El control interno y la gestión pública en la Municipalidad Provincial de San Vicente de Cañete 2019

La investigación se titula: “El control interno y la gestión pública en la Municipalidad Provincial de San Vicente de Cañete 2019”, cuyo objetivo fue “Determinar la relación que existe entre el control interno y la gestión pública en la Municipalidad Provincial de San Vicente de Cañete”. El tipo de investigación es básico, de enfoque cuantitativo, descriptivo correlacional, cuyo diseño de investigación es no experimental transversal. La muestra estuvo conformada por 91 trabajadores que comprenden el personal administrativo de la Municipalidad Provincial San Vicente de Cañete. En el trabajo de campo se utilizó la encuesta y los instrumentos para la recolección de datos fueron dos cuestionarios aplicados a los trabajadores de la municipalidad. Para la validez de los instrumentos se utilizó el juicio de expertos y la confiabilidad de cada instrumento fue dada con el análisis de Alfa de Cronbach. Con relación al objetivo general fue determinar la relación que existe entre el control interno y la gestión pública en la Municipalidad Provincial de San Vicente de Cañete, concluyendo que existe relación directa y significativa entre el control interno y la gestión pública. Lo que se demuestra con la correlación de Spearman es (sig. bilateral = .000 < 0.05; Rho = ,741)

Mutação do Hnf1ß (Mody 5) - Estudo de uma família portuguesa

Prémio de Melhor Caso Clínic

A retrospective assessment of a country performance

publishersversionpublishe

Renal failure and pleural effusion; a diagnostic challenge

Publisher Copyright: © 2023 The Author(s); Published by Society of Diabetic Nephropathy Prevention.Sjögren’s syndrome is a chronic inflammatory disorder mostly involving the exocrine glands. Extraglandular disease may occur in up to one quarter of patients. Kidney involvement is rare, more often manifested by tubular dysfunction secondary to tubulointerstitial nephritis. Primary glomerular disease is uncommon. The authors present the case of a 73-year-old woman with xerostomia and positivity for anti-Ro and anti-La antibodies admitted for acute kidney injury and exudative pleural effusion. Biopsy of salivary glands was compatible with Sjögren’s syndrome. Extraglandular involvement was also confirmed by renal and pleural deposition of AA-amyloid. The patient was started on prednisolone followed by azathioprine with rapid improvement of lung disease. However, due to progressing renal disease and clinical deterioration, prognosis was guarded and the patient died. We describe a case of secondary amyloidosis with systemic involvement and infrequent clinical manifestations, briefly reviewing the key aspects of Sjögren’s syndrome and AA-amyloidosis.publishersversionpublishe

The ATHAC Survey 04-05: observational study regarding the use of neuter dressings or dressings impregnated in an antibacterian agent using an innovative patented technology: the lipid colloid technology for the treatment of acute and/or chronic wounds

