Evaluación del control de los pacientes hipertensos dispensarizados de la policlínica "Omar Ranedo Pubillones" de Guantánamo

Se realizó un estudio con los pacientes hipertensos dispensarizados de la Policlínica "Omar Ranedo Pubillones" de Guantánamo, del 1 de abril  de 1997 al 30 de abril de 1998. De la  totalidad de dichos pacientes en el área se obtuvo una muestra sistemática representativa, con el propósito de evaluar el control de la enfermedad en dicha área de salud. Se encontró que el 58,2% de ellos estaban controlados. La edad y el sexo no influyeron en el grado de control de la presión arterial. La patología asociada que se presentó con mayor frecuencia fue la cardiopatía isquémica. El mejor resultado en el control de la enfermedad se obtuvo con el tratamiento combinado farmacológico y no farmacológico. Se concluye que hay un bajo grado de control de la presión arterial en la muestra estudiada

Promoção de práticas alimentares saudáveis em pré-escolares de uma instituição educacional dacidade de Medellín

Food practices in schoolchildren show a high prevalence of sugar consumption. The objective of the study was to describe the prevalence of cavities, nutritional habits in preschoolers and first and to promote healthy eating practices at the school Ciudadela Nuevo Occidente. Materials and methods: A descriptive study was carried out with the participation of 61 boys and girls of the preschool, first and second grade, 80 parents or representatives and a non-participant observation was made to schoolchildren, school store and innkeepers, to explore the habits of food consumption in the Institution. Finally, a playful educational strategy was implemented that promoted healthy eating practices. A descriptive analysis of the information collected, and a bivariate analysis were carried out to compare the findings within the study period. The development study during the period 2017-II and 2019-II. Results: 60% of the respondents belonged to a level 1 socioeconomic stratum, 61% of parents had complete and incomplete secondary schooling. 58.8% have a daily consumption of sweets and soft drinks. The frequency of caries was 47.5% and white spots was 49.1%. Cariogenic foods are in the environment of children. 18 educational activities were carried out with 160 preschool and first school children and their teachers. Conclusions: practices such as high sugar intake, poor brushing, not packing children’s toothbrush for school,are risk factors that expose schoolchildren to cavities.Las prácticas alimentarias en escolares, muestran una alta prevalencia del consumo azucares. El objetivo del estudio fue describir la prevalencia de caries, los hábitos nutricionales en niños de preescolar y primero y fomentar prácticas alimentarias saludables en la Institución educativa Ciudadela Nuevo Occidente. Materiales y métodos: estudio descriptivo, con la participación de 61 niños y niñas del grado de preescolar y primero, 80 padres de familia o representantes y se realizó una observación no participante a los escolares, tienda escolar y venteros, para explorar los hábitos de consumo de alimentos en la Institución. Se realizó un análisis descriptivo de la información recolectada y un análisis bivariado para comparación de los hallazgos dentro del periodo de estudio. El estudio de desarrollo durante el periodo 2017-II y 2019-II. Resultados: el 60% de los encuestados pertenecía a un estrato socioeconómico nivel 1, el 61% de padres tenían escolaridad de secundaria completa e incompleta. 58,8% tiene un consumo diario de dulces y gaseosas. La frecuencia de caries fue del 47,5% y mancha blanca fue del 49,1%. Los alimentos cariogénicos están en el entorno de los niños. Se realizaron 18 actividades educativas con 160 niños de preescolar y primero y sus profesoras. Conclusiones: prácticas como el alto consumo de azúcar, un cepillado deficiente, no empacar a los niños el cepillo de dientes para el colegio, son factores de riesgo que exponen a los escolares a la aparición de la caries.As práticas alimentares em escolares mostram alta prevalência de consumo de açúcar. O objetivo do estudo foi descrever a prevalência de cáries, hábitos nutricionais em crianças pré-escolares e da primeira série e promover práticas alimentares saudáveis na instituição de ensino Ciudadela Nuevo Oeste. Materiais e métodos: estudo descritivo, com a participação de 61 meninos e meninas da pré-escola e primeira série, 80 pais ou representantes e foi realizada observação não participante dos escolares, loja escolar e lojistas, para explorar hábitos de consumo de alimentos. na Instituição. Foi realizada análise descritiva das informações coletadas e análise bivariada para comparação dos achados no período do estudo. O estudo de desenvolvimento durante o período 2017-II e 2019-II. Resultados: 60% dos entrevistados pertenciam a um estrato socioeconômico de nível 1, 61% dos pais tinham ensino médio completo ou incompleto. 58,8% consomem doces e refrigerantes diariamente. A frequência de cárie foi de 47,5% e de mancha branca foi de 49,1%. Os alimentos cariogênicos estão no ambiente infantil. Foram realizadas 18 atividades educativas com 160 crianças da pré-escola e da primeira série e seus professores. Conclusões: práticas como alto consumo de açúcar, má escovação e não levar as escovas de dente das crianças para a escola são fatores de risco que expõem os escolares ao aparecimento de cáries.

Mortalidad por enfermedad cerebrovascular en el Hospital General Docente “Dr. Agostinho Neto”. Estudio del quinquenio 1993-1997

 Se  realizó  un  estudio tipo caso control  con  el  objetivo  de caracterizar  aspectos de interés relacionados con la  mortalidad por   enfermedad  cerebrovascular  (ECV)  en  el  hospital   "Dr. Agostinho  Neto"  durante  el quinquenio 1993 -  1997.  El  grupo estudio  (fallecidos; n=300) y un grupo control  (vivos;  n=600), ambos  con  diagnóstico de ECV, fueron  seleccionados aleatoriamente  y apareados con una relación 2:1. Los  resultados más  sobresalientes fueron los siguientes: la tasa de  incidencia mostró  una  tendencia  ascendente,  la  ECV  oclusiva  tuvo  una incidencia mayor que la de la ECV hemorrágica. El análisis demostró que  hay una asociación estadísticamente significativa  entre  la ECV y la hipertensión arterial (OR = 830), la edad (OR = 5.78)  y con  el antecedente de ECV previa (OR = 4.33). La  bronconeumonía fue la complicación más frecuente y la causa directa de muerte en el 45.7 % de los fallecidos

Quality of Life and Autonomy in Patients with Intermittent Bladder Catheterization Trained by Specialized Nurses

Intermittent bladder catheterization (IBC) involves regular urine draining using a catheter, which is removed immediately after urinary elimination. It allows for the patient's urological health to be managed and their renal function to be preserved, and it promotes autonomy. Compliance with the prescribed number of daily catheterizations, which must be conducted by the patient, and infection prevention measures are crucial. To identify the patients requiring IBC, and to determine their adherence (whether they followed the prescribed guidelines and their difficulty in carrying out the procedure, as well as to assess how the IBC influences their quality of life and state of mind after receiving self-care training from a specialized nurse), we carried out a prospective, multicenter observational study in 24 Spanish hospitals with one month of monitoring and a sample of 99 patients. The sources of information were the patients' clinical records, the King's Health Questionnaire, the Mini-Mental State Examination (MMSE), and the hospital anxiety and depression scale (HADS). Descriptive and bivariate statistics were used to analyses the paired data. After recruitment (n = 99), 79 patients completed the questionnaire at a mean age of 35.2 years (SD = 20.5 years). In total, 53.5% (53) of the sample consisted of men and 32.3% (32) had neurological damage as the reason for prescription; 67% (67.7) performed self-catheterization and 86.7% adhered to the IBC. After one month of monitoring, a statistically significant improvement in quality of life was observed in all criteria, with the exception of personal relationships (p < 0.005), as well as an improvement in anxiety and depression levels (p < 0.001). Patients who require IBC show good adherence to the IBC with a significant percentage of self-catheterization. After one month of IBC, a significant improvement in the patients' quality of life and mood was observed. These results could be attributed to adequate patient training and adequate personalization of the IBC materials by the specialized nurses

Effectiveness of Modified Vaccinia Ankara-Bavaria Nordic Vaccination in a Population at High Risk of Mpox: A Spanish Cohort Study

Background: With over 7,500 cases notified since April 2022, Spain has experienced the highest incidence of mpox in Europe. From July 12th onwards, the Modified Vaccinia Ankara-Bavaria Nordic (MVA-BN) smallpox vaccine was offered as pre-exposure prophylaxis for individuals at high-risk of mpox, including those receiving pre-exposure prophylaxis for HIV (HIV-PrEP). Our aim was to assess the effectiveness of one dose of MVA-BN vaccine as pre-exposure against mpox virus (MPXV) infection in persons on HIV-PrEP. Methods: We conducted a national retrospective cohort study between July 12 and December 12, 2022. Individuals ≥18 years, receiving HIV-PrEP as of July 12 and with no previous MPXV infection or vaccination were eligible. Each day, we matched individuals receiving a first dose of MVA-BN vaccine and unvaccinated controls of the same age group and region. We used a Kaplan-Meier estimator and calculate risk ratios (RR) and vaccine effectiveness (VE = 1-RR). Results: We included 5,660 matched pairs, with a median follow-up of 62 days (interquartile range 24-97). Mpox cumulative incidence was 5.6 per 1,000 (25 cases) in unvaccinated and 3.5 per 1,000 (18 cases) in vaccinated. No effect was found during days 0-6 post-vaccination (VE -38.3; 95% confidence interval (95%CI): -332.7; 46.4), but VE was 65% in ≥7 days (95%CI 22.9; 88.0) and 79% in ≥14 days (95%CI 33.3; 100.0) post-vaccination. Conclusions: One dose of MVA-BN vaccine offered protection against mpox in a most-at-risk population shortly after the vaccination. Further studies need to assess the VE of a second dose and the duration of protection over time.S

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

Diplomatura Diseño y Gestión de Emprendimientos de Turismo Rural : estrategias de agregado de valor a la producción agropecuaria

Trabajos Finales de Integración y Transferencia, Cohorte Cerro Colorado (Diplomatura Diseño y Gestión de Emprendimientos de Turismo Rural) -- UNC- Facultad de Ciencias Agropecuarias, 2019En esta compilación se presentan una selección de cinco (5) trabajos realizados por los alumnos de la Cohorte de la Diplomatura desarrollada en la localidad de Cerro Colorado que involucra a proyectos en los Departamentos Río Seco, Sobremonte y Tulumba (Noroeste de la provincia de Córdoba, Argentina). El primer proyecto “Tulumba y sus sendas” trata de los diferentes circuitos turísticos en la Villa de Tulumba (Departamento Tulumba); el segundo, denominado “Vivencias camperas” propone vivenciar un día de campo en el establecimiento El Bordo situado en el Departamento Río Seco. El tercer proyecto plantea una “Raíz red turística” que comprende las localidades de Caminiaga, Cerro Colorado, Pozo Nuevo, San Francisco del Chañar y Villa María de Río Seco (Departamentos Río Seco y Sobremonte). “La huella de Don Ata”, en cuarto lugar, plantea un proyecto educativo relacionado al senderismo en la Comuna del Cerro Colorado. Finalmente, en “Soy el Mapa”, los autores proyectan el diseño de un cartel de interpretación ordenado en un solo punto que permita mostrar al turista los lugares relevantes del Cerro Colorado

Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic : a matched analysis

The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with COVID-19-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior non-invasive respiratory support on outcomes. This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICU) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of intensive care unit (ICU) admission. Propensity score (PS) matching was used to achieve balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different timepoint (48 h from ICU admission) for early and delayed intubation. Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After PS matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%, p =0.01), ICU mortality (25.7% versus 36.1%, p=0.007) and 90-day mortality (30.9% versus 40.2%, p=0.02) when compared to the early intubation group. Very similar findings were observed when we used a 48-hour timepoint for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth wave, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (n=294) who were intubated earlier. The subgroup of patients undergoing NIV (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received high-flow nasal cannul

Arte contemporáneo, inclusión y transformación social.

Actividad CePIAbierto (RHCD FA Nº 103/2018). El eje central del proyecto es una exposición de los procesos realizados en los talleres de artes del Centro Vida Nueva (San Juan) y el Centro Educativo Terapéutico Lihue Vidas (Córdoba), junto a una selección de sus producciones visuales. Tanto éstas producciones como su montaje se propone desde un planteo contemporáneo y ampliado de las artes visuales, donde diversas disciplinas (como pintura, fotografía, video, registro de experiencias, textos e instalaciones) y diversos campos no artísticos (como pedagógico, social, psicológico, etc) se entrecruzan y construyen de manera colaborativa la experiencia propuesta, rescatando y revalorizando sobre todo el proceso de trabajo y no sólo el resultado final. Se realizó también una charla-debate con lxs artistas que pone en cuestión ideas ejes que atraviesan el trabajo artístico de las personas con discapacidad, la valoración positiva de la diferencia, la importancia y necesidad de poner en práctica concreta la inclusión en los diferentes ámbitos educativos-artísticos-culturales. Por último, se pintó colectivamente un mural como modo de compartir una experiencia de creación colectiva, junto a lxs artistas expositorxs.Actividad CePIAbierto (RHCD FA Nº 103/2018). Una experiencia artística expositiva que propone pensar la discapacidad no como un problema, sino como una pregunta que nos despierta. Pinturas, dibujos, charlas y un mural colectivo, dan cuenta de un proceso de trabajo artístico y de encuentro entre diversas personas que comparten un mismo hacer y placer: pintar, dibujar (¡y bailar!).Fil: Tamagni, Julia. Universidad Nacional de Córdoba. Centro Educativo Terapéutico Lihue Vidas; Argentina.Fil: Bula, Nadia. Centro Vida Nueva, Institución Aleluya-ARID.Fil: Maggio, Natalia. Universidad Católica de Cuyo. Centro Vida Nueva, Institución Aleluya-ARID.Fil: Scheidegger, Emiliano. Universidad Nacional de Córdoba. Facultad de Artes; Argentina.Fil: Walter, Florencia. Universidad Nacional de Córdoba. Facultad de Artes; Argentina.Fil: Belkys Scolamieri, Delia Lozano. Universidad Católica de Córdoba. Facultad de Educación. Apukay; Argentina

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation