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BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of women's mortality, linked to aging and reduced estrogen during menopause. Estrogen replacement therapy (ERT) is suggested for CVDs prevention. Yet, its timing initiation remains contentious. Thus, we aimed to evaluate the effect of early and late estrogen therapy on cardiac function and lipid metabolism in ovariectomized old female Wistar rats. METHODS: Fifty randomized female Wistar rats were included in 5 groups (n = 10, 18 months old): (1) Sham, (2) 10 weeks post ovariectomy (Ovx-10 w), (3) 10 weeks post Ovx + early estrogen replacement therapy (Ovx 10 w-early ERT), (4) 20 weeks post Ovx (Ovx-20 w) and (5) Ovx 20 w-late ERT. Three days (early ERT) or 10 weeks (late ERT) after surgery 17-ß estradiol was given (5 µg/kg/day), and 10 weeks after the start of ERT, we assessed cardiac function by echocardiography, electrocardiography, and cardiac catheterization. Estradiol, cholesterol, triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels were determined. Cardiac histology was performed with Masson's staining. RESULTS: Ovariectomy (Ovx) increases left ventricle internal systolic diameter (0.4 vs 0.3 cm, *p = 0.020) and decreases shortening fraction (40 vs 54 %, *p = 0.030) regardless of therapy. ERT prevents the increase in left ventricle mass after 10 weeks post-Ovx and the ejection fractionreduction after 20 weeks. Lower P wave amplitudes (18.8 vs 24.2 ms, *p = 0.013) were found in the Ovx-20 w group. A longer duration of the QRS complex after 20 weeks post-Ovx with and without ERT was found (32.5 and 32.1 vs 28.3 ms, *p = 0.003; *p = 0.007). Diastolic blood pressure was higher 20 weeks post-Ovx (86 vs 76 mmHg, *p = 0.047), regardless of ERT. The left ventricle (LV) -dP/dt was decreased in Ovx groups without ERT (-750 vs -1320 mmHg, *p = 0.034). An increase in LV collagen deposition was found in the Ovx 10 w group vs Sham (9.58 vs 4.54 %, *p = 0.028). Early ERT avoids the increase in body weight, cholesterol and LDL caused by Ovx. CONCLUSIONS: Ovariectomy causes time-dependent alterations in lipid metabolism, morphology, electrical activity, and heart contractile function. Early but not late ERT prevents some of these effects.

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Cardiovascular disease incidence increases after menopause due to the loss of estrogen cardioprotective effects. However, there are conflicting data regarding the timing of estrogen therapy (ERT) and its effect on vascular dysfunction associated with impaired glucose metabolism. The aim of this work was to evaluate the effect of early and late ERT on blood glucose/insulin balance and vascular reactivity in aged ovariectomized Wistar rats. Eighteen-month-old female Wistar rats were randomized as follows: (1) sham, (2) 10-week postovariectomy (10 w), (3) 10 w postovariectomy+early estradiol therapy (10 w-early E2), (4) 20-week postovariectomy (20 w), and (5) 20-week postovariectomy+late estradiol therapy (20 w-late E2). Early E2 was administered 3 days after ovariectomy and late therapy after 10 weeks, in both groups. 17ß-Estradiol (E2) was administered daily for 10 weeks (5 µg/kg/day). Concentration-response curves to angiotensin II, KCl, and acetylcholine (ACh) were performed. Heart rate (HR), diastolic and systolic blood pressure (DBP and SBP), glucose, insulin, HOMA-IR, and nitric oxide (NO) levels were determined. Higher glucose levels were found in all groups compared to the sham group, except the 20 w-late E2 group. Insulin was increased in all ovariectomized groups compared to sham. The HOMA-IR index showed insulin resistance in all ovariectomized groups, except for the 10 w-early E2 group. The 10 w-early E2 group increased NO levels vs. the 10 w group. After 10 w postovariectomy, the vascular response to KCl and Ach increases, despite early E2 administration. Early and late E2 treatment decreased vascular reactivity to Ang II. At 20-week postovariectomy, DBP increased, even with E2 administration, while SBP and HR remained unchanged. The effects of E2 therapy on blood glucose/insulin balance and vascular reactivity depend on the timing of therapy. Early ERT may provide some protective effects on insulin resistance and vascular function, whereas late ERT may not have the same benefits.

