Abstract Background: The identification of the reasons for marijuana use has been supported by instruments such as the MMM. Despite its importance, there are still no valid brief versions of this instrument in Latin American countries. This paper seeks to fill this gap by providing evidence of validity and reliability, as well as the structural invariance of the MMM. Method: The sample consisted of 1164 male and female marijuana users, aged between 18 and 49 years, from Lima and Callao. Results: The factor analysis found a penta-factorial structure. The brief version (MMM-P15) and the wide MMM showed favorable properties from structure and reliability (ꙍ > .88, H > .84) with appropriate indicators of the short instrument adjustment (RMSEA = .058 (CI 90% .050, .067), SRMR = .044, TLI = .99, CFI = .99). Likewise, both versions maintain the invariance of the instrument according to sex and evidence of internal validity was found (AVE > .50). Aside from bringing evidence of validity with other constructs like CAST and SWLS scale. Conclusions: The MMM-P15 shows psychometric properties that support its use in both male and female marijuana users, and it is a short, versatile, and useful instrument for research purposes even in clinical settings.

Resumen Antecedentes: La identificación de los motivos por los cuales se consume marihuana se ha visto apoyada por instrumentos como el MMM. A pesar de su importancia, aún no se cuenta con versiones breves válidas de este en países latinoamericanos. Este trabajo busca cubrir esta carencia aportando evidencia de validez y confiabilidad, así como la invarianza estructural del MMM. Método: La muestra comprende 1164 consumidores de marihuana, varones y mujeres, con edades entre 18 y 49 años, de Lima y Callao. Resultados: El análisis factorial halló una estructura pentafactorial. La versión breve (MMM-P15) y extensa (MMM) muestran favorables propiedades de estructura y consistencia interna (ꙍ > .88, H > .84) con adecuados índices de ajuste del instrumento corto (RMSEA = .058 (IC 90% .050, .067), SRMR = .044, GFI = .99, TLI = .99, CFI = .99). Asimismo, ambas versiones mantienen la invarianza según el sexo y se encontró evidencia de validez interna (AVE > .50) y con otros constructos (CAST y SWLS). Conclusiones: El MMM-P15 evidencia propiedades psicométricas que respaldan su uso tanto en hombres y mujeres consumidores de marihuana, además es un instrumento corto, versátil y útil para fines de investigación incluso en contextos clínicos.

Abstract The objective of this work was to study the mean lethal concentration (LC50) and the biosorption capacity of heavy metals in isolated yeasts from Lake Junín and the Yanamate tailings facility. In both bodies of water were evaluated: pH, electrical conductivity, temperature, total dissolved solids (STD) and heavy metals by ICM-MS, according to the Environmental Quality Standards (ECA) of the Ministry of the Environment-MINAM of Peru. The physicochemical parameters evaluated in Lake Junín were higher than the maximum permissible limits (MPL) for the following metals: arsenic, cadmium, copper, chromium and lead. In the Yanamate tailings facility, the evaluated parameters were out of the LMP for type IV water ECAs: pH below 3 (acids), high electrical conductivities and high concentrations of heavy metals. From the sampled waters, yeasts were isolated in YPG medium at 10 ° C and 20 ° C. The LC50 of the Cr+6, Cu+2, Cd+2 and Hg+2 ions in Y. lipolytica AMJ3 were 0.24 mM, 1.34 mM, 0.54 mM y 7.5 0.04 mM in the order described; while the strain Y. lipolytica AMJ6 showed a LC50 of 1.06 mM, 1.42 mM, 0.49 mM y 0.05 mM in the same order. The biosorption capacity of the Cu+2 ion was 90% in the case of the AMJ3 strain, and 92% in the AMJ6 strain, at a concentration of 1.26 mM; likewise, the biosorption of the Cr+6 ion was close to 90% in both strains (AMJ3 and AMJ6) at concentrations of 0.24 mM and 0.96 mM, respectively. Nucleotide sequence analysis of AMJ3 and AMJ6 strains confirmed 100% identity in the Yarrowia lipolytica clade. These LC50 and biosorption capacity results indicate that the studied yeasts have potential in the bioremediation of water bodies and soils contaminated with heavy metals.

Resumen El objetivo del presente trabajo fue estudiar la concentración letal media (CL50) y la capacidad de biosorción de metales pesados en levaduras aisladas del Lago Junín y la relavera Yanamate. Se evaluaron en ambos cuerpos de agua: pH, conductividad eléctrica, temperatura, sólidos totales disueltos (STD) y metales pesados por ICM-MS, según los Estándares de Calidad Ambiental (ECA) del Ministerio del Ambiente-MINAM del Perú. Los parámetros fisicoquímicos evaluados en el Lago Junín fueron superiores a los límites máximos permisibles (LMP) para los siguientes metales: arsénico, cadmio, cobre, cromo y plomo. En la relavera Yanamate, los parámetros evaluados estuvieron fuera del LMP para los ECA de aguas tipo IV: pH inferiores a 3 (ácidos), altas conductividades eléctricas y elevadas concentraciones de metales pesados. A partir de las aguas muestreadas, se aislaron levaduras en medio YPG a 10 °C y 20 °C. La CL50 de los iones Cr+6, Cu+2, Cd+2 y Hg+2 en Y. lipolytica AMJ3 fue 0.24 mM, 1.34 mM, 0.54 mM y 7.5 0.04 mM en el orden descrito; en tanto la cepa Y. lipolytica AMJ6 mostró una CL50 de 1.06 mM, 1.42 mM, 0.49 mM y 0.05 mM en el mismo orden. La capacidad de biosorción del ion Cu+2 fue del 90% en el caso de la cepa AMJ3 y 92% en la cepa AMJ6, a una concentración de 1.26 mM; asimismo, la biosorción del ion Cr+6 fue cercana al 90% en ambas cepas (AMJ3 y AMJ6) a concentraciones de 0.24 mM y 0.96 mM, respectivamente. Los análisis de las secuencias nucleotídicas de las cepas AMJ3 y AMJ6 confirmaron una identidad del 100% en el clado de Yarrowia lipolytica. Los resultados obtenidos de CL50 y la capacidad de biosorción indican que las levaduras bajo estudio tienen potencial en la biorremediación de cuerpos de agua y suelos contaminados con metales pesados.

Abstract An insect gall inventory was carried out in two reserves of the Peruvian Amazon, Allpahuayo-Mishana National Reserve and Quistococha Regional Reserve, both situated in Iquitos, northeastern Peru. Four vegetation types were surveyed between December, 2021 and December, 2022: terra firme forest, white-sand wet forest, and white-sand dry forest in Allpahuayo-Mishana National Reserve, and palm swamp forest in Quistococha Regional Reserve. Overall, we found 262 gall morphotypes, distributed across 75 host species representing 66 plant genera and 30 families. Fabaceae was the plant family with the greatest number of gall morphotypes (n = 48), followed by Calophyllaceae (n = 21) and Euphorbiaceae (n = 20). The plant genera that supported the highest diversity of galls were Caraipa (n = 17), Eschweilera (n = 16), Tapirira (n = 16), Micrandra (n = 14), and Iryanthera (n = 10). The plant species Tapirira guianensis (n = 16), Caraipa utilis (n = 14), Micrandra elata (n = 14), Eschweilera coriacea (n = 11), and Sloanea parvifructa (n = 10) exhibited the highest richness of galls. Among the host plants, C. utilis stands alone as the only species noted as both endemic to the Amazonian region and bearing a Vulnerable (VU) conservation status. The leaves were the most attacked organs (90% of all galls). Most morphotypes are glabrous (89%), green (67%), globoid (53%), and one-chambered (91%). We found galling insects belonging to the orders Diptera, Thysanoptera, Lepidoptera, and Hemiptera. The galling insects of Cecidomyiidae (Diptera) were the most common, inducing 22% of the gall morphotypes. In addition to the gallers, we also observed the presence of successors, cecidophages, and parasitoids. Among the sampled vegetation types, the terra firme forest presented the highest richness of gall morphotypes and host plant species. This is the first systematic inventory of insect galls in this part of the Peruvian Amazon.

