Reducing medication errors for adults in hospital settings

Adulto; Errores de medicación; FarmacéuticosAdult; Medication errors; PharmacistsAdult; Errors de medicació; FarmacèuticsBackground: Medication errors are preventable events that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional or patient. Medication errors in hospitalised adults may cause harm, additional costs, and even death. Objectives: To determine the effectiveness of interventions to reduce medication errors in adults in hospital settings

Análisis de la iniciativa minera en Colombia

This paper reviews several articles related to the Mining presidential program “La Locomotora” of President Juan Manuel Santos. From these documents, an approach to the conflicting mining process in Colombia was made, while analyzing the social and environmental challenges that affect the people who move between the fascination for wealth and the inferno that is left behind that in the ditch. Following this line of thought, this research describes the Colombian mining context, the State involvement in the regulation of tittles and the multinational relationships with the government. Analyzes the effect on populations due to specific factors that have been maintained over decades. First, the lack of social sustainability at long term, as the local economy is defined by market fluctuations; secondly, the absence of an equitable distribution of royalties, due to administrative corruption; thirdly, the presence of groups outside the law controlling the business and, finally, to the permissiveness of the same State granting mining permits in protected areas such as National Parks and river sources. The conclusion reached by the text refers to recognizing the lessons left by the past. the violence to ancestral communities generates indeed, more violence and citizen resentment. The single economic goal does not create wealth, but a momentary bonanza rootless on generations to come.El documento hace una revisión de artículos relacionados con el programa presidencial la Locomotora Minera del presidente Juan Manuel Santos. Desde esos documentos se hace un acercamiento al conflictivo proceso minero en Colombia, al tiempo que se analizan los retos sociales y ambientales a los que se exponen las poblaciones que transitan entre la fascinación por la riqueza y el infierno que al final queda en los socavones. Siguiendo ese orden de ideas, la investigación describe el contexto minero colombiano, la participación del Estado en la regulación de títulos y las relaciones de las multinacionales con el gobierno. Analiza la afectación a las poblaciones debido a factores específicos que se han mantenido a lo largo de décadas: en primer lugar, la ausencia de sostenibilidad social a largo plazo, pues la economía local queda definida por las oscilaciones del mercado; en segundo lugar, por la ausencia de una distribución equitativa de las regalías, esto debido a la corrupción administrativa; en tercer lugar, por la presencia de grupos al margen de la ley que controlan el negocio y, por último, a la permisividad del mismo Estado que otorga títulos mineros en zonas protegidas, como parques naturales y nacimientos de ríos. Las conclusiones a las que llega el texto remiten al reconocimiento de las lecciones que ha dejado el pasado: la violencia a las comunidades ancestrales genera más violencia y resentimiento ciudadano. La sola meta económica no genera riqueza, sino una bonanza momentánea sin raíces en las generaciones venideras

Digital elevation models: altimetric corrections for hydrological usage in flat areas

La representación del movimiento del agua sobre el terreno hacia los cauces se genera a partir del procesamiento de mapas topográficos en un entorno de sistemas de información geográfica y teledetección. El objetivo del trabajo fue la definición de un sistema de drenaje superficial en una cuenca de llanura a partir del modelo digital de elevación global ajustado geodésicamente en el norte de la cuenca del Río Salado (subregión A1). Como información base se utilizaron capas vectoriales de drenaje e información de topografía del SRTM90. Este último ha sido ajustado geodésicamente a través de información geodésica de GPS y nivelación. Con el SRTM corregido y la herramienta Arc Hydro Tools se logró definir un sistema de drenaje que involucra la subregión A1 corregida. Por último se realizó un análisis multitemporal de cuerpos de agua, provenientes de distintas fuentes de información nacional (IGN) e internacional (Observatorio de Inundaciones Dartmouth, USA). Este procesamiento permitió diferenciar su ocupación superficial durante periodos de estiaje o inundación y permite la toma adecuada de decisiones en relación a la prevención o mitigación de alertas en una zona llana; en especial en lugares con proximidad a zonas pobladas o agropecuarias. Se concluye que a medida que se detallan las características topográficas de una zona, con correcciones geodésicas con datos de campo, es posible delimitar con mayor precisión a una cuenca hidrográfica junto con su sistema de drenaje superficial.The representation of water movement on the ground towards the courses of water is generated from the processing of topographic maps in an environment of geographic information systems and remote sensing. The objective of this work was to define a surface drainage system in a plain basin based on a geodetically adjusted digital elevation model in the north of the Salado River Basin (A1 region). Drainage vector layers and the SRTM90 topography information were used as primary data. The latter has been geodetically adjusted through GPS and levelling information. With the corrected SRTM and the Arc Hydro Tools, it was possible to define a drainage system that involves the corrected A1 region. Finally, a multi-temporal analysis of water bodies, from different sources of national (IGN) and international information (Dartmouth Flood Observatory, USA) was carried out. This allowed differentiating its surface occupation behavior during dry or flood periods, and contributes to taking the appropriate decision to prevent or mitigate alerts from the rising of water bodies in a flat area of similar extension; especially in places close to populated or agricultural areas. It is concluded that as the topographic features of a region are detailed and corrected by means of geodetic data, it is possible to delimit a watershed together with its surface drainage system with more precision.Facultad de Ciencias Astronómicas y Geofísica

