Roles of Ferric Peroxide Anion Intermediates (Fe3+O2 -, Compound 0) in Cytochrome P450 19A1 Steroid Aromatization and a Cytochrome P450 2B4 Secosteroid Oxidation Model.

Cytochrome P450 (P450, CYP) 19A1 is the steroid aromatase, the enzyme responsible for the 3-step conversion of androgens (androstenedione or testosterone) to estrogens. The final step is C-C bond scission (removing the 19-oxo group as formic acid) that proceeds via a historically controversial reaction mechanism. The two competing mechanistic possibilities involve a ferric peroxide anion (Fe3+O2 -, Compound 0) and a perferryl oxy species (FeO3+, Compound I). One approach to discern the role of each species in the reaction is with the use of oxygen-18 labeling, i.e., from 18O2 and H2 18O of the reaction product formic acid. We applied this approach, using several technical improvements, to study the deformylation of 19-oxo-androstenedione by human P450 19A1 and of a model secosteroid, 3-oxodecaline-4-ene-10-carboxaldehyde (ODEC), by rabbit P450 2B4. Both aldehyde substrates were sensitive to non-enzymatic acid-catalyzed deformylation, yielding 19-norsteroids, and conditions were established to avoid issues with artifactual generation of formic acid. The Compound 0 reaction pathway predominated (i.e., Fe3+O2 -) in both P450 19A1 oxidation of 19-oxo-androstenedione and P450 2B4 oxidation of ODEC. The P450 19A1 results contrast with our prior conclusions (J. Am. Chem. Soc. 2014, 136, 15016-16025), attributed to several technical modifications.

Oxygen-18 Labeling Defines a Ferric Peroxide (Compound 0) Mechanism in the Oxidative Deformylation of Aldehydes by Cytochrome P450 2B4.

Most cytochrome P450 (P450) oxidations are considered to occur with the active oxidant being a perferryl oxygen (FeO3+, Compound I). However, a ferric peroxide (FeO2®, Compound 0) mechanism has been proposed, as well, particularly for aldehyde substrates. We investigated three of these systems, the oxidative deformylation of the model substrates citronellal, 2-phenylpropionaldehyde, and 2-methyl-2-phenylpropionaldehyde by rabbit P450 2B4, using 18O labeling. The formic acid product contained one 18O derived from 18O2, which is indicative of a dominant Compound 0 mechanism. The formic acid also contained only one 18O derived from H218O, which ruled out a Compound I mechanism. The possibility of a Baeyer-Villiger reaction was examined by using synthesized possible intermediates, but our data do not support its presence. Overall, these findings unambiguously demonstrate the role of the Compound 0 pathway in these aldehyde oxidative deformylation reactions.

Participatory evaluation of the process of co-producing resources for the public on data science and artificial intelligence.

BACKGROUND: The growth of data science and artificial intelligence offers novel healthcare applications and research possibilities. Patients should be able to make informed choices about using healthcare. Therefore, they must be provided with lay information about new technology. A team consisting of academic researchers, health professionals, and public contributors collaboratively co-designed and co-developed the new resource offering that information. In this paper, we evaluate this novel approach to co-production. METHODS: We used participatory evaluation to understand the co-production process. This consisted of creative approaches and reflexivity over three stages. Firstly, everyone had an opportunity to participate in three online training sessions. The first one focused on the aims of evaluation, the second on photovoice (that included practical training on using photos as metaphors), and the third on being reflective (recognising one's biases and perspectives during analysis). During the second stage, using photovoice, everyone took photos that symbolised their experiences of being involved in the project. This included a session with a professional photographer. At the last stage, we met in person and, using data collected from photovoice, built the mandala as a representation of a joint experience of the project. This stage was supported by professional artists who summarised the mandala in the illustration. RESULTS: The mandala is the artistic presentation of the findings from the evaluation. It is a shared journey between everyone involved. We divided it into six related layers. Starting from inside layers present the following experiences (1) public contributors had space to build confidence in a new topic, (2) relationships between individuals and within the project, (3) working remotely during the COVID-19 pandemic, (4) motivation that influenced people to become involved in this particular piece of work, (5) requirements that co-production needs to be inclusive and accessible to everyone, (6) expectations towards data science and artificial intelligence that researchers should follow to establish public support. CONCLUSIONS: The participatory evaluation suggests that co-production around data science and artificial intelligence can be a meaningful process that is co-owned by everyone involved.

