Resumen Marco contextual: Las ambulancias de soporte vital inmediato (SVI) permiten al personal de enfermería intervenir en un contexto prehospitalario, con el apoyo de sus conocimientos técnico-científicos y de complejos protocolos de actuación y regulación médica a través de la telemedicina. Objetivo: Analizar las aportaciones de la intervención del personal de enfermería del SVI en la evolución del estado clínico de la persona en situación crítica (PSC). Metodología: Estudio cuantitativo, descriptivo-correlacional, retrospectivo, realizado en centros de SVI del norte de Portugal. Se analizaron 574 historias clínicas electrónicas entre el 1 de noviembre y el 31 de diciembre de 2019, correspondientes al mismo número de personas evaluadas. Se utilizó la escala National Early Warning Score (NEWS) para evaluar la evolución clínica de la PSC. Resultados: Se observó una evolución positiva en el score NEWS de la PSC, tras la intervención del personal de enfermería del SVI (M = 4,43 ± 3,901 vs 3,34 ± 3,329; sig < 0,001). Por el contrario, el riesgo clínico disminuyó significativamente tras la intervención del personal de enfermería. Conclusión: Se demostró la relevancia de la intervención del personal de enfermería del SVI en el contexto prehospitalario, como garantía de seguridad, calidad y mejora continua en la atención a la PSC.

Abstract Background: Immediate life support (ILS) ambulances allow nurses to intervene in pre-hospital settings, supported by their technical-scientific knowledge and complex protocols of action and regulation through telemedicine. Objective: To analyze the contributions of nursing interventions in the evolution of the clinical state of critical patients. Methodology: Quantitative, descriptive-correlational, retrospective, and observational study conducted in ILS settings in northern Portugal. A total of 574 electronic clinical records were analyzed between 1 November and 31 December 2019, corresponding to the same number of people evaluated. The National Early Warning Score (NEWS) was used to assess the clinical evolution of critical patients. Results: There was a positive evolution of the NEWS score of critical patients after the intervention of ILS nurses (M = 4.43 ± 3.901 vs. 3.34 ± 3.329; sig < 0.001). Similarly, the clinical risk of critical patients decreased after the nurse’s intervention. Conclusion: This study demonstrated the importance of nurses in prehospital care, as a guarantee of safety, quality, and continuous improvement of care for critical patients.

Resumo Enquadramento: As ambulâncias de suporte imediato de vida (SIV) possibilitam ao enfermeiro capacidade de intervenção em contexto pré-hospitalar, suportada pelo seu conhecimento técnico-científico, protocolos complexos de atuação e regulação médica por telemedicina. Objetivo: Analisar os contributos da intervenção dos enfermeiros SIV, na evolução do estado clínico da pessoa em situação crítica (PSC). Metodologia: Estudo quantitativo, descritivo-correlacional, retrospetivo, realizado em meios SIV, na região norte de Portugal. Analisados 574 registos clínicos eletrónicos, entre 01 de novembro e 31 de dezembro de 2019, que correspondem ao mesmo número de pessoas avaliadas. Utilizada a escala National Early Warning Score (NEWS) para avaliar a evolução clínica da PSC. Resultados: Observou-se uma evolução positiva do score NEWS da PSC, após a intervenção do enfermeiro SIV (M = 4,43 ± 3,901 vs 3,34 ± 3,329; sig < 0,001). Em sentido inverso, o risco clínico diminuiu significativamente após a intervenção do enfermeiro. Conclusão: Demonstrou-se a relevância da intervenção do enfermeiro SIV no contexto pré-hospitalar, enquanto garantia de segurança, qualidade e melhoria contínua dos cuidados à PSC.

ABSTRACT Purpose The clinical outcomes of kidney transplantation from deceased donors have seen significant improvements with the use of machine perfusion (MP), now a standard practice in transplant centers. However, the use of perfusate biomarkers for assessing organ quality remains a subject of debate. Despite this, some centers incorporate them into their decision-making process for donor kidney acceptance. Recent studies have indicated that lactate dehydrogenase (LDH), glutathione S-transferase, interleukin-18, and neutrophil gelatinase-associated lipocalin (NGAL) could predict post-transplant outcomes. Materials and Methods Between August 2016 and June 2017, 31 deceased-donor after brain death were included and stroke was the main cause of death. Pediatric patients, hypersensitized recipients were excluded. 43 kidneys were subjected to machine perfusion. Perfusate samples were collected just before the transplantation and stored at -80ºC. Kidney transplant recipients have an average age of 52 years, 34,9% female, with a BMI 24,6±3,7. We employed receiver operating characteristic analysis to investigate associations between these perfusate biomarkers and two key clinical outcomes: delayed graft function and primary non-function. Results The incidence of delayed graft function was 23.3% and primary non-function was 14%. A strong association was found between NGAL concentration and DGF (AUC=0.766, 95% CI, P=0.012), and between LDH concentration and PNF (AUC=0.84, 95% CI, P=0.027). Other perfusate biomarkers did not show significant correlations with these clinical outcomes. Conclusion The concentrations of NGAL and LDH during machine perfusion could assist transplant physicians in improving the allocation of donated organs and making challenging decisions regarding organ discarding. Further, larger-scale studies are required. MP, MP , (MP) However debate this decisionmaking decision acceptance LDH, (LDH) Stransferase, Stransferase S transferase, transferase S-transferase interleukin18, interleukin18 interleukin 18, 18 interleukin-18 gelatinaseassociated gelatinase associated (NGAL posttransplant post 201 2017 3 deceaseddonor patients excluded 4 80ºC. 80ºC ºC -80ºC 5 years 349 34 9 34,9 female 24637 24 6 7 24,6±3,7 nonfunction. nonfunction non function. 233 23 23.3 14 14% AUC=0.766, AUC0766 AUC 0 766 (AUC=0.766 95 CI P=0.012, P0012 P P=0.012 012 P=0.012) AUC=0.84, AUC084 84 (AUC=0.84 P=0.027. P0027 P=0.027 . 027 P=0.027) discarding Further largerscale larger scale required (MP (LDH interleukin1 1 interleukin-1 20 34, 2463 2 24,6±3, 23. AUC=0.766 AUC076 76 (AUC=0.76 P001 P=0.01 01 AUC=0.84 AUC08 8 (AUC=0.8 P002 P=0.02 02 interleukin- 246 24,6±3 AUC=0.76 AUC07 (AUC=0.7 P00 P=0.0 AUC=0.8 AUC0 (AUC=0. 24,6± AUC=0.7 P0 P=0. AUC=0. (AUC=0 24,6 P=0 AUC=0 (AUC= 24, P= AUC= (AUC

ABSTRACT The National University and, particularly, the graduate school, have the task of providing a quality service that generates satisfaction among its students. This is essential to improve the quality of graduate programs. This research aims to establish whether satisfaction with the quality of university service in postgraduate students is related. To achieve this, a non-experimental, correlational and transversal design was used with a sample of 180 students, to whom the questionnaire on quality of university service and the questionnaire on user satisfaction were administered. The results obtained allow us to conclude that there are significant relationships between the two study variables (r = 0.80), as well as between their dimensions that make up each variable.

RESUMO A Universidade Nacional e, particularmente, a pós-graduação, têm a missão de prestar um serviço de qualidade que gere satisfação aos seus alunos. Isso é essencial para melhorar a qualidade dos programas de pós-graduação. Esta pesquisa tem como objetivo estabelecer se a satisfação com a qualidade do serviço universitário em estudantes de pós-graduação está relacionada. Para isso, utilizou-se um desenho não experimental, correlacional e transversal com uma amostra de 180 estudantes, aos quais foram aplicados o questionário sobre qualidade do serviço universitário e o questionário sobre satisfação do usuário. Os resultados obtidos permitem-nos concluir que existem relações significativas entre as duas variáveis do estudo (r = 0,80), bem como entre as suas dimensões que compõem cada variável.

RESUMEN La Universidad Nacional y, particularmente, la escuela de posgrado, tienen la tarea de brindar un servicio de calidad que genere satisfacción entre sus estudiantes. Esto es fundamental para mejorar la calidad de los programas de posgrado. La investigación tuvo como objetivo establecer la relación que existen entre la calidad del servicio universitario ofrecido con la satisfacción del usuario en estudiantes de posgrado de una Universidad Pública de Lima. Para lograrlo se utilizó un diseño no experimental, correlacional y transversal con una muestra de 180 estudiantes, a quienes se les administró el cuestionario sobre calidad del servicio universitario y el cuestionario sobre satisfacción del usuario. Los resultados obtenidos permitieron concluir que, existen relaciones significativas entre las dos variables de estudio (r = 0.80), así como entre sus dimensiones que componen cada variable.

Abstract: The aim of the following research is to report the results of the widespread application of the Eureka test to achieve its standardization in Chile. This test offers a psychopedagogical tool for the early diagnosis of specific learning difficulties (SLD), considering, on one hand, the Chilean national curriculum, and on the other, the cognitive skills necessary to achieve successful learning outcomes. Within this framework, a quantitative analysis was conducted on 2138 language test renditions and 2254 math test renditions given to students from 1st to 8th grade. In the current scenario, there is a noticeable absence of a contextualized assessment for Chilean students, and even at the Latin American level. The research results show that the Eureka test is an instrument that can diagnose SLD in students from first to eighth grade and assists in establishing intervention strategies that enhance teaching practices, tailored according to the results obtained.

Resumen: El objetivo de la siguiente investigación es dar cuenta de los resultados de la aplicación masiva de la prueba Eureka para lograr su estandarización en Chile. Esta prueba permite contar con un instrumento psicopedagógico para el diagnóstico temprano de Dificultades Específicas del Aprendizaje (DEA) considerando, por un lado, el currículum nacional chileno y por otro, las habilidades cognitivas necesarias para alcanzar niveles de aprendizaje exitosos. En este marco, se realizó un análisis cuantitativo de la aplicación de las 2138 rendiciones de la prueba de lenguaje y a 2254 rendiciones de la prueba de matemáticas a estudiantes desde primero hasta octavo básico. En el escenario actual se detecta la carencia de una evaluación contextualizada para los estudiantes chilenos e incluso a nivel latinoamericano. Los resultados de la investigación arrojan que la prueba Eureka es un instrumento que permite diagnosticar DEA en estudiantes de primero a octavo básico y ayuda a establecer estrategias de intervención que mejoran la práctica docente dirigidas de manera personalizada de acuerdo con los resultados obtenidos.

