Resumen El estado de Morelos ocupa el segundo lugar en superficie sembrada (9 687 ha) con maíces eloteros a nivel nacional. El maíz Costeño es utilizado en el estado para la producción de elote, este maíz, es un complejo interracial de las razas Tabloncillo, Vandeño, Tuxpeño y Tepecintle, y aún presenta algunas características negativas en el fenotipo de planta. Ante esta situación, se planteó el objetivo de someter a mejoramiento genético al maíz Costeño para disminuir aspectos indeseables en el fenotipo de la planta. A partir del año 2004, se realizaron un ciclo de selección masal y cuatro de selección recurrente de familias de medios hermanos maternos; posteriormente, cinco ciclos de selección individual, se logró reducir los problemas agronómicos intrínsecos del maíz Costeño, esto permitió realizar su descripción varietal en los años 2013 a 2015 y en el 2019 obtener el registro número 3876-MAZ-2081-130319/C y la denominación V 240 EL en el Catálogo Nacional de Variedades Vegetales, así mismo, el título de obtentor número 2314. La V 240 EL, presenta porte de planta intermedio-alto (251-300 cm), ciclo biológico precoz-intermedio (120 días), floración masculina de 56-60 días y dos días después la femenina, color de grano blanco con textura dentada, rendimiento de elote y grano de 15.1 y 6 t ha-1, respectivamente. La variedad V 240 EL tiene adaptación a las condiciones ambientales de la zona baja (trópico seco) e intermedias (subtrópico subhúmedo) del estado de Morelos y regiones similares de los estados vecinos Guerrero, Puebla y Estado de México.

Abstract The state of Morelos ranks second in area sown (9 687 ha) with corn for green corn cob nationwide. Costeño corn is used in the state for the production of green corn cob, this corn is an interracial complex of the Tabloncillo, Vandeño, Tuxpeño and Tepecintle races, and still has some negative characteristics in the phenotype of the plant. Faced with this situation, the objective of subjecting Costeño corn to genetic improvement was set to reduce undesirable aspects in the phenotype of the plant. From 2004, a cycle of mass selection and four cycles of recurrent selection of families of maternal half-siblings were carried out; subsequently, five cycles of individual selection, it was possible to reduce the intrinsic agronomic problems of Costeño corn, this allowed making its varietal description in the years from 2013 to 2015 and obtaining, in 2019, the registration number 3876-MAZ-2081-130319/C and the denomination V 240 EL in the National Catalogue of Plant Varieties, likewise, the breeder’s title number 2314. V 240 EL has intermediate-tall size (251-300 cm), early-intermediate biological cycle (120 days), male flowering of 56-60 days and the female flowering two days later, white grain with toothed texture, yields of green corn cob and grain of 15.1 and 6 t ha-1, respectively. The V 240 EL variety adapts to the environmental conditions of the low (dry tropics) and intermediate (subhumid subtropics) zones of the state of Morelos and similar regions of the neighboring states of Guerrero, Puebla and State of Mexico.

ABSTRACT Introduction: Urolithiasis causes pain, renal functional deterioration and notorious economic expenses. Objectives: To identify the clinical-epidemiological characteristics of nephrolithiasis. Methods: A descriptive, cross-sectional study was conducted in a total of 2,923 people from to three clinics of Plaza de la Revolution Teaching Community Clinic, Plaza de la Revolution municipality, Havana province, Cuba. They were selected by simple random sampling from the 16 clinics that the health area has. The data was obtained through a survey and structured interview. The information was processed automatically (IBMSPSS 22.0). Frequency distribution analysis was used, prevalence rates were calculated and the homogeneity test was used. Results: The prevalence of urolithiasis was 4.99 per 100 inhabitants, 6.3 among men and 5.7 among white-skinned men. The average age at diagnosis was 39.3 years. Among the risk factors for lithiasis, the high intake of oxalates prevailed (97.3%). Ultrasound was the most used form of diagnosis (67.8%). Phytotherapy was the most used medical treatment (69.2%). A medical permit was issued to 16.4% of the patients in the last two years. Conclusions: The prevalence of urinary lithiasis in Plaza de la Revolution Teaching Community Clinic is high, prevailing in males, in white-skinned and middle aged subjects. High oxalate intake is the most common risk factor for urinary lithiasis found. The most used form of diagnosis is ultrasound and the most used treatment is phytotherapy.

