Espirometría en pacientes infectados con virus de la inmunodeficiencia humana

Objective: To determine if the spirometric evaluation in patients infected with HIV is different than that of those not infected with HIV. Material and Methods: An analytical study of double retrospective cohort was carried out. The study sample consisted of 22 patients who have met the selection criteria divided in equal proportion into two groups HIV(+) and HIV(-) who underwent a spirometry. A linear regression test was used with a model considering only age, sex and HIV status as intervening factors, considering significance (p value) of < 0,05. The study was conducted at the Victor Lazarte Echegaray Hospital in Trujillo. Results: In the HIV(+) group, a normal spirometric pattern was found in 36,36% of the participants and an altered spirometric pattern in 63,64%. In the HIV(-) group a normal spirometric pattern was found in 72,72% and an altered spirometric pattern in 27,27%. In the linear regression model, no statistical significance was found when compared with age, sex or HIV condition. Conclusion: Spirometries are similar regardless of the HIV condition but this is affected by the sample size.Objetivo: Determinar si la evaluación espirométrica en pacientes infectados con VIH es diferente que la de aquellos no infectados por VIH. Material y Métodos: Se llevo a cabo un estudio analítico de doble cohorte retrospectivo. La muestra de estudio estuvo constituida por 22 pacientes que cumplieron los criterios de selección divididos en igual proporción en dos grupos: VIH(+) y VIH(–) a los cuales se les realizó una espirometría. Se uso la prueba de regresión lineal con un modelo considerando solo a la edad, sexo y condición VIH como intervinientes considerando una significancia (valor p) < 0,05. El estudio se realizó en el Hospital Víctor Lazarte Echegaray de Trujillo. Resultados: En el grupo VIH(+) se encontró un patrón espirométrico normal en el 36.36% de los participantes y un patrón espirométrico alterado en el 63,64%. En el grupo VIH(-) se encontró un patrón espirométrico normal en el 72,72% y un patrón espirométrico alterado en el 27,27. En la regresión lineal no se encontró significancia estadística al compararlo con la edad, sexo ni condición VIH. Conclusión: Las espirometrías son similares independientemente de la condición VIH, pero esta, se ve afectada por el tamaño muestral

Psoriasis como factor de riesgo de insuficiencia cardiaca en adultos

The aim of the present investigation was to demonstrate whether psoriasis is a risk factor for heart failure in adults, which was developed in adults attending the cardiology clinic of the Trujillo Regional Teaching Hospital. Material and methods. A case-control study was proposed with a sample of 744 people with a ratio of 3 controls for each case. Results: Psoriasis was present in 4% of the patients with congestive heart failure and in 1,3% of the population without congestive heart failure, finding a p= 0.031. In addition, an odds ratio of 3,08 with a 95% CI of 1,05 – 9,01 was obtained. Conclusions: The proportion of psoriasis exposure was higher in patients with heart failure compared to those without heart failure, and patients with psoriasis have two times the risk of developing congestive heart failure than those without psoriasis.El objetivo de la presente investigación fue demostrar si la psoriasis es un factor de riesgo de la insuficiencia cardiaca en adultos, el cual fue desarrollado en adultos atendidos consultorio de cardiología del Hospital Regional Docente de Trujillo. Material y métodos. Se planteo un estudio de casos y controles con una muestra de 744 personas con una relación de 3 controles por cada caso. Resultados: la Psoriasis estuvo presente en el 4% de los pacientes con insuficiencia cardiaca congestiva y en el 1,3% de la población sin insuficiencia cardiaca congestiva, encontrándose una p = 0,031. Además, se obtuvo un odds ratio de 3,08 con un IC95% de 1,05 – 9,01. Conclusiones: La proporción de exposición de la psoriasis fue mayor en los pacientes con insuficiencia cardiaca comparados con aquellos sin dicha insuficiencia cardiaca y los pacientes con psoriasis tienen dos veces más riego de desarrollar insuficiencia cardiaca congestiva que los que no padecen psoriasis

Predictive models of intensive care unit admission in patients with covid-19: systematic review

Introducción:Es fundamental identificar las características epidemiológicas y clínicas de los pacientes infectados con COVID-19, asociadas a una progresión de la enfermedad que conlleva al ingreso a UCI. El objetivo fue revisar sistemáticamente los modelos o scores de predicción de ingreso a la unidad de cuidados intensivos(UCI)disponibles a la fecha para pacientes con COVID-19.Métodos:El estudio es una revisión sistemática. Se hicieronbúsquedas en PubMed, Scopus, Web of Science, Ovid-Medline, y Embasehasta el 13 de Julio del 2022. Se incluyeron estudios que hayan desarrollado y validado un modelo o sistema de puntuación para predecir el ingreso a la UCI en pacientes con COVID-19.El desenlace primario fue el ingreso a la UCI.La evaluación del riesgo de sesgo se realizó utilizando la herramienta PROBASTque se basa en cuatro dominios: participantes, predictores, desenlace y análisis.Resultados:Se incluyerondosestudiospara la extracción de datos y la evaluación crítica.Se obtuvo como desenlaces primarios los modelos predictivos de ingreso a la UCI y su rendimiento. Los predictores comunes para ambos modelos se asociaron con el compromiso pulmonar (frecuencia respiratoria o ventilación pulmonar) y la inflamación sistémica (proteína C reactiva).Conclusiones:Es factible determinar variables predictoras de ingreso a UCI en los pacientes hospitalizados por COVID-19. Sin embargo; los estudios no determinan un score claramente definido y presentan un alto riesgo de sesgo, porlo que no es factible recomendar la aplicación de alguno de estos modelos en la práctica clínica

Aplicacion de un tratamiento silvicultual experimental en el bosque de La Lupe, Rio San Juan, Nicaragua

This document describes the application on experimental scale of a silvicultural treatment in a forest selectively logged by a timber company in the humid tropics of Nicaragua. Based on a diagnostic sampling in the La Lupe experimental forest, a silvicultural treatment was designed consisting in the liberation of future harvest trees through the elimination of competitors by stem girdling and poisoning. Plots for treatment and 1 ha-permanent sampling plots were established in the experimental area of 15,36 ha. A complementary silvicultural intervention took place three years later by harvesting commercial residual trees which were sawn in the forest by local smallholders with a frame-chainsaw and the resulting blocks hauled with an oxen. The cost of applying the silvicultural treatment was US$23,8/ha, including all inputs and manual labor. Total logging costs amounted US$1635 yielding an average of 4,3 m3 of timber per harvested hectare. The initial effects of the silvicultural interventions on forest dynamics were evaluated based on three periodic measurements of the population of trees 10+ cm dbh. In the four-year period after the silvicultural interventions mortality in the control plots was 11,2 trees/ha/year (4,9% of the original population), whereas in the treated plots it reached 20,3 tress/ha/year (2,4%). The median yearly increment in diameter was from 0,3 to 0,4 cm/year in the control plots and 0,3 to 0,5 cm/year in the treated plots. The median yearly diameter increments during the period oscillated between 0,3 and 0,5 cm

Aprovechamiento mejorado en bosques de produccion forestal: estudio de caso Los Filos, Rio San Juan, Nicaragua

This document describes and analyzes the operations of a technically planned timber harvest applied on experimental scale by a lumber company in a humid tropical forest of the Southeast of Nicaragua. It involves an operational inventory, the planning and building of the network trails and mountain yards, the controlled logging and its dragging and post-harvest activities. The yields and costs were determined for each one of the operations. The costs are similar to those in other regions of the humid tropic. The short term impact of the logging was evaluated in term of the damages to the forest, as well as changes in the silvicultural conditions of the remnants mass. The results show that the damages were smaller, in comparison with traditional methods in Central America; thus, the forest was in good condition to allow its handling in natural form. The population of trees and the regeneration in terms of growth, mortality and recruitment were monitored during four years through a network of permanent plots installed before the intervention. The experience in Rio San Juan indicates that benefits can be obtained with the application of low impact techniques in the commercial timber harvest. One recommendation is to validate these results on an operational scale and increase the information coverage of the results, in order to convince the lumber company, the concessionaire or the forest that a good planning, supervision and qualification in the harvest of the forest is not more expensive and it is at their reach

Nosocomial Infection Control Consortium (INICC)

We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey.We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented.We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95 % confidence interval [CI] 0.55-0.72)], showing a 37 % rate reduction.Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries

Health Care Access and Breast Cancer Screening Among Latinas Along the California–Mexican Border

Latinas are more likely to exhibit late stage breast cancers at the time of diagnosis and have lower survival rates compared to white women. A contributing factor may be that Latinas have lower rates of mammography screening. This study was guided by the Behavioral Model of Health Services Use to examine factors associated with mammography screening utilization among middle-aged Latinas. An academic–community health center partnership collected data from community-based sample of 208 Latinas 40 years and older in the San Diego County who completed measures assessing psychosocial factors, health care access, and recent mammography screening. Results showed that 84.6 % had ever had a mammogram and 76.2 % of women had received a mammogram in the past 2 years. Characteristics associated with mammography screening adherence included a lower acculturation (OR 3.663) a recent physician visit in the past year (OR 6.304), and a greater confidence in filling out medical forms (OR 1.743), adjusting for covariates. Results demonstrate that an annual physical examination was the strongest predictor of recent breast cancer screening. Findings suggest that in this community, improving access to care among English-speaking Latinas and addressing health literacy issues are essential for promoting breast cancer screening utilization

Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations: A multinational prospective research of INICC

Objective: To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors. Design: A prospective cohort study. Setting: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries. Participants: The study included 169,036 patients, hospitalized for 1,166,593 patient days. Methods: Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression. Results: Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower-middle-income countries (3.05); and with patients in public hospitals (5.89). The following variables were independently associated with CAUTI: Age (adjusted odds ratio [aOR], 1.01; P <.0001), female sex (aOR, 1.39; P <.0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05; P <.0001), UC DU ratio (aOR, 1.09; P <.0001), public facilities (aOR, 2.24; P <.0001), and neurologic ICUs (aOR, 11.49; P <.0001). Conclusions: CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities. Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations