Abstract Two new species of Hyalella S.I. Smith, 1874 are described from state of Jalisco, Mexico. Hyalella marysolae sp. nov. can be identified by the presence of small projections or carinae on pleonites 1−2, with the first antenna being composed of 12 articles and the second antenna being composed of 15 articles. The first maxilla bearing 2−3 distal pappose setae, and the propodus in male first gnathopod is hammer-shaped. Conversely, in H. morronei sp. nov., dorsal projections or carinae are absent on pleonites 1−2, with the first antenna being composed of 10 articles and the second antenna of 14 articles. The first maxilla always bears two distal pappose setae, and the propodus in male first gnathopod is hatchet-shaped. Both species are distinguishable from other Hyalella species found in Mexico by the second antenna. In these two species, the second antenna is approximately half as long as the total body length, and the peduncle comprises 14 −15 articles; whereas, in other Mexican species, it is shorter and composed of maximum 12 articles. Here, we add two species to the four previously described in Mexico as it is necessary to increase the knowledge of the alpha taxonomy of this group of crustaceans and compensate for the biodiversity of the genus being underestimated.

RESUMEN Introducción: Las recomendaciones de las guías vigentes están basadas en evidencia de baja calidad. Se requiere su actualización periódica considerando la evidencia reciente. Objetivo: Sintetizar la mejor evidencia clínica disponible sobre eficacia y seguridad de antidepresivos y antipsicóticos de segunda generación en pacientes con anorexia nerviosa. Métodos: Revisión sistemática (CRD42020150577). Se buscaron en PubMed, SCOPUS, Ovid(Cochrane), EMBASE y LILACS los ensayos clínicos aleatorizados realizados en pacientes con anorexia nerviosa que evaluasen el uso de antipsicóticos de segunda generación o antidepresivos orales a cualquier dosis y por cualquier tiempo en el tratamiento ambulatorio y/u hospitalario tomando como resultados el peso (índice de masa corporal), las entidades psicopatológicas y la seguridad. Resultados: Se incluyeron 5 estudios, 4 catalogados como con alto riesgo de sesgo. La evidencia indica que los pacientes que reciben tratamiento con olanzapina o fluoxetina tienden a mantenerse por más tiempo dentro de los programas de tratamiento. La olanzapina mostró resultados favorables (un estudio) en cuanto al aumento de peso, pero no mostró los mismos resultados en psicopatología, donde la evidencia es contradictoria. Conclusiones: En concordancia con las revisiones anteriores, nuestro trabajo permite concluir que hay información contradictoria sobre la eficacia de los psicofármacos para la anorexia nerviosa. El trabajo futuro debe enfocarse en desarrollar ensayos clínicos de alta calidad metodológica.

ABSTRACT Introduction: The recommendations of the current guidelines are based on low quality evidence. Periodic updating is required, taking recent evidence into consideration. Objective: To synthesise the best available clinical evidence on the efficacy and safety of second-generation antidepressants and antipsychotics in patients with anorexia nervosa. Methods: Systematic review (CRD42020150577). We searched PubMed, SCOPUS, Ovid(Cochrane), EMBASE and LILACS for randomised clinical trials performed in patients with anorexia nervosa that evaluated the use of second-generation antipsychotics or oral antidepressants, at any dose and for any length of time, in outpatient and/or hospital treatment, taking weight (body mass index), psychopathological entities and safety as results. Results: Five studies were included, with four assessed as having a high risk of bias. The evidence indicates that patients receiving treatment with olanzapine or fluoxetine tend to stay in treatment programmes for longer. Olanzapine showed favourable results (one study) in terms of weight gain, but did not show the same results in psychopathology, where the evidence is contradictory. Conclusions: In accordance with previous reviews, our work allows us to conclude that there is contradictory information on the efficacy of psychotropic drugs in the treatment of anorexia nervosa. Future work should focus on developing clinical trials of high methodological quality.