Resumo Um inventário de galhas de insetos foi realizado em duas reservas da Amazônia peruana, Reserva Nacional Allpahuayo-Mishana e Reserva Regional Quistococha, ambas situadas em Iquitos, nordeste do Peru. Quatro tipos de vegetação foram pesquisados entre dezembro de 2021 e dezembro de 2022: floresta de terra firme, floresta úmida de areia branca e floresta seca de areia branca na Reserva Nacional Allpahuayo-Mishana, e floresta de pântano de palmeiras na Reserva Regional Quistococha. No total, encontramos 262 morfotipos de galhas, distribuídos em 75 espécies hospedeiras representando 66 gêneros de plantas e 30 famílias. Fabaceae foi a família de plantas com o maior número de morfotipos de galhas (n = 48), seguida por Calophyllaceae (n = 21) e Euphorbiaceae (n = 20). Os gêneros de plantas que apresentaram a maior diversidade de galhas foram Caraipa (n = 17), Eschweilera (n = 16), Tapirira (n = 16), Micrandra (n = 14) e Iryanthera (n = 10). As espécies de plantas Tapirira guianensis (n = 16), Caraipa utilis (n = 14), Micrandra elata (n = 14), Eschweilera coriacea (n = 11) e Sloanea parvifructa (n = 10) apresentaram a maior riqueza de galhas. Dentre as plantas hospedeiras, C. utilis destaca-se como a única espécie listada como endêmica da região amazônica e com um status de conservação Vulnerável (VU). As folhas foram os órgãos mais atacados (90% de todas as galhas). A maioria dos morfotipos é glabra (89%), verde (67%), globoide (53%) e possui apenas uma câmara interna (91%). Encontramos insetos galhadores pertencentes às ordens Diptera, Thysanoptera, Lepidoptera e Hemiptera. Os insetos galhadores da família Cecidomyiidae (Diptera) foram os mais comuns, induzindo 22% dos morfotipos de galhas. Além dos galhadores, também observamos a presença de sucessores, cecidófagos e parasitoides. Entre os tipos de vegetação amostrados, a floresta de terra firme apresentou a maior riqueza de morfotipos de galhas e espécies de plantas hospedeiras. Este é o primeiro inventário sistemático de galhas de insetos nesta região da Amazônia peruana.

Abstract Introduction: one of the causes of Nutritional anemia is that the amount of iron absorbed is insufficient to meet the body's needs. Objective: to determine the effects of microencapsulated and heminic iron supplementation to increase hemoglobin levels and body weight in iron-depleted rats. Methods: a randomized experimental study was designed. Four study groups were formed. Control group (GC), experimental group (GE1) (MC microencapsulated iron supplementation), experimental group 2 (GE2) (heminic iron supplementation) and experimental group 3 (GE3) (MC + heminic iron supplementation). A dry powdered diet containing all normal nutrients except iron was fed to the four groups for 15 days (three times a day). Weight, length and hemoglobin (Hb) were evaluated at pre- and post-test under similar conditions. Results: in Hb, no significant differences were observed in the CG (p = 0.225), despite a -9.6 % decrease in the post-test. GE1 significantly increased hemoglobin (14.3 %, Hb 2.1 g/dl) and body weight (21.6 %, 25.8 g) (p < 0.05) in the post-test. Similarly, GE2 significantly increased hemoglobin (14.5 %, Hb 2.1 g/dl) and body weight (44.5 %, 52.3 g) (p < 0.05). However, in GE3, despite significantly increasing weight (30.2 %, 35.2 g), the increase in hemoglobin levels was similar to what occurred in GE1 and GE2 groups (increasing by 14.5 % and Hb 2.2 g/dl). There were no significant differences in rat length between pre- and post-test in the four groups. Conclusion: these RESULTS suggest that heme iron together with quinoa and cañihua flour could be exploited as a new safe and efficient iron supplement compared to microencapsulated iron, given its higher iron bioavailability and its ability to increase body weight.

