabling the characterization of immune populations and cell-to-cell interactions in granular detail. We review the application of mass cytometry in human and experimental animal studies in the context of transplantation, uncovering invaluable contributions of the tool to understanding rejection and other transplant-related complications. We discuss recent innovations that have the potential to streamline and standardize mass cytometry workflows for application to multisite clinical trials. Additionally, we introduce imaging mass cytometry, a technique that couples the power of mass cytometry with spatial context, thereby mapping cellular interactions within tissue microenvironments. The synergistic integration of mass cytometry and imaging mass cytometry data with other omics data sets and high-dimensional data platforms to further define immune dynamics is discussed. In conclusion, mass cytometry technologies, when integrated with other tools and data, shed light on the intricate landscape of the immune response in transplantation. This approach holds significant potential for enhancing patient outcomes by advancing our understanding and facilitating the development of new diagnostics and therapeutics.

Influence of the chest wall on respiratory function at birth in near-term lambs.

Airway liquid is cleared into lung tissue after birth, which becomes edematous and forces the chest wall to expand to accommodate both the cleared liquid and incoming air. This study investigated how changing chest wall mechanics affects respiratory function after birth in near-term lambs with different airway liquid volumes. Surgically instrumented near-term lambs (139 ± 2 days) were randomized into Control (n = 7) or Elevated Liquid (EL; n = 6) groups. Control lambs had lung liquid drained to simulate expected volumes following vaginal delivery. EL lambs had airway liquid drained and 30 mL/kg liquid returned to simulate expected airway liquid volumes after elective cesarean section. Lambs were delivered, transferred to a Perspex box, and ventilated (30 min). Pressure in the box was adjusted to apply positive (7-8 cmH2O above atmospheric pressure) or negative (7-8 cmH2O below atmospheric pressure) pressures for 30 min before pressures were reversed. External negative pressures expanded the chest wall, reduced chest wall compliance (CCW) and increased lung compliance (CL) in Control and EL lambs. External positive pressures compressed the chest wall, increased CCW and reduced CL in Control and EL lambs. External negative pressure improved pulmonary oxygen exchange, reducing the alveolar-arterial difference in oxygen (AaDO2) by 69 mmHg (95% CI [13, 125]; P = 0.016) in Control lambs and by 300 mmHg (95% CI [233, 367]; P < 0.001) in EL lambs. In contrast, external positive pressures impaired pulmonary gas exchange, increasing the AaDO2 by 179 mmHg (95% CI [73, 285]; P = 0.002) in Control and by 215 mmHg (95% CI [89, 343]; P < 0.001) in EL lambs. The application of external thoracic pressures influences respiratory function after birth.NEW & NOTEWORTHY This study investigated how changes in chest wall mechanics influence respiratory function after birth. Our data indicate that the application of continuous external subatmospheric pressure greatly improves respiratory function in near-term lambs with respiratory distress, whereas external positive pressures impair respiratory function. Our findings indicate that, during neonatal resuscitation at birth, the forces applied to the chest wall should not be ignored as they can have a major impact on neonatal respiratory function.

Dental caries prevalence and severity positively associate with AMY1 gene copy number.

OBJECTIVE: To establish the possible relation between total caries (TC) and caries severity (CS) with the AMY1 gene copy number (AMY1GCN). MATERIALS AND METHODS: This was an observational, cross-sectional, population-based, and association study with 303 participants. Each participant underwent a complete anamnesis and stomatological check-up, and peripheral blood was obtained to extract gDNA. TC and CS were determined as the number of caries at the dental exploration and the number of dental surfaces affected by caries, respectively, and AMY1GCN was determined by qPCR. RESULTS: We found an elevated caries prevalence (92.7%); TC and CS were 8 ± 10 and 10 ± 13 (median ± IR). There were higher TC and CS in those participants with AMY1GCN above the mean value (0.02 and 0.01 p values, respectively). A positive correlation between TC and CS with AMY1GCN (0.11 and 0.125 r values, 0.03 and 0.01 p values, respectively) was found, in addition to an association between TC and CS with AMY1GCN (1.5 and 1.6 OR values, 0.48 and 0.26 p values, respectively). CONCLUSION: TC and CS were positively related to the AMY1GCN. CLINICAL RELEVANCE: Dental caries has a high prevalence and a multifactorial etiology and has been related to a genetic component. Indeed, the salivary enzyme alpha-amylase could play a significant role in caries susceptibility, considering that its codifying gene (AMY1) can show variation in its gene copy number. This can be considered an important factor for the development of caries at a genetic level.

