Conversión de prueba cutánea de derivado proteico purificado durante el tratamiento con anti-TNF-α

Introducción: los anti-TNF-α se asocian con mayor riesgo de desarrollar tuberculosis (TB). La prueba del derivado proteico purificado (purified protein derivative, PPD) se emplea para diagnosticar infección de tuberculosis latente (ITL). Se recomienda el cribado para TB previo al inicio de terapia anti-TNF-α y el seguimiento para evaluar la posible conversión de la PPD durante el tratamiento. El tratamiento de la ITL puede reducir el riesgo de desarrollar enfermedad activa en un 90%. Objetivos: actualmente los resultados de conversión de la PPD y su interpretación durante el tratamiento anti-TNF-α son variables, por tal motivo nos propusimos conocer la frecuencia de conversión de la PPD en este grupo de pacientes de nuestro medio

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Nostalgia, anticonsumo simbólico y bienestar : la agricultura urbana

O estabelecimento de uma cultura de consumo, disseminada globalmente nos últimos anos, teve como consequência a crescente preocupação das pessoas com o impacto dos níveis de consumo sobre o ambiente e seu bem-estar pessoal. Nesse contexto, surge a Agricultura Urbana (AU) associada a diversos benefícios ambientais, sociais e relativos à saúde (SLATER, 2001). O propósito do estudo foi compreender o significado da AU como fenômeno de consumo, identificando as distintas teorias que estão vinculadas a ela, bem como suas inter-relações. Desenvolveu-se uma pesquisa qualitativa com entrevistas em profundidade. Os entrevistados são especialistas em agricultura urbana e praticantes da atividade, residentes em nove bairros da área urbana de uma grande capital brasileira. Com base nos resultados, percebe-se dupla motivação para a prática da AU: uma extrínseca (o exemplo) e outra intrínseca (o bem-estar). Há vinculação da prática da AU com (a) a preocupação com o meio ambiente, a saúde e o bem-estar próprio e dos demais e (b) com o respeito e orgulho nostálgico por uma herança cultural.The establishment of a global consumption culture had as a consequence a growing concern with the impact of consumption practices on the environment, as well as on the general and personal well -being. In this context emerges the urban agriculture (UA) associated to environmental, social and health benefits (SLATER, 2001). The objective of this study is to understand the meaning of the UA phenomenon as a consumption practice, identifying which theories are related to it. In order to reach that goal, a qualitative research used as data collection in-depth interviews. The subjects were experts and practitioners in UA living in 9 neighborhoods in urban areas of a Brazilian city with a population bigger than 1 million inhabitants. Results showed double motivation for the UA practice, extrinsic (example) and intrinsic (well-being), linking the UA to environmental concerns, to health and well-being, and the respect and pride for a nostalgic cultural heritage.El establecimiento de una cultura de consumo, diseminada globalmente los últimos años, tuvo como consecuencia la creciente preocupación de las personas con e impacto de los niveles de consumo sobre el entorno y su bienestar personal. En ese contexto, surge la Agricultura Urbana (AU) asociada a diversos beneficios ambientales, sociales y relativos a la salud (SLATER, 2001). El propósito del estudio fue comprender el significado de la AU como fenómeno de consumo, identificando las diferentes teorías que están vinculadas a ella, así como sus interrelaciones. Se desarrolló un estudio cualitativo con entrevistas en profundidad. Los entrevistados son especialistas en agricultura urbana y practicantes de la actividad, residentes en nueve barrios del área urbana de una gran capital brasileña. Con base en los resultados, se percibe una doble motivación para la práctica de la AU: una extrínseca (el ejemplo) y otra intrínseca (el bienestar). Hay vínculo de la práctica de la AU con (a) la preocupación con el medio ambiente, la salud y el bienestar propio y de los demás y (b) con el respeto y orgullo nostálgico por una herencia cultural

Nostalgia, anticonsumo simbólico y bienestar : la agricultura urbana

O estabelecimento de uma cultura de consumo, disseminada globalmente nos últimos anos, teve como consequência a crescente preocupação das pessoas com o impacto dos níveis de consumo sobre o ambiente e seu bem-estar pessoal. Nesse contexto, surge a Agricultura Urbana (AU) associada a diversos benefícios ambientais, sociais e relativos à saúde (SLATER, 2001). O propósito do estudo foi compreender o significado da AU como fenômeno de consumo, identificando as distintas teorias que estão vinculadas a ela, bem como suas inter-relações. Desenvolveu-se uma pesquisa qualitativa com entrevistas em profundidade. Os entrevistados são especialistas em agricultura urbana e praticantes da atividade, residentes em nove bairros da área urbana de uma grande capital brasileira. Com base nos resultados, percebe-se dupla motivação para a prática da AU: uma extrínseca (o exemplo) e outra intrínseca (o bem-estar). Há vinculação da prática da AU com (a) a preocupação com o meio ambiente, a saúde e o bem-estar próprio e dos demais e (b) com o respeito e orgulho nostálgico por uma herança cultural.The establishment of a global consumption culture had as a consequence a growing concern with the impact of consumption practices on the environment, as well as on the general and personal well -being. In this context emerges the urban agriculture (UA) associated to environmental, social and health benefits (SLATER, 2001). The objective of this study is to understand the meaning of the UA phenomenon as a consumption practice, identifying which theories are related to it. In order to reach that goal, a qualitative research used as data collection in-depth interviews. The subjects were experts and practitioners in UA living in 9 neighborhoods in urban areas of a Brazilian city with a population bigger than 1 million inhabitants. Results showed double motivation for the UA practice, extrinsic (example) and intrinsic (well-being), linking the UA to environmental concerns, to health and well-being, and the respect and pride for a nostalgic cultural heritage.El establecimiento de una cultura de consumo, diseminada globalmente los últimos años, tuvo como consecuencia la creciente preocupación de las personas con e impacto de los niveles de consumo sobre el entorno y su bienestar personal. En ese contexto, surge la Agricultura Urbana (AU) asociada a diversos beneficios ambientales, sociales y relativos a la salud (SLATER, 2001). El propósito del estudio fue comprender el significado de la AU como fenómeno de consumo, identificando las diferentes teorías que están vinculadas a ella, así como sus interrelaciones. Se desarrolló un estudio cualitativo con entrevistas en profundidad. Los entrevistados son especialistas en agricultura urbana y practicantes de la actividad, residentes en nueve barrios del área urbana de una gran capital brasileña. Con base en los resultados, se percibe una doble motivación para la práctica de la AU: una extrínseca (el ejemplo) y otra intrínseca (el bienestar). Hay vínculo de la práctica de la AU con (a) la preocupación con el medio ambiente, la salud y el bienestar propio y de los demás y (b) con el respeto y orgullo nostálgico por una herencia cultural

NOSTALGIA, ANTICONSUMO SIMBÓLICO E BEM-ESTAR: A AGRICULTURA URBANA

The establishment of a global consumption culture had as a consequence a growing concern with the impact of consumption practices on the environment, as well as on the general and personal well-being. In this context emerges the urban agriculture (UA) associated to environmental, social and health benefits (SLATER, 2001). The objective of this study is to understand the meaning of the UA phenomenon as a consumption practice, identifying which theories are related to it. In order to reach that goal, a qualitative research used as data collection in-depth interviews. The subjects were experts and practitioners in UA living in 9 neighborhoods in urban areas of a Brazilian city with a population bigger than 1 million inhabitants. Results showed double motivation for the UA practice, extrinsic (example) and intrinsic (well-being), linking the UA to environmental concerns, to health and well-being, and the respect and pride for a nostalgic cultural heritage

Potential Impacts of Land Use Changes on Water Resources in a Tropical Headwater Catchment

The main objective of this study was to investigate the relationships between land use and future scenarios of land changes on water runoff and groundwater storage in an Environmental Protection Area (EPAs) watershed. The methodology was based on the application of the Soil and Water Assessment Tool (SWAT) hydrological modelling to investigate flow simulations in current land use and in two future scenarios (forest and pasture). The performance of goodness-of-fit indicators in the calibration (NSE = 0.82, R2 = 0.85, PBIAS = 11.9% and RSR = 0.42) and validation (NSE = 0.70, R2 = 0.72, PBIAS = −4% and RSR = 0.55) was classified as good and very good, respectively. The model accurately reproduced the inter-annual distribution of rainfall. The spatial distribution of average annual surface flow, lateral flow, and groundwater flow were different between sub-basins. The future scenario on land use change to forest (FRSE) and pasture (PAST) differed during the year, with greater changes on rainy and dry seasons. FRSE increase of 64.5% in area led to decreased surface runoff, total runoff, and soil water; and increased lateral flow, groundwater, and evapotranspiration. The effect of the natural vegetation cover on soil moisture content is still unclear. The hydrological model indicated the main areas of optimal spatial water flow. Considering economic values, those areas should encourage the development of government policies based on incentive platforms that can improve environmental soil and water sustainability by establishing payment for environmental services (PES)

Guía de buenas prácticas en el tambo

Con el objetivo de concentrar varios esfuerzos aislados que se han llevado a cabo en el país, INTA y APROCAL han tenido la iniciativa de convocar a especialistas y representantes del sector lechero nacional para trabajar en el desarrollo de una Guía de Buenas Prácticas en el tambo, consensuada entre los diferentes representantes del sector lechero. Esta guía, de libre acceso, procura ser una propuesta de fácil interpretación para ser consultada permanentemente por parte de quienes trabajan y conducen los establecimientos lecheros para apoyarse en aspectos que hacen al aseguramiento de la calidad en el tambo. Através de la misma se pretende brindar recomendaciones de Buenas Prácticas para maximizar la producción y la calidad de leche en sistemas productivos sustentables. El establecimiento lechero es un sistema complejo, integrad por diferentes eslabones, y es por este motivo que este material se presenta organizado en capítulos, los que se consideran pilares de las Buenas Prácticas: ordeño e higiene, sanidad animal, alimentación, ambiente, bienestar animal, condiciones de los trabajadores en el tambo.Fil: Rampone, Alberto Oscar José. Universidad Nacional de Villa María; ArgentinaFil: Abdala, Alejandro Ariel. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; ArgentinaFil: González Pereyra, Ana Valeria. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Leiva, Antonio. Empresa SanCor; ArgentinaFil: Callieri, Carlos. Asociación Pro Calidad de Leche y sus Derivados; ArgentinaFil: Pendini, Carlos Rafael. Universidad Nacional de Córdoba. Facultad de Ciencias Agropecuarias; ArgentinaFil: Tentor, Gonzalo Fernán. No especifíca;Fil: Sardi, Graciela Maria Isabel. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Gigli, Isabel. Universidad Nacional de La Pampa; ArgentinaFil: González, Joaquín. Instituto Nacional de Tecnología Agropecuaria. Fundación Argeninta; ArgentinaFil: Rodríguez, Julián Marcelo. Empresa La Lácteo; ArgentinaFil: Raciti, Julio. Empresa Manfrey; ArgentinaFil: García, Karina Elizabet. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Troilo, Liliana Graciela. Instituto Nacional de Tecnología Agropecuaria; ArgentinaFil: Negri Rodríguez, Livia María. Instituto Nacional de Tecnología Agropecuaria; ArgentinaFil: Brunas, Lucas. Empresa García Hermanos; ArgentinaFil: Martinez Luque, Luciana. Universidad Católica de Córdoba. Facultad de Ciencias Agropecuarias; ArgentinaFil: Calvinho, Luis Fernando. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Signorini, Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe; ArgentinaFil: Bontá, Marcos Adrián. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Herrero, Maria Alejandra. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; ArgentinaFil: Aimar, Maria Veronica. Universidad Católica de Córdoba. Facultad de Ciencias Agropecuarias; ArgentinaFil: Larrauri, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Gaggiotti, Mónica del Carmen. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Serrano, Pedro Miguel. Instituto Nacional de Tecnología Agropecuaria; ArgentinaFil: Charlon, Veronica. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; Argentin