Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Several studies from the 1990s found that adverse effects on the fetal environment, such as poor maternal nutrition, can lead to an increased risk of developing chronic diseases in adulthood.  These findings led to the fetal origins of disease hypothesis, commonly known as the Barker hypothesis, which proposes that exposures to insults during critical or sensitive windows of development can permanently reprogram physiological responses, thereby giving rise to metabolic and hormonal diseases and disorders later in life.1,2     Pregnancy remains one of the most vulnerable periods in terms of morbidity and mortality, certainly for the fetus, but also for the mother. According to the INEGI, in 2020 there were 22,637 fetal deaths, which corresponds to a national rate of 6.7 per 10,000 women of childbearing age. 82.9% of fetal deaths occurred before delivery, 15.6% during delivery, and in 1.5% of cases was not specified.3    The main complications, which cause 75% of maternal deaths, are: severe bleeding (mostly after childbirth); infections (usually after childbirth); gestational hypertension (preeclampsia and eclampsia); childbirth complications; unsafe abortions (performed clandestinely, in unsuitable conditions and by untrained personnel).4    Interactions between the product of conception and the mother are bidirectional: the fetoplacental tissues need nutrition and a suitable environment under homeostatic conditions, while the mother, influenced by placental factors, adapts her metabolism and immune system to ensure tolerance, which include embryonic and fetal, placental and maternal elements.5  At the maternal-fetal interface, the placenta contains cells of the immune system and mediators, such as uterine NK cells (uNK, 70%), macrophages (20%), T cells (including CD4+, CD8+, γδ T cells, and regulatory T cells) (10 %), dendritic cells, and few B cells. The numbers of these cells and the roles they play vary at different stages of pregnancy. It has been suggested that there may be several local and systemic modifications related to the protection of the developing fetus against attack by the maternal immune system, mainly the expression of unique human leukocyte antigens (HLA) by trophoblasts, the influence of female sex hormones and the bias of citokines.6   As soon as the embryo makes contact with the maternal endometrium, trophoblast cells fuse with the attachment site, forming a syncytium called a syncytiotrophoblast.7 This tissue and the cytotrophoblast do not express complex major histocompatibility (MHC) class I or class II molecules. In contrast, the extravillous cytotrophoblast does express non-classical MHC molecules (HLA-G or HLA-E), which inhibit the activation of uNK cells, favoring immunological tolerance.8    During the first trimester, uNK cells represent up to 50–70% of decidua lymphocytes. Differently from peripheral-blood NK, these are poorly cytolytic, and they release cytokines/chemokines that induce trophoblast invasion, tissue remodeling, embryonic development, and placentation. NK cells can also shift to a cytotoxic identity and carry out immune defense if infected in utero by pathogens. At late gestation, premature activation of NK cells can lead to a breakdown of tolerance of the maternal–fetal interface and, subsequently, can result in preterm birth.9 HLA-G interacts with receptors ILT2 and KIR2DL4 on macrophages and NK cells to enhance the production of proangiogenic cytokines and and enhance trophoblast integrity, invasion of decidua, thereby promoting spiral artery remodeling. In addition, HLA-G binds to ILT2, ILT4, and KIR2DL4 on NK cells, T cells and macrophages, inhibits the cytotoxicity of NK cells and CD8+ T cells, and causes an increase in the percentage of Treg cells in the population, and thereby contributes to immune tolerance. The abnormal expression and polymorphisms of HLA-G are related to adverse pregnancy outcomes such as preeclampsia (PE) and recurrent spontaneous abortion (RSA).10    Cytokine bias is associated with the predominance of Th2-type immunity, while Th1-type responses are considered potentially dangerous for the continuation of the pregnancy.11 Sex hormones have profound effects on the immune system and play a critical role in shaping Th cell immunity throughout stages of pregnancy. Androgens are considered to promote anti-inflammatory responses whereas estrogens can exhibit both pro- and anti-inflammatory roles depending on the relative expression of estrogen receptor isoforms.12 However, significantly high doses of estrogens such as those observed in pregnancy typically suppress immune responses. Pregnancy levels of estardiol also influence CD4+ T cell polarization through enhanced expression of Th2 associated (GATA3, IL-4) and Treg associated genes (Foxp3, PD-1, IL-10, and TGF-β) while suppressing the expression of Th1 associated (T-bet, IL-2, TNF-α, IFN-γ) and Th17 associated genes (ROR-γt, IL-6, IL-17, IL-23).12,13 During pregnancy progesterone induces anti-inflammatory responses and promotes tolerance through the selectively inducing the differentiation of naive CB T cells into Tregs, while suppressing their differentiation into inflammatory Th17 cells, potentially through suppression of the IL-6 receptor expression, and a systemic decline in its concentration prior to the onset of labor in most animal models.14 In conclusion, both allogeneic and hormonal stimulation are responsible for a harmonious regulation of the immune system leading to a successful pregnancy.

Self-medication (SM) refers to any practice for curative purposes that is not prescribed by a physician. It includes the use of conventional or allopathic medicine (CM) and complementary and alternative medicine (CAM). In the case of ophthalmologic ailments, this division can also be seen, within CM, the use of anesthetics, analgesics and topical antibiotics, for the treatment of mainly traumatic pathologies, to save time and money, advised by their close circle, but always with the risk of not improving, abusing the medication, producing toxicity, masking the condition and giving an incorrect treatment. CAM highlights the use of biological therapies due to the variety of products that have been documented, such as chamomile, tea leaves, garlic, sage, etc. But also the use of mind-body therapies, manipulative and body-based methods; and energy therapies such as acupuncture; there are many more pathologies for which they are used compared to CM, and they resort to it precisely because of the lack of results of CM, the sources of information are usually similar and although they seem harmless, they are not innocuous. In general, it is a subject that is little addressed, but is relevant due to the risks involved. This manuscript seeks to provide an overview so that medical personnel remain expectant and in each intervention detect the areas of opportunity that reduce this practice.

Organ and tissue donation is defined as the transfer of human cells, tissues and organs from a donor to a recipient; it is the only therapeutic option that helps to improve the quality of life and prevent the death of people with tissue or organ failure. However, this process is hampered due to the discrepancy between organ supply and demand worldwide, which increases clinical deterioration and mortality rates on the waiting list of patients with chronic or acute multi-organ failure. The aim of this article is to provide relevant information about the process of organ and tissue donation, highlighting the importance of understanding the process, providing information to the general population, with emphasis on essential groups for its dissemination, mainly health professionals who have the ability to positively influence society's perception of this issue by providing health education during primary care, This is the first contact and an important link in the attention of the potential donor, considering medical units as the closest source of information due to recurrent access, and not least children and young people, as it has been shown that this action increases the acceptance rate, turning this section of the population into agents of social change, generating with this manuscript, a positive impact on the perception and understanding of the subject for society, seeking to increase the availability of donors.

This article falls within a research project devoted to the exploration of teaching scenarios and subjectivities in higher educational contexts from a narrative perspective at an Argentinian state university. Its main purpose is to open the signifier “educational quality”, which has recently become a media mantra in the context of a pandemic which exhibits and highlights deeply unequal scenarios in different schools of our country. This work is presented with the political and pedagogical will of not losing sight of equity in the search for valuing education. Within a qualitative methodological framework, although moving along its edges, this article profits from autobiographical registers and narrative surveys carried out among higher education teachers during the pandemic to build upon, from  auto-etnography, a set of dialogues among readings, lives and feelings/thoughts regarding quality.  It is primarily focused not so much on defining what quality is but rather on exploring how it affects (us) our teaching practices, in a particular context, as situated knowledge. Theoretical positions are supported especially by the decolonial turn and what it brings to this specific discussion. In addition, the present work owes some of its insights to critical pedagogies, queer theories, the anti-methodological approach, the emotional and performative turns, among others.

Introducción: la COVID-19 ha generado estados psicológicos de ansiedad y miedo, entre otras manifestaciones.Objetivo: estimar los niveles de ansiedad y miedo en los diagnosticados con COVID-19 del Consejo Popular “Orlando González” de Majagua en Ciego de Ávila.Métodos: estudio analítico transversal a los 20 pacientes recuperados de COVID-19 en el trimestre enero-marzo/2021 que cumplieron con los criterios investigativos. Las escalas empleadas fueron The Fear of COVID-19 Scale y The Coronavirus Anxiety Scale. Se compararon las medianas entre puntuaciones de ansiedad y miedo por la prueba U de Mann Whitney. Las correlaciones se realizaron mediante la Tau-b de Kendall. Se cumplieron los principios éticos. Resultados: predominó en adultos (45,00 %), en las mujeres (65,00 %), en la escolaridad pre-universitaria (40,00 %) y en trabajadores estatales (50,00 %). La mayoría (60,00 %) padecía de alguna enfermedad no transmisible y 100 % no tenían padecimientos psico-psiquiátricos con anterioridad. La presencia de miedo y ansiedad se mostró equilibrada entre los altos y bajos niveles. En la ansiedad, ambos niveles tuvieron el mismo valor y fue superior el miedo (55,00 %). Se observó una correlación directa significativa entre las variables ansiedad y miedo, lo que denota que mientras mayores fueron los niveles de miedo, mayores fueron de ansiedad y viceversa. Sin embargo, no correlacionaron con el grupo de edad ni con la presencia de enfermedad no transmisible.Conclusiones: las reacciones psicológicas fueron equilibradas entre altos y bajos niveles de ansiedad y miedo. Las manifestaciones de displacer fueron evidentes en el grupo femenino

Introducción: las maloclusiones son variaciones estéticas y funcionales de la oclusión, cuya frecuencia se incrementa en la actualidad.Objetivo: caracterizar el estado de salud ortodóncico de los estudiantes del Instituto Preuniversitario “Pedro Valdivia” del municipio Ciego de Ávila.Resultados: 59,31 % presentaron maloclusiones con predominio en los 16 años (23,45 %) y del sexo femenino (66,21 %). Solo 6,21 % tenían caries proximales y 5,50 % alteraciones en la fórmula dentaria; 53,10 % presentan hábitos bucales deformantes con 35,86 % de maloclusión. La onicofagia fue el hábito más frecuente (40,26 %). La clase II de Angle fue preponderante (40,70 %). La mayoría (88,28 %) no había recibido atención odontológica, 59,31 % necesitaban tratamiento ortodóncico: 16,28 % en el primer nivel de atención y 83,72 % en el segundo; 87,20 % de los escolares con maloclusiones estaban sin tratamiento.Conclusiones: el estado de salud se caracterizó por una elevada frecuencia de maloclusiones y hábitos bucales deformantes en los estudiantes. Más de la mitad nunca habían recibieron tratamiento

The following investigation aims to evaluate the hidden costs generated by employees during teleworking, due to the Covid-19 pandemic in the Republic of Panama. The sample consisted of 383 teleworkers to whom the data collection instrument related to the costs that occur as a result of teleworking was applied, since they had to face extra expenses for this work method. An analysis was carried out using the main descriptive statistics and the Mood median, determining the mean, median and mode of hidden costs in the country and the most relevant differences in hidden costs between the different categories of teleworkers. At the end, the total average costs generated by teleworkers and the expenses that are associated with the teleworker variables are presented, which are: gender, age range, work area, telework modality, working time, the economic availability and the size of the company. It was found that in Panama for teleworking, women have higher costs than men; youth and young adults have lower costs; the work areas with the highest costs were education and marketing, while the lowest were human resources and finance; small and medium-sized businesses generate a greater amount of hidden costs for their employees; the higher the teleworker's income, the higher the hidden costs; the more hours dedicated to teleworking, the higher the costs. Finally, it is confirmed that there is a significant difference between the variables of teleworkers and the hidden costs generated.