Efecto del ácido ascórbico en casos nuevos de Tuberculosis pulmonar baciloscopía positiva que reciben tratamiento en primer nivel de atención: Ensayo clínico controlado

El presente estudio es un ensayo clínico aleatorizado y controlado a triple ciego, fase IV, para evaluar el efecto del ácido ascórbico en pacientes con tuberculosis pulmonar baciloscopía positiva que reciben Tratamiento Acortado Estrictamente Supervisado (TAES) en el primer nivel de atención durante Septiembre 2014 a Enero 2015. La dosis de 500 mg de ácido ascórbico por vía oral cada día adicionada al TAES categoría I, con los datos preliminares al momento se puede observar que en sujetos caso nuevo de Tuberculosis pulmonar Bk+ adscritos al TAES con categoría I en el primer nivel de atención del MINSAL produce una negativización temprana de baciloscopía a la dosis #27, así mismo se pudo evidenciar una leve mejoría clínica y nutricional en todos los sujetos tratados.Tesis para optar al título de Doctor en Medicin

Gestión autónoma de misiones en UAV basada en visión artificial

En el presente documento se tratan los conceptos teórico-prácticos para el diseño de un sistema de visión artificial capaz de detectar personas por medio de un UAV y tomar las acciones pertinentes en cada caso. El sistema se basa en la tecnología de vuelo Pixhawk, sobre la que se embarcará la controladora de vuelo Pixhawk, con el software de vuelo PX4. Además, se creará una misión preprogramada y elaborada con el software QGround, del proyecto Pixhawk. Durante la misión, el sistema de visión artificial para la detección de personas se ejecutará en una Raspberry Pi (ordenador de pequeñas dimensiones) y se embarcará al chasis del UAV. Además, se implementará un algoritmo con una lógica de vuelo que permita detectar elementos de interés que se encuentren dentro del ángulo de visión del UAV. Cuando un cuerpo humano se encuentre en el ángulo de visión del UAV, se deberá enviar una interrupción a la controladora de vuelo para aplicar las acciones pertinentes. Para comunicar la controladora de vuelo con los algoritmos de visión artificial y la lógica de vuelo, se implementará la comunicación entre los ordenadores Pixhawk y Raspberry Pi. En conclusión, el UAV será capaz de suspender la misión actual a partir de un evento de interés, después realizará acciones sobre la controladora de vuelo y por último será capaz de recuperar el estado de la misión inicial una vez terminada la interrupción por el elemento de interés.This paper covers all theoretical and practical concepts about the design of an artificial vision system. The main reason of this artificial vision system is to detect people by a UAV and taking the pertinent actions in each case. The system is based on Pixhawk flight technology, with the onboard computer Pixhawk and the PX4 flight software controller. Also, the software to launch pre planned mission has been QGround, which is part of the Project Pixhawk. During the pre-planned mission, the artificial vision system will be executed over the component Raspberry Pi. This component is a small external onboard computer to compute all the data collected while the mission lasts. Besides, inside this computer an algorithm will be implemented by following a flight logic that allows detecting people who are within the UAV´s angle of vision. And due to this detection, the flight logic will determine which action the flight controller should take. To achieve this system works, will be necessary to implement the communication between the Raspberry Pi, which contains all the flight logic system and the artificial vision system, and the Pixhawk, which contains the PX4 flight software controller. This communication will give the Raspberry Pi the chance to interrupt the flight if needed. To sum up, the UAV will be able to suspend the current mission due to an interest event, execute an action over the flight controller and then recover the status of the initial mission once the interruption is over.Grado en Ingeniería Informátic

Global Antifungal Profile Optimization of Chlorophenyl Derivatives against Botrytis cinerea and Colletotrichum gloeosporioides