Resumo: O objetivo da seguinte pesquisa é relatar os resultados da aplicação massiva do teste Eureka para alcançar sua padronização no Chile. Este teste permite-nos ter um instrumento psicopedagógico para o diagnóstico precoce de Dificuldades Específicas de Aprendizagem (DET) considerando, por um lado, o currículo nacional chileno e, por outro, as competências cognitivas necessárias para alcançar níveis de aprendizagem bem sucedidos. Neste contexto, foi realizada uma análise quantitativa da aplicação dos 2.138 desempenhos da prova de linguagem e dos 2.254 desempenhos da prova de matemática a alunos do primeiro ao oitavo ano. No cenário atual, detecta-se a falta de uma avaliação contextualizada para os estudantes chilenos e mesmo em nível latino-americano. Os resultados da pesquisa mostram que o teste Eureka é um instrumento que permite diagnosticar DEA em alunos do primeiro ao oitavo ano e ajuda a estabelecer estratégias de intervenção que melhorem a prática docente direcionada de forma personalizada de acordo com os resultados obtidos.

ABSTRACT Purpose: The aim of this study is to perform a high-quality meta-analysis using only randomized controlled trials (RCT) to better define the role of postoperative antibiotics in patients undergoing percutaneous nephrolithotomy (PCNL). Materials and Methods: A literature search for RCTs in EMBASE, PubMed, and Web of Science up to May 2023 was conducted following the PICO framework: Population—adult patients who underwent PCNL; Intervention—postoperative antibiotic prophylaxis until nephrostomy tube withdrawal; Control—single dose of antibiotic during the induction of anesthesia; and Outcome—systemic inflammatory response syndrome (SIRS) or sepsis and fever after PCNL. The protocol was registered on the PROSPERO database (CRD42022361579). We calculated odds ratios (OR) and 95% confidence intervals (CI). A random-effects model was employed, and the alpha risk was defined as < 0.05. Results: Seven articles, encompassing a total of 629 patients, were included in the analysis. The outcome of SIRS or sepsis was extracted from six of the included studies, while the outcome of postoperative fever was extracted from four studies. The analysis revealed no statistical association between the use of postoperative antibiotic prophylaxis until nephrostomy tube withdrawal and the occurrence of SIRS/sepsis (OR 1.236, 95% CI 0.731 – 2.089, p=0.429) or fever (OR 2.049, 95% CI 0.790 – 5.316, p=0.140). Conclusion: Our findings suggest that there is no benefit associated with the use of postoperative antibiotic prophylaxis until nephrostomy tube withdrawal in patients undergoing percutaneous nephrolithotomy (PCNL). We recommend that antibiotic prophylaxis should be administered only until the induction of anesthesia in PCNL. Purpose highquality high quality metaanalysis meta RCT (RCT PCNL . (PCNL) Methods EMBASE PubMed 202 framework Populationadult Population adult Interventionpostoperative Intervention Controlsingle Control single Outcomesystemic Outcome systemic (SIRS CRD42022361579. CRD42022361579 CRD (CRD42022361579) OR 95 CI. (CI) randomeffects random effects employed 005 0 05 0.05 Results articles 62 studies SIRSsepsis 1236 1 236 1.236 0731 731 0.73 2089 2 089 2.089 p=0.429 p0429 p 429 2049 049 2.049 0790 790 0.79 5316 5 316 5.316 p=0.140. p0140 p=0.140 140 p=0.140) Conclusion (PCNL 20 CRD4202236157 (CRD42022361579 9 (CI 00 0.0 6 123 23 1.23 073 73 0.7 208 08 2.08 p=0.42 p042 42 204 04 2.04 079 79 531 31 5.31 p014 p=0.14 14 CRD420223615 (CRD4202236157 0. 12 1.2 07 7 2.0 p=0.4 p04 4 53 3 5.3 p01 p=0.1 CRD42022361 (CRD420223615 1. 2. p=0. p0 5. CRD4202236 (CRD42022361 p=0 CRD420223 (CRD4202236 p= CRD42022 (CRD420223 CRD4202 (CRD42022 CRD420 (CRD4202 CRD42 (CRD420 CRD4 (CRD42 (CRD4 (CRD

RESUMEN La modelación del tiempo y el clima a escala local en las montañas han sido relevantes para el estudio de los ecosistemas agroforestales y su evolución futura. El trabajo tuvo como objetivo integrar un conjunto de datos espaciales de alta resolución al modelo numérico de predicción e investigación meteorológica WRF, adecuado para el análisis meteorológico y del clima local en las montañas de Cuba. En el trabajo, se definió como datos espaciales prioritarios los referidos al relieve, la máscara de tierra como interface océano-suelo, el tipo de cobertura y tipo de suelo. Se seleccionaron las bases de datos espaciales de alta resolución nacionales o globales de mejor calidad y más adecuadas a las características del modelo. Las bases de datos integradas al WRF tuvieron resolución espacial entre 0,95 y 0,03 km aproximadamente en el Ecuador. El incremento y actualización de los datos espaciales robustecieron la capacidad del modelo para el análisis de los factores geográficos formadores del clima local, propiciando mejor desempeño en las montañas. Los resultados de la investigación pudieran contribuir a la vigilancia y pronóstico meteorológico y climático a escala local para las montañas de Cuba. De igual manera, beneficiarían los estudios y gestión de riesgos asociados a incendios forestales, eventos hidrometeorológicos severos, la variabilidad climática, el cambio climático, y otros peligros relacionados con el sistema climático que han afectado los ecosistemas agroforestales cubanos.

RESUMO A modelagem do tempo e do clima em escala local nas montanhas tem sido relevante para o estudo dos ecossistemas agroflorestais e sua evolução futura. O objetivo deste trabalho foi integrar um conjunto de dados espaciais de alta resolução ao modelo numérico de pesquisa e previsão do tempo WRF, adequado para a análise do tempo e do clima local nas montanhas de Cuba. No trabalho, os dados espaciais prioritários foram definidos como aqueles referentes ao relevo, à máscara de terra como uma interface oceano-solo, ao tipo de cobertura e ao tipo de solo. Foram selecionados os bancos de dados espaciais nacionais ou globais de alta resolução da mais alta qualidade e mais adequados às características do modelo. Os bancos de dados integrados ao WRF tinham resolução espacial entre 0,95 e 0,03 km aproximadamente no equador. Os dados espaciais ampliados e atualizados fortaleceram a capacidade do modelo de analisar os fatores geográficos que moldam o clima local, levando a um melhor desempenho nas montanhas. Os resultados da pesquisa podem contribuir para o monitoramento e a previsão do tempo e do clima em escala local nas montanhas de Cuba. Eles também beneficiariam estudos e gerenciamento de riscos associados a incêndios florestais, eventos hidrometeorológicos graves, variabilidade climática, mudanças climáticas e outros perigos relacionados ao sistema climático que afetaram os ecossistemas agroflorestais cubanos.

ABSTRACT Local-scale weather and climate modeling in mountains has been relevant for the study of agroforestry ecosystems and their future evolution. The study aimed to integrate a set of high-resolution spatial data to the WRF numerical meteorological prediction and research model, suitable for meteorological and local climate analysis in the mountains of Cuba. In the study, priority spatial data were defined as those referring to the relief, the land mask as the ocean-soil interface, the type of cover and type of soil. The national or global high-resolution spatial databases of the best quality and most appropriate to the characteristics of the model were selected. The databases integrated into the WRF had spatial resolution between approximately 0.95 and 0.03 km in Ecuador. The increase and updating of spatial data strengthened the model's capacity for the analysis of the geographic factors that shape the local climate, promoting better performance in the mountains. The research results could contribute to meteorological and climate monitoring and forecasting at a local scale for the mountains of Cuba. Likewise, studies and risk management associated with forest fires, severe hydrometeorological events, climate variability, climate change, and other dangers related to the climate system that have affected Cuban agroforestry ecosystems would benefit.

RESUMEN Introducción: La relación entre las toxicomanías y el suicidio se asocian en su función como agente causal y precipitante de la conducta suicida. Objetivo: Determinar los factores pronósticos de la conducta suicida en pacientes adictos a sustancias psicoactivas. Métodos: Se desarrolló un estudio observacional transversal. Se trabajó con el universo, constituido por los pacientes adictos atendidos en el Hospital Militar Central “Dr. Carlos J. Finlay”, desde 2016 a 2019. Las variables estudiadas fueron: conducta suicida, función ejecutiva, edad, sexo, características clínicas del consumo, sustancia consumida, deterioro cognitivo, ansiedad y depresión. Se utilizaron técnicas de la estadística descriptiva e inferencial. Resultados: Se estudiaron 257 pacientes con consumo, fundamentalmente de alcohol y marihuana, con edad promedio de 34 años; predominó el sexo masculino (89 %). La conducta suicida estuvo presente en el 53,7 % (n= 138). Los principales factores pronósticos en los pacientes fueron: necesidad subjetiva de consumo (odd ratio-OR= 3,4), depresión (OR= 3,3), deterioro cognitivo (OR= 3,0), tener 30 años de edad o menos al iniciar el consumo (OR= 2,6), antecedentes familiares de adicción (OR=2,3), nivel escolar de 9no grado (OR= 2,0), recaer antes de los 6 meses de tratamiento (OR= 1,1), tiempo consumiendo de 20 años o menos (OR= 3,0) y consumir otras drogas diferentes al alcohol (OR= 2,1). Conclusiones: Los principales factores pronósticos de la conducta suicida en los pacientes adictos estudiados son la necesidad subjetiva de consumo, la depresión y el deterioro cognitivo.

