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INTRODUCTION: The term "Rhupus" was employed to descriptively illustrate the overlap observed in some pediatric patients displaying features of both juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE). Although "Rhupus" is traditionally used in adults, we applied it broadly to emphasize this clinical overlap. METHODS: We sought to identify studies that registered signs, symptoms, imaging characteristics, and treatments given to patients with JIA and SLE. We searched four databases using a Boolean search string, resulting in 231 articles after duplicate removal. Title and abstract screening yielded 57 articles for full-text assessment. Full reviewed 13 extracted data regarding sex, age of onset, serologic and imaging findings, and management strategies. The NIH quality assessment tool was applied to ensure the internal validity of the articles. RESULTS: From the 13 articles evaluated that meet inclusion criteria, none had standardized diagnostic algorithms. The total number of patients in those articles is 26, without discussing treatment guidelines. DISCUSSION: Clinical presentation, diagnostic parameters, and treatment of pediatric Rhupus were synthesized in this review. Fundamental keys help distinguish the joint presentation when Juvenile Idiopathic Arthritis or Lupus is present, compared with the signs and symptoms when developing the overlapping syndrome. We highlight the importance of physicians knowing about this rare condition and call all specialists to report new cases of the disease so a consensus can be reached to establish standardized guidelines for diagnosing and treating Rhupus syndrome.

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OBJECTIVES: Satoyoshi syndrome is a rare multisystem disease of presumed autoimmune aetiology. We carried out a systematic review to evaluate the available evidence to support that autoimmune hypothesis. METHODS: We searched for Satoyoshi syndrome cases in PubMed, the Web of Science and Scopus up to January 2022, using keywords 'Satoyoshi syndrome' or 'Komuragaeri disease'. Data on symptoms, associated autoimmune diseases, presence of autoantibodies and response to treatment were collected. RESULTS: A total of 77 patients from 57 articles published between 1967 and 2021 were included; 59 patients were women. The mean age at diagnosis was 21.2 years. All cases had painful muscular spasms and alopecia. Frequent manifestations included: diarrhoea, malabsorption, growth retardation, amenorrhoea and bone deformity. Satoyoshi syndrome was associated with other autoimmune diseases: myasthenia gravis, autoimmune thyroiditis, idiopathic thrombocytopenic purpura, atopic dermatitis, bronchial and lupus erythematosus. Autoantibody determinations were performed in 39 patients, of which 27 had positive results. The most frequently detected autoantibodies were ANAs. Other less frequently found autoantibodies were: anti-acetylcholine receptor antibodies, anti-DNA antibodies, antithyroid antibodies, anti-glutamic acid decarboxylase (anti-GAD) and anti-gliadin antibodies. Pharmacological treatment was reported in 50 patients. Most of them improved with CS, immunosuppressants and immunoglobulins, or a combination of these medications. CONCLUSION: Satoyoshi syndrome is associated with other autoimmune diseases and a variety of autoantibodies. Improvement after CS or other immunosuppressant treatment was observed in 90% of cases. These data support an autoimmune aetiology for Satoyoshi syndrome. More studies including systematic determination of autoantibodies in all patients with Satoyoshi syndrome will help us advance in our understanding of this disease.

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BACKGROUND: The nutritional traffic light label (NTLL) has become one of the most used Front of Package labels (FOP's) around the world, for its simple and easy to understand graphical system. In Ecuador, this labelling system has recently been implemented; then, this research aims to evaluate the use and knowledge of NTLL and its effectiveness as a public health promotion strategy. METHOD: In a cross-sectional study at two different urban supermarkets in Quito-Ecuador, a survey was conducted in 73 participants to inquire about knowledge, perspectives and purchasing habits regarding the NTLL. Objective data obtained from pictures of the participants'purchase was compared with subjective data obtained from the survey. For categorical variables, Chi square or Fisher's Exact test were used and variables with a statistical significance at α = 0.1 were included in multivariate logistic regression models. RESULTS: 88.7% of participants knew about the NTTL. 27.4% reported using the NTLL, while 28.4% of participants were observed to really use it. Significant associations between self-knowledge of the NTLL and education level (p = 0.007) or knowledge level (p = 0.001) were found. A significant association was also found between the refered use of the NTLL and the shopping influencing factor (p = 0.02). In the multivariate analysis an association between knowledge of the NTLL and observed use was found only when adjusted for the supermarket (p = 0.038). CONCLUSION: This study found that the level of knowledge of the NTLL in the studied population was relatively high; however, both the referred and the observed use of the NTLL were low. Use and knowledge of the NTLL were associated with the socioeconomic and educational status of the participants. Thus, the change in nutritional patterns needs additional strategies to put the NTLL before the brand once customers make their purchases.

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Se expone un estudio evolutivo de las particularidades del proceso de la educación de la sexualidad en Cuba desde los puntos de vista pedagógico, psicológico y sociológico, en el cual se utilizó el método histórico-lógico para la determinación de las tendencias históricas. Asimismo, para el análisis se empleó el enfoque teórico-metodológico del proceso de educación de la sexualidad en la crítica social, implementado en el Programa Nacional de Educación Sexual elaborado por el Centro Nacional de Educación Sexual (CENESEX) y se identificaron 4 etapas de su desarrollo, así como las tendencias en sus transformaciones(AU)

A developmental study of peculiarities of the sex education process in Cuba from the pedagogical, psychological and sociological points of view is presented, which used the historical and logical method for determining historical trends. Also, the analysis was performed using the theoretical and methodological approach to the process of sex education in social criticism, implemented in the National Sex Education Program developed by the National Center of Sex Education(CENESEX), and 4 stages of its development were identified, as well as the trends in its transformations(AU)

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Se expone un estudio evolutivo de las particularidades del proceso de la educación de la sexualidad en Cuba desde los puntos de vista pedagógico, psicológico y sociológico, en el cual se utilizó el método histórico-lógico para la determinación de las tendencias históricas. Asimismo, para el análisis se empleó el enfoque teórico-metodológico del proceso de educación de la sexualidad en la crítica social, implementado en el Programa Nacional de Educación Sexual elaborado por el Centro Nacional de Educación Sexual (CENESEX) y se identificaron 4 etapas de su desarrollo, así como las tendencias en sus transformaciones.

A developmental study of peculiarities of the sex education process in Cuba from the pedagogical, psychological and sociological points of view is presented, which used the historical and logical method for determining historical trends. Also, the analysis was performed using the theoretical and methodological approach to the process of sex education in social criticism, implemented in the National Sex Education Program developed by the National Center of Sex Education(CENESEX), and 4 stages of its development were identified, as well as the trends in its transformations.

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The properties of coal fly ash are strongly dependent on the geological origin and the combustion process of the coal. It is important to characterize regional fly ash in detail to ascertain its potential uses as raw material in the production of high value products. The physicochemical properties of fly ash coming from the "Jose Lopez Portillo" coal-fired power plant, Coahuila, Mexico (MFA), are presented in this work. A detailed study of trace elements, the chemical composition of the amorphous phase, thermal stability and the leaching of contaminant elements under different conditions are included. MFA is composed of mullite, quartz, calcite, magnetite and an amorphous phase. This material contains mainly silica (59.6%), alumina (22.8%) and magnetite (5.6%). Its amorphous phase (78.3%) has a high silica (49.4%) and alumina (14.4%) content. According to its mineralogical and chemical composition, MFA is potentially useful as a raw material for making cement, silica, and alumina, as well as low silica/alumina ratio zeolites. Deleterious elements could be removed during the zeolitization process or with an additional acid treatment. Because of its morphological properties and structural and thermal stability, MFA can be used in thermal isolation and refractory materials and as a support for heterogeneous catalysts.

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Introducción: El Instituto Mexicano del Seguro Social (IMSS) es el principal proveedor de servicios de salud en México. La creciente demanda de enfermedades crónico-degenerativas lo han obligado a reorganizar y descentralizar la atención, esto requiere de acciones estratégicas que fortalezcan la fuerza de trabajo. A partir de 2001 en el Instituto se implantó un Programa de Profesionalización con el propósito de incrementar el nivel profesional hasta lograr el grado académico de licenciatura del personal de enfermería. Objetivos: Determinar el nivel académico del personal de enfermería del IMSS. Metodología: De un total de enfermeras en el Régimen Obligatorio de 86,088 y en IMSS-Oportunidades de 11,603 se autoaplicó un cuestionario de 28 preguntas cerradas en relación a las características personales, laborales y académicas del personal que se encontraba en ese momento en las unidades. Se utilizó análisis descriptivo. Resultados: Contestaron la encuesta 77.8% de Régimen Obligatorio y 90.2% de IMSS-Oportunidades, 17% del personal de enfermería del Régimen Obligatorio y 5% del personal de enfermería de IMSS-Oportunidades cuentan con licenciatura. La mitad del personal encuestado realizó la licenciatura a través de Sistema Universitario Complementario. Tres cuartas partes del personal en el primer nivel ya cuentan con estudios técnicos. Conclusiones: Cabe destacar que el porcentaje del personal de enfermería con licenciatura aumentó de 9.3 a18% en el Régimen Obligatorio, sin embargo, es indispensable que el IMSS continúe con este Programa de Profesionalización, a fin de propiciar la igualdad de oportunidades para mejorar el nivel académico del personal de enfermería.

Introduction: The Mexican Social Security Institute (IMSS) is the main supplier of health services in Mexico. Due to the increasing demand of chronical-degenerative diseases the institute has been obliged to reorganize and decentralize health attention, this requires of strategical actions in order to strengthen work force. The institute implemented a professional programme with the intention of increasing the professional level up to an academical bachalorate degree from nursery staff. Objective: To determine academical degree from nursery staff. Methodology: It was autoapplied a questionnarie of 28 closed questions to staff working in the units at that very moment. From a total amount of 86,088 nurses within Obligatory Regimen and an amount of 11,603 from IMSS-Oportunidades. Descriptive analysis was done. Results: This survey was answered by 77.8% from Obligatory Regimen and 90.2% from IMSS-Oportunidades, 17% from obligatory system nursery staff and 5% IMSS-Oportunidades nursery staff are allready bachalorated. Half of surveyed staff got their bachalorate from Complementary University System. The third part of firts level staff already have thecnical degree studies. Conclusions: There is a significant percentage result in bachalorates within nursery staff (9.3 to 18%) in obligatory system. Nevertheless it is of great importance that IMSS keeps on providing professional programmes in order to give the same opportunities to improved academical level in nursery staff.

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BACKGROUND: Different RET oncogene mutations have been found to be associated with inherited medullary thyroid carcinoma (MTC) in the context of three different syndromes including multiple endocrine neoplasia types 2A (MEN 2A) and 2B (MEN 2B) and familial medullary thyroid carcinoma (FMTC). These mutations have been recorded in different populations, but to date there is no corresponding study in Mexican families. Our purpose was identification of RET mutations in Mexican families with inherited or sporadic MTC (SMTC) and search for RET protein expression as prognostic marker in MTC tumors. METHODS: Nine unrelated families with MTC corresponding either to two MEN 2A, three MEN 2B, or four SMTC were studied. Screening of exons 10, 11, and 13-16 of RET oncogene in DNA from circulating lymphocytes and tumor samples were analyzed. Immuno- staining for RET was performed in the corresponding tumor. RESULTS: Germline 918 ATG-->ACG RET mutation was present in three unrelated MEN 2B individuals and corresponding somatic mutation in one individual with SMTC; 634 TGC-->TTC RET mutation was detected in two related patients in an MEN 2A family and the 634 TGC-->TAC RET mutation was detected in 12 related individuals from a second MEN 2A family. RET protein expression was detected in all MTC tumors showing different staining intensity. CONCLUSIONS: RET mutations found in Mexican patients with MTC are similar to those previously reported in several MTC families worldwide. This indicates that RET mutations are highly conserved and that MTC etiology does not depend to a great extent on environmental factors or ethnic differences. Detection of RET protein in MTC tissue sections is not useful as prognostic marker.

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Los tumores del mesénquima de la vulva son poco frecuentes. Por otra parte, el angiomixoma de comportamiento clínico agresivo es una lesión recientemente caracterizada que se presenta principalmente en los tejidos blandos de la pelvis y tiene tendencia a recurrir localmente. Las variedades benignas suelen ser de dimensiones menores y generalmente se confunden con quistes de la glándula de Bartholin. En este trabajo se describe el caso de un tumor mesenquimatoso mixto gigante y benigno de la vulva con características clínicas atípicas

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Los autores informan el caso de un recién nacido quien tuvo un tumor muy vascularizado, variante rara de teratoma sacrococcígeo. Presentó insuficiencia cardiaca congestiva y anemia lo cual ocasionó su fallecimiento. Se revisó la literatura para hacer sugerencias respecto al diagnóstico prenatal y al manejo quirúrgico urgente de esta variante de teratoma sacrococcígeo en la etapa neonatal

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