ABSTRACT Single nucleotide polymorphisms are variations of a single nucleotide base pair and can be associated to phenotypic characteristics. This study aimed to determine the association of CAPN1 and CAST gene polymorphisms with the tenderness of Creole cattle meat from the Amazonas region, Peru. The texture profile (adhesiveness, cohesiveness, Warner-Bratzler shear force, elasticity, gumminess, and chewiness) of 100 animals was determined in 100 g of Longissimus dorsi et lumborum muscle. Allelic frequencies, genotypic frequencies, and Hardy-Weinberg equilibrium (HWE) of calpain (CAPN-316, CAPN-530) and calpastatin (CAST-2959) gene polymorphisms were studied. Allelic and genotypic frequencies were calculated, as well as the Hardy-Weinberg equilibrium with the Chi-square test. The texture profile of each group of samples corresponding to a polymorphism was compared with the Duncan’s test and the t-test for independent samples (p < 0.05). Genotypic frequencies were 78 % GG and 22 % CC for CAPN-316; 68 % GG, 5 % GA, and 27 % AA for CAPN-530; and 74 % AA, 18 % AG, and 8 % GG for CAST-2959. The CAPN-316, CAPN-530, and CAST-2959 polymorphisms were not in Hardy-Weinberg equilibrium. The CC genotype of CAPN-316 marker influences meat tenderness on day 21 of meat aging. In contrast, the GG genotype of CAST-2959 marker affects meat tenderness at days 14 and 21 of meat aging concerning the other genotypes.

Abstract Recently, interest in studying pigments from lichens has been aroused due to their bioactive properties and health benefits. The Geolashon (Teloschistes flavicans) is a thousand-year-old lichen from the Peruvian Andes characterized by its yellow filaments, traditionally used by the Peruvian inhabitants as a natural pigment for making handicrafts and medicinal purposes. In this sense, this article aims to compile all the studies on Geolashon as a source of natural yellow pigments, starting from its importance and applications by the Andean population to research on obtaining, characterizing, and properties of its extracts. Although studies on this lichen are limited, it was observed that the obtained from lichen are rich in 3-[1’-(2”,3”-dihydroxy-phenyl)-propyl]-7-hydroxy- chroman-4-one, vicanicin, parietin, other compounds and has antidiabetic, antibacterial, antileukemic, antimicrobial, anticancer and termiticide activity that would be interesting for use in the pharmaceutical, cosmetic, food and agricultural industries, generating added value in the final product. Aspects such as processing, functional properties, and toxicology of the bioactive components of Geolashon must be studied for its correct use.

Abstract The objective of this study was to evaluate the spatial distribution and abundance of the only species of freshwater sponge from Lake Titicaca, Balliviaspongia wirrmanni, in the Titicaca National Reserve (RNT). The evaluations were carried out in the aquatic ecosystem of Lake Titicaca, through the random application of quadrats of one m2. In each individual cattail (Schoenoplectus tatora) present in each quadrat, the presence of sponges was evaluated to perform the count. The results were contrasted according to time periods and study areas. Average sponge counts were higher in the RNT zone, with 485 sponges, and lower in the Puno - Capachica zone, with 47 sponges (P < 0.001), with uniform and contagious Morisita dispersion indices, respectively. The abundance was higher in the RNT area with 43.35%, in the months of July and August. The obtained data suggest that sponges prevail in remote areas free of anthropic action and decrease in the proximity of towns and cities because different anthropic activities would be affecting their growth and development in the aquatic ecosystem of Lake Titicaca.

