Characterization of a catalase-peroxidase variant (L333V-KatG) identified in an INH-resistant Mycobacterium tuberculosis clinical isolate.

Mycobacterium tuberculosis catalase-peroxidase (Mt-KatG) is a bifunctional heme-dependent enzyme that has been shown to activate isoniazid (INH), the widely used antibiotic against tuberculosis (TB). The L333V-KatG variant has been associated with INH resistance in clinical M. tuberculosis isolates from Mexico. To understand better the mechanisms of INH activation, its catalytic properties (catalase, peroxidase, and IN-NAD formation) and crystal structure were compared with those of the wild-type enzyme (WT-KatG). The rate of IN-NAD formation mediated by WT-KatG was 23% greater than L333V-KatG when INH concentration is varied. In contrast to WT-KatG, the crystal structure of the L333V-KatG variant has a perhydroxy modification of the indole nitrogen of W107 from MYW adduct. L333V-KatG shows most of the active site residues in a similar position to WT-KatG; only R418 is in the R-conformation instead of the double R and Y conformation present in WT-KatG. L333V-KatG shows a small displacement respect to WT-KatG in the helix from R385 to L404 towards the mutation site, an increase in length of the coordination bond between H270 and heme Fe, and a longer H-bond between proximal D381 and W321, compared to WT-KatG; these small displacements could explain the altered redox potential of the heme, and result in a less active and stable enzyme.

Neural signatures of opioid-induced risk-taking behavior in the prelimbic prefrontal cortex.

Opioid use disorder occurs alongside impaired risk-related decision-making, but the underlying neural correlates are unclear. We developed a novel approach-avoidance conflict model using a modified conditioned place preference paradigm to study neural signals of risky opioid seeking in the prefrontal cortex, a region implicated in executive decision making. Upon establishment of morphine conditioned place preference, rats underwent a subsequent conflict test in which fear-inducing cat odor was introduced in the previously drug-paired side of the apparatus. While the saline control group avoided the cat odor side, the morphine group maintained preference for the paired side despite the presence of cat odor. K-means clustering identified two subsets of morphine-treated rats that exhibited either persistent drug seeking (Risk-Takers) or increased avoidance (Risk-Avoiders) during conflict. Single-unit recordings from the prelimbic cortex (PL) revealed decreased neuronal firing rates upon acute morphine exposure in both Risk-Takers and Risk-Avoiders, but this firing rate suppression was absent after repeated administration. Risk-Avoiders also displayed distinct post-morphine excitation in PL which persisted across conditioning. During the preference test, subpopulations of PL neurons in all groups were either excited or inhibited when rats entered the paired side. Interestingly, while this inhibitory signal was lost during the subsequent conflict test in both saline and Risk-Avoider groups, these inhibitory responses persisted in Risk-Takers. Our results suggest that loss of PL inhibition after opioid conditioning is associated with the formation of contextual reward memory. Furthermore, persistent PL inhibitory signaling in the drug-associated context during conflict may underlie increased risk taking following opioid exposure.

Global transcriptional analysis of Geobacter sulfurreducens gsu1771 mutant biofilm grown on two different support structures.

Electroactive biofilms formation by the metal-reducing bacterium Geobacter sulfurreducens is a step crucial for bioelectricity generation and bioremediation. The transcriptional regulator GSU1771 controls the expression of essential genes involved in electron transfer and biofilm formation in G. sulfurreducens, with GSU1771-deficient producing thicker and more electroactive biofilms. Here, RNA-seq analyses were conducted to compare the global gene expression patterns of wild-type and Δgsu1771 mutant biofilms grown on non-conductive (glass) and conductive (graphite electrode) materials. The Δgsu1771 biofilm grown on the glass surface exhibited 467 differentially expressed (DE) genes (167 upregulated and 300 downregulated) versus the wild-type biofilm. In contrast, the Δgsu1771 biofilm grown on the graphite electrode exhibited 119 DE genes (79 upregulated and 40 downregulated) versus the wild-type biofilm. Among these DE genes, 67 were also differentially expressed in the Δgsu1771 biofilm grown on glass (56 with the same regulation and 11 exhibiting counter-regulation). Among the upregulated genes in the Δgsu1771 biofilms, we identified potential target genes involved in exopolysaccharide synthesis (gsu1961-63, gsu1959, gsu1972-73, gsu1976-77). RT-qPCR analyses were then conducted to confirm the differential expression of a selection of genes of interest. DNA-protein binding assays demonstrated the direct binding of the GSU1771 regulator to the promoter region of pgcA, pulF, relA, and gsu3356. Furthermore, heme-staining and western blotting revealed an increase in c-type cytochromes including OmcS and OmcZ in Δgsu1771 biofilms. Collectively, our findings demonstrated that GSU1771 is a global regulator that controls extracellular electron transfer and exopolysaccharide synthesis in G. sulfurreducens, which is crucial for electroconductive biofilm development.

Propuesta de guía de práctica clínica corta para el manejo de la enfermedad renal crónica

La enfermedad renal crónica constituye un problema de salud debido su impacto sobre los individuos, la sociedad y la economía. Se propone una guía de práctica clínica para atención de la enfermedad renal crónica en la Atención Primaria de Salud. Se realizó una investigación clínica epidemiológica entre los años 2017-2019, en el Policlínico Luis Augusto Turcios Lima, del municipio de Pinar del Río. La guía fue elaborada siguiendo criterios de la medicina basada en la evidencia, por consenso y por opinión de expertos. La evaluación de calidad se realizó con el Instrumento Appraisal of Guidelines, Research and Evaluation for Europe. Se elaboraron recomendaciones, se generalizó y actualizó permanentemente con las nuevas evidencias médicas. Se sistematizaron las prácticas preventivas y de detección precoz de la enfermedad. La guía propuesta provee a los profesionales que laboran en la Atención Primaria de Salud, las herramientas apropiadas para la detección y manejo de la enfermedad renal crónica; además de facilitar la coordinación entre los ámbitos de los niveles primario y secundario de Salud. Se concluye que permite mejorar la atención de los pacientes con esta enfermedad, particularmente en la Atención Primaria de Salud.

Chronic kidney disease constitutes a health problem due to its impact on individuals, society and the economy. A clinical practice guide for chronic kidney disease care in Primary Health Care is proposed. A clinical epidemiological investigation was carried out from 2017 to 2019, at the Luis Augusto Turcios Lima Polyclinic, in the Pinar del Río municipality. The guideline was prepared following evidence-based medicine criteria, by consensus and by expert opinion. The quality evaluation was carried out with the Appraisal of Guidelines, Research and Evaluation for Europe Instrument. Recommendations were elaborated; it was generalized and permanently updated with the new medical evidence. Preventive practices and early detection of the disease were systematized. The proposed guide provides professionals working in Primary Health Care with the appropriate tools for the detection and management of chronic kidney disease; also facilitating coordination between the primary and secondary levels of Health. It is concluded that it allows improving the care of patients with this disease, especially in Primary Health Care.

Estrategia educativa sobre enfermedad renal crónica en el Policlínico Turcios Lima de Pinar del Río / Educational strategy on chronic kidney disease at the Turcios Lima Polyclinic in Pinar del Río

RESUMEN Fundamento la enfermedad renal crónica se reconoce cada vez más como un problema de salud pública, debido al gran impacto económico y social que genera en la población. El conocimiento de aspectos relacionados con el autocuidado y factores de riesgo por los pacientes puede contribuir a una mejor calidad de vida de estos. Objetivo exponer los resultados de una estrategia de intervención educativa sobre la enfermedad renal crónica. Métodos: se realizó un estudio descriptivo, de antes y después, en pacientes con enfermedad renal crónica de 16 consultorios urbanos (N=60) pertenecientes al Policlínico Luis A. Turcios Lima, durante 2019. Se aplicaron encuestas a los pacientes antes y después de la intervención, la cual estuvo orientada a elevar el nivel de conocimientos acerca de aspectos de interés relacionados con la enfermedad. Se utilizó la prueba de McNemar al 95 % de certeza para comparar los resultados. Resultados antes de la intervención cerca del 70 % de los pacientes no identificaron adecuadamente la enfermedad; luego de ella, más del 93 % de los pacientes refirieron haber adquirido esos conocimientos. Lo mismo sucedió con los factores de riesgo, las manifestaciones clínicas, complicaciones, diagnóstico, la prevención y el tratamiento, con diferencia estadísticamente significativa en todos los casos. Conclusión proporcionar educación a los pacientes sobre la enfermedad renal crónica y sus opciones de tratamiento, incrementa su nivel de conocimientos, su capacidad de comprender, razonar y realizar acciones favorables a su estado de salud.

ABSTRACT Background Chronic kidney disease is increasingly recognized as a public health problem, due to the great economic and social impact it generates in the population. Knowledge of aspects related to self-care and risk factors by patients can contribute to a better quality of life for them. Objective to present the results of an educational intervention strategy on chronic kidney disease. Methods a descriptive study was carried out, before and after, in patients with chronic kidney disease from 16 urban clinics (N=60) belonging to the Luis A. Turcios Lima Polyclinic, during 2019. Surveys were applied to patients before and after the intervention, which was aimed at raising the knowledge level about aspects of interest related to the disease. McNemarˈs test at 95% certainty was used to compare the results. Results before the intervention about 70% of the patients did not properly identify the disease; after it, more than 93% of the patients reported having acquired this knowledge. The same happened with risk factors, clinical manifestations, complications, diagnosis, prevention and treatment, with a statistically significant difference in all cases. Conclusion providing education to patients about chronic kidney disease and its treatment options increases their level of knowledge, their ability to understand reason and take actions favorable to their health status.

