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Treatment for heart failure has experienced a major revolution in recent years, and current evidence shows that a combination of four medications (angiotensin receptor-neprilysin inhibitors + ß-blockers + mineralocorticoid receptor antagonists + sodium.glucose cotransporter 2 inhibitors) offer the greatest benefit to our patients with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality. Unfortunately, despite their proven benefits, the implementation of these therapies is still low. Clinical inertia, and unfounded fear of using these drugs might contribute to this. Recently, evidence from randomised clinical trials has shown that intensive implementation of these therapies in patients with heart failure is safe and effective. In this review, we attempt to tackle some of these misconceptions/fears regarding medical therapy for heart failure and discuss the available evidence showing the best strategies for implementation of these therapies.

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Atorvastatin is widely recommended for long-term secondary prevention in STEMI patients with no contraindication. Although high-dose atorvastatin has been shown to reduce important patient outcomes such as MACE, there is still doubt that high-dose atorvastatin could have the same protective effect in patients undergoing PCI in the short and long term. We searched the following electronic databases: Scopus, Web of Science, MEDLINE, EMBASE, and Cochrane Central considering studies that enrolled adult patients with a confirmed diagnosis of STEMI or NSTEMI undergoing PCI. The intervention must have been atorvastatin alone compared to a placebo, standard care, or a different atorvastatin dose. A total of (n = 11) studies were included in the quantitative analysis. Information on (N = 5,399) patients was available; 2,654 were assigned to receive high-dose atorvastatin therapy, and 2,745 comprised the control group. High-dose atorvastatin pre-loading significantly reduced MACE at one month of follow-up (RR: 0.78; 95% CI: 0.67-0.91; p = 0.014) in both STEMI and NSTEMI. All-cause mortality was reduced in patients with STEMI (RR: 0.28; 95% CI: 0.10-0.81; p = 0.029). The quality of the body of evidence was rated overall as moderate. Patients presenting with STEMI or NSTEMI benefit from high-dose atorvastatin pre-loading before PCI by reducing MACE at 30 days. The use of high-dose atorvastatin in STEMI patients reduced all-cause mortality. The beneficial effects of atorvastatin pre-loading are limited to 30 days post-PCI.

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BACKGROUND: Cardiovascular manifestations in patients with COVID-19 are associated with dire outcomes. Long COVID syndrome is the persistence of symptoms after acute disease and is found in up to 40% of subjects. There is little information regarding subacute echocardiographic manifestations after COVID-19, and no study has included a Mexican mestizo population. METHODS: This cross-sectional study included subjects older than 18 with an episode of COVID-19 in the last 3 months. Those with previously known cardiovascular disease were excluded. The patient´s medical history and COVID-19 information were obtained from clinical charts. We performed a transthoracic echocardiogram in every subject and determined left ventricular (LV) index mass, LV ejection fraction (LVEF), left ventricular global longitudinal strain (LV GLS), right ventricular (RV) GLS, and tricuspid annular plane systolic excursion (TAPSE). A descriptive and comparative analysis was performed based on symptom severity and persistence. RESULTS: One hundred subjects were included; 63% were classified with mild and 37% with moderate to severe COVID-19. The median of LVEF was 60% (55-60), LV GLS and RV GLS was impaired in 34% and 74% of patients, respectively. Patients with moderate to severe disease had significantly lower LVEF (Mean Difference: -3.3), TAPSE (mean difference: -1.8), and higher (worse) LV GLS (Mean Difference: 2.5) and RV GLS (mean difference: 2.9). Persistent symptoms were associated with lower TAPSE and higher RVGLS. CONCLUSIONS: Patients who recover from COVID-19 have a high prevalence of subtle RV and LV dysfunction using GLS analysis. A moderate to severe episode was associated with worse RV and LV function measured by RV GLS, TAPSE, and LV GLS. Subjects with persistent symptoms had worse RVGLS and TAPSE.

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INTRODUCTION: Respiratory conditions are the most common reason for admission to the neonatal unit for both term and premature newborns. It is known that nutritional imbalances during pregnancy affect the maturation and functional capacity of organs. OBJECTIVE: to describe the pulmonary histomorpholo- gy of newborn rats due to maternal sugar intake by light microscopy. MATERIAL AND METHOD: Twenty 4-week-old female Wistar rats divided into control and experimental groups with sucrose before and during pregnancy were used. At week 15, the females mated with males overnight. We recorded va lues from the body and lung weight of the newborns. The lungs were stained using Hematoxylin and Eosin, Masson's trichrome, Periodic acid-Schiff, and Verhoeff. RESULTS: Newborns from the experi mental group presented significantly lower body and lung weight (6.980 ± 0.493* g, 0.164 ± 0.022* g; *p < 0,05) compared with controls (7.854 ± 0.497 g, 0.189 ± 0.005 g). The lungs of the experimental group showed structural alterations in the lung parenchyma, as well as changes in glycogen deposits, collagen fibers, and elastin compared with the control group. CONCLUSION: Alterations in newborn lung growth and development are associated with maternal sucrose intake. It is important to re member that interventions on the maternal diet have beneficial effects for both the mother and the newborn.

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Nine-banded armadillos (Dasypus novemcinctus) are naturally infected with Mycobacterium leprae and are implicated in the zoonotic transmission of leprosy in the United States. In Mexico, the existence of such a reservoir remains to be characterized. We describe a wild armadillo infected by M. leprae in the state of Nuevo León, Mexico.

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BACKGROUND: Cadmium uptake by cacao plants can affect plant growth, consumer health and commercialisation. To develop mitigation strategies, it is essential to identify the soil characteristics that could influence this absorption. To determine the relationships between cadmium absorption and the soil characteristics of cacao areas, the responses at concentrations of 0, 2, 5, 10 and 20 µg g-1 of cadmium in three soils of these areas and an andisol were evaluated, using 120-day-old seedlings of four cultivars of Theobroma cacao L. RESULTS: In the present study, several relationships were found between chemical and physical soil characteristics and available cadmium, such as real and bulk densities, as well as contents of iron, sand, magnesium, potassium, sodium and copper. Additionally, moderate to strong correlations between potassium (r2  = -0.56) and real density (r2  = 0.42), with foliar cadmium, were found. Moreover, a differential deleterious effect on cacao growth in variables such as biomass was corroborated in cadmium concentrations from 5 µg g-1 in soils. There were no statistical differences between cultivars with respect to cadmium uptake or plant growth. Finally, a multiple linear regression model is proposed to estimate the foliar cadmium content (r2  = 0.878). CONCLUSION: Some soil characteristics such as density, as well as sand, clay, aluminium, potassium and iron contents, should be considered before establishing cacao crops to avoid cadmium accumulation. The correlation between potassium with foliar cadmium indicated that potassium could be significant in cadmium uptake mitigation strategies. The high correlation between available cadmium and foliar cadmium indicates that the quantification methodology developed using ethylenediaminetetraacetic acid extractant may be a useful diagnostic tool. © 2021 Society of Chemical Industry.

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RESUMEN Se presenta el caso de una paciente de 43 años, con antecedentes de salud aparente, hasta varias semanas previas a su ingreso, cuando comenzó a presentar síncopes precedidos de palpitaciones. Se realizó estudio electrofisiológico y se demostró precocidad en la porción distal del electrodo de registro de seno coronario, que corresponde a la vena cardíaca magna (interventricular anterior) y techo (summit) del ventrículo izquierdo. A pesar del excelente registro precoz se estudiaron estructuras vecinas como el tracto de salida del ventrículo izquierdo en la cúspide coronaria izquierda, aquí el mapeo eléctrico (pace mapping) no fue concordante total. En el sitio de la precocidad obtenida dentro del sistema venoso cardíaco se realizó mapeo concordante 100%, con una precocidad del catéter de ablación de -30 milisegundos. Se decidió ablación con incrementos progresivos de temperatura y potencia con corte de impedancia (termomapping) y se logró el éxito de la ablación sin reproducibilidad de la arritmia y excelente evolución posterior.

ABSTRACT The case of a 43-year-old female patient is presented, with an apparent history of good health, up to several weeks prior to admission, when she began to present syncopes preceded by palpitations. An electrophysiological study was performed and prematurity in the distal portion of the coronary sinus recording electrode was demonstrated, which corresponds to the great cardiac vein (anterior interventricular vein) and summit of the left ventricle. Despite the excellent early registration, neighboring structures were studied, such as the left ventricular outflow tract in the left coronary cusp, here the pace mapping was not totally concordant. At the site of the precocity obtained within the cardiac venous system, a 100% concordant mapping was achieved, with an ablation catheter's precocity of -30 milliseconds. The ablation was decided with progressive increases in temperature and power with thermomapping and the success of the ablation was achieved without reproducibility of the arrhythmia and excellent subsequent evolution.

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A 48-year-old male with a prior diagnosis of diabetes mellitus presented to the emergency department with malaise and nausea. On work-up, he was found with hyperglycemia and high anion gap metabolic acidosis, with a blood pH < 6.94. A diagnosis of severe diabetic ketoacidosis was established; serum electrolyte analysis showed mild hyperkalemia. On work-up, a 12-lead electrocardiogram was obtained, and it showed an ST-segment elevation on anterior leads that completely resolved with diabetic ketoacidosis treatment. ST-segment elevation myocardial infarction can be a precipitant factor for diabetic ketoacidosis, and evaluation of diabetic patients with suspected myocardial infarction can be challenging since they can present with atypical or little symptoms. Hyperkalemia, which usually accompanies diabetic ketoacidosis, can cause electrocardiographic alterations that are well described, but ST-segment elevation is uncommon. A pseudomyocardial infarction pattern has been described in patients with diabetic ketoacidosis; of note, most of these patients presented severe hyperkalemia. We believe this is of great importance for clinicians because they must be able to recognize those patients that present with electrocardiographic abnormalities secondary to the metabolic alterations and those that can be experiencing actual ongoing ischemia, in order to establish an appropriate and prompt treatment.

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Abstract: Objectives: To establish a relationship between global longitudinal strain (GLS) and Galectin-3 in pre-clinical heart failure in diabetic patients. Galectin-3 is a biomarker in heart failure with depressed ejection fraction (HFdEF). The hypothesis is presented that Galectin-3 is related to GLS and can detect left ventricular dysfunction in heart failure with preserved ejection fraction. Methods: Galectin-3 and GLS were measured in 121 asymptomatic individuals: 14 diabetics with mild depressed ejection fraction (mdEF) (LVEF 47.0 ± 6.9); 76 diabetics with preserved ejection fraction (LVEF 61 ± 5.5), and 31 controls (61.7 ± 5.1). Results: Galectin-3 was elevated in all diabetics vs controls (3.46 ± 1.36 ng/ml vs 2.78 ± 0.91 ng/ml; p = .003). It was also elevated in mdEF (3.76 ± 1.12 ng/ml vs 2.78 ± 0.9 ng/ml; p = .009) and pEF subjects (3.41 ± 1.40 ng/ml vs 2.78 ± 0.9 ng/ml; p = .058), respectively, vs controls. No difference in Gal-3 was found between diabetic groups (p = .603). Diabetics had lower GLS than controls (-18.5 ± 3.9 vs -20 ± 2.6; p = .022). Diabetics with mdEF had lower GLS than those with pEF (-13.3 ± 3.41 vs -19 ± 3.2; P<.001). There was no difference in GLS with pEF compared to controls (-19.4 ± 3.2 vs -20 ± 2.6; p = .70). Conclusions: Galectin-3 is elevated in diabetic patients with mdEF, and is associated with a diminished GLS. GLS could be an early marker of left ventricular dysfunction as well as evidence of diabetic cardiomyopathy.

Resumen: Objetivos: Establecer una asociación entre deformación longitudinal global (DLG) y galectina-3 en insuficiencia cardiaca preclínica en pacientes diabéticos. Galectina-3 es un biomarcador en insuficiencia cardiaca con fracción de eyección deprimida. Nuestra hipótesis es que la DLG y galectina-3 correlacionan y pueden detectar disfunción ventricular en insuficiencia cardiaca con FEVI preservada. Métodos: Se midieron galectina-3 y DLG en 121 individuos asintomáticos: 14 diabéticos con FEVI deprimida leve (FEdl) (FEVI 47 ± 6.9); 76 diabéticos con FEVI preservada (FEp) (FEVI 61 ± 5.5) y 31 sujetos controles (FEVI 61.7 ± 5.1). Resultados: Galectina-3 se encontró elevada en todos los diabéticos vs controles (3.46 ± 1.36 ng/ml vs 2.78 ± 0.91 ng/ml; p = 0.003). Está elevada en sujetos con FEdl (3.76 ± 1.12 vs 2.78 ± 0.9 vs ng/ml p = 0.009) y FEp (3.41 ± 1.40 vs 2.78 ± 0.9 ng/ml p = 0.058), respectivamente vs controles; no encontramos diferencia en galectina-3 en ambos grupos de diabéticos (p = 0.603). Los diabéticos tienen menor DLG que los controles (-18.5 ± 3.9 vs -20 ± 2.6; p = 0.022). Los diabéticos con FEdl tienen DLG más disminuida que aquellos con FEp (-13.3 ± 3.41 vs -19 ± 3.2; p < 0.001). No existe diferencia en DLG con FEp y controles (-19.4 ± 3.2 vs -20 ± 2.6; p = 0.70). Conclusiones: Galectina-3 está elevada en diabéticos con FEdl y correlaciona DLG disminuida. DLG podría ser un marcador temprano de disfunción ventricular y evidencia en miocardiopatía diabética.

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Fundamento: la formación de las especialidades médicas en Cuba resulta un elemento crucial en el quehacer de las universidades de las ciencias médicas. Objetivo: caracterizar el proceso formativo del especialista en Cardiología en la Universidad de Ciencias Médicas de Villa Clara. Métodos: se realizó una investigación documental en el período de septiembre de 2016 a marzo de 2017. Se emplearon métodos teóricos, entre ellos: análisis-síntesis e inducción-deducción; y entre los empíricos: el análisis documental del programa de esta especialidad, documentos organizativos del proceso formativo, Reglamento de la Educación de Posgrado de la República de Cuba, y del Sistema de Evaluación y Acreditación de Especialidades de Posgrado para el procesamiento de la información recopilada. Resultados: se caracterizó el proceso formativo del cardiólogo con elementos que sustentan la pertinencia del programa y se destaca la posición central de la actividad profesional especializada desde su proyección curricular, avalado por la cantidad de horas dedicadas a la formación de esta actividad, el empleo de escenarios docentes ubicados en los servicios de salud cardiológicos, y la utilización de la educación en el trabajo como forma de enseñanza donde el residente interactúa con el paciente para estudiar su proceso salud enfermedad. Conclusiones: se identificaron elementos que sustentan la eficacia del currículo en correspondencia con el encargo social, por su coherencia interna y los componentes que avalan la posición central que ocupa la actividad profesional especializada en esta formación.

Background: the training of medical specialties in Cuba is a crucial element in the work of the universities of the medical sciences. Objective: to characterize the training process of the specialist in Cardiology at Villa Clara University of Medical Sciences. Methods: a documentary research was carried out from September 2016 to March 2017. Theoretical methods were used, among them: analysis-synthesis and induction-deduction; and among the empirical ones: documentary analysis of the program of this specialty, organizational documents of the training process, Regulation of Postgraduate Education of the Republic of Cuba, and of the System of Evaluation and Accreditation of Postgraduate Specialties for the processing of the compiled information . Results: the formative process of the cardiologist was characterized with elements that support the relevance of the program and highlights the central position of the specialized professional activity from its curricular projection, supported by the number of hours dedicated to the formation of this activity, the use of teaching sites located in cardiological health services, and the use of the in-service training as a teaching form where the resident interacts with the patient to study its health disease process. Conclusions: elements that support the effectiveness of the curriculum in accordance with the social commitment were identified, due to their internal coherence and the components that support the core position of specialized professional activity in this training.

