Design of an Information System for optimizing the Programming of nursing work shifts

Health institutions operate twenty-four hours a day, seven days a week. They face a demand that fluctuates daily. Unlike jobs with fixed hours and obligatory days off, in health, operational continuity is required. The allocation for nursing shifts generates a rotation of people for health services according to legal and casuistic guidelines. Assigning and planning shifts results in a workload that takes an average of five to six extra hours. Existing applications offer a partial solution because they do not consider the news and contingencies of a health service. A web application is presented that, given a list of nurses, historical shifts and restrictions, a work shift planning is generated. This application comes to support the current shift allocation method based on electronic spreadsheets. The development consists of two modules. The first module has a shift allocation algorithm developed in C ++ and the second module has a graphical interface. As a case study, a set of health services from Chile and Colombia was used. The services have a defined number of nurses, who work different shifts according to the role and need of the institution. The results obtained are similar to a historical one. The proposed system takes less time and delivers various files and parameters that can be useful for nurses, the service and the health institutio

Natural Distribution of Parasitoids of Larvae of the Fall Armyworm, Spodoptera frugiperda, in Argentina

To develop a better understanding of the natural distribution of the fall armyworm, Spodoptera frugiperda (Smith) (Lepidoptera: Noctuidae), and to update the knowledge of the incidence of its complex of parasitoids. S. frugiperda, samplings in whorl-stage corn were carried out in provinces of Argentina from 1999 to 2003. S. frugiperda larvae were collected from corn in localities of the provinces of Tucumán, Salta, Jujuy, Santiago del Estero, La Rioja, Córdoba, San Luis, Chaco and Misiones. In each locality 30 corn plants were sampled and only larvae located in those plants were collected. The parasitoids that emerged from S. frugiperda larvae were identified and counted. The abundance of the parasitoids and the parasitism rate were estimated. The S. frugiperda parasitoids collected were Campoletis grioti (Blanchard) (Hymenoptera: Ichneumonidae), Chelonus insularis (Cresson) (Hymenoptera: Braconidae), Archytas marmoratus (Townsend) (Diptera Tachinidae) and/or A. incertus (Macquart), Ophion sp. (Hymenoptera: Ichneumonidae), Euplectrus platyhypenae Howard (Hymenoptera: Eulophidae), and Incamyia chilensis (Aldrich) (Diptera Tachinidae). C. grioti was the most abundant and frequent during the five-year survey. Similar diversity of parasitoids was obtained in all the provinces, with the exception of I. chilensis and E. platyhypenae that were recovered only in the province of Salta. In the Northwestern region, in Tucumán, C. grioti and species of Archytas were the most abundant and frequent parasitoids. On the contrary, in Salta and Jujuy Ch. insularis was the parasitoid most abundant and frequently recovered. The parasitism rate obtained in Tucumán, Salta and Jujuy provinces were 21.96%, 17.87% and 6.63% respectively with an average of 18.93%. These results demonstrate that hymenopteran and dipteran parasitoids of S. frugiperda occurred differentially throughout the Argentinian provinces and played an important role on the natural control of the S. frugiperda larval population

Effects of serelaxin in patients with acute heart failure

Background: Serelaxin is a recombinant form of human relaxin-2, a vasodilator hormone that contributes to cardiovascular and renal adaptations during pregnancy. Previous studies have suggested that treatment with serelaxin may result in relief of symptoms and in better outcomes in patients with acute heart failure. Methods: In this multicenter, double-blind, placebo-controlled, event-driven trial, we enrolled patients who were hospitalized for acute heart failure and had dyspnea, vascular congestion on chest radiography, increased plasma concentrations of natriuretic peptides, mild-to-moderate renal insufficiency, and a systolic blood pressure of at least 125 mm Hg, and we randomly assigned them within 16 hours after presentation to receive either a 48-hour intravenous infusion of serelaxin (30 μg per kilogram of body weight per day) or placebo, in addition to standard care. The two primary end points were death from cardiovascular causes at 180 days and worsening heart failure at 5 days. Results: A total of 6545 patients were included in the intention-to-treat analysis. At day 180, death from cardiovascular causes had occurred in 285 of the 3274 patients (8.7%) in the serelaxin group and in 290 of the 3271 patients (8.9%) in the placebo group (hazard ratio, 0.98; 95% confidence interval [CI], 0.83 to 1.15; P=0.77). At day 5, worsening heart failure had occurred in 227 patients (6.9%) in the serelaxin group and in 252 (7.7%) in the placebo group (hazard ratio, 0.89; 95% CI, 0.75 to 1.07; P=0.19). There were no significant differences between the groups in the incidence of death from any cause at 180 days, the incidence of death from cardiovascular causes or rehospitalization for heart failure or renal failure at 180 days, or the length of the index hospital stay. The incidence of adverse events was similar in the two groups. Conclusions: In this trial involving patients who were hospitalized for acute heart failure, an infusion of serelaxin did not result in a lower incidence of death from cardiovascular causes at 180 days or worsening heart failure at 5 days than placebo. (Funded by Novartis Pharma; RELAX-AHF-2 ClinicalTrials.gov number, NCT01870778. opens in new tab.

Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients

Background Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. Methods Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. Results A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). Conclusions Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218. opens in new tab.

Tetrapterys crispa

Angiosperm

Prevalencia de Xenopsylla cheopis en Rattus rattus en el distrito de Salas, Lambayeque: Prevalence of Xenopsylla cheopis in Rattus rattus in the Salas district, Lambayeque

Objective: The study of the prevalence of Xenopsylla cheopis in rodents of the Rattus rattus species.The objective of the present investigation is to establish the prevalence of Xenopsylla cheopis in rodents of the Rattus rattus species. Methods: To obtain the sample, Tomahawk and Sherman traps were used that contained baits previously prepared with oatmeal and vanilla, the traps were placed in three areas: intra-home area, peridomyciliary area and in the open area. Ectoparasites were obtained using the fine comb technique. With an entomological clamp, fleas were collected in a 2ml vial, containing 70% alcohol. Results: Its prevalence in Rattus rattus rodents were evaluated, with the highest prevalence rate being the one registered in the locality of Banco in August 2016 (4.08) and the lowest index was 1.3 registered in the locality of the Ramada in November 2015. They were captured 169 rodents Rattus rattus, of which 399 fleas could be collected, 299 belonged to the Xenopsylla cheopis species. Conclusion: it was found that the prevalence of Xenopsylla cheopis in Rattus rattus rodents in the locations of Sauce, Banco, Kerguer, Algarrobo, and Ramada in the Salas district, in the period July - November 2015 and August 2016 was high.Objetivo: La presente investigación tiene como objetivo determinar la prevalencia de Xenopsylla cheopis en roedores de la especie Rattus rattus. Métodos: Para la obtención de la muestra se usaron trampas Tomahawk y Sherman que contuvieron cebos previamente preparados con avena y vainilla, las trampas fueron colocadas en tres zonas: zona intradomiciliar, peridomiciliar y en área descampada. La obtención de ectoparásitos se realizó mediante la técnica del peine fino. Con una pinza entomológica se colectaron las pulgas en un vial de 2ml, conteniendo alcohol al 70 %. Resultados: Se evaluó su prevalencia en roedores Rattus rattus, siendo el índice de prevalencia más alto el registrado en la localidad de Banco en agosto 2016 (4.08) y el menor índice fue 1.3 registrado en la localidad de la Ramada en noviembre 2015. Se capturaron 169 roedores Rattus rattus, de los cuales se pudo colectar 399 pulgas, 299 pertenecían a la especie Xenopsylla cheopis. Conclusión: se encontró que la prevalencia de Xenopsylla cheopis en roedores Rattus rattus en las localidades del Sauce, el Banco, Kerguer, el Algarrobo y la Ramada del distrito de Salas, en el periodo Julio – noviembre 2015 y agosto 2016 fue elevada

NOTES Dried Blood Spots versus Sera for Detection of Rubella Virus-Specific Immunoglobulin M (IgM) and IgG in Samples Collected during a Rubella Outbreak in Peru of rubella virus-specific IgM and IgG results for serum/DBS sample pairs for persons with sus

Most persons with rubella virus-specific immunoglobulin M (IgM)-or IgG-positive sera tested positive (98% [n ‫؍‬ 178] and 99% [n ‫؍‬ 221], respectively) using paired filter paper dried blood spot (DBS) samples, provided that DBS indeterminate results were called positive. For persons with IgM-or IgG-negative sera, 97% and 98%, respectively, were negative using DBS. Simplification of specimen collection, storage, transport, and processing in the field would be a great advantage to rubella surveillance. Recent studies have suggested that filter paper dried blood spots (DBS) are suitable for laboratory detection of measles-specific immunoglobulin M (IgM) The presence of rubella virus-specific IgM in serum according to enzyme immunoassay is diagnostic for rubella, and thus, results from sera were used as the standard. However, because most specimens were collected in the first week after rash onset, a time period when serum IgM and IgG enzyme immunoassays do not detect many rubella cases, we do not refer to serum samples as a "gold standard" (1, 9). Health care workers at the local health care centers in five Regional Health Directorates in Peru enrolled persons 8 months or more in age seen within 28 days of rash and fever onset (clinically suspected rubella). Persons who were vacci-* Corresponding author. Mailing address: Centers for Disease Control and Prevention

Micosis ganglionar: reporte de 7 casos en el Hospital Nacional Cayetano Heredia Lima-Perú y revisión de la literatura

Objetivos: Describir las características clínicas, micológicas e histopatológicas de una serie de pacientes con micosis ganglionar y determinar si las afecciones ganglionares por hongos o micosis ganglionares pueden imitar otras patologías ganglionares infecciosas y no infecciosas. Material y Métodos: Se evaluaron 154 pacientes atendidos en el Departamento de enfermedades infecciosas y transmisibles del Hospital Nacional Cayetano Heredia de Lima entre enero del 2003 y enero del 2004. Estos pacientes participaron en un estudio de validación de una prueba diagnóstica para tuberculosis ganglionar pero tuvieron un diagnóstico definido de micosis ganglionar. Resultados: De 154 pacientes con linfadenopatía evaluados durante el tiempo de estudio, 7 tuvieron micosis ganglionar, dos de ellos eran pacientes inmunocompetentes y los cinco restantes inmunosuprimidos, uno por linfoma y los otros por VIH. Conclusiones: Las afecciones ganglionares por hongos o micosis ganglionares pueden ser grandes imitadoras de otras patologías ganglionares infecciosas y no infecciosas. (Rev Med Hered 2004;15:211-217)