Diagnóstico incidental de hipertensión arterial en el primer nivel de salud / Incidental diagnosis of high blood pressure at the first level of health

La hipertensión arterial (HTA) es el principal factor relacionado con la mortalidad en todo el mundo. Según la Organización Mundial de la Salud es un trastorno que causa casi la mitad de todas las defunciones por accidente cerebrovascular o cardiopatía. Se estima que afecta alrededor de 250 millones de personas en Las Américas,(1) mientras que en Cuba se reporta una prevalencia del 30,9 por ciento en personas de 15 o más años de edad.(2) Lo anterior motivó a los autores a realizar, como parte de la tesis de terminación de especialidad en Medicina General Integral, un estudio que permitiese determinar la eficacia del score de riesgo de hipertensión arterial de Framingham en la predicción de la enfermedad a corto plazo (1 año) en pacientes...(AU)

ACTN-3 and ECA genes expression do not influence the acute change in muscle mechanical and functional properties in youth handballers / Expresiones de los genes ACTN-3 y ECA no influyen en el cambio agudo de las propiedades musculares mecánicas y funcionales en jugadores juveniles de balonmano

The purpose of this study was to explore the potential relationship between ACTN-3 and ACE gene expression over the change in muscle mechanical and functional properties in youth handballers through a congested tournament. 30 players of the first handball division of Costa Rica participated in this study. The participants played a national tournament during three consecutive days (one match per day). The collection of genetic samples was through a mouth rinse with a 5% sucrose solution before the tournament. PCR tests were used to detect the alleles of the ACE and ACTN3 genes and the product ́s reaction was visualized by electrophoresis. Before and after each match, tensiomyography (TMG) and Countermovement jump (CMJ) tests were used to assess mechanical and functional properties respectively. Descriptive frequency analyses and a one-way analysis of variance of independent groups were the statistics test applied. The results showed that the most prevalent polymorphisms expression was ACTN-3 R-X (56.7%) and ECA I-D (43.3%). No significant differences (p> 0.050) were found between genes expressed in the mechanical responses (contraction time (TC), delay time (TD) and, maximum radial displacement (DM)) of the rectus femoral muscle of the dominant leg neither in performance in the test CMJ. Likewise, there was no significant change (p> 0.050) in muscle mechanical or functional properties post official matches. In conclusion, handball players have the genes ACE and ACTN. Nevertheless, it seems to have no influence of these genes on the mechanical or functional muscles acute responses. More investigations will be needed to explain and understand the real impact of this gene’s expression on muscle performance in handball players.(AU)

El propósito de este estudio fue explorar la relación potencial entre la expresión ACTN-3 y ACE sobre el cambio en las propiedades musculares mecánicas y funcionales de jugadores juveniles de balonmano a través de un torneo congestionado. Participaron 30 jugadores de la primera división de balonmano de Costa Rica. Los participantes jugaron un torneo nacional durante tres días consecutivos. La recolección de muestras genéticas se realizó mediante un enjuague bucal con una solución de sacarosa al 5% antes del inicio del torneo. Pruebas de PCR fueron usadas para detectar los aleros de los genes ACTN-3 y ACE y la reacción del producto fueron visualizadas por electroforesis. Antes y después de cada partido, se utilizaron las pruebas de tensiomiografía (TMG) y de salto contramovimiento (CMJ) para evaluar las propiedades mecánicas y funcionales respectivamente. Las pruebas estadísticas aplicadas fueron análisis descriptivo de frecuencias y un análisis de varianza de una vía para grupos independientes. Los resultados mostraron que la expresión de polimorfismos más prevalente fue ACTN-3 R-X (56,7%) y ECA I-D (43,3%). No se han encontrado diferencias significativas (p> 0,050) entre genes expresados en las respuestas mecánicas (tiempo de contracción (TC), tiempo de retardo (TD) and, máximo desplazamiento radial (DM)) del músculo recto femoral de la pierna dominante ni en el rendimiento en la prueba de CMJ. Asimismo, no hubo cambios significativos (p>0.050) en las propiedades mecánicas o funcionales de los músculos después de los partidos. En conclusión, los jugadores de balonmano tienen los genes ACE y ACTN, sin embargo, parece que estos genes no influyen en las respuestas agudas mecánicas o funcionales de los músculos. Se necesitan más investigaciones para explicar y comprender el impacto real de la expresión de estos genes en el rendimiento muscular de los jugadores de balonmano.(AU)

GSU1771 regulates extracellular electron transfer and electroactive biofilm formation in Geobacter sulfurreducens: Genetic and electrochemical characterization.

