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Introducción: El consumo de drogas es un problema de salud que se presenta con mayor frecuencia en la población joven, pues su prevalencia aumenta cada día. En la actualidad existe preocupación sobre la percepción de riesgo del consumo de drogas en estudiantes universitarios. Objetivo: Describir la percepción de riesgo sobre el consumo de drogas en estudiantes universitarios de la provincia Manabí en Ecuador. Métodos: Investigación descriptiva y transversal; universo de 787 estudiantes universitarios de la provincia Manabí en Ecuador. La muestra quedó conformada por 259 estudiantes. Se utilizó la encuesta como técnica de recolección de datos. Como instrumento de investigación se utilizaron las encuestas escolares sobre el uso indebido de drogas de la oficina de las Naciones Unidas contra la droga y el delito. Se utilizó la estadística descriptiva para el procesamiento de los datos. Resultados: Se obtuvo una media de edad de 22,37 años, predominio del sexo femenino (65,25 %) y de estudiantes que consumen algún tipo de droga (79,92 %). El 91,30 % refirió consumo de drogas lícitas (tabaco 43,63 % y alcohol 61,39 %); el 31,26 % consumían drogas medicamentosas y el 23,29 % drogas ilícitas; de ellos, el 85,42 % refirió consumo de marihuana. El 32,04 % tenía una percepción baja sobre el riesgo de consumo de drogas. Conclusiones: En el grupo de estudiantes universitarios de la provincia Manabí que son investigados, existe un aumento del consumo de drogas lícitas, medicamentosas e ilícitas debido a una percepción deficiente del riesgo de consumo de estas sustancias.

Introduction: Drug use is a health problem that occurs more frequently in the young population; its prevalence increases every day. Currently, there is concern about the perception of risk of drug use in university students. Objective: Describe the risk perception of drug consumption in university students from the Manabí province in Ecuador. Methods: Descriptive and cross-sectional research; universe of 787 university students from the Manabí province in Ecuador. The sample was made up of 259 students. The survey was used as a data collection technique. The School Surveys on Drug Abuse from the United Nations Office on Drugs and Crime were used as a research instrument. Descriptive statistics were used to process the data. Results: An average age of 22.37 years was obtained, predominance of the female sex (65.25%) and students who consume some type of drug (79.92%). 91.30% reported consumption of legal drugs (tobacco 43.63% and alcohol 61.39%); 31.26% used medicinal drugs and 23.29% used illicit drugs; Of them, 85.42% reported marijuana use. 32.04% had a low perception of the risk of drug use. Conclusions: In the group of university students from the Manabí province who are investigated, there is an increase in the consumption of licit, medicinal and illicit drugs due to a poor perception of the risk of consumption of these substances.

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The spotted wing drosophila, Drosophila suzukii Matsumura, is native to Southeast Asia and has become a serious pest of soft-skinned fruits worldwide. Several control methods are being tested worldwide as part of an integrated pest management approach. Biological control is a promising alternative tactic that can be used to manage D. suzukii populations, especially in unmanaged areas. This study aimed at exploring the diversity of resident hymenopteran parasitoids of drosophilids in northwestern Patagonia, where D. suzukii is considered an important pest. The survey also aimed to investigate possible associations between parasitoids and D. suzukii in several crops and non-crop fruits, and to determine D. suzukii fruits infestation levels. Fourteen sites with mainly berry crops were sampled biweekly using cider vinegar traps and collecting fresh fruits from a variety of crop and non-crop fruit plants. We identified five species of hymenopteran parasitoids, obtained from the baited traps, that have the potential to associate with D. suzukii: Leptopilina heterotoma Thomson, Ganaspis brasiliensis Ihering, Hexacola hexatoma Hartig (Figitidae), Pachycrepoideus vindemmiae Rondani (Pteromalidae), and Spalangia endius Walker (Spalangiidae). Leptopilina heterotoma is reported for the first time in Argentina. High numbers of D. suzukii adults were recovered from baited traps and field-collected fruits. However, no parasitoid emerged from D. suzukii pupae recovered from fruits, nor were any dead parasitoids recorded inside D. suzukii pupae. Overall infestation levels of D. suzukii on field-collected fruits did not differ significantly between species/varieties. The results are discussed with emphasis on the possible functionality and perspectives of using these species as biological control agents.

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Anurans of the genus Brachycephalus are among the smallest vertebrates in the world, due to an extreme process of miniaturization. As an example of this process, Brachycephalus species show loss of fingers, loss of the eardrum and middle ear, bone fusions, and the presence of paravertebral plates and parotic plaque. However, no studies addressing the consequences of miniaturization on internal organs, such as the lungs and heart, are currently available. Thus, this study aimed to investigate if overall small body size has affected the cardiorespiratory system. We investigated, via dissections, individuals of four Brachycephaloidea species: Brachycephalus rotenbergae, B. pitanga, Eleutherodactylus johnstonei, and Ischnocnema parva. We observed that B. rotenbergae and B. pitanga present a reduction of the atrial septum and absence of the carotid body. On the other hand, despite being a member of the sister genus to Brachycephalus (both genera belong to the Brachycephalidae), individuals of Ischnocnema present a heart with a complete septum and carotid body; this is also observed in E. johnstonei (Eleutherodactylidae). We observed that B. rotenbergae and B. pitanga have thin skin with a one to two cell thick germ layer, and their lungs likely exhibit lower blood supply when compared to individuals of the E. johnstonei and I. parva species. Based on the observed structures, we suggest that in species of Brachycephalus, respiration is performed mainly through the skin, and their lungs may have a reduced respiratory function.

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Introducción: La fractura de Maisonneuve es una lesión caracterizada por la fractura subcapital del peroné asociada a una lesión capsuloligamentaria de tobillo. Su tratamiento supone la restauración de la anatomía ósea y capsuloligamentaria normal para restablecer las fuerzas de contacto tibioastragalinas fisiológicas. Esta calidad de reducción puede ser difícil de alcanzar, sobre todo, con técnicas percutáneas. Objetivo: Evaluar mediante imágenes la calidad de la reducción de fracturas de Maisonneuve reducidas en forma cerrada (bajo visualización directa artroscópica) y fijadas por vía percutánea. Materiales y Métodos: Se analizaron radiografías e imágenes de tomografía computarizada preoperatorias y posoperatorias, comparativas de los tobillos operado y sano. Resultados: Se evaluaron 13 fracturas. Los parámetros radiográficos posoperatorios (espacio claro medial, solapamiento tibioperoneo distal, espacio claro tibioperoneo) no registraron diferencias, excepto por el intervalo tibioperoneo anterior que aumentó en un caso. La medición tomográfica posoperatoria del solapamiento tibioperoneo distal y el intervalo tibioperoneo anterior reveló que todas las reducciones eran satisfactorias. Dos pacientes tenían valores alterados en la sindesmosis tibioperonea distal con diferencia >2 mm respecto del tobillo sano. Conclusión: Recomendamos la asistencia artroscópica para el manejo de la fractura de Maisonneuve como herramienta de control intraoperatorio para una fijación percutánea más segura. Nivel de Evidencia: IV

Introduction: Maisonneuve fracture (MF) is an injury characterized by the subcapital fracture of the fibula associated with a capsuloligamentous injury of the ankle. Treatment involves the restoration of normal bone and capsuloligamentous anatomy in order to reestablish physiological tibiotalar contact forces. This quality of reduction can be difficult to achieve, especially with percutaneous techniques. Objective: To evaluate the quality of reduction in Maisonneuve fractures reduced in a closed manner (under direct arthroscopic visualization) and fixed percutaneously. Materials and Methods: We analyzed comparative preoperative and postoperative radiographs and CT scans of the operated and healthy ankles. Results: 13 fractures were evaluated. Radiographic parameters of postoperative procedures (medial clear space, distal tibiofibular overlap, tibiofibular clear space) did not register differences except for the anterior tibiofibular space, which had increased in 1 case. Postoperative tomographic measurements of tibiofibular clear space and anterior tibiofibular space showed 100% satisfactory reductions. Two patients presented altered distal tibiofibular overlap values with a difference greater than 2 mm compared to the healthy ankle. Conclusion: We recommend arthroscopy for the management of MF as an intraoperative control tool for safer percutaneous fixation. Level of Evidence: IV

