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Aim: The aim of this literature review is to describe the latest treatment available in the solution of this problem through remineralization. Literature review: A literature review was carried out in various electronic databases such as PubMed, MEDLINE, EBSCO, LILACS, EMBASE, Cochrane Library; from 1989 to 2022. The Medical Subject Headings (MeSH) terms used in the literature search were in English: "tooth reminaralization", "dental white spot", "orthodontic. Discussion: White spot lesions after orthodontic appliances is an undesired effect seen in dentistry. There is a wide option of agents that offer remineralization by the process of depositing calcium and phosphate ions into crystal voids in demineralized enamel, producing net mineral gain and preventing early enamel lesions progression, including fluoride toothpastes, fluoride varnishes, fluoride mouth rinses, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). Conclusion: Fluoride-based prevention strategies are the agent with the strongest evidence for the treatment of WSL. The dental professional should offer this therapy in the earliest phase of the lesions so that it can be remineralized.

Objetivo: O objetivo desta revisão de literatura é descrever osmais recentestratamentos disponíveisna remineralizaçãode lesões de mancha branca.Revisão da literatura: Foi realizada uma revisão da literatura em várias bases de dados eletrônicas como PubMed, MEDLINE, EBSCO, LILACS, EMBASE, Cochrane Library; de 1989 a 2022. Os termos do Medical Subject Headings (MeSH) utilizados na busca da literatura foram em inglês: "tooth reminaralization", "dental white spot", "orthodontics".Discussão: A lesão de mancha branca após utilização de aparelhos ortodônticos é um efeito indesejado observado na odontologia. Existe uma ampla opção de agentes que oferecem remineralização pelo processo de deposição de íons cálcio e fosfato nos cristaisdo esmalte desmineralizado, produzindoganho mineral líquido e prevenindo a progressão precoce das lesões do esmalte, incluindo cremes dentais com flúor, vernizes com flúor, enxaguatórios bucaiscom flúor e caseína fosfopeptídeo-fosfato de cálcio amorfo (CPP-ACP).Conclusão: As estratégias de prevenção utilizandoflúor constituem osagentescom mais evidências para o tratamento da mancha branca. O dentista deve oferecer essa terapia na fase inicial das lesões para que haja remineralização.

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Introducción: La esofagectomía es uno de los procedimientos con más alta morbilidad posoperatoria en cirugía oncológica digestiva. Objetivo: Describir las complicaciones relacionadas con la esofagectomía subtotal programada según variables de interés. Métodos: Se realizó un estudio descriptivo y transversal en los Servicios de Cirugía General de los hospitales "Saturnino Lora" y "Juan Bruno Zayas" de Santiago de Cuba, desde 2010 hasta 2019. La población estuvo conformada por 81 pacientes, de la cual se reclutó una muestra aleatoria de 68 enfermos sometidos a esofagectomía subtotal programada por cáncer de esófago. Fueron investigadas las siguientes variables: presencia de complicaciones posoperatorias y tipo de técnica quirúrgica utilizada. Además, se clasificaron en grados según Dindo Clavien. Resultados: Todos los enfermos fueron operados por técnica abierta mediante esofagectomía subtotal programada, donde la resección mediante la técnica de Ivor-Lewis se realizó en el 69,2 por ciento. Para todas las técnicas quirúrgicas empleadas predominó la atelectasia (39,7 por ciento) como complicación posquirúrgica, y entre las infecciosas la neumonía en 30 enfermos (44,1 por ciento), mientras que para las complicaciones quirúrgicas no infecciosas el neumotórax fue mayormente incidente, para el 25,0 por ciento. El mayor número de complicaciones se ubicó en el grado II de Dindo Clavien. Conclusiones: La presencia de complicaciones posquirúrgicas de la enfermedad es notable, en correspondencia a lo reflejado por la literatura médica. Existió relación significativa entre la presencia del hábito de fumar, de enfermedad pulmonar obstructiva crónica y la de toracotomía con algunas de las complicaciones encontradas(AU)

Introduction: Esophagectomy is one of the procedures with the highest postoperative morbidity in digestive cancer surgery. Objective: To describe the complications related to scheduled subtotal esophagectomy according to variables of interest. Methods: A descriptive and cross-sectional study was carried out in the General Surgery Services at Saturnino Lora and Juan Bruno Zayas hospitals in Santiago de Cuba, from 2010 to 2019. The population consisted of 81 patients, out of which a random sample of 68 patients undergoing elective subtotal esophagectomy for esophageal cancer was selected. The variables investigated were presence of postoperative complications and type of surgical technique used. In addition, they were classified in grades according to Clavien-Dindo. Results: All the patients were operated by open technique by programmed subtotal esophagectomy, the resection by the Ivor-Lewis technique was performed in 69.2 percent. For all the surgical techniques used, atelectasis (39.7 percent) prevailed as a postsurgical complication, and among the infectious complications, pneumonia prevailed in 30 patients (44.1 percent), while for non-infectious surgical complications, pneumothorax was mostly incidental for 25.0 percent. The highest number of complications was in Clavien-Dindo grade II. Conclusions: The presence of post-surgical complications of the disease is notable, corresponding to what is reflected in the medical literature. There was significant relationship between the presence of smoking, chronic obstructive pulmonary disease and thoracotomy with some of the complications found(AU)

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Introducción: La morbilidad y la mortalidad continúan siendo altas a escala mundial como consecuencia de la esofagectomía programada por cáncer de esófago. Objetivo: Identificar los factores predictores de complicaciones posquirúrgicas y de muerte, la estadía hospitalaria y las causas de muerte en la población estudiada. Método: Se efectuó un estudio de cohorte de 81 pacientes con diagnóstico de cáncer de esófago, atendidos en los hospitales Saturnino Lora y Dr. Juan Bruno Zayas Alfonso de la provincia de Santiago de Cuba desde enero de 2010 hasta diciembre de 2019, de los cuales se escogió una muestra aleatoria de 68. Para identificar los factores predictivos asociados con las complicaciones y la mortalidad se definieron 2 cohortes de enfermos: los expuestos y los no expuestos a los factores de interés, tales como la realización de toracotomía, las reintervenciones, además de las complicaciones médicas y quirúrgicas infecciosas. Se utilizó el método estadístico de bondad de ajuste de Hosmer-Lemeshow con un nivel de significación α= 0,10. Resultados: Si se realiza toracotomía, la probabilidad de que se desarrollen complicaciones quirúrgicas infecciosas es 2,3 veces mayor que si no se lleva a cabo el proceder; asimismo, el riesgo de fallecer por dichas complicaciones (p=0,024), en contraposición a cuando no se presentan, asciende a 370,0 % (IC 90 %: 1,5-14,8). Conclusión: La realización de toracotomía se establece como factor predictor de complicaciones y la presencia de reintervenciones y de complicaciones médicas y quirúrgicas infecciosas como predictores de muerte en la esofagectomía programada.

Introduction: Morbidity and mortality continue being high worldwide as consequence of the esophagectomy programmed due to esophagus cancer. Objective: To identify the predictor factors of postsurgical and death complications, hospitalization and death causes in the studied population. Method: A cohort study of 81 patients with diagnosis of esophagus cancer was carried out. They were assisted in Saturnino Lora and Dr. Juan Bruno Zayas Alfonso hospitals in the province of Santiago de Cuba from January, 2010 to December, 2019, of which a random sample of 68 was chosen. To identify the prediction factors associated with the complications and mortality 2 cohorts of sick patients were defined: the exposed and those not exposed to interest factors, such as the thoracotomy realization, reinterventions, besides the infectious medical and surgical complications. The statistical method of Hosmer-Lemeshow was used with a significance level of α = 0,10. Results: If thoracotomy is carried out, the probability that infectious surgical complications are developed is 2.3 times more that if it is not carried out; also, the risk of dying due to this complications (p=0.024), in opposition to when they are not presented, ascends to 370.0 % (IC 90 %: 1.5-14.8). Conclusion: The thoracotomy realization is established as predictor factor of complications and the presence of reinterventions and infectious medical and surgical complications as death predictors in the programmed esophagectomy.

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RESUMEN Introducción: El cáncer de esófago es la octava neoplasia diagnosticada con más frecuencia a nivel mundial, con 456 mil nuevos casos al año. Objetivo: Caracterizar a pacientes con cáncer de esófago que se les realiza esofagectomía subtotal programada. Métodos: Se realizó un estudio observacional, descriptivo de una serie de casos en los servicios de cirugía general de los Hospitales Provincial "Saturnino Lora" y General "Juan B. Zayas" de Santiago de Cuba desde 2010 al 2019. El universo estuvo conformado por 81 pacientes con diagnóstico de cáncer de esófago, de los cuales se seleccionaron 68 por cumplir con los criterios de inclusión. Fueron investigadas variables epidemiológicas, clínicas y quirúrgicas. Se calcularon porcentajes, media aritmética y desviación estándar. Resultados: Se observó predominio de los hombres (88,2 %); dentro de los factores epidemiológicos hubo predominio del hábito alcohólico (75,0 %) y del tabaquismo (58,8 %), la disfagia fue el síntoma más frecuente (48 enfermos). Las lesiones tumorales localizadas en el tercio medio e inferior fueron las más frecuentes. Predominó el carcinoma epidermoide en 52 pacientes y la localización del tumor en el tercio medio esofágico. En cuanto al tipo de resección quirúrgica la más utilizada fue la de McKeown (87,2 %). Conclusión: El cáncer de esófago es más frecuente en varones de la tercera década de la vida, fumadores, consumidores de alcohol y con mal estado nutricional. El patrón histológico predominante es el carcinoma epidermoide vegetante. La esofagectomía transhiatal es la variante técnica más utilizada en su tratamiento quirúrgico.

ABSTRACT Introduction: Esophageal cancer is the eighth most frequently diagnosed neoplasm worldwide with 456 thousand new cases per year. Objective: To characterize patients with esophageal cancer who undergo programmed subtotal esophagectomy. Methods: An observational, descriptive study of a case series was carried out in the general surgery services of the Provincial Hospital "Saturnino Lora" and General "Juan B. Zayas" of Santiago de Cuba from 2010 to 2019. The universe was made up of 81 patients diagnosed with esophageal cancer, of which 68 were selected agreeing inclusion criteria. Epidemiological, clinical and surgical variables were investigated. Percentages, arithmetic mean and standard deviation were calculated. Results: A predominance of men was observed (88.2 %); among the epidemiological factors, there was a predominance of alcoholic habit (75.0 %) and smoking (58.8 %), dysphagia in 48 patients was the most frequent symptom. Tumor lesions located in the middle and lower third were the most frequent. Squamous cell carcinoma predominated in 52 patients and the tumor was located in the middle third of the esophagus. Regarding the type of surgical resection, the most used was that of McKeown (87.2 %). Conclusion: Esophageal cancer is more frequent in men in the third decade of life, smokers, chronic alcoholics and poor nutritional status. The predominant histological pattern is vegetative squamous cell carcinoma. Transhiatal esophagectomy is the most widely used technical variant in its surgical treatment.

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RESUMEN Introducción: El cáncer de esófago es una enfermedad presente a escala mundial, sobre todo en naciones en vías de desarrollo. Se realizó una revisión bibliográfica en bases de datos biomédicas mediante el motor de búsqueda de información Google académico. Se seleccionaron 24 de 62 artículos; 22 (91,6 %) del último quinquenio, publicados en español e inglés, relacionados con el objetivo propuesto. Objetivo: Describir algunos aspectos del cáncer de esófago, con énfasis en los epidemiológicos, etiopatogénicos y del tratamiento quirúrgico. Desarrollo: El cáncer de esófago es más frecuente en varones, con proporción hombre/mujer de 6:1, aunque en poblaciones de alto riesgo la incidencia es igual en ambos sexos; aunque algunos refieren que la relación es de 3 a 10 hombres por cada mujer, en dependencia de la zona geográfica. Las áreas de alta frecuencia son: Asia, África Central y del Sur. El carcinoma epidermoide y el adenocarcinoma representan el 95,0 % de todos los tumores esofágicos. La esofagectomía abierta o mínimamente invasiva constituye el pilar básico del tratamiento quirúrgico. Conclusiones: En la etiología del cáncer de esófago, los factores moleculares, genéticos y ambientales juegan un papel importante. El diagnóstico en etapas avanzadas predomina debido a lo tardío de la aparición de los síntomas y a las insuficiencias en el cribaje. El tratamiento quirúrgico constituye un pilar fundamental para los tres primeros estadios de la enfermedad, acompañada o no de quimio-radioterapia adyuvante o de neoadyuvancia (en el estadio II).

ABSTRACT Introduction: Esophageal cancer is a disease present worldwide, especially in developing nations. A bibliographic review was carried out in biomedical databases using the Google Scholar search engine. 24 of 62 articles were selected; 22 (91.6 %) of the last five years, published in Spanish and English, related to the proposed objective. Objective: To describe some aspects of esophageal cancer, with emphasis on the epidemiological, etiopathogenic and surgical treatment. Development: Esophageal cancer is more common in men, with a male/female ratio of 6:1, although in high-risk populations the incidence is the same in both sexes; although some report that the ratio is between 3 and 10 men for every woman, depending on the geographical area. High frequency areas are: Asia, Central and South of Africa. Squamous cell carcinoma and adenocarcinoma represent 95.0 % of all esophageal tumors. Open or minimally invasive esophagectomy is the basic pillar of surgical treatment. Conclusions: In the etiology of esophageal cancer, molecular, genetic and environmental factors play an important role. Diagnosis in advanced stages predominates due to the late onset of symptoms and insufficient screening. Surgical treatment is a fundamental pillar for the first three stages of the disease, accompanied or not by adjuvant or neoadjuvant chemo-radiotherapy (in stage II).

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Los dientes impactados son frecuentemente observados en la práctica clínica. Sin embargo, la presencia de premolares impactados es una anomalía dentaria poco reportada. Se sabe de una relación genética entre la presencia de varias anomalías dentarias en un mismo paciente, así como en una misma familia. Las impactaciones de premolares inferiores pueden estar asociada a impactaciones palatinas de caninos e incisivos laterales superiores con alteración en forma y/o número. Esta investigación tuvo como objetivo describir las causas asociadas a impactación de premolares a través de una serie de 6 casos, en edades comprendidas entre 11 y 15 años de edad. Los resultados encontrados sugieren que las causas asociadas a la impactación de premolares inferiores fueron: retención prolongada de dientes primarios, patrón eruptivo alterado, presencia de supernumerarios, pérdida prematura de dientes primarios y erupción retardada asociada a factor hormonal. Se concluye que la presencia de impactación de premolares apunta a la asociación de varias causas que confluyen observándose no solo una sino varias anomalías dentarias.

Dentes impactados são freqüentemente observados na prática clínica. No entanto, a presença de pré-molares impactados é uma anomalia dentária raramente relatada. Sabe-se de uma relação genética entre a presença de várias anomalias dentárias no mesmo paciente e também na mesma família. As impactações dos pré-molares inferiores podem estar associadas às impactações palatinas dos caninos e incisivos laterais superiores com alteração na forma e / ou número. Esta pesquisa teve como objetivo descrever as causas associadas à impactação de pré-molares por meio de uma série de 6 casos, com idades entre 11 e 15 anos. Os resultados encontrados sugerem que as causas associadas à impactação dos pré-molares inferiores foram: retenção prolongada dos dentes decíduos, padrão eruptivo alterado, presença de supranumerários, perda prematura dos dentes decíduos e erupção tardia associada a fatores hormonais. Concluise que a presença de impactação de pré-molares aponta para a associação de várias causas que convergem, observando-se não apenas uma, mas várias anomalias dentárias.

Impacted teeth are frequently observed in clinical practice. However, the presence of impacted premolars is a rarely reported dental anomaly. It is known of a genetic relationship between the presence of several dental anomalies in the same patient as well as in the same family. Among the anomalies associated with lower premolar impactions are palatal impacted cuspids and upper lateral incisors with alteration in shape or number. This investigation aimed to describe the causes associated with lower premolar impaction through a series of 6 cases, between 11 and 15 years of age. The results found suggest the causes associated with the impaction of lower premolars were prolonged retention of primary teeth, altered eruptive pattern, presence of supernumeraries, premature loss of primary teeth and delayed eruption associated with hormonal factors. It is concluded that the presence of premolar impaction points to an association of several causes that converge, observing not only one but several dental anomalies.

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Although mushrooms have been exploited since ancient times because of their particular taste and therapeutic properties, the interest in edible species as a source of ingredients and bioactive compounds is recent. Their valuable nutritional contents in protein, dietary fiber and bioactive compounds make them ideal candidates for use in foods in efforts to improve their nutritional profiles. This trend is in line with the consumer's growing demand for more plant-based foods. The present review paper explores different studies focused on the use of common edible mushrooms as an ingredient and additive replacer by using them in fresh, dried, or even extract forms, as meat, fat, flour, salt, phosphates, and antioxidant replacers. The replacement of meat, fat, flour, and salt by mushrooms from commercial species has been successful despite sensorial and textural parameters can be affected. Moderate concentrations of mushrooms, especially in powder form, should be considered, particularly in non-familiarized consumers. In the case of antioxidant and antimicrobial properties, results are variable, and more studies are necessary to determine the chemical aspects involved.

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PURPOSE: Identification of a high-risk group of brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) could lead to early interventions and probably better prognosis. The objective of the study was to identify this group by generating a multivariable model with recognized and accessible risk factors. METHODS: A retrospective cohort from patients seen at a single center during 2010-2020, was divided into a training (TD) and validation (VD) datasets, associations with BM were measured in the TD with logit, variables significantly associated were used to generate a multivariate model. Model´s performance was measured with the AUC/C-statistic, Akaike information criterion, and Brier score. RESULTS: From 570 patients with NSCLC who met the strict eligibility criteria a TD and VD were randomly assembled, no significant differences were found amid both datasets. Variables associated with BM in the multivariate logit analyses were age [P 0.001, OR 0.96 (95% CI 0.93-0.98)]; mutational status positive [P 0.027, OR 1.96 (95% CI 1.07-3.56); and carcinoembryonic antigen levels [P 0.016, OR 1.001 (95% CI 1.000-1.003). BM were diagnosed in 24% of the whole cohort. Stratification into a high-risk group after simplification of the model, displayed a frequency of BM of 63% (P < 0.001). CONCLUSION: A multivariate model comprising age, carcinoembryonic antigen levels, and mutation status allowed the identification of a truly high-risk group of BM in NSCLC patients.

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Obstructive sleep apnea syndrome affects 1%-4% of all children worldwide. Currently, diagnosis of obstructive sleep apnea is based on sea-level guidelines, without taking into account the altitude at which the populations live. It has been shown that at 3,200 m of altitude there is an increase in obstructive events in healthy children aged 7 to 16 years; on the other hand, it is known that SpO2 dispersion between individuals becomes wider as altitude increases, a phenomenon that is more marked during sleep. About 17 million Colombians live in regions between 2,500 m and 2,700 m, as do significant populations in other Latin American countries. This research aimed to characterize respiratory polygraphy sleep parameters in healthy, non-snoring children aged 4-9 years living at 2,560 m. We carried out home respiratory polygraphy in 32 children with a mean age of 6.2 years (range 4-9 years). The average recorded sleep time was 7.8 h, the median apnea-hypopnea index was 9.2/h, the obstructive apnea-hypopnea index had a median of 8.8/h (p5 4.2 to p95 17.9) and central apnea a median of 0.4/h. The median SpO2 was 93% (p5 90.5 to p95 94) and transcutaneous CO2 had a median of 39.4 mmHg (p531.7 to p95 42.3). The median oxygen desaturation index ≥ 3% was 11.2 and median oxygen desaturation index ≥ 4% was 3.9. Normal measurements for respiratory polygraphy obtained at sea level do not apply to children at altitude. If such guidelines are used, obstructive sleep apnea will be over-diagnosed, resulting in unnecessary adenotonsillectomies, among other interventions.

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RESUMEN La epidermólisis bullosa engloba un grupo heterogéneo de enfermedades crónicas determinadas genéticamente que se caracterizan por presentar ampollas en piel y mucosas. Esta afección infrecuente también es llamada piel de mariposa o de cristal, y puede provocar un retraso en el neurodesarrollo del niño. Las complicaciones son invalidantes, afectan la calidad de vida, y pueden causar la muerte. Se realizó la rehabilitación domiciliaria de un bebé de un año de edad afectado de epidermólisis bullosa simple, con participación activa de los cuidadores; esta rehabilitación consistió en: tratamiento postural, ejercicios respiratorios, movilizaciones de todas las articulaciones, ludoterapia, terapia ocupacional y atención logofoniátrica. Después de 12 semanas de fisioterapia el paciente logró sentarse solo con equilibrio, apareció el reflejo de paracaídas, y sonreía al estimularlo. El tratamiento debe ser precoz (desde el nacimiento), individualizado e integral. El masaje y los agentes físicos están contraindicados porque pueden causar daños en la piel.

ABSTRACT Epidermolysis bullosa is a heterogeneous group of genetically determined chronic diseases characterized by blistering of the skin and mucosa. This rare condition is also called "butterfly or crystal skin children", and it can cause them a neurodevelopmental delay. Complications are disabling, affect quality of life, and can cause death. Home rehabilitation of a one-year-old baby affected by simple epidermolysis bullosa was performed with active participation of caregivers; this rehabilitation consisted of postural treatment, respiratory exercises, joint mobilization, play therapy, occupational therapy and phoniatric-logopedic care. The patient was able to sit alone, acquired sitting balance, parachute reflex appeared, and smiled when stimulating after 12 weeks of physiotherapy. Treatment must be early (from birth), individualized and comprehensive. Massage and physical agents are contraindicated because they can cause skin damage.

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Introducción: La infección por Helicobacter pylori se considera un problema mundial que eleva lamorbimortalidad por enfermedades gastrointestinales. Objetivo: Determinar la infección por Helicobacter pylori en pacientes con enfermedades digestivas, atendidos en el servicio de endoscopia digestiva diagnóstica superior. Métodos: Se realizó un estudio descriptivo transversal en el servicio de endoscopia digestiva diagnóstica superior del Policlínico Docente ¨Noelio Capote¨, municipio Jaruco, en el período de enero adiciembre del 2018. La población en estudio fue de 165 pacientes con diagnóstico de infección por Helicobacter pylori según positividad del Test de ureasa. Se estudiaron las variables: edad, sexo, enfermedades del tracto digestivo superior; factores de riesgo yevolución clínica, la endoscópica 6 meses después de culminado el tratamiento. La información se obtuvo mediante interrogatorio y revisión de los informes endoscópicos, se realizó un análisis estadístico y se utilizó el software para Windows, SPSS-15.0. Resultados: Predominaron los pacientes con edades entre 50 y 59 años (27.27 por ciento) y el sexo femenino(56.36 por ciento), el diagnóstico más frecuente fue la gastritis aguda (100 por ciento), la ingestión de agua sinhervir; la no práctica del lavado de manos antes de preparar o ingerir alimentos y la ingestiónde alimentos preparados fuera del hogar, los factores de riesgo que más se registraron. Lamayoría de los pacientes mejoraron o curaron con el tratamiento. Conclusiones: La infestación por Helicobacter pylori se incrementa a medida que aumenta la edad, es más frecuente en el sexo femenino, se relaciona con la aparición de diversas afeccionesgastroduodenales y la presencia de factores de riesgo.(AU)

Introduction: Infection by Helicobacter pylori is considered a health problem which increases themorbi-mortality due to gastrointestinal diseases. Objective: To determine the infection by Helicobacter pylori in patients with digestive diseases, assistedat the upper digestive endoscopy service. Methods: A descriptive cross-sectional study was carried out at the upper digestive endoscopy servicefrom ¨Noelio Capote¨ Teaching Polyclinic, in Jaruco municipality, from January to December,2018. The population under study was formed by 165 patients with diagnosis of infection byHelicobacter pylori according to positive Urease Tests. The studied variables were: age, sex, upper digestive tract diseases; risk factors and clinical evolution, and the endoscopy 6 monthsafter the treatment was finished. The data was obtained by a questionnaire and the revisionof the endoscopic information, a statistical analysis was performed and the software for Windows, SPSS-15.0 was used. Results: Patients in the 50 to 59 age group (27.27 per cent) and the female sex prevailed (56.36 per cent), the most frequent diagnosis was acute gastritis (100 per cent), drinking of water without boiling; not to practice the hand washing before preparing or eating foods, ingestion of foods prepared outside home, were the most found risk factors. Most of the patients improved or healed with the treatment.. Conclusions: The infestation by Helicobacter pylori is increases according to the age increasing, it is morefrequent in the male sex, it is related to the appearance of some gastro duodenal affections and the presence of risk factors. (AU)

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Introducción: El envejecimiento progresivo de la población eleva la incidencia y prevalencia de enfermedades cerebrovasculares, las que constituyen causa de muerte e invalidez de origen neurológico.Objetivo: Caracterizar los pacientes con enfermedad cerebrovascular atendidos en el área intensiva municipal del Policlínico Docente Noelio Capote del municipio Jaruco.Métodos: Se realizó un estudio descriptivo transversal, en el período de enero a diciembre de 2018. El universo fueron 51 pacientes con manifestaciones clínicas sugestivas de la enfermedad y la muestra 46 pacientes que cumplieron los criterios establecidos. Se estudiaron las variables:edad, sexo, factores de riesgo, formas clínicas, atención en el área intensiva municipal y mortalidad prehospitalaria. La información se obtuvo mediante interrogatorio y revisión de historias clínicas del servicio, realizando análisis estadístico utilizando el software para Windows, SPSS-15.0.Resultados: Predominaron los pacientes con edades entre 70 a 79 años y el sexo masculino. Los factores de riesgo que más se registraron fueron: la hipertensión arterial, el tabaquismo, el sedentarismo y la malnutrición por exceso, siendo más frecuente en el sexo masculino. Prevalecieron las formas clínicas isquémicas; mientras que las conductas más tomadas en el servicio fueron la realizaron medidas generales y el control de enfermedad de base. Solo fallecieron dos pacientes.Conclusiones: Se concluye que la enfermedad cerebrovascular se relaciona con el incremento de la edad y la presencia de factores de riesgo, tales como: hipertensión arterial, tabaquismo, sedentarismo y obesidad, entre otros. Predominan los tipos isquémicos, siendo frecuente la aplicación de medidas generales y otras medidas, existiendo baja mortalidad prehospitalaria(AU)

Introduction: Progressive aging in the population increases the incidence and prevalence of cerebrovascular diseases which constitute cause of death and neurologic invalidity. Objective: To characterize patients with cerebrovascular diseases assisted in the Intensive Care Unit at Noelio Capote Teaching Policlinic in Jaruco.Methods: A descriptive cross-sectional study was carried out from January to December, 2018. The universe was composed by 51 patients with suggestive clinical manifestations of the disease and the sample 46 patients who fulfilled the established criteria. The variables studied were: age, sex, risk factors, clinical forms, assistance in the municipal Intensive Care Unit and pre-hospital mortality. The information as obtained by interviews and revision of patients ‘charts of the service, performing the statistical analysis using the software for Windows, SPSS-15.0.Results: Patients with 70 to 79 years old and the male sex prevailed. The most frequent risk factors were: hypertension, smoking habit, sedentary life style and malnutrition by excess, being more frequent in the male sex. The clinical forms that prevailed were ischemia; and the managements taken in the service were general measures and the control of the disease they suffered from. Only two patients died.Conclusions: It can be said as a conclusion that cerebrovascular diseases are related to the increasing of age and the presence of risk factors, such as: hypertension, smoking habit, sedentary life style and obesity among others. Ischemia prevailed, general and other measures were applied, pre-hospital mortality was low(AU)

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RESUMEN Se presenta una paciente de 54 años de edad con antecedentes de hipertensión arterial, que ingresa en el servicio de Medicina Interna por dolor torácico intenso, acompañado de falta de aire de moderada intensidad, decaimiento, tos y dificultad para tragar sobre todo los alimentos sólidos. Mediante estudios complementarios se diagnostica un tumor de mediastino anterior, lo que motiva su traslado al servicio de Cirugía General. En el acto quirúrgico se constata absceso del mediastino anterior, el cual se drena mediante esternotomía media, evoluciona favorablemente y es egresada 12 días después de la intervención quirúrgica(AU)

ABSTRACT We present a 54-year-old patient with a history of high blood pressure, admitted to the internal medicine service with severe chest pain, accompanied by a lack of air of moderate intensity, decay, cough and difficulty for swallowing, especially solid foods. Through complementary studies, an anterior mediastinal tumor is diagnosed, which motivates her transfer to the general surgery service. In the surgical act, abscess of the anterior mediastinum is verified and drained by means of median sternotomy. The patient evolves favorably and is discharged 12 days after the surgical intervention(AU)

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Resumen En el desempeño de sus funciones de atención a personas sin empleo, el orientador laboral se encuentra sometido a diversos y frecuentes estresores generadores de ansiedad; uno de estos estresores son los conflictos. Utilizando una muestra compuesta por 90 orientadores laborales del Servicio de Empleo de Andalucía (España), este estudio pretende poner de manifiesto en qué medida la ansiedad manifestada se encuentra relacionada con los estilos de gestión conductual del conflicto adoptado, y este con las estrategias de afrontamiento al estrés. Los resultados muestran elevados niveles de ansiedad (estado y rasgo) en este colectivo, así como asociaciones importantes entre las estrategias de afrontamiento al estrés en general y los estilos de gestión de conflictos, lo que indica que ambos se encuentran conceptualmente relacionados.

Abstract The employment consultant is normally exposed, when he performs his/her function attending to people unemployed, to different and common stressors, one of these stressors are the conflicts. Using a sample of 90 guidance workers of the Andalusian Employment Service (Spain), this study aims to show to what extent the exposed anxiety is related to behavioral conflict management style, and this last with strategies of coping with stress. Results show high levels of anxiety, as well as significant relations between strategies of coping with stress and behavioral styles of management of conflicts, pointing out that they are related conceptually.

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An evaluation of the chromium(VI) adsorption capacity of four magnetite sorbents coated with a polymer phase containing polymethacrylic acid or polyallyl-3-methylimidazolium is presented. Factors that influence the chromium(VI) removal such as solution pH and contact time were investigated in batch experiments and in stirred tank reactor mode. Affinity and rate constants increased with the molar ratio of the imidazolium. The highest adsorption was obtained at pH 2.0 due to the contribution of electrostatic interactions.

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Introducción: la malnutrición por exceso, es considerada un problema en la actualidad, se define como un síndrome clínico caracterizado por exceso de almacenamiento de grasa corporal, de etiología multicausal, dentro de las que se encuentra los factores familiares.Objetivo: caracterizar los factores familiares relacionados con la malnutrición por exceso en un grupo de adolescentes entre 15 y 19 años.Métodos: se realizó un estudio analítico de casos y controles en adolescentes entre 15 y 19 años de la Unidad Educativa Carlos Julio Arosemena Tola, parroquia Pascuales, Ecuador entre enero y diciembre del 2015. El universo fueron 350 familias de los adolescentes y la muestra 120 familias que cumplieron los criterios establecidos, y se dividieron en dos grupos: normopesos y malnutridos por exceso. Se identificaron características sociodemográficas, antecedentes familiares de malnutrición por exceso, actividad física y percepción de los padres del estado nutricional de los hijos. La información se obtuvo mediante examen físico e interrogatorio; y se realizó análisis estadístico aplicando la función estadística no paramétrica Chi Cuadrado (X2) de Pearson.Resultados: predominó la malnutrición por exceso en los adolescentes que tenían antecedentes familiares de la misma. Fue superior la no realización de actividad física y la no percepción de ambos progenitores de la malnutrición por exceso en los adolescentes con este problema de salud.Conclusiones: la malnutrición por exceso en los adolescentes, está relacionada con presencia en la familia de malnutrición por exceso, no realización de actividad física y la no percepción del problema en sus hijos(AU)

