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Introducción: La modificación en los patrones de sueño incrementa la susceptibilidad para la ganancia de peso. Objetivo: Estimar la asociación entre la calidad y la cantidad de horas de sueño por noche con el Índice de Masa Corporal (IMC) en adolescentes universitarios mexicanos. Materiales y métodos: Estudio transversal en estudiantes de nuevo ingreso de Enfermería en una Universidad Pública de México. Muestreo por conveniencia de n=134 estudiantes (18­19 años), voluntarios y matriculados en la facultad. La calidad y cantidad de sueño se midió con el Índice de Calidad de Sueño de Pittsburgh. El IMC se calculó con la fórmula estándar. El protocolo fue aprobado por el Comité de Ética de la facultad, los participantes firmaron el Consentimiento Informado. Resultados: Edad promedio de 18,21 años (DE= ,42 años), 82,84% mujeres, 45,52% (IC 95%= 35,46 ­ 52,86%) con sobrepeso u obesidad. El 44,02% de los participantes reportó dormir ≤ 6 horas por noche, 50,00% refirió una mala calidad de sueño en las últimas cuatro semanas. Después de ajustar por edad, sexo y ocupación, la calidad del sueño no se asoció con el IMC (OR= 1,01; IC 95%= ,94 ­ 1,08; z= ,31; p= ,75); el incremento en el IMC se asoció con una mayor probabilidad de dormir 6 horas o menos (OR= 1,08; IC 95%= 1,01 ­ 1,16; z= 2,25; p= ,02). Discusión: Las alteraciones hormonales, los factores conductuales y el entorno pudieran explicar la asociación. Conclusiones: Es recomendable implementar estrategias educativas para mejorar la higiene del sueño en esta población.

Introduction: Changes in sleep patterns increase susceptibility to weight gain. Objective: To estimate the association between the quality and quantity of sleep hours per night and Body Mass Index (BMI) in Mexican college adolescents. Materials and methods: Cross-sectional study conducted among incoming nursing students in a public university in Mexico. Convenience sampling was used, involving n=134 students (18-19 years old), volunteers, and enrolled in the nursing program. Sleep quality and quantity were measured through the Pittsburgh Sleep Quality Index (PSQI). BMI was calculated using the standard formula. The protocol was approved by the School of Nursing Ethics Committee, and the participants signed informed consent. Results: Mean age 18.21 years (SD= .42 years), 82.84% female, 45.52% overweight or obese (95% CI= 35.46 - 52.86%). 44.02% of participants reported sleeping ≤ 6 hours per night, and 50.00% reported poor sleep quality in the past four weeks. After adjustment for age, sex, and occupation, sleep quality was not associated with BMI (OR= 1.01; 95% CI= .94 - 1.08; z= .31; p= .75); increased BMI was associated with a greater likelihood of sleeping 6 hours or less (OR= 1.08; 95% CI= 1.01 - 1.16; z= 2.25; p= .02). Discussion: Hormonal changes, behavioral factors, and the environment may explain the association. Conclusions: It is advisable to implement educational strategies to improve sleep hygiene among this population.

Introdução: A modificação nos padrões de sono aumenta a suscetibilidade ao ganho de peso. Objetivo: Estimar a associação entre a qualidade e a quantidade de sono por noite e o índice de massa corporal (IMC) em adolescentes universitários mexicanos. Materiais e métodos: Estudo transversal de estudantes de enfermagem ingressantes em uma universidade pública no México. Amostragem por conveniência de n=134 estudantes (18-19 anos de idade), voluntários e matriculados na faculdade. A qualidade e a quantidade do sono foram medidas com o Índice de Qualidade do Sono de Pittsburgh. O IMC foi calculado com a fórmula padrão. O protocolo foi aprovado pelo Comitê de Ética da faculdade e os participantes assinaram o Termo de Consentimento Livre e Esclarecido. Resultados: Idade média de 18,21 anos (DP= ,42 anos), 82,84% do sexo feminino, 45,52% (IC 95%= 35,46 - 52,86%) com sobrepeso ou obesidade. 44,02% dos participantes relataram dormir ≤ 6 horas por noite, 50,00% relataram qualidade de sono ruim nas últimas quatro semanas. Após o ajuste para idade, sexo e ocupação, a qualidade do sono não foi associada ao IMC (OR= 1,01; IC 95%= ,94 - 1,08; z= ,31; p= ,75); o aumento do IMC foi associado a uma maior probabilidade de dormir 6 horas ou menos (OR= 1,08; IC 95%= 1,01 - 1,16; z= 2,25; p= ,02). Discussão: Alterações hormonais, fatores comportamentais e o ambiente podem explicar a associação. Conclusões: É aconselhável implementar estratégias educacionais para melhorar a higiene do sono nessa população.

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BACKGROUND: Irritable bowel syndrome (IBS) and sexual dysfunction (SxD) lowers quality of life (QOL) separately, but the effect of their overlap in unselected populations has not been studied. OBJECTIVE: To evaluate the QOL of IBS women with and without SxD and compare it with controls. METHODS: In this cross-sectional assessment, we studied 51 IBS women (Rome IV criteria) and 54 controls. SxD was determined using the female sexual function index questionnaire. QOL was evaluated by the Short Form 36 (SF-36) and IBS-QOL questionnaires. RESULTS: SxD prevalence was similar between IBS women (39.22%) and controls (38.89%). Compared with other groups, IBS patients with SxD showed lower scores in all domains as well as in the physical, mental summaries of the SF-36 and almost all domains (except for body image, food avoidance, and social reaction compared with IBS patients without SxD) and the total score of IBS-QOL. CONCLUSIONS: These findings show that SxD worsens both general and specific QOL of women with IBS. The consideration of SxD in patients with IBS will allow us to make a more effective diagnostic and therapeutic approach. Clinical trial registry in Mexico City General Hospital: DI/19/107/03/080. CLINICAL TRIALS REGISTRATION: NCT04716738.

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OBJECTIVE: The aim of this study is to determine whether the serum concentrations of progesterone and/or prolactin after fresh embryo transfer are associated with pregnancy rates in in vitro fertilization treatment. METHODS: This retrospective cohort study evaluated in vitro fertilization treatments with fresh embryo transfer, which were performed between 2013 and 2019 in a private clinic in Curitiba, Brazil. The serum concentrations of progesterone and prolactin were evaluated by chemiluminescence nine days after oocyte retrieval. The type of progesterone supplementation and pituitary blockage during the cycle of oocyte stimulation were evaluated. RESULTS: 330 fertilization cycles were performed in the 293 studied patients. The mean age of patients was 35.5±4.1years. The most seen isolated infertility factor was endometriosis (24.2% of the cases), while progesterone supplementation was performed intramuscularly in 73.9% of the cases. The progesterone values above 32.1ng/ml at day 9 (D9) were associated with better pregnancy rates. In cycles using antagonist and intramuscular luteal phase supplementation, higher pregnancy rates with progesterone values above 37.83ng/ml were observed. Moreover, prolactin showed no significant association with any of the studied variables. CONCLUSIONS: The serum progesterone concentrations above 32.1ng/ml at D9 that were taken one week before pregnancy testing were associated with successful in vitro fertilization treatment. Furthermore, prolactin showed no significant association with any of the studied variables.

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Introducción: Las enfermedades reumáticas se caracterizan por la presencia de manifestaciones articulares y extraarticulares. Entre estas últimas, uno de los sistemas menos estudiados es el reproductor. Objetivo: Caracterizar las manifestaciones ginecológicas que con mayor frecuencia se presentan en el curso de las enfermedades reumáticas. Métodos: Se realizó una investigación básica, no experimental, descriptiva y longitudinal que incluyó un total de 117 pacientes femeninas con diagnóstico de varias enfermedades reumáticas según los criterios del Colegio Americano de Reumatología. La muestra quedó conformada por 108 pacientes. Durante la realización del estudio se identificó la incidencia de manifestaciones ginecológicas en las pacientes reumáticas y el tipo de manifestación que se notifica con mayor frecuencia. Resultados: Pacientes con un promedio de edad de 61,19 años, predominio de procedencia urbana (61,11 por ciento) y con diagnóstico de artritis reumatoide (61,11 por ciento). El 39,81 por ciento de ellas refirió tiempo de evolución de la enfermedad entre 3 y 5 años. El 62,04 por ciento de las pacientes presentó algún tipo de manifestación extraarticular ginecológica. La secreción vaginal (50,75 por ciento), vulvovaginitis (25,37 por ciento), cervicitis (20,90 por ciento) y la dispareunia (14,92 por ciento) fueron las de mayor frecuencia de presentación. Conclusiones: Las manifestaciones ginecológicas son frecuentes en las pacientes con enfermedades reumáticas. Las manifestaciones ginecológicas de origen inflamatorio fueron las de mayor presentación y fueron más frecuente en la artritis reumatoide y el lupus eritematoso. En la esclerosis sistémica las manifestaciones neoplásicas fueron las más frecuentes(AU)

Introduction: Rheumatic diseases are characterized by the presence of articular and extra-articular manifestations. Within the latter, one of the least studied systems. Objective: To characterize the gynecological manifestations that most frequently occur in the course of rheumatic diseases. Methods: A basic, non-experimental, descriptive and longitudinal research was carried out that included a total of 117 female patients diagnosed with various rheumatic diseases according to the criteria of the American College of Rheumatology. The sample was made up of 108 patients. During the study, the incidence of gynecological manifestations in rheumatic patients and the type of manifestation that is most frequently reported were identified. Result: average age of 61.19 years, predominance of patients of urban origin (61.11%) and with a diagnosis of rheumatoid arthritis (61.11 percent). 39.81 percent of the patients reported disease evolution time between three and five years. 62.04% of the patients presented some type of extra-articular gynecological manifestation. Vaginal secretion (50.75 percent), vulvovaginitis (25.37 percent), cervicitis (20.90 percent) and dyspareunia (14.92 percent) were the ones with the highest frequency of presentation. Conclusions: Gynecological manifestations are frequently found in patients with rheumatic diseases. Gynecological manifestations of inflammatory origin were those with the highest frequency of presentation and were more frequent in rheumatoid arthritis and lupus erythematosus. In systemic sclerosis, neoplastic manifestations were the most frequent(AU)

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OBJECTIVE: To identify clinical trials registered later than 2015, that study the effect of an intervention on a primary outcome whose "Certainty of Evidence" (CoE) has already been rated "high" in a Cochrane SR. STUDY DESIGN AND SETTING: We searched the Cochrane Library for all SRs from 2015. We analyzed SRs of interventions and excluded withdrawn reviews or those with no Summary of Findings (SoF) table. We retrieved the GRADE CoE ratings of each SR's primary outcomes in the SoF tables and identified those rated "high." We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials to identify records of clinical studies that tackled those outcomes and were registered after the date of publication of the respective 2015 SR. RESULTS: We selected 602 SRs. Eighty-one contained a "high" CoE rating on at least one primary outcome, totaling 152 primary outcomes rated "high." We found 39 clinical trials registered for primary outcomes with evidence already rated as "high" in a 2015 Cochrane SR. CONCLUSION: This study shows the existence of clinical trials registered to study primary outcomes whose CoE has already been rated "high" in a Cochrane SR.

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BACKGROUND: Acquired hemophilia is caused by antibodies against coagulation factors, especially against factor VIII. As it is a low prevalence disease, our objective is to present an idiopathic case of acquired hemophilia to facilitate decision-making in clinical practice for others, exposing the therapeutic modality used. CASE REPORT: 65 years old woman, started with non-trauma hematomas, with asthenia, adynamia and dyspnea. Laboratory studies showed anemia (hemoglobin 7.1 g/dl, hematocrit 21%, mean corpuscular volume 91 fl, mean corpuscular hemoglobin 29.6 pg) and long clotting times (activated partial thromboplastin time 100 seconds) and with prothrombin time and International Normalized Index (17 seconds and 1.2 seconds respectively). So, plasma dilution tests were performed with plasma, without aPTT correction (1:2, 76.6 seconds; 1: 4, 60 seconds; 1: 8, 45 seconds) evidencing the presence of the inhibitor. The diagnosis was confirmed by the decrease in factor VIII (1%) and the presence of the factor VIII inhibitor (256 UB). The treatment started with prednisone and cyclophosphamide. Due to the presence of severe bleeding, treatment with activated prothrombin complex concentrate (CCpa) was required. Subsequently, Rituximab was prescribed, with clinical improvement and increased levels of hgb and reduced aPTT from the first week of treatment. CONCLUSIONS: The approach of acquired hemophilia should include control of the bleeding, the search for the etiology ruling out of the main causes of malignant neoplasms according to age and gender, and the immediate initiation of immunosuppression to decrease inhibitor levels.

INTRODUCCIÓN: La hemofilia adquirida es ocasionada por anticuerpos contra los factores de la coagulación, en especial contra el factor VIII. Por ser de baja prevalencia, presentamos un caso de hemofilia adquirida idiopática exponiendo la modalidad terapéutica utilizada para facilitar a otros la toma de decisiones en la práctica clínica. CASO CLÍNICO: Mujer de 65 años que inició con hematomas no asociados a traumatismo, con astenia, adinamia y disnea. Los estudios de laboratorio mostraron anemia (hemoglobina 7.1 g/dl, hematocrito 21%, volumen corpuscular medio 91 fl, hemoglobina corpuscular media 29.6 pg) y tiempos de coagulación prolongados (tiempo de tromboplastina parcial activado [TTPa] 100 segundos), con tiempo de protrombina e INR (International Normalized Ratio) dentro de parámetros normales (17 y 1.2 segundos, respectivamente), por lo que se realizaron pruebas de dilución con plasma sin corrección del TTPa (1:2, 76.6 segundos; 1:4, 60 segundos; 1:8, 45 segundos), evidenciando la presencia del inhibidor. El diagnóstico se confirmó con la disminución del factor VIII (1%) y la presencia de inhibidor del factor VIII (256 UB). Se inició tratamiento con prednisona y ciclofosfamida. Por presentar hemorragia grave requirió tratamiento con concentrado de complejo de protrombina activado y posteriormente se indicó rituximab, con mejoría clínica, incremento en los niveles de hemoglobina y reducción del TTPa desde la primera semana de tratamiento. CONCLUSIONES: El abordaje de la hemofilia adquirida debe incluir el control de la hemorragia, la búsqueda de la etiología descartando las principales causas de neoplasias malignas de acuerdo con la edad y el sexo, y el inicio inmediato de inmunosupresión para disminuir los niveles de inhibidor.

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BACKGROUND: Parry-Romberg syndrome is characterized by progressive hemiatrophy of the skin, subcutaneous tissue, muscle and bones of the skull. Its incidence is low, with a progressive and slow course. Its etiology is unknown, but it has been associated with several factors. Its clinical presentation involves dermatological, musculoskeletal and neuropsychiatric manifestations. The treatment consists of medical and surgical strategies. The use of steroids, alone or in combination with immunomodulators, has the objective of slowing down progression. The surgical treatment lies in facial reconstruction or volumetric regeneration, to correct the appearance and function of facial structures. The objective is to show three cases of Parry-Romberg syndrome with the representative characteristics of the disease. CLINICAL CASEs: 1) A 41-year-old woman with atrophy and right supraciliary hypochromia associated with seizures and headache. 2) A 43-year-old woman with parietal deformation and right supraciliary atrophy, associated with facial paralysis, depression and headache. 3) A 36-year-old woman with right hemifacial atrophy associated with ocular involvement and headache. The indicated treatment was based on a systemic steroid plus a cytostatic agent. The surgical treatment was evaluated according to the affection of facial structures. CONCLUSIONS: Parry-Romberg syndrome is a rare disease, characterized by progressive atrophy. Clinical manifestations determine the diagnosis and early start of medical and surgical treatment.

INTRODUCCIÓN: El síndrome de Parry-Romberg se caracteriza por hemiatrofia progresiva de la piel, el tejido subcutáneo, los músculos y los huesos del cráneo. Su incidencia es baja, y su curso es progresivo y lento. Se desconoce su etiología, pero se ha asociado a diversos factores. Su presentación clínica involucra manifestaciones dermatológicas, musculoesqueléticas y neuropsiquiátricas. El tratamiento consiste en estrategias médicas y quirúrgicas. El uso de esteroides, solos o en combinación con inmunomoduladores, tiene el objetivo de frenar la progresión. El tratamiento quirúrgico consiste en reconstrucción facial o regeneración volumétrica, a fin de corregir la apariencia y la función de las estructuras faciales. Se presentan tres casos de síndrome de Parry-Romberg con las características representativas de la enfermedad. CASOS CLÍNICOS: 1) Mujer de 41 años, con atrofia e hipocromía supraciliar derecha, asociadas a crisis convulsivas y cefalea. 2) Mujer de 43 años, con deformación parietal y atrofia supraciliar derecha, asociadas a parálisis facial, depresión y cefalea. 3) Mujer de 36 años, con atrofia hemifacial derecha asociada a afección ocular y cefalea. El tratamiento se basó en esteroide sistémico más un agente citostático. El tratamiento quirúrgico se valoró de acuerdo con la afectación de la estructuras faciales. CONCLUSIONES: El síndrome de Parry-Romberg es una enfermedad rara caracterizada por una atrofia progresiva. Las manifestaciones clínicas determinan el diagnóstico y el inicio temprano del tratamiento médico y quirúrgico.

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INTRODUCCIÓN: El linfoma extranodal derivado de células NK/T (LNK/T) es una variedad de linfoma no Hodgkin; el tipo nasal constituye la presentación más común. Nuestro objetivo es presentar un caso de LNK/T con afección del sistema nervioso central (SNC) que simuló una tuberculosis meningea. CASO CLÍNICO: Varón de 31 años con sensación de obstrucción nasal, cefalea, fiebre, panhipopituitarismo y mononeuropatía craneal múltiple, con lesión hipofisaria por imagen de resonancia magnética y engrosamiento dural, que evolucionó con pancitopenia y úlcera en el paladar blando. El diagnóstico se realizó mediante biopsia de cornete nasal compatible con infiltración por linfoma de estirpe T maduro NK. CONCLUSIONES: La afección del LNK/T al SNC es una forma rara de presentación. El diagnóstico de LNK/T se puede ver retrasado por la presencia de síntomas heterogéneos. En nuestra población, la infección por Mycobacterium debe ser considerada como diagnóstico diferencial. BACKGROUND: Lymphoma of NK/T cells (LNK/T) is a variety of non-Hodgkin lymphoma; the nasal type is the most common presentation. The aim of this article is to present a case of LNK/T with affection to central nervous system that imitates meningeal tuberculosis. CASE REPORT: 31 years old man with nasal blockage feeling, headache, fever, panhypopituitarism and multiple cranial mononeuropathy, with a pituitary injury demonstrated by magnetic resonance image and meningeal thickening, that progress with pancytopenia and soft palate ulcer. The diagnosis was made by nasal concha biopsy compatible with lymphoma infiltration, of LNK/T cell linage. CONCLUSIONS: The affectation of LNK/T cell lymphoma in central nervous system is a rare presentation. the diagnosis could be delayed for the presence of heterogeneous symptoms. Mycobacterium infection must be considered as a differential diagnosis in our population.

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Introducción: los programas de optimización del uso de antimicrobianos son fundamentales para mejorar los resultados clínicos de los pacientes. Objetivos: determinar el impacto en el consumo de amikacina y ceftriaxona, además de cambios de sensibilidad de las principales bacterias en la unidad de emergencias del hospital Carlos van Buren de Valparaíso, Chile, luego de la implementación de una guía para el tratamiento de la ITU alta. Materiales y método: estudio cuasi-experimental antes/después. Se implementó una guía de tratamiento para la ITU alta, la cual fue enviada vía WhatsApp a los médicos de la unidad. Luego se midieron las dosis diarias definidas (DDD) de amikacina y ceftriaxona y se compararon con las DDD de los mismos meses del año anterior. Además se extrajo la sensibilidad de E.coli, K. pneumonia y P.mirabilis aisladas de urocultivos. Resultados: posterior a la intervención hubo un aumento de las DDD de amikacina y una disminución de las de ceftriaxona. K.pneumoniae mantuvo su sensibilidad a amikacina y la aumentó para cefotaxima, ertapenem y meropenem. Conclusiones: la implementación de una guía de tratamiento de la ITU alta aumentó el consumo de amikacina y disminuyó el de ceftriaxona. K.pneumoniae aumentó su sensibilidad a cefotaxima, ertapenem y meropenem.

Introduction: different antimicrobial stewardship programs are fundamental to improve clinical results in patients. Objectives: to determine the impact on amikacin and ceftriaxone consumption, in addition to knowing changes in sensitivity of the main agents in the emergency unit of the Carlos van Buren Hospital in Valparaíso, Chile, after the implementation of a treatment guide for pyelonephritis. Materials and methods: quasi-experimental before/after study. A treatment guide was implemented for pyelonephritis. The guide was sent by WhatsApp to all clinicians in the emergency unit. Following the intervention, amikacin and ceftriaxone defined daily dose (DDD) were measured and compared with the DDD for the same months of the previous year. In addition, the sensitivity of E.coli, K. pneumonia and P.mirabilis isolated from urine cultures was extracted. Results: after the intervention there was a sustained increase of the DDD of amikacin and a decrease in the DDD of ceftriaxone in the months studied period. K. pneumoniae maintained its sensitivity to amikacin and increased it to cefotaxime, ertapenem, and meropenem. Conclusions: The guide's implementation for treatment of high UTI in the emergency unit of the Carlos van Buren hospital increased the consumption of amikacin and decreased that of ceftriaxone. K. pneumoniae increased its sensitivity to cefotaxime, ertapenem and meropenem.

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Introducción: a pesar de contar con pruebas de tamizaje para la detección de cáncer cervicouterino aún se presenta como una de las principales causas de mortalidad en la mujer a nivel mundial. Los mitos y vivencias que otras mujeres transmiten pueden convertirse en una barrera para no acudir a realizarse el Papanicolaou. Objetivo: interpretar las vivencias ante la toma del Papanicolaou en estudiantes de la Universidad Autónoma de Aguascalientes. Material y métodos: estudio cualitativo de corte fenomenológico, conformado por una muestra no probabilística por bola de nieve hasta obtener saturación de datos de 10 personas por medio de la entrevista semi estructurada, de octubre a noviembre 2018. Resultados: la información obtenida se analizó mediante codificación axial a través de dos categorías, y estas a su vez divididas en subcategorías las cuales fueron; 1.3. Conocimientos; 2. Interacción con el personal de salud; 2.1. Información que brindó el personal que realizó el Papanicolaou; 2.2. Trato del personal; 2.3. Entrega de resultados. Conclusión: las vivencias de las mujeres que se realizan el Papanicolaou son influenciadas con personal que realiza el tamizaje, ya que en su mayoría resultaron negativas, por la falta de información, los comentarios negativos hacia la persona y la escasa empatía del personal.

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Resumen En la actualidad, el dolor es considerado co-то el quinto signo vital. El objetivo del trabajo fue determinar la efectividad de un programa educativo para el personal de enfermería sobre manejo de dolor en pacientes con problemas crónicos degenerativos y quirúrgicos. El método usado fue el diseño pre-experimental con pretest-postest. La población de estudio estuvo integrada por personal de enfermería (42) de dos instituciones de salud de segundo nivel de atención, del sector público. Se utilizó el cuestionario Conocimiento y Actitudes Respecto al Dolor. La media de respuestas correctas del conocimiento pretest fue de 50.9 (DE = 9.65), valor mínimo de 28.1 y máximo 78.1; y en el postest la media fue de 70.4 (DE = 10.9) valor mínimo de 40.6 y máximo 90.6. Posterior a la intervención educativa, se encontró mayor conocimiento en el personal de enfermeria (t (41)= - 12.98; p < 0.001). El estudio de intervención educativa del personal de enfermería fue efectivo para mejorar el conocimiento sobre el manejo del dolor en los pacientes, ya que los primeros brindaron una mejor atención y cuidados, posteriores a la intervención educativa, no obstante, este fue insuficiente para la mayoría del personal participante.

Abstract Pain is currently considered as the fifth vital sign. The objective of the study was to determine the effectiveness of an educational program for nurses on pain management for patients with chronic degenerative and surgical problems. The employed method was a pre-experimental design with a pre-test and a posttest. The research population was made up of 42 nurses from two secondary health care institutions in the public sector. The Nurse's Knowledge and Attitudes Survey Regarding Pain was used. Results showed that the pre-test mean knowledge of correct answers was 50.9 (SD = 9.65), with a minimum value of 28.1 and a maximum value of 78.1. The post-test mean was 70.4 (SD = 10.9) with a minimum value of 40.6 and a maximum value of 90.6. After the educational intervention, nurses demonstrated an increased level of knowledge regarding pain management (t (41) = -12.98; p < 0.001). The educational intervention study for nurses was effective in improving their knowledge regarding pain management in patients, since the participating nurses provided better attention and care after the educational intervention. This, however, was insufficient for most of the participating personnel.

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OBJECTIVE: To analyze progesterone and prolactin plasma levels nine days after oocyte retrieval and evaluate their correlation with pregnancy rates in in vitro fertilization cycles. To achieve pregnancy, several factors are analyzed before and during the in vitro fertilization cycle. Progesterone supplementation for adequate luteal phase support is indicated despite the presence of multiple corpus luteum in IVF stimulation cycles because of blockage caused by hypothalamic agonists and antagonists. The dosage of progesterone and prolactin on day 09 after follicular retrieval could function as a predictive marker of success in fertility treatments. METHODS: A retrospective study was performed using data from 238 patients submitted to intracytoplasmic sperm injection (ICSI) at a private infertility clinic from January 2013 to December 2015. Hormonal measurements were performed on day 09 after follicular uptake. The data was compared to assess the correlation between prolactin and progesterone dosages and pregnancy rates. RESULTS: The ICSI pregnancy rate was 40.8% (n=238). No statistically significant difference was observed when correlating the success of the procedure with the prolactin dosage (p=0.71). However, progesterone showed a significant difference (p=0.021). The cutoff point, indicated by the ROC curve fit according to which gestation would be identified, is 25.95ng/ml of progesterone. The sensitivity of this point is 61.9% and the specificity is 57.4%. CONCLUSION: Progesterone dosage may be one of the indicators of gestation on day 09 after follicular uptake. Such data can help physicians to monitoring and provides suitable early gestational care. More studies are needed to corroborate the data found.

