Influencia de la Estimulación Temprana en el Desarrollo de los Niños de 2 Años en la Cuna Particular Inmaculada y la Cuna Estatal Jesús Niño, Arequipa, 2004

El objetivo del presente trabajo de investigación es determinar la influencia de la estimulación temprana en el desarrollo de los niños de 2 años en la Cuna Inmaculada y una estatal, es decir, como influye un programa de estimulación temprana en el nivel de desarrollo de los niños en diferentes áreas como: desarrollo cognitivo, desarrollo de la comunicación, desarrollo socio-emocional, desarrollo físico y conducta adaptativa. Para llevar a cabo este trabajo de investigación se conformó un grupo de estudio de 50 niños, conformado por 25 niños de la Cuna Inmaculada y 25 niños de la Cuna Jesús Niño. Para desarrollar este trabajo de investigación, se llevó a cabo una evaluación del nivel de desarrollo usando el Test DAYC entre ambas cunas y una encuesta a las docentes para verificar si trabajaban con programas de estimulación temprana. Los resultados fueron analizados y comparados estadísticamente con la Prueba de Mann Whitney que arrojó diferencias significativas para las cinco áreas evaluadas así como para el cociente general. Los resultados indican que la población de la Cuna Inmaculada se encuentra mayormente distribuida dentro de los rangos promedio mientras que la población de la Cuna Jesús Niño se distribuyen en los rangos debajo del promedio y en cuanto a los resultados de la entrevista nos indica que ambas cunas trabajan con programas de estimulación temprana pero en el caso de la Cuna Jesús Niño no cuenta con los materiales necesarios para realizar la estimulación temprana. Por lo tanto la hipótesis fue verificada

Frecuencia de genotipos del virus de papiloma humano mediante la técnica PCR punto final en pacientes con lesiones papilomatosas de laringe que acuden a un hospital de Managua, febrero 2017-enero 2018

La papilomatosis laríngea es una enfermedad viral crónica producida por Virus del Papiloma Humano (VPH), generando cambios en los queratinocitos del epitelio escamoso estratificado y lesiones hiperproliferativas de las mucosas y de la piel; las cuales pueden desarrollar verrugas, displasia leve hasta un carcinoma epidermoide agresivo, presentando un curso impredecible. Este estudio tuvo como objetivo, determinar la frecuencia de genotipos del virus de papiloma humano mediante la técnica de PCR punto final, en pacientes con lesiones Papilomatosas de laringe atendidos en un hospital de Managua, febrero 2017-marzo 2018. Se realizó un estudio descriptivo, el muestreo fue no probabilístico aplicando criterios de inclusión y exclusión. La muestra estuvo representada por 24 pacientes con diagnóstico histopatológico de papiloma escamoso, estas fueron tomadas por el otorrinolaringólogo del hospital quien posteriormente transportó las muestras hacia el laboratorio de Biología Molecular UNAN-Managua, para la realizar la extracción de ADN y detección de genotipos VPH bajo riesgo (VPH-BR) y alto riesgo (VPH-AR) mediante PCR punto final.Todas las muestras resultaron positivas para alguno de los genotipos de bajo riesgo (BR), en el 21% de estas, además se detectaron genotipos de alto riesgo (AR). En relación a la frecuencia de los genotipos VPH-BR se obtuvo VPH 6 en el 79% de los casos, VPH 11 con un 75%. En cuanto a la frecuencia de VPH-AR se encontró 17% de positividad para VPH 66, 13% para VPH 39 y 8% correspondiente a VPH 58. Además, se detectaron coinfecciones con VPH 6/11 en el 54% de los casos. Los rangos de edades afectados fueron de 0-10 años (46% con VPH 11) y de 55-65 años (17% con VPH6/11). El 46% de los pacientes correspondieron al sexo masculino. En relación entre la presencia de uno o más genotipos con el número de intervenciones quirúrgicas, los resultados sugieren que los pacientes con coinfección por VPH-AR/BR se espera tengan un mayor número de visitas al quirófano con una media de 5 intervenciones al año y los pacientes con VPH 11 se estima presenten una media de 3 intervenciones quirúrgicas en un añ

