Adherencia al tratamiento farmacológico y no farmacológico en pacientes con falla cardiaca

Consequences of non-adherence to treatment are expressed in various spheres of the individual's life, in various components of the health system and in the population's morbidity and mortality, which generates repercussions in the medical and economical aspects and in the individual’s life quality. Objective: To determine the prevalence of adherence to pharmacological and non-pharmacological treatment in patients with heart failure. Methods: A cross sectional study was conducted in patients with heart failure during 2012 in the Heart Failure and Heart Transplant Clinic of the Fundación Cardiovascular de Colombia. 161 adult patients were included with the diagnosis of heart failure. Adherence to pharmacological and non-pharmacological treatment was evaluated as well as compliance of the patients with heart failure. Results: 80.12% (n=129; 95% CI 73.11 – 85.98%) of the patients are often adhered to pharmacological and non-pharmacological treatment, compliance to pharmacological treatment with the Morisky-Green test was of 53.42% (n=86; 95% CI 45.39 - 61.3%). Conclusions: The results of this study are an approach to the problem of adherence to pharmacological and non-pharmacological treatment of patients with heart failure. It is recommended for future researches, the realization of multicenter studies with probabilistic samplings.Las consecuencias de la no adherencia al tratamiento se expresan en diversas esferas de la vida de la persona, en diversos componentes del sistema de salud y en el cuadro de morbilidad y mortalidad de la población, lo cual genera grandes repercusiones desde el punto de vista médico, económico y en la calidad de vida de la persona. Objetivo: Determinar la prevalencia de adherencia al tratamiento farmacológico y no farmacológico en pacientes con falla cardiaca. Métodos: Se realizó un estudio de corte transversal en pacientes con falla cardiaca en el 2012 en la Clínica de Falla Cardiaca y Trasplante Cardiaco de la Fundación Cardiovascular de Colombia. Se incluyeron 161 pacientes adultos con diagnóstico médico de falla cardiaca. Se evaluó la adherencia al tratamiento farmacológico y no farmacológico y el cumplimiento en los pacientes con falla cardiaca. Resultados: El 80.12% (n=129; IC 95% 73.11 - 85.98%) de los pacientes se encuentra frecuentemente adheridos al tratamiento farmacológico y no farmacológico, el cumplimiento al tratamiento farmacológico con el test de Morisky-Green fue de 53.42% (n=86; IC 95% 45.39 - 61.3%). Conclusiones: Los resultados del presente estudio son un acercamiento a la problemática de la adherencia al tratamiento farmacológico y no farmacológico de los pacientes con falla cardiaca. Se recomienda para futuras investigaciones, la realización de estudios multicéntricos con muestreos probabilísticos

Room Temperature In-plane <100> Magnetic Easy Axis for Fe3O4/SrTiO3(001):Nb Grown by Infrared PLD

We examine the magnetic easy-axis directions of stoichiometric magnetite films grown on SrTiO3:Nb by infrared pulsed-laser deposition. Spin-polarized low-energy electron microscopy reveals that the individual magnetic domains are magnetized along the in-plane film directions. Magneto-optical Kerr effect measurements show that the maxima of the remanence and coercivity are also along in-plane film directions. This easy-axis orientation differs from bulk magnetite and films prepared by other techniques, establishing that the magnetic anisotropy can be tuned by film growth.Comment: 3 pages, 3 figure

Intervención no farmacológica como estrategia para favorecer el control de la hipertensión arterial y mejorar el cumplimiento antihipertensivo

ResumenObjetivoComprobar la eficacia de una intervención mediante una revista educacional en el cumplimiento antihipertensivo de la hipertensión arterial (HTA) no controlada.DiseñoEstudio clínico controlado, aleatorizado y multicéntrico.EmplazamientoOchenta y siete Centros de Salud de España.ParticipantesSe incluyeron 450 pacientes hipertensos diagnosticados de HTA no controlada.IntervenciónSe formaron 2 grupos con 225 individuos: a) grupo de intervención (GI), los que recibieron una revista educacional domiciliaria bimensual y b) grupo de control (GC), que tuvieron práctica clínica habitual.Mediciones principalesEl cumplimiento se midió mediante monitores electrónicos (MEMS-Aardex). Se calculó el porcentaje de cumplimiento, el porcentaje de cumplidores del total de dosis y de días en los que tomaba una dosis y el NNT (number needed to treat 'número de pacientes que es necesario tratar'). Se definió cumplidor un consumo del 80 al 110%. Se calculó la presión arterial media y los porcentajes de los controlados.ResultadosConcluyeron 393 individuos (edad: 62,4 años [desviación estándar de 11,6 años]), 196 pacientes del GI y 197 pacientes del GC. Ciento ochenta y cuatro eran varones (46,8%).Fueron cumplidores del total de las dosis tomadas el 83,2% en el GI (del 78 al 88,4%) y el 49,2% del GC (IC del 95%: del 42,2 al 56,2%) (p=0,0001) y fueron cumplidores diarios el 74% del GI (IC del 95%: del 67,9 al 80,1%) y el 42,6% del GC (IC del 95%: del 35,7 al 49,5%) (p=0,0001).El control de la HTA fue del 81,6% en el GI (IC del 95%: del 76,2 al 86,5%) y del 56,3% en el GC (IC del 95%: del 49,4 al 63,2%). El NNT con la intervención fue de 3,3 pacientes.ConclusionesEl incumplimiento del tratamiento fue muy alto. La revista educacional es una estrategia eficaz para disminuir el incumplimiento y mejorar el grado de control de la HTA.AbstractObjetiveTo evaluate the efficacy of an intervention by means of an educational magazine on treatment compliance in uncontrolled arterial hypertension (AHT).DesignControlled, randomised clinical trial.Setting87 primary care centres. Spain.ParticipantsA total of 450 patients with uncontrolled hypertension were included.InterventionTwo groups of 225 patients were formed: 1) Control group (CG): standard health intervention; 2) Intervention Group (IG): received a twice monthly educational magazine at home.Main measurementsCompliance was measured using the Medication Event Monitoring System (MEMS-Aardex). Compliance rate (CR) was recorded. Compliers were defined as individuals with a treatment compliance of 80–110%. The percentage of compliers, the mean percentage of doses taken and the percentage of patients taking the medication at the correct times were estimated. The mean blood pressures (BPs) and the percentage of controlled patientswere calculated. The number needed to treat (NNT) was calculated.ResultsA total of 393 individuals were evaluable (Age: 62.4 years), 196 in the IG and 197 in the CG. There were 83.2% (95% CI 78–88.4) and 49.2% (95% CI 42.2–56.2) (P=0.0001) of overall compliers in the IG and CG, respectively and 74% (95% CI: 67.9–80.1) and 42.6% (95% CI=35.7–49.5) (P=0.0001) of correct times compliers. A total of 81.6% (95% CI=76.2–86.5%)) were controlled in the IG and 56.3% (95% CI=49.4–63.2) in the CG. The NNT was 3.3 patients.ConclusionsTherapeutic non-compliance was very high. The educational magazine is an effective strategy to improve the compliance and degree of control of the AHT

Bullying among adolescent attending school: validation of the nursing diagnosis “risk of violence directed to others”

La adolescencia es una etapa en la cual surgen una serie de cambios físicos, psicológicos y sociales, que&amp;nbsp; contribuyen a la formación de la personalidad; la manera en que los adolescentes afrontan estos cambios se&amp;nbsp; ve reflejada en los comportamientos de permisibilidad y violencia que ellos exteriorizan ante las diversas&amp;nbsp; situaciones de la vida cotidiana. Objetivo: validar el diagnóstico de enfermería “riesgo de violencia dirigida a&amp;nbsp; otros”, en adolescentes escolarizados. Método: estudio de corte transversal, donde la población eran&amp;nbsp; adolescentes de una institución media educativa del municipio de Rionegro (Santander, Colombia). La&amp;nbsp; variable principal fue “riesgo de violencia dirigida a otros”, la recolección de la información se hizo por medio de un instrumento de valoración de tamizaje del adolescente escolarizado. La validez clínica del diagnóstico,&amp;nbsp; se realizó mediante análisis de factores y análisis Rasch. Resultados: la población conformada por 300&amp;nbsp; adolescentes, la mediana de edad fue de 14 años, el 58,67% correspondió al género femenino. Los ítems que&amp;nbsp; ajustaron al modelo de análisis Rasch se encuentran con un INFIT que oscila entre 0,85 el menor y 1,24 el&amp;nbsp; mayor, y el OUTFIT que oscila entre 0,65 el menor y 1,77 el mayor. Muestra que las mujeres son más&amp;nbsp; agresoras que los varones, con una media de 1,53 de riesgo de violencia para las mujeres y una media de&amp;nbsp; 1,03 para los hombres, con una probabilidad p=0,0006. Conclusión: validar clínicamente los diagnósticos de&amp;nbsp; enfermería, aporta a la evidencia y el crecimiento de la profesión como ciencia del cuidado. &amp;nbsp; &amp;nbsp;Adolescence is a stage in which a series of physical, psychological and social factors arise which contribute to&amp;nbsp; the personality shaping;, the way in which adolescents face these changes are reflected in the permissibility&amp;nbsp; and violence behaviors they externalize to various situations of everyday life. Objective: to validate the&amp;nbsp; nursing diagnosis “risk of violence directed to others” among adolescents attending school. Method: a&amp;nbsp; cross-sectional study, where the population was teenagers from a Middle School in Rionegro (Santander,&amp;nbsp; Colombia). The main variable was the “risk of violence directed at others”, the data collection was carried out using an assessment screening instrument for the adolescent attending school. The clinical validity of the&amp;nbsp; diagnosis, was performed using factor analysis and Rasch analysis. Results: the population comprised 300&amp;nbsp; adolescents, the median age was 14 years, and 58.67% were female. The items that fitted the Rasch model&amp;nbsp; analysis with a INFIT are ranging between 0.85 the lowest and 1.24 the the highest, and OUTFIT ranging&amp;nbsp; between 0.65 the lowest and 1.77 the highest. It shows that women are more assailant than males, with a mean of 1.53 risk of violence for women and an average of 1.03 for men, with a probability p=0.0006.&amp;nbsp; Conclusion: clinical validation of nursing diagnoses, contributes to the evidence and the growth of the&amp;nbsp; profession as a science of care

La consulta previa y su influencia en los proyectos de interés nacional estratégico en Colombia

Artículo de investigaciónLa consulta previa es un derecho fundamental que consiste en un mecanismo de participación de las comunidades étnicas e indígenas sobre las medidas administrativas o legislativas que pueden afectar su integridad social, cultural y económica, entre otros. El desarrollo que este mecanismo ha presentado en Colombia, según cifras del Ministerio del Interior (2018) puede calificarse como desmedido. En este sentido, es necesario realizar un análisis acerca del exceso de consultas previas presentadas hoy en día en Colombia. Lo anterior, tiene como finalidad identificar las posibles mejoras que pueden desarrollarse a través de la reglamentación consiente de los procesos de consulta previa, a partir de la identificación real de las afectaciones que puede constituir cada proyecto (PINES). Ponderando el interés general y la necesidad de los proyectos que se encuentran en marcha.1. INTRODUCCIÓN 2. LA CONSULTA PREVIA COMO DERECHO FUNDAMENTAL 3. FUNDAMENTO CONSTITUCIONAL DE LA CONSULTA PREVIA 4. AUTODETERMINACIÓN, CONSENTIMIENTO PREVIO LIBRE E INFORMADO DE LAS COMUNIDADES ÉTNICAS CONCLUSIONES REFERENCIAS 5. PROYECTOS DE INTERÉS NACIONAL Y ESTRATÉGICOS – PINES 6. LA CONSULTA PREVIA Y LOS PROYECTOS DE INTERÉS NACIONAL Y ESTRATÉGICOS – PINES. 7. LA CONSULTA PREVIA Y LA CONSULTA POPULAR Y SU INFLUENCIA EN EL DESARROLLO DEL PAÍSPregradoAbogad

