ABSTRACT Zinc (Zn) is an essential nutrient for plants, and there is limited information on its availability in Paraguayan soils. The objective of the research was to evaluate and classify the availability of Zn in soils of the Eastern region of Paraguay. For this, a database was generated with the results of soil analyses from the FCA-UNA, CIHB-IPTA and FUCAI-UCA laboratories. The concentration of available Zn in soils was classified as "high" (>1.2 mg kg-1); “medium” (0.5 - 1.2 mg kg-1) and “low” (<0.5 mg kg-1), generating a Zn availability map at the district level. The availability of Zn was evaluated at the district and departmental levels, as well as with descriptive statistics parameters. Considering the average Zn levels at the district level, of the 234 districts that make up the Eastern region of Paraguay, 74% of the districts (174 districts) presented a "high" level, 6% a "medium" level (15 districts) and 3% “low” level of Zn (6 districts). Considering the total number of soil samples analyzed (11,395 samples), 79% (9,038 samples) presented "high" levels of Zn, 12% (1,316 samples) presented "medium" levels of Zn, and only 9% (1,041 samples) presented “low” levels of Zn. The national average, considering the 11,395 soil samples, was 6.5 mg kg-1 of Zn, therefore, in 79% of the soils analyzed in the Eastern region there are Zn levels above the critical level of Zn for agricultural activities, forage and forestry production.

RESUMEN El Zinc (Zn) es un nutriente esencial para las plantas, existe limitada información de su disponibilidad en los suelos de Paraguay. El objetivo de la investigación consistió en evaluar y clasificar la disponibilidad de Zn en suelos de la región Oriental del Paraguay. Para ello fue generada una base de datos con los resultados de análisis de suelo de los laboratorios de la FCA-UNA, CIHB-IPTA y FUCAI-UCA. Se clasificó la concentración de Zn disponible de los suelos en nivel “alto” (>1,2 mg kg-1); “medio” (0,5 - 1,2 mg kg-1) y “bajo” (<0,5 mg kg-1), generándose un mapa de disponibilidad de Zn a nivel distrital. Se evaluó la disponibilidad de Zn a nivel distrital, departamental, así como, con parámetros de estadística descriptiva. Considerando la media de los niveles de Zn a nivel de distrito, de los 234 distritos que conforman la región Oriental del Paraguay, en el 74% de los distritos (174 distritos) presentaron nivel “alto”, 6% nivel “medio” (15 distritos) y el 3% nivel “bajo” de Zn (6 distritos). Considerando el número total de muestras de suelo analizadas (11.395 muestras), el 79% (9.038 muestras) presentaron niveles “alto” de Zn, el 12% (1.316 muestras) presentaron niveles “medio” de Zn, y solo el 9% (1.041 muestras) presentaron niveles “bajo” de Zn. La media nacional considerando las 11.395 muestras de suelo fue de 6,5 mg kg-1 de Zn, por lo tanto, en 79% de los suelos analizados de la región Oriental hay niveles de Zn superior al nivel crítico de Zn para las actividades agrícolas, de forrajes y forestales de producción.

Resumen: El hierro (Fe) es un micronutriente requerido por las plantas, existiendo pocos estudios relacionados a su disponibilidad en suelos de Paraguay, por lo que resulta importante conocer su disponibilidad y distribución. El objetivo de la investigación consistió en evaluar y clasificar la disponibilidad de Fe en suelos de la región Oriental del Paraguay a nivel de distrito. Para ello fue generada una base de datos con los resultados de análisis de suelo de los laboratorios de la FCA-UNA, CIHB-IPTA y FUCAI-UCA. Se clasificó el contenido de Fe disponible de los suelos de 11.436 resultados, en nivel “alto” (>12 mg kg-1); nivel “medio” (4 - 12 mg kg-1) y nivel “bajo” (<4 mg kg-1), generándose un mapa de disponibilidad de Fe a nivel distrital. Se realizó una estadística descriptiva a partir de los valores de Fe disponible. De los 234 distritos que conforman la región Oriental del Paraguay, el 82% presentó nivel “alto” de Fe (192 distritos), el 1% nivel “medio” de Fe (2 distritos), y el 17% no fueron clasificados por falta de datos. El departamento con mayor valor promedio de Fe disponible fue Itapúa con 106,6 mg kg-1 y el menor valor promedio de Fe disponible fue Amambay con 23,1 mg kg-1. Considerando el número total de muestras de suelo analizadas, 10.160 presentaron nivel “alto” de Fe, 1.084 muestras presentaron nivel “medio” de Fe y 192 muestras se clasificaron en el nivel “bajo” de Fe. Los suelos de la región Oriental presentan predominio de suelos con alta disponibilidad de Fe, ideales para los sistemas de producción agrícola, ganadera y forestal.

