Ansiedad en los pacientes pre operatorios del Servicio de Cirugía Abdominal del hospital Nacional Arzobispo Loayza, 2017

Trabado de investigacionT02290TIEF 2 G87 2017La ansiedad es una emoción de los seres humanos que incrementa la activación fisiológica para ponernos en alerta ante posibles amenazas externas. A pesar de los avances en la medicina y las técnicas quirúrgicas, la cirugía representa indudablemente un evento estresante para muchos. Objetivo: Determinar el nivel de ansiedad del paciente preoperatorio del servicio de cirugía abdominal del Hospital Arzobispo Loayza. Metodología: Estudio de enfoque cuantitativo; alcance descriptivo y de corte transversal. El tipo de muestreo será no probabilístico, de tipo intencional, atendiendo los criterios de inclusión y exclusión en función a la variable de estudio. El instrumento que se empleará es el inventario de ansiedad de Spielberger, Gorsuch y Lushene (1966), el instrumento se encuentra validado y ha reportado una consistencia interna de 0,90 a 0,93. El instrumento fue sometido a juicio de expertos, con un coeficiente de V Aiken de 1. En cuanto a la confiabilidad se obtuvo un Alfa de Crombach 0,942. Los resultados del estudio permitirán proveer, algunas herramientas necesarias que permitan identificar el grado de ansiedad de los pacientes en el preoperatorio de tal modo que los profesionales de enfermería realicen intervenciones concretas para ayudar a disminuir dicha ansiedad. La relevancia social se fundamenta en que los resultados permitirán la cooperación o soporte de la familia para reducir dicha ansiedad con el propósito de que el estado emocional del paciente sea lo más estable posible ante la cirugía

Molecular tools for cryptic Candida species identification with applications in a clinical laboratory

Candida spp. includes more than 160 species but only 20 species pose clinical problems. C. albicans and C. parapsilosis account for more than 75% of all the fungemias worldwide. In 1995 and 2005, one C. albicans and two C. parapsilosis-related species were described, respectively. Using phenotypic traits, the identification of these newly described species is inconclusive or impossible. Thus, molecular-based procedures are mandatory. In the proposed educational experiment we have adapted different basic molecular biology techniques designed to identify these species including PCR, multiplex PCR, PCR-based restriction endonuclease analysis and nuclear ribosomal RNA amplification. During the classes, students acquired the ability to search and align gene sequences, design primers, and use bioinformatics software. Also, in the performed experiments, fungal molecular taxonomy concepts were introduced and the obtained results demonstrated that classic identification (phenotypic) in some cases needs to be complemented with molecular-based techniques. As a conclusion we can state that we present an inexpensive and well accepted group of classes involving important concepts that can be recreated in any laboratory.Fil: Gamarra, Soledad. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Santa Fe; ArgentinaFil: Dudiuk, Catiana Beatriz. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; ArgentinaFil: Mancilla, Estefanía. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; ArgentinaFil: Vera Garate, María Verónica. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; ArgentinaFil: Guerrero, Sergio Adrian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Santa Fe; Argentina. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; ArgentinaFil: Garcia, Guillermo Manuel. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Santa Fe; Argentin

Rivaroxaban with or without aspirin in stable cardiovascular disease

BACKGROUND: We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS: In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS: The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P<0.001; z=−4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P<0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. CONCLUSIONS: Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events