Post-Harvest Behavior of Seedless Conical and Mini-Conical Peppers: Weight Loss, Dry Matter Content, and Total Soluble Solids as Indicators of Quality and Commercial Shelf-Life.

This study aimed to assess the post-harvest dynamics of seedless conical and mini-conical pepper cultivars in terms of fruit weight loss, dry matter content, and soluble solid content. The above parameters were demonstrated to be effective commercial pepper shelf-life indicators. The commercial quality of pepper fruit intended for export was evaluated weekly under simulated fruit storage conditions for over 28 d. Results revealed that fruit weight loss, dry matter content, and soluble solid content were affected by cultivar type and storage duration. Additionally, a strong correlation between these variables was observed confirming their linear relationship which was more profound between dry matter and total soluble solid content. Daily changes during storage were similar in both seedless conical and mini-conical peppers, while the fruit weight loss daily rate was greater than that of dry matter. Water loss was identified to be the main factor causing reduced fruit quality. Solid content reduction occurred predominately during the initial storage period. Notably, fruit with lower dry matter content at harvest tended to maintain their commercial quality for a longer time due to their ability to resist water loss without any visible signs of deterioration, which is beneficial during prolonged storage.

A Conceptual Approach for the Design of New Catalysts for Ammonia Synthesis: A Metal-Support Interactions Review.

The growing interest in green ammonia production has spurred the development of new catalysts with the potential to carry out the Haber-Bosch process under mild pressure and temperature conditions. While there is a wide experimental background on new catalysts involving transition metals, supports and additives, the fundamentals behind ammonia synthesis performance on these catalysts remained partially unsolved. Here, we review the most important works developed to date and analyze the traditional catalysts for ammonia synthesis, as well as the influence of the electron transfer properties of the so-called 3rd-generation catalysts. Finally, the importance of metal-support interactions is highlighted as an effective pathway for the design of new materials with potential to carry out ammonia synthesis at low temperatures and pressures.

Metal-Organic Frameworks as Formose Reaction Catalysts with Enhanced Selectivity.

The formose reaction is an autocatalytic series of aldol condensations that allows one to obtain monosaccharides from formaldehyde. The formose reaction suffers from a lack of selectivity, which hinders practical applications at the industrial level. Over the years, many attempts have been made to overcome this selectivity issue, with modest results. Heterogeneous porous catalysts with acid-base properties, such as Metal-Organic Frameworks (MOFs), can offer advantages compared to homogeneous strong bases (e.g., calcium hydroxide) for increasing the selectivity of this important reaction. For the very first time, four different Zeolite Imidazolate Frameworks are presented in this work as catalysts for the formose reaction in liquid phase, and their catalytic performances were compared with those of the typical homogeneous catalyst (i.e., calcium hydroxide). The heterogeneous nature of the catalysis, the possible contribution of leached metal or linkers to the solution, and the stability of the materials were investigated. The porous structure of these solids and their mild basicity make them suitable for obtaining enhanced selectivity at 30% formaldehyde conversion. Most of the MOFs tested showed low structural stability under reaction conditions, thereby indicating the need to search for new MOF families with higher robustness. However, this important result opens the path for future research on porous heterogeneous basic catalysts for the formose reaction.

Facile Synthesis of Heterogeneous Indium Nanoparticles for Formate Production via CO2 Electroreduction.

In this study, a simple and scalable method to obtain heterogeneous indium nanoparticles and carbon-supported indium nanoparticles under mild conditions is described. Physicochemical characterization by X-ray diffraction (XRD), X-ray photoelectron microscopy (XPS), scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed heterogeneous morphologies for the In nanoparticles in all cases. Apart from In0, XPS revealed the presence of oxidized In species on the carbon-supported samples, whereas these species were not observed for the unsupported samples. The best-in-class catalyst (In50/C50) exhibited a high formate Faradaic efficiency (FE) near the unit (above 97%) at -1.6 V vs. Ag/AgCl, achieving a stable current density around -10 mA·cmgeo-2, in a common H-cell. While In0 sites are the main active sites for the reaction, the presence of oxidized In species could play a role in the improved performance of the supported samples.

Detección de enfermedad renal crónica oculta mediante determinación de albuminuria en pacientes con diabetes mellitus / Detection of Hidden Chronic Kidney Disease by Determining Albumin Estimates in Patients with Diabetes Mellitus

Introducción: La diabetes mellitus constituye la segunda causa de enfermedad renal crónica en Cuba. La estimación de albuminuria facilitaría la identificación precoz de esta. Objetivo: Determinar el valor predictor de enfermedad renal crónica oculta en la albuminuria de pacientes con diabetes mellitus de la Atención Primaria de Salud en Las Tunas. Métodos: Se realizó un estudio analítico de caso-control en 360 pacientes con diabetes mellitus pertenecientes al Policlínico Manuel Fajardo Rivero, en el período de enero de 2019 a febrero de 2020. La población en estudio fue dividida en dos grupos, atendiendo a la presencia (casos) o no (controles) de daño renal. El poder discriminatorio de la albuminuria como predictor de enfermedad renal crónica oculta se determinó mediante el área bajo la curva ROC, además se identificó el punto de corte óptimo. Se utilizó el análisis multivariado para identificar los factores predictores independientes de enfermedad renal. Resultados: La albuminuria mayor de 160 mg/24h fue identificada como predictor de enfermedad renal crónica oculta (OR: 2,278; IC de 95 por ciento: 1,637-2,908) junto a la edad ˃ 65 años, los años de evolución de DM ˃ 8 años y la hipoalbuminemia. El poder discriminatorio fue bueno, índice C: 0,843 (IC de 95 por ciento: 0,762-0,929). El punto de corte identificado de 160 mg/24h alcanzó una sensibilidad y especificidad de 90,00 por ciento y 97,60 por ciento, respectivamente. Conclusiones: La albuminuria pudiese ser un importante predictor independiente de enfermedad renal crónica oculta en pacientes con diabetes mellitus de la Atención Primaria de Salud(AU)

Introduction: Diabetes mellitus is the second cause of chronic kidney disease in Cuba. Albumin estimates would facilitate its early identification. Objective: To determine the predictive value of albuminuria in hidden chronic kidney disease among patients with diabetes mellitus at primary healthcare level in Las Tunas. Methods: An analytical case-control study was carried out in 360 patients with diabetes mellitus belonging to Manuel Fajardo Rivero Polyclinic, in the period from January 2019 to February 2020. The study population was divided into two groups: occurrence (cases) or not (controls) of kidney damage. The discriminatory power of albuminuria as a predictor of hidden chronic kidney disease was determined by the area under the ROC curve, while its optimal cut-off point was also identified. Multivariate analysis was used to identify independent predictors of kidney disease. Results: Albuminuria over 160 mg on 24 hours was identified as a predictor of hidden chronic kidney disease (OR: 2.278; 95 percent CI: 1.637-2.908) together with age over 65 years, evolution of diabetes mellitus over 8 years, and hypoalbuminemia. The discriminatory power was good: The C index was 0.843 (95 percent CI: 0.762-0.929). The identified cut-off point of 160 mg in 24 hours reached a sensitivity and specificity of 90.00 percent and 97.60 percent, respectively. Conclusions: Albuminuria could be an important independent predictor of hidden chronic kidney disease in patients with diabetes mellitus at primary healthcare level(AU)

Risk of musculoskeletal disorders in pepper cultivation workers.

Agricultural workers have an increased risk of musculoskeletal disorders, mainly due to the manual nature of the work. This study assesses the level of physical well-being in pepper cultivation workers in Almería (Spain). The objective was to analyze pepper cultivation tasks performed in the Almería-type greenhouse, using the OWAS (Ovako Working Posture Assessment System) and RULA (Rapid Upper Limb Assessment) methods. The OWAS results showed a normal posture percentage of 53 %, a medium risk of 30 %, a high risk of 16 %, and a very high risk of 1 %. The body areas most affected were the back and legs. The RULA assessment found high risk/action levels, with 50 % of the postures corresponding to level 3, 35 % to level 4, and 15 % to level 2. Improvements are therefore proposed; these include: redesigning tasks, mechanization, training, team development, and improving the workers' physical condition. The OWAS and RULA data may have overestimated the results, as workers do not appear to be limited in performing tasks and do not normally request sick leave.

Improved Thermochemical Energy Storage Behavior of Manganese Oxide by Molybdenum Doping.

To improve the thermochemical energy storage (TCS) behavior of Mn2O3, several Mn-Mo oxides with varying amounts of MoO3 (0-30 wt%) were prepared by a precipitation method. The physico-chemical properties of the solids were studied by N2 adsorption-desorption, X-ray diffraction (XRD), scanning electron microscopy (SEM), and H2-temperature-programmed reduction (TPR), while their TCS behavior was determined by thermogravimetric analysis coupled with differential scanning calorimetry (TGA-DSC). Apart from Mn2O3 and MoO3 phases, XRD revealed a mixed MnMoO4 phase for MoO3 loadings equal or higher than 1.5 wt%. All samples showed a well-formed coral-like surface morphology, particularly those solids with low MoO3 contents. This coral morphology was progressively decorated with compact and Mo-enriched MnMoO4 particles as the MoO3 content increased. TPR revealed that the redox behavior of Mn2O3 was significantly altered upon addition of Mo. The TCS behavior of Mn2O3 (mostly oxidation kinetics and redox cyclability) was enhanced by addition of low amounts of Mo (0.6 and 1.5% MoO3) without significantly increasing the reduction temperature of the solids. The coral morphology (which facilitated oxygen diffusion) and a smoother transition from the reduced to oxidized phase were suggested to be responsible for this improved TCS behavior. The samples containing 0.6 and 1.5 wt% of MoO3 showed outstanding cyclability after 45 consecutive reduction-oxidation cycles at high temperatures (600-1000 °C). These materials could potentially reach absorption efficiencies higher than 90% at concentration capacity values typical of concentrated solar power plants.