Abstract: Iron (Fe) is a micronutrient required by plants, and there are few studies related to its availability in Paraguayan soils, so it is important to know its availability and distribution. The objective of the research was to evaluate and classify the availability of Fe in soils of the Eastern region of Paraguay at the district level. For this, a database was generated with the results of soil analysis from the FCA-UNA, CIHB-IPTA and FUCAI-UCA laboratories. The available Fe content of the soils of 11,436 samples was classified as "high" (>12 mg kg-1); “medium” level (4 - 12 mg kg-1) and “low” level (<4 mg kg-1), generating a Cu availability map at the district level. Descriptive statistics were performed based on the available Fe values. Of the 234 districts that make up the Eastern region of Paraguay, 82% presented a "high" level of Fe (192 districts), 1% had a "medium" level of Fe (2 districts), and 17% were not classified due to lack of data. The department with the highest average value of available Fe was Itapúa with 106.6 mg kg-1 and the lowest average value of available Fe was Amambay with 23.1 mg kg-1. Considering the total number of soil samples analyzed, 10,160 samples had "high" levels of Fe, 1,084 samples had "medium" levels of Fe, and 192 samples had "low" levels of Fe. The soils of the Eastern region present a predominance of soils with high availability of Fe, ideal for agricultural, livestock and forestry production systems.

ABSTRACT Copper (Cu) is a micronutrient required by plants in small amounts, and there are few studies related to the availability of this nutrient in Paraguayan soils, so it is important to know its availability and distribution. The aim of the research was to classify the availability of Cu in soils of the oriental region of Paraguay at the district level. For this, a database was generated with the results of soil analysis from the FCA-UNA, CIHB-IPTA and FUCAI-UCA laboratories. The availability Cu content of the soils of 11,395 samples was classified as "high" (>0.8 mg kg-1); “medium” level (0.8 - 0.3 mg kg-1) and “low” level (<0.3 mg kg-1), generating a Cu availability map at the district level. Descriptive statistics were performed from the Cu values. Of the 234 districts that make up the oriental region of Paraguay, 71% presented a "high" level, 8% a "medium" level, and 4% a "low" level. The department with the highest average value of Cu was Itapúa with 12.3 mg kg-1) and the lowest average value of Cu was Concepción with 0.8 mg kg-1. Considering the total number of soil samples analyzed, 8,090 samples presented "high" levels of Cu. The soils of the Eastern region present a predominance of soils with high availability of Cu, ideal for agricultural, livestock and forestry production systems.

RESUMEN El cobre (Cu) es un micronutriente requerido por las plantas en pequeñas cantidades, existiendo pocos estudios relacionados a la disponibilidad de este nutriente en suelos de Paraguay, por lo que resulta importante conocer su disponibilidad y distribución. El objetivo de la investigación consistió en clasificar la disponibilidad de Cu en suelos de la región Oriental del Paraguay a nivel de distrito. Para ello fue generada una base de datos con los resultados de análisis de suelo de los laboratorios de la FCA-UNA, CIHB-IPTA y FUCAI-UCA. Se clasificó el contenido de Cu disponible de los suelos de 11.395 muestras, en nivel “alto” (>0,8 mg kg-1); nivel “medio” (0,8 - 0,3 mg kg-1) y nivel “bajo” (<0,3 mg kg-1), generándose un mapa de disponibilidad de Cu a nivel distrital. Se realizó una estadística descriptiva a partir de los valores de Cu disponible. De los 234 distritos que conforman la región Oriental del Paraguay, el 71% presentó nivel “alto”, el 8% nivel “medio” y el 4% nivel “bajo”. El departamento con mayor valor promedio de Cu fue Itapúa con 12,3 mg kg-1 y el menor valor promedio de Cu fue Concepción con 0,8 mg kg-1. Considerando el número total de muestras de suelo analizadas, 8090 muestras presentaron niveles “alto” de Cu. Los suelos de la región Oriental presentan predominio de suelos con alta disponibilidad de Cu, ideales para los sistemas de producción agrícola, ganadero y forestal.

