Tuberculosis pulmonar como factor de riesgo para enfermedad pulmonar obstructiva crónica en pacientes del hospital belén de Trujillo

Demostrar si la tuberculosis pulmonar es factor de riesgo para enfermedad pulmonar obstructiva crónica en pacientes del Hospital Belén de Trujillo. Material y métodos: Se llevó a cabo un estudio retrospectivo, analítico y de casos y controles en el que se incluyeron a 138 pacientes adultos, según criterios de selección los cuales se dividieron en 2 grupos: pacientes con enfermedad pulmonar obstructiva crónica o sin ella; aplicándose el odds ratio, y la prueba estadística chi cuadrado. Resultados: El promedio de edad y las frecuencias de anemia y exposición a biomasa fueron significativamente mayores en el grupo de pacientes con enfermedad pulmonar obstructiva crónica. La frecuencia de enfermedad pulmonar obstructiva crónica en pacientes con tuberculosis pulmonar fue de 16/46 = 34%. La frecuencia de enfermedad pulmonar obstructiva crónica en pacientes sin tuberculosis pulmonar fue de 11/92 = 12%. La tuberculosis pulmonar es factor de riesgo para enfermedad pulmonar obstructiva crónica con un odds ratio de 3.89 el cual fue sginificativo (p<0.059). En el análisis multivariado se reconocen a las variables: tuberculosis pulmonar, exposición a biomasa, edad avanzada y anemia como factores de riesgo para enfermedad pulmonar obstructiva crónica (p<0.05). Conclusión: La tuberculosis pulmonar es factor de riesgo para enfermedad pulmonar obstructiva crónica en pacientes del Hospital Belén de Trujillo.To demonstrate whether pulmonary tuberculosis is a risk factor for chronic obstructive pulmonary disease in patients at Belén de Trujillo Hospital. Material and methods: A retrospective, analytical and case-control study was carried out in which 138 adult patients were included, according to selection criteria which were divided into 2 groups: patients with or without chronic obstructive pulmonary disease; applying the odds ratio, and the chi square statistical test. Results: The average age and frequencies of anemia and exposure to biomass were significantly higher in the group of patients with chronic obstructive pulmonary disease. The frequency of chronic obstructive pulmonary disease in patients with pulmonary tuberculosis was 16/46 = 34%. The frequency of chronic obstructive pulmonary disease in patients without pulmonary tuberculosis was 11/92 = 12%. Pulmonary tuberculosis is a risk factor for chronic obstructive pulmonary disease with an odds ratio of 3.89 which was significant (p <0.059). In the multivariate analysis, the variables are recognized: pulmonary tuberculosis, exposure to biomass, advanced age and anemia as risk factors for chronic obstructive pulmonary disease (p <0.05). Conclusion: Pulmonary tuberculosis is a risk factor for chronic obstructive pulmonary disease in patients at Belén de Trujillo HospitalTesi

Red estructurada para la comunicación en la escuela secundaria oficial Carmen Serdán.

La secundaria oficial 0151 Carmen Serdán actualmente tiene carencias del servicio de internet en toda la institución, ya que sólo se tiene el servicio en el área administrativa y Laboratorio de Cómputo. La señal es deficiente, esto propicia que el trabajo académico que desempeñan los alumnos y docentes sea deficiente con bajo aprovechamiento, además se tiene equipo de cómputo sin ser explotado en todas sus capacidades. En este trabajo se hace una propuesta técnica para la restructuración de la red de computadoras y con ello resolver el problema antes mencionado. La propuesta considera un cableado estructurado con la instalación de dos SITE conectados mediante Fibra Óptica, mismos que podrán distribuir la señal por toda la secundaria con cable UTP categoría 6a para mejorar la transmisión de voz y datos, considerando los estándares internacionales de conexión para un buen desempeño y seguridad de los usuarios. Con ello, el internet será eficiente y proporcionará servicio a toda la institución, a fin de mejorar el aprovechamiento académico sin interferir en las labores administrativas

Sistemas de traducción automática caso: Google Traductor

Este trabajo de investigación está basado en el análisis realizado a traducciones de fragmentos de diversos textos técnicos, estas traducciones fueron realizadas por el sistema de traducción automática Google Traductor, es así que este trabajo de investigación tiene como finalidad encontrar los errores así como las fortalezas y debilidades en dichos textos técnicos al momento de utilizar el sistema de traducción Google Traductor. Por ello el objetivo general de este trabajo de investigación es determinar la confiabilidad del sistema de traducción automática Google Traductor aplicado a las traducciones de textos técnicos, para ello se ha realizado un análisis a nueve fragmentos técnicos. Se plantea como supuesto que el sistema de traducción automática Google Traductor influye en la confiabilidad de las en traducciones de textos técnicos. La variable independiente en esta investigación es el sistema de traducción automática y la variable dependiente es la confiabilidad de las traducciones de textos técnicos. En base a los resultados obtenidos se ha podido evidenciar tanto los aciertos como los desaciertos en las traducciones técnicas mediante el análisis de los errores morfosintácticos, léxico-semánticos y gráficos. Para poder encontrar estos errores la metodología usada fue la observación / el contraste de la versión final del traductor profesional y la traducción ofrecida por Google Traductor. Es así que a través de la siguiente investigación se ha podido comprobar que el Google Traductor, a pesar de su avanzado sistema de búsqueda de términos, no satisface las expectativas del receptor al leer el texto meta, ya que si bien es cierto el texto final se aproxima en un pequeño porcentaje a la versión hecha por un traductor profesional, las falencias que presenta son numerosas, dichos errores en su conjunto envían un mensaje erróneo a los receptores; entre los errores más comunes encontramos el sin sentido, la omisión, las errores léxicos y morfosintácticos

Health Impact of Volcanic Emissions

Volcanoes form along the edges of tectonic plates. Although it is true that volcanic eruptions are destructive, these eruptions also have benefits. Volcanic eruptions provide minerals to the surrounding soil, and these minerals are beneficial to agriculture and can be used as building materials. Exposure to volcanic emissions can threaten the health of inhabitants in many ways; dermal and ocular irritation, cardiopulmonary exacerbations in people who suffer from chronic diseases, and even cancer have been linked with exposure to volcanic emissions. When rainwater passes through volcanic ashes deposited on land surfaces, the leaching of metals leads to significant changes in the chemistry of the surface water, increasing the risk of drinking water and land contamination. In addition to the health effects, volcanic eruptions are known to lead to surface cooling at the regional and global scales because of the emission of fine ash particles; however, these emissions, being a source of sulfates, contribute to acid rain formation. Because volcanic ash is highly abrasive, this ash can lower visibility and cause considerable damage to the engines of transportation systems. To avoid fatalities, it is important to closely monitor volcanic activity and promote a culture of prevention at all levels of society

Aplicación del principio de culpabilidad para determinar responsabilidad administrativa funcional por el Tribunal Superior de Responsabilidad Administrativa, Perú 2017-2018

La presente investigación titulada “APLICACIÓN DEL PRINCIPIO DE CULPABILIDAD PARA DETERMINAR RESPONSABILIDAD ADMINISTRATIVA FUNCIONAL POR EL TRIBUNAL SUPERIOR DE RESPONSABILIDAD ADMINISTRATIVA, PERÚ 2017-2018” con enfoque cualitativo, tiene como objetivo principal establecer los presupuestos jurídicos que viene aplicando el Tribunal Superior de Responsabilidad Funcional para determinar responsabilidad administrativa en los servidores públicos. Debido a que, a pesar que la Ley del Procedimiento Administrativo General establece como un principio del Derecho Administrativo Sancionador el de culpabilidad, los auditores de la Contraloría General de la República optan por un régimen de responsabilidad objetiva para determinar responsabilidad administrativa funcional, convirtiendo la excepción en norma. Está investigación se centró en constatar nuestra hipótesis analizando las distintas resoluciones emitidas por el Tribunal Superior de Responsabilidad Administrativa Funcional, que ayudaron a dilucidar los criterios que viene aplicando el ente sancionador a los servidores públicos, y si éstos consideran el principio de culpabilidad para determinar el grado de sanción. Como primordial resultado se ha obtenido que el Tribunal Superior de Responsabilidad Administrativa del Perú utilizó la evidencia del dolo y culpa para establecer responsabilidad funcional durante los años 2017-2018, en la medida que analizó la conducta de imparcialidad del administrado, analizando la intencionalidad y el incumplimiento de manera general, pero que está no se encuentra acorde con el derecho, toda vez que el TS establece la existencia de responsabilidad administrativa funcional en base al resultado, por lo que fundamenta en la culpabilidad de manera indirecta

High glucose concentrations induce TNF-α production through the down-regulation of CD33 in primary human monocytes

<p>Abstract</p> <p>Background</p> <p>CD33 is a membrane receptor containing a lectin domain and a cytoplasmic immunoreceptor tyrosine-based inhibitory motif (ITIM) that is able to inhibit cytokine production. CD33 is expressed by monocytes, and reduced expression of CD33 correlates with augmented production of inflammatory cytokines, such as IL-1β, TNF-α, and IL-8. However, the role of CD33 in the inflammation associated with hyperglycemia and diabetes is unknown. Therefore, we studied CD33 expression and inflammatory cytokine secretion in freshly isolated monocytes from patients with type 2 diabetes. To evaluate the effects of hyperglycemia, monocytes from healthy donors were cultured with different glucose concentrations (15-50 mmol/l D-glucose), and CD33 expression and inflammatory cytokine production were assessed. The expression of suppressor of cytokine signaling protein-3 (SOCS-3) and the generation of reactive oxygen species (ROS) were also evaluated to address the cellular mechanisms involved in the down-regulation of CD33.</p> <p>Results</p> <p>CD33 expression was significantly decreased in monocytes from patients with type 2 diabetes, and higher levels of TNF-α, IL-8 and IL-12p70 were detected in the plasma of patients compared to healthy donors. Under high glucose conditions, CD33 protein and mRNA expression was significantly decreased, whereas spontaneous TNF-α secretion and SOCS-3 mRNA expression were increased in monocytes from healthy donors. Furthermore, the down-regulation of CD33 and increase in TNF-α production were prevented when monocytes were treated with the antioxidant α-tocopherol and cultured under high glucose conditions.</p> <p>Conclusion</p> <p>Our results suggest that hyperglycemia down-regulates CD33 expression and triggers the spontaneous secretion of TNF-α by peripheral monocytes. This phenomenon involves the generation of ROS and the up-regulation of SOCS-3. These observations support the importance of blood glucose control for maintaining innate immune function and suggest the participation of CD33 in the inflammatory profile associated with type 2 diabetes.</p

Reconstrucción mandibular con colgajo microvascularizado de peroné: Reporte de Caso

Patient male of 10-year-old native of the city of Puno, arriving at the service of head and neck surgery from the National Institute of health of the child to present an expansive left mandibular tumor of 2 years of evolution of insidious onset and progressive course. Compatible with Desmoplastic fibroma diagnosis. Resection of mandibular tumor, up to 10 cm in length, was practiced the hemimandibulectomy since the region right up to the preangular area of the jaw. During this surgical procedure the flap of the fibula, was conducted on the same side as the hemimandibulectomy. Once the fibula osteotomy was performed to rebuild the receptor bed with unilock reconstruction plates and was fixed with screws. Finally the anastomosis was carried out. One of the greatest challenges of the reconstructor surgeon is the coverage of complex defects in extremities, with exhibition of deep tissues and sometimes with absence of them. As described in the literature, the closure of fibula flap is thePaciente de sexo masculino de 10 años de edad, natural de la ciudad de Puno, que llega al servicio de cirugía de cabeza y cuello del Instituto Nacional de Salud del Niño por presentar una tumoración mandibular izquierda expansiva de 2 años de evolución de inicio insidioso y curso progresivo. Diagnóstico compatible con fibroma desmoplástico. Se realizó la resección del tumor mandibular, de hasta 10 cm de longitud, practicándose la hemimandibulectomía desde la región derecha hasta la zona preangular de la mandíbula. Durante ese acto quirúrgico se llevó a cabo el colgajo del peroné, en el mismo lado que la hemimandibulectomía. Una vez obtenido el peroné, se realizó la osteotomía para poder reconstruir el lecho receptor con las placas de reconstrucción unilock y se fijó con los tornillos. Finalmente se llevó a cabo la anastomosis. Uno de los más grandes retos del cirujano reconstructor es la cobertura de defectos complejos en extremidades, con exposición de tejidos profundos y en ocasione

High levels of anti-tuberculin (IgG) antibodies correlate with the blocking of T-cell proliferation in individuals with high exposure to Mycobacterium tuberculosis

SummaryObjectivesTo determine the effect of anti-tuberculin antibodies in the T-cell proliferation in response to tuberculin and Candida antigens in individuals with different levels of tuberculosis (TB) risk.MethodsSixteen high-risk TB individuals, 30 with an intermediate TB risk (group A), and 45 with a low TB risk (group B), as well as 49 control individuals, were studied. Tuberculin skin test (TST) results were analyzed and serum levels of antibodies (IgG and IgM) against purified protein derivative (PPD) were measured by ELISA. Tuberculin and Candida antigens were used to stimulate T-cell proliferation in the presence of human AB serum or autologous serum.ResultsHigh levels of anti-tuberculin IgG antibodies were found to be significantly associated with the blocking of T-cell proliferation responses in cultures stimulated with tuberculin but not with Candida antigens in the presence of autologous serum. This phenomenon was particularly frequent in high-risk individuals with high levels of anti-tuberculin IgG antibodies in the autologous serum when compared to the other risk groups, which exhibited lower levels of anti-tuberculin antibodies.ConclusionsAlthough cellular immunity plays a central role in the protection against TB, humoral immunity is critical in the control of Mycobacterium tuberculosis infection in high-risk individuals with latent TB infection

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030