Abstract Objective: To create the infographic of the Mexicanized Mediterranean Diet food guide and evaluate its understanding. Material and Methods: Descriptive type study, which consisted of two phases, the 1st. The infographic of the Mexicanized Mediterranean Diet food guide was created. 2nd Appreciation and comprehension of the food guide infographic was evaluated online for the university population, including relatives and acquaintances. Results: 273 participants with an average age of 42, 74% women and 26% men, more than 94% of the participants responded that they understood the infographic in its entirety. DMM is practical, applicable, affordable, understandable, good for humans and the environment. Conclusion: The Mediterranean Diet can partially or totally prevent metabolic syndrome, the Mexicanized Mediterranean Diet food guide promotes a healthy life and well-being for all ages, supports the objectives of sustainable development, will be a practical, applicable public health tool, affordable, understandable, suitable for promotion in the Mexican population.

Resumen Objetivo: Crear la infografía de la guía de alimentación de Dieta Mediterránea Mexicanizada (DMM) y evaluar su comprensión. Material y Métodos: Estudio de tipo descriptivo, el cual constó de dos fases la 1ra. Se creó la infografía de la guía de alimentación de Dieta Mediterránea Mexicanizada. 2da. Se evaluó la apreciación y comprensión de la infografía de la guía de alimentación, en línea a población universitaria, incluidos familiares y conocidos. Resultados: 273 participantes de 42 años promedio, 74% mujeres y 26% varones, más del 94% de los participantes respondió comprender en su totalidad la infografía. DMM es práctica, aplicable, asequible, entendible, buena para el ser humano y ambiente. Conclusión: La Dieta Mediterránea puede prevenir parcial o totalmente el síndrome metabólico, la guía de alimentación de Dieta Mediterránea Mexicanizada promueve una vida sana y bienestar para todas las edades, respalda los objetivos de desarrollo sostenible, será una herramienta de salud pública, práctica, aplicable, asequible, entendible, apta para promoverse en la población mexicana.

ABSTRACT Aquaculture combines techniques for breeding and harvesting aquatic organisms used in shrimp production. It is important as a source of income and for generating foreign exchange in the regions where it is practiced. However, the timely detection of diseases continues to be a great challenge for aquaculture and fisheries production. In recent years, Enterocytozoon hepatopenaei (EHP) has emerged as a major pathogen of the Pacific white shrimp Penaeus vannamei in many Asian countries (Vietnam, China, Indonesia, Malaysia, Thailand, India, and Korea). In Latin America, only in Venezuela, and to date, there is no report of its presence in Mexico. It is transmitted directly from shrimp to shrimp by oral or fecal means, cannibalism, or exposure to contaminated water. Hepatopancreatic microsporidiosis (HPM) is mainly associated with stunted growth and severe infections that can cause a poor production cycle, mortality, and problems in larva-producing laboratories. This review aims to overview the main microsporidian parasites and diseases found in white shrimp, including the clinical signs, control and prevention measures for EHP infection, and the detection of HPM using different techniques. In order to offer timely detection tools, different techniques are available for the detection and study of microsporidia. Such as optical microscopy, transmission electron microscopy, and histology; however, for diagnostic purposes, molecular methods are preferred due to their sensitivity, specificity, and short-time analysis. Our review suggests that constant monitoring in shrimp hatcheries and farms is essential to avoid the entry or transference of infected organisms, affecting shrimp production and the ideal development of healthy shrimp.

Abtract: Acrometastasis are defined as localized bone metastases distal to the elbow and knee. Its prevalence is very low, approximately 0.1% of all bone metastases and they present in patients with advanced disease and are considered indicators of poor prognosis. In up to 10% of cases are the first sign of undiagnosed neoplasia. Its clinical and radiological presentation is non-specific which generates delays in its diagnosis and treatment. Magnetic resonance is the image of choice for diagnosis. The treatment in most cases is palliative. We present four patients with acrometastasis and a review of the literature.

Resumen: Las acrometástasis se definen como metástasis óseas localizadas distales al codo y la rodilla. Su prevalencia es muy baja, aproximadamente el 0,1% de todas las metástasis óseas y se presentan en pacientes con enfermedad avanzada y son indicador de mal pronóstico. Hasta en el 10% de los casos se presentan como el primer signo de neoplasia oculta. Su forma de presentación clínica y radiológica es inespecífica, lo que genera retraso en su diagnóstico y tratamiento. La resonancia magnética es la imagen de elección para el diagnóstico. El tratamiento en la mayoría de los casos es paliativo. Presentamos cuatro pacientes con acrometástasis y una revisión de la literatura.

Resumen Introducción: Staphylococcus aureus es una frecuente causa de bacteriemias y el incremento en las tasas de resistencia dificulta su tratamiento inicial. La incidencia de bacteriemias por S. aureus resistente a meticilina (SAMR) ha aumentado, principalmente en las infecciones adquiridas en el medio hospitalario. Este estudio pretende caracterizar clínicamente a los pacientes con bacteriemia por S. aureus detectados en un hospital de Medellín y definir su perfil de resistencia microbiana. Métodos: cohorte retrospectiva en un hospital de tercer nivel. Se incluyeron pacientes >16 años con aislamiento para Staphylococcus aureus en sangre periférica. Se registró información relacionada con el episodio, el sitio de adquisición, la clasificación microbiológica y las características clínicas. Resultados: de 775 reportes de hemocultivos positivos para S. aureus, finalmente se ingresaron 698 pacientes al estudio. La mediana de edad fue de 58 años (RIQ=42-69), 383 eran hombres (54.9%). En 354 pacientes (50.7%) la bacteriemia era de origen nosocomial y el 26.2% (n=183) eran SAMR. En 123 (17.6%) bacteriemias adquiridas en la comunidad, la frecuencia de SAMR fue 33.3% (n=41). El antecedente más frecuente fue tener un catéter vascular en 321 pacientes (46%). Se inició terapia empírica en 67.2% de los casos (n=469). Respecto a la gravedad, la mediana del puntaje SOFA fue de 4 (RIQ=1-5), APACHE II de 15 (RIQ=10-19) y la mortalidad fue del 24.9% (n=174). Conclusiones: a pesar de que la mayoría de bacteriemias son de origen nosocomial, el reporte más frecuente fue SAMS tanto en el grupo nosocomial como en el de la comunidad. Sin embargo, la mortalidad en el grupo de bacteriemia nosocomial fue inferior comparada con la de la comunidad. (Acta Med Colomb 2018; 43: 200-206).

Abstract Introduction: Staphylococcus aureus is a frequent cause of bacteremia and the increase in resistance rates makes initial treatment difficult. The incidence of bacteraemia due to methicillin-resistant S. aureus (MRSA) has increased, mainly in infections acquired in the hospital environment. This study aims to clinically characterize patients with S. aureus bacteremia detected in a Medellín hospital and to define their microbial resistance profile. Methods: retrospective cohort in a tertiary hospital. Patients >16 years with isolation for Staphylococcus aureus in peripheral blood were included. Information related to the episode, the acquisition site, the microbiological classification and the clinical characteristics were recorded. Results: Of 775 reports of blood cultures positive for S. aureus, 698 patients were finally admitted to the study. The median age was 58 years (RIQ = 42-69), 383 were men (54.9%). In 354 patients (50.7%) the bacteremia was of nosocomial origin and 26.2% (n = 183) were MRSA. In 123 (17.6%) bacteremia acquired in the community, the frequency of MRSA was 33.3% (n = 41). The most frequent antecedent was to have a vascular catheter in 321 patients (46%). Empirical therapy was initiated in 67.2% of the cases (n = 469). Regarding severity, the SOFA score median was 4 (RIQ = 1-5), APACHE II of 15 (RIQ = 10-19) and mortality was 24.9% (n = 174). Conclusions: although the majority of bacteremia are of nosocomial origin, the most frequent report was MSSA in both the nosocomial and community groups. Despite this, mortality in the nosocomial bacteremia group was lower compared with that of the community. (Acta Med Colomb 2018; 43: 200-206).

In urban environments, the problems associated with the current production and consumption model are increasing exponentially and promoting their care is the greatest challenge of the present century. In this context, environmental education plays a leading role in meeting this challenge, due to the need of promoting learning systems to breaks traditional schemes, allowing to understand and involve in comprehensive projects. The present article makes known the development of the 2nd stage of a green roof construction at the Polytechnic Institute Gral. San Martin -UNR. This interdisciplinary project highlighted by being unique, so far built by students at a public school in Rosario. Without neglecting the initial stage of the refunctionalization of a disused space, we intend to show the results in spatial, environmental and educational terms, such as those achieved by the students, being an experimental group, indicators of apprentice learning, attitudinal changes and behaviors. We make available to other educational communities the possibility of replicating with similar projects that may impact other schools, helping to raise awareness among students, teachers, authorities and the community in general, by transferring specific knowledge to other areas, with professional advice as a priority, as in our case, provided by teachers and experts.

En los ambientes urbanos los problemas asociados al actual modelo de producción y consumo están aumentando exponencialmente y promover su cuidado es el mayor reto del presente siglo. En este contexto, la educación ambiental es protagonista a la hora de afrontar ese desafío, por la necesidad de fomentar aprendizajes que rompan esquemas tradicionales y permitan comprender e involucrase en proyectos socio-ambientales. El presente artículo da a conocer el desarrollo de la 2da etapa de la terraza verde en el Instituto Politécnico Superior Gral. San Martín - UNR. Proyecto interdisciplinario destacado por ser único, hasta el momento construido por los estudiantes en una escuela pública rosarina. Sin dejar de lado la etapa inicial de refuncionalización de un espacio en desuso, pretendemos mostrar los resultados en términos espaciales, ambientales y educativos, como aquellos alcanzados por los estudiantes siendo el grupo experimental, indicadores de aprendizajes signi?cativos, de cambios actitudinales y de comportamientos. Ponemos a disposición de otras comunidades educativas, la posibilidad de replicar con proyectos similares que puedan impactar en otras escuelas, colaborando a concientizar alumnos, docentes, autoridades y comunidad en general, al permitir transferir conocimientos específicos a otros ámbitos, siendo prioritario el asesoramiento profesional, como en nuestro caso, brindado por docentes y empresas.

ABSTRACT Infectious diseases have been a major limiting factor for large scale production of oyster farming. Several factors have contributed to the emergence and spread of infectious diseases in all cultivation sites around the world. Therefore, the prevention and control of diseases has become a priority for the sustainability of global aquaculture. Crassostrea corteziensis is a native species that contributes to the Mexican Pacific oyster production and used in this study to assess seasonal simultaneous infective events between distant areas in the Gulf of California. The results of the molecular analysis showed a higher prevalence of Perkinsus marinus in the north area and Marteilia refringens in the south. OsHV-1 was only present in summer and autumn with low prevalence in the two areas. The histological analysis of the PCR-positive organisms presented alterations characteristic of infections. The presence of M. refringens in a new location on the Gulf of California suggests that this pathogen is already well established in the area and the dual presence of pathogens in C. corteziensis is reported for the first time.

En esta edición de la ronda clínica y epidemiológica analizamos los resultados del estudio SPRINT, que plantea un control más intensivo de la presión arterial para la prevención de los eventos cardiovasculares. También exponemos los resultados del estudio REVERT, en el que se usó una modificación de la maniobra de Valsalva para tratar pacientes con taquicardias supraventriculares estables. Kane y colaboradores exploran la mejoría de la calidad de vida de pacientes con su primer episodio psicótico, tras recibir un enfoque multidisciplinario en comparación con el tratamiento comunitario habitual. Por último, Toledo y colaboradores estudian la incidencia del cáncer de mama en el estudio PREDIMED luego de seguir un régimen alimentario basado en la dieta mediterránea.

In this edition of the clinical and epidemiological round, we analyze the results of the SPRINT study, which suggest a more intensive control of the blood pressure for prevention of cardiovascular events. In addition, we present the results of the REVERT study, that used a modified Valsalva maneuver to treat stable supraventricular tachycardia. Kane et al. explore the improvement of the quality of life in patents with their first psychotic episode after a multidisciplinary approach versus the usual community care. Finally, Toledo et al. analyze the incidence of breast cancer in the PREDIMED study after the patients have followed a Mediterranean diet.

Nesta edição da ronda clínica e epidemiológica analisamos os resultados do estudo SPRINT, que planteia um controle mais intensivo da pressão arterial para a prevenção dos eventos cardiovasculares. Também exporemos os resultados do estudo REVERT, no que se usou uma modificação da manobra de Valsalva para tratar taquicardias supraventriculares estáveis. Kane y colaboradores exploram a melhoria da qualidade de vida de pacientes com seu primeiro episódio psicótico, após receber uma abordagem multidisciplinário em comparação com o tratamento comunitário habitual. Por último, Toledo e colaboradores estudam a incidência do câncer de mama no estudo PREDIMED logo de seguir uma dieta alimentício baseada na dieta mediterrânea.

En esta edición de nuestra ronda clínica y epidemiológica analizamos cuatro artículos relevantes para la práctica clínica: Etminan y colaboradores estudian los efectos adversos de algunos antimicrobianos buscando una posible asociación entre el uso de fluoroquinolonas orales y el riesgo de neuropatía periférica (1). Fralick y colaboradores estudian el riesgo de muerte súbita tras el consumo de trimetoprim-sulfametoxazol (2). Bakker y colaboradores hacen una interesante contribución sobre la necesidad de usar sonda nasoyeyunal en pacientes con pancreatitis aguda (3). Por último, Kanegaye y colaboradores buscan la mejor prueba diagnóstica para las infecciones urinarias en menores de 4 años (4).

In this edition of the clinical and epidemiological round, we analyze four articles relevant for clinical practice, namely: the adverse effects of some antimicrobials are studied by Etminan et al., looking for a possible association between the use of oral fluoroquinolones and the risk of peripheral neuropathy (1). Fralick et al., studied the risk of sudden death after the use of trimethoprim-sulfamethoxazole (2). Bakker and collaborators make an interesting contribution about the need of nasoyeyunal catheter in patients suffering from acute pancreatitis (3). Finally, Kanegaye et al., look for the best diagnostic test for urinary infections in infants (4).

Nesta edição de nossa ronda clínica e epidemiológica analisamos quatro artigos relevantes para a prática clínica: Etminan e colaboradores estudam os efeitos adversos de alguns antimicrobianos procurando uma possível associação entre o uso de fluoroquinolonas orais e o risco de neuropatia periférica (1). Fralick e colaboradores estudam o risco de morte súbita depois do consumo de trimetoprim-sulfametoxazol (2). Bakker e colaboradores fazem uma interessante contribuição sobre a necessidade de usar sonda nasoyeyunal em pacientes com pancreatites aguda (3). Por último, Kanegaye e colaboradores procuram a melhor prova diagnóstica para as infecções urinárias em menores de 4 anos (4).