Sexual orientation knowledge and attitudes and its association with therapy satisfaction among lesbian, gay, and bisexual + Hispanic Puerto Ricans.

This study aimed to examine the difference in therapy satisfaction between lesbian, gay, and bisexual + (LGB +) individuals and heterosexual individuals, and to identify the association between therapy satisfaction and the perception of knowledge and attitudes of their last therapist among the LGB + participants. Through an exploratory design with a comparative group, 125 LGB + and 75 heterosexual participants were recruited online by availability. Results indicate that the participants' sexual orientation has no significant relation on therapy satisfaction. However, there was a significant positive association between satisfaction with therapy and the LGB + participants' perception that their therapist demonstrated knowledge and positive attitudes. This research highlights the importance for continuous education and curriculum efforts on LGB + issues.

Necesidades de aprendizaje sobre ambientes virtuales, de los docentes en la Facultad de Ciencias Médicas Calixto García

Introducción: En ocasiones los docentes tienen falta de motivación por la incorporación de nuevas técnicas de enseñanza, presentan una preparación mínima o desactualizada de las ventajas de las tecnologías. En otras, poseen habilidades instrumentales para el uso de las TIC, pero no para su uso reflexivo y crítico, para recibir, procesar, producir y compartir información que favorezca la gestión del conocimiento. Objetivo: Determinar las necesidades de aprendizaje y/o actualización de los docentes de la facultad en el uso de los entornos virtuales de enseñanza aprendizaje. Método: Se realizó un estudio descriptivo, de corte transversal, desde septiembre a diciembre del 2021. En el estudio participaron 132 profesores del universo la Facultad de Ciencias Médicas " Calixto García". Se aplicó a cada profesor un cuestionario, creado por los autores. El tratamiento de los datos se realizó mediante el sistema SPSS. Resultados: Acerca del nivel de Habilidades en Entornos Virtuales de Aprendizaje, hay que destacar que en el grupo de estudio no se encontró el nivel Muy Alto. Según categoría docente el nivel Poco de habilidades se manifestaron en Profesor Titular con un 81,82 %, Profesor Auxiliar de 66,67 %, Profesor Asistente con 56,25 % y en la categoría docente de Instructor predominó el nivel Bajo con el 64 %. Conclusiones: Promover capacitaciones para la adquisición de destrezas y habilidades en el uso de herramientas tecnológicas que apoyen los procesos educativos, elevando la calidad de la educación.

Introduction: Sometimes teachers lack motivation for the incorporation of new teaching techniques, they have minimal or outdated preparation of the advantages of technology. In others, they have instrumental skills for the use of ICTs, but not for their reflective and critical use, receive, process, produce and share information that favors knowledge management. Objective: To determine the learning and/or updating needs of faculty teachers in the use of virtual teaching-learning environments. Method: A descriptive, cross-sectional study was carried out from September to December 2021. 132 professors from the "Calixto García" Faculty of Medical Sciences participated in the study. A questionnaire created by the authors was applied to each professor. The treatment of the data was carried out using the SPSS system. Results: Analyzing the level of Skills in Virtual Learning Environments, it should be noted that the Very High level was not found in our study group. According to the teaching category, we should highlight that the Little level of skills was manifested in Full Professor with 81.82%, Assistant Professor with 66.67%, Assistant Professor with 56.25% and in the teaching category of Instructor the Low level prevailed with 64%. Conclusions: Promote training for the acquisition of skills and abilities in the use of technological tools that support educational processes, raising the quality of education.

Neurodesarrollo y estimulación oportuna en niños de madres indígenas migrantes y no migrantes en Chihuahua, México / Neurodevelopment and timely early stimulationin children of indigenous migrant and non-migrant mothers in Chihuahua, Mexico

El objetivo de este estudio fue comparar características generales y de atención en salud entre menores y sus madres migrantes y no migrantes en indígenas Tarahumaras, en Chihuahua, México. Así mismo, se evaluó la asociación entre el riesgo de retraso en neurodesarrollo en niños y las prácticas de estimulación oportuna. Niños y niñas de entre 12 a 48 meses de edad fueron estudiados en dos grupos: 1) menores de madres migrantes ubicados en asentamientos urbanos en la ciudad de Chihuahua y 2) menores de madres no migrantes residentes en sus localidades de origen. La prevalencia de riesgo de retraso del neurodesarrollo moderado y grave (RNMG) fue mayor en menores de madres migrantes versus no migrantes (75.6%, IC95% [69.5, 80.8] vs 59.8%, [51.4, 67.7], p = .003). La proporción de niños(as) que recibieron una estimulación oportuna favorable (EOF) en casa fue mayor en los menores de madres no migrantes (p < .001). La migración de las madres indígenas hacia asentamientos urbanos estuvo asociada al RNMG en sus hijos(as) (p = .03), así como las prácticas insuficientes de estimulación oportuna (p = .03). La asistencia consistente a sesiones de estimulación temprana del programa de Educación Inicial fue mayor en niños(as) de madres no migrantes (p = .01); y la no asistencia fue predictor del RNMG (p = .02).(AU)

This study aimed to compare the general and health care charac-teristics of young children of migrant and non-migrant mothers from in-digenous Tarahumara communities in Chihuahua, Mexico, and to evaluate the association between child risk for neurodevelopment delay with paren-tal practices of early childhood stimulation. Male and female children aged 12 to 48 months were studied in two groups: 1) children of migrant moth-ers residing in urban settlements and 2) children of non-migrant mothers residing in their native rural localities. Prevalence of the risk of moderate to severe neurodevelopment delay (MSND) was greater in children of mi-grant mothers as compared to non-migrant mothers (75.6%, CI95% [69.5, 80.8] vs.59.8%, [51.4, 67.7], p = .003). The proportion of children who re-ceived adequate and favorable early stimulation (FTES) at home was great-er in children of non-migrant mothers (p < .001). The migration of indige-nous mothers to urban settlements was associated with child MSND (p = .03), as well as to insufficient early stimulation practices (p = .03). Con-sistent attendance at early childhood stimulation sessions through the Ini-tial Education program was greater in children of non-migrant mothers (p = .01), and non-attendance predicted child MSND (p = .02).(AU)

Recent Developments in Biomarkers for Diagnosis and Screening of Type 2 Diabetes Mellitus.

PURPOSE OF REVIEW: Diabetes mellitus is a complex, chronic illness characterized by elevated blood glucose levels that occurs when there is cellular resistance to insulin action, pancreatic ß-cells do not produce sufficient insulin, or both. Diabetes prevalence has greatly increased in recent decades; consequently, it is considered one of the fastest-growing public health emergencies globally. Poor blood glucose control can result in long-term micro- and macrovascular complications such as nephropathy, retinopathy, neuropathy, and cardiovascular disease. Individuals with diabetes require continuous medical care, including pharmacological intervention as well as lifestyle and dietary changes. RECENT FINDINGS: The most common form of diabetes mellitus, type 2 diabetes (T2DM), represents approximately 90% of all cases worldwide. T2DM occurs more often in middle-aged and elderly adults, and its cause is multifactorial. However, its incidence has increased in children and young adults due to obesity, sedentary lifestyle, and inadequate nutrition. This high incidence is also accompanied by an estimated underdiagnosis prevalence of more than 50% worldwide. Implementing successful and cost-effective strategies for systematic screening of diabetes mellitus is imperative to ensure early detection, lowering patients' risk of developing life-threatening disease complications. Therefore, identifying new biomarkers and assay methods for diabetes mellitus to develop robust, non-invasive, painless, highly-sensitive, and precise screening techniques is essential. This review focuses on the recent development of new clinically validated and novel biomarkers as well as the methods for their determination that represent cost-effective alternatives for screening and early diagnosis of T2DM.

Current Challenges and Future Trends of Enzymatic Paper-Based Point-of-Care Testing for Diabetes Mellitus Type 2.

A point-of-care (POC) can be defined as an in vitro diagnostic test that can provide results within minutes. It has gained enormous attention as a promising tool for biomarkers detection and diagnosis, as well as for screening of chronic noncommunicable diseases such as diabetes mellitus. Diabetes mellitus type 2 is one of the metabolic disorders that has grown exponentially in recent years, becoming one of the greatest challenges to health systems. Early detection and accurate diagnosis of this disorder are essential to provide adequate treatments. However, efforts to reduce incidence should remain not only in these stages but in developing continuous monitoring strategies. Diabetes-monitoring tools must be accessible and affordable; thus, POC platforms are attractive, especially paper-based ones. Paper-based POCs are simple and portable, can use different matrixes, do not require highly trained staff, and are less expensive than other platforms. These advantages enhance the viability of its application in low-income countries and hard-to-reach zones. This review aims to present a critical summary of the main components required to create a sensitive and affordable enzymatic paper-based POC, as well as an oriented analysis to highlight the main limitations and challenges of current POC devices for diabetes type 2 monitoring and future research opportunities in the field.

Enzymatic Methods for Salivary Biomarkers Detection: Overview and Current Challenges.

Early detection is a key factor in patient fate. Currently, multiple biomolecules have been recognized as biomarkers. Nevertheless, their identification is only the starting line on the way to their implementation in disease diagnosis. Although blood is the biofluid par excellence for the quantification of biomarkers, its extraction is uncomfortable and painful for many patients. In this sense, there is a gap in which saliva emerges as a non-invasive and valuable source of information, as it contains many of the biomarkers found in blood. Recent technological advances have made it possible to detect and quantify biomarkers in saliva samples. However, there are opportunity areas in terms of cost and complexity, which could be solved using simpler methodologies such as those based on enzymes. Many reviews have focused on presenting the state-of-the-art in identifying biomarkers in saliva samples. However, just a few of them provide critical analysis of technical elements for biomarker quantification in enzymatic methods for large-scale clinical applications. Thus, this review proposes enzymatic assays as a cost-effective alternative to overcome the limitations of current methods for the quantification of biomarkers in saliva, highlighting the technical and operational considerations necessary for sampling, method development, optimization, and validation.

Disfunción tiroidea y diabetes mellitus tipo 1 / Thyroid dysfunction and type 1 diabetes mellitus

Introducción: La diabetes mellitus tipo 1 es una enfermedad autoinmunitaria que se relaciona con alteraciones tiroideas. Objetivo: Describir la relación que existe entre diabetes mellitus tipo 1 y enfermedad tiroidea autoinmune. Métodos: Se realizó una revisión de la literatura nacional e internacional de los últimos 15 años en bases de datos, en español y en inglés. Se utilizaron las siguientes palabras clave: diabetes mellitus tipo 1, autoinmunidad, enfermad tiroidea autoinmune, disfunción tiroidea y anticuerpos antitiroideos. Análisis e integración de la información: La alteración más frecuente es el hipotiroidismo subclínico y se presenta con mayor frecuencia en el sexo femenino, por lo que se sugiere realizar periódicamente el perfil tiroideo a estos pacientes. Conclusiones: Se debe tener en cuenta en la práctica clínica estas implicaciones para brindar un tratamiento oportuno, mejorar complicaciones derivadas como las enfermedades cardiovasculares y disminuir las cifras de morbilidad y mortalidad(AU)

Introduction: Type 1 diabetes mellitus is an autoimmune disease that is related to thyroid abnormalities. Objective: Describe the relationship between type 1 diabetes mellitus and autoimmune thyroid disease. Methods: A review of the national and international literature of the last 15 years was carried out in databases, in Spanish and in English. The following keywords were used: type 1 diabetes mellitus, autoimmune, autoimmune thyroid disease, thyroid dysfunction and antithyroid antibodies. Analysis and integration of information: The most common alteration is subclinical hypothyroidism and it occurs most often in the female sex, so it is suggested to periodically perform the thyroid profile to these patients. Conclusions: These implications should be taken into account in clinical practice to provide timely treatment, improve complications such as cardiovascular disease and reduce morbidity and mortality figures(AU)

Estrategias preventivas en los componentes de la triada ecológica ante la COVID-19 / Preventive strategies in the components of the ecological triad against COVID-19

Introducción: Cada enfermedad transmisible, acorde con su mecanismo principal de transmisión, se controla mediante determinadas medidas dirigidas a los elementos de la tríada ecológica: eliminación del reservorio, interrupción del modo de transmisión y protección al organismo susceptible. Objetivo: Examinar algunas estrategias preventivas en los componentes de la triada ecológica ante la COVID-19. Métodos: Revisión bibliográfica de artículos científicos en inglés y español, disponibles en las bases de datos PubMed, Scopus, Medline, SciELO, y en el motor de búsqueda Google Académico, además se exploraron páginas web de ministerios de salud, OMS, OPS, Infomed, otras nacionales e internacionales.. Se analizó la calidad, fiabilidad y validez de los artículos seleccionados. Se estudiaron 71 artículos, de los cuales 53 fueron referenciados. Resultados: Se describen los principales elementos que integran las medidas de prevención y control de la COVID-19 dirigidas a los elementos de la tríada ecológica, entre la multitud de información disponible en el enfrentamiento a este problema de salud. Consideraciones finales: El conocimiento profundo de las relaciones entre el huésped, el patógeno y el medio ambiente junto con su ecología es crucial para contrarrestar los patógenos infecciosos, donde la prevención juega un papel fundamental y primordial. El cumplimiento de las medidas de control en cada uno de los eslabones de la triada ecológica es vital para evitar la diseminación de esta enfermedad(AU)

Introduction: Each communicable disease, in accordance with its main transmission mechanism, is controlled by certain measures directed to the elements of the ecological triad: elimination of the reservoir, interruption of the mode of transmission and protection of the susceptible organism. Objective: Examine some preventive strategies in the components of the ecological triad against COVID-19. Methods: Bibliographic review of scientific articles in English and Spanish, available in databases like PubMed, Scopus, Medline, SciELO, and in the Google Scholar search engine, in addition to exploring websites of ministries of health, WHO, PAHO, Infomed, and other national and international sources. The quality, reliability and validity of the selected items were analyzed. 71 articles were studied, of which 52 were referenced. Results: The main elements that make up COVID-19 prevention and control measures directed to the elements of the ecological triad are described, among the multitude of available information in the confrontation with this health problem. Final considerations: In-depth knowledge of the relationships between the host, the pathogen and the environment jointly with its ecology is crucial to counteract infectious pathogens, where prevention plays a fundamental and primary role. Compliance with control measures at each link in the ecological triad is vital to prevent the spread of this disease(AU)

Complicaciones metabólicas en adolescentes obesos en relación con su peso al nacer / Metabolic complications in adolescents with obesity according to weight born

Introducción: La obesidad ha devenido una enfermedad de carácter epidémico y global, considerada como la epidemia del siglo XXI.Objetivo: Identificar algunas complicaciones metabólicas en adolescentes obesos, según el peso al nacer.Métodos: Estudio descriptivo y de corte transversal en 238 pacientes con diagnóstico de obesidad que asistieron a la consulta del Servicio de Endocrinología del Hospital Pediátrico Docente Juan Manuel Márquez, en el periodo comprendido entre el primero de enero del 2014 al 31 de enero del 2018. Para la clasificación del peso al nacer se tomó como puntos de corte 2500g y 4000g. Las variables en estudio fueron: edad, sexo, peso al nacer, glucemia en ayunas y postpandrial de dos horas, colesterol total, triglicéridos y aminotransferasas hepáticas. Las variables cualitativas se describieron de forma estadística, mediante frecuencias absolutas y relativas, la asociación entre las variables categóricas se exploró con el test X2 y la probabilidad exacta de Fisher. En todas las pruebas estadísticas se consideró un nivel de significación de alfa = 0.05.Resultados: Predominó el sexo masculino en las edades de doce a catorce años, existen valores significativos (p=0.0000) en los triglicéridos y en la transaminasa glutámico pirúvica(p=0.0002), el mayor porcentaje 73.53 por ciento y 69.12 por ciento, se encuentra en los pacientes con alto peso al nacer.Conclusiones: Las alteraciones metabólicas identificadas relacionadas con el peso al nacer son lahipertrigliceridemia y la elevación de la transaminasa glutámico pirúvica.(AU)

Introduction: Obesity has appeared as a disease with epidemic and global character, it is considered as the XXI century epidemic.Objective: To identify some metabolic complications in obese adolescents according to their birth weight.Methods: A descriptive cross-sectional study was carried out in 238 patients with diagnosis of obesity who went to the consultation in the Endocrinology Service at Juan Manuel Márquez, Teaching Pediatric Hospital from January, 2014 to January 1st ,2018. For the classification of the birth weight 2500g y 4000g were taken as cut points. The variables under study were: age, sex, birth weight, glycemia in fast and postprandial of two hours, total cholesterol, triglycerides and hepatic aminotransferases. The qualitative variables were statistically described by absolute and relative frequencies, the association between the categorical variables was expressed with X2 test and the Fisher exact probability. In all the statistical tests an alpha = 0.05 level of signification was considered.Results: The male sex from 12 to 14 years old prevailed, there are significant values (p=0.0000) in triglycerides and in pyruvic glutamic transaminase (p=0.0002), the highest percentages 73.53 per cent and 69.12 per cent, are found in patients with high birth weight.Conclusions: The identified metabolic disorders related to the birth weight are hypertriglyceridemia and the elevation of pyruvic glutamic transaminase.(AU)

Alteraciones del metabolismo de los hidratos de carbono en pacientes pediátricos con obesidad / Alterations in carbohydrate metabolism in paediatric patients with obesity

INTRODUCCIÓN: la elevada prevalencia de la obesidad en las edades pediátricas plantea el desarrollo de comorbilidades, dentro de las cuales se encuentran las alteraciones glucídicas. OBJETIVO: determinar si existe alteración glucídica en pacientes pediátricos con obesidad. MATERIAL Y MÉTODO: estudio descriptivo, transversal, en 76 pacientes pediátricos con diagnóstico de obesidad atendidos en el Servicio de Endocrinología del Hospital Juan Manuel Márquez (La Habana, Cuba), en el periodo de enero de 2015 a enero de 2019. Las variables en estudio fueron: edad, sexo, tipo de prediabetes, tiempo de evolución y grado de obesidad. Las variables cualitativas se describieron estadísticamente mediante frecuencias absolutas y relativas, la asociación entre las variables categóricas se exploró con el test χ2 y la probabilidad exacta de Fisher. En todas las pruebas estadísticas se consideró un nivel de significación de alfa igual a 0,05. RESULTADOS: el 71,05% de los pacientes presentaron prediabetes, de los cuales el 40,59% pertenecían al sexo femenino y el 72,22% eran mayores de 10 años de edad. Predominaron los pacientes con TGA (70,37%), de los cuales el 50,0% eran mayores de 10 años de edad y el 37,04% eran del sexo femenino. El tiempo de evolución de la obesidad no resultó significativo y se constató un incremento de la prediabetes a mayor grado de la obesidad (p = 0,0095). CONCLUSIONES: se presentaron alteraciones del metabolismo de los hidratos de carbono expresadas por la presencia de prediabetes. Predominó el sexo femenino. No existió asociación entre la prediabetes con el tiempo de evolución de la obesidad, pero sí con el grado de obesidad

INTRODUCTION: high prevalence of obesity in the paediatric population carries a risk of development of comorbidities, including abnormal blood glucose levels. OBJECTIVE: to determine whether abnormal blood glucose levels are present in paediatric patients with obesity. MATERIAL AND METHODS: we conducted a cross-sectional descriptive study in 76 paediatric patients with a diagnosis of obesity managed in the Department of Endocrinology of the Juan Manuel Márquez hospital (Havana, Cuba) between January 2015 and January 2019. The variables under study were: age, sex, type of prediabetes, duration and severity of obesity. We described qualitative variables as absolute and relative frequencies and analysed the association between categorical variables with the χ2 and Fisher exact tests. We defined statistical significance as an alpha probability of 0.05. RESULTS: we found that 71.05% of the patients in the sample had prediabetes, of who 40.59% were female and 72.22% aged more than 10 years. There was a predominance of patients with impaired glucose tolerance (70.37%), of who 50.0% were older than 10 years and 37.04% female. We did not find a significant association between the duration of obesity and prediabetes, but we found an increase in prediabetes with increasing severity of obesity (p = 0.0095). CONCLUSIONS: we found abnormalities in carbohydrate metabolism manifesting as prediabetes. The prevalence was higher in female patients. We did not find a significant association between the duration of obesity and prediabetes, but we found an increase in prediabetes with increasing severity of obesity

Cortisol and DHEA-S levels in pregnant women with severe anxiety.

BACKGROUND: A complex interaction between cortisol and dehydroepiandrosterone-sulphate (DHEA-S) is crucial in the stress system balance; several studies have reported increased cortisol levels during chronic stress and a weak counter-regulation by DHEA-S. During pregnancy, scarce information about this system is available, although cortisol and DHEA-S play an important role in the initiation and acceleration of labor. We conducted the present study in order to determine both cortisol and DHEA-S levels during the last trimester of pregnancy in patients exhibiting severe anxiety. METHODS: Pregnant women during the 3rd trimester of pregnancy were evaluated by using the self-reported version of the Hamilton Anxiety Rating Scale (HARS). According to the scores obtained from the psychometric scale, participants were divided into two groups: 1) patients exhibiting a cutoff score > 15 were considered with severe anxiety (ANX) (n = 101), and control pregnant subjects (CTRL) (n = 44) with a cutoff score < 5. Morning cortisol, DHEA-S and Cortisol/DHEA-S index were measured in all participants. Comparisons between groups were performed; additionally, correlations between clinical variables, biochemical data and HARS were calculated. RESULTS: Cortisol levels were significantly higher in the ANX group (p < 0.001), whereas those of DHEA-S were significantly lower in the same group (p < 0.01) when compared to healthy pregnant subjects. An increased cortisol/DHEA-S index was observed in the ANX group (p < 0.05). A significant association between cortisol and HARS scores (p = 0.03), was observed even after adjusting by gestational weeks (p = 0.004). CONCLUSIONS: Our data support that the cortisol/DHEA-S index is higher in pregnant women with high anxiety levels as compared with healthy pregnant women.

COVID-19 in Puerto Rico: Preliminary observations on social distancing and societal response toward a novel health stressor.

Countries worldwide are making wide-ranging attempts to stymie the outbreak of the 2019 novel coronavirus (COVID-19), and most of their efforts depend on the financial, structural, and social resources available. Given the increase in documented cases of COVID-19 in Puerto Rico, the extension of an aggressive and restrictive quarantine has been the correct step to slow down the potential contagion. Nevertheless, in this article, we discuss additional concrete actions that should be considered. This unprecedented scenario provides us the opportunity to rethink our limited resources based on a socioecological perspective, with the aim of creating efficiency and reducing the inequities that could accompany the pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Secular trends in age at menarche in 20th century Mexico: Differences by ethnicity, area of residency, and socioeconomic status.

OBJECTIVES: This study aims to assess the secular trend in age at menarche (AAM) in Mexico over the 20th century, and compare the patterns according to area of residence (rural/urban), socioeconomic status (SES), and ethnicity (indigenous/nonindigenous). METHODS: Data on AAM from 24 380 women aged ≥20 years born between 1906 and 1986 were obtained from the Mexican National Health and Nutrition Survey 2006. Birth cohorts were compared to test for a secular trend and differences in mean AAM by area of residence, SES, and ethnicity were evaluated using the Welch test for heterogeneous variances followed by Tamhane T2 for post hoc comparisons. RESULTS: Mean AAM declined from 13.3 years among Mexican women born before the 1940s to 12.56 years among those born in the 1980s. Across birth cohorts, urban women had significantly earlier AAM than their rural counterparts. Nonindigenous urban women reached menarche the earliest and rural indigenous women the latest of all groups. Nonindigenous urban residents experienced a comparatively earlier decline, while that for the indigenous rural women occurred last. High SES women reached menarche the earliest and low SES women the latest. The historical decline in AAM for high and medium SES groups occurred relatively early, whereas that for the low SES occurred last. CONCLUSIONS: Mean AAM was associated with area of residence, ethnicity, and SES. Our findings indirectly suggest that advances in living conditions experienced in Mexico during the 20th century appear to have been insufficient to overcome the social and biological inequalities accumulated over centuries in some groups.

Influencia de la hipoxia como noxa en el origen temprano de la obesidad y sus complicaciones durante la vida intrauterina / Influence of hypoxia as noxa in the early origin of obesity and its complications during intra-uterine life

La hipoxia es un factor importante que regula el desarrollo placentario y estimula la invasión del trofoblasto y la diferenciación, la angiogénesis y la vasculogénesis. Cuando ocurre la fecundación, la hipoxia a la que está expuesta el blastocisto regula su crecimiento, a la vez que limita el número de células del trofoblasto y el desarrollo placentario posterior, lo cual es clave en el transporte de nutrientes y oxígeno al feto en desarrollo; sin embargo, la hipoxia crónica fetoplacentaria conduce a disfunción vascular placentaria y a la programación intrauterina de enfermedades vasculares y metabólicas, ya que regula, a largo plazo, la expresión de enzimas relacionadas con la vía L-arginina/óxido nítrico en células endoteliales de diferentes lechos vasculares, incluyendo la placenta. Teniendo en cuenta los planteamientos anteriores en la presente investigación se describen los efectos de la hipoxia como noxa durante la vida intrauterina y su influencia en el origen temprano de la obesidad y sus complicaciones.

Hypoxia is an important factor that regulates the placental development and stimulates the invasion of trophoblast as well as differentiation, angiogenesis and vasculogenesis. At the moment of fertilization, hypoxia to which the blastocyte is exposed, regulates its growth, at the same time that it limits the number of trophoblast cells and the posterior placental development, that is essential in the transport of nutrients and oxygen to the developing fetus; however, chronic fetus-placental hypoxia leads to vascular placental dysfunction and to intra-uterine programming of vascular and metabolic diseases, since it regulates, at long term, the expression of enzymes related to the L-arginine/nitric oxide way in endothelial cells of different vascular beds, including placenta. Taking this into account the effects of hypoxia as noxa during intra-uterine life and its influence in the early origin of obesity and its complications are described in the present investigation.

Profiling the interaction of 1-phenylbenzimidazoles to cyclooxygenases.

In the design of 1-phenylbenzimidazoles as model cyclooxygenase (COX) inhibitors, docking to a series of crystallographic COX structures was performed to evaluate their potential for high-affinity binding and to reproduce the interaction profile of well-known COX inhibitors. The effect of ligand-specific induced fit on the calculations was also studied. To quantitatively compare the pattern of interactions of model compounds to the profile of several cocrystallized COX inhibitors, a geometric parameter, denominated ligand-receptor contact distance (LRCD), was developed. The interaction profile of several model complexes showed similarity to the profile of COX complexes with inhibitors such as iodosuprofen, iodoindomethacin, diclofenac, and flurbiprofen. Shaping of high-affinity binding sites upon ligand-specific induced fit mostly determined both the affinity and the binding mode of the ligands in the docking calculations. The results suggest potential of 1-phenylbenzimidazole derivatives as COX inhibitors on the basis of their predicted affinity and interaction profile to COX enzymes. The analyses also provided insights into the role of induced fit in COX enzymes. While inhibitors produce different local structural changes at the COX ligand binding site, induced fit allows inhibitors in diverse chemical classes to share characteristic interaction patterns that ensure key contacts to be achieved. Different interaction patterns may also be associated with different inhibitory mechanisms.

Verbal fluency in Mexican Spanish-speaking subjects with high educational level: Ranking of letters and semantic categories.

Introduction: Verbal fluency tasks are useful tools in clinical practice and research studies across languages and contexts, but specific data obtained using Spanish phonological tasks and semantic tasks with different levels of difficulty are lacking. The present study aimed to determine the difficulty level of a phonological tasks and semantic tasks among Spanish-speakers. Method: Both tasks were ordered across five difficulty levels based on the frequency of use in Mexican Spanish (phonological) and the number of elements given by a group of participants (semantic). One hundred healthy Mexican Spanish-speaking participants (aged 24-63 years; 55 females) were presented with five phonological and five semantic categories. The participants also underwent a neuropsychological test and sociodemographic interview. The number of words correctly produced in each category within one minute was calculated. An ANOVA and a Kruskal-Wallis analysis were conducted in order to know if there were different levels of difficulty in the tasks. Additionally, correlation analyzes were performed to test the effect of the sociodemographic and cognitive variables on the participants' responses. Results: According to the analyzes, there were different levels of difficulty in the categories; P was the easiest and O was the most difficult category in the phonological tasks, and body parts and precious stones were the easiest and most difficult, respectively, in the semantic tasks. Age had a negative correlation with four-legged animals and a positive correlation with O; Positive correlations were also found between education and professions, vegetables, and alcoholic beverages; and between IQ and D, N, musical instruments, sports, vegetables, and trees. Conclusions: Both tasks offer categories with different level of difficulty based on the performance of a highly educated Mexican population. These data may be useful for clinical and research purposes.

Validación al Español de un cuestionario de hábitos de sueño en los niños / Validation to Spanish version of the Children's Sleep Habits Questionnaire

Introducción: Los trastornos del sueño en la infancia constituyen un fenómeno de elevada frecuencia. Los cuestionarios de sueño constituyen un instrumento de innegable valor que complementa los estudios objetivos del sueño. Objetivo: Validar al español un cuestionario que indaga acerca de los hábitos de sueño en niños en el contexto sociocultural cubano. Métodos: Se seleccionó el cuestionario CHILDREN'S SLEEP HABITS QUESTIONNAIRE (NICHD SECCYD-Wisconsin) para su uso en el laboratorio de neurofisiología del Centro Internacional de Restauración Neurológica. En una primera etapa del estudio, el cuestionario se tradujo y adaptó al español según las reglas internacionales. Se entregaron 330 cuestionarios a los padres en una muestra poblacional cubana de niños en edades comprendidas entre los 2 a 10 años. Estos se distribuyeron en escuelas y círculos infantiles con una tasa de respuesta de 93 por ciento. Se recuperaron 295 (96 por ciento) cuestionarios útiles, 25 atendieron a los criterios de exclusión, 270 se aceptaron para estudios de validación. Resultados: La consistencia interna del cuestionario (alfa de Cronbach) fue de 0,67 para la escala completa y varió de 0,42 a 0,61 para las subescalas. Para la confiabilidad test-retes de las subescalas se aplicó una t de students para muestras dependientes, con una n= de 86. Las diferencias fueron significativas en las subescalas 3 y 8 (p= 0,04) Conclusiones: El cuestionario según su versión original y en comparación con la de otros países presentó propiedades psicométricas adecuadas para evaluar los problemas de sueño en niños cubanos entre 2 y 10 años de edad(AU)

Introduction: Sleep disorders in childhood constitute a highly frequent phenomenon. The sleep habits´ questionnaires are instruments of undeniable value that complement the sleep's objective studies. Objective: To validate the Spanish version of a Questionnaire (NICHD SECCYD-Wisconsin) and compare it with the results of previous studies in other countries. Methods: It was selected the Children's Sleep Habits Questionnaire for its use in the neurophysiology laboratory of the International Center of Neurological Restoration (CIREN, by its acronym in Spanish). In the first stage of the study, the questionnaire was translated and adapted to Spanish according to the international standards. 330 questionnaires were delivered to the parents of a Cuban community sample of children aged 2 to10 years old, with a response rate of 93 percent. 295 (96 percent) useful questionnaires were obtained, 25 met the exclusion criteria, 270 were accepted for validation studies. The results were compared with the results of other countries. Results: The Children's Sleep Habits Questionnaire´s internal consistency (Cronbach) was 0.67 for the total scale and ranged from 0.42 to 0.61 for subscales. The test-retest reliability for subscales used t for students in dependent samples, being n= 86.The differences were meaningful for subscales 3 y 8 (p= 0,4). Conclusion: The questionnaire according to its original version and in comparison with that of other countries has adequate psychometric properties to evaluate sleep problems in Cuban children between 2 and 10 years(AU)

Probiotics' effectiveness on symptoms, histological features and feeding tolerance in ulcerative colitis / Efectividad de probióticos sobre síntomas, histología y tolerancia alimentaria en colitis ulcerativa

Background: Probiotics have been used in the adjuvant treatment of Ulcerative Colitis (UC). Objective: To evaluate the role of a combination of probiotics on the clinical, histological changes and feeding tolerance in patients with UC. Methods: An open UC patients with mild to moderate activity and clinical trial was conducted. Patients were randomized to receive or a combination of 6 strains of probiotics for 3 months while continuing their drug treatment established. UC activity was assessed by Truelove and Witts scale and histological findings by Gupta index. Descriptive statistics, Chi square test and Student t test for comparison of the two groups was performed. Results: In each group 17 patients were included. An improvement was found in the disease activity (52.9% vs. 23.5%, p = 0.07) and in histologic index (82.3% vs. 41.1%, p = 0.03) in patients treated with probiotics compared to the control group. Improved food tolerance was also observed in patients treated with probiotics. Conclusion: The study shows a beneficial short-term effect on symptoms, histological findings and feeding tolerance with the administration of a combination of 6 strains of probiotics in patients with UC.

Introducción: los probióticos han sido utilizados en el tratamiento adyuvante de la colitis ulcerativa (CU). Objetivo: evaluar el papel de una combinación de probióticos sobre las manifestaciones clínicas, cambios histológicos y tolerancia alimentaria en pacientes con CU. Métodos: se realizó un ensayo clínico abierto de pacientes con CU y actividad leve a moderada. Los pacientes se aleatorizaron para recibir, o no, una combinación de 6 cepas de probióticos durante 3 meses, mientras continuaban con el tratamiento farmacológico establecido. Se evaluó la actividad de la CU mediante la escala de Truelove and Witts, y los hallazgos histológicos mediante el índice de Gupta. Se realizó estadística descriptiva, prueba de Chi cuadrada y t de Student para la comparación de ambos grupos. Resultados: se incluyeron 17 pacientes por grupo. Se encontró una mejoría en la actividad de la enfermedad (52.9% frente a 23.5%, p = 0.07) y en el índice histológico (82.3% frente a 41.1%, p = 0.03) en los pacientes tratados con probióticos en comparación con el grupo control. También se observó una mejor tolerancia alimentaria en los pacientes tratados con probióticos. Conclusión: el estudio muestra un efecto benéfico a corto plazo sobre los síntomas, hallazgos histológicos y tolerancia alimentaria con la administración de una combinación de 6 cepas de probióticos en pacientes con CU.

Evaluación del conocimiento en higiene de manos pre y post capacitación a residentes en un hospital público / Evaluation of hand-hygiene knowledge before and after training of residents in a public hospital

INTRODUCCIÓN: La higiene de las manos se considera la medida más eficaz para reducir las infecciones relacionadas al cuidado de la salud. A partir de enero 2017 se implementó en el Hospital la Estrategia Multimodal de Mejora de la Higiene de Manos (HM), herramienta desarrollada por la OMS. Esta fue adaptada para ser aplicada en nuestra institución, con el objetivo de alcanzar un incremento sostenido de la adherencia a la higiene de manos e implantarla como parte integrante de la cultura de nuestro centro sanitario. El abordaje multimodal incluye acciones a diferentes niveles: sistema (infraestructura), formación y aprendizaje, evaluación y retroalimentación, recordatorios en los lugares de trabajo y clima institucional de mejora en la HM. Dentro de las actividades de formación y aprendizaje se desarrolló una actividad de capacitación a todos los residentes de las áreas médicas y quirúrgicas del HEC. OBJETIVO: El objetivo fue evaluar los conocimientos basales sobre HM entre los residentes del hospital y compararlos luego de recibir un curso de capacitación teórico- práctico específico en la temática. RESULTADOS: Los resultados obtenidos en el examen posterior a la capacitación fueron significativamente superiores a los resultados observados previos a la misma. La intervención realizada y la información recabada permiten reflexionar acerca que el abordaje de una técnica como es la higiene de manos, focalizada en una actividad de capacitación, mejora los conocimientos y formas de llevarlo a la práctica que se tenían previa a esta instancia.

INTRODUCTION: Hand hygiene is considered the most effective measure to reduce healthcarerelated infections. From January 2017, the Multimodal Hand-Hygiene Improvement Strategy, a tool developed by WHO, was implemented in the hospital. This was adapted to be applied in our institution, aiming at achieving a sustained increase of the compliance to hand hygiene and implemented as an integral part of our healthcare center's cultural characteristics. The multimodal approach includes actions at different levels: system (infrastructure), training and learning, evaluation and feedback, reminders at workplaces and institutional climate of HH improvement. A training activity for all residents of the HEC's medical and surgical areas was developed within the training and learning activities. OBJECTIVE: The objective was to evaluate the basal knowledge on HH among hospital residents, and make a comparison after receiving a training theoretical-practical course that was specific on the subject. RESULTS: The results achieved in the post-training examination were significantly superior to the results observed before the training. The intervention made, and the information collected have allowed us to think that the approach to a technique like hand hygiene, on which a training activity was focused, improves the knowledge and implementation that existed before this instance.

Tecnologías de la Información y las Comunicaciones: desafío que enfrenta la universidad de ciencias médicas / Information and Communication Technologies: a challenge for the university of medical sciences

Como respuesta a las cambiantes condiciones sociales, económicas, políticas, culturales y educacionales generadas por el avance de las tecnologías de la información y las comunicaciones, la educación superior demanda de sus universidades una adaptación de sus estructuras y organización docente. Entre los principales retos de los profesionales de la salud se encuentra el desarrollo de competencias y habilidades para el uso de estas tecnologías. Los autores se propusieron reflexionar sobre la incorporación de sus competencias en los currículos universitarios de pregrado y posgrado para enfrentar el desafío impuesto por la explosión tecnológica de la llamada era o sociedad del conocimiento.

In response to the changing social, economic, political, cultural and educational conditions generated by the advancement of information and communication technologies, higher education demands from its universities an adaptation of its structures and teaching organization. Among the main challenges for health professionals is the development of competences and abilities for the use of these technologies. The authors set out to reflect on the incorporation of their competences in undergraduate and postgraduate university curricula to face the challenge imposed by the technological explosion of the so-called era or knowledge society.