Type IV pili and the >100c-type cytochromes in Geobacter sulfurreducens are essential for extracellular electron transfer (EET) towards metal oxides and electrodes. A previous report about a mutation in the gsu1771 gene indicated an enhanced reduction of insoluble Fe(III) oxides coupled with increased pilA expression. Herein, a marker-free gsu1771-deficient mutant was constructed and characterized to assess the role of this regulator in EET and the formation of electroactive biofilms. Deleting this gene delayed microbial growth in the acetate/fumarate media (electron donor and acceptor, respectively). However, this mutant reduced soluble and insoluble Fe(III) oxides more efficiently. Heme staining, western blot, and RT-qPCR analyses demonstrated that GSU1771 regulates the transcription of several genes (including pilA) and many c-type cytochromes involved in EET, suggesting the broad regulatory role of this protein. DNA-protein binding assays indicated that GSU1771 directly regulates the transcription of pilA, omcE, omcS, and omcZ. Additionally, gsu1771-deficient mutant biofilms are thicker than wild-type strains. Electrochemical studies revealed that the current produced by this biofilm was markedly higher than the wild-type strains (approximately 100-fold). Thus, demonstrating the role of GSU1771 in the EET pathway and establishing a methodology to develop highly electroactive G. sulfurreducens mutants.

Factores de riesgo relacionados con enfermedad renal crónica. Policlínico Luis A. Turcios Lima, Pinar del Río, 2019

RESUMEN Fundamento La enfermedad renal crónica presenta una prevalencia elevada en Pinar del Río, Cuba, y constituye una de las principales causas de muerte; por ello se requiere obtener información de interés y que contribuya a su conocimiento. Objetivo determinar los factores de riesgo relacionados con la enfermedad renal crónica. Métodos se realizó un estudio de casos y controles, con pacientes pertenecientes a 16 consultorios del Policlínico Luis A. Turcios Lima, de Pinar del Río, en el periodo enero-diciembre de 2019. La selección de los participantes se realizó de forma aleatoria 1:2 (30 casos y 60 controles). El análisis estadístico se basó en una estrategia multivariada, la determinación del Odds Ratio, con intervalos de confianza al 95 %, y la prueba de Chi Cuadrado con un nivel de significación estadística de P<0,05. Se analizaron variables sociodemográficas, hábitos tóxicos, antecedentes familiares de enfermedad renal crónica y antecedentes patológicos personales, entre otras. Resultados los factores de riesgo identificados como de mayor incidencia fueron la edad por encima de 60 años, la obesidad, la hipercolesterolemia, los antecedentes patológicos personales de hipertensión arterial y la diabetes mellitus, así como la cardiopatía isquémica, las uropatías obstructivas y tener familiares con enfermedad renal crónica. Conclusión Los principales factores de riesgo fueron la presencia de antecedentes de la enfermedad en la familia, así como padecer hipertensión arterial y diabetes mellitus. Otras de las variables analizadas también se mostraron como tal, pero en menor medida.

ABSTRACT Background Chronic kidney disease has a high prevalence in Pinar del Río, Cuba, and is one of the main causes of death; so, it is necessary to obtain information of interest that contributes to its knowledge. Objective to determine the risk factors related to chronic kidney disease. Methods a case-control study was carried out, with patients belonging to the Luis A. Turcios Lima Polyclinic 16 doctor's office, in Pinar del Río, from January-December 2019. The selection of participants was carried out randomly 1:2 (30 cases and 60 controls). The statistical analysis was based on a multivariate strategy, the determination of the Odds Ratio, with 95% confidence intervals, and the Chi Square test with a level of statistical significance of P <0.05. Sociodemographic variables, toxic habits, family history of chronic kidney disease and personal pathological history, among others, were analyzed. Results the risk factors identified as having the highest incidence were age over 60 years old, obesity, hypercholesterolemia, personal pathological history of arterial hypertension and diabetes mellitus, as well as ischemic heart disease, obstructive uropathies and having relatives with chronic kidney disease. Conclusion The main risk factors were the presence of the disease family history, as well as suffering from high blood pressure and diabetes mellitus. Other variables analyzed were also shown as such, but to a lesser extent.

Neural correlates and determinants of approach-avoidance conflict in the prelimbic prefrontal cortex.

The recollection of environmental cues associated with threat or reward allows animals to select the most appropriate behavioral responses. Neurons in the prelimbic (PL) cortex respond to both threat- and reward-associated cues. However, it remains unknown whether PL regulates threat-avoidance vs. reward-approaching responses when an animals' decision depends on previously associated memories. Using a conflict model in which male Long-Evans rats retrieve memories of shock- and food-paired cues, we observed two distinct phenotypes during conflict: (1) rats that continued to press a lever for food (Pressers) and (2) rats that exhibited a complete suppression in food seeking (Non-pressers). Single-unit recordings revealed that increased risk-taking behavior in Pressers is associated with persistent food-cue responses in PL, and reduced spontaneous activity in PL glutamatergic (PLGLUT) neurons during conflict. Activating PLGLUT neurons in Pressers attenuated food-seeking responses in a neutral context, whereas inhibiting PLGLUT neurons in Non-pressers reduced defensive responses and increased food approaching during conflict. Our results establish a causal role for PLGLUT neurons in mediating individual variability in memory-based risky decision-making by regulating threat-avoidance vs. reward-approach behaviors.

Regularidades del trabajo metodológico en el proceso docente-educativo de la especialización en Medicina General Integral / Methodological regularities in the educative - teaching process associated to the specialty of Comprehensive General Medicine / Regularidades do trabalho metodológico no processo ensino-pedagógico da especialização em Medicina Geral Integral

RESUMEN Introducción: El perfeccionamiento del proceso de formación de especialistas en Medicina General Integral lleva implícito la modelación del trabajo metodológico acorde a las exigencias actuales. Objetivo: Determinar las tendencias del trabajo metodológico en el proceso docente-educativo de la especialización en Medicina General Integral en el Policlínico Docente "Dr. Modesto Gómez Rubio" de San Juan y Martínez, provincia Pinar del Río, durante el curso 2019-2020. Método: Investigación descriptiva y transversal durante el primer semestre del curso 2019-2020. El universo estuvo integrado por 142 profesionales, constituido por residentes, profesores, tutores y directivos de la especialidad de Medicina General Integral de dicha institución. Se utilizaron métodos empíricos y procedimientos de la estadística descriptiva. Resultados: Se determinaron las regularidades actuales del trabajo metodológico en el proceso docente-educativo de la especialización en Medicina General Integral en el policlínico antes mencionado. Conclusiones: De acuerdo con el desarrollo actual de la educación médica y la formación de especialistas en Medicina General Integral para su desempeño en la Atención Primaria de Salud, se hace necesario perfeccionar el trabajo metodológico del proceso docente educativo de esta especialidad, para una mayor contribución a la integralidad de los especialistas que se forman.

ABSTRACT Introduction: The quality improvement in the educational teaching process of specialist in Comprehensive General Medicine implies to perfome important methodological updated methods according to the current requirements. Objective: To determine the methodological methods used in the educational teaching process of specialist in Comprehensive General Medicine at the Policlínico Docente "Dr. Modesto Gómez Rubio" in San Juan y Martínez, Pinar del Río, from 2019 throughout 2020. Method: A descriptive and cross-sectional research during the first semester of the academic year 2019-2020 was conducted. A total of 142 health professionals like resident physicians, professors, tutors and head trainers in the Comprehensive General Medicine specialty were involved in this research. Empirical methods and descriptive statistical procedures were used. Results: Current trends concerning the educational teaching process of specialist in Comprehensive General Medicine at the mentioned clinic was determined. Conclusions: Considering the current development of medical education and the training process of specialist in Comprehensive General Medicine for their performance in Primary Health Care, it is necessary to improve the methodological methods in the educational teaching process of this specialty for a greater contribution in the integrality of specialists in training.

RESUMO Introdução: O aprimoramento do processo de formação de especialistas em Medicina Geral Integral implica a modelagem do trabalho metodológico de acordo com as exigências atuais. Objetivo: Determinar as tendências do trabalho metodológico no processo ensino-pedagógico da especialização em Medicina Geral Integral da Policlínico Docente "Dr. Modesto Gómez Rubio" de San Juan y Martínez, província de Pinar del Río, durante o ano acadêmico 2019-2020. Método: Pesquisa descritiva e transversal durante o primeiro semestre do ano letivo 2019-2020. O universo foi composto por 142 profissionais, entre residentes, professores, tutores e diretores da especialidade de Medicina Geral Integral da referida instituição. Foram utilizados métodos empíricos e procedimentos de estatística descritiva. Resultados: Foram determinadas as regularidades atuais do trabalho metodológico no processo ensino-educativo da especialização em Medicina Geral Integral na referida policlínica. Conclusões: De acordo com o atual desenvolvimento da educação médica e da formação de especialistas em Medicina Geral Integral para sua atuação na Atenção Básica à Saúde, é necessário aprimorar o trabalho metodológico do processo pedagógico pedagógico desta especialidade, para uma maior contribuição para a integralidade dos especialistas formados.

Conocimientos de los médicos de familia sobre los factores de riesgo de la enfermedad renal crónica / Knowledge of family physicians concerning the risk factors of chronic kidney disease

RESUMEN Introducción: la enfermedad renal crónica se reconoce cada vez más como un problema de salud pública de gran importancia. Objetivo: determinar el nivel de conocimientos sobre los factores de riesgo de la enfermedad renal crónica de los médicos del Policlínico Universitario Hermanos Cruz de Pinar del Río, durante el año 2020. Métodos: investigación observacional, descriptiva y transversal, con un universo de 70 médicos de la familia del Policlínico Universitario Hermanos Cruz de Pinar del Río. La muestra la constituyeron 65 médicos, según criterios de inclusión y exclusión; se utilizaron métodos teóricos, empíricos y estadísticos. Resultados: el 60 % de los médicos afirmaron la importancia de la identificación de factores de riesgo para la aplicación de intervenciones terapéuticas en fases más tempranas, el 41,5 % refirió no saber que, el control de los factores de riesgo cardiovascular es efectivo para disminuir el inicio y la progresión de la enfermedad, el 41,5 % de los médicos no conocen que la proteinuria positiva en dos muestras de orina es el marcador más importante y precoz de daño renal; el 70,7 % reconocen que en pacientes fumadores, se recomienda la abstinencia o el abandono del hábito tabáquico, y el 73,8 % declararon no conocer sobre aspectos relacionados con la restricción de proteínas en la dieta. Conclusiones: los médicos de la familia del Policlínico Universitario Hermanos Cruz del municipio Pinar del Río, presentan insuficiente conocimiento acerca de los factores de riesgo de la ERC.

ABSTRACT Introduction: chronic kidney disease is every time more recognized as a public health care problem of great importance. Objective: to determine the level of knowledge concerning the risk factors of chronic kidney disease of family physicians from Hermanos Cruz Polyclinic during the year 2020. Methods: an observational, descriptive and cross-sectional research, having a target group of 70 family physicians from Hermanos Cruz Polyclinic, Pinar del Rio municipality was conducted. The sample comprised 65 physicians according to inclusion and exclusion criteria; theoretical, empirical and statistical methods were applied. Results: sixty percent (60 %) of the physicians considered it is important to identify the risk factors, which will allow the application of therapeutic interventions in early stages, 41,5 % reported not knowing that the control of cardiovascular risk factors is effective in reducing the onset and progression of the chronic kidney disease; 41,5 % of the physicians did not know that positive proteinuria in two urine samples is the most important and early marker of renal damage; 70,7 % of them referred that they know that in patients who smokes the abstinence or smoking cessation is recommended and 73,8 % reported not knowing about aspects related to protein-restrictions in the diet. Conclusions: family physicians from Hermanos Cruz Polyclinic, Pinar del Rio municipality, have deficiencies related to knowledge concerning the risk factors of chronic kidney disease.

Propuesta de metodología para el proceso enseñanza-aprendizaje de la medicina natural y tradicional en Pediatría / Methodological proposal for the teaching-learning process of Natural and Traditional Medicine in Pediatrics

RESUMEN Introducción: el proceso enseñanza aprendizaje de medicina natural y tradicional en la especialidad de pediatría de la Universidad de Ciencias Médicas de Pinar del Río, responde a la necesidad de formar profesionales de la salud con elevado nivel científico. Objetivo: elaborar una metodología para el proceso de enseñanza aprendizaje de la medicina natural y tradicional en la especialidad de pediatría, para el tratamiento de las enfermedades en el niño. Métodos: se realizó una investigación de desarrollo, se utilizaron métodos teóricos y empíricos. Resultados: la metodología propuesta se estructuró en etapas: planificación y organización del proceso de enseñanza aprendizaje de la medicina natural y tradicional en la especialidad de pediatría, ejecución del proceso de enseñanza aprendizaje de la medicina natural y tradicional con la participación activa del residente de pediatría y control del proceso de enseñanza aprendizaje de la medicina natural y tradicional sustentada en las relaciones entre las competencias profesionales y las formas de educación en trabajo como rectoras en la formación de los especialistas en pediatría, para potenciar y fomentar el dominio de las acciones y operaciones conformadoras del modo de actuación para el ejercicio de la profesión para un mejor desempeño profesional. Conclusiones: la puesta en práctica de la metodología permitirá fortalecer el desempeño profesional de los pediatras en formación, en la aplicación de la medicina natural y tradicional.

ABSTRACT Introduction: the teaching-learning process of Natural and Traditional Medicine in the specialty of pediatrics at Pinar del Rio University of Medical Sciences, responds to the need of training healthcare professionals with a high scientific level. Objective: to formulate a methodology for the teaching-learning process of Natural and Traditional Medicine in the specialty of pediatrics, for the treatment of diseases in childhood. Methods: a developmental research was carried out, using theoretical and empirical methods. Results: the proposed methodology was structured in stages: planning and organization of the teaching-learning process of Natural and Traditional Medicine in the specialty of pediatrics, the implementation of the teaching-learning process of Natural and Traditional Medicine with the active participation of the residents in pediatrics and the control of the teaching-learning process for the mastering of Natural and Traditional Medicine, supported on the relations between professional competences and the structure of in-service education as a guiding method for the training of specialists in pediatrics, in order to promote and encourage the mastery of actions and operations in agreement with the mode of acting for the exercise of the profession, and as a result it can be materialized in a better professional performance. Conclusions: the implementation of the methodology will allow strengthening the professional performance of future pediatricians concerning the application of Natural and Traditional Medicine.

