Estrategia de Capacitación para la supervisión de la Educación Física por los directivos en las escuelas de la Educación Especial

La investigación se desarrolla por los limitados conocimientos que poseen los directivos de las escuelas especiales del municipio Ciego de Ávila para la supervisión del Proceso de Enseñanza-Aprendizaje de la Educación Física en las escuelas, no siendo prioridad el proceso desde el trabajo metodológico en las escuelas, constituyen problemáticas no resueltas, por lo que se propone una estrategia de capacitación encaminada a la solución de ellas. La novedad radica en que la estrategia de capacitación que está conformada por talleres, acciones de trabajo metodológico, sustentándose en un enfoque integral físico-educativo, concibiéndose la escuela especial Celia Sánchez Manduley del municipio Ciego de Ávila como sede de la capacitación y el escenario de la mayoría de las acciones que se realizan

A new strategy for multitarget drug discovery/repositioning through the identification of similar 3D amino acid patterns among proteins structures: The case of Tafluprost and its efects on cardiac ion channels

The identification of similar three-dimensional (3D) amino acid patterns among different proteins might be helpful to explain the polypharmacological profile of many currently used drugs. Also, it would be a reasonable first step for the design of novel multitarget compounds. Most of the current computational tools employed for this aim are limited to the comparisons among known binding sites, and do not consider several additional important 3D patterns such as allosteric sites or other conserved motifs. In the present work, we introduce Geomfinder2.0, which is a new and improved version of our previously described algorithm for the deep exploration and discovery of similar and druggable 3D patterns. As compared with the original version, substantial improvements that have been incorporated to our software allow: (i) to compare quaternary structures, (ii) to deal with a list of pairs of structures, (iii) to know how druggable is the zone where similar 3D patterns are detected and (iv) to significantly reduce the execution time. Thus, the new algorithm achieves up to 353x speedup as compared to the previous sequential version, allowing the exploration of a significant number of quaternary structures in a reasonable time. In order to illustrate the potential of the updated Geomfinder version, we show a case of use in which similar 3D patterns were detected in the cardiac ions channels NaV1.5 and TASK-1. These channels are quite different in terms of structure, sequence and function and both have been regarded as important targets for drugs aimed at treating atrial fibrillation. Finally, we describe the in vitro effects of tafluprost (a drug currently used to treat glaucoma, which was identified as a novel putative ligand of NaV1.5 and TASK-1) upon both ion channels’ activity and discuss its possible repositioning as a novel antiarrhythmic drug.This research was funded by the Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT) grants numbers 1191133, 1170662 and from Spanish Ministry of Economy and Competitiveness (projects SEV-2015-0493 and TIN2015-65316-P, grant BES-2016-078046), and from Generalitat de Catalunya (contracts 2017-SGR-1414 and 2017-SGR-1328). The financial support by DICYT-USACH grant 5392102RP-ACDicyt is also acknowledged. The web-server is hosted in the cluster obtained with the grant CONICYT-FONDEQUIP-EQM160063.Peer ReviewedPostprint (published version

Anxiety Level and Prenatal Control in Pregnant Women from the Family Medicine Unit 73

Antecedentes: La OMS establece que toda embarazada debe tener de 4 a 8 consultas de control prenatal.  El embarazo produce alteraciones fisiológicas las cuales podrían estar involucradas con los síntomas de ansiedad, la cual es un estado emocional que tiene cambios somáticos y psíquicos. Objetivo: analizar la relación entre el nivel de ansiedad y el control prenatal en pacientes embarazadas de la UMF No. 73. Material y métodos: se realizó un estudio observacional, analítico y transversal, se aplicó la escala de Hamilton a 331 embarazadas adscritas a la UMF No. 73. Se realizó estadística descriptiva y análisis comparativo con SPSS, se consideró valor de p≤ 0.05 como significativo. Resultados: la edad promedio de la muestra fue de 26.85 ± 6.13 años, con 4 meses de embarazo. El nivel de ansiedad obtenido de la muestra fue moderado en 47% de las participantes y 12% fue severo además el 60% tuvo un control prenatal adecuado. La comparación entre grupos del nivel de ansiedad y el control prenatal fue p>0.050. Conclusiones: Se determina que no hubo diferencia significativa entre el control prenatal y el nivel de ansiedad en mujeres embarazadas, pero si se concluyó que el nivel de ansiedad se encontró en moderado.Background: The WHO establishes that every pregnant woman should have 4 to 8 prenatal control visits. Pregnancy produces physiological alterations which could be involved with anxiety symptoms, which is an emotional state that has somatic and psychological changes. Objective: to analyze the relationship between the level of anxiety and prenatal control in pregnant patients of the UMF No. 73.  Material and methods: an observational, analytical and cross-sectional study was carried out, the Hamilton scale was applied to 331 pregnant women assigned to the UMF No. 73. Descriptive statistics and comparative analysis were carried out with SPSS, a value of p≤ 0.05 was demonstrated as significant. Results: the average age of the sample was 26.85 ± 6.13 years, with 4 months of pregnancy. The level of anxiety obtained from the sample was moderate in 47% of the participants and 12% was severe, and 60% had adequate prenatal care. The comparison between groups of anxiety level and prenatal control was p>0.050. Conclusions: It is determined that there was no significant difference between prenatal control and the level of anxiety in pregnant women, but it is concluded that the level of anxiety was moderate

Linfadenopatía angioinmunoblástica con disproteinemia asociada a crioglobulinemia. Consideraciones acerca de un caso. Angioimmunoblastic lymphadenopathy with dysproteinemia associated with cryoglobulinemia. A case report

Se realizó la presentación de un caso de linfadenopatía angioinmunoblástica con disproteinemia asociado a crioglobulinemia diagnosticado en el Hospital "Abel Santamaría" de Pinar del Río, la cual presentó una forma de debut atípica. Se realiza una breve revisión de dicha enfermedad, considerando sus principales elementos clínicos e histológicos, los que estuvieron presentes en gran medida en nuestra paciente. DeCS: CRIOGLOBULINEMIA/diagnóstico, LINFADENOPATÍA INMUNOBLÁSTICA/diagnóstico.ABSTRACT A female patient suffering from Angioimmunoblastic lymphadenopathy and dysproteinemia associated with cryoglobulina presenting an atypical onset was diagnosed at Abel Santamaría Hospital, Pinar del Río. A brief review of this entity was carried out in order to analyse the main clinical and histopatological present in our patient. DeCS: CRYOGLOBULINEMIA/diagnostic, IMMUNOBLASTIC LYMPHADENOPATHY/diagnostic

Linfadenopatía angioinmunoblástica con disproteinemia asociada a crioglobulinemia. Consideraciones acerca de un caso. Angioimmunoblastic lymphadenopathy with dysproteinemia associated with cryoglobulinemia. A case report

Se realizó la presentación de un caso de linfadenopatía angioinmunoblástica con disproteinemia asociado a crioglobulinemia diagnosticado en el Hospital "Abel Santamaría" de Pinar del Río, la cual presentó una forma de debut atípica. Se realiza una breve revisión de dicha enfermedad, considerando sus principales elementos clínicos e histológicos, los que estuvieron presentes en gran medida en nuestra paciente. DeCS: CRIOGLOBULINEMIA/diagnóstico, LINFADENOPATÍA INMUNOBLÁSTICA/diagnóstico.ABSTRACT A female patient suffering from Angioimmunoblastic lymphadenopathy and dysproteinemia associated with cryoglobulina presenting an atypical onset was diagnosed at Abel Santamaría Hospital, Pinar del Río. A brief review of this entity was carried out in order to analyse the main clinical and histopatological present in our patient. DeCS: CRYOGLOBULINEMIA/diagnostic, IMMUNOBLASTIC LYMPHADENOPATHY/diagnostic

Cirugía combinada cardiaca y pulmonar en un paciente con un histoplasmoma

ResumenLa histoplasmosis pulmonar y su diseminación hemática con el desarrollo de una endocarditis sobre la válvula pulmonar son extremadamente infrecuentes. Presentamos un niño de 10 años que, como complicaciones de una histoplasmosis pulmonar, desarrolló una caverna en la base del pulmón derecho que se fistulizó a un vaso sanguíneo pulmonar y que además presentaba vegetaciones en la válvula pulmonar con peligro de causar infartos pulmonares e insuficiencia valvular pulmonar severa, que obligaron a realizar una compleja intervención quirúrgica cardiopulmonar en un solo tiempo, donde se realizó la resección completa del lóbulo inferior del pulmón derecho, se cerró la comunicación interventricular y se reconstruyó la válvula pulmonar con 3 velos de pericardio autólogo. Seis meses después, el paciente está asintomático, con reexpansión de los lóbulos restantes del pulmón derecho, y la ecocardiografía transtorácica muestra un buen funcionamiento de la neoválvula pulmonar construida con el pericardio autólogo.AbstractIsolated pulmonary valve endocarditis is extremely rare in a patient with histoplasmosis. The case is presented of a ten year-old child, who, as complications of histoplasmosis, developed a cavern at the base of the right lung that fistulised into a pulmonary blood vessel, as well as presenting with vegetations in the pulmonary valve. As there was a danger of pulmonary infarctions and sever pulmonary valve insufficiency, a complete resection of the lower right lung lobe was necessary. The interventicular communication was closed and the pulmonary valve was reconstructed with three autologous pericardial flaps. Six months later, the patient is symptomatic, with re-expansion of the remaining right lung lobes, and the trans-thoracic echocardiography showed good functioning of the newly pulmonary valve constructed with autologous pericardial flaps

Ultrasonography-guided anterior approach for axillary nerve blockade: an anatomical study

Combined ultrasound-guided blockade of the suprascapular and axillary nerves has been proposed as an alternative to interscalene blockade for pain control in shoulder joint pathology or post-surgical care. This technique could help avoid respiratory complications and/or almost total upper limb palsy. Nowadays, the axillary nerve blockade is mostly performed using an in-plane caudal-to-cephalic approach from the posterior surface of the shoulder, reaching the nerve immediately after it exits the neurovascular quadrangular space (part of the spatium axillare). Despite precluding most respiratory complications, this approach has not made post-surgical pain relief any better than an interscalene blockade, probably because articular branches of the axillary nerve are not blocked. Cephalic to caudal Methylene Blue injections were placed in the first segment of the axillary nerve of six Thiel-embalmed cadavers using an ultrasound-guided anterior approach in order to compare the distribution with that produced by a posterior approach to the contralateral axillary nerve in the same cadaver. Another 21 formalin-fixed cadavers were bilaterally dissected to identify the articular branches of the axillary nerve. We found a good spread of the dye on the axillary nerve and a constant relationship of this nerve with the subscapularis muscle. The dye reached the musculocutaneous nerve, which also contributes to shoulder joint innervation. We describe the anatomical landmarks for an ultrasonography-guided anterior axillary nerve blockade and hypothesize that this anterior approach will provide better pain control than the posterior approach owing to complete blocking of the joint nerve. This article is protected by copyright. All rights reserved

Mielitis transversa aguda asociada al puerperio

Introducción: la mielitis transversa aguda es un cuadro neurológico que se desarrolla desde unas horas hasta 7 días con afectación del sistema motor sensitivo y autonómico a la altura de la inflamación medular. Su diagnóstico requiere demostrar que existe inflamación de la médula espinal. Presentación del caso: se presenta el caso de una puérpera cesareada de 5 días de evolución con diagnóstico de mielitis transversa aguda. Presentó paraplejia flácida, debilidad en miembro superior, nivel sensitivo D5, para todas las modalidades de la sensibilidad y arreflexia osteotendinosa. Conclusiones: el diagnóstico oportuno de la mielitis transversa, la valoración integral y multidisciplinaria de la misma y el tratamiento eficaz y temprano favorecen una recuperación rápida y limitan la existencia de graves complicaciones o secuelas que impidan el desarrollo de la vida normal del pacient