Importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, Ucayali, Perú / Cultural importance of the flora used by the Asheninka Sheremashe native community, Ucayali, Peru

The cultural significance of the flora used by the native Asheninka Sheremashe community in Ucayali, Peru was determined. To do this, a fieldwork of over 4 months was conducted, involving semi-structured interviews with 106 residents through non-probabilistic convenience sampling. The community utilizes 139 plant species in their daily lives, belonging to 120 genera and 52 families, with the most abundant being Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae, and Rutaceae. Furthermore, 25.9% of the species are of significant importance to theinhabitants according to the Cultural Index (CI), such as Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, among others. It can be concluded that the flora plays a prominent role in the life of the community, with the categories reporting the highest number of species being: food (29.35%), medicine (28.36%), culture (9.95%), construction (9.45%), lumber (6.97%), commerce (3.48%), craftsmanship (2.49%), toxic (2.49%), and other uses (7.46%)

Se determinó la importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, en Ucayali, Perú. Para ello, se realizó un trabajo de campo de más de 4 meses, donde se aplicaron entrevistas semiestructuradas a 106 habitantes mediante un muestreo no probabilístico por conveniencia. La comunidad emplea 139 especies vegetales en su día a día, pertenecientes a 120 géneros y 52 familias; siendo las más abundantes las Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae y Rutaceae. Además, el 25.9% de las especies tiene gran importancia para los pobladores según el Índice Cultural (IC): Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, entre otras. Se concluye que la flora tiene un rol preponderante en la vida de la comunidad, siendo las categorías que presentaron mayor reporte de especies: alimentación (29.35%), medicina (28.36%), cultura (9.95%), construcción (9.45%), aserrío (6.97%), comercio (3.48%), artesanía (2.49%), tóxico (2.49%) y otros usos (7.46%)

Is the symptom of pain adequately addressed in hospitalization at Internal Medicine? Cross-sectional study / O sintoma dor é abordado adequadamente em internação hospitalar de Clínica Médica? Estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is one of the main reasons for seeking medical care. Thus, the objective of the present study was to evaluate the treatment of pain complaints in a medical clinic ward. METHODS: Cross-sectional and descriptive study at the Santa Lucinda Hospital (Hospital Santa Lucinda - HSL) and Sorocaba Hospital Complex (Conjunto Hospitalar de Sorocaba - CHS). Data was collected by: (1) interviewing the participants using a structured questionnaire drawn up by the researchers, and (2) accessing information such as pain records and drug prescriptions in the medical records. RESULTS: The sample consisted of 85 patients, 11.8% in the HSL and 88.2% in the CHS. More than 80% of patients had already experienced pain at some point in their lives, whether chronic or acute. Forty-one percent of patients had pain during hospitalization, regardless of the reason for admission. A minority of pain events had the complaint recorded in their medical records. Drugs were prescribed for 73.0% of the patients, mostly on demand. There was a mismatch between the type of drug prescribed and the intensity of the pain in 80% of prescriptions. CONCLUSION: The complaint of pain is prevalent in Internal Medicine hospitalizations. In this study, 41.2% of the pain was musculoskeletal, followed by abdominal pain, regardless of the reason for hospitalization. The complaint of pain was medicated in most of the patients' pain reports, but around 23% of the patients complaining of pain did not receive drugs. Most patients (80%) with pain received drugs that were inconsistent with the intensity of the pain; however, the recording of the complaint of pain in the medical records remains insufficient.

RESUMO JUSTIFICATIVA E OBJETIVOS: Dor é um dos principais motivos por assistência ao serviço médico-hospitalar. Desta forma, o objetivo deste estudo foi avaliar o atendimento de queixas dolorosas em enfermaria de clínica médica. MÉTODOS: Estudo transversal e descritivo nos hospitais Santa Lucinda (HSL) e Conjunto Hospitalar de Sorocaba (CHS). A coleta de dados foi realizada por: (1) entrevista com os participantes direcionada por um questionário estruturado elaborado pelos pesquisadores, e (2) acesso a informações como registro de dor e prescrição de fármacos no prontuário. RESULTADOS: A amostra foi composta por 85 pacientes, sendo 11.8% no HSL e 88,2% no CHS. Mais de 80% dos participantes relataram experiência prévia de dor aguda ou crônica em algum momento da vida. Quarenta e um por cento dos participantes relatou dor durante a internação independente da causa da internação. A minoria dos eventos de dor constava nos registros da queixa em seu prontuário. Houve fármaco prescrito para 73% dos pacientes, sendo em sua maioria, por demanda. Houve uma inadequação entre o tipo de fármaco prescrito e a intensidade da dor em 80% das prescrições. CONCLUSÃO: A queixa de dor é um sintoma prevalente entre pacientes internados de Clínica Médica. Neste estudo, 41,2%; das dores foram musculoesqueléticas, seguida de dores abdominais, independente do motivo da internação. A queixa de dor foi medicada na maior parte dos relatos de dor dos pacientes, porém cerca de 23% dos pacientes com queixa de dor não receberam fármacos. A maior parte dos pacientes (80%) com dor recebeu fármacos incoerentes à intensidade da dor; porém o registro da queixa de dor nas evoluções dos prontuários permanece insuficiente.

Medicamentos bioterapéuticos: uso de toxinas botulínicas en la era de biosimilares / Biotherapeutic medicines: use of botulinum toxins in the era of biosimilars

Introducción: Las toxinas botulínicas son medicamentos bioterapéuticos con grandes aplicaciones en el campo de la neurología, como la cefalea y los movimientos anormales. Debido a la importancia médica y al incremento de las indicaciones terapéuticas de la toxina botulínica, este artículo pretende hacer claridad acerca de la terminología básica con respecto a la naturaleza de este medicamento, a las diferencias estructurales con medicamentos convencionales y aspectos importantes en relación con su potencia biológica e inmunogenicidad, para así comprender las potenciales diferencias entre las toxinas disponibles y conceptuar en torno a la no intercambiabilidad o sustitución de una toxina por otra. Materiales y métodos: Revisión no sistemática, según lo recomendado en la Escala para la Verificación de los Artículos Revisiones Narrativas (Sanra). Conclusiones: Los medicamentos biológicos no son intercambiables entre sí, aunque demuestren bioequivalencia. No se pueden evaluar como medicamentos genéricos intercambiables porque son biológicos; no existen estudios comparativos cabeza a cabeza; son diferentes, debido al proceso individual de manufactura.

Introduction: Botulinum toxins are biotherapeutic drugs with great applications in the field of neurology such as headache and abnormal movements. Due to the medical importance and the increase in therapeutic indications of botulinum toxin, this article aims to clarify the basic terminology regarding the nature of this drug, the structural differences with conventional drugs and important aspects in relation to its biological potency and immunogenicity in order to understand the potential differences between the available toxins and conceptualize regarding the non-interchangeability or substitution of one toxin for another. Materials and methods: Non-systematic review as recommended in the Scale for the Verification of Narrative Review Articles (SANRA). Conclusions: Biological drugs are not interchangeable with each other, even if they demonstrate bioequi-valence. They cannot be evaluated as interchangeable generic drugs because they are biologics. There are no head-to-head comparative studies. They are different due to the individual manufacturing process.

Trastornos circadianos del sueño / Circadian Sleep Disorders

Resumen El sistema circadiano está sincronizado al ciclo luz-oscuridad que es generado por la rotación de la tierra, asegurando que la vigilia sea durante el día y que el sueño ocurra durante la noche. Sin embargo, el ritmo de sueño-vigilia puede estar desincronizado del ciclo luz-oscuridad o desincronizado de manera endógena, dando como resultado: insomnio, fatiga y bajo rendimiento en las actividades cotidianas. Mientras que los trastornos del sueño están clasificados por la Asociación Americana de Trastornos del Sueño como: disomnias intrínsecas, disomnias extrínsecas, parasomnias o trastornos del sueño médicos/psiquiátricos. Los trastornos circadianos del sueño se han categorizado por separado, en parte para reconocer que en la mayoría de los casos la etiología de los trastornos circadianos es una mezcla de factores internos y ambientales, o por un desajuste temporal entre ambos. Los síntomas generalmente son insomnio o hipersomnia, síntomas comunes en pacientes con trastornos circadianos del sueño, aunque hay otras causas a las que pueden atribuirse y que deben excluirse antes de realizar el diagnóstico de un trastorno circadiano del sueño. En el paciente sin otra patología del sueño, un registro diario de actividades, comidas, ejercicio, siestas y la hora de acostarse es una herramienta esencial para evaluar los trastornos circadianos del sueño. Estos registros deben mantenerse durante 2 semanas o más, ya que una perturbación debida a cambios de trabajo o viajes a través de zonas horarias puede tener efectos sobre el sueño y el estado de alerta durante el día, semanas después del evento.

Abstract The circadian system is synchronized to the light-dark cycle generated by the rotation of the earth, ensuring that wakefulness is during the day and sleep occurs at night. However, the sleep-wake rhythm may be out of sync with the light-dark cycle or endogenously out of sync, resulting in insomnia, fatigue, and poor performance in activities of daily living. Sleep disorders are classified by the American Sleep Disorders Association, as intrinsic dyssomnias, extrinsic dyssomnias, parasomnias, or medical/psychiatric sleep disorders. Circadian sleep disorders have been categorized separately to recognize that in most cases the etiology of circadian disturbances is a mix of internal and environmental factors or a temporary mismatch between the two. Symptoms are usually insomnia or hypersomnia, common symptoms in patients with circadian sleep disorders although other causes can be attributed and must be excluded before a diagnosis of a circadian sleep disorder is made. In the patient without other sleep pathology, a daily record of activities, meals, exercise, naps, and bedtime is an essential tool in assessing circadian sleep disorders. These records should be kept for 2 weeks or more, as a disturbance due to job changes or travel across time zones can have effects on sleep and daytime alertness weeks after the event.

La hipertensión arterial en animales de laboratorio / High blood pressure in experimental animals

Las Ciencias Médicas y Biológicas requieren, prioritariamente, que la investigación y la experimentación sean desarrolladas sobre organismos completos (los modelos animales). Su utilización ha permitido desarrollar innumerables ensayos preclínicos para evaluar los mecanismos patógenos y terapéuticos de diversas enfermedades, así como el estudio de las causas, naturaleza y cura de múltiples desórdenes de la salud humana. En este trabajo se muestra una panorámica general de los biomodelos de hipertensión arterial donde se describen: conceptos, características, origen, importancia, utilidad y procedimientos experimentales durante su fase de inducción. También se pondera la justificación de los biomodelos empleados en los estudios preclínicos de esta enfermedad. De igual forma, se describen los antecedentes para medir las alteraciones, las técnicas y los métodos directos e indirectos de medición de la presión arterial, la cual fue provocada experimentalmente en los animales de laboratorio para realizar los estudios de hipertensión humana.