ABSTRACT Introduction: The relationship between drug addiction and suicide is associated in its function as a causal and precipitating agent of suicidal behavior. Objective: To determine the prognostic factors of suicidal behavior in patients addicted to psychoactive substances. Methods: An observational and cross-sectional study was developed. It worked with the universe, made up of addicted patients treated at the Central Military Hospital "Dr. Carlos J. Finlay" from 2016 to 2019. The variables studied were: suicidal behavior, executive function, age, sex, clinical characteristics of consumption, substance consumed, cognitive impairment, anxiety and depression. Descriptive and inferential statistical techniques were used. Results: 257 patients with consumption, mainly of alcohol and marijuana, with an average age of 34 years were studied; the male sex predominated (89%). Suicidal behavior was present in 53.7% (n= 138). The main prognostic factors in the patients were: subjective need for consumption (odd ratio-OR= 3.4), depression (OR= 3.3), cognitive impairment (OR= 3.0), being 30 years of age or less at the start of the consumption (OR= 2.6), family history of addiction (OR= 2.3), 9th grade school level (OR= 2.0), relapse before 6 months of treatment (OR= 1.1), time consuming 20 years or less (OR= 3.0) and consuming drugs other than alcohol (OR= 2.1). Conclusions: The main prognostic factors of suicidal behavior in the addicted patients studied are: the subjective need for consumption or craving, depression and cognitive impairment.

RESUMEN Introducción: La enfermedad de Still del adulto es una enfermedad reumática, inflamatoria, sistémica y crónica cuya prevalencia en la población caucásica se estima en 1 caso por cada 100 000 adultos Objetivo: Presentar un paciente adulto joven, con una fiebre de origen desconocido como forma de presentación de la enfermedad de Still del adulto. Caso clínico: Paciente de 29 años de edad con antecedente de fiebre reumática, con un ingreso hospitalario anterior; que presentó un cuadro febril no infeccioso, de 50 días de duración, al cual no se le determinó la causa. Un año después reapareció la fiebre, de similares características, asociada a poliartralgia, hepatoesplenomegalia, anemia, hiperferritinemia, neutrofilia, factor reumatoideo negativo y se constató un cuadro de pericarditis durante el ingreso. Se realizó el diagnóstico de enfermedad de Still del adulto, por exclusión. Se inició tratamiento con esteroides, desapareció la fiebre en las primeras 24 horas y el paciente tuvo una evolución favorable. Conclusiones: La enfermedad de Still del adulto puede presentarse como una fiebre de origen desconocido y se diagnostica por exclusión, ya que no existen manifestaciones clínicas ni pruebas de laboratorio, patognomónicas. La hiperferritinemia es útil para la sospecha diagnóstica.

ABSTRACT Introduction: Adult Still's disease is a rheumatic, inflammatory, systemic and chronic disease whose prevalence in the Caucasian population is estimated at 1 case per 100,000 adults. Objective: To present a young adult patient with a fever of unknown origin as the presentation of adult Still's disease. Clinical case: 29-year-old patient with a history of rheumatic fever, with a previous hospital admission; who presented a non-infectious febrile illness lasting 50 days, for which the cause was not determined. A year later, the fever reappeared, with similar characteristics, associated with polyarthralgia, hepatosplenomegaly, anemia, hyperferritinemia, neutrophilia, negative rheumatoid factor, and pericarditis was noted during admission. The diagnosis of adult Still's disease was made by exclusion. Treatment with steroids was started, the fever disappeared in the first 24 hours and the patient had a favorable evolution. Conclusions: Adult Still's disease can present as a fever of unknown origin and is diagnosed by exclusion, since there are no pathognomonic clinical manifestations or laboratory tests. Hyperferritinemia is useful for diagnostic suspicion.

Abstract Background: Malnutrition is more common in diabetic patients, and this can influence the severity of the diabetic foot due to impaired healing. Objective: To describe the characteristics of hospitalized patients due to diabetic foot, their nutritional status, their stage, and look for correlations between them. Method: Retrospective and analytical study of the Dr. Carlos Macgregor Sánchez Navarro Regional General Hospital from April to July 2023. Sample of 23 patients with diabetic foot with medical records and complete procedures. Demographic, clinical and laboratory data were collected and evaluated with the CONUT and WIFI scales. Results: Average of 61.5 years and an average duration of diabetes of 9.1 years, advanced lesions in the foot, with absent pulses, deformities and claudication. All with anemia and suboptimal glycemic control. Protein ratio suggests inflammation, metabolic stress and malnutrition. WIFI and CONUT scales: advanced injuries and malnutrition. No statistically significant association was found between nutritional status and injury severity. Conclusions: In older patients with long-term diabetes, the diabetic foot is complex. Optimal glucose control and multidisciplinary care are essential. Nutritional status should be evaluated and improved for better clinical outcomes and quality of life.

