Factores de riesgo y diagnóstico citológico del cáncer cervico-uterino

Se analizaron los factores de riesgo y diagnóstico citológico del cáncer cervico-uterino en pacientes de una comunidad de Veracruz bajo un estudio analítico y transversal, en este se incluyó 132 pacientes mayores de 18 años que acudieron al Módulo de Atención a realizarse la citología cervical, las variables fueron factores de riesgo del cáncer cervico-uterino y diagnostico citológico. Se usó como instrumento el “formato de solicitud y reporte de resultados de citología cervical”, se utilizó la chi2 para la asociación de los factores de riesgo con el diagnostico citológico. Se halló que el 79.5% de las mujeres tenían el cuello aparentemente sano, el 9.8% erosión de cuello, 4.5% leucorrea, 2.3% de las mujeres no se observaba el cuello y tenían sangrado anormal, el .8% presento cuello anormal y cervicitis Conclusiones: La enfermera debe dar seguimiento a los casos, ya que es el primer contacto del paciente, así pueda brindar educación para la salud a todas las mujeres que acuden a realizarse esta prueba

The playful mediation strategy for the development of English language skills

Actualmente los ambientes de aprendizaje que contemplan la lúdica y la recreación como estrategia de aprendizaje se muestran como ejes fundamentales para la adquisición de mejores y nuevos saberes. Se buscaba implementar una estrategia lúdica para enseñar el idioma inglés, en los estudiantes de primaria de la Institución Sierra Nevada de Santa Marta.La metodología empleada se orienta desde la investigación cualitativa; la unidad de análisis estuvo conformada por 40 estudiantes entre las edades 8 y 9 años; Dentro de los hallazgos encontrados se puede inferir que un 95% de los estudiantes se sintieron cómodos y con mayores resultados académicos en el área de inglés cuando se implementación de estrategias lúdicas para el aprendizaje de la segunda lengua. Por lo que se puede concluir que los estudiantesse muestrancon mayor interés y aprenden con mayor facilidad cuando seaprende en ambientes donde se encuentre inmersa la lúdica y la recreación.Currently, learning environments that contemplate leisure and recreation as a learning strategy are shown as fundamental axes for the acquisition of better and new knowledge. The aim was to implement a playful strategy to teach the English language among the elementary students of the Sierra Nevada de Santa Marta Institution. The methodology used was from qualitative research, 40 students were taken as a sample; Among the findings found, it can be inferred that 95% of students felt comfortable through the implementation of play strategies for learning the second language. So we can conclude that students are more motivated to learn in environments where play is immersed and recreation

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Agroecology: community experiences for family farming in Colombia

Los territorios rurales en Colombia enfrentan retos actuales relacionados no sólo con los aspectos sociales fundamentales para la paz, sino, también con las condiciones productivas y ambientales necesarias para avanzar hacia modelos de desarrollo rural sostenibles. Objetivos como alcanzar soberanía alimentaria, luchar contra la pobreza rural, adaptar la agricultura a riesgos emergentes y mitigar el efecto del cambio climático, proteger los recursos naturales especialmente suelo, agua y agrobiodiversidad, asegurar la prestación de servicios ecosistémicos, atender a la creciente demanda de alimentos, entre otros, requieren reconfigurar los sistemas agroalimentarios. Simultáneamente, la agricultura familiar viene siendo promovida por movimientos sociales que reconocen el papel esencial que cumplen de producir alimentos y cuidar la naturaleza y exigen el reconocimiento de su rol y políticas diferenciales que les permitan reproducir dignamente sus condiciones sociales de vida. Fortalecer las distintas formas de agricultura campesina, familiar y comunitaria, requiere de nuevos paradigmas científicos y prácticos en el desarrollo rural; uno de estos es la Agroecología, reconocido como el enfoque científico que mejor reconoce el potencial de la agricultura familiar para ayudar a enfrentar los retos mencionados. La Agroecología en Colombia ha sido promovida desde la década de 1980 por ONG’s y la iglesia, y más recientemente por las universidades. La práctica agroecológica ha permitido el surgimiento de innovaciones que han logrado niveles importantes de madurez. Desde la perspectiva de la transición hacia una agricultura sustentable, estas iniciativas comunitarias, reconocidas como “nichos sociotécnicos”, se constituyen en espacios protegidos en los cuales se gestan y desarrollan estas innovaciones hasta lograr que se consoliden y generen cambios consistentes en las condiciones de vida de estas comunidades. El propósito de este libro es analizar algunas de estas experiencias agroecológicas desarrolladas por organizaciones de agricultores familiares en distintos lugares del país, nichos sociotécnicos, donde se generaron aprendizajes prácticos con potencial para fortalecer programas de agricultura campesina, familiar y comunitaria.Rural territories in Colombia currently face challenges to the peace process, not only in terms of social aspects but also with regards to the agricultural and environmental conditions necessary to move toward sustainable rural development models. Objectives including achieving food sovereignty, fighting rural poverty, adapting agriculture to emergent risks and mitigating the effects of climate change, protecting natural resources especially soils, water and agrobiodiversity, assuring the benefits of ecosystem services, responding to the growing demand for food, among others, require a reconfiguration of the food system. Concurrently, social movements are increasingly promoting family agriculture as a response to the aforementioned challenges. They affirm the essential role of food production in caring for conserving the environment and call for differential political agendas that encourage a dignified social reproduction of livelihoods for family farmers. Strengthening the distinct forms of peasant, family and communal agriculture requires new scientific paradigms as well as new practices of rural development; one of these is Agroecology, the scientific focus that best recognizes the potential of family agriculture to confront present day social-environmental challenges. Since the 1980s, Colombian NGO’s and the Catholic Church, and more recently universities, have promoted agroecology. Agroecological practice has led to the emergence of solid innovations. From the perspective of sustainable agriculture, these community-based initiatives, recognized as “social-technical niches”, are established within protected spaces. Communities create and develop such innovations until they become established and successfully generate consistent changes in the livelihoods of these communities. The goal of this volume is to analyze some of the agroecological experiences developed by groups of family farmers in different areas of the country, especially those from social-technical niches that generated practices with the potential to strengthen agricultural programs for peasant, family and communal producers

