Evolución de la capacidad funcional según patologías subagudas más frecuentes en el adulto mayor hospitalizado en la unidad de media estancia de la Clínica Geriátrica San Isidro Labrador. Octubre – noviembre de 2016

Determina la evolución de la capacidad funcional según patologías subagudas más frecuentes en el adulto mayor hospitalizado. Realiza un estudio de enfoque cuantitativo, no experimental y de tipo observacional, descriptivo, prospectivo y longitudinal. Realizado en 74 adultos mayores que ingresan a la Unidad de Hospitalización de Media Estancia en la Clínica Geriátrica San Isidro Labrador durante el mes de octubre y noviembre de 2016, y que cumplieron con los criterios de inclusión. Se usó como técnica de medición la Medida de Independencia Funcional (FIM), mediante la información obtenida en la historia clínica. Encuentra qu la patología urinaria fue la más frecuente (28,4%) y la media de hospitalización fue de 10,4 días. Los promedios de los puntajes totales FIM al ingreso fueron de 70,31 ±18 puntos (64,8% de independencia funcional inicial), versus 83.91 ±20 puntos al alta (77,8% de independencia funcional final); empleando la T de Student se obtuvo que esta evolución de la capacidad funcional fue estadísticamente significativa. Se encontró también que es la patología musculoesquelética la de mayor ganancia funcional (en promedio 20 puntos más), siendo también la que más tiempo de hospitalización tuvo (16 días en promedio), y los adultos mayores con patología urinaria y cardiaca tuvieron una estancia hospitalaria menor (8 días en promedio). Finalmente, de la muestra total, se halló los adultos mayores que permanecieron menos días en hospitalización (menos de 7 días) presentan el mayor promedio de independencia funcional. Concluye que si existe una diferencia significativa en la evolución de la capacidad funcional de todos los adultos mayores hospitalizados que recibieron Rehabilitación Física (de 64,8% a 77,8%)

Protección Humanitaria en la Gestión Integral de Riesgo

Se basa en el aprendizaje teórico y práctico de conceptos y metodologías de acción para brindar respuesta frente a situaciones de riesgo causadas por fenómenos naturales o antrópicos que pongan en peligro la vida de las personas. La eficacia del aprendizaje provee de mecanismos de acción para disminuir los riesgos frente a una amenaza, antes durante y después de una emergencia, los módulos que contiene parten desde la introducción y contextualización de protección humanitaria y riesgos incluyendo conceptos necesarios y específicos, identificando también el marco institucional y organizativo de la gestión de riesgos y aplicando un enfoque integral desarrollado con el fin de formar especialistas en gestión de riesgos comunitarios frente a amenazas a las que están expuestas poblaciones vulnerables, la idea central es que en la práctica real se implemente un enfoque basado en los principios de protección humanitaria. Como prueba de su efectividad se realizó un plan local de gestión de riesgos, un informe de daños y finalmente una evaluación de criterios para seleccionar albergues que cumplan con las condiciones necesarias a la hora de evacuar a las personas. Palabras clave: Amenaza; Vulnerabilidades; Capacidades; Riesgo; Gestión integral de riesgo de desastres; Protección; Protección humanitaria

Impact of moderate coronary atherosclerosis on long-term left ventricular remodeling after aortic valve replacement

