Guía de gestión educativa para nivel inicial

This product has as purpose to present a potentially useful monitoring tool, for the daily actions of the educational director, particularly focused on the initial level. Such interest is born after the deficient results obtained in tests effected to the country, at both the national (SER) and international levels (SERCE), including the results presented in National report of educational progress of Ecuador, published in 2006. Here we can see the imperative need of drastic changes in education. Beyond resources and physical structures, change is inherent in the "head" of the educational system of Ecuador, that is to say, in the way such as have been managed educational processes, without becoming absorbed in the department of education of Ecuador, because outside of the transformations made in this organism and taking as a starting point the decentralization, the change must be effected from the internal management of every educational center.Este producto tiene como propósito presentar una herramienta de acompañamiento potencialmente útil, para el diario accionar del director/a educativo, enfocado de manera particular al nivel inicial. Dicho interés nace tras los deficientes resultados obtenidos en pruebas efectuadas al país tanto a nivel nacional (SER) como internacional (SERCE), incluyendo los resultados presentados en el informe nacional de progreso educativo del Ecuador publicado en 2006; donde se vivencia la necesidad imperativa de efectuar cambios drásticos en la educación. Más allá de recursos y estructuras físicas, el cambio es inherente en la “cabeza” del sistema educativo del Ecuador, es decir en la forma como se han gestionado los procesos educativos; sin enfrascarse en el ministerio de educación del ecuador, pues fuera de las transformaciones efectuadas en este organismo y tomando como punto de partida la descentralización, el cambio debe efectuarse desde la gestión interna de cada centro educativo

Suicide risk factors in pregnant adolescents. 2017-2018

Las causas del suicidio en los adolescentes pueden ser complejas e involucran diversos factores. Se realizó un estudio descriptivo, de corte transversal, con el objetivo de detectar riesgo suicida en gestantes adolescentes del Policlínico 13 de Marzo de Bayamo, Granma, en el período enero 2017-enero del 2018. Universo: 49 gestantes adolescentes. Muestra: 42 gestantes que accedieron a participar en la investigación. Se realizaron entrevistas semiestructuradas para detectar riesgo suicida y factores relacionados. Se empleó una guía práctica validada internacionalmente para evaluar el riesgo. Para el análisis estadístico se utilizó el programa SPSS versión 22 para Windows (estadísticos descriptivos). El 35,7 % de las gestantes adolescentes tenía riesgo suicida, y el factor de riesgo que más destacó fue la relación disarmónica con los padres (66,7 %). Se concluye que la identificación de los factores de riesgo de suicidio en adolescentes y su adecuado manejo, es muy importante para la prevención del suicidio.Suicide causes in adolescence can be complex and they involve various factors. A cross-sectional descriptive study was done with the aim of detecting suicide risk in pregnant adolescents belonging to the policlinic 13 de Marzo in Bayamo, Granma, from January 2017 to January 2018. The universe included 49 pregnant adolescents; the sample included 42 pregnant adolescents. Semistructured interviews were made to detect suicide risks, and risk factors associated. A practical guide internationally validated was used to evaluate the risk. It was also used the SPSS 22 version to do the statistical analysis (descriptive statistics). The 35, 7 % of pregnant adolescents had suicide risk factor, the most relevant risk factor was the lack of harmony with their parents (66, 7 %).  It is concluded that it is of great importance the identification of the suicide risk factors in adolescents and the adequate management to prevent suicide

Educational intervention strategy for the formation of peer promoters on suicidal behavior in adolescence. Bayamo, 2016

Se realizó un estudio de intervención con el objetivo de implementar una intervención educativa para la formación de promotores de salud pares para prevenir la conducta suicida en adolescentes del Instituto Preuniversitario Urbano (IPU) Julio Antonio Mella, de Bayamo, de enero a mayo de 2016. El universo estuvo constituido por 65 estudiantes de la escuela que mostraron motivación personal para desarrollar la labor de prevención como promotores de salud en la comunidad. La muestra se seleccionó de forma probabilística mediante entrevista individual, quedó constituida finalmente por 20 adolescentes. La estrategia se aplicó en dos fases: teórico-práctico  y de trabajo comunitario. Los resultados con el muestreo aplicado antes del taller evidenciaron desconocimiento de los temas a tratar, se obtuvieron resultados positivos con un incremento de conocimientos sobre los temas: la comunicación, técnicas para el desarrollo de su labor como promotor par de salud, conducta suicida en la adolescencia, mitos,  factores de riesgo  y manejo del adolescente con riesgo suicida; la mayoría  de los adolescentes se evaluaron de muy bien y bien en su desempeño como promotores en la comunidad bajo el control de la responsable de la investigación, que comprobó la calidad del nuevo promotor. Los criterios de evaluación utilizados permiten plantear que la estrategia de intervención educativa para la formación de promotores de salud pares fue efectiva.An intervention study was carried out with the objective of implementing an educational intervention for the formation of peer health promoters to prevent suicidal behavior in adolescents from high school Julio Antonio Mella, Bayamo, from January to May 2016. The universe was constituted by 65 students of the school who showed personal motivation to develop the work of prevention as health promoters in the community. The sample was selected probabilistically through an individual interview; finally it was constituted by 20 adolescents. The strategy was applied in two phases: theoretical-practical and community work. The results with the sampling applied before the workshop evidenced a lack of knowledge of the subjects to be treated, positive results were obtained with an increase of knowledge about the subjects: communication, techniques for the development of their work as a health promoter, suicidal behavior in the adolescence, myths, risk factors and management of adolescents with suicidal risk; the majority of adolescents were evaluated very well and well in their performance as promoters in the community under the control of the person in charge of the research, who checked the quality of the new promoter. The evaluation criteria used allow us to propose that the educational intervention strategy for the training of peer health promoters was effective

AT1 receptor autoantibodies mediate effects of metabolic syndrome on dopaminergic vulnerability

The metabolic syndrome has been associated to chronic peripheral inflammation and related with neuroinflammation and neurodegeneration, including Parkinson’s disease. However, the responsible mechanisms are unclear. Previous studies have involved the brain renin-angiotensin system in progression of Parkinson’s disease and the angiotensin receptor type 1 (AT1) has been recently revealed as a major marker of dopaminergic vulnerability in humans. Dysregulation of tissue renin-angiotensin system is a key common mechanism for all major components of metabolic syndrome. Circulating AT1 agonistic autoantibodies have been observed in several inflammation-related peripheral processes, and activation of AT1 receptors of endothelial cells, dopaminergic neurons and glial cells have been observed to disrupt endothelial blood -brain barrier and induce neurodegeneration, respectively. Using a rat model, we observed that metabolic syndrome induces overactivity of nigral pro-inflammatory renin-angiotensin system axis, leading to increase in oxidative stress and neuroinflammation and enhancing dopaminergic neurodegeneration, which was inhibited by treatment with AT1 receptor blockers (ARBs)S

Fatores maternos associados às práticas alimentares com aleitamento materno exclusivo

El abandono precoz de lactancia materna es una problemática de interés mundial. Con el objetivo de determinar la asociación entre factores maternos y duración de la lactancia materna exclusiva (LME) se realizó un estudio observacional, analítico, de cohorte, en niños de seis meses de edad y sus madres, que habitan en el área del policlínico Jimmy Hirzel, municipio Bayamo, provincia Granma, durante el periodo enero-diciembre del 2018. Integraron la muestra 140 niños y sus madres, seleccionados por criterios de inclusión y exclusión. Se exploraron variables maternas: edad, escolaridad, ocupación, paridad, procedencia, conocimientos sobre lactancia materna y prácticas alimentarias con lactancia materna exclusiva. Se utilizaron métodos teóricos, empíricos y estadísticos. Como resultados relevantes, al caracterizar la muestra destacaron las madres de 20 a 34 años de edad (75,7%), nivel de escolaridad preuniversitario (37,1 %), trabajadoras (40,7%), con un solo hijo (66,4%), de procedencia rural (70,7%), con conocimientos adecuados sobre lactancia materna (63,6%). El 65 % ofreció a sus hijos LME por seis meses, la causa principal del abandono del amamantamiento exclusivo fue la hipogalactia materna (59%). Los factores maternos que se asociaron al abandono de la práctica antes de los seis meses fueron: edad (madres adolescentes o añosas 0,0165), menor nivel de escolaridad (0,0373), primiparidad (p= 0,009) y bajo nivel de conocimiento sobre lactancia materna (0,0001).The early abandonment of breastfeeding is a problem of global interest. In order to determine the association between maternal factors and duration of exclusive breastfeeding (SCI), an observational, analytical, cohort study was conducted in six-month-old children and their mothers, who live in the Jimmy Hirzel polyclinic area, Bayamo municipality, Granma province, during the period January-December 2018. The sample comprised 140 children and their mothers, selected by inclusion and exclusion criteria. Maternal variables were explored: age, schooling, occupation, parity, origin, knowledge about breastfeeding and exclusive breastfeeding feeding practices. Theoretical, empirical and statistical methods were used.As relevant results, when characterizing the sample, mothers from 20 to 34 years old (75.7%), pre-university level of education (37.1%), workers (40.7%) stood out. , with a single child (66.4%), of rural origin (70.7%), with adequate knowledge of breastfeeding (63.6%). 65% offered their children SCI for six months, the main cause of abandoning exclusive breastfeeding was maternal hypogalactia (59%). The maternal factors that were associated with abandoning the practice before six months were: age (adolescent or elderly mothers 0.0165), lower level of education (0.0373), primiparity (p = 0.009) and low level of knowledge about breastfeeding maternal (0.0001).O abandono precoce da amamentação é um problema de interesse global. Para determinar a associação entre fatores maternos e duração do aleitamento materno exclusivo (LM), foi realizado um estudo observacional, analítico e de coorte em crianças de seis meses e suas mães, residentes na área policlínica de Jimmy Hirzel. , Município de Bayamo, província de Granma, no período de janeiro a dezembro de 2018. A amostra foi composta por 140 crianças e suas mães, selecionadas por critérios de inclusão e exclusão. As variáveis maternas foram exploradas: idade, escolaridade, ocupação, paridade, procedência, conhecimento sobre aleitamento materno e práticas de aleitamento materno exclusivo. Foram utilizados métodos teóricos, empíricos e estatísticos. Como resultados relevantes, ao caracterizar a amostra, destacaram-se mães entre 20 e 34 anos (75,7%), nível de ensino pré-universitário (37,1%), trabalhadoras (40,7%). , com um filho solteiro (66,4%), de origem rural (70,7%), com conhecimento adequado sobre aleitamento materno (63,6%). 65% ofereceram SCI aos filhos por seis meses, a principal causa do abandono do aleitamento materno exclusivo foi a hipogalactia materna (59%). Os fatores maternos associados ao abandono da prática antes dos seis meses foram: idade (mães adolescentes ou idosas 0,0165), menor escolaridade (0,0373), primiparidade (p = 0,009) e baixo nível de conhecimento sobre aleitamento materno materna (0,0001)

