ABSTRACT Objective: This study aimed to evaluate occlusion development after premature loss or extraction of deciduous anterior teeth, by means of a prospective cohort study. Methods: Fifteen infants and children aged 1 to 5 years old were longitudinally assessed (with loss or extraction of deciduous anterior teeth [n = 9], and without tooth losses [n = 6]). Photographs and dental casts at the baseline and after 24 months of follow-up were performed. Dental casts were scanned, and linear measurements were made on the digitalized models (missing tooth space, arch perimeter, arch length, arch width, intercanine length and intercanine width). The t-test was used for groups comparisons (α = 0.05). Results: Individuals’ mean age at baseline was 2.93 (± 1.18) years. No statistically significant differences were observed in the missing tooth space in the group with tooth loss during the 24 months of follow-up (p > 0.05). Arch perimeter, arch length, arch width, intercanine length and intercanine width did not show differences between the groups (p > 0.05). Qualitative photographic evaluation revealed other changes in the dental arches and occlusion, such as exfoliation and eruption of deciduous teeth, eruption of permanent teeth, self-correction or establishment of malocclusion, among others. Conclusion: The results suggest that the premature loss of deciduous anterior teeth does not affect the perimeter, length and width of the dental arches; however, other alterations that lead to malocclusion could be established. Objective Methods n 9, 9 , 9] 6. 6 . 6]) 2 followup follow up performed scanned perimeter width. width) ttest t test α 0.05. 005 0.05 0 05 0.05) Results Individuals 293 93 2.9 ± ( 1.18 118 18 p selfcorrection self correction others Conclusion however established 6] 00 0.0 29 2. 1.1 11 0. 1.

RESUMO Objetivo: Este estudo teve como objetivo avaliar o desenvolvimento da oclusão após perda prematura ou extração de dentes decíduos anteriores, por meio de um estudo de coorte prospectivo. Métodos: Quinze bebês e crianças de 1 a 5 anos foram avaliados longitudinalmente (com perda ou extração de dentes anteriores decíduos [n = 9] e sem perdas dentárias [n = 6]). Foram realizadas fotografias e modelos dentais no início e após 24 meses de acompanhamento. Os modelos dentários foram escaneados e medidas lineares foram feitas nos modelos digitalizados (espaço dentário perdido, perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos). O teste t foi utilizado para comparações entre grupos (α = 0,05). Resultados: A média de idade dos indivíduos no início do estudo foi de 2,93 (± 1,18) anos. Não foram observadas diferenças estatisticamente significativas no espaço dentário perdido no grupo com perda dentária durante os 24 meses de acompanhamento (p > 0,05). O perímetro da arcada, comprimento da arcada, largura da arcada, comprimento intercaninos e largura intercaninos não apresentaram diferenças entre os grupos (p> 0,05). A avaliação fotográfica qualitativa revelou alterações nas arcadas dentárias e na oclusão, como: esfoliação e erupção de dentes decíduos, erupção de dentes permanentes, autocorreção ou estabelecimento de má oclusão, entre outras. Conclusão: Os resultados sugerem que a perda prematura de dentes anteriores decíduos não afeta o perímetro, comprimento e largura das arcadas dentárias; entretanto, outras alterações que levam à má oclusão poderiam ser estabelecidas. Objetivo prospectivo Métodos n 9 6. 6 . 6]) 2 arcada intercaninos. intercaninos) α 0,05. 005 0,05 0 05 0,05) Resultados 293 93 2,9 ± ( 1,18 118 18 p p> permanentes Conclusão entretanto estabelecidas 6] 00 0,0 29 2, 1,1 11 0, 1,

