Sistema de Gestión Hospitalaria para la atención de la pareja infértil. Centro Territorial de Holguín, 2021

Introducción: La infertilidad es una enfermedad del sistema reproductivo que altera el equilibrio biológico, psicológico y social de las parejas. En Cuba existe un programa para el tratamiento de la pareja infértil y el Ministerio de Salud Pública incluye en sus directrices implementar las bases organizativas, sistema de trabajo, indicadores, funciones y control que garanticen el perfeccionamiento del Programa para la óptima atención de parejas infértiles, y dentro de esto se incluye confeccionar bases de datos donde se registren las parejas tratadas por este motivo. Objetivos: Implementar un Sistema de Gestión Hospitalaria para la atención de la pareja infértil, en el Centro Territorial de Holguín. Métodos: Se realizó un estudio de desarrollo tecnológico, se confeccionó sobre el sistema de base de datos relacional postgreSQL, se empleó la herramienta Odoo con el objetivo de englobar en un único software todas las prestaciones que necesita la consulta. Se utilizó el lenguaje de programación Python. Resultados: SCAPI, permite gestionar la información de los pacientes y sus historias clínicas, está compuesto por módulos relacionados: configuración general, permite crear los perfiles de usuarios y los permisos para interactuar con el sistema; SCAPI muestra y gestiona toda la información relacionada con la historia clínica digital, la agenda de turnos, medios diagnósticos (estudios de reserva ovárica, espermogramas, ecografías ováricas, estudios hormonales, técnicas de baja y alta tecnología entre otros). Conclusiones: El Sistema de Gestión Hospitalaria para la atención de la pareja infértil, contribuye al objetivo de una mayor calidad de la atención al paciente pues gestiona la información de estos y sus historias clínicas de manera rápida, oportuna y fiable.

Introduction: Biological infertility is a disease of the reproductive system that alters the psychological and social balance of couples. In Cuba there is a program for the treatment of infertile women and the Ministry of Public Health includes in its guidelines to implement the organizational bases, work system, indicators, functions and control that guarantee the improvement of the Program, including databases where couples treated for this reason are registered. Objective: To implement a Hospital Management System for the infertile couple care in the Holguín Territorial Center. Methods: A study of technological development was carried out using postgre SQL relational database system, Odoo tool, and Python programming language. Results: SCAPI allows to manage the information of patients and their medical records; it is made up of modules that are related to each other: the general configuration module which allows you to create user profiles and permissions to interact with the system; the SCAPI module which shows and manages all the information related to the digital medical history, appointment schedules, and diagnostic means (ovarian reserve studies, spermograms, ovarian ultrasound, hormonal studies, low and high technology techniques, among others). Conclusions: Hospital Management System for the care of infertile couples allows managing fast, timely and reliable information on patients and their medical records during care consultations for infertile couples with the aim of achieving a higher quality of patient care.

Pseudo-multicomponent reactions.

Classical multicomponent reactions (MCRs) are domino-type one-pot processes in which three or more different reactants are combined sequentially in the same reactor to synthesize compounds containing all or almost all atoms coming from the reactants. Besides, pseudo-MCRs are also domino-type one-pot processes involving combinations of at least three reactants but in which at least one of them takes part in two or more reaction steps. In consequence, the products synthesized through pseudo-MCRs contain also all or almost all atoms but coming from two or more identical reactants. Thus, pseudo-MCRs differ from classical MCRs because the first ones appear to involve an assembly of a higher number of different components than those that are being truly assembled. However, pseudo-MCRs are also useful synthetic tools to generate libraries of complex compounds in few experimental steps, and although the repeated reactants may make them appear less diverse than classical MCRs, this can be offset by the higher number of reactants that can participate in this type of reaction. Overall, there are two types of pseudo-MCRs. The first are those in which the duplicated reagents participate in different steps of the corresponding reaction mechanism. The second kind of pseudo-MCRs are those in which one or more components react simultaneously with a main reagent containing two or more identical functional groups. These latter are known as repetitive pseudo-MCRs. Thus, the aim of the present review is to cover for the first time selected works mainly published in the last two decades about pseudo-MCRs and their repetitive versions toward the synthesis of novel, complex, and highly symmetrical molecules, often including their interesting applications in various fields of science and technology. The manuscript has been categorized considering the number of reagents participating in the corresponding pseudo-MCRs, aiming to give readers novel insights for their future investigations.

Características clinicoepidemiológicas de pacientes sospechosos y confirmados con la COVID-19 en una comunidad con régimen de cuarentena / Clinical epidemiological characteristics of suspicious and confirmed patients with COVID-19 in a community with quarantine regime i: en

Introducción: Para una comunidad densamente poblada con alto riesgo epidemiológico, las enfermedades infecciosas pudieran presentar una rápida expansión. Objetivo: Describir las características clínicas y epidemiológicas de pacientes sospechosos y confirmados con la COVID-19 durante el régimen de cuarentena. Métodos: Se realizó un estudio descriptivo y transversal de 62 pacientes sospechosos y confirmados con la COVID-19, quienes se encontraban en régimen de cuarentena, pertenecientes al Consejo Popular Santa Bárbara de Santiago de Cuba, desde enero hasta febrero de 2021. La información se obtuvo de las encuestas epidemiológicas. Se analizaron las siguientes variables: edad, sexo, comorbilidades, tipo de caso, estado clínico, resultado del PCR, tipo de contacto, signos y síntomas. Resultados: Predominaron el sexo femenino (59,7 %) y los adultos mayores de 60 años de edad (32,3 %). Entre las comorbilidades, la hipertensión arterial (40,3 %) tuvo mayor frecuencia. Resultaron sintomáticos no confirmados 67,3 % de los pacientes. Sobresalieron los sospechosos (82,1 %) con contactos intradomiciliarios. Entre los signos y síntomas, la fiebre (41,2 %) y la diarrea (40 %) prevalecieron entre los confirmados. Todos los pacientes asintomáticos fueron positivos al virus (100,0 %). Conclusión: Se presentaron, en gran medida, las principales características clínicas y epidemiológicas de los pacientes sospechosos y confirmados con la COVID-19 en régimen de cuarentena, lo cual se convirtió en un importante instrumento para adoptar decisiones en escenarios de alto riesgo epidemiológico.

Introduction: For a community densely populated with high epidemiologic risk, infectious diseases could present a quick spreading. Objective: To describe the clinical and epidemiologic characteristics of suspicious and confirmed patients with COVID-19 during the quarantine. Methods: A descriptive and cross-sectional study of 62 suspicious and confirmed patients with COVID-19 who were in quarantine was carried out, belonging to the Santa Bárbara neighborhood in Santiago de Cuba, from January to February, 2021. The information was obtained from the epidemiologic surveys. The following variables were analyzed: age, sex, comorbidities, type of case, clinical state, result of the PCR, type of contact, signs and symptoms. Results: There was a prevalence of the female sex (59.7 %) and elderly over 60 years (32.3 %). Among the comorbidities, hypertension (40.3 %) had the greater frequency. There was a 67.3 % of symptomatic non confirmed patients. Suspicious patients with home contacts stood out with 82,1 %. Between the signs and symptoms, fever (41.2 %) and diarrhea (40 %) prevailed among those confirmed. All the asymptomatic patients were positive to the virus (100.0 %). Conclusion: The main clinical and epidemiologic characteristics of the suspicious and confirmed patients with COVID-19 in quarantine were presented to a great extent, which became an important instrument to adopt decisions in scenarios of high epidemiologic risk.

Prediction methods of maxillary canine impaction: a systematic review.

OBJECTIVE: To describe and assess the available evidence of prediction methods of maxillary canine impaction (MCI). MATERIAL AND METHODS: A systematic search was conducted through PubMed, Cochrane Library, Embase, EBSCOhost, Scopus, ScienceDirect, Bireme and Scielo until December 2020. This systematic review was conducted according to the PRISMA statement. The methodology of the selected studies was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). RESULTS: A total of 2391 articles were identified in the first approach and after a 2-phase selection, 11 studies were included in qualitative analysis. Prediction methods were constructed using equation-based models, geometric measurements and computational methods from clinical and imaging data to predict palatal/buccal MCI. The quality of evidence was low to moderate due to the presence of risk of bias in most of the studies included. Three cohort studies with the best methodological quality proposed prediction models based on geometric measurements, canine position and facial growth pattern that would allow predicting MCI from CBCT, lateral and panoramic radiographs. CONCLUSIONS: The evidence is limited and most of the studies present a low methodological quality. However, it is possible to suggest that some prediction methods based on the position of the canine and facial growth pattern could predict palatal/buccal MCI in mixed dentition. Cohort studies with better methodological quality and long-term follow-up are needed to better validate a prediction model.