Enfermedades bucales que constituyen urgencias estomatológicas

Introduction: the bucco dental diseases are diverse as well as their etiologic and predisposing factors, for which they can be considered multifactorial diseases that affect the oral cavity in a different way. Objective: to provide stomatology professionals with updated data about the diseases that they often have to deal with in the stomatology consultations. Method: it was carried out an exhaustive and updated review in regards to the buccal diseases that constitute Stomatology emergences because they are frequent in stomatology consultations, the signs and symptoms of each one and the treatment to be performed. Results: it was concluded then that the pain is the most important sign of acute dental caries or any other oral disease in acute condition, regardless the age, which constitutes an emergency in stomatology. Conclusions: if buccal diseases that constitute emergencies are not treated properly, they will present a fatal outcome for the tooth; hence it is important that the general dentist have an extensive knowledge about them, taking into account the diagnosis, characteristics and treatment.Introducción: las enfermedades buco dentales son diversas así como sus factores etiológicos y predisponentes por lo que se pueden considerar enfermedades multifactoriales que afectan de diferente manera la cavidad bucal.Objetivo: brindar a los profesionales de la estomatología  datos actualizados sobre enfermedades que tienen que tratar frecuentemente en las consultas estomatológicas. Método: se realizó una revisión y actualización exhaustivas sobre las enfermedades bucales que constituyen urgencias estomatológicas ya que es alta la frecuencia de las mismas en las consultas estomatológicas, los signos y síntomas de cada una y el tratamiento que debe realizarse. Resultados: se concluyó que el signo más relevante de la caries dental aguda, o de cualquier otra enfermedad bucal en estado agudo sea cual sea la edad es el dolor, el cual constituye una urgencia en estomatología.Conclusiones: si las enfermedades bucales que constituyen urgencias no son tratadas correctamente, presentarán un desenlace fatal para el diente, de ahí la importancia que tiene que el estomatólogo general  posea un amplio conocimiento sobre las mismas en lo que a diagnostico, características y tratamiento se refier

Uso de medicamentos e fitofarmacêuticos em mães durante a amamentação

The only food that the baby should receive during the first 6 months of life is the milk of his mother. Any substance she consumes while breastfeeding has repercussions on her child, so the use of medications, phytopharmaceuticals or other substances must be by prescription and strictly monitored. In order to characterize the use of medicines and phytopharmaceuticals in mothers during the period of breastfeeding, a descriptive, cross-sectional observational study was conducted in ten urban offices in Bayamo, Granma province, during the period September 2017 to April 2018. The The universe grouped nursing mothers belonging to these offices, and the sample was made up of those who agreed to be included in the research, with prior informed consent. Mothers were characterized according to the following variables: level of schooling, medications and phytodrugs consumed, duration of exclusive breastfeeding according to medication consumption and type of medication that led to the suspension of breastfeeding. Theoretical, empirical and statistical methods were used (from descriptive statistics, absolute and relative frequencies). As relevant results, 64% of the mothers were between 20 and 34 years old and 54.7% had overcome the level of pre-university education; 69.3 consumed medications and 41.3%, phytopharmaceuticals, highlighting dipyrone and ibuprofen in the former and mint, in the latter. It was concluded that the most influential medications in the suspension of breastfeeding were chlorodiazopoxide and amiodarone.El único alimento que debe recibir el bebé durante los primeros 6 meses de vida es la leche de su madre. Cualquier sustancia que ella consuma mientras esté lactando tiene repercusiones en su hijo, por lo que la utilización de medicamentos, fitofármacos u otras sustancias debe ser por prescripción facultativa y rigurosamente vigilada. Con el objetivo de caracterizar el uso de medicamentos y fitofármacos en madres durante el periodo de lactancia, se realizó un estudio observacional descriptivo, de corte transversal, en diez consultorios urbanos de Bayamo, provincia Granma, durante el periodo septiembre 2017 a abril 2018. El universo agrupó a las madres lactantes pertenecientes a dichos consultorios, y la muestra la integraron las que aceptaron ser incluidas en la investigación, previo consentimiento informado. Se caracterizaron las madres según las variables siguientes: nivel de escolaridad, medicamentos y fitofármacos consumidos, duración de la lactancia materna exclusiva según consumo de medicamentos y tipo de medicamento que motivó la suspensión de la lactancia materna. Se emplearon métodos teóricos, empíricos y como estadísticos (de la estadística descriptiva, las frecuencias absolutas y relativas). Como resultados relevantes, el 64 % de las madres tenía entre 20 y 34 años y el 54,7 % había vencido el nivel de escolaridad preuniversitario; el 69,3 consumía medicamentos y 41,3 %, fitofármacos, destacando dipirona e ibuprofeno en los primeros y la menta, en los segundos. Se concluyó que los medicamentos más influyentes en la suspensión de la lactancia materna fueron el clorodiazépoxido y la amiodarona.O único alimento que o bebê deve receber durante os primeiros 6 meses de vida é o leite de sua mãe. Qualquer substância que ela consuma enquanto amamenta repercute em seu filho, portanto o uso de medicamentos, fitofármacos ou outras substâncias deve ser por prescrição e estritamente monitorado. Com o objetivo de caracterizar o uso de medicamentos e fitoterápicos em mães durante o período de aleitamento materno, foi realizado um estudo observacional descritivo, transversal, em dez consultórios urbanos em Bayamo, província do Granma, no período de setembro de 2017 a abril de 2018. O universo agrupou as nutrizes pertencentes a esses consultórios e a amostra foi composta por aqueles que concordaram em ser incluídos na pesquisa, com consentimento prévio informado. As mães foram caracterizadas de acordo com as seguintes variáveis: nível de escolaridade, medicamentos e fitoterápicos consumidos, tempo de aleitamento materno exclusivo segundo o consumo de medicamentos e tipo de medicamento que levou à suspensão do aleitamento materno. Métodos teóricos, empíricos e estatísticos foram utilizados (da estatística descritiva, frequências absolutas e relativas). Como resultados relevantes, 64% das mães tinham entre 20 e 34 anos e 54,7% haviam superado o nível de ensino pré-universitário; 69,3 consumiram medicamentos e 41,3%, fitofármacos, destacando a dipirona e o ibuprofeno no primeiro e o hortelã no segundo. Concluiu-se que os medicamentos mais influentes na suspensão da amamentação foram clorodiazopóxido e amiodarona.