Resumen Introducción: una de las causas de la anemia nutricional es que la cantidad de hierro absorbida es insuficiente para satisfacer las necesidades del organismo. Objetivo: determinar los efectos de la suplementación de hierro microencapsulado y hemínico para aumentar los niveles de hemoglobina y el peso corporal en ratas alimentadas sin hierro. Métodos: se diseñó un estudio experimental aleatorizado. Se conformaron cuatro grupos de estudio. Grupo control (GC), grupo experimental (GE1) (suplementación de hierro microencapsulado MC), grupo experimental 2 (GE2) (suplementación de hierro hemínico) y grupo experimental 3 (GE3) (suplementación de hierro MC + hierro hemínico). Se administró al GC una dieta seca en polvo que contenía todos los nutrientes normales excepto el hierro. Los tres grupos experimentales fueron alimentados en base a una dieta de harina de quinua y cañihua. A la dieta del GE1 se agregó hierro MC; al GE2, hierro hemínico; y al GE3, hierro MC + hierro hemínico. La suplementación se realizó durante 15 días (tres veces al día). Se evaluaron el peso, la longitud y la hemoglobina (Hb) en el pretest y postest en similares condiciones. Resultados: en la Hb no se observaron diferencias significativas en el GC (p = 0,225), a pesar de disminuir en un -9,6 % en el postest. El GE1 aumentó significativamente la hemoglobina (14,3 %, Hb 2,1 g/dl) y el peso corporal (21,6 %, 25,8 g) (p < 0,05) en el postest. De la misma forma, el GE2 incrementó significativamente la hemoglobina (14,5 %, Hb 2,1 g/dl) y el peso corporal (44,5 %, 52,3 g) (p < 0,05). Sin embargo, el GE3, a pesar de mezclar el hierro MC y hemínico, no logró superar la actuación individual en cada uno de los GE1 y GE2. No hubo diferencias significativas en la longitud de las ratas entre el pretest y el postest en los cuatro grupos. Conclusión: estos resultados sugieren que el hierro hemo junto a la harina de quinua y cañihua podrían explotarse como un nuevo suplemento de hierro seguro y eficiente en comparación con el hierro microencapsulado, dada su mayor biodisponibilidad de hierro y su capacidad de incrementar el peso corporal.

RESUMEN Se presenta revisión narrativa sobre nefritis intersticial crónica de comunidades agrícolas (CINAC, siglas del inglés Chronic Interstitial Nephritis in Agricultural Communities). Se discute la etiología, manifestaciones clínicas, manejo diagnóstico y terapéutico de esta afección.

ABSTRACT A narrative review on Chronic Interstitial Nephritis in Agricultural Communities (CINAC) is presented. The etiology, clinical manifestations, diagnostic and therapeutic management of this condition are discussed.

Summary Objective: The effects of an online prevention program on technological addictions and cognitive-affective dispositions in university students during the COVID-19 pandemic were evaluated. Methods: Forty-two students participated in the sample, of which 21 formed the experimental group (EG) and the other 21 students the control group (CG). Academic efficacy and academic engagement scales were used, as well as cell phone, internet and video game addiction tests. Results: The application of the program significantly reduced the internet addiction, cell phone and video games and at the same time significantly increased the positive assessment of academic engagement and academic efficacy; comparisons between the study groups (GE versus GC) according to the effect sizes (.30 < d >. 50) evidenced important practical differences in the internet addiction, cell phone and video games, for the three variables the GE showed lower averages than the GC; on the other hand the comparisons between GE and GC resulted with effect size differences between medium (d >.50) and large (d >.80) in academic efficacy and academic engagement respectively, in these two variables the GE showed higher averages. Conclusion: the prevention program has reduced technological addictions, as well as increased cognitive-affective dispositions in students.

Resumen Objetivo: Se evaluó los efectos de un programa de prevención en línea sobre las adicciones tecnológicas y disposiciones cognitiva-afectivas en universitarios durante la pandemia COVID-19. Método: Participaron en la muestra 42 estudiantes, de los cuales 21 conformaron el grupo experimental (GE) y los otros 21 estudiantes el control (GC). Se utilizaron las escalas de eficacia académica y engagement académico, así como los test de adicción al teléfono móvil, al internet y a los videojuegos. Resultados: La aplicación del programa redujo significativamente la adicción al internet, teléfono móvil y videojuegos y a la vez aumentó significativamente la valoración positiva del compromiso académico y la eficacia académica; las comparaciones entre los grupos de estudio (GE versus GC) de acuerdo con los tamaños de efecto (.30 < d >.50) evidenciaron diferencias prácticas importantes en cuanto al uso adictivo de internet, del teléfono móvil y los videojuegos, para las tres variables el GE mostró menores promedios que el GC; de otra parte las comparaciones entre GE y GC resultaron con diferencias de magnitudes de efecto entre mediano (d >.50) y grande (d >.80) en eficacia académica y compromiso académico respectivamente, en estas dos variables el GE mostró mayores promedios. Conclusión: el programa de prevención ha reducido las adicciones tecnológicas, así como incrementó las disposiciones cognitiva-afectivas en el estudiantado.

Resumen Se examina un modelo predictor sobre la intención de titularse con tesis, a partir de factores académicos y cognitivo-afectivos, en una muestra de 198 estudiantes de primero a quinto año de psicología. El modelo estructural puesto a prueba mediante Path Analysis presentó un ajuste adecuado (CFI >.95 y RMSEA <.08), observándose que el engagement y la actitud hacia la estadística regulan de modo indirecto la intencionalidad de realizar una tesis, en tanto que la autoeficacia y las competencias metodológicas tienen efectos directos sobre la intencionalidad. Cuando se tiene adecuadas competencias metodológicas el pronóstico de realizar una tesis es 82.6%, en tanto que una actitud favorable hacia la estadística pronostica en 80.6% el interés de titularse con tesis.

Abstract A predictive model of the intention to graduate with a thesis, based on academic and cognitive-affective factors, is examined in a sample of 198 students from the first to the fifth year of psychology. The structural model tested by Path Analysis presented an adequate adjustment (CFI >.95 and RMSEA <.08), observing that engagement and attitude towards statistics indirectly regulate the intentionality of a thesis, while self-efficacy and methodological competencies have direct effects on intentionality. When there are adequate methodological competencies, the prognosis for doing a thesis is 82.6%, while a favorable attitude towards statistics forecasts 80.6% of the interest of graduating with a thesis.

Résumé Un modèle prédictif de l’intention d’obtenir un diplôme avec une thèse, fondé sur des facteurs académiques et cognitivo-affectifs, est examiné dans un échantillon des 198 étudiants de la première à la cinquième année de psychologie. Le modèle structural est testé par Path Analysis et présenté un ajustement adéquat (CFI >.95 and RMSEA <.08), observer que l’engagement et attitude vers les statistiques réguler indirectement l’intentionnalité d’une thèse, et l’auto-efficacité et les compétences méthodologiques ont des effets directs sur l’intentionnalité. Il y a des compétences méthodologiques adéquates, le pronostic pour faire une thèse est 82.6%, et une attitude favorable à l’égard des statistiques prédit 80.6% de l’intérêt de l’intention d’être diplômé avec une thèse.

Resumo Um modelo preditivo é examinado respeito a intenção de obter a licenciatura com dissertação, a partir de fatores acadêmicos e cognitivo-afetivos, em uma amostra de 198 estudantes de graduação do primeiro ao quinto ano da psicologia. O modelo estrutural testado pelo Path Analysis apresentou um adequado ajuste (CFI> .95 e RMSEA <.08), observa-se que o engajamento e a atitude em direção à estatística regulam indiretamente a intencionalidade de realizar uma dissertação, enquanto a auto-eficácia e as competências metodológicas tiveram efeitos diretos sobre a intencionalidade. Quando se possui competências metodológicas adequadas, o prognóstico de fazer uma dissertaçao foi de 82,6%, enquanto uma atitude favorável em direçao à estatística prediz em 80,6% o interesse de obter a licenciatura com dissertação.

Abstract Leprosy or Hansen’s disease is one of the classic neglected diseases that still persists in Peru. The infection is caused by Mycobacterium leprae. The disease varies in a wide range of manifestations from tuberculoid (paucibacillary) to lepromatous (multibacillary) leprosy. We present the case of a 55-year-old man, farmer and wood extractor, from the Peruvian Amazon with old infiltrating cutaneous lesions on the face, neck, thorax, abdomen and extremities. The smear and biopsy examinations confirm the presence of acid-alcohol-resistant bacilli compatible with leprosy. It is concluded, with a long delay, it was a case of nodular lepromatous leprosy. He received therapy with rifampicin, dapsone and clofamizine for two years with slow progressive improvement; however, he presented an erythema nodosum leprosum (type 2 reaction) with response to corticosteroids and thalidomide.

Resumen La lepra o enfermedad de Hansen es una de las clásicas enfermedades olvidadas que aún persiste en Perú. La infección es ocasionada por Mycobacterium leprae. La enfermedad varía en un amplio rango de manifestaciones desde la lepra tuberculoide (paucibacilar) hasta la lepromatosa (multibacilar). Se presenta el caso de un varón de 55 años, agricultor y extractor de madera, procedente de la Amazonia peruana, con lesiones cutáneas antiguas infiltrantes en la cara, cuello, tórax, abdomen y extremidades. La baciloscopia y estudio histológico de una biopsia de piel confirmaron la presencia de bacilos ácido-alcohol resistentes. Se concluyó, en forma tardía, que fue un caso de lepra lepromatosa nodular. Recibió terapia con rifampicina, dapsona y clofamizina por dos años con una lenta mejoría; no obstante, cursó con un eritema nodoso leproso (reacción tipo 2) con buena respuesta a corticoesteroides y talidomida.