Introduction: malnutrition by excess is considered a current problem, it is defined as a clinical syndrome characterized by excess of corporal fat of multi-causal etiology, among them, family factors can be found. Objective: to characterize the family factors related to malnutrition by excess in a group of adolescents between 15 nd 19 years old.Methods: a case and control analytic study was performed in adolescents between 15 and 19 years old from “Carlos Julio Arosemena Tola”, Educative Unit, Pascuales Parish, Ecuador, from January to December, 2015. The universe was formed by 350 families of adolescents, the sample was composed by 120 families, which accomplished the established criteria, they were divided into two groups: norm-weight and badly nourished by excess. Socio demographic characteristics family history of malnutrition by excess physical activity and parents perception of the nutritional status of the children were identified. The information was obtained by the physical examination and interviews; the statistical analysis was performed applying the statistical function non parametrical Pearson Chi Squared (X2)Results: malnutrition by excess prevailed in adolescents who had positive family history. No performance of physical activities and no parents perception of malnutrition by excess in adolescents with this health problem was high.Conclusions: malnutrition by excess in adolescents, is related to the presence of malnutrition by excess in families, no performance of physical activities and no parents perception of the problem in their children(AU)

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Introducción: el embarazo en la adolescencia puede tener consecuencias adversas tanto para la madre como el recién nacido. Objetivos: determinar los resultados perinatales de gestantes adolescentes del municipio Jaruco durante el 2012. Métodos: se realizó un estudio analítico longitudinal prospectivo a partir de un universo de 64 embarazadas adolescentes y una muestra inicial de 48 gestantes escogidas al azar que conformó el grupo de expuestas al factor de estudio y se dispuso de un grupo de no expuestas de 20 o más años de igual cantidad de gestantes siguiendo una relación 1:1; así, la muestra definitiva quedó conformada por 42 y 45 en cada grupo respectivo. Los datos se recolectaron mediante revisión de las historias clínica y obstétrica y como medidas estadísticas se emplearon la media, desviación estándar, porcentaje, test de Student, Chi cuadrado y riesgo relativo. Resultados: en las gestantes adolescentes hubo significativamente mayor preeclampsia RR = 1,81, oligoamnios RR = 1,98, amenaza de parto pretérmino RR = 2,04 y partos pretérmino RR = 1,98, bajo peso al nacer RR = 2,04 y Apgar bajo al minuto de vida RR = 1,81; también se presentó más distrés respiratorio en los neonatos RR = 1,99 y endometritis puerperal RR = 1,88. No hubo diferencias entre ambos grupos en otras afecciones propias del embarazo o complicaciones neonatales y puerperales, ni en la vía del parto.Conclusiones: el embarazo en la adolescencia incrementa el riesgo de resultados perinatales adversos, tanto para la madre, como para el feto y el recién nacido (AU)

Introduction: pregnancy in adolescence may have adverse consequences for the mother and for the newborn. Objectives: to determine the perinatal results of adolescent pregnant women in Jaruco municipality during 2012. Methods: a prospective analytic longitudinal study was performed with a universe of 64 adolescent pregnant women with an initial simple of 48 taken at random which formed the group exposed to the factor of study and another group of non-exposed of 20 or more years old of the same quantity of pregnant women following the relation 1:1; so, the definite sample was formed by 42 y 45 in each respective group. The information was collected by the revision of the clinical and obstetrics histories, the statistics measures used were the medium , standard deviation, percentage, test of Student, Chi square and relative risk. Results: in the adolescent pregnant women group there was significantly higher preeclampsia RR = 1,81, oligoamnios RR = 1,98, threat of preterm delivery RR = 2,04 and preterm deliveries RR = 1,98, low weight newborns RR = 2,04 and low Apgar in the first minute of life RR = 1,81; there was also more respiratory distress in the newborns RR = 1,99 and puerperal endometritis RR = 1,88. There were no differences between both groups in other affections related to pregnancy or neonatal and puerperal complications, as well as the way of delivery. Conclusions: pregnancy in adolescence increases the risk of adverse perinatal results for mother, fetus and newborn (AU)

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OBJECTIVE: Endometriosis is linked to altered cell proliferation and stem cell markers c-kit/stem cell factor (SCF) in ectopic endometrium. Our aim was to investigate whether c-kit/SCF also plays a role in eutopic endometrium. DESIGN: Eutopic endometrium obtained from 35 women with endometriosis and 25 fertile eumenorrheic women was analyzed for in situ expression of SCF/c-kit, Ki67, RAC-alpha serine/threonine-protein kinase (Akt), phosphorylated RAC-alpha serine/threonin-protein kinase (pAkt), Glycogen synthase kinase 3 beta (GSK3ß), and phosphorylated glycogen synthase kinase 3 beta (pGSK3ß), throughout the menstrual cycle. RESULTS: Expression of Ki67 and SCF was higher in endometriosis than in control tissue (P < .05) and greater in secretory rather than proliferative (P < .01) endometrium in endometriosis. Expression of c-kit was also higher in endometriosis although similar in both phases. Expression of Akt and GSK3ß was identical in all samples and cycle phases, whereas pAkt and pGSK3ß, opposed to control tissue, remained overexpressed in the secretory phase in endometriosis. CONCLUSION: Unceasing cell proliferation in the secretory phase of eutopic endometriosis is linked to deregulation of c-kit/SCF-associated signaling pathways.

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