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BACKGROUND Amyloidosis is characterized by tissue deposition of insoluble fibrillar proteins and it affects almost every organ; there are many types and the heart can be affected in all of them. CASE REPORT Our report describes a middle-aged man who presented to the Emergency Department with congestive heart failure. Clinical, electrocardiographic, and echocardiographic findings suggested the presence of an infiltrative disease, so an abdominal fat tissue biopsy was performed. A final diagnosis of systemic amyloidosis with heart involvement was made. CONCLUSIONS This case highlights the importance of combining clinical, electrocardiographic, and echocardiographic information in the diagnosis of complex diseases like amyloidosis with heart involvement.

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OBJECTIVES: To establish a relationship between global longitudinal strain (GLS) and Galectin-3 in pre-clinical heart failure in diabetic patients. Galectin-3 is a biomarker in heart failure with depressed ejection fraction (HFdEF). The hypothesis is presented that Galectin-3 is related to GLS and can detect left ventricular dysfunction in heart failure with preserved ejection fraction. METHODS: Galectin-3 and GLS were measured in 121 asymptomatic individuals: 14 diabetics with mild depressed ejection fraction (mdEF) (LVEF 47.0±6.9); 76 diabetics with preserved ejection fraction (LVEF 61±5.5), and 31 controls (61.7±5.1). RESULTS: Galectin-3 was elevated in all diabetics vs controls (3.46±1.36 ng/ml vs 2.78±0.91 ng/ml; p=.003). It was also elevated in mdEF (3.76±1.12 ng/ml vs 2.78±0.9 ng/ml; p=.009) and pEF subjects (3.41±1.40 ng/ml vs 2.78±0.9 ng/ml; p=.058), respectively, vs controls. No difference in Gal-3 was found between diabetic groups (p=.603). Diabetics had lower GLS than controls (-18.5±3.9 vs -20±2.6; p=.022). Diabetics with mdEF had lower GLS than those with pEF (-13.3±3.41 vs -19±3.2; P<.001). There was no difference in GLS with pEF compared to controls (-19.4±3.2 vs -20±2.6; p=.70). CONCLUSIONS: Galectin-3 is elevated in diabetic patients with mdEF, and is associated with a diminished GLS. GLS could be an early marker of left ventricular dysfunction as well as evidence of diabetic cardiomyopathy.

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Abstract: Introduction: Multiple vascular compression aimed for transradial access have been developed. We aimed to compare the time required to achieve hemostasis in three different radial vascular compression devices. Methods: ST and non-ST elevation MI, unstable and stable angina as well as diagnostic coronary angiograms patients with transradial vascular access (TVA) in 2 centers were enrolled between June 2010-November 2010. Patients were divided according the TVA compression device (TAVCD) used. Group I received TR Band(tm) (Terumo, Tokyo, Japan), Group II received Neptuno(tm) (Biotronik, Berlin, Deutschland) and Group III received Finale(tm) (Merit Medical, South Jordan, UT).Patients were evaluated immediately after TVACD implantation and 24 hour post-procedure follow up. Results: 60 patients were enrolled in this observational study (Group I = 22 patients; Group II = 18; Group III = 20). All patients demonstrated evidence of radial pulse after hemostasis. 28% developed a superficial hematoma (Group I, 31%; Group II, 30%; Group III, 22%). Pain at the access site was uncommon among patients in both immediate and follow-up evaluations, however, 3% (Group I and II) presented paresthesia immediately following the procedure that resolved by the 24-hour evaluation. Conclusion: In our study, all three evaluated radial compression devices successfully achieved hemostasis regardless of the slight alterations of mechanism, yet similarity in aim of non-occlusive compression. Group I (TR band) had a slight increase in compression time recorded but all groups required an approximate three hours to display no evidence of bleeding. None of the patients in the study presented major vascular complications. We consider that further investigation of radial compression devices as compared to manual compression are necessary to evaluate their advantages and may further simplify the procedure

Resumen: Introducción: Múltiples dispositivos de compresión vascular para el acceso radial han sido desarrollados. Nuestro objetivo es comparar el tiempo requerido para lograr la hemostasis con tres diferentes dispositivos de compresión vascular radial. Métodos: Pacientes de angiografía coronaria de diagnóstico, con elevación y no elevación del ST, con angina de pecho inestable y estable, así como pacientes con acceso vascular radial (AVR) en dos centros, fueron incluidos entre junio y noviembre de 2010. Los pacientes fueron divididos según el dispositivo de compresión AVR (DCAVR) usado. Al Grupo I se le dio el TR Band(tm) (Terumo, Tokio, Japón), el Grupo II recibió el Neptuno(tm) (Biotronik, Berlín, Alemania) y el grupo III recibió el Final(tm) (Merit Medica, South Jordan, UT). Los pacientes fueron evaluados inmediatamente después de la implantación del DCAVR y a las 24 horas de postprocedimiento para seguimiento. Resultados: 60 pacientes fueron incluidos en este estudio observacional (Grupo I = 22 pacientes; Grupo II = 18; Grupo III = 20). Todos los pacientes mostraron evidencia de pulso radial después de la hemostasis. 28% desarrolló un hematoma superficial (Grupo I, 31%; Grupo II, 30%; Grupo III, 22%). El dolor en el sitio de acceso fue poco común entre los pacientes de los dos evaluaciones inmediatas y de seguimiento, sin embargo, el 3% (Grupo I y II) presentó parestesias inmediatamente después del procedimiento que se resolvieron para la evaluación de 24 horas. Conclusión: En nuestro estudio, los tres dispositivos de compresión radiales evaluados lograron con éxito la hemostasis sin importar las pequeñas variaciones del mecanismo, dando resultados similares en el objetivo de la compresión no oclusiva. Grupo I (Banda TR) tuvo un ligero aumento en el tiempo de compresión registrado pero todos los grupos requieren un tiempo aproximado de tres horas para mostrar ninguna evidencia de sangrado. Ninguno de los pacientes en el estudio presentó mayores complicaciones vasculares. Consideramos necesario hacer investigación adicional de los dispositivos de compresión radiales, en comparación con la compresión manual para evaluar sus ventajas y poder simplificar aún más el procedimiento.

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In this paper, the production of humic substances (HS) through the bacterial solubilization of low rank coal (LRC) was evaluated. The evaluation was carried out by 19 bacterial strains isolated in microenvironments with high contents of coal wastes. The biotransformed LRC and the HS produced were quantified in vitro in a liquid growth medium. The humic acids (HA) obtained from the most active bacterial strain were characterized via elemental composition (C, H, N, O), IR analyses, and the E4/E6 ratio; they were then compared with the HA extracted chemically using NaOH. There was LRC biotransformation ranged from 25 to 37%, and HS production ranged from 127 to 3100 mg . L(-1). More activity was detected in the isolated strains of Bacillus mycoides, Microbacterium sp, Acinetobacter sp, and Enterobacter aerogenes. The HA produced by B. mycoides had an IR spectrum and an E4/E6 ratio similar to those of the HA extracted with NAOH, but their elemental composition and their degree of aromatic condensation was different. Results suggest that these bacteria can be used to exploit the LRC resulting from coal mining activities and thus produce HS in order to improve the content of humified organic matter in soils.