Propuesta de seminario de actualización farmacoterapéutica sobre hipertensión arterial

Por la repercusión que tiene sobre los índices de morbilidad y mortalidad a nivel internacional, la hipertensión arterial constituye un desafío para la Atención Primaria de Salud. En los últimos años se ha desarrollado un completo arsenal terapéutico de eficacia demostrada, sin embargo, no se alcanzan los logros esperados con el tratamiento, al menos en términos poblacionales, por lo que los investigadores en esta esfera realizan infinitos esfuerzos para dar solución a este problema de salud y las complicaciones que de él se derivan. Una de las formas de contribuir a solucionar esta situación es mantener actualizado al personal médico y promover en los estudiantes un pensamiento científico prescriptivo, por lo que proponemos una forma de desarrollar los seminarios de actualización farmacoterapéutica, tomando como ejemplo la hipertensión arterial

Programme for Harmonization to the International Scale in Latin America for BCR-ABL1 quantification in CML patients: Findings and recommendations

The quantitation of BCR-ABL1 mRNA is mandatory for chronic myeloid leukemia (CML) patients, and RT-qPCR is the most extensively used method in testing laboratories worldwide. Nevertheless, substantial variation in RT-qPCR results makes inter-laboratory comparability hard. To facilitate inter-laboratory comparative assessment, an international scale (IS) for BCR-ABL1 was proposed.The laboratory-specific conversion factor (CF) to the IS can be derived from the World Health Organization (WHO) genetic reference panel; however, this material is limited to the manufacturers to produce and calibrate secondary reference reagents. Therefore, we developed secondary reference calibrators, as lyophilized cellular material, aligned to the IS. Our purpose was both to re-evaluate the CF in 18 previously harmonized laboratories and to propagate the IS to new laboratories.Results Our field trial including 30 laboratories across Latin America showed that, after correction of raw BCR-ABL1/ABL1 ratios using CF, the relative mean bias was significantly reduced. We also performed a follow-up of participating laboratories by annually revalidating the process; our results support the need for continuous revalidation of CFs. All participating laboratories also received a calibrator to determine the limit of quantification (LOQ); 90% of them could reproducibly detect BCR-ABL1, indicating that these laboratories can report a consistent deep molecular response. In addition, aiming to investigate the variability of BCR-ABL1 measurements across different RNA inputs, we calculated PCR efficiency for each individual assay by using different amounts of RNA.Conclusions In conclusion, for the first time in Latin America, we have successfully organized a harmonization platform for BCR-ABL1 measurement that could be of immediate clinical benefit for monitoring the molecular response of patients in low-resource regions.Fil: Ruiz, María Sol. Fundación Cáncer. Centro de Investigaciones Oncológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sánchez, María Belén. Fundación Cáncer. Centro de Investigaciones Oncológicas; ArgentinaFil: Vera Contreras, Yuly Masiel. Fundación Cáncer. Centro de Investigaciones Oncológicas; ArgentinaFil: Agrielo, Evangelina. Laboratorio Especialidades Bioquímicas; ArgentinaFil: Alonso, Marta. Hospital Nacional Profesor Alejandro Posadas; ArgentinaFil: Altuna, María Eugenia. Clinica Roberto Raña; ArgentinaFil: Anchordoqui, María Sol. Argenomics; ArgentinaFil: Asinari, Mariana. Hospital Privado Centro Médico de Córdoba; ArgentinaFil: Bonetto, María Elisa. Hospital Rawson San Juan; ArgentinaFil: Camargo, Mauricio. Laboratorio Medellin; ColombiaFil: Giere, Isabel. Fundación Para Combatir la Leucemia; ArgentinaFil: González, Javier. Meyer Lab; ParaguayFil: Granda Alacote, Ana Cecilia. Laboratorios Medicos Lima; PerúFil: Guerra, Javier. Nanopharmacia Diagnóstica Mexico; MéxicoFil: Gutiérrez, Marina. Stamboulian; ArgentinaFil: Maldonado, Cecilia. Manlab; ArgentinaFil: Makiya, Ricard. No especifíca;Fil: Manrique, Gonzalo. Asociacion Española de Montevideo; UruguayFil: Monaco, María Eugenia. Laboratorio Tucuman; ArgentinaFil: Rozo, Juan Carlos. Unidad de Diagnóstico Hemato Oncológico; ColombiaFil: Santamaría Martín, Carlos Jose. Hospital de Niños San Jose de Costa Rica; Costa Rica. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Seravalle, Analía. Civic Rosario; ArgentinaFil: Zea, Olga. Laboratorio Medellin Colombia; ColombiaFil: Zubillaga, María Noel. Asociación Española de Socorros Mutuos; UruguayFil: Mordoh, José. Fundación Cáncer. Centro de Investigaciones Oncológicas; ArgentinaFil: Larripa, Irene Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Bianchini, Michele. Fundación Cáncer. Centro de Investigaciones Oncológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Biomechanical study of autograft anatomic reconstruction in lateral ankle instability

Introduction: The purpose of this work is perform a biomechanical comparison of anatomic reconstruction of the anterior talofibular ligament (ATFL) with the intact ATFL. Materials and methods: We studied 18 fresh cadaveric ankles with intact ATFL. Each specimen was clinically assessed with the anterior drawer (AD) and varus tilt (VT) tests and the angular movement in the three spatial planes (axial, coronal and sagittal) was measured with an arthrometer using a sensor located in the talus. Results: Statistically significant differences were found in the axial plane, between the intact ATFL versus the sectioned ATFL for AD test with p = 0.012, and for VT test with p = 0.013. Regarding the coronal plane, we also observed a statistically significant difference for VT test with p = 0.016. In the sagittal plane, there are no statistically significant differences in both maneuvers. No statistically significant differences were found when comparing the biomechanics of anatomic ligament reconstruction versus the intact ATFL. Conclusion: Autograft anatomic reconstruction of the ATFL showed biomechanical properties similar to those of the native ATFL, at the zero moment in a cadaveric model.publishersversionpublishe