Experiencias de aprendizaje orientadas al bienestar / Wellbeing-oriented learning experiences

Introducción: En la educación médica, las estrategias de enseñanza orientadas al bienestar comienzan a generar interés, y las experiencias artísticas, de acuerdo con la bibliografía, pueden ser una alternativa. Materiales y métodos: Este estudio tuvo como propósito describir la experiencia del curso electivo virtual ‘Bienestar, arte y salud' en una escuela de medicina en Colombia, que se realizó durante 2021-2022. Se aplicó la metodología para la evaluación de programas en las profesiones de salud. Resultados: Las actividades de aprendizaje buscaron: cambios en la percepción de los estudiantes sobre la relación bienestar, salud y arte; generar procesos reflexivos sobre la experiencia estética y artística; promover la comprensión de la experiencia estética y su impacto en la salud de las personas; y reflexionar sobre el bienestar propio y el bienestar de otros. Los conocimientos previos y las experiencias de los estudiantes en relación con el bienestar propio y el de personas cercanas son importantes para la comprensión de los contenidos del curso. Los proyectos propuestos por los estudiantes se relacionan con experiencias propias y reflexiones sobre situaciones como problemas de salud mental y asociados con el estudio y la práctica médica. Conclusiones: El estudio concluye que el interés por el autocuidado, la transdisciplinariedad y la flexibilidad académica puede beneficiar aprendizajes relacionados con el bienestar.(AU)

Introduction: In medical education, well-being oriented teaching strategies are beginning to generate interest and artistic experiences, according to the literature, can be an alternative. Materials and methods: The purpose of this study was to describe the experience of the virtual elective course: ‘Well-being, art and health', in a medical school in Colombia, which took place during 2021-2022. We applied the methodology for the evaluation of programs in the health professions. Results: The learning activities sought: to change students' perception of the relationship between wellbeing, health and art; to generate reflective processes on the aesthetic and artistic experience; to promote understanding of the aesthetic experience and its impact on people's health; and to reflect on one's own wellbeing and the wellbeing of others. Students' prior knowledge and experiences in relation to the wellbeing of self and others close to them are important for the understanding of the course content. The projects proposed by the students are related to own experiences and reflections on situations such as mental health problems and associated with medical study and practice. Conclusions: The study concludes that interest in self-care, transdisciplinarity and academic flexibility can benefit learning related to wellbeing.(AU)

Valores gasométricos en población adulta y adulta mayor residente de gran altitud / Gasometric values in adult population and elderly in high altitude resident

RESUMEN Introducción. Los valores de gases arteriales y electrolitos sufren modificaciones en la altura, las que pueden alterar la evaluación diagnóstica y pronóstica de ciertas enfermedades. Objetivos. Determinar los valores de gases arteriales y electrolitos en pobladores adultos y adultos mayores sanos que viven en gran altitud. Métodos. Estudio prospectivo, descriptivo, realizado en una población de adultos y adultos mayores, sanos, voluntarios, en el Hospital Nacional Ramiro Prialé Prialé de EsSalud, Huancayo, ciudad localizada a 3250 metros sobre nivel del mar, cuya presión barométrica es de 515 mmHg, a quienes se le tomó muestras de sangre arterial, las cuales se procesaron en el analizador de gases arteriales Roche Omni C. Las variables fueron analizadas con ANOVA y los análisis estadísticos con Excel y SPSS. Resultados. Fueron evaluadas 105 personas de 30 a 87 años. El promedio de las variables analizadas fue: hemoglobina 15,46 ± 2, presión arterial de oxigeno 59,27 ± 6,9, saturación de hemoglobina 91,7 ± 3,2, pH 7,46 ± 0,28, presión arterial de CO2 28,68 ± 4,15, bicarbonato 20,54 ± 2,86, sodio 143,43 ± 5,6, potasio 3,56 ± 0,5 mEq/L. Por cada año de vida, el PaO2 disminuyó en 0,556 mmHg, la saturación de oxígeno en 0,484%, y el pO2/FiO2 en 0,556. Conclusiones. Los hallazgos demuestran que en altura existe variación tanto de gases arteriales como de electrolitos, los cuales se acentúan con la edad y deberían ser considerados para el manejo de pacientes por encima de los 3000 msnm.

