Caracterización de condiciones de salud osteomuscular en trabajadores del área operativa de la empresa Confeccionar E.U de Dosquebradas, durante enero a mayo del año 2018

En la presente investigación se realizó la caracterización de las condiciones de salud osteomuscular de los trabajadores de cargo operativo de la empresa confeccionar E.U de la ciudad de Dosquebradas, en el periodo de enero a mayo del 2018. En esta investigación se identificaron aspectos como: El perfil sociodemográfico de la población, existencia de sintomatología osteomuscular, identificación de las zonas del cuerpo más afectadas y características de estas molestias. Para ello se implementó una investigación de estudio de caso. La técnica de recolección de datos se hizo a través de un cuestionario de sintomatología osteomuscular estandarizado. Se aplicó el instrumento a todos los trabajadores del área operativa (13). Posterior, se analizaron los datos donde se evidenció que respecto al género: El 85% de la población es de género femenino y el 15% al masculino. El 82% de los encuestados presentó alguna molestia osteomuscular, siendo la zona dorsal y lumbar las más afectadas con un 24%, seguido del cuello con un 21%. Cabe resaltar que solo el 16.6 % ha recibido tratamiento o consultado por estos síntomas, por lo cual se hicieron recomendaciones pertinentes, tales como: Diseñar, implementar y mantener un programa de vigilancia epidemiológica osteomuscular, incluir en el programa a todos los trabajadores que presentaron molestias osteomusculares, desarrollar jornadas de capacitación y sensibilización en higiene postural y carga acumulativa en miembro superior espalda y cuello, inspecciones de puesto de trabajo, programa de vigilancia médica, programa de estilos de vida saludables, pausas activas y gimnasia laboral.In the present investigation the characterization of the musculoskeletal health conditions of the operative workers of the company make EU of the city of Dosquebradas was carried out, in the period from January to May 2018. In this investigation aspects such as: sociodemographic profile of the population, existence of musculoskeletal symptoms, identification of the most affected areas of the body and characteristics of these discomforts. For this, a case study investigation was implemented. The data collection technique was done through a standardized musculoskeletal symptom questionnaire. The instrument was applied to all workers in the operational area (13). Subsequently, the data were analyzed where it was shown that regarding gender: 85% of the population is female and 15% male. 82% of the respondents presented some musculoskeletal discomfort, with the dorsal and lumbar areas being the most affected with 24%, followed by the neck with 21%. It should be noted that only 16.6% have received treatment or consulted for these symptoms, for which pertinent recommendations were made, such as: Design, implement and maintain an osteomuscular epidemiological surveillance program, include in the program all workers who had discomfort musculoskeletal, develop training sessions and awareness in postural hygiene and cumulative load in upper back and neck, workplace inspections, medical surveillance program, healthy lifestyle program, active breaks and work gymnastics.Universidad Libre Seccional Pereira - Facultad Ciencias de la Salud - Especialización en Seguridad y Salud en el Trabaj

Conocimiento de cáncer y desempeño del profesional de enfermería en la atención de pacientes oncológicos. Hospital Regional de Ayacucho, 2017

El presente trabajo de investigación tuvo como objetivo determinar la relación entre el conocimiento y desempeño del Profesional de Enfermería en el cuidado de pacientes oncológicos. El tipo de investigación fue correlaciona] de corte transversal con un enfoque cuantitativo, la técnica fue la encuesta y el instrumento cuestionario. Resultados: el 82,5% de profesionales de enfermería tienen conocimiento alto sobre patología del cáncer y 17,5% tienen conocimiento medio, de ellas 58,7% trabajan en equipo adecuadamente y 41.3% no lo hacen; (Rho=0,349, p<0,05). El 60% planifican y prevén adecuadamente y 40% no lo hacen (Rho=0,295, p<0,05). El 76,3% de profesionales de enfermería tienen conocimiento alto de los factores de riesgo del cáncer y 23,7% tienen conocimiento medio, de ellas 58,7% trabajan en equipo adecuadamente y 41.3% no lo realizan; (Rho=0,368, p<0,05). 60% planifican y prevén adecuadamente y 40% no lo hacen (Rho=0,264, p<0,05). El 88,8% de profesionales de enfermería tienen conocimiento alto de las medidas preventivas del cáncer y 11,2% tienen conocimiento medio, de ellas 58,7% trabajan en equipo adecuadamente y 41.3% no lo hacen; (Rho=0,345, p<0,05). El 60% planifican y prevén adecuadamente y 40% no lo hacen (Rho=0,194, p>0,05). Conclusión: El 92,5% de enfermería tienen conocimiento alto del cáncer, de ellas 55% tienen desempeño profesional adecuadamente y 45% tiene desempeño profesional inadecuadamente; (Rho=0,315; p<0,05).Tesis de segunda especialida

Endothelium-dependent vasorelaxation induced by L-carnitine in isolated aorta from normotensive and hypertensive rats

The aim of this work was to investigate the mechanism of the vasodilatory effect induced by L- carnitine. Relaxation produced by L-carnitine was studied in rat aortic rings with and without functional endothelium, pre-contracted with phenylephrine by adding cumulative doses of L- carnitine (10-7 to 10-3 M). The relaxation evoked by L-carnitine reached higher values in aortic rings from spontaneously hypertensive rats than those obtained in arteries from normotensive rats; no relaxation was produced in de-endothelialized arteries. However, in the presence of NG-nitro-L- arginine (3¬10-5 M, a nitric oxide synthase inhibitor), Ro 68070 (10-4 M, a thromboxane synthetase inhibitor–thromboxane A2/prostaglandin H2 receptor antagonist) or ICI 192605 (10- M, a thromboxane A2 receptor antagonist) the relaxant response to L-carnitine was signiicantly inhibited. These results show that L-carnitine induced endothelium-dependent relaxation in the rat aorta and the mechanism of this relaxation appeared to be mostly mediated by endothelial production of nitric oxide but also could involve prevention of the action of cyclooxygenase endothelial products acting on the thromboxane A2/prostaglandin H2 receptor

Uso la plataforma H5P de creación de contenido interactivo como herramienta para la creación de un laboratorio de bioquímica virtual e interactivo

En este proyecto de innovación docente está diseñado para que el alumnado se acerque a un laboratorio de bioquímica virtual e interactivo y conozca los diferentes métodos y técnicas experimentales que se utilizan en ciertos análisis clínicos

Epidemiología básica. Material docente para prácticas en ciencias de la salud

Material docente teórico práctico para apoyar la enseñanza de la epidemiología. Consta de 4 unidades, cada una de ellas con una introducción teórica y unos ejercicios basados en artículos publicados en inglés en revistas científicas

Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19.

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6+/-9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; pPeer reviewe

Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

Educación para el siglo XXI: Derechos humanos, ciudadanía y diversidad sexual

172 p. Libro ElectrónicoEste libro recoge el resultado de la sistematización del programa “Maestros y maestras que inspiran” de la línea de Derechos humanos, ciudadanía y diversidad sexual. Estos documentos contienen los relatos de los docentes participantes, como resultado del trabajo dentro y fuera de las aulas en diferentes colegios del Distrito Capital. Los docentes narran sus experiencias desde los diversos contextos, así como las diferentes metodologías utilizadas todas con el fin de forta-lecer la ciudadanía, no solo de sus estudiantes, sino de ellos mismos, de padres y madres de familia y la comunidad en general. Finalmente nos cuentan, cuáles fueron los principales logros y las recomendacio-nes para otros docentes que quieran seguir sus pasos

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio