PLAN BÁSICO DE SALUD PARA LAS ESTUDIANTES DEL INSTITUTO TECNOLÓGICO SUPERIOR GUAYAQUIL DE LA CIUDAD DE GUAYAQUIL PROVINCIA DEL GUAYAS

En la investigación se analizan normas y políticas de salud en los planteles educativos  que permiten elaborar un plan  básico de salud  que delineen la acción de las autoridades  y profesionales de la salud del Instituto Tecnológico Superior Guayaquil, para mejorar la atención en el estudiante. Se describen sucesos con información preferentemente cualitativa y está destinada a encontrar soluciones dentro de la misma organización, de acuerdo a la realidad del instituto. Los principales resultados son promoción de la salud en las escuelas y colegios, considerando a las personas en su ambiente familiar, comunitario y social, y en su nueva visión enfoca el “empoderamiento de la comunidad” para alcanzar resultados más efectivos y sostenibles. Fomenta un análisis crítico de los valores, conductas, condiciones sociales y estilos de vida, fortaleciendo aquellos que propician el mejoramiento de la salud, del desarrollo humano y del capital social.PALABRAS CLAVE: Plan básico de salud; edad y sexo; hábitos de higiene; recursos humanos en salud.BASIC HEALTH PLAN FOR STUDENTS OF THE GUAYAQUIL SUPERIOR TECHNOLOGICAL INSTITUTE OF THE CITY OF GUAYAQUIL PROVINCE OF GUAYASABSTRACTIn the research, health standards and policies are analyzed in educational establishments that allow the elaboration of a basic health plan that delineate the action of the authorities and health professionals of the Superior Technological Institute of Guayaquil, to improve student care. It describes events with preferably qualitative information and is designed to find solutions within the same organization, according to the reality of the institute. The main results are health promotion in schools and colleges, considering people in their family, community and social environments, and their new vision focuses on "empowering the community" to achieve more effective and sustainable results. Promotes a critical analysis of values, behaviors, social conditions and lifestyles, strengthening those that promote the improvement of health, human development and social capital.KEYWORDS: Basic health plan; age and sex; hygiene habits; human resources in health

Protagonismo del mentor en una actividad tutorial de carácter multidisciplinar en Ingeniería

XIX Congreso Universitario de Innovación Educativa en las Enseñanzas Técnicas : Barcelona, 6 a 8 de julio de 2011En la Escuela Politécnica Superior (EPS) de la Universidad de Sevilla se ha trabajado, por tercer curso consecutivo, en un Plan de Acción Tutorial desarrollado por 16 profesores tutores y 20 alumnos mentores de 5 titulaciones de Ingeniería Técnica. El objetivo perseguido en este curso ha sido potenciar actividades que han surgido del propio albedrío de los alumnos mentores, lo que ha dado como resultado la realización de una serie de actividades de mentoría motivadas y dirigidas desde el principio por los alumnos mentores. La actividad conjunta de todos ellos ha llevado a organizar unos subgrupos de mentorías en función de determinadas características del alumnado de primer curso (deportistas, trabajadores, becarios de otras universidades…), a realizar reuniones presenciales de mentores para puesta a punto de estas actividades así como de puesta al día de los resultados que se iban consiguiendo, además de organizar una segunda captación de mentorizados tras las notas del primer cuatrimestre, y la protagonización de una Jornada de Mentoría al final del curso.A third edition with 16 tutorial lecturers and 20 tutorial students from five different degrees (Technical Engineering of the Polytechnical School, EPS, at University of Seville) in a Tutorial Plan development, has been prepared. During the present year, the main characteristic has been a serial of mentoring actions motivated and directed by these mentors. This activity has been organized considering several subgroups of mentoring depending on special characteristics in first year students (sportsplayers, workers, grant holders from other universities…), moreover the organization of a second recruiting of new students after the first term marks, updating meetings for mentors only, and to be main figures in a Congress on Mentoring at the end of the academic year

Validation of a histologic scoring index for C3 glomerulopathy

12 p.-4 fig.-4 tab.Rationale & objective: A previous study that evaluated associations of kidney biopsy findings with disease progression in patients with C3 glomerulopathy (C3G) proposed a prognostic histologic index (C3G-HI) that has not yet been validated. Our objective was to validate the performance of the C3G-HI in a new patient population.Study design: Multicenter, retrospective cohort study.Setting & participants: 111 patients fulfilling diagnostic criteria of C3G between January 1995 and December 2019, from 33 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases (GLOSEN).Predictors: Demographic, clinical parameters, C3G-HI total activity score, and the C3G-HI total chronicity score.Outcome: Time to kidney failure.Analytical approach: Intraclass correlation coefficients and κ statistic were used to summarize inter-rater reproducibility for assessment of histopathology in kidney biopsies. The nonlinear relationships of risk of kidney failure with the total activity score and total chronicity score were modeled using Cox proportional hazards analysis that incorporated cubic splines.Results: The study group included 93 patients with C3 glomerulonephritis and 18 with dense-deposit disease. Participants had an overall meanage of 35±22 (SD) years. Forty-eight patients (43%) developed kidney failure after a mean follow-up of 65±27 months. The overall inter-rater reproducibility was very good for the total activity score (intraclass correlation coefficient [ICC]=0.63) and excellent for total chronicity score (ICC=0.89). Baseline estimated glomerular filtration rate (eGFR), 24-hour proteinuria, and treatment with immunosuppression were the main determinants of kidney failure in a model with only clinical variables. Only tubular atrophy and interstitial fibrosis were identified as predictors in a model with histological variables. When the total activity score and total chronicity score were added to the model, only the latter was identified as an independent predictor of kidney failure.Limitations: Only a subset of the kidney biopsies was centrally reviewed. Residual confounding.Conclusions: We validated the performance of C3G-HI as a predictor of kidney failure in patients with C3G. The total chronicity score was the principal histologic correlate of kidney failure.Work in this study was supported by the Instituto de Salud Carlos III /Fondo Europeo de Desarrollo Regional (ISCIII/FEDER) grant PI16/01685 and Red de Investigación Renal (RedInRen) (RD12/0021/0029) (to MP), the Autonomous Region of Madrid (S2017/BMD-3673) (to MP); EGdeJ is supported by the Spanish “Ministerio de Ciencia, Innovación y Universidades" (RYC-2013-13395 and RTI2018-095955-B-100).Peer reviewe

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Characterizing carbapenemase-producing Escherichia coli isolates from Spain: high genetic heterogeneity and wide geographical spread

IntroductionCarbapenemase-Producing Escherichia coli (CP-Eco) isolates, though less prevalent than other CP-Enterobacterales, have the capacity to rapidly disseminate antibiotic resistance genes (ARGs) and cause serious difficult-to-treat infections. The aim of this study is phenotypically and genotypically characterizing CP-Eco isolates collected from Spain to better understand their resistance mechanisms and population structure.MethodsNinety representative isolates received from 2015 to 2020 from 25 provinces and 59 hospitals Spanish hospitals were included. Antibiotic susceptibility was determined according to EUCAST guidelines and whole-genome sequencing was performed. Antibiotic resistance and virulence-associated genes, phylogeny and population structure, and carbapenemase genes-carrying plasmids were analyzed.Results and discussionThe 90 CP-Eco isolates were highly polyclonal, where the most prevalent was ST131, detected in 14 (15.6%) of the isolates. The carbapenemase genes detected were blaOXA-48 (45.6%), blaVIM-1 (23.3%), blaNDM-1 (7.8%), blaKPC-3 (6.7%), and blaNDM-5 (6.7%). Forty (44.4%) were resistant to 6 or more antibiotic groups and the most active antibiotics were colistin (98.9%), plazomicin (92.2%) and cefiderocol (92.2%). Four of the seven cefiderocol-resistant isolates belonged to ST167 and six harbored blaNDM. Five of the plazomicin-resistant isolates harbored rmt. IncL plasmids were the most frequent (45.7%) and eight of these harbored blaVIM-1. blaOXA-48 was found in IncF plasmids in eight isolates. Metallo-β-lactamases were more frequent in isolates with resistance to six or more antibiotic groups, with their genes often present on the same plasmid/integron. ST131 isolates were associated with sat and pap virulence genes. This study highlights the genetic versatility of CP-Eco and its potential to disseminate ARGs and cause community and nosocomial infections

Manejo de la vía aérea del paciente en la sala de recuperación del Hospital de Solca Cuenca 2005-2006

La presente investigación pretende dar énfasis en la intervención inmediata de enfermería frente a problemas respiratorios en especial siendo el más importante la depresión respiratoria que puede llevar a la muerte inmediata del paciente, si no existe una intervención correcta e inmediata como es la realización de la intubación endotraqueal. Se considera a una paciente que ingresó al área de recuperación del Hospital de Solca que presentó depresión respiratoria. En el proceso se ha obtenido datos a través del interrogatorio y entrevista directa y participativa de la paciente que me ha permitido lograr el objetivo propuesto que es la intervención de enfermería. En este tipo de complicaciones de igual forma se ha conocido la vida e historia de la paciente. De igual manera se realiza una descripción de signos y síntomas de la patología, impacto fisiológico psicosocial, psicológico, reacciones emocionales el impacto familiar e individualDiplomado Superior en Instrumentación QuirúrgicaCuenc

Problemas hipertensivos propios del embarazo, en madres que acuden a consulta externa del hospital Vicente Corral Moscoso. Cuenca 1991-1992

Licenciado en EnfermeríaCuenc