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Introducción: En las ciencias médicas son diversas las investigaciones asociadas a la modalidad virtual, sobre todo durante la pandemia por COVID-19. Sin embargo, en el campo de la neurofisiología clínica existen pocas experiencias descritas. Objetivo: Describir los resultados del desarrollo virtual de las asignaturas Historia de la Neurociencia y la Neurofisiología en Cuba e Introducción a la Metodología de la Investigación Científica, mediante el aula invertida y el aula virtual en la formación del Técnico Superior en neurofisiología clínica en La Habana. Métodos: Estudio descriptivo de corte transversal y no experimental. Se adecuaron las asignaturas en modalidad virtual, al aplicar un modelo constituido por cuatro fases: preparación, análisis y diseño, desarrollo e implementación, y evaluación. Resultados: Se preparó al claustro en materia de educación virtual. Se diseñaron estrategias didácticas para la virtualización del proceso de enseñanza-aprendizaje, mediante la aplicación del aula invertida y el aula virtual. En la fase de evaluación se obtuvieron valores altos al calcular los indicadores de promoción y calidad, y se aplicó una encuesta a los estudiantes. Para ambas asignaturas predominaron los valores de alta satisfacción en los criterios de la encuesta, excepto en Formas de evaluaciones y Distribución del tiempo en el aprendizaje, con mayores valores de satisfacción media. Conclusión: Los resultados obtenidos en el tránsito a la modalidad virtual cumplieron con los objetivos propuestos en el programa de las asignaturas, por lo que fue posible la enseñanza no presencial mediante el aula invertida y el aula virtual(AU)

Introduction: In medical sciences, there are several pieces of research associated with the virtual modality, especially during the COVID-19 pandemic. However, in the field of clinical neurophysiology, few experiences have been described. Objective: To describe the outcomes of virtually developing the subjects History of Neuroscience and Neurophysiology in Cuba and Introduction to the Methodology of Scientific Research, by means of the inverted classroom and the virtual classroom in the training of higher-degree associates in clinical neurophysiology in Havana. Methods: A descriptive, cross-sectional and nonexperimental study was carried out. The subjects were adapted to the virtual modality by applying a model consisting of four phases: preparation, analysis and design, development and implementation, and evaluation. Results: The faculty was trained in virtual education. Didactic strategies were designed for the virtualization of the teaching-learning process, through the application of the inverted classroom and the virtual classroom. In the evaluation phase, high values were obtained when calculating the promotion and quality indicators, and a student survey was applied. For both subjects, high satisfaction values predominated in the survey criteria, except for evaluations forms and distribution of time for learning, with higher values of the medium satisfaction. Conclusions: The outcomes obtained in the transition to the virtual modality complied with the objectives set in the syllabus of the subjects, making possible non-face-to-face teaching by means of the inverted classroom and the virtual classroom(AU)

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Introducción: Las dificultades del aprendizaje son las alteraciones de mayor presencia en las aulas escolares y sus indicadores pueden diagnosticarse y prevenirse desde edades tempranas. El objetivo de esta investigación fue validar el Test para la detección temprana de las dificultades en el aprendizaje de la lectura y escritura. Métodos: El enfoque de la investigación fue cuantitativo, descriptivo y de corte transversal. Se utilizó la validez de constructo acorde con la propuesta original del test y de fiabilidad a través del Alpha de Cronbach en una muestra de 501 niños ecuatorianos de cuatro años. Resultados: La validación del instrumento evidencia una moderada correlación entre las sub-tareas y alta correlación entre las sub-tareas y el puntaje total. La fiabilidad es buena, α= 0.71, muy próxima a la de la población española α= 0.73. Por lo que, la prueba puede ser utilizada en el contexto ecuatoriano en su versión original, adecuando en las instrucciones dos palabras a la realidad lingüística del país y para la calificación los puntos de corte de dificultad. Conclusión: Considerando su valor y fácil aplicación se recomienda el uso de la prueba de lectura en contextos educativos y de salud.

Introduction: Learning difficulties are the alterations with the most significant presence in school classrooms, and their indicators can be diagnosed and prevented early. This research aimed to validate the test for the early detection of difficulties in learning to read and write. Methods: The research approach was quantitative, descriptive, and cross-sectional. Construct validity was used according to the original proposal of the test and reliability through Cronbach's alpha in a sample of 501 four-year-old Ecuadorian children. Results: The validation of the instrument shows a moderate correlation between the subtasks and a high correlation between the subtasks and the total score. The reliability is good, α = 0.71, very close to that of the Spanish population α = 0.73. Therefore, the test can be used in the Ecuadorian context in its original version, adapting two words in the instructions to the linguistic reality of the country and for the qualification of the cutoff points of difficulty. Conclusion: With the easy application of the "test of reading" in 4-year-old children, the authors recommended its application for the identification of dyslexia and phonological processing deficits in school children in Ecuador. The reading test's validity allows its application at a regional level.