Micromotion analysis of immediately loaded implants with Titanium and Cobalt-Chrome superstructures. 3D finite element analysis.

OBJECTIVE: The aim of this study was to evaluate the amount of micromotion of dental implants under immediate loading supported by Titanium (Ti) and Cobalt-Chrome (Co-Cr) superstructures. MATERIAL AND METHODS: A model of tridimensional half-edentulous maxilla with three dental implants was made using the Finite Element Analysis (FEA). Two standard and one zygomatic implants were connected to a superstructure with an elliptic section of 6x 3 mm (mm). Two study models were established. Model A: Titanium (Ti) alloy superstructure; Model B: Cobalt-Chrome (Co-Cr) alloy superstructure. To simulate an immediate-loading situation, a friction coefficient of 0.71 was applied between the implant and the bone surface. An axial load of 252.04 [N] was applied on standard and zygomatic implants. RESULTS: The Micromotion of dental implants was similar in both superstructure situations. The amount of micromotion was slightly higher in B1 and B3 models (Co-Cr alloy-superstructure) compared with A1 and A3 models (Titanium alloy superstructure). The micromotion values in two groups were greater than 150 µm in the incisive region (standard implant) and molar region (zygomatic). In general, the micromotion was higher on the implant that received the load with respect to the other implants. The greater difference was observed when the load was applied on the standard implant A1 (Model A1 = 189.12 µm) compared with standard implant B1(Model B1 = 263.25 µm). CONCLUSIONS: Within the limits of present study, all implants on different load application points showed micromotion; in general, the amount of micromotion was slightly higher in the implants connected with Co-Cr alloy superstructure.

Craniofacial growth predictors for class II and III malocclusions: A systematic review.

OBJECTIVE: To evaluate the validity of craniofacial growth predictors in class II and III malocclusion. MATERIAL AND METHODS: An electronic search was conducted until August 2020 in PubMed, Cochrane Library, Embase, EBSCOhost, ScienceDirect, Scopus, Bireme, Lilacs and Scielo including all languages. The articles were selected and analyzed by two authors independently and the selected studies was assessed using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The quality of evidence and strength of recommendation was assessed by the GRADE tool. RESULTS: In a selection process of two phases, 10 articles were included. The studies were grouped according to malocclusion growth predictor in (1) class II (n = 4); (2) class III (n = 5) and (3) class II and III (n = 1). The predictors were mainly based on data extracted from cephalometries and characterized by: equations, structural analysis, techniques and computer programs among others. The analyzed studies were methodologically heterogeneous and had low to moderate quality. For class II malocclusion, the predictors proposed in the studies with the best methodological quality were based on mathematical models and the Fishman system of maturation assessment. For class III malocclusion, the Fishman system could provide adequate growth prediction for short- and long-term. CONCLUSIONS: Because of the heterogeneity of the design, methodology and the quality of the articles reviewed, it is not possible to establish only a growth prediction system for class II and III malocclusion. High-quality cohort studies are needed, well defined data extraction from cephalometries, radiographies and clinical characteristics are required to design a reliable predictor.

Bottleneck Effect Explained by Le Bail Refinements: Structure Transformation of Mg-CUK-1 by Confining H2O Molecules.

The structure transformation of Mg-CUK-1 due to the confinement of H2O molecules was investigated. Powder X-ray diffraction (PXRD) patterns were collected at different H2O loadings and the cell parameters of the H2O-loaded Mg-CUK-1 material were determined by the Le Bail strategy refinements. A bottleneck effect was observed when one hydrogen-bonded H2O molecule per unit cell (18% relative humidity (RH)) was confined within Mg-CUK-1, confirming the increase in the CO2 capture for Mg-CUK-1.

Evaluation of short-term effectiveness of orthopedic manual therapy in signs and symptoms of myofascial pain: a controlled clinical trial / Evaluación de la eficacia a corto plazo de la terapia manual ortopédica en signos y síntomas de dolor miofascial: un ensayo clínico controlado

To evaluate the short-term effectiveness of orthopedic manual therapy (OMT) in signs and symptoms of myofascial pain (MFP) in young adults. Materials and Methods: An experimental controlled clinical study was performed in young adults between 19 and 24 years old. Thirty-one patients with MFP according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were divided into two groups. Group A: Orthopedic Manual Therapy (n=16; 10 females, 6 males; 21.6 ± 1.70 years old), and Group B: Control group (n=15; 10 females, 5 males; 20.9 ± 2.00 years old). The participants of group A were treated for a period of 6 weeks; Six therapeutic interventions were performed. Degree of dysfunction (Helkimo index), pain level (VAS scale), and range of mandibular movements (opening and lateral movements) were taken at baseline (T0) and immediately at post-treatment (T1). The data were analyzed with chi-square test and t-test; p<0.05 was considered significant. Result: After the OMT, there were no significant changes in diagnosis of MFP according to RDC/TMD (p=0.41); however, there was a statistically significant improvement in the Helkimo index (p=0.0083) and the level of pain according to the VAS scale (p=0.0004). Mandibular movements did not show significant differences (p>0.05). Conclusion: This study suggested that a 6-week period of OMT treatment has a clinically significant effect in pain level and degree of dysfunction in patients with MFP. A longer follow-up study is required to better assess the effects of manual therapy.

Evaluar la efectividad a corto plazo de la terapia manual ortopédica (TMO) en los signos y síntomas del dolor miofascial (DMF) en adultos jóvenes. Materiales and Métodos: Se realizó un estudio clínico controlado en adultos jóvenes entre 19 y 24 años. Treinta y un pacientes fueron diagnosticados con DMF según los criterios de diagnóstico para trastornos tempo-romandibulares (CDI/TTM) y se dividieron en dos grupos. Grupo A: Terapia manual ortopédica (n = 16; 10 mujeres, 6 hombres; 21,6 ± 1,70 años), y Grupo B: grupo de control (n = 15; 10 mujeres, 5 hombres; 20,9 ± 2,00 años). Los participantes del grupo A fueron tratados por un período de 6 semanas. Se realizaron seis intervenciones terapéuticas. El grado de disfunción (índice Helkimo), el nivel de dolor (escala EVA) y el rango de movimientos mandibulares (movimientos de apertura y laterales) se evaluaron al inicio del estudio (T0) e inmediatamente después del tratamiento (T1). Los datos se analizaron con la prueba de chi-cuadrado y la prueba t de student; se consideró significativo cuando p fue menor a 0.05. Resultados: Después de la TMO, no hubo cambios significativos en el diagnóstico de DMF según CDI /TTM (p=0,41); sin embargo, hubo una mejora estadísticamente significativa en el índice Helkimo (p=0.0083) y el nivel de dolor según la escala EVA (p= 0.0004). Los movimientos mandibulares no mostraron diferencias significativas (p>0.05). Conclusión: Este estudio sugirió que un período de 6 semanas de tratamiento con TMO tiene un efecto clínicamente significativo en el nivel de dolor y el grado de disfunción en pacientes con DMF. Se requiere un estudio de largo plazo para evaluar de mejor forma el efecto de la terapia manual ortopédica.

Predicting the optimal depth of ultrasound-guided right internal jugular vein central venous catheters in neonates.

BACKGROUND: Poor positioning of a central venous catheter (CVC) can cause severe complications. The objective is to create a formula that predicts the optimal insertion depth of a real time ultrasound-guided CVC in the right internal jugular vein (RIJV) in newborns. METHODS: Between 2015 and 2017, 91 newborns that required a CVC were included in a prospective observational study. Variables such as gestational age, gender, weight, height, and neck length were studied. On the chest x-ray, the distance between the insertion site on the skin and the catheter tip was measured. RESULTS: Of the patients included, 50 (54.9%) were males and 40 (44.4%) females; 64 (70.3%) were preterm. Mean gestational age was 33.44 (25 to 41) weeks, weight 2020 (580 to 3980) g, and height 43.04 (26 to 53) cm. Variables were correlated with catheter length and an algorithm was modeled for the introduction method, in which the highest corrected determination coefficient was obtained for weight (R2 = 0.723). CONCLUSION: This study demonstrated that the weight of the newborn was the most significant individual predictor of optimal insertion depth of a CVC in the RIJV. The formula Y = 2.6 + 0.7 (weight in kg) that we suggest is practical and reproducible. LEVEL OF EVIDENCE: Level IV.

Effects of raloxifene on cognition in postmenopausal women with schizophrenia: a 24-week double-blind, randomized, parallel, placebo-controlled trial.

We assessed the utility of raloxifene (60 mg/day) as an adjuvant treatment for cognitive symptoms in postmenopausal women with schizophrenia in a 24-week, double-blind, randomized, placebo-controlled study. Patients were recruited from the inpatient and outpatient services of Parc Sanitari Sant Joan de Déu, Hospital Universitari Institut Pere Mata, and Corporació Sanitària Parc Taulí. Seventy eight postmenopausal women with schizophrenia were randomized to either adjunctive raloxifene or placebo. Sixty-eight began the clinical trial (37 women on raloxifene adjunct) and 31 on placebo adjunct. The outcome measures were: memory, attention and executive function. Assessment was conducted at baseline and at week 24. Between groups homogeneity was tested with the Student's t test for continuous variables and/or the Mann-Whitney U test for ordinal variables and the χ2 test or Fisher's exact test for categorical variables. The differences between the two groups in neuropsychological test scores were compared using the Student's t test. The sample was homogenous with respect to age, formal education, illness duration and previous pharmacological treatment. The addition of raloxifene to antipsychotic treatment as usual showed no differences in cognitive function. The daily use of 60 mg raloxifene as an adjuvant treatment in postmenopausal women with schizophrenia has no appreciable effect.ClinicalTrials.gov Identifier: NCT01573637.

La socialización ética y el sector de la salud. Contradicciones y potencialidades en el momento actual / Ethical socialization and the health sector. Contradictions and potentialities at the current time

Introducción: comprobar la idoneidad de los trabajadores aparece hoy como una obligación para la subsistencia económica del socialismo; la información circulante así lo sostiene. Sin embargo, en determinados sectores, esa misma idoneidad bien pudiera tener un significado mucho más importante al depender de ella la subsistencia ética, esto es un valor esencial para sustentar la real vitalidad del nuevo sistema socioeconómico. Objetivo: mostrar la relación entre eticidad de los trabajadores de la salud y progreso moral de la sociedad socialista. Método: se identifican y explican algunas contradicciones de reciente data en el panorama ético de la relación sector-sociedad. Resultados: al artículo muestra aspectos tales como el dinamismo social y sectorial de la ética, donde el análisis ético en el sector de la salud, (aunque lo tome de punto de partida) no puede quedarse en el facilismo de plantear que la lucha contra el sufrimiento humano se justifica a sí misma, se concerta que "la lucha es la forma más universal de la existencia de todo lo real, y las contradicciones, el contenido donde esta se presenta, adoptando diversas manifestaciones. Conclusiones: las condiciones concretas, tanto en el plano material como en el mental, en que se desempeñan quienes trabajan en el sector de la salud, además de las influencias de la cultura y la ideología imperantes a escala global, y mediante las diversas modalidades de exposición del sujeto a las mismas, producen alteraciones en la manera en que son asimilados el trabajo y su significado en la sociedad(AU)

Introduction: checking the suitability of workers appears today as an obligation for the economic subsistence of socialism; the circulating information supports it. However, in certain sectors, that same suitability may well have a much more important significance as the ethical subsistence depends on it, this is an essential value to sustain the real vitality of the new socioeconomic system. Objective: to show the relationship between the ethicity of health workers and the moral progress of socialist society. Method: some contradictions of recent date are identified and explained in the ethical panorama of the sector-society relationship. Results: the article shows aspects such as the social and sectoral dynamism of ethics, where the ethical analysis in the health sector, (although it takes it from the starting point) can not remain in the ease of proposing that the fight against Human suffering justifies itself, agrees that "the struggle is the most universal form of the existence of everything real, and the contradictions, the content where it is presented, adopting various manifestations. Conclusions: the concrete conditions, both materially and mentally, in which those working in the health sector work, in addition to the influences of prevailing culture and ideology on a global scale, and through the various modalities of exposure of the subject to them, produce alterations in the way in which work and its meaning in society are assimilated(AU)

Introdução: verificar a adequação dos trabalhadores aparece hoje como uma obrigação para a subsistência econômica do socialismo; a informação circulante a suporta. No entanto, em certos setores, essa mesma adequação pode muito bem ter um significado muito mais importante, já que a subsistência ética depende disso, é um valor essencial para sustentar a vitalidade real do novo sistema socioeconômico. Objetivo: mostrar a relação entre a ética dos trabalhadores da saúde e o progresso moral da sociedade socialista. Método: algumas contradições de data recente são identificadas e explicadas no panorama ético da relação setor-sociedade. Resultados: o artigo apresenta aspectos como o dinamismo social e setorial da ética, em que a análise ética no setor saúde (apesar de partir do ponto de partida) não pode permanecer na facilidade de propor que a luta contra O sofrimento humano se justifica, concorda que "a luta é a forma mais universal da existência de tudo o que é real, e as contradições, o conteúdo em que é apresentado, adotam várias manifestações". Conclusões: as condições concretas, tanto materiais como mentais, nas quais trabalham os que trabalham no setor da saúde, além das influências da cultura e ideologia predominantes em escala global, e através das diversas modalidades de exposição do sujeito a eles, produzir alterações na maneira em que o trabalho e seu significado na sociedade são assimilados(AU)

Temporomandibular disorders in growing patients after treatment of class II and III malocclusion with orthopaedic appliances: a systematic review.

OBJECTIVE: To determine if the use of orthopaedic appliances in growing patients applied to correct Class II and III malocclusion is related to the development of temporomandibular disorders (TMD). MATERIAL AND METHODS: A systematic review was conducted between 1960 and July 2017, based on electronic databases: PubMed, Cochrane Library, Embase, Medline, Scopus, EBSCOhost, Scielo, Lilacs and Bireme. Controlled clinical trials (CCTs) and randomized controlled trials (RCTs) were identified. The articles were selected and analyzed by two authors independently. The quality of the evidence was determined according to the guidelines of the Cochrane Risk Bias Assessment Tool and the Cochrane Quality Study Guide. RESULTS: Seven articles were included, four CCTs and three RCTs. The studies were grouped according to malocclusion treatment in (a) class II appliances (n = 4) and (b) class III appliances (n = 3). The quality of evidence was low due to the high risk of bias, independent of the association reported. All studies concluded that the use of orthopaedic appliances would not contribute to the development of TMD. CONCLUSIONS: The quality of evidence available is insufficient to establish definitive conclusions, since the studies were very heterogeneous and presented a high risk of bias. However, it is suggested that the use of orthopaedic appliances to correct class II and III malocclusion in growing patients would not be considered as a risk factor for the development of TMD. High-quality RCTs are required to draw any definitive conclusions.

La socialización ética y el sector de la salud. Contradicciones y potencialidades en el momento actual / Socialização ética e setor de saúde. Contradições e potencialidades no momento atual / Ethical socialization and the health sector. Contradictions and potentialities at the current time

Introducción: comprobar la idoneidad de los trabajadores aparece hoy como una obligación para la subsistencia económica del socialismo; la información circulante así lo sostiene. Sin embargo, en determinados sectores, esa misma idoneidad bien pudiera tener un significado mucho más importante al depender de ella la subsistencia ética, esto es un valor esencial para sustentar la real vitalidad del nuevo sistema socioeconómico. Objetivo: mostrar la relación entre eticidad de los trabajadores de la salud y progreso moral de la sociedad socialista. Método: se identifican y explican algunas contradicciones de reciente data en el panorama ético de la relación sector-sociedad. Resultados: al artículo muestra aspectos tales como el dinamismo social y sectorial de la ética, donde el análisis ético en el sector de la salud, (aunque lo tome de punto de partida) no puede quedarse en el facilismo de plantear que la lucha contra el sufrimiento humano se justifica a sí misma, se concerta que "la lucha es la forma más universal de la existencia de todo lo real, y las contradicciones, el contenido donde esta se presenta, adoptando diversas manifestaciones. Conclusiones: las condiciones concretas, tanto en el plano material como en el mental, en que se desempeñan quienes trabajan en el sector de la salud, además de las influencias de la cultura y la ideología imperantes a escala global, y mediante las diversas modalidades de exposición del sujeto a las mismas, producen alteraciones en la manera en que son asimilados el trabajo y su significado en la sociedad(AU)

Introduction: checking the suitability of workers appears today as an obligation for the economic subsistence of socialism; the circulating information supports it. However, in certain sectors, that same suitability may well have a much more important significance as the ethical subsistence depends on it, this is an essential value to sustain the real vitality of the new socioeconomic system. Objective: to show the relationship between the ethicity of health workers and the moral progress of socialist society. Method: some contradictions of recent date are identified and explained in the ethical panorama of the sector-society relationship. Results: the article shows aspects such as the social and sectoral dynamism of ethics, where the ethical analysis in the health sector, (although it takes it from the starting point) can not remain in the ease of proposing that the fight against Human suffering justifies itself, agrees that "the struggle is the most universal form of the existence of everything real, and the contradictions, the content where it is presented, adopting various manifestations. Conclusions: the concrete conditions, both materially and mentally, in which those working in the health sector work, in addition to the influences of prevailing culture and ideology on a global scale, and through the various modalities of exposure of the subject to them, produce alterations in the way in which work and its meaning in society are assimilated(AU)

Introdução: verificar a adequação dos trabalhadores aparece hoje como uma obrigação para a subsistência econômica do socialismo; a informação circulante a suporta. No entanto, em certos setores, essa mesma adequação pode muito bem ter um significado muito mais importante, já que a subsistência ética depende disso, é um valor essencial para sustentar a vitalidade real do novo sistema socioeconômico. Objetivo: mostrar a relação entre a ética dos trabalhadores da saúde e o progresso moral da sociedade socialista. Método: algumas contradições de data recente são identificadas e explicadas no panorama ético da relação setor-sociedade. Resultados: o artigo apresenta aspectos como o dinamismo social e setorial da ética, em que a análise ética no setor saúde (apesar de partir do ponto de partida) não pode permanecer na facilidade de propor que a luta contra O sofrimento humano se justifica, concorda que "a luta é a forma mais universal da existência de tudo o que é real, e as contradições, o conteúdo em que é apresentado, adotam várias manifestações". Conclusões: as condições concretas, tanto materiais como mentais, nas quais trabalham os que trabalham no setor da saúde, além das influências da cultura e ideologia predominantes em escala global, e através das diversas modalidades de exposição do sujeito a eles, produzir alterações na maneira em que o trabalho e seu significado na sociedade são assimilados(AU)

Centric relation-intercuspal position discrepancy and its relationship with temporomandibular disorders. A systematic review.

OBJECTIVE: The objective of this study is to assess the relationship between centric relation-intercuspal position discrepancy (CR-ICP discrepancy) and temporomandibular disorders (TMDs), by systematically reviewing the literature. MATERIALS AND METHODS: A systematic research was performed between 1960 and 2016 based on electronic databases: PubMed, Cochrane Library, Medline, Embase, Scopus, EBSCOhost, BIREME, Lilacs and Scielo, including all languages. Analytical observational clinical studies were identified. Two independent authors selected the articles. PICO format was used to analyze the studies. The Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. RESULTS: Four hundred and sixty-seven potentially eligible articles were identified. Twenty studies were analyzed, being grouped according to intervention in studies in orthodontic patients (n = 3) and studies in subjects without intervention (n = 17). Quality of evidence was low, with an average score of 3.36 according to Newcastle-Ottawa Scale. In most studies, the presence of CR-ICP discrepancy is associated with the presence of muscle (pain) and joint disorders (noise, disc displacement, pain, crepitus, osteoarthritis and osteoarthrosis). However, the lack of consistency of the results reported reduces the validity of the studies making it impossible to draw any definite conclusions. CONCLUSIONS: Because of the heterogeneity of the design and methodology and the low quality of the articles reviewed, it is not possible to establish an association between CR-ICP discrepancy and TMD. The consequence of CR-ICP discrepancy on the presence of TMD requires further research, well-defined and validated diagnostic criteria and rigorous scientific methodologies. Longitudinal studies are needed to identify CR-ICP discrepancy as a possible risk factor for the presence of TMD.

