Condiciones sociolaborales y satisfacción del trabajo de los servidores públicos en la Municipalidad Distrital de Orurillo - 2019

El objetivo de la investigación fue determinar la influencia de las condiciones sociolaborales en la satisfacción del trabajo de los servidores públicos en la Municipalidad distrital de Orurillo en 2019; la investigación se desarrolló en el enfoque cuantitativo a través de técnica de la encuesta con escala de satisfacción tipo Liker y su instrumento en el formato respectivo, con dos componentes: la primera referida a la variable condiciones sociolaborales y la segunda concerniente a la variable satisfacción del trabajo; el nivel es descriptivo explicativo para el análisis de la satisfacción laboral; el diseño de investigación corresponde al tipo correlacional de corte transversal para determinar la relación entre variables en estudio; las hipótesis específicas se verificó mediante la prueba chi cuadrado de Pearson, cuyos resultados evidencian que, 11 variables muestran un valor de significancia menor a 0.05, que indica que existe asociación entre las variables en estudio. Las variables estado civil, sexo, identidad, motivación y condiciones laborales tienen influencia en la satisfacción del trabajo de los servidores con la atención a usuarios, con la relación interpersonal con sus compañeros y el liderazgo de su jefe, con el horario de trabajo, con la remuneración mensual, ambiente laboral y cumplimiento de las expectativas de los usuarios. Se identificó que el 30,8% de servidores públicos presentan condiciones sociolaborales y satisfacción del trabajo en un nivel bajo; 48% en un nivel medio y el 21,2% en un nivel alto.Tesi

Imaging findings in carcinomatous encephalitis secondary to malignant melanoma

Abstract Background The case of disseminated cancer cell spreading throughout the brain is called “miliary metastases” or “carcinomatous encephalitis”, a very rare and critical condition (primarily associated with lung and breast cancer) in which there are multiple plaque with a perivascular distribution, made of punctate lesions spread in all the brain. To our knowledge this represents the fourth case of melanotic miliary brain metastases described in the literature, also associated with melanin content of the lesions that is already evident on unenhanced T1-weighted images. Case presentation A 75-year-old patient with history of metastatic cutaneous melanoma (BRAF V600E mutate, PD-L1 negative) in treatment with dabrafenib and trametinib after 9 years from the diagnosis developed severe cognitive-motor slowing. Contrast-enhanced brain MRI showed miliary enhancing intra-axial brain lesions involving supra- and sub-tentorial regions and also the perivascular spaces, characterized by a bright appearance on unenhanced T1-weighted images without signal hypointensity in T2*-weighted images, as for melanotic pattern. Thus, the radiological diagnosis of “carcinomatous encephalitis” was made. Neurological examination showed an alert and cooperative subject with increased reaction time in verbal and motor responses. No ocular motility disturbances were found, and there were no motor or sensory deficits in the four limbs. The finger-to-nose test was normal, and no coordination deficit was found bilaterally. Blood tests and body temperature demonstrated no signs of ongoing infection. Electroencephalography showed slow and punctate abnormalities in bilateral fronto-temporal regions, with left prevalence. Corticosteroid therapy was started during hospitalization, improving the clinical picture. The patient was then discharged after 4 days in good clinical conditions with the indication to start second-line treatment with ipilimumab and nivolumab and to perform a whole-brain irradiation. Conclusions Brain MRI plays a crucial role for the non-invasive diagnosis of carcinomatous encephalitis and for the differential diagnosis with other pathologies. Awareness of the existence of this disorder even in patients with melanoma is necessary to avoid diagnostic delays. Miliary brain metastases should be suspected in all melanoma patients with new neurological findings and contrast-enhanced MRI should be performed to assess the real burden of the disease

Immunolocalization, gene expression, and enzymatic activity of cyclooxygenases, prostaglandin E2-9-ketoreductase, and nitric oxide synthases in Mediterranean buffalo (Bubalus bubalis) corpora lutea during diestrus

