Abstract The development of forensic anthropology in Mexico, intimately related to the context of exacerbated violence, is exposed in different regions of our country from the 1960s to the present day. With a special emphasis on two wars, in which the Mexican State itself directed its forces against its own population. We speak about “dirty war” and the “war against drugs” as two episodes that favored crimes against humanity such as forced disappearance and disappearance by private individuals; these occurred in times that establish an intrinsic relationship with the development and application of forensic anthropology in matters of national security.

Resumen El desarrollo de la antropología forense en México se encuentra relacionada íntimamente con el contexto de violencia exacerbada, manifiesta en distintas regiones de nuestro país desde la década de los años sesenta del siglo XX hasta la actualidad. Con un especial énfasis en dos guerras, donde el propio Estado mexicano dirigió sus huestes contra su propia población, en este sentido, hablamos de la “guerra sucia” y de la “guerra contra el narco” como dos episodios que favorecieron crímenes de lesa humanidad como lo fue la desaparición forzada y, asimismo, la desaparición por particulares; acaecidas en temporalidades que establecen una relación intrínseca con el desarrollo y aplicación de la antropología forense en cuestiones de seguridad nacional.

Resumen Las innovadoras tecnologías del metaverso y el chat GPT4 (basado en inteligencia artificial) están presentes en el discurso cotidiano de la sociedad; recientemente se han introducido en la práctica médica y están provocando importantes cambios. En cuanto al metaverso ("después del universo"), diversas escuelas y facultades de medicina del mundo comienzan a utilizarlo como una estrategia innovadora dirigida a la enseñanza de materias como anatomía, histología, oftalmología y simulación en mundos paralelos (virtuales) para el aprendizaje y supervisión de cirugías, así como para otras aplicaciones en educación médica y en la relación médico-paciente. Si bien debe tomarse en cuenta como un área de oportunidad para la transformación de la medicina, es importante considerar las diversas limitaciones y riesgos del metaverso en la práctica médica, la formación de estudiantes y la relación del médico con los problemas de salud a los que se enfrenta en su práctica.

Abstract Innovative technologies such as the metaverse and chat GPT-4 (based on artificial intelligence) are present in the daily discourse of society; recently, they have been introduced into medical practice and are bringing about important changes. In the case of the metaverse ("beyond the universe"), various medical schools and departments around the world are beginning to use it as an innovative strategy for teaching subjects such as anatomy, histology, ophthalmology, and simulation in parallel (virtual) worlds for learning and supervision of surgeries, as well as for other applications in medical education and in the doctor-patient relationship. Although it should be regarded as an area of opportunity for the transformation of medicine, it is important to consider the various limitations and risks of the metaverse in medical practice, student training, and physicians' relationship with the health problems they have to deal with in their practice.

RESUMEN Contexto: Los pólipos son masas protuberantes que crecen a lo largo del tracto intestinal y se consideran los principales precursores del cáncer de colon. En las etapas tempranas, la detección de pólipos representa una probabilidad de supervivencia de hasta el 93%, mientras que, en otras etapas, esta probabilidad disminuye hasta el 8%. A pesar de que la colonoscopia es el método más efectivo para detectar pólipos, varios estudios han demostrado una tasa de pérdida de hasta el 26% en la detección pólipos. Las herramientas computacionales han surgido como una alternativa para soportar la detección y localización de pólipos, pero varios problemas siguen abiertos debido a la alta variabilidad de los mismos. Método: Este trabajo introduce una estrategia computacional que produce mapas de atención visual con la localización más probable de los pólipos para generar alarmas y apoyar la tarea de detección. Cada fotograma de colonoscopia se descompone en un conjunto de características profundas extraídas de arquitecturas preentrenadas. Dichas características se codifican en una representación densa de Hough para obtener una plantilla del pólipo, que posteriormente se propaga en cada fotograma para obtener los mapas de atención visual. Las regiones máximas son proyectadas a la colonoscopia para dibujar las regiones sospechosas de pólipo. Resultados: La estrategia propuesta fue evaluada en los conjuntos de datos ASU-Mayo Clinic y CVC-Video Clinic, reportando una exactitud de 70% de detección entre las cuatro regiones más probables, mientras que con diez regiones se tiene un 80%. Conclusiones: Los mapas de atención obtenidos destacan las regiones más probables con pólipos. El enfoque propuesto puede ser útil para apoyar el análisis de la colonoscopia.

ABSTRACT Context: Polyps are protruding masses that grow along the intestinal tract and are considered to be the main precursors of colorectal cancer. In early stages, polyp detection represents a survival probability of up to 93%, whereas, for other stages, this probability can decrease to 8%. Despite the fact that colonoscopy is the most effective method to detect polyps, several studies have shown a loss rate of up to 26% in detecting polyps. Computer tools have emerged as an alternative to support polyp detection and localization, but various problems remain open due to their high variability. Method: This work introduces a computational strategy that produces visual attention maps with the most probable location of polyps to generate alarms and support detection procedures. Each colonoscopy frame is decomposed into a set of deep features extracted from pre-trained architectures. Such features are encoded into a dense Hough representation in order to obtain a polyp template, which is then propagated in each frame to obtain a visual attention map. The maximum regions are back-projected to the colonoscopy in order to draw suspicious polyp regions. Results: The proposed strategy was evaluated in the ASU-Mayo Clinic and CVC-Video Clinic datasets, reporting a detection accuracy of 70% among the four most probable regions, while ten regions yielded 80%. Conclusions: The obtained attention maps highlight the most probable regions with suspicious polyps. The proposed approach may be useful to support colonoscopy analysis.

Resumen Antecedentes: Los diagnósticos tardíos elevan los costes de atención del cáncer de mama. Objetivo: Analizar los costes directos de la atención del cáncer de mama en etapa temprana y avanzada en el tercer nivel de atención en el Instituto Mexicano del Seguro Social (IMSS). Método: Estudio observacional que compara los costes directos de atención en cáncer de mama en estadios clínicos inicial y avanzado. Los datos analizados fueron estudios de laboratorio, gabinete, tratamiento y hospitalización. El tiempo evaluado incluyó desde la primera atención hasta la finalización del primer tratamiento. Se determinaron los costes de acuerdo con la tabla de Costes Unitarios por Nivel de Atención Médica para el año 2019 del IMSS. Se utilizó la prueba t de Student para diferencias entre grupos, así como estadística descriptiva. Resultados: El estadio avanzado, comparado con el estadio inicial, ocasiona un número mayor de estudios de laboratorio-gabinete, cirugías, día/cama e interconsultas. El coste promedio de la atención del cáncer de mama por paciente es $99,280,36 (US$5,230.78) y $148,023.60 (US$7,789.92) para los estadios inicial y avanzado, respectivamente (p = 0.024). Conclusiones: El coste de la atención médica del estadio inicial es menor que el del estadio avanzado.

Abstract Background: Management of breast cancer is increased by late diagnoses. Objective: To analyse direct costs of breast cancer in early and advanced stage in a third level medical facility at Mexican Social Security Institute. Method: Observational study, direct costs of care in breast cancer in initial and advanced clinical stages are compared. Variables analysed were laboratory and diagnostic imaging studies, drugs, as well as hospitalization costs. The evaluated period included from the first care to the completion of the treatment. Costs were determined according to the table of Unit Costs by Level of Medical Care for the year 2019 of the Mexican Social Security Institute. Student's t test was used to determinate differences between groups, as well as descriptive statistics. Results: The advanced stage compared to the initial stage, causes a greater number of laboratory-cabinet studies, surgeries, day/bed and interconsultations. The average cost of breast cancer care per patient is $99,280.36 (US$5,230.78) and $148,023.60 (US$7,789.92) for the initial and advanced stages, respectively (p = 0.024). Conclusions: Cost of medical attention in the initial stage is lower than that of the advanced stage.

RESUMO: O estudo teve como objetivo avaliar o efeito do sexo e do peso ao abate sobre as características de carcaça e componentes não-carcaça de 1.489 cavalos (739 machos castrados e 750 fêmeas, classificados em oito grupos de acordo com o peso). Os dados foram analisados em um desenho inteiramente casualizado. Os semeadores apresentaram maior rendimento de carcaça quente (HCY) e fria (CCY) do que as fêmeas, porém o amarelecimento da gordura (b*) foi maior nas fêmeas. O peso ao abate (SW) afetou as características de carcaça. HCW, CCW, HCY e CCY aumentaram de acordo com o peso de abate, enquanto CL% foi menor em equinos com peso superior a 300 kg. Além disso, os componentes não-carcaça diminuíram com o aumento do peso dos cavalos. Em conclusão, sexo e peso corporal são fatores a serem considerados na produção de carne equina, uma vez que afetam as características da carcaça e seus componentes.

ABSTRACT: The study evaluated the effect of sex and slaughter weight on carcass traits and non-carcass components of 1,489 horses (739 geldings and 750 females, classified into eight groups according to their weight). Data were analyzed under a completely randomized design. Geldings had a higher (P < 0.05) hot carcass yield (HCY) and cold carcass yield (CCY) than females; however, fat yellowness values (b*) were greater (P < 0.05) in females. Slaughter weight (SW) affected the carcass characteristics. Hot carcass weight (HCW), cold carcass weight (CCW), HCY, and CCY increased (P < 0.05) in accordance with slaughter weight, while cool loss percentage (CL%) was lower (P < 0.05) in horses weighing more than 300 kg. In addition, the non-carcass components decreased (P < 0.05) as the weight of the horses increased. In conclusion, sex and body weight are factors to consider in the production of equine meat since they affect carcass characteristics and non-carcass components.

Abstract This article analyzes the nature of the knowledge, especially that of a specialized nature, evoked in the solution of the questions that made up the National Qualification Exams (NQE), developed within the scope of the Professional Master’s Program in Mathematics in the National Network (PROFMAT), between the years 2012 and 2019. The focus of this program was based on the development of a solid education in Mathematics, which contemplates the needs arising from the daily lives of teachers in the school space and their broad needs for development and professional appreciation. Therefore, a qualitative study was developed in which, from the interpretative content analysis, a total of 62 questions were classified in the light of the conceptual-analytical model Mathematics Teachers’ Specialized Knowledge (MTSK), which composed the NQE applied in the first semester of the 8 years analyzed. The analysis carried out showed that: a) more than 70% of the questions focus exclusively on knowledge that appears in only one subdomain of Mathematical Knowledge (MK), the Knowledge of Topics, while only 5% of them address knowledge that appears in all subdomains of MK; b) Absence, in all questions, of knowledge associated with the Pedagogical Content Knowledge (PCK) domain. Thus, it is concluded that the evaluation developed through the NQE privileges knowledge that appears only in one of the six subdomains of knowledge that really support the teacher in his daily work with mathematics, which is opposed to the results of many relevant studies that emphasize the importance and impact of knowledge associated with the PCK domain in teaching.