Consistent improvement with eculizumab across muscle groups in myasthenia gravis

Objective: To assess whether eculizumab, a terminal complement inhibitor, improves patient- and physician-reported outcomes (evaluated using the myasthenia gravis activities of daily living profile and the quantitative myasthenia gravis scale, respectively) in patients with refractory anti-acetylcholine receptor antibody-positive generalized myasthenia gravis across four domains, representing ocular, bulbar, respiratory, and limb/gross motor muscle groups. Methods: Patients with refractory anti-acetylcholine receptor antibody-positive generalized myasthenia gravis were randomized 1:1 to receive either placebo or eculizumab during the REGAIN study (NCT01997229). Patients who completed REGAIN were eligible to continue into the open-label extension trial (NCT02301624) for up to 4 years. The four domain scores of each of the myasthenia gravis activities of daily living profile and the quantitative myasthenia gravis scale recorded throughout REGAIN and through 130 weeks of the open-label extension were analyzed. Results: Of the 125 patients who participated in REGAIN, 117 enrolled in the open-label extension; 61 had received placebo and 56 had received eculizumab during REGAIN. Patients experienced rapid improvements in total scores and all four domain scores of both the myasthenia gravis activities of daily living profile and the quantitative myasthenia gravis scale with eculizumab treatment. These improvements were sustained through 130 weeks of the open-label extension. Interpretation: Eculizumab treatment elicits rapid and sustained improvements in muscle strength across ocular, bulbar, respiratory, and limb/gross motor muscle groups and in associated daily activities in patients with refractory anti-acetylcholine receptor antibody-positive generalized myasthenia gravis

Eculizumab in refractory generalized myasthenia gravis previously treated with rituximab: subgroup analysis of REGAIN and its extension study

Introduction/Aims Individuals with refractory generalized myasthenia gravis (gMG) who have a history of rituximab use and experience persistent symptoms represent a population with unmet treatment needs. The aim of this analysis was to evaluate the efficacy and safety of eculizumab in patients with refractory anti‐acetylcholine receptor antibody‐positive (AChR+) gMG previously treated with rituximab. Methods This post hoc subgroup analysis of the phase 3 REGAIN study (NCT01997229) and its open‐label extension (OLE; NCT02301624) compared baseline characteristics, safety, and response to eculizumab in participants who had previously received rituximab with those who had not. Rituximab use was not permitted within the 6 months before screening or during REGAIN/OLE. Results Of 125 REGAIN participants, 14 had received rituximab previously (7 received placebo and 7 received eculizumab). In the previous‐rituximab group, 57% had used at least four other immunosuppressants compared with 16% in the no‐previous‐rituximab group. Myasthenia Gravis Activities of Daily Living total scores from eculizumab baseline to week 130 of eculizumab treatment improved in both the previous‐rituximab and no‐previous‐rituximab groups (least‐squares mean −4.4, standard error of the mean [SEM] 1.0 [n = 9] and least‐squares mean −4.6, SEM 0.3 [n = 67], respectively; difference = 0.2, 95% confidence interval −1.88 to 2.22). In addition, in both groups, most patients who were treated with eculizumab for 130 weeks achieved a Myasthenia Gravis Foundation of America post‐intervention status of minimal manifestations (66.7% and 65.0%, respectively). The eculizumab safety profile was similar between groups and consistent with its established profile. Discussion Eculizumab is an effective therapy for patients with refractory AChR+ gMG, irrespective of whether they had received rituximab treatment previously

Long-term safety and efficacy of eculizumab in generalized myasthenia gravis

Introduction: Eculizumab is effective and well tolerated in patients with antiacetylcholine receptor antibody-positive refractory generalized myasthenia gravis (gMG; REGAIN; NCT01997229). We report an interim analysis of an open-label extension of REGAIN, evaluating eculizumab's long-term safety and efficacy. Methods: Eculizumab (1,200 mg every 2 weeks for 22.7 months [median]) was administered to 117 patients. Results: The safety profile of eculizumab was consistent with REGAIN; no cases of meningococcal infection were reported during the interim analysis period. Myasthenia gravis exacerbation rate was reduced by 75% from the year before REGAIN (P < 0.0001). Improvements with eculizumab in activities of daily living, muscle strength, functional ability, and quality of life in REGAIN were maintained through 3 years; 56% of patients achieved minimal manifestations or pharmacological remission. Patients who had received placebo during REGAIN experienced rapid and sustained improvements during open-label eculizumab (P < 0.0001). Discussion: These findings provide evidence for the long-term safety and sustained efficacy of eculizumab for refractory gMG. Muscle Nerve 2019

Correction to: Eculizumab improves fatigue in refractory generalized myasthenia gravis (Quality of Life Research, (2019), 28, 8, (2247-2254), 10.1007/s11136-019-02148-2)

The article “Eculizumab improves fatigue in refractory generalized myasthenia gravis”, written by “Henning Andersen, Renato Mantegazza, Jing Jing Wang, Fanny O’Brien, Kaushik Patra, James F. Howard Jr. and The REGAIN Study Group” was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 23 March 2019 without open access