Immunopresence, gene expression, and enzymatic activity of cyclooxygenase 1 (COX1), COX2, PGE2-9-ketoreductase (PGE2-9-K), endothelial (eNOS) and inducible nitric oxide synthases (iNOS), and hormone in vitro production were examined in early, mid, late, and regressive buffalo corpora lutea (CL). COX1 immunosignals were detected in the cytoplasm of small luteal cells, COX2 in large luteal cells, and PGE2-9-K in all luteal cells. COX2 and PGE2-9-K immunosignals were greater in late CL. Immunopresence of both NOS types were evidenced in the nuclei and cytoplasm of all luteal cells, as well as in the nuclei of endothelial cells, during all stages studied. The eNOS and iNOS immunosignals increased during the early stage. COX1 transcripts were lower in late and regressive CL, COX2 in late, PGE2-9-K higher in regressive, and iNOS higher in early and lower in regressive CL. COX1 enzymatic activity was lower in regressive CL, COX2 increased in mid and late stages, and PGE2-9-K was higher in late CL. Endothelial NOS activity was higher during mid and late stages and lower in regressive, whereas iNOS was greater in late and lower in early. Progesterone in vitro release was higher in mid and lower in late phase, while PGF2 synthesis was higher in late CL and lower in regressive, and PGE2 was higher during regressive stage. These results support the idea that COX, NOS and PGE2-9-K regulate buffalo CL life span. In particular, regressive CL seems involved in the development of the contralateral early CL, through the production of the luteotrophic PGE

Conversion of Femoral-Tibial Bypass Surgery into Deep Vein Arterialization in a Patient with Severe Peripheral Artery Disease: Post-Operative Computed Tomography and Angiography Findings

Deep vein arterialization (DVA) is a therapeutic option in “no option” for revascularization chronic limb-threatening ischemia patients, creating an arteriovenous bypass between a proximal artery and a distal deep venous target at the ankle. Imaging plays a crucial role in peripheral arterial disease (PAD) patient management. We present the case of a 71-year-old PAD patient (Rutherford class 5) with focal gangrene of the first and second toes of the right foot, who was admitted to the vascular surgery department to undergo revascularization surgery by femoro-tibial artery bypass. During surgery a DVA was performed because of an unsatisfactory distal artery target. The post-operative computed tomography angiography showed the saphenous graft patency and opacification of distal foot veins. Subsequent angiography documented the presence of a large venous collateral, responsible for extensive early wash-out to leg venous vessels, which was then embolized. After two months, the patient underwent amputation of the right first and second necrotic toes at the level of the metatarsophalangeal joints. The post-operative course was excellent, with disappearance of pain at rest and good trophism of the surgical wound

Skin Thickening of the Scalp and High Signal Intensity of Dentate Nucleus in Multiple Sclerosis: Association With Linear Versus Macrocyclic Gadolinium-Based Contrast Agents Administration

ObjectiveThe aim of this study was to assess the presence of detectable changes of skin thickness on clinical brain magnetic resonance imaging (MRI) scans in patients with MS, history of multiple gadolinium-based contrast agents (GBCAs) administrations, and evidence of gadolinium deposition in the brain.Materials and MethodsIn this observational cross-sectional study, 71 patients with MS who underwent conventional brain MRI with an imaging protocol including enhanced 3D volumetric interpolated breath-hold examination (VIBE) T1-weighted with fat saturation were assessed. Patients with bilateral isointense dentate nucleus on unenhanced T1-weighted images were assigned to group A (controls without MRI evidence of gadolinium deposition), and patients with visually hyperintense dentate nuclei were assigned to group B. Qualitative and quantitative assessment of the skin thickness were performed.ResultsGroup A included 27 patients (median age, 33 years [IQR, 27-46]; 20 women), and group B included 44 patients (median age, 42 years [IQR, 35-53]; 29 women). Qualitative and quantitative assessment of the skin revealed significant differences between group A and group B. The average skin-to-scalp thickness ratios was significantly higher in group B than in group A (mean +/- standard deviation = 0.52 +/- 0.02 in group B vs 0.41 +/- 0.02 in group A, P < 0.0001) and showed a positive correlation with the total number of enhanced MRI scans (r = 0.39; 95% confidence interval, 0.17-0.57, P < 0.01).ConclusionsBrain MRI detects increased skin thickness of the scalp in patients with MS and dentate nucleus high signal intensity on unenhanced T1-weighted images and shows positive association with previous exposures to linear GBCAs rather than macrocyclic GBCAs