Estepario

El cortometraje de ficción Estepario es un ejercicio de trabajo audiovisual en el cual se aplica los conceptos de cine de arte y ensayo propuesto por David Bordwell, que permite la exploración de temáticas relacionadas con estados emocionales surreales, como lo es el viaje del espíritu después de la muerte

Prenatal Exposure to Endocrine Disruptors and Cardiometabolic Risk in Preschoolers: A Systematic Review Based on Cohort Studies

Background: Follow-up studies have reported both positive and negative associations between prenatal exposure to endocrine disrupting chemicals (EDCs) and some anthropometric indicators of overweight and obesity in children. However, few studies have evaluated the effect of this exposure on cardiometabolic risk factors in preschool-age children. The health and disease development paradigm (DOHaD) proposes that the physiological and metabolic adaptations triggered by the exposure to these compounds, coupled with postnatal conditions, can modify the risk of disease. In this context, cardiometabolic risk factors in children are not only an important outcome derived from prenatal exposure but a predictor/mediator of the children’s future health. Objective: To conduct a systematic review of the evidence published in the last 10 years from cohort studies on the association between prenatal exposure to EDCs and cardiometabolic risk factors in preschoolers. Design: Studies published from January 1, 2007 to May 1, 2017 in PubMed were analyzed. The research strategy was based on specified keywords and following the application of strict inclusion/exclusion criteria, 16 studies were identified and reviewed. Data were extracted and aspects of quality were assessed using an adapted Newcastle–Ottawa scale for cohort studies. Results: Only 5 of the 16 studies reviewed analyzed cardiometabolic risk factors in addition to anthropometric measures in children. The cohort studies included in this review suggest that prenatal exposure to low concentrations of EDCs has an impact on anthropometric variables and biochemical parameters in preschool-age children. Positive associations between prenatal exposure to EDCs and percentage of fat mass, body mass index, waist circumference, skinfolds and risk of overweight persisted after adjustment for important confounding variables. No association was found with lipid profile and glucose levels. Conclusions: Evidence was found to suggest that prenatal exposure to EDCs is positively associated with cardiometabolic risk factors in preschool children

Nutri Juice

Este modelo de negocio se realizó con el fin de complementar un estilo de vida saludable a través de un producto 100% natural, el cual aporta diversos nutrientes y es beneficioso para la salud del consumidor. Uno de los principales problemas que se identificaron en el estudio realizado es la falta de tiempo de las personas para preparar sus propias bebidas, ya sea por trabajo, estudio u otros temas. Esto les conlleva a buscar jugos naturales que sean acorde a sus necesidades, como es el mantener un estilo de vida saludable con un producto que sea beneficioso para su salud. Es por ello, que surge la idea de Nutri Juice, el cual es un jugo 100% natural sin preservantes ni azucares añadidos, está hechos a base de Camu Camu, Aguaje, Acaí y stevia. La presentación de nuestro producto es un envase de vidrio de 300 ml. transparente, con etiquetas donde se podrá visualizar los beneficios que está aportando la fruta que se está consumiendo. Asimismo, en la etiqueta incluirá datos curiosos relacionados a la salud. Nos dirigimos a un sector socioeconómico A y B enfocado en la edad de los millennials 22 a 40 años, ubicados en los distritos más representativos de Lima. Se estima abarcar inicialmente el 7% del mercado objetivo, con un crecimiento del 25% anual en cada año. Para ejecutar el proyecto se necesita una inversión inicial de 32,904, el cual será un 80% de financiamiento de los accionistas y un 20% de financiamiento de terceros.This business model was carried out in order to complement a healthy lifestyle through a 100% natural product, which provides various nutrients and is beneficial for the consumer's health. One of the main problems that were identified in the study carried out is the lack of time for people to prepare their own drinks, whether for work, study or other issues. This leads them to look for natural juices that are according to their needs, such as maintaining a healthy lifestyle with a product that is beneficial to their health. That is why the idea of ​​Nutri Juice arose, which is a 100% natural juice without preservatives or added sugars, it is made from Camu Camu, Aguaje, Acaí and stevia. The presentation of our product is a 300 ml glass container. transparent, with labels where you can see the benefits that the fruit is being consumed. Also, the label includes curious facts related to health. We target a socioeconomic sector A and B focused on the age of millennials 22 to 40 years old, located in the most representative districts of Lima. It is estimated to initially cover 7% of the target market, with an annual growth of 25% each year. To execute the project, an initial investment of 32,904 is needed, which will be 80% financing from shareholders and 20% financing from third parties.Trabajo de investigació

Análisis del proceso de tratamiento de aguas sanitarias en los canales de drenaje con impacto ambiental y salud poblacional. Una revisión de la literatura

This article carried out an extensive review of the literature regarding the problem of wastewater discharges at the global, national and local levels. The literature included the initial phase of the study through consultation in specialized databases, yielding 45,410 publications, where a scientometric analysis and significant findings were made, in addition to the normative components regarding discharges and water quality in order to to have an orientation of the applicable norms and at the same time provide a comparative analytical approach Subsequently, another review was carried out associated with the methods used in Colombia for the treatment of wastewater, this provided knowledge about the methodology imparted from the water treatment plants regarding the physicochemical and microbiological analyses. From the literary review, analysis and conclusion of the adequate normative and methodological bases were made to guarantee a correct continuity to the wastewater treatment process. Taking into account the problems presented to the treatment of wastewater and the impact generated at the population and ecosystem level, a basis of the minimum physicochemical and microbiological regulatory parameters is provided to comply with the legal framework that was initially investigated. This will contribute to the literature on Analysis of the sanitary water treatment process in drainage channels with environmental impact and population health, where it can be taken as references for problems that arise in environments similar to those studied in the literature and will generate a conversion based on regulatory compliance of both social and environmental type.El presente artículo efectuó una revisión extensa de la literatura en cuanto a la problemática de los vertimientos de aguas residuales a nivel mundial, nacional y con un enfoque local. La literatura comprendió la fase inicial de estudio a través de la consulta en las bases de datos especializadas arrojando 45410 publicaciones, donde se hizo un análisis cienciometrico y de hallazgos significativos, además de los componentes normativos en materia de vertimientos y calidad del agua con el fin de tener una orientación de las normas aplicables y brindar al mismo tiempo un enfoque analítico comparativo. Posterior se realizó otra revisión asociada a los métodos utilizados en Colombia para el tratamiento de las aguas residuales, esto brindó conocimiento acerca de la metodología impartida desde las plantas de tratamiento de agua en lo concerniente a los análisis fisicoquímicos y microbiológicos. De la revisión literaria se hizo análisis y conclusión de las bases normativas y metodológicas adecuadas para garantizar una correcta continuidad al proceso de tratamiento de aguas residuales. Teniendo en cuenta la problemática presentada al tratamiento de aguas residuales y el impacto generado a nivel poblacional y de ecosistemas, se brinda una base de los parámetros normativos fisicoquímicos y microbiológicos mínimos para dar cumplimiento al marco legal que inicialmente se investigó. Esto aportará a la literatura sobre Análisis del proceso de tratamiento de aguas sanitarias en los canales de drenaje con impacto ambiental y salud poblacional, donde se podrá tomar como referentes para problemáticas que se presenten en entornos similares a los estudiados en la literatura y generará una conversión efectiva basada en cumplimiento normativo del tipo tanto social como ambiental

Estudio de viabilidad para la creación de un medio tecnológico especializado en la prestación de servicios de salud en la ciudad de Bogotá.

La presente investigación se realiza con el fin de proponer un medio de plataforma digital utilizando tecnologías de la información y comunicación para mejorar la salud y campos relacionados con la misma, que garantice el acceso a consultas médicas domiciliarias en personas no vinculadas a EPS a pesar de que para el 2019 la cobertura total del sistema de salud subió al 94,66% de la población colombiana De acuerdo con el Sistema Integrado de Información de la Protección Social (Sispro), son muchas las problemáticas que se presentan a la hora de solicitar un servicio médico por lo que con esta plataforma se busca mejorar el acceso a un costo razonable para facilitar el acceso.Especialista en Gerencia en Servicios de SaludEspecializació

Chronic Exposure to Arsenic and Markers of Cardiometabolic Risk: A Cross-Sectional Study in Chihuahua, Mexico

