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La auditoría gubernamental es esencial para el desarrollo económico, la complejidad industrial y la globalización de la economía, ayudando a verificar y analizar el estricto cumplimiento de las recomendaciones producto de las auditorías anteriores, el trabajo se desarrolló con la finalidad de conocer los controles operacionales a través de la ejecución de la auditoría gubernamental, realizadas por el Gobierno Provincial de Manabí, a través del paradigma cualitativo haciendo énfasis en los informes de seguimiento y cumplimiento de las recomendaciones realizadas por la Dirección de Auditoría Interna en base a los exámenes especiales, en el cual se utilizó un diseño documental con fuentes primarias, leyes y reglamentos del Gobierno Provincial de Manabí junto con los informes aprobados encontrados en la Contraloría General del Estado, tomando como método aplicado el etnográfico el cual consistió en entrevistas a servidores inmersos en los procesos de auditorías y tiempo de control. En cuanto a las técnicas de recolección de información se desarrolló en base a las conclusiones y recomendaciones de los exámenes especiales e informes aprobado a lo cual el investigador toma como referencia la ponderación de rangos, cálculo de riesgo y niveles de confianza propuesta en el Manual General de Auditoría Gubernamental de la Contraloría General del Estado, se pudo obtener como resultado que la institución presente un nivel moderado en confianza y un nivel de riesgo bajo, pero aun así debe tomar precauciones en el área de Talento Humano, además no se realizan los respectivos seguimientos constantes que permita conocer las condiciones de la empresa.

La arquitectura es parte sustancial de toda sociedad; se logra a través de un proceso productivo que permite la gestación conceptual: proyectar, organizar y, finalmente, materializar, en nuestro caso, la ciudad de México-Tenochtitlan. De su seno ideológico surgió el fenómeno urbano-arquitectónico que tanto ha fascinado, no sólo por el breve periodo en que emergió —menos de doscientos años—, sino también por su trazo preciso, organización urbana e innegable majestuosidad. Pero no surgió de la nada, dada la carencia de espacio constructivo y materiales, los cuales debieron traerse de otros lugares. Fue un logro de ingeniería generar espacio urbano y productivo en un medio acuoso; guarda en sus restos valiosos secretos de audacias constructivas que aún están descubriéndose. El estudio de estos vestigios es parte fundamental del patrimonio cultural e histórico del país y expresión de la composición pluricultural de la Nación Mexicana.

Mexico present high rate of violence against women, which comes from the partner. The risk level assessment of intimate partner violence allows providing security measures to the victims and reducing the re-victimization. The aim was to validate the Severe Intimate Partner Violence Risk Prediction Scale (EPV-R) in the urban context of Chihuahua, Mexico. Methods. The scale was applied in 591 victims of violence, classified into two groups: severe and non-severe violence. An experts committee included three new items: psychological violence, economic violence and aggressor links with organized crime. The Internal consistency, the inter-observer concordance, the discriminative capacity of each of the items and the diagnostic efficacy were analyzed. All test were performed at the 95% of confidence level. Results. Adequate internal consistency (Cronbach's alpha of 0.79) and good agreement between inter-observers (Kappa coefficient 0.79, p < 0.001; Intraclass Correlation Coefficient = 0.96, p = 0.001) were found. Of all 23 items, 20 showed adequate association capacity between severe and non-severe violence groups (p < 0.05), five items presented high capacity, 6 items moderated capacity and 11 items showed low capacity, assigning them a value of 3, 2 and 1 points respectively. The total score mean of the scale was higher in severe group than non-severe group, 22.7 ± 5.9 vs 12.1 ± 7.2 respectively (t = 14.6, p = 0.001). After several cutoff scores tested, a value of 21 combine the best sensitivity, specificity and diagnostic efficacy of the instrument with 70%, 87% and 79% respectively; also, an AUC of 0.86 was found (p = 0.001). From this viewpoint, three levels of severe violence risk were determined: low (0-8), moderate (9-20) and high (20-36). Conclusion. The EPV-R is a reliable and valid instrument to estimate the risk of serious violence against the couple in the urban context of Chihuahua, Mexico.

La presente investigación se basó en el estudio de la contribución significativa que brindan las microempresas en la zona norte de la provincia de Manabí, considerando los cantones Bolívar, Chone, El Carmen, Flavio Alfaro, Tosagua, Jama, Pedernales, San Vicente y Sucre, con el análisis comparativo de las variables ingresos, cantidad de entidades y número de empleados de las empresas según su tamaño, principalmente la comparación relevante entre las microempresas y las grandes empresas, aplicando métodos teóricos de análisis de la información encontrada en las diferentes publicaciones de artículos científicos ubicados en revistas de alta valía científica, así como también la elaboración de tablas con información cuantitativa cuya fuente fueron las entidades de control que manejan información de tipo pública para rendición de cuentas, teniendo como principal resultado, que las microempresas contribuyen significativamente al dinamismo económico por algunos aspectos, dentro de ellos la generación de plazas de trabajo a diferentes tipos de empleados, justificadas por las diversas actividades que desarrollan las microempresas. Como conclusión, las microempresas contribuyen significativamente al dinamismo económico de la zona norte de la provincia de Manabí, porque supera en número a las grandes empresas y en gran medida, supera en diversidad de actividades que desarrollan y sobretodo porque la cantidad de empleados brinda la oportunidad a diferentes personas, con diferentes competencias, destrezas y habilidades para desarrollar productos y ofrecer servicios con la principal finalidad que es contribuir a la satisfacción de los consumidores.

Se revisaron los métodos terapéuticos empleados para enfrentar los diferentes brotes de matlazahuatl en el siglo XVIII, a partir de cuatro escritos novohispanos de ese periodo. La medicina de la Ilustración, en vías de su desarrollo moderno, no influía aún en las prácticas médicas en la Nueva España, según se observa en los recursos paliativos y curativos empleados, así como en su eficacia, a la luz de los testimonios recabados. La literatura médica y otros textos generados en esa época, describen la sintomatología y asignan diversos términos que oscurecen la identificación del matlazahuatl, factores que se han considerado en este trabajo al examinar el fenómeno epidémico.

La música andalusí y árabe forman parte de la cultura de miles de personas que habitan en España, lo cual permite un enriquecimiento cultural de todos. En este artículo, presentamos una propuesta metodológica para la impartición de estos estilos musicales en la etapa de Bachillerato para estudiantes entre los 15 y los 17 años, con la que pretendemos ofrecer conocimientos específicos de música andalusí y árabe. A través de su aprendizaje y comprensión, esperamos que los adolescentes logren incrementar los niveles de interculturalidad entre ellos. El artículo incluye una sucesión de actividades además de los objetivos que se persiguen, la metodología que puede ser utilizada para su enseñanza y una propuesta de evaluación., Andalusian and Arabic music are part of the culture of thousands of people living in Spain, allowing their cultural enrichment. In this paper, we present a methodological proposal for the teaching of these musical styles in Secondary education for students between 15 and 17 years old, to whom we intend to offer the specific knowledge of Andalusian and Arabic music. Through their learning and understanding, we hope that adolescents can increase the levels of interculturality between them. The article includes a series of activities and the objectives pursued by them, the teaching methodology and an assessment proposal.

Background: The knowledge of predictive factors in depression should help to deal with the disease. Aim: To assess potential predictors of remission of major depressive disorders (MDD) in secondary care and to propose a predictive model. Material and methods: A 12 month follow-up study was conducted in a sample of 112 outpatients at three psychiatric care centers of Chile, with baseline and quarterly assessments. Demographic, psychosocial, clinical and treatment factors as potential predictors, were assessed. A clinical interview with the checklist of DSM-IV diagnostic criteria, the Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results: The number of stressful events, perceived social support, baseline depression scores, melancholic features, time prior to beginning treatment at the secondary level and psychotherapeutic sessions were included in the model as predictors of remission. Sex, age, number of previous depressive episodes, psychiatric comorbidity and medical comorbidity were not significantly related with remission. Conclusions: This model allows to predict depression score at six months with 70% of accuracy and the score at 12 months with 72% of accuracy.

Background: Depression is considered the second leading cause of disability worldwide. Aim: To describe the clinical characteristics and the evolution of major depressive disorder (MDD) in secondary care. To evaluate the association between socio-demographic and clinic variables with the first or recurrent major depressive events (MDE). Material and Methods: Clinical features, treatment, remission and duration of MDE were evaluated during a follow up lasting 12 months in 112 participants aged 44 ± 15 years (79% women). Patients were assessed as outpatients every three months at three psychiatric care centers of Chile. Clinical interviews were carried out using DSM-IV diagnostic criteria checklists and the Hamilton Depression Scale was applied. Results: Most patients were referred from primary care. The mean time lapse for referral to the secondary level was 10.8 months. Most patients had episodes that were recurrent, severe, with a high rate of psychosis, with suicide attempts and melancholic features and with psychiatric and medical comorbidities. Remission rate was 27.5%. In only 16 % of patients, the episode lasted six months or less. The group with recurrent episodes had different age, sex and clinical features. Conclusions: MDD treated at the secondary care level is severe and its symptoms are intense. The time lapse prior to referral was prolonged. Primary care management and referral of these patients should be studied more closely.

La investigación tuvo como objetivo fundamental determinar el contenido de β – glucanos presentes en el almidón nativo de la fruta pan (Artocarpus altilis) cultivado en la costa sur del Ecuador y su potencial uso en alimentos funcionales. El almidón fue obtenido utilizando el método húmedo, y para la determinación del contenido de β-glucanos, se sometió la muestra a un ataque enzimático de β-glucosidasa, para posteriormente, cuantificar la glucosa por técnicas de espectrofotometría UV visible, a una longitud de onda de 510 nm. El porcentaje de almidón presente en el cultivar de fruta pan fue de 55,40 %, y el contenido en β-glucanos de 4,39 %, este valor reportado es superior a los que presentan algunos cereales como la avena, cebada, centeno, trigo, entre otros, muy utilizados en la industria de alimentos. El contenido de β-glucanos, presentes en el almidón nativo de la fruta pan, convierten a este cultivar, en una atractiva fuente amilácea a ser considerada, como matriz o insumo, en la elaboración de alimentos funcionales o nutracéuticos.ABSTRACTThe main objective of the research was to determine β – glucans content present in native starch from breadfruit (Artocarpus altilis) cultivated in Ecuador southern coast and its potential use in functional foods. The starch was obtained throughout the wet method; the sample was subjected to β-glucosidase enzymatic action to determine β-glucan content; glucose content was then quantified through visible UV spectrophotometry techniques at a wavelength of 510 nm. The starch percentage present in the breadfruit cultivar was 55.40%, whereas the β-glucan content was 4.39%. This value reported is higher than those reported previously for some cereals such as oats, barley, rye, wheat, among others, widely used in the food industry. The β-glucans content, present in native starch of breadfruit, makes this cultivar an interesting source of starch to be considered, as a matrix or input, in the manufacturing of nutraceuticals or functional foods.

Background The knowledge of predictive factors in depression should help to deal with the disease. Aim To assess potential predictors of remission of major depressive disorders (MDD) in secondary care and to propose a predictive model. Material and Methods A 12 month follow-up study was conducted in a sample of 112 outpatients at three psychiatric care centers of Chile, with baseline and quarterly assessments. Demographic, psychosocial, clinical and treatment factors as potential predictors, were assessed. A clinical interview with the checklist of DSM-IV diagnostic criteria, the Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results The number of stressful events, perceived social support, baseline depression scores, melancholic features, time prior to beginning treatment at the secondary level and psychotherapeutic sessions were included in the model as predictors of remission. Sex, age, number of previous depressive episodes, psychiatric comorbidity and medical comorbidity were not significantly related with remission. Conclusions This model allows to predict depression score at six months with 70% of accuracy and the score at 12 months with 72% of accuracy.

Depression is considered the second leading cause of disability worldwide.To describe the clinical characteristics and the evolution of major depressive disorder (MDD) in secondary care. To evaluate the association between socio-demographic and clinic variables with the first or recurrent major depressive events (MDE).Clinical features, treatment, remission and duration of MDE were evaluated during a follow up lasting 12 months in 112 participants aged 44 ± 15 years (79% women). Patients were assessed as outpatients every three months at three psychiatric care centers of Chile. Clinical interviews were carried out using DSM-IV diagnostic criteria checklists and the Hamilton Depression Scale was applied.Most patients were referred from primary care. The mean time lapse for referral to the secondary level was 10.8 months. Most patients had episodes that were recurrent, severe, with a high rate of psychosis, with suicide attempts and melancholic features and with psychiatric and medical comorbidities. Remission rate was 27.5%. In only 16 % of patients, the episode lasted six months or less. The group with recurrent episodes had different age, sex and clinical features.MDD treated at the secondary care level is severe and its symptoms are intense. The time lapse prior to referral was prolonged. Primary care management and referral of these patients should be studied more closely.

Shigella spp. are responsible for bacillary dysentery in humans. The acquisition or the modification of the virulence plasmid encoding factors promoting entry of bacteria into and dissemination within epithelial cells was a critical step in the evolution of these bacteria from their Escherichia coli ancestor(s). Incorporation of genomic islands (GI) and gene inactivation also shaped interactions between these pathogens and their human host. Sequence analysis of the GI inserted next to the leuX tRNA gene in S. boydii, S. dysenteriae, S. flexneri, S. sonnei and enteroinvasive E. coli (EIEC) suggests that this region initially carried the fec, yjhATS and fim gene clusters. The fim cluster encoding type I fimbriae is systematically inactivated in both reference strains and clinical isolates and distinct mutations are responsible for this inactivation in at least three phylogenetic groups. To investigate consequences of the presence of fimbriae on the outcome of the interaction of Shigella with host cells, we used a S. flexneri strain harboring a plasmid encoding the E. coli fim operon. Production of fimbriae by this recombinant strain increased the ability of bacteria to adhere to and enter into epithelial cells and had no effect on their ability to disseminate from cell to cell. The observations that production of type I fimbriae increases invasion of epithelial cells and that independent mutations abolish fimbriae production in Shigella suggest that these mutations correspond to pathoadaptive events.

Antibiotic-associated diarrhea is one of the most common adverse effects of antimicrobials. Any antimicrobial can potentially produce diarrhea but beta-lactamics have a higher risk. Among these, amoxicillin is widely indicated in ambulatory practice. One of the alternatives suggested to prevent antibiotic-associated diarrhea, is the use of the probiotic Saccharomyces boulardii.To evaluate whether the concomitant use of Saccharomyces boulardii and amoxicillin can prevent antibiotic associated diarrhea in ambulatory adults with acute infections diseases, without provoking other adverse effects.Eighty six adults (aged 15 to 81 years) with acute infectious diseases, excluding those arising in the gastrointestinal tract, that received a prescription of oral amoxicillin for 5 to 10 days, were included. In a controlled randomized, double blind trial, 41 patients were assigned to receive lyophilized Saccharomyces boulardii (500 mg/day) during 12 days, and 45 patients were assigned to placebo for the same period.Ten percent of patients (9/86) reported acute diarrhea, 9,8% (4/41) in the experimental group and 11.196 (5/45) in the control group (p = 100). No adverse effects were associated to the use of the probiotic.Saccharomyces boulardii (500 mg/day) did not prevent diarrhea related to amoxicillin.

Background: Antibiotic-associated diarrhea is one of the most common adverse effects of antimicrobials. Any antimicrobial can potentially produce diarrhea but beta-lactamics have a higher risk. Among these, amoxicillin is widely indicated in ambulatory practice. One ofthe alternatives suggested to prevent antibiotic-associated diarrhea, is the use of the probiotic Saccharomyces boulardii. Aim: To evalúate whether the concomitant use of Saccharomyces boulardii and amoxicillin can prevent antibiotic associated diarrhea in ambulatory adults with acute infections diseases, without provoking other adverse effects. Material and Methods: Eighty six adults (aged 15 to 81 years) with acute infectious diseases, excluding those arising in the gastrointestinal tract, that received a prescription of oral amoxicillin for 5 to 10 days, were included. In a controlled randomized, double blind trial, 41 patients were assigned to receive lyophilized Saccharomyces boulardii (500 mg/day) duríng 12 days, and 45 patients were assigned to placebo for the same period. Results: Ten percent of patients (9/86) reported acute diarrhea, 9,8% (4/41) in the experimental group and 11.196 (5/45) in the control group (p = 100). No adverse effects were associated to the use of the probiotic. Conclusions: Saccharomyces boulardii (500 mg/day) did not prevent diarrhea related to amoxicillin.

Atypical antipsychotics are widely used in psychotic disorders, refractory to conventional neuroleptic agents. They induce minimal extra pyramidal side effects, probably due to their greater affinity for certain dopaminergic receptors. However, this polyreceptor affinity may be responsible for the development of other side effects. We report a 48 years old male drinker and addicted to cocaine, that after two months of Olanzapine use, developed a severe diabetes mellitus with fasting blood glucose values reaching 514 mg/dl. When he was admitted to the hospital, physical examination was normal and his body mass index was 28 kg/m2. Olanzapine was discontinued and blood glucose values gradually returned to normal. After two months of follow up, the patient is on dietary treatment and with a fasting glucose of 132 mg/dl (Rev Méd Chile 2001; 129: 1183-85)

Chronic administration of epinephrine to adult male rats resulted in a significant increase in the rate of ethanol elimination, when given alone or together with the beta-adrenergic blocker alprenolol. This effect was observed concomitantly with an increased hepatic oxygen utilization and no changes in mitochondrial respiratory functions. Epinephrine given acutely did not modify the rate of ethanol metabolism. Blood glucose levels were enhanced in these conditions, but were unaffected in rats treated with epinephrine plus alprenolol. These results suggest that chronic epinephrine treatment induces an increased oxidative capacity in the liver characterized by enhanced rates of oxygen uptake and ethanol metabolism, which is not related to its beta-adrenergic actions.

Glucose intolerance is frequently found in alcoholic patients and an impaired insulin response has been documented in them. To look for alternative mechanisms that could explain this intolerance, a glucose turnover using tritiated glucose and an euglycemic glucose clamp were performed to measure the glucose production rate and peripheral insulin sensitivity, respectively. Two groups of recently abstinent chronic male alcoholic patients without evidence of liver damage were studied. The glucose turnover technique showed a higher basal glucose production rate in alcoholics, compared with normal volunteers (2.83 +/- 0.29 vs. 1.84 +/- 0.22 mg/kg/min); an intravenous ethanol load significantly increased this rate. The euglycemic glucose clamp did not show peripheral insulin resistance in alcoholics, compared with controls.