Resumo Enquadramento: A literacia em saúde (LS) é a capacidade da pessoa obter e traduzir informações a fim de manter e melhorar a saúde. Objetivo: Caracterizar o nível de LS da pessoa internada num hospital oncológico; avaliar a fiabilidade do instrumento European Health Literacy Survey in Portuguese (HLS-EU-PT). Metodologia: Estudo transversal, quantitativo, descritivo e metodológico. Amostra de 188 pessoas internados num serviço de cirurgia oncológica entre maio e setembro de 2020, os dados foram colhidos através de formulário de caracterização sociodemográfica, de saúde e instrumento de avaliação da LS. Resultados: O HLS-EU-PT apresentou elevado nível de consistência interna. Todos os domínios e níveis de processamento do instrumento se correlacionam positivamente entre si. Os participantes apresentam em média um nível problemático de LS. Conclusão: Os resultados indiciam a necessidade de um maior investimento na capacitação da LS. São necessários mais estudos nesta e noutras populações e contextos de prestação de cuidados de saúde, de forma a direcionar a prática de cuidados na resposta eficaz aos problemas de saúde.

Abstract Background: Health literacy (HL) is the ability of an individual to obtain and translate information in order to maintain and improve their health. Objective: To characterize the level of HL of patients admitted to an oncology hospital and assess the reliability of the Portuguese version of the European Health Literacy Survey (HLS-EU-PT). Methodology: Cross-sectional, quantitative, descriptive, and methodological study. Sample of 188 patients admitted to a surgical oncology unit between May and September 2020. Data were collected through a sociodemographic and health characterization form and a HL assessment tool. Results: The HLS-EU-PT had a high level of internal consistency. All domains and information-processing levels correlated positively with each other. Participants had on average a problematic level of HL. Conclusion: The results indicate the need for greater investment in HL training. Further studies are needed in this population and in other populations and healthcare settings to provide an effective response to health problems.

Resumen Marco contextual: La alfabetización en salud (AS) es la capacidad de una persona para obtener y traducir información con el fin de mantener y mejorar su salud. Objetivo: Caracterizar el nivel de AS de las personas ingresadas en un hospital oncológico; evaluar la fiabilidad del instrumento European Health Literacy Survey in Portuguese (HLS-EU-PT). Metodología: Estudio transversal, cuantitativo, descriptivo y metodológico. Muestra de 188 personas ingresadas en un servicio de cirugía oncológica entre mayo y septiembre de 2020, se recogieron datos mediante un formulario de caracterización sociodemográfica y de salud, y una herramienta de evaluación de AS. Resultados: El HLS-EU-PT mostró un alto nivel de consistencia interna. Todos los dominios y niveles de procesamiento del instrumento correlacionaron positivamente entre sí. Por término medio, los participantes tienen un nivel problemático de AS. Conclusión: Los resultados indican la necesidad de una mayor inversión en formación en AS. Son necesarios más estudios en esta y otras poblaciones, y en entornos sanitarios para orientar la práctica asistencial hacia una respuesta eficaz a los problemas de salud.

Resumo: Com base em uma pesquisa online aplicada a 4.943 membros da audiência no Chile, este estudo analisa os fatores sociodemográficos e atitudinais associados a quatro tipos de evitação de notícias: não intencional, evitação consistente, evitação ocasional e evitação seletiva. Os resultados mostram uma relação significativa e negativa, embora apenas moderada, entre evitar intencionalmente as notícias e com que frequência as pessoas dizem consumi-las. Ou seja, embora a audiência tenda a evitar as notícias, isso não necessariamente indica um baixo consumo de notícias e vice-versa. Além disso, a evitação seletiva de notícias é significativamente superior a outros tipos de evitação de notícias entre as audiências. Em relação aos fatores explicativos, os resultados mostram que a confiança nas notícias e o interesse na política são as únicas variáveis significativamente associadas a todos os tipos de evitação de notícias analisados. A literacia mediática, o género, a idade, a inclinação política e o capital cultural estão relacionados com alguns dos tipos de evitação de notícias, mas não com todos, enquanto o capital económico não prediz a evitação de notícias no Chile. Em relação ao baixo consumo de notícias em plataformas mediáticas específicas, os resultados mostram que o interesse na política e o género são preditores consistentes em todas elas.

Resumen: Con base en una encuesta en línea aplicada a 4943 miembros de la audiencia en Chile, este estudio analiza los factores sociodemográficos y actitudinales asociados con cuatro tipos de evitación de noticias: no intencional, consistente, ocasional y selectiva. Los hallazgos muestran una relación significativa y negativa, aunque solo moderada, entre el hecho de evitar intencionalmente las noticias y la frecuencia con que las personas dicen consumirlas. Es decir, si bien la audiencia tiende a evitar las noticias, esto no indica necesariamente un bajo consumo de noticias y viceversa. Asimismo, la evitación selectiva de noticias es significativamente superior a otros tipos entre las audiencias. Respecto de los factores explicativos, los resultados muestran que la confianza en las noticias y el interés en la política son las únicas variables significativamente asociadas con todos los tipos de evitación analizados. La alfabetización mediática, el género, la edad, la inclinación política y el capital cultural se relacionan con algunos de los tipos de evitación de noticias, pero no con todos, mientras que el capital económico no predice la evitación de noticias en Chile. En relación con el bajo consumo de noticias en plataformas mediáticas específicas (televisión, radio, redes sociales, medios impresos y en línea), los resultados muestran que el interés en la política y el género son predictores consistentes en todas ellas. Nuestro estudio revela que la dinámica de evitación de noticias en Chile es multifacética y refleja una interacción compleja entre factores sociodemográficos y actitudinales.

Abstract: Based on an online survey of 4,943 audience members in Chile, this study analyzes sociodemographic and attitudinal factors associated with four types of news avoidance: unintentional, consistent, occasional, and selective news avoidance. The results show a significant and negative, but only moderate, relationship between intentional news avoidance and the frequency with which respondents report consuming the news. Although audiences tend to avoid the news, this does not necessarily mean a low news consumption and vice versa. Likewise, the results show that selective news avoidance is significantly higher among audiences in Chile than the other types of news avoidance. Regarding the factors that explain news avoidance, the results show that trust in news and interest in politics are the only variables significantly associated with all four types of news avoidance analyzed. Media literacy, gender, age, political orientation, and level of education are linked to some types of news avoidance but not to all. At the same time, economic capital does not predict news avoidance in Chile. In terms of low news consumption on specific media platforms, our data shows that interest in politics and gender are consistent predictors for all of them.

Abstract: High-frequency oscillatory ventilation with volume guarantee (HFOV-VG) is a ventilatory mode that controls small tidal volumes at supraphysiological frequencies, potentially beneficial for preterm infants with respiratory distress syndrome (RDS). Objective: To identify the physiological and clinical effects of HFOV-VG in preterm newborns with RDS, compared with conventional HFOV. Method: Exploratory review of studies published between 2019 and 2023 of preterm newborns from 23 to 36 weeks of gestation with RDS, weighing ≥ 450g, with invasive HFOV support, using PRISMA flow diagram. For their critical evaluation, the MINORS and PEDro scales were used. Results: 1,386 articles were initially identified, of which 7 articles were selected. Compared with conventional HFOV, the use of lower tidal volumes (VThf) and higher respiratory rate stands out, as well as better and more stable gas exchange, both as an elective or early rescue strategy in preterm newborns with RDS. Furthermore, an inverse relationship is observed between VThf and respiratory rate. Conclusion: HFOV-VG, used in preterm neonates with RDS, consistently improves oxygenation and ventilation compared with conventional HFOV. Control and reduction of VThf could provide additional lung protection.

Resumen: La ventilación de alta frecuencia (VAF) con volumen garantizado es un modo ventilatorio que controla pequeños volúmenes corriente a frecuencias suprafisiológicas, potencialmente beneficioso para prematuros con síndrome de dificultad respiratoria (SDR). Objetivo: Identificar los efectos fisiológicos y clínicos de la VAF con volumen garantizado en recién nacidos pretérmino con SDR, en comparación con VAF convencional. Método: Revisión exploratoria de estudios publicados entre 2019 y 2023, de recién nacidos prematuros de 23 a 36 semanas de gestación con SDR, con un peso ≥ 450 g soportados con VAF invasiva, utilizando diagrama de flujo PRISMA. Para su evaluación crítica se utilizaron las escalas MINORS y PEDro. Resultados: Se identificaron inicialmente 1,386 artículos, de los cuales se seleccionaron 7 artículos. En comparación con VAF convencional destaca el uso de menores volúmenes corriente (VThf) y mayores frecuencias respiratorias, un intercambio de gases mejor y más estable, tanto como estrategia electiva o de rescate temprano en recién nacidos prematuros con SDR. Además se observa una relación inversa entre VThf y frecuencia respiratoria. Conclusión: La VAF con volumen garantizado, aplicada en recién nacidos prematuros con SDR, consistentemente mejora la oxigenación y ventilación en comparación con la VAF convencional. El control y la reducción de VThf pudiera proporcionar una protección pulmonar adicional.

Abstract Journalists, photographers, war correspondents, or media owners are attractive characters for audiovisual fiction. Television and streaming platforms have portrayed them as heroes or villains, as well as constructed audiovisual imaginaries about iconic cases (such as Watergate or abuses in the Catholic Church in the US) or as a cog in the wheel of power elites. However, both the production and analysis of this type of work focuses on mainstream industries, such as Hollywood or some European countries. We know less about the audiovisual portrayal of journalism in audiovisual productions for television or platforms in Latin America. The analysis of the Chilean series for free-to-air television, Bala Loca, allows us to explore the imaginaries -simultaneously complementary and contradictoryabout journalism and the media in a post-dictatorial and neoliberal society. Then, this article contributes to better understanding this type of audiovisual productions in similar contexts. This reading is anchored in audiovisual and cultural studies and in qualitative methodologies focused on the production (its narratives, representations, characters, and dramatic arcs, as well as its aesthetic features) and the world of reference with which the series dialogues. At these trends’ intersection in problematizing journalism and its fictional and visual representations, this article analyzes the types of journalists and journalisms built up and rearranged within the Chilean series Bala Loca based on its communicability strategy. On one hand, its closeness and/or distance with the world it refers to; that is, Chile during the post-dictatorship from 1990 to now and how it is understood. On the other hand, it refers to the type of narrative and audiovisual resources through which these strategies are constructed. Therefore, journalism appears as heterogeneous in Bala Loca. Nonetheless, it has a strong historical referentiality, incarnates the market orientation of the profession inherited from the dictatorship (1973-1990) and illustrates the lack of public service of contemporary journalism in Chile, both in a symbolic and a material sense.

Resumen Los periodistas, fotógrafos, corresponsales de guerra o dueños de medios de comunicación resultan personajes atractivos para la ficción audiovisual. La televisión y las plataformas de streaming los han representado como héroes o villanos, así como también han construido imaginarios audiovisuales sobre casos iconos (como Watergate o los abusos en la Iglesia Católica en Estados Unidos) o en tanto engranaje de las elites del poder. Sin embargo, tanto la producción como el análisis de este tipo de obras está concentrada en industrias robustas, como la hollywoodense o la de algunos países europeos. Conocemos menos sobre el retrato audiovisual del periodismo en las producciones audiovisuales para televisión o para plataformas realizadas en América Latina. El análisis de la serie chilena para televisión abierta, Bala Loca (Chilevisión, 2016), permite explorar los imaginarios - complementarios y contradictorios, al mismo tiempo sobre el periodismo y los medios en una sociedad postdictatorial y neoliberal. Esta lectura se ancla en los estudios audiovisuales y culturales y en metodologías cualitativas centradas en las condiciones de producción, la narrativa, su estética e intertextualidad. Sobre la base del cruce entre estos distintos ejes analíticos, este artículo describe, analiza y discute los tipos de periodistas y periodismos (re) construidos en la serie chilena Bala Loca a partir de su estrategia de comunicabilidad. Se concluye que el periodismo es heterogéneo en Bala Loca, sin embargo, tiene una fuerte referencialidad histórica, refleja la orientación de la profesión al mercado heredada de la dictadura (1973-1990) y pone en escena un periodismo sin dimensión pública, tanto en un sentido simbólico como material.

Abstract Neuromyelitis optica (NMO), myasthenia gravis (MG), and ulcerative colitis (UC) are disorders in which various autoimmune pathophysiological mechanisms are involved, some of them being shared. According to the literature, these diseases are associated with other autoimmune disorders. However, there are no published cases about the coexistence of these three entities as a continuum of autoimmune manifestations. Here, we present the case of a patient who presented UC posteriorly, MG treated with thymectomy, and finally, met the criteria for NMO, treated with rituximab.

Abstract Introduction: Guillain-Barré syndrome (GBS) is the most frequent cause of acute flaccid paralysis. However, few studies have investigated short-term prognostic factors. Objectives: The objectives of the study were to describe the clinical characteristics of a sample of GBS patients treated at the General Hospital of Mexico and to identify the prognostic factors at discharge. Methods: A descriptive and analytical cohort study, including patients with GBS, was conducted from April 2020 to May 2022. Demographic information, comorbidities, clinical variants, neurophysiological alterations, modified Erasmus GBS Outcome Score (mEGOS) and Erasmus GBS Respiratory Insufficiency Score scales, etc., were collected. Functional recovery at discharge was measured with Hughes scales and Medical Research Council (MRC). A case-control analysis was performed among patients with good and poor functional recovery on discharge based on the Hughes scale. Results: Total sample was 69 patients: 74% men and 26% women, mean age: 43.7 ± 16.3 years; 38 (55%) patients presented classic variant, 22 pure motor variant (31%). Evolution time: 6.8 ± 6.7 days. Most common Hughes score at admission was 4 points (n = 54, 78%). 87% (n = 60) received plasmapheresis. 23 (33.3%) presented an axonal pattern and 46 (66.6%) demyelinating. On discharge, 31 patients had Hughes 3 or less (ambulatory) and 27 Hughes 4 or greater (non-ambulatory). When performing factor analysis, it was found that mEGOS, MRC, total lymphocytes, and creatine phosphokinase (CPK) were associated with the prognosis at discharge. Conclusions: The most frequent clinical variant was the classic (sensitive-motor) with demyelinating alteration; the factors related to better recovery at discharge were mEGOS, MRC on admission, total lymphocyte count, and serum CPK levels.

Abstract: Within the multi-objective (static) optimization field, various works related to the adaptive selection of genetic operators can be found. These include multi-armed bandit-based methods and probability-based methods. For dynamic multi-objective optimization, finding this type of work is very difficult. The main characteristic of dynamic multi-objective optimization is that its problems do not remain static over time; on the contrary, its objective functions and constraints change over time. Adaptive operator selection is responsible for selecting the best variation operator at a given time within a multi-objective evolutionary algorithm process. This work proposes incorporating a new adaptive operator selection method into a Dynamic Multi-objective Evolutionary Algorithm Based on Decomposition algorithm, which we call DMOEA/D-SL. This new adaptive operator selection method is based on a reinforcement learning algorithm called State-Action-Reward-State-Action Lambda or SARSA (λ). SARSA Lambda trains an Agent in an environment to make sequential decisions and learn to maximize an accumulated reward over time; in this case, select the best operator at a given moment. Eight dynamic multi-objective benchmark problems have been used to evaluate algorithm performance as test instances. Each problem produces five Pareto fronts. Three metrics were used: Inverted Generational Distance, Generalized Spread, and Hypervolume. The non-parametric statistical test of Wilcoxon was applied with a statistical significance level of 5% to validate the results.

