Evaluación de Riesgos Laborales y Propuesta de un Plan de Prevención de Riesgos y Emergencias en Centros de Salud Pública (CSP)

This work verifies the legal technical compliance in matters of safety and health at work, as well as the identification and assessment of the most influential risk factors in the jobs of the Health Center of the Industrial Park - IESS of the city of Riobamba. Once the inspection in the work stations of the facilities and the analysis of the risk factors of work of each position through the Colombian Technical Guide (GTC45), the risk prevention plan was carried out in which it was proposed: Implement and adapt the infrastructure, work stations, procedure protocols, vertical safety signage and fire-fighting equipment, EPP's, emergency brigades and periodic follow-ups through verification sheets; generating as a result a reduction of the labor risk index by 27%, additionally the proposal of implementation and relocation of equipment and the formation of brigades in the modular health center improves the evacuation time from 17 to 6 minutes, that is, a reduction of 64.7%, concluding that the risk prevention plan is profitable to reduce labor risk considerably.El presente trabajo verifica el cumplimiento técnico legal en materia de seguridad y salud en el trabajo, así como la identificación y valoración de los factores de riesgos más influyentes en los puestos de trabajo del Centro de Salud del Parque Industrial – IESS de la ciudad de Riobamba. Una vez realizada la inspección en los puestos de trabajo de las instalaciones y el análisis de los factores de riesgos de trabajo de cada puesto mediante la Guía Técnica Colombiana (GTC45), se realizó el plan de prevención de riesgos en el que se propuso: Implementar y adecuar la infraestructura, puestos de trabajo, protocolos de procedimiento, señalética vertical de seguridad y equipos contra incendios, EPP´s, brigadas de emergencia y seguimientos periódicos mediante hojas de verificación; generando como resultado una reducción del índice de riesgos laborales un 27%, adicionalmente la propuesta de implementación y reubicación de equipos y la conformación de brigadas en el modular del centro de salud mejora el tiempo de evacuación de 17 a 6 minutos, es decir una reducción del 64,7 %, concluyéndose que el plan de prevención de riesgos es rentable para disminuir considerablemente el riesgo laboral

Obtención y determinación de la calidad de colorante natural de uvilla para uso alimenticio

La obtención del colorante de uvilla está enfocada en la determinación de sus características físicas, químicas y microbiológicas, para lo cual, se procedió con el análisis sensorial del fruto, en el cual, se determinó sus características físicas, posteriormente se realizó la identificación del proceso de secado más adecuado mediante tres equipos de deshidratación diferentes, determinando que la mejor opción es con el equipo por liofilización, en el cual, se obtuvo el producto seco que cumple las características para tener el mejor rendimiento en la extracción del pigmento con etanol, luego se procedió a la purificación en el rota vapor, recuperando por un lado un alcohol etílico con el 80 % de pureza y por el otro el colorante casi puro, mismo que es llevado al espectrofotómetro UV para identificar la estructura, para lo cual, se efectuó un barrido de 400 a 600 nm de longitud de onda, determinando que  a 427 nm se identifica el pico de β- Carotenos, posteriormente se realizó el análisis proximal y microbiológico, parámetros que cumplen con lo establecido en la norma para uso alimenticio.     &nbsp

Revisión de 13 especies de la familia Triatominae (Hemiptera: Reduviidae) vectores de la enfermedad de Chagas, en México

Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic andsylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest healthrisk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but inYucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors arefound: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatomagerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted tothe domicile), Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodniusprolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmissiondynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health educationprograms, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, healtheducation programs are required, as well as the use of mosquito nets on doors and windows and around beds, asidefrom cementing the stone wall fences.Los transmisores de Trypanosoma cruzi, flagelado causante de la enfermedad, se dividen en intradomiciliados,peridomiciliados y silvestres. Entre los intradomiciliados se encuentran, Triatoma barberi y Triatoma dimidiata, queson los que representan un mayor riesgo para la Salud Pública, en México. Aunque Triatoma dimidiata se encuentraprincipalmente dentro de la vivienda, en Yucatán tiene un comportamiento peridomiciliar, dentro de este grupo seencuentran la mayoría de los transmisores de la enfermedad de Chagas Meccus longipennis, M. mazzottii, M.pallidipennis, M. phyllosomus, M. picturatus, Triatoma gerstaeckeri, T. mexicana, T. rubida, Dipetalogaster máxima,Panstrongylus rufotuberculatus y Rhodnius prolixus. Los transmisores peridomiciliados son de menor riesgo en ladinámica de transmisión comparados con los intradomiciliados. Para el control de los transmisores intradomiciliados,se deben emplear programas de educación para la salud, mejoramiento de vivienda e insecticidas; mientras que paralos vectores visitantes o peridomiciliados, son necesarios programas de educación para la salud, uso de mosquiteros,pabellones y cementación de las bardas de piedra

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Influencia de la energía aportada a la soldadura GMAW de la aleación 5086-H1116 sobre la microestructura y propiedades mecánicas de resistencia y dureza.

Esta investigación se realiza por la necesidad que tiene el País de construir tanques y recipientes de aleaciones de aluminio por sus grandes ventajas como resistencia a la corrosión y peso ligero. Para la construcción de las probetas soldadas por el proceso GMAW de la aleación de aluminio 5086-H116, se utilizaron velocidades de avance 300, 400, 500, 550, 600 y 700 mm/min que están dentro del rango recomendado, las mismas que permitieron variar la energía aportada a la unión. Se utilizó un pirotomo para garantizar la velocidad de avance constante posteriormente se evaluaron las características de la soldadura mediante los ensayos de tracción, dureza y el examen metalográfico permitiendo encontrar la velocidad de avance óptima para el proceso. De los resultados obtenidos en los diferentes ensayos, se determinó que la velocidad de avance de la soldadura más adecuada es 500 mm/min (con una energía aportada de 335,34 J/mm) ,esta energía es la que permitió obtener las mejores propiedades mecánicas en la soldadura de la aleación 5086-H116 a un amperaje de 148 A. A esta energía, se produce la menor pérdida de magnesio, el tamaño de las partículas de Al3Mg2 es más fino y más fácilmente se distribuyen de manera uniforme en la matriz a, lo que permite obtener las mejores propiedades mecánicas. A velocidades menores, esto es 300 y 400 mm/min, la energía aportada es demasiado elevada produciendo una gran pérdida de Mg por evaporación, tanto en la solución sólida a, como en la fase intermetálica Al3Mg2. A velocidades mayores esto es, a 550, 600 y 700 mm, la energía aportada es insuficiente para disolver las partículas de Al3Mg2 y conseguir una distribución uniforme en la matriz a. Entonces, es importante resaltar la influencia positiva sobre las propiedades mecánicas que tiene la cantidad, tamaño y distribución de las partículas intermetálicas de Al3Mg2. El proceso de soldadura se debe realizar bajo parámetros que permitan que las partículas de segunda fase

A revision of thirteen species of Triatominae (Hemiptera: Reduviidae) vectors of Chagas disease in Mexico

Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic and sylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest health risk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but in Yucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors are found: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatoma gerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted to the domicile), Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodnius prolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmission dynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health education programs, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, health education programs are required, as well as the use of mosquito nets on doors and windows and around beds, aside from cementing the stone wall fences

A revision of thirteen species of Triatominae (Hemiptera: Reduviidae) vectors of Chagas disease in Mexico

Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic and sylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest health risk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but in Yucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors are found: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatoma gerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted to the domicile), Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodnius prolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmission dynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health education programs, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, health education programs are required, as well as the use of mosquito nets on doors and windows and around beds, aside from cementing the stone wall fences.Los transmisores de Trypanosoma cruzi, flagelado causante de la enfermedad, se dividen en intradomiciliados, peridomiciliados y silvestres. Entre los intradomiciliados se encuentran, Triatoma barberi y Triatoma dimidiata, que son los que representan un mayor riesgo para la Salud Pública, en México. Aunque Triatoma dimidiata se encuentra principalmente dentro de la vivienda, en Yucatán tiene un comportamiento peridomiciliar, dentro de este grupo se encuentran la mayoría de los transmisores de la enfermedad de Chagas Meccus longipennis, M. mazzottii, M. pallidipennis, M. phyllosomus, M. picturatus, Triatoma gerstaeckeri, T. mexicana, T. rubida, Dipetalogaster máxima, Panstrongylus rufotuberculatus y Rhodnius prolixus. Los transmisores peridomiciliados son de menor riesgo en la dinámica de transmisión comparados con los intradomiciliados. Para el control de los transmisores intradomiciliados, se deben emplear programas de educación para la salud, mejoramiento de vivienda e insecticidas; mientras que para los vectores visitantes o peridomiciliados, son necesarios programas de educación para la salud, uso de mosquiteros, pabellones y cementación de las bardas de piedra