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PURPOSE: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) treatment has classically presented a percentage of associated complications that have limited its expansion. The aim of this study is to describe the morbimortality results obtained from a referral center implemented with the support of a governmental health agency and directed by a surgical team experienced in CRS for Peritoneal Surface Malignancies (PSM). METHODS: Data from the Peritoneal Carcinomatosis Program of Catalonia (PCPC) prospective database, including patients who underwent CRS + HIPEC between September 2006 and January 2021, were analyzed. RESULTS: A total of 1151 consecutive patients underwent 1321 CRS + HIPEC procedures. Colonic origin of peritoneal metastasis was the most frequent (47.3%). Median PCI was 7 and most patients had CC0-1 (96.1%). Multivisceral resection was performed in 44% of all patients, 57% required digestive anastomosis. Median hospital stay was 11 days (range 6-144 days). High-grade complications occurred in 20% of all patient, most of them surgical complications. Anastomotic leak occurred in 0.6% of all cases. The overall in-stay and 30-day mortality rate was 0.4%. The low-rate of complications and the high rate of complete CRS were achieved from the beginning of the PCPC. Median overall survival was 54.7 months, with a 5-year survival rate of 47.5%. CONCLUSIONS: Implementation of a CRS + HIPEC referral program for the treatment of PSM with preferably an experienced surgical team enables acceptable rates of severe morbidity (20%) and mortality (< 1%).

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Objectives: Metabolic syndrome is associated with the development of chronic kidney disease. Bursera simaruba "chaca" is a medicinal plant used in Mexico for hypertension and empirical therapy. In this study, were examined the effects of ethanol extract of B. simaruba on metabolic syndrome. Materials and Methods: For induction of metabolic syndrome, 20% fructose was used, and it was administered in the water and food to male Wistar rats for 12 weeks, after administering ethanol extract of B. simaruba intragastrically (100 and 200 mg/kg/day) for 6 weeks, blood pressure was determined. In plasma, glucose, cholesterol, triglycerides, angiotensin II, oxide nitric, and angiotensin 1-7 were quantified. In the kidney was performed histological study and the activity of anti-oxidant enzymes was quantified. Results: Rats with metabolic syndrome developed obesity, arterial hypertension, dyslipidemia, and kidney damage characterized by proliferative glomerulonephritis, necrosis, and reduced activity of anti-oxidant enzymes. These alterations were significantly ameliorated by ethanol extract of B. simaruba. Conclusion: The ethanolic extract of B. simaruba showed antidyslipidemic, antihypertensive, anti-oxidant, and renoprotective effects.

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Fundamento: la β2microglobulina está reconocida como marcador tumoral para diferentes propósitos en hematopatías malignas de estirpe linfoide; sin embargo, no hay antecedentes de su utilización en la provincia de Cienfuegos. Objetivo describir las características sociodemográficas, clínicas y la distribución de los niveles séricos de β2microglobulina en pacientes con síndrome linfoproliferativo crónico y su relación con los estadios clínicos y la respuesta al tratamiento de primera línea. Métodos: estudio observacional descriptivo transversal. La serie se conformó con todos los pacientes adultos con diagnóstico reciente (sin comenzar terapia antitumoral específica) de mieloma múltiple, leucemia linfoide crónica, linfoma no Hodgkin y linfoma Hodgkin, ingresados en el Servicio de Hematología del Hospital General Universitario Dr. Gustavo Aldereguìa Lima, durante el año 2020. La información se obtuvo mediante revisión documental de historias clínicas y ensayos de laboratorio. Se analizaron las variables: sexo, edad, color de la piel, niveles de β2microglobulina, tipo de enfermedad, estadios clínicos y respuesta al tratamiento. Resultados: el 84 % de la serie presentó niveles elevados del analito, más acentuado en el mieloma. Se constató relación entre los niveles estratificados de β2microglobulina con los estadios clínicos y la respuesta al tratamiento de primera línea. Conclusiones: las características sociodemográficas y las variables clínicas observadas no difieren de forma sustantiva con lo reportado. La distribución de los niveles de la β2microglobulina es sugerente de una relación directa entre los estadios clínicos e inversa con la respuesta al tratamiento.

Background: β2microglobulin is recognized as a tumor marker for different purposes in malignant hematopathies of lymphoid lineage; however, there is no history of its use in the Cienfuegos province. Objective: to describe the sociodemographic and clinical characteristics and the distribution of serum β2microglobulin levels in patients with chronic lymphoproliferative syndrome and their relationship with clinical stages and response to first-line treatment. Methods: cross-sectional descriptive observational study. The series was made up of all adult patients (universe 50) recently diagnosed (without starting specific antitumor therapy) of multiple myeloma, chronic lymphoid leukemia, non-Hodgkin lymphoma and Hodgkin lymphoma, admitted to the Hematology Service of the Dr. Gustavo Aldereguìa Lima General University Hospital, during the year 2020. The information was obtained through documentary review of medical records and laboratory tests. The analyzed variables were: sex, age, skin color, β2microglobulin levels, type of disease, clinical stages and response to treatment. Results: 84% of the series presented high levels of the analyte, more accentuated in myeloma. A relationship was found between the stratified levels of β2microglobulin with the clinical stages and the response to first-line treatment. Conclusions: the sociodemographic characteristics and the clinical variables observed do not differ substantially from what was reported. The distribution of β2microglobulin levels is suggestive of a direct relationship between clinical stages and an inverse relationship with response to treatment.

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The objective of this study is to identify and analyze the most relevant scientific work being undertaken in HR analytics. Additionally, it is to understand the evolution of the conceptual, intellectual, and social structure of this topic in a way that allows the expansion of empirical and conceptual knowledge. Bibliometric analysis was performed using Bibliometrix and Biblioshiny software packages on academic articles indexed on the Scopus and Web of Science (WoS) databases. Search criteria were applied, initially resulting in a total of 331 articles in the period 2008-2022. Finally, after applying exclusion criteria, a total of 218 articles of interest were obtained. The results of this research present the relevant notable topics in HR analytics, providing a quantitative analysis that gives an overview of HR analytics featuring tables, graphs, and maps, as well as identifying the main performance indicators for the production of articles and their citations. The scientific literature on HR analytics is a novel, adaptive area that provides the option to transform traditional HR practices. Through the use of technology, HR analytics can improve HR strategies and organisational performance, as well as people's experiences.

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BACKGROUND: Hypoxemia is a relatively common complication in stable patients during fiberoptic bronchoscopy (FOB). To prevent this complication, high-flow nasal cannula (HFNC) has been described as an alternative to standard oxygen therapy. However, the advantages of HFNC over standard oxygen therapy in acute care patients receiving supplemental oxygen before FOB performed with an oral approach are unknown. METHODS: We conducted an observational study that involved subjects with a presumptive diagnosis of pneumonia and a clinical indication for a bronchial aspirate sample. The type of oxygen support (standard oxygen therapy vs HFNC) was selected according to availability. The oxygen flow in the HFNC group was 60 L/min. In both groups, the FIO2 was set at 0.40. Hemodynamic, respiratory dynamics, and gas exchange data were collected at baseline, before, during, and 24 h after FOB. RESULTS: Forty subjects were included, 20 in each group (HFNC and standard oxygen therapy). The study was performed on day 5 of hospitalization in the HFNC group and on day 4 in the standard oxygen therapy group (P = .10). No significant between-group differences in baseline characteristics were observed. HFNC vs standard oxygen therapy was associated with a smaller decrease in SpO2 levels during the procedure (94% vs 90%; P = .040, respectively) and with less variation between the last SpO2 measured before FOB and the lowest SpO2 during FOB (Δ SpO2 ): 2% versus 4.5% (P = .01, respectively). CONCLUSIONS: In acute subjects who required oxygen support before FOB, the use of HFNC during FOB with an oral approach was associated with a smaller decrease in SpO2 and lower Δ SpO2 compared with standard oxygen therapy.

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Introducción: La osteoartritis se considera una enfermedad de daño reumatológico y la más prevalente de este grupo. Se caracteriza por la pérdida progresiva del cartílago articular, la aposición de hueso nuevo en el arca trabecular del hueso subcondral y la formación de osteofitos en las márgenes de la articulación. Objetivos: Exponer aspectos relacionados con la conceptualización, métodos y enfoques terapéuticos. Métodos: Se emplearon los descriptores del Medical Subject Headings y de ciencias de la salud. Se revisó la bibliografía actualizada acerca de la enfermedad, los métodos y los enfoques terapéuticos para abordar la misma. Conclusiones: El lavado articular por punción y el lavado con desbridamiento artroscópico garantizan la eficacia del tratamiento de la osteoartritis de rodilla ligera y moderada. La artroscopia influye positivamente en la percepción de la calidad de vida de los pacientes con osteoartritis de rodilla.

Introduction: Osteoarthritis is considered a disease of rheumatological damage and the most prevalent of this group. It is characterized by progressive loss of articular cartilage, apposition of new bone in the trabecular ark of subchondral bone, and formation of osteophytes at the margins of the joint. Objectives: To address aspects related to the conceptualization, methods and therapeutic approaches of knee osteoarthritis. Methods: Medical Subject Headings and health sciences descriptors were used. The updated literature on the disease, methods, and therapeutic approaches to address knee osteoarthritis were reviewed. Conclusions: Joint lavage by puncture and lavage with arthroscopic debridement guarantee the efficacy of the treatment of light and moderate knee osteoarthritis. Arthroscopy positively influences the perception of quality of life of patients with knee osteoarthritis.