Background: The role of coronary atherosclerosis (CA+) in ventricular remodeling after aortic valve replacement (AVR) for isolated aortic stenosis (AS) is not well defined. We sought to evaluate the impact of not revascularized moderate coronary atherosclerosis in long-term left ventricular (LV) remodeling after AVR. Methods: We assessed by coronariography the coronary artery disease in 66 patients referred for AVR and evaluated morphological and functional LV data by echocardiography both preoperatively and postoperatively (3 ± 1.2 years). Results: In patients without coronary atherosclerosis, hypertrophy regression was more intense and the absolute reverse remodeling was higher in LV mass index (–55.8 ± 36 g/m2 vs –28.4 ± 34 g/m2, p = 0.004), reduction of LV dimensions (LV end-diastolic diameter [LVEDD]: –4.1 ± 7.4 mm vs –2.2 ± 8.3 mm, p = 0.04), and regression of wall thickness (interventricular septum [IVS]: –3.3 ± 2.6 mm vs –1.6 ± 2.2 mm, p = 0.01; and posterior wall thickness [PWT]: –2.1 ± 2.1 mm vs 0.6 ± 2.1 mm, p = 0.012). Conclusions: After AVR for AS, not revascularized moderate coronary atherosclerosis determines a long-term lesser degree of LV hypertrophy regression and a worse absolute reverse remodeling of LV mass index, LVEDD, IVS and PWT. (Cardiol J 2011; 18, 3: 277–281

Calidad en las empresas del sector restaurantes de la región Junín

La presente investigación tiene como objetivo describir el nivel de cumplimiento de los factores de la gestión de la calidad total en el sector restaurante de la región Junín. Los factores evaluados fueron: (a) alta gerencia, (b) planeamiento de calidad, (c) auditoría y evaluación de calidad, (d) diseño del producto, (e) gestión de la calidad del proveedor, (f) control y mejoramiento del proceso, (g) educación y entrenamiento, (h) círculos de calidad, e (i) enfoque hacia la satisfacción del cliente. El estudio fue realizado con un enfoque cuantitativo, de alcance descriptivo, con diseño no experimental transversal. Se tomó como muestra a 157 empresas del sector restaurante, ubicadas en las provincias de la región Junín. Se utilizó como instrumento un cuestionario basado en 35 preguntas cerradas, donde los encuestados fueron los administradores de cada organización. Como resultado de la investigación, se obtuvo que el nivel de cumplimiento de la gestión de la calidad total en el sector restaurante de la región Junín alcanza un nivel medio basado en la escala de Likert. Los factores alta gerencia, planeamiento de la calidad y control de mejoramiento de procesos tienen un alto nivel de cumplimiento, mientras que los factores diseño de producto y círculos de calidad tienen un bajo nivel de cumplimiento. Los factores auditoría y evaluación de la calidad, gestión de la calidad de proveedores, enfoque hacia la satisfacción del cliente, educación y entrenamiento tienen un nivel de cumplimiento medio. El factor alta gerencia es el más importante en la gestión de la calidad, y, por ello, se recomienda que este involucre a los empleados en la elaboración de sus políticas y planeamiento de la calidad, y que también se implemente el benchmarking con la finalidad de recoger las mejoras prácticas de los restaurantes. Asimismo, se recomienda que, para un mejor uso de la herramienta, se profundice en el perfil del empresario en la Región Junín, y, además, se debe tomar la percepción del mando medio y de los clientes en la implementación de la gestión de la calidad.This research aims to describe the level of compliance of the factors of total quality management in the restaurant industry of the region Junín. The factors evaluated were: (a) senior management, (b) quality planning, (c) audit and quality assessment, (d) product design, (e) provider quality management, (f) control and improvement of the process, (g) education and training, (h) quality circles, and (i) an approach to customer satisfaction. The study was conducted with a quantitative approach, descriptive scope, with no cross experimental design. A sample of 157 companies of the restaurant industry was taken, located in the provinces of the region Junín. A questionnaire of 35 closed questions was used as an instrument to survey the managers of each company. The investigation revealed that the level of compliance with the total quality management in the restaurant industry of the region Junín reaches an average level based on the Likert scale. The factors senior management, quality planning and control of process improvement have a high level of compliance, while the factors product design and quality circles have a low level of compliance. The factors audit and quality assessment, quality management of suppliers, customer satisfaction approach, education and training have a medium level of compliance. The factor senior management is the most important in the quality management, and, therefore, it is recommended that this involves employees in the creation of their policies and quality planning, and benchmarking should also be implemented in order to collect the best practices of the restaurants. It is also recommended that, for a better use of the tool, the profile of the entrepreneur deepens in the Junín region, and, in addition, take the perception of middle management and customers in implementing management qualityTesi

Sustained benefit of left ventricular remodelling after valve replacement for aortic stenosis

Background: Valve replacement for aortic stenosis (AS) determines negative ventricular remodelling. We used cross sectional and Doppler echocardiography to check how rapidly it occurs and to assess if these changes are sustained over time. Methods: We evaluated in 34 patients subjected to aortic valve replacement for AS morphological and functional (ejection fraction and E:A ratio) left ventricular data by echocardiography prior to surgery and 2 postoperative studies: early after surgery (pQ1) and at mid-term evolution (pQ2). Results: Left ventricular mass index was reduced at pQ1 (from 152 &#177; 47 g/m2 to 113 &#177; 31 g/m2; p < 0.01) as well as end-diastolic (from 51.3 mm to 48.3 mm; p < 0.03), end-systolic (from 32.2 mm to 29.4 mm; p < 0.02), interventricular septum (from 12.9 mm to 10.3 mm; p < 0.01), and posterior wall (from 12.5 mm to 11 mm; p < 0.01) dimensions. Left ventricular ejection fraction (from 61.2% to 65.2%; p < 0.04) and E:A ratio (from 0.94 to 0.98; p < 0.01) increased significantly at pQ1. There were no significant differences in measurements between pQ1 and pQ2. Conclusions: Aortic valve replacement surgery leads to a rapid negative left ventricular remodelling during the first 7 months, including a decrease in myocardial hypertrophy and an improvement in systolic and diastolic function. These beneficial hemodynamic changes are sustained for at least 3 years

Chemical-proteomics Identify Peroxiredoxin-1 as an Actionable Target in Triple-negative Breast Cancer

Triple-negative breast cancer (TNBC) is difficult to treat; therefore, the development of drugs directed against its oncogenic vulnerabilities is a desirable goal. Herein, we report the antitumor effects of CM728, a novel quinone-fused oxazepine, against this malignancy. CM728 potently inhibited TNBC cell viability and decreased the growth of MDA-MB-231-induced orthotopic tumors. Furthermore, CM728 exerted a strong synergistic antiproliferative effect with docetaxel in vitro and this combination was more effective than the individual treatments in vivo. Chemical proteomic approaches revealed that CM728 bound to peroxiredoxin-1 (Prdx1), thereby inducing its oxidation. Molecular docking corroborated these findings. CM728 induced oxidative stress and a multi-signal response, including JNK/p38 MAPK activation and STAT3 inhibition. Interestingly, Prdx1 downregulation mimicked these effects. Finally, CM728 led to DNA damage, cell cycle blockage at the S and G2/M phases, and the activation of caspase-dependent apoptosis. Taken together, our results identify a novel compound with antitumoral properties against TNBC. In addition, we describe the mechanism of action of this drug and provide a rationale for the use of Prdx1 inhibitors, such as CM728, alone or in combination with other drugs, for the treatment of TNBC.This project was supported by Centro Atlántico del Medicamento S.A. (CEAMED), CDTI [IDI-20111517], ACIISI [EATIC2017010006], Universidad de Las Palmas de Gran Canaria, Cabildo Insular de Gran Canaria, Fundación del Instituto Canario de Investigación del Cáncer (FICIC), and Miguel Ángel Rodríguez Cardenes. E. Spínola-Lasso is the recipient of a predoctoral fellowship from the Agencia Canaria de Investigación, Innovación y Sociedad de la Información de la Consejería de Economía, Conocimiento y Empleo y por el Fondo Social Europeo (FSE) Programa Operativo Integrado de Canarias 2014-2020, Eje 3 Tema Prioritario 74 (85%) [TESIS2020010081]. J.C. Montero was funded by the Instituto de Salud Carlos III through the Miguel Servet Program [CP12/03073 and CPII17/00015] and received research support from the same institution [PI15/00684 and PI18/00796]. A. Pandiella received funding from the Ministry of Economy and Competitiveness of Spain [BFU2015-71371-R and PID2020-115605RB-I00], Instituto de Salud Carlos III through CIBERONC, Junta de Castilla y León [CSI146P20], CRIS Cancer Foundation, ACMUMA, UCCTA, ALMOM, and the European Community through the Regional Development Funding Program (FEDER)

Physical fitness reference standards for preschool children: The PREFIT project

Objectives Reference values are necessary for classifying children, for health screening, and for early prevention as many non-communicable diseases aggravate during growth and development. While physical fitness reference standards are available in children aged 6 and older, such information is lacking in preschool children. Therefore, the purposes of this study were (1) to provide sex-and age-specific physical fitness reference standards for Spanish preschool children; and (2) to study sex differences across this age period and to characterise fitness performance throughout the preschool period. Design Cross-sectional. Methods A total of 3179 preschool children (1678 boys) aged 2.8–6.4 years old from Spain were included in the present study. Physical fitness was measured using the PREFIT battery. Results Age- and sex-specific percentiles for the physical fitness components are provided. Boys performed better than girls in the cardiorespiratory fitness, muscular strength, and speed-agility tests over the whole preschool period studied and for the different percentiles. In contrast, girls performed slightly better than boys in the balance test. Older children had better performance in all fitness tests than their younger counterparts. Conclusions Our study provides age- and sex-specific physical fitness reference standards in preschool children allowing interpretation of fitness assessment. Sexual dimorphism in fitness tests exists already at preschool age, and these differences become larger with age. These findings will help health, sport, and school professionals to identify preschool children with a high/very low fitness level, to examine changes in fitness over time, and to analyse those changes obtained due to intervention effects

Wpływ umiarkowanej miażdżycy tętnic wieńcowych na przebudowę lewej komory serca u chorych po wymianie zastawki aortalnej

Wstęp: Znaczenie miażdżycy tętnic wieńcowych (CA+) w procesie przebudowy lewej komory po wymianie zastawki aortalnej (AVR) z powodu izolowanej stenozy aortalnej (AS) jest wciąż przedmiotem badań. Celem pracy była ocena wpływu niepoddanych rewaskularyzacji umiarkowanych zmian miażdżycowych tętnic wieńcowych na odległy proces remodelingu lewej komory serca (LV) po AVR. Metody: Za pomocą koronarografii oceniono stopień nasilenia choroby wieńcowej u 66 pacjentów zakwalifikowanych do AVR i pozyskano dane echokardiograficzne dotyczące budowy i funkcji LV zarówno przed-, jak i pooperacyjnie (3 &#177; 1,2 roku). Wyniki: U pacjentów bez miażdżycy tętnic wieńcowych ustąpienie przerostu i całkowite odwrócenie remodelingu były większe niż w grupie chorych z miażdżycą, gdy porównano indeks masy LV (&#8211;55,8 &#177; 36 g/m2 v. &#8211;28,4 &#177; 34 g/m2; p = 0,004). Ponadto w grupie osób bez choroby wieńcowej obserwowano istotne zmniejszenie wymiarów LV [wymiar końcoworozkurczowy LV (LVEDD): &#8211;4,1 &#177; 7,4 mm v. &#8211;2,2 &#177; 8,3 mm; p = 0,04] oraz grubości ścian [przegrody międzykomorowej (IVS): &#8211;3,3 &#177; 2,6 mm v. &#8211;1,6 &#177; 2,2 mm; p = 0,01; i ściany tylnej (PWT): &#8211;2,1 &#177; 2,1 mm v. 0,6 &#177; 2,1 mm; p = 0,012]. Wnioski: Brak rewaskularyzacji umiarkowanych zmian miażdżycowych w nasierdziowych tętnicach wieńcowych u pacjentów poddanych AVR z powodu AS prowadzi w odległej obserwacji do zwolnienia procesu regresji przerostu lewej komory i zaburzenia odwrócenia remodelingu w analizie następujących parametrów: indeksu masy LV, LVEDD, IVS i PTW. (Folia Cardiologica Excerpta 2011; 6, 3: 162&#8211;167

Post-glacial determinants of regional species pools in alpine grasslands

[Aim] Alpine habitats support unique biodiversity confined to high-elevation areas in the current interglacial. Plant diversity in these habitats may respond to area, environment, connectivity and isolation, yet these factors have been rarely evaluated in concert. Here we investigate major determinants of regional species pools in alpine grasslands, and the responses of their constituent species groups.[Location] European mountains below 50° N.[Time period] Between 1928 and 2019.[Major taxa studied] Vascular plants.[Methods] We compiled species pools from alpine grasslands in 23 regions, including 794 alpine species and 2,094 non-alpines. We used species–area relationships to test the influence of the extent of alpine areas on regional richness, and mixed-effects models to compare the effects of 12 spatial and environmental predictors. Variation in species composition was addressed by generalized dissimilarity models and by a coefficient of dispersal direction to assess historical links among regions.[Results] Pool sizes were partially explained by current alpine areas, but the other predictors largely contributed to regional differences. The number of alpine species was influenced by area, calcareous bedrock, topographic heterogeneity and regional isolation, while non-alpines responded better to connectivity and climate. Regional dissimilarity of alpine species was explained by isolation and precipitation, but non-alpines only responded to isolation. Past dispersal routes were correlated with latitude, with alpine species showing stronger connections among regions.[Main conclusions] Besides area effects, edaphic, topographic and spatio-temporal determinants are important to understand the organization of regional species pools in alpine habitats. The number of alpine species is especially linked to refugia and isolation, but their composition is explained by past dispersal and post-glacial environmental filtering, while non-alpines are generally influenced by regional floras. New research on the dynamics of alpine biodiversity should contextualize the determinants of regional species pools and the responses of species with different ecological profiles.The authors thank Daniela Gaspar for support in GIS analyses. B.J.-A. thanks the Marie Curie Clarín-COFUND program of the Principality of Asturias-EU (ACB17-26), the regional grant IDI/2018/000151, and the Spanish Research Agency grant AEI/ 10.13039/501100011033. J.V.R.-D. was supported by the ACA17-02FP7 Marie Curie COFUND-Clarín grant. G.P.M. was funded by US National Science Foundation award 1853665. C.M. was funded by grant no. 19-28491 of the Czech Science Foundation.Peer reviewe

Effectiveness of a cognitive behavioral intervention in patients with medically unexplained symptoms: cluster randomized trial

BACKGROUND: Medically unexplained symptoms are an important mental health problem in primary care and generate a high cost in health services.Cognitive behavioral therapy and psychodynamic therapy have proven effective in these patients. However, there are few studies on the effectiveness of psychosocial interventions by primary health care. The project aims to determine whether a cognitive-behavioral group intervention in patients with medically unexplained symptoms, is more effective than routine clinical practice to improve the quality of life measured by the SF-12 questionary at 12 month. METHODS/DESIGN: This study involves a community based cluster randomized trial in primary healthcare centres in Madrid (Spain). The number of patients required is 242 (121 in each arm), all between 18 and 65 of age with medically unexplained symptoms that had seeked medical attention in primary care at least 10 times during the previous year. The main outcome variable is the quality of life measured by the SF-12 questionnaire on Mental Healthcare. Secondary outcome variables include number of consultations, number of drug (prescriptions) and number of days of sick leave together with other prognosis and descriptive variables. Main effectiveness will be analyzed by comparing the percentage of patients that improve at least 4 points on the SF-12 questionnaire between intervention and control groups at 12 months. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. DISCUSSION: This study aims to provide more insight to address medically unexplained symptoms, highly prevalent in primary care, from a quantitative methodology. It involves intervention group conducted by previously trained nursing staff to diminish the progression to the chronicity of the symptoms, improve quality of life, and reduce frequency of medical consultations. TRIAL REGISTRATION: The trial was registered with ClinicalTrials.gov, number NCT01484223 [http://ClinicalTrials.gov].S