Subtly Modulating Glycogen Synthase Kinase 3 ß: Allosteric Inhibitor Development and Their Potential for the Treatment of Chronic Diseases.

Glycogen synthase kinase 3 ß (GSK-3ß) is a central target in several unmet diseases. To increase the specificity of GSK-3ß inhibitors in chronic treatments, we developed small molecules allowing subtle modulation of GSK-3ß activity. Design synthesis, structure-activity relationships, and binding mode of quinoline-3-carbohydrazide derivatives as allosteric modulators of GSK-3ß are presented here. Furthermore, we show how allosteric binders may overcome the ß-catenin side effects associated with strong GSK-3ß inhibition. The therapeutic potential of some of these modulators has been tested in human samples from patients with congenital myotonic dystrophy type 1 (CDM1) and spinal muscular atrophy (SMA) patients. We found that compound 53 improves delayed myogenesis in CDM1 myoblasts, while compounds 1 and 53 have neuroprotective properties in SMA-derived cells. These findings suggest that the allosteric modulators of GSK-3ß may be used for future development of drugs for DM1, SMA, and other chronic diseases where GSK-3ß inhibition exhibits therapeutic effects.

Esclerodermia generalizada en una niña / Generalized scleroderma in a girl

La esclerodermia es una enfermedad autoinmune de causa desconocida, que puede presentarse afectando solo la piel, llamada morfea, o con afectación sistémica. Dentro de la morfea, la forma generalizada es infrecuente en la infancia. Se presenta el caso de una niña que es llevada al Hospital Pediátrico Provincial Mártires de Las Tunas con un cuadro cutáneo generalizado, con predominio en el tronco y las extremidades, que respetaba la cara, dado por lesiones hiperpigmentadas e hipopigmentadas escleróticas que no permitían el pinzamiento de la piel. Se realizaron varios estudios, descartándose la afectación sistémica y se corrobora el diagnóstico de esclerodermia generalizada, mediante el estudio histopatológico. Se educa a la madre y a la paciente y se adecúa el tratamiento tópico y sistémico acorde a su grado de afectación, mejorando el estado de la paciente(AU)

Scleroderma is an autoimmune condition of unknown causes that can be presented affecting only the skin, called morphea, or affecting body systems. As part of the morphea the generalized form is not very common in childhood. This study presents the case of a girl who was taken to Mártires de Las Tunas Provincial Pediatric Hospital with generalized cutaneous manifestations, mainly in the trunk and limbs, not including the face, and characterized by sclerotic hyperpigmented and hypopigmented lesions which do not allow pinching the skin. Several investigations were performed ruling out systemic affectations and the diagnosis of generalized scleroderma was confirmed by means of a histopathologic study. Mother and patient were given advice and the topic and systemic treatment was adjusted according to the degree of the condition. The patient progressed satisfactorily(AU)

Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: A systematic review from 2003 to 2014.

OBJECTIVE: In order to establish a relationship between bruxism and temporomandibular disorders (TMDs), a systematic review was performed. MATERIALS AND METHODS: A systematic research was performed based on PubMed, Cochrane Library, Medline, Embase, BIREME, Lilacs and Scielo data bases, between 2003 and 2014 including all languages. Descriptive clinical cases were identified. Two independent authors selected the articles. PICO format was used to analyse the studies and the Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. RESULTS: Thirty-nine studies (n = 39) were analysed in this review. According to bruxism diagnosis, articles were grouped as follows: polysomnographic diagnosis (PSG) (n = 7), clinical diagnosis (n = 11) and survey/self-report (n = 21). Thirty-three articles (n = 33) established a positive relation between bruxism and TMD and six (n = 6) did not. Quality of evidence was low to moderate. In general, the most part of the studies showed shortcomings on their design with bias risk, and also had a low sensitivity on bruxism diagnosis. CONCLUSIONS: The evidence based on PSG was not as conclusive as the studies that used surveys and clinical exam to diagnosis bruxism, when bruxism was related to TMD. Sleep bruxism could be associated with myofascial pain, arthralgia and joint pathology as disc displacement and joint noises. Although the evidence at present is inconclusive and does not provide information according to the type of bruxism (bruxism sleep and wakefulness), it is possible to suggest that bruxism would be associated with TMD.