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Background:. Despite the increasing demand, the combination of lip feminization and rejuvenation in patients assigned male at birth with gender dysphoria is rarely reported in the medical literature. We present our 27 years of experience performing these procedures in this patient population Methods:. All patients assigned male at birth with gender dysphoria from 1997 to 2023 were included and grouped into 4 age categories. Combined surgical procedures were performed to achieve lip rejuvenation and feminization, with detailed descriptions of the techniques used. Results were evaluated three months postsurgery using the Global Aesthetic Improvement Scale and the Global Satisfaction Scale. Complications and outcomes were documented, and statistical analysis was conducted to compare the differences between the results obtained. Results:. During a 27-year period, 988 patients underwent 1789 procedures. Of these, 79.8% were younger than 50 years, with the largest group being between 20 and 35 years (47.6%). However, patients older than 65 had the highest average number of procedures (2.4 per patient). The results showed a high degree of improvement and satisfaction on both evaluated scales. There were only 2 hematomas, both resolved without incident. The main issues were volume loss after fat infiltration (14.3%) and poorly positioned scars in lip lifts (13.2%). Conclusions:. Surgical procedures to feminize and rejuvenate lips can be combined in patients assigned male at birth with gender dysphoria, achieving highly satisfactory results, high patient satisfaction, and few complications

This article presents a modified method for designing finned tube heat exchangers based on calculating the K-loss coefficients on the side tube. Besides, a CFD simulation is set up to analyse pressure drop and flow distribution on the staggered tubes. The performance of finned tube heat exchangers depends on several factors, including the number of staggered tubes, tube length, fin pitch, tube pitch, and fin area. Finned tube heat exchangers improve thermal effectiveness, particularly when dealing with gas and liquid fluids. The staggered tube arrangement complicates the prediction of pressure drop on the tube side. Also, two head pipes configure the inlet and outlet flows. The equations for determining pressure drop assume uniform velocity and constant flow distribution throughout the equipment. These correlations do not include the frictional pressure drop caused by the 180° bends welded on the tubes. In addition, equations fail to include the fluid distribution in each parallel circuit of tubes. Considering heat exchanger components as hydraulic resistances in both series and parallel configurations, an equation was developed to sum the K-loss coefficients for the tube bundle, bends, inlet pipe, and outlet pipe. From the hydraulic design results and considering that all tubes distribute water at 93 °C, the next stage consists of the thermal heat exchanger design based on the NTU method to heat air at 50 – 60 ºC. The heat exchanger design is evaluated by comparing the results with an experimental case study. This includes water flow distribution, heat transfer area, hot and cold outlet fluid temperatures, pressure drop and CFD numerical results.

In this study, the batch operation of a solar system equipped with flat plate collectors, considering the effects of scaling fouling is investigated. During this process, the heat extracted from the working fluid as it leaves the collector field is combined with water in a storage tank. Subsequently, this mixture is recirculated through the solar network, repeating the cycle until the desired target temperature is attained. The duration of this process can vary based on the operating period and environmental conditions, and it may extend beyond a single day. Different network structures, which are represented by combinations of series-parallel arrangements with a fixed number of solar collectors are investigated. The objective of this study is to identify the network design that achieves the target temperature and the required thermal load in the shortest possible time, thereby positively impacting pumping costs. As a case study, a solar thermal plant with 40 collectors is analysed. The original structure of the collector field contains 4 lines, each line consists of 2 subsections connected in series, and each subsection includes 5 parallel-connected collectors (referred to as 4Lx5p-2s). The findings indicate that modifying the original structure to a 4Lx2p-5s (4 lines, 5 subsections by line connected in series each one with 2 collectors connected in parallel) arrangement achieves the thermal objective more efficiently, resulting in reduced operating costs, reducing the time to reach the desired temperature in one hour, which results in the increase of the number of batches that can be processed per year from 200 to 216. Over time, scaling builds up in the collectors, leading to increased pressure drops and reduced heat transfer capacity. It is demonstrated that under fouled conditions, an 8Lx5s arrangement yields a system with improved thermohydraulic performance as the batch time is reduced by almost 4 h and the number of batches that can be processed per year increases from 140 to 170.

Tithonia diversifolia se ha difundido en los sistemas de producción animal en América Latina, pero las investigaciones muestran que existe gran variabilidad genética entre los materiales silvestres recolectados. El objetivo de este trabajo fue caracterizar morfológica y productivamente materiales de T. diversifolia recolectados en el noreste del estado Chiapas (México). Las recolectas incluyeron semillas y esquejes. Con las semillas se realizó un bioensayo de germinación y con los esquejes un experimento en campo con evaluaciones a los 90, 120 y 150 días de crecimiento. En ambos casos se utilizó un diseño completamente aleatorizado con tres y 13 repeticiones, respectivamente. Se recolectaron 34 materiales y se georreferenciaron las localidades de su procedencia. Doce presentaron semillas al momento de la recolecta. Todas las semillas mostraron capacidad germinativa. El mayor porcentaje de germinación (32.7 %) lo alcanzó el material # 32 mientras que el # 33 mostró el menor valor (0.7 %). El 50 % de los materiales recolectados tuvieron un índice de velocidad de emergencia (IVE) superior a 0.5, pero cinco no se reprodujeron en campo. Los materiales # 24 y 29 alcanzaron mayor altura y número de hojas por planta. El grupo con mayor producción de materia verde por planta (10.29 kg) estuvo conformado por los materiales # 14 y # 24. Las variables morfológicas y productivas posibilitaron conformar tres grupos de materiales vegetales los cuales se pueden introducir en diferentes alternativas para la producción animal en el estado de Chiapas (México).

IntroductionPatient satisfaction with clinical services can have an effect on retention in HIV care and adherence to antiretroviral therapy. This study assessed patient satisfaction and its association with retention and viral suppression in Zambézia Province, Mozambique.MethodsMonthly exit interviews with persons living with HIV were completed from August 2017-January 2019 in 20 health facilities; clinical data were extracted from medical records. Regression analyses assessed the effect of satisfaction scores on retention and viral suppression, adjusting for age, sex, education, civil status, time on treatment, and site. Satisfaction scores were correlated with time spent at health facilities using generalized linear regression models.ResultsData from 4388 patients were analyzed. Overall median satisfaction score was 75% (IQR 53%-84%); median time spent at facilities (from arrival until completion of clinical services) was 2h54min (IQR 1h48min-4h). Overall satisfaction score was not associated with higher odds of retention or viral suppression, but association was seen between satisfaction regarding attention given to patient and respect and higher odds of viral suppression. Patient satisfaction was negatively associated with time spent in facility (Spearman's correlation -0.63). Increased time spent at facility (from 1 to 3 hours) was not associated with lower retention in care (OR 0.72 [95%CI:0.52-1.01] and 0.83 [95%CI: 0.63-1.09] at 6- and 12-months, respectively), nor with a lower odds of viral suppression (OR 0.96 [95%CI: 0.71-1.32]).ConclusionsStrategies to reduce patient wait times at the health facility warrant continued prioritization. Differentiated models of care have helped considerably, but novel approaches are still needed to further decongest crowded health facilities. In addition, a good client-provider communication and positive attitude can improve patient satisfaction with health services, with an overall improved retention.

Background:. One of the surgical procedures most requested by patients with gender dysphoria is gluteus-trochanteric improvement, and there are few scientific reports on managing this region. We present our 14-year surgical experience combining different surgical procedures for trochanteric gluteal improvement in patients with gender dysphoria. Methods:. From October 2007 to December 2022, patients with male-to-female gender dysphoria who requested feminization of the trochanteric gluteal region were operated on, undergoing combined liposuction, lipoinjection, and gluteal (GI) and hip implant (HI) placement. Results:. One hundred seventy-two patients aged between 23 and 56 years (mean: 36.4 years) were included, with follow-up from 3 to 45 months (mean: 26 years). Lipoinjection alone was performed on buttocks and hips in 132 patients (76.7%), GIs plus hip lipoinjection were performed in 22 patients (12.7%), and 18 patients (10.4%) underwent GIs and HIs. Lipoinjection was added to eight patients in this last group. The overall satisfaction in all groups was 89%. The main reason for dissatisfaction was volume loss secondary to fat reabsorption (8%). There were no significant complications, with the most common adverse events being HI displacement in two of 18 patients (11.11%) and wound dehiscence secondary to GI placement in four of 40 patients (10%). Conclusion:. With the appropriate combination of liposuction, lipoinjection, GIs, and HIs, it is possible to feminize the trochanteric gluteal region with highly satisfactory results.

Background:. Tranexamic acid (TXA) is used to reduce bleeding in body contouring procedures; however, there are no studies that show the effectiveness of TXA when it is also used in the immediate postoperative period. Methods:. A controlled, randomized, parallel, and open-label clinical trial was carried out in adult patients undergoing liposculpture and/or abdominoplasty. A control group administering presurgical TXA and a study group with presurgical and postsurgical TXA were formed. The decrease in hemoglobin and the incidence of blood transfusions between both groups were compared as well as the possible adverse effects of TXA. Results:. Four hundred twenty-seven subjects were included, 208 (48.7%) in the control group and 219 (51.3%) in the study group. The median age was 34 years (interquartile range 28–42). Median postoperative hemoglobin levels at 24 hours were similar in both groups (study 11.3 g/dL versus control 11.1 g/dL, P = 0.07); however, at 72 hours, postoperative hemoglobin was higher in the study group versus control (10.8 versus 10.0 g/dL, P ≤ 0.001). The incidence of transfusions at 72 hours was 1.8% in the study group and 8.6% in the control group, for a risk ratio of 0.21 (95% confidence interval 0.07–0.61). There were no adverse or thromboembolic events. Conclusion:. TXA proved to be more effective in reducing intra- and postsurgical bleeding and the need for transfusions, when used preoperatively and continued for 48 hours after surgery, than when used only preoperatively, without reporting adverse or thromboembolic effects.

El metaparadigma en enfermería es el conjunto de conceptos esenciales que identifican los fenómenos de interés para la enfermería. Este artículo tiene como objetivo proporcionar una mejor base para la comprensión de la importancia del desarrollo de metaparadigma que reflejen de modo adecuado la realidad de la práctica clínica propia de la Enfermería cubana. Se realizó un estudio de tipo teórico-reflexivo, apoyados por la observación sistemática, el razonamiento, la interpretación, y la sistematización de la práctica científica y complementados en una búsqueda bibliográfica en bases de datos como Pubmed, Cuiden® y Scielo y el análisis documental de las obras científicas relacionadas con el tema. Para lograr un cuerpo teórico en la ciencia del cuidado en Cuba, es imprescindible la delineación metaparadigmas que se ajusten a la realidad que viven los enfermeros y enfermeras cubanas lo que le brindara lo que favorecerá a que se brinden cuidados oportunos y de calidad.

This work presents a theoretical study of fouling in flat plate solar collectors. The thermal performance of solar collectors is determined by operating variables such as surface area, network configuration, and flow distribution, as well as external factors such as solar radiation and weather conditions. However, in most flat plate solar collectors, where water is the working fluid, it is common for scaling to occur, reducing heat transfer and increasing pressure drop. Fouling in pipes increases resistance to heat transfer and increases pressure drop. Consequently, the thermal performance of solar collectors decreases while increasing pumping power. An inadequate design of a network of solar collectors causes poor fluid distribution, which affects thermal performance. In channels with low water flow rates, the fluid reaches higher temperatures, which increases the rate of scaling deposition on the surfaces of the pipes. There are few studies on fouling in solar collectors and its effect on thermal and hydraulic performance. Therefore, the use of a model to predict fouling and the development of a mathematical model to determine the flow distribution in the network will allow for the identification of improved network structure designs. It is shown that in retrofit, reduction of free flow area by 40 %, reduces fouling deposition and pressure drop due to scaling but only reduces the maximum outlet temperature by 0.55 °C between the clean and fouled conditions.

Antecedentes: Penaeus vannamei es afectado por la aparición de enfermedades que causan altas mortalidades y pérdidas económicas. Objetivo. Estimular el sistema inmune en camarones Penaeus vannamei posterior al estrés térmico no letal (NLHS). Materiales y métodos: Dos condiciones NLHS (agudo y crónico) fueron desarrolladas. El reto agudo por 30 minutos y colecta de muestras en los tiempos (0,30min,3 ,6 y 12h). El reto crónico por 5 minutos durante siete días. Las muestras fueron colectadas en (0 y 7d) para evaluar respuesta inmunológica y resistencia frente a un estrés osmótico. Los camarones aclimatados a 28°C fueron considerado grupo control. Resultados: El análisis de ANOVA en el reto agudo determinó que la NLHS en P. vannamei en nuestras condiciones de cultivo es 37°C´. Un incremento (P

Black rice (Oryza sativa) stands out for its high content of bioactive compounds with functional properties that play an important role in health benefits. The phytochemical level is affected by industrial processing due to its instability to the hydrothermal process. Studies about the influence of industrial processing on the phytochemical profile of black-rice-based foods are still scarce. This study carried out a comprehensive review of the influence of industrial applications on the bioactive compounds in food products based on black rice and their health-promoting effects. Most industrial processes such as drying, storage, cooking, and extrusion affect phytochemical content and antioxidant capacity. Alternatively, technologies such as fermentation, UV-C irradiation, and sprouting can maintain or improve the phytochemical content in black rice products.

Resumo. É dever dos verdadeiros progressistas e amantes da paz desmentir e desmontar a implementação da “pós-verdade” contra a Nicaragua, isto é, desmentir as fake news que propagam: a) é uma ditadura comunista populista, b) que está suprimindo a liberdade de imprensa, c) que está aprisionando candidatos da oposição que supostamente eles ganhariam as eleições e d) que persegue dissidentes sandinistas que se oporiam a isso dentro do partido do personalismo ditatorial de Daniel Ortega. O objetivo do artigo é apresentar um panorama histórico sobre a Nicarágua desde a ocupação norte-americana, destacando o papel de Sandino até o desdobramento da revolução sandinista; uma retrospectiva das eleições no país; principais crises até a atualidade e os impactos da guerra híbrida na atual crise que o país enfrenta. Concluí que o que está em jogo hoje na Nicarágua é o destino das conquistas da revolução sandinista.

Using the crossover capital framework (Salinas, 2015), this study situated the lived experiences of 12 Black and Latino men community college students across multiple places and spaces, with each space having the potential to oppress and/or privilege the individual. This qualitative phenomenological study revealed that participants actively pursued opportunities to navigate new environments that would potentially privilege them in ways that their home environments would or could not. This paper provides implications for practice and research to advance support for Black and Latino men community college students to navigate their sense of identity in various educational landing spaces via the value they place on access to resources and relationships.

La lengua es un código abierto, variable y adaptable, de acuerdo con la situación comunicativa. Ello implica un recorrido de acceso a los significados circunscrito por la estructura social, y en la cual se establece una distribución del poder, una ideología, y unas relaciones de solidaridad. Pero también implica una organización semiótica realizada en un marco retórico-gramatical de codificación, el registro, y donde se actualiza un significado potencial, un código gramatical, y un código socio-situacional de estructuración genérica. De modo que la situación comunicativa determina que código selecciona el usuario y en que condiciones, y la estructura social establece que código controla el usuario.

Summary:. Lipoabdominoplasty is one of the most commonly performed procedures in body-contouring surgery. We present a retrospective study of our 26 years of experience to improve the results and assure the greatest possible safety in lipoabdominoplasty. We include all of our female patients who underwent lipoabdominoplasty performed from July 1996 to June 2022, dividing the patients into two groups: group I underwent circumferential liposuction avoiding abdominal flap liposuction for the first 7 years, and group II underwent circumferential liposuction including abdominal flap liposuction for the subsequent 19 years, pointing out the differences in the processes, results, and complications of both groups. Over a period of 26 years, 973 female patients underwent lipoabdominoplasty: 310 in group I and 663 in group II. Ages were very similar; however, weight, BMI, amount of liposuction material, and weight of the abdominal flap removed were higher in group I. Twenty percent of patients in group I were obese compared to 7% in group II. The average amount of liposuction in group I was 4990 mL compared to 3373 mL in group II and 1120 g of abdominal flap in group I versus 676 g in group II. Minor and major complications were 11.6% and 1.2% in group I versus 9.2% and 0.6% in group II, respectively. In our more than 26 years of performing lipoabdominoplasty, we have maintained most of our initial procedures. These processes have allowed us to perform surgery safely and effectively with a low morbidity rate.

Resumen Introducción y objetivo Los cambios anatómicos faciales que resultan como consecuencia del envejecimiento son uno de los principales motivos de consulta en Cirugía Estética facial. Nos proponemos determinar los cambios histológicos secundarios a la aplicación de carboxiterapia previa a la ritidoplastia, tomando en cuenta la aceptación de los pacientes en relación a mejora en la calidad de su piel facial tras el tratamiento. Material y método Aplicamos 10 sesiones de carboxiterapia facial 5 semanas antes de la intervención quirúrgica de ritidoplastia. Infiltramos el dióxido de carbono por vía percutánea alrededor de cara y cuello a excepción de las regiones pre y postauriculares derechas. La ritidpolastia fue realizada por diferentes cirujanos y codificamos y analizamos las muestras de piel tomadas de las áreas pre y postauriculares Resultados Llevamos a cabo el estudio en 7 pacientes. Histología: la disposición de las fibras de colágeno fue en espiral y nódulos en la zona preauricular derecha (área no tratada), mientras que en la zona preauricular izquierda la disposición de colágeno fue lineal, diferencia estadísticamente significativa (p=0.0052). La proliferación de tejido celular subcutáneo en la zona preauricular izquierda disminuyó de una manera evidente (p=0.03), mientras que el área postauricular no presentó este fenómeno (p=0.10). Conclusiones La carboxiterapia previa a la cirugía de ritidoplastia es un procedimiento seguro, que en nuestro estudio no prolongó el tiempo quirúrgico ni aumentó la respuesta inflamatoria. Los cambios histológicos hallados demostraron cambios en la disposición del colágeno en las áreas tratadas, con mayor elasticidad de la piel. Hubo también disminución en la proliferación celular en el área que recibió carboxiterapia sin alteración de la estructura de la dermis.

Introducción: La enfermedad cardiovascular es la primera causa de muerte en los pacientes con enfermedad renal crónica. En los hipertensos, la enfermedad renal crónica es la segunda causa de muerte, el daño vascular sistémico es la norma. Objetivo: Identificar los factores de riesgo cardiovascular tradicionales y no tradicionales y su asociación con la enfermedad cardiovascular en pacientes en hemodiálisis. Material y Métodos: Estudio de corte transversal en 247 pacientes en hemodiálisis crónica. Las variables analizadas fueron: causas de enfermedad renal crónica, factores de riesgo cardiovascular tradicionalesy no tradicionales y enfermedades cardiovasculares. Se determinaron tablas de frecuencias y estadísticas de asociación mediante Chi cuadrado. Para determinar el riesgo de mortalidad se utilizó la razón de prevalencia (RP). Se consideró como nivel de significación estadística a p

Introduction: Liposuction is one of the most popular plastic surgery procedures. As in any surgery, there are risks and complications, especially when combined with fat injection. Case reports of fat embolism have been reported. A possible explanation is the puncture and tearing of gluteal vessels during the procedure, especially when a deep injection is planned. Objective: To identify the places where fat can be located after injection during a fat graft in the gluteus. Methods: An experimental study was done in which colorant was injected in four directions using four different quadrants of the gluteus. We Injected 10 cc six times following clock hands until 60 cc were injected, and the cutaneous flap and the muscles were then elevated. Our main purpose was to describe where the colorant went and if it was in contact with the vessels (superior and inferior gluteal vessels). In total, four gluteus muscles were injected and dissected. Results: Injection in the lower lateral quadrant was mainly into the muscle, and colorant was observed in the hypogastric vessels. The injection in the upper quadrants stayed mainly in the subcutaneous tissue. Conclusions. During surgery, it is important to identify the location of the perforators and to avoid a deep injection, especially from the lower lateral quadrant to the superior medial quadrant (Q4 to Q1), as the probability of puncturing and injecting fat into the main vessels from this direction is higher.

Foundation: chronic renal failure has a negative impact in the quality of life and constitutes a morbidity predictor in patients with periodic hemodialysis.Objective: to evaluate the influence of quality of life related to health in the morbidity of patients in intermittent periodic hemodialysis.Methods: a descriptive study was done in patients with three or more time of intermittent periodic hemodialysis at the Nephrology service of the Military Hospital Dr. Carlos J. Finlay. Havana, in a 12 month follow up period. The variables analyzed were: age, sex, time with the substituting renal function treatment, morbidity rate, type of morbidity in hemodialysis and hospital admission rate. A questionnaire for quality of life in patients with renal disease (version 1.3) was applied.Results: patients under 60 years old predominated, of high schooling level, with blood hypertension mainly due to renal failure. The most frequent morbidities were: chills, arterial Hypotension, and complications related to vascular access. The admission rate was low. The summary physical component had the lower punctuation followed by the summary mental component. Among these and age there was found an inversely proportional correlation, so as the morbidity rate and the summary physical component.Conclusion: the results obtained are related to preceding studies. The physical component summary results with higher involvement, mainly in the older adult, considering the negative relation with the morbidity rate and hospital admission.

O ingresso no Ensino Superior é uma escolha multifatorial que envolve questões financeiras, sociais, familiares e pessoais. Comumente a todo o Ensino Superior, há uma taxa de evasão de discentes por questões diversas. Este estudo objetivou conhecer as motivações para a evasão na graduação em Musicoterapia na Universidade Estadual do Paraná, entre 2013 e 2018. Trata-se de estudo de metodologia mista, com dados de estatística descritiva e dados qualitativos. Após aprovação no comitê de ética em pesquisa, foi realizada coleta online com formulários estruturados. Participaram da pesquisa 22 respondentes. As motivações mais frequentes na decisão por abandonar ou trancar o curso referem-se a questões financeiras, a não identificação com a área da Musicoterapia e a dificuldade em desenvolver habilidades e competências musicais. Minimizar a taxa de evasão escolar na graduação em Musicoterapia amplia o número de Musicoterapeutas e fortalece socialmente a Musicoterapia como ciência e a profissão.

Background:. Health care systems worldwide have been affected by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emergence since December 2019. The coronavirus disease 2019 (COVID-19) pandemic caused a steep decrease in elective surgery scheduling, to the extent of complete cancellation without future planning of safe development. Purpose:. We performed a review of the literature and diagnosis data analysis with the aim to reduce the risk of operating a patient infected with SARS-CoV-2/COVID-19 during the incubation period. Methods:. We searched for specific words and phrases about SARS-CoV-2 and COVID-19 in the PubMed database (US National Library of Medicine) from December 2019 to April 2020. A detailed analysis of the clinical picture and existing diagnostic tests for COVID-19 was performed to achieve the desired objectives. Results:. A total of 1273 out of 5930 articles about COVID-19/SARS-CoV-2 did meet the criteria for the searched terms. We reviewed 105 articles, and 60 were selected for analysis. Specific recommendations were described based on our revision. Conclusions:. With the combination of immunoglobulin M and immunoglobulin G antibody tests + real-time polymerase chain reaction for SARS-CoV-2 implemented in different time periods by taking into account the natural history of the disease, it is possible to decrease the risk of operating a patient during the incubation period higher than 93%. Adding other security measures can further increase this percentage. As long as there is no immunity to COVID-19, these measures will help us to perform safer elective surgeries.

Foundation: in response of the health system before a hurricane, municipalities and establishments have a protagonist role. Objective: to describe the Aguada de Pasajeros municipal health system at the Irma hurricane’s path across its territory. Methods: prospective cross study, in the health and service system, developed in the Aguada de Pasajeros Municipality between September the 7th and 30th, 2017. The universe was the territory total of workers and institutions, all involved in the response to Irma’s hurricane. A documentary review was included (plans, instructions from the Defense Councils, and the Minister of Health) and participating observation. Indicators of possible impact and municipal health situation. Results: a total of 88 actions by the municipal health system; 50 during the informative phase and 9 in alert. The plan for disaster reduction was totaly achieved, to which 9 new tasks were added. There were no deaths due to the hurricane nor morbidity after the event. There was maintained assistance coverage in sites of difficult access and shelters. All the institutions maintained vitality. Conclusion: the actions developed in the municipality allowed maintaining the health situation, the comprehensive care to the people who demanded medical services during the path of the natural phenomena across the territory institutional vitality.

Introducción: la ciencia del cuidado debe de nutrirse de un potente sustento teórico- práctico para romper las barreras del aislamiento e inmovilidad en que en algún momento puede estar sumido su objeto de estudio. Objetivo: contribuir a la actividad cognoscitiva de la ciencia del cuidado desde una visión de la dialéctica materialista como concepción, enfoque y método. Método: estudio teórico-reflexivo, que partió desde la observación sistemática, la reflexión, la interpretación, y la sistematización de la práctica científica al asumir como punto de referencia la dialéctica materialista, para producir un nuevo conocimiento. Resultados: la sistematización y el análisis histórico-lógico realizado por los autores, se consideró la concepción dialéctica materialista como el conjunto de ideas, conceptos, juicios y criterios, que forman parte de la expresión de la violencia contra niños y niñas. En este estudio se encontró una fuerte evidencia del carácter humanista de la enfermería, que se manifestó en el recorrido histórico-social del fenómeno de estudio tanto a nivel mundial como a escala nacional. Conclusiones: la investigación sistemática de la práctica de la enfermería, su efecto en el cuidado del paciente o del individuo, de la familia, o de la comunidad, tiene en la dialéctica materialista como concepción, enfoque, método, un útil instrumento para profundizar en su estudio. Ello abre un área de reflexiones de gran utilidad para sistematizar una visión renovada del empleo de la dialéctica materialista como fundamento filosófico de las investigaciones sociales de la enfermería.

Introducción: se conoce la importancia que presentan los marcadores de daño renal para valorar la evolución y el pronóstico de los pacientes con enfermedades renales. Objetivo: identificar la presencia de marcadores de daño renal en pacientes monorrenos quirúrgicos y relacionarlos con la carga de comorbilidades. Métodos: estudio de corte transversal en 88 pacientes atendidos en el HMC "Dr. Luis Díaz Soto". Las variables estudiadas fueron microalbuminuria, proteinuria y la carga de comorbilidades. Se determinó el Odd Ratio (OR) y el Chi cuadrado para las variables cualitativas y la desviación estándar (DS) y la t de Student para las cuantitativas. Se consideró significativo p≤ 0,05, con una confiabilidad de 95 %. Resultados: existió un aumento de la presencia de marcadores de daño renal después de la nefrectomía, la microalbuminuria de 17 a 35 pacientes (p= 0,004 y OR: 2,7), la proteinuria de 12 a 33 (p= 0,005 y OR: 3,8). A mayor carga de comorbilidades mayor presencia de marcadores de daño renal [X2= 19,48; p= 0,000 y OR: 3 (1,19-7,55)]. Conclusiones: la nefrectomía produce un incremento de la presencia de marcadores de daño renal a los dos años de seguimiento, principalmente en los pacientes con mayor número de comorbilidades.

The first institute of Gestalt therapy was founded in 1952 in the United States. Over the years, Gestalt therapy was spread in various countries in the world including Brazil. This wide diffusion also brought various forms for the training of Gestalt therapists. This research is a narrative review of the literature about Gestalt therapy training. We aim to understand this diversity in specifically on Brazilian soil. Initially Gestalt therapy gained much visibility in the US with workshops offered by Fritz Perls. However, its theoretical consistency and systematic dissemination were achieved with the creation of institutes and associations. Conclusion shows that Gestalt therapy in Brazil seems to happen for at least two ways: 1) Courses/specializations; 2) Taking classes and clinical supervision with an experienced Gestalt therapist; 3) contact with Gestalt therapy in undergraduate courses. However, it’s common to find “self-nominated Gestalt therapists" who have had contact with Gestalt therapy only in undergraduate courses.

Resumen: El discurso, como proceso, y el texto, como producto, se desarrollan en una dimensión interaccional de naturaleza retórico-argumentativa. Donde la retórica del discurso tiene que ver con las prácticas sociales que desarrollan diferentes funciones comunicativas, y la retórica del texto con las voces que estructuran un significado para un auditorio. Estas retóricas están situadas en la ejecución de discursos multi-modales y multi-voces. De modo que, podemos definir al texto, en su selección de significados, como una unidad gramatico-retórica, y al discurso como una unidad de interacción entre realidad (y su construcción) y proceso cognitivo, estableciendo una dinámica argumentativa. Abstract: Discourse, as a process, and text, as a product, are developed in an interactional dimension of rhetoric-argumentative nature. Here the discourse’s rhetoric has to do with the social practices that develop different communicative functions, and the text’s rhetoric with the voices that structure a meaning for an audience. These rhetorics are situated in the performance of multi-modal and multi-voice discourses. Thus, we may define the text, from the meaning choice, as a grammatical-rhetoric unity, and the discourse as an interaction unity between reality (and her construction) and cognitive process, establishing an argumentative dynamic.

Geometric morphometrics is a tool capable of measuring the response of organisms to different environmental pressures. We tested the hypothesis that E. cordata wing morphometry, as an indicator of response to environmental pressure, it would vary depending on habitat changes, in the Atlantic Forest, Savanna and dry forest (Caatinga). For analysis of wing shape and size, 18 landmarks were digitized at the intersections of the wing veins 348 individuals. Except for the two populations sampled in Chapada Diamantina, the wing shape had significant statistical variations among the populations (p < 0.05). The wing size variation was also statistically significant among populations (p < 0.05). Although E. cordata is a species tolerant to different environments, the observed morphometric variability may be related to population adaptations to the conditions of each phytophysiognomy.

The importance of knowing how fouling develops and deteriorates the thermal-hydraulic performance of heat transfer processes becomes evident when the problem is already there and is difficult to eliminate. Fouling prediction is important in grassroot design and even more, in retrofit applications. The aim of the present work is to show the use of a fouling model to predict scaling in cooling systems in order to derive design guidelines. Fluid temperature and velocity are the two more important variables that determine the rate at which scaling takes places. This work focuses on retrofit of existing cooling systems for situations where new heat exchangers need to be incorporated into the network. It is shown how the pressure drop, fluid velocity and flow distribution are affected depending on the decision of where to place the new exchangers. All these factors are intimately related to the development of fouling. The model presented in this work includes the prediction with time of the increase of pressure drop and flow redistribution as fouling builds up. The use of the model is illustrated through a case study that shows that in the retrofit of cooling systems, the incorporation of new heat exchangers in parallel is recommended.

We experimentally and numerically investigated elastic waves in parallel arrays of elastically coupled one-dimensional acoustic waveguides composed of aluminum rods coupled along their length with epoxy. The elastic waves in each waveguide take the form of superpositions of states in the space of direction of propagation. The direction of propagation degrees of freedom is analogous to the polarization of a quantum spin; hence, these elastic waves behave as pseudospins. The amplitude in the different rods of a coupled array of waveguides (i.e., the spatial mode of the waveguide array) refer to the spatial degrees of freedom. The elastic waves in a parallel array of coupled waveguides are subsequently represented as tensor products of the elastic pseudospin and spatial degrees of freedom. We demonstrate the existence of elastic waves that are nonseparable linear combinations of tensor products states of pseudospin/ spatial degrees of freedom. These elastic waves are analogous to the so-called Bell states of quantum mechanics. The amplitude coefficients of the nonseparable linear combination of states are complex due to the Lorentzian character of the elastic resonances associated with these waves. By tuning through the amplitudes, we are able to navigate both experimentally and numerically a portion of the Bell state Hilbert space.

Background: in end-stage chronic renal failure, treatments like hemodialysis induce substantial changes in lifestyle. Such therapies aim to achieve functional improvement by reducing symptoms and/or slowing disease progression. Objective: to evaluate the health-related quality of life in patients undergoing regular hemodialysis. Methods: a cross-sectional study was conducted in chronic renal failure patients undergoing regular hemodialysis in the hemodialysis and peritoneal dialysis service of the Dr. Carlos J. Finlay Military Hospital from January through February 2013. The Kidney Disease Quality of Life Short Form version 1.3 was used to evaluate the health-related quality of life. Results: generic dimensions with lower scores were the physical role, general health perception and emotional role. The specific dimensions with lower scores were the burden of kidney disease, employment status and sexual function while dimensions with higher scores were specific: relationship with the dialysis staff (85.62 points), cognitive function (84.33 points) and quality of social relationship (82.88 points). Conclusion: As in other countries, the KDQOL-SF enables the evaluation of health-related quality of life in regular hemodialysis patients in Cuba, since it allows effectively identifying the dimensions and areas most affected.

Segundo a Comissão Econômica para América Latina e o Caribe (CEPAL), desde meados da década dos 90 a novidade na formulação de políticas tem sido considerar o trabalho conjunto de empresas e instituições, situadas em zonas geográficas especificas, cujos atores interagem e colaboram entre si em torno a objetivos comuns com a finalidade de aumentar a produtividade conjunta e inserir-se nos mercados nacionais e internacionais. A importância que assume a proximidade territorial na busca de vantagens competitivas e inovativas reflete-se num conjunto relativamente consensual de argumentos que engloba, prioritariamente, a importância crescente atribuída às aglomerações produtivas locais enquanto elemento central na competitividade econômica e no dinamismo tecnológico das empresas. No ano de 2008, aproximadamente 38,54% do total dos estabelecimentos dedicados às confecções de roupa do Estado de Mato Grosso se concentravam nos municípios de Cuiabá e Várzea Grande, o que, em termos do emprego, representou 8,5% do total existente no Estado para esse setor. Sendo assim, a questão que se coloca é a de saber em que medida a dinâmica econômica das micro e pequenas empresas nos arranjos produtivos estudados decorre de mecanismos interativos de aprendizagem (formais e informais), inovação e cooperação desenvolvidos pelas diferentes empresas locais.

Background:. Liposuction has become one of the most common cosmetic surgical procedures, and severe complications secondary to this procedure have also increased significantly. That is why we carry out a research work to know the most frequent severe complications reported in the scientific literature to indicate criteria for prevention. Methods:. English-language scientific publications about liposuction and its complications were analyzed using the PubMed.gov, from the beginning of PubMed's history through June 10, 2017. Five terms were used to define liposuction and its complications: "liposuction," "liposuction AND complications," liposuction AND major complications," "liposuction AND complications AND death," and "liposuction AND death." The quantities of results for the 5 phrases were analyzed, along with their contents. Results:. One thousand sixty-three results were obtained from 1973 through June 10, 2017 for the phrase "Liposuction and Complications" in humans; for "Liposuction and Major Complications," 153 articles were found; for "Liposuction and Deaths," 89 articles were found; and 42 articles were obtained with the terms "Liposuction and Major Complications and Deaths." After final depuration, all those that were not specific to severe liposuction complications were eliminated, leaving a total of 39 articles that were included in our study. Five problems proved to be the most serious complications when performing liposuction: Thromboembolic disease, fat embolism, pulmonary edema, lidocaine intoxication, and intraabdominal visceral lesion. Conclusions:. The 5 most important complications that can cause death in liposuction are easily preventable using simple measures and proper safety protocols that are described in this work.

A partir da visão de Furtado e dos teóricos nomeados de neoschumpeterianos o trabalho, pretende explicar da forma mais didática possível as incertezas teóricas e econômicas que envolvem o(s) conceito(s) de Arranjos Produtivos Locais e Sistemas de Produção, Inovação Locais (SPILs) e Sistemas Nacionais de Inovação (SNI) assim como explanar a importância da informação e do conhecimento no processo inovativo tendo presente o novo modelo de acumulação capitalista.

El proceso de gestión turística patrimonial con los enfoques del Desarrollo Socioeconómico Local se revierte cada vez más en el aumento de la calidad de vida de los pobladores. Hoy los notables estudios de este fenómeno se realizan a partir de diagnósticos socioculturales y económicos que conducen a elaborar estrategias para la revalorización de los recursos patrimoniales y una nueva forma de economía en aras del desarrollo. Recurrir a los fundamentos del Patrimonio y la cultura y su vinculación con el sector turístico, y a las consideraciones de esta actividad como una nueva forma de economía hacen que la inserción del desarrollo local como tendencia ha permitido interpretar este fenómeno desde la identidad propia de cada una de las localidades, buscando solucionar las problemáticas asociadas a la conversión de expresiones patrimoniales en recursos, y a la revalorización de los mismos, facilitando su preservación y uso; con posibles beneficios para la comunidad, así como los procesos de capacitación de las diversas expresiones culturales en la transmisión a las futuras

Introducción: la hepatitis C se mantiene como un problema de salud en los centros de hemodiálisis. Métodos: se realizó un estudio de cohorte histórico donde se incluyeron 215 pacientes que ingresaron al centro de hemodiálisis del Hospital Militar "Dr. Luis Díaz Soto", entre 1995 y 2008. Se tomaron como períodos de exposición los criterios de aislamiento de pacientes con hepatitis C. Resultados: se halló mortalidad general de 30,2 %, la letalidad y la mortalidad por hepatitis C fueron mayores en el período de exposición con 53,8 % y 16,6 %, respectivamente. En el análisis multivariado por regresión de Cox se observó que constituyeron factores de riesgo de morir, en un menor tiempo de observación, la presencia de hepatitis C y recibir tratamiento con hemodiálisis en los períodos de mayor incidencia (p=0,014), independientemente de la carga de comorbilidades. Conclusiones: la infección por el VHC contribuye a aumentar la mortalidad de los pacientes en tratamiento con hemodiálisis, cuando se tiene en cuenta la carga de comorbilidades.

O trabalho procura demonstrar que o modelo do agronegócio aplicado na ocupação/desenvolvimento do Estado representa uma atividade concentradora de terra, dificultando uma ocupação demográfica tradicional do espaço rural e com claros impactos no tecido urbano. Através da determinação do índice de OIN I para os censos agropecuários dos anos de 1985 e 1995-96, revelam-se implicações desse modelo no tecido urbanos das cidades do Estado, evidenciando as correlações entre as varias variáveis como: concentração fundiária, Imigração, desmatamento, ocupação, destinação das terras e fixação da população.

Investigou-se a desigualdade da distribuição de renda e a pobreza das famílias residentes nas áreas rurais de Mato Grosso em 2004 e 2006, com base nos microdados da PNAD (IBGE). Em especial, o coeficiente de Gini foi decomposto por fonte de renda, para se identificar a contribuição relativa de determinada fonte de renda na desigualdade da renda total. Dentre os principais resultados encontrados, verificou-se que há elevada desigualdade na distribuição de renda entre as famílias rurais mato-grossenses, que a renda das atividades agrícolas contribui para aumentar essa desigualdade e que essa renda se constitui em variável importante e estratégica para a economia do Estado. Os indicadores também sugerem que houve incremento da pobreza entre as famílias rurais do Estado entre 2004 e 2006.Investigates on income distribution inequality and poverty of families living in rural areas of Mato Grosso in 2004 and 2006, based on the microdata of PNAD (IBGE). In particular, the Gini coefficient was broken by source of income to identify the relative contribution of a particular source of income inequality in total income. Among the key findings, it appears that there is high inequality in the income distribution among households in Mato Grosso, that the agriculture income contributes to increasing inequality and that this income is one important and strategic variable for the economy of the state. The indicators also suggest that there was an increase in poverty among rural families of the state between 2004 and 2006.