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Introducción: Se realizó una revisión que permite comprender mejor por qué es necesaria una visión más integradora de la neuropsicología del adolescente para la aplicación de métodos de intervención desde las neurociencias que permitan enfrentar la conducta de riesgo sexual y reproductivo. Objetivo: Actualizar sobre los aspectos particulares de la neurofisiología de la adolescencia, que los puede hacer proclives a desarrollar una conducta de riesgo en cuanto a la función reproductiva. Material y Método: Revisión de la literatura sobre el tema, publicada en el período 2017-2022. Se utilizaron las bases de datos: PubMed/MEDLINE, Lilacs, Scielo, Cochrane, y The National Library of Medicine. Resultaron incluidas 26 fuentes bibliográficas para las citas, por reunir los requisitos de mayor especificidad, originalidad y aporte al tema. Desarrollo: El desarrollo del adolescente genera transformaciones radicales en su personalidad, que están relacionadas con cambios importantes en las estructuras cerebrales, que aún no están completamente desarrolladas. Las técnicas de resonancia magnética muestran que los principales cambios en el cerebro del adolescente afectan la corteza prefrontal, por lo que son más proclives a la falta de autorregulación y a una excesiva excitabilidad. La plasticidad de esta etapa explicaría cómo las conductas erróneas pueden imprimirse negativamente y dar lugar a las actitudes que llevan al fracaso, particularmente aquellas relacionadas con la sexualidad y la función reproductiva. Conclusiones: Se aportaron reflexiones críticas que permiten confirmar el hecho de que existen insuficiencias en los métodos para la modificación de la conducta de riesgo sexual y la función reproductiva en adolescentes. Se aportan nuevos enfoques de enfrentamiento.

Introduction: A review was carried out to allow a better understanding of why a more inclusive vision of adolescent neuropsychology is necessary for the application of intervention methods in the field of neuroscience that allow confronting sexual and reproductive risk behavior. Objective: to update on the particular aspects of the neurophysiology of adolescence, which can make them prone to develop risk behavior in terms of reproductive function. Material and Methods: Review of the literature on the subject, published in the period 2017-2022. Databases such as PubMed/MEDLINE, Lilacs, SciELO, Cochrane, and The National Library of Medicine were used. Twenty-five bibliographic sources were included for citations, as they met the requirements for greater specificity, originality, and contribution to the topic. Development: The development of the adolescent generates radical transformations in his personality, which are related to important changes in brain structures that are not yet fully developed. Magnetic resonance techniques show that the main changes in the adolescent brain affect the prefrontal cortex, which is why they are more prone to a lack of self-regulation and excessive excitability. The plasticity of this stage would explain how erroneous behaviors can be negatively imprinted, giving rise to attitudes that lead to failure, particularly those related to sexuality and reproductive function. Conclusions: Critical reflections are provided, which confirm the fact that there are weaknesses in the methods for the modification of sexual behavior and reproductive risk in adolescents. New confrontation methods are provided.

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The mechanism is unclear for the reported protective effect of hyperbaric oxygen preconditioning against oxidative stress in tissues, and the distinct effects of hyperbaric oxygen applied after stress. The trained mice were divided into three groups: the control, hyperbaric oxygenation preconditioning, and hyperbaric oxygenation applied after mild (fasting) or hard (prolonged exercise) stress. After preconditioning, we observed a decrease in basal levels of nitric oxide, tetrahydrobiopterin, and catalase despite the drastic increase in inducible and endothelial nitric oxide synthases. Moreover, the basal levels of glutathione, related enzymes, and nitrosative stress only increased in the preconditioning group. The control and preconditioning groups showed a similar mild stress response of the endothelial and neuronal nitric oxide synthases. At the same time, the activity of all nitric oxide synthase, glutathione (GSH) in muscle, declined in the experimental groups but increased in control during hard stress. The results suggested that hyperbaric oxygen preconditioning provoked uncoupling of nitric oxide synthases and the elevated levels of GSH in muscle during this study, while hyperbaric oxygen applied after stress showed a lower level of GSH but higher recovery post-exercise levels in the majority of antioxidant enzymes. We discuss the possible mechanisms of the redox response and the role of the nitric oxide in this process.

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The objective of this study is to identify and analyze the scientific literature with a bibliometric analysis to find the main topics, authors, sources, most cited articles, and countries in the literature on virtual reality in education. Another aim is to understand the conceptual, intellectual, and social structure of the literature on the subject and identify the knowledge base of the use of VR in education and whether it is commonly used and integrated into teaching-learning processes. To do this, articles indexed in the Main Collections of the Web of Science, Scopus and Lens were analyzed for the period 2010 to 2021. The research results are presented in two parts: the first is a quantitative analysis that provides an overview of virtual reality (VR) technology used in the educational field, with tables, graphs, and maps, highlighting the main performance indicators for the production of articles and their citation. The results obtained found a total of 718 articles of which the following were analyzed 273 published articles. The second stage consisted of an inductive type of analysis that found six major groups in the cited articles, which are instruction and learning using VR, VR learning environments, use of VR in different fields of knowledge, learning processes using VR applications or games, learning processes employing simulation, and topics published during the Covid-19 pandemic. Another important aspect to mention is that VR is used in many different areas of education, but until the beginning of the pandemic the use of this so-called "disruptive process" came mainly from students, Institutions were reluctant and slow to accept and include VR in the teaching-learning processes.

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RESUMEN El cáncer es una enfermedad multifactorial que provoca alteraciones en la diferenciación celular y un descontrol en la proliferación normal de las células, lo que conlleva a una pérdida de las características estructurales y funcionales de las células en un tejido. Esta enfermedad constituye un importante problema de salud por sus consecuencias desde el punto de vista individual, social y económico. Se conoce que las alteraciones moleculares, tienen un importante rol en las bases fisiopatológicas del cáncer. Esto ha intensificado en los últimos años las investigaciones básicas biomédicas en ese campo como vía para conseguir una mejor prevención, diagnóstico y tratamiento de estas patologías. En la presente revisión se expone una actualización sobre algunos aspectos relacionados con las bases moleculares del cáncer, la cual puede brindar herramientas teóricas útiles para la acción en diferentes escenarios de las ciencias biológicas, médicas y de la salud que mejoren la esperanza de vida del paciente con un padecimiento oncológico.

ABSTRACT Cancer is a multifactorial disease that causes alterations in cell differentiation and a lack of control in the normal proliferation of cells, which leads to a loss of the structural and functional characteristics of cells in a tissue. This disease constitutes an important health problem due to its consequences from the individual, social and economic point of view. Molecular alterations are known to play an important role in the pathophysiological basis of cancer. This has intensified basic biomedical research in this field in recent years as a way to achieve better prevention, diagnosis and treatment of these pathologies. This review presents an update on some aspects related to the molecular bases of cancer, which can provide useful theoretical tools for action in different scenarios of biological, medical and health sciences that improve the patient's life expectancy with an oncological condition.

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BACKGROUND: To examine structural connectivity of white matter tracts in patients with Pantothenate Kinase-Associated Neurodegeneration (PKAN) dystonia and identify those ones which correlate negatively to severity of symptoms. METHODS: In a group of 41 patients suffering from PKAN dystonia and an age- and gender-matched control group, white matter tractography was carried out, based on diffusion tensor imaging magnetic resonance data. Postprocessing included assessment of Quantitative Anisotropy (QA) using q-space diffeomorphic reconstruction in order to reduce influence of iron accumulation in globus pallidus of patients. RESULTS: Whole brain tractography presented significantly reduced QA values in patients (0.282 ± 0.056, as compared to controls (0.325 ± 0.046, p < 0.001). 9 fiber clusters of tracts correlated negatively to the dystonia score of patients: the middle cerebellar peduncle and the tracts of both cerebellar hemispheres as well as corpus callosum, forceps minor, the superior cortico-striate tracts and the superior thalamic radiations of both cerebral hemispheres (False Discovery Rate FDR = 0.041). CONCLUSION: The finding of a reduced global structural connectivity within the white matter and of negative correlation of motor system-related tracts, mainly those between the basal ganglia, cortical areas and the cerebellum, fits well to the concept of a general functional disturbance of the motor system in PKAN.

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Cytomegalovirus infection occurs commonly during infancy. Postnatal infection in term infants is usually asymptomatic; however, infection in preterm infants can be associated with clinical manifestations during the neonatal period. Nevertheless, few studies to assess the frequency of cytomegalovirus infection in preterm infants have been performed outside of high-income countries. We analyzed the incidence of congenital and postnatal cytomegalovirus infection in a cohort of preterm infants. Cytomegalovirus infection was detected during the neonatal period in four of 178 infants; in three of them, the virus was detected during the first 3 weeks of life and, therefore, congenital infection was confirmed (1.7% incidence). Postnatal infection was detected in 44 (36.4%) of 121 infants who were assessed after discharge from the neonatal intensive care unit. Cytomegalovirus infection was significantly associated with the duration of breastfeeding. In addition, we characterized cytomegalovirus strains detected in infants together with sequences available at GenBank, based on sequences of the UL18 gene. Cytomegalovirus UL18-sequences clustered in five distinct clades (A-E), and sequences obtained from infants in our study were distributed in four of the five clades; 44.4% of these sequences were included in clade E. Breastfeeding duration was shorter on average (5.6 months) in infants with sequences in clade E compared to infants with sequences in the other three clades (8.2 months; p = .07). In conclusion, we provide information regarding the high incidence of cytomegalovirus infection in preterm infants. Further studies are warranted to assess if cytomegalovirus strain characteristics are associated with the risk of infection acquisition during infancy.