Musculoskeletal Risks: RULA Bibliometric Review.

The objective of this study was to reveal RULA method applications in terms of the knowledge, country, year and journal categories. The search was performed using the "Web of Science Core Collection". The period from 1993 to April 2019 was selected. Eight hundred nine results were obtained, of which 226 were used. The largest number of publications was determined to be in the fields of industry and health and social assistance, which coincides with the OWAS and Standardized Nordic Questionnaire methods. By country, the USA stands out for its greater number of research studies and categories that are encompassed. By date, 2016 was the year when more studies were carried out, again coinciding with the Standardized Nordic Questionnaire. By journal, "Work-A Journal of Prevention Assessment and Rehabilitation" is highlighted, as it is for the REBA method as well. It was concluded that RULA can be applied to workers in different fields, usually in combination with other methods, while technological advancement provides benefits for its application.

An Overview of REBA Method Applications in the World.

The objective of this work is to review literature, worldwide, in which the Rapid Entire Body Assessment (REBA) ergonomic assessment method was applied and count the number of times that REBA was applied together with other methods and subsequent incidence. The database used was the "Web of Science-Core Collection". Only scientific articles and bibliographic reviews were included, analysing a total of 314 documents and selecting only 91. The use of the REBA method is indicated in terms of knowledge, country, year and journal sectors. It was most used in the knowledge areas of "Manufacturing" (24.18%), "Agriculture, forestry and fishing" (21.98%) and in "Other activities" (19.78%). One of the benefits of REBA is that it evaluates different body parts: upper limbs (arm, forearm and wrist), lower extremities, trunk and neck. It is a useful method to identify the forced postures adopted by workers to thus develop improvement measures if necessary. It is concluded that REBA method use has increased over the last decade, probably due to the digitization of knowledge. It is almost always applied in combination with other methods, and its use can be a positive indicator of company sustainability.

Catalytic Production of Jet Fuels from Biomass.

Concerns about depleting fossil fuels and global warming effects are pushing our society to search for new renewable sources of energy with the potential to substitute coal, natural gas, and petroleum. In this sense, biomass, the only renewable source of carbon available on Earth, is the perfect replacement for petroleum in producing renewable fuels. The aviation sector is responsible for a significant fraction of greenhouse gas emissions, and two billion barrels of petroleum are being consumed annually to produce the jet fuels required to transport people and goods around the world. Governments are pushing directives to replace fossil fuel-derived jet fuels with those derived from biomass. The present mini review is aimed to summarize the main technologies available today for converting biomass into liquid hydrocarbon fuels with a molecular weight and structure suitable for being used as aviation fuels. Particular emphasis will be placed on those routes involving heterogeneous catalysts.

Interplay of Support Chemistry and Reaction Conditions on Copper Catalyzed Methanol Steam Reforming.

A series of Cu catalysts supported on SiO2, Al2O3-SiO2, TiO2 rutile, and Cu/TiO2 anatase metal oxides has been studied for methanol reforming in the vapor phase. The highest activity was obtained on Cu/SiO2 catalysts (5493 µmol H2 min-1·gcat -1) followed by Cu/TiO2 rutile, Cu/Al2O3-SiO2, and anatase. XRD and HRTEM characterization after reaction revealed that on Cu/SiO2 significant sintering occurred during reaction. In contrast, the particle size growth on Cu/TiO2 rutile and anatase was less pronounced, which could be associated with the interaction between Cu clusters and TiO2. Characterization by TGA showed that on Cu/Al2O3-SiO2 the main cause of deactivation was coke deposition.

M orbilidad oculta del síndrome metabólico en pacientes adultos de un consultorio médico de familia / Hidden morbidity of metabolic syndrome in adult patients of a Family Doctors Office

Fundamento: el síndrome metabólico se ha ido imponiendo en el mundo médico, a pesar de no constituir aun un concepto acabado. La combinación de factores genéticos y ambientales , unidos al estilo de vida, puede llevar a la aparición de una asociación de problemas de salud, con la resistencia a la insulina como componente patogénico fundamental.Objetivo: describir la morbilidad oculta del síndrome metabólico en pacientes adultos del Consultorio Médico de la Familia Nº 37, correspondiente al área de salud del Policlínico Universitario “Manuel Fajardo Rivero” del municipio de Las Tunas, durante el periodo de mayo a diciembre de 2015.Métodos: se realizó un estudio observacional, analítico, de corte transversal, de la morbilidad oculta del síndrome metabólico, en pacientes adultos de la referida área de salud y período de tiempo declarado anteriormente. La población de estudio estuvo conformada por los 160 pacientes con manifestaciones clínicas, asociables al síndrome metabólico.Resultados: se diagnosticó más frecuentemente en el sexo femenino, a pacientes de entre 40 y 59 años, con predominio de hipertensión arterial sistólica. Las féminas tuvieron mayor índice de masa corporal y glucemia, con menor circunferencia abdominal y alteraciones en el perfil lipídico. Todos practicaban una actividad física leve. La incidencia varió según la definición empleada, siendo menor cuando se aplicaron los criterios diagnósticos del III Panel de Tratamiento del Adulto, del Programa Nacional de Educación en Colesterol, con respecto a la Federación Internacional de Diabetes.Conclusiones: se describió la morbilidad oculta del síndrome metabólico en la muestra de estudio. Predominaron la hipertensión arterial sistólica y los valores elevados de glucemia(AU)

Background: metabolic syndrome (MS) has become established in the medical world in spite of not being a completed concept. The combination of genetic and environmental factors associated with lifestyle can lead Morbilidad oculta del síndrome metabólico… Regueira Betancourt SM…Revista Electrónica Dr. Zoilo E. Marinello Vidaurreta Vol. 41, número 9, septiembre 2016 to the onset of an association of health problems, having insulin resistance as a fundamental pathogenic component.Objective: to describe the hidden morbidity of metabolic syndrome in adult patients of Doctors Office No. 37 of the health district of "Manuel Fajardo Rivero" Teaching Polyclinic of Las Tunas, from May through December, 2015.Methods: an observational, analytic and cross-sectional study was carried out about the hidden morbidity of metabolic syndrome in adult patients of the health district and period herein mentioned. The study population was made up of the 160 patients with clinical manifestations associated with metabolic syndrome.Results: the syndrome was most frequently diagnosed in female patients between 40 and 59 years of age, with a prevalence of systolic arterial hypertension. The women had a higher body mass index and blood glucose, with a lesser abdominal girth and alterations in the lipidic profile. They all practiced a slight physical activity. The incidence varied according to the definition used, being lesser when applying the diagnostic criteria of the III Panel on the Treatment of the Elderly of the National Educational Program on Cholesterol with regard to the International Federation of Diabetes(AU)

Morbilidad oculta de la enfermedad renal crónica en un consultorio médico de la familia / Morbidity of the occult chronic renal disease in a family doctors office

Fundamento: la enfermedad renal crónica es un importante problema de salud pública global. Si se actúa precozmente es posible frenar su progresión y disminuir el riesgo cardiovascular asociado.Objetivo: describir la morbilidad de la enfermedad renal crónica oculta en pacientes con factores de riesgo asociado, pertenecientes al consultorio médico de la familia (CMF) 12, Policlínico universitario “Dr. Gustavo Aldereguía Lima”, municipio de Las Tunas, desde el 1 de septiembre de 2014 al 30 de abril de 2015.Métodos: se realizó una investigación descriptiva, longitudinal, prospectiva, relacionada con la morbilidad oculta de la enfermedad renal crónica en la población; área de salud y período de tiempo referidos anteriormente.Resultados: la población mayor de 45 años fue de 413 pacientes, sólo el 2,66 por ciento estaban dispensarizados con enfermedad renal crónica. Al término del estudio, se diagnosticaron 37 nuevos casos (8,95 por ciento), totalizando el 11,61 por ciento de la población. Predominó el grupo de edades de 60-74 años, el sexo femenino y el color de la piel blanca. Entre los factores de riesgo asociado, además de la edad, predominaron la hipertensión arterial y la diabetes mellitus. Las manifestaciones clínicas más detectadas fueron la hipertensión arterial, la palidez cutáneo-mucosa y la poliuria. Los exámenes de laboratorio que mostraron los valores más alterados fueron la creatinina, el hematocrito y el ácido úrico. Al clasificar la enfermedad mediante el uso de la ecuación de Cockcroft-Gault, el mayor número de pacientes catalogaron en un estadio 3 A, por descenso moderado del filtrado glomerular, seguido de los que tuvieron un estadio 2 y un daño renal con ligero descenso del filtrado y los que se encontraban en estadios 3B y 4.Conclusiones: se describió la morbilidad de la enfermedad renal crónica en la población de estudio, con predominio de una incidencia que estaba oculta (AU)