Abstract Agro-industrial processing activities generate by-products that are discarded at high economic and environmental costs; however, many of them still contain high levels of bioactive compounds (BCs) such as dietary fiber (DF) and phenolic compounds (PCs), which, when combined, are known as antioxidant dietary fiber (ADF). These BCs have properties that are beneficial to our health, among them anti-inflammatory, antioxidant and cardioprotective. Moreover, DF can regulate glucose and cholesterol levels. The mechanism of ADF action depends on its chemical structure and the interactions between the DF and PCs in it. Recent studies have reported the incorporation of several of these by-products on a diet through food products consumed worldwide, such as bread. This review describes the chemical characteristics of the ADF complex and the effect of its molecular interactions on sensory, nutritional and health-promoting properties of functional bakery goods.

ABSTRACT Introduction: Open tibial fractures are a subset of the trauma burden in Latin America. Questions related to treatment, potentially critical in Cuba, a country with limited resources, but with standardized national health program, coherence in education, and similarities of graduate programs were examined. Objective: To describe the treatment patterns of open tibial fracture in Cuba, and to compare the characteristics of acute and late management in seven provinces of the country. Methods: Sixty seven orthopedic surgeons were surveyed to evaluate four aspects of open fracture management, regarding antibiotic prophylaxis, irrigation and debridement, stabilization, and wound management. The convenience sampling method was used to identify surgeons and the analysis was performed using Fisher's exact test (p <0.05). Results: Postoperative antibiotics were administered for more than 72 hours for GA-I / II fractures (49%) and GA-III fractures (70%). Surgeons in Havana (n = 32) used primary internal fixation for GA-I / II fractures more frequently than surgeons in the remaining provinces (n = 35) (64.3% vs. 30.3%, p = 0.008). Surgeons from other provinces performed primary closure at the time of definitive fixation of GA-I / II fractures more frequently than those from Havana (62.9% vs. 32.3%, p = 0.013). For GA-III fractures, the majority of Havana surgeons (88.6%), as well as those of the remaining provinces (96.8%) preferred to perform deferred closure. Conclusions: The treatment of open tibial fractures in Cuba is generally consistent with other Latin American countries. The characteristics of the management of open tibial fractures in Cuba are described and differences in wound stabilization and treatment methods between provinces are compared, which is useful to assess whether they are the result of differences in surgical practice, or in availability of resources. This is helpful in addressing ways to optimize patient care through specialized training and resource allocation.

RESUMEN Introducción: Las fracturas abiertas de tibia son un subconjunto de la carga de traumatismos en América Latina. Se examinaron cuestiones relacionadas con el tratamiento potencialmente críticas en Cuba, país con recursos limitados, pero con un programa nacional de salud estandarizado, coherencia en educación y similitudes de programas de posgrado. Objetivos: Describir los patrones de tratamiento de la fractura abierta de tibia en Cuba, y comparar las características del manejo agudo y tardío en siete provincias del país. Métodos: Se encuestaron 67 cirujanos ortopédicos para evaluar cuatro aspectos en el tratamiento de la fractura abierta: profilaxis antibiótica, irrigación y desbridamiento, estabilización y tratamiento de heridas. Se utilizó el método de muestreo por conveniencia para identificar a los cirujanos y el análisis se realizó mediante la prueba exacta de Fisher (p < 0,05). Resultados: Se administraron antibióticos posoperatorios durante más de 72 horas para las fracturas GA-I/II (49 %) y las fracturas GA-III (70 %). Los cirujanos de La Habana (n= 32) utilizaron con más frecuencia la fijación interna primaria para las fracturas GA-I/II, que los cirujanos en las restantes provincias (n= 35) (64,3 % vs. 30,3 %, p= 0,008). Los cirujanos de otras provincias realizaron cierre primario en el momento de la fijación definitiva de fracturas GA-I /II con más frecuencia que los de La Habana (62,9 % vs. 32,3 %, p= 0,013). Para fracturas GA-III, la mayoría de los cirujanos habaneros (88,6 %), al igual que los de las restantes provincias (96,8 %) prefirieron realizar cierre diferido. Conclusiones: El tratamiento de fracturas abiertas de tibia en Cuba es generalmente consistente con otros países de América Latina. Se describen las características del manejo de fracturas abiertas de tibia en Cuba y se comparan las diferencias en los métodos de estabilización y tratamiento de heridas entre provincias, lo cual resulta útil para evaluar si son resultado de diferencias en la práctica quirúrgica, o en la disponibilidad de recursos. Esto representa una ayuda al abordar las formas de optimizar la atención al paciente, a través de la capacitación especializada y la asignación de los recursos.