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Obesity leads to chronic oxidative stress promoting the development of cardiovascular diseases including coronary artery disease and endothelial dysfunction. Increased reactive oxygen species production associated with obesity might lead to endothelial dysfunction through cyclooxygenase (COX) pathway. We evaluated arachidonic acid (AA)-dependent coronary vascular responses and explored COX metabolism in obese C57BL/6 mice. In response to arachidonic acid (AA), isolated hearts from obese mice showed increased vasoconstriction compared with control mice. Released thromboxane (TX) A2 during AA-induced vasoconstriction phase was increased in heart perfusates from obese mice. Indomethacin and 1-benzylimidazole, both reduced vasoconstriction response in control and obese mice. Vasoconstriction response to TXA2 mimetic analog U46619 was 2.7 higher in obese mice. Obesity increased COX-2, TXS and TX receptor protein expression as well as oxidative stress evaluated by nitrotyrosine and peroxynitrite levels, compared with control mice. Obese mice treated with FeTMPyP, a peroxynitrite scavenger, reversed all these parameters to control levels. These data suggest that alterations in COX pathway may be associated with increased generation of free radicals, including peroxynitrite, that result from the oxidative stress observed in obesity.

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Cancer therapy advances have yet to impact global cancer mortality. One of the factors limiting mortality burden reduction is the high cost of cancer drugs. Cancer drug repurposing has already failed to meet expectations in terms of drug affordability. The three FDA-approved cancer drugs developed under repurposing: all-trans-retinoic acid, arsenic trioxide, and thalidomide do not differ in price from other drugs developed under the classical model. Though additional factors affect the whole process from inception to commercialization, the repurposing of widely used, commercially available, and cheap drugs may help. This work reviews the concept of the malignant metabolic phenotype and its exploitation by simultaneously blocking key metabolic processes altered in cancer. We elaborate on a combination called BAPST, which stands for the following drugs and pathways they inhibit: Benserazide (glycolysis), Apomorphine (glutaminolysis), Pantoprazole (Fatty-acid synthesis), Simvastatin (mevalonate pathway), and Trimetazidine (Fatty-acid oxidation). Their respective primary indications are: • Parkinson's disease (benserazide and apomorphine). • Peptic ulcer disease (pantoprazole). • Hypercholesterolemia (simvastatin). • Ischemic heart disease (trimetazidine). When used for their primary indication, the literature review on each of these drugs shows that they have a good safety profile and lack predicted pharmacokinetic interaction among them. Based on that, we propose that the BAPST regimen merits preclinical testing.

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Introducción: La enseñanza mediante la modalidad virtual se adoptó como medida preventiva ante la propagación de la COVID-19. Para la educación médica cubana ha implicado un reto en cuanto a la reorganización de los programas de estudio. Con este propósito, se rediseño e implementó la asignatura Fisiología II en modalidad virtual, para garantizar la continuidad en la formación de residentes en Neurofisiología Clínica. Objetivo: Evaluar el desarrollo de la asignatura Fisiología II en su modalidad virtual desde la perspectiva de los estudiantes de la especialidad Neurofisiología Clínica. Métodos: Estudio exploratorio, no experimental y transversal. Mediante un cuestionario de preguntas cerradas y una abierta (aspectos positivos y negativos), se evaluó el desarrollo de la asignatura en modalidad virtual en relación con las variables: programa de la asignatura, desempeño de los profesores, escenario de las plataformas y soporte tecnológico. Resultados: La asignatura Fisiología II en modalidad virtual tuvo una alta aceptación por parte de los estudiantes. Los aspectos identificados como positivos fueron los relacionados con la gestión personal del tiempo, y la aplicabilidad y estructura de la asignatura; mientras que los negativos se orientaron hacia problemas de conectividad de internet y el entorno de estudio. Conclusiones: Las exitosas experiencias obtenidas en el desarrollo de la asignatura virtual Fisiología II sientan las bases para el empleo de este tipo de diseño en la especialidad de Neurofisiología Clínica y la posibilidad de extenderlo a otras asignaturas del plan de estudio(AU)

Introduction: Teaching through virtual modality was adopted as a preventive measure against the COVID-19 spread. For Cuban medical education, it has implied a challenge regarding the reorganization of study programs. For this purpose, the subject Physiology II was redesigned and implemented in virtual modality, in order to guarantee continuity in the training of Clinical Neurophysiology residents. Objective: To assess the development of the subject Physiology II in its virtual modality from the perspective of the students of the Clinical Neurophysiology specialty. Methods: Exploratory, nonexperimental and cross-sectional study. Through a questionnaire made up of closed questions and one open question (positive and negative aspects), the development of the subject in virtual modality was assessed in relation to the variables subject syllabus, professors' performance, platform scenario, and technological support. Results: The subject Physiology II in virtual modality had a high acceptance by the students. The aspects identified as positive were those related to individual time management, as well as the subject's applicability and structure; while the negative ones were oriented towards internet connectivity problems and the study environment. Conclusions: The successful experiences obtained in the development of Physiology II as a virtual subject lay the foundations for using this type of design in the specialty of Clinical Neurophysiology and the possibility of extending it to other subjects of the study plan(AU)

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Agriculture runoffs and discharge of wastewaters are the major causes of eutrophication. Although eutrophication could promote the thriving of any phytoplankter, harmful algal blooms (HABs) are dominated frequently by cyanobacteria. Currently, HABs dominated by the toxigenic cyanobacterium Microcystis aeruginosa in lakes and reservoirs are the main environmental concerns worldwide. This study aimed to determine how M. aeruginosa (Ma) modifies the population growth of Pseudokirchneriella subcapitata (Ps) and Ankistrodesmus falcatus (Af). Growth kinetics were determined for each species and in the combinations: Ps-Ma, Af-Ma, Af-Ps, and Ps-Af-Ma. At the end of experiments, photosynthetic pigments, phycobiliproteins, and microcystins were quantified. A logistic equation significantly described the growth trend for all of the tested species, enabling the identification of negative effects on early stages in the population growth of co-cultures with the cyanobacterium; in addition, the interaction effects on the growth rate and in the maximum attainable population density were determined. The biomasses of A. falcatus and P. subcapitata were significantly higher when cultured individually than in all of the combinations with the cyanobacterium. The concentrations of chlorophyll a and b, as well as carotenoids, were lower in combined cultures, but phycobiliprotein content in the cultures with M. aeruginosa was not significantly affected. Microcystis aeruginosa negatively affected the growth of the microalgae, but A. falcatus was significantly more inhibited than P. subcapitata; however, microcystin concentrations were significantly reduced in the co-cultures with microalgae. These results could help to explain the displacements of microalgae when cyanobacteria are present, giving rise to cyanobacterial blooms in eutrophic freshwaters.

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Introducción: la hiperplasia suprarrenal congénita (HSC) es el desorden adrenal más común en la infancia y la causa más frecuente de ambigüedad sexual. La forma clásica, que representa los casos más severos de este déficit, se asocia en un 75 % con pérdida de sal. Por otra parte, en los recién nacidos (RN) del sexo femenino se pueden presentar grados severos de virilización de genitales. Objetivo: presentar los resultados (durante diez años), del Programa Cubano de Pesquisa Neonatal (PN) de la HSC, soportado en un procedimiento inmunoenzimático desarrollado en Cuba. Resultados: en el período de enero 2005 a diciembre 2014, se han estudiado 1 140 882 RN y se detectaron 56 niños con HSC, para una incidencia de 1:20 373 RN. La cobertura del programa se ha incrementado hasta llegar en el año 2013 al 99.34 % de todos los RN cubanos. Conclusiones: la existencia del Programa Cubano de PN de HSC, ha permitido estimar la incidencia e incrementar el conocimiento de esta enfermedad. La PN ha posibilitado el diagnóstico precoz en la variedad perdedora de sal, contribuyendo a la disminución de la mortalidad infantil. El Programa ha favorecido a pacientes con formas virilizantes de la enfermedad, mediante la asignación correcta del sexo

Introduction: Congenital Adrenal Hyperplasia (HSC) is the most common adrenal disorder in childhood and the most frequent cause of sexual ambiguity. The classic form, which represents the most severe causes of this deficit, is associated in 75 % with loss of salt. On the other hand, in the NB of the female sex that present severe degrees of virilization of the genitals. Objective: To present result of the application for ten years of the Cuban Neonatal Research Program of the HSC, supported by an inmmunoenzymatic procedure developed in Cuba. Result: In the period from January 2005 to December 2014, using the UMELISA 17 OH PROGESTERONA NEONATAL, 1 140882 RN were detected, for an incidence of 1:20373 RN. The coverage of the program has been increasing until2013 reaching 99.34 % of all Cuban RN. Conclusion: The existence of the Cuban HSC PN Program, has allowed estimating the incidence and increase knowledge of this disease in our country. PN has made possible the early diagnosis of patients with the salt losing variety, contributing to decrease in infant mortality nationwide. The Program has favored patients with virilizing form of the disease, through the correct assignment of sex

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RESUMEN Introducción: El consumo de tabaco deviene un trastorno adictivo que pone en peligro la salud tanto de los fumadores como de los que lo rodean. Su evaluación adecuada requiere contemplar los factores psicológicos y sociales que lo propician. Objetivo: Describir el proceso de adaptación al contexto cubano del Cuestionario de clasificación de consumidores de cigarrillos y caracterizar la muestra de fumadores estudiada para ello. Material y métodos: La investigación desarrollada incluye dos etapas. La primera, clasifica como un estudio de desarrollo tecnológico y la segunda, consiste en un estudio descriptivo de corte transversal con un diseño cuantitativo. Participaron 5 expertos y 205 fumadores activos seleccionados a partir de un muestreo intencional procedentes de áreas de salud de La Habana y Santiago de Cuba. Resultados: Se desarrolló una versión válida para la población cubana del cuestionario, que contiene las recomendaciones realizadas por los expertos y obtuvo una consistencia interna de 0,7005. El 49.7% de los participantes clasificó como fumadores fuertes y 48.3% como fumadores moderados (de riesgo). Por otra parte 60% de ellos son hombres, 32,7% son jóvenes y 65% son trabajadores. Conclusiones: Se realizó la adaptación lingüística y cultural al contexto cubano del Cuestionario de clasificación de consumidores de cigarrillos, la cual cuenta con un nivel de fiabilidad adecuado. La mayor parte de los sujetos estudiados clasificaron como fumadores fuertes o moderados. Predominaron los del sexo masculino, jóvenes y trabajadores.

ABSTRACT Introduction: Tobacco consumption becomes an addictive disorder that endangers the health of both smokers and those around them. Its proper evaluation requires an analysis of the psychological and social factors that favor it. Objective: To describe the adaptation process of the questionnaire for classification of cigarette consumers within the Cuban context and characterize the sample of smokers under study. Material and Methods: The research includes two stages: the first stage that is classified as a technological development study, and the second one which consists of a descriptive cross-sectional study with a quantitative design. Five experts and 205 active smokers selected from an intentional sample from the health areas of Havana and Santiago de Cuba participated in the study. Results: A valid version of the questionnaire for the Cuban population was developed, which contains the recommendations made by the experts and obtained an internal consistency of 0.7005. It was observed that 49.7% of the participants classified as strong smokers and 48.3% as moderate smokers (at risk). On the other hand, 60% of them are men, 32.7% are young and 65% are workers. Conclusions: Linguistic and cultural adaptation to the Cuban context of the questionnaire for classification of cigarette consumers was carried out, which has an adequate level of reliability. Most of the subjects studied were classified as strong or moderate smokers. The male sex, young and workers predominated in the study.

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Congenital hypothyroidism (CH) is one of the most frequent inherited-metabolic diseases in the world, and the main cause of treatable mental retardation in children. Because signs and symptoms of this disease are often scarce and not easily recognizable, newborns are screened for the early CH detection at birth. The Center of Immunoassay (CIE) has developed the UMELISA® TSH Neonatal and UMELISA® TSH to determine neonatal thyroid-stimulating hormone (TSH) levels in dried blood and serum samples. Both reagent kits use the same polystyrene plates coated with anti-ß-TSH monoclonal antibodies (MAbs), but one of these is commercially acquired. Obtaining appropriate anti-TSH MAbs at the CIE would guarantee economic independence and security in the production of these kits. Immunization of mice with TSH led to the generation of 7G11E3, an anti-ß-TSH IgG1-secreting hybridoma. The high affinity of 7G11E3 MAb and its characteristic epitopic recognition explain its better performance when adsorbed to UMELISA® plates for capturing low amounts of TSH in comparison with the studied MAbs. Performance of assays using polystyrene plates coated with 7G11E3 MAb was studied. Recovery percentages (100.0-106.7% for UMELISA® TSH NEONATAL and 97.3-99.0% for UMELISA® TSH) and intra (5.2-7.9% for UMELISA® TSH NEONATAL and 3.2-5.3% for UMELISA® TSH) and inter (6.6-7.7% for UMELISA® TSH NEONATAL and 5.2-8.0% for UMELISA® TSH) coefficients of variation were similar to the ones described for the commercial kits. Limits of detection and quantification were 1.0 and 3.8 mIU/L for UMELISA® TSH NEONATAL, and 0.3 and 0.6 mIU/L for UMELISA® TSH, respectively. The results also showed high overall concordance between assays (n = 2 019, ρc = 0.90 for UMELISA® TSH NEONATAL and n = 200, ρc = 0.94 for UMELISA® TSH). The 7G11E3 MAb meets the requirements for its use in the plates of UMELISA® TSH kits for CH newborn screening in Cuba. Abbreviations: CECMED, Center for the State Control of Medicaments and Medical Equipment and Devices; CH, congenital hypothyroidism; CIE, Center of Immunoassay; CLSI, Clinical and Laboratory Standards Institute; CV coefficient of variation; DBS, dried blood spots; LOB, limit of blank; LOD, limit of detection; LOQ, limit of quantitation; SD, standard deviation; Sr, repeatability standard deviation; SUMA, Ultra Micro Analytic System; UMELISA, ultramicro enzyme-linked immunosorbent assay.