Violacein Induces Death of Resistant Leukaemia Cells via Kinome Reprogramming, Endoplasmic Reticulum Stress and Golgi Apparatus Collapse

It is now generally recognised that different modes of programmed cell death (PCD) are intimately linked to the cancerous process. However, the mechanism of PCD involved in cancer chemoprevention is much less clear and may be different between types of chemopreventive agents and tumour cell types involved. Therefore, from a pharmacological view, it is crucial during the earlier steps of drug development to define the cellular specificity of the candidate as well as its capacity to bypass dysfunctional tumoral signalling pathways providing insensitivity to death stimuli. Studying the cytotoxic effects of violacein, an antibiotic dihydro-indolone synthesised by an Amazon river Chromobacterium, we observed that death induced in CD34(+)/c-Kit(+)/P-glycoprotein(+)/MRP1(+) TF1 leukaemia progenitor cells is not mediated by apoptosis and/or autophagy, since biomarkers of both types of cell death were not significantly affected by this compound. To clarify the working mechanism of violacein, we performed kinome profiling using peptide arrays to yield comprehensive descriptions of cellular kinase activities. Pro-death activity of violacein is actually carried out by inhibition of calpain and DAPK1 and activation of PKA, AKT and PDK, followed by structural changes caused by endoplasmic reticulum stress and Golgi apparatus collapse, leading to cellular demise. Our results demonstrate that violacein induces kinome reprogramming, overcoming death signaling dysfunctions of intrinsically resistant human leukaemia cells.TopInstitute pharma (The Netherlands)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Dutch Cancer SocietyErasmus MC Univ Med Ctr, Dept Gastroenterol & Hepatol, Rotterdam, NetherlandsUniv Amsterdam, Acad Med Ctr, Ctr Expt & Mol Med, NL-1105 AZ Amsterdam, NetherlandsUniv Estadual Campinas, Brazil UNICAMP, Dept Biochem, Inst Biol, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Biochem, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Cell Biol, São Paulo, BrazilUniv Grande Rio UNIGRANRIO, Heath Sci Sch, Multidisciplinary Lab Dent Res, Rio de Janeiro, BrazilNatl Inst Metrol Qual & Technol Inmetro, Biotechnol Lab, Bioengn Sect, Rio de Janeiro, BrazilUniv Campinas UNICAMP, Inst Chem, Biol Chem Lab, Rio de Janeiro, BrazilUniv Groningen, Univ Med Ctr Groningen, Dept Pediat Oncol, Beatrix Childrens Hosp, Groningen, NetherlandsFed Univ São Paulo UNIFESP, Dept Biochem, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Cell Biol, São Paulo, BrazilDutch Cancer Society: EMCR 2010-4737Web of Scienc

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Creation of an online database monitoring tool for a medical device company: An insider action research

In order to stay profitable, a company must have effective strategies to remain competitive in the marketplace. Much more so, an organization must constantly improve its current processes and meet its clients’ needs. This action research was meant to increase customer responsiveness and to improve operational efficiency by improving the response time of a Medical Device Company’s Regulatory Affairs Department by introducing a monitoring tool that would gather the status of all FDA applications. It is recognized that manual interventions provide inadequacy through the tasks of the members of the department. With the assistance of action research tools, my collaborators and I have determined that the inability to provide an immediate update on a medical device product was caused by the conventional way of filing FDA documents and applications and no proper turnover of accountabilities within the RA team. To assist the medical device company in implementing the steps of Business Process Reengineering and Lewin’s Change Management Model, this action research paper analyzes the principles and benefits of these philosophies and summarizes their application to the company mentioned herein