RESUMEN Para el presente estudio se ha tomado la Base de Datos Oficial para Huracanes del Centro Nacional de Huracanes (HURDAT-NHC), dependencia de la NOAA, correspondiente al período de 1851-2012 relativos a ciclónicas tropicales para la República Dominicana (Isla Hispaniola) en la Cuenca del Caribe. El análisis ha sido realizado de dos formas diferentes considerando la geografía de la isla (todos los puntos de posicionamiento de los eventos en la Cuenca del Caribe que han impactado el área de estudio al tocar tierra -impactado-- y todos los eventos que han atravesado la República Dominicana en un radio de ~300 km. Se presenta un estudio estadístico de la ocurrencia de estos fenómenos durante el citado período, incluyendo un análisis climatológico de todos los ciclones tropicales que se han registrado (112 eventos en total) en distribuciones decanales, cincuentenarios y mensuales, indicando la de menor y mayor actividad. Por igual se ha ejecutado un análisis de ondeletas sobre los datos continuos de la serie de tiempo para determinar importantes frecuencias. Finalmente mostramos una probabilidad de ocurrencia de que uno de estos fenómenos toque tierra basado en una serie de 162 años para el área de estudio, dentro de un radio de ~100, ~185 y ~300 km, teniendo en cuenta la climatología de huracanes la cual revela la probabilidad de ser impactado tanto por un evento de menor o mayor categoría. El autor muestra una perspectiva de la actividad ciclónica para el área de la República Dominicana la cual forma parte de su tesis doctoral.

ABSTRACT In this study, we re-examined the Official Hurricane Database from the National Hurricane Center (HURDAT-NHC), an agency associated with NOAA, for tropical cyclone activity from 1851 to 2012for the Dominican Republic on the island of Hispaniola in the Caribbean Basin. We performed analyses at two different levels for the island (i.e., all of the storm tracks in the Caribbean Basin near to the study area that made landfall and all of the events that crossed the Dominican Republic from a radius of 300 km from the coastline). This study includes the statistical occurrence of these phenomena during the study period and the climatological analysis of all tropical cyclone tracks (112 total events) by decadal seasonal distribution, fifty-year seasonal distribution and monthly seasonal distribution to show the lowest and highest activities. We performed wavelet analysis on the continuous data over a long time series to determine the important frequencies. This analysis provided a general statistical conclusion resulting from the data collected. A landfall probability for the study area corresponding to the long time series of (it's 162) years within a radius of ~100, ~185 and ~300 km, based on the historical climatology tropical cyclone tracks, reveals the likelihood of a strike for a major or a minor hurricane. We present a review of the tropical cyclone activities that passed the Dominican Republic, which also forms part of the author's dissertation.

Background: cerebrovascular disease is the third cause of death in elder adults of the entire world. Aim: to characterize the epidemiologic, clinical behavior, aspects of the management and the association with atherogenic risk factors of the vascular focal cerebral dysfunction in elder adults. Materials and Methods: we carried out a cross-sectional study, on a “door-to-door” population basis in two directions: one descriptive for determining the prevalence, risk factors, clinical subtypes and management aspects of the Vascular Focal Cerebral Dysfunction (VFCD), and another, cases and controls analytical direction for establishing the risk association in 901 elder people aged 65 years and more who live in a selected area of the Teaching Polyclinic “José Jacinto Milanés” of Matanzas, in the period from January 2003 to November 2006, as part of the international research project 10/66. Outcomes: the obtained prevalence index of vascular focal cerebral dysfunction was 12,9 (116 elder people/43 transitory ischemic stroke and 73 ictus), predominating this affection in women, aged more than 80 years and the clinical subtypes athero- thrombotic ischemic ictus and carotidal transitory ischemic stroke (TIS). Only 29,3 % of the vascular focal cerebral dysfunctions were assessed by a physician during the first 24 hours after the event; in the cardioembolic ictus and hemorrhagic ictus subtypes the percentage increased to 83,3 % and 100 % respectively. The totality of the hemorrhagic ictus, 40, 5 % of the ischemic ictus and only 2,3 % (1 case) of the transitory ischemic seizures were cause of admission. The arterial hypertension (OR-2.56; IC 95 % 1.209-4.815), the associated cardiac disease (OR-2.18; IC 95 % 1.195-4.012), the previous transitory ischemic stroke (OR-50,1; IC 95 % 24,037-104,542) and physical inactivity (OR-2,66; IC 95 % 1,023-6,945) were the main risk factors for the development of an ischemic ictus in the studied group.

Introducción: la enfermedad cerebrovascular constituye la tercera causa de muerte en adultos mayores de todo el mundo. Objetivo: caracterizar el comportamiento clínico, epidemiológico, aspectos del manejo y la asociación con factores de riesgo aterogénicos de la disfunción cerebral focal Vascular en adultos mayores. Materiales y Métodos: se realizó un estudio transversal, de base poblacional “puerta a puerta” en dos vertientes: una descriptiva para determinar la prevalencia, los factores de riesgo, subtipos clínicos y aspectos del manejo de la Disfunción cerebral focal vascular (DCFV) y otra vertiente analítica de casos y controles para establecer la asociación de riesgo en 901 ancianos de 65 años y más que viven en un área seleccionada del Policlínico Universitario “José Jacinto Milanés” de la ciudad de Matanzas, en el periodo comprendido de enero del 2003 a noviembre del 2006, como parte del proyecto de investigación internacional 10/66. Resultados: se obtuvo una tasa de prevalencia de DCFV de 12,9 % (116 ancianos/ 43 ATI y 73 ictus), predominando esta afección en las mujeres, las mayores de 80 años y los subtipos clínicos de ictus isquémico aterotrombótico y ataque transitorio de isquemia (ATI) carotideo. Solo el 29,3 % de las DCFV fueron valoradas por un médico en las primeras 24 h del evento; en los subtipos de ictus cardioembólico e ictus hemorrágico este por ciento se elevó a 83,3 % y 100 % respectivamente. Motivaron ingreso la totalidad de los ictus hemorrágicos, el 40,5 % de los ictus isquemicos y solo el 2,3 % (1 caso) de ATI. La HTA (OR-2.56; IC 95 % 1.209-4.815) la enfermedad cardiaca asociada (OR-2.18; IC 95 % 1.195-4.012), el ATI previo (OR-50,1; IC 95 % 24,037-104,542) y la inactividad física (OR-2,66; IC 95 % 1,023-6,945) constituyeron factores de riesgo para el desarrollo de un ictus isquémico en el grupo estudiado.

Castor bean Ricinus communis L., due to its agro-ecological features, is suitable for family farming. A randomized complete block test was carried out at the district of Escobar, department of Paraguari, Paraguay, between August 2007 and July 2009, in order to assess the feasibility of intercropping castor bean with annual crops, with seven treatments and three repetitions. The treatments were T1: maize monoculture; T2: bean monoculture; T3: cotton monoculture; T4: castor bean monoculture; T5: Castor bean intercropped with maize; T6: Castor bean intercropped with bean; T7: castor bean intercropped with cotton. The following were measured: Primary bunch height, castor bean plant height in the first year and castor bean, maize, beans and cotton yield, both in monoculture and in association with other crops, as well as the association efficiency measured with the Land Equivalent Ratio (LER) in the two years. The highest peaks of primary branch height and the final height of plants were obtained in castor bean in association with maize (149 cm) and castor bean in association with cotton (215 cm) respectively, assessed in the first year of the study. Castor bean yield in monoculture and intercropped during the same year showed slight variation, ranging between 963 and 1059 kg ha-1. In the second year, lower production was obtained in castor bean intercropped with maize (898 kg ha-1) and with cotton (809 kg ha-1) than that obtained with monoculture (1056 kg ha-1). LER results in the two years showed that castor bean intercropped with cotton, maize or bean, leads to a more efficient land use.