Abstract: The main contribution of this paper is the implementation of a multi-objective evolutionary algorithm based on decomposition with adaptive adjustment of control parameters applied to the bi-objective problem of Internet shopping (MOEA/D-AACPBIShOP). For this variant of the IShOP, the minimization of the cost and shipping time of the shopping list is considered. The proposed MOEA/D-AACPBIShOP algorithm produces an approximate Pareto set on a total of nine of instances with real-world data classified as small, medium, and large. The instances are obtained using the Web Scraping technique, extracting some information attributes of technological products from the Amazon site. This optimization problem is a very little studied variant of the Internet Shopping Problem (IShOP). The proposed algorithm is compared with two multi-objective algorithms: A Non-dominated Sorting Genetic Algorithm II (NSGA-II) and the basic MOEA/D version. The results demonstrate that the three algorithms studied have a similar statistical performance with respect to the quality of the solutions they provide. To make a comparison, these algorithms are evaluated using three metrics: Hypervolume, Generalized Dispersion, and Inverted Generational Distance. On the other hand, the Wilcoxon and Friedman non-parametric tests validate the obtained results with a 5% significance level.

Abstract: In the present landscape of cloud computing, the effective scheduling of tasks stands as a pivotal element in optimizing the operational efficiency of distributed systems. This paper conducts a thorough and comparative examination of recent trends and progress within this vital and ever-evolving domain. By meticulously reviewing crucial performance metrics and critically analyzing state-of-the-art methodologies, we present a comprehensive overview of Cloud Task Scheduling. We emphasize the shift towards multi-objective strategies, mirroring the escalating complexity and diversity witnessed in cloud environments. Employing innovative approaches and illustrative case studies, we delve into the practical implementation of prominent algorithms, including L A B C, MaOEA-SIN, and MALO. The detailed analysis not only underscores their efficacy in real-world contexts but also pinpoints areas ripe for enhancement and adaptation within multi-cloud settings. Beyond offering an in-depth understanding of the latest developments in Cloud Task Scheduling, this article endeavors to stimulate collaboration and discourse within the academic and professional community. We aim to ignite future advancements, thereby contributing to the sustained growth of this strategic and dynamic field.

Abstract The present study focuses on the design of a system aimed at evaluating the effectiveness of the weighted Inverse Sum Index (ISI) in predicting physicochemical and biological properties of chemical compounds. To do this, the predictive capacity of the weighted ISI will be compared with that of traditional descriptors in a representative sample of molecules. Both theoretical and empirical methods will be employed to develop and evaluate the performance of the weighted ISI in relation to physicochemical properties. In addition, advanced statistical techniques will be applied to analyze the correlation between the values obtained from traditional descriptors and the values predicted by the weighted ISI. The results obtained are expected to not only contribute to the advancement of cheminformatics and graph theory, but also provide a deeper understanding of the relationship between molecular structure and the properties observed in chemical compounds. This knowledge could have important implications in diverse fields, from drug design to materials engineering, thus expanding practical applications in materials science and biomedicine.

Resumen El presente estudio se centra en el diseño de un sistema destinado a evaluar la eficacia del Índice de Suma Inversa (ISI) ponderado en la predicción de propiedades fisicoquímicas y biológicas de compuestos químicos. Para ello, se comparará la capacidad predictiva del ISI ponderado con la de descriptores tradicionales en una muestra representativa de moléculas. Se emplearán tanto métodos teóricos como empíricos para desarrollar y evaluar el desempeño del ISI ponderado en relación con las propiedades fisicoquímicas. Además, se aplicarán técnicas estadísticas avanzadas para analizar la correlación entre los valores obtenidos a partir de los descriptores tradicionales y los valores predichos por el ISI ponderado. Se espera que los resultados obtenidos no solo contribuyan al avance de la quimioinformática y la teoría de grafos, sino que también proporcionen una comprensión más profunda de la relación entre la estructura molecular y las propiedades observadas en los compuestos químicos. Este conocimiento podría tener importantes implicaciones en diversos campos, desde el diseño de fármacos hasta la ingeniería de materiales, ampliando así las aplicaciones prácticas en la ciencia de materiales y la biomedicina.

Resumen La compasión es aquella conducta que permite a la persona ser capaz de reconocer y validar el sufrimiento de otro ser vivo, generando apoyo que permita evitar ese dolor. El presente estudio buscó determinar las propiedades psicométricas de la escala de compasión a los animales, elaborada por López y colaboradores en el 2021. En el presente estudio, participaron un total de 421 universitarios de ambos sexos, seleccionados mediante un muestreo no probabilístico. Según el Análisis Funcional de Conducta se reflejan índices de ajuste adecuados (X./gl=2,52 < 3, SRMR= 0,03 < 0.08, CFI=0,97 > 0,95), así altos niveles de confiabilidad (0,92). La validez convergente y divergente se realizó con la Escala de conductas prosociales y la escala de conductas agresivas. Estos resultados permiten concluir que la escala cuenta con confiabilidad y validez en población peruana.

Abstract Compassion is that behavior that allows a person to recognize and validate the suffering of another living being, generating support to avoid that pain. The present study aimed to determine the psychometric properties of the animal compassion scale developed by López et al. in 2021. Four hundred twenty-one university students of both sexes participated in the present study; they were selected by non-probabilistic sampling. According to the Functional Behavior Analysis, adequate adjustment indices are reflected (X./gl=2.52 < 3, SRMR=0.03 < 0.08, CFI=0.97 > 0.95), as well as high levels of reliability (0.92). Convergent and divergent validity was performed with the Prosocial Behavior Scale and the Aggressive Behavior Scale. These results allow us to conclude that the scale has reliability and validity in the Peruvian population.

Abstract This work aimed to show which treatments showed efficacy against coronavirus disease 2019 (COVID-19); therefore, the results of 37 clinical trials started in 2020 and completed in 2021 are reviewed and discussed here. These were selected from databases, excluding vaccines, computational studies, in silico, in vitro, and those with hyperimmune sera from recovered patients. We found 34 drugs, one vitamin, and one herbal remedy with pharmacological activity against symptomatic COVID-19. They reduced mortality, disease progression, or recovery time. For each treatment, the identifier and type of trial, the severity of the disease, the sponsor, the country where the trial was conducted, and the trial results are presented. The drugs were classified according to their mechanism of action. Several drugs that reduced mortality also reduced inflammation in the most severe cases. These include some that are not considered anti-inflammatory, such as Aviptadil, pyridostigmine bromide, anakinra, imatinib, baricitinib, and bevacizumab, as well as the combination of ivermectin, aspirin, dexamethasone, and enoxaparin. Nigella sativa seeds with honey have also been reported to have therapeutic activity. On the other hand, tofacitinib, novaferon with ritonavir, and lopinavir were also effective, as well as in combination with antiviral therapies such as danoprevir with ritonavir. The natural products colchicine and Vitamin D3 were only effective in patients with mild-to-moderate COVID-19, as was hydroxychloroquine. Drug repositioning has been the main tool in the search for effective therapies by expanding the pharmacological options available to patients.

Resumen El objetivo del presente trabajo fue conocer qué tratamientos mostraron efectividad contra COVID-19, para lo cual se revisan y discuten los resultados de 37 estudios clínicos iniciados durante 2020 y concluidos en 2021. Estos fueron seleccionados de bases de datos, excluyendo vacunas, estudios computacionales, in silico, in vitro y con sueros hiperinmunes de pacientes recuperados. Se documentaron 34 fármacos, una vitamina y un remedio herbolario, con actividad farmacológica ante COVID-19 sintomático. Estos redujeron la mortalidad, el progreso de la enfermedad, o el tiempo de recuperación. Para cada tratamiento se presenta identificador y tipo de estudio, la gravedad de la enfermedad, patrocinador, país donde se realizó, así como sus resultados. Los fármacos se clasificaron de acuerdo con su mecanismo de acción. Varios fármacos que redujeron la mortalidad también disminuyeron la inflamación en los casos más graves. Esto incluyendo algunos no considerados antiinflamatorios, como el aviptadil, el bromuro de piridostigmina, el anakinra, el imatinib, el baricitinib y el bevacizumab, así como la combinación de ivermectina, aspirina, dexametasona y enoxaparina. También se reportaron con actividad terapéutica las semillas de Nigella sativa con miel. Además, resultaron efectivos el tofacitinib, el novaferón con ritonavir y lopinavir, así como los antivirales en terapias combinadas como el danoprevir con ritonavir. Los productos naturales colchicina y vitamina D3, solo tuvieron actividad en los pacientes en estado leve a moderado de la COVID-19, así como la hidroxicloroquina. El reposicionamiento de fármacos fue la principal herramienta para buscar terapias efectivas ampliando las opciones farmacológicas accesibles a los pacientes.

RESUMEN Fundamento: la insuficiencia placentaria es la causa más común del retardo del crecimiento intrauterino, que puede provocar alteraciones cardiovasculares. Recientemente, se han desarrollado terapias con eritropoyetina que protegen los tejidos cardiacos con hipoxia. Objetivo: evaluar la influencia de la eritropoyetina recombinante humana con bajo contenido de ácido siálico (NeuroEPO) en el corazón fetal en un modelo de insuficiencia placentaria en ratas. Métodos: se utilizaron 14 ratas Wistar gestadas con ligadura unilateral de la arteria uterina derecha en el día 16 de la gestación. Ese mismo día, a siete ratas se le administró NeuroEPO (0,5 mg/kg/día subcutáneo por tres días) y al resto placebo. En el día 20 de la gestación los fetos se dividieron en cuatro grupos: un grupo control, un grupo con retardo del crecimiento intrauterino, un grupo control NeuroEPO y un grupo con retardo del crecimiento intrauterino y NeuroEPO. En los fetos se obtuvo el peso placentario, peso fetal y la eficacia placentaria. En el estudio histológico se cuantificó el número de cardiomiocitos, número de vasos sanguíneos y cantidad de las fibras de colágenos. Resultados: el grupo con retardo del crecimiento intrauterino presentó una disminución del peso fetal, del número de cardiomiocitos, del número de vasos sanguíneos y un aumento en la cantidad de fibras colágenas (p<0.05). Al tratar con NeuroEPO a los fetos con retardo en el crecimiento intrauterino, aumentó el peso fetal, aunque el peso no fue similar al control. El resto de las variables se comportaron semejantes al control. Conclusiones: la administración de esta molécula mejoró el peso fetal y permitió un equilibrio adecuado en el desarrollo del corazón fetal, quizás, debido a los efectos citoprotectores de esta molécula.

ABSTRACT Foundation: placental insufficiency is the most common cause of intrauterine growth retardation, which can cause cardiovascular alterations. Recently, erythropoietin therapies have been developed that protect hypoxic cardiac tissues. Objective: To evaluate the influence of human recombinant erythropoietin with low sialic acid content (NeuroEPO) on the fetal heart in a rat model of placental insufficiency. Methods: 14 Wistar rats gestated with unilateral ligation of the right uterine artery on day 16 of gestation were used. That same day, seven rats were administered NeuroEPO (0.5 mg/kg/day subcutaneously for three days) and the rest received placebo. On day 20 of gestation, the fetuses were divided into four groups: a control group, a group with intrauterine growth retardation, a NeuroEPO control group, and a group with intrauterine growth retardation and NeuroEPO. In the fetuses, placental weight, fetal weight and placental efficiency were obtained. In the histological study, the number of cardiomyocytes, number of blood vessels and quantity of collagen fibers were quantified. Results: the group with intrauterine growth retardation presented a decrease in fetal weight, the number of cardiomyocytes, the number of blood vessels and an increase in the amount of collagen fibers (p<0.05). When fetuses with intrauterine growth retardation were treated with NeuroEPO, fetal weight increased, although the weight was not similar to the control. The rest of the variables behaved similar to the control. Conclusions: the administration of this molecule improved fetal weight and allowed an adequate balance in the development of the fetal heart, perhaps due to the cytoprotective effects of this molecule.

