Abstract It is known that neuronal maturation after birth lasts approximately twenty years and requires a large amount of energy. If a pregnancy occurs before maturation, the energy must be distributed between the mother and the offspring, having an effect on the anatomical and functional processes of the brain. Therefore, the electrical activity of the frontal cortex was compared, as well as the performance of its functions and maternal care in adolescents and young people (less than six months after giving birth). The NEUROPSI test (attention and coding) and a maternal care instrument were applied to primiparous adolescents and young people; electroencephalographic recordings were performed on a sample of this population. Significant differences are observed in the coding and attention processes (F= 4.5, α= 0.03*; F= 79.7, α= 0.00**), and a significant correlation between attention and maternal care (health and affection categories) as well as health care coding. The electrical activity of the frontal lobe was slower in primiparous adolescents as well as maternal care behaviors. The above is related to delay in the neuronal maturation of adolescent mothers.

Resumen Se sabe que la maduración neuronal tras el nacimiento dura aproximadamente veinte años y necesita gran cantidad de energía. Si ocurre un embarazo antes de la maduración, la energía debe repartirse entre la madre y la cría, teniendo efecto en los procesos anatómicos y funcionales del cerebro. Por ello, se comparó la actividad eléctrica de la corteza frontal, así como el desempeño de sus funciones y cuidados maternales en adolescentes y jóvenes (con menos de seis meses posteriores al parto). Se aplicó el test NEUROPSI (atención y codificación) y un instrumento de cuidados maternales a primíparas adolescentes y jóvenes; a una muestra de esta población se les realizó registros electroencefalográficos. Se observan diferencias significativas en los procesos de codificación y atención (F= 4.5, α= 0.03*; F=79.7, α= 0.00**), y una correlación significativa entre la atención y el cuidado maternal (categorías de salud y cariño), así como de la codificación sobre el cuidado de la salud. La actividad eléctrica del lóbulo frontal fue más lenta en las adolescentes primíparas, así como las conductas de cuidado maternal. Lo anterior se relaciona con una menor maduración neuronal de madres adolescentes.

Resumen: La encefalopatía hepática consiste en la disfunción o deterioro cerebral, consecuente a afecciones como insuficiencia hepática e hipertensión portal, en el ámbito médico es catalogada como una grave complicación clínica asociada al daño hepático severo. Se llevó a cabo un estudio cualitativo de revisión sistemática aplicando la declaración PRISMA 2020, en donde se utilizó los documentos disponibles en las diferentes bases de datos y con la aplicación de los operadores booleanos para su búsqueda. De los documentos seleccionados se pudieron obtener 840 referencias de información en una primera búsqueda en las bases de datos y 8 registros de datos. Finalmente, para la investigación se consiguió un total de 16 fuentes bibliográficas. La encefalopatía hepática se compone de un síndrome neuro-psiquiátrico que incluye deterioro psicomotor y/o sensitivo, desorientación, incoordinación, alteración de la memoria, confusión, somnolencia, estupor y coma, existen diversas herramientas para el diagnóstico desde el primer nivel de atención, una de las principales es la anamnesis y la exploración física del paciente donde se espera encontrar hallazgos cognitivos y neuromusculares relacionados a la enfermedad hepática grave, entre los estudios complementarios se emplea principalmente exámenes de laboratorio, Criterios de West Haven, prueba psicométrica, prueba neurofisiológica y estudios de neuroimagen como resonancia magnética.

Resumo: A encefalopatia hepática consiste na disfunção ou deterioração cerebral, consequente a condições como a insuficiência hepática e a hipertensão portal, e é classificada no domínio médico como uma complicação clínica grave associada a lesões hepáticas graves. Foi efectuado um estudo de revisão sistemática qualitativa aplicando a declaração PRISMA 2020, utilizando os documentos disponíveis nas diferentes bases de dados e operadores booleanos para a pesquisa. A partir dos documentos selecionados, foi possível obter 840 referências de informação numa primeira pesquisa nas bases de dados e 8 registros de dados. Por fim, obteve-se um total de 16 fontes bibliográficas para a investigação. A encefalopatia hepática é uma síndrome neuropsiquiátrica que inclui comprometimento psicomotor e/ou sensorial, desorientação, incoordenação, comprometimento da memória, confusão, sonolência, estupor e coma, e existem várias ferramentas para o diagnóstico no primeiro nível de cuidados, Um dos principais instrumentos é a anamnese e o exame físico do doente, onde se esperam encontrar achados cognitivos e neuromusculares relacionados com a doença hepática grave. Os estudos complementares incluem testes laboratoriais, os critérios de West Haven, testes psicométricos, testes neurofisiológicos e estudos de neuroimagem, como a ressonância magnética.

Abstract: Hepatic encephalopathy consists of brain dysfunction or deterioration, consequent to conditions such as hepatic insufficiency and portal hypertension, and in the medical field it is cataloged as a serious clinical complication associated with severe liver damage. A qualitative study of systematic review was carried out applying the PRISMA 2020 statement, using the documents available in the different databases and Boolean operators for the search. From the selected documents it was possible to obtain 840 references of information in a first search in the databases and 8 data records. Finally, a total of 16 bibliographic sources were obtained for the research. Hepatic encephalopathy is composed of a neuropsychiatric syndrome that includes psychomotor and/or sensory impairment, disorientation, incoordination, memory alteration, confusion, somnolence, stupor and coma, there are several tools for diagnosis from the first level of care, One of the main ones is the anamnesis and physical examination of the patient where it is expected to find cognitive and neuromuscular findings related to severe liver disease, among the complementary studies are mainly used laboratory tests, West Haven Criteria, psychometric test, neurophysiological test and neuroimaging studies such as magnetic resonance imaging.

