Pesquisa | SciELO

Resumen El almidón resistente (AR) es una fracción del almidón no digerible por las α-amilasas y a diferencia de la fibra dietética, el AR es fermentado en el colon promoviendo beneficios en la salud. Dentro de los diferentes tipos de AR, el tipo 3 (AR3) se obtiene por autoclaveado y sin el uso de agentes químicos. El objetivo de este estudio fue obtener AR3 a partir de avena y evaluar su efecto a diferentes concentraciones (0, 5, 10, 15 y 20 %, p/p) sobre las propiedades reológicas de la masa, propiedades de textura de las galletas y su aceptabilidad sensorial. El análisis de perfil de textura (TPA) evidenció un incremento en la fracturabilidad, dureza, adhesividad y gomosidad. La incorporación de AR3 incrementó el módulo elástico (G´) y viscoso (G´´) en comparación con la masa control. Todos los tratamientos presentaron comportamiento elástico (G´ > G´´). La dureza en las galletas aumentó con la concentración de AR3, con valores de ≈ 8 N (control) hasta 20 N (AR3-20 %). Las pruebas sensoriales no fueron significativas entre tratamientos, aunque las galletas AR3-20 % tuvieron mayor preferencia. La adición de AR3 en la masa provocó cambios funcionales y de textura significativos que afectaron positivamente los atributos de calidad de las galletas.

Abstract Resistant starch (RS) is a portion of starch that is not digestible by α-amylases and unlike dietary fiber, RS is fermented in the colon, promoting health benefits. Among the different types of RS, type 3 (RS3) is obtained by autoclaving and without chemical agents. The objective of this work was to obtain RS3 from oats and to evaluate its effect at different concentrations (0, 5, 10, 15 and 20 % w/w) on the rheological properties of the dough, textural properties of the cookies and their sensory acceptability. Texture profile analysis (TPA) showed an increased fracturability, hardness, adhesiveness and gumminess. The incorporation of RS3 increased the elastic (G’) and viscous (G’’) modulus compared to the control dough. All treatments showed elastic behavior (G’ > G’’). Hardness in cookies increased with RS3 concentration, with values from ≈ 8 N (control) to 20 N (RS3 - 20 %). Sensory tests were not significant between treatments, although RS3-20 % cookies had a higher preference. The addition of RS3 in the dough caused significant functional and textural changes that positively affected the quality attributes of the cookies.

https://doi.org/10.18633/biotecnia.v25i2.1854

Schwannoma of the dorsal nerve of the penis: case report and differential diagnoses
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Reyes-Esparza, Arturo

; Macias-Flores, Juan C.

; Amaya-Téllez, Mariana

; Miranda-Castañon, Francisco

; Gonzalez-Garcia, Edgardo

Revista médica del Hospital General de México

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Dez 2022, Volume 85 Nº 4 Páginas 197 - 200

Resumo: En | Texto: En | PDF: En

Abstract Schwannomas are tumors that appear in the sheath that surrounds the nerves; they are formed of Schwann cells which form the myelin sheath in peripheral nerves. In this document, we report a case of Schwannoma of the dorsal nerve of the penis in a man 40-year-old male with no history of neurofibromatosis. Despite the abundant innervation of the penis, it is rare to find them in this location with < 50 cases reported in the literature. Its diagnosis is integrated based on physical examination and supported by imaging. The definitive diagnosis is obtained with histopathology with immunohistochemistry.

https://doi.org/10.24875/hgmx.22000020

Diagnóstico de las causas de rezago y deserción en alumnos de la Facultad de Ciencias de la UNAM
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Arnaud Bobadilla, Alfredo Juan

; Sánchez Villarreal, Francisco

; Galindo Miranda, Nora Elizabeth

; Franco Bodek, Daniela

; Ruiz Gutiérrez, Rosaura

RIDE. Revista Iberoamericana para la Investigación y el Desarrollo Educativo

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Jun 2022, Volume 12 Nº 24 elocation e036

Resumo: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

Abstract Due to the historical lag and dropout rates that occur in the careers of the Faculty of Sciences of the Universidad Nacional Autónoma de México (UNAM), the management formed a commission to carry out a study of the causes of said phenomenon. The objective of this work is to expose the results of the afore mentioned diagnosis, as well as to make a series of proposals to improve the lag and dropout rates of the students of the Faculty of Sciences. This diagnosis was made through a survey and the analysis of their responses during the focus group sessions that were formed for the study. In general terms, based on the survey results, professors consider that their students do not have good study habits; they do not come well prepared from their high school courses, and their writing and reading skills are poor. On the other hand, 64% of the professors claimed not to be aware of the annual didactic training courses offered, and almost 60% of the professors consider this kind of courses very necessary. At the end of the study, proposals are also presented to reduce failure and drop out, based on the results collected in this work, as alternatives to the didactic methodology that is currently the predominant.

Resumen Debido a los históricos índices de rezago y deserción que se presentan en las carreras de la Facultad de Ciencias de la Universidad Nacional Autónoma de México (UNAM), la dirección conformó una comisión para que se realizara un estudio de las causas de dicho fenómeno. El objetivo de este trabajo es exponer los resultados del diagnóstico mencionado, así como hacer una serie de propuestas para mejorar los índices de rezago y deserción de los estudiantes de la Facultad de Ciencias. Este diagnóstico se realizó por medio de una encuesta y el análisis de sus respuestas durante las sesiones de los grupos focales que se conformaron para el estudio. Los resultados obtenidos muestran, en términos generales, que, en opinión de los profesores de la UNAM, sus estudiantes no cuentan con buenos hábitos de estudio; no vienen suficientemente bien preparados del bachillerato, y cuentan con habilidades de escritura y comprensión lectora deficientes. Por otro lado, 64 % de los profesores no conocen la oferta anual de cursos de actualización didáctica, y casi 60 % de los profesores considera estos cursos muy necesarios. Al final del estudio, con base en los resultados recogidos, se presentan propuestas para abatir el rezago escolar como alternativas a las clases magistrales que actualmente son la metodología didáctica preponderante en los cursos.

Resumo Devido à defasagem histórica e às taxas de evasão que ocorrem nas carreiras da Faculdade de Ciências da Universidade Nacional Autônoma do México (UNAM), a direção formou uma comissão para realizar um estudo das causas desse fenômeno. O objetivo deste trabalho é expor os resultados do diagnóstico supracitado, bem como fazer uma série de propostas para melhorar as taxas de defasagem e evasão dos alunos da Faculdade de Ciências. Esse diagnóstico foi feito por meio de uma pesquisa e da análise de suas respostas durante as sessões de grupos focais que foram formadas para o estudo. Os resultados obtidos mostram, em linhas gerais, que, na opinião dos docentes da UNAM, seus alunos não possuem bons hábitos de estudo; eles não vêm suficientemente bem preparados no ensino médio e têm habilidades de escrita e compreensão de leitura deficientes. Por outro lado, 64% dos professores desconhecem a oferta anual de cursos de atualização didática, e quase 60% dos professores consideram esses cursos muito necessários. Ao final do estudo, com base nos resultados coletados, são apresentadas propostas de redução da defasagem escolar como alternativas às aulas magistrais, que atualmente são a metodologia de ensino predominante nos cursos.

https://doi.org/10.23913/ride.v12i24.1181 217 downloads

Spatial distribution of human visceral leishmaniasis cases in Cametá, Pará, Eastern Amazon, Brazil
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Miranda, Claudia do Socorro Carvalho

; Bonito, Jorge

; Oliveira, Rafael Aleixo Coelho de

; Guedes, Juan Andrade

; Santos, Conceição

; Oliveira, João Sérgio de Sousa

; Filgueiras, Tainara Garcia

; Oliveira, Francisco de Assis

; Filgueiras, Tainã Garcia

; Gonçalves, Nelson Veiga

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0220-2021

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Human visceral leishmaniasis is considered a major public health problem in the municipality of Cametá, Pará, Brazil. METHODS: This ecological study was conducted using data obtained from official Brazilian agencies. Spatial analysis of the variables was performed using the kernel interpolation technique and the bivariate Global Moran’s Index. RESULTS: The spatial distribution of the disease was not homogeneous, and it was associated with socio-environmental risk factors and public policies. CONCLUSIONS: Different relationships were observed between the variables studied and disease occurrence.

https://doi.org/10.1590/0037-8682-0220-2021

Growth of provenances of Cryptocarya alba during water stress and after re–watering in the nursery
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Meza, Sergio Enrique Espinoza

; Arce, Marco Aliro Yáñez

; Díaz, Carlos Renato Magni

; Herrera, Eduardo Enrique Martínez

; Ortega, Juan Francisco Ovalle

; Miranda, Suraj Antonio Vaswani

Scientia Agricola

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2021, Volume 78 Supl. 1 elocation e20200292

Resumo: En | Texto: En | PDF: En

ABSTRACT: Intensification of drought in Mediterranean–type climates has limited seedling establishment. The knowledge of the ecology of selected species and its intraspecific variation to water stress at the seedling stage should be considered in order to overcome limitations. We investigated variations in growth, survival, and leaf–level physiology in four provenances of the endemic Cryptocarya alba (Mol.) during water stress and after re–watering. Seedlings were cultured in the nursery during 23 months and then subjected to two watering treatments based on soil water content (well–watered and water restriction, 0.38 and 0.17 cm3 cm−3, respectively) for 45 days. At the end of the watering treatments, seedling growth, above– and belowground biomass, survival, and leaf gas exchange were measured. Right after the watering treatments, the surviving seedlings were submitted to a recovery period of 21 days, in which all seedlings were re–watered at 0.38 cm3 cm−3 of soil water content and measured for leaf gas exchange. Provenances differed in growth and biomass allocation. Unlike growth and biomass, interaction between provenance and watering treatments was found for photosynthesis, stomatal conductance, transpiration, and water use efficiency of northern provenances, exhibiting the highest performance under water restriction. However, most variations observed occurred before the re–watering period and only a few occurred after this period. The four provenances under study exhibited similar photosynthesis and stomatal conductance after re–watering. Our study demonstrated phenotypic variation of C. alba and the capability of the species to withstand and recover from water stress.

https://doi.org/10.1590/1678-992x-2020-0292 266 downloads

Decision Support Systems (DSS) Applied to the Formulation of Agricultural Public Policies
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Sánchez Céspedes, Juan Manuel

; Rodríguez Miranda, Juan Pablo

; Ramos Sandoval, Olga Lucia

Tecnura

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Dez 2020, Volume 24 Nº 66 Páginas 95 - 108

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Objetivo: El proceso de formulación de políticas públicas agrarias es altamente complejo por la gran cantidad de variables que intervienen en el proceso. Por eso, el desarrollo de sistemas de soporte de decisiones (SSD) ayudan a mejorar dicho proceso. El artículo revisa los desarrollos que se han realizado con respecto al tema. Metodología: Se realizó una revisión bibliográfica en varias bases de datos científicas, buscando desarrollos de sistemas SSD aplicados al proceso de formulación de políticas agrarias. Al determinar cuáles sistemas SSD se han desarrollado, se procedió a realizar un análisis cualitativo y también descriptivo de los sistemas. Resultados: Se encontraron 30 sistemas SSD aplicados a la formulación de políticas agrarias, donde la mayoría están enfocados al proceso de producción agrícola y su relación con el medio ambiente. Conclusiones: Al formular posibles políticas agrarias, es muy necesario generar sistemas SSD que predigan el futuro comportamiento de las partes involucradas. Adicionalmente, estos sistemas deben ser ajustados para que tengan en cuenta las características de los países localizados en la zona tropical. Financiamiento: Universidad Distrital Francisco José de Caldas, Universidad Militar Nueva Granada.

