Predominant factors of institutionalization in the elderly: a comparative study between home nursing and community dwelling

Purpose: The purpose of this paper was to detect the most significant factors associated with each living alternative to improve socialization and mental health of the elderly. The measurements included affective evaluation, cognitive assessment, anxiety level, physical functionality, quality of life and social relationships. Individuals in home nursing residences were older and had worse affective status, functionality, cognitive state and quality of life. Social relationships in community people were better than in the institutionalized condition, particularly for less aged people. Design/methodology/approach: Comparative descriptive study realized in 200 people older than 70 years in home nursing placement versus community dwelling conditions. Findings: Multivariate analysis and logistic regression indicated that greater disability and poorer quality of social relationships were the main factors influencing the institutionalization process. Specifically, the Sociotype Questionnaire appeared as an efficient tool concerning the detection of social isolation effects as well as an acceptable integrator of prosocial information about home nursing placement. Originality/value: The Geriatric Sociotype survey has shown usefulness in the evaluation of the social network of elderly people, both from the point of view of assessment and prognosis. In this sense it is considered that one of the main contributions of this study is to have included the qualitative evaluation of social relations, and to observe the differences according to the place of residence

Hypoxia Inducible Factor 1-Alpha (HIF-1 Alpha) Is Induced during Reperfusion after Renal Ischemia and Is Critical for Proximal Tubule Cell Survival

Acute tubular necrosis (ATN) caused by ischemia/reperfusion (I/R) during renal transplantation delays allograft function. Identification of factors that mediate protection and/or epithelium recovery could help to improve graft outcome. We studied the expression, regulation and role of hypoxia inducible factor 1-alpha (HIF-1 α), using in vitro and in vivo experimental models of I/R as well as human post-transplant renal biopsies. We found that HIF-1 α is stabilized in proximal tubule cells during ischemia and unexpectedly in late reperfusion, when oxygen tension is normal. Both inductions lead to gene expression in vitro and in vivo. In vitro interference of HIF-1 α promoted cell death and in vivo interference exacerbated tissue damage and renal dysfunction. In pos-transplant human biopsies, HIF-1 α was expressed only in proximal tubules which exhibited normal renal structure with a significant negative correlation with ATN grade. In summary, using experimental models and human biopsies, we identified a novel HIF-1 α induction during reperfusion with a potential critical role in renal transplant

Memorias del Primer Congreso Ecuatoriano de Antropología. Volumen II

Este encuentro permitió visualizar los campos fundamentales en los que la antropología ecuatoriana ha incursionado y ha aportado como ciencia social. Se organizaron diez simposios que, de alguna manera, fueron un reflejo de las principales áreas de interés. Esa diversidad temática mostró que la antropología, a la vez que seguía preocupada por temáticas con larga trayectoria en el país como la arqueología, los estudios urbanos y rurales o la etnohistoria, también había incursionado en temáticas nuevas como son género, medio ambiente, identidad, entre otras

A Review on the importance of metals and metalloids in atmospheric dust and aerosol from mining operations

Contaminants can be transported rapidly and over relatively long distances by atmospheric dust and aerosol relative to other media such as water, soil and biota; yet few studies have explicitly evaluated the environmental implications of this pathway, making it a fundamental but understudied transport mechanism. Although there are numerous natural and anthropogenic activities that can increase dust and aerosol emissions and contaminant levels in the environment, mining operations are notable with respect to the quantity of particulates generated, the global extent of area impacted, and the toxicity of contaminants associated with the emissions. Here we review (i) the environmental fate and transport of metals and metalloids in dust and aerosol from mining operations, (ii) current methodologies used to assess contaminant concentrations and particulate emissions, and (iii) the potential health and environmental risks associated with airborne contaminants from mining operations. The review evaluates future research priorities based on the available literature and suggest that there is a particular need to measure and understand the generation, fate and transport of airborne particulates from mining operations, specifically the finer particle fraction. More generally, our findings suggest that mining operations play an important but underappreciated role in the generation of contaminated atmospheric dust and aerosol and the transport of metal and metalloid contaminants, and highlight the need for further research in this area. The role of mining activities in the fate and transport of environmental contaminants may become increasingly important in the coming decades, as climate change and land use are projected to intensify, both of which can substantially increase the potential for dust emissions and transport.16 page(s

Laboratory scale production of the human recombinant iduronate 2-sulfate sulfatase-Like from Pichia pastoris

