Chemical composition and biological activities of the essential oil from Eugenia stipitata McVaugh leaves.

In the present study, the volatile components and cytotoxic, antibacterial, antioxidant, and antiprotozoal activities of the essential oil obtained from the leaves of Eugenia stipitata McVaugh (Myrtaceae) grown in the Brazilian Northeast region (Araripe) were investigated. The essential oil was obtained by hydrodistillation. The leaves of E. stipitata provided an oil yield of 0.13 ± 0.01% (w/w). The volatile compounds in the essential oil of E. stipitata were analysed using gas chromatography, and the volatile chemical composition was mainly composed of ß-eudesmol (15.28%), γ-eudesmol (10.85%), elemol (10.21%) and caryophyllene oxide (6.65%). The essential oil of E. stipitata was highly selective against Leishmania braziliensis and L. infantum promastigotes. The essential oil exhibited good antibacterial activity. E. stipitata essential oil showed low free-radical scavenging activity. Our results suggest that the E. stipitata essential oil is a relevant source of the primary compounds required for the development of antibacterial and antiprotozoal drugs.

Vaccination in the context of the COVID-19 pandemic.

In this review, we described the history of vaccination, the different types of vaccines, and how vaccination coverage has been affected by the current COVID-19 pandemic. The effectiveness of the vaccines under metabolic host conditions is analyzed, especially when people have lost their immunocompetence, such as in patients with chronic kidney disease who are in dialysis treatment. Vaccines are produced in a variety of industrial methods, modifying costs. The novel field of vaccinomics includes the set of immune responses, the satisfactory levels of neutralizing antibodies, the production of metabolites, and the induction of protein expression. Finally, an analysis is made of the confusing messages regarding vaccination that are disseminated on social networks, and general recommendations are given.

En esta revisión se describen el historial de vacunación, los diferentes tipos de vacunas y cómo la cobertura de vacunación se ha visto afectada por la pandemia actual de COVID-19. Se analiza la efectividad de las vacunas en condiciones metabólicas del huésped, especialmente cuando las personas han perdido su inmunocompetencia, como los pacientes con enfermedad renal crónica que están en tratamiento de diálisis. Las vacunas se producen con una variedad de métodos industriales, modificando los costos. El nuevo campo de la vacunómica incluye el conjunto de respuestas inmunitarias, los niveles satisfactorios de anticuerpos neutralizantes, la producción de metabolitos y la inducción de la expresión de proteínas. Finalmente, se analizan los confusos mensajes sobre vacunación que se difunden en las redes sociales y se dan recomendaciones generales.

Nurturing Grandchildren With Down Syndrome: A Qualitative Study on Grandparents' Needs Using Digital Tools†.

Grandparents who have grandchildren with disabilities are an underrepresented group in existing research related to the field. This qualitative phenomenological study's general purpose is to analyze, from a personal perspective, the situations and needs of grandparents who have grandchildren with Down syndrome. The participants' ages range from 65 to 85, and the ages of their grandchildren with Down syndrome range from 3 to 21 years. All participants had one grandchild with a disability, except for two, who each had two. A sociodemographic questionnaire was administered, and individual interviews were conducted, using open questions, through phone and/or video calls. An analysis of the participants' speech was carried out, which implied the development of a system of meta-categories and categories. This analysis was developed manually, given the COVID-19 environment. The results indicate a substantial change from negative feelings caused by the knowledge of the diagnosis to feelings related to positive experiences expressed currently. The participants see themselves as a fundamental source of support (informal, instrumental, practical, social, emotional, and economic) for their families and, mainly, for their grandchildren with Down syndrome. A need for information and training was observed when the grandparents talked about first being informed of the diagnosis and their concerns about the future of these grandchildren and their siblings. They made social demands, such as greater government involvement or more significant opportunities to access resources and rights for their grandchildren. The results are discussed, as are possible future research directions.

Cytotoxicity of Essential Oil Cordia verbenaceae against Leishmania brasiliensis and Trypanosoma cruzi.

The species Cordia verbenacea DC (Boraginaceae), known as the whaling herb and camaradinha, is a perennial shrub species native to the Atlantic Forest. Its leaves are used in folk medicine as an anti-inflammatory, analgesic, antiulcerogenic and curative agent, in the form of teas or infusions for internal or topical use. The present study aimed to verify the cytotoxicity of the essential oil and the leishmanicidal and trypanocidal potential of C. verbenacea. The essential oil was characterized by GC-MS. The in vitro biological activity was determined by anti-Leishmania and anti-Trypanosoma assays. The cytotoxixity was determined using mammalian fibroblasts. The C. verbenacea species presented α-pinene (45.71%), ß-caryophyllene (18.77%), tricyclo[2,2,1-(2.6)]heptane (12.56%) as their main compounds. The essential oil exhibited strong cytotoxicity at concentrations below 250 µg/mL (LC50 138.1 µg/mL) in mammalian fibroblasts. The potent anti-trypanosome and anti-promastigote activities occurred from the concentration of 62.5 µg/mL and was considered clinically relevant. The results also demonstrate that at low concentrations (<62.5 µg/mL), the essential oil of C. verbenacea managed to be lethal for these activities. This can be considered an indication of the power used in daily human consumption. Therefore, it can be concluded that the essential oil of C. verbenacea contains a compound with remarkable antiparasitic activities and requires further research.

Audiologist Perception on Reporting Hearing Assessment Results to State Early Hearing Detection and Intervention Programs.

Purpose: To describe an evaluation conducted by 39 state Early Hearing Detection and Intervention (EHDI) programs on the reporting process and system usability for audiologists when reporting the hearing test results to the EHDI program and the barriers encountered during reporting. Method: Each author independently extracted numbers, percentages, and texts from the evaluation reports into an Excel spreadsheet, which then became the dataset. Authors then compared and cross-checked the datasets before coding. Texts conveying similar concepts were coded with the same name and organized into categories. Finally, thematic identification and analysis were performed when a theme(s) or concept(s) that pertained to similar challenges encountered by audiologists was identified and organized under a higher-order domain. Results: Some audiologists reported no barriers when reporting hearing test results to the state EHDI programs. Among those audiologists who reported barriers, the most recurrent barrier was a non-user-friendly data system design. The second most recurrent barrier was not having adequate administrative time to report data as a busy clinician. The third most recurrent barrier was an incomplete understanding of the state EHDI reporting requirements. Finally, the method audiologists were required to use when reporting results also posed some challenges, such as no internet connection in rural areas when required to report via an internet portal. Conclusion: Because of the wide variety of barriers faced by audiologists, multiple strategies to improve the reporting process would likely be beneficial.

Dataset for gait analysis and assessment of fall risk for older adults.

This article presents a five-part dataset for human gait analysis in a healthy older adult population (37 women and seven men; age 69.98 ± 8.57 years, body mass index 27.71 ± 4.57). Part 1 compromises demographic data for the 44 participants, along with the results of the Short Physical Performance Battery (SPPB) motor function test and the Mini-Mental State Examination (MMSE). We used the MMSE to ensure the participants could understand the experimental protocol instructions. Part 2 presents the anthropometric measurements of the participants. Part 3 shows the results for each item of the Gait component of the Performance Oriented Mobility Assessment (POMA-G). Part 4 contains five files per participant, storing motion-capture data for the lower limb in the Coordinate 3D (C3D) format. These files were generated using a Vicon motion analysis system, consisting of 24 reflective markers and seven cameras (Vantage V5) sampled at 100 Hz. Part 5 contains 26 gait parameters for each C3D file obtained using Nexus 2.9.3. The dataset is available in a Mendeley repository (Reserved DOI: 10.17632/xgw6bg3g8h.1).

Molecular Heterogeneity of Endometrioid Ovarian Carcinoma: An Analysis of 166 Cases Using the Endometrial Cancer Subrogate Molecular Classification.

Endometrioid ovarian carcinoma (EOC) has clinical and biological differences compared with other histologic types of ovarian carcinomas, but it shares morphologic and molecular features with endometrioid endometrial carcinoma. To analyze the molecular heterogeneity of EOC according to the new molecular classification of endometrial cancer and to evaluate the prognostic significance of this molecular classification, we have analyzed 166 early-stage EOC by immunohistochemistry for mismatch repair proteins and p53 expression, and by Sanger sequencing for the exonuclease domain of polymerase epsilon (POLE EDM). In addition, we have carried out next-generation sequencing analysis of tumors with POLE EDM mutations to confirm the ultramutated profile. Eight tumors carried POLE EDM mutations and were classified as ultramutated (5%), 29 showed mismatch repair deficiency and were classified as hypermutated (18%), 16 tumors had a mutated pattern of p53 expression and were classified as p53 abnormal (11%), and 114 tumors did not have any of the previous alterations and were classified as no specific type (66%). Five tumors showed >1 classification criteria. The frequencies of ultramutated and hypermutated tumors were lower in EOC compared with the frequency reported in endometrial cancer. Subrogate molecular groups differed in both morphologic features (histologic grade, squamous and morular metaplasia, and necrosis) and immunohistochemical expression of several biomarkers (ARID1A, nuclear ß-catenin, estrogen receptors, Napsin A, and HINF1B). In addition, the number of CD8 tumor-infiltrating lymphocytes was higher in ultramutated and hypermutated tumors. The most commonly mutated genes in the ultramutated group were ARID1A (100%), PIK3R1, PTEN, BCOR, and TP53 (67% each), whereas no mutations were detected in KRAS. Although the prognosis did not differ among subgroups in the multivariate analysis, a trend toward a better prognosis in POLE-mutated and a worse prognosis in p53 abnormal tumors was observed. In addition, this classification could have important therapeutic implications for the use of immunotherapy in tumors classified as ultramutated and hypermutated.

Preferred Outcome Measures Used in Randomized Clinical Trials of Total Knee Replacement Rehabilitation: A Systematic Review.

OBJECTIVE: To determine the most frequently used outcome measures in total knee replacement rehabilitation trials. LITERATURE SURVEY: Systematic review of randomized trials searched in five databases: Web of Science, MEDical Literature Analysis and Retrieval System, Physiotherapy Evidence Database, Scopus, and Cochrane Library. METHODOLOGY: Trials were included if participants underwent total knee replacement rehabilitation and outcome measures were used to assess rehabilitation outcomes. A descriptive synthesis determined the frequency of using outcome measures and preferred assessment time points. Outcomes were classified into eight categories: patient- and clinician-reported function, performance-based function, balance, anxiety and depressive symptoms, quality of life, and others. SYNTHESIS: Eighty-one trials were included and 102 different outcome measures were classified. The most frequently reported outcome was knee range of motion, used in 54% of trials, followed by a visual analog scale of pain (43%) and Western Ontario and McMaster Universities Arthritis Index (WOMAC; 40%). Patient- and clinician-reported function were the categories most frequently assessed (74%), whereas performance-based measures were implemented by 56% of trials. The most frequent assessment time points were 1 week presurgery (52%) and 3 months postsurgery (39%). CONCLUSIONS: There is consensus regarding the need to evaluate functional outcomes in total knee replacement rehabilitation trials but none regarding the outcome measure that should be used. These findings suggest that most trials include patient- and clinician-reported functional measures, along with pain and performance-based measures in trial designs.

Evaluating Data Quality of Newborn Hearing Screening.

SCOPE: Jurisdictional-based Early Hearing Detection and Intervention Information Systems (EHDI-IS) collect data on the hearing screening and follow-up status of infants across the United States. These systems serve as tools that assist EHDI programs' staff and partners in their tracking activities and provide a variety of data reports to help ensure that all children who are deaf/hard of hearing (DHH) are identified early and receive recommended intervention services. The quality and timeliness of the data collected with these systems are crucial to effectively meeting these goals. METHODOLOGY: Forty-eight EHDI programs, funded by the Centers for Disease Control and Prevention (CDC), successfully evaluated the accuracy, completeness, uniqueness, and timeliness of the hearing screening data as well as the acceptability (i.e., willingness to report) of the EHDI-IS among data reporters (2013-2016). This article describes the evaluations conducted and presents the findings from these evaluation activities. CONCLUSIONS: Most state EHDI programs are receiving newborn hearing screening results from hospitals and birthing facilities in a consistent way and data reporters are willing to report according to established protocols. However, additional efforts are needed to improve the accuracy and completeness of reported demographic data, results from infants transferred from other hospitals, and results from infants admitted to the Neonatal Intensive Care Unit.

Cytotoxic and anti-kinetoplastid potential of the essential oil of Alpinia speciosa K. Schum.

Alpinia speciosa K. Schum, known as colônia (colony), is native to tropical Asia and found in parts of tropical America. Its leaves are used to wrap food, rhizomes for food preparation and seeds for health maintenance, and have been widely used by the population as a diuretic, antihypertensive, antiulcerogenic and sedative. The present study aimed to verify the leishmanicidal and trypanocidal potential, as well as the cytotoxicity, of the A. speciosa essential oil, in vitro. A. speciosa presented 1,8-cineole (28.46%), camphor (17.10%) and sabinene (9.95%) as major constituents. The cytotoxic activity of the essential oil presented a low value, while the antipromastigote and antiepimastigote activity presented values considered clinically relevant, since it had an action below 500 µg/mL. In relation to this study, it can be concluded that this is a pioneer in the potential of the A. speciosa essential oil and in the use against the parasites Trypanosoma cruzi Chagas and Leishmania brasiliensis Vianna, having its importance also rooted in this fact. Still in accordance with the results, A. speciosa was effective because it presented values of clinical relevance and low toxicity. It was also observed that the chemical constitution of the above identified compounds with remarkable antiparasitic activities.

Anti-platelet aggregation activity of two novel acidic Asp49-phospholipases A2 from Bothrops brazili snake venom.

Phospholipases A2 (PLA2s) are important enzymes present in snake venoms and are related to a wide spectrum of pharmacological effects, however the toxic potential and therapeutic effects of acidic isoforms have not been fully explored and understood. Due to this, the present study describes the isolation and biochemical characterization of two new acidic Asp49-PLA2s from Bothrops brazili snake venom, named Braziliase-I and Braziliase-II. The venom was fractionated in three chromatographic steps: ion exchange, hydrophobic interaction and reversed phase. The isoelectric point (pI) of the isolated PLA2s was determined by two-dimensional electrophoresis, and 5.2 and 5.3 pIs for Braziliase-I and II were observed, respectively. The molecular mass was determined with values ​​of 13,894 and 13,869Da for Braziliase-I and II, respectively. Amino acid sequence by Edman degradation and mass spectrometry completed 87% and 74% of the sequences, respectively for Braziliase-I and II. Molecular modeling of isolated PLA2s using acid PLA2BthA-I-PLA2 from B. jararacussu template showed high quality. Both acidic PLA2s showed no significant myotoxic activity, however they induced significant oedematogenic activity. Braziliase-I and II (100µg/mL) showed 31.5% and 33.2% of cytotoxicity on Trypanosoma cruzi and 26.2% and 19.2% on Leishmania infantum, respectively. Braziliase-I and II (10µg) inhibited 96.98% and 87.98% of platelet aggregation induced by ADP and 66.94% and 49% induced by collagen, respectively. The acidic PLA2s biochemical and structural characterization can lead to a better understanding of its pharmacological effects and functional roles in snakebites pathophysiology, as well as its possible biotechnological applications as research probes and drug leads.

Study of the Cys-His bridge electron transfer pathway in a copper-containing nitrite reductase by site-directed mutagenesis, spectroscopic, and computational methods.

The Cys-His bridge as electron transfer conduit in the enzymatic catalysis of nitrite to nitric oxide by nitrite reductase from Sinorhizobium meliloti 2011 (SmNir) was evaluated by site-directed mutagenesis, steady state kinetic studies, UV-vis and EPR spectroscopic measurements as well as computational calculations. The kinetic, structural and spectroscopic properties of the His171Asp (H171D) and Cys172Asp (C172D) SmNir variants were compared with the wild type enzyme. Molecular properties of H171D and C172D indicate that these point mutations have not visible effects on the quaternary structure of SmNir. Both variants are catalytically incompetent using the physiological electron donor pseudoazurin, though C172D presents catalytic activity with the artificial electron donor methyl viologen (kcat=3.9(4) s-1) lower than that of wt SmNir (kcat=240(50) s-1). QM/MM calculations indicate that the lack of activity of H171D may be ascribed to the Nδ1H…OC hydrogen bond that partially shortcuts the T1-T2 bridging Cys-His covalent pathway. The role of the Nδ1H…OC hydrogen bond in the pH-dependent catalytic activity of wt SmNir is also analyzed by monitoring the T1 and T2 oxidation states at the end of the catalytic reaction of wt SmNir at pH6 and 10 by UV-vis and EPR spectroscopies. These data provide insight into how changes in Cys-His bridge interrupts the electron transfer between T1 and T2 and how the pH-dependent catalytic activity of the enzyme are related to pH-dependent structural modifications of the T1-T2 bridging chemical pathway.

The sunflower transcription factor HaHB11 confers tolerance to water deficit and salinity to transgenic Arabidopsis and alfalfa plants.

Homeodomain-leucine zipper (HD-Zip) transcription factors are unique to the plant kingdom; members of subfamily I are known to be involved in abiotic stress responses. HaHB11 belongs to this subfamily and it was previously shown that it is able to confer improved yield and tolerance to flooding via a quiescent strategy. Here we show that HaHB11 expression is induced by ABA, NaCl and water deficit in sunflower seedlings and leaves. Arabidopsis transgenic plants expressing HaHB11, controlled either by its own promoter or by the constitutive 35S CaMV, presented rolled leaves and longer roots than WT when grown under standard conditions. In addition, these plants showed wider stems and more vascular bundles. To deal with drought, HaHB11 transgenic plants closed their stomata faster and lost less water than controls, triggering an enhanced tolerance to such stress condition and also to salinity stress. Concomitantly, ABA-synthesis and sensing related genes were differentially regulated in HaHB11 transgenic plants. Either under long-term salinity stress or mild drought stress, HaHB11 transgenic plants did not exhibit yield penalties. Moreover, alfalfa transgenic plants were generated which also showed enhanced drought tolerance. Altogether, the results indicated that HaHB11 was able to confer drought and salinity tolerance via a complex mechanism which involves morphological, physiological and molecular changes.

Determinación de IgG contra Chlamidya trachomatis en mujeres con artritis de la Ciudad de Bogotá D.C. Un estudio piloto / Determination of IgG in women infected with Chlamydia trachomatis and reactive- arthritis from Bogota, Colombia: a pilot study

Objetivo. Evaluar la presencia de IgG contra C. trachomatis en mujeres entre 18 a 30 años con diagnóstico de artritis de la ciudad de Bogotá D.C. Métodos. Los grupos de estudio están compuestos por un grupo de casos AR (mujeres con diagnóstico de artritis reumatoide y reactiva) y un grupo control. Se obtuvieron muestras de suero y se realizó la determinación cuantitativa de IgG contra C. trachomatis, la determinación PCR (proteína C reactiva) y FR (factor reumatoide). Resultados. Las variables de talla y peso descritas en la población de estudio, muestran un comportamiento homogéneo, por lo cual no interfieren en los resultados obtenidos. Las medias se compararon por los test Mann Whitney y t test no pareado. El porcentaje de resultados positivos en la determinación cualitativa de PCR fueron de: 36,6% para el grupo de casos y 14,5% para el grupo control. En la determinación cualitativa de FR el porcentaje de resultados positivos fueron: 48,8% para el grupo de casos y 5,3% para el grupo control. Finalmente, el porcentaje de resultados positivos en la determinación de anticuerpos IgG específicos contra C trachomatis fue de 2,4% para el grupo de casos y 22,4% para el grupo de controles. Las variables de PCR y FR mostraron mayor frecuencia de resultados positivos en el grupo de casos, en comparación con el grupo control, lo cual se correlaciona con la existencia de procesos inflamatorios propios del desarrollo de artritis. Sin embargo el grupo control presentó mayor frecuencia de anticuerpos IgG específicos contra C. trachomatis en comparación con el grupo de casos. Estos resultados hacen necesario evaluar a futuro, el comportamiento de las pacientes del grupo control con resultados positivos de IgG contra C. trichomatis que permitirían observar una posible aparición de síntomas relacionados con artritis.

Objective. Evaluate the presence of IgG in women infected with C. trachomatis, and diagnosed with arthritis, aged 18-30 years, in Bogota, Colombia. Methods. This project is composed of two study groups: Firstly, female cases diagnosed with rheumatoid reactive-arthritis and secondly, a control group. Quantitative determination of IgG in serum samples from patients with C. trachomatis. Were determined also, PCR determination (C reactive protein) and RF (rheumatoid factor) were performed. The statistical analysis included the comparison of means, using Mann Whitney and unpaired t test. Results. Patient samples that were positive by PCR: 36.6% for the female case group, and 14.5% for the control group. In the qualitative determination of RF positives, results were: 48.8% for the case group and 5.3% for the control group. Finally, the percentages of positive results for IgG antibodies determination against C. trachomatis were: 2.4% for the case group and 22.4% for the control group. PCR and FR variables showed higher frequency of positive results in the female case group compared with the control group, which correlates with the presence of inflammatory processes, where it is typical in the development of arthritis. However, the control group had increased frequency of specific IgG antibodies against C. trachomatis, when it is compared with the case female group. These results need to be evaluated in the future, where, the control group that tested positive for IgG against C. Trachomatis, would allow to observe the possible apparition of symptoms related to arthritis.

Isotropic exchange interaction between Mo and the proximal FeS center in the xanthine oxidase family member aldehyde oxidoreductase from Desulfovibrio gigas on native and polyalcohol inhibited samples: an EPR and QM/MM study.

Aldehyde oxidoreductase from Desulfovibrio gigas (DgAOR) is a homodimeric molybdenum-containing protein that catalyzes the hydroxylation of aldehydes to carboxylic acids and contains a Mo-pyranopterin active site and two FeS centers called FeS 1 and FeS 2. The electron transfer reaction inside DgAOR is proposed to be performed through a chemical pathway linking Mo and the two FeS clusters involving the pyranopterin ligand. EPR studies performed on reduced as-prepared DgAOR showed that this pathway is able to transmit very weak exchange interactions between Mo(V) and reduced FeS 1. Similar EPR studies but performed on DgAOR samples inhibited with glycerol and ethylene glycol showed that the value of the exchange coupling constant J increases ~2 times upon alcohol inhibition. Structural studies in these DgAOR samples have demonstrated that the Mo-FeS 1 bridging pathway does not show significant differences, confirming that the changes in J observed upon inhibition cannot be ascribed to structural changes associated neither with pyranopterin and FeS 1 nor with changes in the electronic structure of FeS 1, as its EPR properties remain unchanged. Theoretical calculations indicate that the changes in J detected by EPR are related to changes in the electronic structure of Mo(V) determined by the replacement of the OHx labile ligand for an alcohol molecule. Since the relationship between electron transfer rate and isotropic exchange interaction, the present results suggest that the intraenzyme electron transfer process mediated by the pyranopterin moiety is governed by a Mo ligand-based regulatory mechanism.

Sistema de superación en educación en valores para docentes de Tecnología de la Salud / Upgrading system for the education in values for the Health Technology professors

El estudio indaga sobre las necesidades de superación en educación en valores de docentes de la Facultad de Tecnología de la Salud y su objetivo es proponer un sistema de superación profesional posgraduada para una correcta educación en valores de sus educandos. Se aplican métodos del nivel teórico y empírico. A partir de las regularidades identificadas en el diagnóstico se diseña un sistema de superación sustentado en una posición flexible, de carácter dinámico, colaborativo y ajustado a las condiciones concretas en que se desarrolla el proceso pedagógico. Los especialistas consultados destacan la necesidad, actualidad y organización didáctica del sistema(AU)

Hacia una concepción desarrolladora en la calidad de la evaluación del aprendizaje: propuesta de manual / Towards a developing conception in the quality of learning assessment: a booklet proposal

Las actuales demandas de la educación superior precisan de enseñar a pensar a los estudiantes, lo que transforma la toma de decisiones pedagógicas en los profesores. Se realizó una investigación en el Politécnico de la Salud villaclareño, donde se caracterizó el acontecer de las prácticas evaluativas de los docentes y su influencia en el aprendizaje y desarrollo personal de los estudiantes, lo que sirvió de base en la elaboración de un manual para transformar las prácticas evaluativas de los profesores, con un contenido teórico actualizado y didáctico que incluye actividades prácticas que permiten la reflexión, el autodidactismo, autoevaluación y su utilización en actividades metodológicas en diferentes carreras y departamentos de la Facultad, motivándolos a modificar sus prácticas evaluativas. Este documento ha sido socializado en actividades metodológicas y eventos a diferentes niveles y escenarios de la educación superior(AU)

Tumores papilares intraductales del seno / Intraductal papillary tumors of the breast

Introducción. Los tumores papilares intraductales del seno son un grupo heterogéneo de lesiones que se caracterizan por una configuración papilar en el examen macroscópico o microscópico. El objetivo del estudio fue caracterizar los tumores papilares intraductales del seno en relación con sus principales manifestaciones clínicas, características patológicas y métodos diagnósticos. Materiales y métodos. Durante seis años se registró la información de 72 pacientes con tumores papilares intraductales del seno. Todos los pacientes con secreción por el pezón eran candidatos para la resección total de los conductos terminales, si cumplían los siguientes criterios clínicos: secreción espontánea por pezón, unilateral y persistente, o secreción serosa (como agua de roca) o hemorrágica por pezón. Cuando la manifestación clínica era una masa palpable, el algoritmo de manejo se basó en el enfoque de triple diagnóstico. Ante un hallazgo discordante entre los criterios clínico, radiológico y patológico, se indicó la resección completa de la lesión.Resultados. El tipo de papiloma benigno más frecuente fue el tumor papilar intraductal, seguido del carcinoma papilar no invasivo y del papiloma atípico. La secreción hemorrágica por pezón fue la manifestación clínica más frecuente de los tumores papilares intraductales y era la indicación quirúrgica fundamental para su diagnóstico. La mayoría de papilomas benignos intraductales fueron únicos. Conclusión. La historia clínica y el examen físico fueron la piedra angular para el diagnóstico certero. En presencia de secreción espontánea por pezón, persistente, unilateral, hemorrágica o serosa, se recomienda hacer resección total de los conductos terminales, aun cuando la mamografía y la ecografía mamaria sean reportadas como normales. En presencia de una masa palpable, la evaluación ideal es la de triple diagnóstico. La colaboración estrecha entre el patólogo y el cirujano de seno es vital para el manejo correcto de estas lesiones.

Introduction: intraductal papillary tumors of the breast are a heterogeneous group of lesions characterized by a papillary configuration in macroscopic or microscopic examination or both. Objectives: To characterize the main intraductal papillary tumors of the breast in relation to its main clinical manifestations, pathological characteristics and diagnostic methods of detection. Materials and Methods: During 6 years of continuous and systematic manner the authors recorded information of 72 patients with intraductal papillary tumors of the breast. All patients with nipple secretion were candidates for resection of terminal ducts if they met the following clinical criteria: nipple discharge spontaneous, unilateral, persistent, o nipple serous secretion (such as water rock) or hemorrhagic. Patient whose clinical manifestation was the presence of palpable mass, management algorithm was based on the triple diagnostic approach. A finding discordant between clinical and radiological-pathological, we recommended complete resection of the lesion. Results: Benign papillomas were type of breast intraductal tumor papillary most frequent followed by non-invasive papillary carcinomas and atypical papillomas subsequently. Nipple secretion hemorrhagic manifestation was the most frequent of intraductal papillary tumors and was critical to the surgical diagnosis.Most benign intraductal papillomas were single. Conclusion: Clinical history and physical examination were the cornerstone for the diagnosis of intraductal papillary tumors of the breast.Total duct excision is idicated in presence of nipple discharge spontaneous, unilateral, persistent, o nipple serous secretion (such as water rock) or hemorrhagic, even, when mammography and breast ultrasound are reported as normal. In the presence of a palpable mass, the ideal evaluation is of triple diagnosis approach.Close collaboration between surgeon and breast disease is vital to proper management of these lesions.

Algunas consideraciones sobre la evaluación en la asignatura Bioquímica I Curso Regular por Encuentro. Lic. en Enfermería / Some considerations about evaluation in the Biochemical subject of Biochemistry I. Regular Course by Meetings. Nursing Baccalaureate

Con el propósito de perfeccionar el procedimiento evaluativo en la asignatura Bioquímica I, que se imparte en el CRE de Lic. en Enfermería, se realizó el presente estudio en una muestra constituida por los 48 estudiantes del primer año de la carrera en el actual curso escolar, a los que se les aplicó diferentes instrumentos evaluativos: encuesta para conocer los criterios acerca de los diferentes tipos de preguntas utilizados en las evaluaciones parciales de la asignatura Bioquímica I, caracterización del funcionamiento intelectual de los educandos y análisis de los resultados docentes obtenidos al aplicar preguntas de ensayo con respuestas extensas y preguntas tipo test para un mismo contenido de forma simultánea a cada grupo respectivamente. Pudo comprobarse que las preguntas de complemento agrupado fueron consideradas como las de mayor grado de complejidad, seguidas por las de variación relativa y el tercer lugar fue ocupado por las preguntas de ensayo con respuestas extensas. Los argumentos expuestos por los estudiantes indicaron una valoración crítica de sus limitaciones, al reconocer como el principal obstáculo, en las preguntas de complemento agrupado, la inseguridad al elegir la agrupación correcta porque debían valorar varias alternativas simultáneamente, mientras que les resultaba muy complejo establecer la relación existente entre las dos proposiciones que conformaban las preguntas de variación relativa. La dificultad en la organización y expresión coherente de las respuestas de los estudiantes se demostró en las evaluaciones parciales realizadas y los resultados obtenidos permitieron al personal docente elaborar nuevas alternativas en la cualificación del proceso enseñanza- aprendizaje, a la vez que contribuyó a la valoración del carácter formativo de la evaluación.[AU]

El cambio organizacional: elemento esencial para el desarrollo de la Universidad Médica / The organizational change. en essential element for the development of a Medical University

Conociendo los retos y desafíos de la Educación Superior y muy especialmente en las Ciencias Médicas, en los momentos actuales, se realizó un análisis documental de aquellos procesos y elementos esenciales que intervienen en la Universidad Médica y que contribuyen al cambio necesario para lograr el desarrollo de la Educación Médica en el Siglo XXI. Las proyecciones del trabajo estuvieron encaminadas a esclarecer conceptos y formulaciones sobre el papel de la Universidad así como la necesidad de lograr el cambio organizacional en aras de enfrentar con eficiencia y calidad los desafíos en que está inmersa actualmente la Enseñanza Superior. Se determinaron un grupo de conductas presentes en la Facultad de Ciencias Médicas Dr. Faustino Pérez Hernández, las cuales pudieran contribuir a un estancamiento de la organización(AU)

Knowing the challenges of Higher Education and very especially in Medical Sciences, in the current moments, a documentary analysis was made of those processes and essential elements that intervene in the Medical University and that contribute to the necessary change to achieve the development of Medical Education in the XXI Century. The work plans were aimed at clarifying concepts and formulations on the role of the University as well as the necessity to achieve an organizational change in order to face efficiently the challenges in which Higher Education is engaged at the moment. A group of present behaviors were determined in the Dr. Faustino Pérez Hernández Faculty of Medical Sciences, which could contribute to a stagnation of organization(AU)