ABSTRACT Cholecystocolonic fistula (CCF) is a rare complication of cholelithiasis. They are often asymptomatic, difficult to diagnose preoperatively, it despite radiological support, and they are discovered incidentally perioperatively. We present the case of a woman with acute cholecystitis, who was operated by laparoscopy, and a CCF was evidenced, it was resolved by conversion to open surgery. FCC can be complicated and simulate acute abdominal symptoms. It should be taken into account in older adults with a history of cholelithiasis and scleroatrophic vesicles with adhesions. Very few cases have been described in the literature, and none in our country. We present a case of FCC that was admitted as acute cholecystitis, and the diagnosis and treatment of it were during her surgery.

RESUMEN La fístula colecistocolónica (FCC) es una complicación poco común de la colelitiasis. A menudo son asintomáticas, de difícil diagnóstico preoperatorio a pesar del apoyo radiológico, y se descubren de manera incidental perioperatoriamente. Presentamos el caso de una mujer con un cuadro de colecistitis aguda, la cual fue intervenida por laparoscopía, y se evidenció una FCC, la cual fue resuelta mediante conversión a cirugía abierta. La FCC puede complicarse y simular cuadros abdominales agudos. Se debe tener en cuenta en adultos mayores, con historia de colelitiasis, y vesículas escleroatróficas con adherencias. En la literatura se han descrito muy pocos casos, y ninguno en nuestro medio. Presentamos un caso de FCC que ingresó como una colecistitis aguda, y su diagnóstico y tratamiento fueron durante su cirugía.

ABSTRACT This research aimed to find out the frequency and ways of using medicinal plants by pregnant women treated at the Centro de Salud Viña Alta, located in La Molina district. Twenty-one (21) pregnant women voluntarily participated in the study, where they were administered an expert-validated survey regarding the use of medicinal plants. The results showed that 86 % of the pregnant women used medicinal plants and 67 % did not ask their doctor before using them. The most frequent way of using the medicinal plants was by oral intake as herbal teas. The most widely used medicinal plants were chamomile, parsley, eucalyptus, boldo, aloe, mint and rue, some of which produced a teratogenic effect, uterine stimulant action, abortifacient effect, among others. It is necessary to know the actual quantity and most frequent way of using medicinal plants by pregnant women to classify these products as for its safety level and promote the rational use of traditional medicine to contribute to public health.

RESUMEN El objetivo de este trabajo fue conocer la frecuencia y la manera en que las plantas medicinales son empleadas por las gestantes del Centro de Salud Viña Alta del distrito de La Molina. En el estudio participaron veintiuna gestantes, quienes respondieron una encuesta, validada por expertos, sobre el uso de plantas medicinales. Se demostró que el 86,00 % de las gestantes utilizaron plantas medicinales, y que 67,00 % no consultó con un médico sobre su empleo. La manera más frecuente de consumo de las plantas medicinales fue la vía oral, en forma de infusiones. Las plantas medicinales más utilizadas fueron manzanilla, perejil, eucalipto, boldo, aloe, menta y ruda; y algunas de ellas mostraron efecto teratogénico, estimulante uterino, abortivo, entre otros. Es necesario conocer la cantidad real y la manera más frecuente en que las gestantes consumen las plantas medicinales, con la finalidad de clasificar estos productos de acuerdo al nivel de seguridad que ofrecen y promover el uso racional de la medicina tradicional para contribuir en la salud pública.

Abstract In the educational context, it is up to educators to offer schoolchildren different ways to prevent tobacco use, an action that is undertaken through interaction and support with the family and the community. The purpose of this article is to carry out a study on the protection of schoolchildren in risk groups against smoking and their social education.

Resumen En el contexto educativo, les corresponde a los educadores ofrecerles a los escolares diferentes vías para prevenir el consumo de del tabaco, acción que se emprende desde la interacción y apoyo con la familia y la comunidad. El propósito de este artículo es realizar un estudio acerca de la protección de escolares en grupos de riesgos ante el tabaquismo y su educación social.

