Propuesta de capacitación en Licenciados en Enfermería sobre utilización de la auriculoterapia en el asma bronquial

An action-research study is done  with access to a proposal of training  in Nursing graduates working in Primary Health Care (PHC) in San Antonio del Sur,town , with the aim of designing a  training program supported in theoretical and methodological elements that support in ear mode Bioenergetics and Natural Medicine in the treatment of intermittent asthma in children, with the aim of raising the  insufficient level of knowledge observed through empirical contractility of the instruments used in the investigation.Se realiza un estudio de investigación-acción con salida a una propuesta de capacitación a Licenciados en Enfermería que laboran en la Atención Primaria de Salud (APS) de la cabecera municipal perteneciente al municipio San Antonio del Sur, con el objetivo de diseñar un programa de capacitación sustentados en aquellos elementos teóricos metodológicos que avalan la auriculoterapia como modalidad de la Medicina Bioenergética y Natural en el tratamiento del asma bronquial intermitente en la edad pediátrica, con la finalidad de elevar el insuficiente nivel de conocimiento que se observa a través de la contractibilidad empírica de los instrumentos aplicados en la investigación.

Risk factors associated with arterial hypertension in patients with systemic lupus erythematosus. Holguín, Cuba

Introduction: The presence of arterial hypertension in patients with systemic lupus erythematosus is a health problem that has not been studied in Holguín. Objective: To determine the cardiovascular risk factors associated with hypertension in patients with systemic lupus erythematosus. Material and Methods: A cross-sectional study was conducted. The universe was composed of 193 patients with lupus who were treated in the Rheumatology Consultation of the Clinical-Surgical Hospital of Holguín from March 3, 2014 to January 1, 2015. The sample was made up of 81 patients who were randomly selected according to a 95 % confidence interval, a population size of 193, an estimated proportion of arterial hypertension of 0,20, a precision of a 7 %, and a design effect of 1.  The recommendations of the American College of Rheumatology were followed for the diagnosis of lupus erythematosus, and national guidelines were used for the diagnosis of hypertension.  Clinical, anthropometric, and laboratory variables were determined. Odds Ratio (OR), and 95 % confidence intervals (IC95%) for risk determined factors were. Results: The risk factors associated with hypertension in patients with lupus erythematosus are: age (OR=1,04; IC95%:1,01-1,08), age of the lupus onset (OR=1,04; IC95%:1,01-1,08), diabetes mellitus (OR=8,50; IC95%:1,63-44,33), metabolic syndrome (OR=5,09; IC95%:1,87-13,84), hyperuricemia (OR=4,08; IC95%:1,07-15,44), and microalbuminuria (OR=19,81; IC95%:4,24-92,39). Conclusions: The patients with systemic lupus erythematosus presented cardiovascular risk factors associated with arterial hypertension, which are identifiable in the primary health care with variables of relatively easy realization. Keywords: systemic lupus erythematosus, metabolic syndrome, hypertension, risk factors, adults.</p

Risk factors associated with arterial hypertension in patients with Systemic lupus erythematous. Holguín, Cuba

Introduction: The presence of hypertension in patients with systemic lupus erythematous is a health problem that has not been studied in Holguín. Objective:To determine the cardiovascular risk factors associated with hypertension in patients with systemic lupus erythematous. Material and Methods: A cross-sectional study was conducted. The universe was composed of 193 patients with lupus who were treated in the Rheumatology consultation of the Clinical-Surgical Hospital of Holguín from March 3, 2014 to January 1, 2015.  The sample was made up of 81 patients who were randomly selected according to a 95 % confidence interval, a population size of 193, an estimated proportion of arterial hypertension of 0,20, a precision of a 7 %, and a design effect of 1.  The recommendations of the American College of Rheumatology were followed for the diagnosis of lupus erythematous, and national guidelines were used for the diagnosis of hypertension.  Clinical, anthropometric, and laboratory variables were determined.  Odds Ratio (OR), and 95 % (IC95%) confidence intervals for risk factors were determined. Results: The risk factors associated with hypertension in patients with lupus erythematous are: age (OR=1,04; IC95%:1,01-1,08), age of the lupus onset (OR=1,04; IC95%:1,01-1,08), diabetes mellitus (OR=8,50; IC95%:1,63-44,33), metabolic syndrome (OR=5,09; IC95%:1,87-13,84), hyperuricemia (OR=4,08; IC95%:1,07-15,44), and microalbuminuria (OR=19,81; IC95%:4,24-92,39). Conclusions:The patients with systemic lupus erythematous presented cardiovascular risk factors associated with hypertension, which are identifiable in the primary health care with variables of relatively easy realization. Keywords:systemic lupus erythematous, metabolic syndrome, hypertension, risk factors, adults.</p

Prevalence of hypertriglyceridemia and cardiovascular risk factors in students from the University of Medical Sciences. Holguin, 2014-2015

Foundation: Detecting high plasma triglyceride concentrations in children, teenagers and young people is of great importance to prevent future cardiovascular events.Objective: To determine the prevalence of hypertriglyceridemia and cardivascular risk factors associated to medical students.Methods: cross study, with a period of random sampling of 776 students registered during the academic course 2014-2015, in first year medical studies at the University of Medical Sciences Holguin, Cuba. In the sample of 242 students it was analyzed the presence of hypertriglyceridemia related to the variables: age, sex, arterial pressure, anthropometric measurements, laboratory measurements and associated risk factors. The Odd Ratios and the confidence intervals for risk factors were determined. The logistic regression analysis was done with EPIDAT 4,1 with a level of significance of 5 %.Results: The prevalence of hypertriglyceridemia was 30.58%, without differences between sexes. The prevalence of overweight, obesity, weight excess, abdominal obesity, arterial hypertension, high density lipoproteines- low cholesterol, and metabolic syndrome were  15,70 %, 4,13 %, 19,83 %, 22,31 %, 10,74 %, 3,31 %, 23,14 %, 8,26 % y 8,26 %, respectively. The associated significant risk factors metabolic syndrome, supraileac fold, high density lipoproteins- low cholesterol and glucemia.Conclusion: The prevalence rate of hypertriglyceridemia and associated risk factors were relatively high in university students apparently healthy.</p

Propuesta de capacitación en Licenciados en Enfermería sobre utilización de la auriculoterapia en el asma bronquial

An action-research study is done  with access to a proposal of training  in Nursing graduates working in Primary Health Care (PHC) in San Antonio del Sur,town , with the aim of designing a  training program supported in theoretical and methodological elements that support in ear mode Bioenergetics and Natural Medicine in the treatment of intermittent asthma in children, with the aim of raising the  insufficient level of knowledge observed through empirical contractility of the instruments used in the investigation.Se realiza un estudio de investigación-acción con salida a una propuesta de capacitación a Licenciados en Enfermería que laboran en la Atención Primaria de Salud (APS) de la cabecera municipal perteneciente al municipio San Antonio del Sur, con el objetivo de diseñar un programa de capacitación sustentados en aquellos elementos teóricos metodológicos que avalan la auriculoterapia como modalidad de la Medicina Bioenergética y Natural en el tratamiento del asma bronquial intermitente en la edad pediátrica, con la finalidad de elevar el insuficiente nivel de conocimiento que se observa a través de la contractibilidad empírica de los instrumentos aplicados en la investigación.

Factores de riesgo asociados a hipertensión arterial en pacientes con lupus eritematoso sistémico. Holguín, Cuba

Introduction: The presence of hypertension in patients with systemic lupus erythematous is a health problem that has not been studied in Holguín. Objective:To determine the cardiovascular risk factors associated with hypertension in patients with systemic lupus erythematous. Material and Methods: A cross-sectional study was conducted. The universe was composed of 193 patients with lupus who were treated in the Rheumatology consultation of the Clinical-Surgical Hospital of Holguín from March 3, 2014 to January 1, 2015.  The sample was made up of 81 patients who were randomly selected according to a 95 % confidence interval, a population size of 193, an estimated proportion of arterial hypertension of 0,20, a precision of a 7 %, and a design effect of 1.  The recommendations of the American College of Rheumatology were followed for the diagnosis of lupus erythematous, and national guidelines were used for the diagnosis of hypertension.  Clinical, anthropometric, and laboratory variables were determined.  Odds Ratio (OR), and 95 % (IC95%) confidence intervals for risk factors were determined. Results: The risk factors associated with hypertension in patients with lupus erythematous are: age (OR=1,04; IC95%:1,01-1,08), age of the lupus onset (OR=1,04; IC95%:1,01-1,08), diabetes mellitus (OR=8,50; IC95%:1,63-44,33), metabolic syndrome (OR=5,09; IC95%:1,87-13,84), hyperuricemia (OR=4,08; IC95%:1,07-15,44), and microalbuminuria (OR=19,81; IC95%:4,24-92,39). Conclusions:The patients with systemic lupus erythematous presented cardiovascular risk factors associated with hypertension, which are identifiable in the primary health care with variables of relatively easy realization. Keywords:systemic lupus erythematous, metabolic syndrome, hypertension, risk factors, adults.Introducción: La presencia de hipertensión arterial en pacientes con lupus eritematoso sistémico constituye un problema de salud no estudiado en Holguín. Objetivo: Determinar factores de riesgo cardiovascular asociados a la hipertensión arterial en pacientes con lupus eritematoso sistémico. Material y Métodos: Estudio transversal de un universo de 193 pacientes con lupus atendidos en la consulta de Reumatología del Hospital Clínico Quirúrgico de Holguín desde el 3 de marzo de 2014 al 1 de enero de 2015. La muestra de 81 pacientes seleccionados por muestreo aleatorio simple según nivel de confianza de 95%, tamaño poblacional de 193, proporción estimada de hipertensión arterial de 0,20, precisión de 7% y efecto de diseño de 1. Para el diagnóstico de lupus eritematoso se siguieron las recomendaciones de American College of Rheumatology y de la hipertensión arterial por las guías nacionales. Se determinaron variables clínicas, antropométricas y de laboratorio. Se determinaron Odds Ratio (OR) e intervalos de confianza de 95% (IC95%) de los factores de riesgo. Resultados: Los factores de riesgo asociados a la hipertensión en pacientes con lupus son edad (OR=1,04; IC95%:1,01-1,08), edad de debut del lupus (OR=1,04; IC95%:1,01-1,08), diabetes mellitus (OR=8,50; IC95%:1,63-44,33),  síndrome metabólico (OR=5,09; IC95%:1,87-13,84), hiperuricemia (OR=4,08; IC95%:1,07-15,44) y microalbuminuria (OR=19,81; IC95%:4,24-92,39). Conclusiones: Los pacientes con lupus eritematoso sistémico presentaron factores de riesgo cardiovascular asociados a la hipertensión arterial, identificables en la atención primaria de salud con variables de relativa fácil realización.Palabras claves: Lupus eritematoso sistémico, síndrome metabólico, hipertensión arterial, factores de riesgo, adultos

