Vincentiana Vol. 36, No. 1-2 [Full Issue]

+432hlm.;23c

Asociacion del APGAR Familiar y los Valores de Hemoglobina Glicosilada en Pacientes Portadores de Diabetes Mellitus Tipo 2 en los Centro de Salud Carlos Llosa - Hunter y Centro de Salud Edificadores Misti, Arequipa 2018

La diabetes mellitus es una enfermedad crónica prevalente ,según la OMS la prevalencia en adultos mayores de 18 años es de 8,5 % para el 2014. (Salud O. M., 2018) En el Perú el INEI en el 2017 se reportó una prevalencia de 3,3 % en la población adulta mayor a 15 años a nivel nacional. (INEI, 2017).Teniendo esto en cuenta se hace importante entender el funcionamiento familiar para apoyar en el control del paciente diabético y así disminuir los niveles de hemoglobina glicosilada en pacientes portadores de Diabetes Mellitus tipo II que pertenecen a los Centros de Salud Carlos Llosa - Hunter y Edificadores Misti. Y así mejorar el nivel de apoyo l control de enfermedad de esos pacientes y apoyar al Programa de Enfermedades no transmisibles del MINSA y evitar complicaciones crónicas a largo plazo que tienen graves consecuencias no solo para la familia ; sino también a los servicios de salud ya que encarecen los costos de salud. Propósito: El APGAR familiar mide la funcionalidad familiar , esta para el médico familiar es un pilar para el control de múltiples patologías, dentro de ellas la Diabetes Mellitus por tener alta prevalencia de complicaciones en la población general encareciendo los costos de los servicios de salud. El presente trabajo pretende demostrar que uno de los factores más importantes para mejorar el control del paciente diabético que se mide por los niveles de hemoglobina glicosilada es la FUNCIONALIDAD FAMILIAR. Métodos: En el presente trabajo se realizaran visitas domiciliarias A LOS PACIENTES DIABETICOS DENTRO DE LA JURISICCION DE LOS los Centros de Salud Carlos Llosa - Hunter y Edificadores Misti EMPADRONADOS EN EL Programa de Daños no Transmisibles (DANT) , luego De firmaran los consentimientos informados Se procederá a la toma de la hemoglobina glicosilada en sangre y a la aplicación de CUESTIONARIO DE APGAR FAMILIAR , luego de unos 3 meses se procederá a una segunda visita domiciliaria con un segunda toma de hemoglobina glicosilada en sangre y se compararan los resultados. los consentimientos informados autorizaron su participación en la investigación, serán incluidos en el presente estudio Análisis estadístico: El presente trabajo es un estudio descriptivo, observacional, correlacional, y prospectivo, de la información obtenida con el cuestionario de APGAR FAMILIAR y el valor de hemoglobina glicosilada obtenida de las visitas domiciliarias a pacientes diabéticos de la JURISICCION DE LOS los Centros de Salud Carlos Llosa - Hunter y Edificadores Misti EMPADRONADOS EN EL Programa de Daños no Transmisibles (DANT) para lo cual se utilizara el estadístico chi - cuadrado y Correlación de Pearson PALABRAS CLAVE: Diabetes Mellitus tipo 2, Apgar familiar, Hemoglobina GlicosiladaTrabajo académic

Sistema para el Costeo de las Ordenes de Trabajo en Illary Joste S.R.L. Basado en un Costeo por Actividades como Herramienta para la Estimación de Costos, la Fijación de Precios y la Medición del Impacto en la Toma de Decisiones

En la actualidad la competitividad es un tema de vital importancia para una empresa que quiere desarrollarse. El presente trabajo nace de la aplicación de una metodología de costeo por actividades a la realidad de una empresa textil. Con el paso del tiempo, el mercado ha cambiado el cual demanda que las empresas se vuelvan más competitivas para sobrevivir y un pilar para lograr la competitividad es conocer el costo del proceso productivo. Ya que esto nos permite generar ideas para atacar los generadores de costos con la finalidad de reducir estos mismos. Desarrollar el proceso de costeo también tiene aplicaciones tanto a nivel estratégico como operativo, permitiendo asignar a las personas adecuadas a determinadas tareas o decidiendo volúmenes de producción según la conveniencia de la empresa. En el transcurso del trabajo detallaremos como se logró construir un sistema de costeo y una herramienta practica para el uso del sistema basado en actividades para Illary Joste S.R.L. en el cual las ordenes de trabajo viajan a través de cada actividad, absorbiendo sus costos, esto con dos finalidades: una – finalidad a corto plazo, fijación de precios para producción propia y para terceros (servicio) y dos – finalidad a mediano y largo plazo, la herramienta para decidir en donde invertir y a su vez medir el impacto de las inversiones en nuestros procesos en base a los costos de cada actividad, básicamente estos dos conceptos mencionados ayudaran a mejorar la competitividad de la empresa, ya que la empresa contará con una herramienta que dará el soporte necesario para poder fijar precios en base a nuestros costos y de igual manera plantear mejoras y medir el impacto de estas. El presente trabajo se puede aplicar a otras empresas del rubro que realicen los procesos de acabado y tejido puesto que el proceso productivo suele ser el mismo, con ciertas variaciones que deben ser adecuadas a la realidad de cada empresa. Palabras Clave: Costeo por Actividades, Textil, Tejido Plano, Proceso, AcabadoTesi

Hand Grip Strength: age and gender stratified normative data in a population-based study

Extent: 5p.Background: The North West Adelaide Health Study is a representative longitudinal cohort study of people originally aged 18 years and over. The aim of this study was to describe normative data for hand grip strength in a community-based Australian population. Secondary aims were to investigate the relationship between body mass index (BMI) and hand grip strength, and to compare Australian data with international hand grip strength norms. Methods: The sample was randomly selected and recruited by telephone interview. Overall, 3 206 (81% of those recruited) participants returned to the clinic during the second stage (2004-2006) which specifically focused on the collection of information relating to musculoskeletal conditions. Results: Following the exclusion of 435 participants who had hand pain and/or arthritis, 1366 men and 1312 women participants provided hand grip strength measurement. The study population was relatively young, with 41.5% under 40 years; and their mean BMI was 28.1 kg/m2 (SD 5.5). Higher hand grip strength was weakly related to higher BMI in adults under the age of 30 and over the age of 70, but inversely related to higher BMI between these ages. Australian norms from this sample had amongst the lowest of the hand grip strength of the internationally published norms, except those from underweight populations. Conclusions: This population demonstrated higher BMI and lower grip strength in younger participants than much of the international published, population data. A complete exploration of the relationship between BMI and hand grip strength was not fully explored as there were very few participants with BMI in the underweight range. The age and gender grip strength values are lower in younger adults than those reported in international literature.Nicola M Massy-Westropp, Tiffany K Gill, Anne W Taylor, Richard W Bohannon and Catherine L Hil

Ultrasound evaluation in combination with finger extension force measurements of the forearm musculus extensor digitorum communis in healthy subjects

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to evaluate the usefulness of an ultrasound-based method of examining extensor muscle architecture, especially the parameters important for force development. This paper presents the combination of two non-invasive methods for studying the extensor muscle architecture using ultrasound simultaneously with finger extension force measurements.</p> <p>Methods</p> <p>M. extensor digitorum communis (EDC) was examined in 40 healthy subjects, 20 women and 20 men, aged 35–73 years. Ultrasound measurements were made in a relaxed position of the hand as well as in full contraction. Muscle cross-sectional area (CSA), pennation angle and contraction patterns were measured with ultrasound, and muscle volume and fascicle length were also estimated. Finger extension force was measured using a newly developed finger force measurement device.</p> <p>Results</p> <p>The following muscle parameters were determined: CSA, circumference, thickness, pennation angles and changes in shape of the muscle CSA. The mean EDC volume in men was 28.3 cm³and in women 16.6 cm³. The mean CSA was 2.54 cm²for men and 1.84 cm²for women. The mean pennation angle for men was 6.5° and for women 5.5°. The mean muscle thickness for men was 1.2 cm and for women 0.76 cm. The mean fascicle length for men was 7.3 cm and for women 5.0 cm. Significant differences were found between men and women regarding EDC volume (p < 0.001), CSA (p < 0.001), pennation angle (p < 0.05), muscle thickness (p < 0.001), fascicle length (p < 0.001) and finger force (p < 0.001). Changes in the shape of muscle architecture during contraction were more pronounced in men than women (p < 0.01). The mean finger extension force for men was 96.7 N and for women 39.6 N. Muscle parameters related to the extension force differed between men and women. For men the muscle volume and muscle CSA were related to extension force, while for women muscle thickness was related to the extension force.</p> <p>Conclusion</p> <p>Ultrasound is a useful tool for studying muscle architectures in EDC. Muscle parameters of importance for force development were identified. Knowledge concerning the correlation between muscle dynamics and force is of importance for the development of new hand training programmes and rehabilitation after surgery.</p

Strengthening and stretching for rheumatoid arthritis of the hand (SARAH):Design of a randomised controlled trial of a hand and upper limb exercise intervention-ISRCTN89936343

Background: Rheumatoid Arthritis (RA) commonly affects the hands and wrists with inflammation, deformity, pain, weakness and restricted mobility leading to reduced function. The effectiveness of exercise for RA hands is uncertain, although evidence from small scale studies is promising. The Strengthening And Stretching for Rheumatoid Arthritis of the Hand (SARAH) trial is a pragmatic, multi-centre randomised controlled trial evaluating the clinical and cost effectiveness of adding an optimised exercise programme for hands and upper limbs to best practice usual care for patients with RA.Methods/design: 480 participants with problematic RA hands will be recruited through 17 NHS trusts. Treatments will be provided by physiotherapists and occupational therapists. Participants will be individually randomised to receive either best practice usual care (joint protection advice, general exercise advice, functional splinting and assistive devices) or best practice usual care supplemented with an individualised exercise programme of strengthening and stretching exercises. The study assessors will be blinded to treatment allocation and will follow participants up at four and 12 months. The primary outcome measure is the Hand function subscale of the Michigan Hand Outcome Questionnaire, and secondary outcomes include hand and wrist impairment measures, quality of life, and resource use. Economic and qualitative studies will also be carried out in parallel.Discussion: This paper describes the design and development of a trial protocol of a complex intervention study based in therapy out-patient departments. The findings will provide evidence to support or refute the use of an optimised exercise programme for RA of the hand in addition to best practice usual care.Trial registration: Current Controlled Trials ISRCTN89936343Keywords: Randomised controlled trial, Rheumatoid arthritis, Exercise, Hand, Rehabilitatio

Survivors of war in the Northern Kosovo (II): baseline clinical and functional assessment and lasting effects on the health of a vulnerable population

<p>Abstract</p> <p>Background</p> <p>This study documents torture and injury experience and investigates emotional well-being of victims of massive violence identified during a household survey in Mitrovicë district in Kosovo. Their physical health indicators such as body mass index (BMI), handgrip strength and standing balance were also measured. A further aim is to suggest approaches for developing and monitoring rehabilitation programmes.</p> <p>Methods</p> <p>A detailed assessment was carried out on 63 male and 62 female victims. Interviews and physical examination provided information about traumatic exposure, injuries, and intensity and frequency of pain. Emotional well-being was assessed using the "WHO-5 Well-Being" score. Height, weight, handgrip strength and standing balance performance were measured.</p> <p>Results</p> <p>Around 50% of victims had experienced at least two types of torture methods and reported at least two injury locations; 70% had moderate or severe pain and 92% reported constant or periodic pain within the previous two weeks. Only 10% of the victims were in paid employment. Nearly 90% of victims had experienced at least four types of emotional disturbances within the previous two weeks, and many had low scores for emotional well-being. This was found to be associated with severe pain, higher exposure to violence and human rights violations and with a low educational level, unemployment and the absence of political or social involvement.</p> <p>Over two thirds of victims were overweight or obese. They showed marked decline in handgrip strength and only 19 victims managed to maintain standing balance. Those who were employed or had a higher education level, who did not take anti-depressant or anxiety drugs and had better emotional well-being or no pain complaints showed better handgrip strength and standing balance.</p> <p>Conclusions</p> <p>The victims reported a high prevalence of severe pain and emotional disturbance. They showed high BMI and a reduced level of physical fitness. Education, employment, political and social participation were associated with emotional well-being. Interventions to promote physical activity and social participation are recommended. The results indicate that the rapid assessment procedure used here offers an adequate tool for collecting data for the monitoring of health interventions among the most vulnerable groups of a population exposed to violence.</p

Design of the EXercise Intervention after Stem cell Transplantation (EXIST) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of an individualized high intensity physical exercise program on fitness and fatigue in patients with multiple myeloma or (non-) Hodgkin's lymphoma treated with high dose chemotherapy and autologous stem cell transplantation

<p>Abstract</p> <p>Background</p> <p>The use of high-dose chemotherapy combined with autologous stem cell transplantation has improved the outcome of hematologic malignancies. Nevertheless, this treatment can cause persistent fatigue and a reduced global quality of life, role and physical function. Physical exercise interventions may be beneficial for physical fitness, fatigue and quality of life. However, the trials conducted so far to test the effects of physical exercise interventions in this group of patients were of poor to moderate methodological quality and economic evaluations are lacking. Hence there is need for a rigorous, appropriately controlled assessment of the effectiveness of exercise programs in these patients. The aims of the present study are (1) to determine the effectiveness of an individualized high intensity strength and interval training program with respect to physiological and psychological health status in patients with multiple myeloma or (non-)Hodgkin's lymphoma who have recently undergone high dose chemotherapy followed by autologous stem cell transplantation; and (2) to evaluate the cost-effectiveness of this program.</p> <p>Methods</p> <p>A multicenter, prospective, single blind randomized controlled trial will be performed. We aim to recruit 120 patients within an inclusion period of 2 years at 7 hospitals in the Netherlands. The patients will be randomly assigned to one of two groups: (1) intervention plus usual care; or (2) usual care. The intervention consists of an 18-week individualized supervised high-intensity exercise program and counselling. The primary outcomes (cardiorespiratory fitness, muscle strength and fatigue) and secondary outcomes are assessed at baseline, at completion of the intervention and at 12 months follow-up.</p> <p>Discussion</p> <p>The strengths of this study include the solid trial design with clearly defined research groups and standardized outcome measures, the inclusion of an economic evaluation and the inclusion of both resistance and endurance exercise in the intervention program.</p> <p>Trial registration</p> <p>This study is registered at the Netherlands Trial Register (NTR2341)</p