RESUMEN Introducción: Las urolitiasis ocasionan dolor, deterioro funcional renal y notorias erogaciones económicas. Objetivos: Identificar las características clínico-epidemiológicas de la nefrolitiasis. Métodos: Estudio descriptivo, transversal. Se estudiaron 2 923 personas pertenecientes a tres consultorios del Policlínico Plaza; municipio Plaza de la Revolución, provincia La Habana, Cuba., seleccionados por muestreo simple aleatorio de los 16 con que cuenta el área de salud. Los datos se obtuvieron mediante encuesta y entrevista estructurada. La información fue procesada de forma automatizada (IBMSPSS 22.0). Se utilizó análisis de distribución de frecuencias, se calcularon tasas de prevalencia, y fue empleado el test de homogeneidad. Resultados: La prevalencia de urolitiasis fue de 4,99 por cada 100 habitantes, de 6,3 entre los varones y de 5,7 en los de piel blanca. La edad promedio al diagnóstico fue de 39,3 años. Entre los factores de riesgo de litiasis predominó la alta ingestión de oxalatos (97,3 %). La ecografía fue la forma de diagnóstico más usada (67,8 %). La fitoterapia fue el tratamiento médico más utilizado (69,2 %). Al 16,4 % de los pacientes se les expidió certificado médico en los últimos dos años. Conclusiones: La prevalencia de litiasis urinaria en el Policlínico Docente “Plaza de la Revolución” es elevada, con predominio en el sexo masculino, en sujetos de piel blanca y en las edades medias de la vida. La alta ingestión de oxalato es el factor de riesgo de litiasis urinaria más frecuente encontrado. La forma de diagnóstico más utilizada es la ecografía y el tratamiento más empleado es la fitoterapia.

ABSTRACT Introduction: Chronic kidney disease mainly affecting male farmers and not associated to traditional causes has been present in Central America for twenty years. The condition is characterized by the presence of chronic interstitial nephritis, but its ultrastructural features are not fully known. Factors suggested as responsible for its occurrence include the use of agrochemicals and other nephrotoxic agents, chronic dehydration and medicine consumption. Objective: Describe the ultrastructural characteristics of chronic interstitial nephritis in farming communities. Method: A cross-sectional descriptive study was conducted of renal biopsy samples from eight patients diagnosed with chronic interstitial nephritis in farming communities. Results: Of the eight patients studied, two (25%) were farm workers and five (62.5%) were female. Two of the patients (25%) had stage 2 and six (75%) stage 3 chronic kidney disease. In five patients evidence was found of phagolysosomes with lipid component mixed with electrodense material in distal tubule cells. An equal number of patients had myeloid bodies with laminated areas and central nucleus in proximal tubule and blood vessel cells. Conclusions: Evidence of phagolysosomes and myeloid structures of unknown content and origin was found in renal tubules and vessels of patients from farming communities diagnosed with chronic interstitial nephritis.

RESUMEN Introducción: Desde hace 20 años se presenta en Centroamérica una enfermedad renal crónica que fundamentalmente afecta a hombres agricultores y no asociada a las causas tradicionales. Se caracteriza por presentar una nefritis intersticial crónica, en tanto las características ultraestructurales no se conocen con exactitud. En su origen se invoca el uso de agroquímicos y otros agentes nefrotóxicos, la deshidratación crónica, el consumo de medicamentos, entre otros factores. Objetivo: Describir las características ultraestructurales de la nefritis intersticial crónica en comunidades agrícolas. Método: Se realizó un estudio descriptivo de corte transversal. Se estudiaron muestras de biopsias renales de ocho pacientes con diagnóstico de nefritis intersticial crónica de las comunidades agrícolas. Resultados: De los ocho pacientes estudiados, dos (25 %) trabajaban en labores agrícolas y cinco eran del sexo femenino (62,5 %). Dos de los pacientes (25 %) presentaban una enfermedad renal crónica estadio 2, y seis (75 %) estadio 3. En cinco pacientes se hallaron fagolisosomas con presencia de componente lipídico entremezclado con material electrodenso en células del túbulo distal. En igual cantidad de pacientes se observaron cuerpos mieloides con zonas laminadas y núcleo central en células de túbulo proximal y de los vasos sanguíneos. Conclusiones: En pacientes de comunidades agrícolas que padecen nefritis intersticial crónica se evidencian fagolisosomas y estructuras mieloides en túbulos y vasos renales, cuyo contenido y origen se desconocen.

Abstract The pandemic of coronavirus infectious disease-2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a threat to global health. This has become an obstacle for the practice of hematology, mostly in low-middle income countries. For those hematologist and oncologists who perform hematopoietic stem cell transplantation HSCT the usual challenges of this kind of medical procedures have increased because of the COVID-19 pandemic. The importance of find the best route for performing HSCT avoiding excessive COVID-19 risk is of great importance. By doing so, we have been able to conduct 170 hematopoieic stem cell transplants during the COVID-19 pandemia.

Resumen La pandemia de COVID-19 ha causado daños graves a la práctica de la medicina y se ha convertido en un obstáculo para la práctica de algunas especialidades. Los trasplantes de células hematopoyéticas han sufrido las consecuencias de la pandemia y muchos centros de trasplante hematopoyético en todo el mundo suspendieron sus labores. Gracias a la implementación de medidas de escrutinio y aislamiento de los pacientes sometidos a trasplante hematopoyético, hemos podido trasplantar a 170 pacientes en la época del COVID-19.

ABSTRACT This paper aims to present the relationship and benefits that can exist between cooperativism, social responsibility and solid waste management, as a necessary alliance for the better functioning of cooperatives and environmental care. The concept of social responsibility is not utopian, but necessary in a modern and inclusive society. It is used by large global food companies to have an image of respect for the community and concern for the environment, often materialized in charitable foundations. However, these same companies are responsible for the management of many of the solid wastes that are dumped in the streets and communities on a daily basis, so social commitment is questionable.

RESUMEN Este trabajo tiene como objetivo presentar la relación y los beneficios que pueden existir entre cooperativismo, responsabilidad social y manejo de residuos sólidos, como una alianza necesaria para el mejor funcionamiento de las cooperativas y el cuidado del medioambiente. El concepto de responsabilidad social no es utópico, sino necesario en una sociedad moderna e inclusiva. Es usado por las grandes empresas globales de alimentación para tener una imagen respetuosa con la comunidad y de preocupación por el medioambiente, muchas veces materializada en fundaciones benéficas. No obstante, estas mismas empresas son responsables del manejo de muchos de los residuos sólidos que diariamente se vierten en calles y comunidades, por lo que el compromiso social es cuestionable.

ABSTRACT Introduction: An epidemic of chronic kidney disease (CKD) of devastating consequences has been taking place in El Salvador over the last few decades. In a significant portion of affected subjects, no other common cause of chronic kidney disease is present, such as diabetes and hypertension. This illness is usually called Chronic Kidney Disease from Non-Traditional Causes (CKDnT). Previous studies have shown a high prevalence of exposure to agrochemicals in affected populations, particularly in rural areas. In addition to sustained exposure to agrochemicals, the other leading hypothesis to explain this epidemic is prolonged exposure to high temperatures and dehydration in a context of exhausting agricultural work. Objectives: To assess the possible causal effect of exposure to agrochemicals in the emergence of the CKD epidemic in the adult population of El Salvador. Methods: We conducted a case-control analysis based on the 2015 survey of Chronic Diseases in Adults in El Salvador, a national probabilistic sample that covered 4,817 adults ≥20 years old. Those suffering from CKD were considered cases; the rest were managed as controls. Self-reported agrochemical exposures, other risk factors and health conditions were recorded. For binary exposures, the odds ratio (OR) of CKD and CKDnT was estimated. For variables measuring length of exposure, the average values for cases and for controls were compared. In all cases, the corresponding 95% confidence intervals were calculated. Multivariate logistic regression was used to examine the association between exposure to agrochemicals and CKD while controlling for potential confounding variables. Results: Regardless of how past exposure to agrochemicals was characterized (e.g., contact with paraquat or aerial fumigation) the OR of both CKD and CKDnT was always greater than 1.0 (range, 1.36 to 3.75). Similarly, the average number of years of exposure was consistently higher for cases than for controls for all continuous variables examined (greater than 2 years in most cases). Conclusions: The results of this study are consistent with previous epidemiologic and toxicological evidence and support the hypothesis that exposure to agrochemicals may be causally implicated in the ongoing CKD epidemics in El Salvador.

RESUMEN Introducción: Durante las últimas décadas, una epidemia de enfermedad renal crónica (ERC) de consecuencias devastadoras ha tenido lugar en El Salvador. Una parte importante de los sujetos afectados, no padece de una causa frecuente para padecer enfermedad renal crónica, tal como como diabetes e hipertensión. En tal caso, suele distinguirse la dolencia mediante el nombre de Enfermedad Renal Crónica de Causas no Tradicionales (ERCnT). Estudios previos muestran una alta prevalencia de exposición a agroquímicos en las poblaciones afectadas, particularmente en las zonas rurales. Además de la exposición sostenida a agroquímicos, la otra hipótesis principal para explicar esta epidemia es la exposición prolongada a altas temperaturas y deshidratación, en un contexto de trabajo agrícola agotador. Objetivos: Evaluar el posible efecto causal de la exposición a agroquímicos en la irrupción de la epidemia de ERC en la población adulta de El Salvador. Métodos: Se realizó un estudio de casos y controles, a partir de la Encuesta de Enfermedades Crónicas no Transmisibles en Adultos en El Salvador, basada en una muestra probabilística nacional que abarcó 4,817 adultos de 20 o más años de edad, concluida en 2015. Fueron considerados “casos” todos aquellos que padecían ERC; el resto dos restantes participantes se manejaron como controles. Se registraron las exposiciones a agroquímicos, así como a otros factores de riesgo y condiciones de salud según testimonio de los participantes. Para las exposiciones binarias, se estimó la razón de odds (OR) con respecto a padecer ERC y ERCnT. Para las variables que medían la duración de la exposición, se compararon los valores medios para casos y controles. En todos los casos, se calcularon los respectivos intervalos de confianza al 95%. Se utilizó la regresión logística multivariada para examinar la asociación entre la exposición a agroquímicos y la ERC, controlando las posibles variables confusoras. Resultados: Independientemente de cómo fuera caracterizada la exposición pasada a agroquímicos (por ejemplo, contacto con paraquat o fumigación aérea), el OR de ERC y ERCnT siempre fue mayor que 1.0 (rango, 1.36 a 3.75). Del mismo modo, la media de años de exposición fue consistentemente más alta para los casos que para los controles, para todas las variables continuas examinadas (más de 2 años en la mayoría de los casos). Conclusiones: Los resultados de este estudio son consistentes con la evidencia epidemiológica y toxicológica previa y respaldan la hipótesis de que la exposición a agroquímicos puede estar causalmente implicada en la epidemia de ERC que se registra en El Salvador.

In El Salvador, chronic kidney disease had reached epidemic proportions towards the end of this century’s first decade. In 2011–2012, the Ministry of Health reported it was the leading cause of hospital deaths in men, the fifth in women, and the third overall in adult hospital fatalities. Farming was the most common occupation among men in dialysis (50.7%). By 2017, chronic kidney disease admissions had overwhelmed hospital capacity. In 2009, El Salvador’s Ministry of Health, Cuba’s Ministry of Public Health and PAHO launched a cooperative effort to comprehensively tackle the epidemic. The joint investigations revealed a total prevalence of chronic kidney disease in the adult population of farming communities higher than that reported internationally (18% vs.11%–14.8%), higher in men than in women (23.9% vs 13.9%) and higher in men who were farmers/farmworkers than in men who were not (31.3% vs. 14.8%). The disease was also detected in children. An association was found between chronic kidney disease and exposure to agrochemicals (OR 1.4–2.5). In 51.9% of all chronic kidney disease cases, traditional causes (diabetes, hypertension, glomerulopathies, obstructive nephropathies and cystic diseases) were ruled out and the existence of a particular form of chronic kidney disease of nontraditional etiology was confirmed (whose initial cases were reported as early as 2002). In the patients studied, functional alterations and histopathologic diagnosis confirmed a chronic tubulointerstitial nephritis; most presented with neurosensory hearing loss, altered tendon reflexes and tibial artery damage. The main results of this cooperation were the epidemiologic, physiopathologic, clinical and histopathologic characterization of chronic kidney disease of nontraditional etiology. This characterization facilitated case definition for the epidemic and led to the hypothesis of systemic toxicity from agrochemicals (e.g., paraquat, glyphosate), which particularly affect the kidneys and to which farmers/farmworkers (who may also become dehydrated in the fields) are most exposed. The research thus also laid the foundations for design of comprehensive intersectoral government actions to reduce cases and put an end to the epidemic. Chronic kidney disease; chronic renal failure; tubulointerstitial nephritis; epidemiology; histopathology; international cooperation; agrochemicals; environmental pollutants, noxae, and pesticides; occupational health; PAHO; El Salvador; Cuba

RESUMEN Objetivo El dengue es una enfermedad viral generalmente autolimitada, que en México se considera un problema de salud pública. Puede acompañarse de alteraciones de laboratorio como neutropenia, linfopenia y trombocitopenia. El objetivo del estudio fue evaluar la incidencia de alteraciones hematológicas en pacientes con dengue. Métodos Se incluyeron retrospectivamente 64 pacientes, 14 embarazadas, con diagnóstico de dengue en los Hospitales Universitario de Monterrey y Civil Nuevo de Guadalajara, de enero de 2014 a diciembre de 2017. Resultados El dato clínico más común en el grupo general fue cefalea y dolor retroocular en 53 pacientes (83%), seguido de la fiebre, que se presentó en 12 pacientes embarazadas (86%). La mediana de cuenta plaquetaria en el grupo general fue de 51.4x103/pl, además, se encontró trombocitopenia en el 88% de los pacientes, mientras que en las pacientes embarazadas fue de 141.1 x103/pl, con trombocitopenia en 57% de ellas (p=0.002). La recuperación plaquetaria ocurrió en 7 días en el grupo general y 4.5 días en las pacientes embarazadas. Conclusiones Contrario a lo reportado en la literatura, las pacientes embarazadas presentaron una menor incidencia de trombocitopenia y una mayor cuenta plaquetaria, al momento del diagnóstico sin impacto en mortalidad materna ni en el curso del embarazo.

ABSTRACT Objective Dengue is a generally self-limited viral disease, considered a public health problem in Mexico. It can be accompanied by laboratory alterations such as neutropenia, lymphopenia and thrombocytopenia. The objective of the study was to evaluate the incidence of hematological alterations in patients with dengue. Methods We retrospectively included 64 patients, including 14 pregnant women, with a diagnosis of dengue at the Hospital Universitario de Monterrey and Civil Nuevo de Guadalajara from January 2014 to December 2017. Results The most common clinical symptom in the general group was headache and retro-ocular pain in 53 patients (83%), while in pregnant patients it was fever in 12 patients (86%). The median platelet count in the general group was 51.4x103/ μ!, with thrombocytopenia in 88% of patients, while in pregnant patients it was 141.1 x103/ with thrombocytopenia in 57% of patients (p=0.002). Platelet recovery was achieved in 7 days in the general group and 4.5 days in pregnant patients. Conclusions Contrary to that reported in the literature, pregnant patients had a lower incidence of thrombocytopenia and a higher platelet count at time of diagnosis without impact on maternal mortality or in the course of pregnancy.

RESUMEN Objetivo El dengue es una enfermedad viral generalmente autolimitada, que en México se considera un problema de salud pública. Puede acompañarse de alteraciones de laboratorio como neutropenia, linfopenia y trombocitopenia. El objetivo del estudio fue evaluar la incidencia de alteraciones hematológicas en pacientes con dengue. Métodos Se incluyeron retrospectivamente 64 pacientes, 14 embarazadas, con diagnóstico de dengue en los Hospitales Universitario de Monterrey y Civil Nuevo de Guadalajara, de enero de 2014 a diciembre de 2017. Resultados El dato clínico más común en el grupo general fue cefalea y dolor retroocular en 53 pacientes (83%), seguido de la fiebre, que se presentó en 12 pacientes embarazadas (86%). La mediana de cuenta plaquetaria en el grupo general fue de 51.4x103/pl, además, se encontró trombocitopenia en el 88% de los pacientes, mientras que en las pacientes embarazadas fue de 141.1 x103/pl, con trombocitopenia en 57% de ellas (p=0.002). La recuperación plaquetaria ocurrió en 7 días en el grupo general y 4.5 días en las pacientes embarazadas. Conclusiones Contrario a lo reportado en la literatura, las pacientes embarazadas presentaron una menor incidencia de trombocitopenia y una mayor cuenta plaquetaria, al momento del diagnóstico sin impacto en mortalidad materna ni en el curso del embarazo.

ABSTRACT Objective Dengue is a generally self-limited viral disease, considered a public health problem in Mexico. It can be accompanied by laboratory alterations such as neutropenia, lymphopenia and thrombocytopenia. The objective of the study was to evaluate the incidence of hematological alterations in patients with dengue. Methods We retrospectively included 64 patients, including 14 pregnant women, with a diagnosis of dengue at the Hospital Universitario de Monterrey and Civil Nuevo de Guadalajara from January 2014 to December 2017. Results The most common clinical symptom in the general group was headache and retro-ocular pain in 53 patients (83%), while in pregnant patients it was fever in 12 patients (86%). The median platelet count in the general group was 51.4x103/ μ!, with thrombocytopenia in 88% of patients, while in pregnant patients it was 141.1 x103/ with thrombocytopenia in 57% of patients (p=0.002). Platelet recovery was achieved in 7 days in the general group and 4.5 days in pregnant patients. Conclusions Contrary to that reported in the literature, pregnant patients had a lower incidence of thrombocytopenia and a higher platelet count at time of diagnosis without impact on maternal mortality or in the course of pregnancy.

ABSTRACT INTRODUCTION Chronic kidney disease has reached epidemic levels in several Central American countries since the early years of this century. In El Salvador, it is the second cause of death in men, the fifth in persons over 18 years old and the third cause of hospital deaths in the adult population. Its features, especially those of a subtype unassociated with traditional risk factors such as diabetes and high blood pressure, are only partially understood. OBJECTIVE Estimate the magnitude of chronic kidney disease in the adult population of El Salvador, considering both prevalence of the disease in its diverse forms as well as presence of potential risk factors nationally and in major subpopulations. METHODS A descriptive, cross-sectional analysis was conducted on data obtained from the Survey of Chronic Non-communicable Diseases in Adults in El Salvador, completed in 2015. The original data (interviews and measurements) were collected between October 2014 and March 2015 from 4817 adults employing a two-stage probabilistic cluster sample, with stratification of primary sampling units. Our analysis, using 20 of the 118 primary variables included in the original survey, focused on point estimation of prevalence rates and means, related to both traditional biological risk factors and nontraditional ones, such as insufficient hydration, strenuous working conditions and exposure to toxic agents. A separate analysis was performed to estimate prevalence of chronic kidney disease from nontraditional causes. Corresponding confidence intervals were calculated with proper weighting. RESULTS The general prevalence of chronic kidney disease in El Salvador was 12.8% (men 18.0%; women 8.7%). Of the chronically ill kidney patients, 13.1% were between 20 and 40 years of age. Among biological risk factors, the most frequent was high blood pressure (37.0%). Among nontraditional risk factors, high levels of sugary drink consumption (81.0%), insufficient hydration (65.9%) and high levels of exposure to agrochemicals in the work environment (12.6%) were also observed. Prevalence of chronic kidney disease from nontraditional causes was 3.9% (men 6.1%; women 2.2%). CONCLUSIONS Chronic kidney disease has reached epidemic proportions in El Salvador. The data confirm a health tragedy that, although especially striking older men, also takes a severe toll on young men and women. The results confirm findings of previous research in several Salvadoran agricultural communities. The relatively high level of population exposure to agrochemicals is important and alarming, especially in rural areas, meriting health-impact studies that include and go beyond possible impact on chronic kidney disease.

ABSTRACT Introduction: The basis of the National Health System in Cuba is the Primary Health Care; the family doctor registers the patients to evaluate the risks, to carry out the treatment, and follow-up them in the community. Chronic Kidney Disease affects the 10% of the adult population, that is why the active surveillance is necessary. Objectives: To evaluate and compare all patient registries of Chronic Kidney Disease and Chronic Kidney Disease with Diabetes Mellitus (2014- 2017). Material and Methods: The total of patients registered with Chronic Kidney Disease (glomerular filtration rate <60 mL/min/1.73 m2), and among them the diabetic patients; comparing the prevalence rate per 1 000 inhabitants, (sex, age, province). The data were obtained from the registries of the National Direction for Statistics. Results: Dispensarization increased in 2017 vs 2014: CKD 21,0%, and CKD with diabetes mellitus 47,21%. It increased according to age and it reached its maximum value in the group of 60-64 year-old ages for the CKD (8,99 per 1 000 inhabitants) and among them, more than 65 years old (1,35 per 1 000 inhabitants) for CKD with Diabetes Mellitus. There are differences in rates in the provinces in a frequency of CKD (6,28-1,06), and CKD with Diabetes Mellitus (0,82-0,11). The diagnosis of CKD-DM vs the existent diabetic and dispensarized population between 1,25-0,1% also varies. Conclusions: The dispensarization has increased for CKD and CKD with Diabetes Mellitus. The cuban state guarantees the sustainability of the universal access of the medical care in each community; the advice to patients; the diagnostic tools and the covering of essential medications.

RESUMEN Introducción: La base del Sistema Nacional de Salud en Cuba es el médico de la familia quienes registran, evalúan los riesgos, tratan y siguen a los pacientes en su comunidad. La enfermedad renal crónica afecta al 10% de la población adulta por lo cual es necesaria su activa vigilancia. Objetivos: evaluar y comparar la dispensarización por ERC y ERC-DM entre 2014 y 2017. Material y Métodos: Pacientes registrados con ERC (tasa de filtración glomerular <60 mL/min/1,73 m2) total y de causa diabética; tasa de prevalencia x 1 000 habitantes, (sexo, edad, provincia). Los datos se obtuvieron de los registros de la Dirección Nacional de Estadísticas. Resultados: Se incrementa la dispensarizacion en 2017 vs 2014: por ERC 21%, y de ellos con ERC ocasionada por diabetes en un 47,21%. Existió un aumento a mayor edad y alcanzó su valor máximo en el grupo de edades de 60-64 años para la ERC (8,99 x 1 000 habitantes) y entre los mayores de 65 años (1,35 x 1 000 habitantes) para la ERC-DM. Existen diferencias en las tasas provinciales, en la frecuencia de ERC (6,28-1,06), y de ERC-DM (0,82-0,11), también varía el diagnostico ERC-DM vs la población diabética existente y dispensarizada entre un 1,25-0,1% Conclusiones: Existe una mejoría en la dispensarización por ERC y por ERC-DM. La garantía por el Estado Cubano del acceso universal, de la atención centrada desde cada comunidad; en el asesoramiento a los pacientes; de las herramientas diagnósticas y la cobertura de medicamentos esenciales garantiza su sostenibilidad.

ABSTRACT Non-communicable diseases (NCDs) represent one of the greatest challenges for development of the 21st century due to their devastating social, economic and public health impact. The objective of this article are to describe the evolution and risk factors for NCDs in Cuba, mainly in the period 1990–2015, to outline actions undertaken by the Ministry of Public Health of Cuba, and to highlight the most important challenges with a focus on their prevention and control. The information is based on data collected and published by the Directorate of Medical Records and Health Statistics, research on risk factors, other studies and documentation of comprehensive actions. Mortality in Cuba is determined by four major health problems: cardiovascular diseases, malignant tumors, chronic diseases of the lower respiratory tract and diabetes mellitus, which together cause 68.0% of deaths. Cancer presents a growing trend, and chronic kidney disease emerges as a serious health problem. Cuba has a known baseline on risk factors, and hypertension and tobacco consumption are the main factors related to NCDs mortality. In line with the importance of these diseases, there are milestones and interventions with a positive impact, as well as gaps and challenges within the framework of the World Health Organization’s Global Action Plan for the Prevention and Control of NCDs.

RESUMEN Las enfermedades no transmisibles (ENT) representan uno de los mayores desafíos para el desarrollo en el siglo XXI, debido al devastador impacto social, económico y de la salud pública que provocan. El propósito de este artículo es describir la evolución y los factores de riesgo de las ENT en Cuba, principalmente en el período 1990–2015, reseñar las acciones emprendidas por el Ministerio de Salud Pública y destacar los desafíos más importantes para su prevención y control. La información contenida proviene de los datos colectados y publicados por la Dirección de Registros Médicos y Estadísticas de Salud, investigaciones sobre los factores de riesgo, otros estudios fundamentados y la documentación de acciones integrales. La mortalidad en Cuba está determinada por cuatro grandes problemas de salud: enfermedades cardiovasculares, tumores malignos, enfermedades crónicas de las vías respiratorias inferiores y diabetes mellitus, que en conjunto causan el 68,0% de los fallecimientos. La tendencia del cáncer es al ascenso y la enfermedad renal crónica emerge como un grave problema de salud. Cuba cuenta con una línea de base conocida sobre los factores de riesgo, de ellos la hipertensión y el consumo de tabaco son los principales relacionados con la mortalidad por ENT. En consonancia con la importancia de estas enfermedades se aprecian hitos e intervenciones de impacto positivo, así como brechas y desafíos en el marco del Plan de Acción Mundial de la Organización Mundial de la Salud para el enfrentamiento a las ENT.

RESUMO As doenças não transmissíveis (DNT) representam um dos maiores desafios do século 21 para o desenvolvimento devido ao desvastador impacto social, econômico e de saúde pública que elas causam. O objetivo deste artigo é descrever a evolução e os fatores de risco das doenças não transmissíveis em Cuba, principalmente no período de 1990–2015, para delinear as ações realizadas pelo Ministério da Saúde Pública de Cuba e destacar os desafios mais importantes para sua prevenção e controle. A informação vem dos dados coletados e publicados pela Diretoria de Registros Médicos e Estatísticas de Saúde, pesquisa sobre fatores de risco, outros estudos fundamentados e documentação de ações abrangentes. A mortalidade em Cuba é determinada por quatro principais problemas de saúde: doenças cardiovasculares, tumores malignos, doenças crônicas do trato respiratório inferior e diabetes mellitus, que em conjunto causam 68,0% das mortes. O câncer tem uma tendência crescente, e a doença renal crônica surge como um grave problema de saúde. Cuba tem uma linha de base conhecida sobre os fatores de risco, dos quais a hipertensão e o consumo de tabaco são os principais relacionados à mortalidade por DNT. Em consonância com a importância dessas doenças, há marcos e intervenções com impacto positivo, bem como lacunas e desafios no âmbito do Plano de Ação Mundial da Organização Mundial da Saúde para enfrentar as doenças não transmissíveis.

Abstract The INIFAP Genetic Improvement Program, based in Iguala of the Independencia, Guerrero, has released the first improved creole variety of blue maize ‘V-239AZ’ with adaptation to the semi-warm regions of the states of Guerrero, Oaxaca and Puebla. After five cycles of convergent - divergent mass selection that gave origin to this variety, it was possible to reduce the agronomic problems of the original creole, such as higher plant height and ear, susceptibility to lodging, high asynchrony between its blooms and uninform grain color, giving place in 2016 to its liberation.

Resumen El Programa de Mejoramiento Genético del INIFAP con sede en Iguala de la Independencia, Guerrero, ha liberado al comercio la primera variedad criolla mejorada de maíz azul ‘V-239AZ’ con adaptación a las regiones semicálidas de los estados de Guerrero, Oaxaca y Puebla. Después de cinco ciclos de selección masal convergente-divergente que dieron origen a esta variedad, se logró reducir los problemas agronómicos intrínsecos del criollo original, como mayor altura de planta y mazorca, susceptibilidad al acame, alta asincronía entre sus floraciones y color de grano desuniforme, dando lugar en 2016 a su liberación.

Abstract In México maize (Zea mays L.) is the most important crop for its planting area and for the role it plays within the Mexican diet, as its consumption reaches 200 kg per person per year and in tortilla is calculated an average daily intake of 225 g. For this reason, the INIFAP Genetic Improvement Program, based in Iguala, Guerrero, continues the process of generating new maize materials for the different production conditions in the Lower Tropic of México. For the mountain, the regional creoles are conserved and improved, in intermediate areas with varieties and varietal hybrids, and in high productivity areas with conventional hybrids.

Resumen En México el maíz (Zea mays L.), es el cultivo de mayor importancia por su superficie sembrada y el rol que juega dentro de la dieta alimentaria del mexicano, ya que su consumo alcanza 200 kg por persona al año y en tortilla se calcula en promedio una ingesta diaria de 225 g. Por ello el Programa de Mejoramiento Genético del INIFAP con sede en Iguala, Guerrero, continúa el proceso de generar nuevos materiales de maíz para las diferentes condiciones de producción en el trópico bajo de México, para la montaña se conservan y mejoran los criollos regionales, en las áreas intermedias con variedades e híbridos varietalesy las áreas de alta productividad con híbridos convencionales.