Digital elevation models: altimetric corrections for hydrological usage in flat areas

La representación del movimiento del agua sobre el terreno hacia los cauces se genera a partir del procesamiento de mapas topográficos en un entorno de sistemas de información geográfica y teledetección. El objetivo del trabajo fue la definición de un sistema de drenaje superficial en una cuenca de llanura a partir del modelo digital de elevación global ajustado geodésicamente en el norte de la cuenca del Río Salado (subregión A1). Como información base se utilizaron capas vectoriales de drenaje e información de topografía del SRTM90. Este último ha sido ajustado geodésicamente a través de información geodésica de GPS y nivelación. Con el SRTM corregido y la herramienta Arc Hydro Tools se logró definir un sistema de drenaje que involucra la subregión A1 corregida. Por último se realizó un análisis multitemporal de cuerpos de agua, provenientes de distintas fuentes de información nacional (IGN) e internacional (Observatorio de Inundaciones Dartmouth, USA). Este procesamiento permitió diferenciar su ocupación superficial durante periodos de estiaje o inundación y permite la toma adecuada de decisiones en relación a la prevención o mitigación de alertas en una zona llana; en especial en lugares con proximidad a zonas pobladas o agropecuarias. Se concluye que a medida que se detallan las características topográficas de una zona, con correcciones geodésicas con datos de campo, es posible delimitar con mayor precisión a una cuenca hidrográfica junto con su sistema de drenaje superficial.The representation of water movement on the ground towards the courses of water is generated from the processing of topographic maps in an environment of geographic information systems and remote sensing. The objective of this work was to define a surface drainage system in a plain basin based on a geodetically adjusted digital elevation model in the north of the Salado River Basin (A1 region). Drainage vector layers and the SRTM90 topography information were used as primary data. The latter has been geodetically adjusted through GPS and levelling information. With the corrected SRTM and the Arc Hydro Tools, it was possible to define a drainage system that involves the corrected A1 region. Finally, a multi-temporal analysis of water bodies, from different sources of national (IGN) and international information (Dartmouth Flood Observatory, USA) was carried out. This allowed differentiating its surface occupation behavior during dry or flood periods, and contributes to taking the appropriate decision to prevent or mitigate alerts from the rising of water bodies in a flat area of similar extension; especially in places close to populated or agricultural areas. It is concluded that as the topographic features of a region are detailed and corrected by means of geodetic data, it is possible to delimit a watershed together with its surface drainage system with more precision.Facultad de Ciencias Astronómicas y Geofísica

Digital elevation models: altimetric corrections for hydrological usage in flat areas