Medical and biological sciences require, as a priority, that research and experimentation be carried out on complete organisms (animal models). Its use has allowed the development of innumerable preclinical tests to evaluate pathogenic and therapeutic mechanisms of various diseases, as well as to study the causes, nature and cure of multiple human health disorders. In this work, we show a general overview of arterial hypertension biomodels where concepts, characteristics, origin, importance, utility and experimental procedures during their induction phase are described. The justification of the biomodels used in preclinical studies of this disease is also considered. Antecedents are also described to measure alterations, techniques and direct and indirect methods of measurement of arterial pressure, which was provoked experimentally in the laboratory animals to carry out the studies of human hypertension.

Marco jurídico de la prescripción médica en odontología / Legal framework of medical prescription in odontology

La receta médica es la materialización del acto médico a través de la cual el profesional de la salud prescribe a su paciente los fármacos necesarios para aliviar su enfermedad. Existen numerosas sustancias o fármacos que, por sus efectos, no pueden ser ofrecidas al público en general si no es mediante la expedición de una receta médica; por tanto, existen numerosas legislaciones y normas que regulan la prescripción médica con el objetivo de tener un control sobre los fármacos prescritos. A su vez, la receta médica debe tener una estructura específica, misma que está establecida por numerosas leyes y reglamentos sanitarios y que interesantemente es ignorada por múltiples médicos u odontólogos. El objetivo del presente artículo es definir el concepto de prescripción médica, así como indagar en todas las leyes y normas vigentes que regulan la prescripción médica en México (AU)

The medical prescription is the materialization of the medical act through which the health professional prescribes to his patient the necessary drugs to alleviate his illness There are numerous substances or drugs that, due to their effects, cannot be offered to the general public, except through the issuance of a medical prescription, and therefore, there are numerous laws that regulate the medical prescription with the aim of having control over prescribed drugs. In turn, the medical prescription must have a specific structure, which is established by numerous health laws and regulations, and which, interestingly enough, is ignored by many doctors and dentists. The aim of this article is to define the concept of medical prescription as well as to investigate all the current laws and regulations that regulate the medical prescription in Mexico (AU)

Manual para la preparación en temas de investigación experimental en las ciencias básicas biomédicas / Manual for training on experimental research topics in basic biomedical sciences

Fundamento: los contenidos referentes a los temas de investigación experimental en las diferentes especialidades de las ciencias básicas biomédicas son de elevada complejidad, y la literatura relacionada se encuentra de manera dispersa y escasa. Objetivo: diseñar un manual para la preparación en temas de investigación experimental de los residentes de las ciencias básicas biomédicas. Métodos: se realizó un estudio descriptivo transversal desde septiembre-2012 hasta junio-2019 en la Unidad de Investigaciones Biomédicas de la Universidad de Ciencias Médicas de Villa Clara. Se emplearon los métodos teóricos: analítico-sintético, inductivo-deductivo, sistémico-estructural y modelación; empírico: análisis documental. Se seleccionaron 11 expertos para la valoración del manual en cuanto a su pertinencia, autenticidad, actualidad, estructura metodológica, cientificidad y posible generalización. Resultados: se diseñó un material de procedimientos que facilita la consulta de los residentes para su preparación en temas de investigación experimental con modelos biológicos. Está conformado por un prólogo, tres capítulos y un acápite para la literatura consultada, en los que la temática es abordada de forma didáctica con actualización de los aspectos conceptuales, teóricos e históricos. Contiene fotografías tomadas por los propios autores y un lenguaje sencillo, que facilitan la comprensión de procedimientos que se adaptan por primera vez a las condiciones de los centros experimentales de Cuba. Conclusiones: el manual diseñado propicia la preparación requerida en temas de investigación experimental en los especialistas en formación, como aspecto significativo en la educación de los residentes de las ciencias básicas biomédicas, acorde con las exigencias de la enseñanza médica superior.

Background: the contents referring to experimental research topics in the different specialties of basic biomedical sciences are highly complex, and the related literature is scattered and scarce. Objective: to design a manual for the training of residents of basic biomedical sciences in experimental research topics. Methods: a cross-sectional descriptive study was carried out from September-2012 to June-2019 at the Biomedical Research Unit of Villa Clara University of Medical Sciences. Theoretical methods were used: analytical-synthetic, inductive-deductive, systemic-structural and modeling; empirical ones: documentary analysis. Eleven experts were selected to assess the manual in terms of its relevance, authenticity, timeliness, methodological structure, scientificity, and possible generalization. Results: a procedure material was designed that facilitates the consultation of the residents for their training in experimental research topics with biological models. It is made up of a prologue, three chapters and a section for the literature consulted, in which the subject is addressed in a didactic way with updating of the conceptual, theoretical and historical aspects. It contains photographs taken by the authors themselves and simple language, which facilitate the understanding of procedures that are adapted for the first time to the conditions of the experimental centers in Cuba. Conclusions: the designed manual promotes the preparation required in experimental research topics in training specialists, as a meaningful aspect in the education of residents of basic biomedical sciences, in accordance with the requirements of higher medical education.

Herida por asta de toro en el medio rural. Importancia de la preparación en cirugía taurina: Reporte de caso / Bull Horn Wounds in Rural Areas Importance of Preparation in Bullfighting Surgery: Case Report / Lesão com chifre de touro em zonas rurais. Importância da preparação em cirurgia tauromáquica: Relato de caso

Introducción. El trauma abdominal penetrante causado por embestida de asta de toro representa menos del 3%. Son heridas que deben ser consideradas sucias, y la primera causa de muerte por este tipo de trauma es el shock hipovolémico. Presentación de caso. Se presenta el caso de un hombre de 60 años con trauma abdominal penetrante por asta de toro en flanco izquierdo e hipogastrio de 18x8 cm de extensión, con evisceración aguda traumática. Fue llevado a laparotomía exploratoria, donde no se evidenciaron lesiones de órganos sólidos ni de vísceras huecas. El paciente evolucionó sin complicaciones. Discusión. Las heridas por asta de toro dadas sus características son consideradas sucias y alcanzan hasta un 50% de infección. Dentro de su manejo inicial se deben incluir antibióticos y abordajes quirúrgicos, según cada caso. Conclusión. El trauma abdominal penetrante causado por embestida de asta de toro es un mecanismo poco frecuente; sin embargo, los cirujanos deben estar entrenados para tratar o no de manera quirúrgica a este tipo de pacientes.

Introduction. Penetrating abdominal trauma caused by bull horn ramming represents less than 3%. These are wounds that should be considered dirty, and the leading cause of death from this type of trauma is hypovolemic shock. Case Presentation. A 60-year-old man with penetrating abdominal trauma by bull horn in the left flank and hypogastrium, 18x8 cm in extension, with acute traumatic evisceration. He was taken to exploratory laparotomy, where no solid organ or hollow viscera lesions were evidenced. The patient evolved without complications. Discussion. Given their characteristics, bull horn wounds are considered dirty and have an infection rate of up to 50%. Initial management should include antibiotics and surgical approaches, according to each case. Conclusion. Penetrating abdominal trauma caused by bull horn ramming is an infrequent mechanism; however, surgeons must be trained to treat or not to treat this type of patient surgically.

Introdução. O trauma abdominal penetrante causado pelo impulso de chifre de touro representa menos de 3%. São feridas que devem ser consideradas sujas, e a principal causa de morte por esse tipo de trauma é o choque hipovolêmico. Apresentação do caso. Homem de 60 anos com trauma abdominal penetrante por chifre de touro no flanco esquerdo e hipogástrio, 18x8 cm de extensão, com evisceração traumática aguda. Foi encaminado para laparotomia exploratória, onde não foram encontradas lesões em órgãos sólidos ou vísceras ocas. A paciente evoluiu sem complicações. Discussão. Devido às suas características, as feridas de chifre de touro são consideradas sujas e atingem até 50% de infecção. Dentro de seu manejo inicial, antibióticos e abordagens cirúrgicas devem ser incluídos, de acordo com cada caso. Conclusão. Trauma abdominal penetrante causado pelo impulso de chifre de touro é um mecanismo raro; no entanto, os cirurgiões devem ser treinados para tratar esses tipos de pacientes cirurgicamente ou não.

Inteligencia emocional y su relación en el consumo de alcohol en universitarios mexicanos / Emotional intelligence and its relationship in the alcohol consumption in mexican university students / Inteligência emocional e sua relação no consumo de álcool em estudantes universitários mexicanos

RESUMENObjetivo: determinar la relación entre la inteligencia emocional y la prevalencia del consumo de alcohol en jóvenes universitarios. Método: diseñodescriptivo, transversal y correlacional, muestreo no probabilístico por conveniencia con una muestra de 365 estudiantes de una institución pública de educación superior en el periodo 2021-2022, en H. Matamoros, Tamaulipas, México, se utilizó estadística descriptiva y correlacional. Resultados: el género femenino fue mayor (76.7%), con un rango de edad de 18 a 24 años, donde la prevalencia de consumo de alcohol en la vida fue de 77% y la edad de primer consumo se ubicó entre 15 y 18 años (56.4%). El consumo lapsico fue en el último año 38.8%. Las dimensiones inteligencia emocional de atención de los sentimientos y reparación de emociones presentaron en ambos géneros valores similares, en su mayoría un nivel adecuado y excelente. La correlación en mujeres entre edad de consumo de alcohol y las dimensiones la inteligencia emocional, fue significativa e inversa. Conclusión:los estudiantes presentan altas prevalencias de consumo y inteligencia emocional, se encontró que para el género masculino la claridad emocional requiere estrategias que permitan mejorarla.

Objective:to determine the relationship between emotional intelligence and the prevalence of alcohol consumption in university students. Method: descriptive, cross-sectional and correlational design, non-probabilistic convenience sampling with a sample of 365 students from a public institution of higher education in the period 2021-2022, in H. Matamoros, Tamaulipas, Mexico, descriptive and correlational statistics were used. Results: the female gender was higher (76.7%), with an age range of 18 to 24 years, where the prevalence of alcohol consumption in life was 77% and the age of first consumption was between 15 and 18 years. (56.4%). The lapsique consumption was in the last year 38.8%. The emotional intelligence dimensions of attention to feelings and repair of emotions presented similar values in both genders, mostly an adequate and excellent level. The correlation in women between the age of alcohol consumption and the emotional intelligence dimensions was significant and inverse. Conclusion: the students present high prevalences of consumption and emotional intelligence, it was found that for the male gender, emotional clarity requires strategies that allow it to be improved.

Objetivo:determinar a relação entre a inteligência emocional e a prevalência do consumo de álcool em estudantes universitários. Método: desenho descritivo, transversal e correlacional, amostragem não probabilística de conveniência com 365 estudantes de uma instituição pública de ensino superior no período de 2021 a 2022, em H. Matamoros, Tamaulipas, México. Aplicou estatística descritiva e correlacional. Resultados: o sexofeminino foi maior (76,7%), com faixa etária de 18 a 24 anos, onde a prevalência de consumo de álcool na vida foi de 77% e a idade do primeiro consumo foi entre 15 e 18 anos (56,4%). O consumo lapsico foi no ano passado 38,8%. As dimensões da inteligênciaemocional de atenção aos sentimentos e reparação de emoções apresentaram valores semelhantes em ambos os sexos, na sua maioria um nível adequado e excelente. A correlação das mulheres entre a idade de consumo de álcool e as dimensões da inteligência emocional foi significativa e inversa. Conclusão: os alunos apresentam altas prevalências de consumo e inteligência emocional, e verificou-se que para o gênero masculino, a clareza emocional requer estratégias que permitam melhorá-la.

