Abstract Urban ecosystems could jeopardize the existence of vascular epiphytes (VE) given that their occurrence is linked to phorophyte availability and particular climatic conditions. Despite reports of VE in cities, nothing is known about their demography. A first step in this direction is to describe their population structures (PS). We established the PS of VE present in urban parks in Oaxaca City (Mexico), addressing the following questions: 1) what is their demographic status? and 2) are there differences in the structure of populations growing in native versus exotic phorophytes? During 2021, we censused all the trees in six urban parks, recording their origin (native or exotic), the epiphytic species found on them and the development stages present in each VE population. Overall, five VE species were documented: Tillandsia ionantha, T. makoyana, T. sp., T. schiedeana and T. recurvata (Bromeliaceae); the first three with only one individual and the latter two with 95 and 5,694, respectively. A MANOVA test indicated significant differences in PS between T. recurvata (type I structure, suggesting a growing population) and T. schiedeana (type III structure, suggesting a senile population) (Wilkes' λ= 0.821, F-Radio= 11.96 P<0.001). PS showed no differences related to tree origin. Our results indicate that it is necessary to conduct demographic studies to have a more accurate idea of the current condition of vascular epiphytes in cities. For instance, even though we found five VS species, only one of them seems to have viable populations in Oaxaca city.

Resumo Ecossistemas urbanos podem comprometer a existência de epífitas vasculares (EV), dado que sua ocorrência está ligada à disponibilidade de forófitos e condições climáticas particulares. Apesar dos relatos de EV nas cidades, nada se sabe sobre sua demografia. Um primeiro passo nessa direção é descrever suas estruturas populacionais (PS). Estabelecemos o PS dos EV presentes nos parques urbanos da cidade de Oaxaca (Mexico), abordando as seguintes questões: 1) qual é a sua situação demográfica? e 2) existem diferenças na estrutura das populações crescendo em forófitos nativos versus exóticos? Durante o ano de 2021, realizamos o censo de todas as árvores em seis parques urbanos, registrando sua origem (nativa ou exótica), as espécies epífitas encontradas nelas e os estágios de desenvolvimento presentes em cada população de EV. Ao todo, cinco espécies de EV foram documentadas: Tillandsia ionantha, T. makoyana, T. sp, T. recurvata e T. schiedeana; as três primeiras com apenas um indivíduo e as duas últimas com 5.694 e 95, respectivamente. Um teste MANOVA indicou diferenças significativas no PS entre T. recurvata (estrutura tipo I, sugerindo uma população crescente) e T. schiedeana (estrutura tipo III, sugerindo uma população senil) (Wilkes' λ= 0,821, F-Radio= 11,96 e P < 0,001). PS não apresentou diferenças relacionadas à origem da árvore. Os resultados do presente trabalho indicam a necessidade de se realizar estudos demográficos para se ter uma ideia mais precisa da condição atual das epífitas vasculares nas cidades. Embora tenhamos encontrado cinco espécies de VS, apenas uma delas parece ter populações viáveis na cidade de Oaxaca.

Abstract Hantavirus infection is an endemic zoonosis in Chile, with an average lethality of around 36%. The highest lethality (60%) was recorded in 1997. Prevention strategies have been applied since then. Early diagnosis and technologies, such as the use of ECMO (Extracorporeal Membrane Oxygenation) and Hantavirus immune plasma, have contributed to increasing the survival of people due to this disease at the national level. In the newly created Region of Ñuble in Chile, the incidence and lethality of Hantavirus cases are unknown; therefore, the objective of this research is to describe the epidemiological profile of Hantavirus cases in the Region of Ñuble, Chile from 2002 to 2018. This knowledge contributes to substantiating and justifies the need to invest in technology and reinforce interventions related to the early diagnosis and prevention of this disease in the region. Cases reported in the Ñuble region during the period 2002-2018, extracted from the Epidemiological Survey of Environmental Research of Hantavirus cases of the Ministry of Health of Chile, were analyzed retrospectively. The epidemiological profile of the Ñuble region is very similar to the national one in terms of characterizing the individual suffering from the disease. The most affected population is young men, residents in rural areas, and mainly from a low socioeconomic segment. The regional profile of Hantavirus cases makes it possible to identify three communes with the highest number of cases: El Carmen, Coihueco, and San Carlos. A political-administrative response is expected to focus on and optimize strategies and resources to reduce the incidence and lethality of this pathology in the Ñuble region.

Resumo A infecção por hantavírus é uma zoonose endêmica no Chile, com letalidade média em torno de 36%. A maior letalidade (60%) foi registrada em 1997. Estratégias de prevenção vêm sendo aplicadas desde então. O diagnóstico precoce e tecnologias como o uso de ECMO (Extracorporeal Membrane Oxygenation) e plasma imune ao Hantavírus, têm contribuído para aumentar a sobrevida das pessoas por esta doença em nível nacional. Na recém-criada Região de Ñuble no Chile, a incidência e letalidade dos casos de Hantavírus são desconhecidas; portanto, o objetivo desta pesquisa é descrever o perfil epidemiológico dos casos de Hantavírus na Região de Ñuble, Chile de 2002 a 2018. Esse conhecimento contribui para fundamentar e justificar a necessidade de investir em tecnologia e reforçar as intervenções relacionadas ao diagnóstico precoce e prevenção desta doença na região. Os casos notificados na região de Ñuble durante o período 2002-2018, extraídos do Inquérito Epidemiológico de Pesquisa Ambiental de casos de Hantavírus do Ministério da Saúde do Chile, foram analisados retrospectivamente. O perfil epidemiológico da região de Ñuble é muito semelhante ao nacional no que diz respeito à caracterização do indivíduo acometido pela doença. A população mais afetada são homens jovens, residentes em áreas rurais e, principalmente, de um segmento socioeconômico baixo. O perfil regional dos casos de Hantavírus permite identificar três municípios com maior número de casos: El Carmen, Coihueco e San Carlos. Espera-se uma resposta político-administrativa que enfoque e otimize estratégias e recursos para reduzir a incidência e letalidade desta patologia na região de Ñuble.

Resumen Antecedentes: Las poblaciones de Magnolia pugana están disminuyendo, asimismo la precipitación disminuirá 10 % y la temperatura aumentará (2-4 °C) en su área de distribución, de acuerdo al escenario de cambio climático más severo, lo que puede comprometer su germinación. Hipótesis: La interacción del aumento de temperatura y disminución del potencial hídrico reduce y retrasa la germinación de Magnolia pugana. Especie de estudio: Magnolia pugana, endémica del occidente de México, en peligro de extinción. Sitio y año de estudio: Sur de Zacatecas y centro de Jalisco, México. Abril, 2019. Materiales y métodos: Se evaluó la viabilidad de semillas con la prueba de tetrazolio. Se analizó el efecto de temperatura (24, 28 y 37 °C), potencial hídrico (con PEG 8000) (0, -0.3, -0.6, -0.9, -1.2 MPa) y su interacción sobre porcentaje y tiempo medio de germinación, con ANOVA factoriales. Resultados: La viabilidad fue 80 %. Las interacciones entre temperatura y potencial hídrico sobre porcentaje y tiempo medio de germinación fueron significativas. No hubo germinación a 37 °C. El porcentaje de germinación más alto (78 %) se produjo a 24 °C y -0.3 MPa, el menor (3 %) a 28 °C y -0.6 MPa. A 24 °C y 0 MPa germinaron en menor tiempo (23.9 ± 1.5 días), a 28 °C y -0.9 MPa se retrasó 1.5 veces. Conclusiones: La interacción entre bajo potencial hídrico y aumento de temperatura redujo la germinabilidad de Magnolia pugana, condiciones previstas por futuros escenarios de cambio climático, con esto su vulnerabilidad a la extinción podría aumentar.

Abstract Background: Magnolia pugana populations are declining, in addition, it is estimated that precipitation will decrease by up to 10 % and temperatures will increase (2-4 °C) under the most severe climate change scenario, which may affect germination. Hypotheses: The interaction of increased temperature and decreased water potential reduces and delays the germination of Magnolia pugana seeds. Studied species: Magnolia pugana, an endangered species endemic to western Mexico. Study site and dates: Southern Zacatecas and central Jalisco, Mexico. April 2019. Materials and methods: Seed viability was evaluated with tetrazolium test. In addition, the effects of temperature (24, 28, and 37 °C), water potential with PEG 8000 (0, -0.3, -0.6, -0.9, -1.2 MPa) and its interaction on the percentage and mean germination time were analyzed with factorial ANOVA tests. Results: Viability was 80 %. The interactions between temperature and water potential on germination percentage and mean germination time were significant. There was no germination at 37 °C. The highest germination (78 %) was at 24 °C and -0.3 MPa, while the lowest (3 %) was at 28 °C and -0.6 MPa. The control treatment (24 °C and 0 MPa) facilitated germination in a shorter time (23.9 ± 1.5 days). At 28 °C and -0.9 MPa, the mean germination time was slowed by 1.5 times. Conclusions: Magnolia pugana germinability was reduced by the interaction between low water potentials and increased temperature, conditions predicted by future climate change scenarios, therefore its vulnerability to extinction could increase.

ABSTRACT This study aimed to examine the prevalence of intestinal parasites in children and domestic animals from two peri-urban neighborhoods in Corrientes, Argentina. We also evaluated the characteristics of humans, socio-environmental features, and hygiene practices associated with the presence of parasites. Fecal samples were examined using techniques of concentration by sedimentation and flotation. The Graham method was used to diagnose Enterobius vermicularis eggs in children. We carried out the univariate and bivariate analysis of the data. We analyzed 58 dwellings, from which we obtained 146 stool samples from children and 101 from animals. We found at least one parasite species in 54 dwellings (93.1%). We found that 52.7% of children had parasites, mainly Blastocystis spp. (35.6%) and Giardia spp. (21.2%). We found that 67.32% of the animals had parasites, the most prevalent species being hookworms (60.7%). In conclusion, it is evident that the domestic environment can favor the transmission of these parasites.

RESUMEN El objetivo de este estudio fue examinar la prevalencia de parásitos intestinales de niños y animales domésticos en dos barrios periurbanos de la ciudad de Corrientes, Argentina. También evaluamos las características de los humanos, factores socio-ambientales y prácticas de higiene asociadas con la presencia de parásitos. Las muestras fecales fueron examinadas usando técnicas de concentración por sedimentación y flotación. Se detectaron huevos de Enterobius vermicularis en niños utilizando el método de Graham. El análisis de los datos fue univariado y bivariado. En total, 58 viviendas fueron evaluadas, de las cuales se obtuvieron 146 muestras de heces de niños y 101 muestras de animales. Se registró al menos una especie de parásito en 54 viviendas (93,1%). Encontramos parásitos en el 52,7% de los niños, principalmente los protozoos Blastocystis spp. (35,6%) y Giardia spp. (21,2%). Se detectaron parásitos en 67,32% de los animales, principalmente ancilostomídeos (60,7%). En conclusión, es evidente que el ambiente doméstico presenta condiciones favorables para la transmisión de estos parásitos.

Resumen Introducción: El cáncer de mama (CaMa) es el tipo de cáncer con una alta tasa de mortalidad y su diagnóstico oportuno, permitiría una mayor probabilidad de sobrevivencia. Actualmente hay diversos procedimientos para su detección, sin embargo, una posible alternativa no invasiva mediante la detección de compuestos orgánicos volátiles (COV) en el aliento (exhalómica) de las pacientes se está explorando. Métodos: Se realizó una revisión sistemática (hasta junio de 2022) de publicaciones sobre la detección mediante cromatografía de gases de COV en el aliento de mujeres con mama sana, con lesiones benignas o invasoras y en líneas celulares, para buscar potenciales oncometabolitos. Resultados: Existe una gran heterogeneidad de COV (principalmente alcanos) en las pacientes analizadas, además de diferencias entre las distintas poblaciones. Discusión: Aun cuando hay detección de COV exhalados, es necesario un mayor número de estudios. De manera interesante, un grupo de COV son compartidos con otros tipos de cáncer. Conclusiones: Al momento, no se conoce el perfil de COV exhalados asociados con certeza al paciente de CaMa.

Abstract Background: Breast cancer (BrCa) present a highest mortality rate, and its early diagnosis could improve the survival of the patient. At present, there are leading tests used for BrCa detection, but a novel alternative, non-invasive test, such as breath analysis (exhalomic) of volatile organic compounds (VOC) are being taken into consideration. Methods: A systematic review (until June 2022) about VOC detection from breath by using gas chromatography was performed. The goal was to identify probable oncometabolites in the gas sample from healthy breast tissue women, benign or malignant lesions, and including cultured cell lines. Results: There are a complex heterogeneity of exhaled VOC mainly alkanes in the analyzed samples, and between the different populations. Discussion: Even when exhaled VOC are detected, some more works should be performed to have conclusions. Interestingly some VOC are shared with other cancer types. Conclusions: Nowadays, there is no specific BrCa VOC-profile associated for BrCa or benign lesions diagnosis.

ABSTRACT The conservation of forage as silage allows its application during the dry season in dairy cattle feeding. The most commonly used forage for this purpose is maize (Zea mays L.), but due to the possible effects of climate change, the diversification of crops with shorter agronomic cycles as wheat (Triticum aestivum L.) should be considered. Therefore, the objective was to evaluate the chemical composition of silages, the productive response of dairy cows fed wheat and maize silage, as well as their feeding costs. Three treatments were evaluated with 9.8 kg DM cow-1 d-1 silage plus 4.6 kg DM cow-1 d-1 commercial concentrate each. Treatments were 100% wheat silage (WS), 50% wheat silage-50% maize silage (WMS), and 100% maize silage (MS). Six Holstein cows were used in groups of three randomly assigned to treatment sequence in a 3×3 Latin square design repeated twice. There were significant differences (P < 0.05) between treatments in silage chemical composition, except in NDF and ADF (P > 0.05). There were nonsignificant differences in animal variables (P > 0.05) with mean milk yield of 15.4 kg cow-1 d-1, 33.7 g kg-1 milkfat, 30.5 g kg-1 milk protein, 481.2 kg live weight and 2.1 body condition score. There were significant differences (P < 0.05) in silage and total DM intake in the third experimental period (three periods, 14 d each one) with 8.1 and 12.7 kg DM cow-1 d-1, respectively. Although cost for wheat silage were higher than maize silage, all three treatments showed positive margins on feeding costs.

Resumen Introducción: La monoartritis aguda (MA) represen ta una causa relevante de morbilidad que requiere de atención médica oportuna: El estudio del líquido sino vial constituye un elemento clave para su diagnóstico. El objetivo del estudio fue determinar la frecuencia y características clínicas-analíticas de los episodios de MA y bursitis agudas valoradas en un hospital durante un período de 6 años. Métodos: Estudio analítico retrospectivo de corte transversal en un hospital de Córdoba, Argentina. Se identificaron todos los episodios de monoartritis y bur sitis agudas que ocurrieron en pacientes de ≥18 años entre 2012 y 2017. Se excluyeron los cuadros de MA en embarazadas y las monoartritis crónicas. Resultados: Se incluyeron 180 episodios de MA y 12 de bursitis aguda. Entre las MA, 120 (66.7%) ocurrieron en hombres, la edad promedio fue 62.1±16.9 años. La principal causa de MA fue séptica, identificándose 70 (36%) casos, seguida la secundaria a microcristales con 54 episodios (28%) que correspondieron 27 (14%) a MA por gota y 27 (14%) a MA por depósitos de pirofosfato de calcio dihidratado (CPPD). Se identificaron cristales de urato monosódico en 26 (14.3%) pacientes, CPPD en 28 (15.6%) y de colesterol en 1 (0.6%). Discusión: La principal causa de MA fue séptica, seguida de la secundaria a microcristales (gota y secun daria a CPPD). La principal articulación afectada fue la rodilla, seguida del hombro. El análisis del líquido sino vial fue un elemento clave a la hora de poder realizar el diagnóstico diferencial entre las distintas causas de monoartritis aguda y bursitis.

Abstract Introduction: Acute monoarthritis (AM) represents a relevant cause of morbidity that requires prompt medical care. The study of synovial fluid becomes re levant to allow a rapid diagnostic approach. The main objective of the study was to determine the frequency and clinical-analytical characteristics of episodes of AM and acute bursitis evaluated in a hospital during a period of 6 years. Methods: Cross-sectional retrospective analytical study in a hospital at Córdoba, Argentina. All episodes of acute monoarthritis and bursitis that occurred in patients aged 18 years or older between 2012 and 2017 were included. AM in pregnant women and chronic monoarthritis were excluded. Results: One hundred and eighty episodes of AM and 12 of acute bursitis were included. Among the AM, 120 (66.7%) occurred in male patients and the average age was 62.1±16.9 years. The main cause of AM was septic, identifying 70 (36%) cases, followed by microcrystalline AM identify 54 (28%) cases, which corresponded to gout and calcium pyrophosphate dihydrate (CPPD) with 27 (14%) cases each one. Monosodium urate crystals were identified in 26 (14.3%) patients, CPPD in 28 (15.6%) and cholesterol in 1 (0.6%). Discussion: The main cause of AM was septic arthri tis, followed by microcrystalline AM (gout and secondary to CPPD). The main affected joint was the knee, followed by the shoulder. Synovial fluid analysis was a key ele ment when making the differential diagnosis between the different causes of acute monoarthritis and bursitis.

Resumen Objetivo: Describir aspectos clínicos, microbiológicos y ecocardiográficos de endocarditis en un grupo específico de pacientes sin dispositivos intracardiacos ni cardiopatía estructural subyacente. Método: Estudio retrospectivo en el que se revisaron expedientes clínicos y reportes ecocardiográficos durante el periodo de 1997 a 2020. Se aplicaron los criterios modificados de Duke. Se describió la muestra por edad, sexo, enfermedad sistémica, vegetaciones y agente microbiológico. Se excluyeron pacientes con cardiopatía estructural o Libman-Sacks. Análisis estadístico: univariado expresado en frecuencias, utilizando medidas de dispersión y tendencia central. Resultados: Se revisaron 30,000 reportes ecocardiográficos, de los cuales solo 1350 tenían como motivo de envío endocarditis infecciosa, y de estos se seleccionaron 248 casos. La edad promedio fue de 48.1 ± 16.7 años. Hubo 140 hombres (56%) y 108 mujeres (44%). El signo ecocardiográfico más frecuente fue la vegetación, en 278 (93.60%), y la ubicación más común fue mitral (35.55%), con un número mayor de casos en el ventrículo derecho de lo esperado. La enfermedad sistémica más común fue la enfermedad renal, en 135 (41.08%). Se identificó un caso de Streptococcus thoraltensis no reportado previamente en México. Conclusiones: La presencia de endocarditis infecciosa ha aumentado debido a procedimientos invasivos intrahospitalarios y fármacos. Por su complejidad, los equipos multidisciplinarios son indispensables.

