Comorbidity and mortality due to hip fracture in the northwest region of Villa Clara

Introducción: la fractura de cadera presenta una alta incidencia, muchos de los aquejados padecen enfermedades clínicas crónicas o no asociadas que pudieran predisponer a la ocurrencia de estos tipos de traumas. Objetivo: describir la morbilidad y la mortalidad por fractura de cadera en la región noroeste de Villa Clara en el año 2016 con un seguimiento posterior de un año. Método: se realizó un estudio prospectivo transversal de los pacientes con fractura de cadera que acudieron al Hospital “Mártires del 9 de abril” de Sagua la Grande en el año 2016 con enfermedades asociadas. La muestra estuvo constituida por 108 pacientes. Al año de intervenidos quirúrgicamente se contactó telefónicamente con los pacientes o sus familiares para determinar la supervivencia o no, así como causas del fallecimiento. Resultados: un total de 108 pacientes con fractura de cadera, con predominio del sexo femenino de 2:1, media de edades de 80,9±9,1 años, moda de 81 años, 72 pacientes (66,7%) presentaron una o varias enfermedades (hipertensión arterial, cardiopatía isquémica, demencia y diabetes mellitus). La mortalidad al año de la intervención estaba en el orden del 30,6%, 33 fallecidos tuvieron la neumonía como principal causa. Conclusiones: la fractura de cadera aparece asociada a enfermedades clínicas que pudieran incidir en su ocurrencia; si se desarrollaran estrategias de prevención y control efectivas se pudiera disminuir este evento traumático y, por tanto, la mortalidad asociada, que constituye un serio y preocupante problema de salud.Introduction: hip fracture has a high incidence; many of those who present it suffer from chronic or non-associated clinical diseases that could predispose to the occurrence of these types of traumas. Objective: to describe morbidity and mortality due to hip fracture in the northwestern region of Villa Clara in 2016 with a subsequent follow-up of one year. Method: a cross-sectional prospective study was performed on patients with hip fracture who attended the Mártires del 9 de abril Hospital in Sagua la Grande in 2016 with associated diseases. The sample consisted of 108 patients. After one year of surgery, patients or their families were contacted by telephone to determine survival or not, as well as causes of death. Results: a total of 108 patients with hip fracture, with a predominance of female sex of 2:1, mean age of 80.9±9.1 years, mode of 81 years, 72 patients (66.7%) presented one or several diseases (arterial hypertension, ischemic cardiopathy, dementia and diabetes mellitus). Mortality at one year of intervention was 30.6%, 33 deaths had pneumonia as the main cause. Conclusions: hip fracture is associated with clinical diseases that could affect its occurrence; if effective prevention and control strategies were developed, this traumatic event could be reduced and, therefore, the associated mortality, which is a serious and worrisome health problem

Dibenzo[1,2,5]thiadiazepines are non-competitive GABAA receptor antagonists

"A new process for obtaining dibenzo[c,f][1,2,5]thiadiazepines (DBTDs) and their effects on GABAA receptors of guinea pig myenteric neurons are described. Synthesis of DBTD derivatives began with two commercial aromatic compounds. An azide group was obtained after two sequential reactions, and the central ring was closed via a nitrene to obtain the tricyclic sulfonamides (DBTDs). Whole-cell recordings showed that DBTDs application did not affect the holding current but inhibited the currents induced by GABA (IGABA), which are mediated by GABAA receptors. These DBTDs effects reached their maximum 3 min after application and were: (i) reversible, (ii) concentration-dependent (with a rank order of potency of 2c = 2d > 2b), (iii) mediated by a non-competitive antagonism, and (iv) only observed when applied extracellularly. Picrotoxin (which binds in the channel mouth) and DBTDs effects were not modified when both substances were simultaneous applied. Our results indicate that DBTD acted on the extracellular domain of GABAA channels but independent of the picrotoxin, benzodiazepine, and GABA binding sites. DBTDs used here could be the initial model for synthesizing new GABAA receptor inhibitors with a potential to be used as antidotes for positive modulators of these receptors or to induce experimental epilepsy.

Responsabilidad Social y Ciudadanía: Una perspectiva desde la universidad y la administración pública

La importancia de los estudios sobre ciudadanía se vincula con la imperiosa necesidad de fortalecer la democracia en todos aquellos espacios donde se manifiesta, principalmente en países como México, donde la falta de credibilidad en las instituciones democráticas ha permeado a la sociedad.Los desafíos contemporáneos requieren nuevos ajustes en diversos sentidos; al interior de las organizaciones es necesario adecuar los mecanismos con que interactúan frente a la sociedad en la que se desarrollan. Es requisito indispensable que el grueso de las organizaciones sociales se vinculen de manera directa con los problemas globales y nacionales: cambio climático, guerras, exigencias democráticas, movimientos sociales, pobreza, desempleo, inestabilidades políticas etc., ello les exige que se asuman como parte del complejo social, donde sus acciones repercuten de forma directa o indirecta

El desarrollo municipal, factor estratégico en el posicionamiento de México en los escenarios políticos y sociales del siglo XXI

LA DEMOCRACIA COMO GOBERNABILIDAD IMPLICA, EN UN PRIMER MOMENTO, establecer una revisión periódica del papel interventor del Estado, por ser éste el principal factor de estabilidad y desarrollo democrático. En un segundo punto, de forma simultánea al estudio del papel del Estado en la conformación de un ambiente de estabilidad, crecimiento, desarrollo, orden y gobernabilidad, merece especial atención el papel y funciones cumplidas tradicionalmente por sus ámbitos de gobierno, como instancias que son fundamentales para la transición, democratización, liberalización y para la propia gobernabilidad

