La Influencia del maestro en los errores lectores del niño(a)

La jungla escolar, que para muchos estudiantes constituye la escuela; es para la mayoría de adultos simplemente el intercambio útil y consagrado (por demás obligatorio) en el cual maestro y estudiante interactúan y crecen en el ejercicio noble de la enseñanza, que gracias a su carácter formativo y altruista asegura el éxito en el proceso de aprendizaje del niño(a). Fijando su atención en la espera pasiva de resultados satisfactorios; ignorando premeditadamente lo esencial y verdaderamente importante dentro de este proceso: que son la construcción del conocimiento y la interacción social con el medio, resaltando en esta interacción factores que motivan o no al estudiante a disfrutar o rechazar su paso por la escuela

Differential evolution of cell-associated virus in blood and genital tract of HIV-infected females undergoing HAART

AbstractPBMC and vaginal cell (VC) viruses were studied from 5 HIV-infected females for the presence of drug-resistance and non-drug resistance associated mutations. A 1318-bp fragment of polymerase gene was amplified from PBMC and VC proviral DNA. Four of the 5 PBMC viruses exhibited drug resistance-associated mutations in reverse transcriptase and protease genes, whereas only 2 VC viruses contained drug resistance-associated mutations. However, all 5 females showed non-drug resistance-associated mutations both in PBMC and VC virus suggesting continuous evolution of the virus in these compartments. The emergence of drug resistance was slower in PBMC and VC viruses than that observed in the cell-free plasma (P) and vaginal secretion (VS) viruses. Phylogenetic analysis revealed that VC virus was closer to PBMC virus than either cell-free viruses (P and VS) suggesting comparable evolution among cell-associated viruses

The 2022 symposium on dementia and brain aging in low‐ and middle‐income countries: Highlights on research, diagnosis, care, and impact

Two of every three persons living with dementia reside in low‐ and middle‐income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high‐income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC‐focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. Highlights: Two‐thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs

Risk Factors of Unfavorable Outcome in Children with Mitral Valve Repair

The aim of this study was to analyze risk factors of unfavorable outcome (UO) in patients with mitral regurgitation(MR) undergoing mitral valve repair (MVR).Methods: Patients with MR who had undergone MVR from 2004 to 2014 were retrospectively analyzed. Unfavorable outcomewas defined as reoperation or significant MR [moderate to severe (3+) or severe MR (4+)] during follow-up. Variables wereexpressed as median. Univariate and multivariate logistic regression analyses were performed to identify predictive factorsof UO.Results: Sixty five patients with MR3+ and MR4+ underwent MVR. Etiology was dysplasia in 44.6% of cases, infective endocarditisin 13.8%, rheumatic fever in 18.4%, abnormal coronary origin in 7.7% and other disorders in 13.8%. Median follow-uptime was 26.5 months (52 patients are still being followed-up).Ventricular dysfunction was documented in 44.6% of casesand 46.1% had pulmonary hypertension. Fifteen patients presented UO and 9 were reoperated (7 valve replacements and 2re-repairs). Univariate analysis demonstrated a significant association between UO and the following conditions: rheumaticfever (p=0.005), preoperative mitral annulus ≥+5 SD (p=0.002), left ventricular end-systolic diameter ≥+4 SD (p=0.022),pulmonary hypertension (p=0.024) and immediate postoperative residual MR ≥ moderate (p=0.021). Multivariate analysisdemonstrated mitral annulus diameter (p=0.012), rheumatic fever (p=0.026) and early residual MR (p=0.042) as independentvariables of UO. No deaths occurred in this series.Conclusions: Mitral valve repair in children with severe MR demonstrated mid-term favourable results. Rheumatic fever,mitral annulus diameter ≥+5 SD and immediate postoperative residual MR ≥2+ were predictive factors of UO. Neither ageat surgery nor ventricular dysfunction showed statistically significant differences during follow-up.Analizar los factores de riesgo de evolución desfavorable (ED) en niños con insuficiencia mitral (IM) sometidos a plástica mitral (PM). Métodos: Se analizaron pacientes con IM sometidos a PM entre el 2004 al 2014. Se definió ED como reoperación o IM significativa (moderada a severa (3+) o severa (4+)) durante el seguimiento. Las variables se expresaron como mediana. Se realizó análisis multivariado de regresión logística de los factores predictores de ED. Resultados. Sesenta y cinco pacientes con IM3+ y IM4+ se sometieron a PM. La etiología fue: displasia 44,6%, endocarditis infecciosa 13,8%, fiebre reumática 18,4%, anomalía coronaria 7,7%, otros 13,8%. La mediana del seguimiento fue 26,5 meses. 44,6% presentaron disfunción ventricular y el 46,1% hipertensión pulmonar. 52 pacientes se encuentran en seguimiento. Quince presentaron ED: 9 fueron reoperados (7 reemplazos valvulares y 2 re-plástica). El análisis univariado demostró asociación significativa entre ED y: fiebre reumática (p0.005), anillo mitral preoperatorio ≥+5DS (p0.002), diámetro sistólico del ventrículo izquierdo (DSVI) ≥+4DS (p0.022), hipertensión pulmonar (p0. 024) y la IM residual postoperatoria inmediata ≥ moderada (p0.021). El análisis multivariado demostró como variables independientes de ED: diámetro del anillo mitral (p0.012), fiebre reumática (p0.026) y la IM residual temprana (p0.042). No se produjo mortalidad. Conclusiones. La plástica mitral en niños con IM severa demostró resultados favorables a mediano plazo. La fiebre reumática, el diámetro del anillo mitral ≥+5DS y la IM residual ≥2 + fueron factores predictores de ED. Ni la edad, ni la disfunción ventricular mostraron diferencias estadísticamente significativas durante el seguimiento