Introducción: El estudio ATHAC recoge datos sobre heridas agudas y crónicas que son candidatas a un tratamiento a base de apósitos grasos neutros como la gama URGOTUL. Objetivos: Describir las características de las heridas, describir los tratamiento aplicados a estas heridas y explorar las opiniones de los profesionales de enfermería y los pacientes sobre los tratamientos en términos de aplicabilidad, adaptabilidad y confort para el paciente. Material y métodos: 1.500 pacientes fueron incluidos en el estudio de acuerdo al tipo de herida y a los tratamientos en uso. Se recogieron datos a partir de dos cuestionarios: uno para el paciente y otro para la enfermera responsable de sus cuidados. Las enfermeras recogieron los datos en el primer día de inclusión y los pacientes respondían al cuestionario 1 mes más tarde o antes si la herida había cicatrizado. Las variables recogidas por la enfermera fueron: datos sociodemográficos, etiología de las lesiones, características y localización de las heridas, aspectos y opiniones sobre el tratamiento. A los pacientes se les preguntó por la duración del tratamiento, el estado de la lesión en el momento de contestar y desde su punto de vista, así como su opinión sobre el dolor, satisfacción general y aceptabilidad. Se llevaron a cabo análisis descriptivos uni y bivariados. Para cada paciente, si tenía más de una lesión, se recogieron datos de la lesión de mayor tamaño. Resultados: Finalmente, se estudiaron 1.432 pacientes con una o más lesiones (420 tenían más de una lesión). El 60,4% eran mujeres y la edad media fue de 66 ± 19 años. En el caso de las heridas crónicas (657 lesiones) predominaron las úlceras venosas (47%) y las úlceras por presión (23%). En las heridas agudas (775 lesiones), la mayoría fueron traumáticas (41%) y quemaduras (32,5%). La principal localización en todas las lesiones fueron los miembros inferiores (57,4% en heridas crónicas y 39% en agudas). El 84,4% de los casos indicó presentar algún tipo de dolor previo al comienzo de este estudio. Al finalizar el estudio, un porcentaje menor del 20% indicó presentar algún tipo de dolor. El 72% de las heridas agudas y el 35% de las crónicas, como refieren los pacientes, había cicatrizado al finalizar el estudio (en un tiempo medio de entre 20-40 días). El 54% de las heridas crónicas evoluciona favorablemente y el 26% de las agudas. Más del 80% de las heridas estudiadas fueron tratadas con la gama URGOTUL. Conclusión: URGOTUL es una buena opción para el tratamiento de este tipo de heridas, especialmente para las heridas agudas, en relación a su carácter atraumático y a su capacidad de cicatrización, así como la buena aceptación y satisfacción de los pacientes.Introduction: The ATHAC survey collected data on acute or chronic wounds that were candidates for a treatment with grassy dressings like URGOTUL. Aims: To describe the wound’s characteristics, to describe treatments applied to these wounds and to Explore Nurses’ and patients’ opinion about the treatments in terms of applicability, adaptability and patient comfort. Methods: 1,500 patients were included in the study according to wound types and treatments. Data were collected with nurses and patient questionnaires. Nurses collected data the first day of inclusion and patients respond one month after or when wounds healed. Variables collected by nurses were: demographic, aetiology, characteristics and location of the wound, aspects and opinions of the treatment. Patients were asked about duration of treatments, wound state from their point of view and opinions about pain, satisfaction and acceptability. Univariate and bivariate descriptive analysis were conducted. For each patient was selected the biggest wound for data collection. Results: Finally, 1432 patients with one or more lesions were studied (420 had more than one). 60,4% were women and the mean age was 66. Chronic wounds, mainly, were venous leg ulcer (47%) and pressure ulcers (23%). In acute wounds, were traumatic (41%) and burns (32,5%). The main location was inferior extremities (57,4% in chronic and 39% in acute). 49% of cases reported moderate to high spontaneous pain previous to this study. At the end, only 20-30% reported pain (during the study, in more than 80% the dressing used was Urgotul). 72% of acute wounds and 35% of chronic wounds, as referred by patients, were healed when finished the study (between 20-40 days of treatment). Conclusion: Urgotul is a good option for atraumatic treatment of this type of lesions, mainly for acute wounds, since more of them had healed in an acceptable time with a good patient satisfaction

Digital postcompensation using volterra series transfer function

We propose a noniterative digital backward propagation technique, based on an inverse modified Volterra series transfer function to postcompensate transmission linear and nonlinear impairments in the presence of optical noise. Using a single-channel 40-Gb/s nonreturn-to-zero quadrature phase-shift-keying optical signal propagated over 20 x 80 km of standard single-mode fiber, and performing digital postcompensation around the Nyquist rate, our compensation algorithm is able to surpass the maximum accuracy obtained with a symmetric split-step Fourier method, enabling us to increase the nonlinear tolerance by approximately 2 dB