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In this paper, the production of humic substances (HS) through the bacterial solubilization of low rank coal (LRC) was evaluated. The evaluation was carried out by 19 bacterial strains isolated in microenvironments with high contents of coal wastes. The biotransformed LRC and the HS produced were quantified in vitro in a liquid growth medium. The humic acids (HA) obtained from the most active bacterial strain were characterized via elemental composition (C, H, N, O), IR analyses, and the E4/E6 ratio; they were then compared with the HA extracted chemically using NaOH. There was LRC biotransformation ranged from 25 to 37%, and HS production ranged from 127 to 3100 mg.L-1. More activity was detected in the isolated strains of Bacillus mycoides, Microbacterium sp, Acinetobacter sp, and Enterobacter aerogenes. The HA produced by B. mycoides had an IR spectrum and an E4/E6 ratio similar to those of the HA extracted with NAOH, but their elemental composition and their degree of aromatic condensation was different. Results suggest that these bacteria can be used to exploit the LRC resulting from coal mining activities and thus produce HS in order to improve the content of humified organic matter in soils.

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In this paper, the production of humic substances (HS) through the bacterial solubilization of low rank coal (LRC) was evaluated. The evaluation was carried out by 19 bacterial strains isolated in microenvironments with high contents of coal wastes. The biotransformed LRC and the HS produced were quantified in vitro in a liquid growth medium. The humic acids (HA) obtained from the most active bacterial strain were characterized via elemental composition (C, H, N, O), IR analyses, and the E4/E6 ratio; they were then compared with the HA extracted chemically using NaOH. There was LRC biotransformation ranged from 25 to 37%, and HS production ranged from 127 to 3100 mg.L-1. More activity was detected in the isolated strains of Bacillus mycoides, Microbacterium sp, Acinetobacter sp, and Enterobacter aerogenes. The HA produced by B. mycoides had an IR spectrum and an E4/E6 ratio similar to those of the HA extracted with NAOH, but their elemental composition and their degree of aromatic condensation was different. Results suggest that these bacteria can be used to exploit the LRC resulting from coal mining activities and thus produce HS in order to improve the content of humified organic matter in soils.

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OBJECTIVE: Molecular detection of HEV in pig livers destined for human consumption in Nuevo Leon, Mexico. MATERIALS AND METHODS: 87 livers were collected from pigs slaughtered in TIF and 40 livers from butchers. A 212 pb fragment of HEV ORF2 gene was amplified by semi-nested RT-PCR. RESULTS: 19.54% (17) of tif's and 22.5% (9) of butcher's livers were positive for HEV. Sequencing of the amplified products showed a 94%-95% homology with the sequences reported for genotype 3. CONCLUSIONS: Our results indicate that HEV is circulating in swine herds in the state, constituting a probable source of contamination of pig meat products.

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El trabajo tiene como finalidad describir los elementos distintivos del proceso enseñanza aprendizaje de las asignaturas clínicas, para lo cual se emplearon métodos empíricos (revisión documental) y teóricos (análisis y síntesis, inducción-deducción y el sistémico estructural funcional). Se caracterizan los componentes personales y procesales del proceso enseñanza aprendizaje en estas asignaturas, a partir del rol que asumen en el currículo. La Didáctica Especial implica la aplicación de los conceptos y principios generales de la Didáctica, a las condiciones en que acontece el proceso enseñanza aprendizaje: los escenarios docentes son los propios servicios del proceso atencional, y la personalidad del estudiante se transforma al interactuar con el objeto de la profesión. Se requiere de una correcta preparación del profesorado y de la presencia de una labor metodológica que intencione las investigaciones en este campo, para contribuir a un mayor desarrollo de la educación médica cubana.

The objective of this work is to describe the distinctive features of the teaching-learning process of the clinical subjects. Empirical methods were used (review of documents) and theoretical methods (analysis-synthesis, induction-deduction and structural- systemic). The outcomes are presented in items. It was carried out a characterization of the personal and the process components of the teaching-learning process of these subjects; supported by the foundations of the curricular theory. The special didactics of the clinics implies the application of principles and concepts of the general didactics, to the real conditions where the medical cares occur, and the transformation of the student´s personality occurs during the interaction with the ill people. A correct preparation is required on the part of the professors as well as the presence of a good methodological work which encourages carrying out research works in this field, to contribute to a greater development of the Cuban medical education.

