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Frequent consumption of sugar sweetened beverages (SSB) is related to the risks of developing overweight, obesity, cavities, diabetes and other diseases. Policies to significantly increase taxes on SSB have proven to be effective in reducing their consumption. The political debate on implementing these taxes in Colombia shows a series of barriers to placing this policy on the political agenda, and therefore, to its approval. This work analyses the political process involved in the struggle for the approval of an SBB tax in Colombia, as well as barriers and opportunities to putting it on the political agenda. This is done through a policy analysis with three research methods: a documentary analysis, political mapping of actors and semistructured interviews with key actors. Among the main findings, we have that actors who are in favour of the SSB tax stated that it is needed due to the health problems caused by SSB consumption, while those who opposed it argue that Colombia regulations are sufficient and already inform and educate consumers on excessive sugar consumption and its health implications. The Colombian political context is a barrier to SSB taxation, as the government favours and has a close connection with the food and SSB industry. In short, the policy issue has been reaching the agenda intermittently throughout the years. Nevertheless, new opportunities are arising after the COVID-19 pandemic and the 2022 administrative changes and further efforts from policy entrepreneurs are required to make this initiative progress in the political agenda.

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PURPOSE: To evaluate the neurovascular bundle preservation grades during robotic-assisted radical prostatectomy and compared to the trifecta combined outcome (oncologic control, continence, and sexual function) twelve months after the surgery. METHODS: Cohort of patients who underwent nerve-sparing robotic-assisted radical prostatectomy had the neurovascular bundle preservation retrospectively graded from 0 to 8 according to the Hopkins subjective visual classification. Patients then were divided into two groups, according to the median of nerve-sparing grading: those with score six or high and those with score less than six. Main outcome was the trifecta combined outcome and secondary outcomes was the individual trifecta criteria (prospective analysis). A secondary analysis with groups divided according to pre-operatory SHIM score was made. RESULTS: One hundred robotic-assisted nerve-sparing radical prostatectomy were performed, of which 83 were included. There were 53 patients with grading greater than or equal to six (group 1) and 30 patients less than six (group 2). 66.6% patients (35/53) in group 1 had a trifecta combined outcome of compared to 33.3% (10/30) in group 2 (p = 0.017). Individually, the erectile function was higher in group 1 (73.6%) compared to group 2 (46.7%) (p = 0.014). Both the results of the combined endpoint trifecta and erection were also maintained in the group with preoperative SHIM ≥ 17. CONCLUSIONS: The grading of preservation of the neurovascular bundle in radical prostatectomy is related to a better combined trifecta outcome one year after surgery.

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OBJETIVO: Analizar el rol de los factores socioeconómicos y culturales en la vulnerabilidad a la obesidad en madres y sus hijos menores de dos años, en localidades del Sur de Morelos, México. Material y métodos. Se realizó trabajo de campo y observación no participativa. Durante 2019, se aplicaron 17 entrevistas semiestructuradas a una submuestra de una cohorte. Los datos fueron ordenados y analizados con apoyo del software Atlas-Ti v. 7, usando 18 códigos libres. RESULTADOS: Factores sociales como los ingresos del hogar y los roles de género, combinados con la influencia de la parentela y las creencias sobre la preferencia de la niñez por productos ultraprocesados, predisponen la disponibilidad de bebidas y alimentos calóricos que generan vulnerabilidad a la obesidad durante la infancia temprana. La actividad eco-nómica de las madres, la participación de los padres y evitar influencia de parientes puede predisponer una mejor calidad de los alimentos y mayor actividad física. CONCLUSIONES: La baja disponibilidad de alimentos saludables, los riesgos de inseguridad alimentaria y los factores familiares y culturales, que se presentan en contextos de vulnerabilidad económica y social, incrementan la vulnerabilidad del binomio madre-hijo a la obesidad.

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RESUMEN El fútbol es un deporte de varias acciones motrices, donde la recepción del balón se clasifica como una acción de control a diferentes alturas, velocidades y ángulos. El jugador debe tener la capacidad de receptar el balón para poder generar una acción diferente: un pase, tiro o driblar; su optimización implica mayores probabilidades de rendimiento técnico-táctico. En tal sentido, se planteó como objetivo de la investigación analizar biomecánicamente la técnica de la recepción a media altura en futbolistas profesionales y amateurs a partir de video análisis como método de medición. La investigación fue descriptiva-explicativa de orden correlacional, se analizan cuatro variables del movimiento motriz (D: distancia Recorrida; AM: aceleración máxima; VM: velocidad máxima y AF: amplitud de la articulación femorotibial) a través de video-análisis con Kinovea. Se estudiaron a cinco jugadores profesionales (grupo 1) y 15 de nivel amateur (grupo 2). Los futbolistas de nivel amateur presentaron una mayor media en todas las variables estudiadas, "D" (grupo 1: 72.17cm; grupo 2: 101.27cm; p=0.001), "AM" (grupo 1: 61.84m/s2; grupo 2: 101.73m/s2; p=0.000), "VM" (grupo 1: 8.18m/s; grupo 2: 12.55m/s; p=0.000) y "AF" (grupo 1: 62.6°; grupo 2: 75.2°; p=0.002), lo cual se comporta significativamente diferentes en todos los casos. El análisis biomecánico realizado a futbolistas profesionales y amateurs, en la técnica de recepción del balón a media altura, concluye que en los jugadores amateur requieren un mayor perfeccionamiento técnico, independientemente de su experiencia en competencias.

RESUMO O futebol é um esporte de várias ações motoras, onde a recepção da bola é classificada como uma ação de controle em diferentes alturas, velocidades e ângulos. O jogador deve ter a capacidade de receber a bola para poder gerar uma ação diferente: um passe, um chute ou um drible; sua otimização implica em maiores probabilidades de desempenho técnico-tático. Neste sentido, o objetivo da pesquisa era analisar biomecanicamente a técnica de recepção em meia altura em jogadores profissionais e amadores de futebol utilizando a análise de vídeo como método de medição. A pesquisa foi descritiva-explicativa de ordem correlacional, quatro variáveis de movimento motor (D: distância coberta; MA: aceleração máxima; MV: velocidade máxima e FA: amplitude da articulação femorotibial) foram analisadas através de vídeo-análise com Kinovea. Foram estudados cinco jogadores profissionais (grupo 1) e 15 jogadores amadores (grupo 2). Os jogadores de futebol de nível amador apresentaram uma média maior em todas as variáveis estudadas, "D" (grupo 1: 72,17cm; grupo 2: 101,27cm; p=0,001), "AM" (grupo 1: 61,84m/s2; grupo 2: 101. 73m/s2; p=0,000), "VM" (grupo 1: 8,18m/s2; grupo 2: 12,55m/s; p=0,000) e "AF" (grupo 1: 62,6°; grupo 2: 75,2°; p=0,002), que se comportam de forma significativamente diferente em todos os casos. A análise biomecânica realizada sobre jogadores profissionais e amadores de futebol, na técnica de recepção de bola em altura média, conclui que os jogadores amadores requerem um maior aperfeiçoamento técnico, independentemente de sua experiência em competições.

ABSTRACT Soccer is a sport of various motor actions, where the reception of the ball is classified as a control action at different heights, speeds and angles. The player must have the ability to receive the ball in order to generate a different action: a pass, shot or dribble; its optimization implies greater probabilities of technical-tactical performance. In this sense, the objective of the research was to biomechanically analyze the mid-height reception technique in professional and amateur soccer players using video analysis as a measurement method. The research was descriptive-explanatory of correlational order, four variables of the motor movement (D: distance covered; AM: maximum acceleration; VM: maximum speed and AF: amplitude of the femorotibial joint) are analyzed through video-analysis with Kinovea . Five professional players (group 1) and 15 amateur players (group 2) were studied. The amateur soccer players presented a higher mean in all the variables studied, "D" (group 1: 72.17cm; group 2: 101.27cm; p=0.001), "AM" (group 1: 61.84m/s 2 ; group 2: 101.73m/s 2 ; p=0.000), "VM" (group 1: 8.18m/s; group 2: 12.55m/s; p=0.000) and "AF" (group 1: 62.6°; group 2 : 75.2°; p=0.002), which behaves significantly different in all cases. The biomechanical analysis carried out on professional and amateur soccer players, in the technique of receiving the ball at mid-height, concludes that amateur players require greater technical improvement, regardless of their experience in competitions.

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Abstract Objectives: to evaluate feeding practices in the first year of life and their association with the development of overweight and obesity in children in Mexico. Methods: the association between overweight and obesity with different feeding practices were evaluated. The data was processed using the statistical package Stata version 14 using logistic regression models. Results: 396 children were evaluated; the prevalence of overweight and obesity was 6% and 7.7% presented a possible risk of overweight. 6.9% had exclusive breastfeeding in the first 6 months of life and 71.7% were fed infant formula. The variables significantly associated with the development of overweight and obesity in the first year of life were the age of the child (p =0.043, RR=0.57), the introduction of fluids in the first three days of life (p=0.02, RR=2.90), consumption of foods with a high sugar content (p =0.01, RR=0.25), consumption of milk other than breast (p =0.02, RR3.25) and egg consumption (p =0.05; RR=0.28). Conclusions: our results show that it is essential to attend complementary feeding practices and reinforce exclusive breastfeeding in the first year of life, as measures to prevent overweight and obesity to improve health in childhood.

Resumen Objetivos: evaluar las prácticas de lactancia y alimentación en el primer año de vida y su asociación con desarrollo del sobrepeso y obesidad de niños en México. Métodos: estudio transversal, analítico, y explicativo, se evaluó la asociación entre sobrepeso y obesidad con las distintas prácticas de alimentación en menores de un año de edad. Resultados: se evaluaron 396 menores, la prevalencia de sobrepeso y obesidad fue de 6% y 7.7% presentaba posible riesgo de sobrepeso. El 6.9% tuvo lactancia materna exclusiva en los primeros 6 meses de vida; 71.7% fueron alimentados con fórmula infantil. Las variables asociadas significativamente con el desarrollo de sobrepeso y obesidad en el primer año de vida fueron: la edad del menor (p =0.043; RR=0.57), introducción de líquidos en los tres primeros días de vida (p=0.02; RR=2.90), consumo de alimentos con alto contenido de azúcar (p = 0.01; RR=0.25), consumo de leches distintas al pecho (p = 0.02; RR=3.25) y consumo de huevo (p =0.05; RR=0.28). Conclusiones: nuestros resultados muestran que es fundamental atender las prácticas de alimentación complementaria y reforzar la lactancia materna exclusiva en el primer año de vida, como medidas de prevención del sobrepeso y obesidad para mejorar la salud en la infancia.

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Abstract Objective: To present the results of a stakeholder analysis used to construct a map of the actors involved in the delib- eration of a proposal to increase the tax on sugar-sweetened beverages (SSB) in Mexico from 10 to 20 percent per liter. Materials and methods: A literature review and in- terviews to key actors were implemented. The analysis of the actors' power and position was made using Policymaker. Results: There was concern for the obesity epidemic among all stakeholders, but little consensus on the way to solve it. Researchers and non-governmental organizations (NGO) support an increase in the tax on SSB, while government officials and industry representatives oppose this measure. Conclusión: Supporters of an increase to the tax on SSB need to build a coalition in order to force government officials to support this policy and successfully confront the soda industry, which has a solid opposing strategy and enormous financial resources to influence public opinion and congressmen.

Resumen Objetivo: Presentar los resultados de un análisis de grupos de interés para definir un mapa de los actores involucrados en la deliberación de una propuesta para incrementar el impuesto a bebidas azucaradas (BA) en México del 10 al 20% por litro. Material y métodos: Se revisó la literatura y se entrevistó a actores clave. El análisis del poder y posición de los actores se realizó con el programa Policymaker. Resultados: Se identificó una amplia preocupación por la epidemia de obesidad, pero poco consenso sobre cómo resolverla. Los investigadores y las Organizaciones No Gubernamentales (ONG) apoyan un incremento en el impuesto a las BA, mientras que los funcionarios gubernamentales y los representantes de la industria se oponen a dicha medida. Conclusión: Quienes apoyan un incremento al impuesto deben crear una coalición que fuerce a los funcionarios gubernamentales a apoyar el aumento y confrontar exitosa- mente a la industria, la cual cuenta con una estrategia sólida y recursos financieros abundantes para influir en la opinión pública y en los legisladores.

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OBJECTIVE: To present the results of a stakeholder analysis used to construct a map of the actors involved in the delib-eration of a proposal to increase the tax on sugar-sweetened beverages (SSB) in Mexico from 10 to 20 percent per liter. MATERIALS AND METHODS: A literature review and in-terviews to key actors were implemented. The analysis of the actors' power and position was made using Policymaker. RESULTS: There was concern for the obesity epidemic among all stakeholders, but little consensus on the way to solve it. Researchers and non-governmental organizations (NGO) support an increase in the tax on SSB, while government officials and industry representatives oppose this measure. CONCLUSION: Supporters of an increase to the tax on SSB need to build a coalition in order to force government officials to support this policy and successfully confront the soda industry, which has a solid opposing strategy and enormous financial resources to influence public opinion and congressmen.

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INTRODUCCIÓN. Las infecciones del tracto urinario por variedad de bacterias uropatógenas multiresistentes se deben al uso de tratamiento empírico o automedicación. OBJETIVO. Describir en las infecciones de tracto urinario los métodos diagnósticos, tratamiento empírico y la multirresistencia. MATERIALES Y MÉTODOS. Estudio observacional, descriptivo, retrospectivo. Población y muestra de 73 Historias Clínicas de pacientes atendidos en la Unidad de Adultos Área de Emergencias del Hospital de Especialidades Carlos Andrade Marín en el período enero a diciembre 2018. Se incluyeron pacientes mayores de 18 años, de ambos sexos, con diagnóstico clínico y por laboratorio de infección del tracto urinario superior e inferior. La información se obtuvo mediante la base de datos AS400, y se procesó en Epi-info y Excel. RESULTADOS. El 71,23% (52; 73) de mujeres tuvieron infección del tracto urinario. Escherichia coli fue frecuente en un 48,39% (15; 31), con mayor resistencia al Clotrimoxazol. El tratamiento empírico con Ciprofloxacino fue utilizado en 27,40% (20; 73). DISCUSIÓN: Se observó controversia en los tipos de estudios de imagen solicitados para el diagnóstico acorde a la clase de infección de tracto urinario así como el tratamiento empírico por factores propios de cada localidad que evitaron resistencia. CONCLUSIÓN. Escherichia coli se aisló de manera frecuente y registró mayor resistencia al Clotrimoxazol; el principal antibiótico prescrito como tratamiento empírico fue la Ciprofloxacina; el examen más solicitado fue la Urotomografía.

INTRODUCTION. Urinary tract infections due to a variety of multi-resistant uropathogenic bacteria are due to the use of empirical treatment or self-medication. OBJECTIVE. Describe diagnostic methods, empirical treatment and multidrug resistance in urinary tract infections. MATERIALS AND METHODS. Observational, descriptive, retrospective study. Population and sample of 73 Medical Records of patients treated in the Emergency Area Adult Unit of the Carlos Andrade Marín Specialty Hospital in the period january to december 2018. Patients older than 18 years of age, of both sexes, with clinical diagnosis and due to upper and lower urinary tract infection laboratory. The information was obtained through the AS400 database, and was processed in Epi-info and Excel. RESULTS. 71,23% (52; 73) of women had urinary tract infection. Escherichia coli was frequent in 48,39% (15; 31), with greater resistance to Clotrimoxazole. Empirical treatment with Ciprofloxacin was used in 27,40% (20; 73). DISCUSSION: Controversy was observed in the types of imaging studies requested for diagnosis according to the class of urinary tract infection as well as the empirical treatment due to factors specific to each locality that prevented resistance. CONCLUSION. Escherichia coli was frequently isolated and showed greater resistance to Clotrimoxazole; the main antibiotic prescribed as empirical treatment was Ciprofloxacin; the most requested examination was the Urotomography.

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Objetivo: Determinar la asociación entre la presencia de síntomas depresivos y adicción a internet (Al) en alumnas del Colegio Nacional "Rosa de Santa María". Materiales y Métodos: Estudio analítico, observacional, no controlado y transversal. Se aplicó una encuesta a 281 estudiantes utilizando dos escalas para determinar el grado de depresión y de adicción a internet (Zung y EAIL). Resultados: La edad promedio fue 15±0,8 años, predominando alumnas del 5to año de secundaria (49.47 por ciento). El 14.59 por ciento repitió algún año escolar, el 82.21 por ciento vive con sus padres en familias de 4 a 6 integrantes, el 87.19 por ciento cuenta con todos los servicios básicos, el 61.21 por ciento tiene internet en casa, el 23.84 por ciento acude a cabinas públicas y el 51.96 por ciento pasa menos de 6 horas conectado. La prevalencia de depresión fue de 23.13 por ciento. El acceso a internet desde el hogar y la compañía de los padres fueron factores reductores de síntomas depresivos (p<0.05). La prevalencia de Al fue de 25.62 por ciento. La edad, grado de instrucción, fracaso escolar y pensamientos suicidas fueron factores de riesgo para Al (p<0.05). La depresión se asoció significativamente a la Al (OR=3.24, IC: 1.79-5.86, p=0.000005). Conclusiones: La presencia de síntomas depresivos es un factor de riesgo para adicción a internet. Existen variables protectoras de depresión como la compañía de los padres y el acceso a internet desde el hogar. Se determinó que la edad, grado de instrucción, fracaso escolar y pensamientos suicidas son variables que potencian conductas adictivas. Ambas escalas tiene gran consistencia y validez para ser aplicadas en el país.

Objective: To determine the association between the presence of depressive symptoms and Internet addiction (lA) in students of National High School "Rosa de Santa Maria". Materials and Methods: Analytical, observational, non-controlled cross-sectional study. A survey of 281 students using two scales to determine the degree of depression and Internet addiction (Zung and SIAL) was applied. Results: Mean age was 15±0.8 years, mainly students of the 5th year of secondary school (49.47 per cent). The 14.59 per cent repeated a school year, 82.21 per cent live with their parents in families of 4-6 members, the 87.19 per cent has all the basic services, 61.21 per cent have internet at home, 23.84 per cent goes to public payphones and 51.96 per cent within 6 hours passed connected. The prevalence of depression was 23.13 per cent. Access to Internet from home and the company of parents were reducing factors of depressive symptoms (p<0.05). The prevalence of Al was 25.62 per cent. Age, level of education, school failure and suicidal thoughts were risk factors for Al (p<0.05). Depression was significantly associated with Al (OR=3.24, Cl: 1.79-5.86, p=0.000005). Conclusions: The presence of depressive symptoms is a risk factor for internet addiction. There are protective variables of depression as the parent company and internet access from home. It was determined that age, level of education, school failure and suicidal thoughts are variables that promote addictive behaviors. Both scales have high reliability and validity to be applied in the country.

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Los abscesos hipofisarios se diagnostican en la mayoría de los casos solo después del drenaje transesfenoidal, el abordaje terapéutico de elección; son subdiagnosticados y representan una enfermedad con alta mortalidad sin el tratamiento correcto y oportuno. Este es el caso clínico de una paciente de 38 años de edad con amenorrea de un año de evolución, galactorrea, cefalea y déficit campimétrico manifestado por hemianopsia bitemporal. La resonancia magnética nuclear mostró una imagen compatible con adenoma hipofisario, por lo que se realizó abordaje transesfenoidal confirmándose por reporte histopatológico un absceso cerebral. Se llevó terapia antibiótica empírica con vancomicina, metronidazol y ceftriaxona a dosis meníngeas, sin obtener el agente causal en los cultivos. Se concluyó que los abscesos hipofisiarios son una patología potencialmente curable que al manifestarse como una masa selar la gran mayoría recibe un abordaje terapéutico adecuado por vía transesfenoidal, y en la mayoría de los casos dicho procedimiento arroja el diagnóstico y el tratamiento definitivo al mismo tiempo.

Pituitary abscesses are defined as the affection of the pituitary gland by an intrasellar suppurative process caused by an infectious agent. Pituitary abscesses represent less than 1% of the pathologies of the sellar region, the clinical manifestations are due to pituitary dysfunction or mass effect. The diagnosis in most of the cases is only after transsphenoidal drainage which is the therapeutic approach of choice, being underdiagnosed and becoming a disease with high mortality if the right and appropriate treatment is not instituted. Case report. A case of a 38-year-old-female patient with amenorrhea of one year of evolution, galactorrhea, headache and visual field deficits manifested by bitemporal hemianopsia is reported. Magnetic resonance imaging showed an image compatible with pituitary adenoma, a transsphenoidal approach was performed and histopathologic report confirmed a brain abscess. Antibiotic therapy was empirically started with vancomycin, metronidazole and ceftriaxone at meningeal doses, failed to get the agent in cultures. Conclusions. Pituitary abscesses are a potentially curable disease that present as a sellar mass, most receive the appropriate therapy by transsphenoidal approach and in most of the cases this procedure gives the definitive diagnosis and treatment simultaneously.

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Una paciente de sexo femenino de 60 años de edad, costurera, natural de Rio de Janeiro, fue valorada por el servicio de clínica cardiológica por queja de falta aire, catalogada como disnea, que inicia con grandes esfuerzos y que evoluciono en corto tiempo a disnea de medianos esfuerzos con aparecimiento de disnea paroxística nocturna. Su cuadro se acompaña de vértigo y cefalea de más de 30 años de evolución, que empeora en los dos últimos años. Adicionlmente refere dolor de espalda de tipo no anginoso de localización interescapular .

A 60-year-old female patient, a seamstress, a native of Rio de Janeiro, was assessed by the cardiology clinic for a complaint of lack of air, cataloged as dyspnea, which begins with great efforts and evolved shortly time to dyspnea of ​​medium efforts with appearance of paroxysmal nocturnal dyspnea. His picture is accompanied by vertigo and headache of more than 30 years of evolution, which worsens in the last two years. Additionally refer back type pain non-anglo of interscapular location.

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UNLABELLED: The purpose of this study was to compare optimized whole-body (WB) and dedicated high-resolution contrast-enhanced PET/CT protocols and contrast enhanced CT in the preoperative staging of primary squamous cell carcinoma of the head and neck. METHODS: A total of 44 patients with clinically M0 squamous cell carcinoma of the head and neck underwent primary tumor resection and neck dissection within 6 wk of diagnostic imaging. Imaging consisted of a standard WB PET/CT protocol without intravenous contrast enhancement, followed by a high-resolution dedicated head and neck (HN) PET/CT protocol, which included diagnostic-quality contrast-enhanced CT (CECT). Imaging results were compared with histopathology. A 5-point scale was used to designate primary tumor localization and the presence of lymph node metastasis on a per-patient and per-level basis. For cervical nodes, receiver-operating-characteristic curves were generated to determine the differences in performance between the WB and HN PET/CT protocols and CECT. Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated for primary tumor and cervical nodes. RESULTS: No statistical difference was observed between WB and HN PET/CT protocols, both of which significantly outperformed CECT, in the evaluation of the primary tumor. The performance of the HN PET/CT protocol was superior to that of the WB PET/CT in the detection of cervical node metastases, achieving statistical significance on a per-level basis and approaching significance on a per-patient basis, with the greatest advantage in the detection of small positive lymph nodes (<15 mm). No significant difference was observed between the WB PET/CT protocol and CECT in nodal staging, either on a per-patient or on a per-level basis. CONCLUSION: The primary advantage of the dedicated HN PET/CT protocol over the WB protocol or CECT in the staging of head and neck cancer is in the detection of small lymph node metastases.

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