Nivel de resguardo y confidencialidad de la historia clínica de pacientes atendidos por estudiantes de 4° y 5° año de odontología de la Universidad Andrés Bello, sede Santiago, año 2017

Tesis (Cirujano Dentista)La odontología es una carrera que se encuentra establecida en Chile desde el año 1911. Desde ese período hasta la fecha ha existido un aumento exponencial de los dentistas en Chile, principalmente debido a la gran oferta de universidades que imparten la carrera. En el año 2012, según el Servicio de Impuestos Internos, se registraron 16.195 contribuyentes dentistas; a este número se deben agregar 1.800 nuevos odontólogos titulados a fines del año 2012, sumado a 120 colegas extranjeros que ingresaron al país el mismo año. La ética, el cuidado, el respeto y la empatía por el paciente son conceptos que deben ser aplicados transversalmente en el ejercicio de todos los odontólogos y profesionales de la salud. La ética constituye un concepto fundamental en la práctica odontológica generando reflexiones constantes en relación con decisiones clínicas, donde debe prevalecer el respeto, la tolerancia, diversidad, libertad, y justicia. El modelo paternalista de la relación entre el profesional de la salud y el paciente se basa en la carencia de autonomía. (3) Actualmente estos conceptos se han modificado, y el paciente es el actor principal de sus decisiones en salud. El grado de participación del paciente en estas decisiones se ve influenciado por factores tales como la calidad de la relación profesional de la salud y paciente, reconocimiento del nivel de conocimiento del paciente y tiempo para poder participar en la decisión de salud, entre otros. En este contexto ocurre la entrega de información relacionada a estados de salud y datos personales. Estos datos constituyen la historia clínica la que se registra en la ficha clínica. Esta ficha tiene la característica de ser un documento claro, legible, verídico, sistemático, de información personal, evolución clínica, exámenes y planes de tratamiento para cada una de las enfermedades. En Chile es considerada un documento legal, por lo que su cuidado y resguardo es un aspecto sensible para el profesional de salud, el cual tiene el deber de mantener en secreto la información recolectada en la ficha clínica y solo develar esta, en la medida que es útil para el tratamiento de su enfermedad

The effect of orthodontic forces on calcitonin gene-related peptide (CGRP) expression in the human periodontal ligament and its relationship with the human dental pulp

The purpose of this study was to quantify the effect of moderate and severe orthodontic forces on Calcitonin gene-related peptide (CGRP) expression in the healthy human periodontal ligament (PDL) and its possible relationship with the human dental pulp

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Recent changes in tropical-dry-forest connectivity within the Balsas Basin Biogeographic Province: potential effects on endemic-bird distributions

Maintaining landscape connectivity is a conservation priority for biodiversity as it may mitigate the adverse effects of forest degradation, fragmentation, and climate change by facilitating species dispersal. Despite their importance for biodiversity conservation, Mexican tropical dry forests (TDFs) face high fragmentation rates due to anthropogenic activities. In this study, we analyzed the connectivity dynamics of TDFs in the Balsas Basin Biogeographic Province (BBBP) between 2013 and 2018, focusing on old-growth and secondary TDF covers, including Protected Areas and Important Bird Areas. We evaluated the effects of connectivity loss and gain on the distribution areas of 30 endemic bird species with ecological associations with TDFs in the BBBP. We found expansion in TDFs accounting for a total increase of 227,905 ha due to secondary forest increase (12%). In contrast, old-growth forests experienced a reduction of 66,576 ha in the study area (8%). We also found a decrease in areas with high and very-high connectivity, coupled with an increase in low connectivity, except for TDFs inside Protected Areas, which increased by 3,000 ha, leading to higher connectivity. There was an increase in total forest cover in 27 species’ potential distribution, highlighting the possible role of secondary forests in promoting connectivity between old-growth forest patches. Our results reveal the complex dynamics between forest types, connectivity, and bird-species distributions. Despite an overall increase in forested areas, most TDFs continue to have low connectivity, likely impacting biodiversity, particularly for species that rely on highly conserved ecosystems. This study underscores the importance of integrated conservation strategies considering connectivity, forest recovery, and the dynamics of species-ecosystem interactions

Evaluación de herramientas para análisis forense orientado a discos duros.

Tesina (Ingeniería en Informática) (Ingeniería en Comunicaciones y Electrónica), Instituto Politécnico Nacional, UPIICSA, ESIME, Unidad Culhuacán, 2009, 1 archivo PDF, (79 páginas). tesis.ipn.m