Comportamiento clínico epidemiológico del síndrome metabólico en pacientes con lupus eritematoso sistémico

Introducción: la presencia de síndrome metabólico en pacientes con lupus eritematoso sistémico constituye un problema de salud no bien estudiado en Holguín.Objetivo: caracterizar clínica y epidemiológicamente al síndrome metabólico  en pacientes con lupus eritematoso sistémico.Métodos: estudio transversal de un universo de 193 pacientes con lupus atendidos en la consulta de Reumatología del Hospital Clínico Quirúrgico de Holguín desde el 03/02/2014 hasta el 01/12/2015. La muestra de 81 pacientes seleccionados por muestreo aleatorio simple según nivel de confianza de 95%, tamaño poblacional de 193, proporción estimada de SM de 0,20, precisión de 7 % y efecto de diseño de 1. Para el diagnóstico de lupus eritematoso se siguieron las recomendaciones de American College of Rheumatology y el SM se diagnosticó por criterios Adult Treatment Panel III. Se determinaron variables clínicas, antropométricas y de laboratorio.Resultados: no existieron diferencias significativas entre la edad de diagnóstico de la enfermedad, el tiempo de evolución del lupus y el tiempo de uso de esteroides entre los pacientes con síndromemetabólico y sin síndrome. Los factores de riesgo de síndrome metabólico en pacientes con lupus fueron la menopausia, hipertensión, obesidad, obesidad abdominal, hipertrigliceridemia, hipercolesterolemia, LDL-colesterol alto, hiperuricemia, microalbuminuria positiva, índices aterogénicos altos e índice cintura/estatura alto; no constituyeron factores asociados  el hábito de fumar, diabetes mellitus e hipotiroidismo.Conclusiones: los pacientes con síndrome metabólico y lupus presentan numerosos factores de riesgo cardiovascular, identificables en la atención primaria de salud con variables de relativa fácil realización

Prevalence of hypertriglyceridemia and cardiovascular risk factors in students from the University of Medical Sciences. Holguin, 2014-2015

Foundation: Detecting high plasma triglyceride concentrations in children, teenagers and young people is of great importance to prevent future cardiovascular events.Objective: To determine the prevalence of hypertriglyceridemia and cardivascular risk factors associated to medical students.Methods: cross study, with a period of random sampling of 776 students registered during the academic course 2014-2015, in first year medical studies at the University of Medical Sciences Holguin, Cuba. In the sample of 242 students it was analyzed the presence of hypertriglyceridemia related to the variables: age, sex, arterial pressure, anthropometric measurements, laboratory measurements and associated risk factors. The Odd Ratios and the confidence intervals for risk factors were determined. The logistic regression analysis was done with EPIDAT 4,1 with a level of significance of 5 %.Results: The prevalence of hypertriglyceridemia was 30.58%, without differences between sexes. The prevalence of overweight, obesity, weight excess, abdominal obesity, arterial hypertension, high density lipoproteines- low cholesterol, and metabolic syndrome were  15,70 %, 4,13 %, 19,83 %, 22,31 %, 10,74 %, 3,31 %, 23,14 %, 8,26 % y 8,26 %, respectively. The associated significant risk factors metabolic syndrome, supraileac fold, high density lipoproteins- low cholesterol and glucemia.Conclusion: The prevalence rate of hypertriglyceridemia and associated risk factors were relatively high in university students apparently healthy.</p

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)