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Resumen La limitación del esfuerzo terapéutico (LET) es toda acción que implique suspender o no iniciar tratamientos o medidas terapéuticas en pacientes que no se beneficiarán clínicamente. En Latinoamérica, las investigaciones realizadas dejan en evidencia la falta de familiarización y discordancia que hay alrededor del tema y sus prácticas. El presente estudio buscó objetivizar el conocimiento en LET del personal de salud de una institución de Medellín, a partir de una encuesta autoaplicada que permitió el desarrollo de un estudio descriptivo de tipo transversal, con muestreo no probabilístico. Dentro de los resultados se encontró que el 56,5 % de los encuestados refirió conocer el concepto, y el 90 % manifestó aplicarlo. Sin embargo, había discordancias dentro de los conceptos clave de la definición y el ejercicio.

Abstract Limitation of therapeutic effort (LTE) is any action that involves suspending or not initiating medical treatment or therapeutic measures in patients who will not receive any clinical benefit. In Latin America, some research has proven a lack of familiarization and disagreement with the subject and its practices. The present study tried to objectify the knowledge of LTE of healthcare personnel at an institute in Medellín using a self-administered survey that allowed conducting a cross-sectional descriptive study with non-probabilistic sampling. Within the results, 56.5 % of respondents understood the concept of LTE, and 90 % applied it actively. However, there were discrepancies regarding the core concepts of the definition and practice.

Resumo A limitação de esforço terapêutico (LET) é toda ação que implique suspender ou não iniciar tratamentos ou medidas terapêuticas em pacientes que não se beneficiarão clinicamente. Na América Latina, as pesquisas realizadas evidenciam a falta de familiarização e a discordância que há ao redor do tema e suas práticas. O presente estudo procurou objetivar o conhecimento em LET da equipe de saúde de uma instituição de Medellín, utilizando um questionário auto aplicado que permitiu o desenvolvimento de um estudo descritivo de tipo transversal, com amostragem não probabilística. Dentro dos resultados constatou-se que 56,5 % dos pesquisados disseram conhecer o conceito, e 90 % manifestaram aplicá-lo. No entanto, havia discordâncias dentro dos conceitos chave da definição e da prática.

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Introducción: el absentismo laboral constituye un problema serio para las empresas a nivel mundial y los centros de teleoperadores no son la excepción. Objetivos: determinar las causas de absentismo laboral por incapacidad médica e identificar factores sociodemográficos, laborales y costos directos en un centro de teleoperadores de la ciudad de Medellín en el periodo 2016-2017. Material y Métodos: estudio descriptivo, transversal, donde se analizaron 36.283 registros de absentismo laboral que se registraron de acuerdo a diagnósticos (CIE-10), se reclasificaron según criterio médico. Se calcularon indicadores de absentismo laboral según NTC 3793. Resultados: el 99,3% de las ausencias se debió a enfermedad general. El promedio de ausencia es de 4,28 +/-5,64 días por trabajador. Solo el 5% de las incapacidades superaban los cinco días. Las enfermedades gastrointestinales y de vías respiratorias tuvieron los mayores días de ausencia. Los absentistas repetitivos aportaron en total 44.063 días perdidos. Los absentistas crónicos generaron una pérdida de 223 días por cada 100 trabajadores

Introduction: absenteeism constitutes a serious problem for the companies worldwide. Call centers are not the exception Objectives:to determine causes of absenteeism for sickness absence and to identify sociodemographic and labour factors and direct cost in a call center in Medellín, 2016-2017. Material and Methods: a descriptive, transverse study. The study analysed 36.283 records of absenteeism that were registered in accordance to diagnoses (CIE 10). These records were re-classified according to medical criterion and it was calculated rates of absenteeism in accordance to NTC 3793. Results: 99.3% of absences were due to general illness. The average of absence is 4.28 +/-5.64 days per worker. Only 5% of absenteeism exceeded five days. The gastrointestinal diseases and of respiratory tract had the major days of absence. The repetitive absentee contributed a total 44,063 lost days. The chronic absentee generated a loss of 223 days per 100 workers

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Objetivos: El objetivo del estudio es comparar, entre dos grupos de pacientes, una serie de factores cl¡nico-epidemiol¢gicos relacionados a mortalidad: edad, sexo, comorbilidades, tipo de estatus epil‚ptico y uso deventilaci¢n mec nica. Material y M‚todos: El estudio se realiz¢ en el Hospital Cayetano Heredia entre enero de 2012 hasta diciembre de 2014. Incluy¢ 94 pacientes con el diagnóstico de estatus epil‚ptico admitidos durante el per¡odo establecido. El estudio compar¢ datos de los supervivientes contra datos de los fallecidos. Se recolect¢ la información de las historias cl¡nicas en una ficha de datos para la elaboraci¢n de una base de datos. Resultados: La mortalidad intrahospitalaria fue de 8,51%. La media de edad fue de 41,8 a¤os. Las principales etiolog¡as halladas fueron la epilepsia idiop tica (28,72%), la neurocisticercosis (14,89%) y la enfermedad cerebrovascular(14,89%). Se encontr¢ que un 19,5% de pacientes hab¡an abandonado el tratamiento antiepil‚ptico. El an lisisbivariado demostr¢, para la mortalidad intrahospitalaria, una relaci¢n significativa (p<0,05) con un alto Õndice de Comorbilidad Charlson y el uso de ventilaci¢n mec nica. Conclusiones: La presencia de comorbilidades y el uso deventilaci¢n mec nica se relacionan significativamente con mortalidad en pacientes con estatus epiléptico.

Objectives: The goal of this study is to compare, among two groups of patients, a series of clinical-epidemiologicalfactors related to mortality: age, sex, comorbidity, type of status epilepticus and use of mechanical ventilation.Material and Methods: The study was carried out in the Hospital Cayetano Heredia from January 2012 to December2014. It includes 94 patients with status epilepticus admitted during the established period. The study compareddata from the survivors against data from the deceased. Information from medical records was collected in a Data Sheet to elaborate a data bank. Results: In-hospital mortality was 8.51%. The mean of age was 41,8 a¤os. Themain etiologies found were idiopathic epilepsy (28.72%), neurocysticercosis (14.89%) and cerebrovascular disease(14.89%). It was found that 19.5% of patients had discontinued antiepileptic treatment. Bivariate analysis showed,for in-hospital lethality, a significant relationship (p<0.05) with a high Charlson Index and the use of mechanical ventilation. Conclusions: The presence of comorbidities and the use of mechanical ventilation are significantlyrelated with in-hospital mortality in patients with status epilepticus.

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Helicoidea is a diverse group of land snails with a global distribution. While much is known regarding the relationships of helicoid taxa, comparatively little is known about the evolution of the mitochondrial genome in the superfamily. We sequenced two complete mitochondrial genomes from Praticolella mexicana Perez, 2011 representing the first such data from the helicoid family Polygyridae, and used them in an evolutionary analysis of mitogenomic gene order. We found the mitochondrial genome of Praticolella mexicana to be 14,008 bp in size, possessing the typical 37 metazoan genes. Multiple alternate stop codons are used, as are incomplete stop codons. Mitogenome size and nucleotide content is consistent with other helicoid species. Our analysis of gene order suggested that Helicoidea has undergone four mitochondrial rearrangements in the past. Two rearrangements were limited to tRNA genes only, and two involved protein coding genes.

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Fundamento: los moluscos fluviales tienen en la actualidad una gran importancia en la transmisión de enfermedades, tanto al hombre como a los animales, influenciado por el cambio climático.Objetivo: caracterizar la malacofauna fluvial, teniendo en cuenta su distribución en las diferentes zonas del municipio Jesús Menéndez, provincia Las Tunas, estratificando las principales especies de importancia médica y su relación con los principales tipos de ecosistemas.Métodos: se muestrearon 22 ecosistemas fluviales en todo el municipio, durante los años 2013 - 2014, abarcando tanto el período lluvioso como poco lluvioso. La toma de muestra de los criaderos se realizó dos veces por año, mediante capturas (15 minutos por cada punto de encuestas), empleándose un colador circular 15 cm de diámetro, 1 mm de tamaño de malla y 20 cm de mango. Se relacionó cada especie con el hábitat correspondiente.Resultados: Se identificaron 11 especies de moluscos fluviales, siendo Pomacea paludosa (18,3 por ciento), Biomphalaria habanenesis (17 por ciento), Fossaria cubensis (16,1 por ciento), Tarebia granifera (14,8 por ciento), las especies más comunes, y de mayor densidad poblacional. Y los sitios de cría más importantes fueron los criaderos, zanjas, organopónicos y ríos. Conclusiones: El municipio Jesús Menéndez posee una variedad de moluscos fluviales, existiendo especies capaces de servir como hospederos intermediarios transmisores de enfermedades, tanto a la salud humana, como animal (AU)

Background: at present, fluvial mollusks are of great consequence for the transmission of diseases to both man and animals, influenced by climate change.Objective: to characterize fluvial malaco-fauna, considering its distribution in the different areas of Jesus Menendez municipality, Las Tunas province, stratifying the main species of medical importance and their relation to the main ecosystem types.Methods: 22 fluvial ecosystems were sampled throughout the town, during the years 2013 and 2014, covering both rainy and little rainy period. Sampling from the hatcheries was done twice a year, by catches (15 minutes per point of surveys), using a circular 15 cm diameter sieve, 1 mm mesh size and 20 cm handle. Species were related to their corresponding habitat.Results: 11 species of fluvial mollusks were identified, being Pomaceapaludosa (18,3 percent), Biomphalariahabanenesis (17 percent), Fossariacubensis (16,1 percent), and Tarebiagranifera (14,8 percent), the most common species with the highest population density. The most important locations were hatcheries, ditches, organic farms and rivers.Conclusions: Jesus Menendez municipality has a variety of fluvial mollusks, existing species capable of being of use as intermediary hosts for transmitting diseases, both to human and animal health (AU)

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Se realizó un estudio descriptivo de la población de culícidos en el municipio de Jesús Menéndez, Las Tunas, durante el año 2012; con el objetivo de determinar la presencia de nuevas especies de mosquitos que pueden intervenir en la transmisión del virus del Nilo Occidental. El universo lo constituyeron los doce consejos populares del municipio. La captura de larvas y de adultos se realizó de acuerdo a las técnicas normadas en Cuba y según la metodología de la Organización Mundial de la Salud. Se identificaron cinco nuevas especies que son capaces de transmitir el virus: Aedes albopictus (2,1 por ciento), Culex erraticus (0,25 por ciento), Mansonia titillans (0,04 por ciento), Orthopodomia signifera (0,01 por ciento) y Uranotaenia lowii (0,05 por ciento). Los consejos populares con más distribución fueron los urbanos: El Batey (48,02 por ciento), Pueblo Viejo (26,7 por ciento) y El Canal (16,4 por ciento), donde existe mayor acumulación de agua por parte de la población en diferentes depósitos y criaderos naturales dentro de la zona urbana (AU)

A descriptive study of the culicid population of Jesus Menendez Municipality in Las Tunas was carried out during 2012, with the objective of determining the presence of new species of mosquitoes that can get involved in the transmission of the West Nile Virus. The universe was made up of the twelve city districts of the municipality. The catch of larva and adult mosquitoes was done according to the Cuban current regulation techniques and following the World Health Organizations methodology. Five new species able to transmit the virus were identified: Aedes albopictus (2,1 percent), Culex erraticus (0,25 percent), Mansonia titillans (0,04 percent), Orthopodomia signifera (0,01 percent) and Uranotaenia lowii (0,05 percent). The city districts with the highest distribution were the urban ones: El Batey (48,02 percent), Pueblo Viejo (26,7 percent) and El Canal (16,4 percent), where there is the greatest accumulation of water in different kinds of water tanks and the natural farms within the urban area (AU)

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Genotyping-by-sequencing (GBS) technologies have proven capacity for delivering large numbers of marker genotypes with potentially less ascertainment bias than standard single nucleotide polymorphism (SNP) arrays. Therefore, GBS has become an attractive alternative technology for genomic selection. However, the use of GBS data poses important challenges, and the accuracy of genomic prediction using GBS is currently undergoing investigation in several crops, including maize, wheat, and cassava. The main objective of this study was to evaluate various methods for incorporating GBS information and compare them with pedigree models for predicting genetic values of lines from two maize populations evaluated for different traits measured in different environments (experiments 1 and 2). Given that GBS data come with a large percentage of uncalled genotypes, we evaluated methods using nonimputed, imputed, and GBS-inferred haplotypes of different lengths (short or long). GBS and pedigree data were incorporated into statistical models using either the genomic best linear unbiased predictors (GBLUP) or the reproducing kernel Hilbert spaces (RKHS) regressions, and prediction accuracy was quantified using cross-validation methods. The following results were found: relative to pedigree or marker-only models, there were consistent gains in prediction accuracy by combining pedigree and GBS data; there was increased predictive ability when using imputed or nonimputed GBS data over inferred haplotype in experiment 1, or nonimputed GBS and information-based imputed short and long haplotypes, as compared to the other methods in experiment 2; the level of prediction accuracy achieved using GBS data in experiment 2 is comparable to those reported by previous authors who analyzed this data set using SNP arrays; and GBLUP and RKHS models with pedigree with nonimputed and imputed GBS data provided the best prediction correlations for the three traits in experiment 1, whereas for experiment 2 RKHS provided slightly better prediction than GBLUP for drought-stressed environments, and both models provided similar predictions in well-watered environments.

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El municipio Jesús Menéndez de la provincia Las Tunas, constituye un área biológica y ecológica de riesgo para la introducción del Virus del Nilo Occidental, por lo que se realizó un estudio descriptivo con el objetivo de identificar la presencia de aves migratorias, así como de sus lugares de asentamiento por ser áreas de riesgo; para ello se realizó una encuesta y un censo, obteniendo resultados positivos sobre el asentamiento de varias especies de aves migratorias procedentes de Norteamérica. Estos resultados permitieron realizar la estratificación de las áreas de introducción para el Virus del Nilo Occidental (AU)

Jesus Menéndez municipality in Las Tunas province constitutes a biological and ecological area of risk for the introduction of the West Nile Virus (WNO); that is why a descriptive study with the objective of identifying the existence of migratory birds as well as and their rest areas was done; a survey was applied and several species of migrant birds from North America showed positive. The results made possible the stratification of areas for the introduction of the West Nile Virus (AU)

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The biochemical mechanisms of resistance to several heavy metals, which are associated with their accumulation (binding by high-affinity chelating molecules such as thiol-compounds together with their compartmentalization into organelles), are analyzed for the photosynthetic, free-living protist Euglena gracilis. The complete understanding of these mechanisms may facilitate the rational design of strategies for bioremediation of heavy metal polluted water and soil systems.

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The free-living protist Euglena gracilis showed an enhanced growth when cultured in the dark with high concentrations of ethanol as carbon source. In a medium containing glutamate/malate plus 1% ethanol, E. gracilis reached a density of 3 x 10(7) cells/ml after 100 h of culture, which was 5 times higher than that attained with glutamate/malate or ethanol separately. This observation suggested the involvement of a highly active aldehyde dehydrogenase in the metabolism of ethanol. Purification of the E. gracilis aldehyde dehydrogenase from the mitochondrial fraction by affinity chromatography yielded an enrichment of 34 times and recovery of 33% of the total mitochondrial activity. SDS-PAGE and molecular exclusion chromatography revealed a native tetrameric protein of 160 kDa. Kinetic analysis showed Km values of 5 and 50 microM for propionaldehyde and NAD(+), respectively, and a Vm value of 1,300 nmol (min x mg protein)(-1). NAD(+) and NADH stimulated the esterase activity of the purified aldehyde dehydrogenase. The present data indicated that the E. gracilis aldehyde dehydrogenase has kinetic and structural properties similar to those of human aldehyde dehydrogenases class 1 and 2.

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