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Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder caused by the deficiency of one of the five enzymes involved in the biosynthesis of corticosteroids. The most common form of the disease is the lack of 21-hydroxylase which provokes an accumulation of high levels of 17α-hydroxyprogesterone (17-OHP), the main biochemical marker for illness detection. Given the significance of neonatal diagnosis for ensuring a timely treatment to patients suffering from CAH, newborn screening is worldwide performed for the determination of 17-OHP from dried blood spots on filter paper. The non-specificity of antisera employed in immunoassays and the cross-reaction with fetal adrenal hormones produce an overestimation in the 17-OHP quantification. Immunization of mice with 17-OHP-3-(O-carboxymethyl) oxime-bovine serum albumin led to the generation of 15 anti-17-OHP IgG1-and-IgG2b-secreting hybridomas. The 6E2G9 monoclonal antibody presents cross-reactivity values similar to those achieved by rabbit antibodies employed in the solid phase of UMELISA® 17-OH Progesterona Neonatal, assay for the newborn screening of CAH in Cuba. Additionally, the use of 6E2G9 in the evaluation of dried blood spots samples from newborns on filter paper showed a decrease in the mean 17-OHP levels, thus demonstrating it can replace the conventional rabbit antisera.

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In 2015, according to the National Institute of Statistics and Geography (INEGI), malignant breast tumors were the first cause of cancer fatality in women (6,273 fatalities) in Mexico, whereas 2,793 fatalities in women were due to ovarian cancer. A total of 5­10% of breast cancer and 10­15% of ovarian cancer cases are caused by a hereditary breast­ovarian cancer syndrome, with mutations predominantly identified in the BRCA1 and BRCA2 genes. Recently, the Mexican founder mutation BRCA1 ex9­12del was identified (deletion of exons 9­12 with recombination between introns 8­12). This is the most frequently reported mutation in hereditary breast/ovarian cancer in Mexico. Current detection methods include end­point polymerase chain reaction (PCR) and Multiplex Ligation­dependent Probe Amplification (MLPA). In the present study a cheap, sensitive and fast detection method was developed based on quantitative PCR and two TaqMan® probes, one to detect the deletion (recombination region between introns 8 and 12), and the other one a region from exon 11. With this assay, 90 samples were able to be analyzed in 2 h using 2.5 ng of DNA/reaction at a cost of ~2­3 USD. This method is capable of detecting positive samples for DNA deletion and excluding negative ones. Therefore, the method proposed may be a useful high­throughput diagnostic option that could be useful in future association or prevalence studies that use large populations.

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Cystic fibrosis (CF) is a severe autosomal recessive disorder. It is caused by mutations in the CF transmembrane conductance regulator gene. Early diagnosis of CF can be carried out by determining high immunoreactive trypsinogen (IRT) blood values in newborns. A simple sandwich-type ultramicroELISA assay (UMELISA®) has been developed for the measurement of IRT in dried blood spots on filter paper. Strips coated with a high affinity monoclonal antibody directed against IRT are used as solid phase, to ensure the specificity of the assay. The assay is carried out within 20 h. The useful rank of the curve is 0-500 ng/mL, and the lowest detectable concentration is 4.8 ng/mL. Intra- and inter-assay coefficients of variation were lower than 10%. The recovery mean value was 100.3 ± 11.2%. Cross-reactivity with proteins structurally related to IRT (α2-macroglobulin, α1-antitrypsin, and human chymotrypsin) was lower than the detection limit of the assay. Four thousand four hundred six newborn samples from the Cuban Newborn Screening Program were analyzed, and the mean IRT concentration was 12.8 ng/mL. Higher IRT values were obtained when samples were eluted overnight. Regression analysis showed a good correlation with the commercially available AutoDELFIA® Neonatal IRT kit (n = 3948, r = 0.885, ƙ = 0.976, p < 0.01). The analytical performance characteristics of our UMELISA® TIR Neonatal suggest that it can be used for the neonatal screening of CF.

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El reconocimiento de la diabetes de tipo 2 (DM2) como una enfermedad crónica que afecta a millones de personas en el mundo, ha motivado la búsqueda de otros ámbitos de atención de salud, así como enfoques y metodologías que favorezcan un acercamiento real al problema. El objetivo del estudio fue evaluar una intervención educativa en pacientes clasificados de acuerdo a la estimación de riesgo de DM2, Municipio San Diego, Estado Carabobo. Se trató de un estudio descriptivo, de corte longitudinal, de intervención educativa antes-después, con seguimiento de 12 meses y de muestra intencional, que incluyó 80 participantes. Al comparar el nivel de conocimientos y el riesgo de DM2 antes y después de la intervención educativa, se obtuvo diferencias significativas. Se concluye que se produjo un cambio en el nivel de conocimiento de la población estudiada, así como un aumento de la proporción de pacientes que pasaron de un riesgo moderado, a un riesgo bajo de DM2. Los hallazgos encontrados valoran como positiva la intervención educativa y suponen un importante aporte, que evidencia la importancia de la educación en la población.

The recognition of type 2 diabetes (DM2) as a chronic disease affecting millions of people around the world has been a motivation to search for other areas of health care, as well as approaches and methodologies leading to a better management of the problem. The objective of this study was to evaluate an educational intervention in patients classified according to the DM2 risk estimate, from the San Diego Municipality in Carabobo State. This was a descriptive, longitudinal study, of before-after educational intervention, with a 12-month follow-up and an intentional sample, which included 80 participants. When comparing the level of knowledge and risk of DM2 before and after the educational intervention, significant differences were obtained. We conclude that there was a change at the level of knowledge of the studied population, as well as an increase in the proportion of patients who moved from a moderate risk to a low risk of DM2. Findings reveal that educational intervention is positive, as well as an important contribution, which stresses the importance of education in the population.

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Human epidermal growth factor is a small peptide consisting of 53 amino acid residues, which stimulates cell proliferation and is associated with several human carcinomas. A simple sandwich-type ultramicroELISA assay (UMELISA), based on the advantages of high affinity reaction between streptavidin and biotin has been developed for the measurement of EGF in human serum samples. Strips coated with a high affinity monoclonal antibody directed against EGF are used as solid phase, to ensure the specificity of the assay. The EGF assay was completed in 18 hr, with a measuring range of 39-2500 pg/mL. The intra- and inter-assay coefficients of variation were 4.4-7.3% and 0-5.1%, respectively, depending on the EGF concentrations evaluated. Percentage recovery ranged from 96-104%. Regression analysis showed a good correlation with the commercially available Human EGF Immunoassay Quantikine® ELISA kit (n = 130, r = 0.92, P < 0.01). The analytical performance characteristics of our UMELISA EGF endorse its use for the quantification of EGF in human serum samples.

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La dislexia en la edad adulta afecta alrededor del 4% de la población. Por ello, el objetivo de este trabajo es analizar los aspectos metodológicos, así como los temas de investigación, acerca de la dislexia en población adulta. A partir de una búsqueda bibliográfica en la base de datos del Psychological Abstracts: PsycoINFO, se identifican y seleccionan los trabajos sobre los que se centra la revisión. Los resultados indican respecto a la metodología que la mayoría de estudios emplean métodos cuantitativos de investigación (59.4%), frente al 5.7% que emplea métodos cualitativos. También se emplean en el 10% de los trabajos diseños de N = 1, y, en menos del 10%, entrevistas, estudios longitudinales y técnicas neurobiológicas. En cuanto a los temas de investigación, el 40.6% de los trabajos se centran en analizar procesos cognitivos (conciencia fonológica, memoria, inteligencia, velocidad de procesamiento) y el rendimiento académico (lectura de palabras, lectura de pseudopalabras, ortografía y comprensión de textos), el 25.4% son estudios neurobiológicos (neurológicos y genéticos), el 12% se centran en la intervención, el 8% en identificación y el 5.4% analizan los problemas asociados a la dislexia en la edad adulta. Los objetivos prioritarios de la investigación parecen ser la caracterización de las manifestaciones de la dislexia en la edad adulta, seguidos de los estudios que se dirigen al esclarecimiento de las bases neurobiológicas. También se amplía la investigación hacia temas de orden práctico.

Dyslexia in adulthood affects around 4% of the population. Thus, this study offers an overview of the methodological aspects and the areas of research in dyslexia in adulthood. From a bibliographical search conducted in the Psychological Abstracts database: PsycINFO, we identified and selected the studies the review was to focus on. Results show in relation to methodological aspects, quantitative research methods are preferred in 59.4% of cases, whereas 5.7% opted for qualitative methods. Also, in 10% of the studies, used N=1 designs and in an under 10% studies used surveys, longitudinal/ follow-up studies or neurobiological procedures. In relation to the topics of research, 40.6% analyzed cognitive processes (phonemic awareness, memory, IQ, naming speed) and/or academic achievement (word reading, pseudoword reading, spelling, and reading comprehension), the 25.4% were neurobiological studies (neurological and genetics), the 12% were studies focusing on intervention, the 8% focused on identification/ diagnostic, and 5.4% analyzed associated problems to dyslexia in adulthood. The primary objectives of the research appear to be the characterisation of dyslexia and studies about neurobiological basis of dyslexia in adulthood. Research is also extended towards other, more practical matters.

