Abstract Introduction. There is a great human concern about antibiotics resistance due to their inappropriate use as growth promoters in animal husbandry. Objective. To evaluate the effect of a high level of zinc as a substitute to antibiotics in nursery pigs. Material and methods. The study was carried out from June to August 2022 in the province of Chiriqui, Panama. The experimental period was composed of three phases with 14 days per phase. The nursery pigs (n= 54) were distributed to one of three treatments with six replicates per treatment and three pigs per replicate. The treatments were: 1) control diet, which was formulated to meet the nutritional requirements for nursery pigs; 2) similar to treatment 1, plus 200 mg of amoxicillin/kg of feed and 40 mg of florfenicol/kg of feed during phase 1 (P1) and phase 2 (P2), respectively; and 3) similar to treatment 1, plus 2000 ppm and 1600 ppm of zinc during P1 and P2, respectively. In phase 3 (P3), all pigs were fed a common diet. Results. The supplementation of zinc improved the average daily gain in all phases. Pigs fed zinc diet had better F:G ratio in P2 compared to pigs fed antibiotic diet (p < 0.05). A higher concentration of hemoglobin and percentage of monocytes was found in pigs fed with higher level of zinc than the other treatments (p < 0.05). Furthermore, Pigs fed the antibiotic, or the control diet had a lower percentage of fecal dry matter compared to those supplemented with zinc. (p < 0.05). Conclusion. The supplementation of high levels of zinc exerted improvements, in comparison to the antibiotic, in terms of hemoglobin concentration, incidence of diarrhea and weight gain in pigs during 42 days after weaning.

Resumen Introducción. Existe una gran preocupación humana por la resistencia a los antibióticos debido a su uso inadecuado como promotores del crecimiento en la cría de animales. Objetivo. Evaluar el efecto de altos niveles de zinc como sustituto del antibiótico en lechones destetados. Material y métodos. El estudio se realizó de junio a agosto de 2022 en la provincia de Chiriquí, Panamá. El periodo experimental estuvo compuesto por tres fases con 14 días por fase. Los cerdos destetados (n= 54) fueron asignados a uno de tres tratamientos con seis repeticiones por tratamiento y tres cerdos por repetición. Los tratamientos fueron: 1) dieta control, formulada para suplir los requerimientos nutricionales para cerdos destetados; 2) similar al tratamiento 1, más 200 mg de amoxicilina/kg de alimento y 40 mg de florfenicol/kg de alimento durante la fase 1 (P1) y fase 2 (P2), respectivamente; y 3) similar al tratamiento 1, más 2000 ppm y 1600 ppm de zinc durante P1 y P2, respectivamente. En la fase 3 (P3), todos los cerdos fueron alimentados con una dieta común. Resultados. La suplementación con zinc mejoró la ganancia de peso en todas las fases. Los cerdos alimentados con zinc tuvieron mejor relación F:G en P2 en comparación a los cerdos suplementados con antibiótico (p < 0.05). Se encontró una mayor concentración de hemoglobina y porcentaje de monocitos en cerdos alimentados con zinc que en los otros tratamientos (p < 0.05). Los cerdos alimentados con antibiótico o la dieta control tuvieron un menor porcentaje de materia seca fecal en comparación a los suplementados con zinc (p < 0.05). Conclusión. La suplementación de altos niveles de zinc ejerció mejoras, en comparación al antibiótico, en cuanto a la concentración de hemoglobina, incidencia de diarrea y ganancia de peso en cerdos durante los 42 días posteriores al destete.

Resumen Objetivo: recopilar información de factores de riesgo de la enfermedad arterial coronaria en población adulta evidenciados mediante estudios de aleatorización mendeliana. Métodos: de acuerdo con las recomendaciones de la escala para la Evaluación de Artículos de Revisión Narrativa (SANRA), se realizó una revisión desde el usuario de la Universidad Militar Nueva Granada en las bases de datos de PubMed, EMBASE y BIREME. Resultados: se obtuvieron 757 artículos, luego se aplicaron los criterios de inclusión y exclusión, y se eligieron 29 artículos en los que se investiga la asociación de la enfermedad arterial coronaria con la apolipoproteína B, colesterol LDL, triglicéridos, colesterol total, apolipoproteina C3, proteína de transferencia de ésteres de colesterol, HDL, omega 6, lipoproteína (a), obesidad, hemoglobina A1C, diabetes mellitus tipo 2, glucosa en ayunas, inicio del hábito de fumar, presión arterial, hormona paratiroidea sérica, niveles de fosfato sérico, enfermedad del hígado graso no alcohólico, síndrome de ovario poliquístico, globulina fijadora de hormonas sexuales, testosterona, filoquinona circulante, proteína gla de la matriz inactiva, antioxidantes circulantes derivados de la dieta, glicina, homocisteína, ácido úrico, marcadores inflamatorios, hemoglobina, hematocrito y recuento de glóbulos rojos. Conclusión: esta revisión sugiere nuevos estudios con información genética colombiana para respaldar los factores de riesgo aquí presentados, teniendo en cuenta que en ninguno de los estudios evaluados se utilizó información genética latinoamericana, lo cual puede limitar la extrapolación de los resultados.

Summary: Objective: To compile information on risk factors for coronary artery disease in the adult population evidenced by Mendelian randomization studies.. Methods: A search was carried out from the user of the Nueva Granada Military University in the databases of PubMed, EMBASE and BIREME and a narrative review of the literature was carried out in accordance with the recommendations of the scale for the Evaluation of Narrative Review Articles (SANRA). Results: 757 articles were obtained, after the application of inclusion and exclusion criteria, 29 articles were chosen that investigated the association of apolipoprotein B, LDL cholesterol, triglycerides, total cholesterol, apolipoprotein C3, cholesterol ester transfer protein, HDL, omega 6, lipoprotein (a), obesity, hemoglobin A1C, type 2 diabetes mellitus, fasting glucose, smoking initiation, blood pressure, serum parathyroid hormone, serum phosphate levels, non-alcoholic fatty liver disease, polycystic ovary syndrome , sex hormone-binding globulin, testosterone, circulating phylloquinone, inactive matrix protein gla, circulating dietary-derived antioxidants, glycine, homocysteine, uric acid, inflammatory markers, hemoglobin, hematocrit, and red blood cell count, with coronary artery disease. Conclusion: This review suggests new studies with Colombian genetic information to support the risk factors presented here, considering that none of the studies evaluated used Latin American genetic information, which may limit the extrapolation of the results.

Resumen Introducción: la organización mundial de la salud estima que 2000 millones de personas padecen anemia, mientras que la pre-diabetes y la diabetes afectan aproximadamente a 352 y 460 millones de personas, respectivamente. La anemia es una complicación frecuente en la diabetes mellitus (DM). Objetivo: evaluar la asociación y probabilidad de alteraciones de la hemoglobina en pre-diabéticos y diabéticos. Metodología: estudio descriptivo, retorspectivo y transversal, la población fue de 1103 pacientes (211 prediabéticos, 223 diabéticos y 669 normoglucémicos), la muestra fue el total de la población que cumplió con los criterios de inclusión y exclusión: adultos normoglucémicos y pre-diabéticos sin presencia de enfermedad aguda o crónica al momento del examen. La asociación entre variables se realizó por medio de la prueba de chi-cuadrado y la probabilidad fue determinada por la prueba de Odds Ratio. Resultados: las mujeres pre-diabéticas tuvieron una probabilidad 1.72 mayor de anemia que mujeres no diabéticas. Los hombres pre-diabéticos tuvieron una probabilidad 2.80 veces mayor de anemia que los no diabéticos. Las mujeres diabéticas tuvieron una probabilidad 2,37 más alta de tener anemia, mientras que los hombres diabéticos tuvieron una probabilidad 4,41 veces más alta que lo hombres no diabéticos de padecer anemia. Conclusiones: pacientes pre-diabéticos tienen mayor probabilidad de anemia que en no diabéticos. Es posible que la hiperglucemia persistente en pre-diabéticos se asocie a cambios en la concentración de esta hemoproteína años antes del desarrollo de diabetes por mecanismos similares, pero de forma incipiente.

Abstract Introduction: The World Health Organization estimates that 2 billion people suffer from anemia, while pre-diabetes and diabetes affect approximately 352 and 460 million people, respectively. Anemia is a frequent complication in diabetes mellitus. Objective: To evaluate the association and probability of hemoglobin alterations in pre-diabetics and diabetics. Methodology: Descriptive, retrospective and cross-sectional study, the population was 1103 patients (211 prediabetics, 223 diabetics and 669 normoglycemics), the sample was the total population that met the inclusion and exclusion criteria: normoglycemic and prediabetic adults without presence of acute or chronic disease at the time of examination. The association between variables was performed using the chi-square test and the probability was determined by the Odds Ratio test. Results: Pre-diabetic women had a 1.72 higher probability of anemia than non-diabetic women. Pre-diabetic men were 2.80 times more likely to have anemia than non-diabetics. Diabetic women were 2.37 times more likely to have anemia, while diabetic men were 4.41 times more likely than non-diabetic men to have anemia. Conclusions: Pre-diabetic patients are more likely to have anemia than non-diabetics. It is possible that persistent hyperglycemia in pre-diabetics is associated with changes in the concentration of this hemoprotein years before the development of diabetes by similar mechanisms, but in an incipient manner.

Resumo Introdução: Disfunção erétil (DE) é um problema sexual comum entre homens com doença renal crônica (DRC). A gravidade da disfunção sexual tende a piorar com a lesão renal. Este estudo tem como objetivo avaliar função erétil e qualidade de vida sexual de pacientes homens adultos com DRC em hemodiálise (HD) em um hospital na Amazônia brasileira. Métodos: Realizou-se estudo quantitativo transversal no Setor de HD da Unidade de Nefrologia, incluindo homens com DRC ≥ 18 anos, submetidos a ≥ 3 sessões semanais de HD por ≥ 3 meses e sexualmente ativos por ≥ 6 meses. Utilizamos o Quociente Sexual Masculino (QSM) para medir satisfação sexual e o Índice Internacional de Função Erétil (IIEF5) para estabelecer função erétil. A análise estatística foi realizada com o SPSS 21.0 usando testes apropriados, como Mann-Whitney e Kruskal-Wallis (P < 0,05). Resultados: Avaliamos 98 pacientes (51,68 ± 15,28 anos). Eles eram predominantemente casados/ou vivendo com um(a) parceiro(a) (60,20%), com tempo de HD entre 1 e 5 anos (55,10%) e KTV médio de 1,17. A prevalência de DE foi 66,30% e foi associada a maior faixa etária (p = 0,01), menor renda familiar (p = 0,02), diabetes (p = 0,01), menor hemoglobina corpuscular média (p = 0,04), maior cálcio total (p = 0,04) e menor albumina (p = 0,03). Aproximadamente 75% classificaram sua vida sexual como regular a excelente. Conclusão: Apesar da elevada prevalência de DE, a maioria dos homens com DRC em HD relatou vida sexual regular a excelente. O estudo ressalta a importância de estabelecer triagem eficaz e realizar avaliações de rotina sobre questões sexuais nesses homens. Introdução (DE DRC. . (DRC) (HD brasileira Métodos Realizouse Realizou se Nefrologia QSM (QSM IIEF5 IIEF (IIEF5 210 21 0 21. apropriados MannWhitney Mann Whitney KruskalWallis Kruskal Wallis P 0,05. 005 0,05 05 0,05) Resultados 9 51,68 5168 51 68 (51,6 1528 15 28 15,2 anos. anos) casadosou casados ou uma um(a parceiroa parceiro parceiro(a 60,20%, 6020 60,20% , 60 20 (60,20%) 55,10% 5510 55 10 (55,10% 117 17 1,17 6630 66 30 66,30 p 0,01, 001 0,01 01 0,01) 0,02, 002 0,02 02 0,02) 0,04, 004 0,04 04 0,03. 003 0,03 03 0,03) 75 excelente Conclusão (DRC (IIEF 2 00 0,0 51,6 516 (51, 152 15, 602 60,20 (60,20% 55,10 551 (55,10 11 1,1 663 66,3 7 0, 51, (51 60,2 (60,20 55,1 (55,1 1, 66, (5 60, (60,2 55, (55, ( (60, (55 (60 (6