El tártago por sus características agroecológicas se adapta a la agricultura familiar. Para evaluar la factibilidad de la asociación de tártago con cultivos anuales se instaló un experimento con diseño en bloques completos al azar, con siete tratamientos y tres repeticiones, en el Distrito de Escobar, Departamento de Paraguarí, entre agosto de 2007 y julio de 2009. Los tratamientos fueron T1: monocultivo de maíz; T2: monocultivo de poroto; T3: monocultivo de algodón; T4: monocultivo de tártago; T5: tártago asociado a maíz; T6: tártago asociado a poroto; T7: tártago asociado a algodón. Fueron analizadas altura del cacho primario, altura de plantas de tártago en el primer año y rendimiento en granos de tártago, maíz, poroto y algodón en rama, en monocultivo y asociados y la eficiencia de las asociaciones mediante el Índice Equivalente de la Tierra (IET) en los dos años. La mayor altura de inserción del cacho primario y altura final de plantas se obtuvieron en la asociación del tártago con maíz (149,0 cm), y de tártago con algodón (215,0 cm), respectivamente, evaluadas en el primer año de experimentación. El rendimiento de tártago en el mismo año en monocultivo y en asociación presentó escasa variación, entre 963 y 1059 kg ha-1. En el segundo año, se obtuvo menor producción en la asociación de tártago con maíz (898 kg ha-1) y con algodón (890 kg ha-1) que en monocultivo (1056 kg ha-1). El IET obtenido en los dos años indica que asociando el cultivo de tártago con algodón, maíz o poroto se logra un uso más eficiente del suelo.

Considering the extensive use of hot peppers and spicy sauces in the Mexican cuisine, in the present paper, three widely consumed Mexican condiments (mole sauce, achiote, and pasilla hot pepper) were analyzed for their total phenols, flavonoids and proanthocyanidins, antioxidant activity, and protective effect against lipid oxidation in chopped pork meat. All samples were extracted first with methanol and then with acetone, and the extracts were compared. Pasilla pepper showed the highest phenolic and flavonoid content in both solvents, followed by mole and achiote. Achiote showed the highest proanthocyanidin concentration. All samples showed high antioxidant activity, and good correlations with phenolic compounds and flavonoids, while no correlation was observed in the case of condensed tannins. Mole sauce methanolic extract showed the highest inhibition of pork meat oxidation, followed by pasilla pepper, and finally achiote paste extracts. These results suggest that these condiments are useful to prevent meat lipid oxidation during storage.

Lutzomyia antunesi has been commonly reported in outbreaks of cutaneous leishmaniasis (CL) in the Orinoquia region of Colombia. The bionomics of this species were studied in the municipality of Villavicencio (Meta, Colombia). Sandflies were captured over the course of one week per month for one year in intradomiciliary, peridomiciliary and extradomiciliary housing areas. The captures were performed from 06:00 pm-06:00 am using CDC light traps and the females were processed for polymerase chain reaction (PCR) to detect Leishmania spp. A total of 22,097 specimens and 19 species were captured of which Lu. antunesi (89%) and Lutzomyia walkeri (5%) were the most abundant. Other species recognised as anthropophilic (Lutzomyia panamensis, Lutzomyia gomezi, Lutzomyia flaviscutellata and Lutzomyia fairtigi) were present in very low abundance (< 2%). Natural infection with Leishmania spp was detected using PCR in Lu. antunesi, Lu. panamensis and Lu. flavicutellata, showing infection rates of 1%, 4.8% and 7.5%, respectively. The present paper provides information on various ecological aspects of Lu. antunesi. An analysis of seasonality shows that this species increases in abundance in the hottest months (December, January and February), directly correlating with the maximum temperature and inversely correlating with precipitation. The natural infection rate is associated with the peaks of highest abundance.

In 2011 the Cuban health system began a process of sectoral reform to maintain and improve the health of Cuba's population, in response to new challenges and demands in the health sector and population health status. The main actions involved are reorganization, consolidation and regionalization of services and resources. Although community engagement and personal responsibility are not explicitly mentioned in the strategy document, it is advisable to use this opportunity to revitalize both topics and encourage appropriate and full incorporation into the Cuban health system. Both are consistent with the objectives and actions of system reforms proposed, in that they allow the various social actors to assume shared responsibility in working toward social goals-in this case, health gains. This approach also recognizes that reaching such goals is a collective endeavor, to be pursued according to ethical principles (beneficence as responsibility and justice as solidarity), with community involvement and personal responsibility emerging as two important factors subject to reorientation in the context of the health system reform under way.