Abstract Objective Endometrial cancer (EC) is a heterogeneous disease with recurrence rates ranging from 15 to 20%. The discrimination of cases with a worse prognosis aims, in part, to reduce the length of surgical staging in cases with a better prognosis. This study aimed to evaluate the association between Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression and prognostic and morphological factors in EC. Methods This retrospective, cross-sectional, analytical study included 79 EC patients - 70 endometrioid carcinoma (EEC) and 9 serous carcinoma (SC) - and 74 benign endometrium controls. IMP3 expression was evaluated by immunohistochemistry-based TMA (Tissue Microarray), and the results were associated with morphological and prognostic factors, including claudins 3 and 4, estrogen and progesterone receptors, TP53, and KI67. Results IMP3 expression was significantly higher in SC compared to EEC in both extent (p<0.001) and intensity (p=0.044). It was also significantly associated with worse prognostic factors, including degree of differentiation (p=0.024, p<0.001), staging (p<0.001; p<0.001) and metastasis (p=0.002; p<0.001). IMP3 expression was also significant in extent (p=0.002) in endometrial tumors compared with controls. In addition, protein TP53 and KI67 showed significant associations in extent and intensity, respectively. Conclusion IMP3 expression was associated with worse prognostic factors studied. These findings suggest that IMP3 may be a potential biomarker for EC poorer prognosis. (EC 1 20 20% aims part Insulinlike Insulin like mRNAbinding mRNA binding IMP (IMP3 retrospective crosssectional, crosssectional cross sectional, sectional cross-sectional 7 (EEC (SC controls immunohistochemistrybased immunohistochemistry based Tissue Microarray, Microarray , Microarray) 4 receptors TP KI p<0.001 p0001 p 0 001 (p<0.001 p=0.044. p0044 p=0.044 . 044 (p=0.044) p=0.024, p0024 024 (p=0.024 p<0.001, p=0.002 p0002 002 (p=0.002 p<0.001. addition TP5 KI6 respectively studied 2 (IMP p<0.00 p000 00 (p<0.00 p004 p=0.04 04 (p=0.044 p=0.024 p002 02 (p=0.02 p=0.00 (p=0.00 p<0.0 p00 (p<0.0 p=0.0 (p=0.04 p=0.02 (p=0.0 p<0. p0 (p<0. p=0. (p=0. p<0 (p<0 p=0 (p=0 p< (p< p= (p= (p

ABSTRACT Background: Multisystem inflammatory syndrome comprises a febrile, hyperinflammatory state, and life-threatening organ failure associated with SARS-CoV-2 infection or after immunization against COVID-19. The increasing number of cases of this syndrome makes it necessary to understand and generate timely and effective therapeutic approaches. Objective: The objective of the article is to describe the clinical and laboratory data of a 20-year-old woman diagnosed with multisystem inflammatory syndrome after immunization with the Ad26.COV2.S vaccine. Case presentation: A 20-year-old female patient presented with bilateral low back pain, myalgia, arthralgia, fever, and an evanescent salmon-colored rash on acupressure on the elbows, forearms, and ipsilateral hands. These symptoms began one month after the administration of the first dose of the vaccine. Janssen (Ad26.CoV2.S). Laboratory tests show elevated levels of leukocytes and acute phase reactants, broad-spectrum antibiotic management is started without clinical improvement. Urine and/or blood cultures are negative for bacterial growth, therefore antibiotic therapy is suspended. Diseases of autoimmune or hematolymphoid origin associated with the clinical picture were ruled out. Due to persistent clinical deterioration, high doses of corticosteroids are administered with clinical improvement and modulation of inflammatory markers. Conclusions: Myalgia, arthralgia, fever, and rash are symptoms present in post-vaccination multisystem inflammatory syndrome. Immunomodulatory treatment with intravenous corticosteroids, by ruling out an active infectious process, improves the clinical course of the disease.

RESUMEN Introducción: El síndrome inflamatorio multisistémico comprende un estado febril, hiperinflamatorio y falla orgánica potencialmente mortal asociado a la infección por SARS-CoV-2 o después de la inmunización contra la COVID-19. El creciente número de casos de este síndrome hace necesario comprender y generar enfoques terapéuticos oportunos y efectivos. Objetivo: El objetivo del artículo es describir los datos clínicos y de laboratorio de una mujer de 20 años con diagnóstico de síndrome inflamatorio multisistémico después de la inmunización con la vacuna Ad26.COV2.S. Presentación del caso: Paciente femenina de 20 años de edad que presenta dolor lumbar bilateral, mialgias, artralgias, fiebre y rash color salmón evanescente a la digitopresión en codos, antebrazos y manos ipsilateral, estos síntomas inician un mes posterior a la administración de la primera dosis de la vacuna Janssen (Ad26.CoV2.S). Los exámenes de laboratorio presentan niveles elevados de leucocitos y reactantes de fase aguda, se inicia manejo antibiótico de amplio espectro sin mejoría clínica. Urocultivos y/o hemocultivos son negativos para el crecimiento bacteriano por lo cual se suspende la antibioticoterapia. Se descartan enfermedades de origen autoinmune o hematolinfoide asociadas al cuadro clínico. Debido a un deterioro clínico persistente se administran dosis elevadas de corticosteroides con mejoría clínica y modulación de los marcadores de inflamación. Conclusiones: Las mialgias, artralgias, fiebre y rash son síntomas presentes en el síndrome inflamatorio multisistémico posterior a la vacunación. El tratamiento inmunomodulador con corticosteroides intravenosos, al descartar un proceso infeccioso activo, mejora el curso clínico de la enfermedad.

Resumen Introducción: La Atención Farmacéutica consiste en un proceso asistencial sistemático para detectar, resolver y prevenir Problemas Relacionados con Medicamentos. El objetivo del presente trabajo es describir el número y perfil de problemas detectados y resueltos en un conjunto de pacientes adultos atendidos en una Unidad de Optimización de la Farmacoterapia en Argentina, durante un seguimiento farmacoterapéutico promedio de un año. Método: Se realizó un estudio cuasi-experimental, abierto y prospectivo en 40 pacientes ambulatorios. Se registraron las características clínicas y medicamentos, así como su adherencia o no al servicio. Se empleó la clasificación de Problemas Relacionados con Medicamentos de Minnesota, registrando su dimensión, categoría, causa, patología o condición clínica asociada, medicamento asociado, estado de riesgo, estado final y método de resolución. Resultados: Los grupos farmacoterapéuticos mayormente utilizados fueron beta-bloqueantes, estatinas, vitaminas y minerales, analgésicos, inhibidores de la bomba de protones y benzodiacepinas. Los problemas de indicación, especialmente por necesidad de farmacoterapia adicional, prevalecieron como los más frecuentes, incluyendo la falta de farmacoterapia preventiva con vacunas. Se logró resolver el 73,6% de los problemas detectados, de los cuales el 60,3% se hizo a través de informes a los médicos tratantes. El resto se pudo abordar mediante la educación al paciente, especialmente los de adherencia. Conclusiones: La Atención Farmacéutica permitió una descripción sistemática del perfil de problemas farmacológicos detectados y resueltos en un conjunto de pacientes adultos mayores ambulatorios, principalmente de sexo femenino, en el contexto de una Unidad de Optimización de la Farmacoterapia montada en un hospital universitario de Argentina.

Abstract Introduction: Pharmaceutical Care is a systematic process to detect, solve, and prevent Drug Related Problems. The aim of this study is to describe the number and profile of problems detected and solved in a group of adult patients interviewed in a Pharmacotherapy Optimization Unit in Argentina, during an average pharmacotherapeutic follow-up of one year. Method: A quasi-experimental, open-label, prospective study was carried out in 40 outpatients. The Clinical characteristics and medications were revealed, as well as their adherence to the service. The Minnesota classification of Drug Therapy Problems was used, recording dimension, category, cause, associated clinical condition, associated medication, risk status, final status, and resolution method. Results: The most widely used pharmacotherapeutic groups were beta-blockers, statins, vitamins and minerals, analgesics, proton pump inhibitors, and benzodiazepines. Indication problems, especially due to the need for additional pharmacotherapy, prevailed as the most frequent, including the lack of preventive vaccines. It was possible to solve 73.6% of the detected problems, of which 60.3% was done through reports to the treating physicians. The rest could be addressed through patient education, especially those related to adherence. Conclusions: Pharmaceutical Care allowed a systematic pharmacotherapy work-up of Drug Related Problems detected and solved in a group of elderly outpatients, mainly female, in the context of a Pharmacotherapy Optimization Unit set up in a university hospital in Argentina.

Abstract Harsh and extreme environments, such as Antarctica, offer unique opportunities to explore new microbial taxa and biomolecules. Given the limited knowledge on microbial diversity, this study aimed to compile, analyze and compare a subset of the biobank of Antarctic fungi maintained at the UNESP’s Central of Microbial Resources (CRM-UNESP). A total of 711 isolates (240 yeasts and 471 filamentous fungi) from marine and terrestrial samples collected at King George Island (South Shetland Islands, Antarctica) were used with the primary objective of investigating their presence in both marine and terrestrial environments. Among the yeasts, 13 genera were found, predominantly belonging to the phylum Basidiomycota. Among the filamentous fungi, 34 genera were represented, predominantly from the phylum Ascomycota. The most abundant genera in the marine samples were Metschnikowia, Mrakia, and Pseudogymnoascus, while in the terrestrial samples, they were Pseudogymnoascus, Leucosporidium, and Mortierella. Most of the genera and species of the CRM-UNESP biobank of Antarctic fungi are being reported as an important target for biotechnological applications. This study showed the relevance of the CRM-UNESP biobank, highlighting the importance of applying standard methods for the preservation of the biological material and associated data (BMaD), as recommended in national and international standards. environments Antarctica biomolecules diversity compile UNESPs UNESP s CRMUNESP. CRMUNESP CRM . (CRM-UNESP) 71 240 (24 47 South Islands 1 found Basidiomycota 3 represented Ascomycota Metschnikowia Mrakia Pseudogymnoascus Leucosporidium Mortierella applications BMaD, BMaD , (BMaD) standards (CRM-UNESP 7 24 (2 4 (BMaD 2 (

Resumen En las últimas décadas se ha observado un incremento en los efectos erosivos en las costas, lo cual pone en riesgo las infraestructuras y el paisaje del entorno. El departamento del Atlántico (Colombia) no es ajeno a esta repercusión. Se llevó a cabo un estudio de los distintos factores que influyen en las tasas de erosión y de acreción en la zona costera con base en las características hidrodinámicas y de transporte potencial longitudinal de sedimentos (TPLS). Los datos del TPLS se consiguieron mediante dos ecuaciones propuestas por CERC y Kamphuis, cuyos parámetros a escala interanual, intraestacional y anual, están influenciados por el oleaje. Los cambios multitemporales de las líneas de costa del departamento del Atlántico se evaluaron con la herramienta del DSAS (Digital Shoreline Analysis System). Los resultados del Linear Regression Rate (LRR) y End Point Rate (EPR), suministrados por el DSAS, evidencian que los municipios de Barranquilla, Puerto Colombia y Tubará tienen porcentajes de erosión del 40% al 50%, por lo que se concluye que gran parte de la costa del Atlántico se encuentra en procesos erosivos. Finalmente, la ecuación de Kamphuis identifica una similitud con los resultados de la erosión y de acreción en las 8 playas del área de estudio, por lo cual las variables más significativas son la pendiente, la granulometría y la altura de ola.

Abstract In recent decades, there has been an increase in the erosive effects on the coasts, which puts at risk the infrastructures and the surrounding landscape. The department of Atlántico (Colombia) is not immune to this repercussion. A study of the different factors that influence erosion and accretion rates in the coastal zone was carried out based on the hydrodynamic characteristics and the Longitudinal Potential Transport of Sediments (TPLS). The TPLS data were obtained using two equations proposed by CERC and Kamphuis, whose parameters at interannual, intraseasonal and annual scales are influenced by waves. The multi-temporal changes in the coastlines of the department of Atlántico were evaluated with the DSAS (Digital Shoreline Analysis System) tool. The results of the Linear Regression Rate (LRR) and End Point Rate supplied by DSAS show that the Barranquilla, Puerto Colombia, and Tubara areas have erosion percentages of 40% to 50%; therefore, it can be concluded that a large part of the Atlantic coast is in erosion processes. Finally, the equation of Kamphuis identifies a similarity with the results of erosion and accretion in the eight beaches of the study area, for which the most significant variables are: slope, granulometry and wave height.

RESUMO: Ainda não há consenso sobre qual é o protocolo mais apropriado para a produção in vivo de embriões em ovinos, apesar do crescente conhecimento. Uma abordagem para mitigar a variabilidade de resposta de ovelhas à superovulação (SOV) é iniciar a aplicação de gonadotrofinas em uma condição ovariana favorável. O presente estudo comparou três tratamentos em delineamento do tipo crossover: protocolo de SOV tradicional (TRAD) e “Dia 0” D0 SOV sem (D0-GnRH) ou com GnRH (D0+GnRH). Quinze ovelhas Santa Inês foram superovuladas com 200 mg de FSH em seis doses decrescentes e receberam PGF2α na quinta dose de FSH. As ovelhas foram submetidas a monta natural com carneiros férteis e os embriões colhidos por via cirúrgica. O número de embriões viáveis não diferiu entre os tratamentos (TRAD = 6,0 ± 4,7; D0-GnRH = 3,8 ± 6,4; D0+GnRH = 7,5 ± 6,5). Independentemente do tratamento, ovelhas com folículos ≤ 4 mm na primeira dose de FSH produziram mais embriões viáveis (9,6 ± 6,0; P < 0.05) quando comparadas aos animais que apresentavam folículos > 4 mm no início da SOV (2,9 ± 3,1 embriões viáveis). Os grupos TRAD e D0+GnRH apresentaram menor número de animais com folículos grandes (> 4 mm), no momento da primeira dose de FSH, quando comparados ao grupo D0-GnRH (P < 0,05). Em conclusão, os protocolos TRAD e D0+GnRH induziram uma condição ovariana mais favorável (folículos ≤ 4 mm) para a SOV. No entanto, os três tratamentos apresentaram eficiência semelhante em ovelhas Santa Inês.

ABSTRACT: There is still no consensus regarding the best protocol for in vivo embryo production in sheep despite increasing studies in this area. Moreover, there is variability in the response of ewes to superovulation (SOV). An approach to mitigate this inconsistency is to initiate gonadotropin administration under favorable ovarian conditions. The present study compared three treatments in a crossover design: a traditional SOV protocol (TRAD) and “Day 0” D0 SOV protocol with (D0+GnRH), or without Lecilerin (D0-GnRH). Fifteen Santa Inês ewes received 200 mg of FSH at six decreasing doses and PGF2α with the fifth dose of FSH. They were naturally mated with fertile rams and subjected to surgical embryo collection. The number of viable embryos was similar among the different treatments (TRAD = 6.0 ± 4.7; D0-GnRH = 3.8 ± 6.4; D0+GnRH = 7.5 ± 6.5). Regardless of the treatment method, ewes with follicles ≤ 4 mm, at the first FSH dose, produced more viable embryos (9.6 ± 6.0, P < 0.05) compared to ewes that had follicles > 4 mm at the beginning of the SOV (2.9 ± 3.1, viable embryos). Both the TRAD and D0+GnRH groups had fewer animals with large follicles (> 4 mm) at the first FSH dose than the D0-GnRH group (P < 0.05). In conclusion, both the TRAD and D0+GnRH treatments induced a more favorable ovarian condition (follicles ≤ 4 mm) for adequate SOV; although, all three treatments exhibited similar efficacies in Santa Inês sheep.

Abstract Early Warning Systems (EWS) are non-structural measures for landslides disaster prevention. They are based on the detection of impending failure signals. The results of a landslide simulation experiment where accelerometers were used to identify pre-failure signals are presented in this paper. Landslide was simulated in a tilting flume filled with sandy soil. During the experiment, the flume was fixed at 30° inclination and water percolated through the soil until it slid. Accelerometers were embedded into the soil and recorded acceleration data from the beginning of the experiment until failure. Acceleration data were analyzed in time domain aiming at estimating translational velocity of the movement. Angular variation was also estimated from acceleration data. The experiment was recorded with a camera and pictures were used for Particle Image Velocimetry (PIV) analysis, in order to validate the estimated translational velocity. Results showed that accelerometers can identify pre-failure signals before any macroscopic movement could indicate impending failure in fast to very fast landslides, showing their potential to be used in EWS. Validation of estimated velocities was not always possible due to PIV setup constraints and the velocity of the mass movement simulated. In fact, the estimated translational velocities seem to be unreliable. On the other hand, the results suggest that acceleration data and angular position variation trend and rate can be incorporated into EWS.

Abstract With the emergence of new variants of SARS-CoV-2, questions about transmissibility, vaccine efficacy, and impact on mortality are important to support decision-making in public health measures. Modifications related to transmissibility combined with the fact that much of the population has already been partially exposed to infection and/or vaccination, have stimulated recommendations to reduce the isolation period for COVID-19. However, these new guidelines have raised questions about their effectiveness in reducing contamination and minimizing impact in work environments. Therefore, a collaborative task force was developed to review the subject in a non-systematic manner, answering questions about SARS-CoV-2 variants, COVID-19 vaccines, isolation/quarantine periods, testing to end the isolation period, and the use of masks as mitigation procedures. Overall, COVID-19 vaccines are effective in preventing severe illness and death but are less effective in preventing infection in the case of the Omicron variant. Any strategy that is adopted to reduce the isolation period should take into consideration the epidemiological situation of the geographical region, individual clinical characteristics, and mask for source control. The use of tests for isolation withdrawal should be evaluated with caution, due to results depending on various conditions and may not be reliable.