SUMMARY: Because horned animals are prone to conflict, they may have a higher risk of developing a brain contusion as a result of a horn strike. Repeated brain trauma can affect the hippocampus, which is involved in memory and orientation. The aim of this study was to histopathologically examine the blood-brain barrier (BBB) of the hippocampus in horned and hornless female sheep. Skulls of 4 horned and 6 hornless female sheep aged 16±4 months were obtained from the abattoir. Brains were carefully removed and preserved in 10 % formalin for 5 days. Sections were taken from bilateral hippocampus. Specimens were stained with hematoxylin-eosin (H&E) and Tunel methods, and the histopathologic structures of the BBB were examined by light microscopy. BBB damage scores evaluated. The results were analyzed by Mann-Whitney U test. The BBB damage score was found to be higher in horned female sheep. Astrocytes was more branching and BBB was more intact in hornless female sheep. This is considered that more astrocyte branches may play an important role in the protective mechanism. The difference in intracerebral defense mechanism against brain trauma in female sheep may serve as a model for investigating molecular mechanisms. The impairment of the BBB in the hippocampal region of horned female sheep may result in their memory, intelligence, and navigational abilities being lower than those of hornless female sheep. This could open the horizon for better advances in human and animal brain health.

RESUMEN: Debido a que los animales con cuernos son propensos a los conflictos, pueden tener un mayor riesgo de desarrollar una contusión cerebral como resultado de un golpe con un cuerno. Los traumatismos cerebrales reiterados pueden afectar el hipocampo relacionado con la memoria y la orientación. El objetivo de este estudio fue examinar histopatológicamente la barrera hematoencefálica (BHE) del hipocampo en ovejas con y sin cuernos. Se obtuvieron de un matadero los cráneos de 4 ovejas con cuernos y 6 sin cuernos de 16 ± 4 meses de edad. Los cerebros se extrajeron cuidadosamente y se conservaron en formalina al 10 % durante 5 días. Se tomaron secciones del hipocampo bilateral. Las muestras se tiñeron con hematoxilina-eosina (H&E) y métodos Tunel, y las estructuras histopatológicas de la BHE se examinaron mediante microscopía óptica. Se evaluaron las puntuaciones de daño de la BHE. Los resultados fueron analizados mediante la prueba U de Mann-Whitney. Se descubrió que la puntuación de daño de la BHE era mayor en las ovejas con cuernos. Los astrocitos estaban más ramificados y la BHE estaba más intacta en las ovejas sin cuernos. Se considera que más ramas de astrocitos pueden desempeñar un papel importante en el mecanismo de protección. La diferencia en el mecanismo de defensa intracerebral contra el trauma cerebral en las ovejas puede servir como modelo para investigar los mecanismos moleculares. El deterioro de la BHE en la región del hipocampo de las ovejas con cuernos puede provocar que su memoria, inteligencia y capacidades de orientación sean inferiores a las de las ovejas sin cuernos. Esto podría abrir el horizonte para mejores avances en la salud del cerebro humano y animal.

BACKGROUND: Cytomegalovirus (CMV) infection may significantly contribute to morbidity and mortality in infancy OBJECTIVES: To describe the outcomes and characteristics of CMV-infected infants in an HIV-prevalent population METHODS: A retrospective, descriptive study was conducted by reviewing hospital records of infants who had a positive CMV test and were admitted to the academic hospitals in Bloemfontein RESULTS: Inpatient mortality for CMV-infected infants was 13.3% (n=18/135). Of those, 66.6% (12/18) of patients who died were HIV exposed and 33.3% (6/18) had CMV/HIV co-infection. The most common causes of death were sepsis (38.9%), pneumonia/pneumonitis (33.3%) and multi-organ failure (11.2%). Approximately 60.7% (82/135) of all CMV-positive infants were HIV exposed, while 20.7% (28/135) were HIV infected. More than half (55.6%) of the patients had a birth weight <2.5 kg, while 48.7% were preterm. A third (33.3%) of the patients were small for gestational age at birth, with suboptimal postnatal growth in 62.2%. Microcephaly was present at birth in 25.2%. Poor brain growth led to postnatal microcephaly in 46.6% of patients. The most common clinical presentations were CMV pneumonia/pneumonitis (60%) and hepatomegaly (50.4%). Thrombocytopenia was a common finding (41.5%). Half (50%) of the infants who died were not treated with antiviral medication CONCLUSION: CMV infection in infancy is under-appreciated in South Africa. It may contribute to morbidity and mortality, particularly in preterm and low birth weight infants and HIV-exposed or infected infants. Clinicians should have a high index of suspicion for CMV infection in infants who have postnatal growth failure and postnatal microcephaly

ABSTRACT The activities carried out by the nursing professional produce them health problems, with stress being the first factor that will affect one's own rhythm, causing irritability and anxiety. Physical-sports practice has a positive effect on their physical and mental health because it produces the release of endorphins, which leads to a reduction in anxiety, depression and stress because any type of physical activity, whether low or high impact, releases these substances that act directly on the brain, producing a feeling of well-being and immediate relaxation. A research is presented with a non-experimental design, from the quantitative approach of a cross-sectional comparative descriptive type. Its objective is to determine the relationships between physical activity and emotional regulation of a group of nurses from the Sur Hospital in Chilpancingo, Guerrero, Mexico. The TMMS-24 Emotional Intelligence Assessment Scale and the International Physical Activity Questionnaire (IPAQ) were applied. To determine the relationship between the variables, Spearman's Rho Correlation was used. The dimensions studied are attention, clarity and emotional repair by the dependent variable (Emotional Control) and the High, Medium and Low dimensions by the independent variable (Physical Activity). In the community where the signs and symptoms of nervousness, agitation or tension associated with situations of anxiety and stress were observed, direct correlations were established between the intensity of physical activity and the emotional control of the subjects studied, that is, at a lower intensity of physical activity, less control and emotional regulation.

RESUMO As atividades realizadas pelo profissional de enfermagem causam-lhe problemas de saúde, sendo o estresse o primeiro fator que afetará seu próprio ritmo, causando irritabilidade e ansiedade. A prática físico-esportiva tem um efeito positivo sobre sua saúde física e mental, pois produz uma liberação de endorfinas, o que leva a uma redução da ansiedade, da depressão e do estresse, pois qualquer tipo de atividade física, seja ela de baixo ou alto impacto, libera essas substâncias que atuam diretamente no cérebro, produzindo uma sensação de bem-estar e relaxamento imediato. A pesquisa é apresentada em um desenho não-experimental, a partir de uma abordagem quantitativa, descritiva, comparativa, transversal e de corte transversal. Seu objetivo é determinar a relação entre a atividade física e a regulação emocional em um grupo de enfermeiras do Hospital Sur em Chilpancingo, Guerrero, México. Foram aplicados o Emotional Intelligence Rating Scale TMMS-24 e o International Physical Activity Questionnaire (IPAQ). A Correlação Rho de Spearman foi usada para determinar a relação entre as variáveis. As dimensões estudadas são Atenção, Clareza e Reparação Emocional para a variável dependente (Controle Emocional) e as dimensões Alta, Média e Baixa para a variável independente (Atividade Física). Na comunidade onde foram observados os sinais e sintomas de nervosismo, agitação ou tensão associados a situações de ansiedade e estresse, foram estabelecidas correlações diretas entre a intensidade da atividade física e o controle emocional dos sujeitos investigados, ou seja, quanto menor a intensidade da atividade física, menor o controle e a regulação emocional.

RESUMEN Las actividades que realiza el profesional de la enfermería les producen quebranto en la salud, siendo el estrés el primer factor que va a afectar el ritmo propio, ocasionando irritabilidad y ansiedad. La práctica físico-deportiva tiene un efecto positivo sobre su salud física y mental debido a que produce liberación de endorfinas, lo que conlleva una reducción de la ansiedad, la depresión y el estrés, ya que cualquier tipo de actividad física, ya sea de bajo o alto impacto, libera estas sustancias que actúan directamente sobre el cerebro, produciendo sensación de bienestar y relajación inmediata. Se presenta una investigación con un diseño no experimental, desde el enfoque cuantitativo de tipo descriptivo comparativo de corte transversal. Tiene como objetivo: determinar las relaciones entre actividad física y regulación emocional de un grupo de enfermeras (o) s del Hospital Sur en Chilpancingo, Guerrero, México. Se aplicó la Escala para Evaluación de la Inteligencia Emocional TMMS-24 y el Cuestionario Internacional de Actividad Física (IPAQ). Para determinar la relación entre las variables se empleó la Correlación del Rho de Spearman. Las dimensiones estudiadas son la atención, claridad y reparación emocional por parte de la variable dependiente (Control emocional) y las dimensiones Alta, Media y Baja por la variable independiente (Actividad física). En la comunidad donde se observaron los signos y síntomas de nerviosismo, agitación o tensión asociados a situaciones de ansiedad y estrés, se establecen correlaciones directas entre la intensidad de la actividad física y el control emocional de los sujetos investigados, o sea, a menor intensidad de la actividad física menor control y regulación emocional.

Abstract Introduction: Brain and cardiovascular diseases, neoplasms and diseases of the respiratory system are the main causes of mortality in Portugal. Their evolution over the last few decades is distinct, with decreased cardiovascular mortality and increased deaths from neoplasms. Objective: To characterize the population's interest in these causes of death, exploring the association between research peaks and social events that promote health literacy. Methods: A longitudinal, descriptive study of the average relative (AR) search for the terms stroke, ADE, neoplasms, pneumonia, and their synonyms over the last five years using the Google Trends® digital platform. The AR was measured between 0 and 100 (maximum interest in the topic). Comparative analysis between terms was carried out. Results: The AR in the period studied was 14.0±4.9 for stroke; 7.0±5.3 for MAS; 53.0±13.1 for neoplasm; and 7.0±5.7 for pneumonia. The PMR for the term neoplasm was significantly higher (p<0.01) than all the other terms, with a constant search pattern. The terms stroke and MAS showed a search peak, corresponding to moments when public figures were diagnosed with this pathology. There was no significant increase in the PMR of these terms during the annual commemoration weeks/campaigns organised by the corresponding scientific societies. Conclusions: Awareness-raising campaigns, which are undoubtedly important, need to be translated into levels of digital interest. It is essential to invest in prevention strategies based on the promotion of health literacy.

Resumo Introdução: As doenças cérebro e cardiovasculares, as neoplasias e as doenças do sistema respiratório são as principais causas de mortalidade nacional. A sua evolução ao longo das últimas décadas é distinta, com decréscimo da mortalidade cardiovascular e aumento das mortes por neoplasias. Objetivo: Caracterizar o interesse da população nestas causas de morte, explorando a associação entre picos de pesquisa e eventos sociais promotores da literacia em saúde. Métodos: Estudo longitudinal, descritivo da pesquisa média relativa (PMR) dos termos AVC, EAM, Cancro, Pneumonia e seus sinónimos nos últimos cinco anos através da plataforma digital Google Trends®. A PMR foi medida entre 0 e 100 (interesse máximo no tópico). Procedeu-se a análise comparativa entre termos. Resultados: A PMR no período estudado foi 14,0±4,9 para o AVC; 7,0±5,3 para o EAM; 53,0±13,1 para a neoplasia; 7,0±5,7 para a pneumonia. A PMR do termo neoplasia foi significativamente superior (p<0,01) a todos os outros termos, com padrão de pesquisa constante. Os termos AVC e EAM apresentaram um pico de pesquisa, correspondendo a momentos em que figuras públicas foram diagnosticadas com essa patologia. Não se verificou aumento significativo da PMR desses termos nas semanas de comemoração/campanhas anuais realizadas pelas sociedades científicas correspondentes. Conclusões: As campanhas de sensibilização, inequivocamente importantes, carecem de tradução nos níveis de interesse digital. É fundamental investir em estratégias de prevenção que tenham por base a promoção da literacia em saúde.

Resumen El trastorno depresivo mayor (TDM) ha ganado relevancia en los últimos años, ya que es una de las principales causas de discapacidad a nivel mundial y ejerce un impacto significativo en la vida diaria de quienes lo experimentan. La relación entre la disbiosis intestinal y el TDM ha surgido como un componente crucial en el ámbito de la salud mental. La microbiota intestinal, que abarca una amplia diversidad de microorganismos, establece una conexión bidireccional con el TDM a través del eje microbiota-intestino-cerebro, la neuroinflamación y alteración de la función cerebral. El presente trabajo tuvo como objetivo, analizar la relación entre los problemas de equilibrio de los microorganismos en el intestino (fenómeno conocido como “disbiosis”) y el TDM. Se adoptó un enfoque cualitativo que combinó análisis bibliográfico y descriptivo, priorizando fuentes primarias en psicología, neurociencia y microbiología. Se examinaron investigaciones en inglés y español desde 2019 hasta 2023 utilizando motores de búsqueda y bases de datos reconocidas. En este contexto, se observó que el uso de probióticos se ha vuelto cada vez más relevante como parte del tratamiento complementario para el TDM. Los probióticos, como Lactobacillus plantarum DP189 y la bacteria Roseburia intestinalis, ejercen un impacto positivo en la microbiota intestinal, integridad de la barrera hematoencefálica y producción de neurotransmisores. La revisión destaca el papel crucial de la microbiota intestinal en el TDM y la prometedora utilidad de los probióticos como tratamiento complementario. Esto sugiere nuevas perspectivas terapéuticas y subraya la importancia de futuras investigaciones para comprender mejor esta compleja interacción.

Abstract Major depressive disorder (MDD) has gained relevance in recent years, as it is one of the main causes of disability worldwide and has a significant impact on the daily lives of those who experience it. The relationship between gut dysbiosis and MDD has emerged as a crucial component in the field of mental health. The gut microbiota, which encompasses a wide diversity of microorganisms, establishes a bidirectional connection with MDD through the microbiota-gut-brain axis, neuroinflammation and alteration of brain function. The objective of this work was to analyze the relationship between problems with the balance of microorganisms in the intestine (a phenomenon known as “dysbiosis”) and MDD. A qualitative approach was adopted that combined bibliographic and descriptive analysis, prioritizing primary sources in psychology, neuroscience and microbiology. Research in English and Spanish from 2019 to 2023 was examined using recognized search engines and databases. In this context, it was observed that the use of probiotics has become increasingly relevant as part of complementary treatment for MDD. Probiotics, such as Lactobacillus plantarum DP189 and the bacteria Roseburia intestinalis, have a positive impact on the intestinal microbiota, blood-brain barrier integrity, and neurotransmitter production. The review highlights the crucial role of gut microbiota in MDD and the promising utility of probiotics as a complementary treatment. This suggests new therapeutic perspectives and underlines the importance of future research to better understand this complex interaction.

INTRODUCTION: The rising prevalence of stroke in sub-Saharan Africa necessitates the exploration of the role of occupational therapy in rehabilitation of stroke. In the southern African country of South Africa, occupational therapy aligns with healthcare policies and laws, and this article presents a review of synthesized evidence of occupational therapy intervention in stroke care and rehabilitation. METHOD: Rapid review methodology was used to develop a research question about cerebrovascular accident - intervention by occupational therapists., The Cochrane Library and MEDLINE databases were searched for relevant articles published between 2018 and 2023. Twenty four articles met the inclusion criteria and were analysed according to quantitative and qualitative parameters. RESULTS: Evidence of occupational therapy intervention with post-stroke upper limb impairment was found in 37,5% of articles. Occupational therapy for global improvement in function, cognitive rehabilitation, balance, social participation, work, and leisure comprised 45,8% of articles, and one article each reported evidence for occupational therapy addressing ADL and caregiver interventions. CONCLUSION: Evidence from the past five years reflect diverse occupational therapy interventions with clients with stroke. Gaps in recent evidence remain in relation to context-specific interventions, especially from low- and middle-income countries. IMPLICATIONS FOR PRACTICE Occupational therapists adopt a holistic approach to stroke rehabilitation, tailoring interventions to address the multifaceted needs and goals of individual stroke survivors. The effectiveness of individualised, occupation-based approaches across various domains are highlighted. • Therapists stay informed and up to date about emerging technologies and evidence-based practice to enhance their effectiveness in stroke rehabilitation. • This review provides evidence of the prevalence of upper limb impairments post-stroke, which will enable therapists to be well-versed in the diverse intervention approaches for upper limb rehabilitation as outlined in the literature reviewed, including technologies like Brain Computer Interface, Mental Practice, Mirror Therapy, and Action Observation Therapy. • Occupational therapy is vital in addressing cognitive impairments in stroke survivors, and practitioners can apply the evidence provided on interventions such as Virtual Reality and computer-assisted cognitive rehabilitation that have shown promise in improving cognition and ADL.

BACKGROUND. Traumatic brain injury (TBI) can result in significant morbidity and mortality if not diagnosed in a timely manner. Brain computed tomography (CT) is the diagnostic gold standard but is of limited availability in most South African public hospitals, resulting in transfer of TBI patients to tertiary hospitals. OBJECTIVE. To describe the referral patterns and outcomes of patients with TBI referred to Groote Schuur Hospital Trauma Centre. METHODS. This was a retrospective audit of all patients admitted to the Trauma Centre who had a brain CT scan for suspected TBI between 1 February 2022 and 31 March 2022. Demographic data (age, sex), mechanism of injury and Glasgow Coma Score were recorded. Referral pathways were determined, and final disposition of patients was recorded. RESULTS. A total of 522 patients had a brain CT for TBI. Of these, 314 (60.1%) were referred from other hospitals. CT scan was abnormal in 178 (34.1%) patients. Three hundred and two (58.6%) were discharged home within 24 hours. The mean time between referral and CT scan was 13 hours. CONCLUSION. More than half of patients referred for a CT scan were discharged from the Trauma Centre within 24 hours of admission, which indicates. additional costs and inefficiencies in the health system. These data are useful to guide resource planning and allocation for district hospitals, since less expensive point-of-care modalities now exist to diagnose TBI, and which are useful in indicating the prognosis of patients.

Abstract Introduction : Chia and flax seeds are rich in alpha-linolenic acid (ALA), which is bioconverted into the active derivatives eicosapentaenoic (EPA) and doco sahexaenoic (DHA) having multiple beneficial effects. However, there is limited knowledge about the anti-inflammatory effects of chia and flax integral flours diets rich in ALA. Objective : The study aimed to evaluate the anti-inflammatory effect of dietary supplementation with integral chia and flax flours in a murine model of LPS-induced systemic inflammation. Methods : Balb/c mice were distributed into three groups: diet A (control), diet B (supplemented with inte gral chia flour), and diet C (supplemented with integral flax flour). Nutritional, hematological, and biochemical determinations were performed. ALA, EPA, and DHA were assessed by GC-MS in the liver, brain, cardiac and skeletal muscles. NF-kB immunoassays were per formed in kidney, liver, and peritoneal macrophages, respectively. The phagocytic capacity was determined in peritoneal macrophages and the expression of the pro- and anti-inflammatory cytokines was assessed by RT-qPCR in the kidney, liver, and spleen. Results : Diets B and C exhibited optimal nutritional adequacy and caused increased levels of ALA, EPA, and DHA in critical tissues compared to the control. The phagocytic capacity of murine peritoneal macrophages (p< 0.01) and IL-10 transcription increased, whereas the expression of NF-κB, IL-1β, IL-6, and TNF-α decreased in animals fed both experimental diets. Conclusions : This work contributes to the current knowledge of the anti-inflammatory effects of chia and flax integral flours rich in ALA and reinforces the health advantages of their consumption.

Resumen Introducción : Las semillas de chía y lino son ricas en ácido alfa-linolénico (ALA), sus derivados activos eico sapentaenoico (EPA) y docosahexaenoico (DHA) ejercen probados efectos beneficiosos. Existe un conocimiento limitado sobre los efectos protectores de ambas semillas bajo la forma de harinas integrales, siendo de particular interés el efecto antiinflamatorio. Objetivo : El objetivo de este trabajo fue evaluar el efecto antiinflamatorio de la suplementación dietaria con harinas integrales de semillas de chía y lino en un modelo murino de inflamación sistémica inducido por LPS. Métodos : Ratones de la cepa Balb/c fueron distribui dos en tres grupos: dieta A (control), dieta B (suplemen tada con harina integral de chía) y dieta C (suplementa da con harina integral de lino). Se efecturaron determi naciones nutricionales, hematológicas y bioquímicas. El contenido de ALA, EPA y DHA en hígado, cerebro, corazón y músculo esquelético se determinó por cromatografía GC-MS. Se realizó la inmunodetección de NF-kB en macrófagos peritoneales, riñón e hígado. Se determinó la capacidad fagocítica de macrófagos peritoneales y se evaluó la expresión de citoquinas pro y antiinflamatorias por RT-qPCR en riñón, hígado y bazo. Resultados : Las dietas B y C mostraron una adecua ción nutricional óptima y generaron niveles elevados de ALA, EPA y DHA en tejidos críticos. La capacidad fagocítica de los macrófagos peritoneales (p< 0.01) y la transcripción de IL-10 aumentó, mientras que la expre sión de NF-κB, IL-1β, IL-6 y TNF-α disminuyó en animales de los grupos B y C. Conclusiones : Este trabajo contribuye al conocimien to actual de los efectos antiinflamatorios de ambas hari nas integrales y refuerza los beneficios de su consumo.

ABSTRACT Foundation: cerebrovascular disease is any alteration of one or more brain areas, whether temporary or permanent, secondary to a cerebral circulation disorder of ischemic or hemorrhagic origin. For many years it has been considered one of the main causes of death worldwide. It is among the main causes of death in Ecuador. Objective: to describe the risk factors for cerebrovascular diseases in adult patients diagnosed with cerebrovascular diseases at the Tulcán Sur Health Center over a period of 1 year. Methods: a descriptive and cross-sectional study was carried out at the Tulcán Sur Health Center, over a period of 1 year, from September 2022 to September 2023. The universe consisted of 130 patients. The sociodemographic variables were analyzed: age and sex; clinical: presence or absence of high blood pressure, smoking, alcoholism, diabetes mellitus, dyslipidemia, atrial fibrillation and sedentary lifestyle. The normality of the data distribution was analyzed using the Kolmogorov-Smirnov test. Categorical variables were expressed in absolute and relative frequencies. Quantitative variables were described using the mean and standard deviation. Results: the mean age of the population was 61.0 ± 16.5. The male sex predominated with 70 patients (53.8 %). High blood pressure, smoking and obesity were the most common cardiovascular risk factors with 73 (56.5 %), 79 (60.7 %), 64 (49.2 %) patients respectively. Conclusions: high blood pressure, smoking and obesity were the most prevalent risk factors.

RESUMEN Fundamento: la enfermedad cerebrovascular es toda alteración de una o varias áreas encefálicas, ya sea de forma transitoria o permanente, secundaria a un trastorno de la circulación cerebral de origen isquémico o hemorrágico. Por muchos años ha sido considerada una de las principales causas de muerte a nivel mundial. Está entre las principales causas de muerte en Ecuador. Objetivo: describir los factores de riesgo de enfermedades cerebrovasculares en pacientes adultos diagnosticados con enfermedades cerebrovasculares en el Centro de Salud Tulcán Sur en un periodo de 1 año. Métodos: se realizó un estudio descriptivo y transversal, en el Centro de Salud Tulcán Sur, en un periodo de 1 año, desde septiembre del 2022 a septiembre del 2023. El universo lo constituyeron 130 pacientes. Se analizaron las variables sociodemográficas: edad y sexo; clínicas: presencia o no de hipertensión arterial, tabaquismo, alcoholismo, diabetes mellitus, dislipidemia, fibrilación auricular y sedentarismo. La normalidad de la distribución de los datos fue analizada utilizando la prueba de Kolmogorov-Smirnov. Las variables categóricas fueron expresadas en frecuencias absoluta y relativa. Las variables cuantitativas se describieron utilizando la media y la desviación típica. Resultados: la media de edad de la población fue de 61,0 ± 16,5. El sexo masculino predominó con 70 pacientes (53,8 %). La hipertensión arterial, el tabaquismo y la obesidad fueron los factores de riesgo cardiovascular más frecuentes con 73 (56,5 %), 79 (60,7 %), 64 (49,2 %) pacientes respectivamente. Conclusiones: la hipertensión arterial, el tabaquismo y la obesidad fueron los factores de riesgo con más prevalencia.

Resumen La salud mental en general es un tema que ha ganado mucha relevancia e importancia en los últimos años. Pero un elemento central de ésta es el tema de trastornos mentales, y el diagnóstico de ellos. Por mucho tiempo, el método estándar usado para este proceso ha sido lento y costoso. Sin embargo, con nuevas tecnologías como son la inteligencia artificial y el escaneo cerebral hay posibilidad de una detección más rápida, sencilla, y objetiva de estos trastornos, incluido a edades más tempranas. El objetivo de este estudio es verificar la eficacia del reconocimiento de patrones eléctricos cerebrales mediante la inteligencia artificial en el uso médico psicológico, utilizando opiniones profesionales para determinar su factibilidad. El análisis fue cuanti-cualitativo, y se encontró que estas herramientas probablemente serán indispensables para esta área en el futuro cercano, siempre y cuando se le de un enfoque particular a su desarrollo.

Abstract Mental health in general is a subject that has become more and more relevant in the past years. But a central element to this subject is mental disorders, and their diagnosis. For a long time, the standard method used for this project has been lengthy and expensive. However, with new technologies such as artificial intelligence and brainwave scanning there is a chance for faster, simpler, and more objective detection of these disorders, including at ages too young for the current method. The objective of this study is to verify the efficiency of the recognizement of brainwave patterns using artificial intelligence in the psychology-medicinal field, using professional opinions to determine its feasibility. The analysis was quanti-qualitative, and it was found that these tools will most likely be indispensable for this field in the near future, as long as they are given the proper development.

Resumo Introdução: A paralisia supranuclear progressiva (PSP) é uma doença neurodegenerativa, cuja prevalência é de 2-7 casos/100.000 indivíduos. No entanto, dado o desafio diagnóstico, prevê-se que estes dados estejam subestimados e que muitos doentes não cheguem a ser diagnosticados. Descrição do caso: Mulher de 69 anos, com hipertensão arterial e hipotiroidismo controlados, recorreu em dezembro/2018 a consulta aberta na sua USF por se sentir triste, com choro fácil e com falta de iniciativa associado a episódios de ansiedade. Pela presunção do diagnóstico de depressão iniciou sertralina. Em janeiro/2019, em consulta programada, o seu MF detetou um discurso pouco fluente e lentificação psicomotora, facto que a doente não reconhecia como um problema. Após exclusão de causas identificáveis e reversíveis que justificassem o quadro clínico decidiu-se fazer uma referenciação aos cuidados de saúde hospitalares de neurologia. Em março, em neurologia, foi identificada a presença de disartria e de reflexos osteotendinosos ligeiramente vivos, interpretados em provável contexto de uma doença neuromuscular, que foi posteriormente descartada pela eletromiografia, ressonância magnética cerebral e estudo analítico normais. Em junho, a doente acrescentava dificuldades executivas e de escrita e destacava-se a presença de apraxia e disfunção frontal, pelo que se colocou em hipótese a presença de uma doença neurodegenerativa, identificada como possível afasia progressiva primária por uma avaliação neuropsicológica. No entanto, em janeiro/2020 verificou-se um agravamento dos sintomas prévios, foi descrita a presença de quedas ocasionais não provocadas e identificou-se uma discreta limitação do olhar vertical superior que se associou finalmente ao diagnóstico definitivo de PSP. Atualmente a doente é seguida pelo seu MF no que respeita ao seu tratamento paliativo e apoio psicológico à doente e respetiva família. Comentário: O MF é responsável pela prestação de cuidados continuados longitudinalmente ao doente, assim como pela gestão da doença que se apresenta de forma indiferenciada numa fase precoce da sua história natural, características que colocam o MF numa posição privilegiada para diagnosticar, acompanhar, intervir e referenciar nas situações como a que é apresentada no presente caso clínico.

Abstract Introduction: Progressive supranuclear palsy (PSP) is a neurodegenerative disease, with a prevalence of 2-7 cases/100,000 individuals. However, these data are likely to be underestimated and many patients remain undiagnosed due to diagnostic challenges. Case description: In December 2018, a 69-year-old woman with hypertension and hypothyroidism went to an open consultation at her family health unit for being sad, tearful, and unwilling to start any activity associated with an anxiety crisis. As depression was suspected, it was decided to start her on sertraline. In January 2019, at a scheduled appointment, her family doctor (FD) noted a poorly fluent speech with psychomotor slowing, which the patient did not recognize as a problem. It was decided to make a referral to neurology after excluding identifiable and reversible causes that would justify the clinical picture. In March, at the neurology consultation, the presence of dysarthria and slightly hyperactive osteotendinous reflexes were noted and interpreted in the probable context of a neuromuscular disease, which was later ruled out by normal electromyogra-phy, brain magnetic resonance, and analytical study. In June, executive and writing difficulties were added and the presence of apraxia and frontal dysfunction was highlighted. Because of this, the presence of a neurodegenerative disease was hypothesized and a neuropsychological assessment identified a possible primary progressive aphasia. However, in January 2020, there was an exacerbation of previous symptoms and the presence of occasional unprovoked falls, and a slight limitation of the superior vertical gaze was noted, which was finally associated with the definitive diagnosis of PSP. The patient is currently being followed by her FD for palliative care and psychological support for the patient and her family. Comment: The FD is responsible for the longitudinal continuity of the patient's care, as well as for the management of the disease, which presents in an undifferentiated manner, at an early stage of its natural history, characteristics that place the FD in a privileged position to diagnose, monitor, intervene and refer in situations such as the one presented in this clinical case.

RESUMEN Introducción: el traumatismo craneoencefálico muestra una alta prevalencia, representa un problema de salud pública y ocasiona un número importante de muertes violentas. Objetivo: caracterizar la mortalidad de los pacientes por traumatismo craneoencefálico en el Departamento de Medicina Legal de Villa Clara. Métodos: se realizó una investigación de desarrollo, descriptiva, transversal, en el Departamento de Medicina Legal del Hospital Universitario Clínico Quirúrgico “Arnaldo Milián Castro” de Villa Clara en el período comprendido de enero de 2021 a diciembre de 2022. Se utilizaron los métodos histórico e inductivo deductivo, el análisis documental de historias clínicas, las actas de necropsia, de observación y el estadístico. Resultados: las edades jóvenes son las más afectadas, predominó el sexo masculino, la etiología más frecuente es la accidental vinculada a los hechos del tránsito, las lesiones que predominan son la fractura lineal (83,3%) y la hemorragia subaracnoidea (66,7%), el traumatismo craneoencefálico moderado es el más representativo (52,1%) y como causas directas de muerte hubo predominio del edema cerebral (71,9%) y de la hemorragia subaracnoidea (12,5%). Conclusiones: las edades jóvenes y el sexo masculino son los más vulnerables. La etiología médico-legal accidental relacionada con los accidentes de tránsito es la más representativa. La lesión más frecuente es la fractura lineal. Predominó el traumatismo craneoencefálico moderado. La casusa directa de muerte que más prevalece es el edema cerebral.

ABSTRACT Introduction: traumatic brain injury shows a high prevalence, represents a public health problem and causes a significant number of violent deaths. Objective: to characterize the mortality of patients due to traumatic brain injury in the Department of Legal Medicine of Villa Clara. Methods: a descriptive, transversal, developmental research was carried out in the Department of Legal Medicine of the “Arnaldo Milián Castro” Clinical Surgical University Hospital of Villa Clara in the period from January 2021 to December 2022. Historical methods were used. and inductive deductive, documentary analysis of medical records, autopsy records, observation and statistics. Results: young ages are the most affected, the male sex predominated, the most frequent etiology is accidental linked to traffic events, the predominant injuries are linear fracture (83.3%) and subarachnoid hemorrhage (66.3%). 7%), moderate head trauma is the most representative (52.1%) and as direct causes of death there was a predominance of cerebral edema (71.9%) and subarachnoid hemorrhage (12.5%). Conclusions: young ages and the male sex are the most vulnerable. The accidental medico-legal etiology related to traffic accidents is the most representative. The most common injury is the linear fracture. Moderate head trauma predominated. The most prevalent direct cause of death is cerebral edema.

Abstract This article comprehensively reviews existing literature about the consequences of social isolation after the COVID-19 pandemic on mental health and cognition. The objective is to provide useful information that will help to identify the lack of data on some side effects post-pandemic. In addition, the aim is to advocate for research, which leads to evidence of these abnormalities. A search was performed in the databases Pubmed/Medline, Scopus, Science Direct, and Web of Science, from the beginning of the COVID-19 pandemic to the present. The terms used were COVID-19, isolation, cognition, remote care, mental health, age, and technology. Finally, 51 articles were selected that coincided with the terms, objectives that were relevant to the work. In addition, the articles met the methodological and validity criteria provided by the databases. Some studies were found that report various degrees of affectation in brain functions in subjects who remained isolated during the severe acute respiratory syndrome coronavirus type 2 pandemic, whether they have been infected or not. From the analysis of the distinct studies, notable differences between countries according to their economic resources, housing conditions, age, the existence of comorbidities, and emerging intervention tools such as remote care, were some of the main factors that influenced the coping strategies of individuals who were confined. Furthermore, it is evident that there remains a critical need for research employing standardized and specialized neuropsychological tests to measure cognition accurately. In the same way, investigating the effectiveness of current intervention strategies and designing those that are appropriate for each population, given the specific characteristics of the comorbidity caused by the extraordinary situation experienced by the COVID-19 pandemic.

Resumen El presente artículo revisa lo descrito hasta la fecha acerca de las consecuencias del aislamiento social tras la pandemia por COVID-19 en la salud mental y la cognición, con la finalidad de proporcionar un bagaje de información útil en el encauce de acciones para la identificación de los posibles huecos en la información y la elaboración de investigaciones que ayuden a esclarecer las interrogantes aún existentes. Se realizó una búsqueda en las bases de datos Pubmed/Medline, Scopus, ScienceDirect, Web of Science, del inicio de la pandemia por COVID-19 a la actualidad, utilizando los términos COVID-19, aislamiento, cognición, atención remota, salud mental, edad y tecnologia. Finalmente se seleccionaron 51 artículos que coincidían con los términos, objetivo y resultaban relevantes para nuestra revisión. Los hallazgos demuestran que el daño cerebral posterior a síndrome respiratorio agudo por coronavirus tipo 2, las implicaciones en la anatomía del SN por el aislamiento, la edad, diferencias entre países, los recursos económicos, las condiciones en la vivienda y las herramientas emergentes de intervención como la atención remota, son algunos de los factores que se destacaron en los estudios. Todavía falta la implementación de investigaciones que midan la cognición con pruebas neuropsicológicas estandarizadas y especializadas. Así mismo, falta por analizar exhaustivamente la aplicabilidad de estrategias de intervención ya existentes y diseñar intervenciones adecuadas a cada población dadas las características específicas de los daños causados por la situación extraordinaria vivida por la pandemia por COVID-19.