La garantía de la defensa eficaz en el marco del Código Procesal Penal Peruano

La investigación tiene como problema general la siguiente interrogante ¿Cómo influye la Garantía de Defensa Eficaz en el decurso ordinario del Proceso Penal Peruano?, cuyo objetivo es “Analizar cómo influye la Garantía de Defensa Eficaz en el decurso ordinario del Proceso Penal Peruano”, y como supuesto “La Garantía de la Defensa Eficaz influye significativamente en el decurso ordinario del Proceso Penal Peruano”; habiéndose utilizado como metodología general: inductivo – deductivo y el analítico – sintético. La conclusión a la que se arribó “Se determinó que la Garantía de la Defensa Eficaz, si influye en el decurso ordinario del Proceso Penal, ya que contiene sub-garantías que asumen un papel fundamental e imprescindible para la validez y legitimación del proceso penal; por ende, su ausencia deviene en la nulidad de este, y con ello corregir las deficiencias de la protección de principios procesales mínimos”

Spotlight on capecitabine for the treatment of unresectable or metastatic carcinoma of various origin: A retrospective study of 25 dogs

Capecitabine, the oral prodrug of 5-fluorouracil, is indicated in people to treat various malignant epithelial cancers. In dogs, capecitabine has not been extensively evaluated. The aim of this retrospective study was to investigate toxicity and preliminary efficacy of single agent capecitabine in dogs with advanced malignant epithelial cancers of any site, for which no effective therapy existed, conventional treatment failed or was declined. Capecitabine was administered orally at 750 mg/m2 from day 1 to 14, followed by 1-week rest period, given as 3-week cycles. Safety evaluation was performed after 2 cycles, and every 2-3 cycles thereafter. Tumour response was determined every 2-3 cycles. Twenty-five dogs with hepatocellular carcinoma (n = 6), lung papillary carcinoma (n = 4), anal sac adenocarcinoma (n = 3), colic adenocarcinoma (n = 2), and other individually represented epithelial cancers (n = 10) were included. Dogs received a median of 4 cycles (range, 2-43) for a median of 84 days (range, 42-913). Toxicity occurred in 17 (68.0%) dogs; the most frequent adverse events were gastrointestinal, with the majority being self-resolving and of mild grade. Of the 22 dogs with macroscopic disease, 3 (13.6%) achieved partial remission, 16 (72.7%) were stable and 3 (13.6%) progressed; overall clinical benefit rate was 86.4%. Median progression-free interval was 93 days (95% CI 42-154; range, 1-521) and median tumour-specific survival was 273 days (95% CI 116-482; range 45-913). These findings suggest that capecitabine is an attractive option for the treatment of several types of carcinomas in dogs. Prospective studies are warranted to optimize the scheduling of capecitabine and confirm its efficacy

Ambiente da prática em enfermagem e qualidade dos cuidados

Introduction: The environment of nursing practice in health care institutions has an impact on the quality of care provided and client safety. In 2009, the World Health Organization (WHO) launched a document outlining priority areas for research, the study of organizational environments, in an attempt to identify flaws or gaps that could result in compromising client safety in different countries. Aim: To understand the influence of nursing practice environments on the quality of care provided to clients. Methodology: Integrative review by the PI [C] OD method of seven articles, on the subject under study, published between 2013 and 2018. Results/Conclusions: The results suggest that favorable professional nursing environments positively influence the quality of nursing care. nurses perceived by nurses.Introdução: O ambiente da prática de enfermagem em instituições de saúde têm impacto na qualidade dos cuidados prestados e a segurança do cliente. Em 2009 a Organização Mundial da Saúde (OMS) lançou um documento apontando como áreas prioritárias de investigação, o estudo dos ambientes organizacionais, na tentativa de identificar falhas ou lacunas que pudessem resultar no comprometimento da segurança do cliente nos diversos países. Objetivo: Perceber qual a influência dos ambientes de prática de enfermagem na qualidade dos cuidados prestados aos clientes. Metodologia: Revisão integrativa pelo método PI[C]OD de sete artigos, sobre a temática em estudo, publicados entre 2013 e 2018. Resultados/ Conclusões: Os resultados sugerem que os ambientes da prática profissional de enfermagem favoráveis influenciam positivamente a qualidade dos cuidados de enfermagem percecionada pelos enfermeiros

BRCA genetic result disclosure for women with Breast Cancer: influence of +/- predisposition genetic mutation

Background: Albeit the genetic testing/counseling is increasing progressively in oncological clinical practice, psychological impact of BRCA genetic testing has been an under-researched area in oncological population; few studies have examined a wide range of possible predictive individual factors for psychological adaptation after genetic testing for hereditary cancer. Aim of the study was to examine the implication of clinical psychological in BRCA genetic result post-disclosure dealing with the emotional health of patients undergoing genetic testing depending to the personal resources. Methods: Participants were composed of n = 32 female patients in range age 30 - 55 years, who have a BC diagnosis and who underwent BRCA mutation testing. Psychological battery was applied after genetic testing. Results: Our finding highlighted the psychological influence of genetic testing on wellbeing of BC patients, and more drawing clinical perspective for positive/negative disclosure regarding the predictors for psychological distress. Conclusion: Genetic testing needs to be integrated by psychological counseling to manage better the impact of result disclosure (whatever the outcome is) in order to manage better the physical and mental health of patients into efficient personalized medicine toward to the improvement of patient compliance and adherence into well-being perspective and Quality of Life maintaining. Sample size and lack of longitudinal data could be limits of the study

Cuidadores formais de idosos institucionalizados: perceções e satisfação profissional

Introduction: As a result of the growing demographic aging and the increase in the average life expectancy, the institutionalization of the elderly represents an emerging problem today. We therefore consider it pertinent to study the profile of the formal caregiver of institutionalized elderly people and their professional satisfaction in order to improve the quality of care provided. Aim: It was outlined as a main objective to identify the representations that the formal caregivers have about the care provided to the institutionalized elderly. Methodology: Qualitative study through content analysis of the registration units. The data collection instrument used was the semi-structured interview. The sample consisted of twelve formal caregivers from an institution of the elderly in the central zone of the country. Results: The meanings attributed by the caregivers of what it is to be old were: a person deserving of respect, with wisdom, who needs affection and care, to return to being a child and a person with physical limitations. By caring, they understand giving affection / support, transmitting trust, an essential good, caring for the body, mind and heart and also, knowing how to listen. The relationship of caregivers with the elderly is guided by joy and good disposition, a relation of respect for the individuality / will of the elderly person, trying to adapt to the personality of each one. They often perform hygiene (shaving); dressing / undressing; to raise / to lie down; position; feeding / hydration care; recreational activities and support in the deambulation of the elderly. It is in the transportation and positioning of the elderly that they experience greater difficulties. In most cases, the interviewees report that their work is appreciated by all (elderly, family and management). For some caregivers what gives them greater satisfaction is to feel that the elderly are happy / comfortable. Conclusion: All the interviewees reported that the caregiver activity brings them professional satisfaction and identified training needs in some areas of knowledge. The results of this research lead us to reflect on the importance of creating and monitoring programs of action in the field of training in specific areas adapted to the reality of each institution.Introdução: Resultante do crescente envelhecimento demográfico e do aumento da esperança média de vida, a institucionalização do idoso representa nos dias de hoje uma problemática emergente. Consideramos por isso pertinente estudar o perfil do cuidador formal de idosos institucionalizados e a sua satisfação profissional no intuito de melhorar a qualidade dos cuidados prestados. Objetivo: Delineou-se como objetivo principal identificar as representações que os cuidadores formais têm acerca do cuidado prestado ao idoso institucionalizado. Metodologia: Estudo qualitativo através da análise de conteúdo das unidades de registo. O instrumento de recolha de dados utilizado foi a entrevista semiestruturada. A amostra foi constituída por doze cuidadoras formais de uma instituição de idosos da zona centro do país. Resultados: Os significados atribuídos pelas cuidadoras do que é ser idoso foram: uma pessoa merecedora de respeito, com sabedoria, que precisa de afeto e cuidados, que voltar a ser criança e pessoa com limitações físicas. Por cuidar, entendem dar carinho/apoio, transmitir confiança, um bem essencial, cuidar do corpo, mente e coração e ainda, saber escutar. A relação das cuidadoras com os idosos pauta-se pela alegria e boa disposição, uma relação de respeito pela individualidade/vontade da pessoa idosa, tentar adaptar-se à personalidade de cada um. Executam frequentemente os cuidados de higiene (fazer a barba); vestir/despir; levantar/deitar; posicionar; cuidados da alimentação/hidratação; atividades lúdicas e apoio na deambulação dos idosos. É no transporte e posicionamento dos idosos que sentem maiores dificuldades. Na maioria dos casos, as entrevistadas referem que o seu trabalho é apreciado por todos (idosos, família e direção). Para algumas cuidadoras o que lhes dá maior satisfação é sentirem que os idosos estão contentes/confortáveis. Conclusão: Todas as entrevistadas relataram que a atividade de cuidadora lhes traz satisfação profissional e identificaram necessidades formativas em algumas áreas do conhecimento. Os resultados resultantes desta investigação levam-nos à reflexão sobre a importância da criação e monitorização de programas de ação no domínio formativo em áreas especificas adaptado à realidade de cada instituição

Calidad en el servicio de atención al cliente en los restaurantes de Pizza Hut, Lince, 2019

En este trabajo de investigación, la realidad problemática que se presenta a nivel internacional y nacional es la pésima calidad brindada en los servicios de comida rápida según los clientes. Por otro lado, la problemática local que presenta la empresa es la deficiencia en el servicio de atención al cliente por parte del personal. Por ello la presente investigación se propone investigar acerca de la calidad de servicio en la atención al cliente, explicando los conceptos básicos acerca de la calidad y sus características. Para la elaboración de este trabajo el método de recolección de datos que se empleó, fue el análisis documental que poseía la misma empresa, para así lograr el objetivo general de este trabajo que es describir cómo es la calidad en el servicio de atención al cliente en un restaurante de Pizza Hut del distrito de Lince. Donde el diagnóstico de la empresa se realizó a través del SPSS, evaluando 3 criterios, realizando la descripción de cada uno y representado el estado mediante gráficos. El primero de ellos, el cual fue que actualmente el nivel de servicio de la empresa se encuentra en un 94% indicando que se está cumpliendo con el estándar de calidad según el servicio pero hay perdidas del producto debido a ser obsequian estos, el nivel de satisfacción se encuentra en un 97% cumpliendo con el estándar de calidad según la satisfacción del cliente pero se generan pérdidas económicas por productos devueltos y la eficacia se encuentra en promedio del 87%indicando que se necesita un mejor control a la hora de pronosticar las ventas del producto. Dando esto a entender que la empresa está en un buen camino para ser realmente una de las empresas altamente reconocidas por su excelente servicio en atender al cliente, cumpliendo con sus expectativas y dejándolo muy satisfecho con lo brindado

Clinical Features and Outcome of 79 Dogs With Digital Squamous Cell Carcinoma Undergoing Treatment: A SIONCOV Observational Study

In dogs, digit squamous cell carcinoma (SCC) is uncommon. Clinical signs are frequently underestimated, leading to a diagnostic delay. The purpose of this retrospective study was to report our experience regarding the clinical presentation, diagnostic work-up, treatment and outcome of 79 client-owned dogs with SCC of the digit. The greatest majority (84.8%) of dogs was dark-coated. Schnauzers represented approximately one third of the study population, and had a poorer outcome compared with other breeds. The majority of SCCs occurred in the front limbs (61%), and bone lysis was frequently observed (92.4%). Approximately 9% of dogs had involvement of multiple digits, and this was associated with a shorter time to progression (TTP; P = 0.047). Similarly, a duration of clinical signs >90 days was associated with a shorter TTP (P = 0.02). Regional lymph node metastases were documented in 17.7% of dogs at admission and were significantly associated with tumor-related death (P < 0.001). At presentation, none of the dogs had evidence of distant metastasis. Digit amputation achieved adequate local tumor control in the majority of cases. Adjuvant chemotherapy and radiation therapy were carried out in 21.5% of cases, with uncertain benefit. Due to the relatively non-aggressive clinical behavior of digit SCC, chemotherapy should only be offered in the case of metastatic disease. Approximately one fourth of dogs developed de novo SCCs during the follow-up. Careful examination of the digits should be encouraged in breeds considered at high risk and in dogs with a previous history of digital SCC

Estudio de factibilidad para la construcción y diseño del mercado municipal de Turín, departamento de Ahuachapán

Se encuentran aspectos generales del municipio de Turín,lo importante que son los mercados a nivel nacional ademas del planteamiento de la situacion problematica a la cual se pretende dar una solución. En la actualidad el municipio de Turín no posee un mercado municipal para facilitar el desarrollo económico y la incentivación del sector productivo de la zona

The use of bile salt micelles for the prediction of human intestinal absorption

Human intestinal absorption (HIA) will dictate biopharmaceutical performance through its influence on absorption, distribution, metabolism, and elimination and can vary significantly depending upon the nature of the compound under consideration. In this study, an in vitro assay method is proposed for the prediction of HIA through the measurement of drug solubility in an aqueous phase containing micellar bile salt, namely sodium deoxycholate. A series of twenty compounds, displaying a range of physicochemical properties and known HIA values, were analyzed using UV spectroscopy to determine a solubilization ratio for each compound. A micelle/water partition coefficient (Kxm/a) was calculated and then used to develop an equation through simple linear regression; logit HIA = −0.919 + 0.4618 logKxm/a (R2 = 0.85). From this equation, a value for % HIA was determined which compared well with literature. Furthermore, 4 additional drugs were then analyzed using the developed equation and found to match well with literature, confirming the suitability of the method. Using a simple, economic, and robust UV bile salt assay allows prediction of HIA and avoids many of the disadvantages of other techniques, such as animal-based methods

Tirotropina y su correlación con colesterol y triglicéridos en pacientes sanos y con disfunción tiroidea subclínica

Objective: To correlate the levels of thyrotropin with the levels of cholesterol and serum triglycerides in 250 healthy subjects and patients with subclinical thyroid dysfunction with a minimum fasting of 8 hours. Methodology: Analytical methods: total cholesterol, triglycerides: Enzyme-colorimetric and Thyrotropin: ELISA immunoenzymatic. Results: Thyrotropin was found in healthy subjects 88,68% in men and 89,34% in women, in patients with hyper thyroid dysfunction 1,89% for men and 1,52% for women, as well as hypo 9,43% for men and 9,14% for women. Cholesterol in healthy subjects for men is 49,06% and in women 67,01%; in patients with hyper thyroid dysfunction 50,94% for men and 32,99% for women. Triglycerides in healthy subjects 69,81% in men and 62,44% in women, in patients with hyper thyroid dysfunction 30,19% for men and 37,56% in women. Conclusions: A correlation was found between thyrotropin and cholesterol (p <0,05), this is due to an increase in the number of low-density lipoprotein liver receptors (LDL-col), which accelerates its clearance, was not found correlation between thyrotropin and triglycerides (p> 0,05), cholesterol concentrations are high in subjects with hypothyroidism.Objetivo: Correlacionar los niveles de la Tirotropina con los niveles de Colesterol y Triglicéridos séricos en 250 sujetos sanos y pacientes con disfunción tiroidea subclínica con un ayuno mínimo de 8 horas. Metodología: Métodos analíticos: colesterol total, triglicéridos: Enzimático-colorimétrico y Tirotropina: inmunoenzimático ELISA. Resultados: Se encontró Tirotropina en sujetos sanos 88,68% en hombres y 89,34% en mujeres, en pacientes con disfunción tiroidea hiper 1,89% para hombres y 1,52% para mujeres, así como hipo 9,43% para hombres y 9,14% para mujeres. El colesterol en sujetos sanos para hombres es del 49,06% y en mujeres 67,01%; en pacientes con disfunción tiroidea hiper 50,94% para hombres y 32,99% para mujeres. Los triglicéridos en sujetos sanos 69,81% en hombres y 62,44% en mujeres, en pacientes con disfunción tiroidea hiper 30,19% para hombres y 37,56% en mujeres. Conclusiones: Se encontró correlación entre la tirotropina y colesterol (p<0,05), esto se debe bioquímicamente a un aumento del número de receptores hepáticos de lipoproteína de baja densidad (LDL-col), lo que acelera su depuración, no se encontró correlación entre la tirotropina y los triglicéridos (p>0,05), las concentraciones de colesterol están altas en sujetos con hipotiroidismo