Background: the chronic renal disease is an important global public health problem. If there is an early action against it, it will be possible to stop its progression and diminish the associated cardiovascular risk.Objective: to describe the morbidity of the occult chronic renal disease in patients who have associated risk factors and belong to the doctors office 12 of “Dr. Gustavo Aldereguía Lima" Polyclinic in Las Tunas municipality from September 1, 2014 to April 30, 2015. Methods: a descriptive, longitudinal and prospective investigation was carried out related to the morbidity of the occult chronic renal disease in the population, health area and time period mentioned above.Results: the population who were older than 45 years comprised 413 patients; only 2,66 percent of them were diagnosed with chronic renal disease. At the end of the study, 37 new cases were diagnosed (8,95 percent), totalizing 11,61 percent of the population. The age group from 60 to 74 years old, white and female patients prevailed. Among the risk factors, besides age, hypertension and diabetes mellitus predominated. The most frequent clinical manifestations were high blood pressure, mucocutaneous pallor and polyuria. Creatinine, hematocrit and uric acid showed the greatest alterations in the laboratory tests. When classifying the disease by means of the equation of Cockcroft-Gault, the highest number of patients classified in stage 3 A, by moderate decrease of the glomerular filtration rate, followed by those in stage 2 and kidney damage with slight decrease of the glomerular filtration rate, and those who were in stage 3B and 4.Conclusions: Morbidity of the chronic renal disease in the study population was described, with prevalence of an incidence that had been hidden (AU)

Farmacoterapéutica en pacientes diabéticos de un consultorio médico de la familia / Pharmaco-therapeutics in diabetic patients from a Family Doctors Office

Fundamento: la diabetes mellitus constituye un problema de salud a nivel mundial, tanto por ser una de las enfermedades no transmisibles más frecuentes, como por la severidad y diversidad de sus complicaciones crónicas, deviene en uno de los mayores retos de la salud pública del siglo XXI.Objetivo: realizar una intervención relacionada con el manejo de los pacientes diagnosticados con diabetes mellitus, en la población del consultorio médico de la familia No 26, del Policlínico Docente “Dr. Gustavo Aldereguía Lima”, del municipio de Las Tunas, durante el período comprendido entre el 1 de enero y el 31 de diciembre de 2015.Método: se realizó una investigación prospectiva, longitudinal, de intervención, relacionada con el manejo terapéutico de los pacientes diagnosticados con diabetes mellitus, a partir de una correcta clasificación clínica de la enfermedad, en la población del referido consultorio médico de la familia y durante el período señalado.Resultados: después de la intervención todos los pacientes quedaron clasificados con diabetes mellitus tipo 2. Predominó el sexo femenino y el grupo de edades entre 61 y 70 años, con seguimiento correcto por las especialidades de Medicina General Integral y Medicina Interna. Mejoró el control metabólico; predominó el estrés como factor desencadenante del descontrol metabólico; toda la muestra cumplió con el tratamiento. En relación a los grupos farmacológicos más usados, destacaron los compuestos orales hipoglucemiantes. Conclusiones: el total de la población de estudio quedó clasificada como diabetes mellitus tipo 2, con adecuado seguimiento médico. Los grupos farmacológicos más usados fueron los compuestos orales hipoglucemiantes (AU)

Background: diabetes mellitus is a health problem all over the world; as much as for being one of the most frequent non-transmissible diseases as for the severity and diversity of its chronic complications, it becomes one of the biggest challenges in public health of the XXI century. Objectives: to carry out an intervention related to the treatment of those patients diagnosed with diabetes mellitus in the population from the doctors office 26 of Dr. Gustavo Aldereguía Lima polyclinic in Las Tunas municipality, from January, 1 to December 31, 2015.Method: a prospective, longitudinal research of intervention was carried out related to the therapeutic management of the patients diagnosed with diabetes mellitus, starting from a correct clinical classification of the illness, in the population from the doctor´s office 26, at Dr. Gustavo Aldereguía Lima polyclinic of Las Tunas, during the mentioned time period.Results: after the intervention, all the patients from the sample were classified with diabetes mellitus type 2. Females and the age group between 61 and 70 years old prevailed, with correct follow-up by the specialties of General and Internal Medicine. The metabolic control improved; stress as the triggering factor of the metabolic uncontrollability prevailed. The entire sample fulfilled the treatment. In relation to the pharmacological groups mostly used, the hypoglycemic oral compounds prevailed.Conclusions: the entire study population was classified with diabetes mellitus type 2, with appropriate follow-up. The pharmacological groups mostly used were the hypoglycemic oral compounds (AU)

Caracterización clínica epidemiológica y genética de los pacientes menores de 25 años con diabetes mellitus / Clinical, epidemiological and genetic characterization of patients under 25 years old with Diabetes Mellitus

Fundamento: los pacientes jóvenes menores de 25 años debutan con diferentes formas clínicas de diabetes mellitus: tipos 1 y 2 de causas conocidas y las de inicio en la madurez de personas jóvenes, diabetes monogénicas, con un patrón de herencia autosómico dominante.Objetivo: caracterizar según las variables clínicas, epidemiológicas y genéticas a los pacientes con diabetes mellitus menores de 25 años del Centro Provincial de Atención al Diabético de Las Tunas.Métodos: se realizó un estudio observacional descriptivo prospectivo, durante dos años, en 19 pacientes con el diagnóstico de diabetes mellitus, atendidos en el referido centro. Se midieron variables como: edad al debut, sexo, valoración nutricional, valores de glucemia al debut, enfermedades asociadas e historia familiar de diabetes mellitus.Resultados: predominó el sexo femenino sobre el masculino, con un 68,4 por ciento y el grupo de edad al diagnóstico entre 15 y 19 años (57,9 por ciento), en ambos sexos. El 59,7 por ciento de los pacientes fueron normopeso. El 47,4 por ciento presentaron cifras de glucemia al debut por encima de 20 mmol/L. Las enfermedades más frecuentemente asociadas fueron la hipertensión arterial y las tiroidopatías. Igual número de pacientes presentaban familiares de primer y segundo grado de diabetes mellitus y diez tenían familiares de tercer grado.Conclusiones: se pudo caracterizar la población de estudio, en la que existió mayor asociación con las afecciones tiroideas e hipertensión arterial y con historia familiar de diabetes mellitus en tres generaciones consecutivas (AU)

Background: patients under 25 years old begin with different clinical forms of diabetes mellitus: type 1 and 2, of known causes, and those starting at the maturity of young people, monogenic diabetes, with an autosomal dominant inheritance pattern. Objective: to characterize, according to clinical, epidemiological and genetic variables, patients under 25 years old who suffer from diabetes mellitus of the Provincial Diabetes Care Center of Las Tunas.Methods: an observational, descriptive and prospective study was carried out in 19 patients diagnosed with diabetes mellitus and treated at the mentioned center during two years. The variables measured were: starting age, sex, nutritional assessment, blood glucose levels at the beginning, associated diseases and family history of diabetes mellitus.Results: females prevailed with 68, 4 percent, and the age group diagnosed was between 15 and 19 years (57,9 percent) in both sexes. 59, 7 percent of the patients were normo-weight. 47, 4 percent had blood glucose levels above 20 mmol / L at the start. The most frequently associated diseases were hypertension and thyroid disease. The same quantity of patients had first and second degree relatives with diabetes mellitus and ten had third degree relatives.Conclusions: it was possible to characterize the study population, in which there was a greater association with thyroid conditions and high blood pressure and with family history of diabetes mellitus in three consecutive generations (AU)

Adecuada prescripción clínica de la oxigenoterapia continua domiciliaria / Appropriate clinical prescription of home continuous oxygen therapy

Los gases medicinales forman parte del conjunto de medicamentos utilizados en el adecuado tratamiento de las enfermedades, por lo que su prescripción se ha de realizar con la misma precisión y cuidado que con el resto de los medicamentos. La finalidad de la oxigenoterapia es aumentar el aporte de oxígeno a los tejidos, a través de un aumento de la concentración de oxígeno en el aire inspirado, utilizando al máximo la capacidad de transporte de la sangre arterial. Es un servicio de salud a domicilio, que contribuye a que miles de pacientes con problemas respiratorios crónicos puedan disfrutar de una mejor calidad de vida. Dentro de éstos está la oxigenoterapia continua domiciliaria, que consiste en la administración de oxígeno en el domicilio a pacientes estables, en situación de insuficiencia respiratoria crónica. En este trabajo se expone la clasificación de las recomendaciones de oxigenoterapia domiciliaria y calidad de la evidencia según el sistema GRADE y se actualizan los criterios de indicación de este servicio en afecciones como: enfermedad pulmonar obstructiva crónica, enfermedad pulmonar intersticial difusa, hipertensión pulmonar, hipoxemia de esfuerzo y del sueño, fibrosis quística, insuficiencia cardíaca congestiva, cefalea en racimos, síndrome hepatopulmonar y en enfermos terminales. Es preciso tener presente los criterios actuales para la indicación de la oxigenoterapia, reconociendo que su abuso no está exento de efectos adversos y puede aumentar los costes innecesariamente (AU)

Medicinal gases are part of the group of medications used in the appropriate treatment of some illnesses, so their prescription must be done with the same precision and care as the rest of medications. The purpose of the oxygen therapy is to increase the oxygen source to the tissues through an increase of the oxygen concentration in the inspired air, using the arterial blood at its maximum transport capability. It is a home health care that helps thousands of patients with chronic respiratory conditions to enjoy a better quality of life. This treatment consists in the home oxygen administration to those patients in stable condition who are suffering from chronic respiratory failure. In this paper, the classification of the recommendations of home oxygen therapy and the quality of the evidence according to the GRADE system are exposed, as well as the update of indication criteria for the service in affections such as: chronic obstructive pulmonary disease, diffuse interstitial lung illness, pulmonary hypertension, effort and dream hypoxemia, cystic fibrosis, congestive heart failure, cluster headache, hepatic-pulmonary syndrome and in terminal patients. As conclusion: this treatment must be prescribed in an optimized way, according to the up to date criteria and not to overuse it, because it is not free of adverse effects and it increases the costs unnecessarily (AU)

Escalera analgésica en el tratamiento del dolor oncológico / Analgesic stairway in the treatment of oncological pain

El dolor representa el síntoma principal en un importante grupo de pacientes que están en tratamiento activo por cáncer y en enfermos muy avanzados. El objetivo de este artículo es revisar la farmacología básica de los antiinflamatorios no esteroideos, opioides débiles, opioides mayores, coadyuvantes, así como las diferentes técnicas especiales farmacológicas y no farmacológicas que conforman la escalera analgésica en el manejo del paciente con dolor oncológico(AU)

Pain represents the main symptom in an important group of patients who are in active treatment for cancer and in sick people in a very advanced stage. The objective of this article is to review the basic pharmacology of the nonsteroidal antiinflammatory drugs, weak opioids, bigger opioids, as well as the different special pharmacological and non- pharmacological techniques that constitute the analgesic stairway in the management of patients who are suffering from oncological pain(AU)

Melanoma maligno cutáneo en pacientes de la provincia de Las Tunas / Malignant cutaneous melanoma in patients from Las Tunas province

Fundamento: el melanoma maligno es una neoplasia de piel altamente agresiva, que manifiesta un aumento constante y rápido de su incidencia.Objetivo: caracterizar variables en pacientes diagnosticados con melanoma cutáneo, cuyas biopsias fueron analizadas en el departamento de anatomía patológica del Hospital General Docente Dr. Ernesto Guevara de la Serna, durante el período de enero de 2008 a diciembre de 2014.Métodos: se realizó un estudio descriptivo de corte transversal, en 31 pacientes atendidos en el lugar y el período de tiempo referidos anteriormente. Se utilizó el modelo oficial de biopsia como fuente secundaria de recolección de la información y la misma fue procesada utilizando la estadística descriptiva.Resultados: el 10,6 por ciento de las biopsias analizadas correspondieron a melanoma cutáneo, predominó su frecuencia en los años 2011 y 2010, con un 25,8 por ciento y 19,3 por ciento, respectivamente. Se evidenció en mayor por ciento en el sexo masculino (67,7 por ciento) y en el grupo de edad entre 60 y 69 años (35,4 por ciento). Los pacientes de raza blanca fueron los más afectados, con un 90,3 por ciento, y la localización predominante fue en los miembros inferiores, en el 45,1 por ciento de los casos. El nivel de invasión de Clark predominante fue el IV, para el 32,2 por ciento de la muestra y la variedad histológica más frecuente fue el melanoma maligno nodular, en 19 pacientes para un 61,2 por ciento.Conclusiones: el melanoma cutáneo predominó en el sexo masculino, en las extremidades inferiores y se manifestó en los pacientes un diagnóstico tardío, al predominar el nivel IV de invasión de Clark y el melanoma nodular como tipo histológico de mayor frecuencia(AU)

Background: malignant melanoma is a highly aggressive skin neoplasia, whose incidence shows a constant and rapid increase.Objective: to characterize variables in patients diagnosed with cutaneous melanoma, whose biopsies were analyzed in the pathologic anatomy department of Dr. Ernesto Guevara de la Serna General Teaching Hospital from January, 2008 to December, 2014.Methods: a descriptive and cross-sectional study was performed in 31 patients treated in the place and period of time mentioned above. The official form of biopsy was used as a secondary source of collecting information and it was processed using descriptive statistics.Results: the 10,6 percent of the biopsies analyzed corresponded with cutaneous melanoma, its frequency prevailed in 2011 and 2010, with a 25,8 percent and 19,3 percent respectively. It was evident a higher percentage in males (67,7 percent) and in the age group between 60 and 69 years old, with a 35,4 percent. Caucasian patients were the most affected ones, with a 90,3 percent and the predominant location was in the lower limbs in 45,1 percent of the cases. The prevailing Clark invasion level was IV, evident by the 32,2 percent of the sample, and the most frequent histological variety was the malignant nodular melanoma in 19 patients, for a 61,2 percent.Conclusions: cutaneous melanoma prevailed in lower extremities in males and it had a belated diagnosis, since there was prevalence of IV Clark invasion level and nodular melanoma as the most frequent histological type(AU)

Prescripción de Sildenafil en el policlínico docente Manuel Fajardo Rivero / Prescription of Sildenafil at Manuel Fajardo Rivero teaching polyclinic

Fundamento: la sexualidad es ampliamente aceptada como una parte importante e integral del bienestar físico y emocional, un marcador del estado de salud y la calidad de vida del paciente. En el territorio no existen estudios que caractericen el tratamiento con Sildenafil de los pacientes con disfunción sexual eréctil.Objetivo: caracterizar la prescripción de Sildenafil en pacientes diagnosticados con disfunción sexual eréctil, pertenecientes al área de salud del Policlínico Docente Manuel Fajardo Rivero, municipio Las Tunas, durante el período comprendido entre el 5 de enero y el 30 de abril del 2015.Métodos: se realizó un estudio observacional, descriptivo, transversal de los pacientes diagnosticados con disfunción sexual eréctil, pertenecientes al área de salud y durante el período de tiempo referidos en el objetivo. Para la selección de pacientes se adoptó el muestreo no probabilístico consecutivo, ingresando a la base de datos los pacientes que acudieron a consulta a renovar su receta de Sildenafil.Resultados: predominó el grupo de 70-79 años. Hubo deficiencia en los componentes a evaluar para llegar al diagnóstico, con una historia clínica breve, inadecuado examen físico, sin referencia a la historia sexual, ni historia psicosocial, con pocas indicaciones de exámenes de laboratorio. Se desconocía la clasificación y no se evaluó la posible causa. La hipertensión arterial, unida a la diabetes mellitus tipo 2, fueron los antecedentes más referidos. La contraindicación más reportada fue el consumo de Dinitrato de isosorbide. El Enalapril, la Cimetidina y el Amlodipino fueron los fármacos más utilizados, que provocan interacciones medicamentosas con el Sildenafil.Conclusiones: existen deficiencias en la valoración diagnóstica de la disfunción sexual eréctil, que debe ser multidisciplinaria. El tratamiento debe ser escalonado, teniendo en cuenta el costo/riesgo/beneficio en función del estado de salud general del paciente y sus aspiraciones (AU)

Background: sexuality is widely accepted as an important and integral part of the physical and emotional well-being, a marker of health status and quality of life of patients. On the territory there are no studies that characterize Sildenafil treatment of patients with erectile sexual dysfunction.Objective: to characterize the prescription of sildenafil in patients diagnosed with erectile sexual dysfunction, belonging to the health area of Manuel Fajardo Rivero Polyclinic in Las Tunas municipality, from January 5 to April 30, 2015.Methods: an observational, descriptive and cross-sectional study was carried out in patients diagnosed with erectile sexual dysfunction, belonging to the health area and during the time period referred to in the objective. For the selection of patients, the consecutive non-probabilistic sampling was taken, getting those patients who came to the office to renew their prescription of Sildenafil into the database.Results: the age group from 70 to 79 years old prevailed. There were deficiencies in the components to be assessed for diagnosis, with a brief medical history, inadequate physical examination, without reference to sexual history or psychosocial history, with few indications of laboratory tests. Classification was unknown and the possible cause was not assessed. Hypertension, linked to type 2 diabetes mellitus, was the most referred past health histories. The most reported contraindication was isosorbide dinitrate consumption. Enalapril, Cimetidine and Amlodipine were the most common drugs that caused drug interactions with sildenafil.Conclusions: there are deficiencies in the diagnostic evaluation of erectile sexual dysfunction, which must be multidisciplinary. Treatment must be phased, taking into account the cost / risk / benefit depending on the general health of the patient and his aspirations (AU)

Impacto del tratamiento no farmacológico de la hipertensión arterial en pacientes de un consultorio médico de la familia / Impact of the non-pharmacological treatment of arterial hypertension in patients from a family doctors office

Se realizó un estudio de intervención, con el objetivo de evaluar el impacto de los cambios en el estilo de vida en pacientes hipertensos, pertenecientes al Consultorio Médico de la Familia 158-01, área de salud del Policlínico Docente Manuel Fajardo Rivero, municipio de Las Tunas, Cuba; durante el período comprendido entre abril de 2013 y diciembre de 2014. El universo estuvo constituido por toda la población dispensarizada con hipertensión arterial esencial y la muestra con los diagnosticados en el Estadio 1, Grupos A y B. Los pacientes se controlaron mensualmente. En un buen número de pacientes el tratamiento no farmacológico fue suficiente para el control de las cifras de presión arterial y en otros se asoció al tratamiento medicamentoso, lo que disminuyó el número de fármacos utilizados. Su cumplimiento fue muy bajo al inicio de la intervención, lo que se revirtió después. Los pacientes que cumplieron estrictamente el tratamiento no farmacológico presentaron mejores controles de las cifras de presión arterial (AU)

An intervention study was carried out with the objective of assessing the impact of lifestyle modifications in hypertensive patients belonging to the family doctors office 158-01 of Manuel Fajardo Rivero Teaching Polyclinic health area in Las Tunas, Cuba, from April, 2013 to December, 2014. The universe was made up of the whole population identified with essential hypertension and the sample included those diagnosed in stage 1, groups A and B. The patients were monitored every month. The non-pharmacological treatment was enough for controlling the blood pressure numbers in a great number of patients; in others, it was associated to the pharmacological treatment, what diminished the number of drugs used. Its accomplishment was very low at the beginning, what was later reverted. Those patients that completed rigorously the non-pharmacological treatment presented a better control of the blood pressure numbers (AU)