Resumo Analisa-se, neste artigo, a natureza dos conhecimentos, especialmente os de cunho especializado, evocados na resolução das questões que compuseram Exames Nacionais de Qualificação (ENQ), desenvolvidos no âmbito do Programa de Mestrado Profissional em Matemática em Rede Nacional (PROFMAT), entre os anos de 2012 e 2019. O foco nesse programa deu-se por pautar-se no desenvolvimento de uma sólida formação em Matemática, que contemple as necessidades provenientes do cotidiano dos professores no espaço da escola e de suas necessidades amplas de desenvolvimento e de valorização profissional. Para tanto, desenvolvemos uma pesquisa de cunho qualitativo em que, a partir da análise de conteúdo interpretativa, foram classificadas, à luz do modelo conceitual-analítico Mathematics Teachers’ Specialized Knowledge (MTSK), um total de 62 questões, que compuseram os ENQ aplicados no primeiro semestre de oito anos. A análise realizada evidenciou que: a) mais de 70% das questões focam exclusivamente em conhecimentos que figuram apenas em um subdomínio do Mathematical Knowledge (MK), o Knowledge of Topics, enquanto somente 5% delas abordam conhecimentos que figuram em todos os subdomínios do MK; b) Ausência, em todas as questões, de conhecimentos associados ao domínio Pedagogical Content Knowledge (PCK). Assim, conclui-se que a avaliação desenvolvida por meio do ENQ privilegia conhecimentos que figuram somente em um dos seis subdomínios do conhecimento que, realmente, ampara o professor em seu trabalho diário junto à matemática e que se contrapõe aos resultados de diversas e relevantes pesquisas que enfatizam a importância e impacto, na prática docente, de conhecimentos associados ao domínio PCK.

ABSTRACT The objective of this study was to evaluate the effect of milking hygiene practices, herd size, water hardness, and temperature-humidity index (THI) on the physicochemical and microbiological characteristics of raw milk, and standard plate count (SPC) in milking machines of dairy farms in the central region of Mexico. Data were collected from fifty-three dairy farms during one year. The evaluated effects included milking hygiene conditions (good, medium, poor), herd size (1-50, 51-100, 101-150, ≥151 heads), water hardness (soft or moderately hard), and THI (comfortable or stressful). The increase in milking hygiene produced greater milk yield (MY) and energy corrected milk (ECM) but lower protein content, and decreased the individual bacterial count (IBC) and somatic cell count (SCC). The MY, ECM, protein content, IBC, and SCC were higher on bigger farms. The use of soft water reduced MY, IBC, and SCC, but improved fat, lactose, total solids (TS), and non-fat solids (NFS). Heat stress negatively affected fat, protein, TS, NFS, acidity, freezing point (FP), SCC, and methylene blue dye reduction test. Poor milking hygiene contributes to higher SPC in milking machine parts. Water hardness and THI did not affect SPC in all milking machine parts. Proper milking hygiene practices, larger herd size, softer water, lower THI, and adequate cleaning and disinfection of the milking machine parts benefits the physicochemical and microbiological quality of the milk.

Abstract In universities, it is essential to recognize the existence of gender violence and take an active role to eradicate them. The gender policies and attention to violence have turned their gaze to these spaces to generate critical knowledge about inequalities in High Education Institutions. Is important make visible the situation in which women and men develop their academic and professional activities and show the advance in the incorporation of gender perspective. The objective of this work is to systematize the research experience and construction of a protocol for the prevention, care and sanction in matters of gender violence, discrimination and sexual harassment in the Universidad Autónoma de Yucatán, from the perception of the responsible interdisciplinary team integrated by 12 professionals. The methodology is the systematization of experiences, which from an orderly reconstruction process of experiences allows offering a critical interpretation of it with the intention of rescuing the most relevant learning. The techniques used were the discussion groups and the analysis or reports. The results highlight the lessons learned from the experience linked to issues such as expressions of power, institutional decisions, interdiscipline, teamwork, training processes, resistance to change, socialization and evaluation processes, fundamentally. The importance of the responsibility we have as members of society, as university academic staff and as research teams are discussed.