Abstract Objective: The process of formulating agricultural public policies is complex due to the large number of variables involved in it. However, there is a methodology that helps the process: the development of decision support systems (DSS). This article shows the results of reviewing the developments made on implementing DSS on the formulating agricultural public policies. Methodology: A bibliographic review was carried out in various scientific databases by looking for implementations of SSD on the process of formulating agricultural policies. After finding out the SSD systems developed, qualitative and descriptive analyzes of the systems were carried out. Results: Thirty DSS systems applied to the formulation of agricultural policies were found, and the majority is focused on the agricultural production process and its relationship with the environment. Conclusions: When developing potential agricultural policies, there is a fundamental need to generate DSS that determine possible future behavior of stakeholders. These DSS also need to be adjusted to the characteristics of the countries located in the tropical zone. Financing: Universidad Distrital Francisco José de Caldas, Universidad Militar Nueva Granada.

https://doi.org/10.14483/22487638.15768 282 downloads

Biodiversidad y manejo de los residuos agropecuarios en una finca del municipio de Perico, Matanzas
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Oropesa-Casanova, Katerine

; Pentón-Fernández, Gertrudis

; Lezcano-Fleires, Juan Carlos

; Miranda-Tortoló, Taymer

; Núñez-García, Néstor Francisco

Pastos y Forrajes

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Jun 2020, Volume 43 Nº 2 Páginas 112 - 119

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Objective To characterize the biodiversity and management of waste from the agricultural activity in La Palma farm, of the Perico municipality, Matanzas province, Cuba. Materials and Methods In order to obtain information, a diagnosis was conducted in a farmer’s farm through the combination of several tools, such as exploratory tours and informal interviews, formal surveys and semi-structured dialogs, with observations, measurements or both. The number of individuals of each species, which were characterized according to their purpose in the system, was quantified. Results In the farm three subsystems stand out (temporary crops, permanent crops and animals). In the subsystem of permanent crops the natural pastures Dichanthium caricosum (L.) A. Camus, Dichanthium annulatum (Forssk.) Stapf and Paspalum notatum Alain ex Flügé are developed. Meanwhile, among the trees, Leucaena leucocephala (Lam.) de Witt stands out with 2 386 individuals. This species can generate 5 t DM/year of non-edible woody biomass and, in turn, an estimate of 1,5 t of biochar. Conclusions The functionality of this agroecosystem, represented by diversification and agriculture-animal husbandry integration, was proven. Biochar is a waste management alternative in the farm, which can be enriched with cattle waste and non-edible biomass from the pruning of L. leucocephala.

Resumen Objetivo Caracterizar la biodiversidad y el manejo de los residuos de la actividad agropecuaria en la finca La Palma, del municipio Perico, provincia Matanzas, Cuba. Materiales y Métodos Con el propósito de obtener información, se realizó un diagnóstico en la finca de un productor mediante la combinación de varias herramientas, como recorridos exploratorios y entrevistas informales, encuestas formales y diálogos semiestructurados, con observaciones, mediciones o ambas. Se cuantificó el número de individuos de cada especie, las que se caracterizaron de acuerdo con su propósito en el sistema. Resultados En la finca se destacan tres subsistemas (cultivos temporales, cultivos permanentes y animal). En el subsistema de cultivos permanentes se desarrollan los pastos naturales Dichanthium caricosum (L.) A. Camus, Dichanthium annulatum (Forssk.) Stapf y Paspalum notatum Alain ex Flügé. Mientras, entre las arbóreas, Leucaena leucocephala (Lam.) de Witt se destaca con 2 386 individuos. Esta especie puede generar 5 t de MS/año de biomasa leñosa no comestible y, a su vez, un estimado de 1,5 t de biocarbono. Conclusiones Se demostró la funcionalidad de este agroecosistema, representado por la diversificación y la integración agricultura-ganadería. El bicarbono es una alternativa de manejo de residuos de la actividad agropecuaria en la finca, que se pueden enriquecer con los residuales bovinos.

Recomendaciones para la atención de pacientes con diabetes mellitus con factores de riesgo o enfermedad cardiovascular establecida y SARS-CoV-2
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Alcocer-Gamba, Marco A.

; Gutiérrez-Fajardo, Pedro

; Sosa-Caballero, Alejandro

; Cabrera-Rayo, Alfredo

; Faradji-Hazan, Raquel N.

; Padilla-Padilla, Francisco G.

; Garnica-Cuellar, Juan C.

; Hernández-Arispe, Leticia M.

; Reyes-Cianeros, Fernando A.

; León-Suárez, Andrés

; Rivera, José de-Jesús

; Mancillas-Adame, Leonardo

; Gaxiola-Macias, Manuel

; Márquez-Rodríguez, Eduardo

; Miranda-Malpica, Emma

; Sanchez-Pedraza, Valentín

; Lara-Martínez, Daniel S.

; Segovia-Palomo, Antonio

; Nava-Hernández, Angeles

; Rivera-Reyes, Romina

Archivos de cardiología de México

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2020, Volume 90 Supl. 1 Páginas 77 - 83

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract A review is carried out to examine the risk of patients suffering from diabetes mellitus in the context of general morbidity and mortality and related to infection by SARS-CoV-2. Likewise, the general recommendations for food and the prevention of comorbidities that most these patients suffer most frequently are also studied. Finally, a review of the pharmacological recommendations on both oral and parenteral treatment in the outpatient, in hospitalization and in critical states infected with SARS-CoV-2 is made.

Resumen Se realiza una revisión sobre el riesgo de los pacientes que padecen diabetes mellitus en el contexto de morbimortalidad general y relacionada a infección por el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2). Así mismo se repasan las recomendaciones generales, de alimentación y de la prevención de las comorbilidades que más frecuentemente padecen dichos enfermos. Finalmente se hace una revisión de las recomendaciones farmacológicas sobre el tratamiento tanto oral como parenteral en el paciente ambulatorio, en la hospitalización y en estados críticos infectados por el SARS-CoV-2.

https://doi.org/10.24875/acm.m20000074 1059 downloads

Mexico’s 2018 Report Card on Physical Activity for Children and Youth: Full report
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Argumedo, Gabriela

; López y Taylor, Juan Ricardo

; Gaytán-González, Alejandro

; González-Casanova, Inés

; Villalobos, Martín Francisco González

; Jáuregui, Alejandra

; Ulloa, Edtna Jáuregui

; Medina, Catalina

; Miranda, Yoali Selene Pacheco

; Rodríguez, Marcela Pérez

; Resendiz, Eugen

; Pelayo, Ricardo Alejandro Retano

; Martínez, María del Pilar Rodríguez

; Galaviz, Karla I.

Revista Panamericana de Salud Pública

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2020, Volume 44 elocation e26

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivos. O Report Card de 2018 para o México avalia as oportunidades disponíveis para que crianças e jovens mexicanos atinjam níveis adequados de atividade física, sono e comportamento sedentário. Métodos. O Report Card é um sistema de vigilância que reúne dados de pesquisas nacionais, censos, documentos governamentais, websites, literatura cinzenta e estudos publicados para avaliar 16 indicadores em quatro categorias: Comportamentos Diários, Forma Física, Ambientes e Influências, e Estratégias e Investimentos. Os dados foram comparados com indicadores de referência estabelecidos. A cada indicador foi atribuída uma pontuação de 1 a 10 (pontuações abaixo de 6 indicam reprovação) ou "incompleta" se os dados fossem insuficientes/indisponíveis. Resultados. As pontuações para o Comportamento Diário foram as seguintes: atividade física geral: 4; participação em esportes organizados: 5; brincadeiras ativas: 3; transporte ativo: 5; sono: 7; comportamento sedentário: 3. A pontuação para a Forma Física foi de 7. As pontuações para Ambientes e Influências foram: família e amigos, incompleta; escola: 3; comunidade e ambiente: 4. As pontuações para Estratégias e Investimentos foram: estratégias governamentais: 6; organizações não-governamentais: 2. Conclusão. As pontuações baixas em 11 dos 16 indicadores indicam que as escolas, famílias, comunidades e o governo precisam trabalhar juntos para oferecer mais oportunidades de atividade física às crianças e jovens no México.

ABSTRACT Objectives. Mexico’s 2018 Report Card evaluates the opportunities available for Mexican children and youth to reach healthy levels of physical activity, sleep, and sedentary behavior. Methods. The Report Card is a surveillance system that gathers data from national surveys, censuses, government documents, websites, grey literature, and published studies to evaluate 16 indicators in four categories: Daily Behaviors; Physical Fitness; Settings and Sources of Influence; and Strategies and Investments. Data were compared to established benchmarks. Each indicator was assigned a grade from 1 – 10 (< 6 is a failing grade) or “incomplete” if data was insufficient/unavailable. Results. Daily Behavior grades were: Overall Physical Activity, 4; Organized Sport Participation, 5; Active Play, 3; Active Transportation, 5; Sleep, 7; and Sedentary Behavior, 3. Physical Fitness, received a 7. Settings and Sources of Influence grades were: Family and Peers, incomplete; School, 3; and Community and Environment, 4. Strategies and Investments were: Government Strategies, 6; and Non-Government Organizations, 2. Conclusion. Low grades in 11 of the 16 indicators indicate that schools, families, communities, and government need to work together to improve physical activity opportunities for children and youth in Mexico.

RESUMEN Objetivos. El boletín de notas de México correspondiente al 2018 evalúa las oportunidades a disposición de la población infantil y joven mexicana para que puedan desarrollar niveles adecuados de actividad física y sueño, y disminuyan el sedentarismo. Métodos. El boletín es un sistema de vigilancia que recopila los datos obtenidos en las encuestas nacionales, censos, documentos gubernamentales, sitios web, literatura gris y estudios publicados con respecto al análisis de 16 indicadores en 4 categorías: comportamientos diarios, estado físico, entornos y fuentes influyentes, y estrategias e inversión. Los datos fueron cotejados con los puntos de referencia establecidos. A cada indicador se le asignó una calificación entre 1 y 10 (< 6 significa reprobado) o fue marcado como “incompleto” si los datos eran nulos o insuficientes. Resultados. Las calificaciones obtenidas para los comportamientos diarios fueron: actividad física en general: 4; participación en actividades deportivas organizadas: 5; juego activo: 3; modalidades de transporte activas: 5; sueño: 7; y sedentarismo: 3. El estado físico obtuvo un 7. Las calificaciones para los entornos y fuentes influyentes fueron: familiares y pares: “incompleto”; escuela: 3; comunidad y entorno: 4. Para las estrategias e inversión: estrategias gubernamentales: 6; entidades no gubernamentales: 2. Conclusiones. Las bajas calificaciones obtenidas en 11 de los 16 indicadores demuestran que las escuelas, las familias, las comunidades y el gobierno tienen que aunar esfuerzos para mejorar las oportunidades que tiene la población infantil y joven en México para desarrollar niveles de actividad física satisfactorios.

https://doi.org/10.26633/rpsp.2020.26

10.