BackgroundExposure to arsenic (As) concentrations in drinking water > 150 μg/L has been associated with risk of diabetes and cardiovascular disease, but little is known about the effects of lower exposures.ObjectiveThis study aimed to examine whether moderate As exposure, or indicators of individual As metabolism at these levels of exposure, are associated with cardiometabolic risk.MethodsWe analyzed cross-sectional associations between arsenic exposure and multiple markers of cardiometabolic risk using drinking-water As measurements and urinary As species data obtained from 1,160 adults in Chihuahua, Mexico, who were recruited in 2008–2013. Fasting blood glucose and lipid levels, the results of an oral glucose tolerance test, and blood pressure were used to characterize cardiometabolic risk. Multivariable logistic, multinomial, and linear regression were used to assess associations between cardiometabolic outcomes and water As or the sum of inorganic and methylated As species in urine.ResultsAfter multivariable adjustment, concentrations in the second quartile of water As (25.5 to < 47.9 μg/L) and concentrations of total speciated urinary As (< 55.8 μg/L) below the median were significantly associated with elevated triglycerides, high total cholesterol, and diabetes. However, moderate water and urinary As levels were also positively associated with HDL cholesterol. Associations between arsenic exposure and both dysglycemia and triglyceridemia were higher among individuals with higher proportions of dimethylarsenic in urine.ConclusionsModerate exposure to As may increase cardiometabolic risk, particularly in individuals with high proportions of urinary dimethylarsenic. In this cohort, As exposure was associated with several markers of increased cardiometabolic risk (diabetes, triglyceridemia, and cholesterolemia), but exposure was also associated with higher rather than lower HDL cholesterol.CitationMendez MA, González-Horta C, Sánchez-Ramírez B, Ballinas-Casarrubias L, Hernández Cerón R, Viniegra Morales D, Baeza Terrazas FA, Ishida MC, Gutiérrez-Torres DS, Saunders RJ, Drobná Z, Fry RC, Buse JB, Loomis D, García-Vargas GG, Del Razo LM, Stýblo M. 2016. Chronic exposure to arsenic and markers of cardiometabolic risk: a cross-sectional study in Chihuahua, Mexico. Environ Health Perspect 124:104–111; http://dx.doi.org/10.1289/ehp.140874

Association Between Variants in Arsenic (+3 Oxidation State) Methyltranserase ( AS3MT ) and Urinary Metabolites of Inorganic Arsenic: Role of Exposure Level

Variants in AS3MT, the gene encoding arsenic (+3 oxidation state) methyltranserase, have been shown to influence patterns of inorganic arsenic (iAs) metabolism. Several studies have suggested that capacity to metabolize iAs may vary depending on levels of iAs exposure. However, it is not known whether the influence of variants in AS3MT on iAs metabolism also vary by level of exposure. We investigated, in a population of Mexican adults exposed to drinking water As, whether associations between 7 candidate variants in AS3MT and urinary iAs metabolites were consistent with prior studies, and whether these associations varied depending on the level of exposure. Overall, associations between urinary iAs metabolites and AS3MT variants were consistent with the literature. Referent genotypes, defined as the genotype previously associated with a higher percentage of urinary dimethylated As (DMAs%), were associated with significant increases in the DMAs% and ratio of DMAs to monomethylated As (MAs), and significant reductions in MAs% and iAs%. For 3 variants, associations between genotypes and iAs metabolism were significantly stronger among subjects exposed to water As >50 versus ≤50 ppb (water As X genotype interaction P < .05). In contrast, for 1 variant (rs17881215), associations were significantly stronger at exposures ≤50 ppb. Results suggest that iAs exposure may influence the extent to which several AS3MT variants affect iAs metabolism. The variants most strongly associated with iAs metabolism—and perhaps with susceptibility to iAs-associated disease—may vary in settings with exposure level

Validity of the Maternal Antenatal Attachment Scale-Spanish Version for Mexican Pregnant Women

