Análisis del proceso de capacitación profesional que se imparte en la Corporación Universitaria Minuto de Dios-UNIMINUTO VRO sede Villavicencio y su incidencia en la formación de profesionales gerenciales competentes en Administración de Empresas acorde a las exigencias del campo empresarial de la cuidad.

Analizar el perfil Profesional y Laboral del Administrador de empresa de la universidad de Cartagena que requiere el sector empresarial.El presente trabajo abarca una serie de conceptos y procesos en la búsqueda de soluciones prácticas para el buen desarrollo de la educación en la formación de los administradores de empresas mediante el análisis de la capacitación implantada desde su academia, en este caso la Corporación Universitaria MINUTO de Dios UNIMINUTO VRO sede Villavicencio, con el fin de reconocer los profesionales competentes exigidos por el campo empresarial de esta ciudad, teniendo en cuenta sus necesidades, los conceptos ofertados y los posibles vacíos que se presenten durante la formación del profesional. Se emplean conceptos desde bases teóricas como Peter Drucker, Edimer Tobar quienes con sus aportes en base a competencias gerenciales nos dan el respaldo para dar continuidad en la búsqueda de las competencias requeridas por el Administrador de empresas UNIMINUTO, trabajando bajo una línea investigativa mixta descriptiva y correlacional haciendo uso de la población estudiantil del plantel educativo y la población empresarial de la ciudad, por medio de instrumentos de tipo encuesta y entrevista que nos darán la información necesaria y precisa para el análisis de este proceso de capacitación impartido y su incidencia en los profesionales, dando resultados que pueden ser a futuro fuentes de investigaciones innovadoras en educación, transformación social aportando posibles soluciones de problemas locales por medio de la academiaThe present work covers a series of concepts and processes in the search for practical solutions for the good development of education in the training of business administrators by analyzing the training implemented from their academy, in this case the MINUTE University Corporation of God UNIMINUTO VRO headquarters Villavicencio, in order to recognize the competent professionals required by the business field of this city, taking into account their needs, the concepts offered and the possible gaps that arise during the training of the professional. Concepts are used from theoretical bases such as Peter Drucker, Edimer Tobar who have their contributions based on managerial competencies give us the support to give continuity in the search for the competences required by the UNIMINUTO Business Administrator, working under a descriptive mixed research line and correlational making use of the student population of the educational establishment and the business population of the city, through survey and interview instruments that give us the necessary and accurate information for the analysis of this training process and its impact on professionals, giving results that can be a future source of innovative research in education, social transformation providing possible solutions to local problems through the academy

Análisis del proceso de capacitación profesional que se imparte en la Corporación Universitaria Minuto de Dios-UNIMINUTO VRO sede Villavicencio y su incidencia en la formación de profesionales gerenciales competentes en Administración de Empresas acorde a las exigencias del campo empresarial de la cuidad.

Analizar el perfil Profesional y Laboral del Administrador de empresa de la universidad de Cartagena que requiere el sector empresarial.El presente trabajo abarca una serie de conceptos y procesos en la búsqueda de soluciones prácticas para el buen desarrollo de la educación en la formación de los administradores de empresas mediante el análisis de la capacitación implantada desde su academia, en este caso la Corporación Universitaria MINUTO de Dios UNIMINUTO VRO sede Villavicencio, con el fin de reconocer los profesionales competentes exigidos por el campo empresarial de esta ciudad, teniendo en cuenta sus necesidades, los conceptos ofertados y los posibles vacíos que se presenten durante la formación del profesional. Se emplean conceptos desde bases teóricas como Peter Drucker, Edimer Tobar quienes con sus aportes en base a competencias gerenciales nos dan el respaldo para dar continuidad en la búsqueda de las competencias requeridas por el Administrador de empresas UNIMINUTO, trabajando bajo una línea investigativa mixta descriptiva y correlacional haciendo uso de la población estudiantil del plantel educativo y la población empresarial de la ciudad, por medio de instrumentos de tipo encuesta y entrevista que nos darán la información necesaria y precisa para el análisis de este proceso de capacitación impartido y su incidencia en los profesionales, dando resultados que pueden ser a futuro fuentes de investigaciones innovadoras en educación, transformación social aportando posibles soluciones de problemas locales por medio de la academiaThe present work covers a series of concepts and processes in the search for practical solutions for the good development of education in the training of business administrators by analyzing the training implemented from their academy, in this case the MINUTE University Corporation of God UNIMINUTO VRO headquarters Villavicencio, in order to recognize the competent professionals required by the business field of this city, taking into account their needs, the concepts offered and the possible gaps that arise during the training of the professional. Concepts are used from theoretical bases such as Peter Drucker, Edimer Tobar who have their contributions based on managerial competencies give us the support to give continuity in the search for the competences required by the UNIMINUTO Business Administrator, working under a descriptive mixed research line and correlational making use of the student population of the educational establishment and the business population of the city, through survey and interview instruments that give us the necessary and accurate information for the analysis of this training process and its impact on professionals, giving results that can be a future source of innovative research in education, social transformation providing possible solutions to local problems through the academy

Community-Acquired Pneumococcal Pneumonia in Virologically Suppressed HIV-Infected Adult Patients: A Matched Case-Control Study

Background: The study aimed to investigate whether the clinical presentations and outcomes (length of stay, ICU admission, and 30-day mortality) of pneumococcal pneumonia in virologically suppressed patients who were HIV-infected on ART with a CD4+ T-cell count > 350 cells/mm3 are comparable to those seen in patients with HIV, using a case-control design. Methods: A case-control study was carried out in Hospital Clinic, Barcelona, Spain (2001-2016). Control patients were matched by age (±10 years), sex, comorbidities, and pneumonia diagnosis in the same calendar period. Clinical presentation and outcomes of pneumococcal pneumonia in patients who were and were not infected with HIV were compared. Results: Pneumococcal pneumonia was studied in 50 cases (HIV infection) and 100 control patients (non-HIV infection). Compared with the control patients, case patients had higher rates of influenza (14% vs 2%, P = .007) and pneumococcal vaccination (10% vs 1%, P = .016). The group of cases also presented a higher rate of coinfection with hepatitis B virus (6% vs 0%, P = .036). Both groups presented similar ICU admission (18% vs 27%, P = .22), need for mechanical ventilation (12% vs 8%; P = .43), length of stay (7 days vs 7 days, P = .76), and 0% of 30-day mortality. No evidence was found of a more severe presentation or a worse clinical outcome in cases than in control patients. Conclusions: Pneumococcal pneumonia episodes requiring hospitalization in virologically suppressed patients with HIV with > 350 CD4+ T-cell count/mm3 were neither more severe nor had worse prognosis compared with uninfected patients. These results support the fact that such patients do not need treatment, admission, or care sites different to the general population

Antibiotic selection in the treatment of acute invasive infections by Pseudomonas aeruginosa: Guidelines by the Spanish Society of Chemotherapy

Pseudomonas aeruginosa is characterized by a notable intrinsic resistance to antibiotics, mainly mediated by the expression of inducible chromosomic β-lactamases and the production of constitutive or inducible efflux pumps. Apart from this intrinsic resistance, P. aeruginosa possess an extraordinary ability to develop resistance to nearly all available antimicrobials through selection of mutations. The progressive increase in resistance rates in P. aeruginosa has led to the emergence of strains which, based on their degree of resistance to common antibiotics, have been defined as multidrug resistant, extended-resistant and panresistant strains. These strains are increasingly disseminated worldwide, progressively complicating the treatment of P. aeruginosa infections. In this scenario, the objective of the present guidelines was to review and update published evidence for the treatment of patients with acute, invasive and severe infections caused by P. aeruginosa. To this end, mechanisms of intrinsic resistance, factors favoring development of resistance during antibiotic exposure, prevalence of resistance in Spain, classical and recently appeared new antibiotics active against P. aeruginosa, pharmacodynamic principles predicting efficacy, clinical experience with monotherapy and combination therapy, and principles for antibiotic treatment were reviewed to elaborate recommendations by the panel of experts for empirical and directed treatment of P. aeruginosa invasive infections

Rapid Diagnosis of Staphylococcal Catheter-Related Bacteraemia in Direct Blood Samples by Real-Time PCR

Catheter-related bacteremia (CRB) is an important cause of morbidity and mortality among hospitalized patients, being staphylococci the main etiologic agents. The objective of this study was to assess the use of a PCR-based assay for detection of staphylococci directly from blood obtained through the catheter to diagnose CRB caused by these microorganisms and to perform a cost-effectiveness analysis. A total of 92 patients with suspected CRB were included in the study. Samples were obtained through the catheter. Paired blood cultures were processed by standard culture methods and 4 ml blood samples were processed by GeneXpert-MRSA assay for the detection of methicillin-susceptible (MSSA) or methicillin-resistant (MRSA) Staphylococcus aureus, and methicillin-resistant coagulase-negative staphylococci (MR-CoNS). Sixteen CRB caused by staphylococci were diagnosed among 92 suspected patients. GeneXpert detected 14 out of 16 cases (87.5%), including 4 MSSA and 10 MR-CoNS in approximately 1 hour after specimen receipt. The sensitivity and specificity of GeneXpert were 87.5% (CI 95%: 60.4-97.8) and 92.1% (CI 95%: 83-96.7), respectively, compared with standard culture methods. The sensitivity of GeneXpert for S. aureus was 100%. Regarding a cost-effectiveness analysis, the incremental cost of using GeneXpert was of 31.1euro per patient while the incremental cost-effectiveness ratio of GeneXpert compared with blood culture alones was about 180euro per life year gained. In conclusion, GeneXpert can be used directly with blood samples obtained through infected catheters to detect S. aureus and MR-CoNS in approximately 1h after sampling. In addition, it is cost-effective especially in areas with high prevalence of staphylococcal CRB

Risk factors for mortality in patients with acute leukemia and bloodstream infections in the era of multiresistance

Objectives: We assess the epidemiology and risk factors for mortality of bloodstream infection (BSI) in patients with acute leukemia (AL). Methods: Prospectively collected data of a cohort study from July 2004 to February 2016. Multivariate analyses were performed. Results: 589 episodes of BSI were documented in 357 AL patients, 55% caused by gram-positive bacteria (coagulase-negative staphylococci 35.7%, Enterococcus spp 10.8%) and 43.5% by gram-negative bacteria (E. coli 21%, PA 12%). We identified 110 (18.7%) multidrug-resistant (MDR) microorganisms, especially MDR-Pseudomonas aeruginosa (7%) and extended-spectrum beta-lactamase producing Enterobacteriaceae (7%). The 30-day mortality was 14.8%. Age (OR 3.1; 95% CI 1.7–5.7); chronic lung disease (4.8; 1.1–21.8); fatal prognosis according to McCabe index (13.9; 6.4–30.3); shock (3.8; 1.9–7.7); pulmonary infection (3.6; 1.3–9.9); and MDR-PA infections with inappropriate treatment (12.8; 4.1–40.5) were related to mortality. MDR-PA BSI was associated to prior antipseudomonal cephalosporin use (9.31; 4.38–19.79); current use of betalactams (2.01; 1.01–4.3); shock (2.63; 1.03–6.7) and pulmonary source of infection (9.6; 3.4–27.21). Conclusions: MDR organisms were commonly isolated in BSI in AL. Inappropriate empiric antibiotic treatment for MDR-PA is the primary factor related to mortality that can be changed. New treatment strategies to improve the coverage of MDR-PA BSI should be considered in those patients with risk factors for this infection

Time-to-positivity, type of culture media and oxidase test performed on positive blood culture vials to predict Pseudomonas aeruginosa in patients with Gram-negative bacilli bacteraemia

OBJECTIVE: The aim of this study was to determine the usefulness of oxidase test and time-to-positivity (TTP) in aerobic and anaerobic blood culture vials to detect the presence of Pseudomonas aeruginosa in patients with Gram-negative bacilli (GNB) bacteraemia. METHODS: TTP was recorded for each aerobic and anaerobic blood culture vial of monomicrobial bacteraemia due to GNB. Oxidase test was performed in a pellet of the centrifuged content of the positive blood culture. An algorithm was developed in order to perform the oxidase test efficiently taking into account TTP and type of vial. RESULTS: A total of 341 episodes of GNB bacteraemia were analysed. Sensitivity, specificity, positive predictive value and negative predictive value of the oxidase test performed on positive vials with GNB to predict P. aeruginosa were 95%, 99%, 91%, and 99%, respectively. When growth was first or exclusively detected in anaerobic vials, P. aeruginosa was never identified hence the performance of the oxidase test could be avoided. When growth was only or first detected in aerobic vials, a TTP≥8h predicted P. aeruginosa in 37% or cases (63 of 169), therefore oxidase test is highly recommended. CONCLUSIONS: Oxidase test performed onto positive blood culture vials previously selected by TTP and type of vials is an easy and inexpensive way to predict P. aeruginosa. In most cases, this can lead to optimization of treatment in less than 24 hours

Evaluation of a Mixing versus a Cycling Strategy of Antibiotic Use in Critically-Ill Medical Patients: Impact on Acquisition of Resistant Microorganisms and Clinical Outcomes

OBJECTIVE: To compare the effect of two strategies of antibiotic use (mixing vs. cycling) on the acquisition of resistant microorganisms, infections and other clinical outcomes. METHODS: Prospective cohort study in an 8-bed intensive care unit during 35- months in which a mixing-cycling policy of antipseudomonal beta-lactams (meropenem, ceftazidime/piperacillin-tazobactam) and fluoroquinolones was operative. Nasopharyngeal and rectal swabs and respiratory secretions were obtained within 48h of admission and thrice weekly thereafter. Target microorganisms included methicillin-resistant S. aureus, vancomycin-resistant enterococci, third-generation cephalosporin-resistant Enterobacteriaceae and non-fermenters. RESULTS: A total of 409 (42%) patients were included in mixing and 560 (58%) in cycling. Exposure to ceftazidime/piperacillin-tazobactam and fluoroquinolones was significantly higher in mixing while exposure to meropenem was higher in cycling, although overall use of antipseudomonals was not significantly different (37.5/100 patient-days vs. 38.1/100 patient-days). There was a barely higher acquisition rate of microorganisms during mixing, but this difference lost its significance when the cases due to an exogenous Burkholderia cepacia outbreak were excluded (19.3% vs. 15.4%, OR 0.8, CI 0.5-1.1). Acquisition of Pseudomonas aeruginosa resistant to the intervention antibiotics or with multiple-drug resistance was similar. There were no significant differences between mixing and cycling in the proportion of patients acquiring any infection (16.6% vs. 14.5%, OR 0.9, CI 0.6-1.2), any infection due to target microorganisms (5.9% vs. 5.2%, OR 0.9, CI 0.5-1.5), length of stay (median 5 d for both groups) or mortality (13.9 vs. 14.3%, OR 1.03, CI 0.7-1.3). CONCLUSIONS: A cycling strategy of antibiotic use with a 6-week cycle duration is similar to mixing in terms of acquisition of resistant microorganisms, infections, length of stay and mortality

Characterization of Novel Pathogenic Variants Leading to Caspase-8 Cleavage-Resistant RIPK1-Induced Autoinflammatory Syndrome

Pathogenic RIPK1 variants have been described as the cause of two different inborn errors of immunity. Biallelic loss-of-function variants cause the recessively inherited RIPK1 deficiency, while monoallelic variants impairing the caspase-8-mediated RIPK1 cleavage provoke a novel autoinflammatory disease (AID) called cleavage-resistant RIPK1-induced autoinflammatory (CRIA) syndrome. The aim of this study was to characterize the pathogenicity of two novel RIPK1 variants located at the cleavage site of caspase-8 detected in patients with dominantly-inherited, early-onset undefined AID. RIPK1 genotyping was performed by Sanger and next-generation sequencing. Clinical and analytical data were collected from medical charts, and in silico and in vitro assays were performed to evaluate the functional consequences. Genetic analyses identified two novel heterozygous RIPK1 variants at the caspase-8 cleavage site (p.Leu321Arg and p.Asp324Gly), which displayed a perfect intrafamilial phenotype-genotype segregation following a dominant inheritance pattern. Structural analyses suggested that these variants disrupt the normal RIPK1 structure, probably making it less accessible to and/or less cleavable by caspase-8. In vitro experiments confirmed that the p.Leu321Arg and p.Asp324Gly RIPK1 variants were resistant to caspase-8-mediated cleavage and induced a constitutive activation of necroptotic pathway in a similar manner that previously characterized RIPK1 variants causing CRIA syndrome. All these results strongly supported the pathogenicity of the two novel RIPK1 variants and the diagnosis of CRIA syndrome in all enrolled patients. Moreover, the evidences here collected expand the phenotypic and genetic diversity of this recently described AID, and provide interesting data about effectiveness of treatments that may benefit future patients