RESUMEN

In the past few years, the level of physical fitness in children has decreased globally. According to the SIMCE test carried out in 2015, 45% of 8th year students in Chile were overweight. Moreover, international studies have shown that being overweight is associated with the development of chronic illnesses, negatively affecting cognitive mechanisms and processes. Nevertheless, there is little to no evidence that analyzes the relationship between physical fitness and executive functions in students, at a national level. The aim was to analyze the relationship between cardiorespiratory, musculoskeletal, and motor fitness, and performance in an executive functions test, in students from a public school in the south of Chile. A qualitative, descriptive -correlational, non-experimental, and cross-sectional approach was used. In total, 100 students between 9 and 12 and 11 months of age from a public school in the south of Chile completed the physical fitness assessments through the ALPHA fitness test, and 81 students completed the executive function assessments through the ENFEN test. It was evidenced that students who achieved a longer duration of time and a later stage in the Course Navette test, more centimeters in the standing broad jump (SBJ) test, and a shorter duration in the 4 × 10 shuttle run obtained a better score in the gray trail test. Additionally, students who presented a stronger dominant handgrip scored higher in the colored trail tests. We conclude that students who show a higher level of physical fitness also present a better development of executive functions such as working memory and inhibitory control. In addition, these results suggest physical condition is a factor to consider for better cognitive and school performance.

RESUMEN

BACKGROUND: There are 3 treatment options for placenta accreta spectrum: cesarean delivery with hysterectomy, expectant management, and uterine-sparing surgical techniques. One-step conservative surgery is the most extensively described conservative surgical technique, and it has extensive evidence supporting its usefulness; however, few groups apply it, most likely because of the misconception that it is a complex procedure that requires extensive training and is applicable to only a few patients. OBJECTIVE: This study aimed to evaluate the clinical outcomes of patients undergoing one-step conservative surgery in 4 placenta accreta spectrum reference hospitals and provided detailed steps for successfully applying this type of surgery. STUDY DESIGN: This was a multicenter, descriptive, prospective study that described the outcomes of patients with placenta accreta spectrum treated in 4 reference hospitals for this condition. The patients were divided into those managed with one-step conservative surgery and those managed with cesarean delivery and hysterectomy. RESULTS: Overall, 75 patients were included. One-step conservative surgery was possible in 85.3% of placenta accreta spectrum cases (64 patients). Intraoperative staging and placenta accreta spectrum topographic classification allowed for the selection of one-step conservative surgery candidates. The clinical outcomes of the 2 groups were similar, except for the frequency of transfusions (81.8% in the cesarean delivery and hysterectomy group vs 67.2% in the one-step conservative surgery group) and vascular interventions (27.3% in the cesarean delivery and hysterectomy group vs 4.7% in the one-step conservative surgery group), which were both higher in patients who underwent hysterectomy. In addition, the operation time was shorter in the one-step conservative surgery group (164.4 minutes vs 216.5 minutes). CONCLUSION: One-step conservative surgery is a valid procedure in most patients with placenta accreta spectrum. It is an applicable technique even in scenarios with limited resources. However, its safe application requires knowledge of the topographic classification and the application of intraoperative staging.

Asunto(s)

RESUMEN

OBJECTIVE: To analyze the association between the behavioral profile of physical activity and sedentary time with subjective well-being and mental health in university students during the COVID-19 pandemic in Chile. METHODS: Cross-sectional study in a voluntary sample of 469 university students (22.4 ± 0.19 years; 66% women). According to students' self-reports of physical activity and sedentary time, four behavioral profiles were created to investigate their association with subjective well-being and mental health using one-factor ANOVA that was adjusted to a multifactorial model. RESULTS: The physically inactive and sedentary behavior profile presents the lowest levels of subjective well-being (p < 0.001), positive affective experiences (p < 0.001) and general mental health (p = 0.001). When adjusting for confounding variables, it was observed that the physically active and non-sedentary profile was associated with better general mental health (p < 0.01) in contrast to those who are physically active and sedentary. CONCLUSIONS: Chilean university students with a physically inactive and sedentary profile during the pandemic presented worse well-being and mental health, with a sedentary lifestyle being one of the variables that most affects the mental health of these students. Therefore, measures should be implemented to encourage this population to maintain adequate levels of physical activity and reduce sedentary times.

Asunto(s)

RESUMEN

STATEMENT OF PROBLEM: When a cement-retained lithium disilicate crown needs to be removed, perforation is needed to reach the abutment screw. How this process affects its strength is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the fracture strength of milled lithium disilicate implant crowns with screw-access holes created before and after the firing stages. MATERIAL AND METHODS: Nine implant replicas with stock abutments were embedded in acrylic resin. Forty-five lithium disilicate (IPS e.max CAD) crowns were designed, milled, and divided into groups. The control group had no screw access, the blue state group had the screw access created in the intermediate phase of the ceramic, and the postfiring group had the screw access created after firing. The crowns were cemented with a self-adhesive resin cement, placed in an incubator for 24 hours and then thermocycled. The screw-access holes were sealed with composite resin. The crowns were loaded to failure with a universal testing machine using a 1- mm-diameter ball at a crosshead speed of 0.5 mm/min and a 5-kN cell load. Data were analyzed by ANOVA and the Tukey post hoc test (α=.05). RESULTS: Screw-access holes created before and after firing stages had a significant effect on the fracture resistance of lithium disilicate crowns (P=.002). No difference in fracture resistance was observed between the control group and the blue state group (P>.05), while the fracture resistance of the postfiring group was significantly lower than that of the control group and the blue state group (P<.05). CONCLUSIONS: The fracture strength of lithium disilicate crowns was not affected by a screw-access hole created during the blue state of the ceramic followed by repair with composite resin. Creating a screw-access hole after firing the ceramic reduced fracture strength.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Resumen Introducción. La empatía es un elemento importante en la relación médico-paciente, por lo que la formación en empatía de los estudiantes de medicina debe ser un objetivo permanente de los programas universitarios. Objetivo. Determinar si las actividades académicas de formación en empatía médica implementadas en la Universidad del Norte en 2013 produjeron cambios significativos en los estudiantes de medicina matriculados en 2015 respecto a los matriculados en 2012. Materiales y métodos. Estudio transversal realizado en 934 estudiantes de Medicina de la Universidad del norte (426 hombres y 508 mujeres) matriculados en 2015 a los que se les aplicó la versión en español de la escala de empatía médica de Jefferson. Por su parte, el grupo de comparación estuvo conformado por 345 estudiantes de medicina (106 hombres y 239 mujeres) matriculados en 2012 en la misma universidad. Se realizó un análisis de varianza (ANOVA) y se evaluaron las diferencias entre los años académicos y entre género, así como las interacciones entre estos dos factores. Resultados. Aunque en general no se encontraron diferencias significativas en las tres dimensiones evaluadas (p>0.05) para los dos grupos, sí se observaron diferencias significativas en las preguntas 4, 17 y 20, correspondientes a la dimensión Toma de perspectiva, y en la pregunta 6, correspondiente a la dimensión Ponerse en el lugar del otro (p<0.05), ya que las medias de puntaje fueron mayores en la cohorte de 2012. Conclusión. Las actividades de formación en empatía establecidas en el plan de estudios del programa de medicina no produjeron cambios significativos, por lo que es necesario evaluar y perfeccionar tanto los contenidos del currículo, como los procesos de enseñanza-aprendizaje relacionados con la formación en empatía del programa de Medicina de la Universidad del Norte (Barranquilla, Colombia).

Abstract Introduction: Empathy is an important component of the doctor-patient relationship, so the provision of empathy training to medical students must be a permanent goal of MD programs. Objective: To determine whether the academic medical empathy training activities implemented at Universidad del Norte in 2013 resulted in significant changes in medical students enrolled in 2015 compared to those enrolled in 2012. Materials and methods: Cross-sectional study conducted on 934 medical students (426 men and 508 women) enrolled at Universidad del Norte in 2015 who were administered the Spanish version of the Jefferson Scale of Empathy. The comparison group consisted of 345 medical students (106 men and 239 women) enrolled in 2012 at the same university. An analysis of variance (ANOVA) was performed and differences between academic years and between genders were evaluated, as well as the interactions between these two factors. Results: Although, in general, there were no significant differences between both groups in the three dimensions that were evaluated (p>0.05), statistically significant differences were observed in questions 4, 17 and 20, which are part of the Perspective Taking dimension, and in question 6, included in the Walking in Patient's Shoes dimension (p<0.05), since scores medias were higher in the 2012 cohort. Conclusions: The empathy training activities implemented in the medical program did not produce significant changes. Therefore, it is necessary to assess and improve both the contents and the teaching-learning processes related to empathy training in the medical program offered at Universidad del Norte.

RESUMEN

Traditional ecological knowledge (TEK) associated with the use of medicinal plants has been vital to numerous communities around the world. Nowadays, medicinal plants continue to be of great cultural importance and represent a viable option for health care in local communities. This study was conducted Colombian Caribbean region, particularly in the La Rosita neighborhood of the municipality of Puerto Colombia, with the purpose of collecting ethnobotanical information associated with the medicinal uses that the inhabitants give to the plants. For the analysis of ethnobotanical data, the cultural importance (CI) index was calculated. TEK of medicinal plants contributed to healing practices of the municipality of Puerto Colombia because during the decades the inhabitants have been able to verify the effectiveness of these plants in the treatment of diseases. However most of the medicinal species used are not non-native. Our results show the urgency of developing research that contributes to the documentation and analysis of ethnobotanical information and makes the importance of TEK as a cultural service of ecosystems visible.

El conocimiento ecológico tradicional (TEK) asociado con el uso de plantas medicinales ha sido vital para numerosas comunidades en todo el mundo. Hoy en día, las plantas medicinales continúan siendo de gran importancia cultural y representan una opción viable para el cuidado de la salud en las comunidades locales. Este estudio se realizó en la región Caribe colombiana, particularmente en el barrio La Rosita del municipio de Puerto Colombia, con el propósito de recolectar información etnobotánica asociada a los usos que los habitantes otorgan a las plantas. Para el análisis de datos etnobotánicos, se calculó el índice de importancia cultural (IC). TEK de plantas medicinales contribuyó a las prácticas curativas del municipio de Puerto Colombia pues durante décadas los habitantes han podido comprobar la efectividad de estas plantas en el tratamiento de enfermedades. Sin embargo, la mayoría de las especies medicinales utilizadas no son nativas. Nuestros resultados muestran la urgencia de desarrollar investigaciones que contribuyan a la documentación y el análisis de la información etnobotánica y hacen visible la importancia de TEK como un servicio cultural de los ecosistemas.

Asunto(s)

RESUMEN

RESUMEN Se presenta el caso de gestante de 26 años de edad, afecta del síndrome Klippel Trenaunay Weber congénito, con su primer embarazo el cual concluyó a las 39 semanas, mediante cesárea, obteniéndose recién nacido de 3450 gramos, buen Apgar al nacer, con evolución satisfactoria para el binomio madre-hijo. Se revisó bibliografía universal sobre esta patología, resaltándose los riesgos potenciales para la madre y su producto. Aún cuando la frecuencia de aparición de esta entidad es rara, resulta importante su conocimiento para los profesionales que laboran, tanto en la atención primaria de salud, como en la atención secundaria (AU).

ABSTRACT The case of a 26-years-old woman is presented. She presented the Klippel-Trenaunay-Weber syndrome in her first pregnancy finished at the 39th week through caesarian section; the newborn was 3450 grams, with good Apgar at birth: the mother-child binomial had a satisfactory evolution. The universal bibliography on this disease was reviewed, highlighting the potential risk for mother and child. Even when the frequency of this entity is rare, it is important its knowledge for the professionals working in the primary health care as much as in the secondary health care (AU).

Asunto(s)

RESUMEN

RESUMEN Se presenta el caso de gestante de 26 años de edad, afecta del síndrome Klippel Trenaunay Weber congénito, con su primer embarazo el cual concluyó a las 39 semanas, mediante cesárea, obteniéndose recién nacido de 3450 gramos, buen Apgar al nacer, con evolución satisfactoria para el binomio madre-hijo. Se revisó bibliografía universal sobre esta patología, resaltándose los riesgos potenciales para la madre y su producto. Aún cuando la frecuencia de aparición de esta entidad es rara, resulta importante su conocimiento para los profesionales que laboran, tanto en la atención primaria de salud, como en la atención secundaria (AU).

ABSTRACT The case of a 26-years-old woman is presented. She presented the Klippel-Trenaunay-Weber syndrome in her first pregnancy finished at the 39th week through caesarian section; the newborn was 3450 grams, with good Apgar at birth: the mother-child binomial had a satisfactory evolution. The universal bibliography on this disease was reviewed, highlighting the potential risk for mother and child. Even when the frequency of this entity is rare, it is important its knowledge for the professionals working in the primary health care as much as in the secondary health care. (AU)

Asunto(s)

RESUMEN

Se presentan los casos de dos niños, hermanos, de los cuales se recibieron muestras de heces fecales en el laboratorio de microbiología del municipio Güines, provincia Mayabeque. Las muestras contenían minúsculos proglótides, que resultaron ser de Inermicapsifer madagascariensis. Luego del tratamiento con praziquantel 10 mg/kg en dosis única, orientado por el servicio de pediatría, se confirmó la expulsión de restos del parásito y la curación de dicha infección, tras resultados negativos por controles repetitivos de heces fecales durante seis meses. Se decide publicar estos raros casos diagnosticados y estimular estudios de campo que permitan completar el ciclo evolutivo de este parásito(AU)

We are presenting the cases of two sibling children, from whom samples of faeces were received in the microbiology laboratory of the Güines municipality, Mayabeque province. The samples contained tiny proglottids, which turned out to be from Inermicapsifer madagascariensis. After treatment with Praziquantel 10 mg/kg in a single dose, guided by the pediatric service, the expulsion of parasite remains and the cure of this infection were confirmed, after negative results due to repetitive controls of faecal stools for six months. It is decided to publish these rare diagnosed cases and stimulate field studies to complete the evolutionary cycle of this parasite(AU)

Asunto(s)

RESUMEN

A growing body of evidence has demonstrated the role of components of innate immunity, including Toll-like receptors (TLRs), the retinoic acid-inducible gene I/melanoma-differentiation factor 5 (RIG-I/MDA5) and microRNAs (miRNAs) in the recognition of dengue virus (DENV) or its components by infected cells. TLR3, TLR7/8 and RIG-I/MDA5 sense genomic RNA or dsRNA, the product of an intermediate step of DENV replication, activating intracellular pathways leading to the production of antiviral effectors, including interferon and pro-inflammatory cytokines. Recognition by TLR2 and TLR4 also promotes the activation of other intracellular pathways and alters viral replication in an interferon-independent manner. It was also recently demonstrated that cellular miRNAs, a class of post-transcriptional regulatory small RNAs, can affect replication. To accomplish this, miRNAs bind either directly to viral RNA, through base-pair complementarity affecting translation, or indirectly through virus-mediated changes in host protein expression in the viral life cycle. There is also evidence that certain miRNAs can recognize or be recognized by TLRs and RIG-I/MDA5, resulting in alteration of the innate immune response. In this review, we summarize our present knowledge of DENV-host factor interactions, emphasizing the role of TLRs, RIG-I/MDA5 and miRNAs and their possible connection with pathogenesis. Our discussion is based on recent reports suggesting how these different innate immune components might be activated to induce an antiviral response, and how DENV has developed mechanisms to manipulate or evade these antiviral activities.

Asunto(s)

RESUMEN

The peroxisome proliferator-activated receptor (PPAR)-γ drug pioglitazone (PIO) has been shown to protect tissue against oxidant stress. In a swine model of chronic myocardial ischemia, we tested whether PIO increases PGC1-α signaling and the expression of mitochondrial antioxidant peptides. Eighteen pigs underwent a thoracotomy with placement of a fixed constrictor around the LAD artery. At 8 weeks, diet was supplemented with either PIO (3 mg/kg) or placebo for 4 weeks. Regional myocardial function and blood flow were determined at the time of the terminal study. PGC1-α expression was quantified from nuclear membranes by gels and respiration, oxidant stress markers and proteomics by iTRAQ were determined from isolated mitochondria. In the chronically ischemic LAD region, wall thickening from the PIO and control groups was 42 ± 6 and 45 ± 5 %, respectively (NS) with no intergroup differences in basal blood flow (0.72 ± 0.04 versus 0.74 ± 0.04 ml/min g, respectively; NS). In the PIO group, the expression of nuclear bound PGC1-α was higher (11.3 ± 2.6 versus 4.4 ± 1.4 AU; P < 0.05) and the content of mitochondrial antioxidant peptides including superoxide dismutase 2, aldose reductase, glutathione S-transferase and thioredoxin reductase were greater than controls. Although isolated mitochondria from the PIO group showed lower state 3 respiration (102 ± 13 versus 161 ± 22 nmol/min mg; P < 0.05), no differences in oxidant stress were noted by protein carbonyl (1.7 ± 0.7 versus 1.1 ± 0.1 nmol/mg). Chronic pioglitazone does not reduce regional myocardial blood flow or function in a swine model of chronic myocardial ischemia, but may have an important role in increasing expression of antioxidant proteins through PGC1-α signaling.

Asunto(s)

RESUMEN

Objetivo: Identificar las lecciones aprendidas sobre la prevención y el control de enfermedades producidas por el mismo vector desde la comunicación en salud y comunicación de riesgo, de modo que puedan ser de utilidad para otros procesos de intervención en este campo en las regiones afectadas. Método: A partir de una revisión amplia de la literatura de los últimos 10 años se analizaron 52 documentos, entre artículos de investigación, capítulos de libro, guías gubernamentales y cartas al editor encontrados en las diferentes bases de datos especializadas. Resultados: Se encontró que aún son limitadas las investigaciones que evalúan el impacto de estas estrategias de prevención y control, en especial en el caso del Chikungunya. Asimismo, aunque se ha demostrado a nivel global que uno de los modelos recomendados para el caso del dengue, producido por el mismo vector, es COMBI -Communication for Behavioural Impact-, las intervenciones para este último caso, en gran medida, aún se fundan en el modelo de IEC Información, Educación y Comunicación. Conclusión: Las lecciones aprendidas brindan luces para una mejor planeación de la comunicación, con anticipación a futuras epidemias, en la que los voceros oficiales y la relación con los medios de comunicación también hacen parte del éxito de estas experiencias.

Objective: To identify the lessons learned from health communication and risk communication on the prevention and control of diseases caused by the same vector, to be help other regions intervention processes to intervene in this field. Method: From a broad literature review of the past 10 years, 52 documents were analyzed between research articles, book chapters, government guidelines and letters to the editor found in different specialized databases. Results: It was found that research on the evaluation and impact of these strategies is still limited, especially in the case of Chikungunya. Although it has been shown that the global recommended model for the case of dengue, produced by the same vector as Chikungunya, is COMBI -Communication for Behavioural Impact-, interventions still focuses on the IEC -Information, Education, and communication- model. Conclusión: This lessons learned provide lights for a better planning of communication in future epidemics, where it is clear that the official spokesmen and the relationship with the media are also an important part of the success of these experiences.

RESUMEN

BACKGROUND: We have previously shown that mitochondrial uncoupling protein-2 (UCP-2) is increased in a swine model of hibernating myocardium (HM). Although UCP-2 reduces oxidant stress, it can promote inefficiency of the electron transport chain. In this study, we tested whether UCP-2 remains increased in revascularized HM (RHM) after coronary artery bypass grafting (CABG). METHODS: Seven swine underwent thoracotomy with placement of a constrictor on the left anterior descending artery (LAD). Twelve weeks later, a left internal mammary artery graft was placed on the distal LAD. Four weeks post-CABG, computed tomography angiography documented patent grafts and function. At the terminal study, blood flow to the LAD and remote territories were assessed during high dose dobutamine and mitochondria isolated from both regions for analysis. Comparisons were made to a group of swine with HM who underwent constrictor placement without bypass grafting (n = 4). RESULTS: During dobutamine infusion, RHM demonstrated lower blood flows (2.44 ± 0.23 versus 3.43 ± 0.30 mL/min/g; P < 0.05) and reduced wall thickening (33 ± 9% versus 52 ± 13%; P < 0.05) compared with remote regions. RHM had lower respiratory control indices (3.7 ± 0.3 versus 4.3 ± 0.4; P < 0.05) with persistently increased UCP-2 content. CONCLUSIONS: Despite patent grafts, RHM demonstrates a submaximal response to dobutamine infusion and increased mitochondrial UCP-2 expression. These data support the notion that recovery of the mitochondria in RHM is delayed early post-CABG and may contribute to impaired oxygen consumption and contractile reserve during catecholamine challenges.

Asunto(s)

RESUMEN

La historiografía local se enriquece cada vez más con la vida de hijos preclaros que supieron dejar huellas en la sociedad desde el punto de vista médico en el momento histórico en que vivieron. Tal es el caso del presente artículo, que recoge aspectos de la vida de una de las primeras mujeres médicas cubanas del siglo XX, la doctora Gloria María Cabanas OFarril, paradigma de la ginecbstetricia matancera(AU)

Local historiography is enriched again and again with life of the illustrious people who left their imprint in the society from the medical point of view in the historical moment they lived. That is the case of the current article, gathering life aspects of one of the first XX century Cuban woman physician, Dr Gloria Maria Cabanas OFarril, paradigm of the Matanzasan gyneco-obstetrics(AU)

Asunto(s)