Clone IDS28 of the yeast Pichia pastoris expressing the human iduronate 2-sulfate sulfatase-Like (hIDSLike) was employed for low-scale production of the recombinant enzyme in a saline culture media without phosphate. The biological activity found was between 7.3 and 29.5 nmol h-1 mg-1 of total protein. It is about 1.73 to 7 times higher than the result obtained with the same clone in shake flask culture

Control del dolor postoperatorio en hemorroidectomía ambulatoria mediante infusión endovenosa continua domiciliaria

Introduction: Moderate to severe postoperative pain is still a problem in outpatient surgery, since it causes patient flow problems and delays the discharge of patients, being one of the major causes of re-hospitalization and hence a relevant quality indicator of these Units. The use of home invasive analgesic techniques, in all their regimes, can be effective for the management of postoperative pain in these surgical procedures and allow them to be included in outpatient surgery programs. Objectives: The aim of our study was to determine the feasibility and safety of the use of elastomeric continuous perfusion pumps for the administration of home continuous endovenous analgesia, as well as to assess analgesic effectiveness and degree of satisfaction of patients undergoing outpatient hemorrhoidectomy. Material and methods: We conducted a simple prospective study in 61 patients. After the surgical procedure was performed under multimodal analgesia, an elastomeric endovenous pump operating at 5 ml.h-1 with 16,000 mg of metamizol, 500 mg of tramadol and 16 mg of ondansetron in a 275 ml reservoir was used. At home, the Home Care Unit checked the perfusion system and the endovenous access, detected side effects and events attributable to the system and withdrew the system prematurely during the first 48 hours of postoperative. Results: Just 1 out of 61 patients of the study (1.63%) had severe pain during the first day of postoperative, compared to 81.96% of patients that did not have pain at day 1, 95% at day 2 and 98.35% at day 3. The 9,83% of patients required rescue therapy with tramadol and 20 patients reported side effects attributable to analgesics. There were two cases of early withdrawal of the infusion system because of intolerance to tramadol. A 91.8% of patients reported a high degree of satisfaction with the infusion system and the procedure. Conclusion: Our study has shown the feasibility and safety of the use of endovenous elastomeric infusion pumps as a method of postoperative analgesia that allow to manage cases of moderate or severe pain after outpatient surgical procedures. However, further studies are required to compare this technique with conventional analgesic techniques, as well as with different infusion regimes.Introducción: El dolor postoperatorio moderado-severo sigue siendo un problema en cirugía ambulatoria, ya que provoca problemas de flujo de pacientes, retrasando el alta de los pacientes, siendo uno de los principales motivos de reingreso en los hospitales, y por tanto un importante indicador de calidad de estas Unidades. El empleo de técnicas analgésicas invasivas domiciliarias, en todos sus regímenes, puede controlar el dolor postoperatorio en estas intervenciones y permitir incluirlas en los programas de cirugía ambulatoria. Objetivos: El objetivo de nuestro estudio es valorar la viabilidad y la seguridad de la utilización de bombas de perfusión continua elastoméricas para la administración de analgesia endovenosa continua domiciliaria, a la vez que valorar la eficacia analgésica y el grado de satisfacción de los pacientes intervenidos de hemorroidectomía en régimen ambulatorio. Material y métodos: Estudio prospectivo simple en 61 pacientes. Una vez intervenidos bajo estrategia de analgesia multimodal, se les coloca una bomba elastomérica endovenosa a 5 ml.h-1 con 16.000 mg de metamizol, 500 mg de tramadol y 16 mg de ondansetrón en un reservorio de 275 ml. En el domicilio, la Unidad de Atención Domiciliaria realiza revisiones de la integridad del sistema infusor y de la vía endovenosa, detección de efectos secundarios e incidentes atribuibles al sistema y retiradas precoces durante las 48 horas del postoperatorio. Resultados: De los 61 pacientes, sólo se registra un caso (1,63%) de dolor severo durante el primer día del postoperatorio. Un 81,96% de los pacientes no tienen dolor durante el primer día, 95% el segundo y 98,35% el tercer día. Un 9,83% de los pacientes precisan rescate con tramadol. Veinte pacientes presentan efectos secundarios atribuibles a los analgésicos. Dos casos de retirada precoz del sistema infusor por intolerancia al tramadol. En un 91,8% de los pacientes se mostró un alto grado de satisfacción con el sistema infusor y el procedimiento. Conclusión: Nuestro estudio demuestra la viabilidad y seguridad de la utilización de infusores elastoméricos endovenosos como método de analgesia postoperatoria, que permiten controlar los casos de dolor moderado a severo en procedimientos aplicados a la cirugía ambulatoria. Sin embargo se necesitan más estudios comparativos con técnicas analgésicas convencionales, así como con diferentes regímenes de infusión