Background: Breast cancer is the main cause of death among women between 40 and 55 years old, in whom the hereditary cases are common. Therefore, the molecular diagnosis of germ line mutations involved in breast cancer susceptibility is relevant. BRCA1 and BRCA2 have been described as the two major genes involved in familial breast/ovarian cancer. We are performing a screening of BRCA1 and BRCA2 genes, in a group of 50 high risk Chilean families for breast/ovarian cancer. We have detected a mutation, 3936 C>T, that leads to a truncated protein, in two affected women from one of the families in study. Aim: To report the results of the screening for 3936 C>T in healthy relatives of index women. Material and me-thods: The molecular diagnosis of this mutation was offered to the healthy members of this family, and 17 relatives accepted to be tested. The region of the BRCA1 gene that includes the 3936 C>T mutation, was analyzed through PCR amplification, digestion with restriction enzyme BstNI, and direct sequencing. Results: 3936 C>T DNA mutation was present in 8 relatives. Conclusions: Considering the high risk of having a mutation in the BRCA1 gene, specially in pre-menopausal women, the molecualr diagnosis, genetic and clinical counseling are highly relevant. In Chile the molecualr diagnosis is still not widely applied (Rev Méd Chile 2004; 132: 203-8)

The application of the University management in health module as part of the Master’s degree course in Medical Education, aimed at future educators of the Medicine studies in a university of a Latin American country, led to the carrying out of practical exercises in line with the theoretical framework of the curriculum. This module allows to convey the required knowledge and attain the necessary habits, skills and dexterity for the professional performance, and at the institutional level, to provide the future academic team with working tools that will enable it to take a look at the past, to make assessments at the present time and to gain experience for the future of a university in charge of educating the professionals required for solving the population’s health needs, all this is achieved through the application at the moment of the Situational Analysis of the Strategic Planning of Health Interventions in the context of the managerial theory and the management of human resources. The group of participants did an exercise that included the application, after the identification of the institutional mission, of the Analysis of the Institutional Situation and its external context through the positional application by the subjective, inter-subjective, objective and historical analysis; the determination of the type of prevailing management and the image-objective of quality that are desired; the formulation of the institutional vision and its objectives; and the constitution of the situation-objective. In this way, it is possible to arrive at the identification of the institutional problems and of its external context, as a first part or a first moment of the programmed exercise. The sequential exposition of the steps followed by the group of participants headed by the future Dean of the Medical School made it possible, through the implementation of an andragogic and strategic process, to establish the guidelines to cope with prospective situations in the working context.

La aplicación del Módulo de Gerencia Universitaria en Salud como parte de la Maestría en Educación Médica, dirigida a futuros docentes de la carrera de Medicina en una universidad de un hermano país latinoamericano, conllevó la articulación de ejercicios prácticos congruentes con el marco teórico propio del plan de estudios que permitiera transmitir los conocimientos requeridos y obtener los hábitos, habilidades y destrezas necesarias para su desempeño, y en el plano institucional, dejar al futuro equipo académico, herramientas de trabajo que les permitieran echar una mirada hacia el pasado, hacer valoraciones desde el presente y obtener experiencias para el futuro de una universidad dirigida a formar los profesionales requeridos para dar solución a las necesidades en salud de su población, todo ello mediante la aplicación del momento de Análisis Situacional de la Planificación Estratégica de Intervenciones en Salud en el marco de la teoría gerencial y la gestión de recursos humanos. El grupo de maestrantes desarrolló un ejercicio que consistió en la aplicación previa identificación de la Misión institucional, de un Análisis de la Situación Institucional y de su ámbito externo a través de la aplicación posicional mediante el análisis subjetivo, intersubjetivo, objetivo e histórico, la determinación del tipo de gestión imperante a la que se aspira y la imagen objetivo de calidad que se desea alcanzar, la formulación de la visión institucional y sus objetivos, la constitución de la situación objetivo y de esta forma arribar a la identificación de los problemas institucionales y de su ámbito externo, como una primera parte o un primer momento del ejercicio planificado. La exposición secuencial de los pasos seguidos por el grupo de maestrantes encabezados por el futuro Decano de la Facultad de Medicina permitió mediante la aplicación de un proceso andragógico y estratégico sentar pautas para hacer frente a situaciones prospectivas ya en el marco laboral.