Modern technology offers new treatment options for patients and novel avenues of research. However, there is limited available information in easily understandable language for the public explaining how technology relates to them and could influence their healthcare. The researchers, healthcare professionals and public members worked together collaboratively to address this problem by creating new materials for the public. Our paper explores that project through creative methods. Firstly, everyone involved was offered an opportunity to attend training sessions. Then, people took photos and described them to illustrate to others what is their experience of working together. Finally, we all met to use included photos as building blocks to present a shared experience in the project. Afterwards, the professional artist included it as one circular illustration with six interlinked layers. These layers present everyone's experiences (from inside) (1) is about the opportunity to build confidence in a new topic, (2) relationships with others, (3) working remotely during the pandemic, (4) motivation that influenced people to become involved in this particular piece of work, (5) expectation that the project needs be inclusive and accessible, (6) ethical principles that researchers using new technology should follow. We showed that it is possible for researchers, healthcare professionals and members of the public to feel joint ownership of the project and that working together can be meaningful to everyone.

Estrategia de superación profesional sobre fibrilación auricular contextualizada en la Atención Primaria de Salud / A strategy for the professional training related to atrial fibrillation contextualized to the Primary Health Care settings

RESUMEN Introducción: la solución de los problemas de salud que afectan a la población constituye punto de partida para el diseño de la superación profesional, proceso que posibilita la actualización, ampliación y perfeccionamiento continuo de los conocimientos, habilidades básicas y especializadas de los profesionales que laboran en el nivel de atención primaria de salud. Objetivo: diseñar una estrategia de superación profesional sobre fibrilación auricular contextualizada en la atención primaria de salud en el Policlínico Universitario "Luis Augusto Turcios Lima" de Pinar del Río. Métodos: la investigación se sustentó en el enfoque Dialéctico Materialista que permitió profundizar en el conocimiento del proceso y sus interrelaciones en las condiciones históricas sociales de la educación de postgrado en el especialista en MGI. Se utilizaron métodos teóricos como el análisis documental, histórico lógico, de modelación y criterio de expertos. Resultados: se presenta la estrategia de superación profesional sobre fibrilación auricular contextualizada en la atención primaria de salud con base en las derivaciones teóricas y empíricas del proceso investigativo y a partir de fundamentos sustentados en diferentes áreas del conocimiento, se proponen la estructura, características, componentes y relaciones para el proceso en estudio y su validación teórica. Conclusiones: en la estrategia de superación profesional sobre fibrilación auricular contextualizada en la atención primaria de salud se concretaron los propósitos para lograr un desempeño eficiente del mismo en la transformación de la realidad en el área de salud del Policlínico Universitario "Luis Augusto Turcios Lima" de Pinar del Río.

ABSTRACT Introduction: solving the problems of health that influence on the population constitutes the starting point for the design of professional training, a process that makes possible the update, widening and continuous improvement of knowledge, including the basic and specialized skills of healthcare professionals working in Primary Health Care level. Objective: to design a strategy for the professional training related to atrial fibrillation contextualized to the Primary Health Care settings at Luis Augusto Turcios Lima University Polyclinic, Pinar del Rio. Methods: the research was supported on the Dialectic-Materialistic approach which allowed deepening on the knowledge of the process and its interrelation in the historical and social conditions of postgraduate education for the Comprehensive Medicine Specialists. Theoretical methods were mainly used, such as the documentary analysis, historical-logical, modeling and the criteria of experts. Results: the strategy for professional training related to atrial fibrillation contextualized to the Primary Health Care settings was presented and based on theoretical and empirical derivations of the research process and from the foundations supported on the different areas of knowledge, the structure, characteristics, components and relations toward the process in study and its theoretical validation. Conclusions: the strategy for the professional training related to atrial fibrillation contextualized to the Primary Health Care setting, defined the purposes for the achievement of an efficient performance along with the transformation of the reality in the healthcare area of Luis Augusto Turcios Lima University Polyclinic, Pinar del Rio.

Regularidades de la superación profesional sobre fibrilación auricular en la Atención Primaria de Salud / Regularities of professional development on atrial fibrillation in Primary Health Care

RESUMEN Fundamento: en Cuba es prioritaria la Atención Primaria de Salud, lo que requiere de un sistema de superación permanente dirigido a los profesionales para garantizar la calidad del servicio de salud. Objetivo: identificar las regularidades de la superación profesional sobre fibrilación auricular en el Policlínico Turcios Lima de Pinar del Río. Métodos: estudio descriptivo de corte transversal realizado de diciembre de 2019 a febrero del 2020. Se emplearon métodos teóricos y empíricos tales como el histórico-lógico, sistémico-estructural, la revisión documental, encuestas y entrevista, respectivamente. Además métodos estadísticos descriptivos e inferenciales, en un universo de médicos generales integrales(N=90). La muestra fue 60 médicos generales integrales una vez aplicados los criterios de inclusión. La variable estudiada fue la superación profesional sobre fibrilación auricular. Resultados: se constataron limitadas acciones para el desarrollo de los contenidos acerca de la fibrilación auricular en la Atención Primaria de Salud; además de debilidades en la integración de los conocimientos, habilidades y valores sobre dicha entidad, para un adecuado diagnóstico y estratificación de riesgos tromboembólicos y hemorrágicos. Las acciones de superación profesional planificadas no posibilitan la actualización y profundización en los contenidos sobre la enfermedad, necesarios para transformar la realidad del área de salud. Conclusiones: la superación profesional sobre fibrilación auricular en el Policlínico Turcios Lima posee limitaciones para integrar sus contenidos a un adecuado diagnóstico y estratificación de riesgos tromboembólicos y hemorrágicos, lo que dificulta el desempeño eficiente del Médico General Integral en la Atención Primaria de Salud.

ABSTRACT Background: Primary Health Care is a priority in Cuba, requires a permanent improvement system aimed at professionals to guarantee the quality of the health service. Objective: to identify the regularities of professional improvement on atrial fibrillation at the Turcios Lima Polyclinic in Pinar del Río. Methods: descriptive cross-sectional study carried out from December 2019 to February 2020. Theoretical and empirical methods were used, such as historical-logical, systemic-structural, documentary review, surveys, and interviews, respectively. In addition, descriptive and inferential statistical methods, in a universe of comprehensive general practitioners (N = 90). The sample was 60 comprehensive general practitioners once the inclusion criteria were applied. The variable studied was professional improvement over atrial fibrillation. Results: there were limited actions for the development of content about atrial fibrillation in Primary Health Care; in addition to weaknesses in the integration of knowledge, skills and values about said entity, for an adequate diagnosis and stratification of thromboembolic and hemorrhagic risks. The planned professional improvement actions do not make it possible to update and deepen the content on the disease, necessary to transform the reality of the health area. Conclusions: the professional improvement on atrial fibrillation at the Turcios Lima Polyclinic has limitations to integrate its contents to an adequate diagnosis and stratification of thromboembolic and hemorrhagic risks, which make difficult the efficient performance of the Comprehensive General Physician in Primary Health Care.

Implementing undergraduate quality improvement.

BACKGROUND: All clinicians need to have knowledge and expertise to undertake quality improvement (QI). In 2016, a London medical school initiated a core QI and evidence-based practice module for fourth-year students. We describe the structure and content of the module and analyse QI projects (QIPs) and student feedback. METHODS: We collected data on QIPs, including number and location, adherence to QI methodology and level of improvement achieved. We also examined end-of-module feedback with free text analysis of the written comments. RESULTS: A total of 398 students completed 99 QIPs: 90% were based in secondary care and 10% were based in primary care. A total of 72 projects (72%) led to improvements in clinical care, with 14% achieving their stated aim. Adherence to methodology was high: 75% had a 'SMART (specific, measurable, achievable, realistic and timely)' aim; 96% implemented at least one plan-do-study-act (PDSA) cycle (range 1-4), and appropriate run charts for measures occurred in 80% of projects. QIPs were categorised based on their outcome: self-help and self-care, 12%; efficiency, 16%; prevention and early detection, 14%; drug safety, 11%; improvement to pathways and protocols, 44%; and improving patient experience 3%. The implementation challenges encountered were: suboptimal supervisor preparedness; student time limitations; and difficulties with the virtual learning platform. However, the experiences that QIPs offered in preparation for postgraduate training were appreciated by students. CONCLUSIONS: We have demonstrated that students are able to robustly apply QI methodologies, equipping them to act as agents for change, learning as they do, and meaningfully improving QI capacity and capability in local health systems.