Presencia de lesiones quísticas en sacos pericoronarios de terceros molares mandibulares / Presence of cystic lesions in pericoronary sacs of mandibular third molars

Introducción: a pesar de que un tercer molar no erupcionado repre- senta un riesgo de formación quística, la práctica clínica desestima el análisis histopatológico de los folículos de dichos molares. Objetivo: identificar la frecuencia de lesiones quísticas en los sacos pericoronarios de terceros molares mandibulares. Material y métodos: estudio des- criptivo, transversal, analítico y observacional, en donde se incluyeron sacos pericoronarios de terceros molares mandibulares para su análisis histopatológico, descripción de características clínico-radiográficas y su asociación con la presencia de cambios histológicos o lesiones quís- ticas. Resultados: se incluyeron 48 muestras de sacos pericoronarios, la histopatología de los sacos pericoronarios mostró que 83.3% tenían algún tipo de alteración: 13 quistes paradentales (27.1%), cuatro quistes dentígeros (8.3%), 12 folículos hiperplásicos (25.0%) y 11 folículos inflamados (22.9%). La presencia de lesiones quísticas en la población fue de 35.4%. Se detectó asociación estadísticamente significativa entre el sexo y la presencia de lesiones quísticas (p = 0.039) y entre el nivel de erupción y la presencia de cambios histológicos (p = 0.046). Con- clusiones: la frecuencia de lesiones quísticas o cambios histológicos en folículos de terceros molares mandibulares es alta, principalmente en molares parcialmente erupcionados o submucosos y sin importar la ausencia de sintomatología o alteraciones radiográficas (AU))

Introduction: although a non-erupted third molar represents a risk of cystic formation; clinical practice rejects the histopathological analysis of the follicles of said molars. Objective: identify the frequency of the histopathological changes in pericoronary sacs of mandibular third molars. Material and methods: descriptive cross- sectional, observational and analytic study, where pericoronary sacs of mandibular third molars were included for histopathological analysis, description of clinical-radiographic characteristics and their association with the presence of histological changes or cystic lesions. Results: 48 samples of pericoronary sacs were included, the histopathology of the pericoronary sacs showed 83.3% had some type of alteration: 13 paradental cysts (27.1%), four dentigerous cysts (8.3%), 12 hyperplastic follicles (25.0%) and 11 inflamed follicles (22.9%). The presence of cystic lesions in the population was 35.4%. A statistically significant association was detected between sex and the presence of cystic lesions (p = 0.039); and between the level of eruption and the presence of histological changes (p = 0.046). Conclusions: the frequency of cystic lesions or histological changes in mandibular third molar follicles is high, mainly in partially erupted or submucosal molars and regardless of the absence of symptoms or radiographic alterations (AU)

Efecto de la suplementación del zinc sobre el peso fetal en ratas diabéticas gestadas / Effect of zinc supplementation on fetal weight in pregnant diabetic rats

RESUMEN Introducción: La relación entre la deficiencia de Zn y la elevada incidencia de alteraciones en el crecimiento intrauterino en la diabetes materna aún no se ha dilucidado. En la literatura consultada no existen reportes del efecto de la suplementación con el micronutriente sobre el crecimiento fetal en modelos de diabetes con hiperglucemias moderadas. Objetivo: Determinar el efecto sobre el peso fetal de la suplementación con zinc a ratas con diabetes moderada durante la gestación. Métodos: Se utilizó un modelo de diabetes moderada inducida en ratas Wistar al segundo día de nacidas por inducción subcutánea con estreptozotocina (100mg/kg-pc). En la adultez las ratas sanas y diabéticas fueron apareadas con machos sanos. Según correspondiera recibieron durante 20 días de gestación un suplemento de sulfato de zinc (50mg/kg). Se estudiaron 395 fetos de cuatro grupos: fetos de ratas sanas sin suplemento, de ratas sanas suplementadas, de ratas diabéticas sin suplemento y de ratas diabéticas suplementadas. Los fetos se clasificaron en pequeños (PEG), adecuados (AEG) y grandes (GEG) para la edad gestacional. Resultados: La descendencia de las ratas diabéticas suplementadas mostró valores del peso fetal similares a ambos grupos sanos al término de la gestación, presentando menor porcentaje de fetos PEG y GEG, así como mayor porcentaje de AEG respecto al grupo diabético no suplementado. Conclusiones: La suplementación con Zn durante la gestación a ratas diabéticas con hiperglucemias moderadas causó efectos positivos sobre su descendencia al aumentar el porcentaje de fetos con peso adecuado.

ABSTRACT Introduction: the relationship between Zn deficiency and the high incidence of abnormal intrauterine growth in maternal diabetes has not yet been elucidated. There are no reports in the consulted literature of the effect of micronutrient supplementation on fetal growth in models of diabetes with moderate hyperglycemia. Objective: to determine the effect of zinc supplementation on fetal weight in rats with moderate diabetes during pregnancy. Methods: a model of mild diabetes was used in Wistar rats on the second day of birth by subcutaneous streptozotocin induction (100mg/kg-bw). As adults, healthy and diabetic rats were mated with healthy males. As appropriate, they received a zinc sulfate supplement (50mg/kg) during 20 days of gestation. A number of 395 fetuses from four groups were studied: fetuses from healthy rats without supplementation, from healthy rats supplemented, from diabetic rats without supplementation and from diabetic rats supplemented. Fetuses were classified as small (SGA), adequate (AGA), and large (LGA) for gestational age. Results: the offspring of the supplemented diabetic rats showed similar fetal weight values to both healthy groups at the end of pregnancy, having a lower percentage of SGA and LGA fetuses, as well as a higher percentage of AGA compared to the non-supplemented diabetic group. Conclusions: Zn supplementation during pregnancy in diabetic rats with moderate hyperglycemia had positive effects on their offspring by increasing the percentage of fetuses with adequate weight.

Oral manifestations of histiocytosis of langerhans cells: a pediatric case involving mandible bone / Manifestaciones orales de histiocitosis de células de Langerhans: un caso pediátrico relacionado con el hueso mandibular

Abstract Langerhans cells histiocytosis is a rare disease characterized by monoclonal proliferation and migration of special dendritic cells in a variety of organs, most commonly appears eosinophilic granuloma localized, often solitary, and bone lesions that occurs predominantly in pediatric patients. Although is most prevalent in children under the age of 15, this disorder presents in all ages and occurs at a rate of 2 to 5 cases per million per year. LCH is a complex entity; the clinic manifestations can mimic other common conditions and therefore a comprehensive evaluation is indicated. Since oral manifestations are frequent, the early diagnose of this pathology could be detected by dental professionals. The aim of this case report is to describe a case of LCH who initially was misdiagnosed and treated for a dental infection. This disease requires accurate histopathological diagnosis and timely treatment; hence it is necessary to raise awareness among dentists to avoid misdiagnose of oral manifestations of LCH.

Resumen La histiocitosis de las células de Langerhans es una enfermedad poco frecuente que se caracteriza por la proliferación monoclonal y la migración de células dendríticas especiales en una variedad de órganos; lo más común es que aparezca un granuloma eosinofílico localizado, a menudo solitario, así como lesiones óseas que se producen predominantemente en pacientes pediátricos. Aunque es más frecuente en los niños menores de 15 años, este trastorno se presenta en todas las edades y se produce a una tasa de 2 a 5 casos por millón al año. La HCL es una entidad compleja; las manifestaciones clínicas pueden imitar otras afecciones comunes y, por lo tanto, se indica una evaluación exhaustiva. Dado que las manifestaciones orales son frecuentes, el diagnóstico precoz de esta patología podría ser detectado por los profesionales de la odontología. El objetivo de este reporte de caso es describir un caso de HCL que inicialmente fue mal diagnosticado y tratado por una infección dental. Esta enfermedad requiere un diagnóstico histopatológico preciso y un tratamiento oportuno; por lo tanto, es necesario sensibilizar a los dentistas para evitar un diagnóstico erróneo de las manifestaciones orales de la HCL.

Extract of Glycyrrhiza glabra root attenuates nociception in experimental pain models: the role of BKCa channels / Extracto de raíz de Glycyrrhiza glabra atenúa la nocicepción en modelos experimentales de dolor: el rol de los canales BKCa

Abstract: The aim of this study was to evaluate the functional interaction of Glycyrrhiza glabra root extract (GGRE) on the large conductance Ca 2+ - activated K + (BKCa) channels expressed in the peripheral nervo us system by using nociception and inflammation models in rodents in vivo . Besides toxicity studies and open field tests, nociception and inflammation tests were performed on rodents. Different doses of GGRE were given orally to rats and mice. Naloxone, in domethacin, morphine, NS1619 and iberiotoxin (IbTX) were administered. GGRE had both anti - nociceptive and anti - inflammatory activity in rats and mice. GGRE exhibited an analgesic effect by decreasing the time - course of the pain threshold or reaction time i n some nociceptive tests. Furthermore, GGRE reduced level of pro - inflammatory cytokines, including TNF - α and IL - 1ß. As a conclusion, GGRE can alleviate the pain sensation of the afferent nerves and can reduce inflammation and associated pain by activating B KCa channels and reducing the levels of TNF - α, IL1ß

Resumen: El objetivo de este estudio fue evaluar la interacción funcional del extracto de raíz de Glycyrr hiza glabra (GGRE) en los canales de K + (BKCa) activados por Ca 2+ de gran conductancia expresados en el sistema nervioso periférico mediante el uso de modelos de nocicepción e inflamación en roedores in vivo . Además de los estudios de toxicidad y las prueb as de campo abierto, se realizaron pruebas de nocicepción e inflamación en roedores. Se administraron por vía oral diferentes dosis de GGRE a ratas y ratones. Se administraron naloxona, indometacina, morfina, NS1619 e iberiotoxina (IbTX). GGRE tenía activi dad tanto antinociceptiva como antiinflamatoria en ratas y ratones. GGRE mostró un efecto analgésico al disminuir la evolución temporal del umbral del dolor o el tiempo de reacción en algunas pruebas nociceptivas. Además, GGRE redujo el nivel de citocinas proinflamatorias, incluidas TNF - α e IL - 1ß. Como conclusión, GGRE puede aliviar la sensación de dolor de los nervios aferentes y puede reducir la inflamación y el dolor asociado activando los canales BKCa y reduciendo los niveles de TNF - α, IL1ß.

Plataforma CLIMSS como herramienta de alfabetización en salud durante la crisis sanitaria de Covid-19 / CLIMSS online platform as a health literacy tool during the health crisis of Covid-19

Resumen: Objetivo: Describir a la plataforma Cursos en Línea Masivos del IMSS (CLIMSS) como herramienta de alfabetización en salud, a través de la evaluación de la eficiencia terminal, la ganancia de competencias y satisfacción de los usuarios de cursos en línea masivos en el tema de Covid-19. Material y métodos: Se analizaron datos de 20 cursos ofertados entre marzo y octubre de 2020. Se evaluaron las calificaciones pre y pos, el número total de registros, el total de cursos terminados y la satisfacción del usuario. Resultados: Se registraron un total de 4.9 millones de usuarios y 10 millones de inscripciones, en todos los estados de la República mexicana, con una eficiencia terminal de 85%, una ganancia de competencias de 30% y una satisfacción de 9.34 (10). Conclusiones: La plataforma CLIMSS ha mostrado ser una herramienta para la alfabetización en salud con un alcance de millones de mexicanos en temas relacionados con la crisis sanitaria Covid-19.

Abstract: Objective: To describe the Massive Online Open Courses (MOOC) or Cursos en Línea Masivos del IMSS (CLIMSS) platform as a health literacy tool by evaluating the terminal efficiency, the competence gains, and the users' satisfaction of the massive online courses offered by the Mexican Institute of Social Security, on Covid- 19. Materials and methods: Data from 20 courses offered between March and October 2020 were analyzed. We evaluated scores from the pre and post-tests, the total number of registries, total courses completed, and users' satisfaction. Results: We registered a total of 4.9 million users and 10 million registrations, in all Mexican states, with a terminal efficiency of 85%, a competence gain of 30%, and a users' satisfaction of 9.34 (10). Conclusions: The CLIMSS platform has proven to be a tool for health literacy reaching millions of Mexicans on Covid-19 related topics.

Recomendaciones de la Asociación Colombiana de Neurología para el uso de anticuerpos monoclonales antiCGRP en la profilaxis de migraña / Recommendations on the use of the antiCGRP monoclonal antibodies for migraine prophylaxis on behalf of the Colombian Association of Neurology

RESUMEN INTRODUCCIÓN: El desarrollo de anticuerpos monoclonales (mAbs) contra el péptido relacionado con el gen de la calcitonina (CGRP) ha determinado una nueva era terapéutica en la profilaxis de migraña, demostrando su efectividad en pacientes con migraña episódica (ME) y migraña crónica (MC), con respuesta desde pacientes naïve hasta refractarios a múltiples medicamentos. La disminución del 50% de los ataques de migraña al mes (DMM) durante los primeros 3 meses de uso es el desenlace aproximado en el 50% de los pacientes que reciben esta terapia. OBJETIVO: Este consenso de la Asociación Colombiana de Neurología (ACN) tiene el objetivo de guiar la selección y uso racional de los mAbs antiCGRP en pacientes con ME y MC. MATERIALES Y MÉTODOS: El comité de cefalea de la ACN mediante la aplicación de la metodología Delphi y discusiones en reuniones posteriores desarrolló un documento en formato de consenso soportado en literatura y recomendaciones de expertos. RESULTADOS: Se obtuvieron respuestas de 14 expertos en cefalea sobre moléculas utilizadas en profilaxis de migraña, analizando su aplicabilidad en situaciones clínicas frecuentes. DISCUSIÓN: Los mAbs antiCGRP han demostrado efectividad con adecuado soporte fisiopatológico, considerando que son moléculas de alto precio en una enfermedad de alta prevalencia, existe la necesidad de guíar la selección del paciente que mejor puede beneficiarse de su administración CONCLUSIONES: Los mAbs antiCGRP están recomendados en pacientes con ME y MC que presentan falla terapéutica a otras moléculas profilácticas.

ABSTRACT INTRODUCTION: The development of monoclonal antibodies (mAbs) against Calcitonin Gene Related Peptide (CGRP) has determined a new therapeutic era in migraine prophylaxis, demonstrating its effectiveness in patients with episodic migraine (EM) and chronic migraine (CM), obtaining a response in naive patients and in those who are refractory to multiple medications. A 50% decrease in migraine attacks per month during the first 3 months of use is the approximate outcome in 50% of patients receiving this therapy. OBJECTIVE: This consensus from the Colombian Association of Neurology (ACN) has the objective of serving as a guide for the rational use of antiCGRP mAbs in patients with EM and CM. METHODS AND MATERIALS: The headache committee through the application of the Delphi methodology and discussions in subsequent meetings, develops this consensus, supported in the published literature and expert recommendations. RESULTS: Fourteen answers from headache experts were received regarding the use of drugs for migraine prophylaxis, analyzing their applicability in frequent clinical situations. DISCUSSION: AntiCGRP mAbs have proved their effectiveness with adequate pathophysiological support, but with a high price in a highly prevalent disease, there is then a need to select the patient who best benefits from this therapy. CONCLUSIONS: AntiCGRP mAbs are recommended in patients with EM and CM that have previously failed to other prophylactic drugs.

