La habilidad de la escalada como forma de desplazamiento

Este Trabajo Fin de Grado, ligado a la titulación del Grado de Educación Primaria - Mención de Educación Física, se basa en el desarrollo de la escalada como actividad física del medio natural. El objetivo principal es recalcar la importancia que posee adquirir una habilidad apropiada de escalar respecto a la formación integral del niño. Para lograr esto, se han llevado a cabo actividades diferentes vinculadas con esta habilidad. La metodología llevada a cabo posee un carácter práctico, teniendo en cuenta las posibilidades y limitaciones que poseen los alumnos, desarrollando las capacidades motrices básicas de una forma global. Se desarrollarán los aspectos técnicos de la escalada, los tipos de escalada, las medidas de seguridad necesarias y los materiales concretos para su realización, entre otros. Se planteará una Unidad Didáctica sobre la escalada, destinada al tercer ciclo de Educación Primaria, desarrollando la metodología llevada a cabo, así como una secuencia de actividades diversas.Grado en Educación Primari

El juego como recurso creativo

Este Trabajo Fin de Grado ligado a la titulación del Grado de Educación Infantil Mención de Expresión y Comunicación Artística y Motricidad, se basa en la capacidad creativa que poseen los niños y niñas de Educación Infantil y su relación con el concepto de juego. El objetivo principal es fomentar la capacidad creativa de los niños a través del juego. Para lograr esto, se han llevado a cabo actividades diferentes relacionadas con la creatividad. La metodología llevada a cabo posee un carácter experiencial, acomodándose a las formas naturales de creación de conocimiento del niño en esta etapa, la experiencia del conocimiento. El conocimiento surge en el niño con las experiencias de los juegos de infancia, como un dinamismo de actividad. Los resultados de las actividades demuestran diversas características cognitivas y de la personalidad de los niños, las cuales permiten acercarnos a su grado de creatividad. Finalizamos demostrando la importancia que posee desarrollar la creatividad durante la etapa de Educación Infantil.Grado en Educación Infanti

Autocuidado y calidad de vida en pacientes renales estadio V en terapia de hemodiálisis. Centro de Hemodiálisis Mercedes, Lima 2022

El objetivo general de la investigación fue determinar la relación entre la capacidad de autocuidado y la calidad de vida en pacientes renales estadio V en terapia de hemodiálisis del Centro de Hemodiálisis Mercedes, Lima 2022. Se trató de un estudio de tipo básico, nivel descriptivo-correlacional y diseño no experimental con una muestra censal de 75 pacientes que asistieron a la institución en el primer semestre del año 2022. Los instrumentos utilizados fueron dos cuestionarios previamente validados y con alta confiabilidad (ɑ=0,829 autocuidado y ɑ=0,798 calidad de vida), encontrando como resultados que el 90,70% emplean autocuidados en un nivel medio y el 94,7% tiene una calidad de vida regular. La prueba de hipótesis general contrastada con Rho de Spearman arrojó un valor p=0,000 y r=0,685 con valores similares en la correlación de las dimensiones del autocuidado y la calidad de vida. Se concluye que el autocuidado se relaciona significativa, directa y moderadamente con la calidad de vida en los pacientes, así como el seguimiento y control, cuidado de la dieta, cuidado de hábitos nocivos, actividades físicas y cuidado de la tensión y estrés se relacionan significativamente en la calidad de vida de los pacientes

Incidencia del costo de servicio en la rentabilidad de las empresas de servicios. Cajamarca, año 2020

El presente trabajo de investigación, tiene por objetivo Conocer la incidencia del costo de servicio en la rentabilidad de las empresas de servicios, Cajamarca 2020. La investigación es documental con enfoque cualitativo; el estudio se realizó bajo tesis de licenciatura recogidos de los repositorios de la Universidad Privada Del Norte (UPN), Universidad Nacional De Cajamarca (UNC), Universidad Privada Antonio Guillermo Urrelo (UPAGU), Universidad Nacional San Agustín De Arequipa (UNSA), Universidad Técnica de Ambato (UTA) y Universidad César Vallejo (UCV) comprendidos entre los años 2016 y 2020; de los 25 repositorios encontrados se seleccionaron 15, las cuales contienen información relacionada al desarrollo del tema en estudio, considerando criterios de inclusión y exclusión. Según los resultados obtenidos, se destaca que en todos los documentos analizados plantean que el costo de servicios incide de forma significativa y directa sobre la rentabilidad de las empresas de servicios. En consecuencia, el costo del servicio afecta de manera directa en la rentabilidad

Factors Associated with Knowledge, Attitudes, and Practices about Tuberculosis in Peruvians

Objective: To determine the factors associated with knowledge, attitudes, and practices (KAPs) about tuberculosis (TB) in the Peruvian population. Materials and Methods: A cross-sectional, analytical study was carried out by conducting a virtual survey. The instrument that was used consisted of 4 sections: sociodemographic variables (9 questions), knowledge (23 questions), attitudes (9 questions), and practices (8 questions) about tuberculosis. Univariate and bivariate analyses and the Poisson regression model with robust variance were used to obtain crude and adjusted prevalence ratios (PRa). Results: The sample consisted of 1284 participants. Regarding knowledge, attitudes, and practices about TB, an insufficient level was found in 47.97%, 50.3%, and 54.36% of the cases, respectively. The variables that increased the probability of having sufficient knowledge were sex, grade, area, family history, and history of having TB. While only the area and both antecedents were for attitudes. Finally, the age, degree, and history of TB were for the practices. Conclusion: There are insufficient KAPs in around half of the population studied. In addition, there are differences according to the epidemiological characteristics, such as sex, age, academic degree, area, and family history of TB and having had this disease. Therefore, the importance of research in this field should be emphasized in the face of a disease that is related to the differences in the levels of these variables between different strata of the general population

Immature Blood Vessels in Rheumatoid Synovium Are Selectively Depleted in Response to Anti-TNF Therapy

BACKGROUND:Angiogenesis is considered an important factor in the pathogenesis of Rheumatoid Arthritis (RA) where it has been proposed as a therapeutic target. In other settings, active angiogenesis is characterized by pathologic, immature vessels that lack periendothelial cells. We searched for the presence of immature vessels in RA synovium and analyzed the dynamics of synovial vasculature along the course of the disease, particularly after therapeutic response to TNF antagonists. METHODOLOGY/PRINCIPAL FINDINGS:Synovial arthroscopic biopsies from RA, osteoarthritis (OA) and normal controls were analyzed by double labeling of endothelium and pericytes/smooth muscle mural cells to identify and quantify mature/immature blood vessels. To analyze clinicopathological correlations, a cross-sectional study on 82 synovial biopsies from RA patients with variable disease duration and severity was performed. A longitudinal analysis was performed in 25 patients with active disease rebiopsied after anti-TNF-alpha therapy. We found that most RA synovial tissues contained a significant fraction of immature blood vessels lacking periendothelial coverage, whereas they were rare in OA, and inexistent in normal synovial tissues. Immature vessels were observed from the earliest phases of the disease but their presence or density was significantly increased in patients with longer disease duration, higher activity and severity, and stronger inflammatory cell infiltration. In patients that responded to anti-TNF-alpha therapy, immature vessels were selectively depleted. The mature vasculature was similarly expanded in early or late disease and unchanged by therapy. CONCLUSION/SIGNIFICANCE:RA synovium contains a significant fraction of neoangiogenic, immature blood vessels. Progression of the disease increases the presence and density of immature but not mature vessels and only immature vessels are depleted in response to anti-TNFalpha therapy. The different dynamics of the mature and immature vascular fractions has important implications for the development of anti-angiogenic interventions in RA

Distinct synovial immunopathology in Behçet disease and psoriatic arthritis

Introduction The aim of the study was to investigate synovial immunopathology differences between early Behcet disease (BD) and psoriatic arthritis (PsA). Methods Needle arthroscopy of an inflamed knee joint was performed in patients with early untreated BD (n = 8) and PsA (n = 9). Synovial fluid (SF) was collected for cytokines, perforin, and granzyme analysis. Eight synovial biopsies per patient were obtained for immunohistochemical analysis of the cellular infiltrate (T cells, natural killer cells, macrophages, B cells, plasma cells, mast cells, and neutrophils), blood vessels as well as expression of perforin and granzyme. The stained slides were evaluated by digital image analysis. Results The global degree of synovial inflammation was similar in the two types of arthritis. In the analysis of the innate immune cell infiltration, there was a striking neutrophilic inflammation in BD synovitis whereas PsA displayed significantly higher numbers of cells positive for c-kit, a marker of mast cells. As for lymphocytes, CD3(+) T cells, but neither CD20(+) B cells nor CD138(+) plasma cells, were significantly increased in BD versus PsA. Further analysis of the T-lymphocyte population showed no clear shift in CD4/CD8 ratio or Th1/Th2/Th17 profile. The SF levels of perforin, an effector molecule of cytotoxic cells, displayed a significant four-to fivefold increase in BD. Conclusions This systematic comparative analysis of early untreated synovitis identifies neutrophils and T lymphocytes as important infiltrating cell populations in BD. Increased levels of perforin in BD suggest the relevance of cytotoxicity in this diseas

Pielonefritis enfisematosa y hemangioma hepático en una paciente con diabetes mellitus reporte de caso y revisión de la literatura: Emphysematous pyelonephritis and hepatic hemangioma in a patient with diabetes mellitus case report and review of literature

ABSTRACT Emphysematous pyelonephritis is a serious infection of acute presentation, highly fatal due to septic complications. This infection is infrequent and usually affects uncontrolled diabetic women. The causative agents are the gas-producers coliforms and other uropathogenic enterobacteries.The infection usually has a high morbidity and mortality, which requires an early diagnosis and aggressive treatment. On the other hand, hepatic incidentalomas are considered lesions that are discovered in asymptomatic subjects. We describe the case of a 47-year-old patient with Diabetes Mellitus diagnosed 10 years ago, who developed acute emphysematous pyelonephritis caused by Escherichia coli BLEE positive. Diagnosis was confirmed by CT. An early and aggressive antibiotic treatment allowed complete resolution without the need for a surgical approach. Incidentally, a non-homogenous hypodense lesion was found in the liver, compatible with hepatic hemangioma. Key words: Emphysematous pyelonephritis; Diabetes mellitus; Hepatic hemangioma. (source: MeSH NLM) DOI:  10.25176/RFMH.v18.n3.1601RESUMEN La pielonefritis enfisematosa es una infección grave de presentación aguda, altamente mortal por complicaciones sépticas. Esta infección es infrecuente y por lo general afecta a mujeres diabéticas no controladas. Los agentes causales son las enterobacterias coliformes productoras de gas y otros uropatógenos. La infección suele tener una alta morbimortalidad por lo que requiere un diagnóstico temprano y un tratamiento precoz y agresivo. De otro lado se consideran incidentalomas hepáticos a aquellas lesiones que se descubren en sujetos asintomáticos. Se describe el caso de una paciente de 47 años con Diabetes Mellitus diagnosticada 10 años atrás, que desarrolló una pielonefritis aguda enfisematosa causada por Escherichia coli BLEE positivo. El diagnóstico se confirmó mediante TAC y el tratamiento antibiótico temprano y agresivo permitió la resolución completa sin necesidad de abordaje quirúrgico. Incidentalmente se encontró una lesión hipodensa no homogénea en el hígado, compatible con hemangioma hepático. Palabras clave: Pielonefritis enfisematosa; Diabetes mellitus; Hemangioma hepático. (fuente: DeCS BIREME) DOI:  10.25176/RFMH.v18.n3.160

Patients with rheumatoid arthritis in clinical remission and ultrasound-defined active synovitis exhibit higher disease activity and increased serum levels of angiogenic biomarkers.

INTRODUCTION: The aim of this study was to identify and characterize subclinical synovitis in patients with rheumatoid arthritis (RA) in clinical remission using power Doppler ultrasound (PDUS) and serum levels of biomarkers of inflammation and/or angiogenesis. METHODS: We selected patients with RA in clinical remission defined as a Disease activity score of 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) <2.6 for more than six months tested by two independent rheumatologists. Clinical, epidemiological, demographic and serological data were analyzed. PDUS of knees and hands was performed by a sonographer. Synovial hypertrophy (SH) and PDUS signal were scored (grades 0 to 3). SH ≥2 and a PDUS signal was classified as active synovitis. Serum levels of biomarkers of inflammation/angiogenesis were determined by Quantibody Human Array. RESULTS: This study included 55 patients, of whom 25 (45.4%) met criteria for ultrasound-defined active synovitis. Patients with active synovitis had higher DAS28-C reactive protein (P = 0.023), DAS28-ESR (P = 0.06), simplified disease activity score, SDAI (P = 0.064), and only 12% were taking oral glucocorticoids (≤5 mg/day) compared with 40% of patients without active synovitis (P = 0.044). Patients with synovitis also had significantly higher serum levels of the angiogenic biomarkers angiopoietin-2 (P = 0.038), vascular endothelial growth factor-D (P = 0.018), placental growth factor (P = 0.043), stromal cell-derived factor-1 (P = 0.035), matrix metallopeptidase-2 (P = 0.027) and basic fibroblast growth factor (bFGF) (P = 0.007), but not of pro-inflammatory cytokines. CONCLUSIONS: Nearly half of the patients with RA in clinical remission had ultrasound-defined active synovitis, higher disease activity and less frequent oral glucocorticoid consumption than patients without active synovitis. This clinical situation was associated with a specific biological profile characterized by an excess of angiogenic mediators rather than persistent proinflammatory cytokine responses