Estudio de factibilidad para la apropiación tecnológica, dentro del mercado colombiano, de un aerogenerador de 400 w.

Este proyecto se desarrolla como trabajo de grado para la carrera Ingeniería de diseño de producto, enmarcándose dentro de las áreas de la ingeniería inversa, desarrollo sostenible y producción. Su objetivo principal es el de estudiar la factibilidad técnica y económica de realizar la apropiación tecnológica de un pequeño aerogenerador de 400 W, para ser utilizado en zonas no interconectadas del país donde las condiciones de viento sean propicias.127 p.Contenido parcial: Variables relacionadas con la energía eólica -- Situación actual de la energía eólica a nivel mundial -- Estado actual y perspectivas de la energía eólica dentro del mercado latinoamericano -- Viabilidad técnica: proceso de ingeniería inversa -- Definición técnica de una turbina eólica

Estudio observacional del gasto farmacéutico en población inmigrante y autóctona de la región sanitaria de Lleida (Cataluña)

ResumenObjetivosAnalizar si hay diferencias en el gasto farmacéutico entre inmigrantes y autóctonos en la población general y si el ámbito de residencia (urbano/rural) está asociado al gasto en farmacia.DiseñoEstudio observacional transversal.EmplazamientoRegión Sanitaria Lleida.ParticipantesSe estudiaron 22.847 inmigrantes y 174.768 autóctonos de 15 a 64 años de edad, residentes en la Región Sanitaria Lleida.Mediciones principalesGasto en farmacia durante el año 2007, variables demográficas, zona de procedencia y área de residencia (urbana/rural).ResultadosEn todos los grupos terapéuticos, los individuos autóctonos gastaron más que los inmigrantes. En los hombres, la ratio de riesgo relativo de estar en el cuartil superior de gasto era de 3,2 (ICntervalo de confianza [IC] 95%: 2,96–3,44) en autóctonos respecto a inmigrantes y en las mujeres era de 2,1 (IC 95%: 1,97–2,27). Los inmigrantes de Europa del Este eran los que tenían un riesgo inferior de realizar gasto farmacéutico elevado (último cuartil), con diferencias estadísticamente significativas. Los residentes en el medio rural tenían riesgo superior de realizar gasto farmacéutico elevado respecto a los residentes en el medio urbano.ConclusiónSe observaron desigualdades en el gasto en medicamentos entre inmigrantes y autóctonos. Futuros estudios, cualitativos o mixtos, deberían indagar qué factores se asocian a estas diferencias y proponer acciones dirigidas a reducirlas.AbstractObjectiveTo evaluate whether there are differences in drug spending between immigrant and Spanish-born populations and to assess whether drug consumption is associated with living environment (urban/rural).DesignObservational cross-sectional study.SettingLleida Health Region (LHR).Participants22,847 immigrants and 174,768 native born subjects, aged 15 to 64 years, residing in the LHR.Main measurementsDrug spending during the year 2007, demographical variables, region of origin and residence area (urban/rural).ResultsNative-born subjects spent more in all therapeutic drug groups than immigrants. In men, the relative risk ratio (RRR) of being in the highest quartile of expenditure was 3.2 (95% CI: 2.96–3.44) for native born versus immigrant and in women it was 2.1 (95% CI: 1.97–2.27). Immigrants from eastern Europe had the lowest risk of being in the highest quartile of expenditure, with statistically significant differences. Residents in the rural environment were more likely to have a higher pharmaceutical consumption than residents in the urban environment.ConclusionInequalities in drug spending were observed between immigrants and native born subjects. Further studies, either qualitative or mixed, should explore which factors are related to these differences and propose strategies addressed to reducing them

Ischemic heart disease and primary care: identifying gender-related differences. An observational study

Background: Gender-related differences are seen in multiple aspects of both health and illness. Ischemic heart disease (IHD) is a pathology in which diagnostic, treatment and prognostic differences are seen between sexes, especially in the acute phase and in the hospital setting. The objective of the present study is to analyze whether there are differences between men and women when examining associated cardiovascular risk factors and secondary pharmacological prevention in the primary care setting. Methods: Retrospective descriptive observational study from January to December of 2006, including 1907 patients diagnosed with ischemic heart disease in the city of Lleida, Spain. The clinical data were obtained from computerized medical records and pharmaceutical records of medications dispensed in pharmacies with official prescriptions. Data was analyzed using bivariate descriptive statistical analysis as well as logistic regression. Results: There were no gender-related differences in screening percentages for arterial hypertension, diabetes, obesity, dyslipemia, and smoking. A greater percentage of women were hypertensive, obese and diabetic compared to men. However, men showed a tendency to achieve control targets more easily than women, with no statistically significant differences. In both sexes cardiovascular risk factors control was inadequate, between 10 and 50%. For secondary pharmaceutical prevention, the percentages of prescriptions were greater in men for anticoagulants, beta-blockers, lipid-lowering agents and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, with age group variations up to 10%. When adjusting by age and specific diagnoses, differences were maintained for anticoagulants and lipid-lowering agents. Conclusion: Screening of cardiovascular risk factors was similar in men and women with IHD. Although a greater percentage of women were hypertensive, diabetic or obese, their management of risk factors tended to be worse than men. Overall, a poor control of cardiovascular risk factors was noted. Taken as a whole, more men were prescribed secondary prevention drugs, with differences varying by age group and IHD diagnosis

Development of pediatric hydronephrosis patients visiting the San Vicente Foundation University Hospital, Medellín, Colombia

ABSTRACT: Hydronephrosis is one of the most common congenital malformations detected on prenatal ultrasounds. Moderate and severe cases are often associated with urological abnormality. Objetive: To describe a series of pediatric patients diagnosed with hydronephrosis determining their etiology, prenatal diagnosis and frequency of chronic kidney disease (CKD). Materials and methods: A descriptive, retrospective study. Results: The records of 924 patients between the ages of 0 and 18 years were evaluated, 35.7% female and 64.3% male. In 14.4% (133) the diagnosis was prenatal. Hydronephrosis was bilateral in 198 patients (28.5%). In 18.3% (169) no associated urological abnormality was found, reaching 4.2% in CKD (7). Ureteropelvic stenosis was diagnosed in 23.3% (216) followed with 21.5% VUR (199) and posterior urethral valves in 9.4% (87), reaching 10.2% ERC (93). When the hydroneprhosis was diagnosed by urography, those patients presented 11.3% of chronic kidney disease vs. 8.4% in whom the diagnosis was made by ultrasound, when the hydronephosis diagnosed was by prenatal vs postnatal ultrasound, the percentage of CKD was 4.8% vs 10.8%, respectively. Conclusion:Early diagnosis of hydronephrosis allows the detection of urologic abnormalities susceptible of treatment. Although there are still many questions about which one is the ideal strategy of follow up; the ultrasonography, voiding cystourethrogram, urography, scintigraphy and magnetic resonance urography in selected patients are the most useful tools in order to evaluate urinary tract anomaly

Utilización de recursos de atención primaria por parte de inmigrantes y autóctonos que han contactado con los servicios asistenciales de la ciudad de Lleida

ObjetivoEvaluar y comparar la utilización de recursos en los distintos servicios de atención primaria (AP) entre inmigrantes y autóctonos.DiseñoEstudio observacional transversal en población visitada en AP.EmplazamientoPersonas atendidas por 15 médicos de AP en 5 áreas básicas de salud (ABS) de la ciudad de Lleida de marzo a agosto de 2005.ParticipantesSe incluyó a todos los inmigrantes atendidos durante el período de estudio (1.599 pacientes de origen inmigrante). Se realizó un muestreo aleatorio de 300 pacientes en cada una de las 15 consultas participantes (4.156 pacientes de origen autóctono). Se consideró población autóctona aquella cuyo país de origen es España y población inmigrante aquella que proviene de los países de renta baja y media, independientemente del tiempo de asistencia al ABS.Mediciones principalesEdad, sexo, tipo de visitas realizadas y las derivaciones efectuadas. Se utilizaron modelos de regresión multinomial para estimar el riesgo relativo (RR) de haber realizado las visitas.ResultadosLos inmigrantes tienen una probabilidad superior a los autóctonos de realizar más de 3 visitas, frente a 1 o 2 visitas (RR = 1,23; intervalo de confianza [IC] del 95%, 1,04-1,91%). La estimación del RR de haber realizado visitas es superior en los inmigrantes para todas las categorías, excepto en enfermería (RR = 0,59; IC del 95%, 0,5-0,71%).ConclusionesLos inmigrantes que contactan con AP lo hacen con mayor frecuencia en las consultas de medicina de familia y de ginecología, y además se realizan más pruebas complementarias. Sin embargo, la frecuentación del colectivo inmigrante a las consultas de enfermería parece ser inferior.ObjectiveTo evaluate and compare the use of the different primary care (PC) services between immigrants and the indigenous population.DesignCross-sectional observation study of a population seen in (PC).SettingPatients seen by 15 PC doctors, in 5 basic health areas (BHA) in the city of Lleida, Spain, from March to August 2005.ParticipantsAll immigrants (1599 patients of immigrant origin) who seen during the study period were included. A random sample of 300 patients was taken from each of the 15 participating clinics (4156 autochthonous patients). The autochthonous was considered as those whose country of origin is Spain and the immigrant population those who come from low and medium income countries, regardless of the time of residence in the BHA.Primary measurementsAge, sex, type of visit made, and referrals made. Multinomial regression models were used to calculate the relative risk (RR) of having made visits.ResultsImmigrants have a higher probability to make 3 visits than the indigenous population, who would make 1 or 2 visits (RR, 1.23; 95% confidence interval, 1.04-1.91). The estimation of the RR of having made visits is higher in the immigrants for all categories, except nursing.ConclusionsImmigrants who come into contact with PC, make more frequent visits to the family doctor and gynaecology, and also have more complementary tests done. However, the frequency of use of the immigrant group for nursing visits seems to be less

Evolution of pediatric patients diagnosed with hydronephrosis at Hospital Universitario San Vicente Fundación, in Medellín, Colombia between 1960 and 2010

ABSTRACT: Hydronephrosis is one of the most common congenital malformations detected on prenatal ultrasounds. Moderate and severe cases are often associated with urological abnormalities. Objective: To describe the causes of hydronephrosis, and the frequency of its prenatal diagnosis and of chronic kidney disease (CKD) in a series of pediatric patients. Materials and methods: A descriptive, retrospective study of 924 patients under 18 years of age seen at a university hospital in Medellín, Colombia, between 1960 and 2010. Results: 64.3% were male. Diagnosis was prenatal in 133 (14.4%). Hydronephrosis was bilateral in 198 patients (28.5%). In 169 (18.3%) no associated urological abnormality was found; 7 of these (4.2%) reached CKD. Ureteropelvic stenosis was diagnosed in 216 (23.3%) followed by vesicoureteral reflux in 199 (21.5%) and posterior urethral valves in 87 (9.4%); 93 (10.2%) reached CKD. When hydronephrosis was diagnosed by urography, patients developed CKD in 11.3% vs. 8.4% in those whose diagnosis was made by ultrasound; frequency of CKD was 4.8% when diagnosis by ultrasound was prenatal, and 10.8% when it was postnatal. Conclusion: Early diagnosis of hydronephrosis allows the detection of urologic abnormalities susceptible to treatment. There is controversy about the best imaginological method for the follow-up of these patients.RESUMEN: La hidronefrosis es una de las malformaciones congénitas detectadas comúnmente en la ecografía prenatal. Los casos moderados y graves frecuentemente se asocian a anomalías de la vía urinaria. Objetivo: describir las causas de la hidronefrosis, la frecuencia de su diagnóstico prenatal y la de enfermedad renal crónica (ERC) en una serie de pacientes pediátricos. Materiales y métodos: estudio descriptivo, retrospectivo de 924 pacientes atendidos entre 1960 y 2010 en un hospital universitario de Medellín. Resultados: hubo predominio de hombres (64,3%); en el 14,4% el diagnóstico fue prenatal. En el 18,3% no se encontraron anomalías urológicas asociadas. Siete de estos (4,2%) llegaron a la ERC. La estenosis pieloureteral fue la anomalía hallada con mayor frecuencia (28,6%) seguida por el reflujo vesicoureteral (21,5%) y las valvas de la uretra posterior (9,4%); el 10,2% de los pacientes llegaron a la enfermedad renal crónica; al agrupar los pacientes de acuerdo con el método utilizado para el diagnóstico de hidronefrosis, el grupo en que se hizo por urografía excretora tuvo ERC en el 11,3%, en contraste con el 8,4% en quienes el diagnóstico se hizo por ecografía renal; por otro lado. al agrupar los pacientes con diagnóstico ecográfico de hidronefrosis prenatal o posnatal, el porcentaje de ERC fue de 4,8% frente a 10,8%, respectivamente. Conclusión: el diagnóstico temprano de la hidronefrosis permite detectar anomalías urológicas susceptibles de seguimiento o corrección quirúrgica. Todavía existe mucha controversia acerca del mejor seguimiento imaginológico para estos pacientes