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Resumen Introducción: La obesidad es uno de los principales problemas de salud pública en el mundo. Se considera detonante de múltiples enfermedades cardiometabólicas, como el infarto agudo de miocardio, la hipertensión arterial, la diabetes mellitus tipo 2 y el accidente isquémico cerebral. Es interesante conocer diversos factores fisiopatológicos que no dependen solo de la adiposidad, sino también de la masa muscular. Al entender que el músculo como órgano endocrino corresponde al 40% del peso corporal, las miocinas, como sustancias propias de este órgano liberadas desde la contracción, cobran importancia por su efecto antiinflamatorio y cardioprotector, y suponen un esfuerzo mayor para, a partir de su comprensión, realizar una prescripción adecuada del ejercicio. Objetivo: Estudiar las funciones de las miocinas como sustancias reguladoras de diversos procesos metabólicos, fundamentales en la homeostasis corporal. Método: Se hizo una revisión de tema, resultado de la revisión crítica de la literatura disponible sobre las miocinas, sus funciones y los efectos de la actividad física y el ejercicio en su liberación y acción. Conclusiones: El estudio de las miocinas viene en aumento y cobra relevancia clínica. Los efectos antiinflamatorios y cardioprotectores de las miocinas dependen del tipo de entrenamiento y de las cargas aplicadas al músculo una vez ha sido sometido a diferentes tipos de estímulo (aeróbico/anaeróbico, fuerza). Por tanto, la prescripción correcta del ejercicio es crucial en la modulación de estos mediadores: la optimización de su efecto, el acondicionamiento físico y el mantenimiento del peso adecuado.

Abstract Introduction: Obesity is one of the main public health problems worldwide being considered as a trigger for multiple cardiometabolic diseases such as acute myocardial infarction, high blood pressure, type 2 diabetes mellitus, cerebral ischemic accident among others. For this reason, it is of interest to know the various pathophysiological factors which depend not only on adiposity but also on muscle mass. Taking into account that the muscle as an endocrine organ corresponds to 40 % of the body weight, the importance that myokines charge as substances of this organ with an anti-inflammatory and cardioprotective character and which are released from muscle contraction is an additional study to perform an adequate Prescription of the exercise. Objective: To study the functions of myokines as regulatory substances in various metabolic processes, being essential in body homeostasis. Method: It is presented a topic review article, the result of a critical review of the available literature on myokines, their functions and the effects of physical activity and exercise on their release and action. Conclusions: that the study of myokines is increasing and is becoming more important clinical. The anti-inflammatory and cardioprotective effects of myokines depend on the type of training and loads applied to the muscle once subjected to different types of stimulation (aerobic/anaerobic, strength). Therefore, the proper prescription of exercise becomes crucial in the physical conditioning and in the maintenance of the appropriate weight.

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Resumen Este trabajo es el resultado de discusiones realizadas en una Comunidad de Práctica para Terapeutas Ocupacionales Latinoamericanos y del Caribe que trabajan con la Educación (TOE Latinoamérica). TOE Latinoamérica surge con el fin de fortalecer el trabajo colectivo de los terapeutas ocupacionales en el campo de la educación dentro de las especificidades de las organizaciones sociales latinoamericanas. Por tanto, aquí venimos a compartir un poco de este camino, presentando tres tópicos en este ensayo: primero, ponemos las razones concretas de nuestra existencia, como trabajamos y cuáles son en realidad las propuestas del grupo; luego, traemos un debate central sobre el derecho a la educación y los problemas históricos que involucran a América Latina y sus poblaciones, así como identificar el rol y significancia del Terapeuta Ocupacional en el acceso a condiciones de igualdad en educación; finalmente, nos parece pertinente señalar el surgimiento del debate actual que involucra a la pandemia COVID-19 y sus impactos en la vida de individuos y poblaciones, que interfiere directamente en la educación, para decir una vez más sobre nuestra tarea terapéutica-ocupacional ante esto.

Resumo Este trabalho é resultado de discussões realizadas em uma Comunidade de Prática para Terapeutas Ocupacionais latino-americanos e caribenhos que trabalham com Educação (TOE Latino América). TOE Latino América surge com o objetivo de fortalecer o trabalho coletivo de terapeutas ocupacionais no campo da educação dentro das especificidades das organizações sociais latino-americanas. Por isso, aqui passamos a compartilhar um pouco desse caminho, apresentando três temas neste ensaio: primeiro, colocamos as razões concretas para nossa existência, como trabalhamos e quais são as propostas do grupo; em seguida, trazemos um debate central sobre o direito à educação e os problemas históricos envolvendo a América Latina e suas populações, bem como identificamos o papel e a importância do Terapeuta Ocupacional no acesso a condições iguais na educação; por fim, parece pertinente apontar o surgimento do debate atual envolvendo a pandemia COVID-19 e seus impactos na vida de indivíduos e populações, que interfere diretamente na educação, para dizer mais uma vez sobre nossa tarefa terapêutico-ocupacional diante disso.

Abstract This paper results from discussions carried out in a Community of Practice of Occupational Therapists from Latin America and the Caribbean who work with Education (TOE Latin America). TOE Latin America arises to strengthen the collective work of occupational therapists in the field of education within the specificities of Latin American social organizations. Therefore, here we come to share a little of this path, presenting three themes in this essay: First, we describe the concrete reasons for our existence, how we work and what the group's proposals really are; Then, we bring a central debate on the right to education and the historical problems that involve Latin America and its populations, as well as identifying the role and importance of the Occupational Therapist in access to equal conditions in education; Finally, it seems relevant to point out the emergence of the current debate that involves the COVID-19 pandemic and its impacts on the lives of individuals and populations, which directly interferes with education, to say once again about our therapeutic-occupational task facing this.

RESUMO

En la atención al paciente en estadío terminal de causa oncológica, un tema que cobra importancia es la percepción sobre la distanasia y ortotanasia en los cuidadores como alternativa sentida al final de la vida. El objetivo de la investigación fue caracterizar la percepción familiar de los cuidadores de los enfermos terminales sobre la distanasia y la ortotanasia como alternativa sentida al final de la vida en la Policlínica Universitaria ¨Ángel Ortiz Vázquez¨. Se realizó un estudio cuantitativo-cualitativo. La muestra quedó conformada por 6 cuidadores. Se estudiaron las variables conocimiento real y referido en relación con enfermo terminal y enfermedad terminal, así como la ortotanasia y distanasia, la percepción familiar sobre la ortotanasia y distanasia y la elección de alternativa sentida al final de la vida. En el proceso investigativo se emplearon una encuesta, la entrevista, la entrevista en profundidad y la composición. El análisis de los datos se articula a través de la asunción de la triangulación como estrategia metodológica. Emergió que en el 83,3 % de los cuidadores refirieron como alternativa sentida de elección al final de vida la ortotanasia. Mostraron insuficientes conocimientos en relación con los conceptos enfermo terminal-enfermedad terminal y ortotanasia-distanasia en ambas técnicas. La percepción familiar es de aceptación. La percepción familiar de los cuidadores sobre la distanasia-ortotanasia es de aceptación, con actitudes positivas y la elección de la ortotanasia como alternativa sentida al final de la vida para el sujeto, pues consideran que la misma es la mejor opción para disminuir el sufrimiento.

In the care of patients in the terminal stage of oncological causes, an issue that gains importance is the perception of distanasia and orthothanasia in caregivers as an alternative felt at the end of life. The objective of the research was to characterize the family perception of the caregivers of the terminally ill about distanasia and orthothanasia as an alternative felt at the end of life at the ¨Ángel Ortiz Vázquez¨ University Polyclinic. A quantitative-qualitative study was carried out. The sample was made up of 6 caregivers. The variables real and referred knowledge in relation to terminally ill and terminally ill were studied, as well as orthothanasia and distanasia, family perception of orthothanasia and distanasia and the choice of alternative felt at the end of life. In the investigative process, a survey, the interview, the in-depth interview and the composition were used. The data analysis is articulated through the assumption of triangulation as a methodological strategy. It emerged that 83.3% of the caregivers referred to orthothanasia as a felt alternative of choice at the end of life. They showed insufficient knowledge in relation to the terminally ill-terminally ill and orthothanasia-distanasia concepts in both techniques. The familiar perception is one of acceptance. The family perception of caregivers about distanasia-orthothanasia is one of acceptance, with positive attitudes and the choice of orthothanasia as an alternative felt at the end of life for the subject, since they consider that it is the best option to reduce suffering.