ABSTRACT. The communication between doctor and patient is highly relevant as it can influence patients’ health outcomes, their adoption of treatment, their decision to continue or discontinue it, and their satisfaction with the care provided by physicians. On the other hand, defensive medicine encompasses medical attention that does not increase patient benefits and results in the overuse of medical services, driven by the physician’s fear of being sanctioned and/or preventing litigation risks. This research aimed to explore the relationship between the lack of training in communication skills among physicians and defensive medicine. The design was non-experimental, correlational; using a logical deductive method and a quantitative approach. The population studied consisted of physicians from Mexico and Peru, with a sample of 350 professionals (175 from each country). It reaffirmed the importance of training in communication skills for physicians; however, it was evident that a high percentage did not receive such training or received it in a very basic manner. Their behaviors indicated the practice of defensive medicine (although not all were familiar with the concept) and suggested that better communication training could influence a change in attitude.

RESUMEN. La comunicación entre médico y paciente es muy relevante, pues puede influir en los resultados de salud de los pacientes, en la adopción del tratamiento por parte del enfermo, en su decisión por continuar o dejarlo, y en la satisfacción con la atención brindada por los médicos. Por otro lado, la medicina defensiva es toda atención médica que no aumenta los beneficios para el paciente y se traduce en sobreuso de servicios médicos, motivado por el temor del médico a ser sancionado o prevenir riesgos de litigios. Esta investigación planteó explorar la relación entre la ausencia de formación en habilidades comunicacionales en los médicos y la medicina defensiva. El diseño fue no experimental, correlacional, con un método lógico deductivo y un enfoque cuantitativo. La población fueron médicos de México y de Perú, y la muestra estuvo conformada por 350 profesionales (175 de cada país). Se reafirmó la importancia de la formación en habilidades comunicacionales en los médicos; sin embargo, se evidenció que un alto porcentaje no la recibió o la obtuvo de manera muy elemental. Los comportamientos indicaron que sí practican la medicina defensiva (aunque no todos conocían el concepto) y que una mejor formación comunicacional podría incidir en un cambio de actitud.

RESUMO. A comunicação entre médico e paciente é muito relevante, pois pode influenciar nos resultados de saúde dos pacientes, na adoção do tratamento por parte do enfermo, em sua decisão de continuar ou interromper, e na satisfação com a atenção prestada pelos médicos. Por outro lado, a medicina defensiva consiste em toda atenção médica que não aumenta os benefícios para o paciente e resulta no uso excessivo de serviços médicos, motivado pelo medo do médico de ser sancionado e/ou de evitar riscos de litígios. Esta pesquisa buscou explorar a relação entre a falta de formação em habilidades de comunicação nos médicos e a medicina defensiva. O desenho foi não experimental, correlacional; método lógico dedutivo; e abordagem quantitativa. A população foi composta por médicos do México e do Peru, e a amostra foi de 350 profissionais (175 de cada país). A importância da formação em habilidades de comunicação nos médicos foi reafirmada; no entanto, foi evidenciado que uma parcela significativa não a recebeu ou a obteve de maneira muito básica. Os comportamentos indicaram que eles praticam a medicina defensiva (embora nem todos conhecessem o conceito) e que uma melhor formação em comunicação poderia influenciar uma mudança de atitude.