Influencia de la sensibilidad, la calidad y la empatía en la satisfacción de proveedores de servicios de Internet

Este trabajo proporciona elementos para el desarrollo de un modelo conceptual del efecto que presentan la sensibilidad y la empatía sobre la percepción de calidad y la satisfacción, al momento de contratar a proveedores de servicios de internet en el sur del Estado de Quintana Roo, México. El objetivo del estudio es comprender cómo afecta la sensibilidad, la empatía y la calidad sobre la satisfacción de los clientes de los proveedores de servicios de Internet. Se utilizó la técnica de muestreo no probabilístico "bola de nieve" para integrar una muestra de 384 usuarios que proporcionaron información mediante la técnica de encuesta. Se desarrolló un modelo probado empíricamente utilizando el modelo de ecuaciones estructurales para analizar el impacto de las variables en la satisfacción. Los resultados muestran que la calidad del proveedor de internet se encuentra altamente influenciada por la empatía del personal y por la sensibilidad, todos estos factores inciden de manera directa y positiva en la satisfacción del cliente, siendo más importante el valor percibido de la empatía que puede afectar en la opinión del usuario, lo que es relevante porque ayuda a comprender por qué los clientes se quedan con un proveedor de servicios en particular. CLASIFICACIÓN JEL M31, L86

This research provides elements for the development of a conceptual model of the effect that sensitivity and empathy have on the perception of quality and satisfaction, when hiring internet service providers in the south of the State of Quintana Roo, Mexico. The objective of the study is to understand how sensitivity empathy and quality affect the satisfaction of customers of Internet service providers. The non-probabilistic "snowball" sampling technique was used to integrate a sample of 384 users who provided information through the survey technique. An empirically tested model was developed using the structural equation model to analyze the impact of variables on satisfaction. The results show that the quality of the Internet provider is highly influenced by the empathy of the staff and by the sensitivity all these factors directly and positively affect customer satisfaction, being more important the perceived value of empathy that can affect the opinion of the user which is relevant because it helps to understand why customers stay with a particular service provider. JEL CLASSIFICATION M3I, L86

Este artigo fornece elementos para o desenvolvimento de um modelo conceitual do efeito da sensibilidade e da empatia na percepção da qualidade e da satisfação ao contratar provedores de serviços de Internet no sul do estado de Quintana Roo, México. O objetivo do estudo é entender como a sensibilidade, a empatia e a qualidade afetam a satisfação do cliente com os provedores de serviços de Internet. A técnica de amostragem não probabilística "bola de neve" foi usada para integrar uma amostra de 384 usuários que forneceram informações por meio da técnica de pesquisa. Um modelo testado empiricamente foi desenvolvido usando modelagem de equação estrutural para analisar o impacto das variáveis na satisfação. Os resultados mostram que a qualidade do provedor de Internet é altamente influenciada pela empatia e pela capacidade de resposta da equipe, todas com impacto direto e positivo na satisfação do cliente, sendo que o valor percebido da empatia é mais importante e pode afetar a opinião do usuário, o que é relevante porque ajuda a entender por que os clientes permanecem com um determinado provedor de serviços. CLASSIFICAÇÃO JEL M31, L86

Rendimiento en los juegos panamericanos de Santiago 2023: predicción mediante método de suavización exponencial simple / Performance at the Santiago 2023 pan american games: prediction using a simple exponential smoothing method / Desempenho nos jogos pan-americanos de Santiago 2023: predição usando o método de suavização exponencial simples

El objetivo del presente trabajo es analizar el desempeño deportivo de la delegación chilena en los Juegos Panamericanos celebrados entre los años 1951 y 2023, haciendo uso de datos retrospectivos y proyectivos a través de series temporales de tiempo. Para esto se empleó un diseño cuantitativo, no experimental y longitudinal de tendencias y un método de suavización exponencial simple, que utiliza promedios históricos y que permite realizar una predicción o comportamiento futuro basado en una media ponderada de los valores actuales y de los pasados. A partir de los resultados obtenidos, fue posible concluir que, en las últimas décadas, la ubicación de Chile en el ranking de los Juegos Panamericanos se ha estabilizado en torno a un onceavo lugar, posición pronosticada para Santiago 2023. Manteniéndose condiciones similares, el desempeño deportivo general y específico no tendría un quiebre exponencial de la tendencia y los resultados no resultan favorables, específicamente en lo que respecta a la obtención de medallas de oro y la posición general de la delegación.

The objective of this paper is to analyze the sports performance of the Chilean delegation in the Pan American Games held between 1951 and 2023, using retrospective and projective data through time series. For this purpose, a quantitative, non-experimental and longitudinal design of trends and a simple exponential smoothing method was used, which uses historical averages and allows a prediction or future behavior based on a weighted average of current and past values. From the results obtained, it was possible to conclude that, in recent decades, Chile's position in the Pan American Games ranking has stabilized around eleventh place, a position predicted for Santiago 2023. Maintaining similar conditions, the general and specific sporting performance would not have an exponential break in the trend and the results are not favorable, specifically in terms of obtaining gold medals and the overall position of the delegation.

