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INTRODUCCIÓN: La comprensión del comportamiento de la respuesta humoral en COVID-19 continúa siendo un desafío para la producción de vacunas que proporcionen inmunidad más duradera. OBJETIVO: Describir la respuesta humoral natural inducida por SARS- CoV-2 en personal de salud con base en el perfil epidemiológico y clínico. MATERIALES Y MÉTODOS: Estudio transversal en personal de salud de hospitales públicos de referencia del Departamento de Alto Paraná, Paraguay. Se incluyeron 962 participantes, mediante muestreo no probabilístico de tipo consecutivo, aplicación de cuestionario y toma de muestras sanguíneas. Se buscaron anticuerpos por ensayo inmunocromatográfico para detección de IgM e IgG contra SARS- CoV-2 y por el método ELISA de captura de IgG específicos contra la proteína spike (SARS-CoV-2) y se evaluaron factores asociados a la seropositividad. RESULTADOS: La seroprevalencia global fue 36,5% (IC 95%: 33,4 - 39,5); 59,3% (n: 571) de los encuestados refirió haber tenido síntomas compatibles al COVID-19 entre el inicio de la pandemia y la fecha de toma de muestra, de estos 44% (n: 251) resultó seropositivo; 10,4% (n: 100) manifestó no haber tenido síntomas en el periodo estudiado, pero tuvo un resultado positivo. Los factores asociados a la seropositividad fueron: presencia de síntomas (p 90 días). CONCLUSIONES: Las características clínicas fueron mayormente asociadas con la seropositividad y la seropreva- lencia en los sintomáticos varió de acuerdo con el tiempo transcurrido desde el inicio de los síntomas y la serología.

BACKGROUND: Understanding the behavior of humoral response in COVID-19 continues to be a challenge to produce vaccines that provide long-lasting immunity. AIM: To describe the natural humoral response induced by SARS-CoV-2 among healthcare workers based on epidemiological and clinical profiles. METHODS: Cross-sectional study in healthcare workers from public hospitals in the Department of Alto Paraná, Paraguay, 962 participants were recruited through consecutive sampling, using a questionnaire and blood sampling. Antibodies were determined by immunochromatography assay for detection of IgM and IgG and by SARS-CoV-2 IgG anti-spike capture ELISA method and factors associated with seropositivity were evaluated. RESULTS: The overall seropositivity was 36.5% (95% CI: 33.4 - 39.5); 59.3% (n: 571) of respondents reported symptoms compatible with COVID-19 since the start of the pandemic and the date of blood draw, 44% (n: 251) of them tested positive; 10.4% (n: 100) who reported no history of symptoms tested positive. The factors associated with seropositivity were the presence of symptoms (p 90 days). CONCLUSIONS: Clinical characteristics were mostly associated with seropositivity and sero prevalence in symptomatic participants varied according to the time elapsed from the onset of symptoms to serology.

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Background: Febrile neutropenia is a life-threatening condition commonly observed in patients with hematologic malignancies. The aim of this article is to provide updated knowledge about bloodstream infections in febrile neutropenia episodes within the Andean region of Latin America. Method: This retrospective study was based in 6 hospitals in Chile, Ecuador, and Peru and included adult patients with acute leukemia or lymphoma and febrile neutropenia between January 2019 and December 2020. Results: Of the 416 febrile neutropenia episodes, 38.7% had a bloodstream infection, 86% of which were caused by gram-negative rods, with Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa being the most frequently identified bacteria. K pneumoniae isolates were more frequently resistant than E coli to cefotaxime (65% vs 39.6%), piperacillin-tazobactam (56.7% vs 27.1%), and imipenem (35% vs 2.1%) and were more frequently multidrug resistant (61.7% vs 12.5%). Among P aeruginosa, 26.7% were resistant to ceftazidime, piperacillin-tazobactam, and imipenem, and 23.3% were multidrug resistant. Overall 30-day mortality was 19.8%, being higher with vs without a bloodstream infection (26.7% vs 15.3%, P = .005). Fever duration was also significantly longer, as well as periods of neutropenia and length of hospital stay for patients with bloodstream infection. Additionally, the 30-day mortality rate was higher for episodes with inappropriate vs appropriate empirical antibiotic therapy (41.2% vs 26.6%, P = .139). Conclusions: Considering the high rates of bacteria-resistant infection and 30-day mortality, it is imperative to establish strategies that reduce the frequency of bloodstream infections, increasing early identification of patients at higher risks of multidrug bacteria resistance, and updating existing empirical antibiotic recommendations.

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Low health literacy (LHL) significantly impacts patients' ability to participate actively in their healthcare. Registered nurses (RNs) play a crucial role in identifying LHL and addressing patient knowledge gaps and skill deficits. This correlational study examined the relationship between RNs' predictions of patients' health literacy levels (HLL) and the actual HLL of a predominately Hispanic patient population. In addition, personal factors (i.e., demographics) were analyzed to determine their influence on the nurse's predictions and patients' HLL. Data were collected from 84 participant patient-nurse couplets admitted to a medical-surgical unit in a rural setting located on the United States-Mexico border. In addition to demographic information collected via survey, RNs were asked to predict their patient's health literacy abilities while the Newest Vital Sign, a health literacy assessment tool, was deployed to determine the actual HLL of patients participating in the study. Data were analyzed using descriptive statistics, t-tests, and chi-square tests while a Spearman correlational model was used to examine the relationship between predicted HLL and actual HLL. Finally, a logistic regression model was used to analyze the relationship between personal factors and HL data for RNs and patients. Analysis of the data revealed that RNs consistently overestimated patients' abilities, as evidenced by the disparity between patients' actual HLL (mean 1.71) and predicted HLL (mean 4.26) by RNs, with a moderately strong positive relationship (rs = .418). Notably, higher academic preparation and years of experience did not enhance the RNs' ability to identify LHL while the highest level of education completed was the only statistically significant predictor of adequate health literacy in the patient population sampled. These findings emphasize the need to prioritize effective health literacy education in RN academic preparation and clinical practice to support the detection of LHL when a standardized health literacy assessment tool is not utilized in the clinical setting. By recognizing the presence of LHL, healthcare professionals can better support patients' needs and bridge the knowledge gap, ultimately improving patient outcomes.

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Rhipicephalus microplus is the most important tick in veterinary medicine, given its repercussions on animal production. The principal strategy to avoid adverse effects associated with R. microplus is the chemical control of tick populations through organosynthetic acaricides. Therefore, monitoring susceptibility to acaricides is paramount in any control program. This study aimed to analyze the resistance status of 2 populations of R. microplus from northeastern Mexico to the organochlorine (OC) lindane, organophosphates (OP) coumaphos, chlorfenvinphos, diazinon, and chlorpyrifos, and the synthetic pyrethroids (SPs) flumethrin, deltamethrin, and cypermethrin. Discriminating doses (DD) of each acaricide were used in the larval packet bioassay (LPT). Additionally, the presence of the knockdown resistance (kdr) mutation T2134A associated with pyrethroid resistance was evaluated using allele-specific polymerase chain reaction (PCR). The populations of R. microplus showed a high frequency of resistance to SP, with mortality rates of less than 5%; they also showed resistance to the OPs (diazinon and chlorpyrifos) with mortality rates ranging from 1.29% to 34.62%; meanwhile, they were susceptible to coumaphos and chlorfenvinphos. Mortality rates higher than 66% were observed for lindane, indicating susceptibility. The mutant allele of the kdr mutation T2134A was detected in 75% and 100% of the pools analyzed. The populations studied presented a highly resistant profile to pyrethroids, with the presence of the kdr mutant allele A2134. The susceptibility to the organophosphates such as coumaphos and chlorfenvinphos of R. microplus from northeastern Mexico should be noted.

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BACKGROUND: The phylum Chloroflexi is highly abundant in a wide variety of wastewater treatment bioreactors. It has been suggested that they play relevant roles in these ecosystems, particularly in degrading carbon compounds and on structuring flocs or granules. Nevertheless, their function is not yet well understood as most species have not been isolated in axenic cultures. Here we used a metagenomic approach to investigate Chloroflexi diversity and their metabolic potential in three environmentally different bioreactors: a methanogenic full-scale reactor, a full-scale activated sludge reactor and a lab scale anammox reactor. RESULTS: Differential coverage binning approach was used to assemble the genomes of 17 new Chloroflexi species, two of which are proposed as new Candidatus genus. In addition, we recovered the first representative genome belonging to the genus 'Ca. Villigracilis'. Even though samples analyzed were collected from bioreactors operating under different environmental conditions, the assembled genomes share several metabolic features: anaerobic metabolism, fermentative pathways and several genes coding for hydrolytic enzymes. Interestingly, genome analysis from the anammox reactor indicated a putative role of Chloroflexi in nitrogen conversion. Genes related to adhesiveness and exopolysaccharides production were also detected. Complementing sequencing analysis, filamentous morphology was detected by Fluorescent in situ hybridization. CONCLUSION: Our results suggest that Chloroflexi participate in organic matter degradation, nitrogen removal and biofilm aggregation, playing different roles according to the environmental conditions.

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A cerebral arteriovenous malformation (AVM) is a tangle of abnormal blood vessels that irregularly connects arteries and veins. Stereotactic radiosurgery (SRS) has been shown to be an effective treatment for AVM patients, but the factors associated with AVM obliteration remains a matter of debate. In this study, we aimed to develop a model that can predict whether patients with AVM will be cured 36 months after intervention by means of SRS and identify the most important predictors that explain the probability of being cured. A machine learning (ML) approach was applied using decision tree (DT) and logistic regression (LR) techniques on historical data (sociodemographic, clinical, treatment, angioarchitecture, and radiosurgery procedure) of 202 patients with AVM who underwent SRS at the Instituto de Radiocirugía del Perú (IRP) between 2005 and 2018. The LR model obtained the best results for predicting AVM cure with an accuracy of 0.92, sensitivity of 0.93, specificity of 0.89, and an area under the curve (AUC) of 0.98, which shows that ML models are suitable for predicting the prognosis of medical conditions such as AVM and can be a support tool for medical decision-making. In addition, several factors were identified that could explain whether patients with AVM would be cured at 36 months with the highest likelihood: the location of the AVM, the occupation of the patient, and the presence of hemorrhage.

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Background: Solid-organ transplant (SOT) recipients have worse COVID-19 outcomes than general population and effective immunisation in these patients is essential but more difficult to reach. We aimed to determine the immunogenicity of an mRNA SARS-CoV-2 vaccine booster in SOT recipients previously immunised with either inactivated or homologous SARS-CoV-2 mRNA vaccine. Methods: Prospective cohort study of SOT recipients under medical care at Red de Salud UC-CHRISTUS, Chile, previously vaccinated with either CoronaVac or BNT162b2. All participants received a BNT162b2 vaccine booster. The primary study end point was anti-SARS-CoV-2 total IgG antibodies (TAb) seropositivity at 8-12 weeks (56-84 days) post booster. Secondary end points included neutralising antibodies (NAb) and specific T-cell responses. Findings: A total of 140 (50% kidney, 38% liver, 6% heart) SOT recipients (mean age 54 [13.6] years; 64 [46%] women) were included. Of them, 62 had homologous (three doses of BNT162b2) and 78 heterologous vaccine schedules (two doses of CoronaVac followed by BNT162b2 booster). Boosters were received at a median of 21.3 weeks after primary vaccination. The proportion achieving TAb seropositivity (82.3% vs 65.4%, P = 0.035) and NAb positivity (77.4% vs 55.1%, P = 0.007) were higher for the homologous versus the heterologous group. On the other hand, the number of IFN-γ and IL-2 secreting SARS-CoV-2-specific T-cells did not differ significantly between groups. Interpretation: This cohort study shows that homologous mRNA vaccine priming plus boosting in SOT recipients, reaches a significantly higher humoral immune response than inactivated SARS-CoV-2 vaccine priming followed by heterologous mRNA booster. Funding: School of Medicine, UC-Chile and ANID.ClinicalTrials.gov ID: NCT05124509.

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BACKGROUND: Passive immunotherapy has been evaluated as a therapeutic alternative for patients with COVID-19 disease. Equine polyclonal immunotherapy for COVID-19 (EPIC) showed adequate safety and potential efficacy in a clinical trial setting and obtained emergency use authorization in Argentina. We studied its utility in a real world setting with a larger population. METHODS: We conducted a retrospective cohort study at "Hospital de Campaña Escuela-Hogar" (HCEH) in Corrientes, Argentina, to assess safety and effectiveness of EPIC in hospitalized adults with severe COVID-19 pneumonia. Primary endpoints were 28-days all-cause mortality and safety. Mortality and improvement in modified WHO clinical scale at 14 and 21 days were secondary endpoints. Potential confounder adjustment was made by logistic regression weighted by the inverse of the probability of receiving the treatment (IPTW) and doubly robust approach. FINDINGS: Subsequent clinical records of 446 non-exposed (Controls) and 395 exposed (EPIC) patients admitted between November 2020 and April 2021 were analyzed. Median age was 58 years and 56.8% were males. Mortality at 28 days was 15.7% (EPIC) vs. 21.5% (Control). After IPTW adjustment the OR was 0.66 (95% CI: 0.46-0.96) P = 0.03. The effect was more evident in the subgroup who received two EPIC doses (complete treatment, n = 379), OR 0.58 (95% CI 0.39 to 0.85) P = 0.005. Overall and serious adverse events were not significantly different between groups. CONCLUSIONS: In this retrospective cohort study, EPIC showed adequate safety and effectiveness in the treatment of hospitalized patients with severe SARS-CoV-2 disease.

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One recognized cause of cardiorespiratory diseases is air pollution. Older adults (OA) are one of the most vulnerable groups that suffer from its adverse effects. The objective of the study was to analyze the association between exposure to air pollution and changes in cardiorespiratory variables in OA. Observational prospective cohort study. Health questionnaires, blood pressure (BP) measurements, lung functions, respiratory symptoms, physical activity levels, and physical fitness in high and low exposure to air pollution were all methods used in evaluating OAs in communes with high contamination rates. Linear and logistic models were created to adjust for variables of interest. A total of 92 OA participated in this study. 73.9% of the subjects were women with 72.3 ± 5.6 years. 46.7% were obese, while 12.1% consumed tobacco. The most prevalent diseases found were hypertension, diabetes, and cardiovascular disease. Adjusted linear models maintained an increase for systolic BP of 6.77 mmHg (95% CI: 1.04-12.51), and diastolic of 3.51 mmHg (95% CI: 0.72-6.29), during the period of high exposure to air pollution. The adjusted logistic regression model indicated that, during the period of high exposure to air pollution increase the respiratory symptoms 4 times more (OR: 4.43, 95% CI: 2.07-10.04) in the OA. The results are consistent with an adverse effect on cardiorespiratory variables in periods of high exposure to air pollution in the OA population.

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RESUMEN Introducción. La gravedad de los pacientes internados por COVID-19 puede ser determinada por sus características sociodemográficas y las enfermedades de base, así como la alteración de los síntomas y resultados de laboratorios. Objetivo. analizar predictores de gravedad en los pacientes internados por COVID-19 en el Hospital Integrado Respiratorio de Alto Paraná. Metodología. Estudio observacional retrospectivo de corte transversal. Se realizó una revisión retrospectiva de las fichas clínicas de los pacientes internados entre enero a marzo del año 2021. Se analizaron características sociodemográficas, clínicas y factores de riesgo de gravedad. Resultados. De los 137 pacientes estudiados, el 62,0% (n=85) era del sexo masculino. La mortalidad fue del 43,8% (n=60), similar en menores y mayores de 60 años. El ingreso a UTI estuvo asociado a mayor mortalidad 69,4% (n=43) (p<0,001). Los principales síntomas fueron disnea 63,5% (n=87), tos seca 55,47% (n=76) y fiebre 54,0% (n=74), únicamente la disnea se asoció (p<0,05) a óbito. Las enfermedades de base más frecuentes y asociadas a mayor riesgo de muerte (p<0,001) fueron la Hipertensión arterial, Diabetes mellitus y obesidad. Los parámetros laboratoriales alterados en mayor frecuencia fueron leucocitosis, neutrofilia, linfopenia, AST, Dímero D, ferritina y glicemia, pero los marcadores asociados (p<0,05) con óbito fueron linfopenia, AST y glicemia. Conclusión. Se identificaron algunos parámetros de gravedad que contribuyeron al monitoreo de la evolución del paciente, los cuales pueden ser útiles como predictores en las decisiones de los profesionales de la salud para el tratamiento.

ABSTRACT Introduction. The severity of patients hospitalized for COVID-19 can be determined by its sociodemographic characteristics and underlying diseases, as well as changes in symptoms and laboratory results. Objective. to analyze severity predictors in patients hospitalized for COVID-19 at the Alto Paraná Respiratory Integrated Hospital. Methodology. Observational cros-sectional, retrospective study. Clinical charts of patients hospitalized between January and March of 2021 were retrospectively reviewed. Sociodemographic and clinical characteristics and severity risk factors were analyzed. Results. Of the 137 patients studied, 62.0% (n=85) were male. Mortality was 43.8% (n=60), similar in those under and over 60 years old. ICU admission was associated with higher mortality 69.4% (n=43) (p<0.001). The main symptoms were dyspnea 63.5% (n=87), dry cough 55.47% (n=76) and fever 54.0% (n=74), only dyspnea was associated (p<0.05) to death. The most frequent underlying diseases associated with a higher risk of death (p<0.001) were arterial hypertension, diabetes mellitus and obesity. The most frequently altered laboratory parameters were leukocytosis, neutrophilia, lymphopenia, AST, D-dimer, ferritin and glycemia, but the markers associated (p<0.05) with death were lymphopenia, AST and glycemia. Conclusion. Some severity parameters were identified that contributed to the monitoring of the patient's evolution, which can be useful as predictors in the decisions of health professionals for treatment.