coronary angiography as a diagnostic method for all? - a retrospective study

INTRODUCTION: Type 1 diabetes mellitus is associated with an increased risk of coronary artery disease, which is frequently asymptomatic. This risk increases significantly in those with nephropathy. In selected patients, simultaneous pancreas-kidney transplantation is the renal and pancreatic replacement therapy of choice, as it increases longevity and stabilizes diabetic complications. Despite essential, universal screening protocols are still controversial for coronary artery disease in this population. METHODS: We retrospectively analysed 99 simultaneous pancreas-kidney recipients from our centre from 2011 to 2018 and selected 77 patients who underwent coronary angiography during the pre-transplant evaluation. Our aim was to identify potential risk factors associated with significant lesions on coronary angiography. RESULTS: Almost half of our cohort of 77 candidates submitted to coronary angiography had coronary artery disease. Of these, nearly 30% underwent revascularization, although only one of them reported symptoms of myocardial ischemia. In a univariate analysis, the presence of smoking habits was the only risk factor for coronary artery disease. We also found that 20 or more years of type 1 diabetes mellitus was significantly associated with the presence of coronaropathy. DISCUSSION: Selection of diabetic candidates with acceptable cardiac risk before simultaneous pancreas-kidney transplantation is imperative. Given the impact of a correct diagnosis and a low procedural risk, we defend the routine use of coronary angiography as the initial screening method for coronary artery disease in this population. Particularly care must be taken in evaluating asymptomatic patients with long-term type 1 diabetes mellitus and smokers.publishersversionepub_ahead_of_prin

Current status

Domino Liver transplant (DLT) is a strategy to address organ shortage and expand the liver donor pool for liver transplantation. Despite offering some unique technical challenges, DLT appears to be a safe and reasonable option to be considered for selected patients who would otherwise not benefit from liver transplantation. However, the benefit of expanding the donor pool must be balanced against the risk of disease transmission.In this review, we present where the DLT currently stands worldwide and our own experience with this procedure.publishersversionpublishe

Zebrafish model as a screen to prevent cyst inflation in autosomal dominant polycystic kidney disease

Funding Information: Funding: This work was supported by Sociedade Portuguesa de Nefrologia, iNOVA4Health-UID/Multi/04462/2013 (a program financially supported by Fundação para a Ciência e Tecnolo-gia (FCT)/Ministério da Educação e Ciência, through national funds and co-funded by FEDER under the PT2020 Partnership Agreement) and FCT-ANR/BEX-BID/0153/2012 and PTDC/BEX-BID/1411/2014 research grants. M.R.R. was supported by national funds through FCT, first with an iNOVA post-doctoral fellowship and, more recently, with a contract in the context of the celebration of the program contract foreseen in the numbers 4, 5, and 6 of article 23.◦ of D.L. no. 57/2016 of 29 August, as amended by Law no. 57/2017 of 19 July. S.S.L. had a FCT-Investigator contract, followed by NOVA NMS contracts and, at the moment, a FCT CEEC (Concurso Estímulo ao Emprego Científico) contract, as principal investigator. This article is supported by the LYSOCIL project. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 811087. Zebrafish used as an animal model were reproduced and maintained in the CEDOC Fish Facility, with the support from the research infrastructure Congento, co-financed by Lisboa Regional Operational Programme (Lisboa2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and FCT under the project LISBOA-01-0145-FEDER-022170. Funding Information: This work was supported by Sociedade Portuguesa de Nefrologia, iNOVA4Health-UID/Multi/04462/2013 (a program financially supported by Funda??o para a Ci?ncia e Tecnolo-gia (FCT)/Minist?rio da Educa??o e Ci?ncia, through national funds and co-funded by FEDER under the PT2020 Partnership Agreement) and FCT-ANR/BEX-BID/0153/2012 and PTDC/BEX-BID/1411/2014 research grants. M.R.R. was supported by national funds through FCT, first with an iNOVA post-doctoral fellowship and, more recently, with a contract in the context of the celebration of the program contract foreseen in the numbers 4, 5, and 6 of article 23.? of D.L. no. 57/2016 of 29 August, as amended by Law no. 57/2017 of 19 July. S.S.L. had a FCT-Investigator contract, followed by NOVA NMS contracts and, at the moment, a FCT CEEC (Concurso Est?mulo ao Emprego Cient?fico) contract, as principal investigator. This article is supported by the LYSOCIL project. This project has received funding from the European Union?s Horizon 2020 research and innovation programme under grant agreement No 811087. Zebrafish used as an animal model were reproduced and maintained in the CEDOC Fish Facility, with the support from the research infrastructure Congento, co-financed by Lisboa Regional Operational Programme (Lisboa2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and FCT under the project LISBOA-01-0145-FEDER-022170. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.In autosomal dominant polycystic kidney disease (ADPKD), kidney cyst growth requires the recruitment of CFTR (cystic fibrosis transmembrane conductance regulator), the chloride channel that is defective in cystic fibrosis. We have been studying cyst inflation using the zebrafish Kupffer’s vesicle (KV) as model system because we previously demonstrated that knocking down polycystin 2 (PC2) induced a CFTR-mediated enlargement of the organ. We have now quantified the PC2 knock-down by showing that it causes a 73% reduction in the number of KV cilia expressing PC2. According to the literature, this is an essential event in kidney cystogenesis in ADPKD mice. Additionally, we demonstrated that the PC2 knockdown leads to a significant accumulation of CFTR-GFP at the apical region of the KV cells. Furthermore, we determined that KV enlargement is rescued by the injection of Xenopus pkd2 mRNA and by 100 µM tolvaptan treatment, the unique and approved pharmacologic approach for ADPKD management. We expected vasopressin V2 receptor antagonist to lower the cAMP levels of KV-lining cells and, thus, to inactivate CFTR. These findings further support the use of the KV as an in vivo model for screening compounds that may prevent cyst enlargement in this ciliopathy, through CFTR inhibition.publishersversionpublishe

Red Flags Not To Be Missed

BACKGROUND: Urinary sediment is a noninvasive laboratory test that can be performed by an automated analyzer or manually by trained personnel. Manual examination remains the diagnostic standard because it excels at differentiating isomorphic from dysmorphic red blood cells and identifying other urinary particles such as renal tubular epithelial cells (RTECs), lipids, crystals, and the composition of casts. This study aimed to investigate the prevalence of a complete profile of urinary sediment particles and its associations with histologic lesions on kidney biopsy, regardless of diagnosis. METHODS: This was a single-center, observational retrospective study of 131 patients who had contemporary manual urinary sediment evaluation and kidney biopsy. A comprehensive set of urinary particles and histologic lesions were quantified, and their associations were analyzed. RESULTS: In our samples, we found an elevated frequency of findings suggestive of proliferative kidney disease and a low frequency of particles evoking urologic damage. The association of histologic lesions and urinary particles was explored with a multivariate model. We identified urinary sediment characteristics that independently correlated with the presence of some histologic lesions: urinary lipids with mesangial expansion (OR=2.86; 95% confidence interval [95% CI], 1.3 to 6.3), mesangial hypercellularity (OR=2.44; 95% CI, 1.06 to 5.58), and wire loops and/or hyaline deposits (OR=2.89; 95% CI, 1.13 to 7.73); Urinary renal tubular epithelial cells with endocapillary hypercellularity (OR=3.17; 95% CI, 1.36 to 7.39), neutrophils and/or karyorrhexis (OR=4.51; 95% CI, 1.61 to 12.61), fibrinoid necrosis (OR=4.35; 95% CI, 1.48 to 12.74), cellular/fibrocellular crescents (OR=5.27; 95% CI, 1.95 to 14.26), and acute tubular necrosis (OR=2.31; 95% CI, 1.08 to 4.97). CONCLUSIONS: In a population of patients submitted to kidney biopsy, we found that the presence of some urinary particles (renal tubular epithelial cells, lipids, and dysmorphic erythrocytes), which are seldom reported by automated analyzers, is associated with active proliferative histologic lesions. In this regard, manual urinary sediment evaluation may help to shape the indications for performing a kidney biopsy.publishersversionpublishe