Producción científica del Policlínico Universitario Fermín Valdés Domínguez en el periodo 2000-2019 / Scientific production at Fermin Valdes Dominguez University Polyclinic in the period 2000-2019

RESUMEN Introducción: la producción científica de un sector o institución está representada por el conjunto de publicaciones que se generan en sus respectivos ámbitos. Objetivo: describir la producción científica de los profesionales del Policlínico Universitario Fermín Valdés Domínguez entre 2000 y 2019. Métodos: se realizó un estudio bibliométrico de los artículos publicados en revistas científicas cuyos autores declarasen al del Policlínico Universitario Fermín Valdés Domínguez como su afiliación institucional. Se analizaron indicadores de productividad y visibilidad. Resultados: se publicaron nueve artículos científicos por profesionales del policlínico en los 20 años analizados. La Revista de Ciencias Médicas de Pinar del Río fue la más empleada para publicar (88,9 %). El 66,7 % de los artículos fueron citados y en el 44,4 % los profesionales del policlínico lideraron la investigación. Se promedió dos autores por artículo, y las especialidades con más autores fueron Medicina Interna (25,7 %), Estomatología (22,2 %) y Medicina General Integral (22,2 %). Los temas con más frecuencia abordados fueron de ciencias estomatológicas (44,4 %). Según el grado de productividad, se cuantificó un aspirante y al resto como transeúntes. Los artículos Originales fueron la tipología predominante (n=7). Conclusiones: se reportó una baja producción científica de la institución en el período estudiado, donde la Revista de Ciencias Médicas de Pinar del Río fue el destino final de gran parte de esta producción. Las ciencias estomatológicas aportaron altos porcientos de los temas y autores publicados. Emprender estrategias que estimulen la producción científica del centro, constituye una meta impostergable.

ABSTRACT Introduction: the scientific production of a sector or institution is represented by the set of publications generated in their respective fields. Objective: to describe the scientific production of the healthcare professionals from Fermin Valdes Dominguez Polyclinic between 2000 and 2019. Methods: a bibliometric study of the articles published in scientific journals whose authors declared Fermin Valdes Dominguez Polyclinic as their institutional affiliation was conducted; analyzing productivity and visibility as indicators. Results: nine scientific articles were published by professionals of the polyclinic throughout the 20 years analyzed. Pinar del Rio Journal of Medical Sciences was the most used for publication (88,9 %). The 66,7 % of the articles were cited and in 44,4 % the professionals from the polyclinic led the research. The average number of authors per article was two, and the specialties with more authors were Internal Medicine (25,7 %), Dentistry (22,2 %) and General Comprehensive Medicine (22,2 %). The topics most frequently dealt with dentistry-related sciences (44,4 %). According to the degree of productivity, one applicant was quantified and the rest as bystanders. Original articles were the predominant typology (n=7). Conclusions: a low scientific production of the institution was reported in the period under study, where Pinar del Rio Journal of Medical Sciences was the final allocation to most of this production. Dentistry-related sciences contributed to the higher percentages of the topics and the authors published. Undertaking strategies to encourage the scientific production of the center, which is a goal that cannot be postponed.

Nivel de conocimiento de los aptos no incorporados a donar de la Guabina / Level of knowledge of those who are apt but not willing to donate blood in la Guabina people's council

RESUMEN Introducción: las donaciones de sangre se realizan a través de personal calificado proveniente de los bancos e instituciones preparadas para dicha actividad. Objetivo: evaluar el nivel de conocimientos sobre donaciones de sangre de los aptos no incorporados a donar, de tres consultorios del consejo popular La Guabina. Métodos: se realizó una investigación observacional, descriptiva y transversal en los consultorios 45, 35 y 25 pertenecientes al consejo popular La Guabina del municipio Pinar del Río, en el período comprendido entre 1ro de septiembre de 2017 y 15 de marzo de 2018. El universo de estudio estuvo constituido por 236 pacientes de 18 a 65 años, aptos para donar sangre no incorporados a dicho proceso de los tres consultorios seleccionados. Resultados: predominó el sexo femenino (52,97 %). El grupo etario que predominó fue de 45 a 49 (13,98 %). La principal causa por las que no donaban los no incorporados era el miedo a la punción (61,44 %). En cuanto a los conocimientos sobre donación de sangre, predominó el nivel regular en temas donación voluntaria de sangre (48,73 %), sangre de la donación (52,12 %) y lo que sucede con una donación de sangre (50,85 %); se alcanzaron altas calificaciones de regular en el nivel de conocimientos global sobre donación de sangre (40,25%). Conclusiones: una intervención educativa sobre donaciones de sangre podría incrementar el nivel de conocimientos de los participantes e incorporarlos al proceso de donación de sangre.

ABSTRACT Introduction: qualified personnel who work in blood banks and institutions prepared for such activity perform blood donations. Objective: to assess the level of knowledge concerning blood donation of those who are apt but not willing to donate at three doctor's offices in la Guabina people's council. Methods: an observational, descriptive and cross sectional research was conducted at 45, 35 and 25 doctor's offices from la Guabina People's Council, Pinar del Rio municipality from September 1 ,2017 to March 15, 2018. The target group comprised 236 patients (18 to 65 years old); who are apt to donate blood but not willing to be involved in such process from the doctor's offices chosen. Results: female gender prevailed (52,97 %). The age group that predominated was 45-49 (13,98 %). The main cause of denial was the fear of puncture (61,44 %). The level of knowledge concerning blood donation, fair level predominated in topics related to voluntary blood donation (48,73 %), the donation of blood (52,12 %), along with what follows with the donation (50.85 %); reaching high grades of fair concerning the level of global knowledge of blood donation (40,25 %). Conclusions: an educational intervention concerning blood donation could increase the levels of knowledge in the participants, aimed at including them into the process.

Dehydroepiandrosterone increases tonic and phasic dopamine release in the striatum.

Dehydroepiandrosterone (DHEA) modulates dopaminergic neurotransmission. It takes part in neurologic and psychiatric diseases involving monoamine neurotransmitters. Earlier results show that DHEA (120-min treatment) reduced striatal dopamine (DA) turnover in rats, suggesting a reduced DA release. Some investigations report that DHEA increases DA release but inhibits motor activity, which seems contradictory. This research examines the effect of DHEA on striatal DA release, its metabolism and motor activity. Male Wistar rats were implanted in the striatum with a cannula for in vivo microdialysis. DHEA was administered (120 mg/kg) and dialysates were collected for 280 min. A depolarizing stimulus was applied at 120 min. Samples were analyzed by HPLC-ED to determine the concentration of DA and its metabolites. The effect of DHEA on motor activity was also evaluated during 120 min. Extracellular DA concentration was greater in treated animals both before and after depolarization. In contrast, DHEA reduced the areas below the curves for DA metabolites and DA/metabolite ratios. DHEA also reduced motor activity, remarkably in the first 20 min after treatment. In summary, DHEA yielded a stimulatory effect on striatal DA release that was not reflected in neither DA metabolism nor motor activity. Thus, DHEA resembles the effect of typical antipsychotics, increasing DA release but reducing behavioral activation.

Histamine H3 receptor activation reduces the impairment in prepulse inhibition (PPI) of the acoustic startle response and Akt phosphorylation induced by MK-801 (dizocilpine), antagonist at N-Methyl-d-Aspartate (NMDA) receptors.

We have investigated the effect of the local activation of histamine H3 receptors (H3Rs) in the rat prefrontal cortex (PFCx) on the impairment of pre-pulse inhibition (PPI) of the startle response induced by the systemic administration of MK-801, antagonist at glutamate N-Methyl-d-Aspartate (NMDA) receptors, and the possible functional interaction between H3Rs and MK-801 on PFCx dopaminergic transmission. Infusion of the H3R agonist RAMH (19.8 ng/1 µl) into the PFCx reduced or prevented the inhibition by MK-801 (0.15 mg/kg, ip) of PPI evoked by different auditory stimulus intensities (5, 10 and 15 dB), and the RAMH effect was blocked by the H3R antagonist/inverse agonist ciproxifan (30.6 ng/1 µl). MK-801 inhibited [3H]-dopamine uptake (-45.4 ±â€¯2.1%) and release (-32.8 ±â€¯2.6%) in PFCx synaptosomes or slices, respectively, and molecular modeling indicated that MK-801 binds to and blocks the rat and human dopamine transporters. However, H3R activation had no effect on the inhibitory action of MK-801 on dopamine uptake and release. In PFCx slices, MK-801 and the activation of H3Rs or dopamine D1 receptors (D1Rs) stimulated ERK-1/2 and Akt phosphorylation. The co-activation of D1Rs and H3Rs prevented ERK-1/2 and Akt phosphorylation, and H3R activation or D1R blockade prevented the effect of MK-801. In ex vivo experiments, the intracortical infusion of the D1R agonist SKF-81297 (37 ng/1 µl) or the H3R agonist RAMH increased Akt phosphorylation, prevented by D1R/H3R co-activation. These results indicate that MK-801 enhances dopaminergic transmission in the PFCx, and that H3R activation counteracts the post-synaptic actions of dopamine.