Resumen En las universidades es fundamental reconocer la existencia de prácticas de violencia de género y asumir un papel activo para erradicarlas. Las políticas de género y de atención a la violencia han vuelto la mirada a dichos espacios para generar conocimiento crítico sobre las desigualdades en las Instituciones de Educación Superior, visibilizan la situación en la que mujeres y hombres desarrollan sus actividades académicas y profesionales para avanzar en la incorporación de la perspectiva de género. El objetivo de este trabajo es sistematizar la experiencia de investigación y construcción de un protocolo para la prevención, atención y sanción en materia de violencia de género, discriminación, hostigamiento y acoso sexual en la Universidad Autónoma de Yucatán, desde la percepción del equipo interdisciplinario responsable, integrado por 12 profesionales. La metodología es la sistematización de experiencias, la cual, a partir de un proceso de reconstrucción ordenada de varias experiencias permite ofrecer una interpretación crítica de la(s) misma(s) con la intención de rescatar los aprendizajes más relevantes. Las técnicas utilizadas fueron el grupo de discusión y el análisis de relatorías e informes de investigación. Los resultados destacan las lecciones aprendidas de la experiencia, ligadas a temáticas como las expresiones de poder, las decisiones institucionales, la interdisciplina, el trabajo en equipo, los procesos de capacitación, las resistencias al cambio, los procesos de socialización y la evaluación, fundamentalmente. Se discute la importancia de la responsabilidad que tenemos como integrantes de la sociedad, como personal docente universitario y como equipos de investigación.

Abstract Objective: Our objective was to evaluate the frequency of expression and determine the expression levels of the NY-ESO-1 gene in patients with DLBCL as well as to examine its relationship with clinical parameters and survival. Methods: We analyzed NY-ESO-1 gene expression levels using real-time quantitative RT-PCR (RT-qPCR) in 112 patients with DLBCL. The associations between the expression of the NY-ESO-1 gene and the clinical variables were evaluated using the Chi-square test and Fisher’s exact test. Overall survival (OS) was determined using the Kaplan–Meier method. Result: The results showed that the NY-ESO-1 gene was expressed in 46.4% (52/112) of patients with DLBCL, and NY-ESO-1 gene expression was associated with clinical parameters such as LDH, clinical stage, and International Prognostic Index (IPI) (p ≤ 0.05). High levels of NY-ESO-1 gene expression were associated with advanced disease stages, and the survival rates after 5.3 years of tracking were lower in the patients expressing the NY-ESO-1 gene (66.4%) than in those not expressing the gene (23.1%). Conclusion: The expression levels of the NY-ESO-1 gene in patients with DLBCL may be of great utility for diagnosing and determining the prognosis of this disease.

Resumen La Vitis vinifera (planta de uva, vid), usada para elaborar vinos, existe desde antes que el hombre y ha estado vinculada al mismo siempre. Está presente en la Biblia e históricamente se remonta a la antigua Roma, donde elaboraban un vino dorado sin distinguir variedad de uvas. Para hacer vinos es necesario producir fruta de buena calidad, la vid requiere ciertos niveles de luz y calor, y temperaturas extremas pueden afectar de manera negativa la producción. Además, necesita condiciones climatológicas específicas para desarrollarse, ejemplo: un invierno suficientemente frío permite a la planta descansar. Por esa razón, la mayoría de vides se cultivan en latitudes del globo que proporcionan una adecuada cantidad de luz solar, calor y agua, entre el paralelo 30º y 50º, tanto hacia el norte como hacia el sur. Sn embargo, contrario a estas teorías, en Ecuador (paralelo 0º) se producen vides y vinos de excelente calidad. En este artículo se investiga lo antes mencionado en Yaruquí, parroquia rural de Quito, provincia de Pichincha, conociendo que la zona solo tiene un viñedo llamado Chaupi Estancia, donde se realizó una observación de campo que arrojó datos de variedades de cepas producidas, pese a su climatología. A su vez, se evidenció información importante sobre volumen de producción en las plantas, la afectación de la posición del sol considerando la ubicación del terreno en la pigmentación de las uvas, especialmente en variedades blancas, y su influencia en el dulzor de la fruta (contenido de azúcar), que dan como resultado unos sabores peculiares en los vinos.

Abstract Vitis vinifera is a variety of vine (grape plant), suitable for wine making, which has existed before mankind and has been linked to society for a long time. There are records of it uses in the bible and in ancient Rome, where a golden wine was made without distinguishing grape varieties. It is necessary to produce fruit of good quality, to produce good wines; the vine needs certain levels of light and heat, because excessive temperatures can negatively affect its production. The optimal conditions for the plant are areas where the winter is cold enough for them to dormancy. That is why most grapevines are in latitudes around the globe that provide the adequate amount of sunlight, warmth and water, specially between parallel 30º and 50º, both north and south. However, contrary to these theories, in Ecuador (parallel 0º) vines and wines of excellent quality can be produced. This article research about the above-mentioned in Yaruquí, a rural parish of Quito, Pichincha province. The area has one vineyard called Chaupi Estancia, where field observation research was conducted to obtain data on the varieties of strains that grow in the area, in spite of its climate. Additionally, important information on the volume of production in the plants was evidenced, along with data on the effects of the sun, considering the location of the farm (parallel 0º), on the pigmentation of the grapes, especially in white types, which gives a different color to the wines, and has a strong influence in the sweetness (sugar content), that determine the peculiar flavors of wines.

Summary Objetive: In kidney patients, bone-metabolic disease, systemic inflammation and malnutrition exacerbate the risk of vascular calcification (VC) and morbidity and mortality. Given the strong association between VC and fragility fractures, the objective of this study is to assess the contribution of the major determinants of VC to bone deterioration in patients on peritoneal dialysis (PD). Methods: In 31 nodiabetic patients on PD (>6 months), markers of alterations in bone metabolism, vascular damage, inflammation and malnutrition, and their impact on bone deterioration (radiological osteopenia and/or history of fragility fracture) were studied. Results: In these patients (20 men and 11 women; age=54±15 and 60±11 years, respectively (p=0.24)), the prevalence of fragility fractures was 5% in men and 27% in women. Bone deterioration was greater in older people, females, high Charlson and Kauppila indexes, lower muscle mass and with expansion of a highly inflammatory subpopulation of immature low-density granulocytes (iLDG). A logistic regression analysis showed that bone deterioration risk is more influenced by the female sex than by age and that, of the multiple factors associated with greater bone deterioration studied, only the expansion of iLDG estimates the risk of bone alterations in these patients regardless of age and sex. Conclusion: The expansion of iLDG provides an accurate biomarker for the diagnosis of bone deterioration and to monitor strategies that attenuate its progression in PD patients of any age and sex.

Resumen Objetivo: En enfermos renales, la enfermedad ósea‐metabólica, la inflamación sistémica y la malnutrición exacerban el riesgo de calcificación vascular (CV) y la morbimortalidad. Dada la fuerte asociación entre CV y fracturas por fragilidad, el objetivo de este estudio es evaluar la contribución de los mayores determinantes de CV al deterioro óseo en pacientes en diálisis peritoneal (DP). Métodos: En 31 pacientes no diabéticos en DP (>6 meses), se estudiaron marcadores de alteraciones del metabolismo óseo, daño vascular, inflamación y desnutrición, y, su impacto en el deterioro óseo (osteopenia radiológica y/o antecedentes de fractura por fragilidad). Resultados: En estos pacientes, (20 varones y 11 mujeres; edad=54±15 y 60±11 años respectivamente (p=0,24)), la prevalencia de fracturas por fragilidad fue de 5% en hombres y del 27% en mujeres. El deterioro óseo fue mayor en personas de edad avanzada, sexo femenino, índices de Charlson y Kauppila elevados, menor masa muscular y con expansión de una subpoblación altamente inflamatoria de granulocitos inmaduros de baja densidad (LDGi). Un análisis de regresión logística demostró que el riesgo de deterioro óseo está más influenciado por el sexo femenino que por la edad y que, de los múltiples factores asociados a mayor deterioro óseo estudiados, sólo la expansión de LDGi estima el riesgo de alteraciones óseas en estos pacientes independientemente de su edad y sexo. Conclusión: La expansión de LDGi provee de un biomarcador certero para el diagnóstico de deterioro óseo y para monitorizar estrategias que atenúen su progresión en pacientes en DP de cualquier edad y sexo.

Abstract: The identification of multiple risk factors that predispose to bleeding during the obstetric event, such as acquired hemophilia, which is a disorder that develops due to the generation of autoantibodies that inhibit coagulation factors, the objective interpretation of routine laboratory tests , the development of systematized thinking in diagnostic-therapeutic integration by health personnel, and the provision of hospital pharmacological resources, is what frequently determines the prognosis in obstetric patients with extreme morbidity who require multidisciplinary care in the different hospital units of the health sector of our country. The objective is to present a clinical case of extreme morbidity due to acquired hemophilia, its clinical presentation, evolution and fatal outcome. A case referred from another unit of the ISEM (Instituto de Salud del Estado de México) Health Sector, treated at the Obstetric Intensive Care Unit of the «Mónica Pretelini Sáenz» Hospital, is presented, highlighting the importance of diagnostic-therapeutic integration, and the multifactorial interaction of variables related to its fatal outcome. Conclusions: Ignorance of the pathology, delay in diagnosis, multiple conditioning procedures of iatrogenic hemorrhage and the limitation in therapeutic resources are factors that contribute to a fatal outcome.

Resumen: La identificación de múltiples factores de riesgo que predisponen a la hemorragia durante el evento obstétrico, como la hemofilia adquirida que es un trastorno que se desarrolla por la generación de autoanticuerpos inhibidores de factores de la coagulación, la interpretación objetiva de las pruebas de laboratorio rutinarias, el desarrollo de un pensamiento sistematizado en la integración diagnóstico-terapéutica por parte del personal de salud, y la disposición de los recursos farmacológicos hospitalarios, es lo que determina frecuentemente el pronóstico en pacientes obstétricas con morbilidad extrema que requieren atención multidisciplinaria en las diferentes unidades hospitalarias del sector salud de nuestro país. El objetivo es presentar un caso clínico de morbilidad extrema por hemofilia adquirida, su presentación clínica, evolución y desenlace fatal. Se presenta un caso referido de otra unidad del Sector Salud ISEM (Instituto de Salud del Estado de México), atendido en la Unidad de Cuidados Intensivos Obstétricos del Hospital «Mónica Pretelini Sáenz», resaltando la importancia en la integración diagnóstico-terapéutica y la interacción multifactorial de variables relacionadas con su desenlace fatal. Conclusiones: Desconocimiento de la patología, retraso en el diagnóstico, múltiples procedimientos condicionantes de hemorragia iatrógena y la limitación en recursos terapéuticos son factores que contribuyen a un desenlace fatal.

Resumen Objetivo: determinar el efecto de la soledad, la ansiedad y la depresión sobre la adopción del rol cuidador de adultos mayores con enfermedad crónica en una muestra de cuidadores mexicanos durante la pandemia de la covid-19. Materiales y método: diseño correlacional predictivo. Se realizó el estudio en 157 cuidadores mediante la encuesta de caracterización de la diada, escala HADS, escala UCLA y escala adopción del cuidador. El análisis fue con estadística descriptiva e inferencial. Resultados: la mayoría de los participantes fueron mujeres, con un tiempo medio de cuidados de siete meses. Los cuidadores en su mayoría tienen ansiedad como problema clínico en un 27 %, depresión dudosa con un 14,9 %, soledad severa con un 66,2 % y adopción satisfactoria del rol en el 71,2 %. Se encontró que a mayor adopción del rol, menor ansiedad, depresión y soledad (p < 0,05). Los factores psicosociales, la edad de la persona receptora de cuidado, la edad del cuidador informal y el tiempo de cuidado explicaron un 36 % de la varianza de la adopción del rol (F = 13,12; p < 0,01), siendo variable predictora la soledad. Conclusión: la pandemia de la covid-19 ha ocasionado un impacto en la salud mental y la soledad severa de los cuidadores, siendo esta última un predictor de la adopción del cuidador.

