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Androgenetic alopecia, the most common cause of hair loss affecting both men and women, is typically treated using pharmaceutical options, such as minoxidil and finasteride. While these medications work for many individuals, they are not suitable options for all. To date, the only non-pharmaceutical option that the United States Food and Drug Administration has cleared as a treatment for androgenetic alopecia is low-level laser therapy (LLLT). Numerous clinical trials utilizing LLLT devices of various types are available. However, a myriad of other physical treatments for this form of hair loss have been reported in the literature. This review evaluated the effectiveness of microneedling, pulsed electromagnetic field (PEMF) therapy, low-level laser therapy (LLLT), fractional laser therapy, and nonablative laser therapy for the treatment of androgenetic alopecia (AGA). It also explores the potential of multimodal treatments combining these physical therapies. The majority of evidence in the literature supports LLLT as a physical therapy for androgenetic alopecia. However, other physical treatments, such as nonablative laser treatments, and multimodal approaches, such as PEMF-LLLT, seem to have the potential to be equally or more promising and merit further exploration.

Introducción: La respuesta al tratamiento inmunosupresor en la hepatitis autoinmune influye en el curso clínico de la enfermedad y se asocia a mayor sobrevida. Objetivo: Describir la respuesta al tratamiento inmunosupresor en pacientes con hepatitis autoinmune. Método: Se realizó un estudio descriptivo, longitudinal, ambispectivo, en 32 enfermos con hepatitis autoinmune, los cuales recibieron tratamiento inmunosupresor con evaluación de la respuesta a los 6 meses. Las variables incluidas fueron: Tipo de hepatitis autoinmune, forma de presentación, forma de debut y respuesta al tratamiento. Se utilizaron medidas descriptivas de resumen: Media y desviación estándar para variables cuantitativas y porcentaje para las variables cualitativas. Para estimar la función de supervivencia se utilizó la curva de Kaplan-Meier y Log-rank para la comparación de medias. Resultados: El 71,9 % de los enfermos estaban con cirrosis en el momento del diagnóstico. Los 13 pacientes con remisión bioquímica permanecieron sin progresión en la evaluación actual. La supervivencia en los pacientes respondedores fue del 100 % y en los no respondedores de 47,5 % a los 10 años de seguimiento. Conclusiones: La respuesta al tratamiento inmunosupresor tiene un impacto positivo en la no progresión de la hepatitis autoinmune y se asoció a mayor supervivencia.

A fundamental property of sensory systems is their ability to detect novel stimuli in the ambient environment. The auditory brain contains neurons that decrease their response to repetitive sounds but increase their firing rate to novel or deviant stimuli; the difference between both responses is known as stimulus-specific adaptation or neuronal mismatch (nMM). Here, we tested the effect of microiontophoretic applications of ACh on the neuronal responses in the auditory cortex (AC) of anesthetized rats during an auditory oddball paradigm, including cascade controls. Results indicate that ACh modulates the nMM, affecting prediction error responses but not repetition suppression, and this effect is manifested predominantly in infragranular cortical layers. The differential effect of ACh on responses to standards, relative to deviants (in terms of averages and variances), was consistent with the representational sharpening that accompanies an increase in the precision of prediction errors. These findings suggest that ACh plays an important role in modulating prediction error signaling in the AC and gating the access of these signals to higher cognitive levels.

Abstract Among the outstanding questions about the emergence of human-controlled fire is the systematic recurrence between the geochemical remains of fire and its preservation in the archaeological record, as the use of fire is considered a technological landmark, especially for its importance in food cooking, defensive strategies, and heating. Here we report fossil lipid biomarkers associated with incomplete combustion of organic matter at the Valdocarros II site, one of the largest European Acheulean sites in Spain dated to marine isotopic stage (MIS) 8/7 (~ 245 kya) allowing a multiproxy analysis of human-controlled fire use. Our results reveal isolated cases of highly concentrated and diverse polycyclic aromatic hydrocarbons (PAHs) and alkylated PAHs (APAHs), along with diagnostic conifer-derived triterpenoids in two hearth-like archaeological structures. The presence of combustion byproducts suggests the presence of anthropogenic (controlled) fires at Valdocarros—one of the oldest evidence of fire use in Europe-in association with Acheulean tools and bones. Hominins possibly used fire for two main activities, as a means of defense against predators and cooking. Our results help to better delineate major gaps in our current knowledge of human-controlled fire in the context of the Middle-Pleistocene in Europe and suggest that human ancestors were able to control fire before at least 250 kya.

Key Clinical Message Diastrophic dysplasia (DTD) is caused by biallelic pathogenic variants in the SLC26A2 gene. We report the case of a 49‐year‐old female with DTD and esophageal stenosis. This broadens the phenotypic spectrum in adult patients with DTD and raises awareness of extra‐skeletal manifestations that could develop in later stages of life.

Overweight and obesity in adolescents has become a serious public health problem worldwide and Mexico City is no exception. Therefore, the objective of this study was to investigate the epidemiological panorama of overweight and obesity related to eating habits, physical activity and the concurrent presence of depression and anxiety in adolescents from high schools in Mexico City. Anthropometric measurements were taken from 2710 adolescents from 33 participating high schools. Likewise, a previously validated eating habit and physical activity questionnaire was administered, which consisted of four different sections, where each of the sections focused on key aspects of the participants’ lifestyle: (1) eating habits, (2) intake of non-recommended foods, (3) food and company environment, and (4) physical activity. Moreover, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression was applied. In this study, a high prevalence of overweight and obesity (26.5% overweight and 20.0% obese) was found in adolescents from high schools in Mexico City. Only 13.14% of participants had adequate eating habits and 18.19% physical activity habits. An association was found between having inadequate eating habits and obesity in adolescent women (OR = 1.95; CI 1.009–3.76). Additionally, associations were observed between depression symptoms and obesity (OR = 5.68, CI 1.36–32.81; p = 0.01), while anxiety was associated with underweight and obesity adjusted by other dietary habits and psychological factors. Therefore, it is important to identify adolescents with overweight or obesity and establish prevention strategies for weight control in this age group, promoting healthy eating, physical activity and education in mental health.

Abstract The Navachiste complex (NAV) is impacted by neighbored human activities and is located in the southwestern coastal zone of the Gulf of California. The study determines the trace metal (TM) and organochlorine pesticides (OCP) health risk content in the edible tissue of Sphoeroides spp. from NAV. The daily intakes (EDI), target hazard quotient (THQ), hazard index (HI), and carcinogenic and non-carcinogenic risks were calculated. Twenty OCP and seven TM were detected. Cd, Cu, Fe, Mn, Pb, and Zn were above MRLs. The γ‒Chlordane was the most frequent OCP. The highest average concentration was for α‒HCH, followed by γ‒chlordane. With the high ratios of γ‒HCH, p, p′‒ DDD and p, p′‒DDD, and the absence of p, p′‒ DDT, the higher ratios for dieldrin and endrin than for aldrin, α‒ chlordane, γ‒chlordane, heptachlor, and heptachlor epoxide indicates historical contamination. In contrast, the residual products of methoxychlor, endosulfan, and its isomers indicate endosulfan's recent use. The TM EDI, THQ > 1 (at 120 g day−1), and the ILCR (> 1 × 10–6) were above minimum levels, showing a high-risk potential for cancer development in the long term.

Introduction: Human papillomavirus (HPV) infection is the most common sexually transmitted infection (STI), and it is a major risk factor for penile, oropharyngeal and anal cancer. HPV anal infection is common in men-who-have-sex-with-men (MSM), especially in patients living with HIV (MSM-HIV). HPV can also be detected in genitalia and oral tissues. The objective of this cross-sectional study is to analyze the prevalence of HPV genital and oral infection in a HIV-MSM cohort. Methods: This cross-sectional study of HPV infection included 107 HIV-MSM subjects recruited in a HIV follow-up unit of Northwest Spain. HPV-vaccinated subjects were excluded. HPV-DNA was detected with Anyplex™ II HPV28 method. Participants completed a questionnaire on lifestyle and sexual behavior. Results: Median age was 43 years (range 35-54 years); 97 patients received antiretroviral treatment (ART); 81 (75.7%) had undetectable HIV-RNA; median CD4-lymphocyte count was 746 cell/mm3; 70 (65.4%) participants had a previous STI. Genitalia HPV-DNA was detected in n=37 (34.6%) subjects and oral HPV-DNA was detected in 26 (24.3%). In 12 (11.2%) patients, HPV-DNA was detected in both locations. High risk HPV (hrHPV) genotypes were detected in 24 (22.4%) and 15 (14%) patients in genitalia and oral samples respectively. Genitalia HPV-DNA isolation was more common in HIV virologically non-suppressed patients (65.4% vs 24.7%; p

Background: The Platelet-Activating Factor (PAF)/receptor (PAFR) system is involved in asthma and allergic rhinitis; however, its role in chronic rhinosinusitis (CRS) is still unclear. This study aimed to assess the expression of PAFR and the concentration of Lyso-PAF isoforms in the nasal polyps (NP) of patients suffering from CRS with/without comorbidities such as asthma and NSAID-exacerbated respiratory disease (N-ERD) compared to healthy nasal mucosa (NM) from control subjects. Methods: NM (n = 8) and NP tissues were obtained from patients undergoing surgery for septal deviation/turbinate hypertrophy or endoscopic sinus surgery, respectively. Three phenotypes were studied: CRSwNP with no asthma (n = 6), CRSwNP with non-steroidal anti-inflammatory drug (NSAID)-tolerant asthma (n = 6), and CRSwNP with NSAID-exacerbated respiratory disease (n = 6). PAFR protein and mRNA were assessed via immunochemistry, immunofluorescence, Western blot, and real-time quantitative PCR. Lyso-PAF isoforms (C16, C18, and C18:1) were quantified via mass spectrometry. Results: PAFR protein was expressed in the NM and NP, concretely in epithelial cells and submucosal glands. Compared to NM, PAFR mRNA expression was higher in all NP phenotypes (p < 0.05) while all Lyso-PAF isoform concentrations were higher in the NP from asthmatic patients (p < 0.05). Lyso-PAF C16 and C18 concentrations were higher in the NP from asthmatic patients than in the NP from patients without asthma. Conclusions: The PAF/PAFR system could play a pathophysiological role in CRSwNP pathogenesis.

Introduction: Colonoscopy is useful for the diagnosis and treatment of colorectal diseases. It is used as a method of detecting malignant diseases. Most cases of colorectal cancer originate from an adenoma, a process known as the adenoma-carcinoma sequence. Removal of advanced adenomas interrupts the potential pathway for colorectal cancer development. The water method of colonoscopy increases the detection rate of adenomas. Objective: To update knowledge related to colonoscopy with the method of immersion in water. Development: Water-assisted colonoscopy can be subdivided into water immersion, water exchange, or totally underwater. Both immersion and water exchange colonoscopy produce less pain for the patient and reduce the need for sedation medications, with a higher percentage of colonoscopies completed in awake patients. The use of water improves the detection of adenomas by facilitating greater cleaning of the intestine of residual feces, in addition to allowing inspection of the mucosa without completely distending the light as air does, increasing the detection performance of flat lesions. Conclusions: The detection rate of adenomas with the water method, especially at the level of the right colon, is higher than with the air insufflation method.

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder, with an onset in childhood, that accompanies the person throughout their life, with prevalence between 3 and 5% in adults. Recent studies point towards a fourth core symptom of the disorder related to the emotional information processing that would explain the repercussions that ADHD has on the social, academic, and professional life of the people affected. This review aims to describe emotion dysregulation features as well as the brain activity associated in adults with ADHD. A search of the scientific literature was launched in specialized databases: PsycInfo, Medline, Eric, PsycArticle, Psicodoc and Scopus, following PRISMA guidelines. Twenty-two articles met the inclusion criteria: (a) an ADHD clinical diagnosis, (b) participants over 18 years old, (c) emotion regulation measurement, (d) empirical studies, and (c) in English. Due to the heterogeneity of the studies included, they were classified into three sections: measures and features of emotion regulation (ER) in people with ADHD, neurological and psychophysiological activity related to ER, and treatments. The studies found that meet the selection criteria are scarce and very heterogeneous both in aims and in sample features. Adults with ADHD show a more frequent use of non-adaptive emotion regulation strategies compared to people without ADHD symptoms. Moreover, emotion dysregulation was associated with symptom severity, executive functioning, psychiatric comorbidities, and even with criminal conviction. Different patterns of brain activity were observed when people with and without ADHD were compared. These results may suggest that psychopharmacological treatments as well as behavioral therapies could be useful tools for improving emotional difficulties in adult ADHD.

Abstract Survivors to COVID-19 have described long-term symptoms after acute disease. These signs constitute a heterogeneous group named long COVID or persistent COVID. The aim of this study is to describe persisting symptoms 6 months after COVID-19 diagnosis in a prospective cohort in the Northwest Spain. This is a prospective cohort study performed in the COHVID-GS. This cohort includes patients in clinical follow-up in a health area of 569,534 inhabitants after SARS-CoV-2/COVID-19 diagnosis. Clinical and epidemiological characteristics were collected during the follow up. A total of 248 patients completed 6 months follow-up, 176 (69.4%) required hospitalization and 29 (10.2%) of them needed critical care. At 6 months, 119 (48.0%) patients described one or more persisting symptoms. The most prevalent were: extra-thoracic symptoms (39.1%), chest symptoms (27%), dyspnoea (20.6%), and fatigue (16.1%). These symptoms were more common in hospitalized patients (52.3% vs. 38.2%) and in women (59.0% vs. 40.5%). The multivariate analysis identified COPD, women gender and tobacco consumption as risk factors for long COVID. Persisting symptoms are common after COVID-19 especially in hospitalized patients compared to outpatients (52.3% vs. 38.2%). Based on these findings, special attention and clinical follow-up after acute SARS-CoV-2 infection should be provided for hospitalized patients with previous lung diseases, tobacco consumption, and women.

Despite the significant advances in research on diabetes, relatively few researchers have examined the theoretical and empirical usefulness of explanatory models that contribute to self-management of the disease. In response to the theoretical and empirical approaches related to this topic, the objective of this research was to assess a hypothetical model to explain self-management behavior in patients with type II diabetes through structural equation modeling in a population of users of the services of the State Health Department of Tamaulipas, Mexico. The study used a cross-sectional and explanatory design. The sample was intentional. A total of 183 patients with a diabetes diagnosis completed a sociodemographic data questionnaire, the Partners in Health Scale, the Duke-UNC-11, the Family Apgar, the Self-Efficacy Scale, the Personal Health Questionnaire and the Physical Activity Scale. The results indicated that the hypothetical model was improved by excluding the exercise variable. The appropriate model was used to determine the effects of depression, social support, self-efficacy, family functioning, years of formal education and years with a diagnosis on self-management. The goodness-of-fit indices (GFIs) were good, i.e., χ2/gl = 0.89 (p = 0.529), root mean square error of approximation (RMSEA) = 0.000, and comparative fit index (CFI) = 1.000, with an acceptable degree of parsimony (PNFI = 0.409 and PGFI = 317). The model explained 33.6% of the variance. Therefore, this model represents an important advance in knowledge concerning self-management and provides empirical and theoretical evidence, particularly for the Mexican or Latino population.

Leishmaniasis is a neglected tropical infectious disease with thousands of cases annually; it is of great concern to global health, particularly the most severe form, visceral leishmaniasis. Visceral leishmaniasis treatments are minimal and have severe adverse effects. As guanidine-bearing compounds have shown antimicrobial activity, we analyzed the cytotoxic effects of several guanidine-bearing compounds on Leishmania infantum in their promastigote and amastigote forms in vitro, their cytotoxicity in human cells, and their impact on reactive nitrogen species production. LQOFG-2, LQOFG-6, and LQOFG-7 had IC50 values of 12.7, 24.4, and 23.6 µM, respectively, in promastigotes. These compounds exhibited cytotoxicity in axenic amastigotes at 26.1, 21.1, and 18.6 µM, respectively. The compounds showed no apparent cytotoxicity in cells from healthy donors. To identify mechanisms of action, we evaluated cell death processes by annexin V and propidium iodide staining and nitrite production. Guanidine-containing compounds caused a significant percentage of death by apoptosis in amastigotes. Independent of L. infantum infection, LQOFG-7 increased nitrite production in peripheral blood mononuclear cells, which suggests a potential mechanism of action for this compound. Therefore, these data suggest that guanidine derivatives are potential anti-microbial molecules, and further research is needed to fully understand their mechanism of action, especially in anti-leishmanial studies.

Abstract Background Dimensional changes after dental extraction frequently lead to situations in which bone augmentation procedures are required prior to dental implant placement. Bone ring technique (BRT) has been described as a one-stage approach to restore vertical alveolar ridge defects, in which an autogenous or allogeneic cortico-cancellous bone block graft is stabilized with a dental implant inserted simultaneously. The objective of this systematic review was to evaluate the clinical performance of BRT. Materials and methods This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. Results Sixteen studies with a total of 186 patients treated with 219 bone rings bocks were included in the review. The studies showed a mean bone gain of 4.94 mm, mean bone resorption of 0.83 mm, and mean marginal bone loss of 0.57 mm after a mean follow-up period of 13.35 months. A mean bone ring survival rate of 97.26% and implant survival rate of 94.97% were recorded. Conclusions BRT would appear to be an adequate alternative technique for restoring single vertical alveolar ridge defects with simultaneous dental implant placement. However, further studies comparing this technique with other vertical ridge augmentation procedures in different clinical scenarios are needed to confirm the present results.

Body condition for reproduction in capital breeders such as the red deer (Cervus elaphus) is mostly determined by their stored energy reserves. Thus, environmental conditions and resource availability may affect reproductive performance and breeding success. In warm Mediterranean regions, current climate change is driving to a hotter and drier scenario that is expected to affect the biology and dynamics of many populations. We examined the impact of these local climate variations on red deer body condition and the relationship with female reproductive phenology and breeding success. We used satellite information of landscape vegetation along with a 22-year data series of direct field behavioural observations during the rutting season in Doñana National Park (SW Spain). We analyzed faecal nitrogen content (FN) from faeces collected during the rut. We found that poor vegetation availability in drier years was related to worse body condition of deer (measured by FN) and a delay in the rutting season, which associated with lower reproductive rates (measured by the proportion of females with calves observed the next year). We also evidenced an interesting interaction between environmental conditions in consecutive years on the timing of breeding season, with timing of breeding being more delayed when previous year resource availability was high and many females bred, and the consecutive one was poor, so females hardly recovered condition and the rut occurred later. These findings highlight the carry-over effect of reproduction in capital breeders and the potential impact of climate-change conditions on red deer breeding.

Abstract Background Follicular lymphoma is an indolent non-Hodgkin lymphoma that is most commonly diagnosed in elderly individuals. The majority of patients with follicular lymphoma present with advanced disease. Despite the recent advances in treatment, there remains a substantial unmet need for effective treatments for patients with relapsed/refractory follicular lymphoma. The PI3Kδ inhibitor idelalisib was approved by the European Medicines Agency in 2014 as a monotherapy for the treatment of adult patients with follicular lymphoma that is refractory to two prior lines of treatment. Real-world evidence from patients with follicular lymphoma treated with idelalisib indicates its utility in these patients. Case presentation This case report describes an 82-year-old, retired, white, female patient with refractory follicular lymphoma who achieved a partial response with idelalisib treatment. Despite experiencing two incidences of a psoriasis-like rash during idelalisib treatment that required effective management with topical steroids, the patient was able to restart treatment successfully and maintain a continued partial response. Conclusions The clinical relevance of the effective management of adverse events in this case demonstrates the opportunity to enable patients to remain on therapy, thereby maintaining long-term response and improving overall outcomes.

Cancer is a disease caused by the alteration of proto-oncogenes and tumor suppressor genes, has a high prevalence in the population, and is one of the main causes of death worldwide. For its treatment, there are different therapy options; however, these are not always effective for all existing types of cancer, which gives rise to the search for new compounds. The objective of this work is to determine the degree of cytotoxic activity of naphthoxyacetamide using dose–response curves in a cell viability assay. For this, the cytotoxic effects of N-(2-morpholinoethyl)-2-(naphthalen-2-yloxy) were identified in cancer cells (HeLa) based on the metabolic reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenylretrazol (MTT) bromide. The cell cultures were seeded at a density of 5000 cells/well in 96-well plates and treated by hexapplication with various concentrations of the compounds to be tested (0.31–3.16 µM/mL) for 24 h. Microplates were read in an ELISA reader at 575 nm. The dose–response curve of N-(2-morpholinoethyl)-2-(naphthalen-2-yloxy)acetamide (3.16, 1.77, 1, 0.31 µM/mL) showed that at a concentration of 3.16 µM/mL, it presents cytotoxic effects similar to those shown by the drug reference (cisplatin 3.32 µM/mL). In conclusion, N-(2-morpholinoethyl)-2-(naphthalen-2-yloxy)acetamide showed cytotoxic effects similar to cisplatin.

RESUMEN Introducción: La pesquisa activa realizada por estudiantes de medicina en Cuba tiene la finalidad de descubrir tempranamente la morbilidad oculta. Esta permite un diagnóstico precoz y la garantía de una atención continuada. Objetivos: Conocer la valoración de los estudiantes en relación con la calidad de la capacitación recibida, la comunicación con el médico de la familia y la pesquisa de personas mayores en riesgo, así como sobre los aspectos positivos, negativos, interesantes e interrogantes en relación con la pesquisa. Identificar propuestas de mejoras en retroalimentación de la pesquisa. Métodos: Se realizó un estudio descriptivo de corte transversal en el cual fueron encuestados 164 estudiantes que participaron en la pesquisa de casos sospechosos de enfermedad por coronavirus COVID 19, en tres policlínicos de dos municipios de la provincia La Habana, Cuba, en el periodo de tiempo entre mayo y junio del año 2020. Resultados: En los tres policlínicos predominó el sexo femenino entre los estudiantes. La edad promedio de los pesquisadores fue de 20,7 años, es decir, adolescentes casi adultos. La mayor cantidad de estudiantes eran de la carrera de medicina, seguido estomatología, en ambos casos entre los años primero a quinto y uno de cada cinco correspondió a tecnología de la salud de primero y segundo año. Conclusiones: Los estudiantes reconocen la importancia de la pesquisa al mismo tiempo que expresan preocupaciones que, aunque no son expresadas por todos ni en mayoría, cada una contribuye a retroalimentar esta tarea con mejoras en la actividad de capacitación. Además, debe tener en cuenta los pronósticos para los próximos meses sobre otras entidades que se pueden beneficiar con esta actividad.

Background Among entomopathogenic fungi, H. citriformis has been recognized as potential biocontrol agent against the Asian citrus psyllid Diaphorina citri (Hemiptera: Liviidae). Nevertheless, this fungus is poorly characterized. Previous molecular studies have shown high sequence similarities among strains, but significant differences in Diaphorina citri virulence. Objective The aim of the present study was to determine mycelial compatibility and anastomosis, and nucleus numbers in mycelium and conidia of eight H. citriformis strains isolated from mycosed D. citri adults collected from several Mexican states. Methods Mycelial compatibility and anastomosis evaluation was performed after pairing strains, leading to 36 confrontations, and cultured in chlorate minimum medium to obtain mutants for vegetative compatibility group. Results Hypha or conidia nuclei were visualized with safranin-O and 3% KOH, and 0.05% trypan blue–lactophenol solution. H. citriformis strains showed compatibly and anastomosis events after confrontation. In addition, they showed one nucleus per conidium and mycelium section. It was not possible to obtain H. citriformis nit mutants from the chlorate concentrations tested. Conclusions To date, this is the first report demonstrating mycelial compatibility, anastomosis occurrence, and hyphae and conidia nuclei number among H. citriformis strains.

Introducción: la cirugía del cristalino se considera uno de los métodos quirúrgicos más seguros a nivel mundial. Objetivo: describir las consideraciones quirúrgicas a tener en cuenta para lograr el éxito de la facoemulsificación del cristalino en pacientes con cierre angular primario en el Hospital General Docente “Abel Santamaría Cuadrado” de Pinar del Río. Métodos: se realizó una búsqueda de los principales artículos científicos de los últimos años, así como de la literatura impresa que incluye el tema, siendo seleccionados los contenidos más relevantes para la confección del informe final. Desarrollo: la extracción del cristalino constituye un reto quirúrgico en pacientes con cierre angular primario por las peculiaridades anatómicas, variaciones de la presión intraocular y alteraciones del segmento anterior asociadas. Conclusiones: un detallado examen preoperatorio, una adecuada técnica quirúrgica realizada por un cirujano hábil puede reducir el índice de complicaciones y lograr total éxito.

Introducción: la clínica del cierre angular primario puede variar desde una sospecha de la enfermedad hasta estadios avanzados del daño glaucomatoso, lo que puede provocar ceguera. Objetivo: describir la epidemiología del cierre angular primario en pacientes pinareños, una vez identificadas las variables sociodemográficas y oculares que determinan su forma clínica. Métodos: se realizó un estudio descriptivo transversal en Pinar del Río, en los años 2013 y 2017, el universo estuvo constituidos por 293 casos nuevos con diagnóstico de cierre angular primario en cualquiera de sus formas clínicas. El análisis estadístico se realizó con el programa SPSS. Resultados: la edad media fue 57,69 ± 7,35 años; predominaron las mujeres (89,5 %) y el 77,2 % evidenció una situación de estrés. Los valores promedio de longitud axial y amplitud de cámara anterior fueron 21,89 ± 0,49 mm y 2,65 ± 0,27 mm. El 87,03 % de los ojos mostró ángulo estrecho. La media de la presión intraocular basal fue de 23,86 ± 5,81. Al analizar las variables sociodemográficas y oculares en relación a la forma clínica, se encontró que los factores que la determinan fueron: edad (p

Introduction: ultrasound is a non-invasive, widely distributed and low-cost technique that constitutes the study of choice of scrotal disease. Objective: to clinically and ultrasonographically characterize patients with scrotal lesions treated at the “Abel Santamaría Cuadrado” hospital. Method: an observational, descriptive and cross-sectional study was carried out in patients with scrotal lesions treated at the “Abel Santamaría Cuadrado” General Teaching Hospital belonging to the province of Pinar del Río in the period between 2016 and 2018. The universe consisted of 62 patients. Theoretical, empirical and statistical methods were used for data collection and analysis. Results: the age group with the highest incidence was 30 to 39 years old (35,5 %). Pain was found in 61,3 % of patients, lesions that affected the left scrotum predominated (47,0 %). The presence of fluid in the scrotum was the most frequent ultrasonographic finding (48,4 %) and the disease with the highest incidence was varicocele with 43,5 %. Conclusions: scrotal ultrasound is a key piece in the evaluation of patients with symptoms at this level, both for ease of access and repetition, as well as for the great information it provides in most cases, which allows immediately, guide the process and attitude to follow in the patient.

In this article, the effects of cross-section and pitch on the mechanical response of NiTi endodontic files is studied by means of finite element analyses. The study was conducted over a set of eight endodontic rotary files, whose geometry was obtained from combinations of two cross-sections (square and triangular) and four pitches. Each file was subjected to bending and torsional analyses, simulating the testing conditions indicated in the ISO 3630 Standard, in order to assess their stiffness and mechanical strength. The results indicate that endodontic files with a square cross-section have double the stiffness of those with triangular cross-sections, both in terms of bending and torsion. For both loading modes, endodontic files with a triangular cross-section can undergo larger deformations before overload failure than those with a square cross-section: up to 20% more in bending and 40% in torsion. Moreover, under equivalent boundary conditions, endodontic files with triangular cross-sections present a higher fatigue life than those with square cross-sections: up to more than 300% higher for small pitches. The effect of pitch on the stiffness and strength of the file is smaller than that of the cross-section shape, but smaller pitches could be beneficial when using a triangular cross-section, as they increase the bending flexibility, fatigue life, and torsion stiffness. These results suggest a clinical recommendation for the use of files with a triangular-shaped cross-section and a small pitch in order to minimize ledging and maximize fatigue life. Finally, in this study, we reveal the sensitivity of the orientation of files with respect to the bending direction, which must be taken into account when designing, reporting, and interpreting test results under such loading conditions.

Purpose The Mother and Child COVID-19 study is a cohort recruiting pregnant women and their children in Cantabria, North of Spain, during COVID-19 pandemic in order to ascertain consequences of SARS-CoV-2 infection on pregnant women and their descendants. This article reports the cohort profile and preliminary results as recruitment is still open.Participants Three subcohorts can be identified at recruitment. Subcohort 1 includes women giving birth between 23 March and 25 May 2020; they have been retrospectively recruited and could have been exposed to COVID-19 only in their third trimester of pregnancy. Subcohort 2 includes women giving birth from 26 May 2020 on; they are being prospectively recruited and could have been exposed to COVID-19 in both their second and third trimesters of pregnancy. Subcohort 3 includes women in their 12 week of pregnancy prospectively recruited from 26 May 2020 on; they could have been exposed to COVID-19 anytime in their pregnancy. All women are being tested for SARS-CoV-2 infection using both RT-PCR for RNA detection and ELISA for anti-SARS-CoV-2 antibodies. All neonates are being tested for antibodies using immunochemoluminiscency tests; if the mother is tested positive for SARS-CoV-2 RNA, a nasopharyngeal swab is also obtained from the child for RT-PCR analysis.Findings to date As of 22 October, 1167 women have been recruited (266, 354 and 547 for subcohorts 1, 2 and 3, respectively). Fourteen women tested positive to SARS-CoV-2 RNA by the day of delivery. All 14 children born from these women tested negative for SARS-CoV-2 RNA.Future plans Children from women included in subcohort 3 are expected to be recruited by the end of 2020. Children will be followed-up for 1 year in order to ascertain the effect that COVID-19 on their development.

In the last decades, climate change has caused an increase in mean temperatures and a reduction in average rainfall in southern Europe, which is expected to reduce resource availability for herbivores. Resource availability can influence animals' physical condition and population growth. However, much less is known on its effects on reproductive performance and sexual selection. In this study, we assessed the impact of three environmental factors related to climate change (rainfall, temperature and vegetation index) on Iberian red deer Cervus elaphus hispanicus reproductive timing and sexual behaviour, and their effects on the opportunity for sexual selection in the population. We measured rutting phenology as rut peak date, the intensity of male rutting activity as roaring rate, and the opportunity for sexual selection from the distribution of females among harem holding males in Doñana Biological Reserve (Southwest Spain), from data of daily observations collected during the rut over a period of 25 years. For this study period, we found a trend for less raining and hence poorer environmental conditions, which associated with delayed rutting season and decreased rutting intensity, but that appeared to favour a higher degree of polygyny and opportunity for sexual selection, all these relationships being modulated by population density and sex ratio. This study highlights how climate change (mainly rainfall reduction in this area) can alter the conditions for mating and the opportunity for sexual selection in a large terrestrial mammal.

Background: The purpose of this study was to describe temporal trends in the use of antiretroviral therapy (ART) among people living with HIV (PLWHIV) from the cohort of the Spanish HIV/AIDS research network (CoRIS), 2004–2020. Methods: We described the yearly evolution of the proportion of patients receiving ART and the most frequently prescribed antiretroviral drugs among newly recruited treatment-naïve patients and among all patients with active follow-up. Results: Of 15,539 patients included, 14,618 (94.1%) started ART during their follow-up. Regarding initial regimens, the use of 2NRTI plus 1NNRTI (which were the most frequently prescribed until 2014) and 2NRTI plus 1bPI decreased after 2014, being gradually replaced by INI-based triple therapies. Since 2019, other regimens started to be prescribed, mainly dual therapies. TDF/FTC/EFV was the single-tablet regimen (STR) most frequently prescribed as initial ART until 2012, decreasing thereafter as TDF/FTC/RPV, TDF/FTC/EVG/COBI, and ABC/3TC/DTG became available. TAF/FTC/BIC accounted for 53.6% of initial prescriptions in 2020, followed by DTG/3TC (24%). The percentage of patients on ART increased from 45.7% in 2004 to 98.2% in 2020. Among all patients receiving ART, regimens based on 2NRTI plus 1INI increased from 0.1% in 2007 to 53.3% in 2020. During 2007–2015, most patients were receiving TDF/FTC/EFV, which was replaced after 2017 by ABC/3TC/DTG. In 2020, 13.0% of patients were receiving dual therapies. Conclusions: Robust real-world data on ART use in PLWHIV over more than 15 years show historical trends in prescriptions with an unprecedented visualization of the contemporary treatment patterns.

Trypanosoma cruzi infection leads to Chagas disease (CD), a neglected tropical infection of significant public health importance in South and Central America and other, non-endemic, countries. Pregnant women and their children are of particular importance to screen as T. cruzi can be transmitted vertically. The objective of this study was to screen for T. cruzi infection among pregnant women from endemic areas seen at the Hospital General de Mexico for prenatal care, so that they and their children may be quickly connected to CD treatment. Pregnant women were recruited through the hospital prenatal clinic and screened for T. cruzi infection using a series of serological and molecular tests. Of 150 screened patients, mean age 26.8 (SD 6.4), 30 (20.0%) were positive by at least one diagnostic test. Of these, only nine (6%) were positive as determined by PCR. Diagnosis of chronic CD is difficult in endemic places like Mexico due to the limitations of current commercially available diagnostic tests. Further evaluation of diagnostic performance of various assays could improve current CD diagnostic algorithms and proper care management in these regions. Genetic variability in the parasite may also play a role in the differing assay performances seen in this study, and this may be a valuable avenue of further research.

There is a significant number of funerary contexts for the Early Neolithic in the Iberian Peninsula, and the body of information is much larger for the Late Neolithic. In contrast, the archaeological information available for the period in between (ca. 4800-4400/4200 cal BC) is scarce. This period, generally called Middle Neolithic, is the least well-known of the peninsular Neolithic sequence, and at present there is no specific synthesis on this topic at the peninsular scale. In 2017, an exceptional funerary context was discovered at Dehesilla Cave (Sierra de Cádiz, Southern Iberian Peninsula), providing radiocarbon dates which place it at the beginning of this little-known Middle Neolithic period, specifically between ca. 4800-4550 cal BC. Locus 2 is a deposition constituted by two adult human skulls and the skeleton of a very young sheep/goat, associated with stone structures and a hearth, and a number of pots, stone and bone tools and charred plant remains. The objectives of this paper are, firstly, to present the new archaeological context documented at Dehesilla Cave, supported by a wide range of data provided by interdisciplinary methods. The dataset is diverse in nature: stratigraphic, osteological, isotopic, zoological, artifactual, botanical and radiocarbon results are presented together. Secondly, to place this finding within the general context of the contemporaneous sites known in the Iberian Peninsula through a systematic review of the available evidence. This enables not only the formulation of explanations of the singular new context, but also to infer the possible ritual funerary behaviours and practices in the 5th millennium cal BC in the Iberian Peninsula.

Sexual signals play a central role in male-male competition in polygynous species. In red deer (Cervus elaphus), male's ventral area become dark during the rutting season due to urine spraying behaviour and retains many chemical compounds potentially revealing individual features. Here we investigate the variation in size of this trait, exploring its relationship with age and male competitive features such as antlers or body size, as well as populational level of intrasexual competition for mates. We found that the size of the dark ventral patch followed a clearly bimodal distribution, i.e. males mostly expressed the full-size trait or just developed a very small one. For these two groups of males according to trait expression, the relationships of trait size with age and antler size differed. Populational level of intrasexual competition appeared to affect the relationship between antler size and the probability of a fully developed ventral patch. These results indicate that the trait encodes information on body size, antler size, age and populational level of mate competition, thus suggesting a role in signalling male's competitive features and willingness to allocate reproductive effort within a particular season.

Abstract Objective Obtaining high and stable transgene expression is of vital importance for plant genetic engineering. A lot is known about the relationship between terminator efficiency and gene expression, but no studies have addressed the relationship between terminator usage and transgene expression stability or heritable gene silencing. In this paper, we aim to analyze if terminators are a determining factor in the establishment of promoter DNA methylation of plant transgenes. Results Our experiments comparing plants with a LUC reporter under the 35S CaMV promoter and good efficiency terminators (Thsp, T35S) show that the use of efficient terminator sequences does not avoid the accumulation of promoter DNA methylation and transgene silencing. However, Thsp lead to a higher reporter gene expression and lower promoter DNA methylation levels than T35S, supporting that terminator usage is indeed involved in the establishment of TGS by methylation of transgenes’ promoters. In the case of a terminatorless construct, the PTGS initiated by the improperly terminated mRNAs is not followed by the establishment of heritable silencing in the form of strong promoter DNA methylation, like in the case of TAS genes and reactivated TEs (for the transgene DNA methylation levels remained below the 20%).

Introduction: phacolytic ocular hypertension is a condition where an increase in intraocular pressure is observed; which is secondary to the obstruction of the trabecular meshwork due to the deposition of high molecular weight crystalline proteins and macrophages in patients with hyper-mature cataract. Case report: a 68-year-old male patient with facolytic ocular hypertension in the left eye was examined. During the extraction of the lens and the aspiration of cortical remains, it was found that white flocculent material persisted between the posterior capsule of the lens and the anterior hyaloids, a posterior capsulotomy with anterior vitrectomy and IOL implantation in sulcus had to be performed. Despite the risks involved, satisfactory surgical results were achieved. Conclusions: the definitive behavior in any case with ocular facolytic hypertension involves the extraction of the lens; however, the patient’s own ocular characteristics must be assessed in such a way that the behavior to be followed can be individualized in order to obtain a surgical result and a favorable evolution.

This article describes a numerical procedure for estimating the fatigue life of NiTi endodontic rotary files. An enhanced finite element model reproducing the interaction of the endodontic file rotating inside the root canal was developed, which includes important phenomena that allowed increasing the degree of realism of the simulation. A method based on the critical plane approach was proposed for extracting significant strain results from finite element analysis, which were used in combination with the Coffin–Manson relation to predict the fatigue life of the NiTi rotary files. The proposed procedure is illustrated with several numerical examples in which different combinations of endodontic rotary files and root canal geometries were investigated. By using these analyses, the effect of the radius of curvature and the angle of curvature of the root canal on the fatigue life of the rotary files was analysed. The results confirm the significant influence of the root canal geometry on the fatigue life of the NiTi rotary files and reveal the higher importance of the radius of curvature with respect to the angle of curvature of the root canal.

Migrants and refugees need international protection, particularly during a crisis such as the current health pandemic. The aim of this research was to examine the mental health and attitudes towards COVID-19 in migrants and refugees compared to the general Spanish population. Moreover, the nature of resilience was examined as a mixed component though life experiences. For this proposal, an interview was carried out in a sample of 245 participants who volunteered to participate in the study. The sample was divided into Spanish non-migrants, Spanish migrants, non-Spanish migrants and refugees. Attitudes towards COVID-19, resilience (based on BRCS) and mental health (based on DASS-21) were measured. The results obtained can be described as follows: (i) Migrant participants indicated worse mental health than non-migrants, and within the migrant group, refugees presented worse scores; (ii) No differences were found in attitudes towards COVID-19 in any of the subgroups; (iii) A moderating effect of group was found for the relationship between resilience and mental health but not between resilience and fear of COVID-19. These results might be of great interest in making visible the vulnerability of migrants and specifically refugees, and the proposal of intervention programs based on resilience training.

Pneumonia is the leading cause of hospital admission and mortality in coronavirus disease 2019 (COVID-19). We aimed to identify the cytokines responsible for lung damage and mortality. We prospectively recruited 108 COVID-19 patients between March and April 2020 and divided them into four groups according to the severity of respiratory symptoms. Twenty-eight healthy volunteers were used for normalization of the results. Multiple cytokines showed statistically significant differences between mild and critical patients. High HGF levels were associated with the critical group (OR = 3.51; p < 0.001; 95%CI = 1.95–6.33). Moreover, high IL-1α (OR = 1.36; p = 0.01; 95%CI = 1.07–1.73) and low IL-27 (OR = 0.58; p < 0.005; 95%CI = 0.39–0.85) greatly increased the risk of ending up in the severe group. This model was especially sensitive in order to predict critical status (AUC = 0.794; specificity = 69.74%; sensitivity = 81.25%). Furthermore, high levels of HGF and IL-1α showed significant results in the survival analysis (p = 0.033 and p = 0.011, respectively). HGF, IL-1α, and IL 27 at hospital admission were strongly associated with severe/critical COVID-19 patients and therefore are excellent predictors of bad prognosis. HGF and IL-1α were also mortality biomarkers.

Introduction: there is currently a tendency toward phacoemulsification in the primary angular closure due to the crucial role of the lens in the pathophysiology of the disease. Objective: to describe the results of phacoemulsification in patients with primary angular closure in Pinar del Río. Method: a prospective longitudinal descriptive study was carried out in Pinar del Río, between January 2013 and December 2015, which included 43 patients with primary angular closure not controlled by laser peripheral iridotomy or medical treatment, who underwent phacoemulsification. Statistical analysis was performed using the SPSS program. Results: mean age was 54.67 ± 4.22 years and 83.7% were women. The mean amplitude value of the anterior chamber was 2.56  0.11 mm increasing to 3.24  0.08 mm (p = 0.006). 93.02% of the eyes showed a narrow angle, and after treatment 83.72% presented a grade 3-4 (p

Introducción: la trabeculectomía continúa siendo la cirugía incisional más utilizada para controlar la presión intraocular en pacientes glaucomatosos. Objetivo: describir los factores que influyen en el control de la presión intraocular postrabeculectomía. Método: se realizó un estudio descriptivo, longitudinal prospectivo en 91 trabeculectomizados del Hospital General Docente “Abel Santamaría Cuadrado” durante los años 2012 a 2015 y se describió control de la presión intraocular según variables que pudieron influir en este resultado, a través de la estadística descriptiva y el test de chi cuadrado. Resultados: los casos con control adecuado presentaron ausencia de antecedentes oculares (88,6 %), estadio moderado de la enfermedad (65,7 %), presión intraocular previa ≤ 30 mmHg (72,9 %) y ausencia de complicaciones posoperatorias (84,3 %). Con control relativamente adecuado o no adecuado predominaron los pacientes masculinos (92,9 % y 57,1 % respectivamente), con color de piel no blanca (85,7 %), antecedentes de trabeculectomía (57,1 %), daño avanzado y presión intraocular previa > 30 mmHg (85,7 %). Conclusiones: entre los factores que influyen en el control adecuado de la presión intraocular estuvieron los antecedentes oculares negativos, presión intraocular previa menor o igual a 30 mmHg y ausencia de complicaciones posoperatorias mientras que para un control relativamente adecuado o inadecuado influyeron el sexo masculino, color de piel no blanca, antecedente de trabeculectomía previa, daño glaucomatoso avanzado y presión intraocular previa mayor de 30 mmHg.

