Características de la hospitalización en el servicio de medicina interna del hospital san Rafael de Tunja

El presente documento pretende determinar el volumen, estructura, principales causas de ingreso, estancia hospitalaria y mortalidad, en pacientes ingresados al servicio de Medicina Interna del Hospital San Rafael de Tunja, durante los meses de Agosto de 2006 y Julio de 2007

Características de la hospitalización en el servicio de medicina interna del hospital San Rafael de Tunja

Introducción: determinar el volumen, estructura, principales causas de ingreso, estancia hospitalaria y mortalidad, en pacientes ingresados al servicio de Medicina Interna del Hospital San Rafael de Tunja, durante los meses de Agosto de 2006 y Julio de 2007. Métodos: estudio descriptivo de corte transversal. Se realizó una revisión exhaustiva de registros de ingreso hospitalario. La muestra son los ingresos a medicina interna. Se evaluaron las variables: género, edad, enfermedad de base, diagnóstico de ingreso, días de estancia y condición al egreso. Resultados: promedio de permanencia 6,29 días (SD= 5,38); 35,1% de los pacientes permanecen hospitalizados más de 6 días; promedio de edad 61,57 años (SD= 20,28); 62,8% de los pacientes son mayores de 60 años; 36,2% de los pacientes son atendidos por las subespecialidades de neumología y cardiología, seguidas por el servicio de neurología (18,3%); 7,1% de los pacientes ingresados fallecieron en el servicio. Las principales causas de mortalidad fueron las neurológicas (27,5%) seguidas por las afecciones cardiovasculares y respiratorias (24,6%). Conclusiones: se recomienda estructurar y actualizar en el corto plazo protocolos guía para la atención integral de la persona con insuficiencia cardiaca y respiratoria. Conocer la ocurrencia de la morbilidad es de utilidad en la administración del servicio, porque permite articular programas de prevención y reducir el número de hospitalizaciones al igual que la estancia hospitalaria. La actualización permanente del equipo de salud en atención integral al geronte, es un indicador de gestión que contribuye a garantizar la calidad del servicio, aspecto que es evaluado para la acreditación de la Institución.

Episodios de ansiedad y depresión en universitarias de Tunja (Colombia): probable asociación con uso de anticoncepción hormonal. 2012

Introduction: to asses the possible link between use of hormonal contraceptives (oral, injectable or sub dermal implants) with episodes of anxiety and depression in college students from Tunja, adjusting for other factors identified with depression in scientific literature.Materials: study of prevalence, observational, with analytic cross-sectional design. Population was defined as the female students of two universities located in Tunja. It was extracted a sample of 538 women by random sequential sampling, which prior informed consent, was applied the Hamilton Anxiety Scale, and the Beck depression scale .Statistical analysis was made using Epi-Info program.Results: the overall prevalence of depression was 18,95%, an the manifestations of anxiety one was 52,04%. We found statistically significant association between the use of hormonal methods and depression: OR = 3,31 (95% CI: 1,03-5,40, p = 0.0001). The estimate of probable association between hormonal methods and anxiety, showed a statistically significant association, although less strong: OR=1,46 (CI95% 1,03-2,05; p=0,018. It was also found association between manifestations of depression and age more than twenty years.Conclusions: findings reported show positive association, suggesting the need for healthcare providers to evaluate mental state of the young university at the time of prescribing the use of hormonal preparations as a contraceptive method.Objetivo: identificar la posible asociación entre el uso de anticonceptivos hormonales (orales, inyectables e implantes sub-dérmicos), y la ocurrencia de episodios de ansiedad y depresión en estudiantes universitarias de Tunja (Colombia), ajustado por otros factores identificados con la depresión y la ansiedad en la literatura científica.Métodos: estudio de prevalencia, observacional, con diseño de Corte Transversal, Analítico. La población: mujeres estudiantes del área de la salud, de dos universidades localizadas en Tunja; de ellas se extrajo mediante muestreo secuencial no probabilístico, una muestra de 538 mujeres, a quienes previo consentimiento informado se aplicó la Escala de Ansiedad de Hamilton y la escala de Depresión de Beck. El análisis se adelantó con el programa Epi-Info 2004.Resultados: la prevalencia global de depresión fue de 18,95% y la de manifestaciones de ansiedad de 52,04%. Se encontró asociación estadísticamente significativa entre el uso de métodos hormonales y depresión: OR= 3,31 (IC95%: 1,03-5,40; p= 0.0001). La estimación de probable asociación entre uso de métodos hormonales y ansiedad, también registró una asociación estadísticamente significativa, aunque menos sólida: OR= 1,46 (IC95% 1,03-2,05; p> 0,018). Se encontró también asociación entre las manifestaciones de depresión y edad (superior a los 20 años).Conclusiones: los hallazgos reportados muestran asociación positiva entre la anticoncepción hormonal, la depresión y la ansiedad, que sugiere la necesidad que los proveedores de salud consideren el estado mental de las jóvenes universitarias al momento de prescribir el uso de preparados hormonales, como método de anticoncepción

