Participación Ciudadana para una Educación Ambiental Sustentable

The objective of the study was to: determine the activities of citizen participation that promotes the teaching of the L.B. “Sabana Libre” for the strengthening of an environmental education sustainable. It is theoretically based on environmental education, sustainable development and citizen participation. Methodologically approached from the descriptive research, carried out in the context of study. We used the interview technique, through a questionnaire as an instrument for the collection of information, being validated by experts. The instrument was applied to fifty (50) teachers working in the L.B. “Sabana Libre”. Tables with their respective statistical and descriptive interpretation were developed for the analysis. As results were obtained 17% of teachers said to always engage in participatory environmental activities and 29% said to promote environmental values. It is concluded that little conducive to citizen participation as an activity the teacher in the promotion of sustainable environmental education and, consequently, sparing the development of environmental awareness is promoted. So it is suggested the implementation of actions that lead to strengthening the participation to the valuation of the environment.El objetivo del estudio consistió en: Determinar las actividades de participación ciudadana que promueve el docente del L.B. “Sabana Libre” para el fortalecimiento de una educación ambiental sustentable. Teóricamente se fundamenta en la educación ambiental, el desarrollo sustentable y la participación ciudadana. Metodológicamente abordado desde la investigación descriptiva, realizado en el contexto de estudio. Se utilizó la técnica de la entrevista, a través de un cuestionario como instrumento para la recolección de la información, siendo validado por expertos. El instrumento se aplicó a cincuenta (50) docentes que laboran en el L.B. “Sabana Libre”. Para el análisis se elaboró tablas con su respectiva interpretación estadística y descriptiva. Como resultados se obtuvo que 17% de docentes afirmó siempre realizar actividades pro-ambientales participativas y un 29% aseveró promover valores ambientales. Se concluye que poco se propicia la participación ciudadana como actividad del docente en la promoción de la educación ambiental sostenible y, en consecuencia, escasamente se promueve el desarrollo de una conciencia ambiental. Por lo que se sugiere la puesta en práctica de acciones que lleven a fortalecer la participación ciudadana hacia la valoración del ambiente

Análisis fisicoquímico y géneros de mohos en ecotipos cultivados de maíz morado (Zea mays L.)

El maíz morado originario de los Andes de América del Sur es una variedad amilácea que presenta demanda y consumo sostenido por los principios bioactivos que contiene. El objetivo fue determinar las características fisicoquímicas y mohos en las variedades de maíz morado. Las muestras M1 y M2 fueron colectadas en la región Huánuco-Perú. Se evaluaron las características morfológicas del maíz; color (CIE L*, a* y b*); análisis fisicoquímicos (actividad de agua, humedad, cenizas, grasas, fibra, proteína y carbohidratos); y antocianinas con el método de pH diferencial (cianidina-3-glucósido); asimismo se efectuó el recuento de mohos por unidades formadoras de colonias (UFC), aislamiento e identificación. Las evaluaciones determinaron que la humedad de la M1 fue mayor que la M2, por lo tanto, el contenido de materia seca fue inversamente proporcional. La actividad de agua más alta (0.71) fue de M1. Las antocianinas alcanzaron 17.92 (mg de cianidina-3-glucósido g-1 de muestra) en la coronta de la M1. La presencia de mohos fue evidente, sin embargo, se reportó mayor número de colonias en la M1 (1.43 x 107 UFC g-1), la misma que se relaciona con los géneros aislados, tales como Aspergillus, Cladosporium, Fusarium, Penicillium y Rhizopus. Las muestras evaluadas son una fuente importante de nutrientes y destaca el aporte de sustancias antioxidantes como las antocianinas siendo mayor el contenido a nivel de la coronta. La presencia de los mohos es influida por la humedad e inadecuado almacenamiento, considerando que entre los géneros aislados podría asociarse con la formación de micotoxinas. Los granos de maíz son susceptibles a los mohos y sus metabolitos secundarios, representando un problema para la seguridad alimentaria

Frequency of hereditary transthyretin amyloidosis among elderly patients with transthyretin cardiomyopathy