Novel inhibitors of human glucose-6-phosphate dehydrogenase (HsG6PD) affect the activity and stability of the protein

Background: The pentose phosphate pathway (PPP) has received significant attention because of the role of NADPH and R-5-P in the maintenance of cancer cells, which are necessary for the synthesis of fatty acids and contribute to uncontrollable proliferation. The HsG6PD enzyme is the rate-limiting step in the oxidative branch of the PPP, leading to an increase in the expression levels in tumor cells; therefore, the protein has been proposed as a target for the development of new molecules for use in cancer. Methods: Through in vitro studies, we assayed the effects of 55 chemical compounds against recombinant HsG6PD. Here, we present the kinetic characterization of four new HsG6PD inhibitors as well as their functional and structural effects on the protein. Furthermore, molecular docking was performed to determine the interaction of the best hits with HsG6PD. Results: Four compounds, JMM-2, CCM-4, CNZ-3, and CNZ-7, were capable of reducing HsG6PD activity and showed noncompetitive and uncompetitive inhibition. Moreover, experiments using circular dichroism and fluorescence spectroscopy showed that the molecules affect the structure (secondary and tertiary) of the protein as well as its thermal stability. Computational docking analysis revealed that the interaction of the compounds with the protein does not occur at the active site. Conclusions: We identified two new compounds (CNZ-3 and JMM-2) capable of inhibiting HsG6PD that, compared to other previously known HsG6PD inhibitors, showed different mechanisms of inhibition. General significance: Screening of new inhibitors for HsG6PD with a future pharmacological approach for the study and treatment of cancer

Aproximaciones en Psicología educacional : diversidades ante la contingencia actual

Educación, sociedad y cultura : claves para proyectar el siglo XXI / Gallegos, Miguel; Bonantini, Carlos; Quiroga, Víctor; Berra, Martina -- Antecedentes históricos de la psicología educacional en Chile / Salas, Gonzalo; Inzunza, Jorge -- El desarrollo cognitivo desde el modelo de Reuven Feuerstein / Morales, Patricia -- Talento académico. Una aproximación al estado del arte / Cornejo, Claudia; Benavides, Emilia -- Evaluación del funcionamiento cognitivo de niños y adolescentes con discapacidad intelectual / Muñoz, María Teresa; Lucero, Boris -- Adolescencia y prácticas sociales en la educación : aproximaciones a un proceso transicional en un contexto de incertidumbre / Contreras, Roberto -- Rol del psicólogo educacional en contextos educativos no formales e informales / Rodríguez, Luis Alberto -- Resiliencia y educación : nuevas miradas / González Arratia, Norma Ivonne; Valdez, José Luis -- Resiliencia familiar y mundo rural / Saavedra, Eugenio; Castro, Ana -- Rendimiento académico y representación mental del apego con adolescentes hombres y mujeres que muestran alto y bajo nivel de resiliencia / Espinosa, Nancy; Saavedra, Eugenio -- El fracaso escolar : una experiencia española / Artuch, Raquel -- La Psicología Educacional en perspectiva / Catalán, Jorg

Una mirada a las diferentes perspectivas de los negocios internacionales: estrategias, principios y casos de internacionalización

Este libro consolida resultados de investigación que permiten mirar los negocios internacionales a partir de diferentes perspectivas, proporcionando un aporte sistémico para la academia y el mercado. A partir de discusiones del punto de vista de relaciones internacionales, comercio exterior, logística, estrategias de internacionalización y negociación, esta obra discute aspectos actuales aplicables y relacionados a la actuación de las empresas colombianas en el mercado internacional, sus oportunidades y potencialidades competitivas. A lo largo de sus siete capítulos e introducción, el libro “Una mirada a las diferentes perspectivas de los Negocios Internacionales: Estrategias, principios y casos de internacionalización” presenta diferentes metodologías, herramientas, fundamentos y casos de referencia que pueden apoyar profesionales en el estudio y en la práctica de los negocios internacionales

Libro: Las Ciencias Políticas y Sociales ante Contingencias de Amplio Impacto. Incógnitas y Propuestas

Ciencia Política, Administración Pública, Política y Gobierno, y Políticas Públicas. Licencia Creative Commons License 3.0 Reconocimiento-No Comercial-Sin Obras Derivadas. Usted es libre de copiar, distribuir y comunicar públicamente la obra bajo las condiciones siguientes: Reconocimiento - Debe reconocer los créditos de la obra de la manera especificada por el autor o el licenciador (pero no de una manera que sugiera que tiene su apoyo o apoyan el uso que hace de su obra). No comercial - No puede utilizar esta obra para fines comerciales. Sin obras derivadas - No se puede alterar, transformar o generar una obra derivada a partir de esta obra.Se analizan desde una perspectiva internacional a interdisciplinaria las vertientes, problemas, incógnitas y propuestas ante una nueva realidad o normalidad, resultado y consecuencia de la pandemia que se vive de manera contemporánea, de tal manera que la problematización abordada realimente propuestas, acciones y rutas adecuadas y satisfactorias que permitan la construcción de futuros promisorios.Academia Internacional de Ciencias Político-Administrativas y Estudios de Futuro, A.C. (IAPAS por sus siglas en inglés)

Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial

Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results: We included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2-15.1], 13 J/min [IQR 10-17], and 14 J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22). Conclusions: Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele