Resumen Las bebidas vegetales de soja constituyen una alternativa dentro de la dieta habitual. Sin embargo, existe la preocupación de potenciales efectos en la salud reproductiva de la mujer por mecanismos de disrupción endócrina. En esta revisión se evalúan documentos científicos en el área de la Ginecología y la Obstetricia bajo el tamiz de la medicina basada en la evidencia, respondiendo preguntas estructuradas. La metodología se apegó a las guías establecidas por la declaración PRISMA 2020. Los estudios evaluados descartan un riesgo incrementado de pubertad precoz o cáncer de mama; incluso se aprecia un efecto protector frente a dicha neoplasia. Se ha reportado el paso transplacentario de isoflavonas de soja y su presencia en la leche materna, sin que ello implique una relación con complicaciones materno-fetales o malformaciones congénitas. La exposición a productos de soja no parece influir sobre el peso corporal y la salud ósea de la mujer. Los estudios en adultos indican que la soja favorece un mínimo incremento de tirotropina (TSH) en personas con antecedente de hipotiroidismo subclínico. El impacto de los alimentos basados en soja sobre la microbiota intestinal parece ser favorable para su diversidad, particularmente al consumir productos fermentados. Muchos de los estudios en humanos han sido realizados con suplementos de isoflavonas o con productos que contienen proteínas aisladas o texturizadas de soja. Por tanto, los resultados y las conclusiones deben interpretarse con cautela ya que no son totalmente extrapolables a las bebidas comerciales de soja.

Abstract Soy drinks are an increasingly consumed option within the Western diet. However, there are concerns about potential endocrine disruptor effects and possible impact on women's reproductive health. This review evaluates scientific documents in gynecology and obstetrics under an evidence-based medicine approach. All methods adhered to PRISMA 2020 declaration guidelines. The evaluated studies do not support a positive association between soy intake and early puberty or breast cancer; instead, a protective effect against such neoplasm was observed. Transplacental passage of soy isoflavones and their presence in breast milk has been reported without any maternal-fetal complications nor congenital malformations. Exposure to soy-derived products appears to have a neutral effect on body weight and bone health. Studies performed in adults indicate that soy may promote a minimal increase in thyrotropin (TSH) in subjects with subclinical hypothyroidism. The impact of soy-based foods on gut microbiota appears favorable, especially when consuming fermented products. Many of the human studies have been conducted with isoflavones supplements, isolated or textured soy proteins. Therefore, the results and conclusions should be interpreted cautiously, as these are not entirely applicable to commercial soy beverages.

Abstract Mucopolysaccharidosis type VI, also known as Maroteaux-Lamy syndrome, is caused by a deficiency of the arylsulfatase B enzyme, which causes intracellular accumulation of dermatan sulfate. The risk of spinal cord compression is particularly high and frequent at the occipitocervical junction. Enzyme replacement therapy has been essential for patients with this disease; however, it has no effect on skeletal abnormalities, and its impact on spinal stability is still under study. An annual examination (neurological evaluation, radiography, magnetic resonance imaging, and somatosensory evoked potentials) is recommended. In case of anomalies, it should be repeated every 6 months. Despite the high anesthetic risk, myelopathy and progressive symptoms indicate the need for surgical decompression. We present the case of a 12-year-old girl with mucopolysaccharidosis type VI treated with enzyme replacement therapy since the age of 7, who came to the consultation with symptoms compatible with progressive high cervical myelopathy. She underwent occipitocervical decompression and fusion with enlargement of the foramen magnum. This disease is rare; therefore, multidisciplinary patient follow-up is imperative, as well as knowing the risk of spinal cord compression and its timely surgical treatment by spinal surgeons.

Resumen La mucopolisacaridosis tipo VI o síndrome de Maroteaux-Lamy se produce por la deficiencia de la enzima arilsulfatasa B que ocasiona la acumulación intracelular de dermatán sulfato. El riesgo de compresión medular es particularmente elevado y muy frecuente en la unión occipito-cervical. La terapia de reemplazo enzimático ha sido esencial para los pacientes con esta enfermedad; sin embargo, no tiene efecto sobre las alteraciones esqueléticas, y su impacto sobre la estabilidad espinal está aún en estudio. Se sugiere un examen anual (evaluación neurológica, radiografías, resonancia magnética y potenciales provocados somatosensitivos) y, en caso de anomalías, cada 6 meses. Pese al alto riesgo anestésico, la mielopatía y los síntomas progresivos indican la necesidad de una descompresión quirúrgica. Presentamos a una niña de 12 años con mucopolisacaridosis tipoVI tratada con terapia de reemplazo enzimático desde los 7 años, que acude a la consulta con síntomas compatibles con mielopatía cervical alta progresiva. Fue sometida a una descompresión y artrodesis occipito-cervical con ampliación del foramen magno. Esta enfermedad es infrecuente; por lo tanto, es imperativo el seguimiento multidisciplinario del paciente, así como conocer el riesgo de compresión medular y su oportuno tratamiento quirúrgico a cargo de cirujanos espinales.

Abstract The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to “other reasons”, no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.

Resumo O objetivo do presente estudo foi identificar os motivos das extrações dentárias em pacientes que procuram atendimento odontológico em uma clínica odontológica universitária no México. Este é um estudo transversal que avaliou 284 pacientes consecutivos na Faculdade de Odontologia da Universidad Autónoma del Estado de México entre agosto de 2017 e novembro de 2018. No total, foram realizadas 505 extrações. A variável dependente foi o motivo da extração: 0) cárie dentária e sequelas subsequentes (categoria de referência); 1) doença periodontal e sequelas subsequentes; e 2) outros motivos. Variáveis sociodemográficas, socioeconômicas e clínicas foram incluídas como variáveis independentes. A análise foi feita com regressão logística multinomial (Stata 14.0). De todas as extrações, 63,6% (n=321) foram devidas a cárie dentária e sequelas subsequentes; 22,0% (n=111) foram devidas a doença periodontal e sequelas subsequentes; 5,3% (n=27) a insucesso endodôntico; 5,1% (n=26) a indicações protéticas; 1,6% (n=8) a indicações ortodônticas; e o restante (2,4%) foi devido a outros motivos. No modelo multivariado, as extrações por doença periodontal vs. cárie dentária foram associadas ao tabagismo ocasional (Odds Ratio, OR=3,90) ou ao uso diário de tabaco (OR=3,19); ao fato de o dente a ser extraído ter sido restaurado anteriormente (OR=2,35); à extração de dentes anteriores em vez de posteriores (OR=2,63); e a pacientes com extrações múltiplas (OR=2,68). No caso de extrações devido a "outros motivos", nenhuma variável foi significativa. A cárie dentária e a doença periodontal foram os principais motivos de extração dentária nessa amostra. Diversas variáveis, principalmente clínicas, foram associadas às extrações por motivos periodontais.

Resumen Introducción: El quiste óseo aneurismático es una lesión seudotumoral lítica, expansiva, compuesta por espacios llenos de sangre separados por tabiques. Representa el 15% de los tumores primarios en la columna, y su presentación de comportamiento agresivo es aún más infrecuente. Se han descrito diferentes opciones terapéuticas en función de su estadio y tasa de recurrencia. Presentamos a un paciente con compromiso neurológico secundario a un quiste óseo aneurismático en la columna torácica, de comportamiento agresivo, que requirió resolución quirúrgica. Conclusión: Las opciones de tratamiento del quiste óseo aneurismático se deben adecuar a cada caso en particular, según sus características.

Abstract Introduction: An aneurysmal bone cyst is an expansive, lytic, pseudotumoral lesion that consists of blood-filled spaces separated by septa. It represents 15% of primary spinal tumors. An aggressive presentation is even rarer. Different therapeutic options are described depending on its stage and recurrence rate. We present the case of a patient with neurological involvement due to the aggressive behavior of an aneurysmal bone cyst in the thoracic spine, which required surgical treatment. Conclusion: Treatment options for aneurysmal bone cysts must adapt to each case, depending on its characteristics.

Abstract Background: The Mexican Hepato-Pancreato-Biliary Association (AMHPB) conducted a survey, aiming to gather experience and opinions of HPB surgeons about HPB surgery in the 2020 COVID-19 pandemic year. Methods: An online survey was conducted (33 items: demographics, patient referral, COVID-19 screening and limitations, hospital occupancy and surgical practice) to AMHPB members and attendees of the previous meetings of the Society through a self-administered questionnaire. Answers were excluded if respondents were not from Latin America. Results: 88 participants answered (47.5 ± 10 years, 94% male and 65.9% Mexicans). About 8% worked in COVID-19 converted hospitals. About 1.1% did not perform pre-operative COVID-19 testing. Polymerase chain reaction (33%) was the most common COVID-19 pre-operative test. The number of patient referrals decreased 62.5%. About 29.5% had one patient who died from COVID-19 during preoperative surgical evaluation. About 64.7% answered that surgical case volume decreased. About 17% and 23% respondents considered that surgical morbidity and mortality increased, respectively. Hospital resources and COVID-19 infection were responsible for change in surgical outcomes. Lack of ICU beds (54%) was the most common cause of surgical cancellation. Conclusion: COVID-19 had a strong negative impact on HPB surgery in Mexico and Latin America in terms of patient reference, case volume and surgical outcomes.

Resumen Introducción: La Asociación Mexicana Hepato-Pancreato-Biliar (AMHPB) realizó una encuesta con el objetivo de recopilar experiencias/opiniones de cirujanos HPB sobre cirugía HPB en el 2020 con pandemia COVID-19. Métodos: Se realizó encuesta virtual (33 ítems: demografía, derivación de pacientes, tamizaje/limitaciones COVID-19, ocupación hospitalaria y práctica quirúrgica) a miembros de la AMHPB y asistentes a reuniones previas de la Sociedad a través de un cuestionario autoadministrado. Se excluyeron las respuestas que no fueran de América Latina. Resultados: Respondieron 88 participantes (47.5 ± 10 años, 94% hombres y 65.9% mexicanos). 8% trabajaba en hospitales reconvertidos COVID-19. 1,1% no realizó prueba COVID-19 preoperatoria. La Polymerase chain reaction (33%) fue laprueba preoperatoria COVID-19 más común. Lareferencia de pacientes disminuyó 62,5%. El 29,5% tuvo paciente fallecido por COVID-19 durante la evaluación preoperatoria. 64,7% respondió que el volumen de casos quirúrgicos disminuyó. El 17% y23% consideraron que la morbilidad y mortalidad quirúrgicas aumentaron respectivamente. Los recursos hospitalarios e infección por COVID-19 influyeron en los resultados quirúrgicos. La falta de camas de UCI (54%) fue lo más común en cancelación quirúrgica. Conclusión: COVID-19 tuvo un fuerte impacto negativo en la cirugía HPB en México y América Latina en referencia de pacientes, volumen de casos y resultados quirúrgicos.

RESUMEN Introducción: El trasplante de órganos es considerado como uno de los mayores avances de la medicina, no solo por recuperar la salud, sino por mejorar la calidad de vida de las personas con enfermedades crónicas o terminales. Objetivo: Identificar la supervivencia del injerto y pacientes sometidos a trasplante renal, así como los factores asociados en un Hospital de Alta Especialidad de Mérida, Yucatán, México. Material y Método: Estudio epidemiológico, observacional, longitudinal y retrospectivo donde se analizó el 100% de los expedientes disponibles de pacientes con trasplante renal, cuyo procedimiento se realizó a partir de enero de 2010 a diciembre de 2018. Resultados: La supervivencia global de los pacientes, fue de 96,7% a 1 año (IC:95%: 0,92-0,99) y 90,7% a 5 años (IC:95%: 0,75-0,97). La administración de terapia inmunosupresora previa al trasplante es un factor independiente de protección frente al desenlace de mortalidad o fallo del injerto (p=0,02). La supervivencia del injerto fue de 79,2% a 1 año (IC:95%: 0,71-0,85), y 41,37% a 5 años (IC:95%: 0,27-0,54). La dislipidemia (p=0,01), la diabetes tipo 2 (p=0,09), la isquemia fría (p=0,01), la isquemia caliente (p=0,02), la edad (p=0,03), y el Índice de Masa Corporal (p=0,01) fueron determinantes de la supervivencia del injerto. Conclusiones: La supervivencia del paciente y del injerto son distintas. La administración de inmunosupresor previo al trasplante afecta la supervivencia del paciente; mientras que factores de riesgo cardiovascular y los tiempos de isquemia estuvieron ligados a la supervivencia del injerto.

ABSTRACT Introduction: Organ transplantation is considered one of the greatest advances in medicine, not only for restoring health, but also for improving the quality of life of people with chronic or terminal diseases. Objective: To identify graft and renal transplant patient survival and associated factors in a high specialty hospital in Merida, Yucatan, Mexico. Material and Method: Epidemiological, observational, longitudinal and retrospective study analysing all available records of renal transplant patients whose procedure was performed from January 2010 to December 2018. Results: Overall patient survival was 96.7% at 1 year (95% CI:0.92-0.99) and 90.7% at 5 years (95% CI:0.75-0.97). The administration of immunosuppressive therapy prior to transplantation is an independent factor for protection against the outcome of mortality or graft failure (p=0.02). Graft survival was 79.2% at 1 year (95% CI:0.71-0.85), and 41.37% at 5 years (95% CI:0.27-0.54). Dyslipidaemia (p=0.01), type 2 diabetes (p=0.09), cold ischaemia (p=0.01), warm ischaemia (p=0.02), age (p=0.03), and body mass index (p=0.01) were determinants of graft survival. Conclusions: Patient and graft survival are distinct. Pre-transplant immunosuppressant administration affects patient survival, while cardiovascular risk factors and ischaemia times were linked to graft survival.

Resumo Este trabalho apresenta os resultados de um estudo sobre a Caixa Econômica Particular de Ouro Preto desde sua fundação, em 1838, até sua liquidação, em 1901. Acompanharemos a origem e o desenvolvimento dessa instituição por meio de seus estatutos e da legislação bancária do século XIX. A seguir, tentaremos mostrar, a partir de dados primários, duas de suas características mais marcantes: sua relação com o Estado e a diversificação da aplicação de seus fundos, especialmente entre 1880 e 1892. Consideraremos também a concorrência com a “Caixa Econômica pública”. Finalmente, trataremos a crise bancária da década de 1890 e, de maneira mais específica, o ocaso da Caixa Econômica Particular em 1901.

Abstract This paper presents the results of a research about Caixa Econômica Particular de Ouro Preto since its foundation, in 1838, until its bankruptcy, in 1901. First, we will follow the origins and development of this institution through its statutes and the banking legislation of the nineteenth century. In the following, using primary data, we will try to show two of its most striking features: its relationship with the State and the diversity in the application of its funds, especially between 1880 and 1892. Competition with the “Caixa Econômica pública” will also be considered. Finally, we will deal with the banking crisis of the decade of 1890 and more specifically the decline of Caixa Econômica Particular in 1901.

Abstract Objective: The aim of this study is to assess the perceptions of the impact of health-care disruption due to COVID-19 on the academic training and skills of surgical trainees. Material and Methods: We developed a 32-question survey assessing the clinical and surgical impact of COVID-19 on surgical training programs and proposals to compensate for the decrease in surgical education. We got 453 responses of surgical trainees in Mexico City. Results: Sixty-six percent of the respondents answered that their centers had converted to the exclusive attention of COVID-19 patients. Ninety-five percent reported a decrease in surgical skills learning and 91.8% reported a decrease to clinical exposure. On proposals, 75.6% reported that it is essential to take the necessary measures to recover the clinical and surgical milestones lost. In the binary logistic regression analysis, we found that the postgraduate year (≥ PG-Y3) was statistically significant factor (p ≤ 0.000) related to a favorable opinion to developing an academic contingency plan and postponing the end of the academic residency year. Conclusion: More than 90% of the survey respondents reported having been affected by COVID-19 mitigation strategies. Our data calls for urgent training adjustments by hospital and university program leaders to mitigate downstream educational repercussions.

Resumen Objetivo: Evaluar las percepciones del impacto de la interrupción de la atención médica por COVID-19 en la formación académica y las habilidades de los residentes quirúrgicos. Material y Métodos: Realizamos una encuesta de 32 preguntas, evaluando el impacto clínico y quirúrgico del COVID-19 en los programas de entrenamiento quirúrgico y propuestas para compensar la disminución de la educación quirúrgica. Obtuvimos 453 respuestas de residentes quirúrgicos en la Ciudad de México. Resultados: El 66% respondió que sus centros se convirtieron en atención exclusiva de pacientes con COVID-19. El 95% presentó una disminución en el aprendizaje de habilidades quirúrgicas y el 91. 8% presentó una disminución de la exposición clínica. El 75.6% consideró fundamental tomar las medidas necesarias para recuperar las destrezas clínicas perdidas. En el análisis de regresión logística binaria, encontramos que el año de posgrado (> PG-Y3) fue un factor estadísticamente significativo (p <0,000) relacionado con una opinión favorable para desarrollar un plan de contingencia académica y posponer el final del año de residencia académica. Conclusión: Más del 90% de los encuestados fueron afectados por las estrategias de mitigación de COVID-19. Nuestros datos exigen ajustes urgentes por parte de los líderes de programas de hospitales y universidades para mitigar las repercusiones educativas posteriores.

ABSTRACT Introduction: Anisakis species represent one of the most important foodborne pathogenic parasitic groups in relation to their zoonotic capabilities, and can produce an emerging disease called anisakiosis. In Cuba, there are no reports of the disease and there are no publications on the detection of the parasite in samples of fishery products. Objective: To identify Anisakis spp. larvae in samples of fishery products. Methods: A study was conducted to search for Anisakis spp. larvae in samples of canned fish products received at the Laboratory of Food Parasitology of the National Institute of Hygiene, Epidemiology and Microbiology of Cuba. Ninety-six samples of two different brands were received. Each brand was assigned letter A or B to protect the identity of the manufacturer. The larvae recovered were previously rinsed with lactophenol and identified morphologically by microscopy. The identification keys for Anisakis spp. larvae described in the literature were used. Results: 38.5% of the total canned fish samples analyzed were parasitized with Anisakis spp. larvae, with a mean frequency of 1.2 larvae per subsample. The larvae were classified as third instar and type I. Conclusions: For the first time in Cuba, Anisakis spp. larvae were identified in canned fish samples and provided data of interest to health authorities to strengthen public policies related to food quality and safety.

RESUMEN Introducción: Las especies de Anisakis representan uno de los grupos parasitarios patógenos transmitidos por alimentos más importantes en relación con sus capacidades zoonóticas y pueden producir una enfermedad emergente llamada anisakiosis. En Cuba, no existen reportes de la enfermedad como tampoco publicaciones sobre la detección del parásito en muestras de productos pesqueros. Objetivo: Identificar larvas de Anisakis spp. en muestras de productos pesqueros. Métodos: Se realizó un estudio para la búsqueda de larvas de Anisakis spp. en muestras de productos pesqueros en conserva recibidos en el Laboratorio de Parasitología de los alimentos del Instituto Nacional de Higiene, Epidemiología y Microbiología de Cuba. Se recibieron 96 muestras de dos marcas diferentes. A cada marca se le asignó las letras A o B para proteger la identidad del fabricante. Las larvas recuperadas fueron previamente aclaradas con lactofenol e identificadas morfológicamente por microscopía. Se utilizaron las claves de identificación para larvas de Anisakis spp. descritas en la literatura. Resultados: El 38,5 % del total de muestras de pescado en conserva analizadas estuvieron parasitadas con larvas de Anisakis spp., con una frecuencia media de 1,2 larvas por cada submuestra. Las larvas fueron clasificadas de tercer estadio y de tipo I. Conclusiones: Por primera vez se identificó en Cuba larvas de Anisakis spp. en muestras de pescado en conserva y se proporcionó datos de interés a las autoridades sanitarias para el fortalecimiento de políticas públicas relacionadas con la calidad e inocuidad de los alimentos.

Abstract We aimed to measure the efficiency of visual selection of plant vigor for green biomass production of U. ruziziensis using single- and multitrait approaches to maximize the predictive accuracy of the genetic value. The green biomass production and plant vigor of 254 U. ruziziensis clones were measured over nine evaluation cuttings to determine the efficiency of these approaches for production improvement. Individual and multicutting analyses were performed under single-trait and multitrait approaches using mixed models. The efficiency of visual selection was assessed by measuring plant vigor based on direct and indirect genetic gains. Plant vigor showed a high genetic association with green biomass and could be selected for production, especially in the initial phases of breeding programs. The multitrait approach was superior to the single-trait approach in predicting the genetic value of the clones, and it can be used in U. ruziziensis breeding programs.

Resumen Introducción: El dolor lumbar es una de las entidades categorizadas por la Organización Mundial de la Salud como enfermedades prioritarias y una de las principales causas de ausentismo laboral. El bloqueo caudal epidural es una técnica anestésica utilizada para tratar el dolor lumbar de diversos orígenes. Materiales y Métodos: Se realizó un estudio observacional descriptivo retrospectivo en pacientes sometidos a bloqueo caudal guiado por radioscopia, entre el 1 de enero de 2017 y el 31 de enero de 2019. Se excluyó a los pacientes con bloqueo caudal previo, con antecedente de cirugía de columna lumbar y a quienes abandonaron el seguimiento. Se registraron variables relacionadas con el paciente y los resultados del procedimiento (dolor según la escala analógica visual, intervención quirúrgica posterior, actividad laboral posterior y licencia médica solicitada). Resultados: Se incluyó a 38 pacientes (media de la edad 43 años [rango 27-62]). La mediana de dolor a los tres meses fue de 3,5 (rango 2-6), con una diferencia de 4,5 (RIC de -2,7 a -7) respecto del puntaje basal. Estas diferencias fueron estadísticamente significativas (p <0,001). El 55,3% retornó al trabajo al primer mes, y el 52,4% de ellos (n = 11) solo requirió una semana de licencia. Conclusiones: Los valores del dolor a corto plazo luego del procedimiento se modificaron de forma estadísticamente significativa respecto de los valores basales. El promedio de reinserción laboral al mes fue del 55,3% (n = 21) y el 76,2% de ellos (n = 16) lo hizo a las dos semanas.

Abstract Introduction: Low back pain is a very common health problem worldwide and a major cause of disability, affecting performance at work and general well-being. It is included in the priority diseases list of the World Health Organization (WHO). Low back pain is one of the leading causes of work absence worldwide. The caudal epidural block is a popular approach in managing lumbar pain conditions in adults. Materials and Methods: An observational, descriptive, retrospective study was conducted in our institution, from January 2017 to January 2019, on patients who had undergone caudal epidural block for low back pain. We excluded patients with a history of previous epidural blocks, lumbar surgery, or who were lost to follow up. We collected patient demographic and clinical data (including age, sex, etc.) and procedure outcomes (pain score, surgery performed, lost working days, and return to work activity). Results: 38 patients were included. Mean age was 43 (27- 62) years old. Mean pain scores 3 months after treatment were 3.5 (2-6) with a difference of 4.5 (IQR -2.7 - -7) from baseline values. This was statistically significant. 55.3% (n=21) of patients returned to active duty in the first month; it is important to note that 52.4% of those (n=11) did it after the first week. Conclusions: The improvement of pain scores after the procedures was statistically significant. The mean return to work at the end of the first month was 55.3%, and 76.2% of those (n=16) did it after the first two weeks.

Abstract This research aimed to establish the correlation between patient safety and the elements of learning in clinical simulation related to the presence of an AE, in students of the Nursing career of the Juárez University of the State of Durango, during the period between August 2018 and December 2019. A prospective longitudinal, correlational, and quantitative non-experimental study was developed. The entire study population was considered, which was made up of the 98 students from that research context. The mean age of the participants was 19.35 (σ = 1.30), predominantly female with 63.3%. The self-evaluating elements of learning related to the fear of generating an AE predominated (75.50%); while 74.5% considered that they mastered how to act in an emergency. Most of them handled technology well during care (87.80%) and mastered patient safety protocols (74.5%), difficulties related to basic skills in nursing care were detected (67.3%). The greatest success with respect to patient safety resulted in compliance with effective communication protocols, while the most affected was the taking of adequate measures during the administration of medications. Spearman's Rho values allowed to establish a moderate positive correlation significance between patient safety and fear of committing an AE during practical exercise; this one showed a moderate and negative significance with respect to the manifestation of emotional exhaustion.