O objetivo deste artigo é analisar o desempenho esportivo da delegação chilena nos Jogos Pan-Americanos realizados entre 1951 e 2023, usando dados retrospectivos e projetivos por meio de séries temporais. Para isso, foi utilizado um desenho quantitativo, não experimental e longitudinal de tendências e um método de suavização exponencial simples, que utiliza médias históricas e permite uma previsão do comportamento futuro com base em uma média ponderada dos valores atuais e passados. Com base nos resultados obtidos, foi possível concluir que, nas últimas décadas, a posição do Chile no ranking dos Jogos Pan-Americanos se estabilizou em torno do 11º lugar, posição prevista para Santiago 2023. Mantendo-se condições semelhantes, o desempenho esportivo geral e específico não teria uma quebra exponencial na tendência e os resultados não são favoráveis, especificamente em termos de conquista de medalhas de ouro e posição geral da delegação.

Critical values for automated hemograms and peripheral blood smears / Valores críticos para hemogramas automatizados y frotis de sangre periférica

The report of critical values ​​is considered a necessary practice in clinical pathology laboratories, since its immediate communication determines therapeutic decisions that can save lives. The choice of critical values ​​and the way in which they are reported must be a joint decision between the laboratory specialists and the clinical professionals of each health facility, since they must be integrated into the dynamics of the services involved. Among the critical values ​​that have been chosen for this review, we have included quantitative parameters, whose processing is carried out in automated hematology analyzers, and morphological findings in peripheral blood smears, which are evaluated by trained professionals.

El reporte de valores críticos se considera una práctica necesaria en los laboratorios de patología clínica, pues su comunicación inmediata determina decisiones terapéuticas que pueden salvar vidas. La elección de los valores críticos y el modo en que son reportados debe ser una decisión conjunta entre los especialistas del laboratorio y los profesionales clínicos de cada establecimiento de salud, ya que deben integrarse a la dinámica de los servicios involucrados. Entre los valores críticos que se han escogido para esta revisión hemos incluido parámetros cuantitativos, cuyo procesamiento se ejecuta en analizadores hematológicos automatizados, y hallazgos morfológicos en los frotis de sangre periférica, lo cuales son evaluados por profesionales capacitados.

Algoritmo de Emergencias Médicas de Chiapas para pacientes en estado de choque / Medical emergencies of Chiapas algorithm for patients in shock disease / Algoritmo de Emergências Médicas de Chiapas para pacientes em estado de choque

Resumen El abordaje sobre la mejor estrategia para diagnosticar y manejar pacientes en estado de choque (EC) de forma rápida y eficiente es dinámico, depende de las características propias del paciente, de la tecnología disponible y la evidencia científica siempre en evolución; todo esto lleva a que exista considerable variación en la práctica diaria. El objetivo de esta propuesta es dar a conocer un algoritmo basado en criterios clínicos, optimizando las herramientas disponibles y logrando un proceso diagnóstico sencillo y rápido con el principal objetivo de ser útil para el manejo del paciente.

Abstract The approach on the best strategy to diagnose and manage patients in shock disease (CD) quickly and efficiently is dynamic, it depends on the characteristics of the patient, the available technology, the scientific evidence always in evolution; All of this leads to considerable variation in daily practice. The objective of this proposal is to present an algorithm based on clinical criteria and optimizing the available tools, achieving a simple, fast diagnostic process with the main objective of being useful to the patient.

Resumo A abordagem sobre a melhor estratégia para diagnosticar e manejar pacientes em choque (PC) de forma rápida e eficiente é dinâmica, depende das características do paciente, da tecnologia disponível, das evidências científicas sempre em evolução; tudo isso leva a uma variação considerável na prática diária. O objetivo desta proposta é apresentar um algoritmo baseado em critérios clínicos e otimizando as ferramentas disponíveis, alcançando um processo diagnóstico simples e rápido com o objetivo principal de ser útil para o manejo do paciente.

Comparación de 3 modos de ventilación mecánica en colecistectomía laparoscópica / Comparison of 3 mechanical ventilation modes in laparoscopic cholecystectomy

Resumen: El modo ventilatorio asistido durante un procedimiento laparoscópico aún es controversial. Objetivo: Comparar la dinámica ventilatoria según el modo de ventilación asistida: por ventilación controlada por volumen (VCV), controlada por presión (VCP) o por presión con garantía de volumen (VCP-GV), en anestesia para colecistectomía laparoscópica. Material y métodos: 21 pacientes adultos manejados con una de las tres modalidades (7 por grupo). Se analizó durante el procedimiento (a la intubación, la insuflación de CO2 intraabdominal y resolución), su frecuencia respiratoria, el volumen espiratorio, CO2 al final de la espiración (EtCO2), presión pico vía aérea, presión media pulmonar, distensibilidad, saturación de oxígeno y volumen minuto respiratorio. Resultados: Posterior a la intubación, no hubo diferencias clínicas importantes en las mediciones entre los modos de ventilación. A la insuflación los pacientes con modo VCP incrementaron su frecuencia respiratoria, pero conservaron su presión pico; contra aquéllos en modo VCV y VCP-GV que incrementaron su presión pico con escasa reducción de su frecuencia respiratoria. Las otras variables no se modificaron durante el procedimiento y no hubo diferencias entre los modos ventilatorios. Conclusión: Los tres modos de ventilación permitieron un buen control ventilatorio con pocas diferencias respecto a parámetros basales, pero sugerimos que el modo VCP previene mejor los aumentos en la presión pico.

Abstract: The assisted ventilatory mode during a laparoscopic procedure is still controversial. Objective: To compare ventilatory dynamics according to the assisted ventilation mode: by volume-controlled ventilation (VCV), pressure-controlled (PCV) or by pressure with volume guarantee (PVC-VG), in general anesthesia for laparoscopic cholecystectomy. Material and methods: 21 adult patients managed with one of the three modalities (seven per group). Their respiratory rate, minute expiratory volume, end tidal CO2 (EtCO2), peak airway pressure, mean pulmonary pressure, compliance, oxygen saturation and minute respiratory volume were analyzed during the procedure (at intubation, abdominal CO2 insufflation and resolution). Results: After intubation there were no clinical differences in measurements between ventilation modes. On insufflation, patients with PCV mode increased their respiratory rate, but kept their peak pressure; against those in VCV and PCV-VG mode who increased their peak pressure with little reduction in their respiratory rate. The other variables were not modified during the procedure and there were no differences between the ventilatory modes. Conclusion: The three modes of ventilation allowed a good ventilatory control, but we suggest the PCV since it prevents an increase in peak pressure.

Mineralización de tejidos blandos en radiografías panorámicas / Mineralization of Soft Tissues in Panoramic Radiographies

RESUMEN Introducción: La prevalencia de condiciones patológicas que se presentan como radiopacidades a nivel de los tejidos blandos en radiografias panorámicas es una problemática que se da a nivel mundial de la población, siendo este hallazgo radiográfico el diagnóstico inicial de otras afecciones sistémicas. Objetivo: el objetivo de esta investigación fue identificar la frecuencia de radiopacidades mineralizadas que se encuentran a nivel de los tejidos blandos en radiografías panorámicas. Metodología: se analizó 347 radiografías de pacientes mayores de 20 años atendidos en la Clínica Docente Odontológica de la Universidad Católica de Cuenca, Sede Azogues, Ecuador desde diciembre del 2017 hasta mayo del 2018. Resultados: se encontró una prevalencia del 0% de tonsilolitos y anteromas, 1% de ganglios linfáticos calcificados y de antrolitos, 2% de sialolitos, 4% de calcificaciones del ligamento estilohioideo unilateral, 23% de calcificaciones del ligamento estilohioideo bilateral y 65% no presentaron calcificaciones de los tejidos blandos. Conclusión: se pudo identificar que las radiopacidades más frecuentes a nivel de los tejidos blandos es el del proceso estilohioideo calcificado bilateral.

ABSTRACT Introduction: The prevalence of pathological conditions that appear as radiopacities at the level of the soft tissues in panoramic radiographs is a problem that occurs worldwide in the population, being this radiographic finding the initial diagnosis of other systemic affections. Objectives: the aim of this research was to identify the frequency of mineralized radiopacities that are found at the soft tissue level in panoramic radiographs. Material and methods: it was analyzed 347 radiographs of patients over 20 years of age, treated in the "Clínica Docente Odontológica" of the Universidad Católica de Cuenca, Sede Azogues, Ecuador from December 2017 to may 2018. Results: a prevalence of 0% of tonsillolith and atheroma was found, 1% of calcified lymph nodes and of electrolytes, 2% of sialolith, 4% of unilateral stylohyoid ligament calcification, 23% of calcification of bilateral stylohyoid ligament and 65% did not present calcifications of the soft tissues. Conclusion: it was possible to identify that the most frequent radiopacity at soft tissue level is the calcified bilateral stylohyoid process.

Cloning and molecular characterization of a putative habanero pepper SERK1 cDNA expressed during somatic and zygotic embryogenesis

Background: Plant gene homologs that control cell differentiation can be used as biotechnological tools to study the in vitro cell proliferation competence of tissue culture-recalcitrant species such as peppers. It has been demonstrated that SERK1 homologs enhance embryogenic competence when overexpressed in transformed tissues; therefore, cloning of a pepper SERK1 homolog was performed to further evaluate its biotechnological potential. Results: A Capsicum chinense SERK full-length cDNA (CchSERK1) was cloned and characterized at the molecular level. Its deduced amino acid sequence exhibits high identity with sequences annotated as SERK1 and predicted-SERK2 homologs in the genomes of the Capsicum annuum CM-334 and Zunla-1 varieties, respectively, and with SERK1 homologs from members of the Solanaceae family. Transcription of CchSERK1 in plant tissues, measured by quantitative RT-PCR, was higher in stems, flowers, and roots but lower in leaves and floral primordia. During seed development, CchSERK1 was transcribed in all zygotic stages, with higher expression at 14 days post anthesis. During somatic embryogenesis, CchSERK1 was transcribed at all differentiation stages, with a high increment in the heart stage and lower levels at the torpedo/cotyledonal stages. Conclusion: DNA sequence alignments and gene expression patterns suggest that CchSERK1 is the C. chinense SERK1 homolog. Significant levels of CchSERK1 transcripts were found in tissues with cell differentiation activities such as vascular axes and during the development of zygotic and somatic embryos. These results suggest that CchSERK1 might have regulatory functions in cell differentiation and could be used as a biotechnological tool to study the recalcitrance of peppers to proliferate in vitro.

Cuerpo extraño en intestino delgado / Foreign Body in the Small Intestine

RESUMEN Se presenta el caso de un paciente masculino de 39 años de edad, que acude al cuerpo de guardia del Hospital General Docente Abel Santamaría Cuadrado por presentar un cuadro de dolor abdominal de tres días de evolución. Se interviene quirúrgicamente con el diagnóstico presuntivo de apendicitis aguda complicada. En el acto quirúrgico se comprobó que el apéndice cecal era normal y al examinar el íleon terminal, a una distancia aproximada de 50 cm se encontró un divertículo de Meckel, y a 5 cm de este, una espina de pescado adherida a la pared intestinal, la cual parecía ser la causante del cuadro, ya que el divertículo también era normal. El tratamiento consistió en trasladar la espina hacia el divertículo y realizar resección intestinal de ese tramo con anastomosis término-terminal. La evolución posoperatoria fue satisfactoria y el paciente fue dado de alta a los 8 días de la operación(AU)

ABSTRACT We present the case of a male patient, 39 years of age, who presents to the emergency room of Abel Santamaría Cuadrado General Teaching Hospital with a clinical picture of abdominal pain of three days of natural history. He is surgically intervened with the presumptive diagnosis of complicated acute appendicitis. In the surgical act, the cecal appendix was verified to be normal and, when examining the terminal ileum, at a distance of approximately 50 cm, a Meckel's diverticulum was found, and, at 5 cm from this, a fish spine adhered to the intestinal wall, which seemed to be the cause of the clinical picture, since the diverticulum was also normal. The treatment consisted of transferring the spine to the diverticulum and performing intestinal resection of that section with end-to-end anastomosis. The postoperative evolution was satisfactory and the patient was discharged 8 days after the operation(AU)

Association between Streptococcus mutanslevels and severity of caries in Ecuadorian schoolchildren aged 6 to 10 years

Dental caries is a multifactorial, infectious and communicable disease, and Streptococcus mutans is the key microorganism related to this pathology. The objective of this study was to evaluate the association between the levels of Streptococcus mutans and caries in schoolchildren. Descriptive, cross-sectional study conducted on 100 schoolchildren aged 6 to 10 years from the Unidad Educativa Checa Cuenca, Ecuador. ICDAS index and odontogram were used to measure the prevalence and severity of caries. For the identification and quantification of Streptococcus mutans, dental plaque samples were used for cultivation and biochemical tests (MicroScan). The results were analyzed statistically using absolute and relative frequencies, for bivariate analysis Chi-squared test and Fisher's Test (p <0.05) were used. 96% of the schoolchildren presented dental caries, 69% of them were children aged 8 to 10 years, the prevalence of caries was higher in females reaching 57%. High (60,000UFC/ml) and very high (70,000UFC/ml) levels of Streptococcus mutans were found on schoolchildren aged 8 to 10 years reaching 22% and 8%, respectively (p =0.005). Regarding sex, high (60,000UFC/ml) as well as very low (0- 20,000UFC/ml) levels of Streptococcus mutans appeared without difference by sex (p = 0.355). Schoolchildren without caries presented a low count of Streptococcus mutans (0 -20,000 UFC/ml), children with caries presented variable levels of Streptococcus mutans, although higher than 20,000UFC/ml (p <0.001). Conclusion: there is a high prevalence of caries in the school population with high levels of Streptococcus mutans.

Cloning of the Coffea canephora SERK1 promoter and its molecular analysis during the cell-to-embryo transition

Background: Somatic embryogenesis receptor-like kinase 1 (SERK1) is a cell membrane receptor active in different plant tissues and involved in cell differentiation activities including somatic embryogenesis. The identification of promoter elements responsible for SERK1 expression during the onset of somatic embryogenesis can be useful to understand the molecular regulation of the cell-to embryo transition, and these promoter elements represent biotechnological tools in plant organ tissue culture. Results: A −1,620 bp DNA sequence located upstream of the Coffea canephora SERK1 gene homologue (CcSERK1) was isolated, and then, different segments containing key response elements (REs) for somatic embryogenesis onset and development were fused to the uidA (encoding a ß-glucuronidase, GUS) reporter gene to evaluate its expression in transgenic leaf explants. DNA segments of −1,620 and −1048 bp in length directed uidA expression with patterns in leaf explants similar to those occurring during somatic embryogenesis. When a −792-bp fragment was used, uidA expression disappeared only in leaf explants and pro-embryogenic mass but persisted in developing embryos. No uidA expression was detected in any embryogenic stage when a −618-bp fragment was used. Conclusion: DNA deletions showed that a −1048-bp sequence located upstream of the CcSERK1 gene is sufficient to direct gene expression during the onset and the development of C. canephora somatic embryogenesis. The DNA segment located between −1048 and −792 bp (containing BBM and WUS REs) is needed for gene expression before embryogenesis onset but not during embryo development. The promoter segment between −792 and −618 bp (including GATA, ARR1AT, and ANT REs) regulates gene expression in developing embryos.

Extensive hyperdense zone in the mandible: a case report

Hyperdense zones are considered a generic term to define an area of increased density regardless of its cause. Idiopathic hyperdense zones are referred in literature as enostosis, focal osteosclerosis, periapical osteopetrosis or bone scar and are found as imaging finding during a rutine radiograph. They have greater predilection for long bones, but can also appear in the maxillary bones in certain occasions, often located in the jaw, especially in the molar region, with an informed incidence rate that varies from 2,3 to 9,7% depending on the population in which the study is being applied. In 40% of the cases, in spite of being of idiopathic origin, they seem to be associated with patients with occlusal trauma or can be a result of a predominant development of isolated bone during bone growth. The case of a 36-year-old female patient is described, who presents hyperdensity that differs in form, location and imaging features from the commonly documented in this type of anatomical variations. It was diagnosed as idiopathic osteosclerosis, periodic imaging controls were established. The purpose of this case report is to emphasize the importance of performing an appropriate differential diagnosis among hyperdense lesions at maxillofacial level.

Anatomical positions of the inferior dental canal and its relationship with impacted lower third molars in 18-to 29-year-old Ecuadorians

The third molars are the dental organs with the most variations in terms of their formation and time of eruption, which can cause several pathologies. The incidence of third molar impaction varies between 20% and 30%, with predominance in females. Through the inferior dental canal, goes the inferior dental nerve to innervate the molars and lower premolars. Recent studies on variations in the position of the lower dental canal have shown a low incidence of variations. Objective: To determine the prevalence of anatomical variations of the inferior dental canal in relation to impacted lower third molars, by means of digital image analysis in patients who attended the X-Ray Imaging Center in Azogues in 2016. Materials and Methods: A cross-sectional study was conducted on patients who attended the center X-Ray Imaging Center in Azogues in 2016. The following variables were analyzed: sex, age, variation of the position of the inferior dental canal in relation to the third impacted molar, the radiographic details according to the Monaco classification, and tooth position according to the Winter classification. In total, 64 radiographs were analyzed. Results: It was found that 5% of participants showed no relation of the inferior dental canal with the lower third molar, 72% had a relation of the dental canal with the third molar, and 23% presented with absence of the third molar. According to the Winter classification, the prevalence was 53% mesioangular, 18% horizontal, 19% vertical, 6% vestibuloversion, and 4% inverted. Conclusion: The third molars present high indexes of relation with the inferior dental canal in 18- to 29-year-old Ecuadorians

Management of compound odontoma with guided bone regeneration: a case report

An odontoma is a mixed benign odontogenic tumor, being a hamartomatous neoplastic lesion of odontogenic epithelial and mesenchymal cells that form enamel, dentine and cement, which occurs in the second to third decade of life, and is commonly a radiographic finding. The aim of this paper is to describe the management of a compound odontoma with guided bone regeneration. A 20-year-old asymptomatic male patient with no relevant surgical medical history underwent surgery for the enucleation of a compound odontoma followed by guided bone regeneration of the defect, and histopathological study of the specimen. The evolution was favorable, without any sign of recurrence. It is important to carry out a previous surgical plan, taking into account the size of the defect resulting from its enucleation, assess the need for guided bone regeneration and use complementary diagnostic resources for a satisfactory recovery.

Efectividad a 3 y 6 meses de una intervención integral para caries dental en escolares de San Rafael Cedros, Cuscatlán; Jiquilisco, Usulután y Villa Mariona, San Salvador / Effectiveness at 3 and 6 months of a comprehensive intervention for dental caries in schoolchildren from San Rafael Cedros, Cuscatlán; Jiquilisco, Usulután and Villa Mariona, San Salvador

Objetivo: Determinar la efectividad a 3 y 6 meses de una intervención integral para la prevención y tratamiento de caries en dientes permanentes, en escolares de 9 a 11 años, atendidos en Unidades Comunitarias de Salud Familiar de San Rafael Cedros, Cuscatlán; Jiquilisco, Usulután y Villa Mariona, San Salvador en el año 2017. Metodología: Estudio tipo intervención comunitaria cuasi-experimental con grupo control pre y post, en el cual se evaluó la efectividad a los tres y seis meses. La intervención integral incluyó acciones educativas, preventivas y curativas, en 90 pacientes, entre abril a diciembre del 2017, para la recolección de datos se utilizó una guía de observación clínica, y el vaciado, procesado y análisis de datos se realizó en SDENT1 y SPSS. Resultados: Los tratamientos que necesitaron los escolares fueron: técnicas de higiene bucal, remineralización con flúor barniz, 849 sellantes de fosas y fisuras (SFF), seguidos de 198 obturaciones, según los valores del Índice Simplificado de Higiene Oral, el porcentaje de niños con nivel óptimo fue ascendiendo de 24.44 % inicial, a un 42.70% a los 3 meses y 62.5% a los 6 meses. De la misma manera el índice cariado reflejó en el diagnóstico una media de 5 superficies cariadas por niño, la cual disminuyó a 1 superficie cariada a los 3 y 6 meses. A los 6 meses la supervivencia de SFF fue 84% y de obturaciones de 99%. Conclusiones: La intervención integral en escolares de 9 a 11 años fue efectiva según la disminución de placa bacteriana, la disminución del índice de caries y la alta supervivencia de SFF y obturaciones, estos resultados han sido acorde con la literatura consultada.

Eclampsia y síndrome HELLP en los Andes del Perú: complicaciones perinatales / Eclampsia and HELLP syndrome in the Peruvian Andes: perinatal complications

Resumen OBJETIVO: Comparar las complicaciones perinatales en pacientes con eclampsia, síndrome HELLP y su asociación. MATERIALES Y MÉTODOS: Estudio transversal y comparativo efectuado en mujeres con eclampsia, síndrome HELLP, o ambos, y sus neonatos atendidas en el Hospital Regional Docente de Cajamarca, Perú, entre el 1 de enero y el 31 de diciembre de 2015. La información se procesó con el programa Epi Info versión 7. Se usó la ANOVA y χ2 no paramétrica con Kruskal-Wallis para comparar grupos, y se consideró significativo un valor de p < 0.05. RESULTADOS: Se registraron 3411 nacimientos; 71 pacientes tuvieron eclampsia o síndrome HELLP. Las complicaciones perinatales de prematurez, menor peso y talla al nacer y Apgar más bajo fueron significativamente mayores en mujeres con síndrome HELLP que con eclampsia. En cuanto a prematurez hubo 30 (66.6%) casos de madres con síndrome HELLP, 14 (70%) con eclampsia asociada con síndrome HELLP y ninguno con eclampsia (p = 0.01). El peso promedio al nacimiento fue 2133.5 ± 66.7 g en síndrome HELLP y 3083.1 ± 67.8 g en eclampsia (p = 0.001). Hubo Apgar más bajo al minuto y a los cinco minutos en la combinación eclampsia y síndrome HELLP que en solo eclampsia (p = 0.002). No hubo diferencias significativas en la mortalidad, restricción del crecimiento fetal, asfixia neonatal, taquipnea transitoria, enfermedad de membranas hialinas, enterocolitis necrotizante, policitemia, ictericia patológica o sepsis. La tasa de cesáreas en síndrome HELLP fue 41 (91.1%) y en eclampsia 4 (66.6%) (p = 0.03). CONCLUSIONES: Las complicaciones perinatales son mayores pacientes con síndrome HELLP que con eclampsia.

Abstract OBJECTIVES: To compare perinatal complications in patients with eclampsia, HELLP syndrome and association. MATERIALS AND METHODS: a cross-sectional, comparative study conducted in women with eclampsia and / or HELLP syndrome and their perinates in Hospital Regional Docente de Cajamarca , Peru. Data obtained from 01/01/2015 to 12/31/15. Information processing was carried out with the Epi Info program version 7. The ANOVA and non-parametric χ2 with Kruskal-Wallis were used to compare groups, and a value of P <0.05 was considered significant. RESULTS: 71 women had eclampsia and / or HELLP syndrome of 3411 births. Perinatal complications such as prematurity, lower weight and height at birth and lower Apgar were significantly higher in HELLP syndrome than in eclampsia. Regarding prematurity, there were 30 (66.6%) in HELLP syndrome, 14 (70%) in eclampsia associated with HELLP syndrome and none in eclampsia (p = 0.01). Birth weight was 2133.5 ± 66.7 g in HELLP syndrome and 3083.1 ± 67.8 g in eclampsia (p = 0.001). Apgar was lower at minute and at 5 minutes in the combination eclampsia and HELLP syndrome than in eclampsia alone (p = 0.002). There were no significant differences in mortality, IUGR, neonatal asphyxia, transient tachypnea, hyaline membrane disease, necrotizing enterocolitis, polycythemia, pathological jaundice or sepsis. The rate of cesareans in HELLP syndrome was 41 (91.1%) and in eclampsia 4 (66.6%) (p = 0.03). CONCLUSIONS: Perinatal complications are greater in HELLP syndrome than in eclampsia.

Trastornos de la conducta alimentaria en estudiantes de medicina de una universidad de Perú / Eating disorders in medical students of a Peruvian university

Introducción: Los trastornos de la conducta alimentaria afectan con mayor frecuencia a jóvenes, y pueden llegar a tener importantes consecuencias en su salud mental y física. Objetivo: Determinar la prevalencia de probable diagnóstico de trastornos de conducta alimentaria en estudiantes de medicina y sus factores asociados. Métodos: Estudio descriptivo transversal realizado en estudiantes de medicina del primer año de una universidad de Lima, Perú. Se aplicó un cuestionario virtual para recolectar los datos de interés. Aquellos con un puntaje ≥20 en elEatingAttitudes Test-26, se consideronconprobable diagnóstico de trastornos de conducta alimentaria.Para evaluar los factores se calcularon razones de prevalencia y intervalos de confianza al 95% usando regresiones de Poissoncrudas con varianza robusta. Resultados: Del total de 440 estudiantes de primer año, 375 (85,2 por ciento) completaron la encuesta. La prevalencia de probable diagnóstico de trastornos de conducta alimentaria fue de 10,1 por ciento (11,3 en mujeres y 8,6 en varones).Los factores asociados a esta variable fueron: rechazo escolar por trastornos nutricionales, rechazo laboral por la delgadez, rechazo social cercano por la imagen corporal, influencia familiar sobre la imagen corporal, influencia de la imagen corporal de modelos de pasarela e influencia de los anuncios televisivos de productos para adelgazar. Los dos últimos con los mayores valores de la razón de prevalencias. Conclusiones: Aproximadamente uno de cada diez estudiantes presentaprobable diagnóstico de trastornos de conducta alimentaria que se asocian con factores familiares, sociales,laborales y otros relacionados con los medios de comunicación(AU)

Introduction: Eating disorders affect mostly young persons, and may have important consequences on their mental and physical health. Objectives: To determine the probable diagnosis of eating disorders in medical students and to evaluate their associated factors. Methods: Descriptive and cross-sectional study performed in first-year medical students of a private university in Lima, Peru. An electronic survey was administrated to collect data of interest. Those students with a score ≥20 in the Eating Attitudes Test-26 were considered to have probable diagnosis of eating disorders. For assessment of associated factors, we calculated prevalence ratios and 95 percent confidence intervals using Poisson crude regressions with robust variance. Results: Of 440 first-year medical students, 375 (85.2 percent) completed our survey. The prevalence of probable diagnosis of eating disorders in the study population was 10.1 percent (11.3for females and 8.6for males). Associated factors to this variable were: school rejection due to nutritional disorders, job rejection due to thinness, social rejection of body image, family influence on body image, influence of fashion show models' body image and influence of TV advertisement of slimming products. The two latter reached the highest prevalence ratio values. Conclusions: Around one in ten students has a probable diagnosis of eating disorders associated with family, social, work and mass media-related factors(AU)

Células tronco mesenquimales: definiciones, cultivo y aplicaciones potenciales / Mesenchymal stem cells: definitions, culture and potential applications

RESUMEN En los últimos años, las células troncales mesenquimales (Mesenchymal Stem Cells, MSC) han adquirido mucha importancia debido a su gran plasticidad y su capacidad de liberar factores paracrinos con capacidad de interactuar con diversos tipos celulares, tejidos y órganos. El uso de MSC en medicina regenerativa es importante debido a que, al no expresar las moléculas del complejo mayor de histocompatibilidad (MHC) clase II ni moléculas co-estimuladoras y tener baja expresión del MHC clase I, haría que no sean rechazadas por individuos de la misma especie, es posible utilizarlas no sólo de manera autóloga, sino también, eventualmente, alogénica. Sin embargo, es importante demostrar científicamente muchas de sus propiedades, entre ellas las inmunomoduladoras. Al tener varias fuentes de obtención, se debe estandarizar la que sea la mejor para garantizar la pureza y calidad de las MSC. Finalmente, es importante que cuando se trabaje con estas células se demuestre completamente las características del cultivo celular, la inmunotipificación y su capacidad de diferenciación. Se están ensayando muchas aplicaciones clínicas de las MSC. Dentro de ellas, su capacidad para mejorar la recuperación y potencial curación de úlceras crónicas como las diabéticas, ha atraído la atención por su potencial impacto terapéutico.

ABSTRACT In recent years, mesenchymal stem cells (MSC) have become very important due to their high plasticity and their ability to release paracrine factors able to interact with various cell types, tissues and organs. The use of MSC in regenerative medicine became of vital importance, since they do not express histocompatibility MHC molecules class II nor costimulant molecules, and low expression of MHC class I, will not be rejected by individuals of same species, they could be used in an autologous, and eventually, allogeneic manner. However, it is important to scientifically demonstrate many properties, including immunomodulatory ones. Having several sources of obtaining, it should be standardized the best one to ensure the purity and quality of these cells. Finally, it is important when working with these cells, that characteristics of cell culture, immunophenotyping and differentiation capacity are fully demonstrated. MSC have been applied in several clinical uses. Among them, their ability to improve, and even heal chronic ulcers, as diabetic, has attracted attention for its potential therapeutic impact.

Determinación del efecto cicatrizante de Piper aduncum (matico) en fibroblastos humanos / Determination of the healing effect of Piper aduncum (spiked pepper or matico) on human fibroblasts

RESUMEN Objetivos. Evaluar el efecto cicatrizante del extracto hidroetanólico de Piper aduncum, en una línea celular de fibroblastos Dermales Adultos Humanos (hDFa). Materiales y métodos. El extracto se obtuvo mediante extracción sólido-líquido, fue concentrado y liofilizado. Se purificaron las proteínas del extracto mediante cromatografía líquida de alta eficacia de fase reversa (RP-HPLC); las proteínas fueron identificadas por espectrometría de masas en tándem de péptidos trípticos y se analizaron por MALDI-TOF-TOF en un espectrómetro de masa ABSciex4800. Los valores de concentración efectiva media (EC50), concentración inhibitoria media (IC50), y el porcentaje de proliferación celular; fueron determinados por ensayos con sales de tetrazolio (MTT) . La migración celular se evaluó mediante la "técnica de rayado" . Se analizó la expresión de factores de crecimiento mediante el ensayo de reacción en cadena de la polimerasa con transcriptasa reversa a tiempo real (RT- qPCR). Resultados. La línea hDFa evidenció un IC50 de 200 µg/mL con el extracto, el valor de EC50 fue 103,5 µg/mL. En el ensayo de proliferación, la proteína K2; mostró mayor actividad en la proliferación respecto de otros tratamientos (1 µg/mL). En el ensayo de migración de fibroblastos, la proteína K2 mostró mayor actividad (50 µg/mL). La expresión relativa del factor de crecimiento derivado de plaquetas (PDGF) se incrementó 8,6 veces respecto al control, en presencia de la proteína K2. Conclusiones. El extracto hidroetanólico, de Piper aduncum, así como las proteínas que contiene, incrementaron la proliferación y migración de fibroblastos dermales humanos (hDFa); así mismo, aumentaron la expresión de factores de crecimiento que intervienen en el proceso de cicatrización.

ABSTRACT Objectives. To evaluate the healing effect of a Piper aduncum ethanol-water extract on an adult human dermal fibroblast cell line (hDFa). Materials and Methods. After obtaining the extract via solid-liquid extraction, concentration, and lyophilization, extract proteins were purified using reverse phase high-performance liquid chromatography, identified using tandem mass spectrometry of tryptic peptides, and analyzed using MALDI-TOF-TOF on an ABSciex4800 mass spectrometer. Half maximum effective concentration values (EC50), half maximum inhibiting concentration (IC50), and percentages of cell proliferation were determined using tetrazolium salt assays. Cell migration was evaluated using a "scratch assay". Growth factor expression in cells was analyzed via quantitative real-time reverse transcription polymerase chain reaction. Results. Against the hDFa cell line, the extract had an IC50 of 200 μg/mL and EC50 of 103.5 µg/mL. In the proliferation assay, protein K2 (obtained from the extract) exhibited increased proliferative activity relative to other treatments (1 µg/mL); this agent also exhibited increased activity (50 µg/mL) in the fibroblast migration assay.Furthermore, the relative expression of platelet-derived growth factor increased by 8.6-fold in the presence of K2 protein relative to the control. Conclusions. The hydroethanolic extract of Piper aduncum and its component proteins increased the proliferation and migration of hDFa and increased the expression of growth factors involved in the healing process.

Características clínicas y epidemiológicas de la infección respiratoria aguda grave por virus sincitial respiratorio en menores de 5 años

Objetivo: Comparar las características clínicas y epidemiológicas de la infección respiratoria aguda grave en menores de 5 años con y sin infección por virus sincitial respiratorio. Material y métodos: Estudio retrospectivo en una muestra de 65 casos y 65 controles en menores de 5 años con infección respiratoria aguda grave (IRAG) atendidos en el Hospital de Emergencias Pediátricas durante el año 2014. El diagnóstico de VSR se realizó a través del test de inmufluorescencia directa (IFD) en muestras nasales y faríngeas (D3 Ultra 8™ DFA Respiratory Virus Screening & ID Kit). Los resultados fueron expresados en cifras absolutas y relativas, el análisis se realizó a través de medidas de tendencia central, ji cuadrado, t de Student y U de Mann Withney. Resultados: Se encontró diferencias significativas entre los casos y los controles en la media de edad, en el mes de infección, en la media de la frecuencia respiratoria, en el uso de ventilación mecánica, en el tratamiento antibiótico y en el diagnóstico de bronquiolitis al alta. Conclusiones: Los resultados muestran que existen diferencias clínicas y epidemiológicas entre los casos y los controles

Objective: To compare the clinical and epidemiological characteristics of severe acute respiratory infection in children under 5 years old with and without infection due to respiratory syncytial virus. Material and methods: Retrospective study in a sample of 65 cases and 65 controls in children under 5 years old with acute respiratory infection (SARI) treated at the Pediatric Emergency Hospital during 2014. The diagnosis of RSV test was performed using direct inmufluorescencia (IFD) in nasal and throat samples (D3 Ultra DFA Respiratory Virus 8 ™ Screening & ID Kit). The results were expressed in absolute and relative terms; the analysis was performed by measures of central tendency, chi-square, “t” Student and Mann Whitney tests. Results: Significant differences were found between cases and controls in the average age in the month of infection, the average respiratory rate, use of mechanical ventilation in antibiotic treatment and diagnosis of bronchiolitis at medical discharge. Conclusions: The results show that there are clinical and epidemiological differences between the cases and controls

Poblaciones linfocitarias, células dendríticas y perfil de citoquinas en ratones con melanoma tratados con Uncaria tomentosa / Lymphocyte subsets, dendritic cells and cytokine profiles in mice with melanoma treated with Uncaria tomentosa

Evaluar el efecto inmunomodulador sobre poblaciones linfocitarias, células dendríticas (DC), citoquinas Th1/Th2/Th17 (T-helper) e inflamatorias en el ámbito sistémico y/o en el microambiente tumoral de ratones con o sin melanoma. Materiales y métodos. Se obtuvieron muestras de sangre periférica y/o de tumores primarios de ratones con melanoma B16 tratados o no con un extracto hidroalcohólico de Uncaria tomentosa (UT) con 5,03% de alcaloides oxindólicos pentacíclicos (UT-POA) obtenido de la corteza de la planta. Todos los ensayos de medición de células y citoquinas fueron realizados por citometría de flujo. Resultados. UT-POA a nivel sistémico incrementa la relación CD4/CD8a (Cluster of Differenciation), mientras que la activación celular es inversamente proporcional; incrementa la proporción de DCm (DC mieloides); induce un perfil Th1 proinflamatorio y reduce la respuesta Th17. TNF-a (tumor necrosis factor alpha) y IL-17A (interleuquina) correlacionan positiva y negativamente con la relación CD4/CD8a. Conclusiones. El incremento de Th1 (TNF-a) puede tener como consecuencia el incremento de linfocitos CD4 o la activación de macrófagos M1. Aunque UT-POA muestra un incremento de DCm, este no es dosis-dependiente. La disminución de Th17 (IL-17A) puede favorecer el funcionamiento de los linfocitos CD8a. UT-POA muestra mejores efectos inmunomoduladores en el ámbito sistémico que intratumoral...

To evaluate the immunomodulatory effect on lymphocyte subsets, dendritic cells (DC), Th1 / Th2 / Th17 and inflammatory cytokines on systemic level and/or in the tumor microenvironment of mice with or without melanoma. Materials and methods: Peripheral blood and/or primary tumors samples were obtained of mice with B16 melanoma treated or not with a hydroalcoholic extract of Uncaria tomentosa (UT) with 5.03% of pentacyclic oxindole alkaloids (UT-POA) obtained from the bark of the plant. All cell assays and cytokine measurements were performed by flow cytometry. Results. UT-POA systemically increased CD4/CD8a relation while cell activation was inversely proportional; increased the proportion of DCm; induced a pro-inflammatory Th1 profile and reduced Th17 response. TNF-a and IL-17A positively and negatively correlated with CD4/CD8a relation. Conclusions. The increase of Th1 (TNF-a) may result in the increase of CD4 or M1 macrophage activation. Although UT-POA shows increased DCm, is not dose-dependent. Th17(IL-17A) decreased can support the function of CD8a lymphocytes. UT-POA shows better systemic immunomodulatory effects than intratumoral...