Abstract Objective: To describe clinical, microbiological and echocardiographic aspects of endocarditis in a specific group of patients without intracardiac devices or underlying structural heart disease. Method: Retrospective study, clinical records and echocardiographic reports were reviewed during the period 1997 to 2020. Duke’s modified criteria were applied. Statistical analysis: univariate expressed in frequencies, using measures of dispersion and central tendency. Results: 30,000 echocardiographic reports were reviewed, only 1350 had infectious endocarditis as a reason for sending, of which 248 cases were selected. The mean age was 48.1 ± 16.7 years. 140 men (56%) and 108 women (44%). The most frequent echocardiographic sign was vegetation, in 278 (93.60%), and most common location was mitral (35.55%), with a higher number of cases in the right ventricle than expected. The most common systemic disease was kidney disease, in 135 (41.08%). A case of Streptococcus thoraltensis not previously reported in Mexico was identified. Conclusions: The presence of infectious endocarditis has increased due to invasive in-hospital and drug procedures. Due to their complexity, multidisciplinary teams are indispensable.

Peruvian companies' craft brick stands currently experience significant growth in sales. Thus brickyards seek to reduce the amount of waste to increase productivity and reduce cost overruns. In this study, the problem that has the greatest economic impact on a brick company is the excessive amount of waste. For this reason, the implementation of a model based on the Lean Six Sigma (LSS) methodology is proposed, applying Poka Yoke, Jidoka, Standardised Work, and Just in Time in order to reduce the number of defective bricks and cost overruns. The research project focused on the tambourine brick, the type whose percentage of generated waste is the highest in the production batch. To do this, the current situation was analysed; the main causes of the problem were identified and measured; and then Lean Six Sigma tools were used to attack the root cause. Finally, the proposed design reduced overheated bricks by 2.36%, wet bricks by 2.01%, and poorly stacked bricks by 1.8%, obtaining a 6.92% reduction in shrinkage and increasing the level of Six Sigma to 3.9, which contributed to the reduction of losses in the brickyard.

Tans ervaar Peruaanse handwerkbaksteenmaatskappye aansienlike groei in verkope. Daarom poog die steenwerwe om die hoeveelheid afval te verminder om produktiwiteit te verhoog en koste-oorskryding te verminder. In hierdie studie is die probleem wat die grootste ekonomiese impak vir die baksteenmaatskappy genereer die oormatige hoeveelheid afval. Om hierdie rede word die implementering van 'n model gebaseer op die Lean Six Sigma metodologie voorgestel, deur die toepassing van Poka Yoke, Jidoka, Standardised Work en Just in Time, met die doel om die aantal gebrekkige stene en koste-oorskryding te verminder. Die navorsingsprojek fokus op die tipe tamboerynsteen waarvan die persentasie afval wat gegenereer word die hoogste van sy produksiegroep is. Om dit te doen, is die huidige situasie ontleed, waar die hoofoorsake van die probleem geïdentifiseer en gemeet is, en daarna is Lean Six Sigma-instrumente gebruik om die hoofoorsaak aan te pak. Laastens verminder die voorgestelde ontwerp oorverhitte stene met 2.36%, nat stene met 2.01%, en swak gestapelde stene met 1.8%, wat 'n vermindering van 6.92% in krimping verkry en die vlak van Six Sigma tot 3.9 verhoog, wat bygedra het tot die vermindering van verliese in die baksteenwerf.

ABSTRACT The snail Trochita trochiformis is a mollusk captured on the coasts of Jalisco and Guerrero of the Mexican Pacific. Despite its importance in artisanal fisheries, information on its population parameters is still being determined. This research aimed to determine the diameter-weight relationship, sex ratio, cohorts, and growth of this species. Specimens were captured from October 2019 to September 2021. Shell diameter (Sd), total weight (TW), and the sex of the organisms were gathered from a total of 1763 females and 956 males. The sex ratio was 1.84:1, and the X2 test (P < 0.05) indicated significant differences. The Sd-Tw relationship for females and males was potential-type. The values of the allometry coefficient for both sexes were b = 2.61, b = 2.60 for females, and b = 2.62 for males. In all three cases, the t-Student test indicated negative allometric growth, which indicates that the species first grows in shell diameter, then in body weight. The ANCOVA did not show significant differences in the Sd-Tw relationships between sexes (P = 0.902). The Kolmogorov-Smirnov test applied to the Sd data showed differences between sexes (P < 0.001). In females, differences were observed in 71.5% by monthly comparisons, while in males, differences were found in 58.1%. Multinomial analysis showed three modal groups and 14 individual cohorts for both females and males. Case 2 of the Schnute model was the best for females (wi = 0.39) and males (wi = 0.53), showing sigmoidal Gompertz-type growth. The resulting growth curves showed that females exhibit accelerated growth concerning males and that both sexes reach their maximum size, 88.04 and 86.23 mm, respectively, at approximately 10 years of age.