Recomendaciones para el uso racional de la prueba 25-hidroxivitamina D Resumen de política
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Herrera-Molina, Emilio

; González, Nancy Yomayusa

; Low-Padilla, Eduardo

; Oliveros-Velásquez, Juan David

; Mendivelso-Duarte, Fredy

; Gómez-Gómez, Olga Victoria

; Castillo, Ana María

; Barrero-Garzón, Liliana Isabel

; Álvarez-Moreno, Carlos Arturo

; Moscoso-Martínez, Ernesto Augusto

; Ruíz-Blanco, Pilar Cristin

; Luna-Ríos, Joaquín Gustavo

; Ortiz, Natasha

; Herrera, Emiliano Mauricio

; Guevara-Santamaría, Fabián

; Moreno-Gómez, Jairo Enrique

; Cárdenas-Ramírez, Héctor Mauricio

; González-González, Camilo Alberto

; Jannauth, María José

; Patiño-Pérez, Adulkarin

; Pinto, Diego Alejandro

; Acevedo, Juan Ramon

; Torres, Rodolfo Eduardo

; Montero, Jairo Camilo

; Acevedo, Andrés David

; Caceres, Ximena Adriana

; Acuña-Olmos, Jairo

; Arias, Carlos Andrés

; Medardo-Rozo, José

; Castellanos-Parada, Jeffrey

; López-Miranda, Ángelo Mauricio

; Pinzón-Serrano, Estefanía

; Rincón-Sierra, Oswaldo

; Isaza-Ruget, Mario

; Suárez-Ramos, María del Pilar

; Vargas-Rodríguez, Johanna

; Mejia-Gaviria, Natalia

; Moreno-Marín, Sandra Yadira

; García-Guarín, Bibiana María

; Cárdenas, Martha Lucía

; Chavarro, Luis Fernando

; Ronderos-Bernal, Camila

; Rico-Landazabal, Arturo

; Coronado-Daza, Jorge Antonio

; Alfaro-Tejeda, Mercedes Teresa

; Yama-Mosquera, Erica

; Hernández-Sierra, Astrid Patricia

; Restrepo-Valencia, César Augusto

; Arango-Álvarez, Javier

; Rosero-Olarte, Francisco Oscar Fernando

; Medina-Orjuela, Adriana

; Robayo-García, Adriana

; Carballo-Zarate, Virgil

; Rodríguez-Sánchez, Martha Patricia

; Bernal, Dora P.

; Jaramillo, Laura

; Baquero-Rodríguez, Richard

; Mejía-Gaviria, Natalia

; Aroca, Gustavo

Revista Colombiana de Nefrología

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Dez 2019, Volume 6 Nº 2 Páginas 179 - 192

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract The exponential increase in the request for laboratory tests of 25-Hydroxyvitamin D or [25 (OH) D has ignited the alarms and generated a strong call for attention, since it may reflect deficiencies in the standardization of clinical practice and in the use non-systematic scientific evidence for decision-making in real life, which allows to analyze the indications of the test, its frequency, interpretation and even to assess the impact for health systems, especially when contrasted with the minimum or almost. No effects of the strategy of screening or supplying indiscriminately to the general population, without considering a comprehensive clinical assessment of risks and needs of people. From a purely public health impact point of view, the consequence of massive and unspecified requests is affecting most of the health systems and institutions at the global level. The primary studies that determined average population intake values have been widely used in the formulation of recommendations in Clinical Practice Guidelines, but unfortunately misinterpreted as cut points to diagnose disease and allow the exaggerated prescription of nutritional substitution. The coefficient of variation in routine tests to measure blood levels of 25 (OH) D is high (28%), decreasing the overall accuracy of the test and simultaneously, increasing both the falsely high and falsely low values. The most recent scientific evidence analyzes and seriously questions the usefulness and the real effect of the massive and indiscriminate practice of prescribing vitamin D without an exhaustive risk analysis. The available evidence is insufficient to recommend a general substitution of vitamin D to prevent fractures, falls, changes in bone mineral density, incidence of cardiovascular diseases, cerebrovascular disease, neoplasms and also to modify the growth curve of mothers' children. They received vitamin D as a substitute during pregnancy. The recommendations presented in the document are based on the critical analysis of current evidence and the principles of good clinical practice and invite to consider a rational use of 25 (OH) D tests in the context of a clinical practice focused on people and a comprehensive assessment of needs and risks. The principles of good practice suggest that clinicians may be able to justify that the results of the 25 (OH) D test strongly influence and define clinical practice and modify the outcomes that interest people and impact their health and wellness. Currently there is no clarity on how to interpret the results, and the relationship between symptoms and 25 (OH) D levels, which may not be consistent with the high prevalence of vitamin D deficiency reported. For this reason, it is suggested to review the rationale of the request for tests for systematic monitoring of levels of 25 (OH) D or in all cases where substitution is performed. Consider the use of 25 (OH) D tests within the comprehensive evaluation of people with suspicion or confirmation of the following conditions: rickets, osteomalacia, osteoporosis, hyper or hypoparathyroidism, malabsorption syndromes, sarcopenia, metabolic bone disease.

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11.

Trasplante hepático: evolución, curva de aprendizaje y resultados después de los primeros 300 casos
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Guerra, Juan Francisco

; Quezada, José Luis

; Cancino, Alejandra

; Arrese, Marco

; Wolff, Rodrigo

; Benítez, Carlos

; Pattillo, Juan Carlos

; Gana, Juan Cristóbal

; Concha, Mario

; Cortínez, Luis

; Vera, Magdalena

; Miranda, Paula

; Rubilar, Francisco

; Troncoso, Andres

; Briceño, Eduardo

; Dib, Martín

; Jarufe, Nicolás

; Martínez, Jorge

Revista médica de Chile

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Ago 2019, Volume 147 Nº 8 Páginas 955 - 964

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Liver transplantation (LT) is an option for people with liver failure who cannot be cured with other therapies and for some people with liver cancer. Aim: To describe, and analyze the first 300 LT clinical results, and to establish our learning curve. Material and Methods: Retrospective cohort study with data obtained from a prospectively collected LT Program database. We included all LT performed at a single center from March 1994 to September 2017. The database gathered demographics, diagnosis, indications for LT, surgical aspects and postoperative courses. We constructed a cumulative summation test for learning curve (LC-CUSUM) using 30-day post-LT mortality. Mortality at 30 days, and actuarial 1-, and 5-year survival rate were analyzed. Results: A total of 281 patients aged 54 (0-71) years (129 women) underwent 300 LT. Ten percent of patients were younger than 18 years old. The first, second and third indications for LT were non-alcoholic steatohepatitis, chronic autoimmune hepatitis and alcoholic liver cirrhosis, respectively. Acute liver failure was the LT indication in 51 cases (17%). The overall complication rate was 71%. Infectious and biliary complications were the most common of them (47 and 31% respectively). The LC-CUSUM curve shows that the first 30 patients corresponded to the learning curve. The peri-operative mortality was 8%. Actuarial 1 and 5-year survival rates were 82 and 71.4%, respectively. Conclusions: Outcome improvement of a LT program depends on the accumulation of experience after the first 30 transplants and the peri-operative mortality directly impacted long-term survival.

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12.

Experiencias del Sistema de Innovación Agrícola Local para enfrentar los desafíos productivos en el municipio Perico
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Oropesa Casanova, Katerine

; Bober Felices, Katia

; Miranda Tortoló, Taymer

; Machado Martinez, Hilda C

; Alfonso LLanes, Juan A

; Suset Pérez, Antonio

; Ramírez Suarez, Wendy

; Núñez García, Néstor Francisco

; Gonzales Flores, Geyusky M

; Lezcano Freires, Juan C

; Pentón Fernández, Gertrudis

Pastos y Forrajes

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Jun 2019, Volume 42 Nº 2 Páginas 171 - 180

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract The objective of the work was to show how the Local Agricultural Innovation System (SIAL, for its initials in Spanish) in the Perico municipality, Matanzas province, Cuba, was able to solve productive challenges from the moment they were detected in the Management Multi-Actor Platform (MMP), which started with the problem of low yield in the production of Ipomoea batatas (sweet potato) in the productive zone La Angelina. For such purpose different scientific methods and research techniques were used, such as: context diagnosis, surveys, soil sampling, among others. In addition, the results that were reached in the territory with the implementation of this type of approach in the different dimensions, were systematized; which allowed to perform several learning cycles and, in turn, have a plan of measures to increase sweet potato yields and improve the soil as fundamental and irreplaceable resource, capable of supporting crops and life in general.

Resumen El objetivo del trabajo fue mostrar cómo el Sistema de Innovación Agrícola Local (SIAL) en el municipio Perico, provincia Matanzas, Cuba, pudo resolver desafíos productivos a partir de que se detectaron en la Plataforma Multiactoral de Gestión (PMG), lo cual se inició con la problemática de bajo rendimiento en la producción de Ipomoea batatas (boniato) en el polo productivo de La Angelina. Para ello se utilizaron diferentes métodos científicos y técnicas de investigación como: diagnósticos del contexto, encuestas, muestreos de suelo, entre otros. Además, se sistematizaron los resultados que se alcanzaron en el territorio con la implementación de este tipo de enfoque en las diferentes dimensiones; lo que permitió realizar varios ciclos de aprendizaje y, a su vez, contar con un plan de medidas para incrementar los rendimientos del boniato y mejorar el suelo como recurso fundamental e irremplazable, capaz de sustentar los cultivos y la vida en general.

13.

Consenso sobre accidente cerebrovascular isquémico agudo
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Pigretti, Santiago G

; Alet, Matías J

; Mamani, Carlos E

; Alonzo, Claudia

; Aguilar, Martín

; Álvarez, Héctor J

; Ameriso, Sebastián

; Andrade, María G

; Arcondo, Florencia

; Armenteros, Cristian

; Arroyo, José

; Beigelman, Ricardo

; Bonardo, Pablo

; Bres Bullrich, María

; Cabello, Cecilia

; Camargo, Gonzalo

; Camerlingo, Sebastián

; Cárdenas, Rolando

; Cháves, Hernán

; Ciardi, Celina

; Ciarrochi, Nicolas

; Cirio, Juan

; Claverie, Santiago

; Colla Machado, Pedro

; Costilla, Marcelo

; Díaz, María F

; Dossi, Daiana

; Estrella Gimenez, María

; Giber, Fabiana

; Gómez Schneider, Maia

; González, Leonardo

; Hlavnika, Alejandro

; Ioli, Pablo

; Isaac, Cristian F

; Izaguirre, Andrés

; Klein, Francisco

; Kuschner, Pablo

; Lerman, Damián

; López, Rossana

; Marquevich, Victoria

; Miranda, Juan C

; Murgieri, Margarita

; Odzak, Andrea

; Pahnke, Perla

; Persi, Gabriel

; Pizzorno, José

; Pollan, Javier

; Pujol Lereis, Virginia

; Requejo, Flavio

; Robledo, Laura

; Rosales, Julieta

; Rubin, Romina

; Sabio, Rodrigo

; Tejada Jacob, Virginia

; Tumino, Leandro

; Valdez, Pascual

; Videtta, Walter

; Vilela, Andrés

; Villaroel Saavedra, Víctor

; Winkel, Martín

; Zurrú, Maria C

Medicina (Buenos Aires)

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Mai 2019, Volume 79 Supl. 2 Páginas 1 - 46

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Stroke is the third cause of death and the first cause of disability in Argentina. Ischemic events constitute 80% of cases. It requires the implementation of systematized protocols that allow reducing the time of care, morbidity and mortality. Specialists from nine medical societies related to the care of patients with cerebrovascular disease participated in the consensus. A separate agenda was agreed upon in chapters and for the writing of them, work groups were formed with members of different medical specialties. The level of recommendation was discussed and agreed upon for each topic based on the best clinical evidence available for each of them. An adaptation to the local scope of the recommendations was made when it was considered necessary.The American Heart Association system was used to draft the recommendations and their level of evidence. The correction and editing were done by five external reviewers, who did not participate in the writing and with extensive experience in vascular pathology. Once the preliminary document was finalized, a general meeting was held with all the members of the working groups and the reviewers to reach final recommendations. The consensus covers the management of ischemic stroke in the pre-hospital phase, initial evaluation in the emergency center, recanalization therapies (thrombolysis and/ or mechanical thrombectomy), decompressive craniectomy, neuroimaging and clinical care in the hospital.

El accidente cerebrovascular es la tercera causa de muerte y la primera de discapacidad en la Argentina. Los eventos isquémicos constituyen el 80% de los casos. Los accidentes vasculares cerebrales requieren la implementación de protocolos sistematizados que permitan reducir los tiempos en la atención, la morbilidad y mortalidad. En el consenso participaron especialistas de nueve sociedades médicas relacionadas con la atención de pacientes con enfermedad cerebrovascular. Se consensuó un temario separado en capítulos y para la redacción de los mismos se conformaron grupos de trabajo con miembros de diferentes especialidades médicas. Se discutió y acordó para cada tema el nivel de recomendación en base a la mejor evidencia clínica disponible para cada tópico. Se realizó una adaptación al ámbito local de las recomendaciones cuando se consideró necesario. El sistema de la American Heart Association se utilizó para redactar las recomendaciones y su grado de evidencia. La corrección y edición fue realizada por cinco revisores externos, que no participaron en la redacción y con amplia experiencia en enfermedad vascular. Finalizado el documento preliminar, se organizó una reunión general con todos los integrantes de los grupos de trabajo y los revisores para redactar las recomendaciones definitivas. El consenso abarca la atención del paciente con accidente cerebrovascular isquémico en la fase pre-hospitalaria, evaluación inicial en la central de emergencias, terapias de recanalización (trombolisis y/o trombectomía mecánica), craniectomía descompresiva, neuroimágenes y cuidados clínicos en la internación.

3344 downloads

14.

National survey of blindness and visual impairment in Guatemala, 2015
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Chávez, Gloria Marina Serrano

; Barrios, Ana Rafaela Salazar de

; Pojoy, Oscar Leonel Figueroa

; Reyes, Aida del Rosario Monzón Herrera de

; Melgar, Mariano Yee

; Melgar, Juan Francisco Yee

; Régil, Mario de León

; Hernandez, Carlos Alberto Mendoza

; Chanquin, Victor Alfonso Miranda

; Diaz, Evelyn

; Lansingh, Van C.

; Limburg, Hans

; Silva, Juan Carlos

; Furtado, João M.

Arquivos Brasileiros de Oftalmologia

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Mar 2019, Volume 82 Nº 2 Páginas 91 - 97

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO | Objetivo: Estimar a prevalência de cegueira e deficiência visual em idosos que vivem na Guatemala. Métodos: Indivíduos com idade ³50 anos foram selecionados por amostragem aleatória por conglomerados, e os participantes do estudo foram avaliados pelo método de Avaliação Rápida da Cegueira Evitável. A acuidade visual foi medida e o cristalino foi examinado. Se a acuidade visual apresentada fosse <20/60, então também foi testada com um buraco estenopeico e a fundoscopia realizada. A cegueira e a deficiência visual foram classificadas como deficiência visual moderada com acuidade visual <20/60-20/200; deficiência visual grave com acuidade visual <20/200-20/400; ou cegueira com acuidade visual <20/400. A principal causa de cegueira ou deficiência visual em cada olho foi determinada, e naqueles com catarata, as barreiras ao tratamento foram avaliadas. Resultados: O estudo incluiu 3.850 pessoas com ³50 anos de idade; 3.760 (97,7%) foram examinadas. A prevalência de cegueira ajustada à idade e ao sexo foi de 2,9% (intervalo de confiança de 95%, 2,0-3,8%), 5,2% (4,0-6,4%) deficiência visual grave e 27,6% (23,3-32,0%) deficiência visual moderada. A catarata foi a principal de cegueira (77,6%), seguida de outras doenças do segmento posterior (6,0%). Catarata causada por 79,4% de deficiência visual grave, enquanto erros refrativos não corrigidos causaram 67,9% de deficiência visual moderada. Após a cirurgia de catarata, 75% dos participantes tiveram uma acuidade de 20/200, ou melhor, e 19,0% a deficiência visual não foi melhor do que 20/200 com a correção. O custo foi a principal barreira à cirurgia de catarata (56.7%). Conclusões: A prevalência de cegueira em idosos é maior na Guatemala do que na maioria dos outros países da América Central. A maioria dos casos de cegueira e deficiência visual era evitável ou tratável. O aumento da disponibilidade de tratamento de catarata a preços acessíveis e de alta qualidade teria um impacto substancial na prevenção da cegueira.