Abstract Introduction: Erectile dysfunction (ED) is a common sexual problem among men with chronic kidney disease (CKD). The severity of sexual dysfunction tends to worsen with kidney damage. This study aims to evaluate the erectile function and sexual quality of life of adult male CKD patients undergoing hemodialysis (HD) in a hospital located in the Brazilian Amazon. Methods: A cross-sectional quantitative study was performed within the HD Sector of the Nephrology Unit including men with CKD aged ≥ 18 years, undergoing ≥ 3 weekly HD sessions for ≥ 3 months who had been sexually active for ≥ 6 months. We used the Male Sexual Quotient (MSQ) to measure sexual satisfaction and the International Index of Erectile Function (IIEF5) to establish erectile function. Statistical analysis was performed with SPSS 21.0 using appropriate tests, such as Mann-Whitney and Kruskal-Wallis (P < 0.05). Results: Ninety-eight patients (51.68 ± 15.28 years) were evaluated. They were primarily married/or living with a partner (60.20%), with HD time between 1 to 5 years (55.10%), and an average KTV of 1.17. ED prevalence was 66.30%, and it was associated with a higher age group (p = 0.01), lower family income (p = 0.02), diabetes (p = 0.01), lower mean corpuscular hemoglobin (p = 0.04), higher total calcium (p = 0.04), and lower albumin (p = 0.03). Around 75% classified their sex life as regular to excellent. Conclusion: Despite the high ED prevalence, most men with CKD in HD reported experiencing regular to excellent sex life. The study underscores the importance of establishing effective screening and conducting routine evaluations regarding sexual issues in these men. Introduction (ED CKD. . (CKD) damage (HD Amazon Methods crosssectional cross sectional MSQ (MSQ IIEF5 IIEF (IIEF5 210 21 0 21. tests MannWhitney Mann Whitney KruskalWallis Kruskal Wallis P 0.05. 005 0.05 05 0.05) Results Ninetyeight Ninety eight 51.68 5168 51 68 (51.6 1528 15 28 15.2 evaluated marriedor married or 60.20%, 6020 60.20% , 60 20 (60.20%) 55.10%, 5510 55.10% 55 10 (55.10%) 117 17 1.17 6630 66 30 66.30% p 0.01, 001 0.01 01 0.01) 0.02, 002 0.02 02 0.02) 0.04, 004 0.04 04 0.04) 0.03. 003 0.03 03 0.03) 75 Conclusion (CKD (IIEF 2 00 0.0 51.6 516 (51. 152 15. 602 60.20 (60.20% 551 55.10 (55.10% 11 1.1 663 66.30 7 0. 51. (51 60.2 (60.20 55.1 (55.10 1. 66.3 (5 60. (60.2 55. (55.1 66. ( (60. (55. (60 (55 (6

Resumo Introdução: A deficiência de crescimento na doença renal crônica está relacionada à elevada morbidade e mortalidade. O retardo do crescimento nessa doença é multifatorial. É fundamental conhecer os fatores modificáveis e estabelecer estratégias para melhorar o atendimento às crianças afetadas. Objetivos: Descrever padrões de crescimento em crianças com DRC e fatores de risco associados à baixa estatura. Métodos: Analisamos retrospectivamente dados antropométricos e epidemiológicos, peso ao nascer, prematuridade e níveis de bicarbonato, hemoglobina, cálcio, fosfato, fosfatase alcalina e paratormônio de crianças com DRC estágios 3–5, não submetidas a diálise, acompanhadas por pelo menos um ano. Resultados: Incluímos 43 crianças, a maioria meninos (65%). O escore z médio de altura/comprimento/idade das crianças no início e no acompanhamento foi de –1,89 ± 1,84 e –2,4 ± 1,67, respectivamente (p = 0,011). Cinquenta e um por cento das crianças apresentaram baixa estatura, e essas crianças eram mais jovens que aquelas com estatura adequada (p = 0,027). Níveis de PTH no início do acompanhamento correlacionados com escore z de altura/comprimento/idade. Uma subanálise com crianças menores de cinco anos (n = 17) mostrou que 10 (58,8%) delas apresentaram déficit de desenvolvimento e escore z de peso/idade mais baixo (0,031) e escore z de IMC/idade mais baixo (p = 0,047). Conclusão: Crianças, especialmente mais jovens, com DRC, que não estavam em diálise, apresentaram elevada prevalência de baixa estatura. Níveis de PTH foram correlacionados com escore z de altura, e deficiência de crescimento foi associada a pior estado nutricional. Portanto, é essencial monitorar o crescimento dessas crianças, controlar o hiperparatireoidismo e fornecer suporte nutricional. Introdução mortalidade multifatorial afetadas Objetivos Métodos epidemiológicos nascer bicarbonato hemoglobina cálcio fosfato 35 3 5 3–5 diálise ano Resultados 4 65%. 65 65% . (65%) alturacomprimentoidade altura comprimento idade 189 1 89 –1,8 184 84 1,8 24 2 –2, 167 67 1,67 p 0,011. 0011 0,011 0 011 0,011) 0,027. 0027 0,027 027 0,027) n 17 58,8% 588 58 8 (58,8% pesoidade 0,031 0031 031 (0,031 IMCidade IMC 0,047. 0047 0,047 047 0,047) Conclusão Crianças nutricional Portanto 3– 6 (65% 18 –1, 1, –2 16 1,6 001 0,01 01 002 0,02 02 58,8 (58,8 0,03 003 03 (0,03 004 0,04 04 (65 –1 – 00 0,0 58, (58, (0,0 (6 0, (58 (0, ( (5 (0

Abstract Introduction: Growth failure in chronic kidney disease is related to high morbidity and mortality. Growth retardation in this disease is multifactorial. Knowing the modifiable factors and establishing strategies to improve care for affected children is paramount. Objectives: To describe growth patterns in children with chronic kidney disease and the risk factors associated with short stature. Methods: We retrospectively analyzed anthropometric and epidemiological data, birth weight, prematurity, and bicarbonate, hemoglobin, calcium, phosphate, alkaline phosphatase, and parathormone levels of children with stages 3–5 CKD not on dialysis, followed for at least one year. Results: We included 43 children, the majority of which were boys (65%). The mean height/length /age z-score of the children at the beginning and follow-up was –1.89 ± 1.84 and –2.4 ± 1.67, respectively (p = 0.011). Fifty-one percent of the children had short stature, and these children were younger than those with adequate stature (p = 0.027). PTH levels at the beginning of the follow-up correlated with height/length/age z-score. A sub-analysis with children under five (n = 17) showed that 10 (58.8%) of them failed to thrive and had a lower weight/age z-score (0.031) and lower BMI/age z-score (p = 0.047). Conclusion: Children, particularly younger ones, with chronic kidney disease who were not on dialysis had a high prevalence of short stature. PTH levels were correlated with height z-score, and growth failure was associated with worse nutritional status. Therefore, it is essential to monitor the growth of these children, control hyperparathyroidism, and provide nutritional support. Introduction mortality multifactorial paramount Objectives Methods data weight prematurity bicarbonate hemoglobin calcium phosphate phosphatase 35 3 5 3– year Results 4 65%. 65 65% . (65%) heightlength length age zscore z score followup follow up 189 1 89 –1.8 184 84 1.8 24 2 –2. 167 67 1.67 p 0.011. 0011 0.011 0 011 0.011) Fiftyone Fifty 0.027. 0027 0.027 027 0.027) heightlengthage zscore. score. subanalysis sub analysis n 17 58.8% 588 58 8 (58.8% weightage 0.031 0031 031 (0.031 BMIage BMI 0.047. 0047 0.047 047 0.047) Conclusion Children ones zscore, score, status Therefore hyperparathyroidism support 6 (65% 18 –1. 1. –2 16 1.6 001 0.01 01 002 0.02 02 58.8 (58.8 0.03 003 03 (0.03 004 0.04 04 (65 –1 – 00 0.0 58. (58. (0.0 (6 0. (58 (0. ( (5 (0

Resumo: Introdução : A anemia é um distúrbio altamente prevalente. A anemia pré-operatória está associada a maior mortalidade, mais complicações, tempo prolongado de internação e maiores custos de saúde. A transfusão de glóbulos vermelhos (TGV) não melhora esses resultados. A Organização Mundial da Saúde recomenda a implementação de medidas de Gerenciamento de Sangue do Paciente (GSP), pois permitem melhorar esses resultados clínicos, reduzir TGV desnecessárias e economizar custos. Apesar da evidência contundente, a implementação dessas medidas ainda está aquém de ser efetivada. O objetivo deste trabalho é realizar uma análise da situação para conscientizar sobre o problema e incentivar a implementação dessas medidas. Metodologia: Foi realizado um estudo observacional, longitudinal, retrospectivo de coorte histórica, unicêntrico. Foram incluídos todos os pacientes submetidos a cirurgias de coordenação de 01/01/2022 a 01/04/2022 no Hospital de Clínicas. Critérios de exclusão: ausência de hemograma nos três meses anteriores à cirurgia e recusa em participar do estudo. Resultados: Foram analisadas um total de 329 cirurgias. 52 a cada 100 procedimentos foram realizados em pacientes com anemia. Foi encontrada uma associação estatisticamente significativa entre a anemia pré-operatória e a recepção de TGR durante a internação. OR 11,746 (4,518 - 30,540). A anemia e as TGR prolongaram significativamente a internação hospitalar. Dias de internação em função da condição do paciente: Sem anemia: 10,1 ± 1,1 dias, com anemia: 27,2 ± 2,3 dias. Valor p < 0,001. Não transfundidos: 14,5 ± 1,3 dias, transfundidos: 41,8 ± 4,4 dias. Valor p < 0,001. Apenas 49 (28,6%) dos 171 pacientes com anemia tinham metabolismo do ferro antes da cirurgia. Dos 140 pacientes com Hb < 12 mg/dL submetidos a cirurgias com sangramento não insignificante, 4 receberam tratamento específico para otimizar a Hb. Foram administradas um total de 185 unidades de glóbulos vermelhos (UGV) durante a internação. 49 em pacientes instáveis (intraoperatório ou hemorragia aguda) e 136 em pacientes estáveis. Da análise desses últimos, 42,5% dos pacientes receberam 3 ou mais UGV. A hemoglobina pré-transfusional média foi de 7,0 ± 0,1. Foi encontrada uma associação estatisticamente significativa entre receber UGV e falecer durante a internação. OR 17,182 (3,360 - 87,872). Conclusões: Foi realizado uma análise da situação na qual foi observada uma elevada prevalência de anemia pré-operatória, um estudo e tratamento escasso da anemia antes das cirurgias e uma quantidade excessiva de UGV recebidas por alguns pacientes. Este trabalho estabelece a necessidade de implementar programas de Gerenciamento de Sangue do Paciente para reduzir a prevalência de anemia pré-operatória e melhorar nossas práticas transfusionais. Além disso, estabelece um quadro comparativo para avaliar o progresso dessas medidas e aponta possíveis indicadores para avaliar os benefícios de sua implementação.

Abstract: Introduction: Anemia is a highly prevalent disorder. Preoperative anemia is associated with higher mortality, more complications, longer hospital stays, and higher healthcare costs. Red blood cell transfusion (RBC) does not improve these outcomes. The World Health Organization recommends implementing Patient Blood Management (PBM) programmes, as they can improve these clinical outcomes, reduce unnecessary RBC transfusions, and save costs. Despite compelling evidence, the implementation of these measures has yet to be effectively achieved. The objective of this study is to conduct a situational analysis to raise awareness about this issue and encourage the implementation of these measures. Methodology: An observational, longitudinal, retrospective cohort study was conducted at a single center. All patients undergoing elective surgery from 01/01/2022 to 01/04/2022 at the Hospital de Clínicas were included. Exclusion criteria: absence of a complete blood count in the three months prior to surgery and refusal to participate in the study. Results: A total of 329 surgeries were analyzed. 52 out of 100 procedures were performed on patients with anemia. A statistically significant association was found between preoperative anemia and receiving RBC transfusion during hospitalization. OR 11.746 (4.518 - 30.540). Anemia and RBC transfusions significantly prolonged hospital stay. Length of hospitalization based on patient condition: No anemia: 10.1 ± 1.1 days, with anemia: 27.2 ± 2.3 days. Value of p < 0.001. Non-transfused: 14.5 ± 1.3 days, transfused: 41.8 ± 4.4 days. Value of p < 0.001. Only 49 (28.6%) of the 171 patients with anemia had iron metabolism assessed before surgery. Among the 140 patients with Hb < 12 g/dL undergoing surgeries with non-insignificant bleeding, only 4 received specific treatment to optimize Hb. A total of 185 units of red blood cells (RBC) were administered during hospitalization. 49 to unstable patients (intraoperative or acute hemorrhage) and 136 to stable patients. From the analysis of the latter group, 42.5% of the patients received 3 or more RBC units. The average pre-transfusion hemoglobin was 7.0 ± 0.1. A statistically significant association was found between receiving RBC units and dying during hospitalization. OR 17.182 (3.360 - 87.872). Conclusiones: A situational analysis was conducted, revealing a high prevalence of preoperative anemia, scarce study and treatment of anemia before surgeries, and an excessive amount of blood transfusions received by some patients. This work establishes the need to implement Patient Blood Management programs to reduce the prevalence of preoperative anemia and improve our transfusion practices. It also sets a comparative framework to evaluate the progress of these measures and indicates possible indicators to assess the benefits of their implementation.

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Abstract Background: Tillandsia recurvata collected in San Luis Potosí does not have studies focused on its use as an adjuvant in treating diabetes mellitus. Questions and / or Hypotheses: Will Tillandsia recurvata L. (Bromeliaceae) have antidiabetic activity in vitro and in vivo? Studied species: Tillandsia recurvata L. (Bromeliaceae) Study site and dates: T. recurvata was collected in Guadalcázar municipality, San Luis Potosí, Mexico, in December 2021. Methods: The antidiabetic potential of Tillandsia recurvata methanol extract (TRM) was evaluated using in vitro and in vivo models, and its secondary metabolite content was analyzed using Gas chromatography-mass spectrometry. Results: Results demonstrate that extract reduces blood glucose, triglyceride, and cholesterol levels in vivo. In addition, in vitro tests showed that extract diminished the formation of advanced glycation end products, methylglyoxal concentrations, and glycosylated hemoglobin levels. Gas chromatography-mass spectrometry analysis identified several compounds in the extract, including 2-methylbenzaldehyde, 4-hydroxy-2-methylacetophenone, 3',5' dimethoxyacetophenone, pentanoic acid, palmitic acid, linoleic acid, phytol, margaric acid, oleamide, cis-11-eicosenamide, stearic acid, 13-docosenamide, (Z), campesterol, and β-sitosterol. Conclusions: These results highlight the potential of T. recurvata collected in San Luis Potosi as an adjuvant in treatment of diabetes mellitus.

Resumen Antecedentes: Tillandsia recurvata colectada en San Luis Potosí, no cuenta con estudios enfocados a su uso como coadyuvante en el tratamiento de la diabetes mellitus. Preguntas y / o Hipótesis: ¿Tillandsia recurvata L. (Bromeliaceae), tendrá actividad antidiabética in vitro e in vivo? Especies de estudio: Tillandsia recurvata L. (Bromeliaceae) Sitio y años de estudio: T. recurvata fue colectada en el municipio de Guadalcazar, San Luis Potosí, México, en diciembre 2021. Métodos: Se evaluó el potencial antidiabético del extracto de metanol de Tillandsia recurvata (TRM) en modelos in vitro e in vivo y se realizó un perfilamiento de los metabolitos secundarios presentes mediante cromatografía de gases acoplada a espectrometría de masas. Resultados: Los resultados demuestran que el extracto reduce eficazmente los niveles de glucosa, triglicéridos y colesterol en sangre in vivo. Además, las pruebas in vitro indican que el extracto reduce la formación de productos finales de glicación avanzada, así como la concentración de metilglioxal y los niveles de hemoglobina glicosilada. El análisis por cromatografía de gases acoplada a espectrometría de masas identificó varios compuestos presentes en el extracto, incluidos: 2-metilbenzaldehído, 4-hidroxi-2-metilacetofenona, 3',5'-dimetoxiacetofenona, ácido pentanóico, ácido palmítico, ácido linoleico, fitol, ácido margárico, oleamida, cis- 11-Eicosenamida, ácido esteárico, 13-Docosenamida, (Z), campesterol y β-sitosterol. Conclusiones: Los resultados obtenidos resaltan el potencial de T. recurvata recolectada en San Luis Potosí como coadyuvante en el tratamiento de la diabetes mellitus, debido a sus propiedades antidiabéticas.

Abstract Introduction: Morelet’s crocodile (Crocodylus moreletii) is a species distributed in the Mexican southeast and threatened due to multiple pressures. Objective: To characterize the digestive proteases in the acid phase (stomach) and alkaline phase (intestine) of three life stages of C. moreletii in captivity (hatchling, juvenile, and adult). Methods: Total alkaline and acid protease activities were quantified using casein and haemoglobin as substrates. Trypsin, chymotrypsin, leucine aminopeptidase, and elastase activities were quantified using synthetic substrates. Protease profiles were analysed by SDS-PAGE and Native-PAGE. Results: The specific activity of acid and alkaline proteases showed differences between the three stages, finding the highest activity in the juveniles. Trypsin, chymotrypsin, leucine aminopeptidase, and elastase activities were higher in hatchlings. There were differences in optimum pH and temperature of acid and alkaline proteases, trypsin, and leucine aminopeptidase between the three stages, demonstrating the diversification of the enzymes according to different stages, as well as the presence of specific isoforms in each stage of C. moreletii. The acid phase zymogram showed four bands with pepsin-like acid activity in the hatchling and juvenile crocodile, while in the adult only two of the four bands were detected. The alkaline zymogram showed that the hatchling had the highest number of activity bands compared to the other stages, corresponding to the high specific activity reported in the alkaline phase. Conclusions: Digestive proteases of Morelet’s crocodile differ in their biochemical characteristics and the number of proteases between hatchling, juvenile, and adult. This could help in the future design of balanced diets as well to the sustainable management and production of this species.

Resumen Introducción: El cocodrilo de pantano (Crocodylus moreletii) es una especie distribuida en el sureste mexicano y amenazada por múltiples presiones. Objetivo: Caracterizar las proteasas digestivas en fase ácida (estómago) y fase alcalina (intestino) en tres etapas de vida de C. moreletii en cautiverio (cría, juvenil y adulto). Métodos: Se cuantificaron las actividades de proteasas alcalinas y ácidas totales utilizando caseína y hemoglobina como sustrato. Las actividades de tripsina, quimotripsina, leucina aminopeptidasa y elastasa se cuantificaron utilizando sustratos sintéticos. Los perfiles de proteasas se analizaron mediante SDS-PAGE y PAGE nativa. Resultados: La actividad específica de las proteasas ácidas y alcalinas mostró diferencias entre las tres tallas, encontrándose la mayor actividad en el estadio juvenil. Las actividades de tripsina, quimotripsina, leucina aminopeptidasa y elastasa fueron mayores en las crías. Hubo diferencias en el pH y temperatura óptimos de las proteasas ácidas y alcalinas, tripsina y leucina aminopeptidasa entre las tres tallas, demostrando la diversificación de las enzimas según las diferentes tallas, así como la presencia de isoformas específicas en cada talla de C. moreletii. El zimograma en fase ácida mostró cuatro bandas con actividad similar a pepsina en la cría y juvenil, mientras que en el adulto solo se detectaron dos de las cuatro bandas. El zimograma alcalino mostró que la cría tuvo el mayor número de bandas de actividad en comparación con las otras tallas, correspondiente a la alta actividad específica reportada en la fase alcalina. Conclusiones: Las proteasas digestivas del cocodrilo de pantano presentaron características bioquímicas y en número de proteasas diferentes entre cría, juvenil y adulto. Esto podría ayudar en el futuro diseño de dietas balanceadas, así como al manejo y producción sustentable de esta especie.

Abstract Sideroblastic anemias (SAs) are a heterogeneous group of rare pathologies in which heme biosynthesis and iron utilization during hemoglobin synthesis is affected. They are characterized by the presence in the bone marrow of erythroid precursors with pathological iron deposits in the mitochondria. They can be congenital or acquired. The most common hereditary form is X-linked (XLSA), caused by genetic variants in the ALAS2 gene, which encodes for the first enzyme in heme biosynthesis, the delta-aminolevulinic acid synthetase 2 (ALAS2). It predominantly affects hemizygous males, who present with microcytic hypochromic anemia. In some patients, treatment with pyridoxal phosphate is effective. We present three related cases of XLSA due to alteration in the ALAS2 gene.

Resumen Las anemias sideroblásticas (AS) son un grupo heterogéneo de patologías raras en las que se ve afectada la biosíntesis del hemo y la utilización del hierro durante la síntesis de la hemoglobina. Se caracterizan por la presencia en médula ósea de precursores eritroides con depósitos patológicos de hierro en las mitocondrias. Pueden ser congénitas o adquiridas. La forma hereditaria más común es la ligada al cromosoma X (ASLX), debido a variantes genéticas en el gen ALAS2 que codifica para la primera enzima en la biosíntesis del hemo, la delta aminolevulinato sintetasa 2 (ALAS2). Afecta predominantemente a varones hemicigotas, que se presentan con anemia microcítica hipocrómica. En algunos pacientes es efectivo el tratamiento con fosfato de piridoxal. Presentamos tres casos relacionados de ASLX por alteración del gen ALAS2.

Abstract Diabetes mellitus is a metabolic disease that is characterized by an increase in blood glucose levels, causing a systemic inflammatory state that can affect the healing of periapical lesions present in apical periodontitis, a chronic inflammatory disease caused by an endodontic infection whose development is regulated by the host’s immune response. Diabetes could interact with apical periodontitis by triggering immune modulation, being able to affect the clinical outcome of periapical lesions and interfering with healing after endodontic treatment. The objective of this literature review is to analyze the evidence regarding the relationship between diabetes mellitus and the presence and severity of apical periodontitis of endodontic origin. Articles were collected from the PubMed, Scopus and Web of Science databases between the years 2016 and 2021. 31 relevant articles were included for this study. In 41.6% of the studies a greater presence of apical periodontitis was found in patients with diabetes associated with a more complex and compromised apical lesion. 25% of the studies reported that poorly controlled diabetic patients had a greater presence of apical periodontitis. 25% of the studies reported high levels of HbA1c in association with apical periodontitis. A relationship was found between diabetes and apical periodontitis, which means diabetes should be considered as an important preoperative factor in the development and severity of apical periodontitis; however, more standardized experimental studies should be carried out to determine this relationship more accurately, in addition to being able to investigate a bidirectionality between the two.

Resumen La diabetes mellitus es una enfermedad metabólica que se caracteriza por tener un aumento en los niveles de glucemia, causando un estado inflamatorio sistémico que puede afectar la cicatrización de las lesiones periapicales presentes en la periodontitis apical, una enfermedad inflamatoria crónica causada por una infección endodóntica cuyo desarrollo está regulado por la respuesta inmunitaria del huésped. La diabetes podría interactuar con la periodontitis apical al desencadenar la modulación inmunitaria, pudiendo afectar la respuesta clínica de las lesiones periapicales e interferir con la cicatrización después del tratamiento endodóntico. El objetivo de esta revisión de la literatura es analizar la evidencia respecto a la relación entre la diabetes mellitus y la presencia y severidad de la periodontitis apical de origen endodóntico. Se recopilaron artículos de las bases de datos PubMed, Scopus y Web of Science entre los años 2016 y 2021. Se eligieron 31 artículos pertinentes para el estudio. En el 41,6% de los estudios se encontró una mayor presencia de periodontitis apical en pacientes con diabetes asociada a una lesión apical más compleja y comprometida. Un 25% de los estudios encontró que los pacientes diabéticos mal controlados presentan mayor presencia de periodontitis apical. Un 25% de los estudios encontró que niveles altos de HbA1c se asocian a la presencia de periodontitis apical. Se encontró una relación entre la diabetes y la periodontitis apical, por lo que la diabetes debe ser considerada como un factor preoperatorio importante en el desarrollo y severidad de la periodontitis apical, sin embargo, se deben realizar estudios experimentales más estandarizados para poder determinar con mayor exactitud esta relación, además de poder indagar la bidireccionalidad entre ambos.

RESUMEN Introducción: la diabetes mellitus es una patología prevalente y por ello la implementación de estrategias prácticas para su diagnóstico son importantes desde la Atención Primaria. Objetivo: determinar los parámetros laboratoriales de los pacientes de la Unidad de Salud Familiar del barrio Chaipe (Encarnación, Paraguay) con moderado a muy alto riesgo de diabetes mellitus tipo 2 según la prueba de FINDRISK. Metodología: estudio prospectivo, observacional, descriptivo, transversal. Se incluyeron pacientes mayores de 18 años que acudieron a consultar en la Unidad de Salud Familiar del barrio Chaipe desde setiembre del 2022 a febrero del 2023. Se aplicó la prueba de FINDRISK para seleccionar a aquellos con moderado a muy alto riesgo de diabetes mellitus tipo 2 para las determinaciones laboratoriales. Resultados: la muestra estuvo conformada por 142 pacientes, con rango de edad menor a 45 años y predominio del sexo femenino. El 42,96 % tenía índice de masa corporal aumentado y 62,68 % circunferencia abdominal de riesgo. El 52,11 % no realizaba actividad física y el 27,46 % no consumía frutas y verduras diariamente. El 25,35 % eran hipertensos, el 11,97 % presentó en alguna oportunidad glicemia elevada y el 56,34 % tenía familiares con diabetes mellitus. El 4,93 % presentó glicemia ≥ 126 mg/dl y el 10,56 % valores de hemoglobina glicosilada (HBA1C) ≥ 6,5 %. El 14,08 % presentó colesterol total ≥ 200 mg/dl y 19,72 % triglicéridos ≥ 150 mg/dl. El 26,65 % presentó 3 o más criterios para síndrome metabólico y se encontró una relación significativa con el riesgo de diabetes mellitus. Conclusiones: se encontró una proporción significativa de pacientes con parámetros laboratoriales de glicemia, HBA1C, colesterol y triglicéridos aumentados.

ABSTRACT Introduction: diabetes mellitus is a prevalent pathology and therefore the implementation of practical strategies for its diagnosis are important from Primary Care. Objective: to determine the laboratory parameters of patients from the United Family Healthcare of the Chaipe neighborhood (Encarnación, Paraguay) with moderate to very high risk of diabetes mellitus type 2 according to the FINDRISK test. Methodology: prospective, observational, descriptive, cross-sectional study. Patients over 18 years of age who came to consult at the United Family Healthcare in the Chaipe neighborhood from September 2022 to February 2023 were included. The FINDRISK test was applied to select those with moderate to very high risk of diabetes mellitus type 2 for the laboratory’s determinations. Results: the sample was made up of 142 patients, with an age range of less than 45 years and a predominance of the female sex. 42.96 % had an increased body mass index and 62.68 % had an abdominal circumference at risk. 52.11 % did not do physical activity and 27.46 % did not consume fruits and vegetables daily. 25.35 % were hypertensive, 11.97 % had high blood glucose at some point and 56.34 % had family members with diabetes mellitus. 4.93 % had blood glucose ≥ 126 mg/dl and 10.56 % had glycosylated hemoglobin (HBA1C) values ≥ 6.5 %. 14.08 % had total cholesterol ≥ 200 mg/dl and 19.72 % had triglycerides ≥ 150 mg/dl. 26.65 % presented 3 or more criteria for metabolic syndrome and a significant relationship was found with the risk of diabetes mellitus. Conclusions: a significant proportion of patients with increased laboratory parameters of glycemia, HBA1C, cholesterol and triglycerides were found.

ABSTRACT Introduction: Anemia is frequent in patients undergoing replacement therapy for kidney failure. Anemia in the pre- and post-transplantation period might be related to kidney transplant outcomes. The current study therefore sought to assess the relationship between anemia, delayed allograft function (DGF), chronic kidney allograft dysfunction (CAD), and death from any cause following kidney transplantation from a deceased donor. Methods: This was a retrospective study with 206 kidney transplant patients of deceased donors. We analyzed deceased donors’ and kidney transplant patients’ demographic data. Moreover, we compared biochemical parameters, anemia status, and medicines between DGF and non-DGF groups. Afterward, we performed a multivariate analysis. We also evaluated outcomes, such as CAD within one year and death in ten years. Results: We observed a lower frequency of pre-transplant hemoglobin concentration (Hb) but higher frequency of donor-serum creatinine and red blood transfusion within one week after transplantation in the group with DGF. In addition, there was an independent association between Hb concentration before transplantation and DGF [OR 0.252, 95%CI: 0.159–0.401; p < 0.001]. There was also an association between Hb concentration after six months of kidney transplantation and both CAD [OR 0.798, 95% CI: 0.687–0.926; p = 0.003] and death from any cause. Conclusion: An association was found between pre-transplantation anemia and DGF and between anemia six months after transplantation and both CAD and death by any cause. Thus, anemia before or after transplantation affects the outcomes for patients who have undergone kidney transplantation from a deceased donor. Introduction failure pre posttransplantation post DGF, , (DGF) CAD, (CAD) donor Methods 20 donors data Moreover parameters status nonDGF non groups Afterward analysis years Results pretransplant (Hb donorserum serum addition OR 0252 0 252 0.252 95%CI 95CI CI 95 0.159–0.401 01590401 159 401 0.001. 0001 0.001 . 001 0.001] 0798 798 0.798 0.687–0.926 06870926 687 926 0.003 0003 003 Conclusion pretransplantation Thus (DGF (CAD 2 025 25 0.25 9 0.159–0.40 0159040 15 40 000 0.00 00 079 79 0.79 0.687–0.92 0687092 68 92 02 0.2 0.159–0.4 015904 1 4 0.0 07 7 0.7 0.687–0.9 068709 6 0. 0.159–0. 01590 0.687–0. 06870 0.159–0 0159 0.687–0 0687 0.159– 015 0.687– 068 0.159 01 0.687 06 0.15 0.68 0.1 0.6

RESUMO Introdução: A anemia é frequente em pacientes submetidos à terapia substitutiva para insuficiência renal. A anemia nos períodos pré e pós-transplante pode estar relacionada aos desfechos do transplante renal. Portanto, o presente estudo buscou avaliar a relação entre anemia, função retardada do enxerto (FRE), disfunção crônica do enxerto renal (DCE) e óbito por qualquer causa após transplante renal de doador falecido. Métodos: Este foi um estudo retrospectivo com 206 pacientes transplantados renais de doadores falecidos. Analisamos dados demográficos de doadores falecidos e pacientes transplantados renais. Além disso, comparamos parâmetros bioquímicos, status de anemia e medicamentos entre os grupos FRE e não-FRE. Posteriormente, realizamos uma análise multivariada. Também avaliamos desfechos, como DCE em um ano e óbito em dez anos. Resultados: Observamos menor frequência de concentração de hemoglobina (Hb) pré-transplante, mas maior frequência de creatinina sérica do doador e transfusão de hemácias no período de uma semana após o transplante no grupo FRE. Além disso, houve associação independente entre a concentração de Hb antes do transplante e a FRE [OR 0,252; IC 95%: 0,159–0,401; p < 0,001]. Houve também associação entre a concentração de Hb após seis meses de transplante renal e ambos, DCE [OR 0,798; IC95%: 0,687–0,926; p = 0,003] e óbito por qualquer causa. Conclusão: Encontrou-se uma associação entre anemia pré-transplante e FRE e entre anemia seis meses após o transplante e ambos, DCE e óbito por qualquer causa. Assim, a anemia antes ou após o transplante afeta os desfechos de pacientes que foram submetidos a transplante renal de doador falecido. Introdução póstransplante pós Portanto FRE, , (FRE) (DCE falecido Métodos 20 disso bioquímicos nãoFRE. nãoFRE não não-FRE Posteriormente multivariada anos Resultados (Hb prétransplante, prétransplante transplante, OR 0,252 0252 0 252 95% 95 0,159–0,401 01590401 159 401 0,001. 0001 0,001 . 001 0,001] ambos 0,798 0798 798 IC95% IC95 0,687–0,926 06870926 687 926 0,003 0003 003 Conclusão Encontrouse Encontrou se Assim (FRE 2 0,25 025 25 9 0,159–0,40 0159040 15 40 000 0,00 00 0,79 079 79 IC9 0,687–0,92 0687092 68 92 0,2 02 0,159–0,4 015904 1 4 0,0 0,7 07 7 0,687–0,9 068709 6 0, 0,159–0, 01590 0,687–0, 06870 0,159–0 0159 0,687–0 0687 0,159– 015 0,687– 068 0,159 01 0,687 06 0,15 0,68 0,1 0,6

Abstract Objective: The aim of this study is to evaluate the prevalence of anemia in the preoperative period of cardiovascular surgery, its postoperative incidence and its evolution during the first month in our setting. Methods: A prospective cohort study was carried out in which all patients undergoing central cardiovascular surgery operated during the period 09/01/2021-09/01/2022 in a university hospital were included. Clinical and laboratory follow-up was carried out prior to surgery, on the fifth and on the 30th postoperative day. Groups with and without preoperative anemia were compared. Results: The prevalence of anemia in the preoperative period was 32.1%. The incidence of anemia in the postoperative period was 96% in the group of patients without previous anemia. One month after surgery, 73 and 90% of the patients, with and without preoperative anemia, respectively, remained anemic. Patients with preoperative anemia had less recovery of their hemoglobin values at one month. A trend towards higher mortality and a greater need for referral to post-hospital discharge rehabilitation centers was observed in those with preoperative anemia. Conclusions: In this work, a high prevalence and incidence of anemia in the perioperative period of cardiovascular surgeries was evidenced. As well as its subtreatment and high persistence during the month after surgery.

Resumen Objetivo: El objetivo del presente estudio es evaluar en nuestro medio la prevalencia de anemia en el preoperatorio de la cirugía cardiovascular, su incidencia postoperatoria y su evolución durante el primer mes. Métodos: Se realizó un estudio de cohorte prospectivo en el que se incluyeron todos los pacientes sometidos a cirugía cardiovascular central intervenidos durante el periodo del 01/09/2021 al 01/09/2022 en un hospital universitario. Se realizó seguimiento clínico y de laboratorio previo a la cirugía, al quinto y al día treinta del postoperatorio. Se comparó a los grupos con y sin anemia preoperatoria. Resultados: La prevalencia de anemia en el preoperatorio fue del 32.1%. La incidencia de anemia en el postoperatorio fue del 96% en el grupo de pacientes sin anemia previa. Al mes de la cirugía un 73 y un 90% de los pacientes, con y sin anemia preoperatoria respectivamente, persistían anémicos. Los pacientes con anemia preoperatoria tuvieron una menor recuperación de sus valores de hemoglobina al mes. Se observó una tendencia a mayor mortalidad y una mayor necesidad de derivación a centros de rehabilitación postegreso hospitalario en aquellos con anemia preoperatoria. Conclusiones: En este trabajo se evidenció una alta prevalencia e incidencia de anemia en el perioperatorio de las cirugías cardiovasculares. Así como su subtratamiento y elevada persistencia durante el mes posterior a la cirugía.

Resumo Introdução: As complicações micro e macrovasculares da diabetes são resultado de um processo de caráter longo sobre a falta dos cuidados da diabetes, de que resultam problemas cardiovasculares, oftalmológicos e neuropáticos, requerendo por essas questões elevada atenção no tratamento. Descrição do caso: Apresenta-se o relato de caso de um paciente adulto de meia-idade, ex-fumador, com diagnóstico de diabetes mellitus, além da hipertensão e obesidade. A sua alimentação não saudável ao longo dos anos, sedentarismo e altos níveis de estresse resultou num quadro de isquemia vascular periférica, que intensificou as complicações da diabetes, ou seja, problemas micro e macrovasculares, entre eles, a retinopatia e a neuropatia. Por esse histórico, a farmacoterapia do paciente resultou entre as insulinas (regular e NPH), antiagregante plaquetátio, estatina, fibratos, psicotrópicos e os anti-hipertensores. Além disso, detetou-se que seus níveis glicémicos e hemoglobina glicada estão elevados. Ainda se verificaram alterações na lipoproteína de alta densidade (HDL) e triglicéridos. Algumas queixas do paciente no período noturno, como boca seca, tontura e sonolência, são problemas que podem estar relacionados com a terapia concomitante de venlafaxina, gabapentina e amitriptilina. Comentários: De forma geral, recomenda-se a este paciente a prática de exercício físico, como caminhada, por exemplo, diminuição do consumo de hidratos de carbono e sódio, além de algumas alterações na farmacoterapia do paciente.

Abstract Introduction: The micro and macrovascular complications of diabetes are the result of a long process of the lack of diabetes care, which results in cardiovascular, ophthalmological, and neuropathic problems, and for these reasons requires high attention in treatment. Case description: This article presents a case report of a middle-aged adult patient, ex-smoker, diagnosed with diabetes mellitus, in addition to hypertension and obesity. Their unhealthy diet over the years, sedentary lifestyle, and high levels of stress resulted in peripheral vascular ischemia, which intensified the complications of diabetes, that is, micro and macrovascular problems, including retinopathy and neuropathy. Due to this history, the patient’s pharmacotherapy resulted in insulins (regular and NPH), antiplatelet agents, statins, fibrates, psychotropics, and antihypertensives. In addition, his blood glucose levels and glycated hemoglobin were found to be elevated. Furthermore, alterations were observed in high-density lipoprotein (HDL) and triglycerides. Some patient complaints at night, such as dry mouth, dizziness, and drowsiness, are problems that may be related to concomitant therapy with venlafaxine, gabapentin, and amitriptyline. Comments: In general, this patient is recommended to practice physical exercises, such as walking, for example, reducing the consumption of carbohydrates and sodium, in addition to some changes in the patient’s pharmacotherapy.

RESUMEN Introducción: la leishmaniasis representa un grave problema de salud pública en diversas regiones de América Latina. Su impacto, magnitud y brotes epidémicos son consecuencia de políticas gubernamentales ineficientes. Objetivo: caracterizar una serie de casos de leishmaniasis cutánea. Métodos: se realizó una investigación descriptiva, de corte transversal, en la Universidad Nacional de San Cristóbal de Huamanga, Ayacucho, Perú, durante el período julio-septiembre de 2023. De un universo de estudio de siete pacientes, se trabajó con una muestra de igual denominación, obtenida mediante un muestreo intencional. El procesamiento de los datos se realizó con el Paquete Estadístico para las Ciencias Sociales (SPSS), versión 25,0, obteniéndose valores absolutos y porcentajes como medidas de resumen. Los resultados se presentaron en forma de textos, tablas y figuras. Resultados: los casos procedieron de cinco pueblos del distrito Ayna, provincia La Mar, departamento Ayacucho, Perú. El 71,4 % iniciaron los síntomas en el mes de marzo, en tanto cinco de los siete casos eran del sexo femenino y predominaron las lesiones en las extremidades inferiores (57,1 %). En las imágenes mostradas se observa la úlcera típica de fondo limpio, color rosado y tejido granuloso, redondeada, de bordes regulares y elevados. Conforme a los valores de laboratorio, la media para las cifras de hemoglobina resultó de 13,6 mg/dl. Conclusiones: los casos se caracterizaron por no presentar nexo epidemiológico y su presentación ocurrió en una época propicia para la proliferación de mosquitos. Las lesiones típicas permitieron el diagnóstico precoz y tratamiento oportuno.

ABSTRACT Introduction: leishmaniasis represents a serious public health problem in various regions of Latin America. Its impact, magnitude and epidemic outbreaks are a consequence of inefficient government policies. Objective: characterize a series of cases of cutaneous leishmaniasis. Methods: a descriptive, cross-sectional investigation was carried out at the National University of San Cristobal de Huamanga, Ayacucho, Peru, during the period July-September 2023. From a study universe of seven patients, we worked with a sample of the same name, obtained through intentional sampling. Data processing was carried out with the Statistical Package for the Social Sciences (SPSS), version 25.0, obtaining absolute values and percentages as summary measures. The results were presented in the form of texts, tables and figures. Results: the cases came from five towns in the Ayna district, La Mar province, Ayacucho department, Peru. Symptoms began in 71,4 % in the month of March, while five of the seven cases were female and lesions in the lower extremities predominated (57,1 %). In the images shown, the typical ulcer with a clean bottom, pink color and granular tissue, rounded, with regular and raised edges is observed. According to the values of the laboratory tests, the average hemoglobin levels were 13,6 % mg/dl. Conclusions: the cases were characterized by not presenting epidemiological links and its presentation occurred at a time conducive to the proliferation of mosquitoes. Typical lesions allowed early diagnosis and timely treatment.