Resumo Introdução: A promoção da literacia em saúde é crucial para que os utentes possam tomar decisões adequadas em matéria de saúde, promovendo uma utilização mais eficiente dos recursos e contribuindo para a sua sustentabilidade. Objetivos: Promover a literacia em saúde entre os utentes de seis Unidades de Saúde Familiar (USF) no Norte de Portugal acerca da organização e estrutura dos cuidados de saúde primários (CSP) e a especialidade médica de medicina geral e familiar (MGF). Métodos: Estudo observacional, prospetivo, do tipo coorte. Foram aplicados questionários em formato Google® Docs a utentes com 18 ou mais anos, que preenchiam os critérios de inclusão, antes e após um mês da intervenção. A intervenção consistiu na visualização de um vídeo formativo preparado pelos autores acerca da organização e os recursos dos CSP e a especialidade de MGF. Resultados: O questionário pré-intervenção foi preenchido por 274 utentes, 165 visualizaram o vídeo educativo e 113 preencheram o questionário pós-intervenção. Apenas 88 utilizadores participaram em todas as fases do projeto e foram considerados elegíveis para a interpretação dos resultados. Após a intervenção verificou-se uma melhoria estatisticamente significativa na classificação geral obtida no questionário, com um aumento na percentagem de respostas corretas de 66,7% para 72,7% (p=0,004; IC 95%). Verificou-se também um aumento na taxa de respostas corretas em quase todas as questões aplicadas. Discussão e Conclusão: A literacia em saúde ajuda os cidadãos a tomar melhores decisões em relação à sua saúde, com um consequente impacto económico e social. Este projeto culminou na criação de uma ferramenta multimédia capaz de melhorar os conhecimentos dos utentes portugueses acerca dos CSP, passível de ser replicada noutros locais do País.

Abstract Introduction: Promoting health literacy is essential for patients to make informed healthcare decisions, ensuring more efficient resource utilization and contributing to long-term sustainability. Objectives: Enhance health literacy among patients in six health units in Northern Portugal, focusing on the organization and structure of primary healthcare services (PHC) and the medical specialty of general practice/family medicine (GPFM). Methods: An observational, prospective cohort study was conducted. Questionnaires in Google® Docs format were administered to patients aged 18 and older who met the inclusion criteria, both before and one month after the intervention. The intervention involved watching an educational video created by the authors about PHC's organization, resources, and GPFM specialty. Results: The pre-intervention questionnaire received responses from 274 patients, with 165 of them viewing the educational video and 113 completing the post-intervention questionnaire. Eighty-eight participants engaged in all phases of the project and were considered eligible for result analysis. After the intervention, there was a statistically significant improvement in the overall questionnaire score, with the percentage of correct answers increasing from 66.7% to 72.7% (p=0.004; CI 95%). Correct answer rates also improved across most of the questions. Discussion and Conclusion: Health literacy empowers individuals to make informed health choices, resulting in economic and social benefits. This project led to the creation of a multimedia tool that can enhance the understanding of Portuguese patients regarding PHC, with potential for replication in other regions of the country.

ABSTRACT The study aims to analyze convergence and divergence between emotional intelligence and academic performance in the university context, considering that they are two similar categories, but each one with unique characteristics. The prism method has been used, based on the data of scientific documents. It was elaborated based on data collected from Scopus, PubMed and Web of Science, fundamentally considering original articles and literature reviews; for access to relevant documents, advanced search protocols were developed according to the characteristics of each database using Boolean algebra and other arguments. The analysis of 1011 scientific articles, the same ones that after applying inclusion and exclusion criteria were screened and considered for analytical reading of 78 documents. It is concluded that the relationship between the categories is convergent and divergent considering the autonomy of each one. Emotional intelligence, in its relationship with academic performance, is observed not only as a major category, but is also linked to: self-realization, self-concept, adaptability, self-management, motivation, self-esteem, emotion management, anxiety, depression, and resilience. The significant finding is based on the proposal of the concept of academic performance, which leads to the spiritual and cognitive development of the individual.