Association of rs712 polymorphism in a let-7 microRNA-binding site of KRAS gene with colorectal cancer in a Mexican population

Objective(s): The rs712 polymorphism in a let-7 microRNA-binding site at KRAS gene has been associated with cancer. To examine its association with rs712 polymorphism, we analyzed Mexican individuals with colorectal cancer (CRC) and healthy subjects. Materials and Methods: Genotyping of the rs712 polymorphism was performed by polymerase chain reaction in 281 controls and 336 CRC patients. Results: The observed frequencies of rs712 polymorphism indicated an associated protective factor for CRC (P=0.032). An association between genotype and the disease was evident in: colon localization (allele T, odds ratio (OR) 3.82, 95% confidence Intervals (CI) 2.77-5.28, P=0.0001), node metastasis (genotype TT, OR 2.49, 95% CI 1.45-4.28, P=0.0009), poor differentiation (genotype GT, OR 2.35, 95% CI 1.35-4.1, P=0.0033), and poor chemotherapy response (genotype GT, OR 2.6, 95% CI 1.7-4.24, P=0.0001). Conclusion: Comparison of the data from patients with control group showed that polymorphism of rs712 in KRAS gene was protective factor, which was associated with susceptibility for CRC. However, the genotypes TT and GT of rs712 polymorphism in KRAS could contribute significantly to colon localization, node metastasis, poor differentiation and poor chemotherapy response in CRC patients in this sample population

Observation of a topologically protected state in a magnetic domain wall stabilized by a ferromagnetic chemical barrier

The precise control and stabilization of magnetic domain walls is key for the development of the next generation magnetic nano-devices. Among the multitude of magnetic configurations of a magnetic domain wall, topologically protected states are of particular interest due to their intrinsic stability. In this work, using XMCD-PEEM, we have observed a topologically protected magnetic domain wall in a ferromagnetic cylindrical nanowire. Its structure is stabilized by periodic sharp alterations of the chemical composition in the nanowire. The large stability of this topologically protected domain wall contrasts with the mobility of other non-protected and non-chiral states also present in the same nanowire. The micromagnetic simulations show the structure and the conditions required to find the topologically protected state. These results are relevant for the design of future spintronic devices such as domain wall based RF oscillators or magnetic memories

Reexamination of 6Li + p elastic scattering in inverse kinematics

Elastic-scattering measurements have been performed for the Li6+p system in inverse kinematics at the energies of 16, 20, 25, and 29 MeV. The heavy ejectile was detected by the large acceptance MAGNEX spectrometer at the Laboratori Nazionali del Sud in Catania, Italy. The results are considered in a Jeukenne-Lejeune-Mahaux and a continuum discretized coupled-channel calculation framework

Cells from discarded dressings differentiate chronic from acute wounds in patients with Epidermolysis Bullosa

Impaired wound healing complicates a wide range of diseases and represents a major cost to healthcare systems. Here we describe the use of discarded wound dressings as a novel, cost effective, accessible, and non-invasive method of isolating viable human cells present at the site of skin wounds. By analyzing 133 discarded wound dressings from 51 patients with the inherited skin-blistering disease epidermolysis bullosa (EB), we show that large numbers of cells, often in excess of 100 million per day, continually infiltrate wound dressings. We show, that the method is able to differentiate chronic from acute wounds, identifying significant increases in granulocytes in chronic wounds, and we show that patients with the junctional form of EB have significantly more cells infiltrating their wounds compared with patients with recessive dystrophic EB. Finally, we identify subsets of granulocytes and T lymphocytes present in all wounds paving the way for single cell profiling of innate and adaptive immune cells with relevance to wound pathologies. In summary, our study delineates findings in EB that have potential relevance for all chronic wounds, and presents a method of cellular isolation that has wide reaching clinical application