ABSTRACT | Purpose: To estimate the prevalence of blindness and visual impairment in older adults living in Guatemala. Methods: Participants ³50 years of age were selected using random cluster sampling and evaluated using the Rapid Assessment of Avoidable Blindness method. Visual acuity was measured, and the lens was examined. If presenting visual acuity was <20/60, it was also tested with a pinhole and fundoscopy was performed. Blindness and visual impairment were classified as moderate visual impairment (presenting visual acuity <20/60 to 20/200), severe visual impairment (presenting visual acuity <20/200 to 20/400), or blindness (presenting visual acuity <20/400). The primary cause of blindness or visual impairment in each eye was determined, and if the cause was cataracts, the barriers to treatment were assessed. Results: The study included 3,850 people ³50 years of age, of whom 3,760 (97.7%) were examined. The age- and sex-adjusted prevalence of blindness was 2.9% (95% confidence interval, 2.0%-3.8%), while 5.2% (4.0%-6.4%) presented with severe visual impairment, and 27.6% (23.3%-32.0%) presented with moderate visual impairment. Cataracts were the leading cause of blindness (77.6%), followed by other posterior segment diseases (6.0%). Cataracts caused 79.4% of cases of severe visual impairment, while uncorrected refractive errors caused 67.9% of cases of moderate visual impairment. Following cataract surgery, 75% of participants had a presenting visual acuity of 20/200 or better, and in 19.0% of participants, visual acuity was not better than 20/200 with correction. Cost was the main barrier to cataract surgery (56.7%). Conclusions: The prevalence of blindness in older adults is higher in Guatemala than in most Central American countries. Most cases of blindness and visual impairment were either preventable or treatable. Increased availability of affordable, high-quality cataract treatment would have a substantial impact on blindness prevention.

https://doi.org/10.5935/0004-2749.20190029 1355 downloads

15.

Evaluación del modelo comunitario de atención a los trastornos mentales en España
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Gómez-Beneyto, Manuel

; Rodríguez Pulido, Francisco

; Caamaño Sánchez, Virginia

; Cifre Llull, Antonia

; del Río Noriega, Francisco

; Estévez Salinas, Juan Antonio

; Arias García, Paz

; Markez Alonso, Iñaki

; Martínez Calvo, Ana

; Lozano Semitiel, María José

; Redero San Román, José María

; de la Mata Ruíz, Iván

; Sánchez Guerrero, Ana

; Sierra Biddle, Deirdre

; Villegas Miranda, Francisco

Revista de la Asociación Española de Neuropsiquiatría

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Jun 2018, Volume 38 Nº 133 Páginas 19 - 43

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract: Introduction: The objective of this study is to evaluate the implementation of the community mental health care model in the Spanish state in 2014. Secondly, we aim to analyze the changes experienced by the model in 2008, in relation to the economic recession. Materials and methods: We adopted the definition of community model proposed in the Strategy in Mental Health of the National Health System; according to which the model is based on 8 principles and is implemented by means of 39 care practices. The Autonomous Boards of the Spanish Association of Neuropsychiatry conducted a survey on the degree of compliance with the community model in each autonomous community. Results: Responses were obtained from 13 Autonomous Boards, which provided information on the 93% of the Spanish population. Conclusion: The most important shortcomings in the implementation of the community model in 2014 were related to the absence of a public health perspective, to poor management and accountability, and a slowdown in the diversification of community-based teams, services and networks. Globally, the model changed little between 2008 and 2014, but some key practices, such as the free and universal health coverage, the sectorization, the shortening of waiting times, the financial support to users and associations of relatives, and the implementation of the “Dependency Act”, deteriorated substantially in many autonomous communities. However, other practices, such as the computerization of medical files, individualized care plans (Care Programme Approach), and the assertive community treatment, increased their coverage in some communities despite the recession.

Resumen: Introducción: El objetivo de este trabajo consiste en evaluar la implementación del modelo comunitario de atención en salud mental en el Estado español en 2014. Secundariamente, se analizan los cambios que el modelo experimentó en 2008, en relación con la recesión económica. Material y Método: Se adoptó la definición de modelo comunitario que se propone en la Estrategia en Salud Mental del SNS, según la cual el modelo se rige por 8 principios y se implementa mediante 39 prácticas asistenciales. Se elaboró una encuesta dirigida a las Juntas Autonómicas de Gobierno de la Asociación Española de Neuropsiquiatría sobre el grado de cumplimiento del modelo comunitario en cada comunidad. Resultados: Se obtuvieron respuestas de 13 Juntas Autonómicas que incluyeron información sobre el 93% de la población española. Conclusión: Las carencias más importantes en la implementación del modelo comunitario en 2014 se relacionaron con la ausencia de una perspectiva de salud pública, con la mala gestión y rendición de cuentas, y la ralentización del desarrollo de equipos, servicios y redes de servicios de orientación comunitaria. El modelo se modificó poco globalmente entre 2008 y 2014, pero algunas prácticas clave, como la universalidad y gratuidad del sistema, la atención sectorizada, el acortamiento de los tiempos de espera, las subvenciones a las asociaciones de usuarios y familiares, y la aplicación de la “ley de dependencia” se contrajeron de forma sustancial en muchas comunidades. Otras prácticas, como la historia clínica informatizada, los planes Individualizados de atención y el tratamiento asertivo comunitario, incrementaron su cobertura en algunas comunidades a pesar de la recesión..

https://doi.org/10.4321/s0211-57352018000100002 3292 downloads

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