Resumen Antecedentes: La desnutrición es más común en pacientes diabéticos y esto puede influir en la severidad del pie diabético debido a la alteración en la cicatrización Objetivo: Describir las características de los pacientes hospitalizados por pie diabético, su estado nutricional, su estadio y buscar correlaciones entre ellas. Método: Estudio retrospectivo y analítico del Hospital General Regional Dr. Carlos Macgregor Sánchez Navarro de abril a julio de 2023. Muestra de 23 pacientes con pie diabético con registros médicos y de los procedimientos completos. Se recopilaron datos demográficos, clínicos y laboratoriales, se evaluaron con las escalas CONUT y WIFI. Resultados: Promedio de 61.5 años y una duración promedio de diabetes de 9.1 años, lesiones avanzadas en el pie, con pulsos ausentes, deformidades y claudicación. Todos con anemia y control glucémico subóptimo. La relación proteica sugiere inflamación, estrés metabólico y desnutrición. Escalas WIFI y CONUT: lesiones avanzadas y desnutrición. No se encontró asociación estadísticamente significativa entre el estado nutricional y la gravedad de las lesiones. Conclusiones: En pacientes mayores con diabetes de larga duración, el pie diabético es complejo. Es esencial un buen control de glucosa y atención multidisciplinaria. Se debe evaluar y mejorar el estado nutricional para mejores resultados clínicos y calidad de vida.

RESUMEN La problemática socioambiental que experimentan las zonas costeras, ha condicionado la aparición de algunas herramientas y enfoques de gestión ambiental para tratar de dar respuestas y soluciones interdisciplinares a ellas. El surgimiento del enfoque de Manejo Integrado de Zonas Costeras en la década del 70 del siglo XX y su posterior implementación por el mundo ante los desafíos del desarrollo sostenible hizo que el Estado cubano lo asumiera a partir de la década del 90. Una de tantas vías utilizadas fue la aprobación de un programa de maestría para la formación de capacidades en esta área del conocimiento. En este trabajo se fundamenta la importancia que tiene el Programa de Maestría en Manejo Integrado en Zonas Costeras que posee la Universidad de Cienfuegos “Carlos Rafael Rodríguez”. Este programa de maestría persigue la formación de profesionales cuyas investigaciones contribuyan a la comprensión de los fenómenos que ocurren en la zona costera y sus cuencas tributarias; a identificar problemas relacionados con el manejo integrado de las zonas costeras; y a recomendar soluciones, entre otros aspectos. Desde el punto de vista metodológico se realizó un análisis de los avances del programa académico a partir de sus fundamentos teóricos, metodológicos e investigativos. Se concluye que las zonas costeras constituyen un nuevo campo de investigaciones el cual requiere la formación de capacidades interdisciplinarias para el abordaje de los problemas que presentan estos importantes espacios complejos y frágiles.

ABSTRACT The socio-environmental problems experienced by coastal zones have conditioned the emergence of some environmental management tools and approaches to try to provide interdisciplinary answers and solutions to them. The emergence of the Integrated Coastal Zone Management approach in the 1970s and its subsequent implementation throughout the world in the face of the challenges of sustainable development led the Cuban government to adopt it in the 1990s. One of the many ways used was the approval of a master's degree program for capacity building in this area of knowledge. This work is based on the importance of the Master's Program in Integrated Coastal Zone Management at the University of Cienfuegos "Carlos Rafael Rodríguez". This master's program seeks to train professionals whose research contributes to the understanding of the phenomena that occur in the coastal zone and its tributary basins; to identify problems related to the integrated management of coastal zones; and to recommend solutions, among other aspects. From the methodological point of view, an analysis was made of the progress of the academic program based on its theoretical, methodological and research foundations. It is concluded that coastal zones constitute a new field of research which requires the formation of interdisciplinary capacities to address the problems presented by these important complex and fragile spaces.

RESUMEN Fundamento: la infertilidad es un problema de salud, que afecta cada vez con mayor incidencia, a ambos sexos. La endometriosis es una de las afecciones ginecológicas más frecuentes y una de las principales causas de infertilidad femenina. Objetivo: determinar los conocimientos sobre endometritis crónica que poseen las féminas del cantón de Ambato, Ecuador. Método: se realizó un estudio descriptivo de corte transversal en mujeres con endometritis crónica, pertenecientes al cantón de Ambato, durante el período de julio a diciembre de 2022. La muestra fue de 30 pacientes seleccionadas mediante muestreo no probabilístico de bola de nieve. Se realizó un análisis de contenido temático y se empleó el método de Mapas Cognitivos Difusos. Para la recolección de la información se realizó una entrevista semiestructurada. Resultados: existió un predominio de pacientes entre 26 a 30 años de edad. El 76,7 % de las pacientes refirieron no poseer conocimientos sobre el tema, el 86,7 % no había recibido educación sexual y reproductiva formal y el 70 % había sido estigmatizado. El 83,3 % de las féminas refirieron no visitar periódicamente un profesional de salud reproductiva y el 76,7 % no había accedido a información sobre la temática. El 100 % de las pacientes consideraron necesario realizar talleres, charlas y realizar intervenciones comunitarias para sensibilizar sobre el impacto de la endometritis crónica en la fertilidad femenina. Conclusiones: la endometritis crónica estuvo presente en féminas en edad reproductiva, por lo que resulta necesario desarrollar estrategias de prevención de salud para minimizar su incidencia.

ABSTRACT Foundation: infertility is a health problem that affects both sexes with increasing incidence. Endometriosis is one of the most common gynecological conditions and one of the main causes of female infertility. Objective: determine the knowledge about chronic endometritis that women in the canton of Ambato, Ecuador, have. Methods: a descriptive cross-sectional study was carried out in women with chronic endometritis, belonging to the canton of Ambato, during the period from July to December 2022. The sample was 30 patients selected through non-probabilistic snowball sampling. A thematic content analysis was carried out and the Fuzzy Cognitive Maps method was used. To collect the information, a semi-structured interview was carried out. Results: there was a predominance of patients between 26 and 30 years of age. 76,7 % of the patients reported not having knowledge on the subject, 86,7 % had not received formal sexual and reproductive education and 70 % had been stigmatized. 83,3 % of the women reported not periodically visiting a reproductive health professional and 76,7 % had not accessed information on the subject. 100 % of the patients considered it necessary to hold workshops, talks and carry out community interventions to raise awareness about the impact of chronic endometritis on female fertility. Conclusions: chronic endometritis was present in women of reproductive age, so it is necessary to develop health prevention strategies to minimize its incidence.

ABSTRACT Introduction Instruments to manage adverse effects of endocrine therapy with Aromatase inhibitors (AI) may improve adherence and persistence to treatment and Health-Related Quality of Life (HRQL). The 31-item Cervantes Scale (CS-31) is an HRQL questionnaire with particularities of the perimenopausal and postmenopausal period that could be an appropriate instrument to assess HRQL in Breast Cancer (BC) survivors. Objective This study aimed to perform additional validation of the CS-31 for BC survivors undergoing adjuvant endocrine therapy. Methods This prospective study was performed at three time points named T0, T1, and T2: initial, intermediate, and final follow-up period, respectively, totaling 24 months of follow-up. At each time point, the participants completed the CS-31, Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F), and Hospital Anxiety and Depression Scale (HADS). The internal consistency, construct validity, responsiveness analyses, and known-group validity of CS-31 were evaluated. Results This study included 89 postmenopausal women diagnosed with hormone receptor-positive early BC in adjuvant endocrine therapy with AI. The internal consistency was good (Cronbach's alpha = 0.89). Construct validity received a positive rating, with 100% of results consistent with prior hypotheses. A prospective improvement in HRQL was identified for the CS-31 Global Score and FACIT-F Total Score and for most of their domains. Furthermore, women with anxiety and depression by HADS presented worse HRQL by CS-31. Conclusion The authors identified that the CS-31 seems to be appropriate for use in oncology medical routine and may help to monitor adverse effects and HRQL of BC survivors during adjuvant endocrine therapy. AI (AI HealthRelated Health Related HRQL. . (HRQL) 31item item 31 CS31 CS (CS-31 (BC CS-3 T0 T T1 T2 initial intermediate followup follow up respectively 2 followup. up. point CS31, 31, FACITF, FACITF FACIT F , (FACIT-F) HADS. (HADS) analyses knowngroup known group evaluated 8 receptorpositive receptor Cronbachs Cronbach s 0.89. 089 0.89 0 0.89) rating 100 hypotheses domains Furthermore CS31. 31. (HRQL 3 CS3 (CS-3 CS- (FACIT-F (HADS 08 0.8 10 (CS- 0. 1 (CS

ABSTRACT: The intestinal microbiota has an important role in animal health. Therefore, prebiotics have gained interest in the scientific community for their role in manipulating populations of intestinal microorganisms. Among prebiotics, there is Smallanthus sonchifolius Poepp. Endl (yacon) root, which can be ingested in natura or in different forms, such as flours and extracts. This prebiotic has been associated with beneficial effects in different diseases, including metabolic (like type 2 diabetes) and immunological disorders. Thus, mouse models of human diseases caused by immunological factors have been used to better understand the prebiotic effects of yacon. Since prebiotics interfere with animal microbiota, it is important to take into consideration the quality level of mouse facilities. In this way, the beneficial effects of a yacon root pulp were tested in a mouse model of allergic asthma and, considering how animal facility conditions could affect those results, we performed experiments both in conventional facilities and specific pathogen-free (SPF) ones. Our results showed that better prebiotic effects were observed in a SPF facility than in a conventional one and, in some cases, evidence of yacon beneficial effects was observed exclusively in a SPF facility. For example, there were reductions of 63.6% and 58.0% in IgE and eosinophils, respectively, in immunized/yacon-treated animals compared to immunized mice only. Taken together, our results not only showed the beneficial effects of yacon root pulp in an asthma model but also demonstrated the relevance of performing experiments with prebiotics in SPF facilities. ABSTRACT health Therefore microorganisms Poepp (yacon forms extracts like diabetes disorders Thus way pathogenfree pathogen free (SPF ones cases example 636 63 6 63.6 580 58 0 58.0 eosinophils respectively immunized/yacontreated immunizedyacontreated immunized/yacon treated together 63. 5 58. yacontreated immunizedyacon

RESUMO: A microbiota intestinal desempenha um papel importante na saúde dos animais. Portanto, os prebióticos têm despertado interesse na comunidade científica pelo seu papel na manipulação das populações de microrganismos intestinais. Entre os prebióticos, encontra-se a raiz de Smallanthus sonchifolius Poepp. Endl (yacon), que pode ser ingerida in natura ou em diferentes formas, como farinhas e extratos. Esse prebiótico tem sido associado aos efeitos benéficos em diferentes doenças, incluindo distúrbios metabólicos (como diabetes tipo 2) e distúrbios imunológicos. Assim, modelos de camundongos de doenças humanas causadas por fatores imunológicos têm sido usados para melhor entender os efeitos prebióticos do yacon. Uma vez que os prebióticos interferem na microbiota animal, é importante levar em consideração o nível de qualidade das instalações dos camundongos. Dessa forma, os efeitos benéficos da polpa de raiz de yacon foram testados em um modelo de camundongo de asma alérgica e, considerando como as condições da instalação dos animais poderiam afetar esses resultados, realizamos experimentos tanto em instalações convencionais quanto em instalações livres de patógenos específicos (LPE). Nossos resultados mostraram que melhores efeitos prebióticos foram observados em uma instalação LPE do que em uma convencional e, em alguns casos, evidências dos efeitos benéficos do yacon foram observadas exclusivamente em uma instalação LPE. Por exemplo, houve reduções de 63,6% e 58,0% nos níveis de IgE e eosinófilos, respectivamente, em animais imunizados/tratados com yacon em comparação com camundongos imunizados apenas. Em resumo, nossos resultados não apenas mostraram os efeitos benéficos da polpa de raiz de yacon em um modelo de asma, mas também demonstraram a relevância de realizar experimentos com prebióticos em instalações LPE. RESUMO Portanto intestinais encontrase encontra se Poepp yacon, , (yacon) formas extratos 2 Assim animal forma . (LPE) casos exemplo 636 63 6 63,6 580 58 0 58,0 eosinófilos respectivamente imunizadostratados tratados resumo (yacon (LPE 63, 5 58,

Abstract The description of secretory structures in Malvaceae is controversial, and results in conflicting interpretations. Amid conflicting interpretations, therefore, the present study aims to describe the ontogeny diversity and histochemistry in Ceiba, emphasizing the secretory structures in leaves of C. erianthos, C. jasminodora, C. pentandra, and C. speciosa. All analyzed species present mucilaginous, crystalliferous, and phenolic idioblasts. These structures are randomly arranged in the mesophyll, epidermis, petiole cortex, and parenchymatic tissue of the midrib. However, in C. jasminodora and C. pentandra, secretory structures are only found in the midrib area. The development of mucilaginous idioblasts is asynchronous and, when mature, they coalesce forming large structures full of mucilage. Clavate-type pluricellular glandular trichomes were also detected scattered randomly on both leaf surfaces. Their ontogeny is described, and histochemical tests showed the presence of lipophilic substances. Extrafloral nectaries were observed in the middle third of the midrib, on the abaxial side of the leaflets. They originate from the protoderm and ground meristem of the midrib cortex. It is expected that these results will help consolidate knowledge of secretory structures in Malvaceae, leading, in turn, to the elucidation of phylogenetic relationships. controversial interpretations therefore Ceiba C erianthos pentandra speciosa crystalliferous mesophyll epidermis cortex However area mature mucilage Clavatetype Clavate type surfaces described substances leaflets leading turn relationships

Resumo A descrição das estruturas secretoras em Malvaceae não é consenso e resulta em interpretações conflitantes. Em meio a interpretações conflitantes, o presente estudo tem como objetivo descrever a diversidade ontogenética e histoquímica em Ceiba, enfatizando as estruturas secretoras em folhas de C. erianthos, C. jasminodora, C. pentandra e C. speciosa. Todas as espécies analisadas apresentam idioblastos mucilaginosos, cristalíferos e fenólicos. Tais estruturas estão dispostas aleatoriamente no mesofilo, epiderme, córtex do pecíolo e no tecido parenquimático da nervura central. Porém, em C. jasminodora e C. pentandra, encontram-se apenas na região da nervura central. O desenvolvimento de idioblastos mucilaginosos é assíncrono e quando maduros, coalescem formando grandes estruturas repletas de mucilagem. Tricomas glandulares pluricelulares do tipo clavado também foram detectados distribuídos aleatoriamente em ambas as superfícies foliares. Sua ontogenia é descrita e testes histoquímicos evidenciaram a presença de substâncias lipofílicas. Nectários extraflorais foram observados no terço médio da nervura central, na face abaxial dos folíolos. Estes se originam da protoderme e do meristema fundamental do córtex da nervura central. Espera-se que estes resultados ajudem a consolidar o conhecimento das estruturas secretoras em Malvaceae, levando, por sua vez, à elucidação das relações filogenéticas. conflitantes Ceiba C erianthos speciosa fenólicos mesofilo epiderme central Porém encontramse encontram maduros mucilagem foliares lipofílicas folíolos Esperase Espera levando vez filogenéticas