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Inspiratory muscle training (IMT) has been used in different sports, although there is no consensus on its benefits. We investigated the effects of eight weeks of IMT in women's handball. Twenty-four players were randomly distributed into experimental (EXP; n = 13) and control (CON; n = 11) groups. Only the EXP group performed IMT using the POWERBreathe device, following indications of the manufacturers. Before and after the intervention, spirometric variables were evaluated at rest and during a graded test using direct analysis of respiratory gases. Perception of exertion at submaximal intensity was also determined. No significant differences were observed post- vs. pre-intervention (p ≥ 0.05) regarding forced vital capacity (FVC), forced expiratory volume in the 1st second (VEF1), FVC/VEF1, maximal expiratory flow at 50% of FVC or peak inspiratory flow. Post-intervention, only the CON group increased their absolute and relative VO2max (2.1 ± 0.2 L/min pre vs. 2.2 ± 0.3 L/min post; 33.6 ± 3.6 ml/kg∙min pre vs. 34.5 ± 3.2 ml/kg∙min post, respectively). No significant improvements (p ≥ 0.05) were observed in VO2 associated with ventilatory threshold 1 (VT1), nor in the intensity associated with VO2max and VT1. However, there was a tendency for the mentioned variables to decrease in the CON group, while in the EXP group the trend was to maintain or increase previous values. IMT did not determine an improvement in the perception of exertion at submaximal intensity. The use of POWERBreathe, as described in the present study, is feasible in terms of time and effort, although its benefits may not be significant.

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BACKGROUND Involvement of the central nervous system during infection with dengue virus (DENV) is recognized. However, ischemic stroke is rarely reported. Herein are described 2 cases of patients with ischemic stroke in which DENV infection was demonstrated. CASE REPORT The first patient was a 51-year-old woman that presented altered consciousness, monoparesis, facial palsy, dysarthria, Babinski sign, and syncope 7 days from the onset of fever. She had a history of carotid artery atherothrombosis and previous stroke. Magnetic resonance imaging (MRI) showed an acute infarction of the right middle cerebral artery. DENV was confirmed by the presence of NS1 and IgM in serum. The patient was treated with intravenous fluids and recovered well, with only right facial paresis still present at discharge. The second patient was a 50-year-old man who presented with headache, altered consciousness, and mutism after a febrile episode 1 week prior. This patient had a previous history of stroke, glioblastoma resection, epilepsy, hypothyroidism, and diabetes. MRI demonstrated a subacute ischemic event. The diagnosis of dengue was confirmed by serum NS1 and IgM and by RT-PCR in serum and cerebrospinal fluid. DENV-1 serotype was observed in serum and cerebrospinal fluid. The patient was treated with intravenous fluids and was discharged in good condition. In both patients, thrombocytopenia and leukopenia was demonstrated, and hemoconcentration was demonstrated in the second patient. CONCLUSIONS In tropical and subtropical countries, DENV infection can represent a potential cause of ischemic stroke in patients with a history of comorbidities, including stroke.

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Background: Technology plays a fundamental role to achieve higher education key learning objectives. Digital competence (DC) is defined as a set of skills, knowledge, abilities, and attitudes in technological aspects. It is necessary to employ an effective training action plan in higher education institutions to advance towards a level of teaching digital competence (TDC). The objective of this study was to validate the COMDID A instrument to assess Teaching Digital Competence (TDC) of active teachers, through a confirmatory factor and internal reliability analysis. Methods: The research was developed within a descriptive-correlational scope and a non-experimental-cross-sectional design to validate the dimensionality and reliability of the COMDID A instrument and evaluate the self-perceived digital competence of active teachers. The population was made up of 690 professors who were part of the teaching staff of the National University of Chimborazo, Ecuador, in the first academic period of the year 2021. The sample was probabilistic, in a simple random scheme, the percentage of potential error admitted was 3%. The representativeness of the sample was 50%, and the confidence level was 97%. A total of 511 teachers completed the questionnaire compared to the 452 individuals needed. Results: The instrument was robust, and it was reliable for the calculated sample. There were correlations between the variables, and the statistical calculation ensured the development of the multivariate analysis to validate the dimensionality of the instrument. Moreover, the correct dimensionality was determined through a confirmatory analysis and high reliability of the instrument. Conclusions: The calculated factorial scores were defined in order for further studies to be carried out. It is important to apply confirmatory factor analysis in educational technology research to validate the dimensionality of data collection instruments.

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RESUMEN La neurolisteriosis se presenta principalmente como meningitis o meningoencefalitis, en menor frecuencia romboencefalitis o absceso cerebral. Es la principal causa de muerte entre todas las meningitis bacterianas y se asocia con una alta tasa de discapacidad neurológica. Para su diagnóstico se deben tener en cuenta la edad y los factores de riesgo, principalmente individuos mayores de 50 años y con condiciones de inmunosupresión. Las ayudas diagnósticas son clave para lograr el aislamiento de Lm, donde el cultivo de LCR tiene la mejor sensibilidad. Aunque faltan estudios que demuestren la superioridad de los estudios moleculares, el FilmArray-MEP parece ser prometedor en el aislamiento rápido y preciso de los principales microorganismos involucrados en la meningitis piógena, entre estos Lm. La IRM cerebral es el estudio de elección para el diagnóstico de romboencefalitis. La piedra angular del tratamiento sigue siendo ampicilina, cuya asociación con aminoglucósido podría disminuir la mortalidad.

SUMMARY Neurolisteriosis presents mainly as meningitis or meningoencephalitis, to a lesser extent rhombencephalitis or brain abscess frequency. It is the leading cause of death among all Bacterial meningitis and is associated with a high rate of neurological disability. For your diagnosis must take into account age and risk factors, mainly over 50 years and with immunosuppression conditions. Diagnostic aids are key to achieving the isolation of Lm, where CSF culture has the best sensitivity. Although studies are lacking demonstrating the superiority of molecular studies, the Film Array-MEP appears to be promising in fast and accurate isolation of the main microorganisms involved in pyogenic meningitis, among these Lm. Brain MRI is the study of choice for the diagnosis of rhombencephalitis. The cornerstone of treatment remains ampicillin, and its association with aminoglycoside could decrease mortality.

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Non-urgent consultations to an Emergency Department (ED) contribute to overcrowding. Telecommunications represent a potential strategy to reduce some face-to-face consultations. OBJECTIVES: To describe characteristics of patients who used the Teletriage Program during the pilot study, to explore safety and to report user acceptance and satisfaction. METHODS: Cross-sectional study, including all adult patients affiliated to our health insurance attended to via this telemedicine service between January 18th and May 31st, 2019 (during pilot-study). Patients were followed-up for seven days to assess re-consultation to ED or unscheduled hospitalization. RESULTS: 276 effective consultations occurred, corresponding to 241 patients, with a mean of age of 50 years, 68% (189) were women. Chief complaints were related to clinical issues (70%) and remaining (30%) were administrative problems. Only four patients were suggested a referral or face-to-face assessment. Rate of re-consultation to the ED was 18% (51) at seven days of follow-up, and the rate of unscheduled hospitalization was <1% (2), both with good clinical evolution. Patient satisfaction was 72.73%, and regarding acceptability, 66.12% stated that without this channel they would have attended to a face-to-face consultation and 64.02% that they would do so if their needs remained unmet. CONCLUSIONS: Implementing this new communication channel could be a useful and safe strategy to reduce unnecessary non-urgent consultations to the ED.

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El objetivo de la siguiente reflexión consiste en hacer una lectura acerca de la noción de lo psicosocial. Esta convoca a una revisión crítica para aportar elementos de reflexión en la realización de intervenciones psicosociales o caracterizar las formas de comprender procesos de transformación social que impliquen al sujeto y a la comunidad. En este sentido, se interroga ¿de qué manera los profesionales de las ciencias sociales y humanas hacen lectura de contexto e intervienen bajo este híbrido conceptual? Para ello se parte de la crítica hacia el uso indiscriminado del concepto en las múltiples formas en que este es utilizado por parte de los profesionales de las ciencias sociales y humanas; asimismo, de la lectura de este a la luz de la psicología social, gracias a la cual se trasciende el mero uso del concepto y se profundiza en lo que implicaría la unión de lo "psico" y lo "social" en la variedad de discursos y prácticas que existen hoy día en nuestros contextos sociales, posibilitando así una nueva comprensión del sujeto desde la interacción social y el relacionamiento en la construcción de la realidad. Desde esta perspectiva se pretende reflexionar sobre lo psicosocial para conocer la incidencia en las transformaciones sociales.

The aim of the next reflection is to make a reading about the notion of psychosocial. It calls for a critical review to provide elements of reflection in the realization of psychosocial interventions or to characterize ways of understanding processes of social transformation involving the subject and the community. In this sense, it is questioned how social and human science professionals make context reading and intervene under this conceptual hybrid? this is based on the criticism of the indiscriminate use of the concept in the many ways in which it is used by professionals of the social and human sciences, also the reading of it in view of social psychology, thanks to which the mere use of the concept is transcended and the deepening of what would involve the union of the "psycho" and the "social" in the variety of discourses and practices that exist today in our social contexts, this will enable a new understanding of the subject from social interaction and relationship in the construction of reality, from this perspective it is intended to reflect the psychosocial, to know the impact on social transformations.

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El bypass gástrico en Y de Roux (BGYR) es una de las técnicas de elección en pacientes con obesidad mórbida y en la actualidad es el procedimiento de cirugía bariátrica más utilizado. Consiste en una técnica mixta, es decir, tiene un carácter principalmente restrictivo y genera un cierto grado de malabsorción. Puede realizarse por cirugía convencional o laparoscópica, siendo esta última la de elección. La anastomosis retrocólica crea un espacio en el mesenterio, posibilitando la formación de un tipo de hernia transmesentérica denominada "hernia de Petersen". El objetivo de este trabajo es describir y analizar los hallazgos tomográficos de la hernia de Petersen en pacientes con antecedente de bypass gástrico. Se analizaron las historias clínicas de 92 pacientes con antecedente de BGYR (realizados todos en nuestra institución). Tres pacientes presentaron un cuadro de obstrucción intestinal y se les realizó tomografía computada multislice (TCMS) de abdomen. En función de los hallazgos tomográficos consistentes con hernia interna, los pacientes fueron intervenidos quirúrgicamente y se confirmó la presencia de hernia de Petersen. El conocimiento de la técnica quirúrgica, los cambios anatómicos y las posibles complicaciones es de gran utilidad para diagnosticar la causa de dolor abdominal en pacientes sometidos a bypass gástrico. La TCMS brinda información sobre las estructuras extraluminales y su alta resolución espacial permite examinar tanto los cambios anatómicos como las probables complicaciones secundarias al bypass gástrico.(AU)

The Roux-en-Y gastric bypass (RYGBP) is one of the techniques of choice in patients with morbid obesity, and at present, it is the most commonly performed bariatric procedure. It is a mixed technique, it is mainly restrictive but it also generates some degree of malabsorption. This procedure may be performed with a conventional surgical approach or with laparoscopic techniques, with the latter being the method of choice. Retrocolic anastomosis creates a space in the mesentery, allowing for the formation of a transmesenteric type of hernia known as Petersens hernia. The aim of this article is to describe and analyze the CT findings of Petersens hernia in patients with a history of gastric bypass. The medical records of 92 patients with a history of RYGBP (performed at our institution) were reviewed. Three patients had bowel obstruction and underwent abdominal multislice computed tomography (MSCT). Based on CT findings consistent with internal hernia, surgery was performed and the presence of Petersens hernia was confirmed. Knowledge of the surgical technique, anatomical changes and possible complications is very useful for diagnosing the cause of abdominal pain in patients who underwent gastric bypass. MSCT provides information on extraluminal structures and its high spatial resolution allows for better visualization of both anatomical changes and probable complications of gastric bypass.(AU)

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El bypass gástrico en Y de Roux (BGYR) es una de las técnicas de elección en pacientes con obesidad mórbida y en la actualidad es el procedimiento de cirugía bariátrica más utilizado. Consiste en una técnica mixta, es decir, tiene un carácter principalmente restrictivo y genera un cierto grado de malabsorción. Puede realizarse por cirugía convencional o laparoscópica, siendo esta última la de elección. La anastomosis retrocólica crea un espacio en el mesenterio, posibilitando la formación de un tipo de hernia transmesentérica denominada“hernia de Petersen”. El objetivo de este trabajo es describir y analizar los hallazgos tomográficos de la hernia de Petersen en pacientes con antecedente de bypass gástrico. Se analizaron las historias clínicas de 92 pacientes con antecedente de BGYR (realizados todos en nuestra institución) .Tres pacientes presentaron un cuadro de obstrucción intestinal y se les realizó tomografía computada multislice (TCMS) de abdomen. En función de los hallazgos tomográficos consistentes con hernia interna, los pacientes fueron intervenidos quirúrgicamente y se confirmó la presencia de hernia de Petersen. El conocimiento de la técnica quirúrgica, los cambios anatómicos y las posibles complicaciones es de gran utilidad para diagnosticar la causa de dolor abdominal en pacientes sometidos a bypass gástrico. La TCMS brinda información sobre las estructuras extraluminales y su alta resolución espacial permite examinar tanto los cambios anatómicos como las probables complicaciones secundarias al bypass gástrico...

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Definición: la NAC es la infección aguda del parénquima pulmonar que se desarrolla fuera del ambiente hospitalario, se maniefiesta en las primeras 48 horas del ingreso al hospital o después de siete días de haber egresado. Cuadro clínico: Síntomas de una infección aguda del tracto respiratorio inferior: tos y por lo menos uno de los siguientes: expectoración mucopurulenta, dolor torácico de tipo pleurítico, disnea. Por lo menos un síntoma o signo sistémico: sensación de fiebre, suduración, dolores, malestar general y/o temperatura de 38.3°C O más. Infiltrado focal o asimétrico, en la radiografía del tórax, que no se haya observado o descrito previamente y para el cual no se tenga otra explicación. Al examen físico del tórax se puede encontrar o no anormalidades, generalmente localizadas o asimétricas, o signos de consolidación pulmonar. Epidemiología: la NAC es una enfermedad frecuente cuya incidencia varía de acuerdo con la edad, es mayor en los extremos de la vida (mayores de 65 años y menores de cinco) La neumonía es una enfermedad con un alto índice de morbilidad y mortalidad. La mortalidad general producida por la NAC oscila entre 1 por ciento y 25 por ciento, y depende de múltiples factores, entre los que destacan la severidad de la enfermedad y el german causante. Etiología: la posivilidad de identificar el german causante NAC, aun en las mejores condiciones, es relativamente baja (40 por ciento a 60 por ciento). Para el caso colombiano es importante destacar: La causa más frecuente es el S.pneumoniae. M. tuberculosis debe considerarse como causa de NAC en el país, aunque su frecuencia real se desconoce, pero pueden presentarse hasta en 20 por ciento de casos...(AU: Asociación Colombiana de Neumología y Cirugía de Tórax; Asociación Colombiana de Infectología; Asociación Colombiana de Medicina Interna)

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