Resumen El objetivo del estudio fue evaluar la distribución espacial y abundancia de la única especie de esponja dulceacuícola del lago Titicaca, Balliviaspongia wirrmanni, en la Reserva Nacional del Titicaca (RNT). Las evaluaciones se realizaron en el ecosistema acuático del lago Titicaca, mediante la aplicación aleatoria de cuadrantes de un m2. En cada individuo de totora (Schoenoplectus tatora) presente en cada cuadrante se evaluó la presencia de esponjas para realizar el recuento. Los resultados fueron contrastados según periodos de tiempo y zonas de estudio. Los recuentos promedios de esponjas fueron mayores en la zona de la RNT, con 485 esponjas, y menores en la zona de Puno - Capachica, con 47 esponjas (P < 0.001), con índices de dispersión de Morisita uniforme y contagiosa, respectivamente. La abundancia fue mayor en el área de la RNT con el 43.35%, en los meses de julio y agosto. Los datos obtenidos sugieren que las esponjas prevalecen en zonas alejadas y libres de acción antrópica y disminuyen en las proximidades de los pueblos y ciudades, en razón de que diferentes actividades antrópicas estarían afectando su crecimiento y desarrollo en el ecosistema acuático del lago Titicaca.

Abstract This study aimed to verify the impact of high-fat diet consumption for a prolonged period on oxidative stress, fetal growth, umbilical vascular system, and placental structures in pregnant goats. Twenty-two pregnant goats were grouped into the control diet (n= 11) and fat diet (n = 11). Flaxseed meal was added to the fat diet, replacing the corn grain of concentrate, from gestational day 100 to delivery date. Diets were isonitrogenous and isoenergetic, differing in fat content (2.8% vs. 6.3% dry matter). The fat group showed higher feed intake and total plasma lipid levels than the control group (P < 0.001). No difference was found in placentome, and umbilical vascular development. Fat diet-fed goats exhibited a lower systolic peak in the umbilical artery. At delivery, placental traits were similar with the exception of the cotyledon width (P = 0.0075), which was smaller in the fat group and cotyledon surface (P = 0.0047) for multiple pregnancy of fat diet. Cotyledonary epithelium showed more intense staining of lipid droplets and a greater area for lipofuscin staining in the fat group compared to control group (P < 0.001). The mean live weight of the kids was lower in the fat group in the first week after delivery than in control group. Thus, in goats, the continuous administration of a high-fat diet during pregnancy does not appear to modify the fetal-maternal vascular structures but has an impact on a part of the placental structure; therefore, its use must be carefully evaluated.

Abstract This study aimed to investigate the effect of growth and differentiation factor 9 (GDF-9) during the in vitro culture of isolated caprine early antral follicles. The isolated and selected early antral follicles were individually cultured for 18 days, and the following treatments were tested: α-MEM+ (control treatment) or α-MEM+ supplemented with 200 ng/mL GDF-9. The following endpoints were evaluated: follicular growth and morphology, estradiol production, oocyte nuclear maturation, and relative expression of key genes related to steroidogenesis (CYP19A1, CYP17, and insulin receptor) and basement membrane remodeling (MMP-9 and TIMP-2). In both treatments, a decrease was observed in the percentage of morphologically intact follicles with a concomitant increase in the rates of extruded and degenerated follicles (P < 0.05). The GDF-9 treatment showed higher rates of extruded follicles only on day 6 of culture (P < 0.05). Follicle diameter increased progressively throughout the culture period (P < 0.05) with similar diameters between treatments at all culture times (P > 0.05). Growth and differentiation factor 9 increased the daily growth rate from the first to the second third of culture, with higher values (P < 0.05) than control in the second third. Oocyte maturation rate as well as estradiol levels and relative mRNA expression for CYP19A1, CYP17, MMP-9, TIMP-2, and insulin receptor genes were similar between treatments (P > 0.05). This study shows for the first time that GDF-9 added to a culture medium increased the follicle growth rate of goat early antral follicles cultured in vitro.

Resumo Este estudo teve como objetivo investigar o efeito do GDF-9 durante o cultivo in vitro de folículos antrais iniciais caprinos isolados. Os folículos antrais iniciais isolados e selecionados foram cultivados individualmente por 18 dias, e os seguintes tratamentos foram testados: α MEM+ (tratamento controle) ou α-MEM+ suplementado com 200 ng/mL de GDF-9 (tratamento GDF-9). Os seguintes parâmetros foram avaliados: crescimento e morfologia folicular, produção de estradiol, maturação nuclear do oócito e expressão relativa de genes-chave relacionados a esteroidogênese (CYP19A1, CYP17 e receptor de insulina) e remodelamento da membrana basal (MMP-9 e TIMP-2). Em ambos os tratamentos, observou-se diminuição na porcentagem de folículos morfologicamente intactos com aumento concomitante nas taxas de folículos extrusos e degenerados (P < 0,05). O tratamento GDF-9 apresentou maiores taxas de folículos extrusos apenas no 6º dia de cultivo (P < 0,05). O diâmetro do folículo aumentou progressivamente ao longo do período de cultivo (P < 0,05) com diâmetros semelhantes entre os tratamentos em todos os tempos de cultivo (P > 0,05). O GDF-9 aumentou a taxa de crescimento diário do primeiro para o segundo terço de cultivo, sendo maior (P < 0,05) que o controle no segundo terço. A taxa de maturação oocitária assim como os níveis de estradiol e a expressão relativa de RNAm para os genes CYP19A1, CYP17, MMP-9, TIMP-2 e receptor de insulina foram similares entre os tratamentos (P > 0,05). Em conclusão, este estudo mostra pela primeira vez que GDF-9 adicionado a um meio de cultivo aumentou a taxa de crescimento de folículos antrais iniciais caprinos cultivados in vitro.

Resumen La acromegalia es una enfermedad rara, causada principalmente por un tumor hipofisiario secretor de hormona de crecimiento (GH), se caracteriza por tener progresión lenta y asociarse a un compromiso multisistémico, siendo el aparato cardiovascular uno de los más comprometidos, llegando, incluso, desde hace más de 10 años a representar la principal causa de muerte. Las complicaciones cardiovasculares se desarrollan como resultado de las concentraciones sanguíneas elevadas de la GH y del factor de crecimiento similar a la insulina tipo 1 (IGF-1), los cuales ejercen efectos directos e indirectos sobre el endotelio, grandes vasos, riñón y los cardiomiocitos; produciendo hipertensión arterial, enfermedad valvular, arritmia cardiaca y una cardiopatía propia de la acromegalia denominada miocardiopatía acromegálica. Luego de la revisión bibliográfica actualizada relacionada con la fisiopatología, manifestaciones clínicas, diagnóstico y tratamiento del compromiso cardiovascular, encontramos que desde el punto de vista cardiovascular los pacientes con acromegalia pueden variar desde un estado asintomático hasta presentar disfunción cardiaca severa, siendo los marcadores bioquímicos y exámenes de imagen herramientas diagnósticas que permiten evaluar el grado de afección cardiovascular para poder brindar un tratamiento individualizado. La normalización de los valores de la GH y del IGF-1 mejora los parámetros cardiovasculares y, por tanto, su pronóstico.

Abstract Acromegaly is a rare disease, mainly caused by a pituitary tumor secreting growth hormone. It is characterized by slow progression and is associated with a multisystemic involvement, being the cardiovascular system, one of the most involved, even reaching, more than 10 years ago, to represent the main cause of death. Cardiovascular complications develop as a result of elevated blood concentrations of growth hormone and insulin-like growth factor 1, which exert direct and indirect effects on the endothelium, large vessels, kidney and cardiomyocytes; causing arterial hypertension, valve disease, cardiac arrhythmia and a specific heart disease called acromegalic cardiomyopathy. After the literature overview related to the pathophysiology, clinical manifestations, diagnosis and treatment of cardiovascular involvement, we found that from a cardiovascular point of view, patients with acromegaly can range from an asymptomatic state to severe cardiac dysfunction, being the biochemical markers and imaging studies diagnostic tools that allow assessment the degree of cardiovascular disease in order to provide individualized treatment. The normalization of growth hormone and insulin-like growth factor 1 levels improves cardiovascular parameters, and therefore its prognosis.

RESUMEN El objetivo de la investigación fue describir la producción científica sobre estudios psicométricos de instrumentos de tamizaje para la depresión en población peruana. Para ello, se realizó un estudio descriptivo de la literatura científica en Scopus, Web of Science, PubMed y SciELO, con descriptores para depresión, propiedades psicométricas y Perú. Luego del proceso de revisión se incluyeron 22 estudios. Se encontraron validaciones de instrumentos de tamizaje en adultos mayores, adultos, adultos con depresión, mujeres adultas, mujeres embarazadas, profesionales de salud, estudiantes universitarios, estudiantes de secundaria y niños. El Patient Health Questionnaire (PHQ-9) fue el instrumento más estudiado. A pesar de que los estudios psicométricos cubren la mayoría de las poblaciones, quedan pendientes los pueblos originarios y poblaciones clínicas. El PHQ-9, por sus características, podría implementarse en las políticas de salud mental del Perú.

ABSTRACT The aim of the research was to describe the scientific output of psychometric studies on screening instruments for depression in the Peruvian population. We carried out a descriptive study of the scientific literature in Scopus, Web of Science, PubMed and SciELO, with descriptors for depression, psychometric properties, and Peru. After the review process, we included 22 studies. We found validations of screening instruments for older adults, adults, adults with depression, adult women, pregnant women, health professionals, university students, high school students and children. The Patient Health Questionnaire (PHQ-9) was the most widely used instrument. Psychometric studies cover most populations; however, native people and clinical populations remain to be studied. The PHQ-9, due to its characteristics, could be implemented in mental health policies in Peru.

ABSTRACT The aim of the research was to describe the scientific output of psychometric studies on screening instruments for depression in the Peruvian population. We carried out a descriptive study of the scientific literature in Scopus, Web of Science, PubMed and SciELO, with descriptors for depression, psychometric properties, and Peru. After the review process, we included 22 studies. We found validations of screening instruments for older adults, adults, adults with depression, adult women, pregnant women, health professionals, university students, high school students and children. The Patient Health Questionnaire (PHQ-9) was the most widely used instrument. Psychometric studies cover most populations; however, native people and clinical populations remain to be studied. The PHQ-9, due to its characteristics, could be implemented in mental health policies in Peru.

RESUMEN El objetivo de la investigación fue describir la producción científica sobre estudios psicométricos de instrumentos de tamizaje para la depresión en población peruana. Para ello, se realizó un estudio descriptivo de la literatura científica en Scopus, Web of Science, PubMed y SciELO, con descriptores para depresión, propiedades psicométricas y Perú. Luego del proceso de revisión se incluyeron 22 estudios. Se encontraron validaciones de instrumentos de tamizaje en adultos mayores, adultos, adultos con depresión, mujeres adultas, mujeres embarazadas, profesionales de salud, estudiantes universitarios, estudiantes de secundaria y niños. El Patient Health Questionnaire (PHQ-9) fue el instrumento más estudiado. A pesar de que los estudios psicométricos cubren la mayoría de las poblaciones, quedan pendientes los pueblos originarios y poblaciones clínicas. El PHQ-9, por sus características, podría implementarse en las políticas de salud mental del Perú.

ABSTRACT Introduction: Lifestyle is a fundamental role in the risk of cardiovascular diseases and chronic diseases. Objective: To evaluate the effect of the 16/8 intermittent fasting scheme against anthropometric measurements, lipid profile values, blood pressure and cardiovascular risk. Method: Longitudinal analytical study with intervention. Fifteen patients treated in the nutrition area in a private center between January and October 2020 submitted to the 16/8 intermittent fasting scheme for four months, seeking to reduce anthropometric measurements, lipid profile, blood pressure and / or cardiovascular risk. Variables: body weight, body mass index (BMI), waist-hip index (WHI), abdominal circumference, lipid profile, cardiovascular risk according to Framingham (Framingham AMR B table), total cholesterol / HDL and LDL / HDL indices. Results: The average age was 47.1 years, the average height was 1.66 m., The average body weight was 84.3 Kg., The average of the BMI was 30.46, the average of the WHI was 0.94, the average of the abdominal circumference was 99.87, the mean total cholesterol, HDL and LDL were 240.06, 43.73 and 153.2 respectively, the mean cardiovascular risk according to Framingham was 0.11% and the mean total cholesterol / HDL and LDL / HDL indices were 5.88 and 3.69. The evaluation of averages before and after found significant differences (p < 0.05) at 3 and 4 months of evaluation. Conclusions: The intermittent fasting scheme showed a significant reduction in anthropometric measurements, lipid profile and cardiovascular risk. Additionally, an increase in HDL was observed.

RESUMEN Introducción: El estilo de vida juega un rol fundamental en el riesgo de enfermedades cardiovasculares y enfermedades crónicas. Objetivo: Evaluar el efecto del esquema de ayuno intermitente 16/8 frente a las medidas antropométricas, valores de perfil lipídico, presión arterial y riesgo cardiovascular. Método: Estudio analítico longitudinal con intervención. Quince pacientes tratados en el área de nutrición en un centro privado entre enero y octubre del 2020 sometidos al esquema de ayuno intermitente 16/8 por cuatro meses, buscando la reducción de medidas antropométricas, perfil lipídico, presión arterial y/o riesgo cardiovascular. Variables: peso corporal, índice de masa corporal (IMC), índice cintura - cadera (ICC), circunferencia abdominal, perfil lipídico, riesgo cardiovascular según Framingham (tabla de Framingham AMR B), índices colesterol total/HDL y LDL/HDL. Resultados: La edad promedio fue 47.1 años, la talla promedio fue 1.66 m., el peso corporal promedio fue 84.3 Kg., el promedio del IMC fue 30.46, el promedio del ICC fue 0.94, el promedio de la circunferencia abdominal fue 99.87, el promedio del colesterol total, HDL y LDL fue 240.06, 43.73 y 153.2 respectivamente, el promedio del riesgo cardiovascular según Framingham fue 0.11% y el promedio de los índices colesterol total/HDL y LDL/HDL fue 5.88 y 3.69. La evaluación de promedios antes y después encontró diferencias significativas (p < 0.05) a los 3 y 4 meses de evaluación. Conclusiones: El esquema de ayuno intermitente mostró reducción significativa de las medidas antropométricas, perfil lipídico y riesgo cardiovascular. Adicionalmente se observó aumento del HDL.

ABSTRACT Endoscopic retrograde cholangiopancreatography (ERCP) is currently considered a diagnostic and therapeutic procedure in obstructive lesions of the biliary tract, especially choledocholithiasis and stenosis, as well as in pancreatic diseases in general. However, it is known the development of certain complications such as acute pancreatitis, acute cholangitis, cholecystitis among others of lower incidence within which the hepatic subcapsular hematoma takes relevance due to its high mortality. We present the case of a 52-year-old male patient who three hours after undergoing ERCP develops abdominal pain of sudden onset with significant reduction of hematocrit, and imaging study shows a hepatic subcapsular hematoma. He was initially managed conservatively and then proceeded to a percutaneous drainage, subsequently showing residual descending contents by radiological follow-up.

RESUMEN La colangiopancreatografía retrógrada endoscópica (CPRE) es considerado actualmente un procedimiento diagnóstico y terapéutico en lesiones obstructivas del tracto biliar sobretodo coledocolitiasis y estenosis, así como en enfermedades pancreáticas en general. Sin embargo, es conocido el desarrollo de ciertas complicaciones tales como pancreatitis aguda, colangitis aguda, colecistitis entre otras de menor incidencia dentro de las cuales el hematoma subcapsular hepático toma relevancia por su elevada mortalidad. Presentamos el caso de un paciente varón de 52 años que luego de tres horas de ser sometido a CPRE desarrolla dolor abdominal de inicio repentino con reducción importante del hematocrito, y mediante estudio de imágenes se evidencia un hematoma subcapsular hepático. Es manejado inicialmente de forma conservadora y luego se procede a un drenaje percutáneo, evidenciándose posteriormente contenidos residuales en descenso mediante seguimiento radiológico.

Resumen José Carlos Mariátegui, asentamiento humano del distrito de San Juan de Lurigancho (Lima, Perú), es una comunidad donde coexisten e interactúan personas con distintas culturas, entre ellas, pobladores bilingües del castellano y el quechua. Este contexto permite evidenciar la relación entre la lengua y la sociedad, mediante las actitudes lingüísticas que presentan sus habitantes. En este sentido, el presente estudio es un acercamiento a la descripción de las actitudes lingüísticas de un grupo de migrantes andinos bilingües (quechua-castellano) hacia su lengua materna, el quechua, frente al castellano. Desde el enfoque de la teoría mentalista y sus dimensiones: conativo, cognitivo y afectivo, así como también, con la aplicación de un cuestionario y una entrevista de corte sociolingüístico, se analizó la percepción que tienen los adultos bilingües mariateguinos hacia su lengua materna. Los resultados demostraron la valoración positiva hacia el quechua, principalmente desde la dimensión afectiva.

Abstract José Carlos Mariátegui, a human settlement in the district of San Juan de Lurigancho (Lima, Peru), is a community where people living and interacting with different cultures, including bilingual inhabitants of spanish and quechua. This context allows us to show the relationship between language and society through the linguistic attitudes of its inhabitants. In this sense, the present study is an approach to the description of the linguistic attitudes of a group of bilingual Andean migrants (quechua-castilian) towards their mother tongue, quechua, versus castilian. From the perspective of mentalist theory and its dimensions: conative, cognitive and affective, as well as, the application of a questionnaire and a sociolinguistic interview, the perception of bilingual mariateguin adults towards their mother tongue was analyzed. The results showed the positive assessment towards quechua, mainly from the affective dimension.

Resumo José Carlos Mariátegui, assentamento humano do distrito de San Juan de Lurigancho (Lima, Peru), é uma comunidade onde coexistem e interagem pessoas com diferentes culturas, entre elas, habitantes bilíngues do castelhano e do quéchua. Este contexto permite evidenciar a relação entre a língua e a sociedade, mediante as atitudes linguísticas que apresentam os seus habitantes. Neste sentido, o presente estudo é uma aproximação à descrição das atitudes linguísticas de um grupo de migrantes andinos bilíngües (quechua-castelhano) para sua língua materna, o quechua, em frente ao castelhano. Desde o enfoque da teoria mentalista e suas dimensões: conativo, cognitivo e afetivo, bem como, com a aplicação de um questionário e uma entrevista de corte sociolinguístico, analisou-se a percepção que os adultos bilíngues mariateguinos têm da sua língua materna. Os resultados mostraram a avaliação positiva para o quíchua, principalmente da dimensão afetiva.

Abstract The objective of the research was: to determine the influence of motivation on the physical performance of the fourth-year cadets of the School of Officers of the National Police of Peru. It was a study with a quasi-experimental design in order to measure the degree of influence of the independent variable, which is motivation, on the dependent variable, physical performance. A population of 200 cadets is used and two groups are formed: one experimental and one control. The Cooper test for aerobic endurance and the Burpee test for anaerobic endurance are applied. Among the main results is the direct and significant influence of motivation on the physical performance of cadets.

Resumen La investigación tuvo como objetivo: determinar la influencia de la motivación en el rendimiento físico de los cadetes de cuarto año de la Escuela de Oficiales de la Policía Nacional del Perú. Fue un estudio con diseño cuasi experimental con el propósito medir el grado de influencia de la variable independiente que es la motivación, sobre la variable dependiente, el rendimiento físico. Se utiliza una población de 200 cadetes y se forman dos grupos: uno experimental y uno de control. Se aplica el test de Cooper para la resistencia aeróbica y el test de Burpee para la resistencia anaeróbica. Entre los principales resultados se aprecia la influencia, directa y significativa de la motivación en el rendimiento físico de los cadetes.

ABSTRACT Objective: To identify the need to implement Evidence-Based Medicine (EBM) courses in the undergraduate curricula of Peruvian universities. The estudy: Descriptive observational study. The prevalence of teaching the EBM course in the medical schools of Peruvian universities was evaluated, as well as the semester in which it was taught and its obligatoriness. Findings: Of 44 medical schools evaluated, eight (18.2%) included an EBM course in their curricula, of which five(62.5%) corresponded to private universities and in seven(87,5%) the course was mandatory. Conclusions: The teaching of EBM in Peruvian university medical schools is low, potentially leading to less confidence and certainty in clinical decision making.

RESUMEN Objetivo: Identificar la necesidad de implementar cursos de Medicina Basada en la Evidencia (MBE) en los planes de estudio de pregrado de las universidades peruanas. El estudio: Estudio observacional de tipo descriptivo. Se evaluó la prevalencia de la enseñanza del curso de MBE en las escuelas de medicina de universidades peruanas, el semestre en el que se enseñaba y la obligatoriedad. Hallazgos: De 44 escuelas de medicina evaluadas, ocho (18,2%) incluían un curso de MBE en sus planes de estudio, de las que cinco (62,5%) correspondían a universidades privadas y en siete(87,5%) el curso era obligatorio. Conclusiones: La enseñanza de la MBE en las escuelas de medicina de las universidades peruanas es baja, pudiendo conducir a una menor confianza y certeza en la toma de decisiones clínicas.

ABSTRACT Introduction. Dropout rates hinder the achievement of staff training goals, affecting the service they provide to the population. Objective. Identify the main difficulties and obstacles to participate in the academic activities of ENSAP, 2018-2020, that health workers report in order to improve the scope of its academic offer. Methods. Descriptive cross-sectional research at the national level applying an anonymous online Likert-type questionnaire with 44 questions, validated (Cronbach's α of 0.888). Results. We received 3299 responses from personnel with similar general characteristics and representative of the target audience and beneficiary of ENSAP. The answers come from a mostly female sample, with nursing and / or nursing technical training, between 30 and 49 years of age. 41% have an additional job; dedicates a maximum of 5 hours / week to training and after 6:00 p.m. Excessive workload (82%), family burden (51%), poor network connection (57%), lack of recognition or compensation for training hours (49%), forgetting registration (47%) and forgetting platform´s password (41%) were the most mentioned obstacles. Conclusions. Continuous training through online modalities offers a great opportunity to reach more people at the national level. The high number of people enrolled in ENSAP activities reflects a great demand and interest in distance training, but it is necessary to propose alternatives to the obstacles they face to complete training without reinforcing existing inequalities.

RESUMEN Introducción. Las tasas de abandono de cursos obstaculizan el logro de metas de capacitación del personal afectando el servicio que brindan a la población. Objetivo. Identificar las principales dificultades y obstáculos que los trabajadores de salud reportan para participar en las actividades académicas de ENSAP, 2018-2020, con fines de mejorar el alcance de su oferta académica. Métodos. Investigación transversal descriptiva de nivel nacional aplicando un cuestionario virtual anónimo tipo Likert de 44 preguntas, validado (α de Cronbach de 0,888). Resultados. Recibimos 3299 respuestas de personal con características generales similares y representativas del público objetivo y beneficiario de ENSAP. Las respuestas fueron de una muestra mayoritariamente femenina, con formación enfermería y/o técnico en enfermería, entre los 30 y 49 años de edad. 41% tuvo un trabajo adicional; dedica a la capacitación un máximo 5 horas/semana después de las 18:00 hs. La carga laboral (82%), carga familiar (51%), mala conexión a red (57%), la falta de reconocimiento o compensación por capacitación de los jefes (49%), olvidar haberse inscrito (47%) y olvidar la contraseña de acceso (41%) fueron los obstáculos más mencionados. Conclusiones. La formación continua a distancia ofrece una oportunidad para llegar al personal de salud nivel nacional. El alto número de inscritos en las actividades de ENSAP refleja una gran demanda e interés por capacitarse a distancia, pero es necesario plantear alternativas frente a los obstáculos que enfrentan para culminar la capacitación sin reforzar las desigualdades existentes.