Mejora del puesto de trabajo en la línea de empaque de productos farmacéuticos.

Este documento contiene archivo en PDF.El Objetivo de la presente tesis es realizar una evaluación técnica del puesto de trabajo de los empleados de la línea de empaque de productos farmacéuticos, diseñar un modelo ergonómicamente laboral para con esto reducir las enfermedades ocupacionales generadas por la actividad. Se analizó un caso particular de un ciclo de trabajo describiendo la actividad y relacionándolo con las condiciones del trabajador y su medio. Aplicando el método REBA, se decidió que la actividad genera leves trastornos musculo esqueléticos; por lo que las recomendaciones se enfocaron en el medio sugiriendo reemplazo de sillas, rediseño del mesón de trabajo y ejercicios ergonómicos. Con esta mejora del puesto de trabajo se han cumplido los principios básicos de ergonomía laboral para incrementar la producción y reducir las enfermedades ocupacionales en el área de empaque de la industria farmacéutica.The objective of this thesis is to do a technical evaluation of the workplace of the employees of the packing line of pharmaceuticals, design an ergonomically working model for reducing occupational diseases generated by the activity. A particular case of a work cycle describing the activity relating to the conditions of the worker and their environment was analyzed. Applying the REBA method, it was decided that the activity generates minimal musculoskeletal disorders; so the recommendations focused on the environment suggesting replacement of chairs, work table redesign and ergonomic exercises. With this improved workplace they are fulfilled the basic principles of ergonomics activities to increase production and reduce occupational diseases in the packing area of the pharmaceutical industry

Study of Alfvén eigenmode stability in Quasi-Poloidal Stellarator (QPS) plasma using a Landau closure model

The aim of this study is to analyze the linear stability of Alfvén eigenmodes (AE) in the QPS device heated by a tangential neutral beam injector (NBI). The analysis is performed using the gyro-fluid code FAR3d, that solves the reduced MHD equations for the thermal plasma coupled with moments of the kinetic equation for the energetic particles (EP). The AE stability is calculated in several operational regimes of the tangential NBI: EP β between 0.001 and 0.1, EP energy between 12 and 180 keV and different radial locations of the beam. The analysis is performed for vacuum and finite β equilibria as well as QPS configurations with two and three periods. The EP β threshold in the vacuum case is 0.001 and the AE frequency is lower as the energy of the EP population decreases. Toroidal Alfvén eigenmodes with f = 80–120 kHz and elliptical AE between f = 120–350 kHz are triggered between the middle-outer plasma region (r/a > 0.5). The AE stability improves in the simulations with finite β equilibria and three period configurations with respect to the vacuum case with two periods because the continuum gaps are slender, leading to a higher threshold of the EP β, above 0.03 for the AEs triggered by the helical mode families. Helical effects are not strong enough to destabilize Helical Alfvén eigenmodes, the AEs with the largest growth rates are triggered by the n=1 and n=2 toroidal families.This work was supported by NIFS07KLPH004 and the Project 2019-T1/AMB-13648 founded by the Comunidad de Madrid.Publicad

Historic Landscapes of the Guadiamar River basin (Seville): Mining and metallurgy in the easternmost area of the Iberian Pyritic Belt

En este artículo se presentan los primeros resultados, incidiendo especialmente en los aspectos arqueometalúrgicos, del proyecto de investigación Los Paisajes del Guadiamar. Este proyecto se desarrolla desde el año 2010, f inanciado por la “Fundación Focus-Abengoa”, en el valle medio del río Guadiamar (centro-oeste de la provincia de Sevilla). Aunque aún no se ha con- cluido la obtención de todos los datos arqueológicos y analíticos, una valoración preliminar permite adelantar algunas conclusiones y, sobre todo, contrastar hipótesis y teorías enunciadas en anteriores trabajos de investigación.The f irst results of the research project Los Paisajes del Guadiamar are presented in this paper, paying special attention to archaeometallurgical aspects. This project has been going on since 2010, located in the mid-valley of the River Guadiamar (central-western area of the province of Seville) and backed by the “Fundación Focus-Abengoa”. Although not all the archaeo- logical and analytical data are yet available, a preliminary approach permits to put forward some conclusions and, above all, to validate or to refute hypotheses and theories proposed in previous research works

Tratamientos de los trastornos de la conducta alimentaria en niñas y niños de 2 a 12 años en América Latina en el período 2018-2020

Introducción: Los trastornos de la conducta alimentaria (TCA) son afecciones psiquiátricas en las que un niño o niña no puede o se niega a comer, resultando en pérdida de peso, desnutrición, letargo, deterioro del desarrollo intelectual y socioemocional y retraso en el crecimiento. Se estima que el 25-45% de los niños y niñas con desarrollo normal y ≥ 80% con discapacidades del desarrollo experimentan algún tipo de TCA. El propósito del estudio es conocer los tratamientos de los TCA en niños y niñas aplicados en América Latina. Objetivo: Determinar los tratamientos de los trastornos de la conducta alimentaria en niños y niñas de América Latina en el período de 2018 a 2020. Pregunta PICO: P: niñas y niños en América Latina; O: tratamientos de los trastornos de la conducta alimentaria. Metodología: Esta investigación es una revisión bibliográfica de tipo narrativa, descriptiva-transversal. Se emplearon términos DeCS y MeSH con los operadores booleanos AND y NOT en los buscadores Dialnet, EBSCOhost, Google Académico, Hinari/research4life, LILACS/BVS, PMC/NCBI y RI-UES para el período 2018-2020, recuperándose 51 documentos, de los cuales 20 cumplieron con los criterios de inclusión. Resultados: Los documentos se agruparon en 4 categorías: psicoterapias, tratamiento médico y farmacológico, terapias físicas y de rehabilitación, intervenciones de enfermería. El consenso observado es que los tratamientos de primera línea de los TCA son las psicoterapias, principalmente la terapia basada en la familia y la terapia cognitivo-conductual, reservando la hospitalización y medicación en pacientes inestables. Conclusiones: Una combinación de tratamientos (manejo multidisciplinario) funciona mejor para tratar los TCA pediátricos. La evidencia muestra que la psicoterapia con enfoque familiar desempeña un factor clave en tratamientos a largo plazo

Comparison of the reverse bevel versus Franseen type endoscopic ultrasound needle

BACKGROUNDReverse bevel (RB) needle is widely used for endoscopic ultrasound fine needle biopsy (EUS-FNB). A 3-plane symmetrical needle with Franseen geometry (FG) has recently become available. AIMTo compare the clinical efficacy of FG to that of RB needle.METHODSA retrospective cohort study of all adult patients who underwent EUS-FNB for solid and mixed lesions either with 22G RB needle or 22G FG needle between January 2016 and February 2019 was undertaken. All cytology slides were reviewed by an independent gastrointestinal cytopathologist blinded to the needle used and the initial cytology report. The primary and secondary outcomes were to assess the sample adequacy using Euro-cytology criteria and the number of cell clusters, respectively.RESULTSTwo hundred and twenty six procedures were included in the study. RB needle was used in 128 procedures and FG needle in 98 procedures. The baseline characteristics of both groups were comparable. On multivariable analysis, FG needle (P = 0.02) and location of the lesion (P < 0.01) were independently associated with adequate tissue. Further, the use of FG needle (P = 0.04) and the size of the lesion (P = 0.02) were independently associated with acquisition of increased number of cell clusters.CONCLUSIONFG needle is superior to RB needle in acquiring adequate tissue and attaining higher number of cell clusters for solid and mixed lesions

Thermal and non-thermal effects off capacitive-resistive electric transfer application on the achilles tendon and musculotendinous junction of the gastrocnemius muscle: a cadaveric study

Background Calf muscle strain and Achilles tendon injuries are common in many sports. For the treatment of muscular and tendinous injuries, one of the newer approaches in sports medicine is capacitive-resistive electric transfer therapy. Our objective was to analyze this in vitro, using invasive temperature measurements in cadaveric specimens. Methods A cross-sectional study designed with five fresh frozen cadavers (10 legs) were included in this study. Four interventions (capacitive and resistive modes; low- and high-power) was performed for 5¿min each by a diathermy “T-Plus” device. Achilles tendon, musculotendinous junction and superficial temperatures were recorded at 1-min intervals and 5¿min after treatment. Results With the low-power capacitive protocol, at 5¿min, there was a 25.21% increase in superficial temperature, a 17.50% increase in Achilles tendon temperature and an 11.27% increase in musculotendinous junction temperature, with a current flow of 0.039 A¿±¿0.02. With the low-power resistive protocol, there was a 1.14% increase in superficial temperature, a 28.13% increase in Achilles tendon temperature and an 11.67% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.063 A¿±¿0.02. With the high-power capacitive protocol there was an 88.52% increase in superficial temperature, a 53.35% increase in Achilles tendon temperature and a 39.30% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.095 A¿±¿0.03. With the high-power resistive protocol, there was a 21.34% increase in superficial temperature, a 109.70% increase in Achilles tendon temperature and an 81.49% increase in musculotendinous junction temperature at 5¿min, with a current flow of 0.120 A¿±¿0.03. Conclusion The low-power protocols resulted in only a very slight thermal effect at the Achilles tendon and musculotendinous junction, but current flow was observed. The high-power protocols resulted in a greater temperature increase at the Achilles tendon and musculotendinous junction and a greater current flow than the low-power protocols. The high-power resistive protocol gave the greatest increase in Achilles tendon and musculotendinous junction temperature. Capacitive treatments (low- and high-power) achieved a greater increase in superficial temperature

Standard versus simplified radiofrequency ablation protocol for Barrett's esophagus: comparative analysis of the whole treatment pathway.

Background and study aims  The standard radiofrequency ablation (RFA) protocol for Barrett's esophagus (BE) encompasses an intermediary cleaning phase between two ablation sessions. A simplified protocol omitting the cleaning phase is less labor-intensive but equally effective in studies based on single ablation procedures. The aim of this study was to compare efficacy and safety of the standard and simplified RFA protocols for the whole treatment pathway for BE, including both circumferential and focal devices. Patients and methods  We performed a retrospective analysis of prospectively collected data on patients receiving RFA between January 2007 and August 2017 at two institutions. Outcomes assessed were: 1) complete remission of dysplasia (CR-D) and intestinal metaplasia (CR-IM) at 18 months; and 2) rate of esophageal strictures. Results  One hundred forty-five patients were included of whom 73 patients received the standard and 72 patients received the simplified protocol. CR-D was achieved in 94.5 % and 95.8 % of patients receiving the standard and simplified protocol, respectively ( P  = 0.71). CR-IM was achieved in 84.9 % and 77.8 % of patients treated with the standard and simplified protocol, respectively ( P  = 0.27). Strictures were significantly more common among patients who received the simplified protocol (12.5 %) compared to the standard protocol (1.4 %; P  = 0.008). The median number of esophageal dilations was one. Conclusion  The simplified RFA protocol is as effective as the standard protocol in eradicating BE but carries a higher risk of strictures. This needs to be taken into account, particularly in patients with higher pretreatment risk of strictures, such as those with esophageal narrowing from previous endoscopic mucosal resection (EMR)

LOS PAISAJES HISTÓRICOS DEL VALLE DEL GUADIAMAR (SEVILLA): LA MINERÍA Y LA METALURGIA EN EL EXTREMO ORIENTAL DEL CINTURÓN IBÉRICO DE PIRITAS

The f irst results of the research project Los Paisajes del Guadiamar are presented in this paper, paying special attention to archaeometallurgical aspects. This project has been going on since 2010, located in the mid-valley  of the River Guadiamar  (central-western  area of the province of  Seville)  and  backed  by  the  “Fundación  Focus-Abengoa”.  Although  not  all  the  archaeo- logical  and  analytical  data  are  yet  available,  a preliminary  approach  permits  to put  forward some conclusions and, above all, to validate or to refute hypotheses and theories proposed in previous research works.En este artículo se presentan los primeros resultados, incidiendo especialmente  en los aspectos arqueometalúrgicos, del proyecto de investigación Los Paisajes del Guadiamar. Este proyecto se desarrolla  desde  el año 2010,  f inanciado  por la “Fundación  Focus-Abengoa”,  en el valle medio del río Guadiamar (centro-oeste  de la provincia  de Sevilla).  Aunque aún no se ha con- cluido la obtención de todos los datos arqueológicos y analíticos, una valoración preliminar permite adelantar algunas conclusiones  y, sobre todo, contrastar hipótesis y teorías enunciadas en anteriores trabajos de investigación

Image enhanced endoscopy and molecular biomarkers vs Seattle protocol to diagnose dysplasia in Barrett's esophagus

BACKGROUND: Dysplasia in Barrett's esophagus (BE) is often invisible on high-resolution white-light endoscopy (HRWLE). We compared the diagnostic accuracy for inconspicuous dysplasia of the combination of autofluorescence (AFI)-guided probe-based confocal laser endomicroscopy (pCLE) and molecular biomarkers versus HRWLE with Seattle protocol biopsies. METHODS: BE patients with no dysplastic lesions were block randomized to standard endoscopy (HRWLE with Seattle protocol) or AFI-guided pCLE with targeted biopsies for molecular biomarkers (p53 and cyclin A by immunohistochemistry; aneuploidy by image cytometry), with crossover to the other arm after 6-12 weeks. Histological endpoint was diagnosis from all study biopsies (trial histology). Sensitivity analysis was performed for overall histology, which included diagnoses within 12 months from first study endoscopy. Endoscopists were blinded to the referral endoscopy and histology results. Primary outcome was diagnostic accuracy for dysplasia by real-time pCLE versus HRWLE biopsies. RESULTS: Of 154 patients recruited, 134 completed both arms. In the primary outcome analysis (trial histology analysis), AFI-guided pCLE had similar sensitivity for dysplasia compared to standard endoscopy [74.3% (95%CI, 56.7-87.5) vs 80.0% (95%CI 63.1-91.6), p=0.48]. Multivariate logistic regression showed pCLE optical dysplasia, aberrant p53 and aneuploidy had strongest correlation with dysplasia (secondary outcome). This 3-biomarker panel had higher sensitivity for any grade of dysplasia than Seattle protocol (81.5% vs 51.9%, p<0.001) in the overall histology analysis, but not in the trial histology analysis (91.4% vs 80.0%; p=0.16) with an area under receiver operating curve of 0.83. CONCLUSIONS: Seattle protocol biopsies miss dysplasia in approximately half of patients with inconspicuous neoplasia. AFI-guided pCLE has similar accuracy to the current gold standard. Addition of molecular biomarkers could improve diagnostic accuracy