Abstract Competition between formal and informal companies has been increasingly studied. However, there is a lack of studies in the collaboration between formal and informal companies generated using crowdfunding platforms. Based on the signaling theory and using the loans from 2019 of the Kiva crowdfunding platform. The drivers and enablers of the collaboration between formally registered firms (partners micro finances) and informal firms (unregistered firms - borrowers) in the context of the crowdfunding digital platform are studied. The results state a negative relationship between the lender's propensity to make loans and the informal firm's percentage borrowed. However, if the borrower receives a trustworthy partner (micro-finance), the borrower's negative impact decreases. Moreover, the lender's propensity to make loans lesser in projects of the tertiary sector. The study contributes to the entrepreneurship theory to understand the mechanism to legitimization the informal firm through collaboration with formal firms in the digital platforms.

Resumen Introducción: Desde la declaración de pandemia por la OMS el once de marzo de 2020, ha existido un descenso en los ingresos de pacientes quirúrgicos por la paralización de la cirugía electiva y la disminución de procedimientos quirúrgicos emergentes. Objetivo: Analizar la incidencia y características de la patología quirúrgica emergente en un hospital de segundo nivel en Ecuador. Material y métodos: Estudio retrospectivo, descriptivo, que incluyó a todos los pacientes sometidos a cirugía general emergente en el Hospital General Riobamba IESS, desde el once de marzo hasta el once de agosto de 2020. Resultados: En el estudio se incluyeron 63 pacientes, con una media de edad de 48,54 años; el 50,8% fueron hombres. El diagnóstico más frecuente fue apendicitis aguda en 61,9% casos. Se realizaron 66 cirugías, 36,5% fueron apendicectomías convencionales. El abordaje abierto se llevó a cabo en 68,2% de los pacientes. El 12,7% de pacientes presentaron COVID-19 en el perioperatorio de los cuales 25% fallecieron. La mortalidad general fue del 7,9% y todos los pacientes fallecidos fueron hombres. Discusión: La evidencia acerca del manejo quirúrgico durante la pandemia COVID-19 aún es limitada. La patología quirúrgica emergente no se puede diferir, se deben tener en cuenta el incremento en la mortalidad de pacientes infectados y el riesgo de exposición del equipo quirúrgico. Conclusión: Durante la pandemia se produjo un descenso en las cirugías realizadas en nuestro centro, la apendicitis aguda continúa siendo la principal patología quirúrgica emergente. La mortalidad se asoció al sexo masculino y diagnóstico de COVID-19.

Resumo Introdução: Desde a declaração de uma pandemia pela OMS em 11 de março de 2020, houve uma diminuição nas admissões de pacientes cirúrgicos devido à paralisação das cirurgias eletivas e diminuição dos procedimentos cirúrgicos emergentes. Objetivo: Analisar a incidência e as características da patologia cirúrgica emergente em um hospital de segundo nível no Equador. Material e métodos: Estudo retrospectivo, descritivo, que incluiu todos os pacientes submetidos à cirurgia geral de urgência no Hospital Geral de Riobamba IESS, no período de 11 de março a 11 de agosto de 2020. Resultados: O estudo incluiu 63 pacientes, com média de idade de 48,54 anos; 50,8% eram homens. O diagnóstico mais frequente foi apendicite aguda em 61,9% dos casos. Foram realizadas 66 cirurgias, 36,5% foram apendicectomias convencionais. A abordagem aberta foi realizada em 68,2% dos pacientes. 12,7% dos pacientes apresentaram COVID-19 no período perioperatório, dos quais 25% morreram. A mortalidade geral foi de 7,9% e todos os pacientes falecidos eram homens. Discussão: As evidências sobre o manejo cirúrgico durante a pandemia de COVID-19 ainda são limitadas. A patologia cirúrgica emergente não pode ser adiada, o aumento da mortalidade dos pacientes infectados e o risco de exposição da equipe cirúrgica devem ser levados em consideração. Conclusão: Durante a pandemia houve diminuição das cirurgias realizadas em nosso centro, a apendicite aguda continua sendo a principal patologia cirúrgica emergente. A mortalidade foi associada ao sexo masculino e ao diagnóstico de COVID-19.