No cuidado aos pacientes em fase terminal de causas oncológicas, uma questão que ganha importância é a percepção da distanásia e da ortotanásia nos cuidadores como alternativa sentida no final da vida. O objetivo da pesquisa foi caracterizar a percepção de familiares de cuidadores de pacientes em fase terminal sobre distanásia e ortotanásia como uma alternativa sentida no final da vida na Policlínica Universitária ¨Ángel Ortiz Vázquez¨. Foi realizado um estudo quantitativo-qualitativo. A amostra foi composta por 6 cuidadores. Foram estudadas as variáveis ​​conhecimento real e referido em relação ao doente terminal e doente terminal, bem como a ortotanásia e distanásia, a percepção familiar da ortotanásia e distanásia e a escolha da alternativa sentida no final da vida. No processo investigativo utilizou-se o survey, a entrevista, a entrevista em profundidade e a redação. A análise dos dados articula-se no pressuposto da triangulação como estratégia metodológica. Verificou-se que 83,3% dos cuidadores referiram a ortotanásia como uma alternativa sentida de escolha no final da vida. Apresentaram conhecimento insuficiente em relação aos conceitos de doente terminal-terminal e ortotanásia-distanásia em ambas as técnicas. A percepção familiar é de aceitação. A percepção dos familiares dos cuidadores sobre a distanásia-ortotanásia é de aceitação, com atitudes positivas e a escolha da ortotanásia como alternativa sentida no final da vida para o sujeito, por considerarem que é a melhor opção para diminuir o sofrimento.

RESUMO

RESUMEN La pandemia de la COVID-19 ha provocado aproximadamente 182 millones de casos y cerca de cuatro millones de muertes en todo el mundo, comprometiendo con mayor frecuencia a personas de 25 y 64 años de edad. Esta infección afecta principalmente al sistema respiratorio, pero otros órganos y sistemas pueden verse afectados a corto plazo como el neurológico. Una gran población de pacientes ha logrado superar la infección por el SARS-CoV-2, sin embargo, han comenzado a reportarse una serie de manifestaciones clínicas tardías, básicamente neuropsiquiátricas, dentro de ellas se ha referido a la ansiedad, depresión, deterioro del sueño, dolor muscular, mareos, cefaleas, fatiga, anosmia, entre otros; a este conjunto de manifestaciones tardías se le ha denominado síndrome neurológico post-Covid-19 y requiere por un lado, la atención de la comunidad médica para investigar las manifestaciones tardías o secuelas de esta enfermedad y por otro lado, una vigilancia médica ante la consulta de pacientes con estas manifestaciones.

ABSTRACT The COVID-19 pandemic has caused approximately 182 million cases and nearly four million deaths worldwide, most frequently involving people between 25 and 64 years of age. This infection primarily affects the respiratory system, but other organs and systems can be affected in the short term, such as the neurological system. A large population of patients has managed to overcome the SARS-CoV-2 infection, however, a serie of late clinical manifestations have begun to be reported, basically neuropsychiatric, including anxiety, depression, disorder of sleep, muscle pain, dizziness, headaches, fatigue, anosmia, among others; this set of late manifestations has been called post-Covid-19 neurological syndrome and requires, on the one hand, the attention of the medical community to investigate the late manifestations or sequel of this disease and, on the other hand, medical vigilance when consulting patients with these manifestations.

RESUMO

We carried out an observational, retrospective and descriptive study in order to identify the clinical and epidemiological characteristics of children with SARS-CoV-2 infection admitted to a Peruvian national referral hospital. We included patients from one month old to fourteen years old hospitalized between March and August 2020. A total of 125 patients with SARS-CoV-2 infection were admitted, 18.4% (n = 23) had critical illness and 16.8% (n = 21) had multisystem inflammatory syndrome (MIS-C). The absence of comorbidities and previous history of epidemiological contact were more frequent in patients with MIS-C. Patients in critical condition and patients with MIS-C had lower lymphocyte and platelet counts, and higher C-reactive protein, ferritin and D-dimer values than patients who did not have said conditions. Six (4.8%) out of 125 children died, as well as 3 (13%) children from the group of patients in critical condition. None of the children with MIS-C died.

Con el objetivo de conocer las características clínicas y epidemiológicas de niños con infección por SARS-CoV-2 internados en un hospital peruano de referencia nacional realizamos un estudio observacional, retrospectivo y descriptivo e incluimos pacientes de un mes a catorce años hospitalizados entre marzo a agosto del 2020. Se ingresaron 125 pacientes con infección por SARS-CoV-2, el 18,4% (n = 23) presentaron enfermedad crítica y 16,8% (n = 21) síndrome inflamatorio multisistémico (SIM). En los pacientes con SIM fue más frecuente la ausencia de comorbilidades y el antecedente de contacto epidemiológico. Tanto el grupo en estado crítico como del grupo con SIM, en comparación con los que no tuvieron estas condiciones, presentaron menores recuentos de linfocitos y plaquetas, y mayores valores de proteína C reactiva, ferritina y dímero D. Seis (4,8%) niños de los 125 fallecieron, 3 (13%) del grupo en estado crítico y ninguno del grupo con SIM.

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