During pregnancy, parents experiment emotions, thoughts, and behaviors related to their unborn child as precursors of attachment in the caretaker-infant dyad. The Maternal Antenatal Attachment Scale (MAAS) is an instrument that has shown adequate psychometric properties to evaluate this construct in developed countries. The aim of this study was to assess the reliability and concurrent validity of the Maternal Antenatal Attachment Scale-Spanish version for Mexican women (MAAS-Spanish version). A sample of 142 women in their third trimester of pregnancy who received care in a tertiary hospital was selected. The full scale of the MAAS-Spanish version obtained a Cronbach alpha of .79. A significant negative correlation was found between the global MAAS-Spanish version score (r = -.23, p ≤ .01) and the Postpartum Depression Predictors Inventory-Revised and depressive symptoms (r = -.36 , p ≤ .01). The translated and adapted scale has adequate internal consistency and concurrent validity to measure this construct in this population

Bases conceptuales de las actividades profesionales a confiar para la educación de profesionales de la salud en Latinoamérica

The concept of entrustable professional activities emerged as an attempt to overcome some of the criticisms to the competency-based medical education approach; it has had a broad impact in practice and health professions education research. It has been disseminated internationally with its English acronym: EPA. This approach proposes to orient assessment and teaching to specific activities in the profession, which allows the integration of several competencies, and to determine which responsibilities can be entrusted to the trainee, in a gradual and explicit manner. The model assumes the definition of levels of supervision that allow progressive autonomy for each EPA, in students or residents, once they demonstrate the required competencies. Practice, supervision and feedback in real clinical scenarios are key to the development of autonomy in EPA performance. The dissemination of the EPA approach is still limited in Latin America, but it has the potential to create a significant contribution to curriculum design and evaluation, and to assessment practices of health professionals across their careers. It provides a deep review of the assumptions under which healthcare professional practice decisions are made, at under and postgraduate levels.Revisión por pare

Differential Risk of Intracranial Hemorrhage in Patients with Non-valvular Atrial Fibrillation with Usage of Novel Oral Anticoagulantsvs. Warfarin. Systematic Review and Analysis of Subpopulations

Introducción: La anticoagulación en pacientes con fibrilación auricularno valvular previene eventos tromboembólicos con incremento implícitoen el riesgo de complicaciones hemorrágicas, principalmente lahemorragia intracraneana. Métodos: Se realizó una revisión sistemáticade la literatura del periodo 2011-2016 en bases de datos (Pubmed-Embase). Se incluyeron metanálisis, revisiones sistemáticas y ensayosclínicos aleatorizados de las moléculas de interés (apixabán, dabigatrán,edoxabán, rivaroxabán). Se identificaron 512 artículos, tras lo cual seseleccionaron catorce estudios para el análisis final. Resultados: Durantela evaluación comparativa de las cuatro moléculas en diferentes dosisversus warfarina se evidenció una menor prevalencia de hemorragiaintracraneana en pacientes manejados con nuevos anticoagulantes orales;en todos los artículos evaluados, los resultados apoyan su uso. Sinembargo, al evaluar desenlaces hemorrágicos en el caso de subpoblaciones,los resultados parecen tener menor impacto y, en algunos casos, no logranla significancia estadística y se encontró reducción o desaparición delbeneficio. Conclusiones: Los resultados pueden aportar herramientas deutilidad que apoyarían al clínico en la toma de decisiones acerca de laelección del tipo de anticoagulante en escenarios clínicos específicos.1-9Introduction: Patients with non-valvular atrial fibrillationrequire anticoagulation therapy for prevention ofthromboembolic events. The safest type of anticoagulationtherapy regarding intracranial hemorrhage has not beenestablished yet. Methods: We conducted a systematicreview of literature in the time period 2011-2016in databases (PubMed-EMBASE). We included meta-analysis, systematic reviews and randomized clinical trialsaddressing the molecules of interest (apixaban, dabigatran,edoxaban, rivaroxaban). We identified 512 articles, afterwhich 14 studies were selected for the final analysis.Results: Through comparative evaluation of the fourmolecules in different doses versus warfarin, we found adecrease in intracranial hemorrhage in patients on therapywith novel anticoagulants, results support their usage inall of the articles included for analysis. However, whenevaluating hemorrhage-related outcomes in different sub-populations, the results seem to have a smaller impact andin some cases they do not reach statistical significance,also, the benefit was reduced or disappeared. Conclusions:The results from this review can serve as useful tools inorder to support physicians in the decision-making processregarding choice of the right type of anticoagulant therapyin specific clinical situations