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PROBLEM: Breastfeeding's influence on the tolerance to environmental antigens is essential for short- and long-term homeostasis for children. Colostrum is rich in leucocytes, but it is unknown whether regulatory T cells (Treg) account for part of this cell population. METHOD OF STUDY: Frequencies of CD127-  CD25++ Treg and levels of immunoregulatory-associated cell markers were determined in colostrum and were compared with autologous blood cells. In addition, we evaluated whether the birth conditions can affect these features. RESULTS: Higher frequencies of CD127 - CD25++ Treg cells expressing Foxp3 and CD45RO were observed in the colostrum. The cells' CD25, CD152, CD279, and TGF-ß expression levels were greater than those in autologous blood cells. In addition, the CD279 and TGF-ß expressions of colostrum CD127-  CD25++ Treg cells were influenced by gestational age and delivery mode. CONCLUSION: The higher proportion of these cells with a function-associated phenotype may reflect certain tolerogenic effects of breastmilk on newborns and infants, contributing to immune system homeostasis.

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Purpose The purpose of the study was to examine the relationship between knowledge and foot care practices among adults with type 2 diabetes. Methods A descriptive correlational study examined 200 patients with type 2 diabetes in México. Data collected included the Knowledge and Practices Self-Care Questionnaire and a Podiatry Examination Questionnaire. Data analysis included Pearson's correlations and chi-square tests. Results More than half of the participants had poor knowledge and poor foot care practices. A significant negative correlation between knowledge and practices of foot care and risk of developing diabetes foot ulcers was found. There was no relationship between sociodemographic variables and the risk of developing diabetes foot ulcers. Conclusions Patients with type 2 diabetes served in an outpatient clinic had poor knowledge and practices of foot care. They demonstrated decreased knowledge and practice of foot care and therefore showed a greater risk of developing diabetes foot, which may predispose patients to early complications.

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The partial substitution of soybean meal by Gliricidia sepium or Guazuma ulmifolia leaves in the rations of growing lambs was evaluated at an experimental station in the dry tropics of Mexico. Sixteen weaned crossbred male Pelibuey × Blackbelly lambs (initial weight 19 ± 1.66 kg), distributed in a completely randomized design, were assigned to the following protein sources: (a) 100% soybean meal, (b) 50% soybean meal + 50% G. sepium, (c) 50 % soybean meal + 25% G. ulmifolia + 25% G. sepium, and (d) 50% soybean meal + 50% G. ulmifolia in isoproteic rations. The lambs were housed in individual pens and fed ad libitum. Substitution of protein from soybean meal with G. ulmifolia did not affect gain, intake, or feed conversion; however, the inclusion of G. sepium reduced (linear effect, P < 0.01) gain and intake and impaired feed conversion (linear effect, P < 0.01). Partial substitution up to 50% of soybean meal with 50% G. ulmifolia leaves resulted in similar growth and lamb performance, but inclusion of G. sepium leaves adversely affected lamb growth, presumably due to other factors not related to the protein content.

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Introducción: El cáncer de mama es una de las neoplasias más frecuentes en mujeres a nivel mundial y causan más muertes cada año. El diagnóstico oportuno es muy importante ya que es de relevancia en la elección y eficacia del tratamiento, teniendo mayor éxito cuando se detecta temprano. La mejor estrategia para la detección temprana es a través de la prevención primaria mediante información, orientación y educación a la población femenina acerca de los factores de riesgo y la promoción de conductas favorables a la salud. El objetivo del estudio fue identificar dominios y clases afectadas en paciente postoperada de mastectomía. Materiales y Métodos: Estudio de caso en paciente femenina de 47 años de edad diagnosticada con cáncer de mama izquierda, realizándole mastectomía radical izquierda en una institución de salud del sector privado de Tampico, Tamaulipas, México. Se aplicó el proceso enfermero, realizando la valoración de enfermería con la Taxonomía II de Diagnósticos de enfermería, se describen los dominios y clases afectadas en el periodo posoperatorio, implementándose el plan de cuidados de enfermería con las interrelaciones diagnósticos, intervenciones y resultados. Resultados: La paciente evolucionó favorablemente, egresando al tercer día de la intervención quirúrgica, se proporcionó educación para sus cuidados en el domicilio. Discusión y Conclusiones: Al finalizar la investigación del caso, se observó la importancia de llevar a cabo el plan de cuidados de enfermería con las respectivas interrelaciones para brindar atención de calidad.

Introduction: Breast cancer is one of the most common cancers in women worldwide and causes more deaths each year. Early diagnosis is very important because it is relevant in the choice and treatment efficacy, with greater success when caught early. The best strategy for early detection is through primary prevention through information, guidance and education to the female population about risk factors and promoting positive health behaviors. The aim of the study was to identify domains and affected classes in a postoperative mastectomy patient. Materials and Methods: A case study in female patients of 47 years of age diagnosed with left breast cancer, performing left radical mastectomy in a private health institution in Tampico, Tamaulipas, Mexico. The nursing process was applied, making the nursing assessment with Taxonomy II Nursing Diagnoses, domains and affected classes in the postoperative period are described, implementing the nursing care plan with interrelationships, diagnoses, interventions and outcomes. Results: The patient improved, egressing the third day after surgery, education was provided for care at home. Discussion and Conclusions: After investigating the case, the importance of carrying out the plan of nursing care with the respective relationships to provide quality care was observed.

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Hispanic patients with type 2 diabetes mellitus generally have poor glycemic control. Constant hyperglycemia in individuals with type 2 diabetes can cause microvascular and macrovascular complications that lead to early morbidity and mortality. Good glycemic control requires a balance between diet, exercise, and medication, but dietary balance is difficult to achieve for many patients. Of the macronutrients, carbohydrates mostly affect blood glucose levels. Basic carbohydrate counting, glycemic index, and glycemic load are important tools for patients to master to control their blood glucose levels.

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Many studies have focused on the effects of anthropogenic noise on animal communication, but only a few have looked at its effect on other behavioural systems. We designed a playback experiment to test the effect of noise on predation risk assessment. We found that in response to boat motor playback, Caribbean hermit crabs (Coenobita clypeatus) allowed a simulated predator to approach closer before they hid. Two hypotheses may explain how boat noise affected risk assessment: it masked an approaching predator's sound; and/or it reallocated some of the crabs' finite attention, effectively distracting them, and thus preventing them from responding to an approaching threat. We found no support for the first hypothesis: a silent looming object still got closer during boat motor playbacks than during silence. However, we found support for the attentional hypothesis: when we added flashing lights to the boat motor noise to further distract the hermit crabs, we were able to approach the crabs more closely than with the noise alone. Anthropogenic sounds may thus distract prey and make them more vulnerable to predation.

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BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in Chile and worldwide. Framingham functions were developed to calculate overall coronary heart disease risk. However these functions overestimate the risk in some countries like Chile. AIM: To develop Chilean risk tables to assess the overall 10-year risk of coronary heart disease. MATERIAL AND METHODS: The Framingham function was adapted for a population aged 35 to 74 years, based on an estimate of Chilean incidence of coronary heart disease and the prevalence of coronary heart disease risk factors such as age, sex, total cholesterol, high-density lipoprotein cholesterol, blood pressure, diabetes and smoking. RESULTS: The 10-year incidence of coronary heart disease in Chile (2.7% in men, 1.096 in women) was lower than the incidence in the United States (10.096/3.896) and Spain (4.996/2.296), but higher than China (1.196/0.496). Framingham tables have more than 50% of cells in the risk category of 10% or greater. In contrast, Chilean tables have less than 10% of cells in the same risk category. CONCLUSIONS: Adapted tables use local information to calculate overall coronary heart disease risk. A validation study should be conducted to assess their predictive power.

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Background: Cardiovascular disease is the leading cause of morbidity and mortality in Chile and worldwide. Framingham functions were developed to calculate overall coronary heart disease risk However these functions overestimate the risk in some countries ¡ike Chile. Aim To develop Chilean risk tables to assess the overall 10-year risk of coronary heart disease. Material and methods: The Framingham function was adapted for a population aged 35 to 74 years, based on an estimate of Chilean incidence of coronary heart disease and the prevalence of coronary heart disease risk factors such as age, sex, total cholesterol, high-density lipoprotein cholesterol, blood pressure, diabetes and smoking. Results: The 10-year incidence of coronary heart disease in Chile (2.7 percent in men, 1.096 in women) was lower than the incidence in the United States (10.096/3.896) and Spain (4.996/2.296), but higher than China (1.196/0.496). Framingham tables have more than 50 percent of cells in the risk category of 10 percent or greater. In contrast, Chilean tables have less than 10 percent of cells in the same risk category. Conclusions: Adapted tables use local information to calculate overall coronary heart disease risk. A validation study should be conducted to assess their predictive power.

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