RESUMEN El estudio tiene como objetivo analizar convergencia y divergencia entre inteligencia emocional y rendimiento académico en el contexto universitario, considerando que se trata de dos categorías símiles, pero con singulares características. Se ha empleado el método prisma en base a la data de documentos científicos, fue elaborada en base a datos recopilados de Scopus, PubMed y Web of Science, considerando fundamentalmente artículos originales y revisiones de literatura; para el acceso a los documentos relevantes se elaboraron protocolos avanzados de búsqueda de acuerdo a las características de cada base de datos usando álgebra booleana y otros argumentos. El análisis de 1011 artículos científicos, los mismos que luego de aplicar criterios de inclusión y exclusión fueron cribados y considerados para la lectura analítica 78 documentos. Se concluye que la relación entre las categorías es convergente y divergente considerando la autonomía de cada una. La inteligencia emocional, en su relación con el rendimiento académico, es observada no solo como categoría mayor, sino que están vinculadas a: auto realización, autoconcepto, adaptabilidad, autogestión, motivación, autoestima, gestión de emociones, ansiedad y depresión, resiliencia. El hallazgo significativo se sustenta en la propuesta del concepto del rendimiento académico, el mismo que conduce al desarrollo espiritual y cognitivo del individuo.

Resumen: Entre el 16 de febrero de 1996 y el 5 de junio de 1998 y, posteriormente, durante el primer semestre de 2000, Mario Levrero escribió 126 artículos para la revista montevideana Posdata que después serían compilados -en un primer momento por él mismo bajo el auspicio de la editorial Cauce- con el título de Irrupciones. A diferencia de sus novelas y cuentos, la prosa ensayística del autor uruguayo no ha recibido la atención crítica que merece en virtud de su relevancia dentro de su propio corpus escritural y también en el ámbito de las letras hispanoamericanas. En Irrupciones, la categoría de ciudad tiene una importancia cardinal. Por tal motivo, recupero los planteamientos teóricos de Peter Fritzsche con la intención de reconstruir el proceso mediante el que Levrero edificó una “ciudad textual” cimentada en la capital uruguaya de finales del siglo XX, pero también en aquella que ya solo pervivía en su memoria. Esta doble fuente nutricia pautará la visión ambivalente sobre una urbe que experimentaba el cambio de siglo y de milenio.

Abstract: Between February 16, 1996 and June 5, 1998, and later on during the first half of 2000, Mario Levrero wrote 126 articles for the Montevideo magazine Posdata, which would later be compiled -at first by himself under the auspices of the Cauce publishing house- under the title Irrupciones. Unlike his novels and short stories, the Uruguayan author’s essayistic prose has not received the critical attention it deserves by virtue of its relevance within his own writing corpus and also in the field of Hispanic American literature. In Irrupciones, the category of the city is of cardinal importance. For this reason, I recover Peter Fritzsche’s theoretical approaches with the intention of reconstructing the process through which Levrero built a “textual city” based on the Uruguayan capital at the end of the twentieth century, but also on the city that only survived in his memory. This double source of nourishment will shape the ambivalent vision of a city that was experiencing the turn of the century and the millennium.

RESUMEN Introducción y objetivos. Una experiencia con las mujeres de la Asociación Cultural de Carabanchel Alto (ACCA) sobre los activos y recursos de salud de Carabanchel Alto. Métodos. Actividad dinamizada por distintas entidades del barrio, impartida en un aula del Centro de Educación Infantil y Primaria (CEIP) República Dominicana y basada en el conocimiento de los recursos y activos del barrio y la lectura como herramienta de reflexión. Resultados. Nos acercamos a la población mayor del barrio y conocimos su historia. Se creó un ambiente de confianza donde compartimos experiencias y reflexiones. Conclusiones. El contacto con distintos profesionales de la salud fuera del ámbito del trabajo permite establecer un vínculo de confianza para una futura atención en estas entidades.

ABSTRACT Introduction and objectives. An experience with ACCA women on Carabanchel Alto health assets and resources. Methods. This activity, organised by different organisations in the neighbourhood, took place in a CEIP República Dominicana classroom and based on knowledge of the neighbourhood's resources and assets and reading as a tool of reflection. Results. We approached the neighbourhood's older population and got to know their story. A climate of trust was fostered where we shared experiences and reflections. Conclusions. Contact with different health professionals outside the work setting enables a bond of trust to be established for future care in these entities.

Resumen: Este artículo examina tendencias antropocéntricas y ecocéntricas en dos novelas escritas por Mario Vargas Llosa, El hablador y El sueño del celta, para identificar el valor de esas obras en términos ecocríticos. Proporciono este análisis en el contexto de un diálogo académico reciente que observa una relación aparentemente contradictoria entre la presentación de abusos en contra de pueblos amazónicos y de su entorno natural, y la representación de protagonistas occidentalizados como sus salvadores en la narrativa escrita por Vargas Llosa. Este ensayo ofrece una solución a esta paradoja y a otras aparentes contradicciones en la ficción vargasllosiana y postula que a pesar de que el discurso literario antropocéntrico sobre el medio ambiente ha declinado a lo largo de la última parte del siglo XX, en parte, debido al auge del movimiento ambientalista, este tipo de discurso ha cambiado en la obra del premio Nobel, rechazando concepciones erróneas del mundo natural de principios del siglo XX pero aferrándose a creencias neoliberales tecnocéntricas.

Abstract:This article examines anthropocentric and ecocentric tendencies in two major works written by Mario Vargas Llosa, The Storyteller and The Dream of the Celt, to identify the value of those novels in ecocritical terms. I provide this analysis in the context of recent academic dialogue which notes an apparent contradictory relationship between the presentation of abuses of Amazonian people and their environment, and the portrayal of Westernized protagonists as their saviors in fiction written by Vargas Llosa. This essay provides a solution to this paradox and other apparent contradictions in his narratives and posits that even though the anthropocentric literary discourse concerning the environment has declined throughout the latter part of the twentieth century, in part, due to the rise of the environmental movement, this type of discourse has changed in Vargas Llosa’s literature, rejecting early twentieth century misconceptions of the natural world but holding onto technocentric neoliberal beliefs.

Resumo: Este artigo examina as tendências antropocêntricas e ecocêntricas em duas grandes obras escritas por Mario Vargas Llosa, O Faldor e O Sonho do Celta, para identificar o valor dessas obras em termos ecocríticos. Apresento esta análise no contexto de um diálogo acadêmico recente que observa uma relação aparentemente contraditória entre a apresentação de abusos do povo amazônico e seu meio ambiente e a representação de protagonistas ocidentalizados como seus salvadores na narrativa escrita por Vargas Llosa. Este ensaio fornece uma solução para esse paradoxo e outras aparentes contradições na ficção de Vargas Llosa e postula que, embora o discurso literário antropocêntrico sobre o meio ambiente tenha declinado ao longo da última parte do século XX, em parte devido ao surgimento do movimento ambientalista, esse tipo de discurso mudou nas obras de Vargas Llosa, rejeitando os equívocos do início do século XX sobre o mundo natural, mas se apegando a crenças neoliberais tecnocêntricas.

RESUMEN Objetivo: El objetivo del presente estudio fue evaluar la eficacia y seguridad de la combinación de dosis fija montelukast/desloratadina 10mg/5mg cápsula versus la combinación de montelukast/loratadina 10 mg/10 mg tableta en adultos con diagnóstico de rinitis alérgica persistente. Material y métodos: El presente fue un estudio clínico aleatorizado, controlado, doble ciego, prospectivo, longitudinal, multicéntrico, con brazos paralelos. Sujetos con diag nóstico de rinitis alérgica persistente que cumplieran criterios de elegibilidad y firmaran consentimiento informado fueron enrolados para recibir uno de los dos tratamientos cada 24 horas vía oral durante 6 semanas. La eficacia se estableció mediante la evaluación clínica a través de escalas clínicas validadas en idioma español, siendo la variable primaria de eficacia la diferencia de puntuación del cuestionario SNOT-20 al final del tratamiento, mientras que la frecuencia y características de los eventos adversos fue considerada la variable de seguridad. Resultados: Se aleatorizaron 86 pacientes, 74 de ellos fueron analizados por protocolo. Los cuestionarios sobre síntomas de la enfermedad e indicadores de calidad de vida con ambos tratamientos mostraron que más del 90% de los pacientes no presentaron síntomas o solo fueron leves al final del estudio, por lo que ambos tratamientos me joraron significativamente (p < 0.05) la sintomatología de la enfermedad. Los eventos adversos presentados fueron leves a moderados. Conclusiones: El presente estudio demostró que la eficacia de montelukast/deslora tadina 10 mg/5 mg no es inferior al medicamento comparador. Por tanto, el tratamiento de prueba representa una alternativa eficaz y segura para el tratamiento de segunda línea de la rinitis alérgica persistente en pacientes que las monoterapias o primeras líneas de tratamiento no ofrecen mejoría clínicamente relevante.

ABSTRACT Objective: The objective of the present study was to evaluate the efficacy and safety of the fixed dose combination of montelukast/desloratadine 10 mg/5 mg capsule versus the combination of montelukast/loratadine 10 mg/10 mg tablet in adults diagnosed with persistent allergic rhinitis. Materials and methods: The present study was a multicenter, controlled, prospective, longitudinal, randomized, double-blind clinical trial with parallel arms. Patients diagnosed with persistent allergic rhinitis who met eligibility criteria and signed informed consent were enrolled in the study to receive one of the two treatments every 24 hours orally for 6 weeks. Efficacy was established by clinical evaluation through clinical scales vali dated in Spanish, being the primary efficacy variable the difference in the score of the SNOT-20 (Sino-Nasal Outcome Test) questionnaire at the end of treatment; and the frequency and characteristics of adverse events were considered the safety variable. Results: 86 patients were randomized, 74 of which were analyzed per protocol. Ques tionnaires about the symptoms of the disease and quality of life indicators with both treatments showed that more than 90% of patients had mild symptoms or no symptoms at all at the end of the study. So, both treatments significantly improved (p < 0.05) the symptoms of the disease. Adverse events were mild to moderate. Conclusions: The present study showed that the efficacy of montelukast/desloratadine 10 mg/5 mg is not inferior to the comparator. Therefore, the study treatment represents an effective and safe alternative for the second-line treatment of persistent allergic rhinitis in patients in whom monotherapies or first-line treatments don’t offer clinically relevant improvement.

RESUMEN Objetivo: El objetivo del presente estudio fue evaluar la eficacia y seguridad de la combinación de dosis fija montelukast/desloratadina 10mg/5mg cápsula versus la combinación de montelukast/loratadina 10 mg/10 mg tableta en adultos con diagnóstico de rinitis alérgica persistente. Material y métodos: El presente fue un estudio clínico aleatorizado, controlado, doble ciego, prospectivo, longitudinal, multicéntrico, con brazos paralelos. Sujetos con diag nóstico de rinitis alérgica persistente que cumplieran criterios de elegibilidad y firmaran consentimiento informado fueron enrolados para recibir uno de los dos tratamientos cada 24 horas vía oral durante 6 semanas. La eficacia se estableció mediante la evaluación clínica a través de escalas clínicas validadas en idioma español, siendo la variable primaria de eficacia la diferencia de puntuación del cuestionario SNOT-20 al final del tratamiento, mientras que la frecuencia y características de los eventos adversos fue considerada la variable de seguridad. Resultados: Se aleatorizaron 86 pacientes, 74 de ellos fueron analizados por protocolo. Los cuestionarios sobre síntomas de la enfermedad e indicadores de calidad de vida con ambos tratamientos mostraron que más del 90% de los pacientes no presentaron síntomas o solo fueron leves al final del estudio, por lo que ambos tratamientos me joraron significativamente (p < 0.05) la sintomatología de la enfermedad. Los eventos adversos presentados fueron leves a moderados. Conclusiones: El presente estudio demostró que la eficacia de montelukast/deslora tadina 10mg/5mg no es inferior al medicamento comparador. Por tanto, el tratamiento de prueba representa una alternativa eficaz y segura para el tratamiento de segunda línea de la rinitis alérgica persistente en pacientes que las monoterapias o primeras líneas de tratamiento no ofrecen mejoría clínicamente relevante.