ABSTRACT Introduction. Arterial blood gas and electrolyte values undergo changes in high altitude, which can alter the diagnostic and prognostic evaluation of certain diseases. Objective. To determine the values of arterial gases and electrolytes in healthy adults and older adults in high altitude resident. Methods. Prospective, descriptive study, carried out with a population of healthy adults and elderly volunteers, at Ramiro Prialé Prialé National Hospital in EsSalud - Huancayo, a city located 3250 meters above sea level, whose barometric pressure is 515 mmHg. Arterial blood samples were taken from subjects and processed with Roche Omni C arterial gas analyzer. Continuous variables were analyzed with ANOVA and statistical analysis performed with Excel and SPSS. Results. 105 people from 30 to 87 years old were evaluated. The average of the analyzed variables was: hemoglobin 15,46 ± 2, blood oxygen pressure 59,27 ± 6,9, hemoglobin saturation 91,7 ± 3,2, pH 7,46 ± 0,28, blood pressure of CO2 28,68 ± 4,15, bicarbonate 20,54 ± 2,86, sodium 143,43 ± 5,6, potassium 3,56 ± 0,5 mEq / L. For each year of life, PaO2 decreased by 0,556 mmHg, oxygen saturation by 0,484%, and pO2 / FiO2 by 0,556. Conclusions. There is variation of both arterial gases and electrolytes at high altitude, which is accentuated with age and should be considered for the management of patients above 3000 masl.

José Ángel Bustamante O' Leary. Paradigma de la Psiquiatria Cubana / Jose Ángel Bustamante O' Leary. Paradigma de la Psiquiatria Cubana

RESUMEN El profesor José Ángel Bustamante O' Leary fue un eminente psiquiatra y psicólogo cubano. El presente trabajo tiene como objetivo lograr un acercamiento a la vida y obra de este incansable médico que se dedicó, hasta pocos días antes de su muerte, a brindar sus conocimientos para la formación de los profesionales de la psiquiatría cubana y Latinoamericana. Se realizó una investigación de su trayectoria revolucionaria, académica, científica y asistencial. Los actuales médicos y especialmente los psiquiatras defienden con orgullo los aportes de este consagrado científico en la lucha por la salud mental y el bienestar de los pacientes (AU).

SUMMARY Professor José Ángel Bustamante O' Leary was an eminent Cuban psychiatrist and psychologist. This work is aimed to approaching life and work of this tireless doctor, who devoted himself and his knowledge to the training of Cuban and Latin American professionals of Psychiatry until a few days before his death. The authors researched his revolutionary, academic, scientific and welfare trajectory. Current physicians, especially current psychiatrists proudly defend the contribution of this consecrated scientist to the fight for the mental health and well-being of the patients (AU).

Trastorno de insomnio. Consideraciones actuales / Insomnia disorder. Current considerations

RESUMEN El insomnio es el trastorno del sueño más frecuente en la población, se acompaña de un nivel significativo de malestar o deterioro de áreas importantes del funcionamiento humano. Es importante realizar un diagnóstico correcto de este desorden con el objetivo de instaurar un tratamiento adecuado que permita mejorar la calidad de vida de los pacientes que lo padecen. El objetivo de este artículo es ofrecer una revisión actualizada que contribuya al incremento y actualización de la información sobre este tema. Se realizó una revisión en artículos, principalmente de los últimos cinco años y se sistematizan los resultados para de esta forma contribuir a la superación de los profesionales (AU).