Resumen Con el objetivo de establecer la correlación entre la seguridad del paciente y los elementos del aprendizaje en la simulación clínica relativos a la presencia de un EA, en estudiantes de la carrera de Enfermería de la Universidad Juárez del Estado de Durango, durante el período comprendido entre agosto de 2018 y diciembre de 2019. Se desarrolló un estudio cuantitativo, no experimental correlacional y longitudinal prospectivo. Se trabajó con la totalidad de la población de estudio, constituida por los 98 alumnos de ese contexto de investigación. La media de la edad de los participantes fue de 19,35 (σ=1.30), predominando el género femenino con 63,3%. Los elementos autovalorativos del aprendizaje relativos al temor a generar un EA predominaron (75,50%); mientras que, un 74,5% consideró que dominaba cómo actuar ante una situación de emergencia. La mayoría manejó bien la tecnología durante el cuidado (87,80%) y manejaba adecuadamente los protocolos de seguridad del paciente (74,5%), se detectaron dificultades relativas a las competencias básicas en el cuidado de enfermería (67,3%). El mayor acierto con respecto a la seguridad del paciente resultó el cumplimiento de los protocolos de comunicación efectiva; mientras que, la más afectada fue la toma de medidas adecuadas durante la administración de medicamentos. Los valores de Rho de Spearman permitieron establecer una correlación significativa, positiva moderada entre la seguridad del paciente y el temor a cometer un EA durante el ejercicio práctico; la que resultó significativa, moderada y negativa con respecto a la manifestación de agotamiento emocional.

Abstract Degenerative spinal disease is the leading cause of low back pain and sciatica in the general population. It is an important cause of absenteeism and increased expenses. Its incidence increases in people subjected to tasks that overload the spine, such as construction workers. Instrumented arthrodesis is a frequent practice with satisfactory results for its resolution. To date, in our country, we haven´t found statistical data on this group of work-related patients. Our objective was to evaluate laboral impact generated by instrumented lumbosacral arthrodesis in construction workers. We did a retrospective, descriptive, comparative and monocentric study. Construction workers’ patients with degenerative low back pain and instrumented lumbar or lumbosacral arthrodesis who were operated between January 2005 to August 2018 were included. Clinical and imaging evaluation and follow-up for a period of 18 to 24 months. Assessed with the Oswestry Disability Index (IDO) and the Visual Analog Pain Scale (VAS). The sample was analyzed in groups according to the functions at the time of returning to work, retirement or dismissal. We evaluated 139 patients. Mean age 42 years, degenerative spinal disease of the lumbosacral segment, 66.9% of the sample without postoperative complications resumed the same pre-surgical activity. Post-surgical IDO and VAS scores were worse in patients discharged, retired, and/or requalified. Patients under 42 years of age, without postoperative complications who improved more than 1 Oswestry category, returned to their usual tasks with satisfactory results in the medium and long term.

Resumen La enfermedad degenerativa del raquis es la causa más frecuente de lumbalgia y ciática en la población general provocando ausentismo, lo que incrementa el gasto en salud de los distintos subsistemas, así como el gasto del empleador quien deberá suplantar al trabajador. Su incidencia aumenta en personas sometidas a tareas de sobrecarga del raquis, como el caso de obreros de la construcción. La artrodesis instrumentada es una práctica frecuente y con resultados satisfactorios para su resolución. No hemos encon trado publicaciones con datos estadísticos locales sobre este tema. El objetivo fue evaluar el impacto laboral que genera la artrodesis lumbosacra instrumentada en trabajadores de la construcción. Realizamos un estudio retrospectivo, descriptivo, comparativo y monocéntrico, entre enero de 2005 y agosto de 2018, de trabajadores de la construcción con artrodesis del segmento lumbosacro por lumbalgia de origen degenerativo con evaluación y seguimiento clínico e imagenológico por un periodo de 18 a 24 meses, utilizando el Índice de Discapacidad de Oswestry (IDO) y la Escala Visual Analógica del Dolor (EVA). Se analizó la muestra en grupos según las funciones al momento del retorno laboral, jubilación o despido. Se evaluaron 139 pacientes (mediana 42 años). El 66.9% de la muestra no tuvo complicaciones postoperatorias y retomó la misma actividad prequirúrgica. Los puntajes de IDO y EVA postquirúrgicos fueron peores en los pacientes despedidos, jubilados y/o recalificados. Los menores de 42 años, sin complicaciones postoperatorias que mejoran más de 1 categoría del Oswestry retomaron sus tareas habituales con resultados satisfactorios a mediano y largo plazo.

MacLeish in Aiuruoca, Minas Gerais State, Brazil). Eremanthus erythropappus (DC.) MacLeish is a native species, economically appreciated due to its wood and the extraction of essential oil, whose active ingredient is alphabisabolol, but studies on genetic improvement of this species are still scarce. The aim of this study was to evaluate survival, genetic variability and estimate genetic parameters in E. erythropappus progenies in the field at 15, 22 and 30 months of age. The experiment was set up at Fazenda Guapiara, in Aiuruoca, Minas Gerais State, where seedlings of 15 progenies were planted in a randomized block design with five replications and six plants per plot. Plant height evaluations were performed and genetic studies were carried out in the SELEGEN software using the REML/BLUP method. At 30 months, the percentage of seedling survival was evaluated. Significant differences were observed between progenies, and the highest estimates of h²mp (0.48) and Acprog (0.69) were found at 30 months. Therefore, even in the juvenile stage, it was possible to identify genetic variability and analyze its expression over time, which makes it possible to continue studies of genetic improvement of the species.

MacLeish em Aiuruoca, MG, Brasil). Eremanthus erythropappus (DC.) MacLeish é uma espécie nativa, apreciada economicamente devido a sua madeira e à extração de óleo essencial, cujo princípio ativo é o alfabisabolol, porém os estudos em melhoramento genético dessa espécie ainda são escassos. Objetivou-se com este trabalho avaliar a sobrevivência e estimar parâmetros genéticos em progênies de E. erythropappus em campo aos 15, 22 e 30 meses de idade. O experimento foi instalado na Fazenda Guapiara, em Aiuruoca, MG, onde foram plantadas mudas de 15 progênies em delineamento de blocos casualizados, com cinco repetições e seis plantas por parcela. Foram realizadas avaliações da altura das plantas e procederam-se aos estudos genéticos no software SELEGEN por meio do método REML/BLUP. Aos 30 meses, foi avaliado o percentual de sobrevivência das mudas. Verificou-se diferenças significativas entre as progênies, e as maiores estimativas de h²mp (0,48) e de Acprog (0,69) foram encontradas aos 30 meses. Portanto, mesmo em estágio juvenil, foi possível identificar variabilidade genética e analisar a sua expressão ao longo do tempo, o que possibilita dar continuidade aos estudos visando o melhoramento genético da espécie.

Abstract: Introduction: chronic pancreatitis includes a chronic progressive inflammatory syndrome of the pancreas, with irreversible damage and loss of exocrine and endocrine function. Pain is the most frequent symptom. Surgical treatment is superior in comparison to conservative or endoscopic therapies. Objective: Learn the results obtained when performing a Puestow procedure for the management of chronic pancreatitis. Material and methods: All patients who underwent a Puestow Procedure in the National Institute of Medical Sciences and Nutrition “Salvador Zubirán” between 2000 and 2019, were included. Results: 45 patients with a lateral pancreaticojejunostomy were found. The mean age was 46 years. There were 24 (53%) men and 21 (47%) women. Alcoholism and/or smoking history was found in 42.2% of the patients. The most frequent indications for surgery were: pain (46.7%) and acute recurrent pancreatitis (37.8%). Eighteen patients (40%) had recurrence of pain with a mean follow-up of 4.4 years. Conclusions: At the time, there is no ideal surgical procedure for patients with chronic pancreatitis, the type of intervention to be chosen should reflect a balance between the success of the procedure and the inherent risks.

Resumen: Introducción: La pancreatitis crónica comprende un síndrome inflamatorio progresivo crónico del páncreas, con daño irreversible y pérdida de la función exocrina y endocrina. El dolor es el síntoma más frecuente. El tratamiento quirúrgico es superior en comparación con terapias conservadoras o endoscópicas. Objetivo: Conocer los resultados obtenidos en la realización de un procedimiento de Puestow para el manejo de pancreatitis crónica. Material y métodos: Se incluyeron todos los pacientes que fueron sometidos a un procedimiento de Puestow, en el Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” entre los años 2000 a 2019. Resultados: Se encontraron 45 pacientes operados por una pancreatoyeyunoanastomosis lateral. La edad media fue de 46 años. Fueron 24 (53%) hombres y 21 (47%) mujeres. En 42.2% de los pacientes había antecedente de alcoholismo y/o tabaquismo. Las indicaciones más frecuentes para la cirugía fueron: dolor (46.7%) y pancreatitis aguda a repetición (37.8%). Dieciocho (40%) pacientes cursaron con recurrencia del dolor con un seguimiento medio de 4.4 años. Conclusiones: En la actualidad, no existe un procedimiento quirúrgico ideal para pacientes con pancreatitis crónica, el tipo de intervención a elegir debe ser el reflejo del equilibrio entre el éxito del procedimiento y los riesgos inherentes.