Abstract Introduction: Since the declaration of a pandemic by the WHO on March 11, 2020, there has been a decrease in the admissions of surgical patients due to the paralyzation of elective surgery and the decrease in emerging surgical procedures. Objective: To analyze the incidence and characteristics of emerging surgical pathology in a second level hospital in Ecuador. Material and methods: Retrospective and descriptive study, which included all the patients undergoing emergency general surgery at Hospital General Riobamba IESS, from March 11 to August 11, 2020. Results: 63 patients were included in the study, with a mean age of 48.54 years; 50.8% were men. The most frequent diagnosis was acute appendicitis in 61.9% cases. 66 surgeries were performed, 36.5% were conventional appendicectomies. The open approach was carried out in 68.2% of the patients. 12.7% of patients presented COVID-19 in the perioperative period, of which 25% died. Overall mortality was 7.9% and all deceased patients were men. Discussion: The evidence about surgical management during the COVID-19 pandemic is still limited. Emerging surgical pathology cannot be deferred, the increased mortality of infected patients and the risk of exposure of the surgical team must be taken into account. Conclusion: During the pandemic there was a decrease in the surgeries performed in our center, acute appendicitis continues to be the main emerging surgical pathology. Mortality was associated with male sex and diagnosis of COVID-19.

ABSTRACT Acute appendicitis is the most frequent surgical emergency instance in young adults; and its association with parasitic infections is rare. Of these particular cases, appendix location of hydatid cyst is extremely rare; and there have been published reports of such cases only in Iran, India, Tunisia, and Peru. We present the case of a 52-year old male subject born in Puno, with no relevant past medical history, who was admitted with a clinical condition typically consistent with acute appendicitis. When this patient underwent surgery, the appendix was found showing a cystic mass, compatible with complicated Echinococcus granulosus hydatid cyst. Later on, three additional intraabdominal hydatid cysts were identified. There was no surgical or trauma past history, so it was concluded this condition corresponded to disseminated primary intraabdominal location of hydatid disease, including the appendix, liver, and peritoneum.

RESUMEN La apendicitis aguda es considerada la causa más común de emergencia quirúrgica en adultos jóvenes; y su asociación con infecciones parasitarias es rara. De éstas, la localización apendicular del quiste hidatídico, es extremadamente rara; y hasta la fecha solo existen reportes en Irán, India, Túnez, Chile y Perú. Se presenta el caso de un paciente varón de 52 años, natural de Puno, sin antecedentes patológicos, que ingresa con un cuadro clínico típico de apendicitis aguda, y que, al ser intervenido quirúrgicamente, se aprecia al apéndice con una tumoración quística, compatible con un quiste hidatídico complicado de Echinococcus granulosus. Posteriormente, se constatan otros tres quistes hidatídicos intrabdominales. No existió antecedente quirúrgicoo traumático, por lo que se considera una localización primaria intraabdominal diseminada, que incluía al apéndice, hígado y peritoneo.

Abstract Background Adherence to antihypertensive medication is a major challenge in the management of hypertension, and non-adherence is an important barrier to effective management of hypertension. Objectives To determine the adherence rate to hypertensive drug treatment and the factors that influence non-adherence in a cohort of the Argentinean population. Methods A multicenter cross-sectional study was conducted in eight cities of Argentina. Consecutive hypertensive patients seen in general practice offices, receiving pharmacological treatment for at least six months were included. Blood pressure measurements were performed by physicians during the patient visit. The level of adherence was assessed using the Morisky questionnaire, and patients were divided into non-adherent and adherent. Continuous variables were compared using independent t-test. Categorical variables were compared using the χ2 test. To identify the variables independently associated with non-adherence, a forward stepwise binary regression logistic model was performed, and the results expressed as odds ratio (OR) with 95% of confidence interval. All tests were two-tailed, and p-values < 0.05 were considered statistically significant. Results A total of 852 individuals (52% women, 62 ± 13 years) were included. The main reason for lack of adherence was forgetfulness of medication intake and errors in the time of intake (~ 40% in both). Individuals with more cardiovascular risk factors (smoking, diabetes, dyslipidemia and previous cardiovascular events) had lower adherence to antihypertensive treatment, and considerably younger (~ five years younger). Conclusions Adherence rate to antihypertensive drug treatment in our study group was higher than the one reported in previous studies, and the main reason for non-adherence was forgetfulness of medication intake. (Int J Cardiovasc Sci. 2020; 33(3):272-277)