Twenty-two aromatic derivatives bearing a chlorine atom and a different chain in the para or meta position were prepared and evaluated for their in vitro antifungal activity against the phytopathogenic fungi Botrytis cinerea and Colletotrichum gloeosporioides. The results showed that maximum inhibition of the growth of these fungi was exhibited for enantiomers S and R of 1-(40-chlorophenyl)- 2-phenylethanol (3 and 4). Furthermore, their antifungal activity showed a clear structure-activity relationship (SAR) trend confirming the importance of the benzyl hydroxyl group in the inhibitory mechanism of the compounds studied. Additionally, a multiobjective optimization study of the global antifungal profile of chlorophenyl derivatives was conducted in order to establish a rational strategy for the filtering of new fungicide candidates from combinatorial libraries. The MOOPDESIRE methodology was used for this purpose providing reliable ranking models that can be used later

Análisis de la operatividad de la conciliación en equidad en la localidad No. 2 de la ciudad de Cartagena de indias – 2001 al 2006. Referentes teóricos.

Se presentan los referentes teóricos que orientan la investigación sobre la operatividad de la conciliación en equidad en la localidad No. 2 de la ciudad de Cartagena de Indias – Bolívar durante los años 2001 al 2006, como parte de los estudios sobre los mecanismos alternos de solución de conflictos que adelanta el grupo de investigación de Derecho Público. Los referentes parten del estudio del paradigma de la conciliación en Colombia como es el pluralismo jurídico, luego se presentaran las teorías generales sobre los mecanismos alternos de solución de conflictos, para culminar con el análisis de la teoría sustantiva de la conciliación en equidad propiamente dicha, conforme a la revisión de los autores que en Colombia se han dedicado particularmente al estudio de la conciliación en equidad

Chronic fatigue syndrome: aetiology, diagnosis and treatment

Chronic fatigue syndrome is characterised by intense fatigue, with duration of over six months and associated to other related symptoms. The latter include asthenia and easily induced tiredness that is not recovered after a night's sleep. The fatigue becomes so severe that it forces a 50% reduction in daily activities. Given its unknown aetiology, different hypotheses have been considered to explain the origin of the condition (from immunological disorders to the presence of post-traumatic oxidative stress), although there are no conclusive diagnostic tests. Diagnosis is established through the exclusion of other diseases causing fatigue. This syndrome is rare in childhood and adolescence, although the fatigue symptom per se is quite common in paediatric patients. Currently, no curative treatment exists for patients with chronic fatigue syndrome. The therapeutic approach to this syndrome requires a combination of different therapeutic modalities. The specific characteristics of the symptomatology of patients with chronic fatigue require a rapid adaptation of the educational, healthcare and social systems to prevent the problems derived from current systems. Such patients require multidisciplinary management due to the multiple and different issues affecting them. This document was realized by one of the Interdisciplinary Work Groups from the Institute for Rare Diseases, and its aim is to point out the main social and care needs for people affected with Chronic Fatigue Syndrome. For this, it includes not only the view of representatives for different scientific societies, but also the patient associations view, because they know the true history of their social and sanitary needs. In an interdisciplinary approach, this work also reviews the principal scientific, medical, socio-sanitary and psychological aspects of Chronic Fatigue Syndrome

La responsabilidad de la alcaldía municipal de santa ana en el manejo integral de los desechos sólidos, el cumplimiento de las leyes ambientales y sus ordenanzas municipales en la materia

La presente investigación que se denomina LA RESPONSABILIDAD DE LA ALCALDIA MUNICIPAL DE SANTA ANA EN EL MANEJO INTEGRAL DE LOS DESECHOS SÓLIDOS, EL CUMPLIMIENTO DE LAS LEYES AMBIENTALES Y SUS ORDENANZAS MUNICIPALES EN LA MATERIA, en la cual el propósito es conocer el alcance, así como las diferentes limitaciones que se tiene en el trabajo que realiza la Alcaldía Municipal de Santa Ana

Estrategias docentes para el desarrollo de competencias profesionales en la nueva mención de Gestión del Ocio y la Cultura del Grado en Turismo

Memoria ID-0324. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters

This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8–13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05–6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50–75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron