Universidad de Ciencias Médicas de la Habana

La formación psicopedagógica del Licenciado en Cultura Física es importante para su desempeño profesional en la esfera deportiva y recreativa, por lo que aparece como una disciplina en el plan de estudio denominada Psicopedagogía de la Actividad Física. Sin embargo, los egresados no siempre logran aplicar de manera efectiva en su desempeño profesional los contenidos psicopedagógicos recibidos. El objetivo del artículo es valorar las limitaciones existentes en la formación psicopedagógica inicial del Licenciado en Cultura Física, a partir de las inconsecuencias contenidas en el plan de estudio en cuanto a la concepción teórica interdisciplinar de la psicopedagogía para propiciar su perfeccionamiento

Clostridioides difficile causes diarrhea associated with antibiotic use in hospitalized patients. Recent studies have identified that C. difficile ribotypes RT002, RT106, and RT591 as the most prevalent circulating strains in Colombia; thus, we aimed to assess the capability of these ribotypes to elicit an inflammatory response during in vivo infection. To achieve this, C57BL/6 mice were treated with cefoperazone (CPZ) for 5 d to develop C. difficile infection (CDI) model. Two days post-antibiotic treatment, the mice were orally inoculated with 1 × 10⁵ spores of C. difficile strains belonging to ribotypes RT002, RT106, RT591, and RT027 (ATCC strain, used as control). A group of animals was euthanized on day 7 post-infection to determine the bacterial load, total leukocyte number, and chemokines/cytokines levels in situ, and for histopathological analysis. RT002-infected groups showed significantly higher bacterial load, CD45+ leukocytes, and RANTES, eotaxin, MCP-1, G-CSF, and IL-2 levels compared to the other groups, suggesting a robust immune response. Furthermore, histopathological analysis of colonic tissue from the group infected with RT002 revealed the presence of an inflammatory response similar to the hypervirulent strain RT027. These results suggest that RT002 of C. difficile, one of the main circulating strains in Colombia, can induce a severe inflammatory response, potentially correlating with increased virulence and severity of these strains in CDI cases.

Background: Arterial hypertension (AH) is a leading risk factor for cardiovascular diseases (CVDs) and plays a key role in determining cardiovascular risk (CVR). Strategies to reduce CVR are fundamental in primary health care. Objective: To evaluate the effectiveness of an educational intervention on improving knowledge about CVDs and reducing CVR levels in hypertensive patients at a health center in Ecuador. Methods: A quasi-experimental before-and-after study was conducted with 55 hypertensive adults. CVR was assessed using the Globorisk scale, and knowledge about CVDs was measured through a validated questionnaire from the EMDADER-CV study. Baseline and six-month post-intervention measurements were compared. Clinical trial number: not applicable. Ethical considerations: The study was approved by the corresponding ethics committees and conducted in accordance with the Declaration of Helsinki and national regulations. Written informed consent was obtained from all participants. Results: The mean participant age was 58.3 years, with women representing 69.1% of the sample. After six months, the mean CVR significantly decreased from 8.8–5.9% (p < 0.05), and the mean knowledge score significantly increased from 5.2 to 9.0 points (p < 0.05). The proportion of individuals with high or very high CVR declined from 36.4–10.9%, while those at low or moderate risk increased from 63.6–89.1%. Conclusion: The educational strategy was effective in both reducing cardiovascular risk and improving knowledge about CVDs among hypertensive patients in a primary care setting.

Collagen proteins play important roles in wound healing and are of great interest in regenerative medicine. This study evaluated the efficacy of new collagen‐based products and compared them to commercial products in a murine model of cutaneous healing. Circular excisional defects were generated on 72 Wistar rats. Six study groups were established according to the administered collagen treatment: Control (without treatment), SD‐C (semidenatured), Catrix, Hy‐C (hydrolyzed), N‐C (native) and Helix3‐CP. Seven and eighteen days post‐surgery, animals were euthanized. Wound closure was macroscopically assessed by taking zenithal images of the defects. Morphological, histological and immunohistochemical studies were performed to evaluate the healing process. After 7 days, open areas and degree of epithelialization were similar among the groups. Significant differences were observed in contraction between control and the N‐C and Helix3‐CP groups. Untreated animals exhibited a more pronounced granulation tissue with a high number of inflammatory cells and a disorganised extracellular matrix with type III collagen deposition. After 18 days, animals treated with new collagen (Hy‐C and N‐C) exhibited accelerated wound closure, increased epithelialization and a more organised granulation tissue. Local administration of new collagen treatments promotes the progression of the reparative process and significantly accelerates wound closure compared with nontreated wounds.

Background: Treating psychiatric illnesses or influencing mental states with neurofeedback is challenging, likely due to the limited spatial specificity of EEG and the complications arising from the inadequate signal-to-noise ratio reduction of single-trial EEG. Objective: This pilot study aimed to investigate the feasibility of employing a binaural pulse mode-modulation (BPM) device to reduce anxiety by self-regulation. We desired to determine whether anxiety could be significantly reduced or regulated using BPM-type systems. Methods: Sixty adult participants were examined with self-reported anxiety tests (COVID Stress Scale, Generalized Anxiety Disorder 7, Beck Depression Inventory-II), which were completed before treatment, after four weeks, and after 12 weeks post-treatment. This BPM device produced two frequencies which combined to create a binaural pulse through differential auditory tone presentations. The participant calibrated the suitable target tone for optimal treatment efficacy. Each participant adjusted the binaural pulse to enhance the emotional intensity felt when envisioning an experience with comparable emotional significance or while performing a cognitive task while concurrently listening to music. The “treatment” relied on the individual’s regulation of binaural pulses to obtain the desired state. The training concentrated on particular facets of their psychological challenges while listening to an auditory tone, adjusting a knob until the sound amplified the intended emotional state. Another knob was turned to intensify the emotional state associated with distress reduction. Results: On the self-reported measures, the BPM treatment group was significantly better than the sham treatment (control) groups (p < 0.01). These findings indicate that over the four-week intervention period, BPM was similarly effective. On the GAD-7, the significant difference over time was noted before treatment and at the end of treatment for the experimental group, with the average GAD-7 score at the end of treatment being significantly lower (p < 0.01). Conclusions: BPM seems to induce a short-term alteration in self-reported distress levels during therapy. This study’s limitations are examined, and recommendations for future research are provided.

The stable isotope composition of meteoric water has been widely used to understand hydrological processes worldwide. We present a unique dataset, with the isotopic composition (δ¹⁸O and δ²H) of meteoric waters, derived from a nationwide study in Cuba. It includes monthly composite and event-based precipitations, from January 2017 to December 2021 (N = 526 and N = 111 respectively). Monthly data showed minor seasonal trends (dry vs. rainy), with a notable influence of tropical cyclones. Event-based data demonstrated that precipitation associated with tropical cyclones exhibited lower isotopic compositions. The analysis of potential factors influencing the isotopic composition of precipitation showed a minor influence of the rainfall amount, but negligible influence of factors such are relative humidity, elevation, and air temperature. This data set can be used as a tool not only to understand hydrological processes at the country scale, but also to further improve and develop isotope-enabled modelling for assessing water balances and fluxes, understanding the impact of extreme events, and paleoreconstruction in the Intra-Americas Sea.

Objective In this pilot study a binaural pulse modulator was tested to see if it leads to a change in self-reported measures of distress. This binaural pulse modulator produces two frequencies that combine to create a binaural pulse to stimulate the nervous system through a differential auditory tone presentation and the response of the user can be adjusted to the appropriate target tone for effective treatment use. Each individual calibrated the binaural pulse to increase the level of emotion experienced while imagining an experience with a similar emotional valence or while engaged in a cognitive function while also listening to the sound. “Treatment” is based on the client’s control of the binaural pulses to achieve the desired state. Training focuses on specific aspects of their psychological difficulties while listening to an auditory tone, turning a knob until the sound becomes uncomfortable. Finally, another knob is turned to cancel out the uncomfortable noise which appears to be associated with a reduction in distress. Case presentations Four adult Hispanic participants (three females and one male) were studied with self-reported measures of distress (generalized anxiety disorder 7, Coronavirus Disease Stress Scale, posttraumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and Beck depression scale II) were completed at screening, before treatment, after treatment, 4-weeks post-treatment, and 12-weeks post-treatment. Quantitative electroencephalogram and functional magnetic resonance imaging were also performed before and after treatment. Results Preliminary findings indicated that at the end of treatment with binaural pulse modulator there were reported reductions in self-reported levels of distress. Quantitative electroencephalogram as well as functional magnetic resonance imaging changes in brain state were also noted when comparing pre- to post-treatment. Conclusions: binaural pulse modulator use appears to result in temporary changes in self-reported levels of distress during treatment. Limitations of the study are reviewed and directions for further research are offered.

Un trastorno en la calidad del sueño (TCS) constituye una enfermedad que se acompaña con síntomas psíquicos como la ansiedad, la depresión, la angustia y el estrés como protagonista

Objective The aetiology of impairments in autonomic modulation of heart rate variability (HRV) in polycystic ovary syndrome (PCOS) remains unclear, as does the impact of aerobic physical training (APT) on controlling endocrine‐metabolic disorders and HRV. This is because these women often present excess body fat. Therefore, we assessed whether the dysregulation in autonomic modulation of HRV in women with PCOS is due to endocrine‐metabolic disorders and whether the combination of excess body fat with endocrine‐metabolic disorders amplifies cardiovascular autonomic deficits. We also investigated whether APT positively influences autonomic modulation of HRV in PCOS. Design Non‐randomised clinical trial. Participants Women with and without PCOS with different percentages of body fat. Measurements Participants were divided into four groups: women without PCOS with a body fat percentage between 22% and 29% (CONTROL group; 22%–29%); CONTROL (30%–37%) group; PCOS (22%–29%) group; and PCOS (30%–37%) group. Hemodynamic, metabolic, and hormonal characteristics and HRV parameters were obtained before and after 16 weeks of APT. Results The PCOS (22%–29%) group exhibited lower vagal modulation than the CONTROL (22%–29%) group. In contrast, no significant differences were observed between the CONTROL (30%–37%) and PCOS (30%–37%) groups. Furthermore, the PCOS (30%–37%) group demonstrated lower sympathetic modulation than the PCOS (22%–29%) group. After APT, the PCOS (22%–29%) group increased in vagal modulation, while the PCOS (30%–37%) group increased in sympathetic modulation. Conclusion PCOS affects vagal modulation; however, this effect may be masked at elevated levels of body fat. Additionally, the combination of excess body fat with endocrine‐metabolic dysregulation appears to reduce sympathetic modulation, possibly due to sympathetic drive hyperactivity. APT positively affected HRV in both PCOS groups.

Massive spawning of bleached colonies from six coral species was recorded in Guanahacabibes National Park, Cuba in August–September 2023. Bleached corals spawned within regional predictions, which indicates that bleaching did not interrupt sexual coral reproduction for this species. However, it is unclear if larval settlement and survival were reduced.

Background Peripheral neuropathy (PN) constitutes a dose-limiting side effect of oxaliplatin chemotherapy that often compromises the efficacy of antineoplastic treatments. Sensory neurons damage in dorsal root ganglia (DRG) are the cellular substrate of PN complex molecular origin. Dehydropeptidase-1 (DPEP1) inhibitors have shown to avoid platin-induced nephrotoxicity without compromising its anticancer efficiency. The objective of this study was to describe DPEP1 expression in rat DRG in health and in early stages of oxaliplatin toxicity. To this end, we produced and characterized anti-DPEP1 polyclonal antibodies and used them to define the expression, and cellular and subcellular localization of DPEP1 by immunohistochemical confocal microscopy studies in healthy controls and short term (six days) oxaliplatin treated rats. Results DPEP1 is expressed mostly in neurons and in glia, and to a lesser extent in endothelial cells. Rats undergoing oxaliplatin treatment developed allodynia. TNF-𝛼 expression in DRG revealed a pattern of focal and at different intensity levels of neural cell inflammatory damage, accompanied by slight variations in DPEP1 expression in endothelial cells and in nuclei of neurons. Conclusions DPEP1 is expressed in neurons, glia and endothelial cells of DRG. Oxaliplatin caused allodynia in rats and increased TNF-α expression in DRG neurons. The expression of DPEP1 in neurons and other cells of DRG suggest this protein as a novel strategic molecular target in the prevention of oxaliplatin-induced acute neurotoxicity.

Adults with inflammatory bowel disease (IBD) experience a significant decline in quality of life due to various symptoms. Exercise has emerged as a potential therapeutic approach to improve IBD management, but its effectiveness requires further investigation. This systematic review, adhering to PRISMA 2020 guidelines, explored the effects of exercise on IBD progression and its potential as a treatment in adults. A comprehensive search strategy was conducted across three databases and two registries from May 12, 2024, to May 22, 2024. Methodological rigor and potential bias were minimized through quality assessment using the Cochrane risk-of-bias tool 2 (RoB 2) for randomized controlled trials (RCTs), the Newcastle-Ottawa Scale (NOS) for cohort studies, and the Joanna Briggs Institute (JBI) critical appraisal checklist for studies evaluating the effectiveness of non-randomized interventions. This process yielded 12 high-quality studies for analysis. The review identified positive evidence from both RCTs and observational studies. Exercise interventions demonstrated improvements in cardiorespiratory fitness, disease activity, quality of life, and mental health in adults with IBD. Studies explored various modalities, including aerobic exercise, resistance training, and mind-body interventions. However, further research is needed to optimize exercise prescription and elucidate the underlying mechanisms of action. This review strengthens the evidence for exercise as a beneficial intervention for IBD patients. Personalized exercise programs based on individual needs hold promise for improved IBD management and patient outcomes. However, limitations exist due to study design variations and the need for long-term follow-up studies.

Type 2 diabetes mellitus (T2DM) is a major global health concern with a strong association with increased cardiovascular morbidity and mortality. The prevalence of heart failure is significantly higher in the T2DM population compared to non-diabetic individuals. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have emerged as a promising therapeutic class for managing T2DM, with potential cardioprotective effects. This systematic review aims to comprehensively evaluate the impact of SGLT-2 inhibitors on cardiovascular outcomes in adult patients with T2DM. A comprehensive electronic search was conducted across multiple databases and registries from May 8 to June 6, 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Studies published between January 2019 and June 6, 2024 that evaluated the effects of SGLT-2 inhibitors on cardiovascular outcomes in adults with T2DM were included. The risk of bias was assessed using appropriate tools based on the study design. A narrative synthesis was planned to summarize the findings. The search strategy identified 25 studies (22 randomized controlled trials, three cohort studies) for inclusion in the systematic review. Most of the included studies demonstrated a low overall risk of bias, although some observational studies had some limitations. The studies investigated the effects of various SGLT-2 inhibitors, including empagliflozin, canagliflozin, dapagliflozin, and others, on cardiovascular endpoints such as heart failure-related hospitalizations, mortality, cardiac structure and function, and biomarkers. The findings suggest that SGLT-2 inhibitors may have a beneficial impact on reducing the risk of heart failure-related hospitalizations and potentially improving other cardiovascular outcomes in patients with T2DM. This comprehensive systematic review provides valuable insights into the emerging role of SGLT-2 inhibitors in mitigating cardiovascular complications associated with T2DM. The findings have important clinical implications and may inform evidence-based guidelines and treatment strategies aimed at improving cardiovascular outcomes in this high-risk patient population.

Background and purpose In the evolving landscape of healthcare, telerehabilitation is emerging as a pivotal modality, especially in delivering services to vulnerable populations. With the increasing reliance on digital health solutions, there is a pressing need for physiotherapists to be adequately trained in telerehabilitation. This training is essential for them to adapt to new technologies and methodologies, ensuring effective and efficient patient care. The aim of this study was to evaluate the effect of a telerehabilitation educational intervention on physiotherapists' knowledge and perceptions in Bucaramanga and its metropolitan area. Methods A group of 27 physiotherapists underwent an educational intervention focused on telerehabilitation. Before‐ and after‐intervention assessments were conducted to gauge their perceptions and knowledge. Results Participants generally held a positive perception of telerehabilitation both before and after the intervention [Before Median (Md) and interquartile range (IQR): Md = 2.5 (IQR = 2.1–3); after: Md = 2.7 (IQR = 2.4–3.1), p = 0.256]. A significant increase in their knowledge after‐intervention was observed [Before: Md = 55.5 (IQR = 33.3–66.6)]; after: Md = 77.7 (IQR = 66.6–88.8), p = <0.001, emphasizing the potential benefits of targeted educational interventions. Conclusions The educational intervention significantly improved physiotherapists' knowledge of telerehabilitation, underscoring the importance of professional training in this domain. While perceptions remained consistently positive, the notable increase in knowledge suggests that such educational programs are crucial for enhancing the adoption and effective use of telerehabilitation in physiotherapy practice.

Introducción: las enfermedades del corazón son la primera causa de muerte en el mundo tanto en el hombre como en la mujer. La presentación de la cardiopatía isquémica varía dependiendo de múltiples factores, entre ellos el género. Materiales y método: estudio observacional, transversal con componente analítico de todos los pacientes ingresados con síndrome coronario agudo en el Hospital Docente Clínico-Quirúrgico Comandante Manuel Fajardo, entre enero del 2016 y diciembre del 2020. Resultados: el género femenino presentó una mediana de edad de 73 (RIC: 62-80), significativamente superior a la del género masculino, con mayor prevalencia de hipertensión arterial y diabetes mellitus (n = 353 y n = 143, respectivamente; p < 0.01). Se identificaron la edad, el valor de la creatinina y el síndrome coronario agudo con elevación del ST como factores desencadenantes de complicaciones cardíacas (RR: 1.01; IC 95%: 1.00-1.07; p = 0.03; RR: 1.01; IC 95%: 1.00-1.02; p = 0.01; y RR: 2.77; IC 95%: 1.31-5.87; p = 0.02, respectivamente). Conclusiones: las mujeres con síndrome coronario agudo presentaron una edad superior a la de los hombres, con mayor prevalencia de hipertensión arterial y diabetes mellitus, mientras las variables predictoras de complicaciones cardiovasculares intrahospitalarias identificadas fueron la edad, el valor de creatinina sérica y el síndrome coronario agudo con elevación del ST.

Introducción: Una de las alternativas para la enseñanza de la Física lo constituye la aplicación de los conocimientos y vías que se ofrecen desde la neurodidáctica. Esta disciplina científica se desarrolla a partir de las propias indagaciones y de otros campos de la ciencia. Sin embargo, existe un camino por recorrer en las investigaciones científicas que permitan establecer las bases epistemológicas, teóricas y metodológicas de esta disciplina, que, en el caso de la enseñanza y aprendizaje de la física, todavía son limitados. Objetivo: presentar una aproximación a un enfoque neurodidáctico de la enseñanza de la Física en el programa de formación de Técnico Superior de Biofísica Médica en la Universidad de Ciencias Médicas de Matanzas. Metodología: Se utilizó el método analítico-sintético para determinar los aspectos esenciales de los resultados científicos que se relacionan con el tema de investigación. La inducción-deducción favoreció determinar regularidades desde lo facto-perceptual y configurar los aspectos teóricos que se proponen. El hermenéutico-dialéctico se empleó para la interpretación de la información teórica y realizar un análisis crítico. Resultados: Se establecen los aspectos teóricos que fundamentan el enfoque neurodidáctico y los pasos que se deben tener en cuenta para aplicarlo en la enseñanza de la física. Conclusión: Los aportes de la Neurodidáctica favorecen a la comprensión del proceso de enseñanza-aprendizaje de la física y constituye un marco teórico que posibilita el diseño de tareas y actividades que permiten potenciar la atención y motivación hacia el aprendizaje. Área de estudio general: Ciencias de la Educación. Área de estudio específica: Didáctica de la Física. Tipo de estudio: Artículos original

Background: In recent years, cancer has become a noncommunicable disease with a high mortality in the world, constituting the second cause of death. Although it has a predominance of genetic abnormalities, molecular studies have shown that epigenetic alterations share a leading role in its development. Among the epigenetic drugs inhibiting deacetylases, we have valproic acid [VPA], a short-branched chain fatty acid with more than 50 years of clinical use. The potentialities of this drug that justify its use in antineoplastic therapy have been described recently. This drug offers the possibility of reversing some malignant characteristics of cancer cells, and it can be used in small, minimally toxic doses at low cost. Objective: The aim of this study was to evaluate the use of valproic acid as an antineoplastic treatment in animal models. Methods: A systematic review was conducted following the Prisma guidelines. Pubmed and Scopus were consulted for original articles that had evaluated the antineoplastic effect of VPA in vivo in the last 10 years. Results are presented in tables and graphs Results: A total of 41 specific articles on the topic were selected. Few preclinical in vivo studies demonstrated the antineoplastic effects of VPA. Prostatic and hepatocellular carcinoma were the most common cancers in the consulted reports. Combination therapies using VPA with cytotoxic agents prevailed in this research, demonstrating a synergistic effect in reducing tumour volume. Conclusion: VPA has an antineoplastic effect, and combination therapies show better results than monotherapies. However, more studies are required to confirm the usefulness of VPA as an adjuvant in the treatment of cancer.

It is difficult if not impossible to explain intelligent human behavior without the problematic information processing (IP) metaphor. It complicates our thinking by using words and concepts that obfuscate what it is that we are trying to understand. The IP paradigm is illogical. It is predicated on a flawed syllogism, which has two plausible premises and an incorrect conclusion. The first realistic premise is that intelligent behavior is attainable by all computers. The second reasonable premise is that information processors are present in all computers. The erroneous conclusion is that information processors are all entities capable of intelligent behavior. Aside from technical language, the notion that people must process information simply because computers do, is absurd. Historians will almost surely regard it that way when the IP metaphor is eventually dropped, much as we currently see the mechanical and hydraulic metaphors to be absurd. Let us eulogize the metaphor and observe and measure phenomena.