So let me find my way, whatever it will cost me, rather than leaving myself in darkness: experiences of glaucoma in Nigeria.

BACKGROUND: Blindness from glaucoma is associated with socio-economic deprivation, presumed to reflect poor access to care and poor adherence to treatment. OBJECTIVES: To determine why people with glaucoma are presenting late for treatment and to understand access to glaucoma care. Additionally, we sought to identify what patients and the community know, do and think about the condition and why the poor are the most affected with glaucoma blindness. DESIGN: Study participants were from four communities and two hospitals in Abuja-FCT and Kaduna State, Nigeria. A total of 120 participants were involved, including 8 focus group discussions, 7 in-depth interviews with blind/visually impaired glaucoma patients, 5 rapid direct observation visits with these patients and 13 exit interviews of glaucoma patients in the hospital. The data were analysed using content analysis, interpreting participant experiences in terms of three key steps conceptualised as important in the care pathway: what it takes to know glaucoma, to reach a diagnosis and to access continued care. RESULTS: This article presents multiple narratives of accessing and maintaining glaucoma care and how people manage and cope with the disease. People may be presenting late due to structural barriers, which include lack of knowledge and awareness about glaucoma and not finding an appropriately equipped health care facility. What keeps glaucoma patients within the care pathway are a good hospital experience; a support structure involving family, counselling and shared patients' experiences; and an informed choice of treatment, as well as agency. The high cost of purchasing care is a major factor for patients dropping out of treatment. CONCLUSION: The findings suggest the need to address economic and social structural drivers as glaucoma presents another case study to demonstrate that poverty is a strong driver for blindness. There is also a need for clear glaucoma care pathways with early case finding in the community, two-way referral/feedback systems, well-equipped glaucoma care hospitals and better eye health care financing.

Intervención educativa sobre salud sexual y reproductiva en mujerescon riesgo reproductivo preconcepcional / Educational intervention for sexual/reproductive health in women with preconception/reproductive risk

La salud sexual y reproductiva es un estado general de bienestar físico, mental y social y no de mera ausencia de enfermedades o dolencias, en todos los aspectos relacionados con el sistema reproductivo, sus funciones y procesos. El objetivo fue desarrollar una intervención educativa en mujeres con riesgo preconcepcional de la consulta Planificación Familiar del Policlínico Universitario Turcios Lima para contribuir a modificar conocimientos, actitudes y prácticas relacionadas con la salud sexual y reproductiva en septiembre del 2012 a febrero del 2013. Previo consentimiento informado se aplicó un cuestionario. Se impartió un programa educativo y se evaluaron los conocimientos antes y después del mismo. Se determinó una prevalencia de mujeres con riesgo preconcepcional en el grupo de edades comprendidas entre los 26-30 años. La mayor cantidad de mujeres no mostraron hábitos tóxicos. La hipertensión arterial, enfermedades ginecológicas, asma bronquial y cardiopatías fueron identificados como antecedentes personales en las mujeres con riesgo preconcepcional. Los antecedentes obstétricos más referidos fueron abortos previos y antecedentes de malformaciones congénitas. Puesta en práctica la estrategia educativa existió un avance significativo en las mujeres en estudio evidenciado porque la mayoría de ellas conocían sobre su condición y la importancia del control del factor de riesgo reproductivo preconcepcional(AU)

Sexual/reproductive health is a general state of physical, mental andsocial welfare and not the mere absence of diseases or disorders on the aspects related to reproductive system, its functions and processes. The objective was to develop and educational intervention in women with preconception risk in Family Planning Office at Turcios Lima University Outpatient Polyclinic, modifyingknowledge, attitudes and practices related to sexual/reproductive health during September 2012-February 2013.Methods: a quasi-experimental research was carried out, choosing a sample of 197 women from a non-probabilistic sampling; data were processed in Excel XP and SPSS statistical software 1.1. Results were placed in tables and graphics their analysis. A prevalence of women with preconception risk in ages from 26-30 wasobserved. Most of them had no toxic habits. Hypertension, gynecological infections, bronchial asthma and cardiovascular diseases were the medical records most describedin women with preconception risk. The obstetric records identified were: previous abortions and history of congenital malformations. After the implementation of the educational strategy a significant advance was identified in those women studied, where the majority of them knew oftheir condition, giving importance to the reproductive/preconception risk factors(AU)

Dermatitis atópica en un infante / Atopic dermatitis in a child

Se describe el caso clínico de un infante de 2 años de edad, producto de un parto distócico por cesárea a las 40 semanas, debido a una desproporción cefalopélvica, alimentado con lactancia materna exclusiva hasta los 6 meses de vida, quien fue llevado a consulta por presentar prurito persistente, más exacerbado en las noches y lesiones eritematopapulosas en los pliegues de codos y rodillas, así como en el axilar izquierdo. Según los resultados de los exámenes complementarios, los niveles de inmunoglobulinas E estaban elevados, por lo cual fue medicado con antihistamínicos, esteroides en ciclos cortos (vías tópica y oral), factor de transferencia e inmunomoduladores tópicos; también se le ofrecieron orientaciones higienoambientales y dietéticas. Después de 2 meses de tratamiento mejoró ostensiblemente el cuadro clínico y se mantuvo en seguimiento por su área de salud.

The case report of a 2-year-old child born of a dystocia cesarian section at 40 weeks due to a cephalopelvic disproportion is described, who was exclusively breastfed until 6 months of age and taken to the clinic because of persistent itching, which was exacerbated at night, and erythematous papulous lesions in elbow and knee folds, as well as in the left axilla. According to the results of complementary tests there were high levels of immunoglobulin E, so that he received antihistamines, short-course steroids (topical and oral routes), transfer factor and topical immunomodulators; hygienic, environmental and dietetic guidances were also given. After 2 months of treatment the clinical pattern improved significantly and he was monitored in the health area.

Dermatitis atópica en un infante / Atopic dermatitis in a child

Se describe el caso clínico de un infante de 2 años de edad, producto de un parto distócico por cesárea a las 40 semanas, debido a una desproporción cefalopélvica, alimentado con lactancia materna exclusiva hasta los 6 meses de vida, quien fue llevado a consulta por presentar prurito persistente, más exacerbado en las noches y lesiones eritematopapulosas en los pliegues de codos y rodillas, así como en el axilar izquierdo. Según los resultados de los exámenes complementarios, los niveles de inmunoglobulinas E estaban elevados, por lo cual fue medicado con antihistamínicos, esteroides en ciclos cortos (vías tópica y oral), factor de transferencia e inmunomoduladores tópicos; también se le ofrecieron orientaciones higienoambientales y dietéticas. Después de 2 meses de tratamiento mejoró ostensiblemente el cuadro clínico y se mantuvo en seguimiento por su área de salud(AU)

The case report of a 2-year-old child born of a dystocia cesarian section at 40 weeks due to a cephalopelvic disproportion is described, who was exclusively breastfed until 6 months of age and taken to the clinic because of persistent itching, which was exacerbated at night, and erythematous papulous lesions in elbow and knee folds, as well as in the left axilla. According to the results of complementary tests there were high levels of immunoglobulin E, so that he received antihistamines, short-course steroids (topical and oral routes), transfer factor and topical immunomodulators; hygienic, environmental and dietetic guidances were also given. After 2 months of treatment the clinical pattern improved significantly and he was monitored in the health area(AU)

Human cytochrome P450 2E1 mutations that alter mitochondrial targeting efficiency and susceptibility to ethanol-induced toxicity in cellular models.

Human polymorphisms in the 5'-upstream regulatory regions and also protein coding regions of cytochrome P450 2E1 (CYP2E1) are known to be associated with several diseases, including cancer and alcohol liver toxicity. In this study, we report novel mutations in the N-terminal protein targeting regions of CYP2E1 that markedly affect subcellular localization of the protein. Variant W23R/W30R protein (termed W23/30R) is preferentially targeted to mitochondria but very poorly to the endoplasmic reticulum, whereas the L32N protein is preferentially targeted to the endoplasmic reticulum and poorly to mitochondria. These results explain the physiological significance of bimodal CYP targeting to the endoplasmic reticulum and mitochondria previously described. COS-7 cells and HepG2 cells stably expressing W23/30R mutations showed markedly increased alcohol toxicity in terms of increased production of reactive oxygen species, respiratory dysfunction, and loss of cytochrome c oxidase subunits and activity. Stable cells expressing the L32N variant, on the other hand, were relatively less responsive to alcohol-induced toxicity and mitochondrial dysfunction. These results further support our previous data, based on mutational studies involving altered targeting, indicating that mitochondria-targeted CYP2E1 plays an important role in alcohol liver toxicity. The results also provide an interesting new link to genetic variations affecting subcellular distribution of CYP2E1 with alcohol-induced toxicity.

Metabolism of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine by mitochondrion-targeted cytochrome P450 2D6: implications in Parkinson disease.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a neurotoxic side product formed in the chemical synthesis of desmethylprodine opioid analgesic, which induces Parkinson disease. Monoamine oxidase B, present in the mitochondrial outer membrane of glial cells, catalyzes the oxidation of MPTP to the toxic 1-methyl-4-phenylpyridinium ion (MPP(+)), which then targets the dopaminergic neurons causing neuronal death. Here, we demonstrate that mitochondrion-targeted human cytochrome P450 2D6 (CYP2D6), supported by mitochondrial adrenodoxin and adrenodoxin reductase, can efficiently catalyze the metabolism of MPTP to MPP(+), as shown with purified enzymes and also in cells expressing mitochondrial CYP2D6. Neuro-2A cells stably expressing predominantly mitochondrion-targeted CYP2D6 were more sensitive to MPTP-mediated mitochondrial respiratory dysfunction and complex I inhibition than cells expressing predominantly endoplasmic reticulum-targeted CYP2D6. Mitochondrial CYP2D6 expressing Neuro-2A cells produced higher levels of reactive oxygen species and showed abnormal mitochondrial structures. MPTP treatment also induced mitochondrial translocation of an autophagic marker, Parkin, and a mitochondrial fission marker, Drp1, in differentiated neurons expressing mitochondrial CYP2D6. MPTP-mediated toxicity in primary dopaminergic neurons was attenuated by CYP2D6 inhibitor, quinidine, and also partly by monoamine oxidase B inhibitors deprenyl and pargyline. These studies show for the first time that dopaminergic neurons expressing mitochondrial CYP2D6 are fully capable of activating the pro-neurotoxin MPTP and inducing neuronal damage, which is effectively prevented by the CYP2D6 inhibitor quinidine.

Indicadores de efectividad del asesoramiento genético / Indicators for the effectiveness of genetic counselling

Se realizó un estudio descriptivo, de corte transversal, y el análisis de los indicadores del programa de genética del municipio Pinar del Río, en los períodos comprendidos entre los años 2003-2005 y 2006-2008. Se seleccionó mediante un muestreo no probabilístico, 50 familias que fueron atendidas en los servicios de genética por diversos motivos. Se les aplicó mediante una entrevista una serie de instrumentos para evaluar el comportamiento de las variables relacionadas con la efectividad del asesoramiento genético, el aborto selectivo, y la opinión sobre las funciones de los servicios de genética, entre otras. El trabajo recogió un alto porcentaje en la calificación de bueno en el nivel de conocimientos, que miden la efectividad de la asesoría genética, un gran porciento justifica el aborto por motivaciones sociales o éticas, y resultó considerado como muy prioritario, el ofrecer estudios prenatales a las parejas con riesgos de tener hijos con enfermedades genéticas(AU)

A descriptive, cross-sectional study and the analysis of indicators for effectiveness were conducted in Pinar del Rio municipality during the periods of 2003-2005 and 2006-2008. Fifty (50) families attending to genetic services for several reasons were chosen by a non-probabilistic sampling. An interview that comprised a series of tools to evaluate the behavior of the variables associated with the effectiveness of genetic counselling was carried out considering, elective abortion as well as opinions about genetic center services, among others. This study showed a high percentage in qualifying the level of knowledge as good, which assessed the effectiveness of genetic counselling, a great proportion justified abortion expressing social or ethical motivations, they as well considered prenatal studies for couples with risks of having children suffering from genetic diseases, as a priority(AU)

Indicadores de efectividad del asesoramiento genético / Indicators for the effectiveness of genetic counselling

Se realizó un estudio descriptivo, de corte transversal, y el análisis de los indicadores del programa de genética del municipio Pinar del Río, en los períodos comprendidos entre los años 2003-2005 y 2006-2008. Se seleccionó mediante un muestreo no probabilístico, 50 familias que fueron atendidas en los servicios de genética por diversos motivos. Se les aplicó mediante una entrevista una serie de instrumentos para evaluar el comportamiento de las variables relacionadas con la efectividad del asesoramiento genético, el aborto selectivo, y la opinión sobre las funciones de los servicios de genética, entre otras. El trabajo recogió un alto porcentaje en la calificación de bueno en el nivel de conocimientos, que miden la efectividad de la asesoría genética, un gran porciento justifica el aborto por motivaciones sociales o éticas, y resultó considerado como muy prioritario, el ofrecer estudios prenatales a las parejas con riesgos de tener hijos con enfermedades genéticas.

A descriptive, cross-sectional study and the analysis of indicators for effectiveness were conducted in Pinar del Rio municipality during the periods of 2003-2005 and 2006-2008. Fifty (50) families attending to genetic services for several reasons were chosen by a non-probabilistic sampling. An interview that comprised a series of tools to evaluate the behavior of the variables associated with the effectiveness of genetic counselling was carried out considering, elective abortion as well as opinions about genetic center services, among others. This study showed a high percentage in qualifying the level of knowledge as good, which assessed the effectiveness of genetic counselling, a great proportion justified abortion expressing social or ethical motivations, they as well considered prenatal studies for couples with risks of having children suffering from genetic diseases, as a priority.

Evaluación funcional del adulto mayor en la comunidad / Functional assessment of the elderly

Se realizó una investigación descriptiva y transversal a 120 adultos mayores pertenecientes al consultorio médico No 219 del Policlínico Universitario Turcios Lima, Municipio Pinar del Río, en el período comprendido de julio a diciembre de 2009, con el objetivo de precisar el estado funcional de estos. Para la recogida de la información se utilizó el análisis de la situación de salud del sector. Se aplicaron los cuestionarios siempre bajo la voluntariedad y aceptación de las personas a participar en la investigación, basado en la escala geriátrica de evaluación funcional, creada en el Centro Iberoamericano de la Tercera Edad y adoptada por el Programa Nacional de Salud de Cuba, así como en el índice de actividades b ásicas de la vida diaria de Katz y la escala de actividades instrumentadas de la vida diaria de Lawton-Brody. Los datos fueron procesados y analizados con medidas de frecuencias relativas y ji cuadrado con una confiabilidad del 95 por ciento. Se encontró una población en envejecimiento demográfico predominando las edades de 60-69 años. Todas las alteraciones aumentaron con la edad y predominaron los ancianos independientes, activos y satisfechos con la vida que llevan(AU)

A descriptive and cross-sectional research with 120 old people belonging to No-219 Medical Office at Luis A. Turcios Lima, Pinar del Rio municipality was conducted from July to December 2009. This study was aimed at specifying the functional status of the elderly. The Analysis of Health Situation was used to collect the information and the questionnaires were applied considering the voluntary nature and acceptance of participation of the elderly in the research, based on the Geriatric Functional Assessment Scale (GFAS) created by the Latin-American Center for the Old People Care (CITED in Spanish) and accepted by the National Health Program in Cuba, as well as Katz Index of Basic Activities of Daily Living (BADL) and Lawton - Brody Instrumental Activities of Daily Living Scale (IADL). Data were processed and analyzed using frequencies (percentages) and chi-square with a confidence of 95 per cent. A demographic aging population was found prevailing ages between 60-69 years old. All the alterations increased together with the aging process. Independent and active old people showing satisfaction with their lifestyle prevailed(AU)