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RESUMEN: Introducción: La rehabilitación cardíaca después de padecer un evento cardiovascular (CV) grave es un proceso en el cual el paciente establece una relación cercana con el equipo médico, brindando la oportunidad de conocer factores psicosociales que influyeron en el desenlace cardíaco y los eventuales aprendizajes de la experiencia. El objetivo de este estudio fue conocer la percepción sobre su propia salud de mujeres que participaron de un programa de rehabilitación cardíaca. Método: Se invitó a participar a 35 mujeres de 35 a 75 años con diverso nivel educativo, ingreso familiar y situación laboral. Los datos se recolectaron por medio de entrevistas presenciales semiestructuradas. Resultados: A pesar de haber pasado por un proceso de rehabilitación posterior a un evento CV las mujeres mencionaron en forma mayoritaria al cáncer de mama como la principal eventual causa de muerte. En relación con los factores de riesgo de CV, el más nombrado fue el estrés (57%), aunque solo el 29% de las entrevistadas realizó con posterioridad actividades orientadas a su manejo y control. En cuanto a las motivaciones más frecuentes para realizar cambios de hábitos, destacaron el cuidado de la familia (29%), el vivir más (26%) y el deseo de sentirse mejor (23%). Conclusión: Estos resultados sugieren la necesidad de una educación más integral en la mujer durante la rehabilitación, promoviendo no solo hábitos más saludables desde el punto de vista físico, sino también psicológico. Se sugiere integrar el manejo del estrés en los programas de prevención y rehabilitación CV.

ABSTRACT: Introduction: After suffering a serious cardiovascular event (CV), cardiac rehabilitation is a process in which the patient establishes a close relationship with the medical team, providing an opportunity to learn about psychosocial factors that influence cardiac outcome and eventual learnings from the experience. The objective of this study was to learn about women´s perception of their own health after participating in a cardiac rehabilitation program. Method: 35 women from 35 to 75 years of age with varying educational level, household income and employment status were invited to participate. Data was collected through semi-structured face-to-face interviews. Results: Women mentioned breast cancer as the leading cause of death (60%) despite having gone through a post-CV rehabilitation process. Stress was mentioned as the main CV risk factor (57%). Only 29% of responders subsequently carried out activities aimed at their management and control. The most common motivations for making changes in habits, were family care (29%), living longer (26%) and a desire to feel better (23%). Conclusion: These results suggest the need for a more comprehensive education in women during rehabilitation, promoting not only healthier habits from a physical but also from a psychological points of view. The introduction of stress management into CV prevention and rehabilitation programs is suggested.

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RESUMEN Introducción: globalmente, la obesidad está en aumento y representa un desafío para la salud pública. Algunos estudios muestran que existe una asociación entre niveles bajos de vitamina D y un aumento del índice de masa corporal, pero dentro de la comunidad científica existen discrepancias acerca de este tema. Objetivo: determinar la frecuencia del déficit de vitamina D y su relación con la obesidad. Metodología: estudio descriptivo, transversal con componente analítico en pacientes obesos de edad adulta que acuden al Servicio de Endocrinología del Hospital Central del Instituto de Previsión Social (Asunción, Paraguay) durante el año 2017 Resultados: se incluyeron 67 pacientes, con edad media 41±8 años, 58 (86,6%) del sexo femenino, 40 (59,7%) presentaban obesidad mórbida, 13 (19,4%) eran hipertensos y 14 (20,9%) diabéticos. Al dosar la vitamina D, 18 (26,9%) tenían insuficiencia y 38 (56,7%) deficiencia. Las asociaciones entre el déficit de la vitamina D con el índice de masa corporal, la hipertensión y la diabetes mellitus, ninguno alcanzó niveles de significancia. Conclusión: se incluyó muestra mayoritariamente femenina, con baja frecuencia de comorbilidades. La insuficiencia vitamínica D fue 26,9%. No hubo una asociación significativa entre el déficit de vitamina D y el índice de masa corporal, la hipertensión arterial y la diabetes mellitus.

ABSTRACT Introduction: Globally, obesity is increasing and represents a challenge for public health. Some studies show that there is an association between low levels of vitamin D and an increase in body mass index, but within the scientific community there are discrepancies on this issue. Objective: To determine the frequency of vitamin D deficiency and its relationship with obesity. Methodology: Descriptive, cross-sectional study with an analytical component in obese adult patients who attend the Endocrinology Service of the Central Hospital of the Social Security Institute (Instituto de Previsión Social in Spanish) (Asunción, Paraguay) during 2017 Results: Sixty-seven patients were included, with a mean age of 41±8 years, 58 (86.6%) female, 40 (59.7%) had morbid obesity, 13 (19.4%) were hypertensive and 14 (20.9%) diabetics. When dosing vitamin D, 18 (26.9%) had insufficiency and 38 (56.7%) deficiency. The associations between vitamin D deficiency and body mass index, hypertension and diabetes mellitus did not reach significance levels. Conclusion: The sample was mainly female, with a low frequency of comorbidities. Vitamin D insufficiency was 26.9%. There was no significant association between vitamin D deficiency and body mass index, high blood pressure, and diabetes mellitus.

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ANTECEDENTES: Un número creciente de artículos está llamando la atención en forma consistente sobre la eventual asociación que existe entre los denominados trabajadores ocupacionalmente expuestos a bajos niveles de radiación ionizante (POEs) y una mayor frecuencia de aberraciones cromosómicas, a nivel Sudamericano estos estudios son escasos. OBJETIVO: Evaluar la frecuencia de aberraciones cromosómicas en linfocitos de sangre periférica de POEs de un hospital y de sujetos sanos. Adicionalmente, se realizó una revisión exhaustiva de los artículos que a la fecha abordaron este tema. MATERIAL Y MÉTODO: Se condujo un análisis citogenético destinado a cuantificar las aberraciones cromosómicas en sangre periférica de linfocitos de 6 POEs de la unidad de Cardiología Intervencional y, como controles, 6 muestras de sujetos de la población general fueron analizadas. RESULTADOS: Se observó un importante contraste en el número de aberraciones cromosómicas presentadas en los POEs versus la población general no expuesta a radiaciones ionizantes, siendo esta de una relación de 6:1, respectivamente. CONCLUSIÓN: Los resultados preliminares indican una mayor frecuencia de aberraciones cromosómicas en los POEs versus la población general, sin embargo, se deberá esperar los resultados de la segunda fase de investigación, donde al ampliar la muestra en análisis se podrán obtener conclusiones estadísticamente significativas.

BACKGROUND: There is growing evidence of an increased number of chromosomes aberrations in subjects exposed to low levels of ionizing radiation (POEs). There are few studies on this subject in Latin America AIM: To evaluate the frequency of chromosome aberrations in lymphocytes obtained from peripheral blood in subjects working in laboratories where low levels of ionizing radiation are present and to compare these findings to those of unexposed subjects. METHODS: A cytogenic analysis to quantify chromosome aberrations was performed in 6 POs subjects from a cardiology invasive laboratory and 6 controls from a general unexposed population. RESULTS: Compared to controls, an approximately 6-fold increase in the number of chromosome aberrations was observed.in subjects exposed to ionizing radiation CONCLUSION: These preliminary results indicate that there is an increased number of chromosome aberrations in subjects exposed to low levels of ionizing radiation, as occurs in people working in a cardiology interventional laboratory. Studies in large numbers of subjects and preferably followed prospectively are needed to evaluate more precisely this effect.

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Introducción. El envejecimiento de la población y el aumento en la expectativa de vida imponen al médico rehabilitador un reto en el manejo de las comorbilidades que este acarrea. Así, la enfermedad osteodegenerativa de cadera se ha convertido una causa frecuente de consulta; además, la evolución progresiva de la enfermedad en algunos casos requiere manejo quirúrgico el cual puede llegar a ocasionar compromiso en la calidad de vida y funcionalidad. Es aquí donde el médico rehabilitador y un adecuado proceso terapéutico impactan en el reintegro familiar, social y laboral de los pacientes. Así mismo, es fundamental el reentrenamiento de la marcha para la adecuada realización de las actividades de la vida diaria. Objetivos. Revisar la literatura científica sobre las opciones terapéuticas en rehabilitación de la capacidad funcional para la marcha en pacientes intervenidos para reemplazo total de cadera. Método. Revisión sistemática. Se realizó búsqueda de la literatura pertinente en las bases de datos PubMed, Cochrane, ClinicalKey y ScienceDirect, de artículos publicados en revistas indexadas en los últimos 20 años con corte hasta el 1 de diciembre de 2019. Resultados. La primera búsqueda en las bases de datos electrónicas identificó 219 artículos totales distribuidos así: PubMed 105, Cochrane 8, ClinicalKey 103 y ScienceDirect 3; a partir de estos se obtuvieron 196 artículos al retirar duplicados, se excluyeron 166 artículos según su título y resumen, y fueron evaluados 53 artículos a los que se les aplicaron las guías sobre calidad metodológica STROBE y CONSORT, dependiendo del tipo de estudio. Finalmente se seleccionaron 10 artículos que cumplieron los criterios de inclusión y exclusión y lograron llegar a meta-análisis; estos evaluaban programas de fisioterapia supervisada. Es importante realizar una búsqueda de la literatura específica para otras estrategias de rehabilitación como los ejercicios con soporte de peso intensificado e hidroterapia entre otros. Conclusiones. Los estudios evaluados en el metaanálisis eran muy heterogéneos y poco consistentes, y no permiten definir una conclusión a favor o en contra de la fisioterapia supervisada. Serán necesarios más estudios primarios alrededor del tema que permitan responder fehacientemente la pregunta de investigación. Se deberá plantear estudios en el contexto local, ya que los estudios disponibles provienen de países con sistemas de salud diferentes

Introduction. The aging of the population and the increase in life expectancy impose a challenge to the rehabilitation physician in the management of comorbidities. Thus, osteodegenerative hip disease has become a frequent cause of consultation; in addition, the progressive evolution of the disease in some cases requires surgical management which can lead to compromise in the quality of life and functionality. It is here where the rehabilitation physician and an adequate therapeutic process have an impact on the family, social and labor reintegration of patients. Likewise, it is essential to retrain the gait for the proper performance of activities of daily living. Objectives. To review the scientific literature on the therapeutic options in rehabilitation of the functional capacity for walking in patients operated for total hip replacement. Method. Systematic review. The relevant literature was searched in PubMed, Cochrane, ClinicalKey and ScienceDirect databases for articles published in indexed journals in the last 20 years up to December 1, 2019. Results. The first search of the electronic databases identified 219 total articles distributed as follows: PubMed 105, Cochrane 8, ClinicalKey 103 and ScienceDirect 3; from these, 196 articles were obtained by removing duplicates, 166 articles were excluded according to their title and abstract, and 53 articles were evaluated to which the STROBE and CONSORT methodological quality guidelines were applied, depending on the type of study. Finally, 10 articles were selected that met the inclusion and exclusion criteria and were able to reach meta-analysis; these evaluated supervised physical therapy programs. It is important to perform a specific literature search for other rehabilitation strategies such as intensified weight-bearing exercises and hydrotherapy among others. Conclusions. The studies evaluated in the meta-analysis were very heterogeneous and inconsistent, and do not allow defining a conclusion in favor or against supervised physical therapy. More primary studies on the subject will be necessary to provide a reliable answer to the research question. Studies in the local context should be considered, since the available studies come from countries with different health systems.

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OBJECTIVE: To determine whether nursing students have subtle or blatant prejudices towards migrants. METHOD: A descriptive ex post facto study was conducted. The sample consisted of 282 students and the study variables were sex, cultural origin, age, year, and contact with migrants. The Subtle and Blatant Prejudice Scale was used. Descriptive and inferential analyses were performed. RESULTS: There were significant differences in the culture variable, with students of Berber origin and of Muslim faith showing less prejudice than those of European origin and of Christian faith. Fourth-year students had the most blatant prejudices. According to the variable contact with migrants, it is the students who have not had contact with this group who have the greatest blatant prejudices. CONCLUSION: Nursing students have more subtle prejudices rather than blatant prejudices towards the migrant population.

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RESUMEN México es centro de origen del aguacate (Persea americana Mill), la mayoría de los miembros reconocidos del género Persea ocurren primariamente desde la parte central de México hasta Centroamérica. En este estudio se realizó la evaluación molecular de germoplasma de aguacate criollo del Estado de Nuevo León, México, utilizando la técnica del DNA Polimórfico Amplificado al Azar (RAPD's). Se colectaron 27 materiales de aguacate criollo en la región sur y 16 en la región norte de Nuevo León. El nivel de diversidad genética detectado fue del 84%, el cual se considera como alto. Se observaron fragmentos específicos o únicos tipo RAPD's, presentes en un solo individuo, este tipo de fragmentos son de particular interés ya que pueden estar ligados a un genotipo en particular y servir en el diagnóstico para diferenciar un genotipo o una región específica del genoma. Lo anterior es de particular interés para el aguacate criollo del Estado de Nuevo León, cuyo problema para su comercialización es la corta vida de anaquel que presenta, por lo tanto, encontrar gran variación genética como la detectada en este trabajo incrementa la posibilidad de generar nuevos materiales cuya vida de anaquel sea más prolongada, potenciando su valor comercial.

ABSTRACT México is the center of origin of the avocado (Persea americana Mill), most of the recognized members of the genus Persea occur primarily from the central part of México to Central América. In this study, the molecular evaluation of germplasm of wild avocado from the State of Nuevo León, México, was performed using Random Amplified Polymorphic DNA (RAPD's) technique. A total of 27 wild avocado materials were collected in the southern region and 16 in the northern region of Nuevo León. The level of gen et-ic diversity detected was 84%, which is considered high. Specific fragments or only RAPD's type, present in a single individual, were observed, this type of fragments are of particular interest since they can be linked to a particular genotype and serve in the diagnosis to differentiate a genotype or a specific region of the genome. The above is of particular interest for the creole avocado of the State of Nuevo León, whose problem for marketing is the short shelf life that presents, therefore, finding great genetic variation as detected in this work increases the possibility of generating new materials whose shelf life is longer, enhancing its commercial value.

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Background: There is a misconception that the main cause of death among women is breast cancer, even among physicians, who may neglect cardiovascular preventive measures in this gender Aim: To assess the knowledge among physicians about the main cause of death among women. Material and methods: A survey was answered by 231 physicians attending a Cardiology and a Gynecology Meeting. Results: Sixty eight percent of respondents indicated that cardiovascular diseases are the main cause of death among women. A higher proportion of specialists than trainees, answered correctly the question (72 and 56% respectively). No gender differences in the answers were recorded. Conclusions: The knowledge about cardiovascular risk in women should be reinforced among physicians.

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Resumen La ausencia de instrumentos adaptados para la medición del ajuste al divorcio y la separación en Chile representa una barrera para el desarrollo de estudios e intervenciones que aborden el tema del divorcio en este contexto particular. El objetivo de este estudio fue evaluar la validez y fiabilidad de las puntuaciones del Test de Adaptación Psicológica a la Separación (PAST), cuestionario de autoinforme dividido en dos partes independientes que evalúan por un lado el apego a la pareja y la soledad negativa (PAST-A) y, por otro, la coparentalidad negativa (PAST-B). Para ello, se evaluaron dos muestras independientes de personas separadas y divorciadas chilenas (N = 141; N = 594). De los resultados obtenidos, se puede concluir que el PAST posee propiedades psicométricas adecuadas en términos de su fiabilidad y validez. Se discuten las implicancias clínicas de estos hallazgos.

Abstract The lack of instruments adapted to the Chilean context to measure the adjustment to divorce and separation represents an important constraint to the development of a line of research and intervention focused on the topic of divorce in this particular context. The objective of this study was to assess the psychometric properties of the Psychological Adjustment to Separation Test (PAST) Chilean version, which is divided into two parts that evaluate former partner attachment and lonely negativity (PAST-A) and coparenting conflict (PAST-B). To that end, two independent samples of separated individuals (N = 141; N = 594) were evaluated. From the results obtained, we concluded that the PAST has adequate psychometric properties for its use into the Chilean context. Clinical implications of these findings are discussed.

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Objetivos: Describir características clínicas y epidemiológicas de los pacientes con VIH y neoplasias atendidos en la Unidad de Infectología de la Ciudad Hospitalaria "Dr. Enrique Tejera" del 2001 al 2016. Material y Métodos: Estudio retrospectivo Observacional. Consistió en revisión de historias clínicas del 2001 al 2016. Resultados: Se observó la presencia de neoplasias en el 1,63 % de los pacientes, la edad promedio de presentación era 41 años, sin distinción de sexo. El 83 % pertenecía a Graffar IV, 91 % negó usar drogas, 66 % con hábitos tabáquicos presentes. En más del 60 % de los casos la neoplasia se desarrollo luego del diagnóstico de VIH. 58 % de los casos fueron neoplasias definitorias de SIDA. El SK fue el tumor más frecuente con 33 % de los casos. De las No definitorias de SIDA fue el Ca de mama el más frecuente. El contaje de CD4 al diagnóstico de la neoplasia en promedio fueron de 218 cel/mm3, el 66 % de los casos tenían cargas virales para VIH detectables al momento de diagnosticar la neoplasia. 75 % de los casos recibían como tratamiento antirretroviral Inhibidor de proteasa reforzado. Solo 8 % de los casos presentaron coinfecciones virales. Conclusiones: Las neoplasias en los pacientes con VIH son patologías que cada vez se presentan con más frecuencia. Es necesario insistir en su detección precoz.

Objectives: To describe clinical and epidemiological characteristics on HIV patients that develop tumors; that where treated at the Infectious Diseases Unit, "Dr. Enrique Tejera Hospital "from 2001 to 2016. Material and Methods: Retrospective observational studies. Consisted of reviewing medical records from 2001 to 2016. Results: The presence of neoplasias was observed in 1.63 % of the patients, the average age of presentation was 41 years, without distinction of sex. 83 % belonged to Graffar IV, 91.% denied using drugs, 66 % had smoking habits present. In more than 60 % of the cases, the neoplasia developed after the diagnosis of HIV. 58 % of the cases were AIDS defining neoplasms. SK was the most frequent tumor with 33 % of the cases. Nondefining Of AIDS was the most common breast cancer. CD4 count at the diagnosis of neoplasia on average was 218 cells / mm3; 66 % of the cases had detectable viral loads for HIV at the time of diagnosis of the neoplasia. 75 % of cases received antiretroviral therapy Reinforced protease inhibitor. Only 8 % of the cases had viral coinfections. Conclusions: neoplasms in patients with HIV are pathologies that are becoming more frequent, it is necessary to insist on early detection.

RESUMO

BACKGROUND: There is a misconception that the main cause of death among women is breast cancer, even among physicians, who may neglect cardiovascular preventive measures in this gender Aim: To assess the knowledge among physicians about the main cause of death among women. MATERIAL AND METHODS: A survey was answered by 231 physicians attending a Cardiology and a Gynecology Meeting. RESULTS: Sixty eight percent of respondents indicated that cardiovascular diseases are the main cause of death among women. A higher proportion of specialists than trainees, answered correctly the question (72 and 56% respectively). No gender differences in the answers were recorded. CONCLUSIONS: The knowledge about cardiovascular risk in women should be reinforced among physicians.

Assuntos