Double-Blind, Placebo-Controlled, Randomized Study Comparing 0.0003% Calcitriol with 0.1% Tacrolimus Ointments for the Treatment of Endemic Pityriasis Alba

Background. Pityriasis alba (PA) is a frequent cause of consultation in tropical areas due to its chronic course, frequent relapses, and notorious hypopigmented lesions in pediatric dark skin populations. Currently, no treatment is widely accepted. Objective. To assess the efficacy of 0.0003% calcitriol and 0.1% tacrolimus ointments compared with placebo in the treatment of endemic PA. Methods. Twenty-eight children aged 3–17 years with 56 symmetrical lesions and phototype IV-V, were randomly assigned to receive the treatments on target lesions on the face. Improvement was evaluated at baseline and 8 weeks later clinically and by digital quantification of the affected area, colorimetry, and transepidermal water loss (TEWL). Results. Tacrolimus and calcitriol ointments induced a mean improvement of 68%, compared to 44% of placebo. We found an elevated TEWL in PA lesions. In the treated plaques, the reduction of the affected area was associated with improvement of pigmentation and TEWL. Conclusions. Calcitriol and tacrolimus induced similar repigmentation in endemic PA lesions. Melanogenic, anti-inflammatory, and barrier defect restoration properties of these drugs may explain these findings

FOLLETO DE ACTIVIDADES PARA ESTIMULAR LA PRODUCCIÓN DE DIVERSOS TEXTOS EN EL GRUPO DE CLASE MULTIGRADO DE PRIMERO A SEXTO GRADOS

El nivel primario constituye una de las etapas fundamentales en cuanto a adquisición y desarrollo de potencialidades del escolar, tanto en el área intelectual como en lo afectivo motivacional. El perfeccionamiento de la escuela primaria rural abrió un importante espacio para encaminar el debate y la reflexión de los maestros para lograr perfeccionar la calidad en el proceso educativo a partir de la manera que conciben el proceso de enseñanza- aprendizaje, proporcionando una visión más integral para lograr las aspiraciones que se plantean en el Modelo respecto a la calidad del aprendizaje de los escolares rurales. La enseñanza de la Lengua Española en la escuela cubana debe posibilitar que se aprenda a utilizar adecuadamente el idioma. En los programas de esta asignatura tiene un significado especial aprender a leer, e interpretar lo leído, a escribir sin errores ortocaligráficos, empleando las nociones gramaticales para darle belleza al lenguaje tanto oral como escrito

Experiencias de aprendizaje a través de las narrativas y las prácticas cotidianas familiares como estrategia pedagógica para la interculturalidad

La presente investigación tiene como objetivo analizar las experiencias de aprendizaje a través de las narrativas, como prácticas discursivas, y las prácticas cotidianas familiares, empleadas como una estrategia pedagógica para la interculturalidad en escenarios urbanos. En consecuencia, se realizó una investigación de carácter cualitativo y transversal, llevando a cabo un estudio de caso durante 4 meses en el Colegio San Bernardino IED, especialmente con 65 estudiantes de los grados sextos, cuya escolarización se desarrolla en un contexto de expansión urbana sobre la periferia rural de Bogotá. La metodología desarrollada en esta investigación se soporta en la matriz cosmogónica denominada MuisKanoba –esencia del alma de la gente- (Aguilera y Panqueba, 2017; Panqueba y Peralta, 2010; Panqueba y Huérfano, 2007). Entre los resultados más relevantes se establece la pertinencia de la educación intercultural crítica en contexto urbano, se confirma la preeminencia de práctica discursiva por sobre “tradición oral” en las familias que habitan zonas urbanas y las prácticas cotidianas familiares asociadas a los conocimientos específicos de las áreas y asignaturas en congruencia con lo que menciona la pedagogía de las memorias cotidianas (Peralta y Panqueba, 2010, p. 173-175). Finalmente, este trabajo es una invitación a seguir explorando desde la investigación docente, las posibilidades que tiene la educación intercultural crítica en escenarios urbanos y los aportes a la refundación de las sociedades Latinoamericanas, como proyectos pedagógicos decoloniales, considerando la importancia del reconocimiento de las identidades que emergen desde los núcleos familiares que enriquecen la diversificación de nuestras sociedades urbanas. Palabras clave: Estrategias pedagógicas, interculturalidad crítica, prácticas cotidianas familiares y prácticas discursivas.The purpose of this research is to analyze learning experiences through narratives, as discursive practices, and everyday family practices, used as a pedagogical strategy for interculturality in urban settings. Consequently, a qualitative and cross-sectional research was conducted, carrying out a case study for 4 months at the Colegio San Bernardino IED, especially with 65 students in the sixth grades, whose schooling takes place in a context of urban expansion on the rural periphery of Bogotá. The methodology developed in this research is supported by the cosmogonic matrix called MuisKanoba –essence of the soul of the people- (Aguilera and Panqueba, 2017; Panqueba and Peralta, 2010; Pancake and Orphan, 2007). Among the most relevant results is the relevance of critical intercultural education in urban context, confirms the pre-eminence of discursive practice over "oral tradition" in families living in urban areas and family daily practices associated with the specific knowledge of areas and subjects in congruence with what the pedagogy of daily memories mentions (Peralta and Panqueba, 2010, p. 173-175). Finally, this work is an invitation to continue exploring from the teaching research, the possibilities of critical intercultural education in urban settings and the contributions to the refoundation of Latin American societies, as decolonizational pedagogical projects, considering the importance of the recognition of the identities that emerge from the family unit that enrich the diversification of our urban societies. Keywords: Pedagogical strategies, critical interculturality, family daily practices and discursive practices

Gestión del proceso de restauración en el Hotel Islazul Pinar del Río

The approach based on processes to manage the restoration service that intends this work shows contemporary tendencies of the management systems in general, when combining with the strategic business management theories and the service systems. As practical-methodological contribution points about a procedure that was developed by the authors when being applied in one of the operative or business processes in the Hotel Islazul Pinar del Rio, what allowed the validation of the same one. The investigation focuses on the problem linked with the approach of service management that is carried out based on the accomplishment of objectives and independent functions by what the appropriate integration is not achieved among the functional units and of business, what affects the efficacy and the efficiency of the business management in general, all that which is a thesis of Master in Management. Reference is made to the used of diagnosis tools including surveys, interviews and teamwork techniques. By virtue of the transformations taking place in Cuban managerial system, it is considered relevant for this entity to reorganize their services system when guiding it focused on the processes management that take place in it to get the simplification of actions, the reorientation of the priorities toward the vital ones and to eliminate the unnecessary activities, all that which would redound in a higher customer satisfaction, at the time that a remarkable impact would be achieved in the indicators of effectiveness and efficiency of the overall management.El artículo aborda el problema asociado al enfoque de gestión del servicio de restauración en el Hotel Pinar del Río que se realiza basado en el cumplimiento de objetivos y funciones independientes por lo que no se logra la adecuada integración entre las unidades funcionales y de negocios, lo que afecta la eficacia y la eficiencia de la gestión empresarial en general. El objetivo de la investigación fue diseñar un procedimiento de mejora con enfoque a procesos para el servicio de restauración en el Hotel Pinar del Río que contribuya a la elevación de los niveles de eficacia y eficiencia de la gestión empresarial. Entre las herramientas de diagnóstico utilizadas destacan la encuesta, entrevista y técnicas de trabajo en grupo. Los principales fundamentos teóricos y metodológicos que sustentan esta investigación se relacionan con la gestión de procesos en el ámbito hotelero, la cual sugiere que en su vínculo con los enfoques estratégico y de servicio, constituye una herramienta fundamental para lograr la debida orientación hacia la satisfacción del cliente, lo que deviene una vía además, para mejorar los resultados del desempeño organizacional. Entre los resultados más relevantes alcanzados tras la puesta en práctica del procedimiento, destacan la simplificación de acciones, la reorientación de las prioridades hacia las vitales y la eliminación de actividades innecesarias que no agregan valor a la satisfacción del cliente, todo lo cual sugiere como conclusiones que el procedimiento de mejora aplicado ha impactado en los resultados de los indicadores de eficacia y eficiencia de la organización

Intervención educativa dirigida al uso de métodos anticonceptivos en adolescentes

El inicio de las relaciones sexuales en la adolescencia puede generar problemas de salud biopsicosociales, los que pueden ser más complejos sin el adecuado conocimiento acerca del uso oportuno de métodos anticonceptivos. La investigación tuvo el objetivo de valorar la efectividad de una intervención educativa dirigida a las conductas sexuales y reproductivas de riesgo en la adolescencia, en dos Consejos Populares del municipio de Quemado de Güines durante el periodo 2017-2021. Se desarrolló un estudio preexperimental con una población constituida por 1501 adolescentes, de la que se seleccionó una muestra 102 individuos mediante un procedimiento no probabilístico atendiendo a criterios. En el estudio predominó: el sexo femenino (51%), aquellos con edades entre 13 y 15 años (67,7%) y los que no habían comenzado una vida sexual activa (54,9%). La intervención educativa produjo cambios estadísticamente significativos en el contexto de investigación en relación con la información sobre métodos anticonceptivos y la percepción del riesgo sobre su uso inadecuado.The beginning of sexual relations in adolescence can generate biopsychosocial health problems, which can be more complex without adequate knowledge about the timely use of contraceptive methods. The research aimed to assess the effectiveness of an educational intervention aimed at sexual and reproductive risk behaviors in adolescents in two Popular Councils of the Quemado de Güines Hall during 2017-2021. A pre-experimental study was developed with a population of 1501 adolescents, from which a sample of 102 individuals was selected through a non-probabilistic procedure according to criteria. The study predominated: the female gender (51%), the ages between 13 and 15 (67.7%), and those ones who had not started an active sexual life (54.9%). The educational intervention produced statistically significant changes in the research context concerning the information on contraceptive methods and the perception of risk regarding its inappropriate use

Risk of developing checkpoint immune pneumonitis and its effect on overall survival in non-small cell lung cancer patients previously treated with radiotherapy

Introduction:Immune checkpoint inhibitor-related pneumonitis (ICIP) is a potentially lifethreatening immune-related adverse event (irAE), especially in non-small cell lung cancer(NSCLC) patients. Currently, the potential for increased irAE in patients who receiveradiotherapy is scarcely known, although a connection between antitumor immuneresponses and irAEs has been suggested. In this study, we evaluated the developmentof ICIP in non-small cell lung cancer patients with prior radiotherapy, treated withimmunotherapy in the second-line.Methods:In this retrospective trial, we included patients treated with second-lineimmunotherapy at the National Cancer Institute in Mexico City from February 2015 toFebruary 2018. Clinical, radiological and treatment variables were evaluated accordingto the presence of ICIP as defined by the Common Terminology Criteria for AdverseEvents (4.0) in patients with or without a previous (≥months) history of radiotherapy.Results:Among 101 NSCLC patients who received treatment with ICIs, 22 patients(21.8%) were diagnosed with ICIP, of which 73% (16/22) had a history of radiotherapy(OR 6.04, 95% CI 2.03−18.0,p<0.001). Median progression free survival and overallsurvival were similar in patients who developed ICIP compared with those who did not,however, patients who presented grade≥2 ICIP had an increased risk of mortality (HR2.54, 95% CI 1.20−5.34,p= 0.014).Conclusion:In this real-world cohort of NSCLC patients treated with ICI, the historyof prior radiotherapy was associated with increased risk for ICIP development. Unlikeother irAEs, grade≥2 ICIP is an independent prognostic factor for decreased survivalin NSCLC patients

Lectura de Contexto y abordaje psicosocial desde los enfoques narrativos Puente Quetame, Bogotá, Puerto Asís.