Resumo Objetivo: determinar o efeito da solidão, ansiedade e depressão na adoção do papel de cuidador de idosos com doença crônica em uma amostra de cuidadores mexicanos durante a pandemia de COVID-19. Material e método: desenho correlacional preditivo. O estudo foi realizado com 157 cuidadores utilizando a pesquisa de caracterização da díade, a escala HADS, a escala UCLA e a escala de Adoção do papel de cuidador. A análise realizou-se com estatística descritiva e inferencial. Resultados: a maioria dos participantes era do sexo feminino, sendo o tempo médio de atendimento de sete meses. A maioria dos cuidadores apresentou ansiedade como problema clínico (27 %>), depressão duvidosa (14,9 °%), solidão severa (66,2 °%) e adoção satisfatória do papel (71,2 %). Constatou-se que quanto maior a adoção do papel, menor o índice de ansiedade, depressão e solidão (p < 0,05). Os fatores psicossociais, a idade da pessoa que recebe os cuidados, a idade do cuidador informal e o tempo de cuidado explicaram 36 %% da variância na adoção do papel (F = 13,12; p < 0,01), sendo a solidão variável preditora. Conclusão: a pandemia da COVID-19 tem impactado a saúde mental e a solidão severa dos cuidadores, sendo esta última uma variável preditora da adoção do papel de cuidador.

Abstract Objective: To determine the effect of loneliness, anxiety, and depression on adopting the role of caregiver of older adults with chronic conditions in a sample of Mexican caregivers during the COVID-19 pandemic. Materials and method: Predictive and correlational design. The study was conducted with 157 caregivers through the dyad characterization scale, the HADS scale, the UCLA scale, and the Caregiver role adoption scale. The analysis used descriptive and inferential statistics. Results: Most participants were female, with a mean care time of seven months. Mostly, the caregivers have anxiety as a clinical problem (27 %), doubtful depression (14.9 %), profound loneliness (66.2 %), and satisfactory adoption of the role (71.2 %). We found that the more significant the role of adoption, the lower the anxiety, depression, and loneliness levels (p < .05). The psychosocial factors, the age of the person cared for, the age of the informal caregiver, and the care time explained 36 % of the variance in role adoption (F = 13.12; p < .01), with loneliness as a predictive variable. Conclusion: The COVID-19 pandemic has impacted the caregivers' mental health and caused profound loneliness, the latter being a predictor for adopting the role.

Resumen Objetivo: Determinar la influencia de la sarcopenia en la funcionalidad de Adultos Mayores Mexicanos. Método: diseño correlacional-predictivo. Muestra: 316 adultos mayores que asistieron al centro de actividades artísticas y deportivas. Instrumentos: cédula de datos sociodemográficos-clínicos, SARC-F, índice de Barthel y escala de Lawton. Resultados: La sarcopenia tiene impacto negativo sobre las actividades instrumentales de la vida diaria e influye en mayor porcentaje en las básicas convirtiéndola en variable predictora explicando un 34% las actividades de la vidia diaria y un 22% las instrumentales. Conclusiones: La sarcopenia es una variable predictora para las actividades básicas e instrumentales de la vida diaria. Los resultados presentados plantean bases para futuras intervenciones multidisciplinarias para disminuir el riesgo de sarcopenia y complicaciones en quienes la padecen. Es necesario adoptar estrategias de valoración de individuos con sarcopenia o en riesgo de desarrollarla, a través de consultas en el primer nivel de atención, para prevenirla.

Abstract Objective: To determine the influence of sarcopenia on the functionality of Mexican Older Adults. Method: correlational-predictive design. Sample, 316 older adults who attended the center for artistic and sports activities. Sociodemographic-clinical data card instruments, SARC-F, Barthel index and Lawton scale. Results: Sarcopenia has a negative impact on the instrumental activities of daily life and influences a greater percentage in the basic ones, making it a predictor variable, explaining 34% of the activities of daily life and 22% of the instrumental ones. Conclusions: Sarcopenia is a predictor variable for basic and instrumental activities of daily living. The results presented present bases for future multidisciplinary interventions to reduce the risk of sarcopenia and complications in those who suffer from it. It is necessary to adopt assessment strategies for individuals with sarcopenia or at risk of developing it, through consultations at the first level of care for its prevention.