Introducción: la catarata puede ocurrir como una complicación del tratamiento por radiaciones o secundario al uso prolongado de esteroides en pacientes con Leucemia. Caso clínico: se presentó el caso de un paciente, masculino, de 24 años de edad, con antecedentes de Leucemia Mieloide Aguda para lo cual recibió tratamiento con poliquimioterapia y 6 meses más tarde con radiaciones y transplante autólogo. Acude a consulta de oftalmología 17 años después por disminución lenta y progresiva de la visión en ambos ojos. Después de un examen oftalmológico minucioso se hace el diagnóstico presuntivo de catarata subcapsular posterior bilateral secundaria a radiaciones ionizantes. Conclusiones: el cristalino es muy sensible a las radiaciones ionizantes, sin embargo, pueden transcurrir muchos años desde la exposición antes de que la catarata sea clínicamente manifiesta. Si no se asocian otras alteraciones oftalmológicas secundarias al tratamiento o una complicación propia de la enfermedad de base, la evolución es satisfactoria.

Introducción. El Síndrome Metabólico comprende un conjunto de factores de riesgo cardiovascular y constituye uno de los principales problemaspara los pacientes diabéticos. Objetivo. Determinar la frecuencia del síndrome metabólico en pacientes de 40 años y más con diagnóstico de diabetes mellitus tipo 2. Método. Se realizó un estudio transversal a los pacientes con el diagnóstico de diabetes mellitus tipo 2 del consultorio médico 8 del Policlínico Universitario Hermanos Cruz, Pinar del Río, de julio a diciembre de 2014; mediante una encuesta, se obtuvieron las variables edad, sexo y antecedentes patológicos personales. Se les realizó medición de la presión arterial y de la circunferencia de la cintura y determinación en sangre de triglicéridos y HDL-colesterol. Los datos obtenidos fueron descritos a través de frecuencias absolutas y relativas: porcentuales. Resultado. La frecuencia de síndrome metabólico en pacientes con diabetes mellitus tipo 2 fue elevada (73.8%), con predominio del sexo femenino y en edades de 60- 69 años y de los componentes del síndrome metabólico la asociación más frecuente fue la de diabetes tipo 2, hipertensión arterial, obesidad abdominal y triglicéridos elevados . Conclusiones. El Síndrome Metabólico tiene una alta frecuencia en pacientes diabéticos y su diagnóstico temprano nos permitirá aplicar intervenciones que promuevan cambios a estilos de vida saludables y tratamientos preventivos que impidan las complicaciones de la diabetes y de la enfermedad cardiovascular.

Las leucemias son un grupo de enfermedades neoplásicas caracterizadas por una proliferación anormal de células blancas. Las alteraciones oculares que se observan en estos pacientes pueden ser variadas e incluir aquellas que afectan al globo ocular y/o sus anexos. Se realizó una revisión bibliográfica con el objetivo de exponer las principales manifestaciones oftalmológicas en la leucemia; efectuando una búsqueda de los principales artículos científicos de los últimos años, así como de la literatura impresa que incluye el tema, siendo seleccionados los contenidos más relevantes para la confección del informe final. Se obtuvo que las manifestaciones oftalmológicas en pacientes con leucemia se agrupan en tres grupos: las manifestaciones leucémicas primarias o causadas por infiltración de células blásticas, las manifestaciones de origen secundario relacionadas con las variaciones en el perfil hematológico propio de estos pacientes y las manifestaciones secundarias a complicaciones del tratamiento antileucémico. Se hace imprescindible que los médicos especialistas en oftalmología y hematología estén informados y entrenados para detectar las diversas alteraciones oculares asociadas a la enfermedad leucémica, ya que un diagnóstico acertado con manejo oportuno, puede ser importante no solo para la salud visual del paciente, sino también, para la vida del mismo.

Background: iron-deficiency anemia is a nutritional problem of great magnitude, that especially affects children under five years of age.Objective: to assess the nutritional status and hemoglobin levels in children younger than five years of age belonging to the health district of the "Gustavo Aldereguía Lima" University Polyclinic, from January through December 2018.Methods: a cross-sectional descriptive study was carried out with children younger than five years of age of the aforementioned health district and during the time herein declared. The sample was made up of 105 children, who were applied the variables weight, height and hemoglobin determination. To process the information descriptive statistics was used, expressing the values in frequencies and percentages.Results: 22 % of the children presented anemia (16,2 % moderate and 5,8 % mild). In the 23 cases the diagnosis was iron-deficiency anemia. 39,05 % of all the children were thin and 50,48 % had a normal weight. Only about 10 % of the children were obese and overweight. 81,13 % of the children with normal weight according to height presented normal values in their hemoglobin levels. 17 % of the cases of anemia were moderate and only 2 % were mild.Conclusions: nutritional status and hemoglobin levels were described in the sample of children included in the study.

The aim of this study was to analyze the influence of the relative age effect (RAE) on the selection and promotion processes in an elite soccer academy. One hundred and eleven elite youth players who belonged to an elite soccer club from the Spanish "La Liga" participated in this study. Players were classified into three age-categories: under 14 years (U14), under 16 years (U16) and under 18 years (U18); and they were also classified in quartiles based on their date of birth (i.e., January-March, Q1; April-June, Q2; July-September, Q3; October-December, Q4). In addition, two further classification criteria were established based on the selection (i.e., selected and non-selected players) and promotion (i.e., promoted and non-promoted players) processes. The main results showed that in U14 and U16 age-categories, players born early in the year were over-represented compared to players born late in the year, although birth-distribution was not associated with the likelihood of a player to be selected or promoted. In addition, less fat in sum skinfolds, less percentage of fat, higher percentage of muscle and lower endomorphy and mesomorphy components were showed in U14 selected players, in comparison with non-selected players. Likewise, better sprint performance was found in U16 selected players versus non-selected ones. However, no significant differences on anthropometry, body composition, somatotype and physical performance were found between promoted and non-promoted players. Therefore, our results suggest there is need for coaches to reorient their talent identification programs in order to make sure that players selected to continue playing in the club have the potential to promote to the excellence in soccer.

Hit-to-lead virtual screening frequently relies on a cascade of computational methods that starts with rapid calculations applied to a large number of compounds and ends with more expensive computations restricted to a subset of compounds that passed initial filters. This work focuses on set up protocols for alchemical free energy (AFE) scoring in the context of a Docking-MM/PBSA-AFE cascade. A dataset of 15 congeneric inhibitors of the ACK1 protein was used to evaluate the performance of AFE set up protocols that varied in the steps taken to prepare input files (using previously docked and best scored poses, manual selection of poses, manual placement of binding site water molecules). The main finding is that use of knowledge derived from X-ray structures to model binding modes, together with the manual placement of a bridging water molecule, improves the R2 from 0.45 ± 0.06 to 0.76 ± 0.02 and decreases the mean unsigned error from 2.11 ± 0.08 to 1.24 ± 0.04 kcal mol-1. By contrast a brute force automated protocol that increased the sampling time ten-fold lead to little improvements in accuracy. Besides, it is shown that for the present dataset hysteresis can be used to flag poses that need further attention even without prior knowledge of experimental binding affinities.

Introducción y objetivos: Los anillos vasculares son anomalías poco comunes, en los que el enfoque diagnóstico y quirúrgico puede ser controvertido. El objetivo es revisar nuestros resultados quirúrgicos hospitalarios y en seguimiento. Métodos: Estudio observacional descriptivo de pacientes con anillos vasculares intervenidos en nuestro hospital. Resultados: Se incluyó a 26 pacientes con una mediana de edad de 9 meses (rango: 1 mes-38 años). Los pacientes fueron clasificados en 3 grupos: arco aórtico derecho-ligamento ductal izquierdo (n = 14), doble arco aórtico (n = 9) y sling pulmonar (n = 3). Un total de 3 casos fueron diagnosticados en el periodo prenatal (11,5%). En todos los casos el diagnóstico se realizó mediante tomografía computarizada (TC). Se observó divertículo de Kommerell en 11 pacientes (42,3%). Un 19,2% presentaron anomalías intracardiacas asociadas que requirieron cirugía. El abordaje quirúrgico principal fue la toracotomía izquierda con un 72,7%. Un 9,1% requirió cirugía traqueal. Un 13,6% preciso reintervención del anillo vascular. La necesidad de reintervención se asoció estadísticamente a ventilación mecánica previa, traqueomalacia y persistencia de síntomas respiratorios. No hubo mortalidad hospitalaria. La mortalidad en seguimiento ha sido 7,6%, debido a malformaciones mayores asociadas. Conclusiones: El principal método diagnóstico en nuestra serie es la TC. La broncoscopia antes y después del tratamiento quirúrgico permite evaluar el resultado de la técnica; en algunos casos ayuda a valorar la necesidad de realizar una pexia aórtica. La presencia de traqueomalacia y defectos estructurales en la vía aérea, junto con la asociación de cardiopatías congénitas severas, marcan el pronóstico en el seguimiento.

This work aims to argue the atomic model of Bohr and the development of nanoscience in health care. Nanotechnology constitutes an interdisciplinary assembly of various fields of natural sciences that are highly specialized. Achieving the desired material structure and configurations of certain atoms make to play Chemistry an important role; in Medicine specific development aimed at nanoparticles promises to help the treatment of certain diseases. Diseases can be identified by using biomarkers that interact with molecules associated with the disease in the blood, in body fluids or tissues. At present the methods of genetic analysis, proteomic analysis and nanodevices are the pillars for the prevention, detection, diagnosis for imaging, multifunctional therapeutic and improving the quality of life of patients affected by cancer. There is a growing need to improve the technology and instrumentation related to such methods for diagnosis with greater speed, resolution and sensitivity.

Introducción: La Cirugía Plástica Ocular (CPO) es una rama clínico-quirúrgica de la Oftalmología, dedicada a tratar las enfermedades de los anexos oculares. Sus inicios en Cuba datan de la década del 70 en el siglo XX. Objetivo: referir los acontecimientos históricos relacionados con el surgimiento y desarrollo de la Cirugía Plástica Ocular en Pinar del Río. Material y método: se realizó un estudio exploratorio, utilizándose para obtener la información fundamentalmente la revisión documental y los testimonios. Resultados: el avance científico técnico alcanzado fundamentalmente en el Instituto Cubano de Oftalmología permitió el surgimiento de la CPO en Pinar del Río y la Misión Milagro favoreció el desarrollo de la subespecialidad en la provincia, incrementándose los logros alcanzados. Conclusiones: la revisión documental y en especial los testimonios permitieron rescatar la información necesaria sobre los médicos que se han dedicado a esta rama de la oftalmología en Pinar del Río y los sucesos más relevantes en torno al tema.

Introducción: las urgencias oftalmológicas son causa frecuente de consulta en la atención primaria de salud, lo que constituye un reto para el médico. Objetivo: fundamentar los antecedentes históricos y situación actual del desempeño y la superación profesional en el manejo de urgencias oftalmológicas en la atención primaria de salud. Material y método: se realizó un estudio exploratorio. Se utilizó como método empírico la revisión documental; se emplearon los procedimientos lógicos del pensamiento, inducción-deducción y análisis-síntesis. Resultados: desde el surgimiento del programa del Médico General Integral han existido deficiencias en la atención a pacientes con urgencias oftalmológicas dadas fundamentalmente por insuficiencias en la superación. Actualmente existen los recursos humanos y materiales necesarios para revertir esta situación. Conclusiones: la superación profesional en el manejo de urgencias oftalmológicas en la atención primaria de salud es pieza clave para lograr la excelencia en la atención del proceso salud-enfermedad de la población, permitiendo el mejoramiento del desempeño profesional.

Introducción: la visita integral docente-asistencial al hogar constituye una de las formas de educación en el trabajo caracterizada por la aplicación del método clínico. Su realización desde la Atención Primaria de Salud es esencial para lograr en la comunidad indicadores de salud positivos. Objetivo: caracterizar la visita integral docente-asistencial al hogar desde la Atención Primaria de Salud. Material y método: se realizó una investigación descriptiva, transversal y analítica en el Policlínico universitario «Raúl Sánchez Rodríguez» del municipio de Pinar del Río, durante el primer trimestre del año 2015. El universo estuvo constituido por 34 profesores y 220 estudiantes de la carrera de Medicina, y la muestra de estudio lo constituyeron 17 docentes y 90 educandos de dicha institución seleccionados al azar. Se respetó la ética médica. Resultados: el colectivo profesoral estuvo constituido por un 11,8% de profesores auxiliares, 17,6% con categoría docente de asistente y 70,6% de instructores. En las causas de ingreso en el hogar predominaron las infecciones respiratorias agudas y las afecciones asociadas al embarazo con el 47,9% y el 23,2% respectivamente. El 97,2% de la muestra de estudio refirió criterios de bueno sobre la visita integral docente-asistencial al hogar. Conclusiones: se demostró la eficacia de la actividad integral docente-asistencial al hogar como forma de educación en el trabajo, lo cual contribuyó a una mayor calidad y satisfacción en educadores y educandos incidiendo positivamente en la población.