Drogas, historia, consumos y medidas tomadas en relación a su uso

Análisis de la situación actual y medidas tomadas con respecto swl consumo de drogas, desde el área de la prevención de los co0nsumos, centradas en el ámbito educativo propio de España y la Comunidad Autonómica de Aragón, así como una visión multicomponente, a nivel histíorico, social, sanitariio, económico y psicológico en la relación con el uso y consumo de drogas

Colector solar de placa plana de paso doble con lecho poroso

The use of hot air in various processes, requires the development of research to make more efficient and economical methods of producing, where the first option to be evaluated are the solar collectors. As this work develops a modeling of a flat plate solar collector and porous bed using analytical equations solving in block diagrams to structure a software that can simulate the behavior in transient state manifold under various parameters (dimensional, known materials and environmental conditions). In the application to theoretically evaluate the behavior of the porous bed, efficiency, pressure drop, temperature distribution and material used for construction, allowing analysis of the thermal behavior, with an average error compared to experimental results 6%. The model is validated experimentally, with data from an actual collector, where they remain an airflow of 0.119 kg / s and radiation varies between 400-500 W/m2 and observe the temperature distribution, thermal efficiency and falls pressure. In the results reach temperatures of 360 and 375 K in the exhaust air and pressure drops of 10.27 and 14.27 Pa, recording efficiency values of 36.5 and 51.7% respectively for radiation level. This fact demonstrates the suitability of such collectors as an option to capture solar energy.La utilización de aire caliente en diversos procesos hace necesario el desarrollo de investigaciones que hagan más eficientes y económicos los métodos de producirlo, donde la primera opción por evaluar son los colectores solares. Este trabajo desarrolla una modelación de un colector solar de placa plana y lecho poroso, empleando la solución de ecuaciones analíticas en diagramas de bloques, para estructurar un software que permite simular el comportamiento del colector en estado transitorio, bajo diversos parámetros. En la aplicación se evalúa teóricamente el comportamiento del lecho poroso, la eficiencia, la caída de presión, la distribución de temperaturas y los materiales empleados para su construcción. Esto permite un análisis del comportamiento térmico, con un error promedio comparado con resultados experimentales de 6 %. El modelo se valida experimentalmente, con datos de un colector real, donde se mantiene un flujo de aire de 0,119 kg/s y se varía la radiación entre 400 y 500 W/m2; se observa la distribución de temperaturas, la eficiencia térmica y las caídas de presión. En los resultados obtenidos se alcanzan temperaturas de 360 y 375 K en el aire de salida y caídas de presión de 10,27 y 14,27 Pa, con valores de eficiencia de 36,5 y 51,7%, respectivamente, para nivel de radiación. Esto demuestra la idoneidad de este tipo de colectores como una opción para captar energía solar

Evaluación energética de un colector solar de placa plana de doble cubierta

AbstractThis study establishes the effect of the aspect ratio (ratio between length and width of a constant collector area) on the thermal effciency of a fat- plate solar collector that uses a double cover for air heating. The analysis has two approaches: frst, using a physical-mathematical model that develop a steady state analysis from a collector energy balance and the second, using an instrumented prototype to calculate its performance in experimental way. The collector confguration consists in a wood structure, a double glass cover, an absorber plate of solar radiation and blower to extract the heated air. To calculate the performance temperature data, solar radiation and mass fow of air were automatically recorded for about 6 hours for several days and under different weather conditions in the city of Montería, Cordoba. In general it was found, for a constant collector area, where the thermal effciency increases when the aspect ratio increases and that the theoretical model fts in an acceptable way with the experimental results.ResumenEn este artículo se establece la incidencia de la relación de aspecto (razón entre la longitud y ancho de un colector de área constante) sobre la efcien- cia térmica de un colector solar de placa plana que utiliza doble cubierta transparente para el calentamiento de aire. Este estudio se realiza desde dos enfoques: el primero utiliza un modelo físico-matemático a partir de los balances de energía del colector, y el segundo utiliza un prototipo con su respectiva instrumentación para calcular su rendimiento de manera experimental. El colector está compuesto por una estructura en madera, una doble cubierta de vidrio transparente, una placa absorbedora de ra- diación solar y un ventilador para extraer el aire calentado. Para calcular el rendimiento se registraron de manera automática datos de temperatura, radiación solar y fujo másico de aire; durante aproximadamente 6 horas por varios días y bajo distintas condiciones climáticas de la ciudad de Montería, Córdoba (Colombia). En general se encontró, para un área constante del colector, que la efciencia térmica de este aumenta cuando la relación de aspecto aumenta y que el modelo teórico se ajusta de manera aceptable con los resultados experimentales