ABSTRACT Insomnia is the most frequently sleep disorder in the population. It is linked to a significant discomfort and an impairment of important areas of the human functioning. The correct diagnosis of this disorder is important with the objective of prescribing an adequate treatment for improving the life quality of the patients suffering it. The aim of this article is offering an up-dated review contributing to increase and update the information on this topic. The authors carried out a review of articles published mainly during the last five years, and the results were systematized for contributing to the professionals upgrading (AU).

Trastorno Bipolar. Consideraciones clínicas y epidemiológicas / Bipolar disorder. Clinical and epidemiologic characteristics

RESUMEN El trastorno bipolar es un trastorno crónico y recurrente que se caracteriza por fluctuaciones patológicas del estado del ánimo. Las fases de la enfermedad incluyen episodios hipomaniacos, maniacos y depresivos. Estos episodios interfieren de forma significativa en la vida cotidiana del paciente y en su entorno, con importante repercusión en su salud y calidad de vida. Para los psiquiatras es de suma importancia el diagnóstico precoz de esta enfermedad para proporcionar un tratamiento oportuno a los pacientes, teniendo en cuenta la severidad de los síntomas y las complicaciones a las que lleva esta enfermedad. Ante esta realidad se decidió describir las características generales de este desorden mediante una revisión bibliográfica donde se exponen sus principales manifestaciones clínicas, clasificación, aspectos epidemiológicos, curso de la enfermedad, complicaciones y comorbilidad. Para ello se realizó una revisión de los trabajos más relevantes publicados y con ello contribuir al proceso de educación médica continuada para los profesionales de la salud (AU).

ABSTRACT Bipolar disorder is a chronic and recurrent disorder characterized by pathological fluctuations of the mood states. The stages of the disease include hypomanic, maniac and depressive episodes. These episodes interfere in a significant way in the patient´s daily life and his surroundings, with an important repercussion on his health and life quality. For the psychiatrists, the precocious diagnosis of this disease is very important, in order to provide a timely treatment to patients, taking into account the severity of the symptoms and the complications of this disease. Due to this reality, the authors decided to describe the general characteristics of this disorder through a bibliographic review where they exposed the main clinical manifestations, classification, epidemiological aspects, the course of the disease, complications and co-morbidity. The most relevant published works were reviewed to contribute to the process of continued medical education of the health professionals (AU).

Trastorno Bipolar. Consideraciones clínicas y epidemiológicas / Bipolar disorder. Clinical and epidemiologic characteristics

RESUMEN El trastorno bipolar es un trastorno crónico y recurrente que se caracteriza por fluctuaciones patológicas del estado del ánimo. Las fases de la enfermedad incluyen episodios hipomaniacos, maniacos y depresivos. Estos episodios interfieren de forma significativa en la vida cotidiana del paciente y en su entorno, con importante repercusión en su salud y calidad de vida. Para los psiquiatras es de suma importancia el diagnóstico precoz de esta enfermedad para proporcionar un tratamiento oportuno a los pacientes, teniendo en cuenta la severidad de los síntomas y las complicaciones a las que lleva esta enfermedad. Ante esta realidad se decidió describir las características generales de este desorden mediante una revisión bibliográfica donde se exponen sus principales manifestaciones clínicas, clasificación, aspectos epidemiológicos, curso de la enfermedad, complicaciones y comorbilidad. Para ello se realizó una revisión de los trabajos más relevantes publicados y con ello contribuir al proceso de educación médica continuada para los profesionales de la salud.

ABSTRACT Bipolar disorder is a chronic and recurrent disorder characterized by pathological fluctuations of the mood states. The stages of the disease include hypomanic, maniac and depressive episodes. These episodes interfere in a significant way in the patient´s daily life and his surroundings, with an important repercussion on his health and life quality. For the psychiatrists, the precocious diagnosis of this disease is very important, in order to provide a timely treatment to patients, taking into account the severity of the symptoms and the complications of this disease. Due to this reality, the authors decided to describe the general characteristics of this disorder through a bibliographic review where they exposed the main clinical manifestations, classification, epidemiological aspects, the course of the disease, complications and co-morbidity. The most relevant published works were reviewed to contribute to the process of continued medical education of the health professionals.

Trastorno de insomnio. Consideraciones actuales / Insomnia disorder. Current considerations

RESUMEN El insomnio es el trastorno del sueño más frecuente en la población, se acompaña de un nivel significativo de malestar o deterioro de áreas importantes del funcionamiento humano. Es importante realizar un diagnóstico correcto de este desorden con el objetivo de instaurar un tratamiento adecuado que permita mejorar la calidad de vida de los pacientes que lo padecen. El objetivo de este artículo es ofrecer una revisión actualizada que contribuya al incremento y actualización de la información sobre este tema. Se realizó una revisión en artículos, principalmente de los últimos cinco años y se sistematizan los resultados para de esta forma contribuir a la superación de los profesionales.

ABSTRACT Insomnia is the most frequently sleep disorder in the population. It is linked to a significant discomfort and an impairment of important areas of the human functioning. The correct diagnosis of this disorder is important with the objective of prescribing an adequate treatment for improving the life quality of the patients suffering it. The aim of this article is offering an up-dated review contributing to increase and update the information on this topic. The authors carried out a review of articles published mainly during the last five years, and the results were systematized for contributing to the professionals´ upgrading.

Cambios histológicos del tracto genital y riesgo de malignidad, en hombres transgénero sometidos a tratamiento androgénico / Histological changes of the genital tract and risk of malignancy in transgender men undergoing androgenic treatment

RESUMEN Introducción y objetivos: La identidad de género es la vivencia interna e individual del género tal como cada persona la siente. En algunos casos, la adquisición de los caracteres sexuales secundarios del otro género es importante en el proceso de reasignación de género, siendo importante el tratamiento endocrinológico. La cuestión es si la administración prolongada de andrógenos es segura en los casos de pacientes transexuales mujer a hombre, ya que es poca la evidencia científica a largo plazo. El objetivo de este estudio es analizar las características clínicas de los pacientes trans de nuestra unidad, y los hallazgos anatomopatológicos de las piezas quirúrgicas de histerectomía y doble anexectomía, para ver la influencia de la androgenoterapia en los genitales internos femeninos. Métodos: Se trata de un estudio descriptivo donde se analizaron datos demográficos y clínicos de los pacientes remitidos para cirugía genital, así como se analizaron los resultados del estudio anatomopatológico de las piezas de histerectomía y anexectomía. Resultados: Se incluyeron 66 pacientes, de los que 59 se intervinieron. No se halló malignidad en ninguna de las piezas quirúrgicas, sí diversos hallazgos benignos como miomas, atrofia/proliferación endometrial, actividad folicular en ovarios u ovarios tipo síndrome de ovario poliquístico. Conclusiones: La exposición a andrógenos a largo plazo no parece producir cambios malignos en la histología uterina ni ovárica, sin embargo, a menudo lleva a cambios en la actividad y la arquitectura ovárica, apreciándose en la mayoría de los casos ovarios funcionales e incluso semejantes a los observados en mujeres con ovario poliquístico.

ABSTRACT Introduction and objectives: Gender identity is the internal and individual experience of the gender as each person feels it. In some cases, the acquisition of secondary sexual characteristics of the other gender is important in the process of gender reassignment, with endocrinological treatment being important. The question is whether prolonged administration of androgens is safe in cases of transsexual women to men, since there is little scientific evidence in the long term. The aim of this study is to analyze the clinical characteristics of trans patients in our unit, and the anatomopathological findings of the surgical pieces of hysterectomy and double adnexectomy, to see the influence of androgen therapy on the female internal genitalia. Methods: This is a descriptive study where demographic and clinical data of the patients referred for genital surgery were analyzed, as well as the results of the anatomopathological study of the hysterectomy and adnexectomy pieces were analyzed. Results: 66 patients were included, of which 59 were intervened. No malignancy was found in any of the surgical pieces, but several benign findings such as myomas, endometrial atrophy / proliferation, follicular activity in ovaries or ovaries like polycystic ovary syndrome. Conclusions: Long-term exposure to androgens does not seem to produce malignant changes in uterine or ovarian histology, however, it often leads to changes in ovarian activity and architecture, with functional ovaries being seen in most cases and even similar ones. those observed in women with polycystic ovary.

Manifestaciones de conducta violenta en féminas desde la relación de pareja / Manifestations of violent behavior in females from the relationship

Se realizó un estudio cualicuantitativo, con el objetivo de identificar las manifestaciones de conductas violentas de parejas en un grupo de mujeres de la comunidad de Palmira, perteneciente al Policlínico Universitario 4 de Agosto, del municipio de Guantánamo durante el período, enero-noviembre de 2014. El universo estuvo constituido por el 100 por ciento de los casos que acudieron a consulta de salud mental en dicho espacio de tiempo, representado por un total de 56. La muestra se seleccionó, por área poblacional, debido la incidencia y consentimiento informado, la cual quedó representada por el área poblacional suburbana Palmira por ser la de mayor incidencia, con 38 casos, de los cuales 36 accedieron voluntariamente a participar en el estudio de manera anónima. Las variables a investigar fueron: edad, lugar de convivencia de las féminas estudiadas, tipos de violencias practicadas y factores que inciden en la aparición de la violencia con la pareja. Se aplicó un formulario y la entrevista, así como la narración de técnicas grupales(AU)

One quality-quantitative study was conducted in order to identify the manifestations of violent behavior of couples in a group of women from the community of Palmira, belonging to the Policlinic 4 de Abril, Guantanamo from January to November 2014. The universe was constituted by 100 percent of patients who consulted mental health in that space of time, represented by a total of 56. The sample was selected by population area, because the incidence and consent reported, which was represented by the suburban population area Palmira for being the most prevalent, with 38 cases, of which 36 agreed to participate voluntarily in the study anonymously. The variables were investigated: age, place of living of the women, practice and types of factors that influence the occurrence of violence with partner violence. A form, interview and narration group techniques are applied(AU)

Análisis del bienestar psicológico en grupos en riesgo de exclusión social / Analysis of psychological well-being in groups at risk of social exclusion

En el presente artículo analizamos el bienestar psicológico, como un estado integral de salud psicológico, social y laboral, en los grupos con mayor riesgo de exclusión social, entendida ésta como la falta de participación social, económica, política y cultural. Para ello utilizamos una metodología descriptiva de corte transversal. Destacamos que, de un total de 157 participantes, la mayor parte de ellos presentaron un nivel medio de satisfacción en sus vidas; evidenciaron diferencias estadísticamente no significativas en función del sexo; y al comparar los grupos de edad, resultó que no encontramos diferencias significativas en bienestar psicológico en función del grupo de pertenencia. Con esta investigación pretendemos m-jorar sus condiciones socioeconómicas, psicológicas y personales, así como proponer alternativas de actuación para construir una sociedad más equitativa e inclusiva

In this work analyze the psychological well-being as an integral state of health psychological, social and labor, in the groups with risk of social exclusion, understood as the need social, economic, political and cultural participation. In this study use a transversal descriptive methodology. It emphasizes that from a total of 157 participants, most of them presented a medium level of satisfaction in their lives; be found differences statistically not significant based on sex; and to compare the age groups, we found no significant differences in psychological well-being depending on the membership group. This research aims to improve their socio-economic, psychological and personal conditions, as well as to propose alternatives for action to make a more equitable and inclusive society

El rol de las actitudes en la inserción laboral de los desempleados mayores de 45 años / The Role of Attitudes in the Labor Insertion of the Unemployed over 45 Years

La edad se convierte en una de las variables que modula los efectos de la situación de desempleo. Las investigaciones que analizan los efectos del desempleo en los mayores de 45 años muestran que las consecuencias se hacen más notables en este grupo de edad. Se exploraron las actitudes hacia el trabajo de una muestra integrada por 262 personas desempleadas del sur de España. El trabajo concluye con propuestas de intervención y nuevas líneas de investigación en el área.

Age becomes one of the variables that modulate the effects of unemployment. The studies that analyze the effects of unemployed over 45 years show that the consequences made are more noticeable in this age group. The attitudes toward work were explored using a sample consisted on 262 unemployed people who lives in the south of Spain. The work concludes with proposals for intervention and future research in the area.

Variables que afectan a la creatividad de las personas desempleadas / Variables affecting the creativity of people unemployed

En este artículo se analiza la relación entre el nivel de creatividad y variables que afectan al desempleo, como la edad, el género y la duración del desempleo. Se exploraron los niveles de creatividad de 140 personas desempleadas. Los resultados derivados de la aplicación de los diferentes análisis estadísticos, utilizando una metodología cuantitativa de carácter descriptivo, nos indican que las variables estudiadas no tienen una incidencia significativa en la creatividad de las personas desempleadas. Se discute la influencia que tienen las variables mediadoras en el estudio de la creatividad de las personas que no tienen empleo. El trabajo concluye con propuestas de intervención y futuras investigaciones en el área (AU)

In this article is evaluating the relationship between the level of creativity and variables which affect unemployment such as age, gender and period of unemployment. The creativity were explored using a sample consisted on 140 unemployed people. The results derived by application of different statistical analysis, using quantitative methodology of descriptive character, indicated that the studied mediating variables do not show any significant incidence in the creativity of people unemployed. The influence of mediating variables in the creativity of the unemployed is discussed. The work concludes with proposals for intervention and future research in the area (AU)

Estilos de pensamiento y creatividad / Creative intelligence and thinking styles

La Teoría del Autogobierno Mental de Sternberg ha relacionado diferentes estilos de pensamiento (legislativo, ejecutivo y judicial) con la creatividad (Sternberg, 1999). El objetivo general de este trabajo es explorar la relación existente entre los estilos de pensamiento y la creatividad. El Cuestionario de Estilos de Pensamiento (TSI) de Sternberg y Wagner y el Test de Inteligencia Creativa (CREA) de Corbalán y colaboradores fue administrada a una muestra total de 237 alumnos, pertenecientes a la Facultad de Psicología y de Educación de la Universidad de Murcia (España) que cursan 2º y de 1º de carrera respectivamente. La investigación se llevó a cabo a través de un análisis de comparación de medias entre los estudiantes más creativos (situados sobre una desviación típica por encima de la media en creatividad) y de creatividad media y baja. Los resultados arrojan diferencias de medias entre los alumnos más creativos indicando una mayor tendencia a utilizar el estilo de pensamiento legislativo en individuos creativos lo que coincide con la teoría del autogobierno mental de Sternberg. Con todo ello podemos decir que el CREA resulta un buen instrumento para discriminar aquellos sujetos con altas capacidades creativas (AU)

The thinking styles (legislative, ejecutive and judicial styles) and creativity had been put in relation in the Sternberg’s theory of Mental Self-Government. The general objective of this work is to explore the relationship between thinking styles and creativity in students of the faculty of Psychology and Education. The Sternberg-Wagner Thinking Styles Inventory and the test of Corbalán (CREA) were administrated in a sample composed by 237 students. The research was conducted with a mean difference analisys between the most creative subjects (using one standard deviation over the mean as the cutpoint to identify the most creative subjects) and the medium and low creativity persons. Mean differences in the use of the legislative style between the high creative students and the rest were founded. This results indicate that the high creativity students prefer the legislative styles. The data founded here suggests that the CREA seems to be a good instrument to discriminate those subjects with high creativity capacities (AU)