A comparison of stavudine, didanosine and indinavir with zidovudine, lamivudine and indinavir for the initial treatment of HIV-1 infected individuals: Selection of thymidine analog regimen therapy (Start II)

Objective: Comparison of stavudine (d4T), didanosine (ddl) and indinavir (IDV) with zidovudine (ZDV), lamivudine (3TC) and IDV in HIV-1 infected patients. Design: Randomized, open-label. Setting: Fourteen HIV Clinical Research Centers. Patients: Two-hundred and five patients with less than 4 weeks antiretroviral treatment, naive to 3TC and protease inhibitors and with CD4 cell counts ≥ 200 x 10 6/l and plasma HIV-1 RNA levels ≥ 10 000 copies/ml. Interventions: Stavudine 40 mg and ddl 200 mg twice daily plus IDV 800 mg every 8 h compared with ZDV 200 mg every 8 h or 300 mg twice daily, 3TC 150 mg twice daily plus IDV. Main outcome measures: The proportion of patients with plasma HIV-1 RNA levels \u3c 500 copies/ml and ≤ 50 copies/ml and changes in CD4 cell counts were compared. Results: In an analysis of the primary endpoint, 61% of patients on d4T + ddl + IDV and 45% of patients on ZDV+ 3TC + IDV had all HIV-1 RNA values obtained between weeks 40 and 48 \u3c 500 copies/ml [95% confidence interval (Cl) for the difference between proportions, 1.7-30.3%; P = 0.038]. In an intent-to-treat analysis, the percentage of all patients randomized with all HIV-1 RNA levels \u3c 500 copies/ml between 40 and 48 weeks were 53% for the d4T + ddl + IDV arm and 41% for the ZDV + 3TC + IDV arm (95% Cl, -1.4% to 25.7%; P = 0.068). At 48 weeks 41% and 35% were ≤ 50 copies/ml for the stavudine- and ZDV-containing arms respectively (P \u3e 0.2). The median time-weighted average increases in CD4 cells count over 48 weeks were 150 x 10 6/l cells for the d4T arm and 106 x 10 6/l cells for the ZDV arm (P = 0.001). The occurrence of serious adverse events was not significantly different between arms. Conclusion: The combination of stavudine, ddl and IDV resulted in potent antiretroviral effects over a 48-week period, comparable or superior to zidovudine, 3TC and IDV supporting the use of stavudine, ddl and a protease inhibitor as an initial antiretroviral treatment. (C) 2000 Lippincott Williams and Wilkins