Concepciones y concepciones alternativas de estudiantes universitarios/as de biologia y futuros maestros/as de Ciencia de escuela secundaria sobre la teoria de evolucion biologica por seleccion natural

NASA Astrophysics Data System (ADS)

Morales Ramos, Egda M.

La teoria de evolucion biologica (TEB) por seleccion natural es uno de los conceptos unificadores mas importantes del curriculo de Biologia. En Puerto Rico se han hecho pocas investigaciones que abunden sobre las concepciones y concepciones alternativas (CA) que tienen los estudiantes universitarios/as de Biologia y los maestros/as de Ciencia del nivel secundario sobre esta teoria. La politica publica educativa actual establece mediante documentos normativos como los Estandares de contenido y Expectativas de grado del Programa de Ciencias [Puerto Rico Core Standards] la ensenanza de esta teoria. Sin embargo, no se encontraron preguntas sobre la seleccion natural en los ejercicios de practica provistos por el Departamento de Educacion para las pruebas estandarizadas lo cual puede influir para que no se ensene adecuadamente. Las preguntas de investigacion fueron 1. ¿Cuales son las concepciones y concepciones alternativas de estudiantes universitarios/as y de los futuros maestros y maestras de Ciencia sobre la TEB? 2. ¿Cuales conceptos que seleccionan los estudiantes universitarios/as y los futuros maestros y maestras de Ciencia sobre la TEB coinciden con lo aceptado como valido por la comunidad cientifica? y 3. ¿Como comparan las respuestas de la prueba original. v. Entendiendo el cambio biologico que mide concepciones y CA sobre la TEB por seleccion natural, con las de la traducida al idioma espanol? Se utilizo el metodo cuantitativo con un diseno de investigacion transversal por encuesta. La tecnica principal para recopilar los datos fue una prueba con doce items, que formo parte de un instrumento para el cual se recopilaron diversas fuentes de evidencia acerca de su validez. Las muestras estuvieron formadas por 69 estudiantes de Ciencias Naturales y por 16 estudiantes futuros maestros y maestras del nivel secundario de la UPR-RP. Se utilizaron estadisticas descriptivas, analisis de Ji cuadrado y se calcularon los coeficientes alfa de Cronbach y de Spearman. Estos demostraron que la prueba es confiable para medir las concepciones y CA de la TEB por seleccion natural. Aunque los estudiantes escogieron conceptos relacionados con esta teoria, mantienen en sus procesos de razonamiento CA sobre la seleccion natural que no se limitan a la lamarckiana y a la teleologica.

Management of postoperative pain in abdominal surgery in Spain. A multicentre drug utilization study

PubMed Central

Vallano, Antonio; Aguilera, Cristina; Arnau, Josep Maria; Baños, Josep-Eladi; Laporte, Joan-Ramon

1999-01-01

Participating centres: Hospital Universitario San Juan, Alicante: Maria Jesús Olaso, Javier Agulló, Clara Faura. Hospital Torrecárdenas, Almería: Carmen Fernández Sánchez, Miguel Lorenzo Campos, Juan Manuel Rodríguez Alonso. Hospital Quirúrgic Adriano, Barcelona: Carmen Alerany Pardo, Paquita Alvarez González, Teresa Martín Benito. Hospital Universitari del Mar-IMIM, Barcelona: Magí Farré, Maite Terán. Corporació Sanitària Parc Taulí, Sabadell: Montserrat Cañellas, Sergio Zavala, Josep Planell. Hospital Universitari de la Santa Creu i Sant Pau: Gonzalo Calvo, Rosa Morros, Silvia Mateo. Hospital General Vall d’Hebron, Barcelona: Carmen Bosch, María José Martínez. Hospital Universitario Virgen de la Victoria, Málaga: Maribel Lucena, José Antonio González, Gabriel Carranque. Hospital Clínico Universitario San Carlos, Madrid: Emilio Vargas, Amparo Gil López-Oliva, Míriam García Mateos. Hospital Universitario Marqués de Valdecilla, Santander: Mario González, Antonio Cuadrado. Hospital Universitario Virgen de la Macarena, Sevilla: Juan Antonio Durán, Pilar Máyquez, María Isabel Serrano. Hospital Universitario Virgen del Rocío, Sevilla: Jaume Torelló, Juan Ramón Castillo, María de las Nieves Merino. Aims Postoperative pain is common in hospital-admitted patients. Its management is determined by different therapeutic traditions and by the attitudes of health professionals in each hospital. The aim of this study was to describe the patterns of prescription and administration of analgesic drugs used for postoperative pain after abdominal surgery in Spanish hospitals, to know the prevalence and the severity of postoperative pain, and to determine the extent of variability in the management of postoperative pain among the participating centres. Methods The study was a multicentre descriptive cross-sectional drug utilization study in 12 Spanish hospitals. The subjects were an unselected sample of consecutive patients undergoing abdominal surgery, admitted between October 1994 and January 1995. For each patient, information about the surgical procedure and the use of analgesics was prospectively collected. The severity of postoperative pain was assessed during the first day after surgery by means of a six-category (none, mild, moderate, severe, very severe, and unbearable) rating scale and a visual analogue scale (VAS). Results Nine hundred and ninety-three patients (547 men) were included. The most common surgical procedures were inguinal hernia repair (315, 32%), cholecystectomy (268, 27%), appendectomy (140, 14%), bowel resection (137, 14%), and gastric surgery (58, 6%). Fifty-nine percent of patients (587) received nonopioid analgesics only, 9% (89) received opioid analgesics only, and 27% (263) received both opioid and nonopioid analgesics. The most frequently administered drugs were metamizole (667 patients) and pethidine (213 patients). Although in the majority of medical orders the administration of analgesics was scheduled at regular time intervals, the majority of actual doses were given ‘as-needed’. The average administered daily doses of all analgesics were lower than those prescribed. Thirty-eight percent (371/967) of patients rated their maximum pain on the first day as severe to unbearable. Wide interhospital variability was recorded in the surgical procedures which had been performed, in the analgesics used, and also in the pain scores referred by patients. The percentage of patients in each centre who suffered severe to unbearable pain varied from 22 to 67%. Conclusions In Spain many patients still suffer severe pain after abdominal surgery, and this seems to be due to an inadequate use of analgesics. Wide interhospital variability in the management of postoperative pain and in its prevalence was also recorded. PMID:10383545

PREJUICIO Y DISTANCIA SOCIAL HACIA PERSONAS HOMOSEXUALES POR PARTE DE JÓVENES UNIVERSITARIOS

PubMed Central

Fernández Rodríguez, María del C.; Squiabro, José Calderón

2014-01-01

Se realizó un estudio descriptivo transversal con el propósito de explorar actitudes de rechazo y distancia social hacia las personas gays y lesbianas (GL) en 565 universitarios. Se utilizó una escala para medir Prejuicio y otra escala para medir Distancia Social. Los participantes reflejaron niveles moderados de prejuicio y distancia social (DS) hacia las personas gays y lesbianas. Los varones (M=104.5, DT= 27.47) mostraron significativamente más prejuicio que las mujeres (M=98.8, DT= 23.41). Los hombres (M=22.7, DT= 7.00) mostraron significativamente mayor DS que las mujeres (M=21.1, DT= 5.41). Las personas que asisten con regularidad a la iglesia mostraron más prejuicio y DS que los que no asisten. Se analiza importancia de incluir el tema de la diversidad sexual a través del currículo para desmontar prejuicios hacia la comunidad homosexual. PMID:25606066

COMMITTEES: SQM2009 - 14th International Conference on Strangeness in Quark Matter SQM2009 - 14th International Conference on Strangeness in Quark Matter

NASA Astrophysics Data System (ADS)

2008-04-01

Local Organizing Committee Takeshi Kodama Chair, UFRJ Jun Takahashi Co-chair, UNICAMP Ignácio Bediaga e Hickman CBPF Eduardo Fraga UFRJ Frederique Grassi USP Yogiro Hama USP Gastão Krein IFT Erasmo Madureira Ferreira UFRJ Marcelo G. Munhoz USP Fernando Navarra USP Sandra Padula IFT Alejandro Szanto de Toledo USP César Augusto Zen Vasconcellos UFRGS International Advisory Committee Jörg Aichelin Nantes Federico Antinori Padova Tamás Biró Budapest Peter Braun-Munzinger GSI Jean Cleymans Cape Town Láaszló Csernai Bergen Timothy Hallman BNL Huan Zhong Huang UCLA Takeshi Kodama Rio de Janeiro Yu-Gang Ma Shanghai Jes Madsen Aarhus Ágnes Mócsy Pratt University Berndt Müller Duke University Grazyna Odyniec LBNL Helmut Oeschler Darmstadt Johann Rafelski Arizona Hans Georg Ritter LBNL Gunther Rolland MIT Karel Šafařík CERN Ladislav Sandor Kosice University Jack Sandweiss Yale University George S F Stephans MIT Horst Stöcker Frankfurt Larry McLerranBNL Helmut Satz Universitä Bielefeld Nu Xu LBNL Fuqiang Wang Purdue University William A. Zajc Columbia University Pengfei Zhuang Tsinghua University

Norms for 10,491 Spanish words for five discrete emotions: Happiness, disgust, anger, fear, and sadness.

PubMed

Stadthagen-González, Hans; Ferré, Pilar; Pérez-Sánchez, Miguel A; Imbault, Constance; Hinojosa, José Antonio

2017-09-18

The discrete emotion theory proposes that affective experiences can be reduced to a limited set of universal "basic" emotions, most commonly identified as happiness, sadness, anger, fear, and disgust. Here we present norms for 10,491 Spanish words for those five discrete emotions collected from a total of 2,010 native speakers, making it the largest set of norms for discrete emotions in any language to date. When used in conjunction with the norms from Hinojosa, Martínez-García et al. (Behavior Research Methods, 48, 272-284, 2016) and Ferré, Guasch, Martínez-García, Fraga, & Hinojosa (Behavior Research Methods, 49, 1082-1094, 2017), researchers now have access to ratings of discrete emotions for 13,633 Spanish words. Our norms show a high degree of inter-rater reliability and correlate highly with those from Ferré et al. (2017). Our exploration of the relationship between the five discrete emotions and relevant lexical and emotional variables confirmed findings of previous studies conducted with smaller datasets. The availability of such large set of norms will greatly facilitate the study of emotion, language and related fields. The norms are available as supplementary materials to this article.

76 FR 67792 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

..., Baja California, Mexico; DOB 14 Nov 1968; Alt. DOB 14 Nov 1966; POB Culiacan, Sinaloa, Mexico; Citizen... Costa Bella, Ensenada, Baja California, Mexico; (ENTITY) [SDNTK] 2. AUTODROMO CULIACAN RACE PARK, Blvd. Universitarios No. 196 Ote., Piso 4, Colonia Tierra Blanca, Culiacan, Sinaloa, Mexico; Carretera Libre, Culiacan...

77 FR 2347 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-17

... identified by the President. In addition, the Secretary of the Treasury, in consultation with the Attorney.... 80010, Mexico; Boulevard Universitarios No. 789, Local 4, Colonia Villa Universidad, Culiacan, Sinaloa C.P. 80010, Mexico; Localidad San Jose del Barranco S/N, Badiraguato, Sinaloa C.P. 80500, Mexico; DOB...

From Student Associations to CEUNE: The Development of Student Representation in Spain

ERIC Educational Resources Information Center

Parejo, José Luis; Lorente, Javier

2012-01-01

The forms of students' political participation in the administration of higher education in Spain have evolved throughout history. Spain has developed from a period characterised by the corporatist model of Sindicato Espanõl Universitario--as a single syndicate of students controlled by the Franco Regime--towards the emergence of a student…

[Programme review of somatropin deficit in pediatrics at the Hospital Universitario Virgen del Rocío].

PubMed

Lavaredas, A; de la Puerta, R; Álvarez del Vayo, C

2013-01-01

To develop a program review of somatropin deficit, applied in pediatrics at the Hospital Universitario Virgen del Rocío, using two groups of patients: the ones diagnosed with deficiency of this hormone, and those born small for gestational age, with the intention of evaluating its effectiveness in the first year of treatment. Attaining a retrospective study of the cohort of patients treated with growth hormone under the above diagnoses, with cross-sectional and observational methodology, to which we applied a statistical analysis with the Statistical Package for Social Sciences®. After the beginning of the treatment, the growth rate had increased and the bone age approximated to the chronologic age. In the two treated groups in the first year of treatment were the female patients aged between 0 to 12 years with a deficit of growth hormone who responded better to therapy. We observed that the treatment instituted appeared highly effective in both groups of patients, allowing a favorable increase in height. Copyright © 2013 SEFH. Published by AULA MEDICA. All rights reserved.

PubMed

Redondo Del Río, María Paz; De Mateo Silleras, Beatriz; Carreño Enciso, Laura; Marugán de Miguelsanz, José Manuel; Fernández McPhee, Marina; Camina Martín, María Alicia

2016-09-20

Introducción: la alimentación de los jóvenes universitarios se aleja cada vez más de la dieta mediterránea (DM). El binomio alimentación-actividad física es fundamental para mantener un adecuado estado de salud.Objetivo: comparar la ingesta en un grupo de estudiantes universitarios deportistas frente a otro que no realiza deporte habitualmente.Sujetos y métodos:estudio observacional transversal realizado en 49 voluntarios de la Universidad de Valladolid. Se determinaron peso, talla y actividad física (cuestionario GPAQ). La ingesta se evaluó a partir de un cuestionario de frecuencia de consumo y un registro de alimentos de 3 días. La adherencia a la DM se estimó con el Mediterranean Diet Score. Las diferencias entre las variables en función del sexo y la práctica deportiva se analizaron con la t de Student o la U-Mann-Whitney. Significación estadística: p < 0,05.Resultados: todos los sujetos presentaron normopeso, sin diferencias en función de la práctica deportiva. El nivel de actividad física fue inferior en las mujeres. En todos los estudiantes la dieta fue ligeramente hiperproteica, rica en grasas y colesterol, con un inadecuado perfil lipídico y deficiente en hidratos de carbono y fibra. Se cubren los requerimientos de micronutrientes. Destaca un escaso consumo de frutas-verdurashortalizas, cereales, aceite de oliva, pescado y frutos secos; y un exceso de carne, mantequilla, bollería-industrial, dulces, snacksy refrescos. El 50% de la muestra tiene una adherencia baja o muy baja a la DM.Conclusión: las dietas de los jóvenes universitarios no cumplen los objetivos nutricionales para la población española y presentan una adherencia media-baja a la DM, independientemente de la práctica deportiva.

Genome Sequence of Klebsiella pneumoniae KpQ3, a DHA-1 β-Lactamase-Producing Nosocomial Isolate

PubMed Central

Tobes, Raquel; Codoñer, Francisco M.; López-Camacho, Elena; Salanueva, Iñigo J.; Manrique, Marina; Brozynska, Marta; Gómez-Gil, Rosa; Martínez-Blanch, Juan F.; Álvarez-Tejado, Miguel; Pareja, Eduardo

2013-01-01

Klebsiella pneumoniae KpQ3 is a multidrug-resistant isolate obtained from a blood culture of a patient in a burn unit in the Hospital Universitario La Paz (Madrid, Spain) in 2008. The genome contains multiple antibiotic resistance genes, including a plasmid-mediated DHA-1 cephalosporinase gene. PMID:23469341

FORWINE - Statistical Downscaling of Seasonal forecasts for wine

NASA Astrophysics Data System (ADS)

Cardoso, Rita M.; Soares, Pedro M. M.; Miranda, Pedro M. A.

2016-04-01

The most renowned viticulture regions in the Iberian Peninsula have a long standing tradition in winemaking and are considered world-class grapevine (Vitis Vinifera L.) producing regions. Portugal is the 11th wine producer in the world, with internationally acclaimed wines, such as Port wine, and vineyards across the whole territory. Climate is widely acknowledged of one of the most important factors for grapevine development and growth (Fraga et al. 2014a and b; Jackson et al. 1993; Keller 2010). During the growing season (April-October in the Northern Hemisphere) of this perennial and deciduous crop, the climatic conditions are responsible for numerous morphologically and physiological changes. Anomalously low February-March mean temperature, anomalously high May mean temperature and anomalously high March precipitation tend to be favourable to wine production in the Douro Valley. Seasonal forecast of precipitation and temperature tailored to fit critical thresholds, for crucial seasons, can be used to inform management practices (viz. phytosanitary measures, land operations, marketing campaigns) and develop a wine production forecast. Statistical downscaling of precipitation, maximum, minimum temperatures is used to model wine production following Santos et al. (2013) and to calculate bioclimatic indices. The skill of the ensemble forecast is evaluated through anomaly correlation, ROC area, spread-error ratio and CRPS

Merit Pay, Scientific Production and Comision Nacional Evaluadora de la Acitividad Investigadora del Profesorado Universitario

ERIC Educational Resources Information Center

Polo, Gema; de las Heras, Gustavo

2008-01-01

Some authors have given the CNEAI (National Commission for the Evaluation of Research Activity) a notorious role in the promotion of scientific research in Spain when considering the requirements for this institution as one of the essential elements in the increase of the Spanish scientific production in the last few years. We hereby expose that…

No Anticorrelation between Cyclotron Line Energy and X-ray Flux in 4U 0115+634

DTIC Science & Technology

2013-01-01

University of California, San Diego, La Jolla, CA 92093, USA 10 Instituto Universitario de Física Aplicada a las Ciencias y las Tecnologías, University of...Space Agency CNES through CNRS. S.M.N. and J.M.T. acknowledge support from the Spanish Ministerio de Ciencia , Tecnología e Innovación (MCINN) through

Actitudes de Estudiantes Universitarios que Tomaron Cursos Introductorios de Estadistica y su Relacion con el Exito Academico en La Disciplina

ERIC Educational Resources Information Center

Colon-Rosa, Hector Wm.

2012-01-01

Considering the range of changes in the instruction and learning of statistics, several questions emerge regarding how those changes influence students' attitudes. Equally, other questions emerge to reflect that statistics is a fundamental course in the university academic programs because of its relevance to the professional development of the…

Struggling Authorial Identity of Second Language University Academic Writers in Mexico (La lucha de identidad de escritores académicos universitarios de segunda lengua en México)

ERIC Educational Resources Information Center

Crawford, Troy; Mora Pablo, Irasema; Lengeling, M. Martha

2016-01-01

This paper explores the different factors that appear to affect the on-going construction of second language authorial identity in a professional academic environment in Mexico. Through narrative research methodology from a qualitative paradigm, the everyday struggles of two university professors to maintain their professional status in second…

Modelos Interactivos en el Proceso de la Ensenanza y el Aprendizaje en el Nivel Universitario (Interactive Models in the Process of Teaching and Learning at the University Level).

ERIC Educational Resources Information Center

Carrasquillo, Angela; Lopez, Carmen

This article, written in Spanish (with an abstract in English) presents an overview of recommended interactive instructional models at the college level. The first section lists characteristics of a reflective college professor stressing that reflection revolves around the students, the curriculum, the methodology, and the college's overall…

The Role of Discussion Boards in a University Blended Learning Program (El papel de los foros de discusión en un programa universitario de aprendizaje mixto)

ERIC Educational Resources Information Center

González Moreno, Rosa Isabel

2011-01-01

Discussion boards as tools in blended "English language" learning programs have unique characteristics when compared to other synchronous and asynchronous communication tools that are different. Therefore, it is important to investigate the way they operate, their role within a given program and the students', teachers' and tutors'…

Desarrollo de un instrumento para medir percepciones sobre el contexto de construccion del conocimiento cientifico de estudiantes universitarios de nuevo ingreso

NASA Astrophysics Data System (ADS)

Garcia-Ramirez, Jaime Antonio

En esta investigacion, se desarrollo un instrumento que permite medir percepciones relacionadas al contexto de constriccion del conocimiento cientifico. Se examinaron instrumentos existentes y se encontro que el VOSTS (Views on science, technology, and society), instrumento desarrollado empiricamente en Canada por Aikenhead, Ryan y Fleming, podia traducirse y validarse en el contexto cultural puertorriqueno. El instrumento es extenso, consta de 113 reactivos, cada uno con una premisa basica relacionada a la tematica ciencia, tecnologia y sociedad y un numero de alternativas relacionadas a la premisa que oscila entre siete y trece. Se delimito su utilizacion a los quince reactivos identificados por los autores como relacionados a la construccion social del conocimiento cientifico. Metodologicamente, se procedio a utilizar el modelo de adaptacion intercultural, que permite que el instrumento desarrollado satisfaga las dimensiones de equivalencia semantica, de contenido, tecnica, de criterio y conceptual, atemperado asi al instrumento original. Se cumplio con este proposito mediante la traduccion de la version original en ingles al espanol y viceversa. Se utilizaron comites para examinar la traduccion y la retro-traduccion del instrumento. Se realizo una prueba piloto con estudiantes universitarios de nuevo ingreso, utilizando el instrumento traducido para asegurar su intelegibilidad. La confiabilidad del instrumento se determino mediante la intervencion de un panel de expertos quienes clasificaron las distintas posiciones dentro de cada reactivo en: realista, con merito e ingenua; se transformaron estas opciones en valores numericos lo que permitio establecer una escala Likert para cada una. Se suministro el instrumento a una muestra de estudiantes universitarios de nuevo ingreso con caracteristicas similares a las de la poblacion puertorriquena en cuanto a ejecucion en las pruebas de aptitud verbal y matematica del College Board. Los resultados de sus contestaciones fueron transformados numericamente para poder obtener el coeficiente de correlacion de Spearman-Brown para el instrumento (0.661, p < 0.01). El analisis de las contestaciones de los estudiantes refleja percepciones diversas y, en algunos casos, contradictorias con respecto al contexto de construccion del conocimiento cientifico.

Razonamiento de Estudiantes Universitarios sobre Variabilidad e Intervalos de Confianza en un Contexto Inferencial Informal = University Students' Reasoning on Variability and Confidence Intervals in Inferential Informal Context

ERIC Educational Resources Information Center

Inzunsa Cazares, Santiago

2016-01-01

This article presents the results of a qualitative research with a group of 15 university students of social sciences on informal inferential reasoning developed in a computer environment on concepts involved in the confidence intervals. The results indicate that students developed a correct reasoning about sampling variability and visualized…

Experiencias, Sentido y Significado de la Consejeria en Justicia Social a Nivel Universitario: Estudio de Caso Cualitativo Mediante Tres Narrativas De Consejeros Profesionales en Educacion Superior

ERIC Educational Resources Information Center

Santiago Tosado, Virginia

2012-01-01

The purpose of the study was to understand and profoundly describe the nature of social justice practice, as is comes up from the experience of three professional counselors whose working settings are the academic arena. Detailed descriptions are presented concerning the meanings and sense of counseling for social justice, as the interviews…

Introversion/Extroversion & Teachers' Perception on Dominican EFL College Students' Performance = La Introversion/Extroversion vs. La Percepcion Profesoral en el Desempeno de Estudiantes Universitarios Dominicanos de Ingles como Lengua Extranjera

ERIC Educational Resources Information Center

Tavarez Da Costa, Pedro

2012-01-01

This article discusses the relationship between introversion/extroversion and a student's performance (academic achievement) as perceived by Teachers of English as a Foreign Language in three regional centers of the Universidad Autonoma de Santo Domingo. There have been a great number of international studies already published to try to explain…

Birds of Antioquia: Georeferenced database of specimens from the Colección de Ciencias Naturales del Museo Universitario de la Universidad de Antioquia (MUA).

PubMed

Rozo, Andrea Morales; Valencia, Fernando; Acosta, Alexis; Parra, Juan Luis

2014-01-01

The department of Antioquia, Colombia, lies in the northwestern corner of South America and provides a biogeographical link among divergent faunas, including Caribbean, Andean, Pacific and Amazonian. Information about the distribution of biodiversity in this area is of relevance for academic, practical and social purposes. This data paper describes the dataset containing all bird specimens deposited in the Colección de Ciencias Naturales del Museo Universitario de la Universidad de Antioquia (MUA). We curated all the information associated with the bird specimens, including the georeferences and taxonomy, and published the database through the Global Biodiversity Information Facility network. During this process we checked the species identification and existing georeferences and completed the information when possible. The collection holds 663 bird specimens collected between 1940 and 2011. Even though most specimens are from Antioquia (70%), the collection includes material from several other departments and one specimen from the United States. The collection holds specimens from three endemic and endangered species (Coeligena orina, Diglossa gloriossisima, and Hypopirrhus pyrohipogaster), and includes localities poorly represented in other collections. The information contained in the collection has been used for biodiversity modeling, conservation planning and management, and we expect to further facilitate these activities by making it publicly available.

The importance of audiometric monitoring in patients with multidrug-resistant tuberculosis.

PubMed

Vasconcelos, Karla Anacleto de; Frota, Silvana Maria Monte Coelho; Ruffino-Netto, Antonio; Kritski, Afrânio Lineu

2017-01-01

A total of 771 cases of multidrug-resistant tuberculosis (MDR-TB) were reported in Brazil in 2014. Treatment of MDR-TB with aminoglycosides can produce serious side effects such as permanent and irreversible hearing loss, which occurs in 5-64% of cases, and severely compromise patient quality of life. The goal of this research was to evaluate auditory and vestibular side effects in patients treated for MDR-TB and to identify associations between these complaints and the type of aminoglycoside used. We performed a retrospective review of 599 medical records from patients with MDR-TB who were treated at the Hélio Fraga/Fiocruz Reference Center between 2006 and 2010. Cases without auditory or vestibular complaints and patients who were not treated with aminoglycoside drugs were excluded from the study. Of 164 eligible cases, 55 (33.5%) reported an auditory or vestibular complaint and medication was subsequently suspended, although hearing damage was not confirmed in all cases. Audiometric testing confirmed hearing loss in 11 (21.7%) of 12 cases submitted for evaluation. Hearing loss related to ototoxicity was confirmed in 15 (62.5%) cases. Tinnitus was significantly associated with the use of amikacin and streptomycin. Evaluations of ototoxicity symptoms were not usually reported in the routine care of patients with MDR-TB. Complaints of tinnitus were associated with amikacin and streptomycin use. These results require confirmation in future studies.

A Comparison of Chinese and Colombian University EFL Students Regarding Learner Autonomy (Comparación entre estudiantes universitarios de inglés chinos y colombianos con respecto a su autonomía como aprendices)

ERIC Educational Resources Information Center

Buendía Arias, Ximena Paola

2015-01-01

This research seeks to gain deeper understanding of learner autonomy in English as a Foreign Language students from different cultures through the identification and analysis of similarities and differences between Chinese and Colombian students from two public universities: Tianjin Foreign Studies University in China and Universidad Surcolombiana…

CLAVE: Revista Especializada de ASOVELE (Asociacion Venezolana para la Ensenanza de la Lengua), 1997-1998 (CLAVE: Specialized Magazine of ASOVELE [Venezuelan Association for Language Teaching], 1997-1998).

ERIC Educational Resources Information Center

Rondon, Adolfo, Ed.; Serron, Sergio, Ed.

1998-01-01

These two issues of the journal "CLAVE" contain these articles in Spanish with one article in English: "La ensenanza de la lingua materna" (Pablo Arnaez); "Saben resumir los alumnos universitarios de nuevo ingreso?" (Marisol Garcia); "El desempeno en la escritura de cartas argumentativas y cuentos en alumnos de octavo grado" (Yolanda Perez, Maria…

Feedback Cheerleader, Mean-Spirited Feedback Estudio Critico Discursivo De Ideologias Sobre El Feedback Escrito En Un Departamento Universitario De Espanol En Estados Unidos

ERIC Educational Resources Information Center

Dominguez-Mujica, Maria Eugenia

2012-01-01

The aim of this research is to investigate ideologies that monitor and control styles of written feedback as well as discursive resources used in the expression of those ideologies. Using socio-cognitive analysis, a development of critical discourse studies, I have analyzed 44 sessions of chat on the Internet, 78 journal notes, 31 emails and 12…

Oral Testimony from the Hispanic Community of Greater Boston; Programa Para el Desarrollo de un Curriculo Universitario en Estudios Etnicos Puertorriquenos y Cubanos (Program for the Development of a University Curriculum in Puerto Rican and Cuban Ethnic Studies).

ERIC Educational Resources Information Center

Forbes, Robert J., Ed.

The oral testimony presented in this document was designed to supplement materials, strategies, and recommendations contained in "Guidelines for the Development of a Program in Puerto Rican and Cuban Ethnic Heritage Studies at the Post-Secondary Level" (Curry College, 1976). Part 1, "The Hispanic Media," consists of interviews…

Beliefs of Chilean University English Teachers: Uncovering Their Role in the Teaching and Learning Process (Creencias de profesores universitarios de inglés: descubriendo su papel en el proceso de enseñanza y aprendizaje)

ERIC Educational Resources Information Center

Díaz Larenas, Claudio; Alarcón Hernández, Paola; Vásquez Neira, Andrea; Pradel Suárez, Boris; Ortiz Navarrete, Mabel

2013-01-01

Beliefs continue to be an important source to get to know teachers' thinking processes and pedagogical decisions. Research in teachers' beliefs has traditionally come from English-speaking contexts; however, a great deal of scientific work has been written lately in Brazil, Mexico, Colombia, and Argentina. This study elicits 30 Chilean university…

Iranian EFL and Indian ESL College Students' Beliefs about Reading Strategies in L2 (Creencias de estudiantes universitarios iraníes EFL e hindúes ESL acerca de las estrategias de lectura en L2)

ERIC Educational Resources Information Center

Karbalaei, Alireza

2010-01-01

The notion of "learner beliefs" has garnered much attention in the field of second language acquisition. Although different studies have been conducted to study learners' beliefs about language learning, little research has looked into the issue of L2 readers' beliefs and their relations to reading strategies. This study investigated…

[Results of a health education intervention in the continuity of breastfeeding].

PubMed

Molinero Diaz, Patricia; Burgos Rodríguez, María José; Mejía Ramírez de Arellano, Mercedes

2015-01-01

evaluate the efficacy of a nursing intervention based on active observation and resolution of the problems of breastfeeding in the period 24-48h post-partum as regards stopping breastfeeding in mothers who gave birth in Hospital General Universitario, Ciudad Real. A clinical trial was conducted on 100 healthy women who had given birth to a healthy baby in the maternity unit of the Hospital General Universitario Ciudad Real. The results showed that 39.8% of women have problems, and 72% need help to initiate the breastfeeding. Approximately 79.9% continue with breastfeeding after hospital discharge as a result of our intervention. Breastfeeding was stopped by 31.1% of the control group, and by 10.9% in the experimental group (nursing intervention), with significant differences being observed in both groups, with RR 1.29 and 95% CI; 1.04-1.61. Hypogalactia (low milk production) was the most frequent reason for stopping, with no differences in both groups. At 3 months, 16.9% had stopped breastfeeding in the control group, and 9% in the experimental group. At 6 months, 19.3% of the control group did not continue with breastfeeding versus 15.9% in the experimental group. Action, and not only intervention, protocols in the period 48h pospartum when there were problems with breastfeeding were effective for initiation breastfeeding at hospital discharge. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

A Novel 3D Hybrid FEM-PO Technique for the Analysis of Scattering Problems

DTIC Science & Technology

2004-04-23

Magdalena Salazar-Palma3 Tapan K. Sarkar4 1Departamento de Ingeniería Audiovisual y Comunicaciones , Universidad Politécnica de Madrid 2Departamento de...Teoría de la Señal y Comunicaciones , Universidad de Alcalá Escuela Politécnica, Campus Universitario, Ctra. Madrid-Barcelona Km. 33.600 28806 Alcalá de...NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Departamento de Ingeniería Audiovisual y Comunicaciones , Universidad Politécnica de

Opportunities at Independent Colleges and Universities in New York State through the Higher Education Opportunity Program = Las Oportunidades en las Instituciones Independendientes de Nivel Universitario en el Estado de Nueva York a traves de los Programas de Oportunidades Educativas Universitarias.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Higher Education Opportunity Programs.

A guide to the opportunities at private colleges and universities in New York State through the Higher Education Opportunity Program (HEOP) is presented. The HEOP is designed to meet the special needs of students from disadvantaged backgrounds through screening, testing, counseling, tutoring, teaching, and financial assistance. Generally, students…

Effectiveness of surgical treatment in chronic migraine.

PubMed

Amaya-Blas, Francisco Javier; Mecott, Gabriel A; Marfil-Rivera, Alejandro; Tamayo-Esquivel, María de Lourdes; García-Pérez, Mauricio Manuel; Chacón-Moreno, Hernán; Pérez-Porras, Sergio; Coutiño, Rosa; Castro-Góvea, Yanko

2018-01-01

Migraine affects more than 35 million people in the United States of America, and 10% of the population in the world. The purpose of this study was to evaluate the effectiveness of surgical treatment in chronic migraine with frontal or occipital trigger areas. We designed a pilot, proof of concept, and prospective study to analyze the effectiveness of surgical release of trigger nerves in severe frontal or occipital chronic migraines. The study was approved by the Ethics and Investigation Committee of Hospital Universitario Dr. José Eleuterio González (Monterrey, N.L., Mexico). We included patients diagnosed with chronic migraine by the neurology service of Hospital Universitario Dr. José Eleuterio González that attended our consult from March to December 2012. The patients were assessed by the MIDAS questionnaire and the diagnosis confirmed by injecting 2% lidocaine in the trigger sites. We realized a superior palpebral approach in frontal migraines to resection the glabellar muscles and an occipital approach to free the greater occipital nerve bilaterally. We evaluated complete and partial clinical response measuring the frequency, intensity, and duration of migraine episodes. We included three patients with Stage IV (severe incapacitating) frontal or occipital chronic migraines. Two were occipital trigger sites and one frontal. We obtained complete clinical response in two patients and a partial response in one. Pain intensity decreased in all patients. Surgical treatment is effective in Stage IV (severe incapacitating) frontal or occipital trigger chronic migraines. Copyright: © 2018 Permanyer.

Afebrile pneumonia (whooping cough) syndrome in infants at Hospital Universitario del Valle, Cali, 2001-2007.

PubMed

Villegas, Dolly; Echandía-Villegas, Connie Alejandra; Echandía, Carlos Armando

2012-04-01

Afebrile pneumonia syndrome in infants, also called infant pneumonitis, pneumonia caused by atypical pathogens or whooping cough syndrome is a major cause of severe lower respiratory infection in young infants, both in developing countries and in developed countries. To describe children with afebrile pneumonia syndrome. Through a cross-sectional study, we reviewed the medical records of children diagnosed with afebrile pneumonia treated at Hospital Universitario del Valle, a reference center in southwestern Colombia, between June 2001 and December 2007. We obtained data on maternal age and origin, prenatal care, the childs birth, breastfeeding, vaccination status, symptoms, signs, diagnosis, treatment, and complications. We evaluated 101 children with this entity, noting a stationary presentation: June-August and November- December. A total of 73% of the children were under 4 months of age; the most common symptoms were: cyanotic and spasmodic cough (100%), respiratory distress (70%), and unquantified fever (68%). The most common findings: rales (crackles) (50%), wheezing and expiratory stridor (37%); 66% were classified as mild and of the remaining 33%, half of them required attention in the intensive care unit. In all, there was clinical diagnosis of afebrile pneumonia syndrome in infants, but no etiologic diagnosis was made and despite this, 94% of the children received macrolides. These data support the hypothesis that most of these patients acquired the disease by airway, possibly caused by viral infection and did not require the indiscriminate use of macrolides.

Afebrile pneumonia (whooping cough) syndrome in infants at Hospital Universitario del Valle, Cali, 2001-2007

PubMed Central

Villegas, Dolly; Echandía-Villegas, Connie Alejandra

2012-01-01

Introduction: Afebrile pneumonia syndrome in infants, also called infant pneumonitis, pneumonia caused by atypical pathogens or whooping cough syndrome is a major cause of severe lower respiratory infection in young infants, both in developing countries and in developed countries. Objective: To describe children with afebrile pneumonia syndrome. Methods: Through a cross-sectional study, we reviewed the medical records of children diagnosed with afebrile pneumonia treated at Hospital Universitario del Valle, a reference center in southwestern Colombia, between June 2001 and December 2007. We obtained data on maternal age and origin, prenatal care, the childs birth, breastfeeding, vaccination status, symptoms, signs, diagnosis, treatment, and complications. Results: We evaluated 101 children with this entity, noting a stationary presentation: June-August and November- December. A total of 73% of the children were under 4 months of age; the most common symptoms were: cyanotic and spasmodic cough (100%), respiratory distress (70%), and unquantified fever (68%). The most common findings: rales (crackles) (50%), wheezing and expiratory stridor (37%); 66% were classified as mild and of the remaining 33%, half of them required attention in the intensive care unit. In all, there was clinical diagnosis of afebrile pneumonia syndrome in infants, but no etiologic diagnosis was made and despite this, 94% of the children received macrolides. Conclusions: These data support the hypothesis that most of these patients acquired the disease by airway, possibly caused by viral infection and did not require the indiscriminate use of macrolides. PMID:24893051

El Cambiante panorama demografico de la poblacion estudiantil en los departamentos de lenguas: soluciones efectivas a nivel universitario y recomendaciones para su implementacion en la escuela secundaria (The Changing Demographics of the Student Population in Foreign Language Departments: Effective University-Level Solutions and Recommendations for Their Implementation in Secondary Schools).

ERIC Educational Resources Information Center

Castro, Obdulia

2002-01-01

Describes an interdisciplinary program offering modified Spanish classes to students with special needs. Through preliminary identification, eligible students are signed up for classes. Exemplifies an effective way to confront problems related to a more diverse student population; to comply with regulations imposed by the Americans with…

[Medical movement in Mexico. To 50 years. Open file].

PubMed

Sandoval-Gutiérrez, José Luis

2017-01-01

Gutiérrez-Samperio hace una excelente narrativa del movimiento denominado «blanco» hace medio siglo, encabezado por médicos y otros trabajadores de salud, principalmente enfermeras. Es importante revisar los logros y limitaciones que dicho fenómeno alcanzó. Por ejemplo, actualmente el residente que cursa una especialidad cuenta con un reconocimiento institucional, universitario y de profesiones al término de su formación, además de tener una beca económica (probablemente insuficiente) y días de vacaciones programados.

Observations on kangaroo baby care.

PubMed

Mukasa, G K

1992-01-01

The author's visit to "kangaroo care" programs in Guatemala and Colombia has led Uganda's University of Kampala to consider the introduction of this innovation in its neonatal special care unit. Such programs, which place premature infants in direct contact with their mother's skin during breastfeeding, represents a simple, inexpensive strategy for infant survival in developing countries and eliminates the need for mechanical incubators. Research conducted at the Hospital Universitario de Valle in Cali, Colombia, found that falls in the infant's body temperature. In the Latin American programs, premature infants are entered into the breastfeeding program immediately after delivery.

Exploring Conceptions about Writing and Learning: Undergraduates' Patterns of Beliefs and the Quality of Academic Writing (Acercamiento a las concepciones sobre la escritura y el aprendizaje: patrones de creencias de los universitarios y la calidad de su redacción académica)

ERIC Educational Resources Information Center

Martínez-Fernández, J. R.; Corcelles, M.; Bañales, G.; Castelló, M.; Gutiérrez-Braojos, C.

2016-01-01

Introduction: In this study, the conceptions of learning and writing of a group of undergraduates enrolled in a teacher education programme were identified. The relationship between them were analysed, and a set of patterns of beliefs about learning and writing were defined. Finally, the relation between these patterns and the quality of a text…

Impacts of changes in land use and fragmentation patterns on Atlantic coastal forests in northern Spain.

PubMed

Teixido, Alberto L; Quintanilla, Luis G; Carreño, Francisco; Gutiérrez, David

2010-01-01

Changes in forested landscapes may have important consequences for ecosystem services and biodiversity conservation. In northern Spain, major changes in land use occurred during the second half of the 20th century, but their impacts on forests have not been quantified. We evaluated the dynamics of landscape and forest distribution patterns between 1957 and 2003 in Fragas do Eume Natural Park (northwestern Spain). We used orthoimages and a set of standard landscape metrics to determine transitions between land cover classes and to examine forest distribution patterns. Eucalypt plantations showed the greatest increase in area (197%) over time. Furthermore, transitions to eucalypt plantations were found in all major land cover classes. Forest showed a net decline of 20% in total area and represented 30% of the landscape area in 2003. Forest losses were mainly due to eucalypt plantations and the building of a water reservoir, while forest gains were due to increases in shrubland, meadows and cultivated fields which had been recolonised. Forest patch size and core area decreased, and edge length increased over time. In turn, increases were obtained in mean distance between forest patches, and in adjacency to eucalypt plantations and to a water reservoir. These results suggest an increase in forest fragmentation from 1957 to 2003, as well as a change in the nature of the habitat surrounding forest patches. This study shows that land use changes, mostly from eucalypt plantation intensification, negatively affected forested habitats, although some regeneration was ongoing through ecological succession from land abandonment. Copyright 2009 Elsevier Ltd. All rights reserved.

A novel method of placing right ventricular leads in patients with persistent left superior vena cava using a conventional j stylet.

PubMed

Mora, Guillermo

2014-03-01

Locating pacemaker electrodes can become complicated by congenital abnormalities such as persistent left superior vena cava (LSVC). To evaluate a technique for the implanting of ventricular electrode in patients with persistent LSVC. The study was carried out from June 2001 to June 2010 involving all patients who were admitted to the Hospital Universitario Mayor, Instituto de Corazon de Bogota and Hospital Universitario Clinica San Rafael (Bogota-Colombia) for implanting pacemakers or cardiac defibrillators. LSVC was diagnosed by fluoroscopic observation (anterior-posterior view) of the course of the stylet. Four steps were followed: 1) Move the electrode with a straight stylet to the right atrium. 2) Change the straight stylet by a conventional J stylet and push the electrode to the lateral or anterolateral wall of the right atrium. 3) Remove the guide 3-5 cm and 4) Push the electrode which crosses the tricuspid valve into the right ventricle and finally deploy the active fixation mechanism. A total of 1198 patients were admitted for pacemaker or cardiac defibrillator implant during the 9-year study period, 1114 received a left subclavian venous approach. There were 573 males and 541 females. Persistent LSVC was found in five patients (0.45%) Fluoroscopy time for implanting the ventricular electrode ranged from 60 to 250 seconds, 40 to 92 minutes being taken to complete the whole procedure. We present a simple and rapid technique for electrode placement in patients with LSVC using usual J guide and active fixation electrodes with high success.

Bacteria mediated dissolution of pyromorphite Pb5(PO4)3Cl in presence of Pseudomonas putida bacteria - an effect on Pb remobilization in the environment

NASA Astrophysics Data System (ADS)

Flis, Justyna; Manecki, Maciej; Merkel, Broder J.; Latowski, Dariusz

2010-05-01

The objective of the study was to determine the mechanisms of microbially enhanced dissolution of lead phosphate-pyromorphite Pb5(PO4)3Cl). Contrary to the current literature, the results of our experiments indicate a great potential for Pb remobilization in the environment by an aerobic microorganism acquiring phosphates. Broad knowledge exists about the role of Pb-apatites in regulating the behavior and the bioavailability of Pb in soils and wastewater. In situ Pb immobilization is one of the methods now routinely applied for the reclamation of Pb-contaminated soils, including shallow unconfined aquifers (Magalhaes & Silva, 2003; Magalhaes, 2002; Ma et al. 1993). This method is based on the principle that aqueous phosphates added to soil pore solutions form a very stable (insoluble) mineral pyromorphite (Pb-apatite) Pb5(PO4)3Cl. Bioavailability of aqueous Pb is thus minimized due to the very low solubility and the high thermodynamic stability of pyromorphite (Flis, 2007; Nriagu, 1974). Several reports have examined the ability of different bacterial species including Pseudomonas to solubilise insoluble inorganic phosphate compounds for example apatites (Welch et al., 2002; Maurice et al., 1999; Rodriguez and Fraga, 1999 ). Various species of Pseudomonas genera are encountered as common inhabitants of soils and wastes in the industrial areas under strong pollution influence. To date, there has not been any published evidence of microbial dissolution of pyromorphite. The major objective of the project was to study Pseudomonas putida growth in the presence of Pb-apatite (Pb5(PO4)3Cl) as the sole source of phosphate. It was to test the hypothesis that in the phosphate deficient environment bacteria are able to actively scavenge for P from the Pb-apatite which results in remobilization of Pb in the environment. The bacteria growth was investigated at 22oC. Commercially available Pseudomonas putida strain was used throughout. The experiment and its controls were run in standard growth medium for the period of 10 days, at starting pH=6.5. Samples were periodically analysed for pH, bacterial density, Pb and P (UV-vis, ICP). Our results indicate that Pb may be mobilized from pyromorphite by microbial activity, both in phosphorous-rich and phosphorous-deficient environment. At the experimental conditions the presence of bacteria enhances the dissolution of pyromorphite, resulting in up to 20 times increase of Pbaq. The observed effects of microorganisms on Pb remobilization need to be considered in Pb remediation strategies that rely on pyromorphite formation. References: FLIS J.M., (2007). "Thermodynamic properties of minerals from pyromorphite-mimetite series"- Master Thesis, AGH-University of Science and Technology, Faculty of Geology, Geophysics and Environmental Protection, Department of Mineralogy, Petrography and Geochemistry, Cracow, Poland. MA Q.Y., TRAINA S.J., LOGAN T.J., RYAN J.A. (1993). "In-situ lead immobilization by apatite". Environ. Sci. Technol., 27: 1803-1810. MAURICE P.A, LEE Y.J., HERSMAN L.E. (1999). "Dissolution of Al-substituted goethites by an aerobic Pseudomonas mendocina var. Bacteria." Gechim. Cosmochim. Acta. 64: 1363-1374. MAGALHÃES M.C.F. (2002). "Arsenic. An environmental problem limited by solubility". Pure Appl. Chem., 74(10): 1843-1850. MAGALHÃES M.C.F., SLIVA, M.C.M.(2003). "Stability of lead(II) arsenates". Monat. fur Chem. 134: 735-743 NRIAGU J.O., (1974). "Lead orthophosphates IV. Formation and stability in the environment." Geochim. Cosmochim. Acta, 37: 367-377. RODRIGUEZ H. & FRAGA R. (1999). "Phosphate solubilizing bacteria and their role in plant growth promotion". Biotechn. Advan. 17: 319-339. WELCH S.A., TAUNTON A.E., BANFIELD J.F. (2002). "Effect of Microorganisms and Microbial Metabolites on Apatite Dissolution". Geomicrobil. J. 19: 343-367.

Mitigation of Disagreement in Peer Review among L2 Learners and Native Speakers in a College Writing Class (Mitigación del Impacto de las Opiniones de Desacuerdo en el Proceso de Revisión por Pares entre Estudiantes de una Segunda Lengua y Hablantes Nativos en una Clase de Escritura a Nivel Universitario)

ERIC Educational Resources Information Center

Christoffersen, Katherine O'Donnell

2015-01-01

Peer review is now a commonplace practice in process-oriented writing instruction. A crucial aspect of peer review is assessing another classmate's work, which encompasses the act of disagreement. Given its prevalence in the classroom, it is necessary to analyze how L2 learners mitigate disagreement in the context of peer review with other L2…

Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis.

PubMed

González-Álvaro, Isidoro; Castrejón, Isabel; Ortiz, Ana M; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto

2016-01-01

To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI's AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28's AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

PubMed

Ramírez-Vélez, Robinson; Triana-Reina, Héctor Reynaldo; Carrillo, Hugo Alejandro; Ramos-Sepúlveda, Jeison Alexander

2016-11-29

Objetivo: evaluar la relación entre la percepción de las barreras para la práctica de la actividad física (AF) con la presencia de obesidad abdominal (OA) en universitarios de Colombia.Métodos :estudio descriptivo y transversal en 5.663 sujetos entre 18 y 30 años de edad (3.348 hombres), pertenecientes a tres ciudades de Colombia. Se midió la circunferencia de cintura (CC) como indicador de OA y el riesgo se clasificó según valores de referencia internacionales. La autopercepción de barreras se determinó con el cuestionario Barriers to Being Active Quiz (BBAQ-21) validado en Colombia. Se calcularon razones de prevalencia (RP) entre cada dominio del cuestionario y clasificación de OA.Resultados: la prevalencia de obesidad abdominal fue del 10,4% con diferencias por sexo (7,3% hombres vs.12,6% mujeres p < 0,01). La "falta de tiempo", la "influencia social" y la "falta de habilidades" fueron las barreras más prevalentes para cesar la práctica de AF en el grupo de entrevistados con OA en ambos sexos. Al comparar los estudiantes con CC saludable, la RP de presentar OA fue mayor en el grupo de mujeres que en hombres en los dominios del cuestionario BBAQ-21 "falta de tiempo" (RP = 1,33 [IC 95% 1,11-1,60]) vs.(RP = 1,14 [IC 95% 1,03-1,26]) y "falta de recursos" (RP = 1, 93 [IC 95% 11,67-2,24])vs. (RP = 1,83 [IC 95% 1,68-1,99]), respectivamente.Conclusión: una mayor autopercepción de las barreras para realizar AF se relacionó con mayor frecuencia en el grupo con OA en universitarios de Colombia.

Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis

PubMed Central

Castrejón, Isabel; Ortiz, Ana M.; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto

2016-01-01

Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI’s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28’s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis. PMID:27603313

[Case reports of drug-induced liver injury in a reference hospital of Zulia state, Venezuela].

PubMed

Mengual-Moreno, Edgardo; Lizarzábal-García, Maribel; Ruiz-Soler, María; Silva-Suarez, Niniveth; Andrade-Bellido, Raúl; Lucena-González, Maribel; Bessone, Fernando; Hernández, Nelia; Sánchez, Adriana; Medina-Cáliz, Inmaculada

2015-03-01

Drug-induced liver injury (DILI) is an important cause of morbidity and mortality worldwide, with varied geographical differences. The aim of this prospective, descriptive, cross-sectional study was to identify and characterize cases of DILI in a hospital of Zulia state, Venezuela. Thirteen patients with a presumptive diagnosis of DILI attended by the Department of Gastroenterology, Hospital Universitario, Zulia state, Venezuela, from December-2012 to December-2013 were studied. Ibuprofen (n = 3; 23.1%), acetaminophen (n = 3; 23.1), isoniazid (n = 2; 15.4%) and Herbalife products (n = 2; 15.4%) were the main drugs involved with DILI. Acetaminophen and ibuprofen showed a mixed pattern of liver injury (n = 3; 23.1%) and isoniazid presented a hepatocellular pattern (n = 2; 15.4%). The CIOMS/RUCAMS allowed the identification of possible (n = 7; 53.9%), probable (n = 4; 30.8%) and highly-probable cases (n = 2; 15.4%) of DILI. Amoxicillin/clavulanate, isoniazid, isotretinoin, methotrexate and Herbalife nutritional products were implicated as highly-probable and probable agents. The highest percentage of DILI corresponded to mild cases that recovered after the discontinuation of the agent involved (n = 9; 69.3%). The consumption of Herbalife botanical products is associated with probable causality and fatality (n = 1; 7.7%). In conclusion, the frequency of DILI cases controlled by the Department of Gastroenterology of the Hospital Universitario of Maracaibo was low, being ibuprofen, acetaminophen, isoniazid and products Herbalife the products most commonly involved. It is recommended to continue with the prospective registration of cases, with an extended follow up monitoring period and to facilitate the incorporation of other hospitals in the Zulia State and Venezuela.

[Risk factors associated with the development of perinatal asphyxia in neonates at the Hospital Universitario del Valle, Cali, Colombia, 2010-2011].

PubMed

Torres-Muñoz, Javier; Rojas, Christian; Mendoza-Urbano, Diana; Marín-Cuero, Darly; Orobio, Sandra; Echandía, Carlos

2017-04-01

Perinatal asphyxia is one of the main causes of perinatal mortality and morbidity worldwide and it generates high costs for health systems; however, it has modifiable risk factors. To identify the risk factors associated with the development of perinatal asphyxia in newborns at Hospital Universitario del Valle, Cali, Colombia. Incident cases and concurrent controls were examined. Cases were defined as newborns with moderate to severe perinatal asphyxia who were older than or equal to 36 weeks of gestational age, needed advanced resuscitation and presented one of the following: early neurological disorders, multi-organ commitment or a sentinel event. The controls were newborns without asphyxia who were born one week apart from the case at the most and had a comparable gestational age. Patients with major congenital malformations and syndromes were excluded. Fifty-six cases and 168 controls were examined. Premature placental abruption (OR=41.09; 95%CI: 4.61-366.56), labor with a prolonged expulsive phase (OR=31.76; 95%CI: 8.33-121.19), lack of oxytocin use (OR=2.57; 95% CI: 1.08 - 6.13) and mothers without a partner (OR=2.56; 95% CI: 1.21-5.41) were risk factors for the development of perinatal asphyxia in the study population. Social difficulties were found in a greater proportion among the mothers of cases. Proper control and monitoring of labor, development of a thorough partograph, and active searches are recommended to ensure that all pregnant women have adequate prenatal care with the provision of social support to reduce the frequency and negative impact of perinatal asphyxia.

EL PROCESO DE MENTORÍA DENTRO DE UN PROYECTO PARA EL DESARROLLO DE INFRAESTRUCTURA DE INVESTIGACIÓN A NIVEL UNIVERSITARIO

PubMed Central

MÁRQUEZ, LILLIAN ARVELO; SANTIAGO, NILDA G. MEDINA

2015-01-01

This article aims to describe the experience of Proyecto VIAS - RIMI (Violence & Asthma - Research Infrastructure in Minority Institutions) of Universidad del Este in Puerto Rico to achieve one of its main objectives: the development and promotion of mentoring in research. It describes the way the project has operationalized the mentoring process to empower mentees, as well as the innovative ways in which university professors have received training to become better mentors. The authors argue that mentoring has been fundamental to achieve the goals of the students who have participated in the project and recommend continuing such initiatives in academia. PMID:27066161

PubMed

Zaragoza-Martí, Ana; Sánchez-SanSegundo, Miriam; Ferrer-Cascales, Rosario

2016-11-29

Introducción: el trastorno por atracón o "Binge Eating Disorders" (BED) se caracteriza por el consumo de grandes cantidades de comida en un breve periodo de tiempo acompañado de una sensación de falta de control sobre la ingesta. El BED se relaciona con una alimentación poco equilibrada, contribuyendo a la aparición de diversas patologías. La alimentación y los estilos de vida desempeñan un factor clave en la prevención de estas patologías, siendo la dieta mediterránea (DM) uno de los estándares de la alimentación saludable.Objetivo: analizar la relación entre la DM y el BED en una muestra de estudiantes universitarios.Método: se realizó un estudio descriptivo transversal en una muestra de 120 estudiantes de la Universidad de Alicante. Para establecer la relación entre el patrón de atracón y el grado de adherencia a la DM se determinó el coefi ciente de correlación r de Pearson. Los resultados se expresaron en odds ratios (OR) e intervalo de confi anza (IC) al 95%.Resultados: los sujetos con un patrón de BED presentaron menor adherencia a la DM (OR = 4,03; IC 95%, 1,80-18,69), mayores índices de exceso de peso (OR = 5,31; IC 95%, 1,81-15,64), y vidas más sedentarias (OR = 1,4; IC 95%, 0,52-4,12). El BED correlacionó negativamente con el grado de adherencia DM (r = -0,3, p < 0,01).Conclusión: el patrón de DM se asocia de manera inversa con el riesgo de sufrir trastorno por atracón y además dicho patrón de atracón se asocia significativamente con el riesgo de sufrir exceso de peso en estudiantes universitarios. Son necesarios estudios que confi rmen que la DM reduce el riesgo de sufrir trastorno por atracón.

[R-ALERGO. Allergy-healthy routes in Valencia].

PubMed

Temes Cordovez, Rafael R; Moya Fuero, Alfonso; Martí Garrido, Jaume; Perales Chordá, Carolina; Díaz Palacios, Miguel; Hernández Fernández de Rojas, Dolores

2016-01-01

R-ALERGO is a project developed by researchers from the Universitat Politècnica de València and the Hospital Universitario La Fe (Valencia, Spain). The main objective of the project is to create a mobile application identifying, within the city of Valencia, the most favorable routes for allergic individuals. The application is developed using nine environmental variables with a potential effect on the development of clinical manifestations in allergic individuals. The application combines the use of spatial analysis based on network technology and implemented with a geographic information system software. The first 01 version is under evaluation for a Healthy app hallmark. The next step in this project is to design a clinical validation process to test its usefulness in allergic individuals. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

La utilizacion de los mapas conceptuales en la ensenanza de biologia y su efecto sobre el dominio del proceso de fotosintesis en los estudiantes universitarios

NASA Astrophysics Data System (ADS)

Gonzalez Rivera, Maria M.

Se investigo el efecto de los mapas conceptuales sobre el dominio del proceso de fotosintesis en estudiantes universitarios. La investigacion utilizo dos estrategias: mapas conceptuales individuales y mapas conceptuales colaborativos, con el fin de investigar si existen diferencias significativas en el dominio del proceso de fotosintesis. El analisis de los datos incluyo aspectos cualitativos y cuantitativos. Se desprende del estudio que el 80% de los estudiantes describen la utilizacion de los mapas conceptuales como una experiencia beneficiosa. El 70% de los estudiantes expreso que los mapas conceptuales son utiles en el aprendizaje del proceso de fotosintesis y el 61% indico que facilitan la comprension de los conceptos. Los hallazgos mas importantes del analisis cuantitativo indican que los estudiantes que utilizaron los mapas conceptuales mejoraron significativamente su desempeno en la posprueba global. Se utilizo la prueba Mann-Whitney para investigar si existian diferencias significativas en la posprueba y preprueba global, el valor de W = 1945.0, para un valor p de 0.00, lo cual establece diferencias significativas. Para determinar si existian diferencias significativas entre la posprueba y preprueba del grupo individual, se realizo la prueba nuevamente. El valor de W correspondio a 490.5, que es significativo, con un valor p de 0.00. Se concluye que existen diferencias significativas entre la ejecucion de la posprueba y preprueba del grupo individual. Los datos proveen suficiente evidencia para sostener que los estudiantes que utilizaron la estrategia de mapas conceptuales individuales mejoraron el dominio del proceso de fotosintesis significativamente. Se realizo nuevamente la prueba para los resultados de posprueba y preprueba del grupo colaborativo. El valor de W correspondio a 446 con un valor p de 0.00. Se concluyo que existen diferencias significativas entre la ejecucion de la posprueba y preprueba del grupo colaborativo. Finalmente, se efectuo una prueba Mann-Whitney comparando la posprueba de ambos grupos. El valor de W fue de a 777, para un valor p de 0.2782. Aunque las puntuaciones de las pospruebas del grupo colaborativo fueron mayores que las puntuaciones de la posprueba del grupo individual, la diferencia no fue estadisticamente significativa.

Investigaccion-accion en la sala de clases sobre las creencias de la cultura de la ciencia de un grupo de estudiantes universitarios y su relacion reciproca con el aprendizaje de las ciencias biologicas

NASA Astrophysics Data System (ADS)

Cordova-Santiago, Lizzette Astrid

La investigacion---accion que se llevo a cabo en la sala de clases tenia como punto de partida las creencias de la cultura de la ciencia de un grupo de estudiantes universitarios para luego examinar sus implicaciones en el proceso de aprendizaje de las Ciencias Biologicas. ¿Que se supone que hagan las creencias en relacion con el aprendizaje? ¿En que consiste incorporar este aspecto a la practica educativa universitaria? Utilizando el modelo de Kemmis y McTaggart (1987) la investigacion-accion se planteo como un proceso dinamico en cuatro momentos en espiral constituidos por la planificacion, la accion, la observacion y la reflexion. Cada una de las fases tuvo una intencion retrospectiva y prospectiva formando una espiral de autorreflexion del conocimiento y la accion. Se llevaron a cabo audio grabaciones en clases y analisis de documentos. Ademas, la profesora-investigadora hizo un portafolio para reflexionar sobre las creencias de la cultura de la ciencia que tienen los estudiantes y las creencias del aprendizaje que tiene la profesora y sobre como la comprension de estos elementos ayudo a mejorar su practica educativa a traves del tiempo. Los resultados obtenidos apuntan a que las creencias de la cultura de la ciencia que tiene el grupo de estudiantes son diversas. Ellos si creen que la ciencia tiene una cultura la cual describieron como: complicada y desconocida que evoluciona constantemente, que es un conjunto de metodos, que es altamente tecnologica, que resuelve problemas de salud, ayuda a interpretar la realidad del mundo que los rodea y su origen y que existen unas intersecciones entre la ciencia y el poder. Sobre las creencias del proceso de aprendizaje de la profesora-investigadora, estas senalan que el modelaje de actores, la vision de la academia que tiene ella asi como la participacion y negociacion entre todos los involucrados en el proceso educativo, son factores que inciden en el proceso de aprendizaje.

Binge drinking: a pattern associated with a risk of problems of alcohol use among university students.

PubMed

Bedendo, André; Andrade, André Luiz Monezi; Opaleye, Emérita Sátiro; Noto, Ana Regina

2017-09-12

to evaluate problems associated with alcohol use among university students who reported binge drinking in comparison to students who consumed alcohol without binging. a cross-sectional study among university students (N=2,408) who accessed the website about alcohol use. Logistic and linear regression models were included in the statistical analyzes. alcohol use in the last three months was reported by 89.2% of university students; 51.6% reported binge drinking. Compared to students who did not binge drink, university students who presented this pattern were more likely to report all evaluated problems, among them: black out (aOR: 5.4); having academic problems (aOR: 3.4); acting impulsively and having regrets (aOR: 2.9); getting involved in fights (aOR: 2.6); drinking and driving (aOR: 2.6) and accepting a ride with someone who had drunk alcohol (aOR: 1.8). Students who binged also had higher scores on the Alcohol Use Disorders Identification Test (b=4.6; p<0.001), more negative consequences (b=1.0; p<0.001) and a reduced perception of the negativity of the consequences (b=-0.5; p<0.01). binge drinking was associated with an increase in the chances of manifesting problems related to alcohol use. The conclusions of this study cannot be generalized for all of the Brazilian population. avaliar problemas associados ao uso de álcool entre universitários que relataram binge drinking em comparação a estudantes que consumiram álcool sem binge drinking. estudo transversal entre universitários (N=2.408) que acessaram website sobre o uso de álcool. Nas análises estatísticas incluíram-se modelos de regressão logística e linear. o uso de álcool, nos últimos três meses, foi relatado por 89,2% dos universitários e 51,6% referiram uso binge. Comparados a estudantes que não praticaram binge, universitários que apresentaram esse padrão tiveram maior chance de relatar todos os problemas avaliados, entre eles: incapacidade de lembrar o que aconteceu (aOR:5,4); problemas acadêmicos (aOR:3,4); agir impulsivamente e se arrepender (aOR:2,9); envolver-se em brigas (aOR:2,6); dirigir após beber (aOR:2,6) e pegar carona com alguém que bebeu (aOR:1,8). Estudantes que consumiram álcool no padrão binge também apresentaram maior pontuação no Alcohol Use Disorders Identification Test (b=4,6; p<0,001), mais consequências negativas (b=1,0; p<0,001) e menos percepção da negatividade das consequências (b=-0,5; p<0,01). a prática de binge drinking esteve associada ao aumento das chances de manifestação de problemas relacionados ao uso de álcool. As conclusões deste estudo não podem ser reproduzidas para toda realidade brasileira. evaluar problemas asociados al uso de alcohol entre estudiantes universitarios que relataron binge drinking en comparación a estudiantes que consumieron alcohol sin binge drinking. estudio transversal entre estudiantes universitarios (N=2.408) que visitaron una página web sobre el uso de alcohol. En los análisis estadísticos, fueron incluidos modelos de regresión logística y linear. el uso de alcohol, en los últimos tres meses, fue relatado por 89,2% de los estudiantes universitarios, y entre ellos 51,6% relataron uso binge. En comparación a estudiantes universitarios que no practicaron binge, los estudiantes que presentaron ese estándar tuvieron una mayor oportunidad de relatar todos los problemas evaluados, entre ellos: incapacidad de recordar lo que sucedió (aOR:5,4); problemas académicos (aOR:3,4); actuar por impulso y arrepentirse (aOR:2,9); involucrarse en peleas (aOR:2,6); manejar después de beber (aOR:2,6) y compartieron viaje con alguien que bebió (aOR:1,8). Estudiantes que consumieron alcohol dentro del estándar binge también presentaron una mayor puntuación en el Alcohol Use Disorders Identification Test (b=4,6; p<0,001), más consecuencias negativas (b=1,0; p<0,001) y menor percepción de la negatividad de las consecuencias (b=-0,5; p<0,01). la práctica de binge drinking estuvo asociada al aumento de las oportunidades de manifestación de problemas relacionados al alcohol. Las conclusiones de este estudio no pueden ser adaptadas a toda la realidad brasileña.

Outbreak of acute hepatitis A in the health area served by the Hospital Universitario Virgen de la Victoria (HUVV): a change in epidemiology.

PubMed

García Ferreira, Alejandro José; Ortega Alonso, Aida; Cobos Rodríguez, Julia; Bardón de Tena, Paula; Calderón Cid, Miguel; García García, Alberto Manuel; García Escaño, María Dolores; Alcántara Benitez, Ramiro; Clavijo Frutos, Encarnacíon; García-Cortés, Miren; Andrade, Raúl

2018-03-12

In 2016, an outbreak of hepatitis A was identified in the Malaga province among patients with specific epidemiological characteristics, which were predominantly males. This is a report of 51 subjects with acute hepatitis A and a mean age of 35.7 years, 90% were male and 55% of cases were men who had had sex with other men within the last two months. Half of them required hospitalization for significant coagulopathy at diagnosis and no cases progressed to fulminant failure or encephalopathy. Four patients had ascites at the time of diagnosis. This outbreak adds to those reported in the United Kingdom and the Netherlands with a similar number of cases and epidemiology. These studies highlight the importance of epidemiological surveillance, the need for vaccination in this particular at risk population and the need for informative campaigns in order to prevent this disease.

[Silent myocardial ischemia in patients with transient ischemic attacks].

PubMed

Sánchez Valiente, S; Mostacero, E; del Río, A; Morales, F

1994-10-01

Given evidence that ischemic heart disease is the most frequent cause of death in patients with cerebrovascular disease, we used ergometrics to screen 80 patients with TIA for silent myocardial ischemia (SMI) at the neurological unit of Hospital Clínico Universitario in Zaragoza, Spain. The patients were compared with a control group of 80 with no signs of heart disease. Neither the patients nor the controls had ever shown clinical signs of coronary ischemia and their baseline electrocardiograms were normal. Stress test results were positive in 25 (31%) of the TIA patients, and in 4 (5%) (p < 0.001) of the controls, showing that the prevalence of SMI is significantly higher in TIA patients than in the general population. Hiperlipidemia (75% testing positive versus 43% negative, p < 0.01) and diabetes (31% testing positive versus 13% negative, p < 0.01) were the risk factors statistically related with a positive stress test.

[PRENATAL DIAGNOSIS: EVOLUTION OF CLINICAL INDICATIONS AND THE SOCIETY IN THE PAST 30 YEARS].

PubMed

Sagredo, José Miguel García

2014-01-01

Here we report the results of prenatal diagnosis at the Hospital Universitario Ramón y Cajal since its opening in 1979 to 2010, establishing a parallelism between the different methodologies for screening and prenatal diagnosis, clinical indications, and demographic changes. It shows how the indications have varied as to the structure of the population did. These changes have been possible thanks to the fact that the screening and prenatal diagnosis methods have allowed it. Demonstrating, once again, how procedures evolve with technology and adapt to the demography. This evolution has allowed to make a more effective prenatal diagnosis because the clinical indications have been more precise what has allowed to detect the same number of fetuses with chromosomal abnormalities by performing less invasive procedures, which has led to an optimization of prenatal diagnosis saving resources and personnel and, above all, avoiding unnecessary fetal losses.

En torno al rechazo, la salud mental y la resiliencia en un grupo de jóvenes universitarios gays, lesbianas y bisexuales

PubMed Central

del C. Fernández Rodríguez, María; Calle, Fernando Vázquez

2014-01-01

These descriptive cross-sectional study explores aspects related to mental health and resilience in 44 youth identified as gays, lesbians and bisexuals (GLB). A survey and a semi structured interviews were conducted. Approximately one in three young people surveyed showed suicidal thoughts. The 18.2% of all young people carried out suicide attempts, which represented about 50% of those who expressed suicidal thoughts. Young people respondents with suicidal thoughts reported a mean score significantly lower on scales of mental health and vitality, but a higher score on the scale of perceived stigma. 75% of GLB youth respondents exhibited high levels of self-esteem and resilience. These findings account for the inherent complexity related to be accepted as gay, lesbian or bisexual, since the person wants to express himself, even with the social costs that entails and implies. PMID:25664146

Recessive Dystrophic Epidermolysis Bullosa and Pregnancy.

PubMed

Boria, F; Maseda, R; Martín-Cameán, M; De la Calle, M; de Lucas, R

2017-12-01

Dystrophic epidermolysis bullosa is a rare inherited disease caused by mutations in the COL7A1 gene. Its recessive variant (recessive dystrophic epidermolysis bullosa) is characterized by the absence or considerably reduced expression of type VII collagen, which leads to marked fragility of the skin and mucous membranes and subsequent blister formation, whether spontaneously or following minimal injury. There have been very few reports of this disease in pregnant women. We present 2 cases of pregnant women with recessive dystrophic epidermolysis bullosa managed in our High-Risk Pregnancy Unit at Hospital Universitario La Paz, Madrid, Spain. Both patients underwent full-term cesarean delivery, with no further complications for mother or child. Although recessive dystrophic epidermolysis bullosa increases the risk of maternal complications, a patient is not advised against pregnancy. With adequate monitoring, these patients can fulfil their desire to become mothers. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

En torno al rechazo, la salud mental y la resiliencia en un grupo de jóvenes universitarios gays, lesbianas y bisexuales.

PubMed

Del C Fernández Rodríguez, María; Calle, Fernando Vázquez

2013-12-01

These descriptive cross-sectional study explores aspects related to mental health and resilience in 44 youth identified as gays, lesbians and bisexuals (GLB). A survey and a semi structured interviews were conducted. Approximately one in three young people surveyed showed suicidal thoughts. The 18.2% of all young people carried out suicide attempts, which represented about 50% of those who expressed suicidal thoughts. Young people respondents with suicidal thoughts reported a mean score significantly lower on scales of mental health and vitality, but a higher score on the scale of perceived stigma. 75% of GLB youth respondents exhibited high levels of self-esteem and resilience. These findings account for the inherent complexity related to be accepted as gay, lesbian or bisexual, since the person wants to express himself, even with the social costs that entails and implies.

Acinic Cell Carcinoma of the Parotid Gland with Four Morphological Features

PubMed Central

Rosero, David S; Alvarez, Ramiro; Gambó, Paula; Alastuey, María; Valero, Alberto; Torrecilla, Nerea; Roche, A. Belén; Simón, Sara

2016-01-01

Acinic cell carcinoma arising in salivary glands is a rare tumor, accounting for 2% to 5% of the primary neoplasms of the parotid gland. When these tumors are well-differentiated, the neoplasia has innocuous aspect, due to the similarity to normal parotid tissue. This makes the diagnosis difficult. Initially the malignancy of this tumor was uncertain; however, recent studies have declared it as malignant. The female / male ratio is 3:2. The nodule usually presents as solitary and well defined shape. Several authors have used different terms to describe histomorphological patterns of these tumors. Four descriptive categories (solid, microcystic, papillary-cystic and follicular) are useful for pathologists. Here we report a case of a 49 yr old man with a left parotid nodule of 5 cm. Parotidectomy was performed at the Hospital Universitario Miguel Servet, in Zaragoza (Spain). The microscopy showed a tumor with acinic semblance, having the four morphologic patterns previously described. The morphological and immunohistochemical study was consistent with the diagnosis of acinic cell carcinoma. PMID:27499783

Acinic Cell Carcinoma of the Parotid Gland with Four Morphological Features.

PubMed

Rosero, David S; Alvarez, Ramiro; Gambó, Paula; Alastuey, María; Valero, Alberto; Torrecilla, Nerea; Roche, A Belén; Simón, Sara

2016-01-01

Acinic cell carcinoma arising in salivary glands is a rare tumor, accounting for 2% to 5% of the primary neoplasms of the parotid gland. When these tumors are well-differentiated, the neoplasia has innocuous aspect, due to the similarity to normal parotid tissue. This makes the diagnosis difficult. Initially the malignancy of this tumor was uncertain; however, recent studies have declared it as malignant. The female / male ratio is 3:2. The nodule usually presents as solitary and well defined shape. Several authors have used different terms to describe histomorphological patterns of these tumors. Four descriptive categories (solid, microcystic, papillary-cystic and follicular) are useful for pathologists. Here we report a case of a 49 yr old man with a left parotid nodule of 5 cm. Parotidectomy was performed at the Hospital Universitario Miguel Servet, in Zaragoza (Spain). The microscopy showed a tumor with acinic semblance, having the four morphologic patterns previously described. The morphological and immunohistochemical study was consistent with the diagnosis of acinic cell carcinoma.

[Breast feeding: an effective method to prevent breast cancer].

PubMed

Aguilar Cordero, Maria J; González Jiménez, E; Álvarez Ferre, J; Padilla López, C A; Mur Villar, N; García López, P A; Valenza Peña, Maria C

2010-01-01

Breast cancer is the most common gynecological tumor in young women in Western countries. Its profound implications for health and an increasingly early age of diagnosis have been carefully analyzed its causes and possible preventive measures, making their study in a primary goal of epidemiological research. We reviewed medical records pertaining to 504 female patients aged 19 to 91 years. All of them were diagnosed and treated for breast cancer between 2003-2008 at the Hospital Universitario "San Cecilio" of Granada (Spain). We found a significant correlation (p = 0.001) between the age of cancer diagnosis, length of breastfeeding, and the existence of personal and family history for cancer. By contrast, there were no statistically significant differences test (t-test) between the average age of diagnosis of cancer and having had offspring or not (t = 0.559, p = 0.576). Breastfeeding for periods of longer than six months, not only provides children with many health benefits, but may also protect the mother from serious diseases, such as breast cancer.

Implementation of a management information system for hospital use at the Policlinico Universitario A. Gemelli.

PubMed

Mobilia, G

1996-01-01

First, the experience with the implementation of HISs at the "Policlinico Gemelli", is reported. They were adopted since long for management support. In fact, they are playing an increasingly relevant role in health care facilities. Subsequently, operational applications are described with particular reference to the most recent ones, implemented within European projects with partial EEC financing. They are very useful to the medical and nursing personnel and for patient data management during treatment. Finally, the accounting system for cost centers, using, processing and integrating data of all used information systems, is described. It affords a low cost aggregation of all information about costs and services required for the management of four-hundred elementary operating units which constitute the structure. This system is representative of all managerial information of the "Policlinico" which is included in monthly reports, also described. They are sent to the Direction and managers of the organizational units. The system is a strategic tool of the utmost importance for rapid and effective management.

Trends in Lung Cancer Incidence in a Healthcare Area.

PubMed

Molina, Antonio J; García-Martínez, Lidia; Zapata-Alvarado, Julio; Alonso-Orcajo, Nieves; Fernández-Villa, Tania; Martín, Vicente

2015-11-01

The aim of this study was to identify trends in the incidence of lung cancer in the Leon Healthcare Area. All cases of cancer among residents of the Leon healthcare catchment area listed in the hospital-based tumor registry of the Centro Asistencial Universitario de Leon (CAULE) between 1996 and 2010 were included. Gross incidence rates over 3-year intervals were calculated and adjusted for the worldwide and European populations. A total of 2,491 cases were included. In men, incidence adjusted for the European population rose from 40.1 new cases per 100,000 population (1996-1998) to 61.8 (2005-2007), and then fell to 54.6 (2008-2010). In women, incidence tripled from 3.0 (1996-1998) to 9.2 new cases per 100,000 (2008-2010). Although lung cancer is an avoidable disease, it is a serious problem in the Leon Healthcare Area. Of particular concern is the rising incidence among women. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

Estudio de la estructura logica utilizada en la ensenanza y el aprendizaje de los conceptos sobre el comportamiento de gases en el curso introductorio de quimica a nivel universitario

NASA Astrophysics Data System (ADS)

Costa Diaz, Agnes

El estudio que se presenta es de caracter cualitativo, un estudio multicasos donde se estudia la estructura logica utilizada por cuatro (4) profesores universitarios que ensenan el curso introductorio de quimica, en la planificacion, presentacion y evaluacion del tema sobre el comportamiento de los gases. Se utilizaron varias fuentes de informacion como: cuestionarios de profesores y estudiantes, entrevistas, grabaciones videomagnetofonicas, materiales didacticos y una prueba conceptual, entre otros. La informacion recopilada fue analizada de acuerdo al orden logico del contenido presentado, el estilo de ensenanza del profesor, las tecnicas y estrategias utilizadas para el desarrollo de destrezas de pensamiento, el ambiente fisico en el salon de clase y los instrumentos de evaluacion y avaluo. El estudio demuestra que lo que los profesores piensan y planifican para hacer sus presentaciones no necesariamente es lo que ocurre en el salon de clases. El desarrollo de destrezas de pensamiento, que constituye una prioridad de los profesores, no se elaboran efectivamente. El uso de las estrategias de resolucion de problemas numericos predomino. La participacion del estudiante en el salon de clases fue limitada y no se logro demostrar el desarrollo de las destrezas de pensamiento deseadas. Aunque los profesores tienen su propio estilo de ensenanza, el orden logico del contenido presentado en clase fue el mismo o siguio muy de cerca el orden establecido por el libro de texto. Los profesores utilizaron preferentemente la tiza y la pizarra para sus presentaciones y la dinamica en el salon de clases fue esencialmente tradicional. Los profesores hicieron su presentacion y los estudiantes copiaron pasivamente la informacion. Las evaluaciones de los estudiantes fueron esencialmente, pruebas escritas de seleccion multiple de acuerdo con el estilo en que se les enseno. El avaluo fue casi inexistente. La prueba conceptual administrada revela un aprendizaje pobre en los conceptos mas basicos sobre el comportamiento de los gases. El estudio senala que la ejecutoria del profesor en todos los aspectos de la ensenanza y el aprendizaje es un factor clave que debe darsele prioridad. Se recomienda que el profesor, en general, tenga un conocimiento basico de las teorias de aprendizaje, de los factores que afectan el aprendizaje y las tecnicas y estrategias mas efectivas en el desarrollo de destrezas de pensamiento entre sus estudiantes. La estructura de la disciplina debe incluir tanto lo experimental como lo teorico.

Dataset of long-term monitoring of ground-dwelling ants (Hymenoptera: Formicidae) in the influence areas of a hydroelectric power plant on the Madeira River in the Amazon Basin.

PubMed

Fernandes, Itanna O; de Souza, Jorge L P

2018-01-01

Biodiversity loss is accelerating rapidly in response to increasing human influence on the Earth's natural ecosystems. One way to overcome this problem is by focusing on places of human interest and monitoring the changes and impacts on the biodiversity. This study was conducted at six sites within the influence area of the Santo Antônio Hydroelectric Power Plant in the margins of the Madeira River in Rondônia State. The sites cover a latitudinal gradient of approximately 100 km in the Brazilian Amazon Basin. The sampling design included six sampling modules with six plots (transects) each, totaling 30 sampling plots. The transects were distributed with 0 km, 0.5 km, 1 km, 2 km, 3 km and 4 km, measured perpendicularly from the river margin towards the interior of the forest. For sampling the ground-dwelling ants, the study used the ALL (ants of the leaf litter) protocol, which is standardized globally in the inventories of ant fauna. For the purpose of impact indicators, the first two campaigns (September 2011 to November 2011) were carried out in the pre-filling period, while campaigns 3 to 10 (February 2012 to November 2014) were carried out during and after the filling of the hydroelectric reservoir. A total of 253 events with a total of 9,165 occurrences were accounted during the monitoring. The ants were distributed in 10 subfamilies, 68 genera and 324 species/morphospecies. The impact on ant biodiversity during the periods before and after filling was measured by ecological indicators and by the presence and absence of some species/morphospecies. This is the first study, as far as we know, including taxonomic and ecological treatment to monitor the impact of a hydroelectric power plant on ant fauna. Until recently, most studies conducted on hydroelectric plants, located in the Amazon Basin, were carried out after the implementation of dams in order to assess their impacts on the environment and biodiversity (Benchimol and Peres 2015, Latrubesse et al. 2017, Sá-Oliveira et al. 2015). Recent studies on dam impacts have begun to be conducted prior to dam implementation (e.g. Bobrowiec and Tavares 2017, Fraga et al. 2014, Moser et al. 2014), thus providing a better overview of the impact and a better assessment of its magnitude.

Addressing critical issues in the development of an Oncology Information System.

PubMed

Urda, D; Ribelles, N; Subirats, J L; Franco, L; Alba, E; Jerez, J M

2013-05-01

This paper presents the experience on the design and implementation of a user-centered Oncology Information System developed for the Medical Oncology Department at the "Hospital Universitario Virgen de la Victoria", in Málaga, Spain. The project focused on the aspects considered in the literature as critical factors for a successful deployment and usage of a health information system. System usability, adequate technology, integration of clinical routines, real-time statistical analysis of data, information confidentiality and standard protocol-based external interconnection were the key aspects considered. The developed system is based on a web application with a modular and layered architecture accounting for usability, ease of maintenance and further system development. Evaluation of system usability was carried at three and fifteen months after system deployment to analyze the advantages/disadvantages experienced by the end-users. A thorough prior analysis of clinical activities and workflows, the use of the adequate technology, and the availability of data analysis tools will almost guarantee success in the deployment of an Oncology Information System. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Documenting Modern Mexican Architectural Heritage for Posterity: Barragan's Casa Cristo, in Guadalajara, Mexico

NASA Astrophysics Data System (ADS)

Mezzino, D.; Pei, W.; Santana Quintero, M.; Reyes Rodriguez, R.

2015-08-01

This contribution describes the results of an International workshop on documentation of historic and cultural heritage developed jointly between Universidad de Guadalajara's Centro Universitario de Arte, Arquitectura y Diseño (CUAAD) and Carleton University's Architectural Conservation and Sustainability Program. The objective of the workshop was to create a learning environment for emerging heritage professionals through the use of advanced recording techniques for the documentation of modern architectural heritage in Guadalajara, Mexico. The selected site was Casa Cristo, one of the several architectural projects by Luis Barragán in Guadalajara. The house was built between 1927 and 1929 for Gustavo R. Cristo, mayor of the city. The style of the building reflects the European influences derived from the architect's travel experience, as well as the close connection with local craftsmanship. All of these make the house an outstanding example of modern regional architecture. A systematic documentation strategy was developed for the site, using different survey equipment and techniques to capture the shape, colour, spatial configuration, and current conditions of Casa Cristo for its eventual rehabilitation and conservation.

[Influence of promotional material on hand hygiene in the safety culture of a tertiary hospital].

PubMed

Molina-Cabrillana, J; Dorta-Hung, M E; Otero Sanz, L; Henández Vera, J R; Martín-Rodríguez, M M; García de Carlos, P

2016-06-01

In order to increase safety culture about hand hygiene by means of messages and reminders about its importance in preventing nosocomial infections, we developed a new set of materials in the Complejo Hospitalario Universitario Insular Materno-Infantil of Las Palmas, Gran Canaria, constitued by two centres with 450 beds each and acredited for medical internal residents training. We hired a well-known caricaturist, who adapted the messages to the local way of speaking, by using characters that used to appear in his artwork in the local newspaper. Also, we continued to work with other graphic design professionals. We monitored adherence and consumption of products for hand rubbing. We noted an increase in both indicators in the following months after the implementation of this strategy. Moreover, we revised the infrastructures for hand hygiene, and were able to demonstrate improvements in most of the patient care areas. The material was well accepted by professionals, patients and visitors. No other interventions were made, so we think improvements can be attributable to this strategy in our setting. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

Direct Endonasal Approach with Partial Upper Posterior Septectomy. A “Rescue Flap” Technique Modification

PubMed Central

Sotomayor-González, Arturo; Díaz-Martínez, Armando José; Radillo-Gil, Ramón; García-Estrada, Everardo; Morales-Gómez, Jesús Alberto; Palacios-Ortiz, Isaac Jair; Pérez-Cárdenas, Samuel; Arteaga-Treviño, Mauricio; De León, Ángel Martínez-Ponce

2016-01-01

Objective Report a modification of the “rescue flap” technique using a direct endonasal approach with a partial superior septectomy for approaching pituitary tumors developed in our institution. Design Prospective study. Setting Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo León. Main Outcome Measures Since April 2015, we have performed 19 cases employing a direct endonasal approach with partial superior septectomy. Results and a technical note are described below. Results Nineteen patients were included in this report. Six patients presented transoperatory cerebrospinal fluid (CSF) leak, so a nasoseptal rescue flap was harvested. No patients developed postoperative CSF leak in this group. Two patients were submitted to a second surgical procedure. Nasoseptal flap was harvested without complications. In both patients, the size of the flap was enough to cover the dural defect and avoid CSF leak. Conclusion Direct endonasal approach with a partial posterior septectomy allows enough exposition of the sphenoidal sinus while preserving the nasoseptal septum with the possibility of a successful rescue flap when needed. PMID:28321383

Direct Endonasal Approach with Partial Upper Posterior Septectomy. A "Rescue Flap" Technique Modification.

PubMed

Sotomayor-González, Arturo; Díaz-Martínez, Armando José; Radillo-Gil, Ramón; García-Estrada, Everardo; Morales-Gómez, Jesús Alberto; Palacios-Ortiz, Isaac Jair; Pérez-Cárdenas, Samuel; Arteaga-Treviño, Mauricio; De León, Ángel Martínez-Ponce

2017-04-01

Objective  Report a modification of the "rescue flap" technique using a direct endonasal approach with a partial superior septectomy for approaching pituitary tumors developed in our institution. Design  Prospective study. Setting  Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León. Main Outcome Measures  Since April 2015, we have performed 19 cases employing a direct endonasal approach with partial superior septectomy. Results and a technical note are described below. Results  Nineteen patients were included in this report. Six patients presented transoperatory cerebrospinal fluid (CSF) leak, so a nasoseptal rescue flap was harvested. No patients developed postoperative CSF leak in this group. Two patients were submitted to a second surgical procedure. Nasoseptal flap was harvested without complications. In both patients, the size of the flap was enough to cover the dural defect and avoid CSF leak. Conclusion  Direct endonasal approach with a partial posterior septectomy allows enough exposition of the sphenoidal sinus while preserving the nasoseptal septum with the possibility of a successful rescue flap when needed.

Safety and Traceability in Patient Healthcare through the Integration of RFID Technology for Intravenous Mixtures in the Prescription-Validation-Elaboration-Dispensation-Administration Circuit to Day Hospital Patients.

PubMed

Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

2016-07-28

This work presents the integration of the RFID technology with the aim of ensuring the traceability of patients and minimization of adverse events during the process of prescription-validation-elaboration-dispensation-administration of medication by means of the implementation of various passive and active WIFI RFID systems in the Pharmacy and Day Hospital services of the Complejo Hospitalario Universitario A Coruña. Obtaining patient traceability and using the patient/drug binomial during this process allows us to minimize the occurrence of adverse events. The key points in this work are the unmistakably unique identification and accurate real time location of the controlled items (patients and medication). RFID technology has proved to be invaluable in assisting with the everyday clinical practice of a hospital, and has been successfully implemented in this environment and others. In services such as the day hospital, the implementation of said technology is further justified by the high costs of the service and the high risk to the patient.

Evaluation of a Tracking System for Patients and Mixed Intravenous Medication Based on RFID Technology.

PubMed

Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

2016-11-30

At present, one of the primary concerns of healthcare professionals is how to increase the safety and quality of the care that patients receive during their stay in hospital. This is particularly important in the administration of expensive and high-risk medicines with which it is fundamental to minimize the possibility of adverse events in the process of prescription-validation-preparation/dosage-dispensation-administration of intravenous mixes. This work is a detailed analysis of the evaluation, carried out by the health personnel involved in the Radiofrequency Identification (RFID) system developed in the Day Hospital and Pharmacy services of the Complejo Hospitalario Universitario A Coruña (CHUAC). The RFID system is evaluated by analyzing surveys completed by said health personnel, since their questions represent the key indicators of the patient care process (safety, cost, adequacy with the clinical practice). This work allows us to conclude, among other things, that the system tracks the patients satisfactorily and that its cost, though high, is justified in the context of the project context (use of dangerous and costly medication).

Safety and Traceability in Patient Healthcare through the Integration of RFID Technology for Intravenous Mixtures in the Prescription-Validation-Elaboration-Dispensation-Administration Circuit to Day Hospital Patients

PubMed Central

Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

2016-01-01

This work presents the integration of the RFID technology with the aim of ensuring the traceability of patients and minimization of adverse events during the process of prescription-validation-elaboration-dispensation-administration of medication by means of the implementation of various passive and active WIFI RFID systems in the Pharmacy and Day Hospital services of the Complejo Hospitalario Universitario A Coruña. Obtaining patient traceability and using the patient/drug binomial during this process allows us to minimize the occurrence of adverse events. The key points in this work are the unmistakably unique identification and accurate real time location of the controlled items (patients and medication). RFID technology has proved to be invaluable in assisting with the everyday clinical practice of a hospital, and has been successfully implemented in this environment and others. In services such as the day hospital, the implementation of said technology is further justified by the high costs of the service and the high risk to the patient. PMID:27483269

Evaluation of a Tracking System for Patients and Mixed Intravenous Medication Based on RFID Technology

PubMed Central

Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

2016-01-01

At present, one of the primary concerns of healthcare professionals is how to increase the safety and quality of the care that patients receive during their stay in hospital. This is particularly important in the administration of expensive and high-risk medicines with which it is fundamental to minimize the possibility of adverse events in the process of prescription-validation-preparation/dosage-dispensation-administration of intravenous mixes. This work is a detailed analysis of the evaluation, carried out by the health personnel involved in the Radiofrequency Identification (RFID) system developed in the Day Hospital and Pharmacy services of the Complejo Hospitalario Universitario A Coruña (CHUAC). The RFID system is evaluated by analyzing surveys completed by said health personnel, since their questions represent the key indicators of the patient care process (safety, cost, adequacy with the clinical practice). This work allows us to conclude, among other things, that the system tracks the patients satisfactorily and that its cost, though high, is justified in the context of the project context (use of dangerous and costly medication). PMID:27916915

Sleep disturbance: a forgotten syndrome in patients with Chiari I malformation.

PubMed

Ferré Masó, A; Poca, M A; de la Calzada, M D; Solana, E; Romero Tomás, O; Sahuquillo, J

2014-06-01

Chiari type I malformation (CM-I) is characterised by caudal ectopia of the cerebellar tonsils through the foramen magnum. This is associated with brain stem, high spinal cord, and cranial nerve compression phenomena. The most frequent symptoms are occipital headaches and dizziness. Less well-known symptoms are sleep disorders and nocturnal respiratory abnormalities. MEDLINE and information from patients evaluated at the Neurosurgery and Clinical Neurophysiology Departments at Hospital Universitario Vall d'Hebron. Review article based on data obtained from MEDLINE articles since 1966, using combinations of the following keywords: «Chiari malformation» or «Arnold-Chiari malformation» and «sleep apnea» or «sleep disorders». CM-I patients show a higher prevalence of sleep disorders than that observed in the general population. Some studies report a 50% prevalence of sleep apnea-hypopnea syndrome (SAHS), probably associated with sudden death in some cases. These results support analysing sleep respiratory parameters in theses patients. Identifying SAHS symptoms may help optimise treatment, thereby improving quality of life and prognosis. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

[BURNOUT SYNDROME AND STRESS OF NURSING STAFF IN A OURENSE HOSPITAL].

PubMed

Soto-Rodríguez, Anxela; Pérez-Fernandez, Ma Reyes

2015-02-01

Set up the stress prevalence and burnout syndrome in different units of nursing staff of the Complexo Hospitalario Universitario de Ourense (CHUOU) and analyse which factors cause it. It has been designed a transversal, descriptive study by performing three assessment instruments: questionnaire of social-demographic variables; Maslach Burnout Inventory (MBI), and Nursing Stress Scale (NSS), to a 117 nursing staff of CHUOU as population. The average age was 39.23 years old and 83.8% were women. The average scoring in the emotional exhaustion dimension was 24.44, in the component of depersonalization was 7.58, and in the personal accomplishment was 34.50. Moreover, 89.7% suffer stress related with work environment. The average score in the dimension of emotional exhaustion was 24.44, the depersonalization of 7.58 and the personal accomplishment of 34.50. The 89.7% suffered from work-related stress. Nursing staff present high burnout syndrome and stress. It has been observed a higher vulnerability to the syndrome from subjects with temporary contract and rotary shift. There has been statistically significant differences in young nursing staff and less career seniority, whom present hiqher stress levels.

Detection of carbapenemases and other mechanisms of enzymatic resistance to β-lactams in Enterobacteriaceae with diminished susceptibility to carbapenems in a tertiary care hospital.

PubMed

Gómara, Marta; López-Calleja, Ana Isabel; Iglesia, Berta María Pilar Vela; Cerón, Isabel Ferrer; López, Antonio Rezusta; Pinilla, María José Revillo

2018-05-01

Our objective was to characterize the enzymatic β-lactam resistance in clinical Enterobacteriaceae isolates with diminished susceptibility to carbapenems from 2013 to 2014 at Hospital Universitario Miguel Servet. A total of 63 clinical isolates were analyzed for the presence of carbapenemases (KPC, OXA-48 and MBL), ESBLs and AmpC enzymes by combined disk methods and PCR detection of carbapenemase-encoding and beta-lactamase-encoding genes. Fifteen isolates had a phenotypic test compatible with carbapenemase production; two of these were confirmed by PCR as OXA-48 producers. ESBL detection was positive in 27 isolates (43%); plasmid-mediated AmpC was detected in nine isolates (14.2%) and derepressed AmpC β-lactamase was present in 18 isolates (28%). During the study period, the decreased susceptibility to carbapenems in Enterobacteriaceae in our area was not due to true carbapenemases but rather to β-lactamase activity (82.5% were ESBL or AmpC producers), probably in combination with decreased permeability of the outer membrane. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Diagnostic hysteroscopy indications and results in Complexo Hospitalario Universitario De Ourense].

PubMed

Pato-Mosquera, Mónica; Vázquez-Rodríguez, Marta; Pérez-Adán, Marta; García-García, María Jesús; Blanco-Pérez, Susana

2013-07-01

Diagnostic hysteroscopy is an endoscopic technique that allows the evaluation of the endocervical canal and uterine cavity. To evaluate indications, complications and referral to operative hysteroscopy. To analyze the correlation between sonographic display, hysteroscopy findings and histological diagnosis. Retrospective and descriptive study of 904 patients who underwent diagnostic hysteroscopy between January 1, 2008 and June 30, 2012. The most frequent indication was sonographic detection of endometrial polyps (75% were premenopausal and 71.2% postmenopausal). The complication rate associated with the test was 11.4%. The reduction experimented in operative hysteroscopies was from 31.2% in 2008 to 12.2% between January and June 2012. When a polyp or a myoma was detected by sonography, diagnostic hysteroscopy showed them in 64.4% y 62.5% of the cases, respectively. The correlation between hysteroscopic findings and histopathologic diagnosis was 77.7% for normal endometrium, 77.9% for polyps, 17.8% for hyperplasic appearance and 100% for carcinoma suspicion. Diagnostic hysteroscopy is a safe technique that allows small interventions avoiding operative hysteroscopies. There is a good relation between hysteroscopic visual inspection and anatomopathologic diagnosis, but biopsy should be taken except if normal endometrium is visualized.

Compression of the right coronary artery by an aortic pseudoaneurysm after infective endocarditis: an unusual case of myocardial ischemia.

PubMed

Lacalzada-Almeida, Juan; De la Rosa-Hernández, Alejandro; Izquierdo-Gómez, María Manuela; García-Niebla, Javier; Hernández-Betancor, Iván; Bonilla-Arjona, Juan Alfonso; Barragán-Acea, Antonio; Laynez-Cerdeña, Ignacio

2018-01-01

A 61-year-old male with a prosthetic St Jude aortic valve size 24 presented with heart failure symptoms and minimal-effort angina. Eleven months earlier, the patient had undergone cardiac surgery because of an aortic root dilatation and bicuspid aortic valve with severe regurgitation secondary to infectious endocarditis by Coxiela burnetii and coronary artery disease in the left circumflex coronary artery. Then, a prosthesis valve and a saphenous bypass graft to the left circumflex coronary artery were placed. The patient was admitted to the Cardiology Department of Hospital Universitario de Canarias, Tenerife, Spain and a transthoracic echocardiography was performed that showed severe paraprosthetic aortic regurgitation and an aortic pseudoaneurysm. The 64-slice multidetector computed tomography confirmed the pseudoaneurysm, originating from the right sinus of Valsalva, with a compression of the native right coronary artery and a normal saphenous bypass graft. On the basis of these findings, we performed surgical treatment with a favorable postoperative evolution. In our case, results from complementary cardiac imaging techniques were crucial for patient management. The multidetector computed tomography allowed for a confident diagnosis of an unusual mechanism of coronary ischemia.

[Detection of Entamoeba histolytica and Entamoeba dispar by PCR in children, less than five years of age with diarrhea, in Maracaibo, Venezuela. A preliminary study].

PubMed

Bracho Mora, Angela; Rivero de Rodríguez, Zulbey; Arraiz, Nailet; Villalobos, Rafael; Urdaneta, Haydee

2013-12-01

To determine the prevalence of Entamoeba histolytica as a producer of diarrhea, a study was conducted in children, less than five years of age, with diarrhea who attended several out patient clinics of the Servicio Aut6nomo Hospital Universitario, Maracaibo, Venezuela. A macroscopic and microscopic examination with physiological saline, lugol and Kinyoun staining were performed to the stool samples obtained. The remainder of the sample was frozen until DNA extraction, and PCR amplification was performed separately for E. histolytica and E. dispar. Microscopic examination showed no trophozoites and/or cysts of Entamoeba histolytica/dispar/moshkovskii, or intestinal coccidians in any of the 50 samples analyzed. Parasites detected were Giardia lamblia (6%), Blastocystis sp. (4%), Pentatrichomonas hominis (2%), Ascaris lumbricoides (2%) and Trichuris trichiura (2%). By PCR, six samples (12%) had DNA of E. dispar and two (4%) had DNA from E. histolytica; no child showed association of both amoebae. The two children who had E. histolytica were one-year-old. E. dispar was detected in younger children. We suggest that the prevalence of E. histolytica in children under five years is really low.

Multidisciplinary Approach in Hepatocellular Carcinoma in a Level II Hospital: The First Decade of Hospital Universitario Fundacion Alcorcon.

PubMed

Loinaz Segurola, C; LIedó Navarro, J L; Burgos, R de la Cruz; Martín Ríos, D; Ochando Cerdán, F; Alonso López, S; Martel Villagrán, J; Gutiérrez Garcia, M L; Fernandez Cebrián, J M; Fernández Rodríguez, C

2015-06-01

Mean survival in hepatocellular carcinoma remains low. Many efforts have been done during the last years through screening, diagnosis and treatment to improve the results. The aim of this work is to present the experience of our hospital multidisciplinary group during the first decade of this century. The patients with hepatocellullar carcinoma presented at the multidisciplinary meeting from 1999 to 2009 were prospectively studied. According to the tumor and functional status they were treated through the current available guidelines by transplant, partial hepatectomy, local/regional procedures, systemic or symptomatic treatment. One hundred and forty two patients were studied. Median tumor size was 3 cm. A single tumor was diagnosed in 64.8% of the patients. Eighteen patients had liver resection (6 transplantation and 12 with partial resection), 53 tumors were not treated due to advanced stage or liver dysfunction, and in the remaining patients radiofrequency, ethanol or embolization treatments were used, single or combined. a multidisciplinary approach of hepatocellular carcinoma in a second level hospital with trained professionals permits a diagnosis in early tumoral and functional stages in the majority of patients, and a variety of possible treatments with adequate survival outcomes.

An optimization design proposal of automated guided vehicles for mixed type transportation in hospital environments.

PubMed

González, Domingo; Romero, Luis; Espinosa, María Del Mar; Domínguez, Manuel

2017-01-01

The aim of this paper is to present an optimization proposal in the automated guided vehicles design used in hospital logistics, as well as to analyze the impact of its implementation in a real environment. This proposal is based on the design of those elements that would allow the vehicles to deliver an extra cart by the towing method. So, the proposal intention is to improve the productivity and the performance of the current vehicles by using a transportation method of combined carts. The study has been developed following concurrent engineering premises from three different viewpoints. First, the sequence of operations has been described, and second, a proposal of design of the equipment has been undertaken. Finally, the impact of the proposal has been analyzed according to real data from the Hospital Universitario Rio Hortega in Valladolid (Spain). In this particular case, by the implementation of the analyzed proposal in the hospital a reduction of over 35% of the current time of use can be achieved. This result may allow adding new tasks to the vehicles, and according to this, both a new kind of vehicle and a specific module can be developed in order to get a better performance.

Dataset of long-term monitoring of ground-dwelling ants (Hymenoptera: Formicidae) in the influence areas of a hydroelectric power plant on the Madeira River in the Amazon Basin

PubMed Central

2018-01-01

Abstract Background Biodiversity loss is accelerating rapidly in response to increasing human influence on the Earth’s natural ecosystems. One way to overcome this problem is by focusing on places of human interest and monitoring the changes and impacts on the biodiversity. This study was conducted at six sites within the influence area of the Santo Antônio Hydroelectric Power Plant in the margins of the Madeira River in Rondônia State. The sites cover a latitudinal gradient of approximately 100 km in the Brazilian Amazon Basin. The sampling design included six sampling modules with six plots (transects) each, totaling 30 sampling plots. The transects were distributed with 0 km, 0.5 km, 1 km, 2 km, 3 km and 4 km, measured perpendicularly from the river margin towards the interior of the forest. For sampling the ground-dwelling ants, the study used the ALL (ants of the leaf litter) protocol, which is standardized globally in the inventories of ant fauna. For the purpose of impact indicators, the first two campaigns (September 2011 to November 2011) were carried out in the pre-filling period, while campaigns 3 to 10 (February 2012 to November 2014) were carried out during and after the filling of the hydroelectric reservoir. A total of 253 events with a total of 9,165 occurrences were accounted during the monitoring. The ants were distributed in 10 subfamilies, 68 genera and 324 species/morphospecies. The impact on ant biodiversity during the periods before and after filling was measured by ecological indicators and by the presence and absence of some species/morphospecies. This is the first study, as far as we know, including taxonomic and ecological treatment to monitor the impact of a hydroelectric power plant on ant fauna. New information Until recently, most studies conducted on hydroelectric plants, located in the Amazon Basin, were carried out after the implementation of dams in order to assess their impacts on the environment and biodiversity (Benchimol and Peres 2015, Latrubesse et al. 2017, Sá-Oliveira et al. 2015). Recent studies on dam impacts have begun to be conducted prior to dam implementation (e.g. Bobrowiec and Tavares 2017, Fraga et al. 2014, Moser et al. 2014), thus providing a better overview of the impact and a better assessment of its magnitude. PMID:29674939

[Not Available].

PubMed

Navarro-González, Inmaculada; Ros, Gaspar; Martínez-García, Brígida; Rodríguez-Tadeo, Alejandra; Periago, M Jesús

2016-07-19

Introducción y objetivos: la evolución que ha experimentado en los últimos años la sociedad española ha originado una serie de cambios sociológicos y/o culturales que afectan claramente a los hábitos y preferencias alimentarias. El objetivo del presente trabajo ha sido evaluar la adherencia a la dieta mediterránea (DM) de la población universitaria en la ciudad de Murcia y la calidad de su desayuno, estableciendo la relación existente entre estas dos variables entre sí, y otras variables sociológicas analizadas.Métodos: se evaluó la adherencia a la DM en una muestra de 312 estudiantes mediante el test KIDMED, cuestionario de 16 preguntas. La calidad del desayuno fue determinada en función de la ingesta de los distintos grupos de alimentos (lácteos, cereales y frutas), de forma que se establecieron las siguientes categorías de calidad: pésima, mala, regular y buena. De cada encuestado se registraron los datos personales, lugar de origen, zona geográfica y tipo de residencia, sexo, edad, titulación universitaria, curso y las variables antropométricas (peso, altura, perímetro de cintura y cadera).Resultados: la muestra estuvo formada por 238 mujeres y 74 hombres todos ellos estudiantes universitarios de distintos títulos de grado. El 7,85% de los universitarios mostró una baja adherencia a la DM, el 48,4% media y el 43,8% alta. Los estudiantes de grado en Educación Primaria mostraron una mayor adherencia media a la DM; los estudiantes de grado en Enfermería tomaron más de una ración de verdura al día; y los de Ciencia y Tecnología de los Alimentos consumían una pieza de fruta al día. Teniendo en cuenta el sexo de los participantes, el 37,8% de las mujeres tomaban más de una verdura diaria y el 91,5% desayunaba bollería industrial; mientras que el 54,1% de los hombres tomaban frutos secos (al menos 2 o 3 veces por semana) y el 74,5% desayunaba todos los días. El 1,15% de los estudiantes mostró una calidad del desayuno pésima, el 17,65% mala, el 60,65% regular y el 20,45% buena, coincidiendo la buena calidad con el consumo de fruta en esta comida. Además, se observó una asociación significativa entre el tiempo y la calidad del desayuno, ya que aquellos estudiantes que dedicaban más de diez minutos a desayunar tomaban un desayuno de buena calidad.Conclusión: en este estudio se ha visto que la calidad del desayuno está estrechamente relacionada con el grado de adherencia al patrón dietético mediterráneo.

An optimization design proposal of automated guided vehicles for mixed type transportation in hospital environments

PubMed Central

González, Domingo; Espinosa, María del Mar; Domínguez, Manuel

2017-01-01

Aim The aim of this paper is to present an optimization proposal in the automated guided vehicles design used in hospital logistics, as well as to analyze the impact of its implementation in a real environment. Method This proposal is based on the design of those elements that would allow the vehicles to deliver an extra cart by the towing method. So, the proposal intention is to improve the productivity and the performance of the current vehicles by using a transportation method of combined carts. Results The study has been developed following concurrent engineering premises from three different viewpoints. First, the sequence of operations has been described, and second, a proposal of design of the equipment has been undertaken. Finally, the impact of the proposal has been analyzed according to real data from the Hospital Universitario Rio Hortega in Valladolid (Spain). In this particular case, by the implementation of the analyzed proposal in the hospital a reduction of over 35% of the current time of use can be achieved. This result may allow adding new tasks to the vehicles, and according to this, both a new kind of vehicle and a specific module can be developed in order to get a better performance. PMID:28562681

LQAS usefulness in an emergency department.

PubMed

de la Orden, Susana Granado; Rodríguez-Rieiro, Cristina; Sánchez-Gómez, Amaya; García, Ana Chacón; Hernández-Fernández, Tomás; Revilla, Angel Abad; Escribano, Dolores Vigil; Pérez, Paz Rodríguez

2008-01-01

This paper aims to explore lot quality assurance sampling (LQAS) applicability and usefulness in the evaluation of quality indicators in a hospital emergency department (ED) and to determine the degree of compliance with quality standards according to this sampling method. Descriptive observational research in the Hospital General Universitario Gregorio Marañón (HGUGM) emergency department (ED). Patients older than 15 years, diagnosed with dyspnoea, chest pain, urinary tract colic or bronchial asthma attending the HGUGM ED from December 2005 to May 2006, and patients admitted during 2005 with exacerbation of chronic obstructive pulmonary disease or acute meningitis were included in the study. Sample sizes were calculated using LQAS. Different quality indicators, one for each process, were selected. The upper (acceptable quality level (AQL)) and lower thresholds (rejectable quality level (RQL)) were established considering risk alpha = 5 per cent and beta = 20 per cent, and the minimum number of observations required was calculated. It was impossible to reach the necessary sample size for bronchial asthma and urinary tract colic patients. For chest pain, acute exacerbation of chronic obstructive pulmonary disease, and acute meningitis, quality problems were detected. The lot was accepted only for the dyspnoea indicator. The usefulness of LQAS to detect quality problems in the management of health processes in one hospital's ED. The LQAS could complement traditional sampling methods.

Objectively assessed physical activity levels in Spanish cancer survivors.

PubMed

Ruiz-Casado, Ana; Verdugo, Ana Soria; Solano, María J Ortega; Aldazabal, Itziar Pagola; Fiuza-Luces, Carmen; Alejo, Lidia Brea; del Hierro, Julio R Padilla; Palomo, Isabel; Aguado-Arroyo, Oscar; Garatachea, Nuria; Cebolla, Héctor; Lucia, Alejandro

2014-01-01

To objectively assess physical activity (PA) levels in a cohort of Spanish cancer survivors. Descriptive, cross-sectional. The Hospital Universitario de Fuenlabrada and two healthcare centers in Madrid, Spain. 204 cancer survivors and 115 adults with no history of cancer. Participants wore a triaxial accelerometer for seven or more consecutive days to assess PA levels. Body mass index (BMI), indirect indicators of adiposity (waist circumference, waist-to-hip ratio), and cardiorespiratory fitness also were determined. Light, moderate, vigorous, and total PA (sum of the former). Most (94%) of the cancer survivors met international recommendations for moderate PA, but very few (3%) fulfilled those (75 minutes or more per week) for vigorous PA. Except for lower total (minute per day, p=0.048) and vigorous PA levels (p<0.001 for both minute per day and minute per week) recorded in the cancer survivors group, no between-group differences were detected (p>0.05). A high percentage of the survivors (33%) were obese (BMI greater than 30 kg/m2), and many also showed poor cardiorespiratory fitness (45% were below the 8 metabolic equivalent threshold). Although cancer survivors overall met international PA recommendations for a healthy lifestyle, their BMI and cardiorespiratory profiles were not within the healthy range. Cancer survivors need to be informed about healthy lifestyle habits and should be regularly monitored.

Economic impact of the new oral treatments for multiple sclerosis.

PubMed

Álvarez Ayuso, L; Rodríguez Marrodán, B; Blasco Quílez, M R; García-Merino, J A; Sánchez Guerrero, A

2018-01-11

Multiple sclerosis (MS) is a chronic disease affecting the central nervous system and is characterised by inflammation, demyelination, gliosis, and axonal damage. The introduction of dimethyl fumarate and teriflunomide has led to an increase in the number of alternative first-line therapies for MS. The objective of this study was to evaluate the economic impact of the incorporation of new oral therapies at the reference unit (CSUR) at Hospital Universitario Puerta de Hierro Majadahonda. We performed a retrospective observational study including patients diagnosed with MS, who underwent treatment with disease-modifying drugs in 2015 and were followed up for a minimum mean time of one year. Data were collected from patients' electronic clinical histories and the pharmacy service's programme for dispensing drugs to outpatients. Evaluating the cost of changing 125 patients' treatment from other drugs to dimethyl fumarate and teriflunomide, and comparing this with the cost that would have resulted from maintaining their previous treatment, demonstrated a total saving of €169,107.31 over the study period. In addition to contributing new therapeutic alternatives, dimethyl fumarate and teriflunomide produced an economic saving in MS treatment at our hospital. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Efficacy and economic impact evaluation of a navigation system for assisted lung biopsy

PubMed Central

Giannatiempo, Sara; Petitti, Tommasangelo; Zobel, Bruno B.; Grasso, Rosario F.; Guglielmelli, Eugenio

2018-01-01

This Letter reports on the testing and assessment of an optical computed tomography-navigation system for percutaneous lung interventional, SIRIO, showing how the lesion diameter affects the bioptic procedure. Clinical data, relating to 501 patients, were collected at the Department of Interventional Radiology of Policlinico Universitario Campus Bio-Medico. This Letter shows that the diameter of lesion affects only the procedure duration (50.91 ± 18.87 min for lesions of diameter ≤20 mm and 44.98 ± 19.43 min for lesions of diameter >20 and ≤40 mm). For the nodules with a diameter ≤20 mm, there is a significant increase in the duration of the procedure (for each mm less the time increases by 6 s). Other parameters like the mean effective radiation dose and the presence of a diagnostic or non-diagnostic specimen do not depend, instead, on the lesion size. The economic analysis based on the biopsy procedure with SIRIO shows the necessity to adopt a new reimbursement system for percutaneous biopsy performed using navigation systems to stimulate their use to get important non-economic gains such as early diagnosis, reduction of the absorbed dose of X-rays and increasing number of lung cancers in a curable early stage. PMID:29750112

Efficacy and economic impact evaluation of a navigation system for assisted lung biopsy.

PubMed

Giannatiempo, Sara; Carpino, Giorgio; Petitti, Tommasangelo; Zobel, Bruno B; Grasso, Rosario F; Guglielmelli, Eugenio

2018-04-01

This Letter reports on the testing and assessment of an optical computed tomography-navigation system for percutaneous lung interventional, SIRIO, showing how the lesion diameter affects the bioptic procedure. Clinical data, relating to 501 patients, were collected at the Department of Interventional Radiology of Policlinico Universitario Campus Bio-Medico. This Letter shows that the diameter of lesion affects only the procedure duration (50.91 ± 18.87 min for lesions of diameter ≤20 mm and 44.98 ± 19.43 min for lesions of diameter >20 and ≤40 mm). For the nodules with a diameter ≤20 mm, there is a significant increase in the duration of the procedure (for each mm less the time increases by 6 s). Other parameters like the mean effective radiation dose and the presence of a diagnostic or non-diagnostic specimen do not depend, instead, on the lesion size. The economic analysis based on the biopsy procedure with SIRIO shows the necessity to adopt a new reimbursement system for percutaneous biopsy performed using navigation systems to stimulate their use to get important non-economic gains such as early diagnosis, reduction of the absorbed dose of X-rays and increasing number of lung cancers in a curable early stage.

[Skin reactivity frequency to aeroallergens in patients with clinical symptoms of allergic disease].

PubMed

Rojas-Méndez, Isabel Cristina; Arana-Muñoz, Oswaldo; López-García, Aída Inés; Rivero-Yeverino, Daniela; Caballero-López, Chrystopherson Gengyny; Papaqui-Tapia, Sergio; Camero-Martínez, Heriberto; Vázquez-Rojas, Elizabeth

2017-01-01

Allergic diseases diagnosis must be based on adequate allergological anamnesis and an immunological sensitization test; the most sensitive and specific is the skin prick test. To determine the frequency of skin reactivity to aeroallergens, by age groups, in patients of the Department of Allergy and Clinical Immunology of the Hospital Universitario de Puebla, in Mexico. A cross-sectional study was conducted that included patients aged 2 to 64 years with symptoms suggestive of allergic disease, in which skin prick tests with aeroallergens were performed; the diagnostic criteria were those of international guidelines. Frequencies, percentages and dispersion measures were calculated. Of 173 patients, 63 % were females. Mean age was 22.3 years. The frequency of skin reactivity for Quercus sp. was 12.72 %, for Periplaneta americana, 9.83 %, for Dermatophagoides farinae, 9.25 %, for Cynodon dactylon, 8.09 %, for Blatella germanica, 8.09 %, for Holcus halepensis, 6.94 %, for Dermatophagoides pteronyssinus, 6.36 %, for Schinus molle, 5.78 %, for Fraxinus uhdei, 5.20 %, for Lolium perenne, 5.20 %, for Ambrosia eliator, 5.20 % and for Artemisa tridentata, 4.62 %. Although Dermatophagoides are the most frequently reported aeroallergens, the most common aeroallergen in this study was pollen, probably owing to geographical and environmental factors, although this was not observed in the analysis by age groups.

Design and development of a nutritional assessment application for smartphones and tablets with Android OS.

PubMed

Carnero Gregorio, Miguel; Blanco Ramos, Montserrat; Obeso Carillo, Gerardo Andrés; García Fontán, Eva; Álvarez González, Miguel Ángel; Cañizares Carretero, Miguel Ángel

2014-10-03

To design and develop a nutritional application for smartphones and tablets with Android operating system for using to in- and outpatients that need a nutritional assessment. To check the validity of the results of such software. The application was compiled for version 2.1 of the Android operating system from Google. A cohort of 30 patients was included for evaluating the reliability of the application. The calculations were performed by staff of the Nutrition Unit of the Complexo Hospitalario Universitario de Vigo, manually and through e-Nutrimet software on a smartphone and a tablet. Concordance was absolute between results of different methods obtained using e-Nutrimet on a smartphone and a tablet (Fleiss index κ= 1). The same level of concordance was obtained by comparing handmade and e-Nutrimet made results. The degree of correlation is good, and it would be extended to all healthcare staff who wants to determine whether a patient has malnutrition, or not. The nutritional assessment software e-Nutrimet does not replace healthcare staff in any case, but could be an important aid in assessing patients who may be in risk of malnutrition, saving time of evaluation. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Acute parvovirus B19 infection in adults: a retrospective study of 49 cases.

PubMed

Rodríguez Bandera, A I; Mayor Arenal, M; Vorlicka, K; Ruiz Bravo-Burguilllos, E; Montero Vega, D; Vidaurrázaga Díaz-Arcaya, C

2015-01-01

Our aim was to describe the epidemiologic, clinical, and laboratory characteristics of acute parvovirus B19 infection in adults. This study describes all cases of acute parvovirus B19 infection in patients older than 18 years of age who were treated at Hospital Universitario La Paz in Madrid, Spain, in 2012. Forty-nine adults were treated for acute parvovirus B19 infection. Most were young women who were infected in the spring or early summer. In over half the cases skin lesions were key diagnostic signs.We saw the full range of types of rash of purplish exanthems that were fairly generalized; vasculitis was relatively common (in >18%). Mild or moderate abnormalities in blood counts and indicators of liver dysfunction resolved spontaneously in all but 2 immunocompromised patients, who developed chronic anemia. This is the largest case series of acute parvovirus B19 infection published to date. This infection should be suspected on observing signs of purplish skin rashes, no matter the location or pattern of distribution, or vasculitis, especially if accompanied by fever and joint pain in young women in the spring. Measures to avoid infection should be recommended to individuals at risk. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

The systemic inflammatory response syndrome (SIRS) to identify infected patients in the emergency room.

PubMed

Jaimes, Fabián; Garcés, Jenny; Cuervo, Jorge; Ramírez, Federico; Ramírez, Jorge; Vargas, Andrea; Quintero, Claudia; Ochoa, Jorge; Tandioy, Fabio; Zapata, Láder; Estrada, Juan; Yepes, Maria; Leal, Hiulber

2003-08-01

Evaluation of the usefulness of criteria for systemic inflammatory response syndrome (SIRS) compared with the final diagnosis of infection in patients admitted to the emergency room of two university-based hospitals. Longitudinal cohort study. Hospital Universitario San Vicente de Paul and Hospital General de Medellín, Medellín, Colombia. PATIENTS. Seven hundred thirty-four patients with suspected infection as main diagnosis for admittance into the emergency room. Sensitivity, specificity, predictive values and likelihood ratios (LR) of SIRS criteria at admission were determined using, as gold standards, the diagnosis at the time of discharge based on clinical history and evolution, and microbiological confirmation of infection. SIRS criteria were met by 503 patients (68.5%); the discharge diagnosis of infection was found in 657 (89.4%) and 276 (37%) had microbiological confirmation. SIRS criteria exhibited a sensitivity of 69%, specificity of 35%, positive predictive value (PPV) of 90%, negative predictive value (NPV) of 12% and positive LR of 1.06. There were no differences between the two gold standards. The finding of two or more SIRS criteria was of little usefulness for diagnosis of infection. It is necessary to work with new criteria and probably with biological markers, in order to obtain a simple, precise and operative definition of the sepsis phenomenon.

Allergic contact dermatitis due to cosmetics: A clinical and epidemiological study in a tertiary hospital.

PubMed

Zaragoza-Ninet, V; Blasco Encinas, R; Vilata-Corell, J J; Pérez-Ferriols, A; Sierra-Talamantes, C; Esteve-Martínez, A; de la Cuadra-Oyanguren, J

2016-05-01

The incidence of allergic contact dermatitis (ACD) to cosmetics in the general population is rising with the increasing use of cosmetic products and their proliferation and diversification. The aims of this study were to determine the prevalence of ACD to cosmetics in our setting, analyze changes over time, describe the clinical and epidemiological features of this allergic reaction, and identify the allergens and cosmetics involved. We performed a prospective study at the skin allergy unit in Hospital General Universitario de Valencia in Spain between 2005 and 2013 and compared our findings with data collected retrospectively for the period 1996 to 2004. The 5419 patients who underwent patch testing during these 2 periods were included in the study. The mean prevalence of ACD to cosmetics increased from 9.8% in the first period (1996-2004) to 13.9% in the second period (2005-2013). A significant correlation was found between ACD to cosmetics and female sex but not atopy. Kathon CG (blend of methylchloroisothiazolinone and methylisothiazolinone), fragrances, and paraphenylenediamine were the most common causes of ACD to cosmetics during both study periods, and acrylates and sunscreens were identified as emerging allergens during the second period. Copyright © 2016 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

New Worlds in Astroparticle Physics: Proceedings of the Fifth International Workshop

NASA Astrophysics Data System (ADS)

Mourão, Ana M.; Pimenta, Mário; Potting, Robertus; Sá, Paulo M.

Preface -- Group photo -- pt. 1. Overviews in astroparticle physics. An overview of the status of work on ultra high energy cosmic rays / A. A. Watson. Gravitational waves from compact sources / K. D. Kokkotas and N. Stergioulas. Neutrino physics and astrophysics / E. Fernandez. Black holes and fundamental physics / J. P. S. Lemos -- pt. 2. Contributions. Cosmic ray physics. Phenomenology of cosmic ray air showers / M. T. Dova. First results from the MAGIC experiment / A. de Angelis. How to select UHECR in EUSO - the trigger system / P. Assis. Pressure and temperature dependence of the primary scintillation in air / M. Fraga ... [et al.]. Overview of the GLAST physics / N. Giglietto ... [et al.]. Velocity and charge reconstruction with the AMS/RICH detector / L. Arruda ... [et al.]. Isotope separation with the RICH detector of the AMS experiment / L. Arruda ... [et al.]. Gravitational waves and compact sources. Gravitational radiation from 3D collapse to rotating black holes / L. Baiotti ... [et al.]. The role of differential rotation in the evolution of the r-mode instability / P. M. Sá and B. Tomé. Analytical r-mode solution with gravitational radiation reaction force / Ó. J. C. Dias and P. M. Sá. Space radiation: effects and monitoring. Particles from the sun / D. Maia. Simulations of space radiation monitors / B. Tomé. GEANT4 detector simulations: radiation interaction simulations for the high-energy astrophysics experiments EUSO and AMS / P. Goncalves. Software for radiological risk assessment in space missions / A. Trindade, P. Rodrigues. Neutrino physics. Results from K2K / S. Andringa. SNO: salt phase results and NCD phase status / J. Maneira. The ICARUS experiment / S. Navas-Concha. Cosmological parameters measurements. High redshift supernova surveys / S. Fabbro. SNFactory: nearby supernova factory / P. Antilogus. A polarized galactic emission mapping experiment at 5-10 GHz / D. Barbosa ... [et al.]. Galaxy clusters as probes of dark energy / P. T. P. Viana. Black hole physics. Acoustic black holes / V. Cardoso. Superradiant instabilities in black hole systems / Á. J. C. Dias ... [et al.]. Microscopic black hole detection in UHECR: the double bang signature / M. Paulos. Generalized uncertainty principle and holography / F. Scardiali and R. Casadio. Testing covariant entropy bounds / S. Gao and J. P. S. Lemos. Dark matter and dark energy. Dark energy - dark matter unification: generalized Chaplygin gas model / O. Bertolami. Cosmology and spacetime symmetries / R. Lehnert. Scalar field models: from the pioneer anomaly to astrophysical constraints / J. Páramos. Braneworlds, conformal fields and dark energy / R. Neves. Sun and stars as cosmological tools: probing supersymmetric dark matter / I. Lopes. ZEPLIN III: xenon detector for WIMP searches / H. Araújo. Dark matter detectability with Čerenkov telescopes -- List of participants.

[Not Available].

PubMed

Ballesteros-Pomar, María; Villar-Taibo, Rocío; Calleja-Fernández, Alicia; Pintor-de-la-Maza, Begoña; Álvarez-Del-Campo, Cecilia; Vidal-Casariego, Alfonso; Cano-Rodríguez, Isidoro

2016-06-03

Los datos del estudio PREDYCES® nos revelaron que en España la desnutrición relacionada con la enfermedad (DRE) afecta a uno de cada cuatro pacientes hospitalizados. Esta cifra aumenta hasta el 36,8% en los pacientes hematológicos. Se calcula que un 20% de los pacientes oncológicos muere por complicaciones relacionadas con la DRE. Nuestro grupo se planteó en 2011 comenzar la implantación de un cribado nutricional en los servicios con mayor riesgo de DRE. La presente revisión trata de describir todo el proceso que hemos seguido para mejorar la situación nutricional en los pacientes ingresados en el Servicio de Hematología del Complejo Asistencial Universitario de León (CAULE), mayoritariamente con diagnóstico de neoplasias hematológicas. En un primer estudio piloto, detectamos una alta prevalencia de desnutrición, que tendió a aumentar durante la hospitalización. Además, solo el 8,3% los enfermos valorados recibieron algún tipo de soporte nutricional y no se estaban cubriendo sus necesidades ni calóricas ni proteicas, lo que se asociaba a un peor pronóstico. Por este motivo, nos decidimos a implantar de manera sistemática un cribado y una intervención nutricional adecuada, que comenzó en 2011 y que ha recibido el reconocimiento como Buena Práctica del Sistema Nacional de Salud.

[Staphylococcus aureus nasal colonization in medical students: importance in nosocomial transmission].

PubMed

López-Aguilera, Sara; Goñi-Yeste, María Del Mar; Barrado, Laura; González-Rodríguez-Salinas, M Carmen; Otero, Joaquín R; Chaves, Fernando

2013-10-01

Staphylococcus aureus is the main pathogen causing nosocomial infections. Health professionals, including medical students, could be a source of transmission. The aims of the study were to determine the rate of nasal carriage of S.aureus susceptible and resistant to methicillin (MRSA) and evaluate the knowledge and adherence that students had about hand hygiene. The study included medical students attached to the Hospital Universitario 12 de Octubre (Madrid, Spain). We collected samples from both nasal vestibules, and the antimicrobial susceptibility was determined on all isolates. Data collection was performed using a self-administered questionnaire that included risk factors for colonization, hygiene habits and knowledge of hand hygiene protocols. Of the 140 students included, 55 (39.3%) were colonized by S.aureus, and 3 (2,1%) by MRSA. The exposure to antibiotics in the last 3 months was lower in colonized students (12.3% vs. 25.9%, P=.03). Self-assessment showed that 56.4% of students almost never washed their hands before to attending to the first patient, and only 38.6% always washed after examining patients. More than a third (35.7%) ignored the hand hygiene protocol, and 38.6% had not received specific formation. Medical students should be included in hospital infection control programs. Hand hygiene training should be given to students before they begin their practices in the hospital. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Clinical magnification and residual refraction after implantation of a double intraocular lens system in patients with macular degeneration.

PubMed

Amselem, Luis; Diaz-Llopis, Manuel; Felipe, Adelina; Artigas, Jose M; Navea, Amparo; García-Delpech, Salvador

2008-09-01

To evaluate the efficacy of a standard double intraocular lens (IOL) system (IOL-Vip) in patients with low vision and central scotoma due to macular degeneration and assess the predictability of the residual refraction and magnification. Ophthalmology Department, Hospital General Universitario, Valencia, Spain. This interventional prospective noncomparative case series comprised 13 consecutive surgical procedures in 10 patients with central scotoma. Follow-up was 12 months. Evaluation included the difference between preoperative and postoperative best corrected visual acuity (BCVA), refraction, position of the IOLs, endothelial cell density, and occurrence of postoperative complications. Residual refraction and eye magnification were calculated using a theory developed in a previous study, and the values were compared with the clinical results. The mean BCVA was 1.37 logMAR preoperatively and 0.68 logMAR 1 year postoperatively. The mean best corrected clinical gain was 44%. There was no statistically significant difference between the clinically evaluated and theoretically calculated residual refractions (P = .17). No intraoperative or postoperative complications occurred. Implantation of the double IOL system improved BCVA in patients with low vision due to advanced maculopathy. The results were best in myopic patients (long eyes); patients with hyperopia (short eyes) had high residual refraction. The postoperative clinical gain and residual refraction were predictable, showing the feasibility of implanting a customized double IOL.

Dermatofibroma of the face: a clinicopathologic study of 20 cases.

PubMed

Estela, J R; Rico, M T; Pérez, A; Unamuno, B; Garcías, J; Cubells, L; Alegre, V

2014-03-01

Dermatofibroma is one of the most common benign skin tumors. It typically develops on the lower limbs between the third and fifth decade of life and is more common in women. Clinical diagnosis is often straightforward. Dermatofibromas are associated with a very low rate of local recurrence following excision. To describe the clinical and histologic features of dermatofibroma of the face based on our experience. Descriptive retrospective study of the clinicopathologic features of dermatofibromas of the face diagnosed at the dermatology department of Hospital General Universitario de Valencia between 1990 and 2012. Twenty cases of dermatofibroma of the face (1.11% of all dermatofibromas diagnosed) were studied. The age at onset varied widely, from 28 to 84 years. The mean age at onset was 57.15 years and the median was 54 years. There were 11 women and 9 men. Mean follow-up was 83 months and there were no local recurrences. All the tumors were confined to the papillary and reticular dermis and the storiform pattern was the most common growth pattern observed. This study of facial dermatofibromas diagnosed at our hospital over a period of 22 years suggests that the face is an uncommon site but that dermatofibromas in this location behave similarly to those occurring elsewhere on the body. Copyright © 2013 Elsevier España, S.L. and AEDV. All rights reserved.

[Prevalence of myasthenia gravis in Antioquia, Colombia].

PubMed

Sánchez, J L; Uribe, C S; Franco, A F; Jiménez, M E; Arcos-Burgos, O M; Palacio, L G

Myasthenia gravis (MG), considered the commonest of all the illnesses that affect neuromuscular transmission, is a disorder in which the autoimmune system attacks the post synaptic acetylcholine receptor proteins in the end plate terminal; it is characterised by weakness and skeletal muscle fatigue, with no anomalies in reflexes, sensitivity or coordination. Epidemiological indicators, such as incidence and prevalence, are not known in Colombia. AIMS. To determine the prevalence of MG among the inhabitants of Antioquia, through the use of the capture recapture method. The capture recapture method was used for two sources, the Instituto Neurológico de Antioquia and the Hospital Universitario San Vicente de Pa l, which are the most important institutions for the diagnosis of neurological diseases in Antioquia. MG prevalence was calculated using the following formula: p= n/N 105. We examined the data from the period between 1 July 1995 and 30 June 2000 with the aim of identifying subjects who fitted the profile of MG sufferers. General MG prevalence in Antioquia was 27.7 cases per million inhabitants (CI 95%= 23.2 32.2). The male/female ratio was 1:3.77. The estimated prevalence of MG is lower than that reported in United States and other temperate regions, where it varies between 60 and 150 cases per million. The prevalence of MG is low in Antioquia, as in other tropical areas

[Phenotypic variations of susceptibility in Klebsiella pneumoniae strains of nosocomial origin and their association with biofilm formation].

PubMed

Barreto, Silvio; Zambrano, María; Araque, María

2009-06-01

Klebsiella pneumoniae is the principal opportunist pathogen associated with nosocomial infections. The morbidity and mortality produced by this microorganism is related mostly to antimicrobial resistance and its capacity to form biofilms. In this study, the phenotypic variations of susceptibility in 50 Klebsiella pneumoniae strains (26 betaLEE-producer and 24 no betaLEE-producer) isolated from pediatric patients with nosocomial septicemia at the High-risk Neonatal Unit of the Instituto Aut6nomo Hospital Universitario de Los Andes, Mérida, Venezuela and their associations with biofilm formation were analyzed. These strains were biochemically identified by standard microbiology methods. Antimicrobial susceptibility was determined by minimal inhibitory concentration and biofilm formation was detected by spectrophotometric techniques. Most of betaLEE strains were frequently associated with resistance markers such as tobramycin, kanamycin, tetracycline, chloramphenicol (38% each), streptomycin (36%) and netilmicin (34%). The predominant multiresistent phenotype was composed of betaLEE+ -AMG-TET-CLF (30%). 18% of K. pneumoniae strains were sensible to the antibiotics tested. Formation of biofilm was observed in 77.8% and 96.2% of sensible and resistent strains, respectively. There was no statistic relation between phenotipic variations of susceptibility and biofilm formation (p > = 0.05). However, both characteristics of K. pneumoniae should be evaluated to determine the therapeutic conduct to treat patients with nosocomial infection.

[Implementation of a post-discharge surgical site infection system in herniorrhaphy and mastectomy procedures].

PubMed

San Juan Sanz, Isabel; Díaz-Agero-Pérez, Cristina; Robustillo-Rodela, Ana; Pita López, María José; Oliva Iñiguez, Lourdes; Monge-Jodrá, Vicente

2014-10-01

Monitoring surgical site infection (SSI) performed during hospitalization can underestimate its rates due to the shortening in hospital stay. The aim of this study was to determine the actual rates of SSI using a post-discharge monitoring system. All patients who underwent herniorraphy or mastectomy in the Hospital Universitario Ramón y Cajal from 1 January 2011 to 31 December 2011 were included. SSI data were collected prospectively according to the continuous quality improvement indicators (Indicadores Clinicos de Mejora Continua de la Calidad [INCLIMECC]) monitoring system. Post-discharge follow-up was conducted by telephone survey. A total of 409patients were included in the study, of whom 299 underwent a herniorraphy procedure, and 110 underwent a mastectomy procedure. For herniorrhaphy, the SSI rate increased from 6.02% to 7.6% (the post-discharge survey detected 21.7% of SSI). For mastectomy, the SSI rate increased from 1.8% to 3.6% (the post-discharge survey detected 50% of SSI). Post-discharge monitoring showed an increased detection of SSI incidence. Post-discharge monitoring is useful to analyze the real trend of SSI, and evaluate improvement actions. Post-discharge follow-up methods need to standardised. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Spontaneous speech prosody and discourse analysis in schizophrenia and Fronto Temporal Dementia (FTD) patients].

PubMed

Martínez, Angela; Felizzola Donado, Carlos Alberto; Matallana Eslava, Diana Lucía

2015-01-01

Patients with schizophrenia and Frontotemporal Dementia (FTD) in their linguistic variants share some language characteristics such as the lexical access difficulties, disordered speech with disruptions, many pauses, interruptions and reformulations. For the schizophrenia patients it reflects a difficulty of affect expression, while for the FTD patients it reflects a linguistic issue. This study, through an analysis of a series of cases assessed Clinic both in memory and on the Mental Health Unit of HUSI-PUJ (Hospital Universitario San Ignacio), with additional language assessment (analysis speech and acoustic analysis), present distinctive features of the DFT in its linguistic variants and schizophrenia that will guide the specialist in finding early markers of a differential diagnosis. In patients with FTD language variants, in 100% of cases there is a difficulty understanding linguistic structure of complex type; and important speech fluency problems. In patients with schizophrenia, there are significant alterations in the expression of the suprasegmental elements of speech, as well as disruptions in discourse. We present how depth language assessment allows to reassess some of the rules for the speech and prosody analysis of patients with dementia and schizophrenia; we suggest how elements of speech are useful in guiding the diagnosis and correlate functional compromise in everyday psychiatrist's practice. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

[Study protocol of a prevention of recurrent suicidal behaviour program based on case management (PSyMAC)].

PubMed

Sáiz, Pilar A; Rodríguez-Revuelta, Julia; González-Blanco, Leticia; Burón, Patricia; Al-Halabí, Susana; Garrido, Marlen; García-Alvarez, Leticia; García-Portilla, Paz; Bobes, Julio

2014-01-01

Prevention of suicidal behaviour is a public health priority in the European Union. A previous suicide attempt is the best risk predictor for future attempts, as well as completed suicides. The primary aim of this article is to describe a controlled study protocol designed for prevention of recurrent suicidal behaviour that proposes case management, and includes a psychoeducation program, as compared with the standard intervention (PSyMAC). Patients admitted from January 2011 to June 2013 to the emergency room of the Hospital Universitario Central de Asturias were evaluated using a protocol including sociodemographic, psychiatric, and psychosocial assessment. Patients were randomly assigned to either a group receiving continuous case management including participation in a psychoeducation program (experimental group), or a control group receiving standard care. The primary objective is to examine whether or not the period of time until recurrent suicidal behaviour in the experimental group is significantly different from that of the control group. PSyMAC proposes low cost and easily adaptable interventions to the usual clinical setting that can help to compensate the shortcoming of specific action protocols and suicidal behaviour prevention programs in our country. The evaluation of PSyMAC results will determine their real effectivity as a case-magament program to reduce suicidal risk. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

Vocal Changes Following Thyroid Surgery: Prospective Study of Objective and Subjective Parameters.

PubMed

Delgado-Vargas, Beatriz; Lloris Romero-Salazar, Azucena; Cobeta, Ignacio

2017-10-19

Vocal changes are frequent following a surgical procedure to the thyroid gland. Even though they are a recognized morbidity, their bases are yet to be defined as well as their effect on vocal parameters. This study investigates the objective and subjective changes that occur after the surgery. This study is a prospective analysis of consecutive cases. This study was conducted in a single-center tertiary care facility. Patients programmed for any thyroid procedure in Hospital Universitario Ramón y Cajal were enrolled consecutively to perform the vocal analysis before and after the surgery from April 2014 to April 2016. Patients were divided according to the vocal fold motility, and their vocal and aerodynamic parameters were obtained by means of electroglottography and phonatory aerodynamic system. Patients filled in the 10-item Voice Handicap Index (VHI-10) questionnaire. Statistical analysis was performed comparing vocal and aerodynamic parameters and quality of life before and after the surgery. 218 patients met inclusion criteria and completed the protocol. A total of 86.6% of the sample showed no vocal motility impairment, whereas the rest of the patients showed a paresis or a paralysis. Maximum phonatory time and VHI-10 questionnaire showed a statistically significant difference (P < 0.05) between groups. No differences were assessed regarding other vocal parameters. Efforts are still needed to understand the groundings and magnitude of the vocal changes after a thyroid surgery. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Development of ISO 13606 archetypes for the standardisation of data registration in the Primary Care environment.

PubMed

Barros Castro, Jesús; Lamelo Alfonsín, Alejandro; Prieto Cebreiro, Javier; Rimada Mora, Dolores; Carrajo García, Lino; Vázquez González, Guillermo

2015-01-01

On daily procedures, companies and organizations produce a wide quantity of data. Medical information doubles every five years approximately, and most of this information has no structure and cannot be utilised. Information obtained during Primary Health Care (PC) consultations is expected to be standardized and organised following instructions made by archetype 13606 of the International Organization for Standardization (ISO) in order to guarantee the Continuity of Care as well as the potential use of these data for secondary purposes, such as investigation or statistics. This study was designed to investigate the feasibility of representing the information collected in Primary Care consultations in a structured and normalized way. A key difference to other approaches is that the intended solution is, to the best of our knowledge, the first one to register all the information collected in this area. The participation of the Primary Health Care service (PC) from Complejo Hospitalario Universitario de A Coruña (CHUAC) has been of vital importance in this project as it has provided the necessary clinical knowledge and it has allowed us to verify the effectiveness obtained in actual environments. The archetypes developed can be reused in a wide range of projects. As an example of use, we have used these archetypes to create an intelligent system that generates organised reports based on the information dictated on a medical consultation which, afterwards, can be analysed from an analytical point of view.

[Changes in the epidemiology of gastroenteritis caused by Salmonella during 2005-2014 in Salamanca, Spain].

PubMed

Cores-Calvo, Olaia; Valero-Juan, Luis Félix; García-Sánchez, Enrique; García-Sánchez, José Elias; García-García, María Inmaculada

2016-04-01

In Spain there are not many updated population studies about salmonellosis, despite being one of the most common etiologies of acute gastroenteritis (AGEs) caused by bacteria in the world. The aim of the study was to know the most relevant epidemiological features of AGEs produced by Salmonella spp. between 2005 and 2014 in Salamanca (Spain). Descriptive cross-sectional study carried out through review of the clinical microbiologic records at Complejo Asistencial Universitario de Salamanca. Culture, isolation, identification and serotyping were performed according to standard methodology. Salmonella was isolated in 1,477 patients, representing 47.7% of all positive stool cultures and 53.3% of all income bacterial AGE. The average prevalence was 42.1 cases/100,000 people per year. The mean age was 23 ± 28 years and the median 7 years. 40.2% of all isolates occurred in children under 5 years, with an average prevalence of 45.1 cases/ 10,000 people per year. Overall, the most frequently isolated serotype was S. Typhimurium with 57%, followed by S. Enteritidis with 35.8%. The prevalence of Salmonella decreased over time. The group aged 0-4 years had the highest rate throughout the period. However, Salmonella produced the highest percentage of hospitalizations for bacterial AGE. In recent years, S. Typhimurium serotype has replaced S. Enteritidis serotype and predominates in younger patients. It is observed under-reporting of cases of salmonellosis produced in Salamanca despite being mandatory notification of these since 2007.

[Risk of developmental dysplasia of the hip in patients subjected to the external cephalic version].

PubMed

Sarmiento Carrera, Nerea; González Colmenero, Eva; Vázquez Castelo, José Luis; Concheiro Guisán, Ana; Couceiro Naveira, Emilio; Fernández Lorenzo, José Ramón

2018-03-01

Developmental dysplasia of the hip (DDH) refers to the spectrum of abnormalities of maturation and development of the hip. Breech presentation is associated with DDH. This risk factor can be modified by external cephalic version (ECV). The aim of this study is to evaluate the incidence of DDH in patients who successfully underwent ECV, as well as to evaluate need for these children (breech for a period during gestation) to be included in the DDH screening protocol. A prospective cohort study was conducted in the Hospital Universitario de Vigo from January 1, 2015 to December 31, 2015. It included children born in cephalic presentation after a successful ECV, as well as children born in breech presentation. They all were screened for DDH by ultrasound examination of the hip. Out of a total of 122 newborns included in the study, ECV was attempted on 67 (54.9%), of which 35 (52.2%) were successful. Out of the 14 children diagnosed with DDH, 3 of those born in cephalic presentation after a successful ECV were found to be normal on physical examination. Successful ECV is associated with a lower incidence of DDH as regards breech presentation. However, these patients should be included in the DDH screening protocol for the early detection of this disorder. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Dermoscopic features of skin lesions in patients with mastocytosis.

PubMed

Vano-Galvan, Sergio; Alvarez-Twose, Iván; De las Heras, Elena; Heras, Elena De Las; Morgado, J M; Matito, Almudena; Sánchez-Muñoz, Laura; Plana, Maria N; Planas, Maria Nieves; Jaén, Pedro; Orfao, Alberto; Escribano, Luis

2011-08-01

To evaluate dermoscopic features in a group of 127 patients with mastocytosis in the skin and to investigate the relationship between different dermoscopic patterns and other clinical and biological characteristics of the disease. Clinical and laboratory data were compared among patients with mastocytosis grouped according to the different dermoscopic patterns. Patients were selected from the Instituto de Estudios de Mastocitosis de Castilla La Mancha and the Department of Dermatology of Hospital Universitario Ramón y Cajal from April 1 through September 30, 2009. Patients Overall, 127 consecutive patients (70 females [55.1%] and 57 males [44.9%]; median age, 17 years; range, 0-81 years) with mastocytosis in the skin were included in the study. Evaluation of dermoscopic patterns and investigation of potential predictive factors for more symptomatic forms of the disease according to the need for daily antimediator therapy. Four distinct dermoscopic patterns were observed: yellow-orange blot, pigment network, reticular vascular pattern, and (most frequently) light-brown blot. A reticular vascular pattern was identified in all telangiectasia macular eruptiva and some maculopapular mastocytosis. In turn, all patients with mastocytoma displayed the yellow-orange blot pattern. The reticular vascular dermoscopic pattern was associated with the need for daily antimediator therapy; this pattern, together with serum tryptase levels and plaque-type mastocytosis, represented the best combination of independent factors to predict the need for maintained antimediator therapy. Dermoscopy is a feasible method for the subclassification of mastocytosis. Of note, a reticular vascular pattern is more frequently associated with the need for antimediator therapy.

Maternal underweight and perinatal outcomes: a restrospective cohort study

PubMed

Vilar Sánchez, Ángel; Fernández Alba, Juan Jesús; González Macías, María Del Carmen; Paublete Herrera, María Del Carmen; Carnicer Fuentes, Concepción; Carral San Laureano, Florentino; Torrejón Cardoso, Rafael; Moreno Corral, Luis Javier

2017-06-05

Introduction: Some studies have linked maternal underweight with adverse perinatal outcomes such as spontaneous abortion, abruptio placentae, small for gestational age newborn, intrauterine growth retardation and preterm birth. Objective: To determine the influence of maternal underweight in the onset of labor, route of delivery, birth weight, Apgar score and preterm birth. Methods: Retrospective cohort study. We included pregnant women from the Hospital Universitario de Puerto Real. Period of study: 2002-2011. Study group: underweight at the beginning of gestation (BMI < 18.5 kg/m2). Control group: pregnant women with normal body mass index (BMI) at the beginning of gestation (18.5-24.9 kg/m2). The risk (OR) of induction of labor, cesarean section, small for gestational age newborn, macrosomia, 5’ Apgar score < 7, and preterm birth was calculated. Results: The prevalence of underweight was 2.5% versus 58.9% of pregnant women who had a normal BMI. We found no significant differences in the rate of induction of labor, fetal macrosomia, Apgar at 5’ < 7 or preterm delivery. Maternal underweight was associated with a decreased risk of caesarean section (adjusted OR 0.45, 95% CI 0.22 to 0.89) and an increased risk of small for gestational age newborn (adjusted OR 1.74; 95% CI 1.05 to 2.90). Conclusions: Maternal underweight at the start of pregnancy is associated with a lower risk of caesarean section and a greater risk of small for gestational age newborns (birth weight < P10).

[Epidemiology of Staphylococcus aureus nosocomial infections in a high-risk neonatal unit].

PubMed

Velazco, Elsa; Nieves, Beatriz; Araque, María; Calderas, Zoila

2002-01-01

Nosocomial infections are a significant cause of morbidity and mortality throughout the world. In developing countries it is difficult to carry out effective surveillance and control programs for this type of infection because of the cost in both human and material resources. These considerations prompted us to perform a prospective study to determine the epidemiologic and microbiologic characteristics of nosocomial infections due to Staphylococcus aureus in the High-risk Neonatal Unit (HRNU) of the Instituto Autónomo Hospital Universitario de Los Andes (IAHULA), during the period of November 1997 to October 1998. Among a total of 120 microorganisms, 24 (20%) strains of Staphylococcus aureus were isolated; 47% were recovered from blood and 33% from conjunctive samples. Among the cases of conjunctivitis, S. aureus was the only pathogen isolated in 42%. Twenty of the 24 Staphylococcus aureus strains (83%) were methicillin-resistant (MRSA). According to their resistance profiles, we established 12 groups of strains from neonates with nosocomial infections and 1 group of strains from the two carriers among the healthcare personnel detected by microbiological screening. The MeRGmR pattern was the most frequent. Plasmid analysis disclosed two profiles, each having a plasmid molecular weight over 23.130 bp. The MRSA strains isolated from the neonates and those isolated from the carriers showed the same plasmid profile. This suggests that the healthcare personnel may have acted as reservoirs of the MRSA strains found in neonates with nosocomial infection.

Real-time PCR assay for the diagnosis of pleural tuberculosis

PubMed Central

Cárdenas Bernal, Ana María; Giraldo-Cadavid, Luis Fernando; Prieto Diago, Enrique; Santander, Sandra Paola

2017-01-01

Abstract Introduction: The diagnosis of pleural tuberculosis requires an invasive and time-consuming reference method. Polymerase chain reaction (PCR) is rapid, but validation in pleural tuberculosis is still weak. Objective: To establish the operating characteristics of real-time polymerase chain reaction (RT-PCR) hybridization probes for the diagnosis of pleural tuberculosis. Methods: The validity of the RT-PCR hybridization probes was evaluated compared to a composite reference method by a cross-sectional study at the Hospital Universitario de la Samaritana. 40 adults with lymphocytic pleural effusion were included. Pleural tuberculosis was confirmed (in 9 patients) if the patient had at least one of three tests using the positive reference method: Ziehl-Neelsen or Mycobacterium tuberculosis culture in fluid or pleural tissue, or pleural biopsy with granulomas. Pleural tuberculosis was ruled out (in 31 patients) if all three tests were negative. The operating characteristics of the RT-PCR, using the Mid-P Exact Test, were determined using the OpenEpi 2.3 Software (2009). Results: The RT-PCR hybridization probes showed a sensitivity of 66.7% (95% CI: 33.2%-90.7%) and a specificity of 93.5% (95% CI: 80.3%-98.9%). The PPV was 75.0% (95% CI: 38.8%-95.6%) and a NPV of 90.6% (95% CI: 76.6%-97.6%). Two false positives were found for the test, one with pleural mesothelioma and the other with chronic pleuritis with mesothelial hyperplasia. Conclusions: The RT-PCR hybridization probes had good specificity and acceptable sensitivity, but a negative value cannot rule out pleural tuberculosis. PMID:29021638

Value of digital exploration for diagnosing injuries to the left side of the diaphragm caused by stab wounds.

PubMed

Morales, C H; Villegas, M I; Angel, W; Vásquez, J J

2001-10-01

The digital exploration of stab wounds in the left thoracoabdominal region allows the early diagnosis of diaphragmatic lesions. Diagnostic test study. The digital exploration of the diaphragm was compared with laparotomy (the gold standard) and thoracoscopy. The study setting was the Hospital Universitario San Vicente de Paúl (Medellín, Colombia). This is a referral trauma center for the general community. The study included 82 consecutive patients who were admitted to our institution during a 12-month period with injuries caused by stab wounds to the left thoracoabdominal region and who did not have indications for immediate surgery. Digital exploration of the wound was performed by the attending surgeon in the emergency department. If a lesion of the diaphragm was identified, a laparotomy was performed; if no diaphragmatic lesion was found, a diagnostic left thoracoscopy and/or laparotomy was performed. Results of the laparotomy (n = 63) or thoracoscopy (n = 19) were used as the standard of reference for the determination of sensitivity, specificity, and predictive values of digital exploration. The integrity of the diaphragm was determined by digital exploration through the stab wound. Sensitivity, specificity, predictive value, and likelihood ratio were calculated. For the detection of diaphragmatic lesions, digital exploration demonstrated a sensitivity of 96%, a specificity of 83.3%, a positive predictive value of 91%, and a negative predictive value of 93.7%. Digital exploration is a reliable method for the detection of injuries to the left side of the diaphragm caused by stab wounds.

[Dermatology consultations in an emergency department prior to establishment of emergency dermatology cover].

PubMed

Martínez-Martínez, M L; Escario-Travesedo, E; Rodríguez-Vázquez, M; Azaña-Defez, J M; Martín de Hijas-Santos, M C; Juan-Pérez-García, L

2011-01-01

an increasing number of patients seek emergency treatment for dermatologic complaints. The aim of this study was to assess the characteristics of skin complaints seen in an emergency department prior to establishment of specialist dermatology cover. a retrospective, descriptive study was undertaken using data on urgent dermatology cases seen by nonspecialist physicians in the emergency department of Hospital General Universitario de Albacete, Spain, in 2008. a total of 3662 patients with skin diseases were seen (2.59% of all emergency cases; approximately 10 patients per day). The mean age was 27.73 years and there was a slight predominance of female patients. Children and adolescents accounted for 5.85% of cases. A total of 96 different conditions were diagnosed and 84% of cases corresponded to one of 21 different diagnostic entities, urticaria being the most frequent (19.27%). The 96 diagnoses were grouped into 16 categories to facilitate analysis. According to this classification, most patients had infectious diseases (47.49%), followed by urticaria and angioedema (20.13%), "nonspecific diagnosis" (11.93%), and "descriptive diagnosis" (6.49%). In 4.8% of cases, the patient was admitted, most frequently for cellulitis. in nonspecialist emergency services, the number of different diagnoses is small in relation to the number of patients seen and the proportion of nonspecific and descriptive diagnoses is relatively large. In our opinion, an on-call dermatologist should be made available within emergency departments in order to offer a higher quality of care to patients with skin conditions. Copyright © 2010 Elsevier España, S.L. y AEDV. All rights reserved.

Colorectal surgery and surgical site infection: is a change of attitude necessary?

PubMed

Elia-Guedea, Manuela; Cordoba-Diaz de Laspra, Elena; Echazarreta-Gallego, Estibaliz; Valero-Lazaro, María Isabel; Ramirez-Rodriguez, Jose Manuel; Aguilella-Diago, Vicente

2017-07-01

Surgical site infection (SSI) can be as high as 30% in patients undergoing colorectal surgery and is associated with an increase in morbidity and mortality. The aim of this study is to evaluate the impact of a set of simple preventive measures that have resulted in a reduction in surgical site infection in colorectal surgery. Prospective study with two groups of patients treated in the colorectal unit of the "Clinico Universitario Lozano Blesa" hospital in Zaragoza. One group was subject to our measures from February to May 2015. The control group was given conventional treatment within a time period of 3 months before the set of measures were implemented. One hundred forty-nine patients underwent a major colorectal surgical procedure. Seventy (47%) belonged to the control group and were compared to the remaining 79 patients (53% of the total), who were subject to our treatment bundle in the period tested. Comparing the two groups revealed that our set of measures led to a general reduction in SSI (31.4 vs. 13.6%, p = 0.010) and in superficial site infection (17.1 vs. 2.5%, p = 0.002). As a consequence, the postoperative hospital stay was shortened (10.0 vs. 8.0 days, p = 0.048). However, it did not, the number of readmissions nor the re-operation rate. SSI was clearly related to open surgery. The preventive set of measures applied in colorectal surgery led to a significant reduction of the SSI and of the length of hospital stay.

[Decrease in hospitalizations due to polyvalent medical day hospital].

PubMed

Escobar, M A; García-Egido, A A; Carmona, R; Lucas, A; Márquez, C; Gómez, F

2012-02-01

The day hospital is an alternative to hospitalization. This alternative improves accessibility and comfort of the patients, and avoids hospitalizations. Nevertheless, the efficacy of the polyvalent medical day hospital in avoiding hospitalizations has not been evaluated. To analyze hospital stays avoided by the polyvalent medical day hospital of a university hospital of the Andalusian Health Service. An observational prospective study of the patients studied and/or treated in the polyvalent medical day hospital of the Hospital Universitario Puerto Real over a one year period. A total of 9640 patients were attended to, with 1413 procedures and 4921 i.v. treatments. There were 3182 visits to the priority consultation of the polyvalent medical day hospital. The most frequent consultation complaints were constitutional symptoms (15.9%) and anemia (14.5%). After the first visit, 21.5% of the patients were discharged and fewer than 3% were hospitalized. Hospitalization was avoided in 16.8% of the patients, there being a 6.0% decrease in the need for hospital beds (5.0% reduction in the internal medicine unit). Inadequate hospitalizations and 30-day readmissions decreased 93.3% and 4.2%, respectively. The most frequent diagnosis was neoplasm (26.0%), and most of the beds freed up were generated by patients diagnosed of neoplasm (26.7%). With this type of polyvalent medical day hospital, we have observed improved efficiency of health care, freeing up hospital beds by reducing hospitalizations, inadequate hospitalizations and re-admissions in the medical units involved. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Dependence for basic and instrumental activities of daily living after hip fractures.

PubMed

González-Zabaleta, Jorge; Pita-Fernandez, Salvador; Seoane-Pillado, Teresa; López-Calviño, Beatriz; Gonzalez-Zabaleta, Jose Luis

2015-01-01

The objective of the study is to determine basic activities of daily living (Barthel Index) and instrumental activities of daily living (Lawton-Brody Index) before and after hip fracture. Follow-up study of patients (n=100) with hip fracture, operated at Complejo Hospitalario Universitario de A Coruña (Spain). Period January/2009-December/2011. Demographic characteristic of the patients, Charlson Index, Glomerular filtration rate, Barthel index, Lawton index, type of proximal femur fracture and surgical treatment delay were recorded. Multivariate regression was performed. Informed patient consent and ethical review approval were obtained. Before fracture were independent for activities of daily living (ADL) a 38.0%, at 90 days were 15.4%. The Barthel index score decreased from 75.2±28.2 to 56.5±31.8) (p<0.0001). If we consider the age, gender, comorbidity (Charlson index), renal function, fracture type and surgical delay objectify the only independent variable to predict dependency effect is age. If we also consider the Barthel score objectify the variable that significantly modifies that score at 90 days is the baseline value of the index. The prevalence of independence for instrumental activities of daily living (IADL) at the baseline moment is 11% and at 90 days is decreased to 2.2%. There is a decrease in the independence effect in all activities. The variable predictor of independence for all activities after taking into consideration age, sex, comorbidity, fracture type, surgical delay and renal function is the baseline score of the Barthel and Lawton index. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Alfabetización astronómica

NASA Astrophysics Data System (ADS)

Tignanelli, H.

A fines de 1991, en una revista de educación en ciencias, José L. Sérsic reflexionaba acerca de los problemas que enfrentaría la enseñanza de los conocimientos astronómicos en nuestro país, en los umbrales del Siglo XXI. Entonces postulaba como un objetivo mínimo, que los jóvenes deberían mostrar signos claros de que se hallan astronómicamente alfabetizados. Era el año en que se realizaba por primera vez una Asamblea General de I.A.U. en Buenos Aires, una oportunidad de singulares características para la comunidad astronómica local y, simultáneamente el comienzo de un cambio radical en la estructura del sistema educativo argentino. ?`Contempla ese cambio el objetivo que postulara Sérsic? ?`Estamos en condiciones de afirmar que estamos en camino de lograrlo? ?`Con qué parámetros?. Presentamos aquí un panorama general sobre algunas de las acciones realizadas en función de alcanzar esa alfabetización científica, analizando exclusivamente la actividad de enseñanza hasta el nivel universitario, sin detenernos en el mismo, ya que lo consideramos una instancia superior e independiente de aquella alfabetización. Tampoco nos referiremos a la tarea de difusión, divulgación o popularización de la Astronomía, ya que su condición de asistemática y subjetiva no es evaluable en términos de la formación integral de un individuo.

[Natural killer cell cytotoxic activity in critical pediatric patients with suspected hemophagocytic syndrome].

PubMed

Martínez, I; Fernández, L; Valentín, J; Castillo, C; Chamorro, C; Pérez-Martínez, A

2015-05-01

To determine the role of natural killer (NK) cytotoxic activity in patients with suspected hemophagocytic lymphohistiocytosis syndrome (HLH). A prospective study was conducted from September 2008 to February 2014. The study was carried out in the Hematological Oncology Laboratory of Hospital Infantil Universitario Niño Jesús, Madrid (Spain). We analyzed 30 peripheral blood samples from intensive care patients with suspected HLH. There were 18 males and 12 females, with a mean age of 4.7 years (range 0.2-22). NK cell cytotoxicity was compared with healthy controls according to age and sex. In vitro NK cell cytotoxicity against the K562 cell line was determined by time-resolved fluorescence (Europium-TDA) under resting conditions, after interleukin 15 stimulation, and following block with Fas ligand antibody. NK cell cytotoxicity. A total of 20 patients showed a significant decrease of NK cell activity compared with controls (P=.001). Nine of these patients were diagnosed with primary HLH. A total of 10 patients were diagnosed with secondary HLH. Cytotoxic activity was normal in 10 subjects. None of them were diagnosed with HLH. Interleukin 15 stimulation increased NK cell cytotoxicity in secondary HLH, and blocking Fas ligand on NK cells decreased cytotoxic activity in primary HLH patients (P=.001). In our experience, NK cell cytotoxic activity measured by time-resolved fluorescence is a simple and useful clinical diagnostic test for HLH. Interleukin 15 stimulation and Fas ligand blocking on NK cells could help differentiate between primary and secondary HLH. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

[Epidemiology of maxillofacial fractures due to traffic accidents in Medellin (Colombia)].

PubMed

Agudelo-Suárez, Andrés A; Duque-Serna, Francisco Levi; Restrepo-Molina, Lucas; Martínez-Herrera, Eliana

2015-09-01

To characterize maxillofacial fractures due to traffic accidents in patients attending the Hospital Universitario San Vicente Fundación (Medellin-Colombia) from 1998 to 2010. A descriptive study (n =1609) was carried out with information from the medical records of patients meeting the inclusion criteria established by the general objective of the study. The variables consisted of sex, age, year, type and number of fractures, and type of vehicle. A descriptive analysis of the variables was performed and the frequency of fractures due to traffic accidents was calculated according to year and sex. Crude and adjusted odds ratios (aOR) were estimated to establish associations among age, type of vehicle, and the presence of two or more fractures with stratification by sex. The frequency of maxillofacial fractures due to traffic accidents increased in 2007 (men: n=198, women: n=35) and decreased from 2008 to 2010 in both sexes. Fractures were more frequent in persons aged <35 years (80%) and in men (82%). The highest frequency of fractures was observed in motorists. Male users of motorcycles (aOR=1.41; confidence interval 95% [95%CI]: 1.02- 1.94) and bicycles (aOR=1.61; 95%CI: 1.01- 2.56) were more likely to report two or more fractures compared with pedestrians, after adjustment for other variables. Most maxillofacial fractures occurred in men and in motorists. Future studies should analyze other determinants affecting the epidemiology of maxillofacial fractures. Strategies should be designed to improve the use of protective elements and drivers' knowledge and practices. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Symptom clusters in advanced cancer.

PubMed

Jiménez, Ana; Madero, Rosario; Alonso, Alberto; Martínez-Marín, Virginia; Vilches, Yolanda; Martínez, Beatriz; Feliu, Marta; Díaz, Leyre; Espinosa, Enrique; Feliu, Jaime

2011-07-01

Patients with advanced cancer often experience multiple concurrent symptoms. Few studies have explored symptom clusters (SCs) in this population. The aim of the present study was to explore SCs in advanced cancer, evaluate the characteristics associated with various clusters, and determine their relationship to survival. This study included patients in the palliative care program of the Hospital Universitario La Paz from 2003 to 2005. The Edmonton Symptom Assessment System and a supplement including 13 other symptoms were used to detect symptoms. Principal component analysis was performed to determine symptom relationships and compare SCs with associated parameters. In total, 406 patients were included, 61% men and 39% women. The median age was 66.4 (range 18-95). The most common primaries were gastrointestinal (35%), lung (25%), genitourinary (8%), breast (5%), and head and neck (5%) carcinomas. The following clusters were identified: confusion (cognitive impairment, agitation, urinary incontinence), neuropsychological (anxiety, depression, and insomnia), anorexia-cachexia (anorexia, weight loss, and tiredness), and gastrointestinal (nausea and vomiting). The presence of these SCs was influenced by primary cancer site, gender, age, and performance status. Survival was related to the number of SCs present in a given patient: zero SC, 52 days; one SC, 38 days; two SCs, 23 days; and three to four SCs, 19 days; P < 0.001. Different SCs can be identified in patients with advanced cancer. These SCs are influenced by primary cancer site, gender, age, and Eastern Cooperative Oncology Group performance status, and they can have prognostic value. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

The relationship between neonatal hyperbilirubinemia and sensorineural hearing loss.

PubMed

Corujo-Santana, Cándido; Falcón-González, Juan Carlos; Borkoski-Barreiro, Silvia Andrea; Pérez-Plasencia, Daniel; Ramos-Macías, Ángel

2015-01-01

Severe jaundice that requires exchange transfusion has become a relatively rare situation today. About 60% of full term neonates and 80% of premature ones will suffer from jaundice within the first week of life. Hyperbilirubinemia at birth is a risk factor associated with hearing loss that is usually further linked to other factors that might have an effect on hearing synergistically. This study aimed to identify the relationship between hyperbilirubinemia at birth as a risk factor for sensorineural hearing loss in children born at Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, in the 2007-2011 period. This was a retrospective study of 796 newborns that had hyperbilirubinemia at birth, using transient evoked otoacoustic emissions and evoked auditory brainstem response. Hundred eighty-five newborns (23.24%) were referred for evoked auditory brainstem response. Hearing loss was diagnosed for 35 (4.39%): 18 neonates (51.43%) with conductive hearing loss and 17 (48.57%) with sensorineural hearing loss, 3 of which were diagnosed as bilateral profound hearing loss. Half of the children had other risk factors associated, the most frequent being exposure to ototoxic medications. The percentage of children diagnosed with sensorineural hearing loss that suffered hyperbilirubinemia at birth is higher than for the general population. Of those diagnosed, none had levels of indirect bilirubin≥20mg/dl, only 47% had hyperbilirubinemia at birth as a risk factor and 53% had another auditory risk factor associated. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

[Dual diagnosis in psychiatric inpatients: prevalence and general characteristics].

PubMed

Rodríguez-Jiménez, Roberto; Aragüés, María; Jiménez-Arriero, Miguel Angel; Ponce, Guillermo; Muñoz, Antonio; Bagney, Alexandra; Hoenicka, Janet; Palomo, Tomás

2008-06-01

Comorbidity between a substance use disorder (SUD) and another psychiatric disorder is known as dual diagnosis. It is of great relevance due to its important clinical consequences and costs of care. There are practically no published studies on dual diagnosis prevalence in patients admitted to psychiatric hospitalization units in general hospitals (PHUGH) in our country. The objectives were to estimate the prevalence of dual diagnosis in psychiatric inpatients admitted consecutively to a Psychiatric Hospitalization Unit (Hospital Universitario 12 de Octubre, Madrid, Spain) in one year, to compare clinical and sociodemographic variables between the dual diagnosis group (DD group) and the group with a psychiatric disorder but no SUD (PD group), and to study the types of substances used. This is a retrospective study, based on the review of the clinical charts of the 257 patients admitted to this PHUGH in one year. The results showed that, excluding nicotine dependence, 24.9% of our inpatients had a SUD as well as another psychiatric disorder. A statistically significant predominance of men was found in the DD group, as well as a younger age at the time of the study, at the beginning of their psychiatric attention and on their first psychiatric admission, and they had received diagnoses of schizophrenia or related psychoses more often than the PD group, who had mostly affective disorders. The substances most frequently used in the DD group were alcohol (78.1%), cannabis (62.5%), and cocaine (51.6%). Due to the high prevalence and repercussions of dual diagnosis, it would be advisable to have specialized therapeutic programs for its treatment.

Clinical presentation and treatment of septic arthritis in children.

PubMed

Moro-Lago, I; Talavera, G; Moraleda, L; González-Morán, G

The aim of this study is to determine the epidemiological features, clinical presentation, and treatment of children with septic arthritis. A retrospective review was conducted on a total of 141 children with septic arthritis treated in Hospital Universitario La Paz (Madrid) between the years 2000 to 2013. The patient data collected included, the joint affected, the clinical presentation, the laboratory results, the appearance, Gram stain result, and the joint fluid culture, as well as the imaging tests and the treatment. Most (94%) of the patients were less than 2 years-old. The most common location was the knee (52%), followed by the hip (21%). The septic arthritis was confirmed in 53%. No type of fever was initially observed in 49% of them, and 18% had an ESR (mm/h) or CRP (mg/l) less than 30 in the initial laboratory analysis. The joint fluid was purulent in 45% and turbid in 12%. The Gram stain showed bacteria in 4%. The fluid culture was positive in 17%. Staphylococcus aureus was the most common pathogen found, followed by Streptococcus agalactiae, Streptococcus pneumoniae, and Kingella kingae. Antibiotic treatment was intravenous administration for 7 days, followed by 21 days orally. Surgery was performed in 18% of cases. The diagnosis was only confirmed in 53% of the patients. Some of the confirmed septic arthritis did not present with the classical clinical/analytical signs, demonstrating that the traumatologist or paediatrician requires a high initial level of clinical suspicion of the disease. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

[Analysis of neurological assistance demand in immigrant population].

PubMed

Martínez, A Miralles; Tejedor, E Díez

2008-01-01

Immigration has been a growing phenomenon in recent years due to the aging of the population and demographic pressure of immigration in Spain. This study has aimed to know the community out-patient neurological care pressure of the immigrant population and the differences between them and the Spanish population. A descriptive, prospective and observational study of neurological out-patient care in the community of the population covered by the Hospital Universitario La Paz over 12 consecutive months was performed. We analyzed three community out-patient clinics of neurology. The variables analyzed were: demographic (age, gender, nationality, stay time in Spain), care variables (visit type, source of consultation, existence of previous diagnosis and attendance at neurological citation) and diagnostic variables (diagnostic group defined in the ICD-9 M). Of the 4,771 visits analyzed, 8.26% (393) were immigrants. They accounted for a younger population 37.4 +/- 15.2 years, with a larger percentage of women (70.7%; p<0.001). The countries with the greater number of immigrants attended were Ecuador (21.9%) and Colombia (9.9%). Referral to the emergency department was greater for the immigrant patients (p=0.042). Failure to come to the appointment was greater among the immigrant patients (p=0 0.001). Diagnosis of headache and epilepsy were significantly more prevalent in the immigrant population, but syncope, poorly-defined signs and symptoms of those being studied and absence of neurological disorders were more frequent in the Spanish group. Neurological assistance demand of the immigrant population is that expected according to their demographic weight. The most frequent diagnostic groups among the immigrants are headache and epilepsy.

Influence of meteorological conditions on hospital admission in patients with acute coronary syndrome with and without ST-segment elevation: Results of the AIRACOS study.

PubMed

Dominguez-Rodriguez, A; Juarez-Prera, R A; Rodríguez, S; Abreu-Gonzalez, P; Avanzas, P

2016-05-01

Evaluate whether the meterological parameters affecting revenues in patients with ST-segment and non-ST-segment elevation ACS. A prospective cohort study was carried out. Coronary Care Unit of Hospital Universitario de Canarias We studies a total of 307 consecutive patients with a diagnosis of ST-segment and non-ST-segment elevation ACS. We analyze the average concentrations of particulate smaller than 10 and 2.5μm diameter, particulate black carbon, the concentrations of gaseous pollutants and meteorological parameters (wind speed, temperature, relative humidity and atmospheric pressure) that were exposed patients from one day up to 7 days prior to admission. None. Demographic, clinical, atmospheric particles, concentrations of gaseous pollutants and meterological parameters. A total of 138 (45%) patients were classified as ST-segment and 169 (55%) as non-ST-segment elevation ACS. No statistically significant differences in exposure to atmospheric particles in both groups. Regarding meteorological data, we did not find statistically significant differences, except for higher atmospheric pressure in ST-segment elevation ACS (999.6±2.6 vs. 998.8±2.5 mbar, P=.008). Multivariate analysis showed that atmospheric pressure was significant predictor of ST-segment elevation ACS presentation (OR: 1.14, 95% CI: 1.04-1.24, P=.004). In the patients who suffer ACS, the presence of higher number of atmospheric pressure during the week before the event increase the risk that the ST-segment elevation ACS. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Prolonged fasting with fluid therapy is related to poorer outcomes in medical patients.

PubMed

Kyriakos, Georgios; Calleja-Fernández, Alicia; Ávila-Turcios, Dalia; Cano-Rodríguez, Isidoro; Ballesteros Pomar, María D; Vidal-Casariego, Alfonso

2013-01-01

An inadequate fluid therapy can worsen the outcomes of surgical patients, but there are no data in medical patients. The aim of this study was to determine the adequacy of fluid therapy in hospitalised patients of medical wards, and its influence on outcomes. Cross-sectional study including nil-per-os patients admitted in medical wards of the Complejo Asistencial Universitario de León. The administered fluid therapy was compared with the standardised requirements. Nutritional status was evaluated with Subjective Global Assessment. Fasting was considered inappropriate if it lasted > 7 days in well-nourished, and >5 days in malnourished patients if nutritional support had not been provided. Fluid therapy lasted 4 (IQR = 2) days, and fasting was inadequately maintained in 27% of patients. Fluid requirements were correctly fulfilled, but patients received an excess of sodium (+58.4%) and chloride (+62.2%), and potassium administration was insufficient (-35.1%). Glucose supply was 68.8 (29.2) g/d, and 99% received < 130 g/d. Patients with an inadequate duration of fasting had a longer hospital stay after adjusting for sex, age, nutritional status, infused volume, electrolytes, glucose and diseases. Only malnutrition predicted mortality during hospitalisation (OR 10.5; 95%CI 1.3 to 83.2), when multivariate analysis was performed. Fasting medical patients receive an inadequate supply of glucose and electrolytes. Prolonged fluid therapy and malnutrition may worsen the outcomes of these patients, independently of other conditions like age or diseases. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

[Prediction instrument for obesity in adolescents at the Policlínico Universitario "Manuel González Díaz", 2013-2014].

PubMed

Piña Borrego, Carlos Enrique; Fernández Fernández, María de Lourdes; Fonte Rodríguez, Norge; Piña Rodríguez, Lorena Karla

Obesity is one of the principal non declarable diseases affecting children and adolescents. With the objective of developing a predictive instrument to identify high-risk adolescents with obesity, a cohort prospective study was carried out at the Policlinic "Manuel González Díaz", Bahía Honda City from 2013-2014. It was developed in three stages. In the first stage, 1800 adolescents from 10-19 years of age were included. The prevalence was identified and the most relevant characteristics of obesity were described (defined as body mass index >97 th percentile according to age and sex). In the second stage we identified the possibility of the diagnosis of factors that increase the probability of obesity. The third stage elaborated and validated an obesity predictor instrument from the results of the initial stages. To apply the instrument to sample A for internal elaboration and validation, sensitivity was 77.78% and specificity was 86.11%. Area under the curve (AUC) receiver operating characteristic (ROC) was 0.86, whereas for sample B the sensitivity was 79.63% and specificity was 92.13%. Positive predictive value (PPV) was 83.5% and negative predictive value (NPV) was 90.05%. The instrument allows predicting the risk for developing obesity in adolescents with acceptable sensitivity and high specificity. Its routine application will be interesting in pediatric health consultations. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

ALFABETIZACION EN SALUD EN PACIENTES QUE ASISTEN A UN HOSPITAL UNIVERSITARIO

PubMed Central

KONFINO, JONATAN; MEJIA, RAUL; MAJDALANI, MARIA PIA; PEREZ-STABLE, ELISEO J.

2014-01-01

Health literacy in patients attending a University Hospital. Low level of health literacy is associated with poor communication between patients and clinicians and with increased hospitalization rates, less frequent screening for cancer, poor control of diabetes, and disproportionately high rates of disease and mortality. Despite the importance of health literacy in medicine, there is no information about its prevalence in Latin America. The aim of this study was to assess the prevalence of inadequate health literacy in a random sample of patients, at a University Hospital where a descriptive study was performed during 2007. Health literacy was assessed through the Short Assessment of Health Literacy for Spanish-speaking Adults. Participants were randomly selected from the ambulatory clinic and from the medical inpatient ward during 2007.There were a total of 2345 patients potentially eligible during the time of the study, 234 were approached after random selection and 229 patients were interviewed (98% response); 54.6% of respondents were women and 62% were recruited from the ambulatory clinic. The respondents had a median age of 56 years. The prevalence of inadequate health literacy was 30.1% (69 patients). Patients with ≤ 7 years of formal education had more risk of having inadequate health literacy compared with those with > 12 years of education OR = 45.1 (IC 9.6-211.6). We found a high prevalence of inadequate health literacy, being strongly associated with the level of formal education. It is important that health care providers know the implications of health literacy and its consequences. PMID:20053602

[Opinion of healthcare professionals on patient safety in a primary level hospital].

PubMed

Skodová, M; Velasco Rodríguez, M J; Fernández Sierra, M A

2011-01-01

To identify the patient safety (PS) culture perceived by health professionals of the Hospital Universitario Virgen de las Nieves (HUVN) in Granada. A descriptive cross-sectional study of professionals working in HUVN using the Spanish version of the questionnaire Hospital Survey On Patient Safety Culture (AHRQ), in July-August 2008. The sample size was estimated as 476 surveys (included 60% losses). The response rate was 62.8% (299 questionnaires). In the previous 12 months, 90.2% of professionals had not notified any adverse event (AE). The average perception of PS was 6.57 ± 1.82 (scale 0-10). Teamwork in the unit for PS was the best rated dimension (66.9%). There was a positive correlation (c. Pearson) between the perception of PS and the years that professionals had worked in specialisation (0.21), hospital (0.197) and unit (0.138), respectively (all, p < 0.05). According to category, the physicians have reported an AE with a likelihood 32.26 times greater than the assistants and technicians (p < 0.05). The PS perception dimension was viewed favourably by 34.1%. The management support (3.7%) and staffing (9%) were the main areas for improvement. The perception of PS at HUVN is good, even if the communication of errors is poor. The main area for improvement is a non-punitive communication of errors. It is advisable to promote a campaign to raise public awareness of the problem, to perform training programs for professionals and to implement systems for recording adverse events. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

[Use of alternative medicine in the treatment of allergic diseases].

PubMed

Félix Berumen, José Alfredo; González Díaz, Sandra Nora; Canseco González, Carlos; Arias Cruz, Alfredo

2004-01-01

The alternative medicine and the complementary medicine are forms of treatment very spread and frequently demanded by patients with allergic diseases. According to recent studies, homeopathy, acupuncture and herbal medicine are the most commonly used types of alternative medicine. To know the frequency in the use of different types of alternative medicine for the treatment of allergic diseases in patients attended at the Centro Regional de Alergia e Immunologia Clínica of the Hospital Universitario de Monterrey, Nuevo León. A transversal, descriptive and observational study was done by the use of questionnaires applied to patients and/or patients' relatives attended in this Center. This survey included questions to focus the investigation in the use of a Iternative medicine for the treatment of any allergic disease. The data analysis was done by descriptive statistics. Four hundred one questionnaires were applied. The average age of the patients was of 14 years (range from 1 to 73 years). Fourty-seven percent (189 patients) were female and 58.2% (212 patients) were male. The diagnoses included: allergic rhinitis in 215 patients (53.6), asthma in 97 (24.2%), rhinitis and asthma in 73 (18.2) and atopic dermatitis in 16 (4%). Out of the patients 34.4% (138) had used at least one type of alternative medicine for the treatment of their allergic disease. Homeopathy was the most commonly used type of alternative medicine (78.2%), followed by the natural medicine (31.5%). Alternative medicine for the treatment of allergic diseases is frequent in patients who attend to this center. Homeopathy and the natural medicine are the most used.

[Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients].

PubMed

Jaramillo, Adriana; Arce, Roger; Contreras, Adolfo; Herrera, Julián A

2012-06-01

Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student's t tests were used, with a significance level of p≤0.05. Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.

Fluid overload and kidney failure in children with severe sepsis and septic shock: A cohort study.

PubMed

Naveda Romero, Omar E; Naveda Meléndez, Andrea F

2017-04-01

In children with sepsis, fluid overload as a result of an aggressive fluid replacement or excessive fluid administration may result in kidney impairment and increased mortality. Objective. To determine the association between fluid overload and the rate of kidney failure in a group of children with severe sepsis and septic shock. This was a prospective cohort study conducted in the intensive care unit of Hospital Universitario de Pediatría “Dr. Agustín Zubillaga” (Barquisimeto, Lara State, Venezuela), between March 2013 and May 2016, in children with severe sepsis or septic shock. One hundred and forty-nine patients were included in the analysis. Sepsis predominated in 59.7% of cases; patients' average age was 6.4 ± 3.3 years old, their average weight was 17.8 ± 3.6 kg, 30.2% had fluid overload, and overall mortality was 25.5%. Kidney failure occurred in 16.1% of cases. A binary logistic regression model was used to identify fluid overload (odds ratio [OR]: 1.5; 95% confidence interval [CI]: 1.2-4.9, p = 0.028) and shock for more than 2 days (OR: 1.7; 95% CI: 1.3-6.3, p = 0.039) as independent predictors of kidney failure. In addition, a significant increase in the risk of mortality among children with kidney failure and fluid overload was observed as per the Kaplan-Meier method (p= 0.019). Fluid overload and shock for more than 2 days increase the risk for kidney failure in critically ill children with severe sepsis and septic shock.

[New methodological advances: algorithm proposal for management of Clostridium difficile infection].

PubMed

González-Abad, María José; Alonso-Sanz, Mercedes

2015-06-01

Clostridium difficile infection (CDI) is considered the most common cause of health care-associated diarrhea and also is an etiologic agent of community diarrhea. The aim of this study was to assess the potential benefit of a test that detects glutamate dehydrogenase (GDH) antigen and C. difficile toxin A/B, simultaneously, followed by detection of C. difficile toxin B (tcdB) gene by PCR as confirmatory assay on discrepant samples, and to propose an algorithm more efficient. From June 2012 to January 2013 at Hospital Infantil Universitario Niño Jesús, Madrid, the stool samples were studied for the simultaneous detection of GDH and toxin A/B, and also for detection of toxin A/B alone. When results between GDH and toxin A/B were discordant, a single sample for patient was selected for detection of C. difficile toxin B (tcdB) gene. A total of 116 samples (52 patients) were tested. Four were positive and 75 negative for toxigenic C. difficile (Toxin A/B, alone or combined with GDH). C. difficile was detected in the remaining 37 samples but not toxin A/B, regardless of the method used, except one. Twenty of the 37 specimens were further tested for C. difficile toxin B (tcdB) gene and 7 were positive. The simultaneous detection of GDH and toxin A/B combined with PCR recovered undiagnosed cases of CDI. In accordance with our data, we propose a two-step algorithm: detection of GDH and PCR (in samples GDH positive). This algorithm could provide a superior cost-benefit ratio in our population.

IBD-related work disability in the community: Prevalence, severity and predictive factors. A cross-sectional study

PubMed Central

Ramos, Alexis; Sicilia, Beatriz; Vergara, Mercedes; Figuerola, Ariadna; Motos, Jaume; Sastre, Adoración; Villoria, Albert; Gomollón, Fernando

2015-01-01

Background and aims Data on the prevalence of work disability in patients with inflammatory bowel disease (IBD) are heterogeneous. As most studies have been performed in selected, often severe, IBD patients, the true prevalence of disability in the community remains controversial. The aim of this cross-sectional study was to evaluate the prevalence and severity of disability and its predictive factors in a community-based IBD population. Patients and methods Patients recorded in the community-based IBD register at the Hospital Universitario de Burgos were contacted. After informed consent they completed a set of questionnaires including demographic, clinical, disability and quality of life data. The statistical study was performed using SPSS 21. Results A total of 293 patients were included – 151 Crohn's disease (CD), 142 ulcerative colitis (UC), 137 female, mean age: 45 ± 11 years, mean time since diagnosis: 10.6 ± 11 years. Twelve patients (4.1%) had a work-disability pension. In addition, 93 (32%) of all patients had an officially recognized disability degree, which was generally moderate (n = 73, 25%) or severe (N = 16, 5%). Age, time since IBD diagnosis, CD, perianal disease, incontinence, active disease, the need for anti-TNF or psychological treatment, previous surgeries and the number of diagnostic tests and medical visits in the previous year were predictors of disability. Major predictors of qualifying for a disability pension were age, IBD activity, incontinence, need for biological drugs and ostomy. Conclusion Mild to moderate work disability is frequent in IBD. However, only a minority of patients develop severe disability qualifying them for a pension. PMID:26279841

Subclinical Synovitis Measured by Ultrasound in Rheumatoid Arthritis Patients With Clinical Remission Induced by Synthetic and Biological Modifying Disease Drugs.

PubMed

Cruces, Marcos; Al Snih, Soham; Serra-Bonett, Natalí; Rivas, Juan C

2017-10-09

Rheumatoid arthritis (RA) patients with disease in clinical remission might show subclinical synovitis, which can be related to the progress of structural joint damage. To determine and compare the degree of synovial inflammation by ultrasound (US) in patients with RA in clinical remission, treated with DMARD or combination therapy with DMARD and anti-TNF. Hospital-based cross-sectional study of 58 patients with RA in sustained remission for at least 6 months by DAS28 <2.6, who attended the Rheumatology Service at the Hospital Universitario de Caracas. Patients underwent clinical, functional, and laboratory assessments. Ultrasound was performed in hands measuring synovial effusion, synovial hypertrophy and power Doppler signal; using a semiquantitative 4-point scale of 0=none to 3=severe. Chi-square and t-test were used to compare the clinical, functional, laboratory and US assessments between the DMARD (N=37) and combination therapy with DMARD and anti-TNF (N=21) groups. A p-value <0.05 was considered statistically significant. Out of 58 patients, 25.9% had remission by US and 74.1% had synovial effusion or hypertrophy or positive power Doppler signal. Non-significant differences in US synovitis between the two groups were found. Persistent US activity was evident in a high percentage of rheumatoid arthritis patients in clinical remission by DAS28. No differences in subclinical synovitis measured by US were found between patients with DMARD and anti-TNF-induced clinical remission. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Conceptuaciones de los estudiantes de las facultades de educacion y ciencias naturales de la Universidad de Puerto Rico, recinto de Rio Piedras, acerca de la ciencia y la pseudociencia

NASA Astrophysics Data System (ADS)

Reyes Medina, Hector A.

Esta investigacion describe las conceptuaciones de los estudiantes de tercer ano o mas a nivel de bachillerato de los programas de Educacion en Ciencia y Ciencias Naturales de la Universidad de Puerto Rico, Recinto de Rio Piedras, acerca de lo establecido en la literatura para distinguir el conocimiento cientifico de las creencias pseudocientificas. Este estudio se guio por un diseno tipo encuesta transversal que permitio conocer de manera consistente las conceptuaciones de los estudiantes encuestados acerca de la Ciencia y la Pseudociencia. Ademas, permitio desarrollar inferencias estadisticas relacionadas a la poblacion de estudio, sus conceptuaciones y su inclinacion teorica en torno al Realismo y al Racionalismo cientifico moderados. El instrumento utilizado fue el Cuestionario acerca de las concepciones de la ciencia y la pseudocienca en estudiantes universitarios, Reyes (2015). Este cuestionario fue validado mediante la recopilacion de diversas fuentes de evidencias, entre estas se encuentran las evidencias basadas en el contenido, el proceso de respuesta, la estructura interna y de constructo. Tambien, se calculo el Alfa de Crombach para la escala total y para cada componente y se realizo un analisis de factores que demostro la presencia de seis componentes claramente definidos de acuerdo a lo esperado sobre las caracteristicas originales del instrumento. Las estadisticas utilizadas fueron descriptivas. Participaron 302 alumnos, de las facultades de educacion y ciencias naturales. Se encontro que las conceptuaciones de los estudiantes de ambas facultades se inclinan en un 66.2% a favor con lo establecido en el modelo teorico en torno al Realismo y al Racionalismo cientifico moderados. Sin embargo, aun hay un 33.8% de los estudiantes de ambas facultades que poseen conceptuaciones distintas al modelo teorico propuesto.

Has the aetiology of ischaemic stroke changed in the past decades? Analysis and comparison of data from current and historical stroke databases.

PubMed

Sánchez-Larsen, Á; García-García, J; Ayo-Martín, O; Hernández-Fernández, F; Díaz-Maroto, I; Fernández-Díaz, E; Monteagudo, M; Segura, T

2016-09-16

We aimed to determine whether the aetiology of ischaemic stroke has changed in recent years and, if so, to ascertain the possible reasons for these changes. We analysed the epidemiological history and vascular risk factors of all patients diagnosed with ischaemic stroke at Complejo Hospitalario Universitario de Albacete (CHUA) from 2009 to 2014. Ischaemic stroke subtypes were established using the TOAST criteria. Our results were compared to data from the classic Stroke Data Bank (SDB); in addition, both series were compared to those of other hospital databases covering the period between the two. We analysed 1664 patients (58% were men) with a mean age of 74 years. Stroke aetiology in both series (CHUA, SDB) was as follows: atherosclerosis (12%, 9%), small-vessel occlusion (13%, 25%), cardioembolism (32%, 19%), stroke of other determined aetiology (3%, 4%), and stroke of undetermined aetiology (40%, 44%). Sixty-three percent of the patients from the CHUA and 42% of the patients from the SDB were older than 70 years. Cardioembolic strokes were more prevalent in patients older than 70 years in both series. Untreated hypertension was more frequent in the SDB (SDB = 31% vs CHUA = 10%). The analysis of other databases shows that the prevalence of cardioembolic stroke is increasing worldwide. Our data show that the prevalence of lacunar strokes is decreasing worldwide whereas cardioembolic strokes are increasingly more frequent in both our hospital and other series compared to the SDB. These differences may be explained by population ageing and the improvements in management of hypertension and detection of cardioembolic arrhythmias in stroke units. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Genotype distribution of human papillomavirus (HPV) in histological sections of cervical intraepithelial neoplasia and invasive cervical carcinoma in Madrid, Spain

PubMed Central

2012-01-01

Background Human Papillomavirus (HPV) genotype distribution and co-infection occurrence was studied in cervical specimens from the city of Madrid (Spain), as a contribution to the knowledge of Human Papillomavirus genotype distribution and prevalence of carcinogenic HPV types in cervical lesions in Spain. Methods A total of 533 abnormal specimens, from the Hospital General Universitario “Gregorio Marañón” of Madrid, were studied. These included 19 benign lesions, 349 cervical intraepithelial neoplasias 1 (CIN1), 158 CIN2-3 and 7 invasive cervical carcinomas (ICC). HPV genotyping was performed using PCR and tube array hybridization. Results We detected 20 different HPV types: 13 carcinogenic high-risk HPV types (HR-HPVs), 2 probably carcinogenic high-risk HPV types (PHR-HPVs) and 5 carcinogenic low-risk HPV types (LR-HPVs). The most frequent HPV genotypes found in all specimens were HPV16 (26.0%), 31 (10.7%) and 58 (8.0%). HPV 18 was only detected in 5.0%. Co-infections were found in 30.7% of CIN 1 and 18.4% cases of CIN2-3. The highest percentage of HR HPVs was found in those specimens with a CIN2-3 lesion (93.7%). Conclusion As our study shows the current tetravalent vaccine could be effective in our geographical area for preventing all the invasive cervical carcinomas. In addition, upon the estimates of the important presence of other HR-HPV types – such as 31, 58, 33 and 52 – in different preneoplasic lesions the effectiveness of HPV vaccination in our geographical area, and others with similar genotype distribution, should be limited. PMID:23167826

Detection of Helicobacter pylori DNA in the oral cavity and gastroduodenal system of a Venezuelan population.

PubMed

Berroteran, Alejandra; Perrone, Marianella; Correnti, María; Cavazza, Maria E; Tombazzi, Claudio; Goncalvez, Rosa; Lecuna, Vicente

2002-09-01

Dental plaque has been suggested as a reservoir for Helicobacter pylori but the hypothesis that the oral microflora may be a permanent reservoir of H. pylori is still controversial. The aims of this study were to determine the presence of H. pylori DNA in the gastric antrum and dental plaque of a Venezuelan population by PCR and to investigate the relationship between this infection and the oral hygiene index. Thirty-two patients from the Hospital Universitario de Caracas, attending for routine gastroscopy, and 20 asymptomatic subjects (control group) were evaluated. The patients' gingiva and plaque were assessed by the gingival and plaque indices of Sillness and Löe. Supragingival plaque was analysed by a PCR for a specific internal urease gene. Gastric antrum biopsies were taken for histological examination and PCR. H. pylori was detected in antral samples from 24 (75%) of 32 patients, all of whom had chronic gastritis. H. pylori was also detected in dental plaque samples of 12 (37.5%) of the 32 patients. In 7 (58%) of these 12 patients, H. pylori was identified in the gastric biopsy. Seven patients with chronic gastritis carried H. pylori in dental plaque and antral samples. Of these patients, four also had dysplasia and one had metaplasia. Three subjects in the control group were positive by PCR. In the present study there was no correlation between H. pylori infection and dental hygiene, dental caries, periodontal disease or use of dentures. The oral cavity may be a reservoir for H. pylori infection and oral secretions may be an important means of transmission of this micro-organism. H. pylori in dental plaque may represent a risk factor for gastrointestinal re-infection and ulcer relapse after antibiotic therapy.

[Has the use of antipyretics been modified after the introduction of different concentrations of ibuprofen into the market?].

PubMed

García Blanes, C P; Rodríguez-Cantón Pascual, P; Morales-Carpi, C; Morales-Olivas, F J

2014-12-01

Due to the emergence of new pharmaceutical presentations of ibuprofen (40 mg/ml), an analysis was made on the use of antipyretics in pediatric outpatient in Spain. A cross-sectional, observational, descriptive study was carried out on a sample of children under 14 years old with treated febrile syndrome, seen in the Emergency Room of the Hospital General Universitario de Valencia from November 2012 to January 2013. Of the 217 children included, 144 were treated with paracetamol or ibuprofen, 69 received both drugs, and one received paracetamol and metamizol. There were 58.7% of exposures to paracetamol and 40.9% to ibuprofen. The parents decided the use of antipyretics in 63.2% of cases. In 98 exposures the dose was different from that authorized in the labeling of the drug (off-label use). Ibuprofen was used off-label in 40.2% of cases, mostly by underdosing (35.9%). Paracetamol was used off-label in 29.8% of cases, predominantly overdose (26.8%), with the difference being statistically significant. No significant differences were observed in the off-label use in either monotherapy or combined use. There were also no differences when antipyretics prescribed by doctors or given directly by parents were evaluated separately. The majority of children with treated febrile syndrome seen in the Emergency Room were receiving antipyretic drugs after a parental decision. Paracetamol is the most commonly used drug and one in three children received it simultaneously with ibuprofen. The antipyretics were used off label in one-third of the cases. Off label use of ibuprofen is increasing, and is probably due to the existence of different pharmaceutical presentations. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Numerical and clinical precision of continuous glucose monitoring in Colombian patients treated with insulin infusion pump with automated suspension in hypoglycemia.

PubMed

Gómez, Ana M; Marín Sánchez, Alejandro; Muñoz, Oscar M; Colón Peña, Christian Alejandro

2015-12-01

Insulin pump therapy associated with continuous glucose monitoring has shown a positive clinical impact on diabetes control and reduction of hypoglycemia episodes. There are descriptions of the performance of this device in other populations, but its precision and accuracy in Colombia and Latin America are unknown, especially in the routine outpatient setting. Data from 33 type 1 and type 2 diabetes patients with sensor-augmented pump therapy with threshold suspend automation, MiniMed Paradigm® Veo™ (Medtronic, Northridge, California), managed at Hospital Universitario San Ignacio (Bogotá, Colombia) and receiving outpatient treatment, were analyzed. Simultaneous data from continuous glucose monitoring and capillary blood glucose were compared, and their precision and accuracy were calculating with different methods, including Clarke error grid. Analyses included 2,262 continuous glucose monitoring -reference paired glucose values. A mean absolute relative difference of 20.1% was found for all measurements, with a value higher than 23% for glucose levels ≤75mg/dL. Global compliance with the ISO criteria was 64.9%. It was higher for values >75mg/dl (68.3%, 1,308 of 1,916 readings), than for those ≤ 75mg/dl (49.4%, 171 of 346 readings). Clinical accuracy, as assessed by the Clarke error grid, showed that 91.77% of data were within the A and B zones (75.6% in hypoglycemia). A good numerical accuracy was found for continuous glucose monitoring in normo and hyperglycemia situations, with low precision in hypoglycemia. The clinical accuracy of the device was adequate, with no significant safety concerns for patients. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Has clinical activity in paediatric neurology changed in the past 11 years?

PubMed

Martínez Menéndez, B; Escolar Escamilla, E; Pinel González, A; Cerezo García, M; Martínez Sarries, F J; Morlán Gracia, L

We believe that the demand for paediatric neurology (PN) care has increased over the past decade, and that reasons for requesting consultations have also changed. The objective of this study is to complete a registry study to profile the demand for PN care in 2013 and compare results to those from a study performed in 2002. A prospective registry of PN healthcare activities was completed at Hospital Universitario de Getafe in 2013. Results were compared with those from a prospective registry study conducted in 2002. The number of visits increased from 1,300 in 2002 to 1,982 in 2013 (a 52.46% increase), and from 32.6 visits per 1,000 children to 57.48 (a 76.32% increase). Outpatient consultations accounted for 92.2% of all PN consultations in 2013. Currently, attention deficit-hyperactivity disorder (ADHD) is the most frequent diagnosis (27.6% in 2013 vs. 8.1% in 2002). Although the percentage of headache consultations has decreased (19% in 2013 vs. 22% in 2002), headache was still the most common reason for an initial visit in 2013 (32.1%), followed by ADHD (19.1%). Epilepsy remains the most frequent diagnosis in hospitalised patients (30.3% in 2013 vs. 36.7% in 2002). PN is fundamentally an outpatient activity that has increased considerably in recent years. This increase is mainly due to neurodevelopmental disorders, especially ADHD. We might state that the role of ADHD in PN is comparable to that of dementia in general neurology. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

[Fear and preoperative anxiety behaviour and pain intensity perceived after knee arthroscopy].

PubMed

Anguita-Palacios, M Carmen; Talayero-San-Miguel, Marta; Herrero-Cereceda, Salomé; Martín-Cadenas, Mar; Pardo-Cuevas, Pilar; Gil-Martínez, Alfonso

2016-01-01

The aim of this study was to investigate the short-term (24hours) association between postoperative pain and preoperative psychological variables (anxiety, pain catastrophizing and kinesiophobia) in a sample of knee arthroscopy ambulatory surgery. Observational cross-sectional study, conducted with 40 adult subjects who underwent knee arthroscopy in the surgical area of Cantoblanco Hospital (Hospital Universitario La Paz) in Madrid. The fear-avoidance beliefs and anxiety were assessed using validated questionnaires of pain catastrophizing, kinesiophobia and anxiety. Pre and post-surgical pain and perceived disability were evaluated by the Verbal Numeric Scale. Mean age of the sample (22 men and 18 women) was 52.85±14.21 without significant differences between gender. No statistically significant data for the association between variables of kinesiofobia, anxiety and pain catastrophizing and the intensity of perceived pain by the postoperative knee arthroscopy patient were found. Length of surgery in our study has a correlation with the immediate post-surgical pain (r=0.468; P=.002) and there is a relationship between age and pain intensity at 24hours (r=-0.329; P=.038), and between age and perceived disability (r=-0.314; P=.049). An association between catastrophizing and kinesiophobia scales (r=0.337; P=.033) is obtained likewise. In conclusion, preoperative fear-avoidance beliefs like pain anxiety or pain catastrophizing and kinesiophobia were not associated with acute postoperative pain in our study. Analyses of secondary pain related outcomes, however, indicated that reduced time of surgery may contribute to enhance clinical postoperative pain. If confirmed and replicated in larger samples, this may potentially enable clinicians to improve postoperative pain management in future patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Incidence of Anal Dysplasia in a Population of High-Risk Women: Observations at a Cervical Pathology Unit.

PubMed

Oliver-Pérez, María de Los Reyes; Bravo Violeta, Victoria; Legorburu Alonso, Beatriz; Betancor Pérez, Diana; Bebia Conesa, Vicente; Jiménez López, Jesús S

2017-10-01

This study aimed to evaluate the incidence of anal dysplasia in women at high risk of developing those lesions and to assess the relationships between positive anal cytology and different risk factors. We performed an observational cross-sectional study involving a patient survey and chart review. The study was conducted at the cervical pathology unit at the Hospital Universitario 12 de Octubre, Madrid, Spain, from 2011 to 2015. Patients were 215 women aged 18 to 65 years old with risk factors for anal dysplasia, for whom anal evaluation was indicated. Anal cytology was performed in all patients. High-resolution anoscopy and anal biopsy were used to investigate abnormalities. All patients completed a survey regarding sexual practices. The patients' demographic and clinical data were collected by using a retrospective chart review. The main outcome measure was the incidence of anal dysplasia in this population. Of the 215 patients, 45 (21.0%) presented with cytological abnormalities (atypical squamous cells of undetermined significance, 13.5%; low-grade squamous intraepithelial lesion, 5.6%; high-grade squamous intraepithelial lesion, 1.9%). Anoscopy was performed in 31 patients (14.4%) and 2 patients (0.9%) had abnormal findings. One case (0.5%) of low-grade anal intraepithelial neoplasia was identified. Only immunosuppression (p = .01) and smoking status (p = .02) were significantly correlated with positive anal cytology results. Limitations of the study include the small single-center sample, a lack of controls, the retrospective design, potential survey response biases, and the nonstandardized survey. The incidence of abnormal cytological findings was 21.0%, whereas low-grade anal intraepithelial was confirmed in 0.5% of the patients. There is a higher incidence of cytological abnormalities among immunosuppressed women and smokers.

Analysis and evaluation of the effectiveness of epidural analgesia and its relationship with eutocic or dystocic delivery.

PubMed

Sánchez-Migallón, V; Sánchez, E; Raynard, M; Miranda, A; Borràs, R M

Numerous studies have demonstrated the difference in the verbal rating scale with regard to obstructed labour and induced labour, so that obstructed labour and foetal macrosomia have been related to a greater sensation of pain during labour, particularly in the first stage. Even the epidural analgesia is linked to the need for instrumented or caesarean section due to foetal obstruction. The goal of the study is to analyze and evaluate the effectiveness of epidural analgesia in normal versus obstructed labour. One hundred and eighty pregnant women were included in an observational, analytical, longitudinal and prospective study, that was performed in the Obstetrics Department of the Hospital Universitario Dexeus. All the nulliparous or multiparous over 36 weeks of pregnancy, after 3cm of cervical dilatation in spontaneous or induced labor were included. All the patients were given epidural analgesia according to protocol. The basic descriptive methods were used for the univariate statistical analysis of the sample and the Mann-Whitney U test was used for the comparison of means between both groups. The correlations between variables were studied by means of the Spearman coefficient of correlation. The differences regarded as statistically significant are those whose P<.05. In our population there were no statistically significant differences in the effectiveness of epidural analgesia in normal versus obstructed labour. Patients who got epidural analgesia and had obstructed labors have the same degree of verbal rating scale as patients that do not had obstructed labors (P>.05). Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Cost-effectiveness of omalizumab in severe persistent asthma in Spain: a real-life perspective.

PubMed

Levy, Alberto Nahon; García A Ruiz, Antonio J; García-Agua Soler, Nuria; Sanjuan, María Victoria Hidalgo

2015-03-01

To determine the cost-effectiveness of omalizumab compared with routine clinical practice in the treatment and control of severe persistent asthma. Cost-effectiveness analysis using pre- and post-treatment with omalizumab after 10 months of 47 patients diagnosed with uncontrolled severe persistent asthma attended by the Pneumology Service, Hospital Universitario Virgen de la Victoria, Malaga. Effectiveness was assessed by the number of emergency room (ER) visits for exacerbations and quality-adjusted life years (QALY) gained. The costs of treatment with omalizumab and ER visits were analyzed using the National Health System perspective. Results are expressed in cost per QALY gained and cost per ER visit avoided (costs €2012). Exacerbations with ER visits decreased significantly (p < 0.001) after 10 months of omalizumab treatment compared with the previous 10 months [7.94 (6.52-9.37) vs 0.19 (0.03-0.35)]. Health utilities increased significantly (p < 0.001) during the same period [0.5967 (0.5722-0.6212) vs 0.7566 (0.7232-0.7900)], representing 0.1333 (0.1053-0.1612) QALYs gained (p < 0.001).The mean cost per patient was €1850.78 (1519.46-2182.10) in the 10 months before treatment and €5431.87 (4930.72-5933.02) after 10 months of omalizumab treatment. The incremental cost-effectiveness ratios (ICERs) were €462.08/exacerbation avoided (347.65-606.22) and €26 864.89/QALY gained (21 632.07-33 859.49). Our results confirm that adding omalizumab to the treatment of patients with uncontrolled severe persistent asthma reduces the number of exacerbations with ER visits and increases health-related quality of life after 10 months of treatment and produces ICERs favorable to omalizumab and acceptable from the health system perspective.

Translation and Validation of the Multidimensional Dyspnea-12 Questionnaire.

PubMed

Amado Diago, Carlos Antonio; Puente Maestu, Luis; Abascal Bolado, Beatriz; Agüero Calvo, Juan; Hernando Hernando, Mercedes; Puente Bats, Irene; Agüero Balbín, Ramón

2018-02-01

Dyspnea is a multidimensional symptom, but this multidimensionality is not considered in most dyspnea questionnaires. The Dyspnea-12 takes a multidimensional approach to the assessment of dyspnea, specifically the sensory and the affective response. The objective of this study was to translate into Spanish and validate the Dyspnea-12 questionnaire. The original English version of the Dyspnea-12 questionnaire was translated into Spanish and backtranslated to analyze its equivalence. Comprehension of the text was verified by analyzing the responses of 10 patients. Reliability and validation of the questionnaire were studied in an independent group of COPD patients attending the pulmonology clinics of Hospital Universitario Marqués de Valdecilla, diagnosed and categorized according to GOLD guidelines. The mean age of the group (n=51) was 65 years and mean FEV1 was 50%. All patients understood all questions of the translated version of Dyspnea-12. Internal consistency of the questionnaire was α=0.937 and intraclass correlation coefficient was=.969; P<.001. Statistically significant correlations were found with HADS (anxiety r=.608 and depression r=.615), mMRC dyspnea (r=.592), 6MWT (r=-0.445), FEV1 (r=-0.312), all dimensions of CRQ-SAS (dyspnea r=-0.626; fatigue r=-0.718; emotional function r=-0.663; mastery r=-0.740), CAT (r=0.669), and baseline dyspnea index (r=-0.615). Dyspnea-12 scores were 10.32 points higher in symptomatic GOLD groups (B and D) (P<.001). The Spanish version of Dyspnea-12 is a valid and reliable instrument to study the multidimensional nature of dyspnea. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Municipal distribution and trends in bladder cancer incidence in health area of León, Spain (1996-2010).

PubMed

del Canto, M; García-Martínez, L; Fernández-Villa, T; Molina, A J; Campanario, F; García-Sanz, M; López-Abente, G; Honrado, E; Martín-Sánchez, V

2015-01-01

Spain is a country where bladder cancer incidence and mortality rates are some of the highest in the world. The aim of this study is to know the incidence, trends and geographical distribution of bladder cancer in the health area of León. the new cases of bladder cancer (CIE-188) in patients residing in the health area of León and registered in the Hospital Tumor Registry of the Centro Asistencial Universitario in León (Spain) between 1996-2010 were included in this study. Triennial crude incidence and adjusted incidence rates to the worldwide and European population were calculated. Population data of the municipalities of Leon (Spain) were obtained from National Institute of Statistic of Spain (INE, Instituto Nacional de Estadística). Data were disaggregated by sex-groups and five-year age groups. Spatial distribution of smoothed municipal relative risks (RR) of bladder cancer was carried out using a Besag, York and Mollié model. Bayesian model were used to calculate the posterior probability (PP) of RR greater than one. 1.573 cases were included. Incidence rates standardized to European population increased among men from 20,8/100.000 (1996-98) to 33,1/100.000 (2006-2008) and among women these rates increased from 1,9/100.000 to 5,9/100.000 for the same period of time. No relevant differences were found in the municipal distribution of the incidences. bladder cancer incidence rates are high in the European context. Rising trends in incidence in both sexs, particularly in women are observed. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

[Sensory evaluation of enteral nutritional supplements].

PubMed

Granell Vidal, Lina; Sánchez Juan, Carlos; Alfonso García, Antonio

2014-07-01

Enteral nutrition (EN) is indicated in patients who, although they may not eat enough food, maintain a sufficient function to receive, digest and absorb nutrients digestive system. Oral Nutritional Supplements (SON) are nutritionally complete or incomplete formulas (depending on whether or not provide all the nutrients needed to serve as the sole source of nutrients), which supplement inadequate oral diet. This study aims to evaluate the organoleptic characteristics of hyperproteic, normoproteic and fiber-enriched oral SON. SON test, carried out at the Department of Endocrinology and Nutrition Consortium Hospital General Universitario de Valencia from October 2012 to February 2013. 137 SON were evaluated in total, of which 47 were hyperproteic, 46 normoproteic and 44 enriched in fiber. Of the SON evaluated in the group of hyperproteic the following 3 SON obtained the best scores: Fresenius Prot Energy Drink® (21,27, vanilla flavor), Avant Standard Nut® (20.3 , strawberry flavor) and Resource® Protein (20.01, chocolate flavor) In the group of normoproteic SON the 3 best rated were: Ensure Plus® (22.3, banana flavor), Ensure Plus® (21.9, peach flavor) and Fresubin Energy Drink® (21, strawberry flavor) In the group of fiber-enriched the 3 SON most appreciated were: 2 Kcal Fresubin Fibre Drink® (23.78, vanilla flavor), Ensure Plus® TwoCal (22.9, banana flavor) and Fortimel Compact® (21.5, strawberry flavor) The study aims to guide clinicians on what SON may be more acceptable to the patient, so that the SON serve their purpose and restore or improve nutritional status, as the SON intervention is safe and cost - effective, since they improve both the functionality and quality of life. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Effect of phosphate fertilization on the bioavailability of iron in calcareous soils

NASA Astrophysics Data System (ADS)

Sánchez-Rodríguez, A. R.; del Campillo, M. C.; Barrón, V.; Torrent, J.

2012-04-01

Iron (Fe) chlorosis is the most important nutritional problem in sensitive plant species cultivated in calcareous soils, its main symptoms being interveinal yellowing in the younger leaves due to lack of chlorophyll and reduced growth. Fe chlorosis has been related to the content of poorly crystalline Fe oxides in soil. The effect of other nutrients, especially phosphorus (P), is, however, a matter of debate. In this work we examined whether fertilization with P alters the availability of Fe to sensitive plants growing in two different Fe chlorosis-inducing calcareous soils. Phosphate at rates of 0 (control), 25, 50, 100 and 200 mg P kg-1 soil was applied to pots where six-months-old olive trees cv. Arbequina were grown. The experiment lasted three years and took place in a shaded house. Chlorophyll concentration in the young leaves was estimated with the SPAD value (using a Minolta apparatus) three-four times per year. Furthermore, shoot length, dry weight of annual pruning and mineral element concentration were measured at the end of each year. In one of the soils, SPAD and leaf Fe concentration decreased with increasing P dose. However in the other soil, SPAD was not correlated with the rate of applied P. In both soils, potassium and zinc concentrations in plants fertilized with P were lower than those in the control plants. This work was funded by the Spanish Ministry of Science and Innovation, Projects: AGL 2005-06691-C02-01 and AGL 2008-05053-C02-02, and the European Regional Development Funds. ARSR acknowledges the finnancial support from the Spanish Ministry of Education as a fellow of the program "Training of University Teachers" (Formación del Profesorado Universitario, AP2008-04716)

Relationship between target organ damage and blood pressure, retinal vessel calibre, oxidative stress and polymorphisms in VAV-2 and VAV-3 genes in patients with hypertension: a case-control study protocol (LOD-Hipertension).

PubMed

Gomez-Marcos, Manuel A; Gonzalez-Sarmiento, Rogelio; Recio-Rodríguez, José I; Agudo-Conde, Cristina; Gamella-Pozuelo, Luis; Perretta-Tejedor, Nuria; Martínez-Salgado, Carlos; García-Ortiz, Luis

2014-04-03

Target organ damage (TOD) is associated with increased cardiovascular risk. The study objectives were to analyse the relationship of TOD to blood pressure, size of retinal arteries and veins, oxidative stress and different polymorphisms in the VAV-2 and VAV-3 genes in participants with hypertension. A case-control study to analyse the relationship between clinical, biochemical and genetic parameters and presence of cardiac, vascular and renal TOD in 486 patients with hypertension. Participants with TOD will be considered as cases, and those without TOD will be enrolled as controls. This will be a collaborative study conducted by the groups of Primary Care, Cardiovascular and Metabolic and Degenerative Diseases of the Instituto de Investigación Biomédica of Salamanca (IBSAL). Assessment of cardiac, renal and vascular TOD. Measurement of peripheral and central blood pressure, size of eye fundus arteries and veins, and oxidative stress, and polymorphisms in the VAV-2 and VAV-3 genes. The study will be conducted after approval is obtained from the Ethics Committee of Hospital Clínico Universitario of Salamanca. All study participants will sign an informed consent to agree to participate in the study, and another consent to agree on the genetic study, in compliance with the Declaration of Helsinki and the WHO standards for observational studies. The results of this study will allow for an understanding of the relationship of the different TODs with blood pressure, retinal artery and vein diameters, oxidative stress and polymorphisms in VAV-2 and VAV-3 genes. Clinical Trials. gov Identifier: NCT02022618.

Relationship between target organ damage and blood pressure, retinal vessel calibre, oxidative stress and polymorphisms in VAV-2 and VAV-3 genes in patients with hypertension: a case–control study protocol (LOD-Hipertensión)

PubMed Central

Gomez-Marcos, Manuel A; Gonzalez-Sarmiento, Rogelio; Recio-Rodríguez, José I; Agudo-Conde, Cristina; Gamella-Pozuelo, Luis; Perretta-Tejedor, Nuria; Martínez-Salgado, Carlos; García-Ortiz, Luis

2014-01-01

Introduction Target organ damage (TOD) is associated with increased cardiovascular risk. The study objectives were to analyse the relationship of TOD to blood pressure, size of retinal arteries and veins, oxidative stress and different polymorphisms in the VAV-2 and VAV-3 genes in participants with hypertension. Methods and analysis A case–control study to analyse the relationship between clinical, biochemical and genetic parameters and presence of cardiac, vascular and renal TOD in 486 patients with hypertension. Participants with TOD will be considered as cases, and those without TOD will be enrolled as controls. This will be a collaborative study conducted by the groups of Primary Care, Cardiovascular and Metabolic and Degenerative Diseases of the Instituto de Investigación Biomédica of Salamanca (IBSAL). Assessment of cardiac, renal and vascular TOD. Measurement of peripheral and central blood pressure, size of eye fundus arteries and veins, and oxidative stress, and polymorphisms in the VAV-2 and VAV-3 genes. Ethics and dissemination The study will be conducted after approval is obtained from the Ethics Committee of Hospital Clínico Universitario of Salamanca. All study participants will sign an informed consent to agree to participate in the study, and another consent to agree on the genetic study, in compliance with the Declaration of Helsinki and the WHO standards for observational studies. The results of this study will allow for an understanding of the relationship of the different TODs with blood pressure, retinal artery and vein diameters, oxidative stress and polymorphisms in VAV-2 and VAV-3 genes. Trial registration number Clinical Trials. gov Identifier: NCT02022618. PMID:24699462

[Male sterility and its association with genital disease and environmental factors].

PubMed

Merino Ruiz, M C; De León Cervantes, M G; García Flores, R F

1995-10-01

Semen quality may be affected by many factors, as there is evidence that conditions as varicocele, criptorquidia, orchitis and bacterian infections; as well as to exposure to physical agents as heat, or chemical substances, or ingestion of alcohol and drugs, may affect semen quality. The objective of this study is to investigate the risk implied in the exposure to these factors on the semen quality. The study was carried out in a prospective way in a group of males at Clínica de Infertilidad, Unidad de Biología de la Reproducción del Hospital Universitario Dr. J.E. González. Ninety nine males were studied, they received an intentioned questionnaire about antecedents of exposure to environmental factors, and urologic resolved pathology. Espermatobioscopy was done and it was classified according to OMS. Two groups were formed, one with the individuals with normal espermatobioscopy (n = 25); and the abnormal ones (n = 74). The statistical Incidences Reason, square Xi and Atributable Risk, were applied in order to determine the impact that different factors may have on semen quality. The found alterations in semen were astenozoospermia (n = 58); hypospermia (n = 22); oligozoospermia (n = 18); teratozoospermia (n = 7); polizoospermia (n = 7); and azoospermia (n = 6). The results of the mentioned statistical tests, show that in these alterations there is an associated risk factor to the use of tobacco, exposure to chemical substances, to physical aggresors; and anatomic anomalies previously corrected. It is considered that obtention of this information is a great help because once the unfavorable factors are eliminated, the environment is improved in order to obtain an espermatogenesis in optimal conditions.

[Motivations and emotional experiences of the first hospital multidisciplinary team trained to care for people with Ebola in Andalusia, Spain (2014-2016)].

PubMed

Casado-Mejía, Rosa; Brea-Ruiz, Ma Teresa; Torres-Enamorado, Dolores; Albar-Marín, Ma Jesús; Botello-Hermosa, Alicia; Santos-Casado, María; Casado-Rojas, Irene

2016-01-01

The Hospital Universitario Virgen del Rocío (HUVR) of Seville was chosen as the reference Andalusian site to treat possible cases of Ebola. After the health alert (WHO, 2014), a voluntary group of healthcare and non-healthcare professionals was set up, which, after being trained, treated a possible case. In this light, the aim is to understand the motivations and emotional experiences of this group and to identify the facilitators of and obstacles to its operation. Qualitative, interpretative and phenomenological study. Observation unit: professional team of the HUVR trained to treat Ebola cases. Analysis units: teamwork, motivations and emotions. Three interviews with key informants were conducted, as well as three discussion groups involving 23 of the 60 team members (2014-2016). A content analysis of the motivations, emotions and elements affecting the team's operation was conducted with QSRNUDISTVivo10. data sources, techniques and disciplinary perspectives were triangulated. The results were presented to the team, which duly agreed with the findings. Training, professional responsibility, professional self-esteem, risk appetite or loyalty to the leader stood out as motivations to voluntarily join the team. Emotional experiences evolved from fear and stress to self-pressure control, while essential elements for the team's operation were found to be calmness and confidence based on training and teamwork. Family, source department, resources, communication media and emotional management were facilitators of or obstacles to the team's success. An understanding of the key motivational and influential factors may be important in the management of effective and successful multidisciplinary teams during health alerts. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

PubMed

López, Ana Cristina; Cecchetto, Eugenio; Aguirre, Ana Noemí; Ontiveros, Marina Celeste; Roitter, Claudia Valentina; Garcia, Adelaida Judith; Bernet, Jorgelina; Aguirre, Jorge Alberto

2018-03-23

El objetivo del estudio fue describir características clínicas, sociodemográficas y hábitos en adultos con diabetes mellitus y estudiar su asociación con la calidad de vida relacionada con la salud. Se seleccionó una muestra de 311 pacientes del Programa de Diabetes de una obra social universitaria, de la provincia de Córdoba. Se analizaron los datos a como proporciones y los componentes físico y mental del cuestionario SF-36® . El 57,4% alcanzó un nivel de instrucción terciario o universitario. La hipertensión arterial fue el factor de riesgo cardiovascular más prevalente (86,8%), seguida por dislipemia (50,6%) y obesidad (46,5%). El 24,8% tenía complicación macrovascular y el 29% microvascular. En el componente físico (CF) de calidad de vida las mujeres tuvieron una chance 4,2 veces mayor de reportar un valor inferior en relación a los varones. Entre los 50 y los 70 años se triplicó y los mayores de  70 años tuvieron 4 veces peor una puntuación en el CF respecto a los más jóvenes. Las complicaciones macro y microvasculares y los que reportaron menos de 2 hábitos de vida saludables tuvieron el doble de chances de puntuar por debajo del promedio general en el CF. La asociación entre complicaciones y peor calidad de vida es un motivo más para alcanzar un buen control metabólico, optimizar el manejo de factores de riesgo, evitando o retrasando la aparición de complicaciones.

[Rationale, design and methodology of physical attributes identification of the fear of falling syndrome (FISTAC study)].

PubMed

Esbrí Víctor, Mariano; Huedo Rodenas, Isabel; López Utiel, Melisa; Martínez Reig, Marta; López Jiménez, Esther; Herizo Muñoz, María Ángeles; Sánchez Nievas, Ginés; Abizanda Soler, Pedro

The aim of this study was to identify the physical determining factors of the Fear of Falling Syndrome (FoF) in older adults with a history of falls. An observational study was conducted on 183 subjects older than 64 years with a fall in the previous year, with data collected from the geriatrics outpatient clinic of the Complejo Hospitalario Universitario from Albacete, Spain. Sociodemographic and anthropometric data, as well as comorbidity, drugs usually taken, functional status, physical function, frailty, cognitive and affective status were collected. Muscle mass was measured using bioimpedancy meter (BIA), and densitometry (DXA), strength with digital hand-held JAMAR dynamometer and with a Leg-press machine, muscle potency with a T-Force instrument, gait variability with the Gait-Rite instrument, and postural stability with the Neurocom Balance Master posturograph were also determined. An analysis was performed to determine if the FoF is associated with physical impairments adjusted for the study covariates. The study included 140 subjects with FoF, and 43 without it. The mean age was 78.4 years, and 147 were women. Posturography could be measured in 182 participants, DXA in 117, BIA in 165, and muscle potency in 146. FoF was associated with female sex, frailty, depressed mood, social risk, muscle strength and power, physical function, number of drugs used, and orthostatic hypotension in the overall sample. After adjusting for sex, only frailty, depressed mood, and number of drugs remained associated. Rationale, design, and methods of the FISTAC study are presented. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Use of Health Resources and Healthcare Costs associated with Frailty: The FRADEA Study.

PubMed

García-Nogueras, I; Aranda-Reneo, I; Peña-Longobardo, L M; Oliva-Moreno, J; Abizanda, P

2017-01-01

Frailty is associated with adverse health outcomes, but its association with hospital healthcare costs has not been analyzed. The main objective was to estimate the adjusted annual costs and use of hospital healthcare resources in frail older adults compared to non frail ones. FRADEA Study. Mean follow-up 1044 days (SD 314). Albacete city, Spain. 830 adults ≥70 years. Age, sex, comorbidity measured with the Charlson index and Fried´s Frailty phenotype as independent variables, and use of hospital resources (hospital admissions, emergency visits, and specialist visits), and hospital healthcare costs as outcome variables. Outcome data were collected from Minimum Data Set of the Complejo Hospitalario Universitario Albacete. The cost base year was 2013. Logistic regression and two-part models were used to analyze the association between frailty and the use of healthcare resources. Generalized Linear Models were applied to estimate the impact of frailty and comorbidity on the healthcare costs. The average cost associated with the use of health resources was 1,922€/year. Frail participants had an average total cost of health resources of 2,476€/year, pre-frail 2,056€/year, and non-frail 1,217€/year. 67% of the total health cost was associated with hospital admission cost, 29% with specialist visits cost and 4% with emergency visits cost. Frailty and comorbidity were the most important factors associated with the use of hospital healthcare resources. Adjusted healthcare costs were 592€/year and 458€/year greater in frail and pre-frail participants respectively, compared to non-frail ones, and having a Charlson index ≥ 3, was associated with an increased costs of 2,289€/year. Frailty and comorbidity are meaningful and complementary associated with increased hospital healthcare resources use, and related costs.

A validity study of the Spanish-World Health Organization Quality of Life short version instrument in persons with traumatic spinal cord injury.

PubMed

Salvador-De La Barrera, Sebastián; Mora-Boga, Rubén; Ferreiro-Velasco, Mª Elena; Seoane-Pillado, Teresa; Montoto-Marqués, Antonio; Rodríguez-Sotillo, Antonio; Pertega Díaz, Sonia

2018-05-23

This was a psychometric study. To determine the validity of the Spanish version of the World Health Organization Quality of Life instrument (WHOQOL-BREF) for its use in persons with traumatic spinal cord injury and, as secondary objectives, to correlate the results with variables such as functional status, psychological well-being, and social support. Spinal Cord Injury Unit, Complejo Hospitalario Universitario de A Coruña, Galicia (Spain). Fifty-four people with spinal cord injury were enrolled in this study. Relevant variables were analyzed based on the scores reported by each participant in the Spanish versions of the WHOQOL-BREF questionnaire, the Spinal Cord Independence Measure, the Hospital Anxiety and Depression Scale (HADS), and the Duke-UNC Functional and Social Support Questionnaire. Both parametric and non-parametric tests were used to compare various variables. The instrument's internal consistency and test-retest reliability were also confirmed. The mean scores of each domain of the WHOQOL-BREF were lower, but nonsignificant, among people who need help to perform activities of daily living. The correlation between the scores obtained in the "Psychological" domain and the items of the HADS scale was significant. Significant differences were also observed when comparing the results of the "Social relationships" and "Environment" domains among people with low scores in the Duke questionnaire. Both an adequate consistency (Cronbach's α: 0.887) and test-retest reliability were demonstrated. The Spanish version of the WHOQOL-BREF questionnaire is useful and reliable to evaluate the quality of life of persons with spinal cord injuries in our population of Spanish-speaking people.

Factors associated with suicidal ideation among university students.

PubMed

Santos, Hugo Gedeon Barros Dos; Marcon, Samira Reschetti; Espinosa, Mariano Martínez; Baptista, Makilin Nunes; Paulo, Paula Mirianh Cabral de

2017-05-15

to analyze the factors associated with suicidal ideation in a representative sample of university students. cross-sectional study, carried out with 637 students of the Federal University of Mato Grosso. The presence of suicidal ideation, demographic and socioeconomic variables, use of alcohol through the Alcohol, Smoking and Substance Involvement Screening Test, and depressive symptoms (Major Depression Inventory) were investigated. Bivariate analysis was performed with the Chi-square test and multivariate analysis using the Poisson regression model. it was found that 9.9% of the students had suicidal thoughts in the previous 30 days and, in the bivariate analysis, the variables economic class, sexual orientation, religious practice, suicide attempts in the family and among friends, alcohol consumption and depressive symptoms were associated with suicidal ideation. In the multivariate analysis sexual orientation, suicide attempts in the family and the presence of depressive symptoms remained as associated factors. these findings constitute a situational diagnosis that enables the formulation of academic policies and preventive actions to confront this situation on the university campus. analisar os fatores associados à ideação suicida em uma amostra representativa de estudantes universitários. estudo transversal analítico, realizado com 637 estudantes de uma Universidade Federal de Mato Grosso. Investigadas variáveis de presença de ideação suicida, demográficas e socioeconômica, uso de álcool por meio do Alcohol, Smoking and Substance Involvement Screening Test, e sintomas depressivos (Inventário de Depressão Maior). A análise bivariada foi realizada com o teste do Qui-quadrado, e a análise múltipla pelo modelo de regressão Poisson. constatou-se que 9,9% dos estudantes tinham ideias suicidas nos últimos 30 dias, e na análise bivariada as variáveis classe econômica, orientação sexual, prática religiosa, tentativas de suicídio na família e entre amigos, consumo de álcool e sintomas depressivos apresentaram associação com ideação suicida. Na análise múltipla permaneceu como fatores associados orientação sexual, tentativas de suicídio na família e presença de sintomas depressivos. tais achados constituem um diagnóstico situacional que possibilita a formulação de políticas acadêmicas e de ações de prevenção para o enfrentamento dessa situação no campus universitário. analizar los factores asociados a la ideación suicida en una muestra representativa de estudiantes universitarios. estudio transversal analítico, realizado con 637 estudiantes en una Universidad Federal de Mato Grosso. Fueron investigadas las variables: presencia de ideación suicida; demográficas y socioeconómicas; uso de alcohol por medio del Alcohol, Smoking and Substance Involvement Screening Test; y síntomas depresivos (Inventario de Depresión Mayor). El análisis bivariado fue realizado con el test de Chi-cuadrado y el análisis múltiple con el modelo de regresión de Poisson. se constató que 9,9% de los estudiantes tuvieron ideas suicidas en los últimos 30 días, y en el análisis bivariado las variables: clase económica; orientación sexual; práctica religiosa; intentos de suicidio en la familia y entre amigos; consumo de alcohol; y síntomas depresivos, presentaron asociación con ideación suicida. En el análisis múltiple permanecieron como factores asociados la orientación sexual, los intentos de suicidio en la familia y la presencia de síntomas depresivos. estos hallazgos constituyen un diagnóstico situacional que posibilita la formulación de políticas académicas y de acciones de prevención para enfrentar esa situación en el campus universitario.

Molecular epidemiology of coagulase-negative bloodstream isolates: detection of Staphylococcus epidermidis ST2, ST7 and linezolid-resistant ST23.

PubMed

Martínez-Meléndez, Adrián; Morfín-Otero, Rayo; Villarreal-Treviño, Licet; Camacho-Ortíz, Adrián; González-González, Gloria; Llaca-Díaz, Jorge; Rodríguez-Noriega, Eduardo; Garza-González, Elvira

2016-01-01

The mechanisms contributing to persistence of coagulase-negative staphylococci are diverse; to better understanding of their dynamics, the characterization of nosocomial isolates is needed. Our aim was to characterize phenotypic and molecular characteristics of Staphylococcus epidermidis and Staphylococcus haemolyticus human blood isolates from two tertiary care hospitals in Mexico, the Hospital Universitario in Monterrey and the Hospital Civil in Guadalajara. Antimicrobial susceptibility was determined. Biofilm formation was assessed by crystal violet staining. Detection of the ica operon and Staphylococcal Cassette Chromosome mec typing were performed by PCR. Clonal relatedness was determined by Pulsed-fiel gel electrophoresis and Multi locus sequence typing. Methicillin-resistance was 85.5% and 93.2% for S. epidermidis and S. haemolyticus, respectively. Both species showed resistance >70% to norfloxacin, clindamycin, levofloxacin, trimethoprim/sulfamethoxazole, and erythromycin. Three S. epidermidis and two S. haemolyticus isolates were linezolid-resistant (one isolate of each species was cfr+). Most isolates of both species were strong biofilm producers (92.8% of S. epidermidis and 72.9% of S. haemolyticus). The ica operon was amplified in 36 (43.4%) S. epidermidis isolates. SCCmec type IV was found in 47.2% of the S. epidermidis isolates and SCCmec type V in 14.5% of S. haemolyticus isolates. No clonal relatedness was found in either species. Resistance to clindamycin, levofloxacin, erythromycin, oxacillin, and cefoxitin was associated with biofilm production for both species (p<0.05). A G2576T mutation in 23S rRNA gene was detected in an S. haemolyticus linezolid-resistant isolate. All linezolid-resistant S. epidermidis isolates belonged to ST23; isolate with SCCmec type IV belonged to ST7, and isolate with SCCmec type III belonged to ST2. This is the first report of ST7 in Mexico. There was a high genetic diversity in both species, though both species shared characteristics that may contibute to virulence. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

[Not Available].

PubMed

Chivu, Elena Cristina; Artero-Fullana, Ana; Alfonso García, Antonio; Sánchez Juan, Carlos

2016-07-19

Introducción: conociendo la elevada prevalencia de la desnutrición hospitalaria, se hace necesaria su detección precoz. Cuando, por diversos motivos, no es posible realizar una valoración completa del estado nutricional, se recomienda el empleo de herramientas validadas de cribado nutricional. Estas ayudarían a detectar de forma rápida a aquellos pacientes que necesiten de un tratamiento nutricional.Objetivos: determinar la prevalencia del riesgo de desnutrición, en el Hospital General Universitario de Valencia, empleando para ello la herramienta de cribado nutricional HEMAN y comprobar si la implementación de esta herramienta en la práctica clínica, sería lo más adecuado.Métodos: estudio transversal, realizado sobre una muestra de 1.099 pacientes ingresados en un hospital terciario. A todos ellos se les realizó el cribado nutricional HEMAN a las 24-48 horas del ingreso. Las variables cualitativas se compararon mediante Chi-cuadrado, y las cuantitativas mediante el test t de Student.Resultados: la prevalencia del riesgo de desnutrición fue del 33,5%. Los pacientes que resultaron positivos en el cribado (HEMAN ≥ 3), tenían mayor edad que los pacientes normonutridos, referían pérdidas de peso entre el 5-10%, el 55,2% disminuyó su ingesta a menos del 50% de la habitual. Además, ingresaron con patologías consideradas de leves a moderadas. La utilización del método HEMAN como herramienta de cribado, resultó ser práctica y efectiva, y ayudó a disminuir el tiempo empleado con cada paciente encuestado evaluado.Conclusiones: se detectó una elevada prevalencia de riesgo de desnutrición entre los pacientes evaluados, por lo tanto se hace imprescindible la utilización de métodos de cribado nutricional en la rutina diaria del hospital, para ello recomendamos especialmente la utilización del método HEMAN.

Pediatric Allergic Contact Dermatitis: Clinical and Epidemiological Study in a Tertiary Hospital.

PubMed

Ortiz Salvador, J M; Esteve Martínez, A; Subiabre Ferrer, D; Victoria Martínez, A M; de la Cuadra Oyanguren, J; Zaragoza Ninet, V

Few epidemiological studies have investigated the incidence of allergic contact dermatitis in children. Underdiagnosis has been observed in some studies, with many cases in which the condition is not suspected clinically and patch tests are not performed. However, the prevalence of pediatric sensitization to allergens has been reported to be as high as 20%, and the diagnosis should therefore be contemplated as a possibility in this age group. We performed a retrospective analysis of the skin allergy database of the Dermatology Department of Consorcio Hospital General Universitario de Valencia. Children between 0 and 16 years of age diagnosed with allergic contact dermatitis in the previous 15 years (between 2000 and 2015) were included in the analysis. Epidemiological (age, sex, history of atopy) and clinical (site of the lesions, allergen series applied, positive reactions, and their relevance) variables were gathered. Patch tests had been performed on 4,593 patients during the study period. Of these, 265 (6%) were children aged between 0 and 16 years. A positive reaction to at least one of the allergens tested was observed in 144 (54.3%) patients in that group. The allergens most frequently identified were the following (in decreasing order of frequency): thiomersal, cobalt chloride, colophony, paraphenylenediamine, potassium dichromate, mercury, and nickel. The sensitization was considered relevant in 177 (61.3%) cases. More than half of the children studied showed sensitization to 1 or more allergens, with a high percentage of relevant sensitizations. All children with a clinical suspicion of allergic contact dermatitis should be referred for patch testing. As no standardized test series have been developed for this age group, a high level of clinical suspicion and knowledge of the allergens most commonly involved are required when selecting the allergens to be tested. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Climatic effects on decomposing litter and substrate chemistry along climatological gradients.

NASA Astrophysics Data System (ADS)

Berg, B.

2009-04-01

Climatic effects on decomposing litter and substrate chemistry along climatological gradients. B. Berg, Dipartimento Biologia Strutturale e Funzionale, Complesso Universitario, Monte San Angelo, via Cintia, I-80126 Napoli, Italy and Department of Forest Ecology, P.O. Box 27, University of Helsinki, FIN-00014, Helsinki, Finland. Studies of several processes, using climatic gradients do provide new information as compared with studies at e.g. a single site. Decomposition of plant litter in such gradients give response in decomposition rates to natural climate conditions. Thus Scots pine needle litter incubated in a climate gradient with annual average temperature (AVGT) ranging from -0.5 to 6.8oC had a highly significant increase in initial mass-loss rate with R2 = 0.591 (p<0.001) and a 5o increase in temperature doubled the mass-loss rate. As a contrast - needle litter of Norway spruce incubated in the same transect had no significant response to climate and for initial litter a 5o increase increased mass-loss rate c. 6%. For more decomposed Scots pine litter we could see that the effect of temperature on mass-loss rate gradually decreased until it disappeared. Long-term decomposition studies revealed differences in litter decomposition patterns along a gradient, even for the same type of litter. This could be followed by using an asymptotic function that gave, (i) a measure a maximum level of decomposition, (ii) the initial decomposition rate. Over a gradient the calculated maximum level of decomposition decreased with increasing AVGT. Other gradient studies revealed an effect of AVGT on litter chemical composition. Pine needle litter from stands under different climate conditions had nutrient concentrations related to AVGT. Thus N, P, K, and S were positively related to AVGT and Mn negatively, all of them significantly. This information may be used to explain the changing pattern in decomposition over the gradient.

Teamwork: relevance and interdependence of interprofessional education.

PubMed

Tamayo, M; Besoaín-Saldaña, A; Aguirre, M; Leiva, J

2017-04-27

Determine the perception of university students regarding interprofessional and interdependent work between team members in their inclusion in primary care. Analytical cross-sectional study. The sampling had a probabilistic, stratified random type with 95% confidence and 5% margin of error. Seven-hundred and four students of Public Universities in Santiago (Chile) answered self-administered questionnaire. Ninety-seven point eight of students say that interprofessional work is important; 27.1% of them declare that their university did not seem to show that their study plans were important. The professionals listed as most important in teams are physicians and nurses. Spaces for development and institutional support are key elements to promote interprofessional work. If this competence can involve each academic unit in their different formative spaces there will be a significant contribution to said promotion. Teamwork is a pending task. Determinar la percepción de estudiantes universitarios respecto al trabajo interprofesional e interdependencia entre los miembros del equipo en su inserción en la atención primaria. Estudio de tipo analítico y transversal. El muestreo fue de tipo aleatorio, probabilístico estratificado con un 95% de confianza y un 5% de margen de error. Se utilizó un cuestionario auto-administrado en 704 estudiantes de Universidades del Estado en Santiago de Chile. Un 97,8% de los estudiantes opinan que el trabajo interprofesional es importante; un 27,1% de ellos declara que su universidad no le ha entregado importancia en sus planes de estudios. Los profesionales mencionados como más importantes en el equipo son los médicos y enfermeras. Espacios de desarrollo y respaldo institucional son elementos claves para promover el trabajo interprofesional. Que esta competencia logre involucrar a cada unidad académica en sus diferentes espacios formativos será un aporte significativo en aquello. Trabajo en equipo es una tarea pendiente.

Harmonization of clinical laboratories in Africa: a multidisciplinary approach to identify innovative and sustainable technical solutions.

PubMed

Putoto, Giovanni; Cortese, Antonella; Pecorari, Ilaria; Musi, Roberto; Nunziata, Enrico

2015-06-01

In an effective and efficient health system, laboratory medicine should play a critical role. This is not the case in Africa, where there is a lack of demand for diagnostic exams due to mistrust of health laboratory performance. Doctors with Africa CUAMM (Collegio Universitario Aspiranti Medici Missionari) is a non-profit organization, working mainly in sub-Saharan Africa (Angola, Ethiopia, Mozambique, Sierra Leone, South Sudan, Tanzania and Uganda) to help and sustain local health systems. Doctors with Africa CUAMM has advocated the need for a harmonized model for health laboratories to assess and evaluate the performance of the facilities in which they operate. In order to develop a harmonized model for African health laboratories, previous attempts at strengthening them through standardization were taken into consideration and reviewed. A survey with four Italian clinicians experienced in the field was then performed to try and understand the actual needs of health facilities. Finally a market survey was conducted to find new technologies able to update the resulting model. Comparison of actual laboratories with the developed standard - which represents the best setting any African health laboratory could aim for - allowed shortcomings in expected services to be identified and interventions subsequently prioritized. The most appropriate equipment was proposed to perform the envisaged techniques. The suitability of appliances was evaluated in consideration of recognized international recommendations, reported experiences in the field, and the availability of innovative solutions that can be performed on site in rural areas, but require minimal sample preparation and little technical expertise. The present work has developed a new, up-to-date, harmonized model for African health laboratories. The authors suggest lists of procedures to challenge the major African health problems - HIV/AIDS, malaria, tubercolosis (TB) - at each level of pyramidal health system. This model will hopefully support the non-governmental organization (NGO) Doctors with Africa CUAMM in its activities in sub-Saharan hospitals, providing them with a guideline to programme future interventions.

[METABOLIC SYNDROME AND CARDIOVASCULAR RISK IN PATIENTS WITH SCHIZOPHRENIA, BIPOLAR DISORDER AND SCHIZOAFFECTIVE DISORDER].

PubMed

Muñoz-Calero Franco, Paloma; Sánchez Sánchez, Blanca; Rodríguez Criado, Natalia; Pinilla Santos, Berta; Bravo Herrero, Sandra; Cruz Fourcade, José Fernando; Martín Aragón, Rubén

2015-12-01

patients with severe mental ilness such as schizophrenia, schizoaffective disorder and bipolar disorder die at least 20 years earlier than general population. Despite preventive strategies, cardiovascular disease is the first cause of death. analyse the percentage of patients with a high body mass index, metabolic syndrome and their cardiovascular risk at 10 years in patients with a diagnosis, based in DSM-IV criteria for schizophrenia, schizoaffective disorder or bipolar disorder. These patients were hospitalized because and acute condition of their mental ilness in the Brief Hospitalization Unit of Hospital Universitario de Móstoles between November of 2014 and June of 2015. in 53 patients, 34 with a diagnosis of schizophrenia, 16 with a diagnosis of bipolar disorder and 3 with a schizoaffective disorder, weight, size abdominal perimeter measures and blood pressure were collected. The body mass index was assesed. Blood tests were taken and we use sugar, triglycerides, total cholesterol and HDL cholesterol levels as paramethers for the ATP III and Framingham criteria. We also review the clinical history of the patients and lifestyle and use of toxic substances were registered. 51% of the patients were men and 49% were women. The average age was 40. 38% of the patients were overweighed, 22% obese and 4% had morbid obesity. 26% of the patients had metabolic syndrome, the clinical evolution of the majority of these patients was of more tan 10 years and they also have been treated with different antypsychotics and antidepressants. Using the Framingham criteria, 11% of the patients had a cardiovascular risk higher than 10 % in the next 10 years. overweight and its consequences in patients with a severe mental ilness are intimately related with their lifestyle, disparities in the access to health resources, the clinical evolution of the disease and pharmacotherapy. Strategies to promote physical health in these patients in the spanish health sistme are insufficient. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

[Prenatal treatment with magnesium sulphate: Initial clinical outcomes in pre-term infants less than 29 weeks and correlation with neonatal magnesium levels].

PubMed

García Alonso, Laura; Pumarada Prieto, Marcelino; González Colmenero, Eva; Concheiro Guisán, Ana; Suárez Albo, María; Durán Fernández-Feijoo, Cristina; González Durán, Luisa; Fernández Lorenzo, José Ramón

2017-03-01

Antenatal magnesium sulphate (MgSO4) administration has shown to be effective in minimising cerebral palsy and severe motor dysfunction at the age of 2 years. The aim of this study is to analyse the initial clinical outcome of preterm neonates less than 29 weeks who have received prenatal MgSO 4 , as well as to determine the relationship between the magnesium dose delivered to the mother and the magnesium concentration in the neonates. A prospective cohort study was conducted on neonates of less than 29 weeks gestation admitted to the Neonatal Intensive Care Unit (NICU) of Hospital Universitario de Vigo from December 2012 to July 2015. Comparative analysis was performed on the perinatal outcomes, neonatal morbidity, mortality, and magnesium levels between the groups of neonates exposed to magnesium sulphate and the control group. A total of 42 neonates were included in the study. The mothers of 28 of them had received MgSO4 as a neuroprotective agent. Statistical significance was obtained in the mortality variable. There were no significant differences in the rest of studied variables. There was a significant correlation between the full dose of MgSO4 received by the mother and the levels of magnesium in the neonate in the first 24hours of life (r 2 0.436; P<.001). A lower mortality was observed in the group that had been exposed to MgS04. No significant side effects were found as a result of administering of MgS04. The MgS04 dose received by mother has a linear relationship with the magnesium levels obtained in neonates. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Recurrence of cystic echinococcosis in an endemic area: a retrospective study.

PubMed

Velasco-Tirado, Virginia; Romero-Alegría, Ángela; Belhassen-García, Moncef; Alonso-Sardón, Montserrat; Esteban-Velasco, Carmen; López-Bernús, Amparo; Carpio-Perez, Adela; Jimenez López, Marcelo Fernando; Muñoz Bellido, Juan Luis; Muro, Antonio; Cordero-Sanchez, Miguel; Pardo-Lledias, Javier; Muñoz-Bellvis, Luis

2017-06-27

Cystic echinococcosis (CE) is a chronic, complex and neglected zoonotic disease. CE occurs worldwide. In humans, it may result in a wide spectrum of clinical manifestations, ranging from asymptomatic infection to fatal disease. Clinical management procedures have evolved over decades without adequate evaluation. Despite advances in surgical techniques and the use of chemotherapy, recurrence remains one of the major problems in the management of hydatid disease. The aim of this study was to determine the frequency of CE recurrence and the risk factors involved in recurrence. A descriptive longitudinal-retrospective study was designed. We reviewed all patients diagnosed with CE according to ICD-9 (code 122-0 to 122-9) criteria admitted at Complejo Asistencial Universitario de Salamanca, Spain, between January 1998 and December 2015. Among the 217 patients studied, 25 (11.5%) had a hydatid recurrence after curative intention treatment. Median duration of recurrence's diagnosis was 12.35 years (SD: ±9.31). The likelihood of recurrence was higher [OR = 2.7; 95% CI, 1.1-7.1; p < 0.05] when the cyst was located in organs other than liver and lung, 22.6% (7/31) vs 14.2% (31/217) in the cohort. We detected a chance of recurrence [OR = 2.3; 95% CI, 1.4-6.5; p > 0.05] that was two times higher in those patients treated with a combination of antihelminthic treatments and surgical intervention (20/141, 14.2%) than in patients treated with surgical intervention alone (5/76, 6.6%). Despite advances in diagnosis and therapeutic techniques in hydatid disease, recurrence remains one of the major problems in the management of hydatid disease. The current management and treatment of recurrences is still largely based on expert opinion and moderate-to-poor quality of evidence. Consequently, large prospective and multicenter studies will be needed to provide definitive recommendations for its clinical management.

[GeSIDA quality care indicators associated with mortality and hospital admission for the care of persons infected by HIV/AIDS].

PubMed

Delgado-Mejía, Elena; Frontera-Juan, Guillem; Murillas-Angoiti, Javier; Campins-Roselló, Antoni Abdon; Gil-Alonso, Leire; Peñaranda-Vera, María; Ribas Del Blanco, María Angels; Martín-Pena, María Luisa; Riera-Jaume, Melchor

2017-02-01

In 2010, the AIDS Study Group (Grupo de Estudio del SIDA [GESIDA]) developed 66 quality care indicators. The aim of this study is to determine which of these indicators are associated with mortality and hospital admission, and to perform a preliminary assessment of a prediction rule for mortality and hospital admission in patients on treatment and follow-up. A retrospective cohort study was conducted in the Hospital Universitario Son Espases (Palma de Mallorca, Spain). Eligible participants were patients with human immunodeficiency syndrome≥18 years old who began follow-up in the Infectious Disease Section between 1 January 2000 and 31 December 2012. A descriptive analysis was performed to evaluate anthropometric variables, and a logistic regression analysis to assess the association between GESIDA indicators and mortality/admission. The mortality probability model was built using logistic regression. A total of 1,944 adults were eligible (median age: 37 years old, 78.8% male). In the multivariate analysis, the quality of care indicators associated with mortality in the follow-up patient group were the items 7, 16 and 20, and in the group of patients on treatment were 7, 16, 20, 35, and 38. The quality of care indicators associated with hospital admissions in the follow-up patients group were the same as those in the mortality analysis, plus number 31. In the treatment group the associated quality of care indicators were items 7, 16, 20, 35, 38, and 40. Some GeSIDA quality of care indicators were associated with mortality and/or hospital admissions. These indicators are associated with delayed diagnosis, regular monitoring, prevention of infections, and control of comorbidities. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

[Predictive factors of clinically significant drug-drug interactions among regimens based on protease inhibitors, non-nucleoside reverse transcriptase inhibitors and raltegravir].

PubMed

Cervero, Miguel; Torres, Rafael; Jusdado, Juan José; Pastor, Susana; Agud, Jose Luis

2016-04-15

To determine the prevalence and types of clinically significant drug-drug interactions (CSDI) in the drug regimens of HIV-infected patients receiving antiretroviral treatment. retrospective review of database. Centre: Hospital Universitario Severo Ochoa, Infectious Unit. one hundred and forty-two participants followed by one of the authors were selected from January 1985 to December 2014. from their outpatient medical records we reviewed information from the last available visit of the participants, in relation to HIV infection, comorbidities, demographics and the drugs that they were receiving; both antiretroviral drugs and drugs not related to HIV infection. We defined CSDI from the information sheet and/or database on antiretroviral drug interactions of the University of Liverpool (http://www.hiv-druginteractions.org) and we developed a diagnostic tool to predict the possibility of CSDI. By multivariate logistic regression analysis and by estimating the diagnostic performance curve obtained, we identified a quick tool to predict the existence of drug interactions. Of 142 patients, 39 (29.11%) had some type of CSDI and in 11.2% 2 or more interactions were detected. In only one patient the combination of drugs was contraindicated (this patient was receiving darunavir/r and quetiapine). In multivariate analyses, predictors of CSDI were regimen type (PI or NNRTI) and the use of 3 or more non-antiretroviral drugs (AUC 0.886, 95% CI 0.828 to 0.944; P=.0001). The risk was 18.55 times in those receiving NNRTI and 27,95 times in those receiving IP compared to those taking raltegravir. Drug interactions, including those defined as clinically significant, are common in HIV-infected patients treated with antiretroviral drugs, and the risk is greater in IP-based regimens. Raltegravir-based prescribing, especially in patients who receive at least 3 non-HIV drugs could avoid interactions. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

[A lower adherence to Mediterranean diet is associated with a poorer self-rated health in university population].

PubMed

Barrios-Vicedo, Ricardo; Navarrete-Muñoz, Eva Maria; García de la Hera, Manuela; González-Palacios, Sandra; Valera-Gran, Desirée; Checa-Sevilla, José Francisco; Gimenez-Monzo, Daniel; Vioque, Jesús

2014-09-15

A higher adherence to Mediterranean diet is considered as a protective factor against the large number of deaths attributable to the main chronic degenerative diseases in developed countries. Self-rated health is established as a good indicator of population health status and as a predictor of mortality. Studies exploring the relationship between the adherence to Mediterranean diet and self-rated health are scarce, especially, in young adults. Our aim was to explore the factors related, specially the adherence to a priori-defined Mediterranean diet with self-rated health in a cohort of Spanish university students. We analyzed data from 1110 participants of Spanish DiSA-UMH (Dieta, Salud y Antropometría en universitarios de la Universidad Miguel Hernández) study. Diet was assessed using a validated food frequency questionnaire and the adherence to Mediterranean diet was calculated using the relative Mediterranean Diet Score (rMED; score range: 0-18) according to the consumption of 9 dietary components. Self-rated health was gathered from the question: "In general, how do you consider your health to be? (Excellent, good, fair, poor, very poor). Information on sociodemographic and lifestyle characteristics was also collected. Multinomial logistic regression (using relative risk ratio, RRR) was used to analyze the association between the adherence to Mediterranean diet (low rMED: 0-6 points; medium: 7-10 points; high: 11-18 points) and self-rated health (Excellent (reference), good and fair/ poor/very poor). A low, medium or high adherence to Mediterranean diet conformed to 26.8%, 58.7% and 14.4% of participants, which of them reported an excellent (23.1%), good (65.1%) and fair/poor or very poor health, respectively. In multivariate analysis, a lower adherence to Mediterranean diet was significantly (p. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

[Burnout syndrome among nursing staff at a hospital in Madrid].

PubMed

Albaladejo, Romana; Villanueva, Rosa; Ortega, Paloma; Astasio, P; Calle, M E; Domínguez, V

2004-01-01

The term "burnout" is related to a situation arising increasingly more often among the professionals performing their duties by way of a long-term, direct, people-to-people relationship, which includes all healthcare professionals. This study is aimed at determining the prevalence of the Burnout syndrome and of the three components involved therein (emotional exhaustion, impersonalization and lack of personal fulfillment) among the nursing staff at the "Hospital Clínico Universitario San Carlos" in Madrid and the relationship thereof to certain socio-demographic, job-related and institutional factors. A cross-sectional study was conducted among the professionals assigned to the nursing staff at the above-mentioned hospital. The variables involved were gathered by means of a questionnaire prepared by those conducting this study. The Burnout syndrome was measured by means of the Maslach Burnout Inventory, in the validated Spanish version thereof. The nursing staff is more impersonalized (p=0.004) and less fulfilled (p=0.036) than the nursing assistant/technician group. When the results of the four scales by units were analyzed, burnout was found to be greater among the nursing staff assigned to oncology and emergency care units (p=0.001), the impersonalization in the emergency rooms (p=0.007), and Burnout is once again greater in the oncology and emergency units (p=0.000). Those professionals who answered that there was little recognition of their nursing care scored worst regarding Burnout and the three aspects thereof (p =0.000). The lower the degree of on-the-job satisfaction, the higher the scores on the four scales (p=0.000). The conclusion which may be drawn from this study is that the profile of a person affected by Burnout is that of a professional with on-the-job experience who nevertheless considers very little recognition to be given to their caregiving and a high degree of dissatisfaction with the way in which their workplaces are managed.

[Secondary Preventive Program of atherosclerosis in a university hospital. Results and predictors of clinical course].

PubMed

Pintó, Xavier; Meco, José F; Corbella, Emili; Figueras, Rosaura; Pallarés, Carlos; Esplugas, Enric; Castiñeiras, María J; Marrugat, Jaume; Pujol, Ramon

2003-05-31

Lipid therapeutic goals are not achieved in a high percentage of patients with coronary artery disease (CAD). We describe in this paper the methodology and results of the Hospital Universitario de Bellvitge Atherosclerosis Secondary Preventive Program (PPSHB), which is aimed at preventing ischemic recurrences by controlling atherogenic factors. From January 1992 to December 1996, 882 patients with acute CAD entered the PPSHB and were seen on at least 2 occasions at the Unidad de Lípidos y Arteriosclerosis during a mean period of 10.4 (3.8) months. In 753 patients data on clinical follow-up were available. Follow-up data were collected by telephone interview and review of medical records. During the follow-up period at the Unidad de Lípidos y Arteriosclerosis, 71.9% of patients achieved the therapeutic goals or their LDLc improved >= 15%. These results were seen in 83.6%, 78.7% and 83.6% of patients with regard to HDLc, triglycerides and HDLc/LDLc ratio, respectively, while the percentage of patients receiving lipid-lowering drugs increased from 28% to 69%. During a follow-up of 33.7 (15.9) months, death (all causes; mean survival time: 20 [13.4] months) occurred in 41 patients (5.4%). On the other hand, hospitalization for cardiovascular disease was required in 113 patients (15%) during a mean follow-up until the first admission of 18.4 (14.2) months. The main independent predictor of unfavourable clinical course was not to reach the HDLc/LDLc ratio goal (HDLc/LDLc >= 0.27 or an increase >= 15%; OR = 2.1; 95% CI, 1.1-4.03). A systematic secondary preventive strategy may help achieve an adequate control of dyslipidemia in most CAD patients. In these patients, achieving the HDLc/LDLc therapeutic goal is associated with a less than half risk of hospitalization for cardiovascular disease or death from any cause.

Lineage Analysis of Circulating Trypanosoma cruzi Parasites and Their Association with Clinical Forms of Chagas Disease in Bolivia

PubMed Central

del Puerto, Ramona; Nishizawa, Juan Eiki; Kikuchi, Mihoko; Iihoshi, Naomi; Roca, Yelin; Avilas, Cinthia; Gianella, Alberto; Lora, Javier; Gutierrez Velarde, Freddy Udalrico; Renjel, Luis Alberto; Miura, Sachio; Higo, Hiroo; Komiya, Norihiro; Maemura, Koji; Hirayama, Kenji

2010-01-01

Background The causative agent of Chagas disease, Trypanosoma cruzi, is divided into 6 Discrete Typing Units (DTU): Tc I, IIa, IIb, IIc, IId and IIe. In order to assess the relative pathogenicities of different DTUs, blood samples from three different clinical groups of chronic Chagas disease patients (indeterminate, cardiac, megacolon) from Bolivia were analyzed for their circulating parasites lineages using minicircle kinetoplast DNA polymorphism. Methods and Findings Between 2000 and 2007, patients sent to the Centro Nacional de Enfermedades Tropicales for diagnosis of Chagas from clinics and hospitals in Santa Cruz, Bolivia, were assessed by serology, cardiology and gastro-intestinal examinations. Additionally, patients who underwent colonectomies due to Chagasic magacolon at the Hospital Universitario Japonés were also included. A total of 306 chronic Chagas patients were defined by their clinical types (81 with cardiopathy, 150 without cardiopathy, 100 with megacolon, 144 without megacolon, 164 with cardiopathy or megacolon, 73 indeterminate and 17 cases with both cardiopathy and megacolon). DNA was extracted from 10 ml of peripheral venous blood for PCR analysis. The kinetoplast minicircle DNA (kDNA) was amplified from 196 out of 306 samples (64.1%), of which 104 (53.3%) were Tc IId, 4 (2.0%) Tc I, 7 (3.6%) Tc IIb, 1 (0.5%) Tc IIe, 26 (13.3%) Tc I/IId, 1 (0.5%) Tc I/IIb/IId, 2 (1.0%) Tc IIb/d and 51 (25.9%) were unidentified. Of the 133 Tc IId samples, three different kDNA hypervariable region patterns were detected; Mn (49.6%), TPK like (48.9%) and Bug-like (1.5%). There was no significant association between Tc types and clinical manifestations of disease. Conclusions None of the identified lineages or sublineages was significantly associated with any particular clinical manifestations in the chronic Chagas patients in Bolivia. PMID:20502516

[Not Available].

PubMed

Fehrman-Rosas, Pamela; Delgado-Sánchez, Claudia; Fuentes-Fuentes, Jessica; Hidalgo-Fernández, Andrea; Quintana-Muñoz, Carol; Yunge-Hidalgo, Wilma; Fernández-Godoy, Eloina; Durán-Agüero, Samuel

2016-06-30

Objetivo: asociar patrones alimentarios con la autopercepción del estado nutricional en estudiantes universitarios chilenos de Nutrición y Dietética.Material y métodos: estudio transversal en el que se evaluó a 634 estudiantes de Nutrición y Dietética, de los cuales un 86,4% eran mujeres. A cada alumno se le mostraron siete modelos anatómicos correspondientes a valores de índice de masa corporal (IMC) de 18, 22, 25, 27, 30, 35 y 40 kg/m2. Cada estudiante debía elegir el modelo con el que mejor se identificaba. Posteriormente, se realizó la evaluación antropométrica, se calculó el IMC real comparándolo posteriormente con el IMC percibido, y finalmente se le aplicó una encuesta alimentaria.Resultados: se observa que los sujetos que sobreestiman su peso presentan un menor porcentaje de cumplimiento en el consumo de frutas y verduras al día; en cambio, el mayor porcentaje de sujetos que sigue las recomendaciones se encuentra en el grupo que se ve igual. Hay unaasociación entre una buena percepción de la imagen corporal y el consumo de 3 o más porciones de frutas al día OR = 0,554 (IC 95%; 0,360-0,852), 2 o más porciones de verduras al día OR = 0,438 (IC 95%; 0,283-0,678) y un consumo de alcohol menor de una vez a la semanaOR = 0,451 (IC 95%; 0,270-0,752).Conclusión: los estudiantes que registran una ingesta adecuada de verduras y frutas autodefinen su alimentación como saludable e ideal y tienden a autopercibirse coherentemente en relación con su estado nutricional; además, estos sujetos son los que presentan una ingesta menor de alimentos poco saludables.

Special Issue "Natural Hazards' Impact on Urban Areas and Infrastructure" in Natural Hazards

NASA Astrophysics Data System (ADS)

Bostenaru Dan, M.

2009-04-01

In 2006 and 2007, at the 3rd and 4th General Assembly of the European Geosciences Union respectivelly, the session on "Natural Hazards' Impact on Urban Areas and Infrastructure" was convened by Maria Bostenaru Dan, then at the Istituto Universitario di Studi Superiori di Pavia, ROSE School, Italy, who conducts research on earthquake management and Heidi Kreibich from the GFZ Potsdam, Germany, who conducts research on flood hazards, in 2007 being co-convened also by Agostino Goretti from the Civil Protection in Rome, Italy. The session initially started from an idea of Friedemann Wenzel from the Universität Karlsruhe (TH), Germany, the former speaker of the SFB 461 "Strong earthquakes", the university where also Maria Bostenaru graduated and worked and which runs together with the GFZ Potsdam the CEDIM, the Center for Disaster Management and Risk Reduction Technology. Selected papers from these two sessions as well as invited papers from other specialists were gathered for a special issue to be published in the journal "Natural Hazards" under the guest editorship of Heidi Kreibich and Maria Bostenaru Dan. Unlike the former special issue, this one contains a well balanced mixture of many hazards: climate change, floods, mountain hazards like avalanches, volcanoes, earthquakes. Aim of the issue was to enlarge the co-operation prospects between geosciences and other professions in field of natural hazards. Earthquake engineering and engineering seismology are seen more frequently co-operating, but in field of natural hazards there is a need to co-operate with urban planners, and, looking to the future, also in the field of integrated conservation, which implies co-operation between architecture and urban planning for the preservation of our environment. Integrated conservation is stipulated since the 1970s, which are the years when the participatism, and so the involvment of social sciences started.

[In Process Citation].

PubMed

Almeida Dos Santos, Alyne Dayana; Sabino Pinho, Cláudia Porto; Santos do Nascimento, Alexsandra Camila; Oliveira Costa, Ana Carolina

2016-03-25

Introducción: la sarcopenia se define como un síndrome geriátrico, multifactorial, caracterizado por la pérdida progresiva de masa muscular esquelética, asociada a consecuencias graves, tales como comorbideces, mala calidad de vida y mortandad. Objetivo: identificar la prevalencia y los factores asociados a la sarcopenia en ancianos atendidos ambulatoriamente. Métodos: estudio transversal y observacional realizado con pacientes ancianos de ambos sexos atendidos en ambulatorio geriátrico, entre junio y diciembre de 2014, en un hospital universitario ubicado en el nordeste brasileño. Se determinó la sarcopenia a través de la masa muscular (circunferencia de la pantorrilla < 31 cm), fuerza muscular (evaluada por la fuerza de prensión palmar < 30 kg para hombres y < 20 kg para mujeres) y velocidad de marcha (< 0,8 metros/segundo). Entre las variables de asociación, se consideraron aspectos socioeconómicos y demográficos, variables clínicas, estilo de vida y antropometría. La tabulación y análisis de los datos se realizaron por medio del paquete estadístico SPSS versión 13.0. Resultados: la muestra se compuso de 50 pacientes, con promedio de edad de 73,9 (± 7,4) años, en la que se verificó una prevalencia de sarcopenia del 18%. La sarcopenia fue más prevalente en individuos con edad ≥ 80 años (p = 0,012), en los ancianos con bajo peso según el IMC (p < 0,001), con desnutrición de acuerdo con la CB (p = 0,004) y en los pacientes sin hipertensión arterial (p = 0,027), no encontrándose asociación con variables socioeconómicas, clínicas y del estilo de vida. Conclusiones: la prevalencia de la sarcopenia fue significativa y semejante a la descrita por otros autores, encontrándose asociación con la edad avanzada, desnutrición y ausencia de hipertensión.

[Vulvovaginitis caused by Candida spp. and Trichomonas vaginalis in sexually active women].

PubMed

Azzam-W, Maha; Cermeño-Vivas, Julman R; Orellán-García, Yida; Penna, Salvador J

2002-03-01

Vulvovaginitis accounts for 20 to 30% of gynecological diseases and it is observed in women from 20 to 30 years of age. It has a higher frequency in women using oral contraceptives and during the third trimester of pregnancy. The aim of this research was to assess the prevalence of Candida spp and Trichomonas vaginalis in patients with the diagnosis of vulvovaginitis from the Gynecology Service in Hospital Universitario "Ruiz y Páez" in Ciudad Bolívar and Hospital "Raúl Leoni" in San Félix (Bolívar State, Venezuela). Two hundred women with symptoms of vulvovaginitis were examined, and samples were taken from the uterocervical cul-de-sac. Each patient was asked to fill a questionnaire. The following studies were made in each sample: a) fresh wet mount examination, b) orange acridine and Giemsa stains for Trichomonas and c) culture for the identification of yeasts. The latter were identified by means of the germinal tube assay, resistance to actidione and the presence of clamidospores in rice-cream agar and sugar utilization test, using the commercial kit ID32C (BioMérieux). Only in 57 women of 200 patients with vulvovaginitis the causative agent was demonstrated; Candida spp was present in 84.2% (n = 48) and Trichomonas vaginalis in 14% (n = 8). A single case of Zygosaccharomyces spp (1.8%) was detected. The age group mainly affected was that of 25-35 years old, the 38.6% of the studied population. Candida species detected were: C. albicans in 87% of cases (n = 42), C. glabrata, in 10.42% (n = 5), and C. guillermondii, in 2.08 (n = 1). Vaginal flux, vulvar pruritus and leucorrhoea were observed in significant number of patients with vulvovaginal candidiasis. The use of antibiotics was considered predisposing factor for Trichomonas vaginalis infection. The relationship between age and the etiological agent was not statistically significant. Due to the low specificity of clinical manifestations of infections caused by Candida spp and Trichomonas vaginalis, we conclude that performing the etiologic diagnosis of vulvovaginitis is necessary in order to take the appropriate therapeutic and preventive measures, specially in those patients with a recurrent disease.

El aprendizaje significativo en las ciencias al participar en proyectos de investigacion cientifica

NASA Astrophysics Data System (ADS)

Mora Polanco, Miguelena

La ciencia es el eje fundamental a traves del cual se desarrollan las habilidades necesarias para el pensar cientifico que va a la busqueda del conocimiento cientifico. La intencion de este estudio fue indagar en el tema de investigacion cientifica desde el punto de vista de los participantes en los siguientes aspectos relacionados con la experiencia de investigacion cientifica: a) conceptos, b) proceso, c) destrezas y d) disposicion. Tambien se analizaron: a) las perspectivas del metodo cientifico, b) la estrategia de ensenanza, c) la cultura cientifica y d) la exposicion del proyecto investigativo en la Feria Cientifica; como parte del aprendizaje significativo de la ciencias de los participantes. Esta investigacion cualitativa propuso como diseno el estudio de caso. Los aspectos relacionados a la experiencia de participar en proyecto de investigacion cientifica son el fenomeno o caso bajo estudio. En el estudio participaron cinco (5) estudiantes egresados de escuela publica o privada que cursaban hasta el tercer ano de estudios universitarios, conducentes a un bachillerato en educacion secundaria en ciencias o en ciencias naturales. Las tecnicas utilizadas para recopilar los datos fueron: analisis de documentos del DEPR, revision de artefactos y entrevistas profundas. Para el analisis de los datos de las entrevistas se utilizo el modelo de Wolcott (1994). Del analisis de documentos del DEPR se identificaron areas a mejorar en las guias de las cartas circulares con relacion a la investigacion escolar y la feria cientifica. El analisis de los artefactos proveyo evidencia de como los internados, simposios e investigaciones fomentan el que los estudiantes se superen en el aspecto cognitivo, se conviertan en creadores del conocimiento, al hacer suyo los conceptos para poder explicarlos al publico. De las entrevistas los participantes manifestaron que la experiencia de investigacion fue una de aprendizaje significativo que los marco para toda la vida y les expandio su curiosidad de modo que lo aplican en su vida. La experiencia los ayudo en el entendimiento y la aplicacion de conceptos, procesos y destrezas relacionados con la ciencia. Finalmente, los participantes proveyeron las estrategias didacticas que desde su perspectiva facilitan la ensenanza-aprendizaje de la ciencia.

Implementacion de modulos constructivistas que atiendan "misconceptions" y lagunas conceptuales en temas de la fisica en estudiantes universitarios

NASA Astrophysics Data System (ADS)

Santacruz Sarmiento, Neida M.

Este estudio se enfoco en los "misconception" y lagunas conceptuales en temas fundamentales de Fisica como son Equilibrio Termodinamico y Estatica de fluidos. En primer lugar se trabajo con la identificacion de "misconceptions" y lagunas conceptuales y se analizo en detalle la forma en que los estudiantes construyen sus propias teorias de fenomenos relacionados con los temas. Debido a la complejidad en la que los estudiantes asimilan los conceptos fisicos, se utilizo el metodo de investigacion mixto de tipo secuencial explicativo en dos etapas, una cuantitativa y otra cualitativa. La primera etapa comprendio cuatro fases: (1) Aplicacion de una prueba diagnostica para identificar el conocimiento previo y lagunas conceptuales. (2) Identificacion de "misconceptions" y lagunas del concepto a partir del conocimiento previo. (3) Implementacion de la intervencion por medio de modulos en el topico de Equilibrio Termodinamico y Estatica de Fluidos. (4) Y la realizacion de la pos prueba para analizar el impacto y la efectividad de la intervencion constructivista. En la segunda etapa se utilizo el metodo de investigacion cualitativo, por medio de una entrevista semiestructurada que partio de la elaboracion de un mapa conceptual y se finalizo con un analisis de datos conjuntamente. El desarrollo de este estudio permitio encontrar "misconceptions" y lagunas conceptuales a partir del conocimiento previo de los estudiantes participantes en los temas trabajados, que fueron atendidos en el desarrollo de las distintas actividades inquisitivas que se presentaron en el modulo constructivista. Se encontro marcadas diferencias entre la pre y pos prueba en los temas, esto se debio al requerimiento de habilidades abstractas para el tema de Estatica de Fluidos y al desarrollo intuitivo para el tema de Equilibrio Termodinamico, teniendo mejores respuestas en el segundo. Los participantes demostraron una marcada evolucion y/o cambio en sus estructuras de pensamiento, las pruebas estadisticas de t-pareada fueron significativas para ambos modulos a pesar que en la pos prueba no todos llegaron a la respuesta correcta. El analisis cualitativo de las respuestas de los participantes confirmo la dificultad de remover "misconception" y lagunas conceptuales.

Traumatismo craneoencefálico leve

PubMed Central

Ortega Zufiría, José Manuel; Prieto, Noemí Lomillos; Cuba, Bernardino Choque; Degenhardt, Martin Tamarit; Núñez, Pedro Poveda; López Serrano, María Remedios; López Raigada, Azahara Belén

2018-01-01

Resumen Introducción y objetivo: El TCE leve representa un problema sanitario de enorme interés debido a que un número significativo de enfermos con trauma leve desarrollará complicaciones potencialmente mortales. El objetivo de este estudio ha sido describir una serie amplia de pacientes adultos, mayores de 14 años, que sufren TCE leve, atendidos en el Hospital Universitario de Getafe, entre los años 2010 y 2015 (n = 2480), estudiar el perfil epidemiológico y analizar el diagnóstico y el tratamiento efectuados, así como establecer los principales factores pronósticos que influyen en el resultado final. Método: Se ha realizado un estudio retrospectivo, de revisión de historias clínicas, analizando los resultados con estudio estadístico bivariable y multivariable. Resultados: El TCE leve es más frecuente en varones, y el mecanismo causante más común en nuestro medio es el accidente de tráfico. Se propone un modelo de clasificación de pacientes según grupos de riesgo, que los subdivide en riesgo bajo, intermedio o alto, que se correlaciona bien con la probabilidad de desarrollar complicación intracraneal, y, consecuentemente, con el resultado final. Se discute la indicación de la radiografía simple de cráneo y de la Tomografía Computarizada (TC), así como del ingreso hospitalario para observación neurológica. Conclusiones: En este estudio, la presencia de focalidad neurológica en la exploración clínica, la edad, las alteraciones de la coagulación y la existencia de fractura en la radiografía simple se relacionan con mayor posibilidad de desarrollar lesiones traumáticas intracraneales y con peor pronóstico final. La escala de Glasgow para el Coma es deficitaria en la determinación del resultado final del paciente que sufre TCE, porque no considera variables tales como la amnesia o la pérdida de conocimiento, muy frecuentes en el traumatismo craneoencefálico leve. PMID:29430327

Juxtarenal aortic aneurysm with hostile neck anatomy: midterm results of minilaparotomy versus f-EVAR.

PubMed

Barillà, D; Sobocinski, J; Stilo, F; Maurel, B; Spinelli, F; Haulon, S

2014-10-01

The aim of this study was to compare the results of complex aneurysm (hostile neck anatomies) repair in high-risk patients with two minimally invasive techniques, fenestrated endografting (f-EVAR where EVAR stands for endovascular aneurysm repair) and minilaparotomy. All high-risk patients (N.=50, group 1) with hostile neck abdominal aortic aneurysms (AAAs) operated in the vascular surgery department of the "Policlinico Universitario G. Martino" of Messina (Italy) during a 5-year period (January 2006-December 2010) were cross-matched with 50 similar patients (group 2) treated in the Vascular Surgery Department of the "Hopital Cardiologique" University of Lille (France) with similar anatomies, comorbidities and risk factors. The patients in group 1 underwent open minilaparotomy surgery, and the patients in group 2 were treated with f-EVAR. The aim of our study was to compare perioperative complications, survival and reintervention rates. Perioperative cardiac complications occurred in 5 patients (10%) in group 1, and 1 patient (2%) in group 2 (P<0.092). Renal impairment not requiring permanent hemodialysis was significantly higher in group 1 (14% vs. 2% P<0.027), as well as respiratory complications (32% vs. 2% P<0.0001). Five patients (10%) in group 1 underwent reintervention vs. 4 patients in group 2 (P<0.7268). There was no statistically significant difference for survival rates at 30 days (92% in group 1 and 96% in group 2; P=0.399); at six months (90% vs. 96%; P=0.239); at one year (90% vs. 96%; P=0.239); and at two years (84% vs. 94%; P=0.110). However, we observed statistically significant differences in survival rates at three years (74% vs. 94%; P<0.006); at four years (70% vs. 86%; P<0.005); and at five years (65% vs. 68%; P<0.003). Our results showed that both techniques are effective in the treatment of AAA with hostile neck in high-risk patients. Although operative mortality rate was not statistically different, f-EVAR showed better results in terms of early complications and late survival.

Profesionalismo: Un estudio fenomenologico sobre experiencias de universitarios en programas de salud

NASA Astrophysics Data System (ADS)

Lopez Ortiz, Wilma J.

Some studies suggest that, upon admission, medicine programs students display eagerness for community service, aspirations to be useful, and to contribute to society's well-being. Those same studies reflect that qualities of idealism, moral nature, and internal motivation, suffer a subsequent diminishing. The researchers inferred that the main reason for this process of change in the mood and disposition of these future physicians lies in the modeling they receive from medical professionals throughout clinical learning activities, by way of behavior and relationships exhibited during daily interaction with peers, patients and the students themselves. This phenomenological study used a cross-sectional sample to explore the experiences of future health workers as they went through didactic and clinical phases of their training curriculum. The study employed semi-structured interviews and reflective journals to explore those experiences and to discover the meanings ascribed by the participants. The analysis revealed that the students defined "professionalism" in terms of scientific knowledge, commitment, respect for human dignity, comradeship, courtesy, empathy, integrity, altruism, motivation. They also described their feelings as they went through the didactic and clinical experiences, and recognized as very important the extracurricular activities of community service, describing them as useful opportunities which contributed to understand their work in terms of a mission dedicated to the achievement of the social benefit. From their individual perspectives, the clinical environment could, in general, be described as congruent with those characteristics of professionalism. During the study we had the opportunity to share, in a little deeper way, the environment... the world... of this small group of young students as we went on trying to decipher their feelings and thoughts. At the end, we realized the richness of their sensibilities, we perceived the intensity of their moral and ethical convictions, we were able to understand their concerns, worries, struggles and efforts. This life event had profound and significant repercussions in our personal and professional life. As a result, and from now on, we will no longer look at our young scholars and apprentices without imagining a noble spirit, with goals which at times could seem unattainable... without completely visualizing or conceiving real hope for a better country.

[In Process Citation].

PubMed

Alarcón Hormazábal, Manuel; Delgado Floody, Pedro; Castillo Mariqueo, Lidia; Thuiller Lepelegy, Nicole; Bórquez Becerra, Pablo; Sepúlveda Mancilla, Carlos; Rebolledo Quezada, Sara

2016-03-25

Introducción: existe una alta prevalencia de sedentarismo, sobrepeso y obesidad en jóvenes universitarios. Objetivo: el propósito del estudio fue determinar los efectos de un programa de entrenamiento intervalado de alta intensidad (HIIT) sobre el perfil antropométrico, glicemia basal y VO 2 máx (consumo máximo de oxígeno) de jóvenes sedentarios con malnutrición por exceso. Material y métodos: 6 mujeres y 2 hombres (2 obesos y 6 con sobrepeso) se sometieron a un programa de entrenamiento de alta intensidad de 8 semanas de duración (3 sesiones/semana). Se evaluó en ayuno y posterior a 72 horas de la última intervención; peso, índice de masa corporal (IMC), contorno de cintura (CC), perímetro de cadera y glicemia de basal. El VO 2 máx fue evaluado en condiciones normales previo a la primera sesión. Resultados: las variables de estudio no presentaron cambios significativos (p > 0,05), pero reportaron disminuciones porcentuales. El peso disminuyó un 0,18%, el IMC un 0,27%, el CC 2,67%, el perímetro de cadera un 1,15%, y el VO 2 máx un 0,48%. La glicemia basal presentó la mayor disminución, pasó de 95,13 ± 23,91 a 89,88 ± 12,45 mg/dl (5,52%), estabilizando y mejorando sus niveles en cada uno de los participantes. Conclusiones: el programa de entrenamiento intervalado de alta intensidad fue factible de realizar sin resultados adversos para la salud de los participantes, la glicemia basal mostró la mayor variación, estabilizando sus valores en los participantes, lo que es un indicador positivo dentro del programa. Es necesario seguir investigando sobre esta metodología HIIT y aumentar los tiempos de estudio para ver los cambios que se pueden producir en distintos parámetros metabólicos, antropométricos y físicos en población con malnutrición por exceso.

Rationale and study design for an individualised perioperative open-lung ventilatory strategy with a high versus conventional inspiratory oxygen fraction (iPROVE-O2) and its effects on surgical site infection: study protocol for a randomised controlled trial.

PubMed

Ferrando, Carlos; Soro, Marina; Unzueta, Carmen; Canet, Jaume; Tusman, Gerardo; Suarez-Sipmann, Fernando; Librero, Julian; Peiró, Salvador; Pozo, Natividad; Delgado, Carlos; Ibáñez, Maite; Aldecoa, César; Garutti, Ignacio; Pestaña, David; Rodríguez, Aurelio; García Del Valle, Santiago; Diaz-Cambronero, Oscar; Balust, Jaume; Redondo, Francisco Javier; De La Matta, Manuel; Gallego, Lucía; Granell, Manuel; Martínez, Pascual; Pérez, Ana; Leal, Sonsoles; Alday, Kike; García, Pablo; Monedero, Pablo; Gonzalez, Rafael; Mazzinari, Guido; Aguilar, Gerardo; Villar, Jesús; Belda, Francisco Javier

2017-07-31

Surgical site infection (SSI) is a serious postoperative complication that increases morbidity and healthcare costs. SSIs tend to increase as the partial pressure of tissue oxygen decreases: previous trials have focused on trying to reduce them by comparing high versus conventional inspiratory oxygen fractions (FIO 2 ) in the perioperative period but did not use a protocolised ventilatory strategy. The open-lung ventilatory approach restores functional lung volume and improves gas exchange, and therefore it may increase the partial pressure of tissue oxygen for a given FIO 2 . The trial presented here aims to compare the efficacy of high versus conventional FIO 2 in reducing the overall incidence of SSIs in patients by implementing a protocolised and individualised global approach to perioperative open-lung ventilation. This is a comparative, prospective, multicentre, randomised and controlled two-arm trial that will include 756 patients scheduled for abdominal surgery. The patients will be randomised into two groups: (1) a high FIO 2 group (80% oxygen; FIO 2 of 0.80) and (2) a conventional FIO 2 group (30% oxygen; FIO 2 of 0.30). Each group will be assessed intra- and postoperatively. The primary outcome is the appearance of postoperative SSI complications. Secondary outcomes are the appearance of systemic and pulmonary complications. The iPROVE-O2 trial has been approved by the Ethics Review Board at the reference centre (the Hospital Clínico Universitario in Valencia). Informed consent will be obtained from all patients before their participation. If the approach using high FIO 2 during individualised open-lung ventilation decreases SSIs, use of this method will become standard practice for patients scheduled for future abdominal surgery. Publication of the results is anticipated in early 2019. NCT02776046; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Comprension de los conceptos de los enlaces ionico y covalente en estudiantes universitarios del primer curso de quimica general

NASA Astrophysics Data System (ADS)

Ballesteros Benavides, Maria Elvira

Para este trabajo utilizamos el estudio de casos cualitativo que se llevo a cabo en una universidad privada de Puerto Rico. Empleamos como unidad de analisis el concepto de enlace quimico, ionico y covalente. Los participantes fueron los estudiantes de la seccion nocturna del curso de Quimica General I. La investigacion se desarrollo por medio de dos entrevistas de persona a persona, observaciones de las expresiones no verbales y la hoja de identificacion de conceptos. Para la triangulacion tomamos en consideracion las preconcepciones erroneas, las concepciones alternativas y el mapa de conceptos de cada participante. Preparamos un mapa de conceptos para el enlace quimico validado por un comite de expertos. Tambien, elaboramos los mapas de conceptos de los participantes que sirvieron para varios propositos: conocer la estructura conceptual, expresar los logros, hacer comparaciones e identificar la presencia de concepciones alternativas. Entre los hallazgos encontramos que todos los participantes poseen conocimiento previo de los enlaces quimicos ionico y covalente y dentro de ese conocimiento existen preconcepciones erroneas mas numerosas para el enlace ionico. Al principio del semestre el 50% de los participantes demostraron tener "carencia fuerte de conceptos" tanto para el enlace ionico como para el covalente. Al finalizar el semestre encontramos en el 40% de los participantes concepciones alternativas tanto para el enlace ionico como para el covalente y el 90% no lograron distinguir un enlace del otro. Nuestras conclusiones fueron que los participantes sin distincion del aprovechamiento academico demostraron tener la tendencia de "carencia fuerte de conceptos" tanto para el enlace ionico como para el covalente, presentaron dificultad al integrar los conceptos de los enlaces quimicos ionico y covalente que se pusieron de manifiesto al dar los ejemplos. Las preconcepciones erroneas contribuyen en el desarrollo de las concepciones alternativas. Ademas, los participantes no lograron diferenciar los dos enlaces quimicos. Esto implica que reflexionemos sobre la necesidad de revisar tanto las competencias cognoscitivas como la forma de ensenar quimica en el salon de clase. Recomendamos indagar y dar importancia al conocimiento previo de los estudiantes, enfatizar la ensenanza de los conceptos y propiciar el aprendizaje con significado.

Human papillomavirus genotypes in human immunodeficiency virus-positive patients with anal pathology in Madrid, Spain

PubMed Central

2013-01-01

Background We studied anal specimens to determine the distribution of human papillomavirus (HPV) genotypes and co-infection occurrence. This information will contribute to the knowledge of HPV genotype distributions and provide an estimate of the prevalence of different oncogenic HPV genotypes found in patients in Madrid (Spain). Methods We studied a total of 82 anal biopsies from the Hospital General Universitario Gregorio Marañón of Madrid. These included 4 specimens with benign lesions, 52 specimens with low-grade anal squamous intraepithelial lesion, 24 specimens with high-grade anal squamous intraepithelial lesions and 2 specimens with invasive anal carcinoma. HPV genotyping was performed with PCR amplification and reverse dot blot hybridization. Results We detected 33 different HPV genotypes, including 16 HPVs associated with a high risk of carcinogenesis, 3 HPVs associated with a highly likely risk of carcinogenesis and 14 HPVs associated with a low-risk of carcinogenesis. In two specimens, an uncharacterized HPV genotype was detected. The most frequent HPV genotypes found were HPV-16 (10.3%; 95% CI: 6.6%-15.1%), HPV-52 (8.5%; 95% CI: 5.2%-13%) and HPV-43/44 (7.6%; 95% CI: 4.5%-11.9%). HPV-18 was only detected in 0.9% (95% CI: 0.1%-3.2%) of the total viruses detected in all lesions. HPV co-infections were found in 83.9% of all types of lesions. The majority of cases (90.2%) were concomitantly infected with the human immunodeficiency virus (HIV). Conclusion The prevalence of high-risk carcinogenic genotypes in anal pathological samples was remarkable. Therefore, further studies that include a greater number of samples, particularly invasive carcinoma cases are needed to evaluate the potential influence of these HPV genotypes in the appearance of anal carcinomas. Also, the influence of other accompanying infections should be evaluated clarify the appearance of this type of carcinoma. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2075238024106058. PMID:24325764

Essays on Eclipses, Transits and Occultations as Teaching Tools in the Introductory Astronomy College Course. (Spanish Title: Ensayos sobre Eclipses, Tránsitos y Ocultaciones Como Herramientas de Enseñanza en el Curso Universitario Introductorio a la Astronomía.) Ensaios sobre Eclipses, Trânsitos e Ocultações Como Ferramentas de Ensino em um Curso Universitário Introdutório de Astromomia

NASA Astrophysics Data System (ADS)

Dcruz, Noella L.

2014-07-01

We occasionally include projects in our learner-centered introductory astronomy college course to enable non-science major students explore some astronomical concepts in more detail than otherwise. Such projects also highlight ongoing or upcoming astronomical events. We hope that students will feel more interested in astronomy through projects tied to astronomical events. In Spring 2012, we offered short essays focused on eclipses, transits and occultations to promote the rare transit of Venus that occurred on June 5th, 2012. We asked students to write two short essays from three that were offered. The essays contained descriptive and conceptual parts. They were meant to serve as teaching tools. 62% of 106 essays from 55 students earned A, B or C grades. 21% of 47 feedback survey respondents felt the essays increased their interest in astronomy. 49% of respondents felt that the essays were not educationally beneficial and should not be offered again. The most common written response to our survey indicated that students need more guidance and better preparation in writing successful essays. Since students found the conceptual parts of the essays difficult, in the future we will provide relevant activities prior to essay deadlines to help students create successful essays. Ocasionalmente, incluimos proyectos en nuestro curso de introducción a la astronomía universitario centrado en el alumno para permitir que los estudiantes de carreras no científicas exploren algunos conceptos astronómicos en más detalle que lo habitual. Estos proyectos también ponen en relevancia eventos astronómicos en curso o futuros. Esperamos que los estudiantes se sientan más interesados en la astronomía a través de proyectos vinculados a eventos astronómicos. En el período de primavera de 2012 (EUA), propusimos breves ensayos centrados en los eclipses, tránsitos y ocultaciones para promover el raro tránsito de Venus que se produjo el 5 de junio de 2012. Le pedimos a los estudiantes que escribieran dos ensayos cortos de tres que se proponían. Los ensayos contenían partes descriptivas y conceptuales. Los mismos estaban destinados a servir como herramientas de enseñanza. 62% de los 106 ensayos de 55 estudiantes obtuvo grados A, B o C. 21% de los 47 encuestados que respondieron al cuestionario posterior consideró que los ensayos aumentaron su interés por la astronomía. 49% de los encuestados consideró que los ensayos no eran educacionalmente útiles y que no deben ser propuestos de nuevo. Las respuestas escritas más comunes a nuestra encuesta indicaran que los estudiantes necesitan más orientación y una mejor preparación en la redacción de ensayos exitosos. Dado que los estudiantes encontraron las piezas conceptuales de los ensayos difíciles, en el futuro vamos a ofrecer actividades pertinentes antes de los plazos de redacción para ayudar a los estudiantes a crear ensayos de mayor calidad. Nós ocasionalmente incluímos projetos em nosso curso universitário introdutório centrado no aluno para permitir aos estudantes que pertencem às carreiras não científicas explorar alguns conceitos astronômicos em mais detalhes do que o normal. Tais projetos também enfatizam eventos astronômicos em curso ou futuros. Esperamos que os alunos se sintam mais interessados na astronomia através de projetos ligados a eventos astronômicos. No termo de Primavera de 2012 (EUA), propomos ensaios curtos focados em eclipses, trânsitos e ocultações para promover o raro trânsito de Vênus que ocorreu no dia 5 de junho de 2012. Pedimos aos alunos que escrevessem dois ensaios curtos dentre três que foram propostos. Os ensaios continham partes descritivas e conceituais. Eles foram feitos para servir como ferramentas de ensino. 62% de 106 ensaios de 55 alunos ganhou graus A, B ou C. 21% dos 47 entrevistados que responderam ao levantamento posterior sentiu que os ensaios aumentaram seu interesse na astronomia. 49% dos inquiridos consideraram que os ensaios não eram benéficos para a educação e que não devem ser propostos novamente. As respostas escritas mais comuns da nossa pesquisa indicaram que os alunos precisam de mais orientação e melhor preparação para escrever ensaios bem sucedidos. Como os alunos consideraram difíceis os aspectos conceituais dos ensaios, no futuro iremos fornecer atividades relevantes antes dos ensaios para ajudar os alunos a escrevê-los com sucesso.

PubMed

Fernández Alba, Juan Jesús; Paublete Herrera, María Del Carmen; González Macías, María Del Carmen; Carral San Laureano, Florentino; Carnicer Fuentes, Concepción; Vilar Sánchez, Ángel; Torrejón Cardoso, Rafael; Moreno Corral, Luis Javier

2016-11-29

Introducción: el sobrepeso y la obesidad se asocian a una mayor probabilidad de que el parto finalice en cesárea. Dado que dicho incremento del riesgo podría estar sesgado por variables de confusión como la diabetes o la hipertensión, en el presente trabajo pretendemos determinar si este riesgo persiste tras ser ajustado por numerosas variables de control.Objetivo: determinar si el sobrepeso y/o la obesidad son factores de riesgo independientes para que el parto finalice en cesárea.Métodos: estudio de cohortes retrospectivo. Se han incluido gestantes adscritas al Hospital Universitario de Puerto Real. Periodo de estudio: 2002-2011. Se incluyeron dos grupos de estudio: sobrepeso al inicio de la gestación (IMC entre 25 y 29,9) y obesidad al inicio de la gestación (IMC ≥ 30). Grupo ontrol: IMC al inicio de la gestación normal (entre 18,5 y 24,9). El riesgo de cesárea fue analizado mediante un estudio de regresión logística múltiple incluyendo como covariables: edad materna, parto inducido, diabetes gestacional, diabetes pregestacional, macrosomía, hipertensión arterial, nuliparidad, cesárea anterior, parto pretérmino y parto postérmino.Resultados: de los 18.243 partos registrados, el IMC al inicio de la gestación constaba en 4.711 casos (25,8%). El 26,1% presentaban sobrepeso, el 12,4% obesidad y el 58,9% IMC normal. Sin ajustar por variables control, se asociaron a un incremento del riesgo de cesárea: sobrepeso (OR 1,48; IC95% 1,27-1,73); obesidad grado 1 (OR 2,09; IC95% 1,66-2,64); obesidad grado 2 (OR 3,23; IC95% 2,31-4,53); obesidad grado 3 (OR 2,57; IC95% 1,56-4,22). El riesgo aumentado se mantuvo significativo en el análisis multivariante: sobrepeso (OR 1,51; IC95% 1,24-1,84); obesidad (OR 2,15; IC95% 1,67-2,76).Conclusiones: encontramos una asociación significativa e independiente entre el sobrepeso/obesidad maternos y la finalización del parto mediante cesárea incluso ajustando por numerosas variables de control como: edad materna, nuliparidad, cesárea anterior, hipertensión, diabetes, peso al nacer y edad gestacional al parto.

Ultra-Sensitive C-Reactive Protein (US-CRP) in Patients With Periodontal Disease and Risk of Acute Myocardial Infarction.

PubMed

Uriza, Catalina Latorre; Arregoces, Francina Escobar; Porras, Juliana Velosa; Camargo, Maria Beatriz Ferro; Morales, Alvaro Ruiz

2011-02-01

The purpose of this study was to determine if the US-CRP values associated with periodontal disease are risk markers for Acute Myocardial Infarction (AMI) and to determine if the US-CRP levels associated with recent AMI are higher in patients with Periodontal disease. In order to meet the goal of the study, a case control study design was conducted. The analysis sample consisted of 401 adults (30 - 75 years old), living in Bogota D.C., Colombia, from the Hospital Universitario San Ignacio, the Faculty of Dentistry at the Pontificia Universidad Javeriana, and the Fundacion Cardio Infantil. Patients with current infections, antibiotic use in the last 3 months, periodontal treatment at least six months before the baseline of this study, mouth ulcerations caused by any type of prosthesis, candidiasis, stomatitis, or less than 7 teeth in mouth were excluded. Periodontal examination for the case group and the control group was conducted by three previously calibrated examiners. Periodontal disease was diagnosed by the presence of bleeding on probing and attachment loss. The Chronic Periodontitis diagnosis was confirmed with these clinical signs, according to the 1999 Armitage classification. The assessment of the US-CRP was performed using the IMMULITE method containing one monoclonal and one polyclonal anti-CRP antibody. This method provides a measurement range of 0.1 - 500 mg/L. Statistical analysis of variables was performed with OR and confidence intervals. A multivariate analysis was performed to determine the association between the US-CRP increase, periodontal disease and acute myocardial infarction, adjusting for smoking and other confounding factors identified in the analysis. The study population was constituted by 401 patients, 56.1% (225) males, with a mean age of 52.6. When groups were compared it was observed that, in those patients with AMI and chronic severe or moderate periodontitis, 24.2% had HDL-C values lower than 40 mg/dl, 78.8% had LDL-C values higher than 100 mg/dl, 55.2% had triglycerides over 150 mg/dl, and US-CRP over 2 mg/L in 53.3%. Periodontal disease (moderate, severe, and chronic periodontal disease) may increase the risk of Acute Myocardial Infarction (AMI) by increasing the US-CRP levels.

Immediate reactions to iodinated contrast media.

PubMed

Morales-Cabeza, Cristina; Roa-Medellín, Dasha; Torrado, Inés; De Barrio, Manuel; Fernández-Álvarez, Carmen; Montes-Aceñero, Juan Francisco; De La Riva, Inmaculada; Prieto-García, Alicia

2017-12-01

Immediate hypersensitivity reactions (IHRs) to iodinated contrast media (ICMs) remain a common clinical concern. Positive skin test and basophil activation test results suggest a specific IgE-mediated mechanism in some cases. Skin test and controlled challenge test (CCT) are useful to manage these patients. To study clinical and allergologic features of IHRs to ICMs in a Spanish tertiary hospital during a 7-year period. Demographic and clinical data concerning the reaction were recorded. Patients treated at the Allergy Department of Hospital General Universitario Gregorio Marañón, Madrid, Spain, underwent skin tests. In those with positive results, CCTs with an alternative skin-test-negative ICM was performed. Global reaction rate was calculated and compared for each ICM. A total of 342 reactions occurred in 329 patients. Cutaneous symptoms were the most common (87.7%). A total of 196 patients underwent an allergy workup, 15 (7.6%) of whom had positive skin test results. Reactions were more severe in patients with positive vs negative skin test results (grade 1, 46.7% vs 73.6%; grade 2, 33.3% vs 20.9%; grade 3, 20% vs 5.46%; P < .05). Three patients had cross-reactivity to 3 ICMs, all including ioversol and iomeprol. Six patients allergic to iopamidol tolerated ioversol and 1 tolerated iomeprol. Four patients allergic to ioversol and 1 allergic to iomeprol tolerated iopamidol. The global reaction rate was 0.2%, differing for each ICM (iopamidol, 0.14%; ioversol, 0.2%; and iomeprol, 0.4%; P < .001). Positive skin test results were found in a low percentage of patients in whom skin test-based CCT identified an alternative non-cross-reactive ICM. Low-grade cross-reactivity was found, especially between iopamidol and ioversol. Reactions were more severe in patients with positive skin test results. The reaction rate was greater for iomeprol compared with iopamidol (reaction rate, 2.8%) and ioversol (reaction rate, 2%). This study identified a possible underlying specific IgE-mediated mechanism by positive skin test result in a low percentage of patients with IHRs to ICMs. In these patients, the CCT based on skin test results was useful for identifying an alternative non-cross-reactive ICM. More studies are needed to investigate the underlying mechanism in patients with IHRs and negative skin test results. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Precipitation effects on aerosol concentration in the background EMEP station of Zarra (Valencia), Spain

NASA Astrophysics Data System (ADS)

Calvo, Ana Isabel; San Martín, Isabel; Castro, Amaya; Alonso-Blanco, Elisabeth; Alves, Célia; Duarte, Márcio; Fernández-González, Sergio; Fraile, Roberto

2014-05-01

Aerosols and precipitation are closely related, presenting a bidirectional influence and constituting an important source of uncertainties on climate change studies. However, they are usually studied independently and in general are only linked to one another for the development or validation of cloud models. The primary and secondary pollutants may be removed by wet and dry deposition. Wet deposition, including in-cloud and below-cloud scavenging processes, can efficiently remove atmospheric aerosols and it is considered a critical process for determining aerosol concentrations in the atmosphere. In this study, aerosols and precipitation data from a background Spanish EMEP (Cooperative Programme for the Monitoring and Evaluation of Long Range Transmission of Air Pollutants in Europe) station located in Zarra, Valencia (Spain) were analyzed (1° 06' W and 39° 05' N, 885 m asl). The effect of precipitation on aerosol concentration was studied and the correlation between the intensity of precipitation and scavenging effect was investigated. In order to evaluate the effects of precipitation on different aerosol size ranges three different aerosol fractions were studied: PM10, PM10-2.5 and PM2.5. In order to eliminate the influence of the air mass changes, only the days in which the air mass of the precipitation day and the previous day had the same origin were considered. Thus, from a total of 3586 rainy days registered from March 2001 to December 2010, 34 precipitation days satisfied this condition and were analyzed. During the period of study, daily precipitation ranged between 0.2 and 28.8 mm, with a mean value of 4 mm. Regarding the origin of the air masses, those from west were dominant at the three height levels investigated (500, 1500 and 3000 m). In order to obtain additional information, aerosol and precipitation chemical composition were also studied in relation to the days of precipitation and the previous days. Furthermore, in order to identify the type of weather associated with each particular synoptic situation, a Circulation Weather Type (CWT) classification was applied. Acknowledgment: This work has been funded by the Spanish Ministry of Science and Innovation (Grant TEC2010-19241-C02-01). S. Fernández-González acknowledges the grant from the "Programa de Formación de Profesorado Universitario (FPU)" awarded by the Spanish Ministry of Education.

PTGER4 gene variant rs76523431 is a candidate risk factor for radiological joint damage in rheumatoid arthritis patients: a genetic study of six cohorts.

PubMed

Rodriguez-Rodriguez, Luis; Ivorra-Cortes, Jose; Carmona, F David; Martín, Javier; Balsa, Alejandro; van Steenbergen, Hanna W; van der Helm-van Mil, Annette H M; González-Álvaro, Isidoro; Fernandez-Gutiérrez, Benjamín

2015-11-05

Prostaglandin E receptor 4 (PTGER4) is implicated in immune regulation and bone metabolism. The aim of this study was to analyze its role in radiological joint damage in rheumatoid arthritis (RA). Six independent cohorts of patients with RA of European or North American descent were included, comprising 1789 patients with 5083 sets of X-rays. The Hospital Clínico San Carlos Rheumatoid Arthritis, Princesa Early Arthritis Register Longitudinal study, and Hospital Universitario de La Paz early arthritis (Spain) cohorts were used as discovery cohorts, and the Leiden Early Arthritis Clinic (The Netherlands), Wichita (United States), and National Databank for Rheumatic Diseases (United States and Canada) cohorts as replication cohorts. First, the PTGER4 rs6896969 single-nucleotide polymorphism (SNP) was genotyped using TaqMan assays and available Illumina Immunochip data and studied in the discovery and replication cohorts. Second, the PTGER4 gene and adjacent regions were analyzed using Immunochip genotyping data in the discovery cohorts. On the basis of pooled p values, linkage disequilibrium structure of the region, and location in regions with transcriptional properties, SNPs were selected for replication. The results from discovery, replication, and overall cohorts were pooled using inverse-variance-weighted meta-analysis. Influence of the polymorphisms on the overall radiological damage (constant effect) and on damage progression over time (time-varying effect) was analyzed. The rs6896969 polymorphism showed a significant association with radiological damage in the constant effect pooled analysis of the discovery cohorts, although no significant association was observed in the replication cohorts or the overall pooled analysis. Regarding the analysis of the PTGER4 region, 976 variants were analyzed in the discovery cohorts. From the constant and time-varying effect analyses, 12 and 20 SNPs, respectively, were selected for replication. Only the rs76523431 variant showed a significant association with radiographic progression in the time-varying effect pooled analysis of the discovery, replication, and overall cohorts. The overall pooled effect size was 1.10 (95 % confidence interval 1.05-1.14, p = 2.10 × 10(-5)), meaning that radiographic yearly progression was 10 % greater for each copy of the minor allele. The PTGER4 gene is a candidate risk factor for radiological progression in RA.

Lesson's-learned from a 2003-2006 USA-Honduras NGO and University Geosciences Education Partnership in Land use Land / Land Cover Change Analysis using Remote Sensing and GPS

NASA Astrophysics Data System (ADS)

Ford, R. E.

2006-12-01

Between 2004 and 2006 the Loma Linda University ESSE21 Mesoamerican Project (Earth System Science Education for the 21st Century) collaborated with a series of academic, NGO (nongovernmental) and government agencies, including a USAID (United States Agency for International Development) integrated environmental resource management project to: a) build the human and technical capacity of local partners in the use of geospatial technologies, e.g. GIS, GPS, Remote Sensing, b) improve their capacity to apply these tools to biodiversity, health, sustainability, protected-area management, and other NRM (Natural Resource Management) decision-making needs and problems, and c) establish long term institutional relationships for teacher/student exchange, including development of joint curricula and research projects focused on health geoinformatics as well as sustainable development. Much of this has contributed toward a new "geotourism" effort adopted by Honduras called the SAVE Honduras strategy (Scientific, Academic, Volunteer, Educational). A central element of this initiative is to increase joint collaborative research and learning together by students and faculty at US universities working with Honduran institutions (private and public). See SAVE Strategy page = http://www.fundacionsave.com/home_eng.html In the presentation we describe our experience over the last three years collaborating with key partners such as the Central American Observatory of Suyapa based at the UNAH (Universidad Nacional Autónoma de Honduras) which has opened a new GIS/Remote Sensing Laboratory. We also collaborated closely with CURLA (Centro Universitario Regional del Litoral Atlántico) located near La Ceiba--a land grant-type institution- -to support outreach and extension activities by students and staff to local-level NGOs and community groups dealing with conservation, hazards mitigation, biodiversity, fisheries and related problems. We have also participated in joint "informal education" efforts doing environmental and ecotourism outreach with groups such as the Hugh Parkey Foundation and EarthWatch Institute in Belize and others in Honduras such as FUCSA (Fundacion Cuero y Salado), FUPNAPIB (Fundacion Parque Nacional Pico Bonito), REHDES (Red Ecologista Hondurena para el Desarrollo Sostenible), and SMBC (Sociedad Mesoamericana para la Biologia y Conservacion). See more about the projects on water resources, herpetofauna on the Pacific coast, and the West Indian manatee at: http://resweb.llu.edu/rford/ Lessons learned about designing, organizing, implementing, and financing such geosciences educational partnerships will be presented as well as describing "next steps". Suggestions about how other universities could join with us will be also proposed.

Randomized clinical trial to evaluate the effect of fecal microbiota transplant for initial Clostridium difficile infection in intestinal microbiome.

PubMed

Camacho-Ortiz, Adrián; Gutiérrez-Delgado, Eva María; Garcia-Mazcorro, Jose F; Mendoza-Olazarán, Soraya; Martínez-Meléndez, Adrián; Palau-Davila, Laura; Baines, Simon D; Maldonado-Garza, Héctor; Garza-González, Elvira

2017-01-01

The aim of this study was to evaluate the impact of fecal donor-unrelated donor mix (FMT-FURM) transplantation as first-line therapy for C. difficile infection (CDI) in intestinal microbiome. We designed an open, two-arm pilot study with oral vancomycin (250mg every 6 h for 10-14 days) or FMT-FURM as treatments for the first CDI episode in hospitalized adult patients in Hospital Universitario "Dr. Jose Eleuterio Gonzalez". Patients were randomized by a closed envelope method in a 1: 1 ratio to either oral vancomycin or FMT-FURM. CDI resolution was considered when there was a reduction on the Bristol scale of at least 2 points, a reduction of at least 50% in the number of bowel movements, absence of fever, and resolution of abdominal pain (at least two criteria). From each patient, a fecal sample was obtained at days 0, 3, and 7 after treatment. Specimens were cultured to isolate C. difficile, and isolates were characterized by PCR. Susceptibility testing of isolates was performed using the agar dilution method. Fecal samples and FMT-FURM were analyzed by 16S rRNA sequencing. We included 19 patients; 10 in the vancomycin arm and 9 in the FMT-FURM arm. However, one of the patients in the vancomycin arm and two patients in the FMT-FURM arm were eliminated. Symptoms resolved in 8/9 patients (88.9%) in the vancomycin group, while symptoms resolved in 4/7 patients (57.1%) after the first FMT-FURM dose (P = 0.26) and in 5/7 patients (71.4%) after the second dose (P = 0.55). During the study, no adverse effects attributable to FMT-FURM were observed in patients. Twelve isolates were recovered, most isolates carried tcdB, tcdA, cdtA, and cdtB, with an 18-bp deletion in tcdC. All isolates were resistant to ciprofloxacin and moxifloxacin but susceptible to metronidazole, linezolid, fidaxomicin, and tetracycline. In the FMT-FURM group, the bacterial composition was dominated by Firmicutes, Bacteroidetes, and Proteobacteria at all-time points and the microbiota were remarkably stable over time. The vancomycin group showed a very different pattern of the microbial composition when comparing to the FMT-FURM group over time. The results of this preliminary study showed that FMT-FURM for initial CDI is associated with specific bacterial communities that do not resemble the donors' sample.

Percepcion de los profesores universitarios acerca del concepto cultura cientifica y de sus implicaciones en el nuevo bachillerato del Recinto de Rio Piedras de la Universidad de Puerto Rico

NASA Astrophysics Data System (ADS)

Ramos Pastrana, Nilsa

El Senado Academico del Recinto de Rio Piedras de la Universidad de Puerto Rico aprobo en el ano academico 2005-2006 la Certificacion 46, que contiene los lineamientos de un nuevo bachillerato. Este nuevo bachillerato introdujo cambios significativos en el curriculo tradicional. Entre ellos se encuentra la reduccion del componente de educacion general y el de Ciencias Biologicas en particular. La reduccion de creditos en el componente de Ciencias Biologicas ha obligado a reevaluar el concepto de cultura cientifica que desarrollan esos cursos. El proposito del estudio consistio en auscultar las percepciones de los profesores de las Facultades de Administracion de Empresas, Humanidades, Ciencias Sociales, Ciencias Naturales, Educacion y Estudios Generales del Recinto de Rio Piedras de la Universidad de Puerto Rico en torno al concepto de cultura cientifica, los contenidos disciplinares del curso de Ciencias Biologicas y la reduccion de creditos en el nuevo bachillerato. Las preguntas que guiaron la investigacion fueron: ¿cuales son las percepciones que tienen los profesores de las Facultades de Administracion de Empresas, Ciencias Sociales, Estudios Generales, Ciencias Naturales, Humanidades y Educacion, en torno al concepto de cultura cientifica y los contenidos disciplinares del curso de Ciencias Biologicas? ¿cuales son las percepciones que tienen los profesores de Ciencias Biologicas en torno al concepto cultura cientifica y los contenidos disciplinares del curso de Ciencias Biologicas? ¿existen diferencias significativas por facultad, genero, experiencia, rango y nombramiento en las percepciones que tienen los profesores del Recinto de Rio Piedras de la Universidad de Puerto Rico sobre los elementos que caracterizan la cultura cientifica y los contenidos biologicos que deben tener los egresados del Recinto? ¿que implicaciones curriculares tienen estos testimonios en el desarrollo del concepto de cultura cientifica en el nuevo bachillerato? Para realizar la investigacion se utilizo una metodologia cuantitativa y la herramienta para lograrlo fue una encuesta. La encuesta se analizo estadisticamente mediante analisis de frecuencias y por cientos, prueba ANOVA, prueba t, pruebas Post Hoc de Tukey y de Levene. Tambien se realizo nuevamente una prueba de confiabilidad mediante el alfa de Cronbach. Los resultados reflejaron que los profesores de las Facultades de Administracion de Empresas, Ciencias Sociales, Ciencias Naturales, Educacion, Humanidades, Estudios Generales y el Departamento de Ciencias Biologicas tienen una percepcion muy positiva del concepto de cultura cientifica, los contenidos curriculares de Ciencias Biologicas y del nuevo bachillerato.

Psychopathological features in Noonan syndrome.

PubMed

Perrino, Francesca; Licchelli, Serena; Serra, Giulia; Piccini, Giorgia; Caciolo, Cristina; Pasqualetti, Patrizio; Cirillo, Flavia; Leoni, Chiara; Digilio, Maria Cristina; Zampino, Giuseppe; Tartaglia, Marco; Alfieri, Paolo; Vicari, Stefano

2018-01-01

Noonan syndrome (NS) is an autosomal dominant disorder characterized by short stature, skeletal and haematological/lymphatic defects, distinctive facies, cryptorchidism, and a wide spectrum of congenital heart defects. Recurrent features also include variable cognitive deficits and behavioural problems. Recent research has been focused on the assessment of prevalence, age of onset and characterization of psychiatric features in this disorder. Herein, we evaluated the prevalence of attention deficit and hyperactivity disorder (ADHD), anxiety and depressive symptoms and syndromes in a cohort of individuals with clinical and molecular diagnosis of NS. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS PL) has been used for the assessment of psychiatric disorders according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI) have been assessed for the evaluation of anxiety and depressive symptoms and syndromes, whereas Conners Teacher and Parent Rating Scales-long version (CRS-R) have been used to evaluate ADHD. The study included 27 individuals (67% males) with an average age of 10.4 years (range 6-18 years) receiving molecular diagnosis of NS or a clinically related condition, evaluated and treated at the Neuropsychiatric Unit of Children's Hospital Bambino Gesù and at the Center for Rare Diseases of Fondazione Policlinico Universitario Agostino Gemelli, in Rome. Twenty individuals showed mutations in PTPN11, five in SOS1 and two in SHOC2. The mean IQ was 94 (Standard Deviation = 17, min = 56, max = 130). Seventy percent of the individuals (n = 19; 95% Confidence Interval = 52-85%) showed ADHD features, with six individuals reaching DSM-IV-TR criteria for ADHD disorder, and thirteen showing subsyndromal traits. Symptoms or syndrome of anxiety were present in 37% of the cohort (n = 10; 95% Confidence Interval = 19-56%), with two individuals showing anxiety disorder and eight cases exhibiting subsyndromal traits. Our results show individuals with NS do present a very high risk to develop psychiatric disorders or symptoms during paediatric age. Based on these findings, preschool assessment of inattentive, hyperactivity/impulsivity and anxiety/depressive symptoms is recommended in order to plan a personalized treatment for psychological/psychiatric issues in affected individuals. Dedicated prospective studies are required to confirm the present data and better characterize the psychopathological profile in NS. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Spirituality and Cultural Identification Among Latino and Non-Latino College Students

PubMed Central

Campesino, Maureen; Belyea, Michael; Schwartz, Gary

2010-01-01

The purposes of this study were to examine (a) differences in spiritual perspectives and practices of Latino and non-Latino young adults and (b) the cultural relevance of the Latino Spiritual Perspective Scale (LSPS). Studies indicate that spiritual perspectives are embedded within cultural group norms and vary significantly across ethnic groups. A cross-sectional survey design was used with a convenience sample of 223 Latino and non-Latino university students in the Southwestern United States. The Spiritual Perspective Scale (SPS), the LSPS, the Orthogonal Cultural Identification Scale, and a demographic questionnaire were used. Latinos scored significantly higher than non-Latinos in both measures of spiritual perspectives. Self-reported behavioral measures, such as frequency of personal prayer, were also higher among the Latino group. Latino cultural identification was the only significant predictor of LSPS scores. Findings from this study indicate that spirituality among Latinos has meanings specific to the cultural group context. These findings have implications for nursing research involving the conceptualization and measurement of spirituality among multiethnic groups. Los propósitos de este estudio eran examinar: (a) diferencias en perspectivas espirituales y prácticas de jóvenes Latinos y no Latinos; y (b) la relevancia cultural de la Escala de la Perspectiva Espiritual Latina. Estudios indican que perspectivas espirituales están incrustadas entre normas culturales del grupo y varían considerablemente entre grupos étnicos. Un diseño transversal y de encuesta fue utilizado con una muestra de conveniencia de 233 estudiantes universitarios Latinos y no Latinos en el Suroeste de los Estados Unidos. La Escala de la Perspectiva Espiritual (EPE), la Escala de la Perspectiva Espiritual Latina (EPEL), la Escala Ortogonal de Identificación Cultural, y un cuestionario demográfico fueron utilizados. Los Latinos calificaron considerablemente más alto que los no Latinos en ambas medidas de perspectivas espirituales. Medidas de comportamiento auto-reportadas, como la frecuencia de oración, también estuvieron más altas en el grupo Latino. La identificación con la cultura Latina fue el único vaticinador de las calificaciones de la EPEL. Los resultados de este estudio indican que la espiritualidad entre Latinos tiene significados específicos al contexto del grupo cultural. Estas conclusiones tienen implicaciones para las investigaciones de enfermería que involucran la conceptualización y medida de la espiritualidad entre grupos multiétnicos. PMID:20165566

Spirituality and Cultural Identification Among Latino and Non-Latino College Students.

PubMed

Campesino, Maureen; Belyea, Michael; Schwartz, Gary

2009-01-01

The purposes of this study were to examine (a) differences in spiritual perspectives and practices of Latino and non-Latino young adults and (b) the cultural relevance of the Latino Spiritual Perspective Scale (LSPS). Studies indicate that spiritual perspectives are embedded within cultural group norms and vary significantly across ethnic groups. A cross-sectional survey design was used with a convenience sample of 223 Latino and non-Latino university students in the Southwestern United States. The Spiritual Perspective Scale (SPS), the LSPS, the Orthogonal Cultural Identification Scale, and a demographic questionnaire were used. Latinos scored significantly higher than non-Latinos in both measures of spiritual perspectives. Self-reported behavioral measures, such as frequency of personal prayer, were also higher among the Latino group. Latino cultural identification was the only significant predictor of LSPS scores. Findings from this study indicate that spirituality among Latinos has meanings specific to the cultural group context. These findings have implications for nursing research involving the conceptualization and measurement of spirituality among multiethnic groups.Los propósitos de este estudio eran examinar: (a) diferencias en perspectivas espirituales y prácticas de jóvenes Latinos y no Latinos; y (b) la relevancia cultural de la Escala de la Perspectiva Espiritual Latina. Estudios indican que perspectivas espirituales están incrustadas entre normas culturales del grupo y varían considerablemente entre grupos étnicos. Un diseño transversal y de encuesta fue utilizado con una muestra de conveniencia de 233 estudiantes universitarios Latinos y no Latinos en el Suroeste de los Estados Unidos. La Escala de la Perspectiva Espiritual (EPE), la Escala de la Perspectiva Espiritual Latina (EPEL), la Escala Ortogonal de Identificación Cultural, y un cuestionario demográfico fueron utilizados. Los Latinos calificaron considerablemente más alto que los no Latinos en ambas medidas de perspectivas espirituales. Medidas de comportamiento auto-reportadas, como la frecuencia de oración, también estuvieron más altas en el grupo Latino. La identificación con la cultura Latina fue el único vaticinador de las calificaciones de la EPEL. Los resultados de este estudio indican que la espiritualidad entre Latinos tiene significados específicos al contexto del grupo cultural. Estas conclusiones tienen implicaciones para las investigaciones de enfermería que involucran la conceptualización y medida de la espiritualidad entre grupos multiétnicos.

Cost-effectiveness of laparoscopic versus open appendectomy in developing nations: a Colombian analysis.

PubMed

Ruiz-Patiño, Alejandro; Rey, Samuel; Molina, German; Dominguez, Luis Carlos; Rugeles, Saul

2018-04-01

Colombia is a developing nation in need for efficient resource administration in fields such as health care, where innovation is constant. Since the introduction of laparoscopic appendectomy (LA), direct costs have been increasing without definitive results in terms of clinical outcomes. The objective of this study is to determine the cost-effectiveness of open appendectomy (OA) versus LA and thereby help surgeons in clinical decision-making in a limited resource setting. A retrospective cost-effectiveness analysis comparing OA versus multiport LA during 2013 in a third-level university hospital (Hospital Universitario San Ignacio) in Bogota, Colombia was performed. Effectiveness was determined as the number of days in additional length of stay (LOS) due to the complications saved. A total of 377 clinical histories were collected by the authors and analyzed for the following variables: surgery type, conversion to open laparotomy, complications (surgical site infection, reintervention, and readmission), hospital LOS, and total cost of hospitalization for initial surgery and subsequent complications-related hospitalizations. The total accumulative costs and LOS for OA and LA plus complications were estimated. The cost-effectiveness threshold was set at US $46 (139,000 Colombian Peso [COP]), the cost of an additional day in LOS. An incremental cost-effectiveness ratio was calculated for OA as the comparator and LA as the intervention. The number of LA was 130 and of OA was 247. The two groups were balanced in terms of population characteristics. Complication rate was 13.7 % for OA and 10.4% for LA (P < 0.05), and LOS was 2 days for LA and OA (P = 0.9). No conversions from LA to OA were recorded. The total costs for complications for OA were US $8523 (25,569,220 COP) and US 3385 (10,157,758 COP) for LA. Cumulative costs including cost of surgery and complications and LOS for OA were US $65,753 (197,259,310 COP) and 297, respectively. Similarly, for LA were US $66,425 (199,276,948 COP) and 271, respectively. The incremental cost-effectiveness ratio was US $25.86 (77,601 COP) making LA a cost-effective alternative with a difference of US $20.76 (62,299 COP) under the cost-effectiveness threshold. LA is a cost-effective alternative over OA with an increasing cost of $25.85 per day of additional hospitalization due to complications saved. This is accounting the low cost of surgical interventions and complications in developing nations such as Colombia. Copyright © 2017 Elsevier Inc. All rights reserved.

Concepciones Alternativas de "Fotosintesis" en estudiantes Universitarios del curso basico de Biologia y posibles correcciones con el Modelo Educativo MODEF

NASA Astrophysics Data System (ADS)

De Jesus Roman, Sandra

Concepciones Alternativas de Fotosíntesis en estudiantes Universitariosdel curso básico de Biología y posibles correcciones con el Modelo Educativo MODEF El modelo educativo para la enseñanza de Fotosíntesis (MODEF) se implantó para trabajar el problema de las concepciones alternativas (CA) en un curso de Biología General. Se evaluaron los resultados en cuanto al logro del aprendizaje significativo. La pregunta central de la investigación fue: ¿Cómo aporta el modelo educativo en la didáctica y comprensión del tema de fotosíntesis? Se efectuó una investigación acción con una fase cuantitativa y una cualitativa. Para la fase cuantitativa se elaboró una prueba para determinar las concepciones alternativas, se validó y se sometió a los estudiantes que participaron en el estudio antes y después de ofrecer la unidad de metabolismo celular. Los participantes eran estudiantes de primer año de la Universidad de Puerto Rico en Bayamón (UPRB). Se llevó a cabo un análisis de consistencia interna de la prueba mediante el método Alfa de Cronbach. Se analizaron las contestaciones a cada pregunta mediante la prueba de Ji cuadrado de contingencia, se efectuó la prueba de t y el coeficiente r de Pearson. La fase cualitativa incluyó la observación participativa de la investigadora- profesora, las reflexiones de los estudiantes y la información de las entrevistas semi-estructuradas que se realizaron a tres estudiantes del curso. El análisis se llevó a cabo mediante el Modelo de Wolcott. Se trabajaron diez CA de las cuales siete fueron corregidas mediante el Modelo MODEF. Las actividades más importantes para el proceso de aprendizaje incluyeron el trabajo de investigación o búsqueda de información para hacer una presentación digital, la elaboración de tablas, los mapas de conceptos, el uso de visuales o videos y las analogías para explicar conceptos o procesos. En conclusión: se recomienda el uso del Modelo MODEF para la discusión del tema de Fotosíntesis a base de los resultados cuantitativos y cualitativos de esta investigación. El Comité Institucional para la Protección de los Seres Humanos en la Investigación (CIPSHI) autorizó el estudio.

Task Group 7B: Cellular and Molecular Mechanisms of Biological Aging: The Roles of Nature, Nurture and Chance in the Maintenance of Human Healthspan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weier, Heinz-Ulrich; Arya, Suresh; Grant, Christine

The degree to which an individual organism maintains healthspan and lifespan is a function of complex interactions between genetic inheritance ('nature'), environment, including cultural inheritance (nurture) and stochastic events ('luck' or 'chance'). This task group will focus upon the role of chance because it is so poorly understood and because it appears to be of major importance in the determination of individual variations in healthspan and lifespan within species. The major factor determining variations in healthspan and lifespan between species is genetic inheritance. Broader aspects of cellular and molecular mechanisms of biological aging will also be considered, given their importancemore » for understanding the cellular and molecular basis of successful aging. The task force will consider the cellular and molecular basis for nature, nurture and chance in healthspan and life span determination. On the basis of comparisons between identical and non-identical twins, geneticists have estimated that genes control no more than about a quarter of the inter-individual differences in lifespan (Herskind 1996). Twin studies of very old individuals, however, show substantially greater genetic contributions to Healthspan (McClearn 2004; Reed 2003). The environment clearly plays an important role in the length and the quality of life. Tobacco smoke, for example has the potential to impact upon multiple body systems in ways that appear to accelerate the rates at which those systems age (Bernhard 2007). To document the role of chance events on aging, one must rigorously control both the genetic composition of an organism and its environment. This has been done to a remarkable degree in a species of nematodes, Caenorhabditis elegans (Vanfleteren 1998). The results confirm hundreds of previous studies with a wide range of species, especially those with inbred rodents housed under apparently identical but less well controlled environments. One observes wide variations in lifespan in all these studies. For the C. elegans experiments, the distributions of lifespan fit best with two parameter or three parameter logistic models and not with the classical Gompertz model nor the Weibull model. Many mutations have been shown to substantially increase lifespan in C. elegans. It is of interest, however, that the ranges of the lifespan variations among such mutant strains overlap with those of wild type strains (Kirkwood 2002). Many of these long-lived mutant strains exhibit enhanced resistance to a variety of stressors, notably heat shock. It was therefore predicted that variable degrees of response to heat shock stress might form a basis, or a partial basis, for individual variations in longevity. An initial set of experiments demonstrated that is indeed the case, at least for a transgenic construct that includes the promoter of a small heat shock gene (Rea 2005). There was a very strong correlation between the response to a heat stress and longevity, with good responding worms living longer. Strikingly, this phenotype was not heritable. The progeny of a worm showing a strong heat stress reaction exhibited the broad distribution of lifespans shown by the starting population. The heat stress reaction was therefore stochastic. The nature of the chance events that determine the reaction remains unknown. They could be related to the intrinsic instability of the transgene, making it important to repeat such experiments utilizing endogenous genes as reporters of the response to heat shock and other stressors. It could be due to epigenetic drifts in gene expression, perhaps involving random changes in gene promoters or in the state of chemical modifications to histone proteins that coat chromosomes. Such changes have indeed been observed in aging human identical twins (Fraga 2005). While those changes have been interpreted as being driven by the environment, one cannot at present rule out random variations unrelated to environmental influences. Variations in gene expression in genetically identical organisms examined under environmentally identical conditions have also been attributable to intrinsic 'noise' in fundamental molecular processes such as the transcription and translation of genes. Most such observations have been made using microorganisms (Elowitz 2002), but stochastic bursts of transcription have also been noted in mammalian cells (Raj 2006). Moreover, substantial variation in the levels at which genes are transcribed have shown to occur in mouse tissues, and that variation was shown to increase with age (Bahar 2006). Chance events are also of major significance in the determination of diseases of aging. For the case of cancer, mutations have been shown to be of major importance. A likely key to malignancy, however, is the chance event of suffering a mutation in a gene which, when mutated, now greatly enhances the general frequency of mutation.« less

La Spezia and the research network for outreach and education in marine sciences.

NASA Astrophysics Data System (ADS)

Locritani, Marina; Furia, Stefania; Giacomazzi, Fabio; Merlino, Silvia; Mori, Anna; Nacini, Francesca; Nardi, Elisabetta; Stroobant, Mascha; Talamoni, Roberta; Zocco, Olivia

2013-04-01

La Spezia is a small town located in the southeastern corner of the Liguria Region (Italy). The close relationship with the sea conditioned the ancient and recent activities of the town that embraces the namesake gulf. The Gulf of La Spezia overlooks on the Liguria Sea which is characterized by a high biodiversity, due to the heritage of coastal habitats, where numerous interesting species to preserve live, often a priority for the EC Directives. Therefore, along the Liguria arc, five coastal Marine Protected Areas have been instituted, two of them insist in La Spezia Province: the Marine Protected Areas of Cinque Terre National Park and Porto Venere Regional Park, both included in the UNESCO World Heritage Site. Moreover, the importance of the cetacean communities in the Ligurian Sea led to the establishment of the Cetacean Sanctuary. Resulting from a positive geographic coincidence, six Research Institutions are located in La Spezia: CMRE-NATO (Centre for Maritime Research and Experimentation, formerly NURC-NATO Undersea Research Centre), CNR (National Research Council), CSSN (Naval Experimentation and Support Centre - Navy), ENEA (Italian National Agency for New Technologies, Energy and Sustainable Economic Development), INGV (National Institute of Geophysics and Volcanology), Polo Universitario Marconi (University of Genoa - seat of La Spezia). These Institutions share a long time experience of work at sea and in coastal environments according to their different scientific interests (biology, engineering, geology, physic, and oceanography). Moreover, in 2009 the Liguria Region promoted the institution of the Liguria Cluster of Marine Technologies (Distretto Ligure delle Tecnologie Marine), whose core target is the regional development of marine technologies and science. This unique concentration of Research Institutes, Marine Protected Areas and sea activities (civil and military) brought to implement a collaborative network among the scientific and territorial institutions, resulting in a wealth of knowledge ready to be shared with the territory to increase economy competitiveness and raise society awareness. Marine science is a general interest topic suitable to be spread in the schools: it is multi-disciplinary and offers technological and social arguments. The Research Institutions of La Spezia deal with different fields of investigation which are complementary and integrated in a complete and effective education proposal. Results are improved by the cooperation with LABTER (Laboratorio Territoriale di Educazione Ambientale - Territory Laboratory of Environmental Education) afferent to La Spezia Municipality. This panel intends to show the activities carried out from 2009 to 2012 and resulting from the cooperation among the Research Institutions and Local Authorities to improve the education and information effectiveness in the field of marine science. Considering all the above mentioned assumptions, La Spezia is, finally, a "cultural hotspot" for marine science issues.

Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay.

PubMed

Bentancor, Ana; Hernández, Ana Laura; Godoy, Yamile; Dapueto, Juan J

2016-07-04

To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team. In this case study, the following aspects were analyzed: 1) historical background; 2) implementation of Law 18,897 of October 22, 2012; and 3) functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay), taking into account three dimensions: structure, process, and results. Between December 2012 and November 2013, a total of 6,676 voluntary interruptions of pregnancy were reported in Uruguay; out of these, 80 were conducted at the Hospital de Clínicas. The patients' demographic data agreed with those reported at the national level: Of the total patients, 81.0% were aged over 19 years; 6.2% decided to continue with the pregnancy; and only 70.0% attended the subsequent control and received advice on contraception. In its implementation year in Uruguay, we can assess the experience as positive from the point of view of women's health. Our experience as a mental health team at the Hospital de Clínicas, inserted into the multidisciplinary voluntary interruption of pregnancy team, is in the process of assessment and reformulation of practices. Describir la conformación y funcionamiento de un equipo de interrupción voluntaria del embarazo de un hospital universitario, desde la mirada del equipo de salud mental. En este estudio de caso, se analizan los siguientes aspectos: 1) antecedentes históricos; 2) implementación de la Ley 18.897 de 22 de octubre de 2012; y 3) funcionamiento del programa en el Hospital de Clínicas de la Facultad de Medicina (Universidad de la República, Uruguay), teniendo en cuenta tres dimensiones (estructura, proceso y resultados). Entre diciembre de 2012 y noviembre de 2013, se reportaron en Uruguay un total de 6.676 interrupciones voluntarias del embarazo; de ellas, 80 se llevaron a cabo en el Hospital de Clínicas. Los datos sociodemográficos de las pacientes concordaron con los reportados a nivel nacional: 81,0% de las pacientes que consultaron era mayores de 19 años; 6,2% decidieron continuar con el embarazo; solo 70,0% concurrieron al control posterior y recibieron asesoramiento sobre anticoncepción. Al año de su implementación, en Uruguay, podemos evaluar la experiencia como positiva desde el punto de vista de la salud de las mujeres. Nuestra experiencia como equipo de salud mental en el Hospital de Clínicas, inserto dentro del equipo multidisciplinario de interrupción voluntaria del embarazo, se encuentra en pleno proceso de evaluación y reformulación de prácticas.

Impact of the incorporation of tyrosine kinase inhibitor agents on the treatment of patients with a diagnosis of advanced renal cell carcinoma: study based on experience at the Hospital Universitario Central de Asturias.

PubMed

Muriel, Carolina; Esteban, Emilio; Corral, Norberto; Fonseca, Paula J; Luque, María; Berros, José Pablo; Fernández, Yolanda; Blay, Pilar; Fra, Joaquín; Villanueva, Noemí; Sanmamed, Miguel; Pardo, Pablo; Izquierdo, Marta; Vieitez, José María; Estrada, Enrique; Lacave, Ángel J

2010-08-01

For nearly the past two decades, cytokines (CKs) have been the only systemic treatment option available for advanced renal cell carcinoma (RCC). In recent years, tyrosine kinase inhibitors (TKIs) have demonstrated clinical activity on this tumour. Our purpose is to describe one centre's experience with the use of CKs and TKIs in the treatment of patients with advanced RCC. This study was designed as a retrospective chart review of RCC patients who were treated with CKs and/or TKIs in our department between July 1996 and June 2008. Efficacy and toxicity were assessed using World Health Organization (WHO) criteria. The Kaplan-Meier method was used to estimate progression-free (PFS) and overall (OS) survival. Ninety-four patients were classified into three groups depending on the modality of treatment administered: 46 were treated with CKs alone and/or chemotherapy (27 with immunotherapy, one with chemotherapy and 18 with both), 28 with TKIs alone (25 with sunitinib and 13 with sorafenib) and 20 with TKIs in second-line treatment following failure with CKs (17 with sunitinib, eight with sorafenib, four with bevacizumab and one with lapatinib). The median age was 60 years in the CK group and 65 and 62, respectively, in TKI in first and second-line treatment groups. Eighty-five percent of patients treated with CKs and 75% in the TKI group in first-line treatment and 80% in second-line treatment were men. Overall, 89% of patients had favourable risk, and 11% had intermediate risk. All patients were considered evaluable for toxicity. The main grade 3-4 (%) toxicity was asthenia for both groups, (ten in TKIs and 15 in CKs). Other grade 1-2 toxicities were mucositis (39), bleeding (8), hypertension (19), skin toxicity (33) and hypothyroidism (12.5) associated with TKIs; and anaemia (33), cough (29), asthenia (39) and emesis (14) associated with CKs. The objective response rate among 80 patients evaluable for activity was 10.6% with CKs and 46.5% and 35%, respectively, with TKIs in first- and second-line treatments. Disease stabilisation with CKs was recorded at 59% of patients and with TKIs 25% and 50% in first- and second-line treatment groups, respectively. The median progression-free survival (PFS) with CKs was 122 days [95% confidence interval (CI) 82-162] and with TKIs 201 days (65-337) in the first and 346 days (256-436) in second-line treatment groups. The median overall survival (OS) was 229 days (142-316) and 2,074 days (1,152-2,996) for patients treated with CKs and TKIs. Our results are in line with the activity and survival rates previously reported in the literature regarding the use of TKIs for patients with advanced RCC in first- and second-line treatment, which has demonstrated an acceptable toxicity level.

Quality of nursing documentation before and after the Hospital Accreditation in a university hospital.

PubMed

Nomura, Aline Tsuma Gaedke; Silva, Marcos Barragan da; Almeida, Miriam de Abreu

2016-11-21

to analyze the quality of nursing documentation by comparing the periods before and after the preparation for the hospital accreditation, using the Quality of Nursing Diagnoses, Interventions and Outcomes - Brazilian version (Q-DIO- Brazilian version). observational study of interventions conducted in a university hospital. Nursing documentation of 112 medical records for the period before and 112 for the period after the hospital accreditation were compared using the Q-DIO instrument - Brazilian version. Data were statistically analyzed. there was a significant improvement in the quality of nursing documentation. When the total score of the instrument was evaluated, a significant improvement was observed in 24 out of the 29 items (82.8%). there was commitment to the shift of culture by means of the interventions carried out, which resulted in the conquest of the quality seal ensured by the Joint Commission International. analisar a qualidade dos registros de enfermagem, comparando o período antes e depois do preparo para a acreditação hospitalar, fazendo uso do Quality of Nursing Diagnoses, Interventions and Outcomes - Versão brasileira (Q-DIO-Versão brasileira). estudo observacional de intervenções realizado em um hospital universitário. Comparados os registros de enfermagem em 112 prontuários referentes ao período anterior a acreditação hospitalar e 112 ao período posterior, por meio do instrumento Q-DIO - Versão brasileira. Os dados foram analisados estatisticamente. houve melhora significativa da qualidade dos registros de enfermagem. Quando avaliado o escore total do instrumento evidenciou melhora significativa em 24 dos 29 itens (82,8%). houve empenho à mudança de cultura por meio das intervenções realizadas, refletida na conquista do selo de qualidade da Joint Commission Internacional. analizar la calidad de los registros de enfermería, comparando los períodos antes y después de la preparación para la acreditación hospitalaria, haciendo uso del Quality of Nursing Diagnoses, Interventions and Outcomes - Versión brasileña (Q-DIO- Versión brasileña). estudio observacional de intervenciones realizado en un hospital universitario. Los registros de enfermería de 112 historias clínicas del período anterior y 112 historias clínicas del período posterior a la acreditación hospitalaria se compararon mediante el instrumento Q-DIO - Versión brasileña. Los datos fueron analizados estadísticamente. se observó una mejora significativa de la calidad de los registros de enfermería. Cuando se evaluó la puntuación total del instrumento, se observó una mejora significativa en 24 de los 29 ítenes (82,8%). hubo un compromiso con el cambio en la cultura por medio de las intervenciones realizadas, lo que resultó en la conquista del sello de calidad garantizado por la Joint Commission International.

University Students' Conceptions about the Moon Phases. (Spanish Title: Concepciones de Estudiantes Universitários sobre Las Fases de la Luna.) Concepções de Estudantes Universitários sobre as Fases da Lua

NASA Astrophysics Data System (ADS)

de Fátima Oliveira Saraiva, Maria; da Silveira, Fernando Lang; Steffani, Maria Helena

2011-07-01

In this article we describe the development of a multiple choice test about lunar phases and analyze the results of its application to ten groups of Physics students at the UFRGS. During the improvement of the test, we noticed that the percentage of right answers about some concepts increased significantly when associated with the reformulation of the question, emphasizing the importance of being careful to avoid incorrect answers generated by unclear questions, and not by ignorance on the matter. We confirm the results of other studies that show that students have great difficulty to relate the Moon's phase with its position in the sky at given time. On the other hand, our results suggest that, in general, students of Physics understand the phenomenon of lunar phases better than the average of university students. En estese artículo se describe la elaboración de una prueba de opción múltiple sobre las fases de la Luna y se analizan los resultados de su aplicación en diez grupos de estudiantes de Física de UFRGS. Durante el mejoramiento de la prueba observamos que el porcentaje de aciertos creció considerablemente cuando considerada una nueva redacción de la pregunta, destacando el cuidado que se debe tomar a fin de evitar respuestas incorrectas generadas por preguntas poco claras y no a causa de la ignorancia de los estudiantes sobre el tema. Confirmamos los resultados de otros estudios que las mayores dificultades de los alumnos sobre el tema fases de la Luna están en relacionar la fase de la Luna con su posición en el cielo en determinado momento. Por otra parte, nuestros resultados sugieren que, en general, los estudiantes de la Física comprenden mejor el fenómeno de las fases lunares que el promedio de los estudiantes universitarios. Neste artigo descrevemos a elaboração de um teste de múltipla escolha sobre as fases da Lua e analisamos os resultados de sua aplicação em dez grupos de estudantes de Física da UFRGS. Durante o aprimoramento do teste notamos que a porcentagem de acertos a respeito de alguns conceitos teve um aumento significativo associado à reformulação da pergunta, ressaltando a importância de tomar cuidado para evitar respostas erradas geradas por perguntas pouco claras e não por ignorância do respondente sobre o assunto. Confirmamos os resultados de outros estudos de que as maiores dificuldades dos alunos sobre o tema Fases da Lua dizem respeito a relacionar a fase que a Lua apresenta com a sua posição no céu em determinada hora. Por outro lado, nossos resultados sugerem que, em geral, os estudantes de Física entendem melhor o fenômeno das fases lunares do que a média dos estudantes universitários.

Vulnerability to alcohol consumption, spiritual transcendence and psychosocial well-being: test of a theory.

PubMed

Heredia, Luz Patricia Díaz; Sanchez, Alba Idaly Muñoz

2016-06-07

to demonstrate the relations among vulnerability, self-transcendence and well-being in the young adult population and the effect of each of these variables on the adoption of low-risk consumption conducts. quantitative and cross-sectional correlation study using structural equations analysis to test the relation among the variables. an inverse relation was evidenced between vulnerability to alcohol consumption and spiritual transcendence (β-0.123, p 0.025) and a direct positive relation between spiritual transcendence and psychosocial well-being (β 0.482, p 0.000). the relations among the variables spiritual transcendence, vulnerability to alcohol consumption and psychosocial well-being, based on Reed's Theory, are confirmed in the population group of young college students, concluding that psychosocial well-being can be achieved when spiritual transcendence is enhanced, as the vulnerability to alcohol consumption drops. demonstrar as relações entre vulnerabilidade, autotranscendência e bem-estar na população adulta jovem e o efeito de cada uma destas variáveis na adoção de condutas de baixo risco de consumo. estudo quantitativo, transversal do tipo correlacional que utilizou a análise estatística de Equações Estruturais para comprovar a relação entre as variáveis. evidenciou-se uma relação inversa entre a vulnerabilidade ao consumo do álcool e a transcendência espiritual (β-0.123, p 0.025) e uma relação direta positiva entre a transcendência espiritual e o bem-estar psicossocial (β 0.482, p 0.000). Conclusões: as relações das variáveis transcendência espiritual, vulnerabilidade ao consumo do álcool e bem-estar psicossocial, fundamentadas na Teoria de Reed, são confirmadas no grupo populacional de jovens adultos universitários, concluindo que é possível alcançar o bem-estar psicossocial quando se incrementa a transcendência espiritual, enquanto a vulnerabilidade ao consumo do álcool se reduz. demostrar las relaciones entre vulnerabilidad, autotrascendencia y bienestar en la población adulta joven y el efecto de cada una de estas variables en la adopción de conductas de bajo riesgo de consumo. estudio de abordaje cuantitativo, trasversal de tipo correlacional que utilizó el análisis estadístico de Ecuaciones Estructurales para la comprobación de la relación entre las variables. se evidenció relación inversa entre la vulnerabilidad al consumo de alcohol y la trascendencia espiritual (β-0.123, p 0.025) y una relación directa positiva entre la trascendencia espiritual y el bienestar psicosocial (β 0.482, p 0.000). las relaciones de las variables trascendencia espiritual, vulnerabilidad al consumo de alcohol y bienestar psicosocial, fundamentadas en la Teoría de Reed, son confirmadas en el grupo poblacional de adultos jóvenes universitarios, concluyendo que es posible alcanzar el bienestar psicosocial cuando se incrementa la trascendencia espiritual, en tanto que la vulnerabilidad al consumo de alcohol se reduce.

Strong and Electroweak Matter 2004

NASA Astrophysics Data System (ADS)

Eskola, Kari J.; Kainulainen, Kimmo; Kajantie, Keijo; Rummukainen, Kari

RHIC experimental summary: the message from pp, d+Au and Au+Au collisions / M. Calderón de la Barca Sánchez -- Hydrodynamic aspects of relativistic heavy ion collisions at RHIC / P. F. Kolb -- Photon emission in a hot QCD plasma / P. Aurenche -- In search of the saturation scale: intrinsic features of the CGC / H. Weigert -- From leading hadron suppression to jet quenching at RHIC and LHC / U. A. Wiedemann -- Lattice simulations with chemical potential / C. Schmidt -- Mesonic correlators in hot QCD / M. Laine -- Thermalization and plasma instabilities / P. Arnold -- Transport coefficients in hot QCD / G. D. Moore -- Classical fields and heavy ion collisions / T. Lappi -- Progress in nonequilibrium quantum field theory II / J. Berges and J. Serreau -- A general effective theory for dense quark matter / P. T. Reuter, Q. Wang and D. H. Rischke -- Thermal leptogenesis / M. Plümacher -- Cold electroweak Baryogenesis / J. Smit -- Proton-nucleus collisions in the color glass condensate framework / J.-P. Blaizot, F. Gelis and R. Venugopalan -- From classical to quantum saturation in the nuclear wavefunction / D. N. Triantafyllopoulos -- Charge correlations in heavy ion collisions / A. Rajantie -- Whitening of the quark-gluon plasma / S. Mrówczyński -- Progress in anisotropic plasma physics / P. Romatschke and M. Strickland -- Deconfinement and chiral symmetry: competing orders / K. Tuominen -- Relation between the chiral and deconfinement phase transitions / Y. Hatta -- Renormalized Polyakov loops, matrix models and the Gross-Witten point / A. Dumitru and J. T. Lenaghan -- The nature of the soft excitation at the critical end point of QCD / A. Jakovác ... [et al.] -- Thermodynamics of the 1+1-dimensional nonlinear sigma model through next-to-leading order in 1/N / H. J. Warringa -- Light quark meson correlations at high temperature / E. Laemann ... [et al.] -- Charmonia at finite momenta in a deconfined plasma / S. Datta ... [et al.] -- QCD thermodynamics: lattice results confront models / M. D'Elia and M. P. Lombardo -- Singlet free energies of a static quark-antiquark pair / K. Petrov -- Contributions to transport theory from multi-particle interactions and production processes / M. E. Carrington -- Transport coefficients and the 2PI effective action in the large N limit / G. Aarts and J. M. Martinez Resco -- Thermal features far from equilibrium: prethermalization / S. Borsányi -- QCD phase diagram at small Baryon densities from imaginary [symbol]: status report / O. Philipsen and Ph. de Forcrand -- Two loop renormalisation of the magnetic coupling in hot QCD and spatial Wilson loop / P. Giovannangeli -- Thermodynamics of deconfined QCD at small and large chemical potential / A. Ipp -- Evading the infrared problem of thermal QCD / Y. Schroder -- Chiral mesons in hot matter / A. Gómez Nicola, F. J. Llanes-Estrada and J. R. Peláez -- Thermal production of axinos in the early universe / A. Brandenburg and F. D. Steffen -- The 2-PI-1/N approximation applied to tachyonic preheating / A. Tranberg, A. Arrizabalaga and J. Smit -- Nonequilibrium dynamics in scalar hybrid models / J. Baacke and A. Heinen -- Photon mass in inflation and nearly minimal magnetogenesis / T. Prokopec -- Transport equations for chiral fermions to order [symbol] and electroweak Baryogenesis / S. Weinstock, M. G. Schmidt and T. Prokopec -- The gapless 2SC phase / M. Huang and I. A. Shovkovy -- Gapless CFL and its competition with mixed phases / M. Alford, C. Kouvaris and K. Rajagopal -- Transport coefficients in color superconducting quark matter / C. Manuel -- Renormalization and resummation in finite temperature field theories / A. Jakovác and Zs. Szép -- Renormalization and gauge symmetry for 2PI effective actions / U. Reinosa -- Out-of-equilibrium massless Schwinger model / R. F. Alvarez-Estrada -- Selfconsistent calculations of hadrons at finite temperature / C. Beckmann -- Fermion production in classical fields / D. D. Dietrich -- Numerical study of the equation of state for two flavor QCD at non-zero Baryon density / S. Ejiri ... [et al.] -- Phase conversion after a chiral transition: effects from inhomogeneities and finite size / E. S. Fraga -- Coherent Baryogenesis and nonthermal leptogenesis: a comparison / B. Garbrecht, T. Prokopec and M. G. Schmidt -- Two aspects of color superconductivity: gauge independence and neutrality / A. Gerhold -- QCD phase diagram in nonlocal chiral quark models / D. Gómez Dumm -- QCD equation of state and dark matter / M. Hindmarsh and O. Philipsen -- Analytical approach to SU(2) Yang-Mills thermodynamics / R. Hofmann -- Free energies of static three quark systems / K. Hübner ... [et al.] -- Color ferromagnetic state of dense quark matter / A. Iwazaki -- Axial currents from CKM matrix CP violation and electroweak Baryogenesis / T. Konstandin -- Dilute monopole gas, and K-tensions in gluodynamics / C. P. Korthals Altes and P. Giovannangeli -- Infrared QCD and the renormalisation group / D. F. Litim ... [et al.] -- Residual confinement in high-temperature Yang-Mills theory / A. Maas ... [et al.] -- Scalar O(N) model at finite temperature - 2PI effective potential in different approximations / J. Baacke and S. Michalski -- Cutoff effects in meson spectral functions / T. Blum and P. Petreczky -- Anomalous specific heat in ultradegenerate QED and QCD / A. Gerhold, A. Ipp and A. Rebhan -- Color-superconducting phases in cold and dense quark matter / A. Schmitt -- Non fermi liquid effects in dense matter and compact star cooling / K. Schwenzer and T. Schäfer -- Prethermalisation and the build-up of the Higgs effect / D. Sexty and A. Patkós -- Vector meson at non-zero Baryon density and zero sound / S. J. Hands and C. G. Strouthos -- Impact of Baryon resonances on the chiral phase transition / D. Zschiesche ... [et al.].

[Steroid and xenobiotic receptor (SXR), multidrug resistance gene (MDR1) and GSTs, SULTs and CYP polymorphism expression in invasive bladder cancer, analysis of their expression and correlation with other prognostic factors].

PubMed

Rioja Zuazu, J; Bandrés Elizalde, E; Rosell Costa, D; Rincón Mayans, A; Zudaire Bergera, J; Gil Sanz, M J; Rioja Sanz, L A; García Foncillas, J; Berián Polo, J M

2007-01-01

Steroid and Xenobiotic Receptor (SXR) has demonstrated its activation by numerous drugs, including cytochrome P450 potent inducers like rifampicina or cotrimazol. The role of SXR is well known, and lies regulating in a positive manner cytochrome P450 3A4 (CYP3A4) transcription and the multidrug resistance gene (MDR1), it's considered a key in the xenobiotic detoxification mechanism, being involved in all phases of the detoxification process. Enzymes involved in Policyclic Aromatic hidrocarbures (PAH) metabolism and degradation are polymorphic in humans, including glutation S-transferases (GSTs), N-acetiltransferases (NATs), sulfotransferases (SULTs)1A1 and cytochrome p450 (CYP)1B1. The objectives we've planned are: 1. Analyze the expression of the transcription factor SXR and MDR1 in bladder by means of RT-PCR real time, both in normal bladder and in tumoral bladder. 2. Analyze the relation between clinical and pathological factors with the expression of SXR and MDR1. 3. Analyze the expression of the polymorphims CYP1B1, GSTM1 GSTT1 and SULT1A1 and their correlation with different clinic-pathological and molecular factors. In a prospective way the size of the sample was estimated. In 67 patients from two institutions (Hospital Universitario Miguel Servet (49 HUMS) and Clinica Universitaria de Navarra (18 CUN)), diagnosed of invasive bladder cancer and treated by means of radical cystectomy, were determined the expression of both SXR and MDR1 by means of real time PCR, as well as the polymorphisms CYP1B1, GSTM1 GSTT1 y SULT1A1 by means of RFLP (Restriction fragment length polymorphism). Correlations with other prognostic factors by contingency tables were performed. Average follow up was 23.7 months with a median of 28.26 months. Of the 67 patients studied, 31 patients (46.3) presented disease progression, in form of local recurrence or in distant metastasis or both. With a average time to progression of 12.4 months and a median of 10 months, with a range of 1.1 month to 31.9 month. 36 patients (53.7%) did not have any evidence of disease progression during follow up. The Steroid and Xenobiotic Receptor as well as the Multidrug Resistance Gene (MDR1) are expressed in both normal bladder (0.94DeltaCt y 0.94DeltaCt) and tumoral bladder in the cystectomy specimen (1.09 DeltaCt y 0.45 DeltaCt). We've analyzed their expression in a quantitative manner and in a qualitative manner. The expression of SXR correlates with the presence of ca. in situ (p=0.024), vasculo-lymphatic invasion (p=0.05) mean while MDR1 correlates with presence of vasculo-lymphatic invasion (p=0.05) Both factors are correlate between each others (p=0.011). Polymorphisms: CYP1B1, GSTM1, GSTT1 and SULT1A1, are expressed in these patients but their expression doesn't correlates with any prognostic factor Both SXR and MDR1 are expressed in normal bladder as well as in tumoral bladder. And their expression correlates with different prognostic factors with influence in the survival described in the literature.

Como Lo Hago Yo: Mielomeningocele En Bolivia

PubMed Central

Dabdoub, Carlos F.; Dabdoub, Carlos B.; Villavicencio, Ramiro; Quevedo, Germán

2014-01-01

Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusión: En esta serie, el diagnóstico prenatal del MMC fue ocasional y la derivación al HUJ de los recién nacidos con esta malformación fue generalmente tardía. No hubo predominio de género y la mayoría de los casos presentaron sus lesiones en la región lumbar y lumbosacra. La mortalidad general y postoperatoria fue similar a la reportada en la literatura. Pocos enfermos realizaron controles posteriores al alta hospitalaria. Igual que otros países de Sudamérica, las falencias en el sistema público de salud y el nivel sociocultural, son factores determinantes para un mal pronóstico en estos niños. Por sus múltiples complicaciones, el MMC requiere de una especial atención gubernamental, sobre todo de carácter preventivo mediante el uso de ácido fólico en mujeres fértiles, como también de un equipo profesional multidisciplinario, a fin de realizar un tratamiento adecuado y oportuno. Al mismo tiempo, trabajos multicéntricos en hospitales de América Latina, ayudarán al mejor manejo de estos pacientes. PMID:24791220

The effects of work on the health of nurses who work in clinical surgery departments at university hospitals.

PubMed

Silva, Rosângela Marion da; Zeitoune, Regina Célia Gollner; Beck, Carmem Lúcia Colomé; Martino, Milva Maria Figueiredo de; Prestes, Francine Cassol

2016-08-08

to analyze the effects of work on the health of nurses who work in clinical surgery departments at university hospitals in relation to physical, social and psychological suffering and pain. a quantitative transversal study was carried out between 2012 and 2013 in four institutions in a state located in the south of Brazil. We studied 65 nurses who responded to questions on their habits. We also obtained sociodemographical information on them as well as conducting an evaluation on work relational damage using an evaluation scale. Associations were checked through the use of the Chi-Sqaure and Fisher's exact test. Correlations were checked using the Spearmann test. we found that physical ailments persisted and that there were connections between social and psychological pain/suffering and variable physical activities as well as connections with accidents in the work place and the option to work shifts. We noted correlations between social and psychological pain/suffering. nurses had their health compromised due to their work in clinical surgery departments. analisar os efeitos do trabalho na saúde de enfermeiros que atuam em clínicas cirúrgicas de hospitais universitários, relacionando-os aos danos físicos, sociais e psicológicos. estudo quantitativo, transversal, realizado entre 2012 e 2013 em quatro instituições de um Estado da região sul do Brasil. A amostra foi composta por 65 enfermeiros que responderam questões sobre os hábitos de vida e dados sociodemográficos e a Escala de Avaliação de Danos Relacionados ao Trabalho. Associações foram verificadas pelo teste Qui-Quadrado e Exato de Fisher e as correlações pelo teste de Spearmann. prevaleceu o adoecimento físico, encontrando associação entre os fatores Danos Sociais e Psicológicos e as variáveis prática de atividade física, acidente de trabalho e opção pelo turno de trabalho. Evidenciou-se correlação entre Danos Sociais e Psicológicos. o trabalho realizado por enfermeiros que atuam em clínica cirúrgica nas instituições hospitalares pesquisadas produz efeitos danosos à saúde. analizar los efectos del trabajo en la salud de enfermeros que actúan en clínicas quirúrgicas de hospitales universitarios, relacionándolos a daños físicos, sociales y psicológicos. estudio cuantitativo, transversal, realizado entre 2012 y 2013, en cuatro instituciones de un estado de la región sur de Brasil. La muestra estuvo compuesta por 65 enfermeros que respondieron preguntas sobre los hábitos de vida y datos sociodemográficos; se uso la Escala de Evaluación de Daños Relacionados al Trabajo. Las asociaciones fueron verificadas con el test Chi-Cuadrado y Exacto de Fisher y las correlaciones con el test de Spearmann. prevaleció la enfermedad física, encontrando asociación entre los factores Daños Sociales y Psicológicos y las variables: práctica de actividades físicas, accidente de trabajo y opción por el turno de trabajo. Se evidenció correlación entre Daños Sociales y Psicológicos. el trabajo realizado por enfermeros, que actúan en clínica quirúrgica en las instituciones hospitalarias investigadas, produce efectos que perjudican a la salud.

Resonances and Tides in Natural Satellites Systems. (Breton Title: Ressonâncias e Marés em Sistemas de Satélites Naturais.) Resonancias y Mareas en Sistemas de Satélites Naturales

NASA Astrophysics Data System (ADS)

Callegari, Nelson, Jr.

2006-12-01

In this work we describe some aspects of the dynamics of the mean-motion resonances. Emphasis to the case of resonances between regular satellites of the giant planets will be given, even so some aspects of the physics of the resonances in extra-solar planetary systems are also briefly treated. The role of the resonances in satellites systems is discussed through examples, showing how certain resonances, and its relations with the tidal dissipation effects, can be the key of the explanation of some phenomena still not explained in the Solar System. Amongst some examples we highlight the problem of the resurfacing of Enceladus, the existence of active volcanoes in Io, and the possible existence of the subsurface ocean in Europe. This work has as objective the divulgation of some topics in Celestial Mechanics and Planetary Sciences for an undergraduate public in exact sciences, as Astronomy and Physics, and not their detailed description. Neste trabalho descrevemos alguns aspectos da dinâmica de ressonâncias de movimentos médios. Será dada ênfase maior ao caso de ressonâncias entre satélites regulares dos planetas gigantes, embora alguns aspectos da física das ressonâncias em sistemas planetários extra-solares também sejam discutidos brevemente. A importância do estudo de ressonâncias em sistemas de satélites é discutida mais detalhadamente através de exemplos, mostrando como certas ressonâncias e suas relações com efeitos de dissipação de maré podem ser a chave de parte da explicação de alguns fenômenos ainda não explicados no Sistema Solar. Dentre vários exemplos destacamos o problema da remodelagem da superfície do satélite Enceladus, a existência de vulcões ativos em Io, e a possível existência do oceano subterrâneo em Europa. Este trabalho tem como objetivo a divulgação de alguns tópicos de Mecânica Celeste e Planetologia para um público de nível de graduação em disciplinas na área de exatas, em especial Astronomia e Física, e não a descrição detalhada dos conceitos aqui discutidos. Describimos en este trabajo algunos aspectos de la dinámica de resonancias de movimientos promedio. Será dado un énfasis mayor al caso de las resonancias entre satélites regulares de los planetas gigantes, aunque también son discutidos brevemente algunos aspectos de la física de resonancias en sistemas panetarios extrasolares. La importancia del estudio de las resonancias en sistemas de satélites es discutida más detalladamente através de ejemplos, mostrando cómo ciertas resonancias y los efectos de disipación por mareas pueden ser la clave de parte de la explicación de algunos fenómenos aún no comprendidos en el Sistema Solar. Entre varios ejemplos se destacan el problema de la superficie remodelada del satélite Enceladus, la existencia de volcanes activos en Io y la posible existencia de un océano subterráneo en Europa. Este trabajo tiene como objetivo la divulgación de algunos tópicos en Mecánica Celeste y Planetología para un público universitario de ciencias exactas, en particular Astronomía y Física, y no la descripción detallada de los conceptos aquí discutidos.

Autologous cell therapy with CD133+ bone marrow-derived stem cells for refractory Asherman's syndrome and endometrial atrophy: a pilot cohort study.

PubMed

Santamaria, Xavier; Cabanillas, Sergio; Cervelló, Irene; Arbona, Cristina; Raga, Francisco; Ferro, Jaime; Palmero, Julio; Remohí, Jose; Pellicer, Antonio; Simón, Carlos

2016-05-01

Could cell therapy using autologous peripheral blood CD133+ bone marrow-derived stem cells (BMDSCs) offer a safe and efficient therapeutic approach for patients with refractory Asherman's syndrome (AS) and/or endometrial atrophy (EA) and a wish to conceive? In the first 3 months, autologous cell therapy, using CD133+ BMDSCs in conjunction with hormonal replacement therapy, increased the volume and duration of menses as well as the thickness and angiogenesis processes of the endometrium while decreasing intrauterine adhesion scores. AS is characterized by the presence of intrauterine adhesions and EA prevents the endometrium from growing thicker than 5 mm, resulting in menstruation disorders and infertility. Many therapies have been attempted for these conditions, but none have proved effective. This was a prospective, experimental, non-controlled study. There were 18 patients aged 30-45 years with refractory AS or EA were recruited, and 16 of these completed the study. Medical history, physical examination, endometrial thickness, intrauterine adhesion score and neoangiogenesis were assessed before and 3 and 6 months after cell therapy. After the initial hysteroscopic diagnosis, BMDSC mobilization was performed by granulocyte-CSF injection, then CD133+ cells were isolated through peripheral blood aphaeresis to obtain a mean of 124.39 million cells (range 42-236), which were immediately delivered into the spiral arterioles by catheterization. Subsequently, endometrial treatment after stem cell therapy was assessed in terms of restoration of menses, endometrial thickness (by vaginal ultrasound), adhesion score (by hysteroscopy), neoangiogenesis and ongoing pregnancy rate. The study was conducted at Hospital Clínico Universitario of Valencia and IVI Valencia (Spain). All 11 AS patients exhibited an improved uterine cavity 2 months after stem cell therapy. Endometrial thickness increased from an average of 4.3 mm (range 2.7-5) to 6.7 mm (range 3.1-12) ( ITALIC! P = 0.004). Similarly, four of the five EA patients experienced an improved endometrial cavity, and endometrial thickness increased from 4.2 mm (range 2.7-5) to 5.7 mm (range 5-12) ( ITALIC! P = 0.03). The beneficial effects of the cell therapy increased the mature vessel density and the duration and intensity of menses in the first 3 months, with a return to the initial levels 6 months after the treatment. Three patients became pregnant spontaneously, resulting in one baby boy born, one ongoing pregnancy and a miscarriage. Furthermore, seven pregnancies were obtained after fourteen embryo transfers, resulting in three biochemical pregnancies, one miscarriage, one ectopic pregnancy, one baby born and one ongoing pregnancy. Limitations of this pilot study include the small sample size and the lack of control group. This novel autologous cell therapy is a promising therapeutic option for patients with these incurable pathologies and a wish to conceive. This study was funded by the Spanish Ministry of Science and Innovation (SAF 2012-31017, Principal Investigator C.S.), Spanish Ministry of Health (EC11-299, Principal Investigator C.S.) and Regional Valencian Ministry of Education (PROMETEOII/2013/018, Principal Investigator C.S.). Four authors (X.S., I.C., A.P. and C.S.) are co-inventors of the patent resulting from this work (Application number: 62/013,121). S.C., C.A., F.R., J.F., J.P. and J.R. have no conflict of interest in relation to this work. This study was registered with ClinicalTrials.gov (NCT02144987). © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Tumores neonatales y malformaciones congénitas

PubMed Central

Tornero, O. Berbel; García, J.A. Ortega; Tortajada, J. Ferrís i; Castell, J. García; Colomer, J. Donat i; Soldin, O.P.; Soler, J.L. Fuster

2013-01-01

Introducción La asociación entre tumores y malformaciones congénitas está bien establecida, pero no existen datos exclusivos en el período neonatal y se desconocen los mecanismos subyacentes que generan dicha relación. Objetivos Este trabajo tiene dos objetivos: primero, analizar la frecuencia de los tumores neonatales asociados a malformaciones congénitas, y segundo, comentar las posibles hipótesis etiopatogénicas de la relación entre ambas entidades. Materiales y método Estudio retrospectivo de las historias clínicas de los tumores neonatales, en el Hospital Universitario Materno- Infantil La Fe de Valencia, desde enero de 1990 hasta diciembre de 1999. Selección y descripción de las variedades histológicas asociadas a malformaciones congénitas. Éstas se han agrupado siguiendo los criterios de la Clasificación Internacional de Enfermedades CIE-9, códigos 740.0–759.9. Revisión sistemática bibliográfica de los últimos 25 años, obtenida del Medline, Cancerlit, Index Citation Science y Embase. El perfil de búsqueda utilizado fue la combinación de “neonatal/congenital-tumors/cancer/neoplasms” y “congenital malformations/birth defects”. Resultados Se identificaron 72 tumores neonatales (2,8 % del total de tumores pediátricos diagnosticados en dichos años) y 15 de ellos (20,8 %) asociados a malformaciones congénitas, enfermedades o síndromes congénitos. Las asociaciones entre tumores neonatales y malformaciones congénitas fueron las siguientes: a) angioma en 3 pacientes: con dos cardiopatías congénitas y una atresia de coanas-laringomalacia; b) neuroblastoma en 2 pacientes: uno con riñón en herradura y anomalías vertebrales, y otro con cardiopatía congénita; c) teratoma en 2 pacientes: uno con fisura palatina y anomalías vertebrales, y otro con metatarso varo; d) tumor del sistema nervioso central en un paciente con hernia de Bochdaleck; e) tumor cardíaco en 4 pacientes con esclerosis tuberosa; f) leucemia aguda en un paciente con síndrome de Down y cardiopatía congénita; g) tumor renal en un caso con hidrocefalia triventricular, y h) tumor adrenal en un caso con hemihipertrofia. En la bibliografía específica, las publicaciones engloban tumores de diferentes épocas pediátricas y sin unanimidad de criterios para clasificar las malformaciones congénitas. Apenas existen datos en el período neonatal y la asociación entre ambas entidades se obtiene de registros de instituciones médicas. La prevalencia oscila entre el 15 y el 31,6 %. Las hipótesis etiopatogénicas que explican la asociación entre tumores neonatales y malformaciones congénitas están basadas en las exposiciones prenatales (preconcepcionales y transplacentarias) a factores de riesgo potencialmente mutagénicos y carcinogénicos. Conclusiones Probablemente, los tumores neonatales se asocian con mayor frecuencia a malformaciones congénitas que los tumores diagnosticados en épocas posteriores de la vida. Para conocer la prevalencia real de la asociación entre tumores neonatales y malformaciones congénitas, es necesario unificar los criterios de inclusión y definición de ambas entidades. La obtención de una minuciosa historia medioambiental en todos los tumores neonatales asociados a malformaciones congénitas, donde se detallen y registren todos los factores de riesgo constitucionales y ambientales, es fundamental para mejorar nuestros escasos conocimientos de los mecanismos prenatales subyacentes y avanzar en su prevención. PMID:18559198

Measurement of the area of venous ulcers using two software programs.

PubMed

Eberhardt, Thaís Dresch; Lima, Suzinara Beatriz Soares de; Lopes, Luis Felipe Dias; Borges, Eline de Lima; Weiller, Teresinha Heck; Fonseca, Graziele Gorete Portella da

2016-12-19

to compare the measurement area of venous ulcers using AutoCAD(r) and Image Tool software. this was an assessment of reproducibility tests conducted in a angiology clinic of a university hospital. Data were collected from 21 patients with venous ulcers, in the period from March to July of 2015, using a collection form and photograph of wounds. Five nurses (evaluators) of the hospital skin wound study group participated. The wounds were measured using both software programs. Data were analyzed using intraclass correlation coefficient, concordance correlation coefficient and Bland-Altman analysis. The study met the ethical aspects in accordance with current legislation. the size of ulcers varied widely, however, without significant difference between the measurements; an excellent intraclass and concordance correlation was found between both software programs, which seem to be more accurate when measuring a wound area >10 cm². the use of both software programs is appropriate for measurement of venous ulcers, appearing to be more accurate when used to measure a wound area > 10 cm². comparar a mensuração de área de úlceras venosas por meio dos softwares AutoCAD(r) e Image Tool. trata-se de um estudo de avaliação de reprodutibilidade de testes, realizado em um ambulatório de angiologia de um hospital universitário. Os dados foram coletados de 21 pacientes com úlceras venosas, no período de março a julho de 2015, por meio de formulário de coleta e fotografia das feridas. Cinco enfermeiros (avaliadores) do Grupo de Estudos de Lesões de Pele do hospital participaram da pesquisa. As feridas foram mensuradas em ambos os softwares. Os dados foram analisados por meio do Coeficiente de correlação intraclasse, Coeficiente de correlação de concordância e procedimento de Bland e Altman. A pesquisa respeitou os aspectos éticos de acordo com a legislação vigente. os tamanhos das úlceras apresentaram grande amplitude, porém, sem diferença significativa entre as mensurações, existe excelente correlação intraclasse e de concordância entre os softwares, os quais parecem ser mais precisos na mensuração de feridas com área > 10 cm². o uso de ambos os softwares é indicado para a mensuração de úlceras venosas, parecendo ser mais precisos quando utilizados para mensurar feridas com área > 10 cm². comparar la medida del área de úlceras venosas por medio de los softwares AutoCAD(r) e Image Tool. se trata de un estudio de evaluación de reproducibilidad de pruebas, realizado en un ambulatorio de angiología de un hospital universitario. Los datos fueron recolectados de 21 pacientes con úlceras venosas, en el período de marzo a julio de 2015, por medio de formulario de recolección y fotografías de las heridas. Cinco enfermeros (evaluadores) del Grupo de Estudios de Lesiones de Piel del hospital participaron de la investigación. Las heridas fueron medidas en ambos softwares. Los datos fueron analizados por medio de: Coeficiente de correlación intraclase, Coeficiente de correlación de concordancia y Procedimiento de Bland y Altman. La investigación respetó los aspectos éticos de acuerdo con la legislación vigente. los tamaños de las úlceras presentaron gran amplitud, sin embargo, sin diferencia significativa entre las medidas; existe excelente correlación intraclase y de concordancia entre los softwares, los que parecen ser más precisos en medidas de heridas con área > 10 cm². el uso de ambos softwares es indicado para medir úlceras venosas, pareciendo ser más precisos cuando utilizados para medir heridas con área > 10 cm².

Ash in fire affected ecosystems

NASA Astrophysics Data System (ADS)

Pereira, Paulo; Jordan, Antonio; Cerda, Artemi; Martin, Deborah

2015-04-01

Ash in fire affected ecosystems Ash lefts an important footprint in the ecosystems and has a key role in the immediate period after the fire (Bodi et al., 2014; Pereira et al., 2015). It is an important source of nutrients for plant recover (Pereira et al., 2014a), protects soil from erosion and controls soil hydrological process as runoff, infiltration and water repellency (Cerda and Doerr, 2008; Bodi et al., 2012, Pereira et al., 2014b). Despite the recognition of ash impact and contribution to ecosystems recuperation, it is assumed that we still have little knowledge about the implications of ash in fire affected areas. Regarding this situation we wanted to improve our knowledge in this field and understand the state of the research about fire ash around world. The special issue about "The role of ash in fire affected ecosystems" currently in publication in CATENA born from the necessity of joint efforts, identify research gaps, and discuss future cooperation in this interdisciplinary field. This is the first special issue about fire ash in the international literature. In total it will be published 10 papers focused in different aspects of the impacts of ash in fire affected ecosystems from several parts of the world: • Fire reconstruction using charcoal particles (Burjachs and Espositio, in press) • Ash slurries impact on rheological properties of Runoff (Burns and Gabet, in press) • Methods to analyse ash conductivity and sorbtivity in the laboratory and in the field (Balfour et al., in press) • Termogravimetric and hydrological properties of ash (Dlapa et al. in press) • Effects of ash cover in water infiltration (Leon et al., in press) • Impact of ash in volcanic soils (Dorta Almenar et al., in press; Escuday et al., in press) • Ash PAH and Chemical extracts (Silva et al., in press) • Microbiology (Barreiro et al., in press; Lombao et al., in press) We believe that this special issue will contribute importantly to the better understanding of the role of ash in fire affected areas. Acknowledgments The 'Litfire' Project (MIP-048/2011; 181 Pereira) funded by the Lithuanian Research Council, Soil quality, erosion control and plant cover recovery under different post-firemanagement scenarios (POSTFIRE), funded by the Spanish Ministry of Economy and Competitiveness (CGL2013-47862-C2-1-R), Preventing and Remediating Degradation of Soils in Europe Through Land Care (RECARE) funded by the European Commission (FP7-ENV-2013-TWO STAGE) and European Research Project LEDDRA (243857) and COST action ES1306 (Connecting European connectivity research). References Balfour, V.N., Determining wildfire ash saturated hydraulic conductivity and sorptivity with laboratory and field methods. Catena. doi:10.1016/j.catena.2014.01.009 Barreiro, A., Fontúrbel, M.T., Lombao, A., Martín, C., Vega, J.A., Fernández, C., Carballas, T., Díaz-Raviña, M., Using phospholipid fatty acid and community level physiological profiling techniques to characterize soil microbial communities following an experimental fire and different stabilization treatments. Catena. doi:10.1016/j.catena.2014.07.011 Bodi, M., Martin, D.A., Santin, C., Balfour, V., Doerr, S.H., Pereira, P., Cerda, A., Mataix-Solera, J. (2014) Wildland fire ash: production, composition and eco-hydro-geomorphic effects. Earth-Science Reviews, 130, 103-127. Bodí, M.B., Doerr, S.H., Cerdà, A. and Mataix-Solera, J. (2012) Hydrological effects of a layer of vegetation ash on underlying wettable and water repellent soils. Geoderma, 191, 14-23. Burjachs, F., Expósito, I., Charcoal and pollen analysis: examples of Holocene fire dynamics in Mediterranean Iberian Peninsula. Catena. doi:10.1016/j.catena.2014.10.006 Burns, K., Gabet, E., The effective viscosity of slurries laden with vegetative ash. Catena. doi:10.1016/j.catena.2014.06.008 Cerdà, A. Doerr, S.H. (2008). The effect of ash and needle cover on surface runoff and erosion in the immediate post-fire period. Catena, 74 , 256-263. Dlapa, P., Bodí, M.B., Mataix-Solera, J., Cerdà, A., Doerr, S.H., Organic matter and wettability characteristics of wildfire ash from Mediterranean conifer forests. Catena. doi:10.1016/j.catena.2014.06.018 Dorta Almenar, I., Navarro Rivero, F.J., Arbelo, C.D., Rodríguez, A., Notario del Pino, J., The temporal distribution of water-soluble nutrients from high mountain soils following a wildfire within legume scrubland of Tenerife, Canary Islands, Spain. Catena. Escuday, M., Arancibia-Miranda, N., Pizarro, C., Antilén, M., Effect of ash from forest fires on leaching in volcanic soils. Catena. doi:10.1016/j.catena.2014.08.006 León, J., Echeverría, M.T., Marti, C., Badía, D., Can ash control infiltration rate after burning? An example in burned calcareous and gypseous soils in the Ebro Basin (NE Spain). Catena. doi:10.1016/j.catena.2014.05.024 Lombao, A., Barreiro, A., Carballas, T., Fontúrbel, M.T., Martín, C., Vega, J.A., Fernández, C., Díaz-Raviña, M., 2014. Changes in soil properties after a wildfire in Fragas do Eume Natural Park (Galicia, NW Spain). Catena. doi:10.1016/j.catena.2014.08.007 Pereira, P., Jordan, A., Cerda, A., Martin, D. (2014) Editorial: The role of ash in fire-affected ecosystems, Catena (In press) doi:10.1016/j.catena.2014.11.016 Pereira, P., Úbeda, X., Martin, D., Mataix-Solera, J., Cerdà, A., Burguet, M. (2014a) Wildfire effects on extractable elements in ash from a Pinus pinaster forest in Portugal, Hydrological Processes, 28, 3681-3690. Pereira, P., Ubeda, X., Mataix-Solera, J., Oliva, M., Novara, A. (2014) Short-term spatio-temporal spring grassland fire effects on soil colour,organic matter and water repellency in Lithuania, Solid Earth, 5, 209-225. Silva, V., Pereira, J.S., Campos, I., Keizer, J.J., Gonçalves, F., Abrantes, N., Toxicity assessment of aqueous extracts of ash from forest fires. Catena doi:10.1016/j.catena.2014.06.021

Domestic violence on children: development and validation of an instrument to evaluate knowledge of health professionals.

PubMed

Oliveira, Lanuza Borges; Soares, Fernanda Amaral; Silveira, Marise Fagundes; Pinho, Lucinéia de; Caldeira, Antônio Prates; Leite, Maísa Tavares de Souza

2016-08-18

to develop and validate an instrument to evaluate the knowledge of health professionals about domestic violence on children. this was a study conducted with 194 physicians, nurses and dentists. A literature review was performed for preparation of the items and identification of the dimensions. Apparent and content validation was performed using analysis of three experts and 27 professors of the pediatric health discipline. For construct validation, Cronbach's alpha was used, and the Kappa test was applied to verify reproducibility. The criterion validation was conducted using the Student's t-test. the final instrument included 56 items; the Cronbach alpha was 0.734, the Kappa test showed a correlation greater than 0.6 for most items, and the Student t-test showed a statistically significant value to the level of 5% for the two selected variables: years of education and using the Family Health Strategy. the instrument is valid and can be used as a promising tool to develop or direct actions in public health and evaluate knowledge about domestic violence on children. elaborar e validar um instrumento para avaliação do conhecimento dos profissionais de saúde sobre a violência doméstica contra a criança. estudo realizado com 194 profissionais médicos, enfermeiros e cirurgiões dentistas. Para elaboração dos itens e identificação das dimensões, realizou-se a revisão da literatura. A validação aparente e de conteúdo foram realizadas por meio da análise de três especialistas e de 27 professores universitários da área de saúde da criança. Para a validação de construto, avaliou-se o coeficiente alfa de Cronbach, e o teste Kappa foi usado para verificar a reprodutibilidade. A validação de critério foi conduzida com uso do teste t-student. o instrumento final apresentou 56 itens, o alfa Cronbach foi de 0,734, o teste Kappa revelou concordância superior a 0,6 para a maioria dos itens, e o teste t-student apresentou valor estatisticamente significante até o nível de 5% para as duas variáveis selecionadas, tempo de formação e tempo na Estratégia Saúde da Família. o instrumento apresentou-se válido e, deste modo , pode ser usado como ferramenta promissora para desenvolver ou direcionar as ações em saúde pública e avaliação do conhecimento sobre a violência doméstica contra a criança. elaborar y validar un instrumento para evaluación del conocimiento de los profesionales de la salud sobre la violencia doméstica ejercida contra el niño. estudio realizado con 194 profesionales: médicos, enfermeros y cirujanos dentistas. Para elaboración de los ítems e identificación de las dimensiones, se realizó una revisión de la literatura. La validación aparente y de contenido fueron realizadas por medio del análisis de tres especialistas y de 27 profesores universitarios del área de la salud del niño. Para la validación de constructo, se evaluó el coeficiente alfa de Cronbach, y la prueba Kappa fue usada para verificar la reproductibilidad. La validación de criterio fue realizada con uso de la prueba t de Student. el instrumento final presentó 56 ítems, el alfa Cronbach fue de 0,734, la prueba Kappa reveló concordancia superior a 0,6 para la mayoría de los ítems, y la prueba t de Student presentó valor estadísticamente significativo hasta el nivel de 5% para las dos variables seleccionadas: tiempo de graduación y tiempo en el programa Estrategia Salud de la Familia. el instrumento se presentó válido y, de ese modo, puede ser usado como herramienta promisora para desarrollar o dirigir acciones de salud pública y evaluar el conocimiento sobre la violencia doméstica contra el niño.

Factors associated with poor sleep quality in women with cancer.

PubMed

Mansano-Schlosser, Thalyta Cristina; Ceolim, Maria Filomena

2017-03-02

to analyze the factors associated with poor sleep quality, its characteristics and components in women with breast cancer prior to surgery for removing the tumor and throughout the follow-up. longitudinal study in a teaching hospital, with a sample of 102 women. The following were used: a questionnaire for sociodemographic and clinical characterization, the Pittsburgh Sleep Quality Index; the Beck Depression Inventory; and the Herth Hope Scale. Data collection covered from prior to the surgery for removal of the tumor (T0) to T1, on average 3.2 months; T2, on average 6.1 months; and T3, on average 12.4 months. Descriptive statistics and the Generalized Estimating Equations model were used. depression and pain contributed to the increase in the score of the Pittsburgh Sleep Quality Index, and hope, to the reduction of the score - independently - throughout follow-up. Sleep disturbances were the component with the highest score throughout follow-up. the presence of depression and pain, prior to the surgery, contributed to the increase in the global score of the Pittsburgh Sleep Quality Index, which indicates worse quality of sleep throughout follow-up; greater hope, in its turn, influenced the reduction of the score of the Pittsburgh Sleep Quality Index. analizar los factores asociados a la mala calidad del sueño, sus características y componentes en mujeres con cáncer de mama, antes de la cirugía de retirada del tumor y a lo largo del seguimiento. estudio longitudinal, en hospital universitario con muestra de 102 mujeres. Fueron utilizados: un cuestionario de caracterización sociodemográfica y clínica; el Índice de Calidad del Sueño de Pittsburgh; el Inventario de Depresión de Beck; y la Escala de Esperanza de Herth. La recolección comprendió los momentos: antes de la cirugía de retirada del tumor (T0), en (T1) en promedio 3,2 meses, en (T2) en promedio 6,1 meses y en (T3) en promedio 12,4 meses. Se utilizó estadística descriptiva y el modelo de Ecuaciones de Estimación Generalizada. la depresión y el dolor contribuyeron para el aumento del puntaje del Índice de Calidad del Sueño de Pittsburgh y la esperanza para la reducción del puntaje, de manera independiente, a lo largo del seguimiento. Los trastornos del sueño fueron el componente con puntuación más elevada, a lo largo del seguimiento. la presencia de la depresión y del dolor, previos a la cirugía, contribuyeron para el aumento del puntaje global del Índice de Calidad del Sueño de Pittsburgh, lo que indica peor calidad del sueño, a lo largo del seguimiento y, la mayor esperanza, a su vez, influenció en la reducción del puntaje del Índice de Calidad del Sueño de Pittsburgh. analisar os fatores associados à má qualidade do sono, suas características e componentes em mulheres com câncer de mama antes da cirurgia de retirada do tumor e ao longo do seguimento. estudo longitudinal, em hospital universitário com amostra de 102 mulheres. Foram utilizados: questionário de caracterização sociodemográfica e clínica, Índice de Qualidade do Sono de Pittsburgh; Inventário de Depressão de Beck; Escala de Esperança de Herth. Coleta compreendeu antes da cirurgia de retirada do tumor (T0) em T1, em média 3,2 meses; T2, em média 6,1 meses; T3, em média 12,4 meses. Utilizou-se estatística descritiva e o modelo de Equações de Estimação Generalizada. a depressão e a dor contribuíram para o aumento do escore do Índice de Qualidade de Sono de Pittsburgh, e a esperança, para a redução do escore, de maneira independente, ao longo do seguimento. Os transtornos do sono foram o componente com pontuação mais elevada, ao longo do seguimento. a presença de depressão e de dor, previamente à cirurgia, contribuiu para o aumento do escore global do Índice de Qualidade do Sono de Pittsburgh, o que indica pior qualidade do sono, ao longo do seguimento e, a maior esperança, por sua vez, influenciou na redução do escore do Índice de Qualidade do Sono de Pittsburgh.

The effects of progressive muscular relaxation as a nursing procedure used for those who suffer from stress due to multiple sclerosis.

PubMed

Novais, Paolla Gabrielle Nascimento; Batista, Karla de Melo; Grazziano, Eliane da Silva; Amorim, Maria Helena Costa

2016-09-01

to evaluate the effect of progressive muscle relaxation as a nursing procedure on the levels of stress for sufferers of multiple sclerosis. random clinical trials conducted at the Neurology outpatients unit at a University Hospital. The sample consisted of 40 patients who were being monitored as outpatients (20 in a control group and 20 in an experimental group). The Progressive Muscle Relaxation technique was used. The control variables were collected through interviews that were recorded on forms and on the Perceived Stress Scale that we used. Five meetings were held every fortnight covering a period of eight weeks. The experimental group was advised to carry out daily progressive muscle relaxation activities. After eight weeks of these activities, they were evaluated again to measure their levels of stress. In order to analyze the data used, the software package Statistics for Social Sciences version 19.0 was used. the application of the t test showed a significant reduction in the Perceived Stress Scale scores in the experimental group (p<0.001), which in turn proved that there was a reduction in the levels of stress after the application of the relaxation practic-es. the progressive muscle relaxation activities contributed to the reduction in stress levels for multiple sclerosis suffers and thus can be used in nursing for patients. NCT 02673827. avaliar o efeito do Relaxamento Muscular Progressivo, como intervenção de Enfermagem nos níveis de estresse em pessoas com Esclerose Múltipla. ensaio clínico randomizado conduzido em um ambulatório de Neurologia de um Hospital Universitário. A amostra constituiu-se por 40 pacientes em acompanhamento ambulatorial (20 no grupo controle e 20 no experimental). Empregou-se a técnica de Relaxamento Muscular Progressivo. As variáveis de controle foram coletadas pela técnica de entrevista com registro em formulário e a Escala de Stress Percebido foi aplicada. Foram realizados cinco encontros quinzenais em um período de oito semanas. O grupo experimental foi orientado a realizar diariamente o Relaxamento Muscular Progressivo. Após oito semanas de intervenção avaliou-se novamente os níveis de estresse. Para análise dos dados foi utilizado o pacote Estatístico para Ciências Sociais-versão 19.0. a aplicação do Teste t demonstrou uma diminuição significante dos escores da Escala de Stress Percebido no grupo experimental (p<0,001), evidenciando diminuição nos níveis de estresse após a prática do relaxamento. a intervenção Relaxamento Muscular Progressivo contribui para redução dos níveis de estresse em pessoas com Esclerose Múltipla, podendo ser incluída como prática na assistência de enfermagem prestada a esses pacientes. NCT 02673827. evaluar el efecto del Relajamiento Muscular Progresivo, como intervención de Enfermería en los niveles de estrés en personas con Esclerosis Múltiple. ensayo clínico aleatorio conducido en un ambulatorio de Neurología de un Hospital Universitario. La muestra estuvo constituida por 40 pacientes acompañados en ambulatorio (20 en el grupo control y 20 en el experimental). Se empleó la técnica de Relajamiento Muscular Progresivo. Las variables de control fueron recolectadas por la técnica de entrevista con registro en formulario y se aplicó la Escala de Estrés Percibido. Fueron realizados cinco encuentros quincenales en un período de ocho semanas. El grupo experimental fue orientado a realizar diariamente el Relajamiento Muscular Progresivo. Después de ocho semanas de intervención se evaluó nuevamente los niveles de estrés. Para analizar los datos fue utilizado el programa Estadístico para Ciencias Sociales versión 19.0. la aplicación de la Prueba t demostró una disminución significativa de los puntajes de la Escala de Estrés Percibido en el grupo experimental (p<0,001), evidenciando la disminución de los niveles de estrés después de la práctica del relajamiento. la intervención Relajamiento Muscular Progresivo contribuye para reducir los niveles de estrés en personas con Esclerosis Múltiple, pudiendo ésta ser incluida como práctica en la asistencia de enfermería prestada a esos pacientes. NCT 02673827.

The effects of acupressure on labor pains during child birth: randomized clinical trial.

PubMed

Mafetoni, Reginaldo Roque; Shimo, Antonieta Keiko Kakuda

2016-08-08

to analyze the effects of acupressure on the sanyinjiao point for pregnant women in labor at public maternity wards. single-blind controlled clinical trial, randomly done employing a pragmatic profile. We selected 156 pregnant women in their ≥ 37 week/s, who had cervical dilations of ≥ 4 cm and with two or more contractions in 10 minutes. The pregnant women were randomly divided into three groups at a university hospital in the suburbs of Sao Paulo, Brazil, in order to receive either acupressure treatment, a placebo or participate as part of a control group. The acupressure was applied on the sanyinjiao point during the contractions for 20 minutes. Then the intensity of the pain was evaluated using the Visual Analogue Scale (VAS). The averages for the pain measured using the VAS were not different for the three groups that were a part of the study (p-value=0.0929), however they were less in the acupressure groups immediately after receiving the treatment (p-value=<0.0001). This was also the case where the treatment lasted for 1 hour (p-value=0.0001). This was the case in comparison with placebo and control groups. the use of acupressure on the sanyinjiao point is a useful way to alleviate pain in a non-invasive manner. It can improve the quality of care given to pregnant women in labor. Register: RBR-9mhs8r. analisar os efeitos da acupressão no ponto sanyinjiao sobre a dor na fase ativa do trabalho de parto, em gestantes atendidas em maternidade pública. trata-se de um ensaio clínico controlado e randomizado, simples-cego e de caráter pragmático. Foram selecionadas 156 mulheres com idade gestacional ≥ 37 semanas, dilatação cervical ≥ 4 cm e com duas ou mais contrações em 10 minutos. As gestantes foram divididas aleatoriamente em três grupos em um hospital universitário do interior do estado de São Paulo, Brasil, para receber acupressão, placebo ou participar como controle. A acupressão foi aplicada no ponto sanyinjiao durante as contrações, por 20 minutos, e a intensidade da dor avaliada por meio de uma Escala Analógica Visual (EAV). as médias de dor pela EAV não foram diferentes nos três grupos na admissão (p-valor=0,0929), porém foram menores no grupo de acupressão imediatamente após (p-valor=<0,0001) e com 1 h do tratamento (p-valor=0,0001) ao se comparar com placebo e controle. a acupressão no ponto sanyinjiao se mostrou uma medida útil no alívio da dor, não invasiva e um meio de melhorar a qualidade dos cuidados a parturiente. Registro: RBR-9mhs8r. analizar los efectos de la acupresión, en el punto sanyinjiao, sobre el dolor en la fase activa del trabajo de parto, en embarazadas atendidas en maternidad pública. ensayo clínico controlado y aleatorio, simple ciego y de carácter pragmático. Fueron seleccionadas 156 mujeres con edad gestacional ≥ 37 semanas, dilatación cervical ≥ 4 cm y con dos o más contracciones en 10 minutos. Las embarazadas fueron divididas aleatoriamente en tres grupos en un hospital universitario del interior del estado de Sao Paulo, Brasil, para recibir acupresión, placebo o participar como control. La acupresión fue aplicada en el punto sanyinjiao durante las contracciones, por 20 minutos; la intensidad del dolor fue evaluada por medio de una Escala Analógica Visual (EAV). los promedios del dolor por la EAV no fueron diferentes en los tres grupos en la admisión (valor p=0,0929), sin embargo fueron menores en el grupo de acupresión inmediatamente después (valor p=<0,0001) y también después de 1 hora del tratamiento (valor p=0,0001) al compararse con el placebo y control. la acupresión en el punto sanyinjiao se mostró una medida útil en el alivio del dolor, no invasiva y un medio de mejorar la calidad de los cuidados la parturienta. Registro: RBR-9mhs8r.

Professional nursing practice in critical units: assessment of work environment characteristics.

PubMed

Maurício, Luiz Felipe Sales; Okuno, Meiry Fernanda Pinto; Campanharo, Cássia Regina Vancini; Lopes, Maria Carolina Barbosa Teixeira; Belasco, Angélica Gonçalves Silva; Batista, Ruth Ester Assayag

2017-03-02

assess the autonomy, control over environment, and organizational support of nurses' work process and the relationships between physicians and nurses in critical care units. cross-sectional study conducted with 162 nurses working in the intensive care units and emergency service of a university hospital. The workers' satisfaction with their work environment was assessed using Brazilian Nursing Work Index - Revised, translated and adapted for the Brazilian culture. average age was 31.6 ± 3.9 years; 80.2% were women; 68.5% Caucasians and 71.6% worked in intensive care units. The nurses considered autonomy (2.38 ± 0.64) and their relationship with physicians (2.24 ± 0.62) to be characteristics of the work environment that favored professional practice. Control over environment (2.78 ± 0.62) and organizational support (2.51 ± 0.54), however, were considered to be unfavorable. No statistically significant differences were found between the units based on the scores obtained by the professionals on the Brazilian Nursing Work Index - Revised. autonomy, relationship between physicians and nurses, and organizational support were considered by the units to be characteristics that favored nurses' professional practices. On the other hand, control over environment and organizational support were considered unfavorable. evaluar la autonomía, el control sobre el ambiente, el soporte organizacional del proceso de trabajo de los enfermeros y las relaciones entre médicos y enfermeros, en unidades críticas. estudio transversal realizado en 162 enfermeros de las unidades de terapia intensiva y del servicio de emergencia de un hospital universitario. La evaluación de la satisfacción del profesional con el ambiente de trabajo fue realizada utilizando el Brazilian Nursing Work Index - Revised, traducido y adaptado para la cultura brasileña. el promedio de edad fue 31,6 ± 3,9 años, 80,2% eran mujeres, 68,5% blancos y 71,6% trabajaban en la unidad de terapia intensiva. Los enfermeros consideraron que la autonomía (2,38 ± 0,64) y la relación médico y enfermero (2,24 ± 0,62) fueron las características del ambiente de trabajo favorables a la práctica profesional. Entretanto, consideraron como desfavorables el control del ambiente (2,78 ± 0,62) y el soporte organizacional (2,51 ± 0,54). No hubo diferencia estadísticamente significativa en el Brazilian Nursing Work Index - Revised entre la evaluación de los profesionales de las unidades evaluadas. en las unidades evaluadas, la autonomía, la relación médico y enfermero y el soporte organizacional fueron las características que favorecieron la práctica profesional del enfermero. En contrapartida, el control del ambiente y el soporte organizacional fueron relatados como desfavorables. avaliar a autonomia, o controle sobre o ambiente, o suporte organizacional do processo de trabalho dos enfermeiros e as relações entre médicos e enfermeiros em unidades críticas. estudo transversal realizado com 162 enfermeiros das unidades de terapia intensiva e do serviço de emergência de um hospital universitário. A avaliação da satisfação do profissional com o ambiente de trabalho foi realizada por meio do Brazilian Nursing Work Index - Revised, traduzido e adaptado para a cultura brasileira. a média de idade foi 31,6 ± 3,9 anos, 80,2% mulheres, 68,5% brancos e 71,6% trabalhavam em unidade de terapia intensiva. Os enfermeiros consideraram que autonomia (2,38 ± 0,64) e relação médico e enfermeiro (2,24 ± 0,62) foram características do ambiente de trabalho favoráveis à prática profissional. Entretanto, consideraram como desfavoráveis o controle do ambiente (2,78 ± 0,62) e o suporte organizacional (2,51 ± 0,54). Não houve diferença estatisticamente significativa no Brazilian Nursing Work Index - Revised entre a avaliação dos profissionais das Unidades avaliadas. nas unidades avaliadas, a autonomia, relação médico e enfermeiro e o suporte organizacional foram características que favoreceram a prática profissional do enfermeiro. Em contrapartida, o controle do ambiente e o suporte organizacional foram relatados como desfavoráveis.

Factors associated with the healing of complex surgical wounds in the breast and abdomen: retrospective cohort study.

PubMed

Borges, Eline Lima; Pires, José Ferreira; Abreu, Mery Natali Silva; Lima, Vera Lúcia de Araújo; Silva, Patrícia Aparecida Barbosa; Soares, Sônia Maria

2016-10-10

to estimate the healing rate of complex surgical wounds and its associated factors. retrospective cohort study from 2003 to 2014 with 160 outpatients of a Brazilian university hospital. Data were obtained through consultation of the medical records. Survival function was estimated using the Kaplan-Meier method and Cox regression model to estimate the likelihood of the occurrence of healing. the complex surgical wound healing rate was 67.8% (95% CI: 60.8-74.9). Factors associated with a higher likelihood of wound healing were segmentectomy/quadrantectomy surgery, consumption of more than 20 grams/day of alcohol, wound extent of less that 17.3 cm2 and the length of existence of the wound prior to outpatient treatment of less than 15 days, while the use of hydrocolloid covering and Marlex mesh were associated with a lower likelihood of healing. the wound healing rate was considered high and was associated with the type of surgical intervention, alcohol consumption, type of covering, extent and length of wound existence. Preventive measures can be implemented during the monitoring of the evolution of the complex surgical wound closure, with possibilities of intervention in the modifiable risk factors. estimar a taxa de cicatrização de ferida cirúrgica complexa e seus fatores associados. coorte retrospectiva de 2003 a 2014 com 160 pacientes ambulatoriais de um hospital universitário brasileiro. Os dados foram obtidos por meio de consulta aos prontuários médicos. Função de sobrevida foi estimada pelo método de Kaplan-Meier e modelo de regressão de Cox para estimação do risco de ocorrência da cicatrização. a taxa de cicatrização da ferida cirúrgica complexa foi 67,8% (IC 95%: 60,8-74,9). Os fatores associados a um maior risco de cicatrização da ferida foram cirurgia de setorectomia / quadrantectomia, consumo de mais de 20 gramas/dia de etanol, extensão da ferida menor que 17,3 cm2 e tempo de existência da ferida pré-tratamento ambulatorial inferior a 15 dias, enquanto uso de cobertura hidrocoloide e tela de Marlex estiveram associados a um menor risco de cicatrização. a taxa de cura da ferida foi considerada elevada, e esteve associada ao tipo de intervenção cirúrgica, consumo de etanol, tipo de cobertura, extensão e tempo de existência da ferida. Condutas preventivas podem ser implementadas durante o acompanhamento da evolução do fechamento da ferida cirúrgica complexa, com possibilidades de intervenção nos fatores de risco modificáveis. estimar la tasa de cicatrización de herida quirúrgica compleja y sus factores asociados. cohorte retrospectivo de 2003 a 2014 con 160 pacientes de ambulatorio de un hospital universitario brasileño. Los datos fueron obtenidos por medio de consulta a las fichas médicas. La función de supervivencia fue estimada por el método de Kaplan-Meier y el modelo de regresión de Cox para estimar el riesgo de ocurrencia de cicatrización. la tasa de cicatrización de la herida quirúrgica compleja fue 67,8% (IC 95%: 60,8-74,9). Los factores asociados a un mayor riesgo de cicatrización de la herida fueron cirugía de sectorectomía / cuadrantectomía, consumo de más de 20 gramos/día de etanol, extensión de la herida menor que 17,3 cm2 y tiempo de existencia de la herida antes del tratamiento en ambulatorio inferior a 15 días; en lo que se refiere al uso de cubrimiento hidrocoloide y tela de Marlex estuvieron asociados a un menor riesgo de cicatrización. la tasa de cura de la herida fue considerada elevada, y estuvo asociada al tipo de intervención quirúrgica, consumo de etanol, tipo de cubrimiento, extensión y tiempo de existencia de la herida. Conductas preventivas pueden ser implementadas durante el acompañamiento de la evolución del cierre de la herida quirúrgica compleja, con posibilidades de intervenir sobre los factores de riesgo modificables.

Satisfaction with medication in coronary disease treatment: psychometrics of the Treatment Satisfaction Questionnaire for Medication.

PubMed

Liberato, Ana Carolina Sauer; Rodrigues, Roberta Cunha Matheus; São-João, Thaís Moreira; Alexandre, Neusa Maria Costa; Gallani, Maria Cecília Bueno Jayme

2016-06-07

to psychometrically test the Brazilian version of the Treatment Satisfaction Questionnaire for Medication - TSQM (version 1.4), regarding ceiling and floor effect, practicability, acceptability, reliability and validity. participants with coronary heart disease (n=190) were recruited from an outpatient cardiology clinic at a university hospital in Southeastern Brazil and interviewed to evaluate their satisfaction with medication using the TSQM (version 1.4) and adherence using the Morisky Self-Reported Measure of Medication Adherence Scale and proportion of adherence. The Ceiling and Floor effect were analyzed considering the 15% worst and best possible TSQM scores; Practicability was assessed by time spent during TSQM interviews; Acceptability by proportion of unanswered items and participants who answered all items; Reliability through the Cronbach's alpha coefficient and Validity through the convergent construct validity between the TSQM and the adherence measures. TSQM was easily applied. Ceiling effect was found in the side effects domain and floor effect in the side effects and global satisfaction domains. Evidence of reliability was close to satisfied in all domains. The convergent construct validity was partially supported. the Brazilian TSQM presents evidence of acceptability and practicability, although its validity was weakly supported and adequate internal consistency was observed for one domain. realizar o teste psicométrico da versão brasileira do Treatment Satisfaction Questionnaire for Medication - TSQM (versão 1.4) [Questionário Satisfação com Tratamento Medicamentoso] com relação aos efeitos de teto e chão, praticidade, aceitabilidade, confiabilidade e validade. os participantes com doença cardíaca coronária (n=190) foram recrutados num ambulatório de cardiologia de um hospital universitário no sudeste do Brasil e entrevistados para avaliar satisfação em relação ao tratamento medicamentoso através da TSQM (versão 1.4) e adesão através da Morisky Self-Reported Measure of Medication Adherence Scale [Medida de Auto-Relato de Adesão ao Tratamento Medicamentoso] e proporção de aderência. Os efeitos Teto e Chão foram analisados considerando os 15% piores e 15% melhores escores possíveis obtidos no TSQM; Praticidade foi avaliada pelo tempo gasto na aplicação do TSQM durante a entrevista; Aceitabilidade foi verificada pela proporção de itens não respondidos e participantes que responderam todos os itens; Confiabilidade foi verificada com o coeficiente alfa de Cronbach e Validade através da validade de construto convergente entre o TSQM e as medidas de adesão. o TSQM foi facilmente aplicado. O efeito teto foi encontrado no domínio efeitos colaterais e o efeito chão foi encontrado nos domínios efeitos colaterais e satisfação global. Evidência de confiabilidade foi próxima de satisfatória em todos os domínios. A validade de construto convergente foi parcialmente apoiada. a versão brasileira do TSQM apresenta evidência de aceitabilidade e praticidade embora sua validade tenha sido pouco apoiada e consistência interna adequada foi observada em um domínio. testar las propiedades psicométricas de la versión brasileña del Treatment Satisfaction Questionnaire for Medication - TSQM (versión 1.4), considerando los efectos techo y suelo, factibilidad, aceptabilidad, confiabilidad y validez. participantes con enfermedad coronaria (n=190) fueron reclutados de una clínica ambulatoria de cardiología en un hospital universitario en el sudeste de Brasil y entrevistados para evaluar su satisfacción con la medicación con el TSQM (versión 1.4) y su adhesión con la Morisky Self-Reported Measure of Medication Adherence Scale y proporción de adhesión. Los efectos techo y suelo fueron analizados considerando los 15% peores y mejores puntuaciones en el TSQM; la factibilidad fue evaluada por el tiempo gasto durante las entrevistas de TSQM; la aceptabilidad por la proporción de ítems no respondidos y participantes que contestaron a todos los ítems; la confiabilidad con el coeficiente alfa de Cronbach y la validez de constructo convergente entre el TSQM y las medidas de adhesión. el TSQM fue aplicado con facilidad. El efecto de techo fue encontrado en el dominio de los efectos secundarios y el efecto suelo en los dominios de efectos secundarios y satisfacción global. Las evidencias de confiabilidad fueron aproximadamente satisfechas en todos los dominios. La validez de constructo convergente fue parcialmente apoyada. la versión brasileña del TSQM presenta evidencias de aceptabilidad y factibilidad, a pesar del soporte débil a su validez y de la observación de consistencia interna adecuada para un dominio.

Measurement of Family-centered care perception and parental stress in a neonatal unit.

PubMed

Balbino, Flávia Simphronio; Balieiro, Maria Magda Ferreira Gomes; Mandetta, Myriam Aparecida

2016-08-08

to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of São Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. there was a statistically significant improvement in the perceptions of the parents in most items assessed (p ≤0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant´s hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress. avaliar os efeitos da implementação do Modelo do Cuidado Centrado no Paciente e Família na percepção de pais e profissionais de saúde e no estresse parental. Estudo quase experimental com grupos não equivalentes para avaliação dos efeitos da intervenção na percepção de pais; e com grupos equivalentes para a avaliação na percepção de profissionais de saúde, desenvolvido na unidade neonatal de um hospital universitário do município de São Paulo. Os instrumentos, Percepção do Cuidado Centrado na Família- Pais versão brasileira, Percepção do Cuidado Centrado na Família- Equipe versão brasileira e Parental Stress Scale: Neonatal Intensive Care Unit, foram aplicados com 132 pais de recém-nascidos internados e 57 profissionais da equipe. houve melhora estatisticamente significante na percepção dos pais na maioria dos itens avaliados (p≤0,05) e para os profissionais em relação ao acolhimento da família na unidade neonatal (p= 0,041) e a compreensão da vivência da família com a hospitalização (p=0,050). Houve redução dos escores médios do estresse parental, com maior queda na Alteração do Papel de Pais de 4,2 para 3,8 (p=0,048). as intervenções realizadas melhoraram a percepção de pais e de profissionais da equipe de saúde sobre o Cuidado Centrado no Paciente e Família e contribuíram para a redução do estresse parental. evaluar los efectos de la implementación del Modelo del Cuidado Centrado en el Paciente y la Familia en la percepción de los padres y profesionales de la salud y en lo estrés parental. estudio cuasi-experimental con grupos no equivalentes para evaluar los efectos de la intervención en la percepción de los padres; y grupos equivalentes para evaluar la percepción de los profesionales de la salud, desarrollado en la unidad neonatal de un hospital universitario en el municipio de Sao Paulo. Los instrumentos de Percepción del Cuidado Centrado en el Paciente y la Familia- Padres versión brasileña, Percepción del Cuidado Centrado en el Paciente y la Familia-Equipo versión brasileña y Parental Stress Scale: Neonatal Intensive Care Unit, se aplicaron a 132 padres de los recién nacidos hospitalizados y 57 profesional del equipo. se observó una mejoría estadísticamente significativa en la percepción de los padres en la mayoría de los ítems evaluados (p = 0,05) y para los profesionales en relación con el cuidado de la familia en la unidad neonatal (p = 0,041) y la comprensión de la experiencia de la familia con la hospitalización (p = 0,050). Hubo una reducción en las puntuaciones medias de estrés de los padres, con una mayor disminución en la Alteración del Rol Parental 4.2 a 3.8 (p = 0,048). las intervenciones mejoran la percepción de los padres y los profesionales del equipo de salud en el Cuidado Centrado en el Paciente y la Familia y ha contribuido a reducir el estrés de los padres.

Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital.

PubMed

Ferreira, Carolina Justus Buhrer; Plodek, Caroline Koga; Soares, Franciny Kossemba; Andrade, Rayza Assis de; Teleginski, Fernanda; Rocha, Maria Dagmar da

2016-01-01

to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r) program, and frequencies were calculated. 786 errors were observed, 63.9% (502) in Phase 2, and 36.1% (284) in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes. analisar o impacto de diretrizes sobre erros em medicamentos prescritos para administração via sondas enterais. estudo quantitativo, em três fases, realizado em clínica médica, neurologia e unidade de terapia intensiva de hospital geral universitário. Na Fase 1 elaborou-se: protocolo de diluição, unitarização - transformação e administração para 294 medicamentos via sondas enterais; fluxograma decisório; procedimentos operacionais-padrão de diluição e unitarização de formas farmacêuticas orais e de administração de medicamentos via sondas enterais. Na Fase 2 investigou-se, retrospectivamente, erros em 872 medicamentos prescritos via sondas enterais, em 293 prescrições de pacientes internados de março a junho. Seguiu-se capacitação das equipes sobre diretrizes estabelecidas. Na Fase 3 investigou-se, prospectivamente, erros e intervenções farmacêuticas em 945 medicamentos prescritos via sondas enterais, em 292 prescrições de pacientes internados de agosto a setembro. Dados coletados, em formulário estruturado, foram compilados no programa Microsoft Office Excel(r) e calculadas as frequências. foram observados 786 erros, 63,9% (502) na Fase 2 e 36,1% (284) na Fase 3. Na Fase 3 verificou-se redução na frequência de prescrição de medicamentos, via sondas enterais, contraindicados e sem informações disponíveis. diretrizes e intervenções farmacêuticas foram determinantes na prevenção dos erros de medicamentos via sondas enterais. analizar el impacto de directrices sobre errores en medicamentos prescritos para administración vía sondas enterales. estudio cuantitativo, en tres fases, realizado en una clínica médica-neurología y en unidad de terapia intensiva de un hospital general universitario. En la Fase 1 se elaboró: protocolo de dilución, reenvasado - transformación y administración para 294 medicamentos vía sondas enterales; diagrama de flujo de decisión; procedimientos operacionales estándar de dilución y reenvasado - transformación de formas farmacéuticas orales y de administración de medicamentos vía sondas enterales. En la Fase 2 se investigó, retrospectivamente, errores en 872 medicamentos prescritos vía sondas enterales, en 293 prescripciones de pacientes internados de marzo a junio. La continuación, capacitación de los equipos sobre directrices establecidas. En la Fase 3 se investigó, prospectivamente, errores e intervenciones farmacéuticas en 945 medicamentos prescritos vía sondas enterales, en 292 prescripciones de pacientes internados de agosto a septiembre. Datos fueron colectados en un formulario estructurado, compilados en el programa Microsoft Office Excel(r) y se calcularon las frecuencias. se observaron 786 errores, 63,9% (502) en la Fase 2 y 36,1% (284) en la Fase 3. En la Fase 3 se verificó una reducción en la frecuencia de prescripción de medicamentos, vía sondas enterales, contraindicados y sin informaciones disponibles. las directrices e intervenciones farmacéuticas fueron determinantes en la prevención de los errores de medicamentos vía sondas enterales.

The Practice of Research of a Basic Education Teacher Involving Mental Models of the Phases of the Moon and Eclipses. (Spanish Title: La Práctica de Investigación de un Maestro de Educación BÁsica con El Uso de los Modelos Mentales de Las Fases de la Luna Y Eclipses.) A Prática de Pesquisa de um Professor do Ensino Fundamental Envolvendo Modelos Mentais de Fases da Lua e Eclipses

NASA Astrophysics Data System (ADS)

Pessôa Queiroz, Glória; Jubitipan Borges de Sousa, Carlos; Auxiliadora Delgado Machado, Maria

2009-12-01

The inclusion of basic education teachers in the survey domain is a controversial issue and fully debated in the academy. The opportunity for a collective work that incorporated school teachers from a public school to a university's group of physics teaching at university allowed us to glimpse the redefinition of the function of a science teacher (a coauthor of this paper) by himself, such that now he includes research on the knowledge construction by students in his teacher practice. The formation of inter-institutional groups for action planning and research in these areas has proved productive for the task of knowledge construction to support educational processes in school, while the university enriches its collection of experiences critically validated, and can consider the results in teachers initial and continued education. The active participation of the teacher in a research group at the university led him to reflect on the possible didactical ways to be described, analyzed and communicated to other teachers. The construction of a pedagogy that took into account the mental models of students on the basic topics of astronomy, and the changes developed resulting from the lessons taught, led to far-reaching consequences on the pedagogy adopted by the teacher, who incorporates now a new vision of science and alternative forms to dialogue with students, essential components for a researcher in Science Education. La inclusión de los maestros de la escuela básica en el universo de la investigación es polémica y está en amplio debate en el mundo académico. La oportunidad de trabajo colectivo de los maestros de una escuela pública en Río de Janeiro con un grupo universitario de enseñanza de la física nos ha permitido vislumbrar la redefinición de la función de un maestro de ciencias (uno de los coautores de este documento) por él mismo, ahora para incluir la investigación sobre la construcción del conocimiento por los alumnos en su práctica como docente. La formación de grupos interinstitucionales para la planificación de la acción y la investigación ha resultado productiva para el trabajo de construcción de conocimiento de apoyo a los procesos educativos en la escuela, mientras que la universidad enriquece su colección de experiencias validadas, considerando los resultados de la educación inicial y continua de maestros. La participación activa del maestro en un grupo de investigación en la universidad lo llevó a reflexiones sobre los posibles caminos didácticos que pueden ser descriptos, analizados y comunicados a los demás docentes. La construcción de una pedagogía propia, que tuvo en cuenta los modelos mentales de los estudiantes sobre los temas básicos de astronomía, y los cambios desarrollados a partir de las lecciones que enseñó, trajeron consecuencias de largo alcance sobre la pedagogía adoptada por el maestro, que ahora incorpora una nueva visión de la ciencia y formas alternativas al diálogo con los estudiantes, los componentes esenciales para un investigador en Educaciónen Ciencias. A inclusão do professor da escola básica no universo da pesquisa é questão controvertida e em pleno debate no meio acadêmico. A oportunidade de trabalho coletivo que incorporou professores de uma escola municipal no Rio de Janeiro a um grupo de ensino de Física da universidade nos possibilitou vislumbrar a ressignificação da função de um professor de Ciências (co-autor deste trabalho) por ele próprio, agora passando a incluir a pesquisa sobre a construção de conhecimento pelos alunos em sua prática como docente. A formação de grupos interinstitucionais para o planejamento de ações e de pesquisas tem-se mostrado produtiva para um trabalho de construção de conhecimentos a fim de subsidiar processos educativos na escola, ao mesmo tempo em que a universidade enriquece seu acervo de experiências validadas criticamente, podendo considerar seus resultados na formação inicial e continuada de professores. A participação ativa do professor num grupo de pesquisa na universidade o levou à reflexão sobre caminhos didáticos possíveis de serem descritos, analisados e comunicados a outros professores. A construção de uma pedagogia própria, levando em conta os modelos mentais dos alunos sobre temas básicos de Astronomia, e as mudanças promovidas a partir das aulas dadas, trouxeram amplas conseqüências sobre a pedagogia adotada pelo professor. Hoje a prática desse professor incorpora uma nova visão de ciência e formas alternativas de dialogar com os alunos, elementos indispensáveis a um pesquisador em Educação em Ciências.

Groundwater contamination in the basement-complex area of Ile-Ife, southwestern Nigeria: A case study using the electrical-resistivity geophysical method

NASA Astrophysics Data System (ADS)

Adepelumi, A. A.; Ako, B. D.; Ajayi, T. R.

2001-11-01

Hydrogeoenvironmental studies were carried out at the sewage-disposal site of Obafemi Awolowo University campus, Ile-Ife, Nigeria. The objective of the survey was to determine the reliability of the electrical-resistivity method in mapping pollution plumes in a bedrock environment. Fifty stations were occupied with the ABEM SAS 300C Terrameter using the Wenner array. The electrical-resistivity data were interpreted by a computer-iteration technique. Water samples were collected at a depth of 5.0 m in 20 test pits and analyzed for quality. The concentrations of Cr, Cd, Pb, Zn, and Cu are moderately above the World Health Organization recommended guidelines. Plumes of contaminated water issuing from the sewage ponds were delineated. The geoelectric sections reveal four subsurface layers, with increasing depth, lateritic clay, clayey sand/sand, and weathered/fractured bedrock, and fresh bedrock. The deepest layers, 3 and 4, constitute the main aquifer, which has a thickness of 3.1-67.1 m. The distribution of the elements in the sewage effluent confirms a hydrological communication between the disposal ponds and groundwater. The groundwater is contaminated, as shown by sampling and the geophysical results. Thus, the results demonstrate the reliability of the direct-current electrical-resistivity geophysical method in sensing and mapping pollution plumes in a crystalline bedrock environment. Résumé. Des études géo-environnementales ont été réalisées sur le site d'épandages du campus universitaire d'Obafemi Awolowo, à Ile-Ife (Nigeria). L'objectif de ce travail était de déterminer la fiabilité de la méthode des résistivités électriques pour cartographier les panaches de pollution dans un environnement de socle. Cinquante stations ont été soumises à mesures au moyen d'un ABEM SAS 300C Terrameter en utilisant le dispositif de Wenner. Les données de résistivité électrique ont été interprétées au moyen d'une technique de calcul itérative. Des échantillons d'eau ont été prélevés à une profondeur de 5,0 m dans 20 puits tests et analysés pour la qualité. Les concentrations en Cr, Cd, Pb, Zn et Cu sont légèrement au-dessus des valeurs recommandées par l'OMS. Des panaches d'eau contaminée provenant de bassins d'eaux usées ont été délimités. Les profils géoélectriques mettent en évidence quatre couches, qui sont successivement en profondeurs croissantes une argile latéritique, un sable ou un sable argileux, le substratum altéré, puis fissuré, et enfin le substratum non altéré. Les niveaux 3 et 4 les plus profonds constituent l'aquifère principal, de 3,1-67,1 m d'épaisseur. La distribution des éléments dans les effluents d'égouts confirme l'existence d'une communication hydrologique entre les bassins d'épandage et la nappe. Les eaux souterraines sont contaminées, comme le prouvent les résultats des prélèvements et de la géophysique. Par conséquent, les résultats démontrent la fiabilité de la méthode géophysique de résistivité électrique pour la détection et la cartographie de panaches de pollution dans un environnement de socle cristallin. Resumen. Se ha efectuado un estudio hidrogeológico ambiental en el punto de vertido de las aguas residuales del Campus Universitario de Obafemi Awolowo, en Ile-Ife (Nigeria). El objetivo era determinar la validez del método de la resistividad eléctrica para delimitar penachos de contaminación en un medio rocoso. Se utilizó 50 estaciones con un Terrameter ABEM SAS 300C, utilizando la matriz de Wenner. Se interpretó los resultados por medio de una técnica iterativa automática. Se recogieron muestras de agua a una profundidad de 5 m en 20 pozos de ensayo, las cuales fueron posteriormente analizadas en laboratorio. Las concentraciones de cromo, cadmio, plomo, cinc y cobre son ligeramente superiores a los valores guía de la Organización Mundial de la Salud. Se delineó el penacho de agua contaminada procedente de las balsas de aguas residuales. Las secciones geoeléctricas revelan la existencia de cuatro capas, que están formadas, de menor a mayor profundidad, por arcilla laterítica, arena arcillosa/arena, matriz rocosa meteorizada/fracturada, y roca sin alterar. Las dos capas más profundas constituyen el acuífero principal, que tiene un espesor comprendido entre 3,1-67,1 m. La caracterización química de las aguas residuales confirma que hay una conexión hidrológica entre las balsas de estabilización y las aguas subterráneas. Éstas muestran síntomas de contaminación, de acuerdo con el muestreo y la interpretación geofísica. Los datos evidencian la fiabilidad del método geofísico de la resistividad eléctrica por corriente directa para detectar y delimitar penachos contaminantes en un medio rocoso cristalino.

Chronic respiratory disease in adults treated for tuberculosis in Khartoum, Sudan

PubMed Central

Mortimer, K.; Bjune, G.; El Sony, A. I.

2016-01-01

Background: Chronic respiratory disease (CRD) causes substantial morbidity and mortality. Although the global CRD epidemic collides with the tuberculosis (TB) epidemic in many low- and middle-income country settings, the risk of TB-associated CRD is not well described in countries with a high burden of TB. Methods: We recruited 136 patients with a history of sputum smear-positive pulmonary TB (PTB) from the TB clinic at Omdurman Teaching Hospital in Khartoum, Sudan, and 136 age- and sex-matched community controls, between 28 July 2013 and 30 December 2013. Data were collected using standardised questionnaires and spirometry was performed before and after bronchodilator. Results: The mean age of the subjects with previous PTB and controls was respectively 44.0 years (SD 8.5) and 44.5 years (SD 8.6), with 27.2% females in both groups. Chronic respiratory symptoms such as chronic cough (OR 6.67, 95%CI 2.98–14.90, P < 0.001) and the presence of chronic airflow obstruction (OR 12.4, 95%CI 1.56–98.40, P = 0.02) were both strongly associated with a past history of PTB after adjusting for potential confounders. Conclusion: The clinical features of CRDs are strongly associated with past history of PTB. An integrated approach to improve the management of these common conditions should be considered. Contexte : Les maladies respiratoires chroniques (MRC) sont à l'origine d'une morbidité et d'une mortalité considérables dans le monde. Bien que l'épidémie mondiale des MRC entre en conflit avec l'épidémie de tuberculose (TB) dans de nombreux pays à revenu faible ou moyen, le risque de MRC associée à la TB n'est pas bien décrit dans les pays durement frappés par la TB. Méthodes : Nous avons recruté 136 patients ayant des antécédents de tuberculose pulmonaire (TBP) à frottis positif dans le service de pneumologie du Centre Hospitalier Universitaire Omdurman à Khartoum, Soudan, et 136 témoins de la communauté, appariés sur l'âge et le sexe, entre le 28 juillet 2013 et le 30 décembre 2013. Les données ont été recueillies grâce à des questionnaires standardisés ainsi qu'à une spirométrie avant et après bronchodilatateur. Résultats : L'âge moyen des cas et des témoins a été de 44,0 ans (DS 8,5) et 44,5 ans (DS 8,61), respectivement, avec 27,2% de femmes dans les deux groupes. Des symptômes respiratoires chroniques comme une toux chronique (OR 6,67 ; IC95% 2,98–14,90 ; P < 0,001) et la présence d'une obstruction chronique des voies aériennes (OR 12,39 ; IC%95 1,56–98,40 ; P = 0,02) ont été tous deux fortement associés à des antécédents de TBP après ajustement sur les facteurs de confusion potentiels. Conclusion : Les caractéristiques cliniques des MRC sont fortement associées à des antécédents de TBP. Une approche intégrée visant à améliorer la prise en charge de ces pathologies fréquentes devrait être envisagée. Marco de referencia: La enfermedad pulmonar crónica (EPC) es una causa importante de morbilidad y mortalidad. Aunque la epidemia mundial de EPC rivaliza con la epidemia de tuberculosis (TB) en muchos entornos de países con bajos y medianos recursos, el riesgo de aparición de EPC asociado con la TB se ha descrito cabalmente en los países con una alta carga de morbilidad por TB. Métodos: Entre el 28 de julio y el 30 de diciembre del 2013, participaron en el estudio 136 pacientes con antecedente de tuberculosis pulmonar (TBP) y baciloscopia positiva del esputo que habían recibido tratamiento en el consultorio de neumología del Hospital Universitario Omdurman de Jartún, en Sudán, y 136 testigos sanos de la comunidad, emparejados en función de la edad y el sexo. Se recogieron datos mediante cuestionarios normalizados y se practicó una espirometría antes y despuès una prueba de broncodilatación. Resultados: El promedio de la edad en el grupo de los casos fue 44,0 (desviación estándar 8,5 años) y en el grupo de testigos fue 44,5 años (8,6 años); la proporción de mujeres en ambos grupos fue 27,2%. Se observó una fuerte asociación entre la presencia de síntomas respiratorios crónicos como la tos (OR 6,67; IC95% 2,98–14,90; P < 0,001) y la presencia de obstrucción crónica al flujo en las vías respiratorias (OR 12,39; IC95% 1,56–98,40; P = 0,02) en las personas con antecedente de TBP, una vez corregidos los posibles factores de confusión. Conclusión: La presencia de rasgos clínicos de EPC exhibe una fuerte correlación con el antecedente de TBP. Es preciso considerar la posibilidad de aplicar un enfoque integrado con el fin de mejorar la atención de ambas enfermedades tan frecuentes. PMID:27695684

PREFACE: XII Latin American workshop on plasma physics (17-21 September 2007, Caracas, Venezuela)

NASA Astrophysics Data System (ADS)

Puerta, Julio

2008-10-01

Some years ago a group of Latin American physicists took the initiative to consult about the viability of organizing a meeting on plasma physics for researchers and students of the region. The result was that it was not only a good idea, but a necessity in order to show and share everyone's work, and to keep updated on latest advances and technologies on plasma physics. It was decided that for new researchers as well as students of Physics, it would prove to be the best way to keep them posted on such matters. This was the birth of a series of meetings known as Latin American workshops on plasma physics that take place every two years in a different Latin American country. In Venezuela we have had the opportunity to organize two editions of this interesting and important reunion of physicists. The first of these Latin American workshops on plasma physics was held in Cambuquira (Brazil) in 1982. After organizing the first six editions of the workshop, the VII LAWPP meeting was realized in Caracas in January 1997. It was designed with a structure similar to the first edition. It developed in two stages, a first week devoted to short courses with lecturers in different fields of plasma physics and a second week for contributed and invited presentations. Participants from sixteen different countries were present, half of them from this continent and the other half from overseas, demonstrating the international character of this meeting. There have been four more editions of the workshop and once again, we have had the opportunity to organize this latest edition of the series: the XII Latin American workshop on plasma physics, which took place in Caracas, Venezuela from the 17th to the 21st of September 2007. The structure was modified, because contributed and review papers were together during the first stage, with short courses realized during the second one, called mini-courses, and given by several high level contributors such as José Boedo, Leopoldo Soto, Claude Deutsch, Ricardo Galvao, Carlos Hidalgo, Paulo Sakanaka, Konosuke Sato, Malcom Haines and Maher Boulos. The general feeling is that these mini-courses were very successful. As an original idea of Professor Ricardo Magnus Osorio Galvão, Director of Centro Brasileiro de Pesquisas Físicas, we saluted the creation of The Vladimir Tsypin Award to the best Poster in the meeting. This prize was presented by Professor Galvão in memoriam of Vladimir Semenovich Tsypin. It was suggested that the granting of this award be made in every meeting from now on. We think that it is very important to emphasise the mini-courses due to the necessity of increasing in the near future a better formation for our young scientists. The contributions of all the lecturers are greatly appreciated. We had the typical fields in plasma physics as in past meetings. We also appreciated very much the lectures of Professor Malcolm Haines, Professor Sergey Popel, Professor Claude Deutsch, and Professor Antony Peratt for their very interesting talks on the Z-Pinch recorded to prehistory. Special thanks again to these lecturers since they have joined and honoured our meetings in the past as well. As in the VII LAWPP, all the sessions of the workshop were held at the Universidad Simon Bolivar campus, located in the nice green Valley of Sartenejas near Caracas. We also appreciate the stimulus and the financial support that we have always had for the preparation of these workshops from our institution by means of its authorities: Professor Benjamin Sharifker (Rector), Professor Aura Lopez (Dean of Academic Activities), (Professor Jose Luis Paz (Dean of Research and Development), Professor Pedro Berrisbeitia (Dean of Postgraduate Studies) and Professor William Colmenares (Dean of Extended Activities). We must also mention and appreciate the collaboration of architect Alejandro Chataing Roncajolo as Secretary and Coordinator of the Congress, as well as the daily important collaborations of our students Anais Möller, Laura Beiras, Juan Contreras, Gabriel Torrente, Aimée Guerrero, Francisco Jose Blanco Tovar, and last but not least, my son Johann Puerta. Without their generous help and great effort, it would have been impossible for me to organize, reach all the goals and finally, successfully realize the workshop. We are also grateful for the financial support of CLAF (Centro Latino American de Fisica), Fonacit (Fondo Nacional de Ciencia Investigacion y Tecnología), IVIC (Instituto Venezolano de Investigaciones Cientificos), Fundacion Banco Mercantil, whose sponsorship and finnacial support were vital to the realization of the event. We would like to thank La Universidad del Zulia, Universidad Central de Venezuela, Instituto Universitario de Tecnología, IDEA (Instituto de Estudios Avanzados), and Asociación de Amigos de la Universidad Simón Bolivar for their help and support in different ways for the good results we achieved in most of the meetings and the participation of their students who attend the Workshops. Finally we appreciate very much the Ministry for Science and Technology (Ministerio del Poder Popular para la Ciencia y la Tecnología) for their contribution to the workshops and to the publication process. We are under the impression that our meeting was successful, as we expected, and we are thankful for the collaboration of our Institution, and the close relation we had with all the physics researchers of Latin America and abroad (Europe, USA, Australia and Russia). Lastly, many thanks to the invited speakers for their lectures presented which have given a whole overview of the state of the art in different areas of the Physics of Plasma.

Chronic respiratory disease in adults treated for tuberculosis in Khartoum, Sudan.

PubMed

Osman, R K; Mortimer, K; Bjune, G; El Sony, A I

2016-09-01

Background: Chronic respiratory disease (CRD) causes substantial morbidity and mortality. Although the global CRD epidemic collides with the tuberculosis (TB) epidemic in many low- and middle-income country settings, the risk of TB-associated CRD is not well described in countries with a high burden of TB. Methods: We recruited 136 patients with a history of sputum smear-positive pulmonary TB (PTB) from the TB clinic at Omdurman Teaching Hospital in Khartoum, Sudan, and 136 age- and sex-matched community controls, between 28 July 2013 and 30 December 2013. Data were collected using standardised questionnaires and spirometry was performed before and after bronchodilator. Results: The mean age of the subjects with previous PTB and controls was respectively 44.0 years (SD 8.5) and 44.5 years (SD 8.6), with 27.2% females in both groups. Chronic respiratory symptoms such as chronic cough (OR 6.67, 95%CI 2.98-14.90, P < 0.001) and the presence of chronic airflow obstruction (OR 12.4, 95%CI 1.56-98.40, P = 0.02) were both strongly associated with a past history of PTB after adjusting for potential confounders. Conclusion: The clinical features of CRDs are strongly associated with past history of PTB. An integrated approach to improve the management of these common conditions should be considered. Contexte : Les maladies respiratoires chroniques (MRC) sont à l'origine d'une morbidité et d'une mortalité considérables dans le monde. Bien que l'épidémie mondiale des MRC entre en conflit avec l'épidémie de tuberculose (TB) dans de nombreux pays à revenu faible ou moyen, le risque de MRC associée à la TB n'est pas bien décrit dans les pays durement frappés par la TB. Méthodes : Nous avons recruté 136 patients ayant des antécédents de tuberculose pulmonaire (TBP) à frottis positif dans le service de pneumologie du Centre Hospitalier Universitaire Omdurman à Khartoum, Soudan, et 136 témoins de la communauté, appariés sur l'âge et le sexe, entre le 28 juillet 2013 et le 30 décembre 2013. Les données ont été recueillies grâce à des questionnaires standardisés ainsi qu'à une spirométrie avant et après bronchodilatateur. Résultats : L'âge moyen des cas et des témoins a été de 44,0 ans (DS 8,5) et 44,5 ans (DS 8,61), respectivement, avec 27,2% de femmes dans les deux groupes. Des symptômes respiratoires chroniques comme une toux chronique (OR 6,67 ; IC95% 2,98-14,90 ; P < 0,001) et la présence d'une obstruction chronique des voies aériennes (OR 12,39 ; IC%95 1,56-98,40 ; P = 0,02) ont été tous deux fortement associés à des antécédents de TBP après ajustement sur les facteurs de confusion potentiels. Conclusion : Les caractéristiques cliniques des MRC sont fortement associées à des antécédents de TBP. Une approche intégrée visant à améliorer la prise en charge de ces pathologies fréquentes devrait être envisagée. Marco de referencia: La enfermedad pulmonar crónica (EPC) es una causa importante de morbilidad y mortalidad. Aunque la epidemia mundial de EPC rivaliza con la epidemia de tuberculosis (TB) en muchos entornos de países con bajos y medianos recursos, el riesgo de aparición de EPC asociado con la TB se ha descrito cabalmente en los países con una alta carga de morbilidad por TB. Métodos: Entre el 28 de julio y el 30 de diciembre del 2013, participaron en el estudio 136 pacientes con antecedente de tuberculosis pulmonar (TBP) y baciloscopia positiva del esputo que habían recibido tratamiento en el consultorio de neumología del Hospital Universitario Omdurman de Jartún, en Sudán, y 136 testigos sanos de la comunidad, emparejados en función de la edad y el sexo. Se recogieron datos mediante cuestionarios normalizados y se practicó una espirometría antes y despuès una prueba de broncodilatación. Resultados: El promedio de la edad en el grupo de los casos fue 44,0 (desviación estándar 8,5 años) y en el grupo de testigos fue 44,5 años (8,6 años); la proporción de mujeres en ambos grupos fue 27,2%. Se observó una fuerte asociación entre la presencia de síntomas respiratorios crónicos como la tos (OR 6,67; IC95% 2,98-14,90; P < 0,001) y la presencia de obstrucción crónica al flujo en las vías respiratorias (OR 12,39; IC95% 1,56-98,40; P = 0,02) en las personas con antecedente de TBP, una vez corregidos los posibles factores de confusión. Conclusión: La presencia de rasgos clínicos de EPC exhibe una fuerte correlación con el antecedente de TBP. Es preciso considerar la posibilidad de aplicar un enfoque integrado con el fin de mejorar la atención de ambas enfermedades tan frecuentes.

Speaking, writing, and memory span in children: output modality affects cognitive performance.

PubMed

Grabowski, Joachim

2010-02-01

Low-level processes of children's written language production are cognitively more costly than those involved in speaking. This has been shown by French authors who compared oral and written memory span performance. The observed difficulties of children's, but not of adults' low-level processes in writing may stem from graphomotoric as well as from orthographic inadequacies. We report on five experiments designed to replicate and expand the original results. First, the French results were successfully replicated for German third-graders, and for university students. Then, the developmental changes of the cognitive costs of writing were examined during primary school, comparing the performance of second- and fourth-graders. Next, we show that unpractised writing modes, which were experimentally induced, also lead to a decrease of memory performance in adults, which supports the assumption that a lack of graphomotoric automation is responsible for the observed effects in children. However, unpractised handwriting yields clearer results than unpractised typing. Lastly, we try to separate the influences of graphomotoric as opposed to orthographic difficulties by having the words composed through pointing on a "spelling board". This attempt, however, has not been successful, probably because the pointing to letters introduced other low-level costs. In sum, throughout the four years of primary school, German children show worse memory span performance in writing compared to oral recall, with an overall increase in both modalities. Thus, writing had not fully caught up with speaking regarding the implied cognitive costs by the end of primary school. Therefore, conclusions relate to the question of how to assess properly any kind of knowledge and abilities through language production. Los procesos de bajo nivel en la producción de lenguaje escrito en niños son más costosos a nivel cognitivo que los que están implicados en el habla. Esto ha sido demostrado por autores franceses quiénes compararon la ejecución en la capacidad de retención en la memoria oral y escrita. Las dificultades observadas en niños, pero no en adultos, en procesos de bajo nivel en la escritura pueden derivarse de la inadecuación grafomotriz u ortográfica. Informamos sobre cinco experimentos diseñados para replicar y ampliar los resultados originales. Primero, los resultados franceses fueron replicados con éxito para alemanes en tercer curso y para estudiantes universitarios. Después, los cambios evolutivos en costes cognitivos en la escritura fueron estudiados durante la educación primaria, comparando la ejecución de los alumnos del segundo y cuarto curso. Posteriormente, demostramos que las formas de escribir no practicadas, que se han inducido experimentalmente, conducen a la disminución de la ejecución en la memoria también en adultos, lo cual apoya la hipótesis de que la falta de la automatización grafomotriz es la responsable de los efectos encontrados en niños. Sin embargo, la escritura a mano muestra resultados más claros que la escritura a máquina. Por último, hemos intentado separar la influencia de la grafomotricidad frente a las dificultades ortográficas componiendo las palabras señalando en una "pizarra de ortografía". Este intento, sin embargo, no ha tenido éxito, probablemente porque señalar letras ha introducido otros costes de bajo nivel. Resumiendo, a lo largo de los cuatro años de la educación primaria, los niños alemanes muestran peor ejecución en retención en memoria en la escritura, en comparación con el recuerdo oral, con un incremento general en ambas modalidades. Por tanto, al final de la educación primaria, la escritura no ha igualado todavía el habla en cuanto a los costes cognitivos. Por consiguiente, las conclusiones están relacionadas con la cuestión de cómo evaluar cualquier tipo de conocimiento o habilidades mediante la producción de lenguaje. Les processus de bas niveau de la production du langage écrit chez les enfants sont cognitivement plus coûteux que ceux impliqués dans le langage parlé. Ceci a été démontré par des auteurs français qui ont comparé la performance de l'étendue de la mémoire orale et écrite. L'observation de difficultés dans les processus de bas niveau dans l'écriture chez les enfants, et non chez les adultes, pourrait être due aux inadéquations graphomotoriques et orthographiques. Nous rapportons cinq expérimentations dont le but était de répliquer et d'élargir les résultats originaux. Premièrement, les résultats français ont été répliqués avec succès pour les élèves allemands de troisième année et pour les étudiants universitaires. Ensuite, les changements développmentaux des coûts cognitifs de l'écriture ont été examinés à l'école primaire en comparant la performance des élèves de deuxième et de quatrième années. Par la suite, nous avons montré que les modes d'écriture non pratiqués qui étaient expérimentalement induits indiquent une diminution de la performance de la mémoire, chez les adults aussi, ce qui supporte la supposition qu'un manque d'automatisme graphomotorique est responsable des effets observés chez les enfants. Cependant, une écriture à la main sans entraînement mène à des résultats plus claires que la dactylographie sans entraînement. Enfin, nous avons tenté de séparer les influences des difficultés graphomotoriques versus difficultés orthographiques à travers la composition des mots en les indiquant sur un tableau d'ortographe. Cependant, cette tentative n'a pas réussi, probablement à cause du fait d'indiquer les lettres présente d'autres coûts dont le niveau est bas. En résumé, à travers les quatre années de l'école primaire, les enfants allemands montrent une pire performance de l'étendue de mémoire dans l'écriture, en comparaison au rappel oral, avec une augmentation globale dans les deux modalités. Ainsi, toujours à la fin de l'école primaire, l'écriture n'a pas rattrapé l'expression orale en ce qui concerne les coûts cognitifs implicites. Par conséquent, les conclusions se rapportent à la question de comment évaluer correctement n'importe quel type de connaissances et d'habiletés à travers la production du langage.

Relation of runoff and soil erosion to weather types in the Mediterranean basin

NASA Astrophysics Data System (ADS)

Nadal-Romero, Estela; Peña-Angulo, Dhais

2017-04-01

Nadal-Romero, E. (1), Peña-Angulo, D. (1), Albaladejo, J. (2), Andreu, V. (3), Bahri, H. (4), Bagarello, V. (5), Batalla, R., (6), Bienes, R. (7), Campo, J. (3), Campo-Bescós, M.A. (8), Canatario, A. (9), Cantón, Y. (10), Casali, J. (8), Castillo, V. (2), Cid, P. (11), Cortesi, N. (12), Desir, G. (13), Díaz, E. (2), Ferreira, C. (14), Ferro, V. (5), Giménez, R. (8), Gimeno, E. (3), Gómez, J.A. (15), Gómez-Gutiérrez, A. (16), González-Hidalgo, J.C. (1), Klotz, S. (17) Kosmas, C. (18), Lana-Renault, N. (19), Lasanta, T. (20), Lázaro, R., (21), Le Bissonnais, Y. (22), Le Bouteiller, C. (17), Licciardello, F. (23), López-Tarazón, J.A. (24), Lucía, A. (25), Marín, C. (13), Marqués, M.J., (26) Martínez-Fernández, J. (27), Martínez-Mena, M. (2), Martínez-Murillo, J.F. (28), Mateos, L. (15), Novara, A. (5), Pachecho, E. (29), Raclot, D. (22), Rodríguez-Blanco, M.L. (30), Romero-Díaz, A. (31), Rubio, J.L. (3), Ruiz-Sinoga, J.D. (28), Schnabel, S. (16), Simonneaux, V. (32), Solé-Benet, A. (21), Taguas, E.V. (33), Taboada-Castro, M.M. (30), Taboada-Casto, M.T. (30), Todisco, F. (34), Úbeda, X. (29), Varouchakis, E. A. (35), Zabaleta, A. (36), Zorn, M. (37) (1) Departamento de Geografía, Instituto Universitario de Ciencias Ambientales (IUCA), Universidad de Zaragoza, Zaragoza, Spain (2) Soil and water conservation research group, CEBAS-CSIC, Murcia, Spain (3) Degradación y conservación de suelos, Centro de Investigación sobre Desertificación (CIDE), Valencia, Spain (4) INRGREF, Tunis, Tunisia (5) Department of Scienze Agrarie e Forestali, University of Palermo, viale delle scienze, Palermo, Italy (6) Department de Medi Ambient, Universitat de Lleida, Lleida, Spain (7) Departamento Investigación Aplicada y Extensión Agraria. Instituto Madrileño de Investigación y Desarrollo Rural, Agrario y Alimentario (IMIDRA), Madrid, Spain (8) Escuela Técnica Superior de Ingeniería Agrónoma, Universidad Pública de Navarra, Pamplona, Spain (9) Polytechnic Institute of Catelo Branco, School of Agriculture (ESACB), Portugal (10) Departamento de Agronomía, Universidad de Almería, Almería, Spain (11) Center for Research and Advanced Studies of the Nactional Polytechnic Institute, Mexico City, DF, Mexico (12) Centro Nacional de Supercomputacion, Department of Earth Sciences, Barcelona, Spain (13) Departamento de Ciencias de la Tierra, Universidad de Zaragoza, Zaragoza, Spain (14) Centro de Estudos de Recursos Naturais, Ambiente e Sociedade (CERNAS), Coimbra Agrarian Technical School, Polytechnic Institute of Coimbra, Coimbra, Portugal (15) Instituto de Agricultura Sostenible—CSIC, Córdoba, Spain (16) Grupo de Investigación GeoAmbiental (GIGA), Área de Geografía Física, Facultad de Filosofía y Letras. Universidad de Extremadura, Cáceres, Spain (17) Department of Waters, National Research Institute of Science and Technology for Environment and Agriculture, France (18) Department of Natural Resources Management and Agricultural Engineering, Agricultural University of Athens, Athens, Greece (19) Area of Physical Geography, Luis Vives Building, Luis de Ulloa Street, University of La Rioja, 26006 Logroño, Spain (20) Instituto Pirenaico de Ecología, IPE-CSIC, Zaragoza, Spain (21) Estación Experimental de Zonas Áridas, EEZA-CSIC, Almería, Spain (22) IRD, LISAH, Montpellier, France (23) Department of Agri-Food and Environmental Systems Management, University of Catania, Catania, Italy (24) Institute of Earth and Environmental Science, University of Potsdam, Potsdam, Germany (25) Center for Applied Geosciences. Faculty of Science, Eberhard Karls Universität Tübingen, Germany (26) Departamento de Geología y Geoquímica, Universidad Autónoma Madrid, Madrid, Spain (27) Departamento de Geografía, Universidad de Salamanca, Salamanca, Spain (28) Departamento de Geografía, Grupo de Investigación Geografía Física y Territorio—RNM279, Andalucía Tech, Universidad de Málaga, Málaga, Spain (29) Grup de Recerca Ambiental Mediterrània, Departamento de Geografia Física i AGR, Universitat de Barcelona, Spain (30) Facultad de Ciencias and Centro de Investigaciones Científicas Avanzadas (CICA), University of A Coruña, Campus de A Coruña, Spain (31) Departamento de Geografía, Universidad de Murcia, Murcia, Spain (32) French National Research Institut for Sustainable Development (IRD), CESBIO Laboratory, Toulouse, France. (33) Escuela Técnica Superior de Ingeniería Agronómica e I. de Montes, Departamento de Ingeniería Rural, Universidad de Córdoba, Córdoba, Spain (34) Departament of Environmental and Agricultural Sciences, Università degli Studi di Perugia, Perugia, Italy (35) Technical University of Crete, School of Environmental Engineering, Chania, Greece (36) Departamento de Geodinámica, Universidad del País Vasco UPV/EHU, Leioa, Spain (37) Geographical Institute, Research Centre of the Slovenian Academy of Sciences and Arts, Ljubljana, Slovenia Erosion processes and land degradation are recognized as one of the most significant environmental problems worldwide. In the Mediterranean region, intense erosion processes occur as a consequence of complex interactions between environmental conditions (e.g. climate, lithology) and human-related factors (e.g. history of human activity, land use changes) (García-Ruiz et al., 2013). Precipitation has been recognized as one of the main factors driving soil erosion. In climatology, one of the most common approaches in analyzing spatial and temporal precipitation variability is the circulation of weather types (WTs), which categorize the continuum of atmospheric circulation into a small number of classes or types. Flood generation and soil erosion are associated with specific weather conditions. Previous research in the Iberian Peninsula has analyzed the relationship between precipitation and specific WTs, demonstrating that specific WTs are the main drivers of precipitation and soil erosion in the different areas (Cortesi et al., 2014; Nadal-Romero et al., 2015). In this study, we present a preliminary analysis of WTs and runoff and soil erosion data from 50 study areas in the Mediterranean basin including different land uses. To do so,we have collected and jointed different research groups cross the Mediterranean Basin, and combined different databases (plots and small representative catchments) with the WT classification calculated using the NCEP/NCAR 40-Year Reanalysis Project. This pioneer research will be a valuable tool in understanding the relationships between weather types, precipitation and soil erosion dynamics. Acknowledgments Estela Nadal-Romero was the beneficiary of a "Ramón y Cajal" postdoctoral contract (Spanish Ministry of Economy and Competitiveness). José Andrés López-Tarazón is in receipt of a Marie Curie Intra-European Fellowship (Project ''Floodhazards'', PIEF-GA-2013-622468, Seventh EU Framework Programme). References Cortesi, N., González-Hidalgo, J.C., Trigo, R.M., Ramos, A.M., 2014. Weather types and spatial variability of precipitation in the Iberian Peninsula. International Journal of Climatology 34(8), 2661-2677. García-Ruiz, J.M., Nadal-Romero, E., Lana-Renault, N., Beguería, S., 2013. Erosion in Mediterranean landscapes: Changes and future challenges. Geomorphology 198, 20-36. Nadal-Romero, E., González-Hidalgo, J.C., Cortesi, N., Desir, G., Gómez, J.A., et al., 2015. Relationship of runoff, erosion and sediment yield to weather types in the Iberian Peninsula. Geomorphology 228, 372-381.

Are Japanese groups more competitive than Japanese individuals? A cross-cultural validation of the interindividual-intergroup discontinuity effect.

PubMed

Takemura, Kosuke; Yuki, Masaki

2007-02-01

The interindividual-intergroup discontinuity effect is the tendency for relationships between groups to be more competitive than the relationships between individuals. It has been observed robustly in studies conducted in the United States, which is a society characterized as "individualistic." In this study, it was explored whether the effect was replicable in a "collectivistic" society such as Japan. From the traditional view in cross-cultural psychology, which emphasizes the collectivistic nature of East Asian peoples, it was expected that the discontinuity effect would be greater in Japan than in the United States. On the other hand, based on recent empirical findings suggesting that North Americans are no less group-oriented than East Asians, it was expected that the discontinuity effect would be no greater in Japan than in the United States. One hundred and sixty Japanese university students played a 10-trial repeated prisoner's dilemma game: 26 sessions of interindividual and 18 sessions of intergroup. Following exactly the procedure of prior experiments in the US, individuals and groups were allowed face-to-face communication with their opponents before making their decisions, and participants in the intergroup condition were further allowed to converse freely with their in-group members. Results replicated previous findings in the United States; groups made more competitive choices than did individuals. In addition, neither the magnitude of the discontinuity effect, nor the frequency of competitive choices made by the groups, were larger in Japan than they were in the majority of prior studies conducted in the United States. These findings suggest cross-cultural robustness of the interindividual-intergroup discontinuity effect. Also, interestingly, they contradict the simple distinction between individualism and collectivism. Implications for studies of culture and group processes are discussed. This research was supported by grants from the Center for the Study of Cultural and Ecological Foundations of the Mind, a 21(st) Century Center of Excellence Program at Hokkaido University. The authors would like to thank Dr. Laura Hernández-Guzmán, three anonymous reviewers, and Robin Cooper, Mark H. B. Radford, and Paul A. Wehr for their helpful comments on earlier versions of this article. They would also like to thank Dr. Chester A. Insko for his kind and valuable advice during the planning of this experiment as well as the interpretation of its results, Kaori Akaishi for her help with data collection, and, finally, colleagues at Hokkaido University who helped to recruit potential participants from their classes. L'effet de discontinuité entre les individus et entre les groupes est la tendance des relations entre les groupes à être plus compétitives que les relations entre les individus. Cet effet fut fermement démontré dans des études menées aux États-Unis, une société caractérisée d' «individualiste». Dans la présente étude, nous avons exploré dans quelle mesure l'effet était applicable à une société «collectiviste» comme le Japon. À partir du point de vue traditionnel de la psychologie interculturelle, laquelle met l'emphase sur la nature collectiviste des peuples de l'Asie de l'Est, il était attendu que l'effet de discontinuité allait être plus grand au Japon qu'aux États-Unis. D'un autre côté, se basant sur les données empiriques récentes qui suggèrent que les Nord-américains ne sont pas moins orientés vers le groupe que les Asiatiques de l'Est, il était attendu que l'effet de discontinuité ne serait pas plus important au Japon qu'aux États-Unis. Cent soixante étudiants universitaires japonais ont pris part à un jeu de dilemme de prisonnier de 10 essais répétés: 26 sessions entre individus et 18 sessions entre groupes. Suivant exactement la procédure des expériences menées précédemment aux États-Unis, les individus et les groupes avaient la permission de communiquer face-à-face avec leur opposant avant de prendre leur décision. De plus, les participants de la condition entre groupes avaient également la possibilité de converser librement avec les membres de leur propre groupe. Les résultats se sont révélés semblables à ceux des études antérieures réalisées aux États-Unis; les groupes ont fait des choix plus compétitifs que les individus. En outre, ni la magnitude de l'effet de discontinuité, ni la fréquence des choix compétitifs faits par les groupes n'étaient plus grands chez les Japonais comparativement à la majorité des études antérieures menées aux États-Unis. Ces résultats soutiennent la robustesse interculturelle de l'effet de discontinuité entre les individus et entre les groupes. Aussi, fait intéressant, ils contredisent la simple distinction entre l'individualisme et le collectivisme. Les implications pour des études sur les cultures et les processus de groupe sont discutées. El efecto de discontinuidad entre individuos y entre grupos es la tendencia a que las relaciones entre grupos sean más competitivas que las relaciones entre individuos. Se ha observado con insistencia en estudios conducidos en Estados Unidos, una sociedad caracterizada como "individualista". En el presente estudio, se exploró si el efecto se repetía en una sociedad "colectivista" como la japonesa. Desde la perspectiva tradicional de la psicología trans cultural, que subraya la naturaleza colectivista de los pueblos asiáticos, se esperaba que el efecto de discontinuidad fuese mayor en Japón que en Estados Unidos. Por otra parte, con base en los hallazgos empíricos recientes que sugieren que los estadounidenses no están menos orientados al grupo que los de este asiático, se esperaba que el efecto de discontinuidad no fuera mayor en Japón que en los Estados Unidos. Ciento sesenta estudiantes universitarios japoneses participaron en un juego del dilema de un prisionero de diez ensayos repetidos: veintiséis sesiones entre individuos y diez y ocho entre grupos. Siguiendo exactamente el procedimiento de los experimentos previos en los Estados Unidos, se permitió tanto a los individuos como a los grupos una comunicación cara a cara con sus oponentes antes de tomar sus decisiones, y se permitió a los participantes en la condición entre grupos que conversaran libremente con los miembros de su propio grupo. Los resultados repitieron los hallazgos previos en los Estados Unidos; los grupos hicieron elecciones más competitivas que los individuos. Además, ni la magnitud del efecto de discontinuidad ni la frecuencia de las elecciones competitivas de los grupos, fueron mayores en Japón que en la mayoría de los estudios previos en Estados Unidos. Estos hallazgos sugieren la robustez trans cultural del efecto de discontinuidad entre individuos y entre grupos. También, de manera interesante, contradicen la simple distinción entre individualismo y colectivismo. Se discutieron las implicaciones para los estudios sobre cultura y procesos grupales.