Resumen Introducción: La contaminación ambiental en las áreas urbanas, se debe principalmente a las emisiones de gases de efecto invernadero emitidas por la quema del combustible del parque automotor, el cual se incrementa en situaciones de congestión vehicular, que adicionalmente como fuente de contaminación sonora, incide en la salud física y mental de los ciudadanos. Objetivo: Esta investigación pretende determinar desde la percepción de los consultores independientes de transporte urbano, las causas de la congestión vehicular y su relación con la contaminación ambiental y la salud. Materiales y métodos: La investigación tiene un corte cuantitativo de diseño no experimental, de tipo observacional y descriptivo, donde inicialmente mediante la observación se permitió la selección de las zonas con mayor congestión de la ciudad de Lima metropolitana; además de la participación de 22 consultores independientes quienes a través de una entrevista estructurada permitieron la identificación de las causas de la congestión vehicular y su relación con la contaminación ambiental y la salud. Resultados: conforme con los resultados obtenidos las principales causas del congestionamiento identificadas por los consultores son: una deficiente gestión y planificación vial, falta de educación vial por parte de conductores y peatones, paraderos informales y vehículos obsoletos. Conclusiones: persisten en la ciudad capital niveles de congestión vehicular, que inciden en altos niveles de contaminación, los cuales afectan la salud y economía del peruano. Del análisis a raíz de las encuestas de los expertos, se recomienda dirigir estrategias y políticas de solución que incluyan reformas institucionales que favorezcan mejoras de eficiencia y eficacia en la gestión del transporte urbano, faciliten la renovación del parque automotor y se implementen campañas de sensibilización para crear cultura ciudadana.

Resumo Introdução: a poluição ambiental nas zonas urbanas deve-se principalmente à emissão de gases com efeito de estufa provenientes da queima de combustível pela frota automóvel, que aumenta em situações de congestionamento de veículos, o que, além de ser uma fonte de poluição sonora, afeta a saúde física e mental dos cidadãos. Objetivo: determinar a percepção de peritos independentes em matéria de transportes urbanos sobre as causas do congestionamento dos veículos e a sua relação com a poluição ambiental e a saúde. Materiais e métodos: um estudo observacional e descritivo na cidade de Lima, através da identificação de pontos críticos de congestionamento veicular e de entrevistas estruturadas com consultores independentes, sobre as causas do trânsito, da poluição ambiental e da saúde. Resultados: os principais geradores de tráfego observados foram: construções, ruas fechadas, comércio ambulatório, paragens informais, estacionamento não autorizado e acidentes. Enquanto as causas do congestionamento, identificadas pelos consultores: má gestão e planeamento das estradas, falta de educação em segurança rodoviária para condutores e peões, paragens informais e veículos obsoletos. Conclusões: a capital ainda sofre de elevados níveis de congestionamento de tráfego, que afetam a saúde e a economia dos peruanos. A partir da análise baseada nas opiniões dos peritos, recomenda-se a orientação de estratégias e políticas para soluções que incluam reformas institucionais que favoreçam melhorias na eficiência e eficácia na gestão do transporte urbano, facilitem a renovação da frota automóvel e implementem campanhas de sensibilização para criar uma cultura cidadã.

Abstract Introduction: environmental pollution in urban areas is mainly due to greenhouse gas emissions from the burning of fuel in the vehicle fleet, which increases in situations of vehicle congestion, which, in addition to being a source of noise pollution, affects the physical and mental health of citizens. Objective: to determine the perception of independent urban transport consultant experts on the causes of vehicle congestion and its relationship with environmental pollution and health. Materials and methods: an observational and descriptive study in the city of metropolitan Lima, through the identification of critical points of vehicular congestion and through structured interviews with independent consultants, on the causes of traffic, environmental pollution and health. Results: the main traffic generators observed were constructions, closed streets, ambulatory commerce, informal stops, unauthorized parking, and accidents. While the causes of congestion, identified by the consultants, were based on poor management and road planning, lack of road safety education for drivers and pedestrians, informal stops, and obsolete vehicles. Conclusions: the capital city still suffers from high levels of traffic congestion, which affects the health and economy of Peruvians. From the analysis based on the opinions of experts, it is recommended that strategies and policies be directed towards solutions that include institutional reforms that favor improvements in efficiency and effectiveness in the management of urban transportation, facilitate the renewal of the vehicle fleet and implement awareness campaigns to create a citizen culture.

RESUMO Ser um portador ϵ4 no gene Apoϵ tem sido sugerido como um fator modificador da interação entre fatores cardiometabólicos, de risco social e o desenvolvimento de comprometimento cognitivo. Objetivo: O objetivo principal deste trabalho é avaliar a existência de tal interação em uma amostra da população idosa de Bogotá. Métodos: Um estudo transversal foi realizado com 1.263 indivíduos com mais de 50 anos. Cada participante foi diagnosticado por consenso após avaliações neuropsicológicas e neuropsiquiátricas, sob um diagnóstico de cognição normal, comprometimento cognitivo leve de acordo com os critérios de Petersen ou demência de acordo com os critérios do Manual Diagnóstico e Estatístico de Trastornos Mentais (DSM-IV). Apoϵ4 foi tipificada e uma análise do Montréal Cognitive Assessment Test (teste de MoCA) foi realizada em cada grupo portador ou não do alelo ϵ4. Resultados: Nosso estudo mostrou que 75% eram mulheres com idade mediana de 68 anos (intervalo interquartil 62 a 74 anos) e escolaridade mediana de seis anos (intervalo interquartil 4 a 12 anos). A demência estava relacionada ao baixo nível de escolaridade ≤5 anos Odds Ratio (OR)=11,20 (intervalo de confiança — IC95% 4,99–25,12), pressão alta OR=1,45 (IC95% 1,03–2,05) e idade acima de 70 anos OR=7,68 (IC95% 3,49–16,90), independentemente de ser ou não portador do alelo ϵ4. Indivíduos diabéticos com demência portadores do alelo ϵ4 mostraram tendência de exibir pontuações mais baixas no teste MoCA quando comparados com indivíduos diabéticos com demência não portadores do alelo ϵ4. Conclusões: A presença do alelo ϵ4 não modifica a relação entre o comprometimento cognitivo e os diferentes fatores de risco cardiometabólico e social, exceto em diabéticos portadores de ϵ4 com demência, que exibiram tendência a apresentar menores escores no teste MoCA quando comparados com indivíduos diabéticos com demência não portadores do alelo ϵ4.

ABSTRACT Being an ϵ4 carrier in the Apoϵ gene has been suggested as a modifying factor for the interaction between cardio-metabolic, social risk factors, and the development of cognitive impairment. Objective: The main objective of this study was to assess the existence of such interaction in a sample of Bogota’s elderly population. Methods: A cross-sectional study was conducted with 1,263 subjects older than 50 years. Each participant was diagnosed by consensus, after neuropsychological and neuropsychiatric evaluations, under a diagnosis of normal cognition, mild cognitive impairment (MCI) according to Petersen’s criteria, or dementia according to DSM-IV criteria. Apoϵ was typified and an analysis of MoCA test was performed in each group carrying or not ϵ4 allele. Results: Our study showed that 75% were women with a median age of 68 years (interquartile range 62–74 years) and a median schooling for 6 years (interquartile range 4–12 years). Dementia was related to low education level of ≤5 years OR=11.20 (95%CI 4.99–25.12), high blood pressure (HBP) OR=1.45 (95%CI 1.03–2.05), and age over 70 years OR=7.68 (95%CI 3.49–16.90), independently of being or not an ϵ4 allele carrier. Diabetic subjects with dementia carrying ϵ4 allele showed a tendency to exhibit lower scores on the MoCA test, when compared with noncarriers’ diabetic subjects with dementia. Conclusions: The presence of ϵ4 allele does not modify the relationship between cognitive impairment and the different cardio-metabolic and social risk factors, except in diabetic subjects ϵ4 carriers with dementia who showed a tendency to exhibit lower scores of the MoCA test, when compared with noncarriers’ diabetic subjects with dementia.

Resumen: Debido a la emergencia sanitaria por causa de la COVID-19 en 2020, se produjeron cambios en los distintos ámbitos sociales, y en el contexto educativo fueron muy significativos; en el caso de la Universidad Estatal a Distancia de Costa Rica (UNED) se tomaron medidas de contingencia desde lo administrativo y académico para asegurar la continuidad a los procesos educativos de las diferentes carreras y programas. En este artículo se ofrecen los hallazgos más relevantes de un estudio que tuvo como objetivo principal conocer la opinión del estudiantado de la UNED sobre esos cambios académicos implementados durante el primer cuatrimestre del año 2020 a raíz de la emergencia sanitaria suscitada por la COVID-19. Se desarrolló un estudio descriptivo basado en encuesta en línea que incluyó una muestra de 443 personas estudiantes de esta institución. En términos generales, la población participante en el estudio no presenta problemas con respecto a la tenencia de dispositivos móviles y acceso a internet. Utilizaron las redes sociales como los principales medios para informarse sobre las acciones tomadas por la Universidad. De igual manera, la inducción y apoyo recibidos por parte de las personas funcionarias institucionales para cumplir sus tareas académicas fueron valorados de manera positiva. Las acciones de contingencia implementadas para asegurar la continuidad del proceso de aprendizaje del estudiantado durante la emergencia fueron percibidas positivamente; se destacó el hecho de contar con acompañamiento desde el principio, no solo por la instancia correspondiente, sino también con soporte e información por parte de otras dependencias, lo que lleva a concluir que los cambios implementados a raíz de la situación tuvieron resultados que tendieron a ser positivos para la población estudiantil participante.

Resumo: Devido à emergência sanitária por causa da COVID-19 em 200, foram produzidas mudanças nos diferentes âmbitos sociais, sendo estas muito significativas no contexto educacional; no caso da Universidad Estatal a Distancia da Costa Rica (UNED), foram adotadas medidas de contingencia nas áreas administrativase acadêmicas para garantir a continuidade dos processos educacionais das diferentes carreiras e programas. O artigo oferece os resultados mais relevantes de um estudo cujo objetivo principal era conhecer a opinião dos estudantes da UNED sobre essas mudanças acadêmicas implementadas durante o primeiro quadrimestre do ano 2020 devido a emergência sanitária causada pela COVID-19. Foi desenvolvido um estudo descritivo baseado em uma pesquisa on-line que incluiu uma amostra de 443 estudantes desta instituição. Em termos gerais, a população que participou do estudo não apresentou problemas com respeito à propriedade de dispositivos móveis e acesso à Internet. As redes sociais foram utilizadas como meio principal para se informar sobre as ações adotadas pela Universidade. Também, a indução e apoio recebidos pelos funcionários da instituição para cumprir com suas tarefas acadêmicas foi avaliado positivamente. As ações de contingência implementadas para garantir a continuidade do processo de aprendizagem dos estudantes durante a emergência foram percebidas de forma positiva; destacou-se o fato de contar com acompanhamento desde o início não só da instancia correspondente, mas também com suporte e informações por parte de outros departamentos o que permite concluir que as mudanças implementadas em virtude da situação tiveram resultados que tenderam a ser positivos para a população estudantil participante.

Summary: Due to the health emergency caused by COVID-19 in 2020, changes occurred in the different social areas, these being very significant in the educational context. In the case of the Universidad Estatal a Distancia de Costa Rica [UNED] (State Distance University of Costa Rica), contingency measures were taken from the administrative and academic aspects to ensure the continuity of the educational processes of the different majors and programs. This article offers the most relevant findings of a study the main object of which was to know the opinion of the UNED students on those academic changes implemented during the first four months of 2020 as a result of the health emergency caused by COVID-19. A descriptive study was developed based on an online survey that included a sample of 443 students from this institution. In general terms, the population participating in the study does not present problems with regard to the possession of mobile devices and internet access. They used social networks as the main means to find out about the actions taken by the University. Similarly, the induction and support received from institutional officials to fulfill their academic tasks was valued positively. The contingency actions implemented to ensure the continuity of the student’s learning process during the emergency were positively perceived. The fact of having support from the beginning was highlighted, not only by the corresponding instance, but also with support and information from other agencies, which leads to the conclusion that the changes implemented as a result of the situation had results that tended to be positive for the participating student population.

Resumen: La enfermedad de Gaucher (GD) es el trastorno de almacenamiento lisosomal que se caracteriza por la deficiencia en la actividad enzimática de la β-glucosidasa (BGLU), lo que produce la acumulación de glucosilceramida en las células. Su diagnóstico se orienta a la valoración de la enzima en los leucocitos afectados. Se han realizado estudios en DBS para la actividad de BGLU en el seguimiento de poblaciones de alto riesgo; sin embargo, presentan interferencias relacionadas a leucopenias severas o expresión aumentada de la isoforma neutra de la enzima BGLU, molécula no relacionada con GD. El objetivo de este estudio fue la estandarización de un método de tamizaje en DBS (punch: 5 mm) con el uso de 4-metilumbeliferil-β-D-glucósido y conduritol-β-epóxido. Se analizaron muestras de DBS de 395 individuos con sospecha clínica (población de alto riesgo o AR), 151 controles y 16 pacientes afectados, usando la elución de un corte de 5 mm (≈10 μl de sangre) en 300 μl de Tritón X-100/(0,5 %). Como resultados, se obtuvieron los rangos, AR: 0,84-26,92 nmol/ml/h, controles: 3,56- 8,92 nmol/ml/h (M = 5,56, DS = 1,15) y pacientes confirmados con GD: 0,82- 2,88 nmol/ml/h (M = 1,64, DS = 0,57). El punto de corte entre deficientes y controles fue 3,22 nmol/ml/h, obtenido a partir de análisis ROC (99 % confianza, 100 % sensibilidad y 100 % especificidad). El protocolo permitió evidenciar la deficiencia en todos los casos de GD, confirmados mediante el análisis en paralelo de la enzima en aislamiento leucocitario. Se recomienda el uso del CBE y realizar la elución del corte a 5 mm, a fin de llevar a cabo la valoración enzimática con un volumen mayor aproximado de sangre y en ausencia de la actividad generada por la isoforma neutra.

Abstract: Gaucher disease (GD) is a lysosomal storage disorder characterized by a deficiency in the enzymatic activity of β-glucosidase (BGLU), resulting in the accumulation of glucosylceramide in cells. Its diagnosis is aimed at checking the enzyme in the affected leukocytes. Studies have been conducted on dried blood spots (DBS) for bglu activity to monitor high-risk populations; however, they exhibit interferences related to severe leukopenias or increased expression of the neutral bglu isoform, a molecule not related to gd. This study intends to standardize a screening method on dbs (punch: 5 mm) using 4-methylumbelliferyl-β-D-glucoside and conduritol-β-epoxide (CβE). dbs samples from 395 individuals clinically suspected of gd (high-risk or hr population), 151 controls, and 16 affected patients were analyzed using the elution of 5 mm punches (≈10 μl of blood) in 300 μl of Triton X-100/ (0.5 %). As a result, the following ranges were obtained; HR: 0.84-26.92 nmol/ml/h, controls: 3.56-8.92 nmol/ml/h (M = 5.56, SD = 1.15), and patients with confirmed GD: 0.82-2.88 nmol/ml/h (M = 1.64, SD = 0.57). The cut-off point between patients with gd and controls was 3.22 nmol/ml/h, obtained from roc analysis (99 % ci, 100 % sensitivity, and 100 % specificity). The protocol revealed a deficiency in all gd cases, confirmed by parallel bglu analysis in isolated leukocytes. The use of cbe and the elution of 5 mm punches are recommended for enzymatic evaluation with a higher approximate volume of blood and in the absence of neutral isoform activity.

Resumo: A doença de Gaucher (GD) é o trastorno de armazenamento lisosomal caracterizado pela deficiência na atividade enzimática da β-glucosidase (BGLU), o que produz a acumulação de glucossilceramida nas células. Seu diagnóstico está orientado à avaliação da enzima nos leucócitos afetados. Foram realizados estudos em dbs para a atividade de BGLU no seguimento de populações de alto risco; contudo, são apresentadas interferências relacionadas a leucopenias graves ou a expressão aumentada da isoforma neutra da enzima BGLU, molécula não relacionada com GD. O objetivo deste estudo foi a padronização de um método de tamisação emdbs (punch: 5 mm) com o uso de 4-metilumbeliferil-β-D- glicosídeo e conduritol-β-epóxido. Foram analisadas amostras de dbs de 395 indivíduos com suspeita clínica (população de alto risco ou ar), 151 controles e 16 pacientes afetados, usando a eluição de um corte de 5 mm (≈10 μl de sangue) em 300 μl de Tritão X-100/(0,5 %). Como resultados, foram obtidos os intervalos: AR: 0,84-26,92 nmol/ml/h, controles: 3,56-8,92 nmol/ml/h (M = 5,56, DS = 1,15) e pacientes confirmados com GD: 0,82- 2,88 nmol/ml/h (M = 1,64, DS = 0,57). O ponto de corte entre deficientes e controles foi 3,22 nmol/ml/h, obtido a partir de análise ROC (99 % confiança, 100 % sensibilidade e 100 % especificidade). O protocolo permitiu evidenciar a deficiência em todos os casos de GD, confirmados mediante a análise em paralelo da enzima em isolamento leucocitário. É recomendado o uso do cbe e a realização da eluição do corte a 5 mm, a fim de implementar a avaliação enzimática com um volume maior aproximado de sangue e em ausência da atividade gerada pela isoforma neutra.

Resumen Derivado de un ejercicio de reflexión, se propone en este artículo evidenciar cómo las epistemologías otras, provenientes de la experiencia de la discapacidad, pueden nutrir las metodologías participativas y la investigación en diseño. Con énfasis en la perspectiva del conocimiento situado y del diseño encarnado, atravesado por las diferentes formas de investigar en diseño, se busca presentar una mirada en el que estas nuevas apuestas epistemológicas puedan ser posibles y, al mismo tiempo, funcionar como herramientas de transformación en el marco del diseño inclusivo. Se concluye que este acercamiento epistémico a otras formas de ser y estar en el mundo puede tanto igualar los principios de participación de los sujetos en la práctica del diseño, como impactar las relaciones entre el diseñador y el usuario para tornarlas más equitativas y paritarias, así como una forma de visibilizar y valorar nuevas formas de ser y estar en el mundo.

Resumo O resultado de um exercício de reflexão, se propõe mostrar como as epistemologias outras derivadas da experiência da deficiência, podem conseguir nutrir as metodologias participativas e a pesquisa em design. Focado em uma perspectiva do conhecimento situado e do design encarnado, atravessada pelas diferentes formas de pesquisar o design, por se quer mostrar uma perspectiva na qual essas novas apostas epistemológicas podem ser possíveis e, ao mesmo tempo, podem funcionar como ferramenta da transformação dentro da estrutura do que conhecemos como design inclusivo. Finalmente, a conclusão diz que a aproximação epistêmica das outras formas no mundo do design, pode tanto chegar a igualar os princípios de participação dos sujeitos na prática, como impactar as relações entre designer - usuário. Para que estes possam se tornar mais equitativos e paritários, bem como uma maneira de tornar visíveis e valorizar novas formas de ser e estar no mundo.

Abstract As a result of an exercise of reflection, this article proposes to show how the other epistemologies stemming from the disability experience, can nourish the participative methodologies and the design research. With emphasis on the situated knowledge perspective and embodied design, and crossing by the different ways of design research, the aim is to present a view in which these new epistemological proposais can be possible and attend like transformation tools within the framework of what we know as inclusive design. Finally, it is concluded that this epistemic approach to other ways of being in the world into design, can both equate the principles of participation of subjects in the practice and impact the relationships between designer-user, so, these could become more equitable and parity and also as a way of make visible and value new ways of being in the world.

Résumé Dérivé d'un exercice de réflexion, cet article propose de montrer comment des autres épistémologies venant de l'expérience du handicap peuvent contribuer aux méthodologies participatives et à la recherche en design. Axé sur une perspective basée sur la connaissance localisée et un design incarné, traversé par différentes méthodes de recherche en design, il cherche à montrer une perspective dans laquelle ces nouveaux paris épistémologiques peuvent être possibles et en même temps servir d'outil de transformation dans le cadre du design inclusif. Finalement, il est conclu que cette approche épistémique d'autres manières d'être et de sentir dans le monde depuis le design peut atteindre à la fois les principes de participation des sujets à la pratique du design et avoir un impact sur les relations entre designer et l'utilisateur afin qu'ils deviennent plus équitables et égaux, ainsi qu'un moyen de visualiser et d'apprécier de nouvelles façons d'être et d'être dans le monde.

Resumen En el escenario clínico es cada vez más frecuente la atención de pacientes adultos mayores, lo cual es un desafío debido a la presencia de mayor comorbilidad y de condiciones o síndromes geriátricos (fragilidad, sarcopenia, caídas) que usualmente los acompañan. La fragilidad es un síndrome común en el paciente anciano, en quien existe una disminución de la reserva fisiológica que genera vulnerabilidad frente a factores estresantes. Su prevalencia aumenta a la par con la expectativa de vida, y tiene un impacto significativo en la salud pública ya que estudios han demostrado que se asocia con mayores tasas de hospitalización, desenlaces adversos quirúrgicos, mortalidad y costos para los sistemas de salud. Se hace revisión actualizada de la relación existente entre la fragilidad y enfermedad cardiovascular. El conocimiento sobre fragilidad sirve como guía para tomar decisiones y como objeto de investigación de un segmento de una población con gran crecimiento.

Abstract The care of elderly patients is becoming increasingly more common in the clinical setting. This presents a challenge due to there being increased comorbidity and the presence of geriatric conditions or syndromes (frailty, sarcopenia, falls) that usually accompany them. Frailty is a common syndrome in the elderly patient, in which there is a decrease in physiological reserve that can lead to vulnerability to stress factors. Its prevalence increases on a par with life expectancy, and has a significant impact on public health since studies have demonstrated that it is associated with higher hospital admission rates, adverse surgical outcomes, mortality, and costs for the health systems. An update review has been made on the existing relationship between frailty and cardiovascular disease. Knowledge about frailty will serve as a guide to make decisions and as an objective in the investigation of an increasingly growing segment of the population.

Resumen El objetivo de este estudio fue evaluar la colonización de macroinvertebrados y el porcentaje de pérdida de masa seca de hojas de Eucalyptus sp. y Tibouchina lepidota en una quebrada afectada por la actividad minera ubicada en la parte alta de la cuenca del río Chinchiná (Manizales, Colombia). Se seleccionaron dos áreas de muestreo: una reconocida como de referencia al no mostrar evidencia de impactos antropogénicos, y otra con influencia de actividades mineras auríferas. Se utilizaron 192 bolsas con 5 g de hojas senescentes de las especies seleccionadas y de una mezcla (1:1), y se extrajeron cuatro réplicas por punto de muestreo en tiempos predeterminados (+3, 7, 15, 30, 45, 60, 75 y 90 días). Se recolectaron 18.070 individuos distribuidos en ocho órdenes, 24 familias y 34 géneros. En la zona de referencia se obtuvo, comparativamente, una mayor riqueza, densidad y diversidad de macroinvertebrados. Se aspira a que los resultados de este trabajo contribuyen al conocimiento de la dinámica de la colonización de macroinvertebrados acuáticos y su papel en la descomposición de hojas de especies exóticas y nativas en microcuencas altoandinas de Colombia.

Abstract The objective of this study was to evaluate the colonization of macroinvertebrates and the dry mass loss percentage of Eucalyptus sp. and Tibouchina lepidota leaves in a headwater stream with mining impact located in the upper part of the Chinchiná River basin (Manizales, Colombia). Two sampling areas were selected: One recognized as a reference zone with no evidence of anthropogenic impacts and another with the influence of gold mining activities. We used 192 bags containing 5 g of senescent leaves of the selected species and a mixture (1:1) and we extracted four replicates per sampling point at predetermined times (+3, 7, 15, 30, 45, 60, 75, and 90 days). We collected 18,070 individuals belonging to 8 orders, 24 families, and 34 genera. In the reference area, we registered a greater richness, density, and diversity of macroinvertebrates. The results of this study will contribute to the knowledge of the dynamics of the colonization of aquatic macroinvertebrates and their role in the decomposition of leaves of exotic and native species in Colombian high Andean micro-catchments.

Abstract: Social memory and political culture are studied to understand the appropriation of public space and the right to the city. This right goes beyond the distribution of public goods and services and includes the acknowledgment of difference, participation, and the possibility of producing space through the act of inhabiting. A qualitative methodological approach is taken, to study two public spaces in Cuenca, Ecuador. The analysis shows that centrality, identity and belonging, elements linked to memory, stimulate social interaction. Meanwhile, a political culture characterized by marked hierarchies, paternalism, and weak empowerment affects social organization; such culture contributes to tame conflict, avoiding the configuration of a collective actor, and reinforcing institutional dependencies.

Resumen: Se examinan la memoria social y la cultura política como elementos para comprender la apropiación del espacio público y el derecho a la ciudad. Este derecho va más allá de la redistribución de bienes y servicios públicos e incluye el reconocimiento de la diferencia, la participación, y la posibilidad de producir el espacio por medio del acto de habitar. Mediante una metodología cualitativa se indagaron dos espacios públicos en Cuenca, Ecuador. El análisis muestra que centralidad, identidad y pertenencia, elementos vinculados a la memoria, dinamizan las interacciones sociales. Mientras, una cultura política con bajo empoderamiento, relaciones jerárquicas y paternalismo afecta las relaciones sociales y la organización social; esta cultura contribuiría a domesticar el conflicto al limitar la configuración de un actor colectivo y reforzar las dependencias institucionales.

ABSTRACT This research was focused on the analysis and chemical risks assessment caused by volatile organic compounds in high traffic painting activities on Ambato Municipality. The objective was to assess chemical risks by isomers of dimethyl benzene and its impact on health of the painters to decrease the workers exposure to the mentioned risk. This research consider the use of the theory of chemical risks assessment based on the maximum acceptable exposure limits in the workplace according to the American Conference of Governmental Industrial Hygienists and using the concept National Institute for Occupational Safety and Health to determine the exposure dose. The following methods were used: questionnaire, observation and bibliographic documentary research. It was obtained that is additive, the value was obtained 1.75, is over the acceptable limit for humans that is 1, which causes serious diseases and the rate of morbidity is high.

RESUMEN Se analizan los riesgos químicos producidos por los compuestos orgánicos volátiles en las actividades de pintura de alto tráfico del Municipio de Ambato, ubicado en Ecuador. El objetivo fue evaluar los riesgos químicos por isómeros de dimetil benceno y su incidencia en la salud de los pintores para disminuir la exposición de los trabajadores ante el riesgo mencionado. Se contempló el uso de la teoría de evaluación del riesgo químico en base a los límites máximos permisibles de exposición en lugares de trabajo de la Conferencia Americana de Higienistas Industriales Gubernamentales y utilizando el concepto del Instituto Nacional de Seguridad y Salud Ocupacional para determinar la dosis de exposición. Se emplearon los siguientes métodos: cuestionario, observación e investigación bibliográfica documental. Se obtuvo que la dosis es aditiva, se obtuvo 1,75 valor por encima al límite permisible para el ser humano que es 1, lo cual conlleva a que se generen enfermedades graves y el índice de morbilidad sea alto.

This paper features a summary of the Peruvian Social Security (EsSalud) Clinical Practice Guidelines (CPG) for prevention and management of preterm birth. A specialized group was formed for writing this CPG, which included clinical and methodology specialists, who formulated 11 clinical questions. Systematic searches in PubMed and CPG repositories were performed aiming to answer the questions, and relevant evidence was selected. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In regular work meetings, the specialized group used the GRADE approach for reviewing the evidence and for developing recommendations. At the end, this CPG formulated twenty recommendations (13 strong and 7 conditional), 24 good clinical practice points, one recommendation for implementation, and a flowchart.

El presente artículo resume la guía de práctica clínica (GPC) para la prevención y manejo del parto pretérmino en el Seguro Social del Perú (EsSalud). Para el desarrollo de esta GPC, se conformó un grupo elaborador de la guía (GEG) que incluyó especialistas clínicos y metodólogos, el cual formuló 11 preguntas clínicas. Para responder cada pregunta se realizó búsquedas sistemáticas en Pubmed y en repositorios de GPC, y se seleccionó la evidencia pertinente. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones periódicas, el GEG usó la metodología GRADE para revisar la evidencia y emitir las recomendaciones. Se emitieron 20 recomendaciones (13 fuertes y 7 condicionales), 24 puntos de buena práctica clínica, una recomendación de implementación y un flujograma.

Abstract Amelogenesis imperfecta (AI) is a group of enamel development disorders that alter the structure and chemical composition of the tissue. There is great variability in the clinical presentation; according to Witkop, AI can be categorized into 14 subtypes, which makes its diagnosis extremely complex. Objective: This study aimed to describe and determine the frequency of clinical and radiographic features and inheritance patterns found in 41 Chilean families diagnosed with diverse types of AI. Material and Methods: We analyzed the clinical records, photographs, pedigrees and radiographs of 121 individuals recruited between 2003 and 2016. All of the information was included in a database that was analyzed using the application Stata 14. Results: The 72 affected individuals had average age of 16 years, and no sex association with the presence of AI was found. The most frequent clinical subtypes were as follows: 43% hypomature, 25% hypoplastic, 21% hypomature/hypoplastic, 7% hypocalcified and 4% hypocalcified/hypoplastic. The number of severely affected teeth was 22, which occurred in the patients with hypocalcified and hypocalcified/hypoplasic AI who presented the highest number of damaged teeth. Caries and periodontal disease were found in 47 and 32% of the patients, respectively. Malocclusions were observed in 43% of the individuals with AI, with open bite being the most frequent. Radiographically, the thickness of the enamel decreased in 51% of the patients, and 80% showed decreased radiopacity of the enamel compared to that of dentin. Autosomal dominant inheritance pattern was found in 37% of the families with hypoplastic AI, and autosomal recessive pattern was present in 56% of the other clinical subtypes, but more frequently in those affected with hypomature and hypocalcified AI. Conclusion: Of the five clinical subtypes, autosomal recessive hypomature, autosomal dominant hypoplastic and autosomal recessive hypomature/hypoplastic AI were the most prevalent subtypes in this group.

Abstract Introduction Infertility is a disease characterized by the inability to achieve a pregnancy after 12 months or more of unprotected sex. In Mexico, assisted reproduction is on par with any country, being the third nation in Latin America with the largest number of reproduction centers. Objective To determine the demographic characteristics of mothers and children undergoing assisted reproduction techniques (ART) at the Hospital Español de México in 2016. Material and methods This is a descriptive, retrospective study that included newborns product of ART performed in the Hospital Español de México in 2016. Information was obtained on the method of delivery, number of products, weeks of gestation at birth, birth weight and height, and if they required admission to the NICU, as well as the complications presented. Results 292 patients undergoing ART were included. Of the associated maternal complications, the most prevalent were infections during pregnancy. Data were obtained from 373 newborns. The complications in these patients are described, the most frequent being respiratory. Conclusions ART are increasingly used treatments. Care must be taken when informing prospective parents about associated complications, taking into account the variability of the available data.

Resumen Introducción La infertilidad es una enfermedad caracterizada por la incapacidad de lograr un embarazo después de 12 meses o más de relaciones sexuales no protegidas. En México, la reproducción asistida se encuentra a la par de cualquier país, siendo la tercera nación de Latinoamérica con mayor número de centros de reproducción. Objetivo Determinar las características demográficas de las madres e hijos sometidos a técnicas de reproducción asistida (TRA) en el Hospital Español de México en 2016. Material y métodos Se trata de un estudio descriptivo, retrospectivo que incluyó a los recién nacidos producto de TRA del Hospital Español de México en 2016. Se obtuvo información sobre el método de interrupción del embarazo, el número de productos, las semanas de gestación al nacimiento, peso y talla al nacimiento y si requirieron ingreso a la UCIN, así como las complicaciones presentadas. Resultados Se incluyeron 292 pacientes sometidas a TRA. De las complicaciones maternas asociadas, las más prevalentes fueron las infecciones durante el embarazo. Se obtuvieron datos de 373 recién nacidos. Se describen las complicaciones en estos pacientes; las más frecuentes fueron las respiratorias. Conclusiones Las TRA son tratamientos cada vez más utilizados. Hay que ser cuidadosos a la hora de informar a los futuros padres acerca de las complicaciones asociadas, teniendo en cuenta la variabilidad de datos disponibles.