Transthyretin amyloid cardiomyopathy (ATTR-CM) is increasingly recognized as a cause of heart failure in the elderly. Although wild-type transthyretin amyloidosis is the most frequent form of ATTR-CM found in the elderly, hereditary transthyretin amyloidosis (ATTRv) can also occur. We sought to determine the prevalence of ATTRv among elderly ATTR-CM patients, identify predictors of ATTRv and evaluate the clinical consequences of positive genetic testing in this population. Prevalence of ATTRv in elderly ATTR-CM patients (≥70 years) was assessed in a cohort of 300 consecutive ATTR-CM patients (median age 78 years at diagnosis, 82% ≥70 years, 16% female, 99% Caucasian). ATTRv was diagnosed in 35 (12%; 95% confidence interval [CI] 3.1–8.8) and 13 (5.3%; 95% CI 5.6–26.7) patients in the overall cohort and in those ≥70 years, respectively. Prevalence of ATTRv among elderly female patients with ATTR-CM was 13% (95% CI 2.1–23.5). Univariate analysis identified female sex (odds ratio [OR] 3.66; 95% CI 1.13–11.85; p = 0.03), black ancestry (OR 46.31; 95% CI 3.52–Inf; p = 0.005), eye symptoms (OR 6.64; 95% CI 1.20–36.73; p = 0.03) and polyneuropathy (OR 10.05; 95% CI 3.09–32.64; p<0.001) as the only factors associated with ATTRv in this population. Diagnosis of ATTRv in elderly ATTR-CM patients allowed initiation of transthyretin-specific drug treatment in 5 individuals, genetic screening in 33 relatives from 13 families, and identification of 9 ATTRv asymptomatic carriers. Hereditary transthyretin amyloidosis is present in a substantial number of ATTR-CM patients aged ≥70 years. Identification of ATTRv in elderly patients with ATTR-CM has clinical meaningful therapeutic and diagnostic implications. These results support routine genetic testing in patients with ATTR-CM regardless of ageThis study has been funded by Instituto de Salud Carlos III (ISCIII) through the projects ‘PI18/0765 & PI20/01379’ (co-funded by European Regional Development Fund/European Social Fund ‘A way to make Europe’/‘Investing in your future’). AMB receives grant support by ISCIII (CM20/002209). The CNIC is supported by the ISCIII, MCIN, the Pro-CNIC Foundation, and the Severo Ochoa grant (CEX2020-001041-S

Conservative management of perforated duodenal diverticulum: a case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs

Worldwide trends in underweight and obesity from 1990 to 2022 : a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

A list of authors and their affiliations appears online. A supplementary appendix is herewith attached.Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.peer-reviewe

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

El Dr. José María Bengoa y “La Universidad de Sanare”

Hace 75 a&ntilde;os, una hermosa poblaci&oacute;n rural del centro occidente de Venezuela, Sanare, no so&ntilde;aba siquiera con tener el milagro de contar con un m&eacute;dico que atendiese sus dolencias y enfermedades. Sin embargo, en 1938 se hace realidad la esperanza colectiva de los sanare&ntilde;os de recibir como un miembro m&aacute;s de su comunidad a un hombre, el Dr. Jos&eacute; Mar&iacute;a Bengoa, quien sin siquiera sospecharlo en ese entonces se convertir&iacute;a en una figura inolvidable para esa y las siguientes generaciones. A&uacute;n hoy se escuchan de sus vivencias, sus ense&ntilde;anzas y su proceder de coraz&oacute;n, de quienes compartieron junto al Dr. Bengoa la &eacute;poca de su vida, que seg&uacute;n &eacute;l mismo hizo saber al pueblo de Sanare:&nbsp;&ldquo;de toda mi vida profesional, de la que guardo mejor recuerdo es la &eacute;poca en que fui m&eacute;dico rural&rdquo;. Mucho hemos le&iacute;do de la vida y obra del Dr. Jos&eacute; Mar&iacute;a Bengoa y sus constantes referencias al pueblo de Sanare. Sin embargo, les puedo decir con gran convicci&oacute;n que sus escritos no le hacen justicia al profundo amor y el servicio desprendido que recibieron los habitantes de esa poblaci&oacute;n, no solo durante sus a&ntilde;os de m&eacute;dico rural, sino a&ntilde;os m&aacute;s tarde cuando regres&oacute; a esa tierra que lo acogi&oacute; con el mismo afecto que &eacute;l les brind&oacute;. En sus relatos puede verse reflejado el sentido de pertenencia al pueblo de Sanare y c&oacute;mo reflexionaba sobre los aspectos cotidianos de la vida pueblerina como un sanare&ntilde;o m&aacute;s. Frases como&nbsp;&ldquo;&Eacute;ramos&nbsp;un pueblo terminal, y la vida social exig&iacute;a una m&iacute;nima presencia&hellip; No&nbsp;lleg&aacute;bamos&nbsp;a tanto, pero&nbsp;ten&iacute;amos&nbsp;nuestro estilo formal, muy reverencioso&rdquo;, nos muestran una compenetraci&oacute;n tal, que se expresa como lo habr&iacute;a hecho alguien nacido en esa tierra. El Dr. Bengoa no s&oacute;lo brind&oacute; afecto, no s&oacute;lo cultiv&oacute; amistad, no s&oacute;lo sirvi&oacute; a la comunidad, no s&oacute;lo ayud&oacute; al necesitado, sino que adem&aacute;s rescat&oacute; decenas de sonrisas de ni&ntilde;os tristes, agobiados por el flagelo de la desesperanza, la desnutrici&oacute;n y la indiferencia de una sociedad, que no se hab&iacute;a detenido a mirarlos y brindarles una mano, una oportunidad, un camino. A&uacute;n hoy, despu&eacute;s de 75 a&ntilde;os, Sanare sigue sus ideas y luego de algunos tropiezos, no las ha abandonado manteniendo en funcionamiento un centro de recuperaci&oacute;n nutricional, que hoy d&iacute;a complementa las acciones de nutrici&oacute;n en salud p&uacute;blica que el municipio ejecuta