Work–family interaction, self-perceived mental health and burnout in specialized physicians of Huelva (Spain): a study conducted during the SARS-CoV-2 Pandemic

Background: The medical staff who work in specialized healthcare are among the professionals with a greater risk of presenting negative indicators of mental health. These professionals are exposed to numerous sources of stress that can have a negative influence on their personal life. Currently, SARS-CoV-2 poses an additional and relevant source of stress. The aim of this study was to identify the interactions between the work and family environments, as well as to analyze self-perceived mental health and burnout in physicians who, during the COVID-19 pandemic, carried out their jobs in public health in Huelva (Spain), also considering a series of sociodemographic variables. Methods: This is a descriptive, cross-sectional study. Information from 128 participants was collected using the SWING, MBI-HSS and GHQ-12 questionnaires, along with sociodemographic data and possible situations of contact with SARS-CoV-2. The data were analyzed, and correlations were established. Results: Most of the sample obtained a positive interaction result of work over family. Those who had been in contact with SARS-CoV-2 represented higher percentages of a positive result in GHQ-12, negative work–family interaction, burnout, emotional exhaustion and depersonalization. In general, the men showed a worse mental health state than women. Conclusions: The medical staff of Huelva who had been in contact with situations of SARS-CoV-2 in their work environment presented worse indicators of mental health and greater negative interaction of work over family than those who had not been in contact with these situations.info:eu-repo/semantics/publishedVersio

Salud de los trabajadores

Actividad física y su relación con los factores de riesgo cardiovascular de carteros chilenosAnálisis de resultados: riesgos psicosociales en el trabajo Suceso-Istas 21 en Cesfam QuellónAusentismo laboral por enfermedades oftalmológicas, Chile 2009Brote de diarreas por norovirus, posterremoto-tsunami, Constitución, Región del MauleCalidad de vida en profesionales de la salud pública chilenaCaracterización del reposo laboral en personal del SSMN durante el primer semestre de 2010Concentración de nicotina en pelo en trabajadores no fumadores expuestos a humo de tabaco ambientalCondiciones de trabajo y bienestar/malestar docente en profesores de enseñanza media de SantiagoDisfunción auditiva inducida por exposición a xilenoErgonomía aplicada al estudio del síndrome de dolor lumbar en el trabajoEstimación de la frecuencia de factores de riesgo cardiovascular en trabajadores de una empresa mineraExposición a plaguicidas inhibidores de la acetilcolinesterasa en Colombia, 2006-2009Factores de riesgo y daños de salud en conductores de una empresa peruana de transporte terrestre, 2009Las consecuencias de la cultura en salud y seguridad ocupacional en una empresa mineraPercepción de cambios en la práctica médica y estrategias de afrontamientoPercepción de la calidad de vida en la Universidad del BiobíoPesos máximos aceptables para tareas de levantamiento manual de carga en población laboral femeninaRiesgo coronario en trabajadores mineros según la función de Framingham adaptada para la población chilenaTrastornos emocionales y riesgo cardiovascular en trabajadores de la salu

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Introduction: Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors. Methods: Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit. Results: The median [p25–p75] time from discharge to follow-up was 3.57 [2.77–4.92] months. Median age was 60 [53–67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO < 80% and 24% having DLCO < 60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO < 60% were chronic lung disease (CLD) (OR: 1.86 (1.18–2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37–1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18–1.63)), urea (OR: 1.16 (0.97–1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73–1.06)). Bacterial pneumonia (1.62 (1.11–2.35)) and duration of ventilation (NIMV (1.23 (1.06–1.42), IMV (1.21 (1.01–1.45)) and prone positioning (1.17 (0.98–1.39)) were associated with fibrotic lesions. Conclusion: Age and CLD, reflecting patients’ baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio