La formación de las especialidades de Ciencias Básicas Biomédicas en Pinar del Río / The training of specialties of Basic Biomedical Sciences in Pinar del Río

RESUMEN Introducción: la calidad del desempeño profesoral en la educación médica es una necesidad, particularmente en la enseñanza de las ciencias básicas. La especialidad de Ciencias Básicas Biomédicas tiene como propósito fundamental proporcionar la posibilidad al graduado de Medicina y Estomatología de formarse como cuadro científico pedagógico, investigaciones o ambas. Objetivo: mostrar la evolución histórica de la formación de especialistas de Ciencias Básicas Biomédicas en la Universidad de Ciencias Médicas de Pinar del Río. Métodos: se realizó un estudio cualitativo de carácter descriptivo y de corte histórico con el empleo de métodos teóricos y empíricos. Resultados: se caracterizó el proceso de formación de especialistas de las ciencias básicas biomédicas en la provincia y su aporte a las necesidades del proceso docente educativo. Conclusiones: la enseñanza de las Ciencias Básicas Biomédicas en Pinar del Río ha transitado por tres etapas según los requerimientos del proceso formativo. Se ha producido el desarrollo profesional de estos especialistas desde el perfeccionamiento de las competencias para su desempeño como profesores, lo que ha repercutido en el crecimiento de la institución y su visibilidad en el exterior.

ABSTRACT Introduction: the quality of professor performance in medical education is a necessity, particularly in the teaching of the basic sciences. The specialty of Basic Biomedical Sciences has as fundamental purpose to provide the possibility to the graduates of Medicine and Dentistry to be trained as a pedagogical scientific team of specialists, investigative or both. Objective: to show the historical evolution of the training of specialists in Basic Biomedical Sciences at Pinar del Río University of Medical Sciences, from 2019. Methods: a qualitative study of a descriptive and historical nature was carried out using theoretical and empirical methods. Results: the process of training specialists in the basic biomedical sciences in the province and their contribution to the needs of the educational teaching process was characterized. Conclusions: the teaching of Basic Biomedical Sciences in Pinar del Río went through three stages according to the requirements of training process, produced in the professional development of its specialists from the improvement of competences for their performance as professors and researchers, with the consequent favorable repercussion in the majority of the times of the institution and its visibility abroad, the first certified University of Medical Sciences of the country.

Técnicas histológicas básicas en la formación del especialista de Histología: una mirada de renovación estratégica / Basic histological techniques in the training of Histology specialist: a view of a strategic renewal

RESUMEN Introducción: en los últimos años se observa progresiva demanda de perfeccionamiento en el proceso de enseñanza aprendizaje de la especialidad de Histología, dado el incremento el considerable del progreso científico-tecnológico y las opciones de aprendizaje para estudiantes y profesores. Objetivo: argumentar el proceso de enseñanza- aprendizaje de las técnicas histológicas básicas en la formación del especialista en Histología, como instrumento estratégico de la ciencia y la tecnología en la sociedad actual. Métodos: guiados por el método general materialista dialéctico, se utilizan otros teóricos (histórico lógico y modelación) y el empírico, revisión documental para la obtención de los resultados. Desarrollo: se abordan antecedentes de la enseñanza en la asignatura Técnicas Histológicas Básicas, características del proceso de enseñanza-aprendizaje actual y sus fundamentos con base en adelantos científico-técnicos y didácticos que permite la definición de conocimiento histológico en función de la formación del especialista en correspondencia con necesidades de salud y la educación. Conclusiones: el proceso de enseñanza aprendizaje que se analiza, constituye instrumento estratégico de la ciencia y la tecnología para la formación del especialista, en correspondencia con las necesidades actuales de las ciencias médicas, su evolución refleja flexibilidad y apertura de la didáctica en educación de posgrado y posibilita enriquecer estructura interna de los contenidos como componente didáctico del mismo.

ABSTRACT Introduction: in recent years there has been a progressive demand for improvement in the teaching and learning process of the specialty of Histology, given the considerable increase in scientific-technological progress and learning options for students and professors. Objective: to show the teaching-learning process of basic histological techniques in the training of the specialists in Histology, as a strategic instrument of science and technology in today's society. Methods: guided by the general dialectical materialist method, other theoretical approaches are used (historical-logical and modeling), and the empirical along with the documentary review to obtain the results. Development: the background of teaching in the subject Basic Histological Techniques, characteristics of the current teaching-learning process and its fundamentals are based on scientific-technical and didactic progress that allow the definition of histological knowledge according to the training of the specialists in association with health care and education needs. Conclusions: the process of teaching and learning that is analyzed constitutes a strategic instrument of science and technology for the training of the specialists, in accordance with the current needs of the medical sciences, its evolution reflects flexibility and openness of the didactics in postgraduate education and makes it possible to enrich the internal structure of the contents as its didactic component.

Influencia de los tiempos entre el inicio de síntomas, la toma de frotis nasofaríngeo y su procesamiento en laboratorio en la detección de gripe / Effect of the time between symptom onset, swabbing and testing on the detection of influenza virus

Introducción La vigilancia epidemiológica de la gripe requiere la recogida de frotis nasofaríngeos en atención primaria para su análisis en laboratorios de referencia. Evaluamos la influencia en el resultado de laboratorio, de los tiempos transcurridos desde el inicio de síntomas hasta la recogida del frotis (TSF) y desde entonces hasta su procesamiento en laboratorio (TFL).Métodos Analizamos las muestras recogidas en la red centinela de gripe de Navarra en la temporada 2009-2010. Los hisopados se conservaron refrigerados hasta su estudio mediante RT-PCR y cultivo viral. Se analizó el porcentaje de positividad a gripe en función del TSF y del TFL mediante regresión logística. Resultados Se analizaron 937 frotis y 373 (40%) fueron positivos para gripe mediante RT-PCR. El TSF osciló entre 0-15 días. En el análisis ajustado por periodo, laboratorio y edad, la detección del virus de la gripe descendió a menos de la mitad en el cultivo cuando el TSF era de 4-5 días (OR = 0,47; IC 95% 0,24-0,94), y en la RT-PCR, cuando el TSF era mayor de 5 días (OR = 0,24; IC 95% 0,09-0,65). El TFL no afectó de forma significativa al resultado de muestras procesadas por RT-PCR (OR por día transcurrido = 0,96; IC 95% 0,88-1,04), ni por cultivo viral (OR por día transcurrido = 0,97; IC 95% 0,89-1,06).Conclusiones Un TSF superior a 3 días redujo la probabilidad de confirmación de gripe, afectando más al cultivo que a la PCR. El TFL dentro de un rango de dos semanas no afectó de forma relevante al resultado de la RT-PCR ni del cultivo (AU)

Background Influenza surveillance requires the collection of nasopharyngeal swabs in Primary Care for testing in reference laboratories. We evaluated the influence on the laboratory results of the time since the onset of symptoms to swabbing (TSS) and from then until laboratory processing (TSL).Methods We analysed swabs collected in the Sentinel Network of Navarra during the 2009-2010 influenza season. The samples were kept refrigerated until analysed by RT-PCR and viral culture. We analysed the percentage of positive swabs to influenza virus in accordance with the TSS and TSL by logistic regression. Results From a total of 937 swabs, 373 (40%) were positive for influenza by RT-PCR. The TSS ranged from 0-15 days. In the adjusted analysis by period, laboratory and age, having a positive influenza culture decreased to less than half when the TSS was 4-5 days (OR=0.47; 95% CI, 0.24-0.94), and having a positive RT-PCR decreased when the TSS was 5 days or more (OR=0.24, 95% CI, 0.09-0.65). TSL does not significantly affect the result of the RT-PCR (OR by each day=0.96; 95% CI, 0.88-1.04), or the result of the viral culture (OR by each day=0.97, 95% CI, 0.89-1.06).Conclusions A TSS over 3 days reduced the likelihood of confirmation of influenza, affecting the viral culture more than the RT-PCR. A TSL within a range of two weeks had no significant effect on the results of the RT-PCR or the viral culture (AU)

Effectiveness of rotavirus vaccines in preventing cases and hospitalizations due to rotavirus gastroenteritis in Navarre, Spain.

Two rotavirus vaccines have been available since 2006. This study evaluates the effectiveness of these vaccines using a test-negative case-control design in Navarre, Spain. We included children 3-59 months of age who sought medical care for gastroenteritis and for whom stool samples were taken between January 2008 and June 2011. About 9% had received the pentavalent vaccine (RotaTeq) and another 8% received the monovalent vaccine (Rotarix). Cases were the 756 children with confirmed rotavirus and controls were the 6036 children who tested negative for rotavirus. Thirty-five percent of cases and 9% of controls had required hospitalization (p<0.0001). The adjusted effectiveness of complete vaccination was 78% (95% CI: 68-85%) in preventing rotavirus gastroenteritis and 83% (95% CI: 65-93%) in preventing hospitalization for rotavirus gastroenteritis. No differences between the two vaccines were detected (p=0.4523). Both vaccines were highly effective in preventing cases and hospital admissions in children due to rotavirus gastroenteritis.

[Effect of the time between symptom onset, swabbing and testing on the detection of influenza virus]. / Influencia de los tiempos entre el inicio de síntomas, la toma de frotis nasofaríngeo y su procesamiento en laboratorio en la detección de gripe.

BACKGROUND: Influenza surveillance requires the collection of nasopharyngeal swabs in Primary Care for testing in reference laboratories. We evaluated the influence on the laboratory results of the time since the onset of symptoms to swabbing (TSS) and from then until laboratory processing (TSL). METHODS: We analysed swabs collected in the Sentinel Network of Navarra during the 2009-2010 influenza season. The samples were kept refrigerated until analysed by RT-PCR and viral culture. We analysed the percentage of positive swabs to influenza virus in accordance with the TSS and TSL by logistic regression. RESULTS: From a total of 937 swabs, 373 (40%) were positive for influenza by RT-PCR. The TSS ranged from 0-15 days. In the adjusted analysis by period, laboratory and age, having a positive influenza culture decreased to less than half when the TSS was 4-5 days (OR=0.47; 95% CI, 0.24-0.94), and having a positive RT-PCR decreased when the TSS was 5 days or more (OR=0.24, 95% CI, 0.09-0.65). TSL does not significantly affect the result of the RT-PCR (OR by each day=0.96; 95% CI, 0.88-1.04), or the result of the viral culture (OR by each day=0.97, 95% CI, 0.89-1.06). CONCLUSIONS: A TSS over 3 days reduced the likelihood of confirmation of influenza, affecting the viral culture more than the RT-PCR. A TSL within a range of two weeks had no significant effect on the results of the RT-PCR or the viral culture.

Antimicrobial resistance among respiratory pathogens in Spain: latest data and changes over 11 years (1996-1997 to 2006-2007).

A nationwide multicenter susceptibility surveillance study (Susceptibility to the Antimicrobials Used in the Community in España [SAUCE] project), SAUCE-4, including 2,559 Streptococcus pneumoniae, 2,287 Streptococcus pyogenes, and 2,736 Haemophilus influenzae isolates was carried out from May 2006 to June 2007 in 34 Spanish hospitals. Then, the results from SAUCE-4 were compared to those from all three previous SAUCE studies carried out in 1996-1997, 1998-1999, and 2001-2002 to assess the temporal trends in resistance and the phenotypes of resistance over the 11-year period. In SAUCE-4, on the basis of the CLSI breakpoints, penicillin (parenteral, nonmeningitis breakpoint) and cefotaxime were the antimicrobials that were the most active against S. pneumoniae (99.8% and 99.6%, respectively). Only 0.9% of isolates had a penicillin MIC of > or = 2 microg/ml. In S. pyogenes, nonsusceptibility to erythromycin was observed in 19.4% of isolates. Among the H. influenzae isolates, a beta-lactamase-positive prevalence of 15.7% was found. A statistically significant temporal decreasing trend over the 11-year period was observed for nonsusceptibility (from 60.0% to 22.9%) and resistance (from 36.5% to 0.9%) to penicillin and for the proportion of erythromycin-resistant isolates of S. pneumoniae of the macrolide-lincosamide-streptogramin B (MLS(B)) phenotype (from 98.4% to 81.3%). A similar trend was observed for the prevalence of ampicillin resistance (from 37.6% to 16.1%), beta-lactamase production (from 25.7% to 15.7%), and beta-lactamase-negative ampicillin resistance (BLNAR) in H. influenzae (from 13.5% to 0.7%). Among erythromycin-resistant isolates of S. pyogenes, a significant increasing trend in the prevalence of MLS(B) was observed (from 7.0% to 35.5%). SAUCE-4 confirms a generalized decline in the resistance of the main respiratory pathogens to the antimicrobials as well as a shift in their resistance phenotypes.

Infección por Blastocystis hominis y diarrea / Blastocystis hominis infection and diarrhoea

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The aetiology of paediatric inflammatory vulvovaginitis.

UNLABELLED: Vulvovaginitis is the most common gynaecological problem in prepubertal girls and clear-cut data on the microbial aetiology of moderate to severe infections are lacking. Many microorganisms have been reported in several studies, but frequently the paediatrician does not know the pathogenic significance of an isolate reported in vaginal specimens of girls with vulvovaginitis. A multicentre study was performed, selecting 74 girls aged 2 to 12 years old with a clinical picture of vulvovaginitis and inflammatory cells on Gram stain. All the specimens were cultured following standard microbiological techniques and the paediatricians completed a questionnaire to highlight risk factors after interviewing the parents or tutors. The data were compared with those obtained in a control group of 11 girls without vulvovaginitis attending a clinic. Streptococcus pyogenesand Haemophilus spp.were isolated in 47 and 12 cases, respectively. Upper respiratory infection in the previous month ( P<0.001) and vulvovaginitis in the previous year ( P<0.05) were identified as significant risk factors. Foreign bodies, sexual abuse, poor hygiene and bad socioeconomic situation were not identified as risk factors for the infection. CONCLUSION: Paediatric inflammatory vulvovaginitis is mainly caused by pathogens of the upper respiratory tract and the most common risk factor for this infection is to have suffered an upper respiratory tract infection in the previous month.

Lesión edematosa-eritematosa en el dedo de un ganadero / Edematous-erythematous lesion in the digit of a cattle farmer

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Diagnóstico de artritis tuberculosa a partir del aislamiento de Mycobacterium tuberculosis en agar sangre y agar chocolate / Diagnostic of tuberculous arthritis from the isolation of Mycobacterium tuberculosis in blood and chocolate agar plates

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