ABSTRACT Objective: The objective of the present study was to evaluate the efficacy and safety of the fixed dose combination of montelukast/desloratadine 10 mg/5 mg capsule versus the combination of montelukast/loratadine 10 mg/10 mg tablet in adults diagnosed with persistent allergic rhinitis. Materials and methods: The present study was a multicenter, controlled, prospective, longitudinal, randomized, double-blind clinical trial with parallel arms. Patients diagnosed with persistent allergic rhinitis who met eligibility criteria and signed informed consent were enrolled in the study to receive one of the two treatments every 24 hours orally for 6 weeks. Efficacy was established by clinical evaluation through clinical scales vali dated in Spanish, being the primary efficacy variable the difference in the score of the SNOT-20 (Sino-Nasal Outcome Test) questionnaire at the end of treatment; and the frequency and characteristics of adverse events were considered the safety variable. Results: 86 patients were randomized, 74 of which were analyzed per protocol. Ques tionnaires about the symptoms of the disease and quality of life indicators with both treatments showed that more than 90% of patients had mild symptoms or no symptoms at all at the end of the study. So, both treatments significantly improved (p < 0.05) the symptoms of the disease. Adverse events were mild to moderate. Conclusions: The present study showed that the efficacy of montelukast/desloratadine 10 mg/5 mg is not inferior to the comparator. Therefore, the study treatment represents an effective and safe alternative for the second-line treatment of persistent allergic rhinitis in patients in whom monotherapies or first-line treatments don’t offer clinically relevant improvement.

Abstract: To understand the origin of the benefits of Dolphin-Assisted Therapy (DAT), it is important to know the factors that intervene during it, as well as the patient’s reactions to these factors. The purpose of this work is to measure the frequencies emitted by the dolphin through the use of specialized transducers for aquatic environments, which allow us to measure the sound waves coming from the dolphin. In this way, it is sought to know the real time in which they were emitted and the spectral density of these frequencies.

Resumen La hidrocefalia es una entidad nosológica común que en muchos casos tiene como tratamiento de elección la derivación ventricular hacia cualquier cavidad. Dentro de las complicaciones más frecuentes, tenemos las abdominales con formación de colecciones, así como irrupción a sistema intestinal con posterior migración del mismo con presentación de sintomatología a este nivel. Presentamos el caso de un paciente con nula sintomatología abdominal y migración del catéter distal hacia el recto.

Abstract Hydrocephalus is a common nosological entity, with ventricular shunting towards any cavity as the treatment of choice in many cases. Among the most frequent complications, we have the abdominal ones with the formation of collections, as well as irruption to the intestinal system with subsequent migration of the same with presentation of symptoms at this level. We present the case of a patient with no abdominal symptoms and migration of the distal catheter towards the rectum.

Resumen. Existen tres razas de Fusarium oxysporum f. sp. cubense (Foc) que afectan a bananos y plátanos, los cultivares de banano grupo Cavendish son resistentes a Foc raza 1 (FocR1) y Foc raza 2 (FocR2). Sin embargo, no existen métodos de control efectivos para la Raza 4 Tropical (R4T). Lo anterior, hace necesario generar estrategias de control biológico utilizando a FocR2 como modelo fúngico que está presente en México, y que coadyuven ante la posible introducción de FocR4T al país. Se evaluó la inhibición in vitro de las cepas bacterianas Bacillus subtilis (BASU), B. velezensis (BAVE), B. sonorensis (BASO) contra tres aislamientos de FocR2 (MIC17188, MIC17191 y MIC17192) obtenidos de muestras vegetales colectadas en tres sitios de producción de plátano de Puebla, Michoacán y Oaxaca. A los 14 días, la cepa BASU tuvo en promedio, mayor inhibición (55.1%) con respecto a BAVE y BASO (45.8 y 21.7%, respectivamente) contra las tres cepas fúngicas antes mencionadas. También se evaluó la inhibición in vitro de las bacterias Paenibacillus sp. (BSP 1.1) y Serratia sp. (AC35) en tres tiempos de pre-inoculación bacteriana. La cepa BSP1.1 presentó mayor inhibición (80.1%) cuando se pre-inoculó de manera individual, siete días antes del hongo y durante siete días de confrontación.

Abstract There are three races of Fusarium oxysporum f. sp. cubense (Foc) that affect bananas and plantains, though the Cavendish group banana cultivars are resistant to Foc race 1 (FocR1) and Foc race 2 (FocR2). However, there are no effective control methods for the Tropical Race 4 (R4T). The foregoing makes it necessary to generate biological control strategies for FocR2 fungal model that is present in Mexico, forecasting the potential introduction of FocR4T into our country. In vitro inhibition was evaluated of bacterial strains Bacillus subtilis (BASU), B. velezensis (BAVE), and B. sonorensis (BASO) against three isolates of FocR2 (MIC17188, MIC17191 and MIC17192), obtained from plant samples collected in three banana production sites in the states of Puebla, Michoacán and Oaxaca. At 14 days, the strain BASU had in average high inhibition (55.1%) in comparison to BAVE and BASO strains (45.8 and 21.7%, respectively) against the three fungal strains mentioned before. In addition, the in vitro inhibition of Paenibacillus sp. (BSP 1.1) and Serratia sp. (AC35) was also evaluated by considering three pre-inoculation timings; the strain BSP1.1 showed high inhibition (80.1%) when pre-inoculated individually seven days before the fungus and at seven days of confrontation.

Abstract Thousands of people have died of COVID-19 in El Salvador. However, little is known about the mental health of those who are mourning the loss of a loved one to COVID-19. Therefore, the objective of this study was to examine the dysfunctional grief associated with COVID-19 death among Salvadoran adults. A sample of 435 Salvadorans ( M = 29 years; SD = 8.75) who lost a family member or loved one to COVID-19 completed a digital survey using the Google Forms platform, during April 2 and 28, 2022. The results revealed that 35.1% reported clinically elevated symptoms of dysfunctional grief and among those mourners, and 25.1% also exhibited clinical levels of coronavirus anxiety. A binary logistic regression revealed that predictor variables such as COVID-19 anxiety ( p = .003), depression ( p = .021), and COVID-19 obsession ( p = .032) were significant ( χ 2 = 84.31; Nagelkerke R 2 = .242) and predict a 24.2% chance of dysfunctional bereavement.

SUMMARY OBJECTIVE: The objective of this study was to evaluate fresh medical graduates’ perceptions regarding the general aspects of ethics teaching in Brazilian medical schools. METHODS: A structured questionnaire was applied to 4,601 participants among the 16,323 physicians who registered in one of the 27 Regional Medical Councils of Brazil in 2015. Answers to four questions regarding general aspects of ethics education in medical school were analyzed. Sampling procedures involved two stratification variables: legal nature (public vs. private) of medical schools and monthly household income higher than 10 minimum wages. RESULTS: A large percentage of the participants had witnessed unethical behaviors during contact with patients (62.0%), toward coworkers (51.5%), and in relationships with patients’ families (34.4%) over the course of their medical training. Even though most of the responders (72.0%) totally agreed that patient-physician relationship and humanities education were part of their medical school curriculum, important topics such as conflicts of interest and end-of-life education were not satisfactorily addressed in the participants’ medical training. Statistically significant differences were found between the answers of public and private school graduates. CONCLUSION: Despite great efforts to improve medical ethics education, our findings suggest the persistence of deficits and inadequacies in the ethics training currently given in medical schools in Brazil. Further modifications in ethics training must be made to address the deficiencies shown in this study. This process should be accompanied by continuous evaluation.

RESUMEN La revisión fue elaborada para conocer el efecto que tiene la fibra usada como prebiótico en pollo de engorda y gallinas de postura. Se realizó una revisión sobre las generalidades de la fibra y los beneficios que aporta sobre la inmunidad, desarrollo digestivo, digestibilidad de los nutrientes y rendimiento productivo. Se encontró que la fibra como aditivo se puede incluir a niveles menores del 3% para mejorar la respuesta inmune de las aves, aumenta el desarrollo de vellosidades intestinales y la cantidad de citoquinas reguladoras de la quimiotaxis limitando la permeabilidad de sustancias tóxicas al torrente sanguíneo, además, regula la respuesta inflamatoria del intestino. La fibra estimula el microbiota intestinal evitando la adherencia y desarrollo de bacterias patógenas, así como la producción de péptidos antimicrobianos. Además, la fibra puede regular la motilidad intestinal, la microbiota general, la acumulación de lípidos en hígado, disminuir el colesterol, contribuir al funcionamiento hepático, disminuir emisiones contaminantes al ambiente y mejorar la absorción de los nutrientes. Por lo tanto, la fibra puede mejorar la ganancia de peso, la conversión del alimento y el desarrollo muscular de la molleja. Se concluye que la fibra como prebiótico puede ser incluida en la dieta de las aves para sustituir a los aditivos sintéticos para incrementar el rendimiento productivo de las aves.

ABSTRACT The review was elaborated to know the effect of fiber used as a prebiotic in broilers and laying hens. A review was made on generalities of fiber and its benefits on immunity, digestive development, nutrient digestibility and productive performance. It was found that fiber as an additive can be included at levels lower than 3% to improve the immune response of birds, increase the development of intestinal villi and the amount of cytokines that regulate chemotaxis, limiting the permeability of toxic substances to the bloodstream, and regulate the inflammatory response of the intestine. Fiber stimulates the intestinal microbiota by preventing the adherence and development of pathogenic bacteria, as well as the production of antimicrobial peptides. In addition, fiber can regulate intestinal motility, general microbiota, lipid accumulation in the liver, lower cholesterol, contribute to liver function, reduce pollutant emissions to the environment and improve nutrient absorption. Therefore, fiber can improve weight gain, feed conversion and gizzard muscle development. It is concluded that fiber, as a prebiotic can be included in the poultry diet to replace synthetic additives to increase the productive performance of poultry.

Abstract Background: The prevalence of urolithiasis is 7-10% and has increased over the past years. Simple nephrectomy is, therefore, indicated when renal exclusion is associated with recurrent urinary tract infections and/or chronic pain. Objective: The aim of the study was to describe the surgical experience of laparoscopic nephrectomy (LPN) due to urolithiasis in Mexican South-east and which factors can predispose conversion to open surgery. Methods: This was a retrospective study including patients with renal exclusion secondary to urolithiasis, who underwent laparoscopic simple nephrectomy between 2016 and 2019. Results: Forty simple LPN for renal exclusion due to urolithiasis was performed between 2016 and 2019. Mean age was 47 ± 10.8 and 82.5% were female. The mean BMI was 30.2 ± 5 kg/m2, mean operative time was 165.2 ± 64. Conversion rate was 12.5% (n = 5). Conversion was significantly associated with abnormal hilum vascular anatomy (p = 0.001), hilum adherences (p = 0.001), and hydronephrosis (p = 0.001). Conclusion: LPN is a safe surgical technique for renal exclusion due to urolithiasis. Hydronephrosis, abnormal vascular anatomy, and the adherences that involved de hilum are the factors that could predictive conversion to open surgery.

Resumen Introducción: La prevalencia the urolitiasis es del 7-10% sin embargo a presentado un incremento del numero de casos en los ultimos años. La nefrectomia simple laparoscopica esta indicada en pacientes con exclusión renal asociado a cuadros repetitivos de infecciones en el tracto urinario y o dolor cronico a nivel fosa renal. Objetivo: Describir la experiencia de nefrectomia simple laparoscopica en pacientes con exclusion renal secundario litiasis en un hospital del sur de México, y que factores pueden predisponer la conversión a cirugia abierta. Materials y metodos: Estudio restrospectivo que incluyo pacientes con exclusion renal secundario a urolitiasis durante el periodo comprendido entre 2016 y 2019. Resultados: Se realizaron 40 nefrectomias simples laparoscopica durante el periodo comprendido 2016 y 2019 en paciente con exclusion renal asociada a litiasis. La media edad 47 ± 10.8 años, el 82.5% de los pacientes fueron del sexo femenino. La media de Indice de masa corporal fue de 30.2 ± 5 kg/m2, La tasa de conversion fue del 12.5% (n = 5), los factores que se asociaron a conversion a cirugia abierta fueron anormalidades dependientes del hilio vascular renal (p = 0.001)., adherencias dependientes del hilio renal (p = 0.001). e hidronefrosis (p = 0.001). Conclusión: La nefrectomia simple laparocopica es un procedimiento seguro en pacienres con exclusion renal secundaria a urolitiasis. Hidronefrosis, anormalidades dependientes del hilio vascular renal y adherencias que involucren el hilio renal son factores que pueden predisponer conversion a cirugia abierta.