La representación del movimiento del agua sobre el terreno hacia los cauces se genera a partir del procesamiento de mapas topográficos en un entorno de sistemas de información geográfica y teledetección. El objetivo del trabajo fue la definición de un sistema de drenaje superficial en una cuenca de llanura a partir del modelo digital de elevación global ajustado geodésicamente en el norte de la cuenca del Río Salado (subregión A1). Como información base se utilizaron capas vectoriales de drenaje e información de topografía del SRTM90. Este último ha sido ajustado geodésicamente a través de información geodésica de GPS y nivelación. Con el SRTM corregido y la herramienta Arc Hydro Tools se logró definir un sistema de drenaje que involucra la subregión A1 corregida. Por último se realizó un análisis multitemporal de cuerpos de agua, provenientes de distintas fuentes de información nacional (IGN) e internacional (Observatorio de Inundaciones Dartmouth, USA). Este procesamiento permitió diferenciar su ocupación superficial durante periodos de estiaje o inundación y permite la toma adecuada de decisiones en relación a la prevención o mitigación de alertas en una zona llana; en especial en lugares con proximidad a zonas pobladas o agropecuarias. Se concluye que a medida que se detallan las características topográficas de una zona, con correcciones geodésicas con datos de campo, es posible delimitar con mayor precisión a una cuenca hidrográfica junto con su sistema de drenaje superficial.The representation of water movement on the ground towards the courses of water is generated from the processing of topographic maps in an environment of geographic information systems and remote sensing. The objective of this work was to define a surface drainage system in a plain basin based on a geodetically adjusted digital elevation model in the north of the Salado River Basin (A1 region). Drainage vector layers and the SRTM90 topography information were used as primary data. The latter has been geodetically adjusted through GPS and levelling information. With the corrected SRTM and the Arc Hydro Tools, it was possible to define a drainage system that involves the corrected A1 region. Finally, a multi-temporal analysis of water bodies, from different sources of national (IGN) and international information (Dartmouth Flood Observatory, USA) was carried out. This allowed differentiating its surface occupation behavior during dry or flood periods, and contributes to taking the appropriate decision to prevent or mitigate alerts from the rising of water bodies in a flat area of similar extension; especially in places close to populated or agricultural areas. It is concluded that as the topographic features of a region are detailed and corrected by means of geodetic data, it is possible to delimit a watershed together with its surface drainage system with more precision.Facultad de Ciencias Astronómicas y Geofísica

Riesgo de preeclampsia y suplementación de vitamina C y E: revisión sistemática y metanálisis

Introducción: Se ha sugerido que la preeclampsia puede ser prevenida por la ingesta de vitamina E y C, dado el mecanismo fisiopatológico de esta enfermedad. Objetivo: Determinar la eficacia conjunta de la vitamina C y E en la prevención de la preeclamsia. Métodos: Revisión sistemática de ensayos clínicos aleatorizados. Se realizó una búsqueda en las bases de datos pubmed/medline, SCOPUS, Web of Science, Cochrane Library, EMBASE, y Clinical Trials. El riesgo de sesgo de los ensayos clínicos aleatorios se evaluó mediante la herramienta Cochrane versión 2. Se realizó un metanálisis de efectos aleatorios y se calcularon los riesgos relativos, con los correspondientes intervalos de confianza al 95 %. Resultados: Se incluyeron 7 estudios (n= 1 475). No se encontró asociación estadísticamente significativa del tratamiento con suplementación de vitamina C y E con respecto a la preeclampsia (riesgo relativo: 1,03; IC95 %: 0,78-1,26). Conclusiones: La suplementación dual de vitamina C y E no previene la preeclamsia en gestantes con riesgo de padecer la enfermedad.Campus Lima Nort

Risk scores' performance and their impact on operative decision‑making in left‑sided endocarditis: a cohort study

Theaccuracy of contemporary risk scores in predicting perioperative mortality in infective endocarditis (IE) remains controversial. The aim is to evaluate the performance of existent mortality risk scores for cardiovascular surgery in IE and the impact on operability at high-risk thresholds. A single-center retrospective review of adult patients diagnosed with acute left-sided IE undergoing surgery from May 2014 to August 2019 (n = 142) was done. Individualized risk calculation was obtained according to the available mortality risk scores: EuroScore I and II, PALSUSE, Risk-E, Costa, De Feo-Cotrufo, AEPEI, STS-risk, STS-IE, APORTEI, and ICE-PCS scores. A cross-validation analysis was performed on the score with the best area under the curve (AUC). The 30-day survival was 96.5% (95%CI 91-98%). The score with worse area under the curve (AUC = 0.6) was the STS-IE score, while the higher was for the RISK-E score (AUC = 0.89). The AUC of the majority of risk scores suggested acceptable performance; however, statistically significant differences in expected versus observed mortalities were common. The cross-validation analysis showed that a large number of survivors (> 75%) would not have been operated if arbitrary high-risk threshold estimates had been used to deny surgery. The observed mortality in our cohort is significantly lower than is predicted by contemporary risk scores. Despite the reasonable numeric performance of the analyzed scores, their utility in judging the operability of a given patient remains questionable, as demonstrated in the cross-validation analysis. Future guidelines may advise that denial of surgery should only follow a highly experienced Endocarditis Team evaluation

Analysis of the discrepancies between the vertical reference frames of Argentina and Brazil

The vertical reference frames for Argentina and Brazil present discrepancies due to their different datums and realizations. Thus, since 2008, we have started a series of activities with the aim of unifying the Argentine and Brazilian national vertical networks (NVNs). To achieve this goal, we have connected the two NVNs at three border points by using the geodetic levelling approach. Additionally, the gravity field approach was also applied, based on a suitable representation of the geoid by considering the Earth GravitationalModel (EGM2008) in its full resolution. In this regard, 1266 co-located Global Positioning System (GPS) and levelling benchmarks regularly distributed over Argentina (612) and Brazil (654) were considered. The geodetic levelling approach shows an offset value of 54 cm, which implies that the Argentine vertical reference frame is above that of the Brazilian vertical reference frame. However, the result of the gravimetric approach shows an offset of 57 cm, which implies a difference of approximately 3 cm between both methods. Hence, since Brazil and Argentina represent a significant part of South America, the solution to the datum problem between both countries could point towards a common vertical reference frame for the Atlantic side.Facultad de Ciencias Agrarias y Forestale

Frequency of cancer in children residing in Mexico City and treated in the hospitals of the Instituto Mexicano del Seguro Social (1996–2001)

BACKGROUND: The objective of this article is to present the frequency of cancer in Mexican children who were treated in the hospitals of the Instituto Mexicano del Seguro Social in Mexico City (IMSS-MC) in the period 1996–2001. METHODS: The Registry of Cancer in Children, started in 1996 in the IMSS-MC, is an on-going, prospective register. The data from 1996 through 2001 were analyzed and the different types of cancer were grouped according to the International Classification for Cancer in Children (ICCC). From this analysis, the general and specific frequencies by age and by sex were obtained for the different groups of neoplasms. Also, the frequency of the stage of the disease that had been diagnosed in cases of children with solid tumors was obtained. RESULTS: A total of 1,702 new cases of children with cancer were registered, with the male/female ratio at 1.1/1. Leukemias had the highest frequency with 784 cases (46.1%) and, of these, acute lymphoblastic leukemias were the most prevalent with 614 cases (78.3%). Thereafter, in descending order of frequency, were tumors of the central nervous system (CNST) with 197 cases (11.6%), lymphomas with 194 cases (11.4%), germinal cell tumors with 110 cases (6.5%), and bone tumors with 97 cases (5.7%). The highest frequency of cancer was found in the group of one to four year-olds that had 627 cases (36.8%). In all the age groups, leukemias were the most frequent. In the present work, the frequency of Hodgkin's disease (~4%) was found to be lower than that (~10%) in previous studies and the frequency of tumors of the sympathetic nervous system was low (2.3%). Of those cases of solid tumors for which the stage of the disease had been determined, 66.9% were diagnosed as being Stage III or IV. CONCLUSIONS: The principal cancers in the children treated in the IMSS-MC were leukemias, CNST, and lymphomas, consistent with those reported by developed countries. A 2.5-fold reduction in the frequency of Hodgkin's disease was found. Of the children, the stage of whose disease had been determined, two thirds were diagnosed as having advanced stages of the disease

Impacto del Centro de Estudios para el Desarrollo de la Producción Animal (CEDEPA) en la ganadería del territorio. 1. Programa de formación en extensión rural

The impact of a teaching program to train people as rural extension workers was evaluated at livestock centers in Camagüey province, Cuba, from 1996 to 2006. This project, named Rural Extension and Agricultural Technology Office (OFERTA), is and agricultural extension working tool developed by CEDEPA affiliated to the Faculty of Agricultural Sciences from Camagüey University. The highest impact of this program was centered on the project management and integration as well graduate and postgraduate teaching to train people as rural extension workers for regional livestock centers. Qualified personnel can be found at every production structure level; however, they are not always oriented towards the communication with simple producers, technology transfer, their own re-qualification, and the links and feedback with alike universities and research centers.Se evaluó el impacto de un programa de formación de recursos humanos como extensionistas, en el período de 1996 a 2006 en empresas ganaderas de Camagüey, Cuba. El proyecto se nombra Oficina de Extensión Rural y Tecnología Agropecuaria (OFERTA), dispositivo de trabajo en extensión agrícola creado en el Centro de Estudios para el Desarrollo de la Producción Animal (CEDEPA) de la Facultad de Ciencias Agropecuarias de la Universidad de Camagüey. Las áreas de mayor impacto del programa fueron la gestión-integración de proyectos y, por supuesto, la docencia de pre y posgrado para la formación de recursos humanos en extensión rural para las empresas ganaderas de la región. En las estructuras de producción hay personal calificado en cada frente, pero no siempre orientado al trabajo de comunicación con el productor de base, la transferencia de tecnología, su propia recalificación y el enlaceretroalimentación con las universidades y centros de investigación afines