Desafíos más allá y más acá de la pandemia… derecho a la educación superior y fortalecimiento de las trayectorias educativas : La práctica docente junto a estudiantes de primer año de la carrera de Trabajo Social, FCH, Unicen

Es nuestro objetivo compartir algunas reflexiones en torno a una experiencia de trabajo docente con estudiantes “ingresantes” a la Licenciatura en Trabajo Social (FCH-UNICEN) en el escenario social actual. Desde hace varios años venimos trabajando con estudiantes en el ingreso y los primeros años de formación, y siempre en este proceso hemos intentando problematizar y analizar nuestra propia experiencia profesional y práctica docente en vinculación con las transformaciones societales que se producen, en pos del fortalecimiento de las trayectorias estudiantiles en el marco de la Universidad Pública y con el fin de garantizar el Derecho a la Educación Superior. Consideramos que es posible realizar acciones concretas en la Universidad, con fundamentos y sentidos políticos en la dirección de garantizar efectivamente derechos. Sabemos que los desafíos que tenemos como docentes de los primeros años de formación son múltiples y diversos. Consideramos necesario partir de nuestras experiencias, de los aprendizajes que vamos construyendo, y de lo que los y las estudiantes rescatan y expresan como valioso para poder continuar orientando nuestras prácticas docentes; para generar en cada encuentro, en cada aula, desde cada materia, condiciones y acciones para que nuestros/as estudiantes se sientan parte, puedan permanecer y graduarse si así lo desean.Especialización en Docencia Universitari

Nuevos registros de Puya (Bromeliaceae) en el departamento de Lambayeque, Perú

This study provides an annotated checklist of the Puya (Bromeliaceae) species registered from Lambayeque Department; Peru. A total of five species are reported, four are registered for the first time and one of them is confirmed as endemism of Lambayeque Andes. Species were from the seasonal Dry Forest (BSe), Desert Scrub-Dry Forest transition (MD-BS) and Jalca (JA) ecoregions. A key for the Puya reported species is presented and the reasons for endemisms, threats and their categorization criteria are discussed.Este estudio proporciona una lista comentada de las especies de Puya (Bromeliaceae) registradas en el departamento de Lambayeque, Perú. Se reportan un total de cinco especies, de las cuales cuatro se registran por primera vez y una de ellas se confirma como endemismo de los Andes del Departamento. Las ecorregiones donde se encuentran corresponden al Bosque Seco estacional (BSe), la transición Matorral Desértico-Bosque Seco (MD-BS) y Jalca (JA). Se presenta una clave para las especies reportadas y se discuten las razones de los endemismos, amenazas y sus criterios de categorización

Primer reporte de queratitis por Nocardia brasiliensis en Paraguay

La queratitis producida por Nocardia spp es raramente reportada en el mundo por lo que su incidencia no está aún bien establecida. En el presente estudio se reporta el primer caso de queratitis por Nocardia brasiliensis en Paraguay en un paciente de sexo masculino, de profesión jardinero, procedente de la ciudad de Asunción, y con antecedente de traumatismo con rama de arbusto quince días antes de la consulta. El paciente acude al servicio de Oftalmología del Hospital de Clínicas, debido a ojo rojo, agudeza visual disminuida e intenso dolor en el ojo izquierdo con una semana de evolución. Se realiza tratamiento con la aplicación de colirio reforzado de gentamicina 14 mg/ml y cefazolina 50 mg/ml, cada una hora, observándose mejoría de los síntomas y de la agudeza visual a los 10 días de seguimiento. La evolución clínica en queratitis a Nocardia spp es buena siempre que el diagnóstico etiológico se realice sin demora y correctamente. Es muy importante diferenciar los bordes de las lesiones de la úlcera de córnea producidas por hongos, bacterias filamentosas y otras bacterias, además considerar la presencia de lesiones satélites

Optimal Sampling Strategies for Therapeutic Drug Monitoring of First-Line Tuberculosis Drugs in Patients with Tuberculosis

BACKGROUND: The 24-h area under the concentration-time curve (AUC24)/minimal inhibitory concentration ratio is the best predictive pharmacokinetic/pharmacodynamic (PK/PD) parameter of the efficacy of first-line anti-tuberculosis (TB) drugs. An optimal sampling strategy (OSS) is useful for accurately estimating AUC24; however, OSS has not been developed in the fed state or in the early phase of treatment for first-line anti-TB drugs. METHODS: An OSS for the prediction of AUC24 of isoniazid, rifampicin, ethambutol and pyrazinamide was developed for TB patients starting treatment. A prospective, randomized, crossover trial was performed during the first 3 days of treatment in which first-line anti-TB drugs were administered either intravenously or in fasting or fed conditions. The PK data were used to develop OSS with best subset selection multiple linear regression. The OSS was internally validated using a jackknife analysis and externally validated with other patients from different ethnicities and in a steady state of treatment. RESULTS: OSS using time points of 2, 4 and 8 h post-dose performed best. Bias was < 5% and imprecision was < 15% for all drugs except ethambutol in the fed condition. External validation showed that OSS2-4-8 cannot be used for rifampicin in steady state conditions. CONCLUSION: OSS at 2, 4 and 8 h post-dose enabled an accurate and precise prediction of AUC24 values of first-line anti-TB drugs in this population. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02121314)

A dose ranging trial to optimize the dose of Rifampin in the treatment of tuberculosis

The study was funded by the EDCTP (European & Developing Countries Clinical Trials Partnership), NACCAP (Netherlands-African partnership for Capacity development and Clinical interventions Against Poverty-related diseases) and the Bill & Melinda Gates Foundation.Rationale: Rifampin at a dose of 10 mg/kg was introduced in 1971 based on pharmacokinetic, toxicity and cost considerations. Available data in mice and humans showed that an increase in dose may shorten the duration of tuberculosis treatment. Objectives: To evaluate the safety and tolerability, the pharmacokinetics and the extended early bactericidal activity of increasing doses of rifampin. Methods: Patients with drug-susceptible tuberculosis were enrolled into a control group of 8 patients receiving the standard dose of 10 mg/kg rifampin, followed by consecutive experimental groups with 15 patients each receiving rifampin 20 mg/kg, 25 mg/kg, 30 mg/kg and 35 mg/kg, respectively, for 14 days. In all patients isoniazid, pyrazinamide and ethambutol were added in standard doses for the second 7 days of treatment. Safety, pharmacokinetics of rifampin, and fall in bacterial load were assessed. Measurements and Main Results: Grade 1 and 2 adverse events were equally distributed between the five dose groups; there were 5 grade 3 events of which 1 was a possibly related hepatotoxicity. Areas under the time-concentration curves and peak serum concentrations of rifampin showed a more than proportional increase with dose. The daily fall in bacterial load over 14 days was 0.176, 0.168, 0.167, 0.265, and 0.261 log10CFU/ml sputum in the 10, 20, 25, 30 and 35 mg/kg groups respectively. Conclusions: Two weeks of rifampin up to 35 mg/kg was safe and well tolerated. There was a non-linear increase in exposure to rifampin without an apparent ceiling effect and a greater estimated fall in bacterial load in the higher dosing groups. Clinical trial registration available at www.clinicaltrials.gove, ID NCT01392911.PostprintPeer reviewe

Frecuencia de prolongación del intervalo QTc en adultos infectados con VIH de Paraguay en 2020

Introduction: the prolonged QTc interval predisposes to serious arrhythmias. Various medications, including antiretrovirals, can prolong it. The objectives were to determine the demographic, clinical characteristics and the frequency of the prolonged QTc interval in patients with HIV. Methods: we conducted a prospective, observational study with a control group. Men and women, over 18 years of age, with HIV infection, who attended the National Hospital (Itauguá, Paraguay) during 2020, were included. Medical students acted as a control group. All subjects who did not give their consent and those with arrhythmias were excluded. Demographic, clinical, laboratory variables and 12-channel electrocardiogram at rest were measured. The study was approved by the Ethics Committee of the Universidad Privada del Este (Paraguay). Results: 39 HIV patients and 39 healthy controls entered the study. The mean age of the cases was 37 ± 11 years, being 59% male. The most frequent comorbidity in the cases was obesity (7.6%). The mean values ​​of urea, creatinine, K, Ca and Mg in the cases were in the normal range. Prolonged QTc was detected in 18% of the cases and in 0% of the controls. The subjects with the electrocardiographic alteration were all on antiretroviral and multiple antibiotic treatment known to be associated with prolonged Qtc. Conclusion: the frequency of prolonged QTc in HIV patients was 18% and in healthy controls it was 0%. Regular monitoring of the electrocardiogram is recommended in HIV patients receiving drugs that prolong the QT interval.Introducción: el intervalo QTc prolongado predispone a arritmias graves. Diversos medicamentos, entre ellos los antirretrovirales, pueden prolongarlo. Los objetivos fueron determinar las características demográficas, clínicas y la frecuencia del intervalo QTc prolongado en pacientes con VIH. Métodos: estudio observacional, prospectivo, con grupo control. Se incluyeron varones y mujeres, mayores de 18 años, portadores de infección por VIH, que acudieron al Hospital Nacional (Itauguá, Paraguay) durante 2020. Actuaron como grupo control los estudiantes de Medicina. Se excluyeron todos los sujetos que no dieron su consentimiento y los portadores de arritmias. Se midieron variables demográficas, clínicas, laboratoriales y electrocardiograma de 12 canales en reposo. El estudio contó con la aprobación del Comité de Ética de la Universidad Privada del Este (Paraguay). Resultados: ingresaron al estudio 39 pacientes con VIH y 39 controles sanos. La edad media de los casos fue 37 ± 11 años, siendo 59% del sexo masculino. La comorbilidad más frecuente en los casos fue la obesidad (7,6%). Los valores medios de urea, creatinina, K, Ca y Mg en los casos se hallaban en rango normal. Se detectó 18% de QTc prolongado en casos y 0% en los controles. Estos sujetos con alteración electrocardiográfica se hallaban todos en tratamiento antirretroviral y antibiótico múltiple de conocida asociación con QTc prolongado. Conclusión: la frecuencia de QTc prolongado en pacientes con VIH fue del 18% y en controles sanos fue del 0%. Se recomienda el control periódico del electrocardiograma en pacientes con VIH en tratamiento con fármacos que prolongan el intervalo QT

Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study

Aim Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. Methods TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. Results 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with &gt;10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by &gt; 2 months. Conclusion Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop

MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network.

The continuous flow of new research articles on MDR-TB diagnosis, treatment, prevention and rehabilitation requires frequent update of existing guidelines. This review is aimed at providing clinicians and public health staff with an updated and easy-to-consult document arising from consensus of Global Tuberculosis Network (GTN) experts. The core published documents and guidelines have been reviewed, including the recently published MDR-TB WHO rapid advice and ATS/CDC/ERS/IDSA guidelines. After a rapid review of epidemiology and risk factors, the clinical priorities on MDR-TB diagnosis (including whole genome sequencing and drug-susceptibility testing interpretations) and treatment (treatment design and management, TB in children) are discussed. Furthermore, the review comprehensively describes the latest information on contact tracing and LTBI management in MDR-TB contacts, while providing guidance on post-treatment functional evaluation and rehabilitation of TB sequelae, infection control and other public health priorities

Engaging the user community for advancing societal applications of the surface water ocean topography mission

Scheduled for launch in 2021, the Surface Water and Ocean Topography (SWOT) mission will be a truly unique mission that will provide high-temporal-frequency maps of surface water extents and elevation variations of global water bodies (lakes/reservoirs, rivers, estuaries, oceans, and sea ice) at higher spatial resolution than is available with current technologies (Biancamaria et al. 2016; Alsdorf et al. 2007). The primary instrument on SWOT is based on a Ka-band radar interferometer (KaRIN), which uses radar interferometery technology. The satellite will fly two radar antennas at either end of a 10-m (33 ft) mast, allowing it to measure the elevation of the surface along a 120-km (75 mi)-wide swath below. The availability of high-frequency and high-resolution maps of elevations and extents for surface water bodies and oceans will present unique opportunities to address numerous societally relevant challenges around the globe (Srinivasan et al. 2015). These opportunities may include such diverse and far-ranging applications as fisheries management, flood inundation mapping/risk mitigation/forecasting, wildlife conservation, global data assimilation for improving forecast of ocean tides and weather, reservoir management, climate change impacts and adaptation, and river discharge estimation, among others

Nuevos registros de Puya (Bromeliaceae) en el departamento de Lambayeque, Perú

Este estudio proporciona una lista comentada de las especies de Puya (Bromeliaceae) registradas en el departamento de Lambayeque, Perú. Se reportan un total de cinco especies, de las cuales cuatro se registran por primera vez y una de ellas se confirma como endemismo de los Andes del Departamento. Las ecorregiones donde se encuentran corresponden al Bosque Seco estacional (BSe), la transición Matorral Desértico-Bosque Seco (MD-BS) y Jalca (JA). Se presenta una clave para las especies reportadas y se discuten las razones de los endemismos, amenazas y sus criterios de categorización