ABSTRACT The transformation of doctoral training in an economic and social interest of nations, along with other factors, has determined that changes are implemented in all its aspects. The comparative method allows the determination of trends in doctoral training in Europe and America. The study assumes Europe and America as spaces for comparison. The objective of the article is to analyze the main transformations that occur in the field of doctoral training in Europe and America. 10 units of analysis were selected, namely: Institutional structure, Duration of doctoral training, Tutoring, Abandonment, Mobility, Types of doctorates, Students, Financing, Employability and Quality assurance. The main findings are related to the different forms of institutionalization, as well as to new types of doctorates. Dropout emerged as the most stable trend in the comparison, for which strategies are implemented to enhance the reduction of its triggers. The duration of the program, financing, mobility and mentoring are the causes of exodus analyzed. Employability and quality assurance emerged as necessary indicators when integrating the remaining units of analysis.

RESUMEN La transformación de la formación doctoral en un interés económico y social de las naciones, junto a otros factores, ha determinado que se implementen cambios en todos sus aspectos. El método comparado permite la determinación, de tendencias en la formación doctoral en Europa y América. El estudio asume Europa y América como espacios de comparación. El objetivo del artículo es analizar las principales transformaciones que se producen en materia de formación doctoral en Europa y América. Se seleccionaron 10 unidades de análisis a saber: Estructura institucional, Duración de la formación doctoral, Tutoría, Abandono, Movilidad, Tipos de doctorado, Estudiantes, Financiamiento, Empleabilidad y Aseguramiento de la calidad. Los principales hallazgos se relacionan con las diferentes formas institucionalización, así como de nuevas tipologías de doctorados. El abandono emergió como la tendencia más estable en la comparación, para lo cual se implementan estrategias para potenciar la disminución de sus factores desencadenantes. La duración del programa, el financiamiento, la movilidad y la tutoría son las causas de éxodo analizadas. La empleabilidad y el aseguramiento de la calidad surgieron en indicadores necesarios a la hora de integrar las restantes unidades de análisis.

ABSTRACT The outbreak of the infection by the new coronavirus SARSCoV-2, COVID-19, in December in Wuhan Province of China, has become a pandemic and health emergency given the deficiency of antiviral therapy for the acute respiratory syndrome that generates danger to life. The debut of the epidemic was in China, then the epicenter developed in Europe, northern Italy that suffered a severe blow. Worldwide, more than 10 million people are infected with the virus that has impacted on health systems until it practically collapsed, resulting in thousands of deaths. Today the epicenter of the pandemic has shifted to the Americas. Alarming figures highlight the United States of North America with some 2,737,600 infected and more than 128,471 deaths, followed by the South American giant Brazil with 1.3 million infections and 57,659 deaths. The Caribbean has a better setting. In Cuba, by the end of June, 2,340 cases of patients infected with deaths from COVID-19 were reported. We conducted a review, analysis and evaluation study of more than 150 articles from international journals, update bulletins of the WEB sites, health pages of the MINSAP of Cuba, and summaries selected for their methodological quality, and reviews, on the subject COVID-19 and autoimmune-rheumatic diseases by MEDLINE: database prepared by the National Library of Medicine of The USA contains bibliographic references and abstracts from more than 4,000 biomedical journals published in the United States and in 70 other countries, We also use Latin American and Caribbean Center for Information on Health Sciences: System, in Latin America and the Caribbean, since 1982. Our objective and results achieved have been to develop the theoretical-practical bases in an updated scientific document that allow access in an essential and summarized way to current knowledge about the infection by SACOV-2, COVID-19, and its repercussion and impact on patients suffering from rheumatic autoimmune diseases, and thus outline a coping and action strategy with recommendations for the Cuban rheumatologists in their health care work, and for patients as a guideline, given their well-founded concerns and fears given their underlying condition and the immunosuppressive drugs prescribed in an unfavorable context of a pandemic. The information is based on international experiences with the most published scientific evidence and those treasured national experiences in the face of similar situations of epidemics, faced by the vast health system and achievements of Cuban science.

RESUMEN Al igual que en las enfermedades autoinmunes y reumáticas, las infecciones por virus pueden ser disparadores de mecanismos inmunopatogénicos. El SARSCoV-2 puede causar la liberación de citocinas y provocar un daño tisular grave, sobre todo pulmonar, con peligro para la vida. Se suma a ello el riesgo del uso de medicamentos inmunosupresores, empleados en los protocolos de tratamiento de las afecciones autoinmunes y también contra la infección viral de COVID-19. Hoy no contamos con conocimientos y evidencias científicas suficientemente sólidas para el enfrentamiento a la COVID-19, y cómo puede impactar entre los pacientes inmunodeprimidos por afecciones reumáticas. El Grupo Nacional de Atención y Enfrentamiento a la COVID-19 de la Sociedad Cubana de Reumatología se propuso elaborar un documento científico actualizado con las bases teórico-prácticas que permita acceder al conocimiento acerca de la infección por SARSCoV-2 y la COVID-19, y su repercusión sobre los pacientes con enfermedades autoinmunes y reumáticas para esbozar una estrategia de trabajo y ofrecer recomendaciones para los reumatólogos y pacientes cubanos. Se realizó un estudio de revisión y actualización acerca de la asociación entre las enfermedades reumáticas y autoinmunes y la COVID-19. Se emplearon las palabras clave enfermedades reumáticas, lupus eritematoso sistémico, artritis reumatoide, virus SARSCoV-2 y COVID-19. Se realizó una amplia búsqueda en MEDLINE y LILACS, y se revisaron más de 150 artículos, boletines de actualización de los sitios Web, páginas de salud de Cuba, resúmenes seleccionados por su calidad metodológica, revisiones y metaanálisis sobre el tema. A partir de la información recogida, se estableció una discusión y análisis considerando las principales experiencias internacionales, criterios de expertos, experiencias previas con otros virus en el Sistema de Salud de Cuba, con la participación de su red de científicos liderados por la Sociedad Cubana de Reumatología y su Grupo Nacional y el apoyo de la comunidad de reumatólogos.

Aim: To determine the associated factors with mortality of adult patients hospitalized with COVID-19. Methods: We conducted a prospective cohort study and included patients older than 18 years hospitalized with the diagnosis of SARS-CoV-2 infection. Those patients with a positive rapid serological test on admission, but no respiratory symptoms nor compatible images were excluded. We collected the data from clinical records. Results: A total of 813 adults were included, 544 (66.9%) with confirmed COVID-19. The mean age was 61.2 years (SD: 15.0) and 575 (70.5%) were male. The most frequent comorbidities were hypertension (34.1%) and obesity (25.9%). The most frequent symptoms on admission were dyspnea (82.2%) and cough (53.9%). A total of 114 (14.0%) patients who received mechanical ventilation, 38 (4.7%) were admitted to the Intensive Care Unit (ICU) and 377 (46.4%) died. The requirement for ventilatory support, greater lung involvement, comorbidities, and inflammatory markers were associated with mortality. It was found that for every 10 - year increase in age, the risk of dying increased by 32% (RR: 1.32 95% CI: 1.25 to 1.38). Those who required admission to the ICU and mechanical ventilation had 1.39 (95% CI: 1.13 to 1.69) and 1.97 (95% CI: 1.69 to 2.29) times the risk of dying compared to those who did not. Conclusion:  We found a high mortality rate in hospitalized patients associated with greater age, more elevated inflammatory markers, and more severe respiratory compromise.

Objetivos. Determinar los factores asociados a mortalidad de los pacientes adultos hospitalizados con COVID-19 en un hospital de referencia de la seguridad social. Materiales y métodos. Se realizó un estudio de cohorte prospectivo. Se incluyó a pacientes mayores de 18 años hospitalizados con el diagnostico de infección por SARS-CoV-2 y se excluyó a quienes ingresaron asintomáticos respiratorios, con prueba rápida serológica positiva al ingreso y sin imágenes compatibles. Los datos se recolectaron a partir de la historia clínica. Resultados. Se incluyó un total de 813 adultos, 544 (66.9%) tuvieron COVID-19 confirmado. La media de la edad fue de 61.2 años (DE: 15.0) y 575 (70.5%) fueron de sexo masculino. Las comorbilidades más frecuentes fueron hipertensión arterial (34.1%) y obesidad (25.9%). Los síntomas más frecuentes al ingreso fueron disnea (82.2%) y tos (53.9%). Un total de 114 (14.0%) pacientes recibieron ventilación mecánica, 38 (4.7%) ingresaron a UCI y 377 (46.4%) fallecieron. El requerimiento de soporte ventilatorio, el mayor compromiso pulmonar, las comorbilidades y los marcadores inflamatorios se asociaron a la mortalidad. Se halló que por cada 10 años que aumenta la edad, el riesgo de morir se incrementa en 32% (RR: 1.32 IC95%: 1.25 a 1.38). Aquellos que requirieron ingreso a UCI y ventilación mecánica tuvieron 1.39 (IC95%: 1.13 a 1.69) y 1.97 (IC95%: 1.69 a 2.29) veces el riesgo de morir, respectivamente. Conclusión. La mortalidad encontrada en nuestro estudio fue alta y estuvo asociada a la edad,  marcadores inflamatorios y compromiso respiratorio. 

Resumen El proceso de leudado de los productos horneados es fundamental para desarrollar sus propiedades de calidad. El objetivo de este estudio fue evaluar el efecto de diferentes tipos de polvos para hornear en las propiedades de calidad de muffins. Se evaluaron las propiedades físico-químicas tanto del batido como del producto final. Además de su influencia en las propiedades farinológicas de la harina y las propiedades texturales y sensoriales del producto en el almacenamiento. Se encontró la formulación PH16 como la más adecuada, siendo la de mayor altura (47.66 ± 0.35 mm), menor contenido de humedad (24.31 ± 0.18 %), menor dureza (12.34 ± 0.34 N) y firmeza de miga más baja (1.84 ± 0.01). El comportamiento de la muestra PH16 en almacenamiento y a nivel sensorial no tuvo diferencias significativas con la muestra control seleccionada.

Abstract The leavening process of baked goods is essential to develop their quality properties. The aim of this study was to evaluate the effect of different types of baking powder on quality properties of muffins. The physicochemical properties of both the batter and the final product were evaluated, in addition to its influence on the farinological properties of flour and the textural and sensory properties of the product in storage. The PH16 formulation was found to be the most suitable; being the highest (47.66 ± 0.35 mm), with lower moisture content (24.31 ± 0.18%), lower hardness (12.34 ± 0.34 N), and lower crumb firmness (1.84 ± 0.01). The behavior of the PH16 sample in storage and at sensory level showed no significant differences with the chosen control sample.

Abstract Congenital toxoplasmosis in twin pregnancies is infrequent. We present the case of a monozygotic and monocorial twin pregnancy with maternal toxoplasmosis infection diagnosed at 33 weeks gestation by detecting reactive IgM and IgG and low avidity test for IgG. The detection of the parasite in amniotic fluid could not be performed because the amniocentesis was not done. The term newborns presented cerebral calcifications and bilateral active chorioretinitis without other associated clinical manifestations. They had IgG and IgM reactive for toxoplasmosis. The detection of Toxoplasma gondii was not performed by placental PCR or cord blood. They received treatment during the first year of life with pyrimethamine, sulfadiazine and folinic acid. They had no adverse events associated with the therapy. The diagnostic assessment and treatment does not differ from pregnancies with a single fetus. One or both newborns may be compromised. Multidisciplinary monitoring is essential for the early detection of reactivations or progression of lesions.

Resumen La toxoplasmosis congénita en embarazos gemelares es infrecuente. Presentamos el caso de un embarazo gemelar monocigótico, monocorial con una infección materna por toxoplasmosis diagnosticada a las 33 semanas de gestación mediante detección de IgM e IgG reactivas y test de baja avidez de IgG. No pudo realizarse la detección del parásito en líquido amniótico debido a que no se hizo amniocentesis. Las recién nacidas (RN) de término presentaron calcificaciones cerebrales y coriorretinitis activa bilateral, sin otras manifestaciones clínicas asociadas. Tuvieron IgG e IgM reactiva para toxoplasmosis. No se realizó RPC para Toxoplasma gondii en placenta ni en sangre de cordón. Recibieron tratamiento durante el primer año de vida con pirimetamina, sulfadiazina y ácido folínico, sin eventos adversos asociados a la terapia. La metodología diagnóstica y el tratamiento no difieren de los embarazos con feto único. Uno o ambos RN pueden estar comprometidos. Es fundamental el seguimiento multidisciplinario para la detección precoz de reactivaciones o progresión de las lesiones.