Lacticaseibacillus rhamnosus CRL 2244 secreted metabolites display killing and antibiotic synergistic activity against multi-drug resistant pathogens.

A growing increase in the number of serious infections caused by multidrug resistant bacteria (MDR) is challenging our society. Despite efforts to discover novel therapeutic options, few antibiotics targeting MDR have been approved by the Food and Drug Administration (FDA). Lactic acid bacteria have emerged as a promising therapeutic alternative due to their demonstrated ability to combat MDR pathogens in vitro. Our previous co-culture studies showed Lacticaseibacillus rhamnosus CRL 2244 as having a potent killing effect against carbapenem-resistant Acinetobacter baumannii (CRAB) strains. Here we report that cell-free conditioned media (CFCM) samples obtained from Lcb. rhamnosus CRL 2244 cultures incubated at different times display antimicrobial activity against 43 different pathogens, including CRAB, methicillin-resistant Staphylococcus aureus (MRSA) and carbapenemase Klebsiella pneumoniae (KPC)-positive strains. Furthermore, transwell and ultrafiltration analyses together with physical and chemical/biochemical tests showed that Lcb. rhamnosus CRL 2244 secretes a <3 kDa metabolite(s) whose antimicrobial activity is not significantly impaired by mild changes in pH, temperature and various enzymatic treatments. Furthermore, sensitivity and time-kill assays showed that the bactericidal activity of the Lcb. rhamnosus CRL 2244 metabolite(s) enhances the activity of some current FDA approved antibiotics. We hypothesize that this observation could be due to the effects of Lcb. rhamnosus CRL 2244 metabolite(s) on cell morphology and the enhanced transcriptional expression of genes coding for the phenylacetate (PAA) and histidine catabolic Hut pathways, metal acquisition and biofilm formation, all of which are associated with bacterial virulence. Interestingly, the extracellular presence of Lcb. rhamnosus CRL 2244 induced the transcription of the gene coding for the CidA/LgrA protein, which is involved in programmed cell death in some bacteria. Overall, the findings presented in this report underscore the promising potential of the compound(s) released by Lcb. rhamnosus CRL2244 as an alternative and/or complementary option to treat infections caused by A. baumannii as well as other MDR bacterial pathogens.

Genetic variability profiling of the p53 signaling pathway in chronic lymphocytic leukemia. Individual and combined analysis of TP53, MDM2 and NQO1 gene variants.

TP53 gene disruption, including 17p13 deletion [del(17p)] and/or TP53 mutations, is a negative prognostic biomarker in chronic lymphocytic leukemia (CLL) associated with disease progression, treatment failure and shorter survival. Germline variants in p53 signaling pathway genes could also lead to p53 dysfunction, but their involvement in CLL has not been thoroughly evaluated. The aim of this study was to determine the association of TP53, MDM2 and NQO1 gene variability with clinical and genetic data of CLL patients. Individual genotype and haplotype data of CLL patients were compared with clinical prognostic factors, cytogenetic and molecular cytogenetic findings as well as IGHV and TP53 mutational status. The study included 116 CLL patients and 161 healthy blood donors. TP53 (rs1042522, rs59758982, rs1625895), NQO1 (rs1800566) and MDM2 (rs2279744, rs150550023) variants were genotyped using different PCR approaches. Analysis of genotype frequencies revealed no association with the risk of CLL. TP53 rs1042522, rs1625895 and MDM2 rs2279744 variants were significantly associated with abnormal karyotype and the presence of del(17p). Similarly, these two TP53 variants were associated with TP53 disruption. Moreover, TP53 C-A-nondel and G-A-del haplotypes (rs1042522-rs1625895-rs59758982) were associated with an increased likelihood of carrying del(17p) and TP53 disruptions. MDM2 T-nondel haplotype (rs2279744-rs150550023) was found to be a low risk factor for del(17p) (OR = 0.32; CI: 0.12-0.82; p = 0.02) and TP53 disruptions (OR = 0.41; CI: 0.18-0.95; p = 0.04). Our findings suggest that TP53 and MDM2 variants may modulate the risk to have chromosome alterations and TP53 disruptions, particularly del(17p). To our knowledge this is the first study of several germline variants in p53 pathway genes in Argentine patients with CLL.

Revolutionizing Three-Dimensional Printing: Enhancing Quality Assurance and Point-of-Care Integration through Instrumentation.

Three-dimensional printing in the field of additive manufacturing shows potential for customized medicines and solving gaps in paediatric formulations. Despite successful clinical trials, 3D printing use in pharmaceutical point-of-care is limited by regulatory loopholes and a lack of Pharmacopoeia guidelines to ensure quality. Semi-solid extrusion is a 3D printing technology that stands out for its versatility, but understanding the fluid dynamics of the semi-solid mass is critical. The aim of this research is to look into the advantages of instrumenting a 3D printer with a semi-solid extrusion motor-driven printhead, which is able to record the printing pressure over time, for in situ characterization of the semi-solid mass and quality evaluation of dosage forms. Four formulations using hydrochlorothiazide as the active pharmaceutical ingredient and several excipients were used. Their flow properties were studied at different printing speeds and temperatures using traditional techniques (rheometer and Texture Analyzer) and the proposed semi-solid extrusion motor-driven printhead incorporated into a printing platform. In addition, the influence of printing speed in the printing process was also evaluated by the study of printing pressure and printlet quality. The results demonstrated the similarities between the use of a Texture Analyzer and the semi-solid extrusion motor-driven. However, the latter enables temperature selection and printing speed in accordance with the printing process which are critical printing parameters. In addition, due to the incorporation of a sensor, it was possible to conclude, for the first time, that there is a link between changes in essential printing parameters like printing speed or formulations and variations in printing pressure and printlet quality attributes such as the energy require to obtain a single dosage unit, weight or diameter. This breakthrough holds a lot of potential for assuring the quality of 3D printing dosage forms and paving the way for their future incorporation into point-of-care settings.

Efecto del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado: Estudio cuasiexperimental / The effect of Problem-Based Learning on Care Management skills: A quasi-experimental study / O efeito da Aprendizagem Baseada em Problemas nas habilidades de Gestão do Cuidado: Estudo quase-experimental

Objetivo: evaluar el efecto preliminar del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado. Método: cuasiexperimental pretest-postest, con alumnos de la carrera de Licenciatura en Enfermería de una institución educativa. Muestra de 29 alumnos (Grupo Experimental) y 74 (Grupo Control). El Grupo Experimental solucionó cuatro escenarios bajo el método de Aprendizaje Basado en Problemas con los 7 pasos propuestos por la Universidad de McMaster, en un programa de Gestión del Cuidado en modalidad a distancia. El instrumento autoinformado evaluó las habilidades de Gestión del Cuidado pretesty postesten ambos grupos. Se obtuvieron valores medios y se realizó estadística descriptiva e inferencial (t de Student, t pareada, regresión lineal). Resultados: el Grupo Experimental obtuvo puntuaciones más elevadas en habilidades analíticas, de acción y globales que el Grupo Control (p<0,05). No se registraron diferencias en las habilidades interpersonales ni en el uso de la información. El Grupo Control no presentó diferencias significativas antes y después de la enseñanza habitual, mientras que en el Grupo Experimental sí se reportaron diferencias (p<0,05). Conclusión: a pesar de que existe poca evidencia en el desarrollo de habilidades de Gestión del Cuidado en Enfermería, el presente estudio demuestra que el Aprendizaje Basado en Problemas es un método efectivo y significativo en educación a distancia.

Objective: to assess the preliminary effect of Problem-Based Learning on Care Management skills. Method: a quasi-experimental pre- and post-test conducted with students attending the Bachelor's Degree in Nursing offered by an educational institution. The sample was comprised by 29 (Experimental Group) and 74 (Control Group) students. The Experimental Group solved four scenarios under the Problem-Based Learning method with the 7 steps proposed by McMaster University, in a Care Management program in distance mode. The self-reporting instrument assessed the pre- and post-test Care Management skills in both groups. Mean values were obtained and descriptive and inferential statistics were performed (Student's t, paired t, linear regression). Results: the Experimental Group obtained higher scores in analytical, action-related and global skills than the Control Group (p<0.05). No differences were recorded in interpersonal skills or in use of the information. The Control presented no significant differences before and after usual teaching, whereas differences were in fact reported in the Experimental Group (p<0.05). Conclusion: despite the fact that there is little evidence on the development of Nursing Care Management skills, the current study shows that Problem-Based Learning is an effective and significant method in remote education.

Objetivo: avaliar o efeito preliminar da Aprendizagem Baseada em Problemas nas habilidades de Gestão do Cuidado. Método: pré e pós-teste quase experimental, realizado com alunos do curso de Bacharelado em Enfermagem de uma instituição de ensino. A amostra foi composta por 29 (Grupo Experimental) e 74 (Grupo Controle). O Grupo Experimental resolveu quatro cenários sob o método de Aprendizagem Baseada em Problemas com os 7 passos propostos pela McMaster University, em um programa de Gestão do Cuidado na modalidade à distância. O instrumento de autorrelato avaliou as habilidades de Gestão do Cuidado pré e pós-teste em ambos os grupos. Valores médios foram obtidos e estatísticas descritivas e inferenciais foram realizadas (t de Student, t pareado, regressão linear). Resultados: o Grupo Experimental obteve escores mais elevados em habilidades analíticas, de ação e globais do que o Grupo Controle (p<0,05). Não foram registradas diferenças nas habilidades interpessoais ou no uso da informação. O Grupo Controle não apresentou diferenças significativas antes e depois do ensino usual, enquanto as diferenças foram de fato relatadas no Grupo Experimental (p<0,05). Conclusão: apesar de haver poucas evidências sobre o desenvolvimento de habilidades de Gestão do Cuidado de Enfermagem, o presente estudo mostra que a Aprendizagem Baseada em Problemas é um método eficaz e significativo na educação à distância.

Family functioning and school connectivity in Mexican high school adolescents / Funcionamento familiar e conectividade escolar em adolescentes mexicanos do Ensino Médio

Family functionality has shown its relevance in the comprehensive development of adolescents, with school connectivity being a very important aspect. To determine the association between family functioning and school connectivity in Mexican high school adolescents, an analytical cross-sectional study was carried out in a census of 396 adolescents in a public high school in Mexico. The self-report of family functioning and the school connectedness scale were used, both with α > 0.84. ꭕ2 and ANOVA were applied. The results show significant differences in conflict with shift (morning ꭕ2 = 42.47 vs. evening ꭕ2 = 40.35, F = 4.57, p = 0.033), and leadership with degree (1st ꭕ2 = 8.14, 2nd ꭕ2 = 8.97, 3rd ꭕ2 = 8.90, F = 3.52, p = 0.030). Connectivity associated with school variables (p < 0.05). There are no differences or association between sex, age or qualifications with connectivity. Family functioning was associated in affective expression with school (ꭕ2 = 3.77, p = 0.055) and in leadership with students (ꭕ2 = 2.92, p = 0.05). It is concluded that the leadership of the parents and the affective expression of the family favors school connectivity between students and with their school.

A funcionalidade familiar tem mostrado sua relevância no desenvolvimento integral dos adolescentes, sendo a conectividade escolar um aspecto muito importante. Para determinar a associação entre funcionamento familiar e conectividade escolar em adolescentes mexicanos do Ensino Médio, foi realizado um estudo transversal analítico em um censo de 396 adolescentes em uma escola pública no México. Foram utilizados o autorrelato de funcionamento familiar e a escala de conectividade escolar, ambos com α > 0,84. ꭕ2 e ANOVA foram aplicados. Os resultados mostram diferenças significativas no conflito com turno (ꭕ2 da manhã = 42,47 vs. ꭕ2 da noite = 40,35, F = 4,57, p = 0,033) e liderança com grau (1º ꭕ2 = 8,14, 2º ꭕ2 = 8,97, 3º ꭕ2 = 8,90, F = 3,52, p = 0,030). Conectividade associada a variáveis escolares (p < 0,05). Não há diferenças ou associação entre sexo, idade ou qualificações com conectividade. O funcionamento familiar foi associado na expressão afetiva com a escola (ꭕ2 = 3,77, p = 0,055) e na liderança com os alunos (ꭕ2 = 2,92, p = 0,05). Conclui-se que a liderança dos pais e a expressão afetiva da família favorece a conectividade escolar entre os alunos e com sua escola.

Funcionalidad familiar y rendimiento académico en estudiantes de ciencias de la salud: una revisión sistemática / Family functionality and academic performance in health sciences students: a systematic review

RESUMEN Objetivo: Identificar los factores de la funcionalidad familiar asociados al rendimiento académico de los estudiantes de ciencias de la salud a nivel de educación superior, según lo reportado en la literatura. Materiales y método: Se llevó a cabo una revisión sistemática de la literatura en las siguientes bases de datos: PubMed (MedLine), ProQuest, SciELO y Google Académico, utilizando descriptores clave, criterios de selección y límites de búsqueda durante el proceso de revisión. Veintitrés documentos fue el insumo final seleccionado para el análisis. Resultados: Adicional a los hallazgos descriptivos de los estudios, emergieron factores positivos y negativos que se constituyen en categorías explicativas de la asociación existente entre la funcionalidad familiar y el rendimiento académico en los estudiantes de ciencias de la salud en educación superior. Conclusión: La literatura científica sobre funcionalidad familiar y su asociación con el rendimiento académico en los estudiantes universitarios, aunque ha ido en aumento de forma significativa, se ha desarrollado desde perspectivas diversas. Se requiere mayor integración y estudios de investigación que incluyan a la familia y a la universidad como entornos próximos y de desarrollo de los estudiantes.

ABSTRACT Objective: to identify the factors of family functionality, associated with the academic performance of health sciences students at the higher education level, as reported in the literature. Materials and Method: a systematic review of the literature was carried out in the following databases: PubMed (MedLine), ProQuest, SciELO, and Google Scholar, using key descriptors, selection criteria, and search limits during the review process. 23 documents were selected as the final input for the analysis. Results: in addition to the descriptive findings of the studies, positive and negative factors emerged that constitute explanatory categories of the existing association between family functionality and academic performance in health sciences students in higher education. Conclusion: the scientific literature on family functionality and its association with academic performance in university students, although has been significantly increasing, has developed from different perspectives. Greater integration and research studies that include the family and the university as close and developmental environments for students are required.

Violencia de pareja y depresión en mujeres que trabajan en una institución de salud de México / Intimate partner violence and depression among adult women working in a health facility in Mexico

Objetivo: Evaluar el efecto de la violencia de pareja, experimentada en los últimos 12 meses, sobre el riesgo de depresión y la sintomatología depresiva en mujeres adultas. Método: Se analizaron los datos de 470 mujeres de la Cohorte de Trabajadores de la Salud de México. El tipo y la gravedad de la violencia de pareja se midieron en los años 2004 y 2011. El evento principal fue el diagnóstico médico de depresión (2011). Un evento secundario fue la sintomatología depresiva (2004 y 2011), evaluada mediante la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D). El riesgo de depresión y la sintomatología depresiva en relación con la violencia se evaluaron con modelos de regresión de efectos aleatorios logísticos y lineales, respectivamente. Resultados: El 41,9% experimentó violencia de pareja en la medición basal. La incidencia de depresión fue del 7,2%. El riesgo de depresión aumentó con la violencia de pareja de cualquier tipo (odds ratio ajustada [ORa]=2,9; intervalo de confianza del 95% [IC95%]: 1,4-6,2) y con las violencias física (ORa=4,3; IC95%: 1,8-10,1), psicológica (ORa=3,1; IC95%: 1,4-6,6) y sexual (ORa=3,1; IC95%: 1,2--8,2). Los síntomas depresivos (CES-D) aumentaron ligeramente con las violencias física y sexual. Conclusiones: La violencia de pareja se asoció a un mayor riesgo de depresión en mujeres trabajadoras de una institución de salud de México. Los resultados indican la necesidad de contar con infraestructura, implementar estrategias de atención y consejería, y brindar un ambiente seguro en los lugares de trabajo para quienes sufren violencia de pareja. (AU)

Objective: To assess the effect of intimate partner violence on the risk of depression and depressive symptoms among adult women. Method: We analyzed data from the Mexican Health Workers' Cohort study (n=470). Type and severity of intimate partner violence was ascertained between 2004 and 2011. Self-reported medical diagnosis of depression (2011) was the main outcome; depressive symptoms ascertained with the Centre for Epidemiologic Studies-Depression (CES-D) scale was the secondary outcome. Random-effects regressions were run to model the risk of depression (logistic) and depressive symptoms (linear) in relation to intimate partner violence. Results: 41.9% women experienced intimate partner violence at baseline. The incidence of depression was 7.2%. The risk of depression increased with any type of IPV (adjusted odds ratio [aOR]=2.9; 95% confidence interval [95%CI]: 1.4-6.2) and with physical (aOR=4.3; 95%CI: 1.8-10.1), psychological (aOR=3.1; 95%CI: 1.4-6.6) and sexual (aOR=3.1; 95%CI: 1.2-8.2) violence. Depressive symptoms (CES-D) increased slightly with physical and sexual intimate partner violence. Conclusions: Intimate partner violence was associated with a higher risk of depression in this sample of women working in a Mexican health facility. Our results indicate the need to develop infrastructure, to implement strategies of attention and counselling, and to provide a safe environment in the workplace for women who experience intimate partner violence. (AU)

Hábitos de alimentación asociados a sobrepeso y obesidad en adultos mexicanos: una revisión integrativa

RESUMEN Objetivo: Describir hallazgos publicados de hábitos de alimentación y su relación con sobrepeso y obesidad en adultos mexicanos. Material y Método: Revisión integrativa basada en 5 pasos sugeridos por Crossetti, utilizando las palabras clave "hábitos de alimentación", "sobrepeso", "obesidad" y "adultos mexicanos", con operadores booleanos "AND" y "OR"; se buscó en Scielo, PubMed, Conricyt, Scopus y WOS, entre los años 2005 y 2020, publicaciones en español e inglés. Resultados: Se identificaron 64 artículos, de estos se descartaron 52, quedando 12 acordes a criterios de inclusión; los artículos fueron analizados en extenso, identificando 4 categorías: 1) Zona de vivienda; 2) Estrato socioeconómico; 3) Género y 4) Cultura; cada una de ellas con subcategorías. Conclusiones: Las zonas rurales reportan mayor consumo de frutas, verduras, cereales, vitaminas y menor consumo calórico; en zonas urbanas se consume mayor cantidad de grasa, alimentos procesados, azúcares refinadas y menos vegetales, frutas y cereales. Un mayor estrato socioeconómico se asocia con alimentación menos calórica y comidas más naturales. Los hombres consumen más carne, grasa y alcohol, las mujeres consumen más hidratos de carbono y azúcares refinadas. En cuestiones culturales reportan distracciones a la hora de comer, como uso de celular, bajo consumo de agua y alto consumo de gaseosas (70%); refieren barreras para alimentarse sanamente, como el trabajo pagado y doméstico, realizando comidas a prisa, sin considerar la calidad de los alimentos que se consumen. Estos hallazgos sugieren considerar factores socioeconómicos y culturales en las acciones preventivas que los profesionales de enfermería realizan en la práctica clínica y comunitaria.

ABSTRACT Objective: To describe published findings on eating habits and their relationship with overweight and obesity in Mexican adults. Materials and Methods: Integrative review based on 5 steps suggested by Crossetti, using the keywords "feeding habits", "overweight", "obesity" and "Mexican adults" along with Boolean operators "AND" and "OR" in the Scielo, PubMed, Conricyt, Scopus and WOS databases, with publications in Spanish and English, between the years 2005 and 2020. Results: 64 articles were identified and 52 were discarded, leaving 12 that complied with the inclusion criteria. The articles were extensively analyzed, identifying 4 categories: 1) Housing area; 2) Socioeconomic stratum; 3) Gender and 4) Culture; each of them divided into subcategories. Conclusions: Rural areas report higher consumption of fruits, vegetables, cereals, vitamins and lower caloric consumption, while in urban areas more fat, processed food, refined sugars and fewer vegetables, fruits and cereals are consumed. A higher socioeconomic stratum is associated with a less caloric diet and more natural food. Men consume more meat, fat and alcohol, while women consume more carbohydrates and refined sugars. Regarding cultural issues, people report distractions at mealtime, such as cell phone use, low water consumption and high consumption of soft drinks (70%); they also refer to barriers to healthy eating, such as work, eating meals quickly without considering the quality of food. These findings suggest considering socioeconomic and cultural factors in the preventive actions that nursing professionals carry out in clinical and community practice.

RESUMO Objetivo: Descrever os resultados publicados sobre hábitos alimentares e sua relação com sobrepeso e obesidade em adultos mexicanos. Material e Método: Revisão integrativa baseada em 5 etapas sugeridas por Crossetti, utilizando as palavras-chave "hábitos alimentares", "sobrepeso", "obesidade" e "adultos mexicanos", com operadores booleanos "AND" e "OR", a busca foi realizada em Scielo, PubMed, Conricyt, Scopus e WOS, entre os anos de 2005 e 2020, publicações em espanhol e inglês. Resultados: Foram identificados 64 artigos, destes, 52 foram descartados, restando 12, de acordo com os critérios de inclusão; os artigos foram amplamente analisados, identificando 4 categorias: 1) Área de habitação; 2) Estrato socioeconómico; 3) Gênero e, 4) Cultura; cada um deles com subcategorias. Conclusões: As áreas rurais relatam maior consumo de frutas, hortaliças, cereais, vitaminas e menor consumo calórico; nas áreas urbanas, o consumo maior é de gordura, alimentos processados, açúcares refinados e menor consumo de vegetais, frutas e cereais. Um estrato socioeconómico mais elevado está associado a uma dieta menos calórica e alimentos mais naturais. Os homens consomem mais carne, gordura e álcool, as mulheres consomem mais carboidratos e açúcares refinados. Em questões culturais, relatam distrações na hora das refeições, como uso do celular, baixo consumo de água e alto consumo de refrigerantes (70%), referem-se a barreiras para uma alimentação saudável, como trabalho remunerado e doméstico, alimentação rápida, sem considerar a qualidade dos alimentos consumidos. Os resultados sugerem considerar fatores socioeconómicos e culturais nas ações preventivas que os profissionais de enfermagem realizam na prática clínica e comunitária.

Efecto de la Socialización Organizacional en el Engagement de Trabajadores Mexicanos: Claridad y Futuro / Effect of Organizational Socialization on Mexican workers' engagement: Clarity and Future

Resumen Introducción: En el estudio del comportamiento organizacional se destaca con más frecuencia la importancia del proceso de socialización organizacional, relacionado con la adaptación al trabajo y el desarrollo de las competencias para el rol laboral; así como un interés creciente por los estados positivos en el trabajo como el work engagement (caracterizado por el vigor, dedicación y absorción) y que puede evidenciar la identificación del trabajador con la cultura de la organización. Objetivo: Examinar el efecto de los dominios de la socialización organizacional sobre el work engagement que reportan tener los trabajadores mexicanos de la muestra. Método: Estudio transversal-correlacional analítico, mediante análisis de regresión con los datos del Inventario de Socialización Organizacional de Taormina (1994), y el Utrecht Work Engagement Scale, en su versión al español por Schaufeli, Bakker y Salanova (2006), en 187 trabajadores mexicanos. Resultados: Los análisis de regresión mostraron que la combinación de la comprensión funcional y las perspectivas de futuro se combinan para la aparición del vigor (Beta .29, .21), la absorción (Beta .23, .23) y la dedicación al trabajo (Beta .34, .25) en los trabajadores de la muestra. Se encontró que los cuatro factores de la socialización organizacional correlacionan con el vigor (.35), la absorción (.34) y la dedicación (.47). Conclusiones: En los trabajadores de la muestra la comprensión y las perspectivas de beneficios, generan efectos en el vigor, la absorción y la dedicación al trabajo. Se señala la importancia de la socialización en la aparición de engagement como antecedente y componente de la productividad y el bienestar en el trabajo.

Abstract Introduction: not only the importance of the process of organizational socialization related to work adaptability and the development of competencies for the job role, has recently been highlighted more frequently in organizational behavior studies, but also a growing interest in positive states of work such as work engagement (characterized by vigor, dedication and absorption) and which can demonstrate the identification of the worker with the culture of the organization. Objective: to examine the effect of the domains of organizational socialization on the work engagement reported by the Mexican workers in the sample. Method: A transversal-correlational analytical study through a regression analysis with the data of the Inventory of Organizational Socialization of Taormina (1994), and the Utrecht Work Engagement Scale, in its Spanish version by Wilmar Schaufeli, Arnold Bakker and Salanova (2006), in 187 Mexican workers, was conducted. Results: Regression analysis showed that the combination of understanding and future prospects were integrated for the display of vigor (Beta .29, .21), absorption (Beta .23, .23) and dedication to work (Beta .34, .25) in the sample workers. It was found that the four factors of organizational socialization correlate with vigor (.35), absorption (.34) and dedication (.47).dedication. Conclusions: In the workers of the sample the understanding and the perspectives of benefits, generate effects in the vigor, the absorption and the dedication to the work. The importance of socialization in the appearance of engagement as a psychological state related to productivity and well-being at work is pointed out.

Referential intervals of the pulsatility index of fetal umbilical artery in Peruvian population / Intervalos referenciales del índice de pulsatilidad de la arteria umbilical fetal en población peruana

OBJECTIVE: To describe the reference values of the umbilical artery Doppler pulsatility index in healthy fetuses of pregnant women aged 14 - 40 weeks attended at the National Maternal Perinatal Institute during the period 2011-2016. MATERIAL AND METHODS: A Retrospective observational study. We evaluated all healthy fetuses of 2,633 pregnant women at low risk, in the fetal-obstetrics department of National Maternal Perinatal Institute, from 14 to 40 weeks, who were measured the pulsatility index between 2011 and 2016. PARTICIPANTS: Healthy fetuses in order to determine referential intervals of pulsatility index. RESULTS: The percentile shows a progressive decrease from 14 to 40 weeks. The pulsatility index in percentile 50 started with 1.7 in week 14 and decreased to 0.81 in week 40. The pulsatility index percentile 95 started with 2.35 in week 14, decreased to 1.68 in week 20, 1.29 in week 30, to 1.18 in week 36 and to 1.13 in week 40. The pulsatility index 1.13 in percentile 95 is normal for everyone weeks. The pulsatility index 2.35 is abnormal for every one week. CONCLUSIONS: The pulsatility index curve of the uterine artery presents similar descriptions in previous studies of other populations; however, knowledge of the eigenvalues in the Peruvian population can be useful as an indicator to discriminate fetus in good conditions in our population

OBJETIVO: describir los valores de referencia del índice de pulsatilidad Doppler de la arteria umbilical en fetos sanos de mujeres peruanas embarazadas de 14 a 40 semanas de edad gestacional. MATERIAL Y MÉTODOS: estudio observacional retrospectivo. Se evaluaron todos los fetos sanos de 2.633 mujeres peruanas embarazadas con bajo riesgo que presentaron una edad gestacional entre 14 a 40 semanas, atendidas en el departamento de medicina fetal del Instituto Nacional Perinatal Materno. RESULTADOS: el percentil muestra una disminución progresiva de 14 a 40 semanas. El índice de pulsatilidad en el percentil 50 comenzó con 1,7 en la semana 14 y disminuyó a 0,81 en la semana 40. El percentil índice de pulsatilidad 95 comenzó con 2,35 en la semana 14, disminuyó a 1,68 en la semana 20, a 1,29 en la semana 30, 1,18 en la semana 36 y a 1,13 en la semana 40. El índice de pulsatilidad 1,13 en el percentil 95 es normal para todas las semanas. El índice de pulsatilidad 2,35 es anormal por cada semana. CONCLUSIONES: la curva del índice de pulsatilidad de la arteria uterina presenta similares descripciones en estudios previos de otras poblaciones; sin embargo, el conocimiento de los valores propios en población peruana puede ser de utilidad como indicador para discriminar un feto en buenas condiciones en una población como la nuestra

Descripción de actitudes sobre ética profesional en estudiantes de dos escuelas profesionales en el área de salud, 2016 / Description of attitudes about professional ethics in students of two professional schools of health, 2016

Introducción: La universidad tiene la responsabilidad de formar profesionales integrales comprometidos éticamente en su actuar profesional. Objetivo: Comparar las actitudes sobre ética profesional que tienen los estudiantes de dos escuelas del área de salud de la Universidad Nacional Mayor de San Marcos. Método: Estudio transversal. Participaron del estudio 284 estudiantes a los que se les aplicó la Escala de Actitudes sobre Ética Profesional de Hirsch, adecuado y validado para estudiantes de pregrado, en cuatro competencias (cognitivas y técnicas, sociales, éticas, afectivo-emocionales). Resultados: La valoración de las respuestas a las cuatro competencias fue similar en ambas escuelas, siendo las positivas mayores a 80% en tres competencias. Conclusión: En ambos grupos se encontró mayor porcentaje de actitud positiva ante las cuatro competencias, valorando en primer lugar las afectivo-emocionales, segundo lugar las cognitivas y técnicas, tercer lugar las éticas y por último las sociales.

Introduction: The university has the responsibility to train integral professionals, who are ethically committed in their professional actions. Objective: To compare the attitudes about professional ethics in students of two schools of health area from the Universidad Nacional Mayor de San Marcos. Methods: A transversal study. 284 undergraduate students participated in the study and a validate version of Hirsch Professional Ethics Attitude Scale was applied to them. Four competences from Hirch’s scale were evaluated: cognitive and technical, social, ethical and affective-emotional. Results: The assessment of the answers was similar in both schools, with positive ones greater than 80% in three competitions. Conclusion: A higher percentage of positive attitude was found in the four competences. Both groups valuing in first place, the affective-emotional component; in second place, cognitive and technical component; thirdly, ethics and finally, the social component.

Validación del perfil de estrés de nowack en estudiantes universitarios mexicanos / Validation of nowack's stress profile in mexican university students

RESUMEN Objetivos a. Adaptar y validar el "Perfil de Estrés" para la población mexicana; b. Determinar la proporción de varianza que el instrumento es capaz de explicar de los datos originales a partir de un modelo factorial; c. Agrupar las variables en los factores en donde saturan con mayor claridad; d. Evaluar la validez de contenido del instrumento, y; e. Evaluar la consistencia interna del instrumento. Método La muestra de validación estuvo compuesta por 883 participantes, 58.3% mujeres y 41.7% hombres, con edades entre 15 y 76 años (M=21.40, DE=10.02). Para verificar la validez psicométrica de la escala se llevaron a cabo el procedimiento propuesto por Reyes-Lagunes y García-Barragán (2008), el cual consta de los siguientes pasos: a. Frecuencia incluyendo sesgo para la selección de reactivos; b. Discriminación de reactivos para grupos extremos con base en el cual se eliminarán los que no cumplen con el requisito; c. Confiabilidad interna, y; d. Validez. Resultados El "Perfil de Estrés" presenta características psicométricas adecuadas para la población mexicana (alfa de Cronbach de 0.65 a 0.93). Conclusión El "Perfil de estrés" fue adaptado y validado para la cultura mexicana. Se considera que se trata de un instrumento útil para estudios que se propongan evaluar los factores asociados con el estrés en general, incluyendo los hábitos de salud, los estilos de afrontamiento y bienestar psicológico.(AU)

ABSTRACT Objectives This work sees to a) adapt and validate the "Stress profile" for the Mexican population, b) determine the proportion of variance that the instrument is able to explain based on the original data of a factorial model, c) group the variables into factors where they saturate most clearly, d) evaluate the validity of the content of the instrument, and e) evaluate the internal consistency of the instrument. Methods The validation sample consisted of 883 participants, 58.3% women and 41.7% men, aged between 15 and 76 years (M=21.40, SD=10.02). To verify the psychometric validity of the scale, the procedure proposed by Reyes-Lagunes and García-Barragán (2008) was used. It consists of the following steps: a) frequency, including bias for the selection of reagents; b) discrimination of reagents for extreme groups, having in mind that those that do not comply with the requirement will be eliminated; c) internal reliability; and d) validity. Results The "Stress Profile" has adequate psychometric characteristics for the Mexican population (Cronbach's alpha of 0.65 to 0.93). Conclusion The "Stress Profile" was adapted and validated for the Mexican population. This is a useful tool for studies that aim to evaluate the factors associated with stress in general, including health habits, coping styles and psychological well-being.(AU)

Usos y actitudes del personal de enfermería acerca de las terapias alternativas en un hospital pediátrico / Uses and attitudes of the nursing staff about alternative therapies in a pediatric hospital

Resumen

Introducción: en México el uso de las terapias alternativas es popular. El personal de enfermería es por excelencia el educador del paciente y la familia; por lo tanto, sus actitudes y opiniones son relevantes acerca del uso de las TA.

Objetivo: conocer el uso de las terapias alternativas que hace el personal de enfermería y su opinión y actitudes en torno a ese uso con los pacientes y la familia.

Metodología: estudio descriptivo transversal, mediante el cual se le aplicaron 268 cuestionarios al personal de enfermería. El cuestionario fue diseñado ex profeso y validado para su aplicación.

Resultados: el 68% utilizó terapias alternativas y la mitad consideró que son seguras, el 27% mencionó que las recomienda a los pacientes y el 5% tuvo conocimiento del tema. El uso personal se asoció con la recomendación.

Conclusiones: la mayoría no indaga el antecedente del uso de terapias alternativas que hacen los pacientes. La recomendación de su uso se basa probablemente en la experiencia personal.

Abstract

Introduction: In Mexico the use of alternative therapies is popular. Par excellence, the nursing staff educates the patient and the family members; therefore, nursing staffs attitudes and opinions are relevant about the use of these therapies.

Objective: To know the use of alternative therapies by the nursing staff and their opinion and attitudes with patients and family concerning this use.

Methods: Cross-sectional descriptive study. 268 questionnaires were administered to the nursing staff. The questionnaire was designed with a purpose and validated.

Results: 68% of the nurse staff used alternative therapies, half believed these therapies are safe, 27% recommended them to patients, and 5% had knowledge of the subject. Personal use was associated with the recommendation.

Conclusions: The majority of the nursing staff does not investigate the antecedent of the use of alternative therapies by patients. The recommendation of its use is probably based on personal experience.

Relación entre factores psicosociales, agotamiento emocional laboral y burnout en odontólogos mexicanos / Relationship between Psychosocial Factors, Work Emotional Exhaustion and Burnout in Mexican Dentists

Resumen El objetivo del estudio fue determinar la relación de factores psicosociales con agotamiento emocional laboral y el síndrome de burnout. Se realizaron entrevistas semiestructuradas. Se usó la Escala de Agotamiento Laboral, el Inventario de Burnout de Maslach y el Cuestionario de Factores Psicosociales referido a aspectos personales, sociales y de trayecto. Se formaron dos grupos: 72 dentistas docentes pareados con 72 de práctica privada. Los resultados determinaron relación directa entre la dimensión trayecto de los factores psicosociales con tensión laboral (AEL) y cansancio emocional (MBI); pero, relación inversa con realización personal (MBI). Se encontraron niveles altos de tensión laboral y dificultad en la relación con los compañeros en dentistas docentes. No hubo diferencia en los niveles de burnout entre los grupos.

Abstract The objective of the study was to determine the relationship among psychosocial factor, emotional labor exhaustion and burnout syndrome. In semi structured interviews, 144 participants completed self-report Questionnaires: Emotional Labor Scale, Maslach Burnout Inventory and a Questionnaire to identify psychosocial factors which refers to personal, social or path (home-work-home) problems. The sample consisted of two groups of dentists: 72 teachers paired with 72 of private practice. The results showed direct relationship among psychosocial risk factor of path with job strain and emotional exhaustion, and inverse relationship with personal accomplishment. High levels of job strain and difficulty in peer relationships were reported in teaching dentists. No difference was found in levels of burnout among groups.

Saúde Mental Positiva Ocupacional: proposta de modelo teórico para abordagem positiva da saúde mental no trabalho / Occupational Positive Mental Health: proposal of a theoretical model for the positive approach of mental health at work / Salud Mental Positiva Ocupacional: propuesta de un modelo teórico para el abordaje positivo de la salud mental en el trabajo

Resumo Propõe-se um modelo teórico para a abordagem da saúde mental positiva ocupacional baseado na psicologia positiva, a psicologia ecológica, a salutogênese e o humanismo. O modelo compreende uma estrutura de seis fatores: bem-estar pessoal no trabalho, relações interpessoais positivas no trabalho, filosofia da vida laboral, empoderamento no trabalho, fortalezas pessoais no trabalho, e imersão no serviço; que é traduzido em quatro dimensões: cognitiva, socioafetiva, de comportamento e espiritual. Para fundamentar essa proposta, foi realizada uma análise dos dois principais posicionamentos referentes a saúde mental: o tradicional, predominantemente negativo, centrado na supressão ou ausência de doença, e o positivo, focado na promoção da saúde e desenvolvimento de círculos virtuosos. Derivado da análise, encontramos uma postura mista e vazios teóricos que justificam a proposta de um modelo autenticamente positivo. Finalizamos com algumas conclusões e implicações práticas de relevância para esse tema.

Abstract We propose a theoretical model for the approach of Occupational Positive Mental Health based on positive psychology, ecologic psychology, salutogenesis and humanism. The model has a six-factor structure: personal wellbeing at work, positive interpersonal relationships at work, work-life philosophy, empowerment at work, personal strengths at work, and task immersion. These six aspects are translated into four dimensions: cognitive, socio-affective, behavioral, and spiritual. In order to support this proposal, an analysis of the two main approaches to mental health was developed, the traditional, focused on the negative, the suppression or absence of sickness, and the positive, focused on health promotion and the development of virtuous circles. Derived from the analysis, we found a mixed approach and a theoretical shortage that justify the need of an authentic positive model proposition. We finalize with some conclusions and practice implications of social relevance for the topic.

Resumen Se propone un modelo teórico para el abordaje de la salud mental positiva ocupacional basado en la psicología positiva, la psicología ecológica, la salutogénesis y el humanismo. El modelo comprende una estructura de seis factores: bienestar personal en el trabajo, relaciones interpersonales positivas en el trabajo, filosofía de vida laboral, empoderamiento en el trabajo, fortalezas personales en el trabajo, e inmersión en la tarea; lo cual se traduce en cuatro dimensiones; cognitiva, socioafectiva, comportamental y espiritual. Para fundamentar esta propuesta, se realizó un análisis de los dos principales posicionamientos referente a la salud mental, el tradicional, predominantemente negativo, centrado en la supresión o ausencia de enfermedad, y el positivo, enfocado en la promoción de la salud y desarrollo de círculos virtuosos. Derivado del análisis, encontramos una postura mixta y vacíos teóricos que justifican la propuesta de un modelo auténticamente positivo. Finalizamos con algunas conclusiones y las implicaciones prácticas de relevancia social para este tema.

Capital psicológico y su relación con el estilo de vida de universitarios mexicanos / Psychological capital and its relationship with lifestyle of Mexican university students

Introducción: en algunos estudios se ha reportado que los universitarios no tienen un estilo de vida saludable (EVS) por lo que es necesario identificar no solo las variables psicosociales negativas, sino también las variables de Psicología Positiva que pueden favorecerlo. Objetivo: Determinar la relación entre el capital psicológico (CapPsi) y el estilo de vida (EV) de estudiantes universitarios mexicanos. Método: se realizó un estudio transversal y correlacional con 320 estudiantes de una universidad pública. La muestra fue no probabilística por cuotas. Para evaluar los factores del CapPsi se utilizaron los instrumentos Escala General de Autoeficacia, Escala de Esperanza para Adultos, Cuestionario de Resiliencia y Test de Orientación en la Vida (optimismo); para evaluar el EV se usó el Cuestionario Fantástico. Resultados: las variables del CapPsi mostraron una correlación estadísticamente significativa con el EV; resiliencia (r = 0,505, p < 0,01); esperanza (r = 0,432, p < 0,01); optimismo (r = 0,412, p < 0,01); autoefi cacia (r = 0,400, p < 0,01). El 33,3 de la varianza total del EV es explicado por el CapPsi (R2 = 0,333). Conclusiones: con base en los resultados, se asume que el CapPsi favorece el EVS; no obstante, es necesario que futuras investigaciones detallen si la influencia es en la adopción y/o mantenimiento del EVS, así como identificar cómo influye particularmente en cada factor del EV. El CapPsi tiene un porcentaje representativo de predicción del EV saludable. Es necesario que los programas de promoción y prevención en salud incorporen el abordaje del CapPsi para lograr un EV saludable en los universitarios (AU)

Background: University students don’t have a healthy lifestyle so it is necessary to identify psychosocial variables that can increase it. Objective: To determine the relationship between the psychological capital (CapPsi) and lifestyle (EV) of Mexican university students. Method: A cross-sectional and correlational study was carried out among 320 students of a public university. The sample was non probabilistic by quotas. To assess the factors of CapPsi were used the General Scale of Self-effi cacy, the Scale of Hope for Adults, Questionnaire of Resilience, the Life Orientation Test and; to assess the lifestyle was used the Fantastic questionnaire. Results: The variables of the CapPsi correlated with the healthy lifestyle; resilience (r = 0.505, p < 0.01); hope (r = 0.432, p < 0.01); optimism (r = 0.412, p < 0.01); and self-effi cacy (r = 0.400, p < 0.01). The 33.3 of the total variance of the lifestyle was explained by the CapPsi (R2 = 0.333). Conclusions: Based on the results, it is assumed that the CapPsi improve lifestyle; however, further research is necessary to determine if the infl uence of CapPsi is in the adoption and / or maintenance of healthy lifestyle and identify how each one of its factors influences it particularly. The CapPsi has a representative percentage of prediction of healthy lifestyle. It is necessary that health promotion and prevention programs incorporate the approach of CapPsi to achieve a healthy lifestyle in the university students (AU)

Representación del autocuidado de la salud en el trabajo de conductores de autobús urbano de Guadalajara, México / Representation of self-care of health at work among urban bus drivers in Guadalajara, Mexico / Representação do autocuidado da saúde no trabalho de motoristas de ônibus urbano em Guadalajara, México

Resumen: El objetivo del estudio fue analizar las representaciones sociales del autocuidado de la salud en el trabajo en conductores de autobús urbano de Guadalajara, México. La metodología fue cualitativa, con un diseño multimétodo, basado en la teoría de las representaciones sociales. En una primera etapa se efectuaron sesiones de observación participante, la información se registró en notas de campo; en una segunda fase se aplicaron las técnicas de la carta asociativa y los tris jerarquizados sucesivos a 20 conductores, los datos se sometieron a análisis clásico de las asociaciones libres; en una tercera etapa se realizaron entrevistas semi-estructuradas a 4 conductores, siendo sometidas a análisis de contenido. Los resultados indican que, estructuralmente, la representación se centra en la alimentación, presentándose en niveles periféricos el descanso y el cuidado correctivo de la salud. Procesualmente, la representación gira en torno a los factores psicosociales que se desprenden de las condiciones de trabajo, el resto de las características del ejercicio laboral se consideran poco riesgosas para la salud. Las acciones de autocuidado mencionadas se enfocan en las condiciones de trabajo percibidas como riesgosas. La representación social del autocuidado de la salud en el trabajo es una construcción mental colectiva, desarrollada y modificada a través de la interacción social, la cual influye en las acciones de autocuidado empleadas frente a los riesgos existentes en el entorno laboral.

Abstract: This study aimed to analyze the social representations of health self-care at work among urban bus drivers in Guadalajara, Mexico. The methodology was qualitative, with a multi-method design based on the theory of social representations. The first stage involved active observation sessions with the information recorded in field notes; in the second stage, the associative letter technique and successively hierarchized trees technique were applied to 20 drivers, submitting the data to a classical analysis of the free associations; a third stage involved semi-structured interviews with 4 drivers, submitted to content analysis. The results indicate that structurally, the representation is centered on alimentation, presenting the concepts rest and corrective health care at peripheral levels. Procedurally, the represeentation centers in the psychosocial factors derived from the working conditions, while the rest of the work characteristics are seen as low risk to health. The self-care actions mentioned by the participants only focus on the workinging conditions perceived as risky. The social representation of health self-care at work is a collective mental construction, developed and modified through social interactions, which influences self-care measures used against the risks perceived in the workplace.

Resumo: O objetivo deste estudo foi analisar as representações sociais do autocuidado da saúde no trabalho dos motoristas de ônibus urbano de Guadalajara, México. A metodologia foi qualitativa, com uma abordagem multimétodo, baseada na teoria das representações sociais. Em uma primeira etapa foram efetuadas sessões de observação participante, a informação foi registrada em anotações de campo; na segunda fase foram aplicadas técnicas de cartas associativas e momentos hierárquicos sucessivos a 20 motoristas, cujos dados foram submetidos à análise clássico das associações livres; em uma terceira etapa foram realizadas entrevistas semiestruturadas a quatro motoristas, sendo submetidas a análises de conteúdo. Os resultados indicam que, estruturalmente, a representação está focada na alimentação, apresentando-se em níveis periféricos o descanso, junto com o cuidado correto da saúde. Processualmente, a representação vira em torno dos fatores psicossociais, que se desprendem das condições de trabalho, o resto das características da atividade laboral foi considerado pouco arriscado para a saúde. As ações de autocuidado citadas foram focadas às condições de trabalho percebidas como arriscadas. A representação social do autocuidado da saúde no trabalho é uma construção mental coletiva, desenvolvida e modificada através da interação social, a qual influencia as ações de autocuidado empregadas frente aos riscos existentes no entorno laboral.

Componentes clásicos y no tradicionales del síndrome metabólico en niños y adolescentes con exceso ponderal / Classic and nontraditional components of metabolic syndrome in overweight children and adolescents

Introducción: Los componentes del Síndrome Metabólico (SM) en niños son complicaciones que sin intervención oportuna tendrán repercusiones dramáticas, antes de llegar a la adultez. Objetivos: Identificar y comparar componentes clá- sicos y no tradicionales del síndrome metabólico en ni- ños y adolescentes con exceso ponderal. Material y métodos: Estudio transversal en pacientes 6-15 años con exceso ponderal. Variables: Circunferencia de cintura (cm), glucosa(mg/dl), lipoproteína de alta densidad (mg/dl), triglicéridos(mg/dl), presión arterial (mm/Hg), insulina(µU/ml), índice de resistencia insulínica (HOMA), acantosis nigricans (AN), ácido úrico (mg/dl) e hígado graso no alcohólico. Protocolo: estándares internacionales para edad y gé- nero de variables y ultrasonido hepático, diagnóstico de SM por Federación Internacional de Diabetes (FID) y Asociación Latinoamericana de Diabetes (ALAD). Estadística. Frecuencias, porcentajes y X2. Resultados: N= 172. 55.2% sexo femenino, 69.8% adolescentes (11-15 años), 30.2% niños en etapa escolar (6-10 años). Promedio de edad: 11.7 ± 2.3. Componentes de SM: Obesidad visceral 94%; pre-hipertensión 18%; hipertensión arterial 25.6%; hipertrigliceridemia 72.6%; HDL bajo 59.3%; Hiperglucemia 6.4%; Hiperuricemia 52.9%; Hiperinsulinemia 76.7%; Resistencia Insulínica (HOMA) 80.8%; Diabetes Mellitus 2.3%; AN 88.4% e Hígado graso no alcohólico 14%.Diagnóstico de SM: 48.8%. La hipertensión arterial, hiperinsulinemia, RI, hiperuricemia y AN fueron más frecuentes en adolescentes. Un componente fue mayor en niños (p 0.017) y 4 componentes en adolescentes (p 0.002). Conclusiones: Los componentes más frecuentes del SM en pediatría son factores de riesgo cardiovascular, la hiperuricemia es componente novel que debiera investigarse por ser predictor de daño endotelial. Los niños presentaron menos componentes, aumentando en cantidad y severidad en adolescentes (AU)

Introduction: The components of the metabolic syndrome (MS) in children are complications that without opportune intervention will cause dramatic repercussions before reaching adulthood. Aim: To Identify and compare the traditional and nontraditional components of the metabolic syndrome in overweight children and adolescents. Methods: A cross-sectional study was performed using data from 172 obese patients (6-15 years old). The variables analyzed were: Waist circumference (cm), glucose (mg / dl), high density lipoprotein (mg / dl), triglycerides (mg / dl), blood pressure (mm / Hg), insulin (microU / ml), index insulin resistance (HOMA), acanthosis nigricans (AN), uric acid (mg / dl) and NAFLD. Protocols: International standards for age and gender applied to the variables and liver ultrasound, diagnosis of MS by the International Diabetes Federation (IDF) and Latin American Diabetes Association (ALAD). The statistics performed were frequencies, percentages and X2. Results: N = 172. 55.2% female, 69.8% adolescents (11-15 years), 30.2% children (6-10 years). Average age: 11.7 ± 2.3. Components of MS: visceral obesity 94%; pre-hypertension 18%; hypertension 25.6%; hypertriglyceridemia 72.6%; Low HDL 59.3%; Hyperglycemia 6.4%; Hyperuricemia 52.9%; Hyperinsuli nemia 76.7%; Insulin Resistance (HOMA) 80.8%; Diabetes Mellitus 2.3%; AN 88.4% and Nonalcoholic fatty liver 14%. Diagnosis of MS: 48.8%. Hypertension, hyperinsulinemia, RI, hyperuricemia and AN were more common in adolescents. One component was higher in children (p 0.017) and 4 components in adolescents (p 0.002). Conclusions: The most frequent pediatric components of MS are cardiovascular risk factors, the hyperuricemia is a novel component that should be investigated for being predictor of endothelial damage. The children had fewer components, increasing in quantity and severity in adolescents (AU)