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The use of Information and Communication Technologies (ICTs) has gained an important role to enhance healthcare systems by increasing access to services, and improving the quality and equity of care. In order to evaluate the stage of ICTs adoption in the Uruguayan healthcare system, the Governmental Salud.uy Program carried out a national survey to establish the baseline for ICTs adoption, as well as define a set of indicators so as to evaluate the progress on this topic. Data was recorded following the OECD methodology.

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OBJETIVO: presentar una propuesta de sistema de indicadores para valorar el sistema de acciones dirigidas a la formación y desarrollo de expertos en una organización de alta tecnología. MÉTODOS: se analizaron las diferentes teorías que abordan la formación y desarrollo de expertos, valorando sus aspectos y componentes. Para el diseño del sistema de indicadores se aplicaron encuestas y se realizaron observaciones directas. El sistema de indicadores diseñado fue validado empleando el método Delphi, con la aplicación de la escala Likert y el tratamiento estadístico de las respuestas de los expertos, utilizando la mediana y el rango intercuartílico para establecer el consenso de los expertos. RESULTADOS: se propuso una definición de trabajo para el concepto experto. Se establecieron dos dimensiones: cualificación del experto y gestión del experto, con sus variables, indicadores y criterios de medida tanto individual como colectivo. El coeficiente alfa de Cronbach (0,8655) demostró la consistencia interna del instrumento empleado. Los valores de las medianas y los rangos intercuartílicos alcanzados permitieron establecer el consenso de los participantes en la validación del sistema de indicadores. CONCLUSIONES: el sistema de indicadores elaborado con sus dos dimensiones permite valorar el estado de la formación y desarrollo de expertos en el Centro de Neurociencias de Cuba, así como de su sistema de acciones. El indicador de más bajos resultados es el relacionado con la productividad de los expertos en la formación de recursos humanos de alto nivel académico

OBJECTIVE: present a proposal of a system of indicators to assess actions aimed at the training and development of experts in a high-tech organization. METHODS: an analysis was conducted of the various theories dealing with the training and development of experts, examining their features and components. Design of the system of indicators was based on surveys and direct observation. The system of indicators thus designed was validated with the Delphi method, the application of the Likert scale and the statistical treatment of answers provided by experts, using median and interquartile range values to establish the consensus of experts. RESULTS: a working definition is proposed of the concept expert based on two dimensions: qualification and performance, and individual and collective variables, indicators and measurement criteria. Cronbach's alpha coefficient (0,8655) showed the internal consistency of the tool used. The median and interquartile range values obtained made it possible to establish the consensus of participants in the validation of the system of indicators. CONCLUSIONS: the system of indicators developed and its two dimensions make it possible to assess the training and development of experts at the Cuban Neuroscience Center, as well as the system of actions performed. The indicator showing the lowest results is that of productivity of experts in the training of human resources of high academic level

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Objetivo: caracterizar el síndrome metabólico (SM) en un medio rural venezolano. Contexto y tipo de estudio: la frecuencia de SM es elevada en el mundo y es elemento de riesgo en el desarrollo de diabetes mellitus y enfermedad cardiovascular, pero existe limitada información sobre SM en las zonas rurales de la mayoría de los países. Se realizó un estudio descriptivo y transversal en un sector rural del estado Cojedes, Venezuela. Material y método: fueron 39 los sujetos con edades entre 20-59 años, 51.3% mujeres y 56.4% tenían antecedentes familiares de riesgo cardiometabólico. Se definió según el Tercer Reporte del Panel de Expertos del Programa Nacional de Educación (NCEP/ATPIII), como SM a la presencia de por lo menos tres de los cinco factores siguientes: obesidad abdominal (> 88 cm en mujeres y de 102 cm en hombres) hiperglicemia en ayunas (> 110 mg/dL), hipertensión arterial (> 130/85 mmHg), lipoproteína de alta densidad (HDL-c) (< 50 mg/dL) y triglicéridos elevados (> 150 mg/dL). Resultados: la prevalencia de SM fue 20.5%, 12.8% hombres y 7.7% mujeres, el criterio diagnóstico predominante fue la hipertrigliceridemia (53.8%) y las mujeres con SM eran más hipertensas, hiperglicémicas, con menos HDL-c, mayor concentración de triglicéridos y obesas que los hombres. Conclusión: el SM afecta por igual al medio rural y urbano, pero en Venezuela la prevalencia es mayor en la región urbana llanera. El género masculino es también el más afectado y la diabetes mellitus e HTA son los antecedentes familiares más frecuentes. La obesidad abdominal e hipertrigliceridemia los factores de riesgo SM más señalados. Se infiere adopción rural de hábitos alimentarios urbanos. (Acta Med Colomb 2012; 37: 177-182).

Objective: to characterize the metabolic syndrome (MS) in a rural Venezuelan environment. Context and Type of Study: MS has a high frequency worldwide and is a risk factor in the development of diabetes mellitus and cardiovascular disease, but the information about SM in these areas is limited. We performed a cross-sectional descriptive study in a rural sector in Cojedes state, Venezuela. Methods: we studied 39 subjects aged 20-59 years. 51.3% female and 56.4% had a family history of cardiometabolic risk. According to the Third Report of the Expert Panel of the National Education Program (NCEP / ATPIII), SM was defined as the presence of at least three of the following five factors: abdominal obesity (> 88 cm in women and 102 cm in men) fasting hyperglycemia (> 110 mg / dL), hypertension (> 130/85 mmHg), high density lipoprotein (HDL-C) (<50 mg / dL) and triglycerides (> 150 mg / dL). Results: the prevalence of MS was 20.5% (12.8% men and 7.7% women). The predominant diagnostic criteria was hypertriglyceridemia (53.8%) and women with MS were more hypertensive, hyperglycemic, with less HDL-C, higher triglycerides, and were more obese than men. Conclusion: MS equally affects both rural and urban areas, but in Venezuela the prevalence is higher in urban plains. Male gender is also the most affected and diabetes mellitus and hypertension are the most frequent family history. Abdominal obesity and hypertriglyceridemia are the most signaled SM risk factors. It infers the rural adoption of urban food habits. (Acta Med Colomb 2012; 37: 177-182).

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INTRODUCTION: Since 2004, with the ratification of the Framework Convention on Tobacco Control, Uruguay has implemented a wide range of legal restrictions designed to reduce the devastating impacts of tobacco. This legal process generated an increase in demand for tobacco cessation treatment, which led to the need to train a large number of physicians. Information and Communication Technologies (ICTs) are evolving constantly, creating new opportunities to make online education more interactive. The evolution of ICTs presents an opportunity to develop innovative continuing medical education (CME) experiences to meet the increasing demand for this topic. METHODS: A blended-learning course on tobacco cessation was developed and implemented, combining face-to-face and online activities. Educational strategy focused on (1) facilitating interaction among generalists and between generalists and experts, and (2) providing high impact CME incorporating multifaceted interventions with wiki-type collaborative construction of practical knowledge. Multiple-choice tests and commitments-to-change were used for evaluation. RESULTS: Three hundred thirty-five health professionals participated in the course. Of these, 145 (43.3%) attended the on-site workshop, 216 (64.5%) participated in the online activities, and 109 (32.5%) completed both phases. Fifty of the 105 (47.6%) participants completing the pretest had a passing score, while 78.1% received a passing score on the final test (p < .001). Differences between mean pretest and posttest scores among those who completed both phases compared with those who only did the online phase were statistically significant (p = .003 and p = .009, respectively). DISCUSSION: The need to train physicians on tobacco cessation skills can be addressed via ICTs and educational activities that include participant interaction.

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Bone mineral density (BMD) is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk. From a technical point of view Quantitative Computed Tomography (QCT) should be the gold standard in bone densitometry. On the other hand, it is known that a greater percentage increase in skin dose is needed as the patient size is increased: positive results and side effect of long-term steroid treatment as obesity have been found for Duchenne muscular dystrophy (DMD), characterized by a progressive muscle degeneration and substitution with fat. The present work is an effort to improve osteoporosis diagnostic efficacy in children by analyzing the trabecular bone texture in CT L3 vertebra by two methods which are independent of image intensity: fractal dimension with power spectrum and wavelet packets. As results, comparing healthy children (44 children both sexes) with osteoporotic subjects (13 adult women, aged 52-87 years) great differences were noticed in all image texture indicators (p<0.0146). For DMD children (7 boys, not overweight) classified by z-score as osteoporotic because of their low BMD, texture image analysis did not exhibited high spatial frequencies as in the osteoporotic group; the probability that these two groups were similar was weak (p<0.0059), suggesting a more similar bone condition to normal or osteopenia. None of the pediatric groups exhibited as high spatial frequencies as did the osteoporotic women group. These analyses could help to determine osteoporosis in children, where it is often a diagnostic challenge.

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