Toda actividad de la lengua requiere unas representaciones cognitivas y unas construcciones lógicas para actuar sobre el mundo y situarse ante lo necesariamente o probablemente verdadero. Ello hace que, en la comunicación lingüística, el texto se construya de acuerdo a unas alternativas lógicas particulares y sociales, y que dentro de cada discurso haya una racionalidad construida adaptable a los interlocutores y a las situaciones, y variable de acuerdo con las capacidades de los participantes y sus cálculos estratégicos. En este marco, de interacción social y de relación lengua-pensamiento, se despliega una lógica argumentativa que se caracteriza por ser abierta a la situación comunicativa, y por estar marcada de forma prominente por un carácter expresivo, convencional, o retórico. De modo que, usar la lengua es interpretar la realidad, trazándola, al menos, desde dos perspectivas: la del hablante y la del oyente. Siendo la construcción retórica del texto la que da forma a la manera en que la gente, en su vida diaria, ve su realidad y su existencia. Se trata de estructuras sintácticas funcionando en una dinámica racional de interacción comunicativa y construyendo unas realidades comunicativas con un determinado sentido lógico y una determinada fuerza pragmática. Y donde se establece una correspondencia entre la estructura del texto y la estructura del mundo, y donde la acción del discurso construye una realidad exterior y sustenta una realidad interna.

El rechazo crónico se ha convertido en el mayor desafío a la supervivencia a largo plazo de los trasplantes de órganos sólidos. La generación de especies reactivas del oxígeno es una relevante consecuencia de todos los fenómenos considerados como factores de riesgo de este proceso. Es por esto que resulta de gran interés esclarecer el posible papel patogénico de estas especies químicas en los cambios vasculares que caracterizan la disfunción tardía de los injertos, a la luz de los conocimientos actuales. Se discuten las principales evidencias que permiten establecer un vínculo estrecho entre el daño oxidativo y los mecanismos implicados en la hiperplasia de la íntima, que deterioran funcionalmente los órganos trasplantados a largo plazoThe chronic rejection has become a great challenge to long-term survival of solid organ transplantations. The generation of reactive oxygen species is a relevant consequence of all the phenomena considered as risk factors in this process. This is the reason why the determination of the possible pathogenic role of these chemical species in the vascular changes taking place in late graft failure is of great interest in the light of the present scientific knowledge. The main evidence that make possible to establish a close linking between oxidative damage and the mechanisms involved in intimal hyperplasia that functionally deteriorate transplanted organs in the long run are discussed

El artículo explora las religiones tradicionales practicadas por los pueblos ewe-mina, ewe-fon, bantú y yoruba del África subsahariana, antes de abordar las formas como estas prácticas religiosas persisten en el “Nuevo Mundo” tras la llegada forzosa de aquellos esclavizados africanos. Con base en la presencia de estas religiones tradicionales africanas en distintos países latinoamericanos y caribeño, se evidencia un conjunto religioso fusionado por historias, mitos, leyendas, danza, música, etc. de ascendencia africana y se hace un llamado a los/ as investigadores/as, que desde América Latina y el Caribe, indagan sobre las religiones tradicionales yoruba, para que franqueen los límites de Nigeria con el fin de abarcar a toda la diáspora yoruba.

Abstract Background Different models exist to provide HIV/STI services for most-at-risk populations (MARP). Along the Tete traffic corridor in Mozambique, linking Malawi and Zimbabwe, a night clinic opening between 4 and 10 PM was established targeting female sex workers (FSW) and long-distance truck drivers (LDD). The clinic offers free individual education and counselling, condoms, STI care, HIV testing, contraceptive services and outreach peer education. To evaluate this clinic model, we assessed relevance, service utilisation, efficiency and sustainability. Methods In 2007-2009, mapping and enumeration of FSW and LDD was conducted; 28 key informants were interviewed; 6 focus group discussions (FGD) were held with FSW from Mozambique and Zimbabwe, and LDD from Mozambique and Malawi. Clinic outputs and costs were analysed. Results An estimated 4,415 FSW work in the area, or 9% of women aged 15-49, and on average 66 trucks stay overnight near the clinic. Currently on average, 475 clients/month visit the clinic (43% for contraception, 24% for counselling and testing and 23% for STI care). The average clinic running cost is US$ 1408/month, mostly for human resources. All informants endorsed this clinic concept and the need to expand the services. FGD participants reported high satisfaction with the services and mentioned good reception by the health staff, short waiting times, proximity and free services as most important. Participants were in favour of expanding the range of services, the geographical coverage and the opening times. Conclusions Size of the target population, satisfaction of clients and endorsement by health policy makers justify maintaining a separate clinic for MARP. Cost-effectiveness may be enhanced by broadening the range of SRHR-HIV/AIDS services, adapting opening times, expanding geographical coverage and targeting additional MARP. Long-term sustainability remains challenging and requires private-public partnerships or continued project-based funding.

La insuficiencia renal aguda (IRA) tiene una incidencia anual de 100 casos por millón de habitantes y un elevado costo económico. Se presentaron los resultados de una investigación realizada para caracterizar y conocer su incidencia en una Unidad de Cuidados Intensivos (UCI). Se realizó un estudio observacional, retrospectivo y descriptivo que incluyó a todos los pacientes que ingresaron en el período de 1 año y a quienes los médicos de asistencia le realizaron el diagnóstico de IRA. Los datos se obtuvieron de los registros primarios de la UCI y de las historias clínicas de los pacientes. La IRA predominó en los casos quirúrgicos complicados, mayores de 45 años, hombres y color de la piel blanca. La incidencia fue mayor en los ventilados con cifras de creatinina sérica entre 132 y 200 µmol/L y en los ventilados se encontró significación estadística. Como factores causales de IRA predominaron la deshidratación, el shock y la hipotensión. Las complicaciones más frecuentes fueron la sepsis y el fallo multiorgánico y dentro de las causas de muerte predominaron el shock, el fallo multiorgánico y la bronconeumonía bacteriana. Se demostró que la IRA continúa siendo frecuente en pacientes graves y se debe continuar la atención adecuada de los pacientes susceptibles de padecerla para lograr su mejor evolución clínica.Acute renal failure (ARF) has an annual incidence rate of 100 cases per one million habitants and a high financial cost. The results of a research work aimed at characterizing and determining the incidence of this condition in the Intensive Care Unit(ICU) were put forward in this paper. A retrospective, descriptional and observational study was conducted, which included all those patients admitted to the hospital in one year and diagnosed with acute renal failure by attending physicians. Primary records of the ICU together with the patients´ medical histories provided required data. ARF prevailed in complex surgical cases, over 45 years age group, males and Caucasians. The highest incidence was observed in ventilated patients with serum creatinine values of 132-200 µmol/L and also, statistical significance was found in the ventilated patients. The commonest factors were sepsis and multiple organ failure whereas the main causes of death were shock, multiple organ failure and bacterial bronchial pneumonia. It was proved that ARF continues being a frequent entity in critical patients and that adequate care must be provided to patients with susceptibility of suffering it to contribute to their best clinical recovery.

