RESUMEN Esta revisión tiene como objetivo conocer el estado del consumo de sustancias psicoactivas en el departamento del Quindío, Colombia, para lo cual se acudió a una revisión sistemática documental tomando como modelo una matriz de protocolo Prisma-P. Se encontró que existe un incremento en el consumo de sustancias psicoactivas en el Quindío que resulta análogo a lo sucedido en Colombia, y que tiene como particularidad que la edad de inicio es cada vez más temprana, lo que ubica a los jóvenes y adolescentes como la población de mayor riesgo de consumo, reincidencia y abuso de sustancias. El consumo se asoció al encierro y al aumento de la violencia intrafamiliar durante la pandemia, al tiempo que un factor de vulnerabilidad es ser mujer, madre cabeza de hogar y, además, convivir con una pareja consumidora. También, ha aumentado el microtráfico y la experimentación con nuevas drogas de diseño, situación que tuvo mucho auge durante el confinamiento por pandemia, y que se ha extendido y mantiene en la postpandemia o "nueva normalidad".

RESUMO O objectivo desta revisão é conhecer o estado do uso de substâncias psicoactivas no departamento de Quindío, Colômbia, para o qual foi realizada uma revisão documental sistemática utilizando uma matriz do protocolo Prisma-P como modelo. Verificou-se que há um aumento do consumo de substâncias psicoactivas em Quindío, o que é análogo ao que aconteceu na Colômbia, e que a idade de início é cada vez mais jovem, o que coloca os jovens e adolescentes como a população em maior risco de consumo, reincidência e abuso de substâncias. O consumo foi associado ao confinamiento e ao aumento da violência intra-familiar durante a pandemia, enquanto que um factor de vulnerabilidade é ser mulher, mãe e chefe de família, e também viver com um parceiro que consome drogas. Houve também um aumento do microtráfico e da experimentação de novos medicamentos de marca, uma situação que se desenvolveu durante o confinamiento pandémico, e que se espalhou e continua no pós-pandémico ou "novo normal".

ABSTRACT The objective of this review is to determine the state of psychoactive substance use in the department of Quindío, Colombia, for which a systematic documentary review was carried out using a Prisma-P protocol matrix as a model. It was found that there is an increase in the consumption of psychoactive substances in Quindío, which is analogous to the situation in Colombia, and that the age of onset is increasingly younger, which places young people and adolescents as the population at greatest risk of consumption, recidivism and substance abuse. Consumption was associated with confinement and an increase in intrafamily violence during the pandemic, while a vulnerability factor is being a woman, a mother and head of household, and living with a partner who is a consumer. There has also been an increase in micro-trafficking and experimentation with new designer drugs, a situation that boomed during the pandemic confinement, and which has spread and continues in the post-pandemic or "new normal".

Resumo Fundamento A COVID-19 adicionou um fardo enorme sobre os médicos ao redor do mundo, especialmente as mulheres médicas, que são afetadas pelo aumento da carga de trabalho e pela perda da qualidade de vida. Objetivo Avaliar os efeitos da pandemia de COVID-19 na qualidade de vida, burnout e espiritualidade de médicas brasileiras que atendem pacientes com COVID-19 direta ou indiretamente. Método Estudo prospectivo, observacional realizado de 28 de julho a 27 de setembro de 2020, no Brasil, com mulheres médicas de 47 especialidades, a mais frequente sendo a cardiologia (22,8%), sem restrição de idade. Elas responderam voluntariamente um questionário online com questões sobre características demográficas e socioeconômicas, qualidade de vida (WHOQOL-brief) e espiritualidade (WHOQOL-SRPB) e enunciados do Oldenburg Burnout Inventory. A análise estatística utilizou o software R, regressão beta, árvores de classificação e matriz de correlação policórica, com nível de significância de 5%. Resultados Das 769 respondentes, 61,6% relataram sinais de burnout. Cerca de 64% relataram perda salarial de até 50% durante a pandemia. Algumas relataram falta de energia para as tarefas diárias, sentimentos negativos frequentes, insatisfação com a capacidade para o trabalho, e que cuidar de outras pessoas não agregava sentido às suas vidas. Os sentimentos negativos correlacionaram-se negativamente com a satisfação com a vida sexual, a satisfação com as relações pessoais e a energia para as tarefas diárias. A incapacidade de permanecer otimista em tempos de incerteza correlacionou-se positivamente com a sensação de insegurança no dia a dia e com o não reconhecimento de que cuidar de outras pessoas trouxesse sentido à vida. Conclusão O presente estudo mostrou uma alta frequência de burnout entre as médicas brasileiras que responderam ao questionário durante a pandemia de COVID-19. Apesar disso, apresentavam uma qualidade de vida relativamente boa e acreditavam que a espiritualidade trazia-lhes conforto e segurança nos momentos difíceis.

Abstract Background COVID-19 has placed a tremendous burden on physicians worldwide, especially women physicians, affected by increased workload and loss of quality of life. Objective To assess the effects of the COVID-19 pandemic on the quality of life, burnout and spirituality of Brazilian women physicians directly or indirectly providing care to COVID-19 patients. Methods Prospective, observational study performed from July 28 to September 27, 2020, in Brazil, with women physicians from 47 specialities, the most frequent being cardiology (22.8%), with no age restriction. They voluntarily answered an online survey with questions on demographic and socioeconomic characteristics, quality of life (WHOQOL-brief), spirituality (WHOQOL-SRPB), and statements from the Oldenburg Burnout Inventory. Statistical analysis used the R software, beta regression, classification trees, and polychoric correlation matrix, with a 5% of significance level. Results Of the 769 respondents, 61.6% reported signs of burnout. About 64% reported wage loss of up to 50% during the pandemic. Some reported lack of energy for daily tasks, frequent negative feelings, dissatisfaction with capability for work, and caring for others not adding meaning to their lives. Negative feelings correlated negatively with satisfaction with sexual life and personal relations, and energy for daily tasks. The inability to remain optimistic in times of uncertainty correlated positively with feeling unsafe daily and not acknowledging that caring for others brings meaning to life. Conclusion This study showed a high frequency of burnout among Brazilian women physicians who answered the survey during the COVID-19 pandemic. Nevertheless, they presented with a relatively good quality of life and believed that spirituality comforted and reassured them in hard times.

ABSTRACT To delve in history is necessary to reinforce the identity values identifying people. The most relevant aspects of the University Students Federation in the Matanzas University of Medical Sciences, from 1989 to early 2021 are described. The collected notes evoke the work of the leaders and other students of different generations who excelled in political, teaching, scientific, cultural, sport-recreational, and university extension activities.

RESUMEN Profundizar en la historia es necesario para reforzar los valores identitarios que nos distinguen. Se describen los aspectos más relevantes de la Federación Estudiantil Universitaria en la Universidad de Ciencias Médicas de Matanzas, desde 1989 hasta principios de 2021. Los apuntes recopilados evocan la labor de sus líderes y otros estudiantes de diferentes generaciones, quienes se destacaron en actividades políticas, docentes, científicas, culturales, deportivo-recreativas y de extensión universitaria.

ABSTRACT Introduction: Mucormycosis is an infection produced by opportunistic aerobic saprophytic fungi of different genera, belonging to the order of the Mucorales; pathogens that, under immunocompromised conditions such as diabetes and AIDS, produce diseases. There are several forms of clinical presentation: rhinocerebral, pulmonary, mucocutaneous, gastrointestinal and disseminated. The rhinocerebral presentation is frequently fatal, with a morbidity and mortality of 85-100 % despite the use of amphotericin B, hyperbaric therapy, and aggressive surgical resection. Early diagnosis and systemic patient support are essential. The limited availability of contemporary treatments constitutes a barrier for patients in underdeveloped country settings. Patients and methods: The objective is to carry out a brief review of the literature about rhino-orbital-cerebral mucormycosis, its incidence and mortality in a tertiary hospital in Mexico. Results: In a period of 3 years (July 2018-July 2021), three patients with a diagnosis of rhino-orbital-cerebral mucormycosis were treated. All the cases presented a diagnosis of type 2 diabetes mellitus with poor control of the disease. Two of three patients died during their hospitalization episode despite multidisciplinary management that included multi-organ support and radical surgical treatment in all cases. Conclusions: Mucormycosis continues to present a high mortality in developing countries, despite advances in medical and surgical treatments. The most important prognostic factor continues to be the early detection of the disease and the adequate treatment of associated diseases.

RESUMEN Introducción: La mucormicosis es una infección producida por hongos aerobios saprofitos oportunistas de distintos géneros, pertenecientes al orden de los mucorales, patógenos que, bajo condiciones de inmunocompromiso como diabetes y SIDA, producen enfermedades. Existen varias formas de presentación clínica: rinocerebral, pulmonar, mucocutánea, gastrointestinal y diseminada. La presentación rinocerebral es frecuentemente fatal, con una morbimortalidad del 85-100 %, a pesar del uso de la anfotericina B, terapia hiperbárica y resección quirúrgica agresiva. Es primordial el diagnóstico temprano y el soporte sistémico del paciente. La disponibilidad limitada de tratamientos contemporáneos constituye una barrera para los pacientes en entornos de países subdesarrollados. Pacientes y métodos: El objetivo es realizar una breve revisión de la literatura acerca de la mucormicosis rino-órbito-cerebral, su incidencia y mortalidad en un hospital de tercer nivel de México. Resultados: En un periodo de 3 años (julio de 2018-julio de 2021) se trataron tres pacientes con diagnóstico de mucormicosis rino-órbito-cerebral. Los tres casos revisados presentaron diagnóstico de diabetes mellitus tipo 2 con un mal control de la enfermedad. Dos de los tres pacientes atendidos fallecieron durante su episodio de hospitalización a pesar del manejo multidisciplinario que incluyó soporte multiorgánico y tratamiento quirúrgico radical en todos los casos. Conclusiones: La mucormicosis sigue presentando una alta mortalidad en los países en desarrollo, a pesar del avance en los tratamientos médicos y quirúrgicos. El factor pronóstico más importante sigue siendo la detección temprana de la enfermedad y el adecuado tratamiento de las enfermedades asociadas.

