Fibromialgia en el distrito de Lambayeque: un estudio preliminar

Objetivo. Determinar la frecuencia delsíndrome de fibromialgia en el distrito de Lambayeque y validar localmente los tests de Zung para ansiedad y depresión. Material y Métodos. Estudio descriptivo, trasversal y prospectivo; muestreo aleatorio, estratificado, bietápico. El distrito de Lambayeque fue dividido en cinco zonas arbitrarias para el muestreo. Ocho alumnos de la Escuela de Medicina fueron capacitados en la aplicación de los criterios del American College of Rheumathology de 1990 para el diagnóstico de fibromialgia. Se aplicó los tests de Zung de depresión y ansiedad y una ficha de recolección de datos para diagnóstico deFibromialgia. resultadOs. Se entrevistó a 94 personas. El promedio de edadfue de 37,3± 12,3años; hubo74 mujeres (78,7%). El valor de los coeficientes de Alfa de Cronbach para los tests de depresión y ansiedad de Zung fueron de 0,71 y 0,73. Se identificó cuatropacientes con fibromialgia (4,2%),cuatrocon síndrome depresivo (4,2%)y nuevede síndrome ansioso (9,7%). Conclusión. La frecuencia de fibromialgia en el distrito de Lambayeque fue relativamente común y los test de Zung paradepresión y ansiedad tuvieron validez y confiabilidad aceptables en dicha población

Comparación del uso del ácido amsónico y Blanco de Calcofluor para colorear hongos sobre bloques de agar

Introducción El diagnóstico temprano y veraz de las micosis invasivas es fundamental para mejorar la calidad de vida de pacientes inmunocomprometidos al disminuir las complicaciones fatales. Aunque las coloraciones que se están aplicando son útiles, tienen baja especificidad y valor predictivo positivo que disminuyen su eficacia en el diagnóstico. Es por esto que es necesario explorar nuevos colorantes como los derivados del estilbeno que son capaces de emitir fluorescencia al unirse a enlaces presentes en la pared celular fúngica. Objetivo Identificar las características operativas de la técnica de coloración ácido amsónico y compararlas con la coloración Blanco de Calcofluor. Materiales y métodos Se realizó un estudio de pruebas diagnósticas, en el que se evaluaron 186 láminas parafinadas para cada coloración con hongos o bacterias. Resultados La especificidad de la microscopía fue mayor con ácido amsónico que con Blanco de Calcofluor (100% y 49,4%, respectivamente). La sensibilidad fue del 96,7% con Blanco de Calcofluor y 93,5% con ácido amsónico. Conclusiones El ácido amsónico es una técnica más específica que el Blanco de Calcofluor y las dos coloraciones requieren entrenamiento previo para la detección microscópica de hongos

Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. METHODS: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. RESULTS: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. CONCLUSION: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Genetic characterization of Escherichia coli isolated from cattle carcasses and feces in Mexico State

Meat of bovine origin is one of the major vehicles in the transmission of verotoxigenic Escherichia coli (VTEC) to human consumers. This pathogen can produce serious human illness, including bloody diarrhea and hemolytic uremic syndrome. The aim of the current study was to characterize E. coli isolates (mainly VTEC strains) belonging to several serotypes in samples from cattle carcasses and feces of three municipal slaughter plants from Mexico State. The genetic diversity and molecular relatedness among the isolates was evaluated with multiple-locus variable-number tandem repeat analysis (MLVA). To our knowledge, and with the exception of E. coli O157:H7, this is the first time that serotypes analyzed here have been subtyped by MLVA in Mexico. MLVA typing grouped the 37 strains from this study into 30 distinct genotypes, 26 of which were unique. These findings indicate that cattle carcasses and feces from slaughter plants in Mexico are a source of VTEC that are genetically diverse in terms of serotypes and virulence profiles. The presence of these pathogens in carcasses indicates the high probability of the spread of VTEC strains during slaughter and processing.Fil: Reyes Rodríguez, Nydia E.. Universidad Nacional Autónoma de México; MéxicoFil: Soriano Vargas, Edgardo. Universidad Nacional Autónoma de México; MéxicoFil: Barba León, Jeannette. Universidad de Guadalajara; MéxicoFil: Navarro, Armando. Universidad Nacional Autónoma de México; MéxicoFil: Talavera Rojas, Martín. Universidad Nacional Autónoma de México; MéxicoFil: Sanso, Andrea Mariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; ArgentinaFil: Bustamante, Ana Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentin

Protección de la innovación : Un diálogo entre la ciencia y la sociedad

El proyecto: Dínamo Innovador de la Escuela de Relaciones Internacionales, de la Universidad Nacional de Costa Rica, ha cargo del Dr. Juan Carlos Bermúdez Mora, en un esfuerzo conjunto con académicos, investigadores, sector público y privado, han gestado el presente libro electrónico denominado: “Protección de la Innovación: un diálogo entre la ciencia y la sociedad”. En este, se cuenta con grupo de investigación interdisciplinario, que desde sus diversas perspectivas, se aborda un tema de trascendental importancia para las empresas y, que constituye en un factor fundamental de la competitividad, manifiesta y propia de siglo XXI: la innovación. El reto de los negocios y, en particular, de las empresas que desean participar en los negocios internacionales, corresponde a la protección de su innovación, de su marca; pero a la vez, resulta necesario establecer un diálogo honesto y profundo que permita a la ciencia acercarse a la sociedad y establecer en conjunto estrategias diferenciadas que conlleven al éxito de los distintos empredimientos. Por ello, ésta obra pretende compilar los aportes multidisciplinares en torno a la gestión de la protección de la innovación como un diálogo entre las ofertas de la ciencia y las demandas de la sociedad para el desarrollo humano sostenible; donde el papel de los diferentes actores es fundamental para llegar a buen puerto. Esta obra trata diversos temas, desde diversas perspectivas, escenarios y contextos, lo cual enriquecerá, sin lugar a dudas, al lector, para que desde una introspección individual se adapten los modelos propuestos a la realidad particular. El documento cuenta a la vez, con diversos casos de estudios que facilitarán la comprensión de que el proceso de innovación dentro de las organizaiones debe ser estructurado, continuo y bajo un liderazgo claro, para que éste no se pierda en el tiempo. No obstante, se finaliza con una reflexión sobre los retos que el avance científico y tecnológico demanda a la sociedad contemporánea. Es por ello, que en un esfuerzo generador de sinergías, el Proyecto Dínamo Innovador y el Proyecto Capacidades de Gestión de la Propiedad Industrial e Intelectual en los Procesos de Emprendimiento en las PYMES de América Central y República Dominicana agradecen la participación de las distintas Facultades y Unidades Académicas de la Universidad Nacional de Costa Rica, así como el apoyo de la Vicerrectoría Académica y de la Dirección de Investigación, así como al Fondo Institucional para el Desarrollo Académico (FIDA). En la misma línea, agradecemos a nuestros colegas del Grupo de Investigación “Propiedad Industrial y Nuevas tecnologías” (PROINDTEN) de la Universidad Carlos III de Madrid, España. Finalmente, quisiera dejar en este espacio plasmado, mi más sincero agradecimiento al Dr. Juan Carlos Bermúdez Mora, quien me ha propuesto la futura coordinación del Proyecto Dínamo Innovador, lo cual representa un reto profesional pero un orgullo personal por la confianza brindada. Extiéndase las gracias al M.Sc. Max Sáurez Ulloa, Director de la Escuela de Relaciones Internacionales de la Universidad Nacional de Costa Rica, quien concordó y accedió en dicha propuesta. Gracias a ambos.The project: Innovative Dynamo of the School of International Relations, of the National University of Costa Rica, has been in charge of Dr. Juan Carlos Bermúdez Mora, in an effort together with academics, researchers, the public and private sectors, have created the present e-book called: “Protection of Innovation: a dialogue between science and the society". In this, there is an interdisciplinary research group, which from its diverse perspectives, an issue of transcendental importance for companies is addressed and, which constitutes a fundamental factor of competitiveness, manifest and typical of the century XXI: innovation. The challenge of business and, in particular, of companies that want to participate in business international, corresponds to the protection of your innovation, your brand; but at the same time, It is necessary to establish an honest and deep dialogue that allows science to approach society and jointly establish differentiated strategies that lead to success of the different ventures. Therefore, this work intends to compile the multidisciplinary contributions around the management of the protection of innovation as a dialogue between the science offers and society demands for sustainable human development; where the role of the different actors is essential to reach a successful conclusion. This work deals with various topics, from different perspectives, settings and contexts, which will enrich, without a doubt, the reader, so that from an individual introspection adapt the proposed models to the particular reality. The document has at the same time, various case studies that will facilitate the understanding that the innovation process within organizations must be structured, continuous and under clear leadership, to may it not be lost in time. However, it ends with a reflection on the challenges that scientific and technological advance demands of contemporary society. That is why, in an effort to generate synergies, the Innovative Dynamo Project and the Project Capacities for the Management of Industrial and Intellectual Property in the Processes of Entrepreneurship in SMEs in Central America and the Dominican Republic appreciate the participation of the different Faculties and Academic Units of the National University of Costa Rica, as well as the support of the Academic Vice-rector and the Research Directorate, as well as the Institutional Fund for Academic Development (FIDA). In the same line, we thank our colleagues from the Research Group “Industrial Property and New technologies ”(PROINDTEN) of the Carlos III University of Madrid, Spain. Finally, I would like to leave in this space, my most sincere thanks to Dr. Juan Carlos Bermúdez Mora, who has proposed to me the future coordination of the Project Innovative Dynamo, which represents a professional challenge but personal pride in the confidence given. Thank you to M.Sc. Max Sáurez Ulloa, Director of the School of International Relations of the National University of Costa Rica, who agreed and agreed on said proposal.Universidad Nacional, Costa RicaEscuela de Relaciones Internacionale