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

Dear Editor, The interesting article by Salgado et al.,(1) published in the Revista Habanera de Ciencias Médicas, offers a comprehensive review of the neurophysiology of sexual behaviour in adolescents, highlighting factors that influence decision-making and reproductive risk. Within this context, the purpose of this Letter to the Editor is to contribute to the discussion by addressing the impact of physical exercise on adolescents’ neurocognitive and emotional development, given its potential as a modulating factor in behavioural regulation and the prevention of impulsivity-related risks.

Introduction: Alzheimer's disease progressively impairs patients' autonomy and requires ongoing care, usually assumed by family members. This situation creates a significant emotional and physical burden for both patients and their caregivers.Objective: To evaluate the quality of life of patients with Alzheimer's disease and their caregivers by applying the SF-36 questionnaire.Material and Methods: A systematic review was conducted in the SCOPUS database using the PRISMA methodology, with a closing date of October 14, 2024. A total of 195 initial studies were filtered down to 20 primary studies. All studies related to the quality of life of patients and caregivers were included using the SF-36; those that did not answer the research question, had an errata report or retraction letter, and those with conflicts of interest were excluded.Results: The results show that the quality of life of Alzheimer's patients is particularly low in terms of mental health, reflecting a considerable impact on their mood and ability to maintain relationships. For caregivers, physical health is perceived as moderate, with an average of 62.97, while mental health is more vulnerable, with an average of 57.54 attributed to constant emotional pressure and stress from prolonged caregiving.Conclusions: Patients with Alzheimer's disease have a better perception of their physical health than their mental health. Caring for patients with Alzheimer's disease significantly affects caregivers' quality of life, especially in the emotional realm. The most effective interventions combine psychoeducational support and respite strategies, improving both caregivers' mental and physical health.

The application of glycerin to dental composite resins before curing has been widely discussed in academic and clinical settings, often without empirical validation. This systematic review aimed to evaluate whether glycerin application prior to light-curing improves the surface hardness of composite resins, synthesizing evidence from in vitro studies. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library, following PRISMA guidelines and a registered PROSPERO protocol. Eligible studies included in vitro research comparing surface hardness outcomes between glycerin-treated and untreated composite resin groups. Risk of bias was assessed using the RoBDEMAT tool, and data were narratively synthesized due to methodological heterogeneity. Three studies met the inclusion criteria. All reported a consistent increase in surface hardness following glycerin application, attributed to its ability to minimize the oxygen-inhibited layer and enhance polymerization. Notably, medical-grade glycerin demonstrated superior performance compared to dental formulations. However, exposure to acidic environments post-curing was found to reduce this benefit. Risk of bias analysis revealed moderate concerns, particularly due to unreported randomization and operator blinding procedures. In conclusion, in vitro evidence supports the beneficial role of glycerin in enhancing the surface hardness of composite resins when applied before curing. These findings reinforce glycerin's utility as a clinically relevant adjunct in restorative dentistry. Nonetheless, the lack of clinical studies and standardization in glycerin formulation highlights the need for further high-quality research under simulated oral conditions to establish definitive clinical guidelines.

Introduction: The teaching and learning of English in biomedical programs represents a challenge and an urgent need in the current context of globalization and access to scientific knowledge.Objective: To identify pedagogical approaches that optimize the English proficiency of biomedical students.Materials and Methods: A systematic review was conducted using the PRISMA methodology. A multimodal search was implemented in both English and Spanish, using the databases PubMed, Scopus, and Web of Science, as well as the academic search engine Google Scholar. The selection was structured in three phases: identification: initial retrieval of records using search engines and elimination of duplicates; screening: evaluation of titles/abstracts to determine preliminary relevance; and eligibility: comprehensive analysis of full texts, verifying alignment with methodological and thematic criteria.Results: It was identified that the teaching of English in biomedical programs requires a combination of pedagogical methods that address both general language skills and field-specific competencies. Approaches such as task-based learning or collaborative learning promote active participation and problem-solving, while others, such as the communicative approach or integrated content and language learning, seek to develop practical skills in real-life contexts. English proficiency in Ecuador is similar to that of other Latin American countries, although it faces some additional challenges.Conclusions: Integrating English into biomedical training ensures that students not only have access to the latest scientific knowledge but can also actively contribute to the advancement of science and medicine internationally.

Introduction: Healthcare workers played a fundamental role by becoming the first line of defense against the health emergency. However, their work was marked by adverse conditions that seriously compromised their physical and emotional well-being, as well as their labor rights.Objective: To determine the impact of the COVID-19 pandemic on the labor rights and well-being of the healthcare personnel.Material and Methods: A systematic review was conducted using the PRISMA methodology in the scientific databases SCOPUS, PubMed, and Web of Science. The study variables were: main impacts on labor rights; the physical, emotional, and psychosocial impacts on healthcare workers during the COVID-19 pandemic; and the institutional measures or labor policies that have been implemented to protect the rights and promote the well-being of healthcare personnel.Results: An impact on the labor rights of healthcare personnel was found during the COVID-19 pandemic. Work overload, extended shifts, insufficient personal protective equipment, and precarious contracts emerged as common patterns in the 33 studies analyzed. From the perspective of emotional and psychosocial impact, the data show a clear intensification of disorders such as anxiety, depression, insomnia, and chronic burnout, recurring elements in most of the articles reviewed.Conclusions: Among the main impacts on labor rights, work overload, lack of personal protective equipment, extended workdays, and contractual instability stood out. These conditions not only violated minimum labor standards but also intensified existing inequalities.

Introduction: Artificial intelligence is emerging as a transformative tool to drive sustainability in health tourism, a rapidly growing sector, by optimizing resource management and personalizing experiences that respect the well-being of both visitors and the local environment. Objective: To identify, analyze, and synthesize the role of artificial intelligence in the sustainability of health tourism through a systematic literature review. Materials and Methods: A systematic review article based on the PRISMA methodology was conducted. Thirty-three studies from the Scopus and Web of Science databases were analyzed, with publications from 2020 to 2025. The variables studied were: artificial intelligence technologies, sustainability-oriented applications, destinations and activities associated with health tourism, economic and social implications, and opportunities and challenges of using artificial intelligence. Results: Supervised learning, unsupervised learning, reinforcement learning, deep learning, neural networks, hybrid models, language models, and symbolic artificial intelligence are widely used technologies in health tourism. These technologies are applied in six functional areas: recommendation and decision support systems, demand forecasting and strategic planning, service segmentation and personalization, operational process automation, multilingual communication and accessibility, and remote clinical diagnosis and monitoring. Conclusions: Artificial intelligence actively contributes to the sustainability of health tourism by optimizing resources, improving the patient experience, and strengthening the competitiveness of destinations.

Introduction: Ambulatory blood pressure monitoring is an effective instrument for the diagnosis, stratification and management of hypertensive adolescents with sleep disorders. Objective: To describe the risk factors, chronobiology and sleep disorders in hypertensive adolescents. Material and Methods: A descriptive cross-sectional study was carried out at the Manuel Ascunce Domenech University Hospital in Camagüey during the period from January 2021 to December 2022. Of a universe of 71 hypertensive adolescents with sleep disorders who were selected through intentional non-probabilistic sampling, a total of 60 were studied. The variables analyzed included: age group, sex, those contributed by ambulatory blood pressure monitoring, risk factors, circadian rhythm, sleep disorders and high blood pressure phenotype. Results: There was a predominance of the age group of 17-18 years (56.7%) for both sexes. The male sex reached the greatest preponderance with 47 cases (78.3%), in adolescents with daytime systolic arterial hypertension and hypertension upon awakening. Overweight or obesity (58.3%) was the risk factor with the highest incidence. Sleep disorders were related to the use of electronic devices (35.0%) and the masked arterial hypertension phenotype. Conclusions: The main risk factors in hypertensive adolescents with sleep disorders were late adolescence, male sex, and overweight or obesity. The non-dipper circadian rhythm allowed us to identify the predominant masked arterial hypertension phenotype in adolescents with sleep disorders due to the use of electronic devices.

Introduction: Oral health in childhood is crucial for comprehensive development, but conditions such as dental caries and gingivitis are common, affecting quality of life and school performance. This study analyzes the influence of oral hygiene and eating habits in schoolchildren in Riobamba, Ecuador, in a context of socioeconomic inequalities. Objective: To determine the prevalence of oral conditions in schoolchildren and their relationship with oral hygiene and eating habits. Material and Methods: A descriptive and cross-sectional study was carried out in 190 schoolchildren aged 5 to 11 years, randomly selected from two educational institutions in the Riobamba canton, between March and October 2023. The data were obtained through validated questionnaires and clinical dental examinations. The statistical analysis included Chi square tests to identify relationships between variables. Results: The most prevalent conditions were dental caries (38.4%), tartar (20%), tooth discoloration (17.9%), gingivitis (15.3%), and halitosis (13.7%). In addition, 75% of children had inadequate brushing habits, and 93.7% of them frequently ate sweets. Higher rates of oral conditions were found in schoolchildren from public institutions, reflecting socioeconomic disparities. Conclusions: The high prevalence of oral conditions demonstrates the need for preventive and educational interventions. It is essential to implement public policies to improve oral hygiene, regulate the consumption of cariogenic foods, and reduce inequalities in access to dental resources.

Introduction: Neurodegenerative diseases, such as multiple sclerosis, represent a challenge for modern medicine. Along with clinical and laboratory criteria, magnetic resonance imaging (MRI) is the gold standard for visualizing demyelinating lesions, detecting alterations in the brain and the spinal cord in patients without obvious clinical symptoms. Objective: To identify and analyze relevant aspects of MRI in the diagnosis of patients with multiple sclerosis, based on a review of the national and international literature and evidence that supports or refutes the success of the most assertive criteria for diagnosis. Material and Methods: More than 150 articles published between 2020 and 2025 were reviewed using keywords in PubMed/MEDLINE, SciELO, The National Library of Medicine, and Google Scholar. Those referring to multiple sclerosis, MRI, and the McDonald criteria for diagnosing the disease were selected. Results: The epidemiology of this disease is changing rapidly. There has been an increase in its incidence due to improved diagnosis, since the introduction of magnetic resonance imaging and from prevalence to increased survival. The McDonald 2024 diagnostic criteria consider additional characteristics that allow for diagnosis at an earlier stage of the disease, even without clinical symptoms. Conclusions: Magnetic resonance imaging is important in the diagnosis, monitoring, prognosis, and investigation of multiple sclerosis, a chronic, inflammatory, and neurodegenerative disease of the brain and spinal cord. The McDonald 2024 criteria point to a reasonable clinical suspicion, along with supportive magnetic resonance imaging and paraclinical evidence.