Abstract Alcohol abuse reduces response rates to IFN therapy in patients with chronic hepatitis C. To model the molecular mechanisms behind this phenotype, we characterized the effects of ethanol on Jak-Stat and MAPK pathways in Huh7 human hepatoma cells, in HCV replicon cell lines, and in primary human hepatocytes. High physiological concentrations of acute ethanol activated the Jak-Stat and p38 MAPK pathways and inhibited HCV replication in several independent replicon cell lines. Moreover, acute ethanol induced Stat1 serine phosphorylation, which was partially mediated by the p38 MAPK pathway. In contrast, when combined with exogenously applied IFN-α, ethanol inhibited the antiviral actions of IFN against HCV replication, involving inhibition of IFN-induced Stat1 tyrosine phosphorylation. These effects of alcohol occurred independently of i) alcohol metabolism via ADH and CYP2E1, and ii) cytotoxic or cytostatic effects of ethanol. In this model system, ethanol directly perturbs the Jak-Stat pathway, and HCV replication. Infection with Hepatitis C virus is a significant cause of morbidity and mortality throughout the world. With a propensity to progress to chronic infection, approximately 70% of patients with chronic viremia develop histological evidence of chronic liver diseases including chronic hepatitis, cirrhosis, and hepatocellular carcinoma. The situation is even more dire for patients who abuse ethanol, where the risk of developing end stage liver disease is significantly higher as compared to HCV patients who do not drink 12. Recombinant interferon alpha (IFN-α) therapy produces sustained responses (ie clearance of viremia) in 8–12% of patients with chronic hepatitis C 3. Significant improvements in response rates can be achieved with IFN plus ribavirin combination 456 and pegylated IFN plus ribavirin 78 therapies. However, over 50% of chronically infected patients still do not clear viremia. Moreover, HCV-infected patients who abuse alcohol have extremely low response rates to IFN therapy 9, but the mechanisms involved have not been clarified. MAPKs play essential roles in regulation of differentiation, cell growth, and responses to cytokines, chemokines and stress. The core element in MAPK signaling consists of a module of 3 kinases, named MKKK, MKK, and MAPK, which sequentially phosphorylate each other 10. Currently, four MAPK modules have been characterized in mammalian cells: Extracellular Regulated Kinases (ERK1 and 2), Stress activated/c-Jun N terminal kinase (SAPK/JNK), p38 MAP kinases, and ERK5 11. Interestingly, ethanol modulates MAPKs 12. However, information on how ethanol affects MAPKs in the context of innate antiviral pathways such as the Jak-Stat pathway in human cells is extremely limited. When IFN-α binds its receptor, two receptor associated tyrosine kinases, Tyk2 and Jak1 become activated by phosphorylation, and phosphorylate Stat1 and Stat2 on conserved tyrosine residues 13. Stat1 and Stat2 combine with the IRF-9 protein to form the transcription factor interferon stimulated gene factor 3 (ISGF-3), which binds to the interferon stimulated response element (ISRE), and induces transcription of IFN-α-induced genes (ISG). The ISGs mediate the antiviral effects of IFN. The transcriptional activities of Stats 1, 3, 4, 5a, and 5b are also regulated by serine phosphorylation 14. Phosphorylation of Stat1 on a conserved serine amino acid at position 727 (S727), results in maximal transcriptional activity of the ISGF-3 transcription factor complex 15. Although cross-talk between p38 MAPK and the Jak-Stat pathway is essential for IFN-induced ISRE transcription, p38 does not participate in IFN induction of Stat1 serine phosphorylation 1416171819. However, cellular stress responses induced by stimuli such as ultraviolet light do induce p38 MAPK mediated Stat1 S727 phosphorylation 18. In the current report, we postulated that alcohol and HCV proteins modulate MAPK and Jak-Stat pathways in human liver cells. To begin to address these issues, we characterized the interaction of acute ethanol on Jak-Stat and MAPK pathways in Huh7 cells, HCV replicon cells lines, and primary human hepatocytes.

La acreditación es el resultado de la aplicación de un sistema de autoevaluación y de evaluación externa, dirigido a reconocer públicamente que una institución o programa reúne determinados requisitos de calidad y se exponen algunas consideraciones sobre ello. Se revisaron los documentos básicos aprobados del Sistema de Evaluación y Acreditación de Especialidades de Postgrado de la República de Cuba, los que están constituidos por el Reglamento, el Patrón de Calidad y la Guía de Evaluación, considerando que durante muchos años las especialidades de postgrado han tenido como columna vertebral la actividad profesional en organismos como el Ministerio de Salud Pública. Se exponen algunos aspectos sobre cómo está preparándose la Universidad de Ciencias Médicas de Matanzas para realizar sus procesos de evaluación de la calidad y las diferentes especialidades que están en condiciones de realizar su autoevaluación y someterse al proceso de evaluación externa para logar ser acreditadas.

RESUMEN Introducción: el cuidado y preservación de la salud en los trabajadores es un factor clave para el incremento de la productividad, la sostenibilidad del trabajo realizado y el bienestar de todos sus empleados. El cultivo intensivo de la tilapia en Cuba es un proceso clave en la producción de alimentos saludables. Sin embargo, en esta actividad existen un conjunto de factores de riesgo que pueden provocar incidentes/accidentes laborales en las diferentes fases de su cultivo y que además pueden provocar enfermedades profesionales o comunes en los trabajadores involucrados. Objetivo: evaluar los factores de riesgos presentes en la actividad de cultivo intensivo de tilapia, desarrollada en una empresa pesquera. Materiales y métodos: e stán referidos a los tipos de investigación utilizados: exploratorios, descriptivos y explicativos. En cuanto a los métodos empíricos aplicados se incluyen la revisión bibliográfica, el método científico inductivo-deductivo y el análisis y la síntesis. Además de las herramientas propias del campo de investigación implicado (herramienta mapa del cuerpo y método binario de evaluación de riesgo). Resultados: s e identifican y evalúan los riesgos para la seguridad y salud de los trabajadores que laboran en el cultivo intensivo de la tilapia. Además, se identifican las principales dolencias en el cuerpo por la incidencia de las condiciones de trabajo y las tareas a desarrollar, considerando tres momentos: inicio, mediado y final de la jornada laboral. Se proponen las acciones preventivas a considerar para evitar problemas de salud, incidentes o accidentes laborales en función de las evaluaciones realizadas. Conclusiones: se destaca que el procedimiento utilizado y los resultados obtenidos constituyen una guía útil para las diferentes organizaciones que deseen conocer la incidencia que tienen los factores de riesgo encontrados en la salud de sus trabajadores, proponiendo un conjunto de medidas preventivas y correctivas para atenuar las situaciones desfavorables.