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Introducción La fisiología del polo acuático ha resultado difícil de estudiar debido a sus características en el campo de juego y la electrofisiología cardíaca de estos deportistas se conoce poco, menos aún en las mujeres. La electrocardiografía del polo acuático femenino de élite se ha estudiado escasamente. Objetivos Analizar la repolarización ventricular en mujeres practicantes de polo acuático de la Preselección Nacional de Cuba. Material y métodos Estudio transversal en una muestra conformada por dos grupos de mujeres: uno de 20 deportistas y otro de 20 personas sanas no deportistas, que se compararon respecto de parámetros electrocardiográficos de repolarización ventricular. Resultados La media de edad fue de 22,45 ± 5,30 años vs. 22,45 ± 5,30 años; p > 0,05. El peso fue mayor en las deportistas (69,63 ± 7,73 kg vs. 51,20 ± 6,63 kg; p < 0,001). La media de edad deportiva fue de 13,5 años. No existieron diferencias significativas del QTc y el JTc en la derivación DII entre ambos grupos, pero fueron mayores en las deportistas en la derivación V5 (QTc: 405 ms vs. 424 ms; p < 0,05 - JTc: 307 ms vs. 329 ms; p < 0,05). La dispersión del intervalo QT fue mayor en las deportistas que en las controles (74 ms vs. 43 ms; p < 0,001), el intervalo Tpico-Tfinal (Tpeak-Tend) alcanzó valores superiores en las deportistas en las derivaciones V1 (64 ms vs. 81 ms; p < 0,05), V3 (78 ms vs. 92 ms; p < 0,05), V4 (72 ms vs. 83 ms; p < 0,05) y V5 (63 ms vs. 80 ms; p < 0,05). Conclusiones Los intervalos QTc y JTc y la dispersión del QT fueron significativamente mayores en las deportistas. El intervalo Tpico-Tfinal fue significativamente mayor en las derivaciones V1, V3, V4 y V5 en las deportistas; la dispersión del intervalo Tpico-Tfinal fue superior en las deportistas, pero no estadísticamente significativo.

Background The physiology of water polo has been difficult to study due to the characteristics of the game in the field of play. Little is known about cardiac electrophysiology in these athletes, particularly in women. The electrocardiographic variables in elite water polo athletes have been rarely studied. Objectives To analyze ventricular repolarization in female water polo players from the National Pre-selection Team of Cuba Methods A cross-sectional study was performed in two groups of women, one with 20 athletes and another with 20 healthy nonathletes. The electrocardiographic parameters of ventricular repolarization were compared between both groups. Results Mean age was 22.45±5.30 years vs. 22.45±5.30 years; p >0.05. Weight was greater in athletes compared to nonathletes (69.63±7.73 kg vs. 51.20±6.63 kg; p <0.001). Mean duration of sporting practice was 13.5 years. There were no significant differences in QTc and JTc intervals in lead DII between both groups, yet the intervals measured in lead V5 were longer in athletes (QTc: 405 ms vs. 424 ms; p <0.05 - JTc: 307 ms vs. 329 ms; p <0.05). QT interval dispersion was greater in athletes compared to non-athletes (74 ms vs. 43 ms; p <0.001). Tpeak-Tend interval was greater in athletes in leads V1 (64 ms vs. 81 ms; p <0.05), V3 (78 ms vs. 92 ms; p< 0.05), V4 (72 ms vs. 83 ms; p <0.05) and V5 (63 ms vs. 80 ms; p <0.05). Conclusions QTc and JTc intervals and QT interval dispersion were significantly greater in water polo athletes. Tpeak-Tend interval was significantly longer in leads V1, V3, V4 and V5 in the athlete group. Finally, although this group showed greater Tpeak- Tend interval dispersion, it was not statistically significant.