En el presente documento plasmaremos las actividades finales propuestas recopilando los saberes abordados en el trascurrir del mismo y dándoles aplicabilidad con los casos que se nos presentan, de esta manera articulamos el conocimiento de todas las Unidades vistas, llevando sus temáticas a una interacción vincularía en el que hacer psicológico, una apropiación de ese conocimiento en escenarios que aunque se saben que son reales y que no abordamos directamente nos permite desarrollar capacidades y habilidades de la mano de la experiencia que imprime el contexto histórico de nuestro país. En el presente trabajo se integraran conocimientos adquiridos en las unidades correspondientes al acompañamiento de acción psicosocial en contextos de violencia tales como el enfoque sistémico , la importancia de saber direccionar a la víctima desde las pregunta y que ella misma encuentre recursos en su relato capaces de transformar esa situación de victima pasiva, mártir , en situación de persona resiliente capaz de contar su relato desde una perspectiva positiva , que construye que crea un andamiaje con su estrategia de afrontamiento.In this document we will present the proposed final activities by gathering the knowledge addressed in the course of the same and giving them applicability with the cases that are presented to us, in this way we articulate the knowledge of all the Units seen, taking their topics to a linkage interaction in the what to do psychological, an appropriation of that knowledge in scenarios that although they are known to be real and that we do not address directly, allows us to develop skills and abilities hand in hand with the experience that imprints the historical context of our country. In the present work, knowledge acquired in the units corresponding to the accompaniment of psychosocial action in contexts of violence such as the systemic approach, the importance of knowing how to address the victim from the questions and that she herself finds resources in her story capable of transforming that situation of passive victim, martyr, in a situation of resilient person able to tell his story from a positive perspective, which builds that creates a scaffolding with his coping strategy

Predictors of positive (18) F-FDG PET/CT-scan for large vessel vasculitis in patients with persistent polymyalgia rheumatica

Objective: Polymyalgia rheumatica (PMR) is often the presenting manifestation of giant cell arteritis (GCA). Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) scan often discloses the presence of large vessel vasculitis (LVV) in PMR patients. We aimed to identify predictive factors of a positive PET/CT scan for LVV in patients classified as having isolated PMR according to well-established criteria. Methods: A set of consecutive patients with PMR from a single hospital were assessed. All of them underwent PET/CT scan between January 2010 and February 2018 based on clinical considerations. Patients with PMR associated to other diseases, including those with cranial features of GCA, were excluded. The remaining patients were categorized in classic PMR (if fulfilled the 2012 EULAR/ACR classification criteria at disease diagnosis; n=84) or atypical PMR (who did not fulfill these criteria; n=16). Only information on patients with classic PMR was assessed. Results: The mean age of the 84 patients (51 women) with classic PMR was 71.4±9.2 years. A PET/CT scan was positive in 51(60.7%). Persistence of classic PMR symptoms was the most common reason to perform a PET/CT scan. Nevertheless, patients with positive PET/CT scan often had unusual symptoms. The best set of predictors of a positive PET/CT scan were bilateral diffuse lower limb pain (OR=8.8, 95% CI 1.7-46.3; p=0.01), pelvic girdle pain (OR=4.9, 95% CI 1.50-16.53; p=0.01) and inflammatory low back pain (OR=4.7, 95% CI 1.03-21.5; p=0.04). Conclusion: Inflammatory low back pain, pelvic girdle and diffuse lower limb pain are predictors of positive PET/CT scan for LVV in PMR

Validation of inertial measurement units based on waveform similarity assessment against a photogrammetry system for gait kinematic analysis

When assessing gait analysis outcomes for clinical use, it is indispensable to use an accurate system ensuring a minimal measurement error. Inertial Measurement Units (IMUs) are a versatile motion capture system to evaluate gait kinematics during out-of-lab activities and technology-assisted rehabilitation therapies. However, IMUs are susceptible to distortions, offset and drifting. Therefore, it is important to have a validated instrumentation and recording protocol to ensure the reliability of the measurements, to differentiate therapy effects from system-induced errors. A protocol was carried out to validate the accuracy of gait kinematic assessment with IMUs based on the similarity of the waveform of concurrent signals captured by this system and by a photogrammetry reference system. A gait database of 32 healthy subjects was registered synchronously with both devices. The validation process involved two steps: 1) a preliminary similarity assessment using the Pearson correlation coefficient, and 2) a similarity assessment in terms of correlation, displacement and gain by estimating the offset between signals, the difference between the registered range of motion (∆ROM), the root mean square error (RMSE) and the interprotocol coefficient of multiple correlation (CMCP). Besides, the CMCP was recomputed after removing the offset between signals (CMCPoff). The correlation was strong (r &gt; 0.75) for both limbs for hip flexion/extension, hip adduction/abduction, knee flexion/extension and ankle dorsal/plantar flexion. These joint movements were studied in the second part of the analysis. The ∆ROM values obtained were smaller than 6°, being negligible relative to the minimally clinically important difference (MCID) estimated for unaffected limbs, and the RMSE values were under 10°. The offset for hips and ankles in the sagittal plane reached -9° and -8°, respectively, whereas hips adduction/abduction and knees flexion/extension were around 1°. According to the CMCP, the kinematic pattern of hip flexion/extension (CMCP &gt; 0.90) and adduction/abduction (CMCP &gt; 0.75), knee flexion/extension (CMCP &gt; 0.95) and ankle dorsi/plantar flexion (CMCP &gt; 0.90) were equivalent when captured by each system synchronously. However, after offset correction, only hip flexion/extension (CMCPoff = 1), hip adduction/abduction (CMCPoff &gt; 0.85) and knee flexion/extension (CMCPoff &gt; 0.95) satisfied the conditions to be considered similar

Identifying the needs of older people living with HIV (≥ 50 years old) from multiple centres over the world: a descriptive analysis

BackgroundOlder People Living with HIV (OPWH) combine both aging and HIV-infection features, resulting in ageism, stigma, social isolation, and low quality of life. This context brings up new challenges for healthcare professionals, who now must aid patients with a significant comorbidity burden and polypharmacy treatments. OPWH opinion on their health management is hardly ever considered as a variable to study, though it would help to understand their needs on dissimilar settings.MethodsWe performed a cross-sectional, comparative study including patients living with HIV aged >= 50 years old from multiple centers worldwide and gave them a survey addressing their perception on overall health issues, psychological problems, social activities, geriatric conditions, and opinions on healthcare. Data was analyzed through Chisquared tests sorting by geographical regions, age groups, or both.ResultsWe organized 680 participants data by location (Center and South America [CSA], Western Europe [WE], Africa, Eastern Europe and Israel [EEI]) and by age groups (50- 55, 56-65, 66-75, >75). In EEI, HIV serostatus socializing and reaching undetectable viral load were the main problems. CSA participants are the least satisfied regarding their healthcare, and a great part of them are not retired. Africans show the best health perception, have financial problems, and fancy their HIV doctors. WE is the most developed region studied and their participants report the best scores. Moreover, older age groups tend to live alone, have a lower perception of psychological problems, and reduced social life.ConclusionsPatients' opinions outline region- and age-specific unmet needs. In EEI, socializing HIV and reaching undetectable viral load were the main concerns. CSA low satisfaction outcomes might reflect high expectations or profound inequities in the region. African participants results mirror a system where general health is hard to achieve, but HIV clinics are much more appealing to them. WE is the most satisfied region about their healthcare. In this context, age-specific information, education and counseling programs (i.e. Patient Reported Outcomes, Patient Centered Care, multidisciplinary teams) are needed to promote physical and mental health among older adults living with HIV/AIDS. This is crucial for improving health-related quality of life and patient's satisfaction