RESUMEN Objetivos. Evaluar las comorbilidades asociadas a la mortalidad en pacientes adultos hospitalizados por COVID-19 de diferentes grupos de edad en hospitales de Lima y Callao. Materiales y métodos. En este estudio de cohorte retrospectiva analizamos datos de pacientes adultos hospitalizados por COVID-19, notificados al Sistema Nacional de Vigilancia Epidemiológica del Ministerio de Salud de Perú de marzo a octubre del 2020. Se estimaron riesgos relativos con intervalos de confianza al 95% mediante modelos de regresión de Poisson con varianza robusta para evaluar las comorbilidades asociadas a la mortalidad por grupos de edad: jóvenes (18-29 años), adultos (30-59 años) y mayores (≥60 años). Resultados. Se incluyeron 2366 jóvenes, 23781 adultos y 25356 adultos mayores en el análisis. Los adultos mayores presentaron la mortalidad más alta (63,7%) en comparación con adultos (27,1%) y jóvenes (8,5%). Independientemente del grupo de edad, la presencia de enfermedad neurológica, enfermedad renal, enfermedad hepática y cáncer se asoció a un mayor riesgo de mortalidad. Adicionalmente, la enfermedad cardiovascular fue también un factor de riesgo en los jóvenes; la obesidad, la diabetes, la enfermedad cardiovascular, la enfermedad pulmonar crónica y la inmunodeficiencia en los adultos; y la obesidad y la enfermedad pulmonar crónica en los mayores. Conclusiones: Independientemente de los grupos de edad, los individuos con enfermedad neurológica crónica, enfermedad renal, enfermedad hepática y cáncer tendrían un alto riesgo de morir por la COVID-19.

ABSTRACT Objectives. To evaluate comorbidities associated with mortality in adult patients hospitalized due to COVID-19 in hospitals in Lima and Callao. Materials and methods. In this retrospective cohort study, we analyzed data from adult patients hospitalized due to COVID-19 reported to the National Epidemiological Surveillance System of the Peruvian Ministry of Health from March to October 2020. We estimated relative risks with 95% confidence intervals using Poisson regression models with robust variance to assess comorbidities associated with mortality by age group: young adults (18-29 years), adults (30-59 years) and older adults (≥60 years). Results. We included 2366 young adults, 23,781 adults and 25,356 older adults. Older adults had the highest mortality (63.7%) compared to adults (27.1%) and young adults (8.5%). Regardless of age group, the presence of neurological disease, renal disease, liver disease, and cancer was associated with an increased risk of mortality. Additionally, cardiovascular disease was also a risk factor in young adults; obesity, diabetes, cardiovascular disease, chronic lung disease, and immunodeficiency in adults; and obesity and chronic lung disease in the elderly. Conclusions. Regardless of age groups, individuals with chronic neurologic disease, renal disease, liver disease, and cancer were at high risk of death from COVID-19.

Resumen Introducción: La colocación de catéteres intravasculares venosos umbilicales (CVU) y arteriales (CAU) es el procedimiento invasivo más frecuente en la unidad de cuidados intensivos neonatales (UCIN). Para introducirlos se utilizan las fórmulas de Wright y de Shukla, aunque esta última podría estar asociada con una inserción incorrecta, especialmente en neonatos < 1500 g. El objetivo de este estudio fue determinar mediante radiografía de tórax cuál fórmula es mejor para la correcta colocación de catéteres umbilicales en recién nacidos ≤ 1500 g. Métodos: Se incluyeron los pacientes ingresados en la UCIN de un hospital de segundo nivel entre 2021-2022 que recibieron CVU o CAU mediante las fórmulas de Wrigth o Shukla. Resultados: Se incluyeron en total 129 recién nacidos: 78 CVU y 51 CAU. En CVU, Wright 50% y Shukla 36.8% tuvieron localización correcta, p = 0.24. En las CAU, Wright 56.6% y Shukla 52.4% tenían una ubicación correcta, p = 0.76. En CVU con peso < 1000 g, Wright 36.4% y Shukla 33.3% bien situados, p = 0.58. En CVU > 1000 g, Wright 66.6% y Shukla 38.4% bien situados, p = 0.065. En CAU < 1000 g, Wright 45% y Shukla 42.9%, p = 0.63. En CAU con peso > 1000 g, Wright 80% y Shukla 57.1%, p = 0.23. Conclusiones: La colocación del CVU fue 13% mejor con la fórmula de Wright. La fórmula de Wright superó en el 29% la colocación del CVU en los neonatos > 1000 g en comparación con la de Shukla, aunque no hubo diferencia significativa debido al tamaño de la muestra.

Abstract Background: Intravascular venous (VUC) or arterial (AUC) umbilical catheter placement is the most frequent invasive procedure in the neonatal intensive care unit (NICU). Either Wright’s or Shukla’s formula is used to introduce the catheters. However, Shukla’s formula is associated with incorrect insertion, especially for newborns < 1500 g. This study aimed to determine by chest X-ray if Wright’s formula is better than Shukla’s formula for the correct placement of umbilical catheters in newborns ≤ 1500 g. Methods: We included patients admitted to the NICU of a secondary-level hospital between 2021-2022 who received VUC or AUC through the Wright or Shukla formulas. Results: A total of 129 newborns were included: 78 with VUC and 51 with AUC. In VUC, 50% with Wright and 36.8% with Shukla formulas had the correct location, (p = 0.24). In AUC, 56.6 % with Wright and 52.4% with Shukla formulas were placed correctly placed, (p = 0.76). VUC with weight < 1000 g were correctly placed in 36.4% with Wright and 33.3% with Shukla formulas (p = 0.58). VUC in newborns > 1000 g were correctly placed in 66.6% with Wright and 38.4% with Shukla formulas (p = 0.065). AUC in newborns < 1000 g were correctly placed in 45% using Wright and 42.9% Shukla formulas (p = 0.63). AUC in newborns > 1000 g were correctly placed in 80% using Wright and 57.1% Shukla formulas (p = 0.23). Conclusions: We found 13% more correctly placed VUC using Wright’s formula. Moreover, Wright’s formula was 29% above Shukla’s VUC placement in neonates > 1000 g, although there was no significant difference due to the sample size.

Resumen Objetivo: Evaluar las competencias logradas por estudiantes de medicina en la realización de una apendicectomía abierta y jareta en el modelo de simulación creado, evaluar el grado de satisfacción de su uso y determinar sus costos. Método: Estudio preexperimental de grupo único, prospectivo y longitudinal. Se evaluaron las competencias logradas por 24 alumnos de pregrado de medicina en la realización de una apendicectomía abierta y jareta en el simulador, mediante las pautas OSATS (Objective Structured Assessment of Technical Skills) a través de enseñanza virtual. Se realizó una encuesta a los alumnos para evaluar el simulador y se determinaron sus costos. Resultados: Hubo un incremento significativo en las pautas OSATS de las competencias logradas de 7 (pre-test) a 26 ± 5.71 puntos (pos-test final) (p = 0.0001) y una reducción del tiempo operatorio de 12 ± 3.81 minutos (primer pos-test) a 8 ± 2.02 minutos (pos-test final) (p = 0.0001). El 41% de los alumnos estuvieron totalmente satisfechos con los logros obtenidos y el 59% parcialmente satisfechos. El costo del simulador fue de 4.64 dólares americanos. Conclusiones: Los estudiantes lograron una mejora de sus competencias en la técnica quirúrgica. Este modelo de simulación es de bajo costo y presenta un nivel adecuado en la satisfacción de los logros obtenidos por los alumnos.

Abstract Objective: To evaluate the skills achieved by the undergraduate medical student in performing an open appendectomy and purse string in the simulation model created, to evaluate the degree of satisfaction of its use and to determine its costs. Method: Pre-experimental, prospective and longitudinal study. The skills achieved by 24 undergraduate medical students in performing an open appendectomy and purse string in the simulator were evaluated using the OSATS (Objective Structured Assessment of Technical Skills) through virtual teaching. A survey was conducted to the students to evaluate the simulator and its costs were determined. Results: There was a significant increase in the OSATS of the skills achieved, from 7 (pre-test) to 26 ± 5.71 points (final post-test) (p = 0.0001) and reduction in the operative time from 12 ± 3.81 minutes (first post-test) to 8 ± 2.02 minutes (final post-test) (p = 0.0001). 41% of the students were totally satisfied with the achievements obtained and 59% partially satisfied. The cost of the simulator was 4.64 USD. Conclusions: The students achieved an improvement in their skills in the surgical technique. This simulation model is low cost and presents an adequate level in the satisfaction of the achievements obtained by the students.

Resumen Objetivo: Analizar la alimentación habitual de los afromexicanos en el contexto de dos procesos históricos y el ejercicio regional de producción/poder. Metodología: Entrevistas y observación participante en dos regiones con historia de producción hacienda/ejido; referencias socioeconómicas, dieta de recordatorio de 24 horas, lactancia y alimentación complementaria. Resultados: Las listas de alimentos reflejan disponibilidad y biodiversidad, pero no acceso y consumo habitual. Quedaron identificados intersticios, espacios con mayor margen de libertad para la manifestación y desarrollo de una cultura alimentaria campesina. Limitaciones: La dieta de 24 horas fue de un día y el consumo fuera del hogar no fue considerado. Conclusiones: La condición sociohistórica de producción determina buena parte del sistema alimentario, con base en alimentos y técnicas reproducidos por la población indígena. Hay diferencias alimentarias regionales, sin embargo, en buena medida corresponde a la alimentación de las poblaciones campesinas. Los alimentos aportan suficiente energía/vitaminas y esta proviene principalmente del maíz, frijol, arroz y las verduras de color verde, blanca y roja.

Abstract Objective: To analyze the habitual food of Afro-Mexicans in the context of two historical processes and the regional exercise of production/power. Methodology: Interviews and participant observation in two regions with a history of hacienda/ejido production; socioeconomic references, 24-hour recall diet, breastfeeding, and complementary feeding. Results: The food lists reflect availability and biodiversity, but not access and habitual consumption. Interstices, spaces with a greater margin of freedom were identified for the manifestation and development of a peasant food culture. Limitations: The 24-hour diet was for one day and consumption outside home was not considered. Conclusions: The sociohistorical condition of production/power determines a major part of the food system, based on foods and techniques reproduced by the indigenous population. There are regional dietary differences, however, to a large extent it corresponds to the diet of rural populations. The food provides enough energy/vitamins, and this comes mainly from corn, beans, rice and green, white and red vegetables.

ABSTRACT Objectives: To determine the frequency of depression and anxiety among Latin American medical students during social distancing in the COVID-19 outbreak period. Methods: Observational, descriptive and cross-sectional design, the study included all Latin American medical students affiliated to the Federación Latinoamericana de Sociedades Científicas de Estudiantes de Medicina (FELSOCEM) selected through non-probabilistic convenience sampling who agreed to participate in the study. Data was collected through a questionnaire, consisting primarily of socio-demographic characteristics such as age, gender, marital status, and country of origin; as a second section, the Goldberg depression and anxiety test was applied, and an analysis was carried out by the nature of the variables. The research protocol was approved by an institutional ethics committee. Results: Of 1579 participating students, from 15 Latin American countries, 68.59% (1083) were women, 65.04% (1027) were between 20 and 24 years old, 95.63% (1510) were single, 23.18% (366) lived in Panama and 11.08% (175) in Chile. 87.14% (1376) have symptoms of anxiety, 66.88% (1056) have symptoms of depression and 64.34% (1016) have both symptoms. Conclusions: A high percentage of medical students in Latin American population suffered symptoms of anxiety and depression during the social distancing measures in the covid-19 outbreak period, data that must be taken into account for future mental health strategies.

RESUMEN Objetivos: Determinar la frecuencia de depresión y ansiedad en estudiantes de la carrera de medicina de Latinoamérica durante el distanciamiento social en el período de brote del COVID-19. Métodos: Diseño observacional, descriptivo y corte transversal, se incluyó en el estudio todos los estudiantes de medicina de Latinoamérica que se encuentren afiliados a la Federación Latinoamericana de Sociedades Científicas de Estudiantes de Medicina (FELSOCEM) seleccionados a través del muestreo no probabilístico por conveniencia que accedieron participar del estudio. Mediante un cuestionario se recopilaron datos, compuesto primeramente por características sociodemográficas como edad, género, estado civil y país de procedencia; como segunda sección, el instrumento estuvo compuesto por el test de depresión y ansiedad de Goldberg, se realizó un análisis en concordancia con la naturaleza de las variables. El protocolo de investigación fue aprobado por un comité de ética institucional. Resultados: De 1579 estudiantes participantes, de 15 países latinoamericanos, 68.59% (1083) fueron mujeres, 65.04% (1027) tenían entre 20 y 24 años, 95.63% (1510) eran solteros, 23.18% (366) vivían en Panamá y 11.08% (175) en Chile. El 87.14% (1,376) tienen síntomas de ansiedad, el 66.88% (1,056) tienen síntomas de depresión y el 64.34% (1,016) tienen ambos síntomas. Conclusiones: Un alto porcentaje de la población médico-estudiantil latinoamericana padecieron de síntomas de ansiedad y depresión durante las medidas de distanciamiento social en el periodo de brote del covid-19, dato que tiene que ser tomado en cuenta para futuras estrategias sobre salud mental.