Teste de Progresso: a percepção do discente de Medicina / Progress Test: the perception of the medical student

Resumo: Introdução: O Teste de Progresso (TP) como instrumento de avaliação na educação médica constitui-se em relevante subsídio para avaliar a eficiência do programa. Contudo, a percepção do aluno quanto ao seu desempenho e o impacto do TP na aprendizagem podem variar de acordo com contextos pessoais, educacionais, sociais e culturais. Objetivo: Esta pesquisa descritiva de abordagem qualitativa objetivou analisar a percepção dos estudantes do curso de graduação em Medicina de um centro universitário do noroeste paulista sobre o seu desempenho no TP, bem como o impacto dessa percepção em curto prazo sobre suas estratégias de estudo. Método: A amostra de conveniência foi constituída por 20 participantes após aprovação da pesquisa no Comitê de Ética em Pesquisa. Utilizou-se a técnica de grupos focais em dois momentos distintos para a coleta de dados: um grupo foi constituído por dez estudantes do quinto período, e o outro, por dez estudantes do oitavo período. A análise de dados fundamentou-se na análise de conteúdo temática descrita por Bardin et al. Resultado: Identificou-se que os estudantes entrevistados consideram: 1. as condições de realização do TP inadequadas; 2. o TP uma ferramenta pedagógica relevante que permite a autoavaliação e a correção das lacunas de aprendizagem, mas sugerem que seja aprimorado; 3. a participação no TP determinou sentimentos contraditórios para os estudantes, conforme o período que estão cursando. Conclusão: O TP é considerado pelos estudantes uma "ferramenta pedagógica" relevante. Entretanto, o impacto dos resultados de desempenho obtidos e o feedback recebidos não promoveram em curto prazo mudanças no plano de estudo dos estudantes entrevistados. A prática da autoavaliação ainda não se constitui cultura na vida acadêmica. É preciso considerar novas estratégias para a entrega do feedback formativo que permita a discussão das questões e dos resultados do curso/das turmas de forma reflexiva, de modo a potencializar o processo ensino-aprendizagem.

Abstract: Introduction: The Progress Test (PT) as an assessment tool in medical education is an important tool to evaluate the efficiency of the program. However, students' perception of their performance and the impact of the PT on learning may vary according to personal, educational, social and cultural contexts. Objective: This descriptive research with a qualitative approach aimed to analyze the perception of undergraduate medical students of a University Center in northwestern São Paulo about their performance in the PT, as well as the impact of this perception in the short term on their study strategies. Method: The convenience sample was composed of twenty participants, after approval of the research by the Research Ethics Committee. The focus group technique was used in two different moments for data collection; one group consisted of ten fifth-period students and the other, of ten eighth-period students. Data analysis was based on content analysis, thematic modality, as described by Bardin (2011). Results: It was identified that the interviewed students consider: 1. the PT performance conditions as inadequate; 2. the PT a relevant pedagogical tool, which allows self-assessment and the correction of learning gaps, but they suggest that it should be improved; 3. sitting the PT determined contradictory feelings for the students, according to their period of study. Conclusion: The Progress Test is considered by students a relevant "pedagogical tool". However, the impact of the performance results obtained and the feedback received did not promote changes in the study plan of the interviewed students in the short term. The practice of self-assessment is not yet a culture in academic life. It is necessary to consider new strategies for the delivery of formative feedback, allowing for reflective discussion of the issues and the course/class results in order to enhance the teaching-learning process.

Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force

Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle-Ottawa Scale to assess the quality of nonrandomized studies. Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.

Los desafíos de la educación médica en México / The challenges of medical education in Mexico

La educación médica genera impacto en la salud de las poblaciones; formar médicos profesionalizados con capacidad para adaptarse a entornos cambiantes permite comprender con mayor detalle la epidemiología de una comunidad o país y mejorar la salud pública. Dar al estudiante de medicina las herramientas necesarias para proporcionar una atención de calidad puede mejorar la salud de cientos de pacientes. La educación médica está llena de desafíos y se encuentra en una búsqueda continua de excelencia. El modelo educa-tivo actual busca centrarse en las competencias requeridas por los sistemas de salud y educación de México, pero COVID-19 rompió paradigmas y revolucionó la manera en la que se enseña medicina, centrándose en el aprendizaje autorregulado. El mundo está en constante cambio y la educación médica debe evolucionar con el mundo. La tecnología es la herramienta que revoluciona la enseñanza y permite introducir la globalización a las escuelas, aprendiendo así sobre otras culturas y su manera de practicar la medicina. La salud mental de los estudiantes es determinante para evitar la deserción y formar médicos sanos. El integrar condiciones de bienestar a nivel nacional e institucional tendrá un impacto positivo en la vida de los estudiantes, y los ayudará a desempeñarse mejor en el futuro. El reto de la educación médica actualmente es inspirar la formación de médicos capaces de insertarse en un mercado laboral competitivo, sin descuidar la atención al paciente, con habilidades directivas y organizacionales, evitando la sobre-especialización como limitante del desarrollo profesional.

Medical education creates an impact on the health of the population. To train professional doctors capable of adapting to changing environments allows a more detailed understanding of the epidemiology in a community or country; and improves public health. When medical students have the tools needed to provide quality care, it can improve the health of hundreds of patients. Medical edu-cation is full of challenges and is in a continuous search of excellence. The current educational model focuses on the skills required by Mexico ́s health and educational systems, but COVID-19 broke paradigms and revolutionised the way we teach medicine, focusing on self-regulated learning. The world is in constant change, and medical education has to evolve with the world. Technology is a tool that revolutionises teaching and allows us to introduce globalisation to schools while learning about other cultures and how they practice medicine. Focusing on the mental health of students is a determining factor in training healthy doctors and avoiding desertion. Incor-porating well-being conditions at hospitals and schools can have a positive impact on the lives of the students, helping them have a better performance. The challenge of medical education today is to inspire the training of doctors capable of inserting themselves in a competitive labour market without neglecting patient care and with managerial and organisational skills, avoiding over-specialization as a limitation of professional development