ABSTRACT Bibliometrics is a branch of scientometrics that allows the study of scientific activity. Its unit of analysis is the scientific article. The interest in this area of research lies in its implication in decision making, as part of knowledge management, by suggesting the development of lines of research that have been little studied or supervising the development of others and evaluating the scientific work of authors, institutions and even countries. The central theme of this article is to analyze bibliometrically the scientific production related to academic achievement in the university context. The approach used was quantitative, because it used statistics to give the desired result. The type of research was descriptive because it sought to characterize bibliometric indicators such as year of publication, country where the study was carried out, journal of publication, main topics, methodologies and areas of knowledge used. A total of 145 scientific articles related to the scientific production on human talent and academic achievement published in the Scopus databases were taken into account, corresponding to the period sampled between 2006-2021.

RESUMEN La Bibliometría es una rama de la Cienciometría que permite estudiar la actividad científica. Su unidad de análisis es el artículo científico. El interés por esta área de investigación radica en su implicancia en la toma de decisiones, como parte de la gestión del conocimiento, al sugerir el desarrollo de líneas de investigación poco estudiadas o supervisar el desarrollo de otras y evaluar el quehacer científico de autores, instituciones e incluso países. El tema central de este artículo es analizar bibliométricamente la producción científica relacionada con el aprovechamiento académico en el contexto universitario. El enfoque utilizado fue el cuantitativo, esto porque utilizó la estadística para dar el resultado deseado. El tipo de investigación fue el descriptivo porque buscó caracterizar indicadores bibliométricos tales como año de publicación, país donde se efectuó el estudio, revista de publicación, principales temáticas, metodologías y utilizadas áreas del conocimiento. Se tomaron en cuenta 145 artículos científicos que guardan relación con la producción científica sobre talento humano y aprovechamiento académico publicados en las bases de datos Scopus correspondientes al periodo muestreado entre los años 2006-2021.

Resumen La dialéctica del espacio y la justicia es una temática surgida desde las culturas clásicas; a pesar de ello, no hay una definición establecida para el concepto de la justicia espacial, y cada autor lo aborda desde diferentes perspectivas, escalas y enfoques, a partir del entorno que lo rodea. Por ello, el propósito de este trabajo radica en el análisis de la justicia espacial, desde la conceptualización de un marco referencial desarrollado por investigadores asiáticos, con el objetivo de encontrar la aplicabilidad de este término en los espacios públicos de México. Este artículo surge de la revisión de literatura a través de medios digitales (buscadores académicos como Google Scholar y Redalyc), para inferir los componentes que resaltan la vivencia de la justicia espacial en el país. Los resultados muestran que hay componentes que, por su magnitud y su alto impacto, deberían ser analizados como factores primordiales, como en el caso de la seguridad, la privatización del espacio público y la accesibilidad universal. Se concluye con la generación un marco conceptual que integra teóricamente los factores determinantes a escala nacional para el análisis de la justicia espacial, y se sugiere, como seguimiento a la línea de investigación, crear nuevos instrumentos aplicados a espacios públicos específicos dentro del país.

Abstract The dialectic of space and justice is a theme that has emerged from classical cultures. Despite this, there is no established definition for the concept of spatial justice, and each author approaches it from different perspectives, scales and approaches, based on the surrounding environment. Therefore, the purpose of this paper lies in the analysis of spatial justice from the conceptualization of a referential framework developed by Asian researchers to find the applicability of this term in public spaces in Mexico. This paper arises from the literature review through digital media (academic search engines such as Google Scholar and Redalyc) to infer the components that highlight the experience of spatial justice in the country. The results show that there are components that, due to their magnitude and high impact, should be analyzed as primary factors, as in the case of security, privatization of public space and universal accessibility. It concludes with the generation of a conceptual framework that theoretically integrates the determining factors on a national scale for the analysis of spatial justice, suggesting as a follow-up to the line of research, the creation of new instruments applied to specific public spaces within the country.

Resumo: Introdução: A infecção por SARS-CoV-2 em Wuhan China causou uma pandemia de tal magnitude que causou a morte de milhões de pessoas por pneumonia devido a doença infecciosa causada pelo coronavírus 19 (COVID-19). Assumimos a tarefa de coletar todas as características dos pacientes internados por essa doença em nossa unidade de terapia intensiva adulto. Material e métodos: Realizou-se um estudo analítico, descritivo, observacional e retrospectivo em pacientes com diagnóstico de COVID-19 internados na Unidade de Terapia Intensiva (UTI) do Hospital Ángeles Clínica Londres na Cidade do México, validado para o período de 23 de março de 2020 a 10 de maio de 2020. Os prontuários médicos foram revisados e seus dados coletados, as variáveis do tipo demográficas foram descritas, fatores de risco, sinais e sintomas, tratamento médico e cuidados respiratórios. Foram revisadas as escalas de mortalidade SAPS III, APACHE II, SOFA e CALL-score. Dois grupos foram formados com e sem mortalidade, realizando análises bivariadas e multivariadas das variáveis significativas. A análise estatística foi realizada com o programa SPSS 25. Resultados: No período considerado, 25 prontuários atenderam aos critérios de inclusão para os mesmos: dados demográficos e fatores de risco foram 18 (72%) correspondentes a homens e 7 (38%) a mulheres. Com mortalidade de 10 (40%). Os fatores de risco mais frequentes são diabetes mellitus (DM) em 7 (38%), hipertensão arterial (HAS) 6 (24%), obesidade 4 (16%), doença pulmonar obstrutiva crônica (DPOC) 1 (4%), tabagismo 11 (44%) e alcoolismo 7 (28%). Encontrou-se diferenças estatisticamente significativas nos grupos sem mortalidade e com mortalidade de 15 e 10 pacientes respectivamente, observando a seguinte significância: glicose 105 mg/dL (percentil [PE] 88) versus 171 mg/dL (PE 125) p = 0.012, uréia 33 mg/L (PE 22) versus 95 mg/L (PE 57) p = 0.03, BUN 15.3 mg/L (PE 11) versus 44.2 mg/L (PE 26.28) p = 0.04, TGO 32 U/L (PE 24.4) versus 58 U/L (PE 43.8) p = 0.010, DHL 239 U/L (PE 198) 454 (PE 260) p = 0.003, triglicerídeos 148 mg/dL (PE 120) versus 187.5 mg/dL (PE 165) p = 0.002, CPK 70 U/L (PE 35) versus 81 U/L (PE 78.25) p = 0.003, ferritina 446 mg/L (PE 238) versus 1030 mg/L (PE 665) p = 0.007. Realizou-se análise bivariada com regressão logística binária, com a variável mortalidade dicotômica, não resultando em teste significativo. Conclusões: Entende-se que nenhuma variável é predominantemente importante para explicar a mortalidade e que usamos muitos fatores que se conjugam para explicar esse desfecho, sendo um deles a mesma gravidade do problema respiratório em que o paciente se encontra.

Abstract: Introduction: The SARS-CoV-2 infection in Wuhan, China caused a pandemic of such magnitude that it has caused the death of millions of people from pneumonia due to infectious disease caused by coronavirus 19 (COVID-19). We took on the task of collecting all the characteristics of the patients who were hospitalized for this disease in our Adult Intensive Care Unit. Material and methods: An analytical, descriptive, observational and retrospective study was carried out in patients with a diagnosis of COVID-19 admitted to the Intensive Care Unit (ICU) of the Hospital Ángeles Clínica Londres in Mexico City, evaluated in the period of March 23 from 2020 to May 10, 2020. The files were reviewed and the data taken from them, demographic variables, risk factors, signs and symptoms, medical treatment and respiratory care were described. SAPS III, APACHE II, SOFA and CALL-score mortality scales were reviewed. Two groups were formed with and without mortality, performing bivariate and multivariate analyzes of the significant variables. Statistical analysis was performed with the SPSS 25 program. Results: In the period considered, 25 files met the inclusion criteria for them: demographics and risk factors were 18 (72%) corresponding to men and seven (38%) to women. With a mortality of 10 (40%). The most frequent risk factors are diabetes mellitus (DM) in seven (38%), arterial hypertension (SAH) six (24%), obesity four (16%), chronic obstructive pulmonary disease (COPD) one (4%), smoking 11 (44%) and alcoholism seven (28%). Statistically significant differences were found in the groups without mortality and with mortality 15 and 10 patients respectively, observing the following significance: glucose 105 mg/dL (percentil [PE] 88) versus 171 mg/dL (PE 125) p = 0.012, urea 33 mg/dL (PE 22) versus 95 mg/dL (PE 57) p = 0.03, BUN 15.3 mg/dL (PE 11) versus 44.2 mg/dL (PE 26.28) p = 0.04, TGO 32 U/L (PE 24.4) versus 58 U/L (PE 43.8) p = 0.010, DHL 239 U/L (PE 198) 454 U/L (PE 260) p = 0.003, triglycerides 148 mg/dL (PE 120) versus 187.5 mg/dL (PE 165) p = 0.002, CPK 70 U/L (PE 35) versus 81 U/L (PE 78.25) p = 0.003, ferritin 446 mg/L (PE 238) versus 1,030 mg/L (PE 665) p = 0.007. A bivariate analysis with binary logistic regression was performed, with the dichotomous mortality variable, not resulting in this significant test. Conclusions: It is understood that no variable is predominantly important to explain mortality and that many factors are involved that are combined to explain this outcome, one of these being the same severity of the respiratory problem in which the patient is.

Resumen: Introducción: La infección por SARS-CoV-2 en Wuhan, China, ocasionó una pandemia de tal magnitud que ha provocado la muerte por neumonía a causa de enfermedad infecciosa por coronavirus 19 (COVID-19) de millones de personas. Nos dimos a la tarea de recolectar todas las características de los pacientes que estuvieron hospitalizados por esta enfermedad en nuestra UCI adultos. Material y métodos: Se realizó un estudio de tipo analítico, descriptivo, observacional y retrospectivo en pacientes con diagnóstico de COVID-19 ingresados en la Unidad de Cuidados Intensivos (UCI) del Hospital Ángeles Clínica Londres en la Ciudad de México, evaluados en el periodo del 23 de marzo de 2020 al 10 de mayo de 2020. Se revisaron los expedientes y se tomaron los datos de los mismos, se describieron variables de tipo demográfico, factores de riesgo, signos y síntomas, tratamiento médico y atención respiratoria. Se revisaron escalas de mortalidad SAPS III, APACHE II, SOFA y CALL-score. Se formaron dos grupos con y sin mortalidad realizándose análisis bivariado y multivariado de las variables significativas. El análisis estadístico se efectuó con el programa SPSS 25. Resultados: En el periodo considerado, 25 expedientes cumplieron con los criterios de inclusión, de ellos la demografía y factores de riesgo, 18 (72%) correspondieron a hombres y siete (38%) a mujeres con una mortalidad de 10 (40%). Los factores de riesgo más frecuentes fueron diabetes mellitus (DM) en siete (38%) pacientes, hipertensión arterial (HAS) en seis (24%), obesidad en cuatro (16%), enfermedad pulmonar obstructiva crónica (EPOC) en uno (4%), tabaquismo en 11 (44%) y alcoholismo en siete (28%). Se encontraron diferencias estadísticamente significativas en los grupos sin mortalidad y con mortalidad, 15 y 10 pacientes, respectivamente, observando las siguientes significancias: glucosa 105 mg/dL (percentil [PE 88]) versus 171 mg/dL (PE 125) p = 0.012, urea 33 mg/dL (PE 22) versus 95 mg/dL (PE 57) p = 0.03, BUN 15.3 mg/dL (PE 11) versus 44.2 mg/dL (PE 26.28) p = 0.04, TGO 32 U/L (PE 24.4) versus 58 U/L (PE 43.8) p = 0.010, DHL 239 U/L (PE 198) 454 U/L (PE 260) p = 0.003, triglicéridos 148 mg/dL (PE 120) versus 187.5 mg/dL (PE 165) p = 0.002, CPK 70 U/L (PE 35) versus 81 U/L (PE 78.25) p = 0.003, ferritina 446 mg/L (PE 238) versus 1,030 mg/L (PE 665) p = 0.007. Se realizó un análisis bivariado con regresión logística binaria, con la variable mortalidad dicotómica, no resultando significativa con esta prueba. Conclusiones: Se entiende que ninguna variable es predominantemente importante para explicar la mortalidad y que se recurre a muchos factores que se conjugan para explicar este desenlace, uno de éstos es la severidad misma del problema respiratorio en que se encuentre el paciente.

ABSTRACT Introduction: Few studies are available about excessive accumulation of adipose tissue and its association to changes in biochemical indicators in pregnancy and the postpartum period. Objective: Determine the association between cardiometabolic vulnerability due to body adiposity and biochemical indicators during recruitment of pregnant women and in the postpartum period. Methods: An observational prospective study was conducted of cardiometabolic vulnerability due to body adiposity and biochemical indicators in 773 women recruited as healthy and adequate weight, 119 of them in the postpartum period, at Chiqui Gómez Lubián polyclinic. Biochemical indicators were studied by cardiometabolic vulnerability group at recruitment and in the postpartum period. Statistical analysis was based on the Kruskal-Wallis test. Results: Pregnant women recruited with overall vulnerability due to high general intermediate and central adiposity had lower uric acid mean values (238.78 mmol/l), higher triglyceride mean values (1.37 mmol/l), cholesterol (4.70 mmol/l) and insulin resistance (8.32). Women with overall vulnerability due to high general intermediate and central adiposity in the postpartum period had higher triglyceride mean values (1.18 mmol/l), very low density lipoproteins (0.54 mmol/l), and lower high density lipoprotein mean values (1.06 mmol/l). Women with extreme overall vulnerability due to high general and central adiposity had higher mean values: glycemia (4.90 mmol/l), cholesterol (4.30 mmol/l), low density lipoproteins (2.76 mmol/l), lipid accumulation product (42.63 mmol/l) and visceral adiposity index (2.32 mmol/l). Conclusions: Evaluating cardiometabolic vulnerability using anthropometric techniques complemented with biochemical indicators, facilitates aiming preventive actions at progressive cardiometabolic damage during pregnancy and the postpartum period.

RESUMEN Introducción: Son escasos los estudios sobre acumulaciones excesivas de tejido adiposo y su asociación con cambios en indicadores bioquímicos estudiados durante el embarazo y el posparto. Objetivo: Determinar asociaciones de la vulnerabilidad cardiometabólica por adiposidad corporal con indicadores bioquímicos en el momento de la captación de la embarazada y el posparto. Métodos: Se realizó estudio observacional prospectivo de la vulnerabilidad cardiometabólica por adiposidad corporal e indicadores bioquímicos en 773 mujeres captadas como sanas de peso adecuado, de ellas 119 al posparto, en el policlínico “Chiqui Gómez Lubián”. Se estudiaron por grupo de vulnerabilidad cardiometabólica indicadores bioquímicos a la captación y el posparto. Se aplicó prueba estadística de Kruskal-Wallis. Resultados: Gestantes captadas con vulnerabilidad global por adiposidad general intermedia y central alta tuvieron valores medios más bajos del ácido úrico (238,78 mmol/L), más altos de triglicéridos (1,37 mmol/L), colesterol (4,70 mmol/L) y resistencia a la insulina (8,32). Mujeres con vulnerabilidad global por adiposidad general intermedia y central alta al posparto presentaron valores medios más elevados de triglicéridos (1,18 mmol/L) y lipoproteínas de muy baja densidad (0,54 mmol/L), más bajos de lipoproteínas de alta densidad (1,06 mmol/L); mujeres con vulnerabilidad global extrema por adiposidad general y central alta, tuvieron valores medios más elevados: glicemia (4,90 mmol/L), colesterol (4,30 mmol/L), lipoproteínas de baja densidad (2,76 mmol/L), producto de acumulación de lípidos (42,63 mmol/L) e índice de adiposidad visceral (2,32 mmol/L). Conclusiones: Evaluar vulnerabilidad cardiometabólica por técnicas antropométricas, complementadas con indicadores bioquímicos, facilita orientar acciones preventivas sobre daños cardiometabólicos progresivos en la gestación y su posparto.

ABSTRACT Background: the insertion of informational competences in the work of the medical science professional implies the management of new roles that integrate the consumption of electronic information, the generation of new knowledge and its socialization. Objective: to characterize the development of informational competences in health professionals belonging to the Teaching Gynecological-obstetric Hospital of Palma Soriano municipality in Santiago de Cuba province. Methods: a descriptive study was carried out at “Nelia Irma Delfín Ripoll” Gynecological-obstetric Teaching Hospital, in Palma Soriano during 2020, Theoretical methods were used: analysis-synthesis and inductive-deductive and the systemic approach; empirical ones: documentary analysis, questionnaire and observation. Results: there was a predominance of university education, the need for information as something objective, inadequate use of search strategies, type of information sources used electronically for self-study, inadequate collaborative work and discussion groups for research. Conclusions: the development of informational competences in health professionals belonging to the Teaching Gynecological-Obstetric Hospital in Palma Soriano was characterized, with a view to achieving a wide thematic coverage and quality of the contents of the organization in the management systems and the development of informational competencies that promote retroactivity in the confrontation of health problems.

RESUMEN Fundamento: la inserción de las competencias informacionales en la labor del profesional de ciencias médicas supone la gestión de nuevos roles que integren el consumo de información digital, la generación de nuevos conocimientos y su socialización. Objetivo: caracterizar el desarrollo de competencias informacionales en los profesionales de salud pertenecientes al Hospital Ginecobstétrico Docente del municipio Palma Soriano en la provincia Santiago de Cuba. Métodos: se realizó un estudio descriptivo en el Hospital Ginecobstétrico Docente “Nelia Irma Delfín Ripoll”, durante el año 2020, en Palma Soriano. Se emplearon métodos teóricos: análisis-síntesis e inductivo-deductivo y enfoque sistémico; empíricos: análisis documental, el cuestionario y la observación. Resultados: se constató un predomino de la escolaridad universitaria, necesidad de información como algo objetivo, inadecuada utilización de estrategias de búsqueda, tipo de fuentes informativas utilizadas digitales para el autoestudio, inadecuado trabajo colaborativo y de grupos de discusión para la investigación. Conclusiones: se caracterizó el desarrollo de competencias informacionales en los profesionales de salud pertenecientes al Hospital Ginecobstétrico Docente en Palma Soriano, con vistas a lograr una amplia cobertura temática y calidad de los contenidos de la organización en los sistemas de gestión y el desarrollo de competencias informacionales que propicien la retroactividad en el enfrentamiento de los problemas de salud.

ABSTRACT Background: the timely identification of strategies and learning goals in students is important in the success of the purposes of the teaching-learning process. Objective: to describe the learning strategies and academic goals in students enrolled from first to sixth semesters, during the academic period October 2016 - February 2017, at the Faculty of Health Sciences of the National University of Chimborazo. Method: a descriptive observational study was carried out, during the academic period October 2016 - February 2017, at the Faculty of Health Sciences of the National University of Chimborazo, in which the questionnaires for the evaluation of academic goals (QEAG) were applied and autonomous work strategies (AWS), whose resulting data were analyzed and interpreted using statistical methods of the descriptive and inferential parametric levels. Results: a predominance of independence was observed between the career they were studying and the learning strategies; but there was a significant dependence (p = 0.02 <0.05) with respect to conceptualization and very significant for participation (p = 0.006 <0.01). The mean of the types of academic goals studied placed almost all of them in the category at times (means between 3.11 and 3.28); With the exception of those oriented to learning (3.59 on average) for 41.78%. Conclusions: none of the learning strategies predominated among the studied population, the category at times prevailed in each one; however, among the academic goals, those oriented to learning predominated, which were mostly located in the scale value many times.

RESUMEN Fundamento: la identificación oportuna de estrategias y metas de aprendizaje en estudiantes es importante en el éxito de los propósitos del proceso enseñanza aprendizaje. Objetivo: describir las estrategias de aprendizaje y metas académicas en estudiantes matriculados de primero a sexto semestres, durante el período académico octubre 2016 - febrero 2017, en la Facultad de Ciencias de la Salud de la Universidad Nacional de Chimborazo. Método: se realizó un estudio observacional descriptivo, durante el período académico octubre 2016 - febrero 2017, en la Facultad de Ciencias de la Salud de la Universidad Nacional de Chimborazo, en el que se aplicaron los cuestionarios para la evaluación de metas académicas (CEMA) y de estrategias de trabajo autónomo (CETA), cuyos datos resultantes fueron analizados e interpretados utilizando métodos estadísticos de los niveles descriptivo e inferencial paramétrico. Resultados: se observó un predominio de la independencia entre la carrera que cursaban y las estrategias de aprendizaje; pero existió dependencia significativa (p=0,02<0,05) con respecto a las de conceptualización y muy significativa para las de participación (p=0,006<0,01). La media de los tipos de metas académicas estudiadas ubicó a casi todos en la categoría algunas veces (medias entre 3,11 y 3,28); a excepción de las orientadas al aprendizaje (3,59 de media) para un 41,78 %. Conclusiones: ninguna de las estrategias de aprendizaje predominó entre la población estudiada, prevaleció la categoría algunas veces en cada uno; sin embargo, entre las metas académicas predominaron aquellas orientadas al aprendizaje, las que se ubicaron mayoritariamente en el valor de escala muchas veces.

Resumo: Apresentamos o relato do caso de um paciente de 63 anos com SARS-CoV-2, secundário a COVID-19, é admitido no Serviço de Terapia Intensiva com sinais de pneumonia grave, requer suporte avançado de vias aéreas e tratamento anticoagulante com dose terapêutica secundária à trombose na mão direita, é realizado estudo tomográfico relatando o diagnóstico de hemorragia subaracnóide de Fisher III, a anticoagulação é suspensa após 5 dias, são incluidas evacuações tipo melena e gasto por sonda nasogástrica em borra de café, com presença de trombocitopenia de 95,000 μ/L fibrinogênio 198 mg/dL, INR 1.30, TTP 20.4 seg, TP 12.7 seg, atendendo aos critérios para coagulação intravascular disseminada. A apresentação deste caso nos interessa pela associação que a infecção por COVID-19 tem com a alteração da cascata de coagulação, apresentando hemorragias secundárias.

Abstract: This is a case report of a 63-year-old patient with SARS-CoV-2. Secondary to COVID-19 showing signs of severe pneumonia he is admitted to the intensive care service, requires advanced airway support and anticoagulation treatment at therapeutic doses. Derived from right hand thrombosis a tomographic study was carried out, reporting the diagnosis of Fisher 3 subarachnoid hemorrhage, the anticoagulation was suspended after 5 days, melena-type evacuations and expenditure by nasogastric tube in coffee grounds are manifested, with data of 95,000/μL thrombocytopenia, 198 mg/dL fibrinogen, INR 1.30, TTP 20.4 s, TP 12.7 s, meeting criteria of disseminated intravascular coagulation. The presentation of this case seems interesting because of the association that COVID-19 infection has to the alteration of such coagulation cascade, showing secondary bleeding.

Resumen: Este es el reporte de caso de un paciente de 63 años de edad con SARS-CoV-2. A resultas de COVID-19 con signos de neumonía grave se le ingresa al servicio de terapia intensiva, requiere apoyo avanzado de la vía aérea y tratamiento de anticoagulación a dosis terapéutica; a consecuencia de trombosis de mano derecha se realiza estudio tomográfico, reportándose el diagnóstico de hemorragia subaracnoidea Fisher 3, a los cinco días se suspende régimen anticoagulante, se manifiestan evacuaciones de tipo melena y gasto por sonda nasogástrica en posos de café, con datos de trombocitopenia de 95,000/μL, fibrinógeno 198 mg/dL, INR 1.30, TTP 20.4 s, TP 12.7 s, cumpliendo criterios de coagulación intravascular diseminada. Parece interesante la presentación de este caso por la asociación que tiene la infección por COVID-19 con la alteración de la cascada de dicho proceso coagulatorio, mostrando sangrados secundarios.

OBJECTIVE: This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved. METHODS: A total of 54 patients, aged ≥18 years of both sexes, were evaluated 2-4 months after hospital discharge in São Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization. RESULTS: Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r=−0.28, p=0.04), Short Physical Performance Battery score (r=−0.28, p=0.03), and forced vital capacity (r=−0.29, p=0.03). CONCLUSION: Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities.

Abstract BACKGROUND: Recent studies refers pregnant women as a population of high risk due to the pandemic of COVID-19, because they are more vulnerable to the most aggressive manifestations in the illness and for the high risk of experiencing obstetric and neonatal complications. This study has objective to present the report of a pregnant woman&apos;s case infected by SARS-CoV-2 that had a critical state of health and in who a favorable maternal-infantile evolution was achieved. CLINIC CASE: Feminine of 27 years old, with pregnancy of 30 weeks of gestation, who was diagnosed with pneumonia for SARS-CoV-2. Because a critical state of health, pregnancy was interrupted for Caesarean operation and the patient had to be treated with mechanic ventilation and pharmacological cocktail, having a favorable evolution after 22 days of hospitalization. It is suspected that the maternal hypoxia can be cause of fetal suffering; however, there is not documented evidence that establishes it, therefore, it will be carried out biophysical profile in all pregnant patient with oxygen saturation smaller than 90% in order to corroborate fetal well-being and to value interruption of the pregnancy in an opportune way. A positive correlation is observed among pneumonia by SARS-CoV-2 and premature birth. CONCLUSION: Due to the complicated health situation caused by the COVID-19 pandemic in particular for infected pregnant women, timely diagnostic algorithms must be established and the most effective medical interventions should be used based on the review of cases in which a good outcome and prognosis for the mother and her child.

Resumen ANTECEDENTES: Los estudios más recientes consideran a las mujeres embarazadas un grupo de alto riesgo ante la pandemia de COVID-19 debido a su vulnerabilidad ante las manifestaciones más agresivas de la enfermedad y por el alto riesgo de experimentar complicaciones obstétricas y neonatales. OBJETIVO: Reportar el caso de una paciente embarazada, infectada por SARS-CoV-2. CASO CLÍNICO: Paciente de 27 años, con 30 semanas de embarazo y neumonía por SARS-CoV-2. Debido a su estado crítico de salud se finalizó el embarazo por vía abdominal; se trató con ventilación mecánica y una combinación de fármacos. Su evolución fue favorable luego de 22 días de hospitalización. Todo indicó que la hipoxia materna fue la causa del sufrimiento fetal. Por lo anterior, se recomienda el perfil biofísico a todas las embarazadas con saturación de oxígeno menor a 90% para corroborar el bienestar fetal y valorar la finalización oportuna del embarazo. Se observó una correlación positiva entre la neumonía por SARS-CoV-2 y el parto prematuro. CONCLUSIÓN: Debido a la complicada situación sanitaria derivada de la pandemia de COVID-19, en particular para las embarazadas infectadas, deben establecerse algoritmos diagnósticos oportunos y aplicar las intervenciones médicas más eficaces con base en la revisión de casos en los que se haya obtenido un buen desenlace y pronóstico para la madre y su hijo.