Declining glacier cover drives changes in aquatic macroinvertebrate biodiversity in the Cordillera Blanca, Perú.

Ongoing climate change threatens the biodiversity of glacier-fed river ecosystems worldwide through shifts in water availability and timing, temperature, chemistry, and channel stability. However, tropical glacier-fed rivers have received little attention compared to those in temperate and Arctic biomes, despite their unique biodiversity potentially responding differently due to additional stress from higher altitude locations thus lower oxygen availability, diurnal freeze-thaw cycles, and annual monsoon rainfall disturbances. However, tropical glacier-fed rivers have received little attention compared to those in temperate and Arctic biomes, despite their unique biodiversity potentially responding differently due to additional stress from higher altitude locations thus lower oxygen availability, diurnal freeze-thaw cycles, and annual monsoon rainfall disturbances. This study quantified aquatic biodiversity responses to decreasing glacier cover in the Cordillera Blanca range of the Peruvian Andes. Ten rivers were studied along a gradient of decreasing glacier cover in the Parón, Huaytapallana, and Llanganuco basins, with a specific focus on macroinvertebrates and physicochemical parameters in both the dry and wet seasons. We found higher temperatures, more stable and lower turbidity rivers as glacier cover decreased, which were related significantly to higher local diversity and lower ß-diversity. Analysis of similarity revealed significant differences in the macroinvertebrate community among rivers with high, medium, or low glacier cover, illustrating turnover from specialists to generalists as glacial influence decreased. Redundancy analysis demonstrated that there were more species found to prefer stable beds and water temperatures in medium and low glacier cover in a catchment rivers. However, certain taxa in groups such as Paraheptagyia, Orthocladiinae, Anomalocosmoecus, and Limonia may be adapted to high glacial influence habitats and at risk of glacier retreat. Although species composition was different to other biomes, the Cordillera Blanca rivers showed similar benthic macroinvertebrate biodiversity responses to glacier retreat, supporting the hypothesis that climate change will have predictable effects on aquatic biodiversity in mountain ranges worldwide.

Factores de riesgo psicosocial en trabajadores universitarios: un estudio comparativo antes y durante el COVID-19 / Psychosocial risk factors in university workers: A comparative study before and during COVID-19

Resumen En el 2018, se publicó, en el Diario Oficial de la Federación, la Norma 035 que evalúa los factores de riesgo psicosocial (FRP) en los trabajadores mexicanos para promover su bienestar laboral. En 2020, en México, el COVID-19 cambió el estilo de trabajo de universidades y empresas, por lo que su análisis es interesante. El objetivo de este estudio fue comparar los FRP en trabajadores de la Universidad Autónoma de Nuevo León, en dos condiciones: oficina y teletrabajo, e identificar la relación entre el género y la modalidad laboral con el riesgo psicosocial. Para ello, el instrumento se aplicó a través de dos modalidades, en entorno de oficina, en noviembre 2019, previo a la pandemia COVID-19, y en trabajo a distancia, en junio 2020, a inicio del distanciamiento social. Los resultados reflejaron que desempeñar tareas en el entorno de oficina provocó un riesgo psicosocial general alto, mientras que en teletrabajo un riesgo general medio, de acuerdo con la NOM-035. Sin embargo, el análisis estadístico no mostró una diferencia significativa (P < 0.05) de riesgo general entre ambos ambientes laborales, ni en la comparativa del riesgo entre géneros. No obstante, en el análisis de las categorías y dominios que integran el riesgo psicosocial, se encontró diferencia (P < 0.05) entre algunos de ellos. Los hombres presentaron mayor riesgo en oficina en la categoría de liderazgo y relaciones laborales, que disminuyó (P < 0.05) por efecto del teletrabajo. La presencia del riesgo psicosocial que reportaron algunos de los trabajadores en diferentes categorías y dominios, indica la necesidad de implementar políticas que reduzcan estos riesgos, considerando tanto la modalidad laboral como el género. Esto permitirá además de cumplir con la NOM-035, mejorar la calidad de vida laboral de los trabajadores.

Abstract In 2018, standard 035 (known in Spanish as NOM-035-STPS-2018) was published in the Official Gazette of the Federation. Such standard evaluates Psychosocial Risk Factors (PRF) in Mexican workers to promote their job well-being. In 2020, COVID-19 changed the work practices ofuniversities and companies in Mexico. Therefore, their analysis is timely and relevant. The objective of this study was to compare the PRFs among workers at the Universidad Autónoma de Nuevo León in two conditions: pre-pandemic office and home office during social distancing due to COVID-19, and to identify the relationship between gender and modality with the psychosocial risk. Consequently, the instrument was administered through two modalities, one test was administered in the office environment in November 2019, prior to the COVID-19 pandemic, and the other in remote work in June 2020, at the beginning of social distancing. The results showed that performing tasks in the office environment generates a high general psychosocial risk, while home office is a medium general risk, according to NOM-035. However, the statistical analysis did not show a significant difference (P < 0.05) in general risk between both work contexts, nor in the comparison of risk between genders. Nonetheless, in the analysis of the categories and domains that make up psychosocial risk, a significant difference (P < 0.05) was found between some of them. Men presented a higher risk in the office in the category of leadership and job relations, which decreased (P < 0.05) due to the effect of home office. The presence of psycho-social risk reported by some of the workers in different categories and domains indicated the need to implement policies that reduce these risks, considering both work modality and gender. This will allow, in addition to complying with NOM-035, to improve the quality of the job well-being of workers.

Green taxes as ecosystem conservation: an analysis of the industrial sector's view in Peru.

Background: Environmental problems are becoming more recurrent nowadays, which is why many countries have acted on the matter, through different forms, laws and taxes that can contribute and reduce the polluting impact of companies at the time of manufacturing their products. One of the reforms has been environmental taxes, which are not only aimed at raising money, but also at taking corrective action on the behavior of companies that damage both the environment and the health of the population. The research is intended to finding out the opinion and interest of managers of different companies in the industrial sector on environmental taxes, also known as green taxes, and whether they consider it necessary to add green taxes to the current tax system. Method: For data collection of the research, 120 managers of small and medium-sized enterprises in the industrial sector were questioned about whether green taxes could have an influence on ecosystem conservation and several other questions. Results: 63.3% of the managers surveyed agree that the application of an environmental tax is necessary. Conclusion: It is concluded that managers are in favor of green taxes and  approve that  such taxes should be given as part of ecosystem conservation and environmental protection for all businesses, and that they promote businesses that do not generate any side effects or transformations to the environmental balance, thus improving the quality of life of residents.

Competencies of the nurse in educational institutions: a look from educational managers. / Competencias de la enfermera en instituciones educativas: una mirada desde los gestores educativos.

OBJECTIVE: Describe and analyze the attributes of the nurse competencies in caring of students since the manager look of educational institutions. METHOD: Qualitative descriptive-exploratory study. Seven principals of educational institutions of Trujillo (Peru) participates in a non-structured interview during the first semester of 2016 and the analysis of oral discourse was used. RESULTS: Empirical categories: The nurse in the promotion of educational community health; The nurse in the prevention of the educational community illness; The student nurse articulating health - education in the everyday life of students. FINAL CONSIDERATIONS: This study contributes to the conceptual support of the competencies of the student nurse for the intersectoral health - education action and the setting-up of health with students in the educational institutions.

Competencias de la enfermera en instituciones educativas: una mirada desde los gestores educativos / Competências da enfermeira nas instituições educacionais: uma visão dos gestores da educação / Competencies of the nurse in educational institutions: a look from educational managers

Resumen OBJETIVO Describir y analizar los atributos de las competencias de la enfermera en el cuidado de los escolares vista por los gestores de instituciones educativas. MÉTODO Estudio cualitativo descriptivo-exploratorio. Siete directores de instituciones educativas de Trujillo (Perú) participaron en una entrevista no estructurada, durante el primer semestre del año 2016 y se utilizó el análisis de discurso oral. RESULTADOS Categorías empíricas: La enfermera en la promoción de la salud de la comunidad educativa; La enfermera en la prevención de la enfermedad en la comunidad educativa; La enfermera escolar articulando salud-educación en el cotidiano de vida de los escolares. CONSIDERACIONES FINALES El estudio contribuye al sustento conceptual de las competencias de la enfermera escolar para la acción intersectorial salud-educación y el establecimiento de políticas de promoción de salud de los escolares dentro las instituciones educativas.

Resumo OBJETIVO Descrever e analisar os atributos das competências da enfermeira escolar no cuidado escolares a partir da perspectiva dos gestores de instituições de ensino. MÉTODO Estudo qualitativo descritivo-exploratório: Sete diretores de instituições de ensino em Trujillo (Peru), participaram em uma entrevista no estruturada e se utilizou a análise de depoimentos orais. RESULTADOS Os resultados reportam as categorias empíricas: a enfermeira na promoção da saúde da comunidade educativa; a enfermeira na prevenção de doenças da comunidade educativa; A enfermeira escolar articulando a saúde e a educação no cotidiano do escolar. CONSIDERAÇÕES FINAIS O estudo contribui ao marco conceitual das competências da enfermeira escolar para a ação inter setorial em saúde-educação e para o estabelecimento de políticas na promoção da saúde dos escolares no interior das instituições educativas.

Abstract OBJECTIVE Describe and analyze the attributes of the nurse competencies in caring of students since the manager look of educational institutions. METHOD Qualitative descriptive-exploratory study. Seven principals of educational institutions of Trujillo (Peru) participates in a non-structured interview during the first semester of 2016 and the analysis of oral discourse was used. RESULTS Empirical categories: The nurse in the promotion of educational community health; The nurse in the prevention of the educational community illness; The student nurse articulating health - education in the everyday life of students. FINAL CONSIDERATIONS This study contributes to the conceptual support of the competencies of the student nurse for the intersectoral health - education action and the setting-up of health with students in the educational institutions.

Alzheimer’s disease: oral manifestations, treatment and preventive measures / Enfermedad de Alzheimer: manifestaciones orales, tratamiento y medidas preventivas

In the treatment of patients with dementia Alzheimer's type non-current and are facing tough situations. Treatment should be tailored to each stage of the disease and for each patient. In this type of disease is very important to involve families and caregivers to improve the quality of life of patients. The main goal with these patients is prevention. Patients should be all oral manifestations caused by the lack of inadequate oral hygiene, xerostomia and manifestations derived by taking drugs. The aim of this review is to describe the main oral manifestations that can result from this disease and the best treatment options taking into account the clinical stages in which patients are found.

En el tratamiento a pacientes con demencias tipo Alzheimer se afrontan situaciones infrecuentes y comprometidas. El tratamiento debe personalizarse para cada estadio de la enfermedad y para cada paciente. En este tipo de enfermedades es muy importante involucrar a los familiares y cuidadores para mejorar la calidad de vida del enfermo. El principal objetivo con estos pacientes es la prevención. Se deben controlar todas las manifestaciones orales provocadas por la falta de una inadecuada higiene oral, la xerostomía y las manifestaciones derivadas por los fármacos que consumen. El objetivo de esta revisión es describir cuáles son las principales manifestaciones orales que pueden derivar de esta enfermedad y las mejores opciones de tratamiento teniendo en cuenta las etapas clínicas en las que se encuentran los pacientes.

Woman with virilizing congenital adrenal hyperplasia and Leydig cell tumor of the ovary.

We report the case of a 36-year-old woman with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, and corticosteroid replacement therapy since birth. She manifested persistent virilization and high testosterone levels that were attributed to nonadherence to medical treatment. The patient was referred to our gender unit for genitoplastic surgery. We recommended the patient for left oophorectomy after detecting an ovarian mass. Pathologic findings confirmed an ovarian hilus cell tumor. Testosterone levels fell back to normal and masculinization disappeared but ACTH remained elevated. This case represents a very rare type of primary ovarian tumor that must be considered in persistent virilizing symptoms in women with CAH.

[Molecular test Genotype® MTBDRplus, an alternative to rapid detection of multidrug resistance tuberculosis]. / Prueba molecular Genotype® MTBDRplus, una alternativa para la detección rápida de tuberculosis multidrogorresistente.

The Genotype®MTBDRplus molecular test is a method that allows identification of the most frequent mutations associated with resistance to major first-line antituberculosis drugs, Isoniazid (INH) and Rifampicin (RFP). The aim of this study was to evaluate the performance of the molecular test with culture and smear- positive sputum samples. We evaluated 95 cultures and 100 sputum samples with resistance profiles previously determined by the reference method "Agar Plate Proportions" (APP). The molecular test from cultures showed a sensitivity of 100 %, 97,5 % and 96,97 % for RIF, INH and MDR respectively while from sputums the sensitivity was 95,65 %, 96,77 % and 95,24 % for RIF, INH and MDR respectively. We conclude that the molecular test Genotype®MTBDRplus is a very useful tool to detect resistance to isoniazid and rifampicin simultaneously (MDR-TB) in up to 72 hours from sputum samples or cultures.

Prueba molecular genotype MTBDRplus, una alternativa para la detección rápida de tuberculosis multidrogorresistente / Molecular test genotype MTBDRplus, an alternative to rapid detection of multidrug resistance tuberculosis

La prueba molecular Genotype MTBDRplus, es un método que permite identificar las mutaciones más frecuentes asociadas con la resistencia a las drogas antituberculosas de primera línea: isoniacida (INH) y rifampicina (RIF). El objetivo de este estudio fue evaluar el desempeño de la prueba molecular con cultivos y muestras de esputo con baciloscopía positiva. Se evaluó 95 cultivos y 100 esputos con perfiles de resistencia previamente determinados por el método de referencia “proporciones agar en placa” (APP). La prueba molecular a partir de cultivos mostró una sensibilidad de 100 por ciento;97,5 por ciento y 96,9 por ciento para RIF, INH y multidrogorresistente (MDR) respectivamente; mientras que para esputo la sensibilidadfue de 95,7 por ciento; 96,8 por ciento y 95,2 por ciento para RIF, INH y MDR respectivamente. Se concluye que Genotype MTBDRplus es una herramienta muy útil para la detección rápida de la resistencia a INH y RIF simultáneamente (MDR) en un máximo de72 h a partir de esputo o de cultivo

[National evaluation of the diagnosis of activated protein C resistance]. / Evaluación nacional del diagnóstico de la resistencia a la proteína C activada.

Thrombophilia or prothrombotic state appears when activation of blood hemostatic mechanisms overcomes the physiological anticoagulant capacity allowing a thrombotic event. Thrombosis is the leading worldwide mortality cause and due to its high associated morbidity and mortality, it should be insisted in the opportune identification of a thrombophilic state. The study of thrombophilia identifies individuals at high risk for thrombosis. This meeting was conceived first to analyze the current status of the diagnosis of thrombophilia in Mexico and second to create the base for a national consensus for thrombophilia screening and for the establishment of a national center for laboratory reference and quality control for thrombophilia. Since searching of activated protein C resistance (APCR) and FV Leiden seem to have priority either in the clinical setting and in public health services, it was decided to start with these two abnormalities as a model to analyze the current status of thrombophilia diagnosis in the clinical laboratory. At this time, several thrombophilic abnormalities have been described however, APCR remains the most important cause of thrombophilia, accounting for as much as 20% to 60% of all venous thrombosis. APCR is a consequence of the resistance of activated FV to be inactivated by activated protein C. Procoagulant activity of activated FV increases the risk of thrombosis. Hereditary APCR is almost always due to a point mutation at the nucleotide 1691 of the FV gen inducing an Arg506Glu substitution in FV molecule. This mutation is better known as FV Leiden. Heterocygous carriers of FV Leiden have a thrombotic risk 5 to 10 times higher than general population while the risk for the homocygote state is increased 50 to 100-fold. When activated PC is added to plasma from patients with FV Leiden, this last resists the anticoagulant effect of activated PC. Therefore, thrombin production is not inhibited. This phenomenon is called APCR. The functional test evaluates the partially activated thromboplastin time (aPTT) in a plasma sample before and after adding activated PC. The result is reported as a standardized sensibility index: aPTT post-activated PC/aPTT pre-activated PC. The conclusions of this national reunion pretend to optimize the available resources in our country in order to allow a wide and less-expensive diagnosis of patients with thrombosis.