Advanced management of ventricular arrhythmias in chronic Chagas cardiomyopathy

Chagas cardiomyopathy is a parasitic infection caused by Trypa-nosoma cruzi. Structural and functional abnormalities are the result of direct myocardial damage by the parasite, immunological reactions, dysautonomia, and microvascular alterations. Chronic Chagas cardiomyopathy (CCC) is the most serious and important manifestation of the disease, affecting up to 30% of patients in the chronic phase. It results in heart failure, arrhythmias, thromboembolism, and sudden cardiac death. As in other cardiomyopathies, scar-related reentry frequently results in ventricular tachycardia (VT). The scars typically are located in the inferior and lateral aspects of the left ventricle close to the mitral annulus extending from endocardium to epicardium. The scars may be more prominent in the epicardium than in the endocardium, so epicardial mapping and ablation frequently are required. Identification of late potentials during sinus rhythm and mid-diastolic potentials during hemodynamically tolerated VT are the main targets for ablation. High-density mapping during sinus rhythm can identify late isochronal regions that are then targeted for ablation. Preablation cardiac magnetic resonance imaging with late enhancement can identify potentials areas of arrhythmogenesis. Therapeutic alternatives for VT management include antiarrhythmic drugs and modulation of the cardiac autonomic nervous system.Revista Internacional - No indexadaN

Law 78 of 1886

La imagen contiene una noticia acerca de la Ley 78 del año 1886, donde se aprueba un contrato con algunas modificaciones y se obliga a pagar una fianza al Ministerio del Tesoro como garantía de cumplimiento de dicho contrato, además del compromiso de vender los ejemplares que soliciten los alumnos de las Escuelas Primarias . Noticia publicada en Gaceta de Cundinamarca No. 72, Mayo 31, 1887.The image contains news about Law 78 of 1886, where a contract is approved with some modifications and a bond is required to be paid to the Ministry of the Treasury as a guarantee of compliance with said contract, in addition to the commitment to sell the copies requested. Primary School students. News published in Gaceta de Cundinamarca No. 72, May 31, 1887

Law 81 of 1886

La imagen contiene una noticia acerca de la Ley 81 de 1886 por la cual se autoriza la celebración de un contrato con D. Rafael Pombo, donde cede al Gobierno el Derecho a publicar la primera edición de su obra "Fábulas y verdades". Noticia publicada en Gaceta de Cundinamarca No. 73, Junio 3, 1887.The image contains news about Law 81 of 1886, which authorizes the conclusion of a contract with Mr. Rafael Pombo, where he transfers to the Government the Right to publish the first edition of his work "Fables and truths". News published in Gaceta de Cundinamarca No. 73, June 3, 1887

Law 82 of 1886

La imagen contiene una noticia acerca de La Ley 82 de 1886 por la cual se aprueba un contrato celebrado entre el Ministro de Instrucción Pública y el señor D. Gabriel Rosas, para la compra de 500 ejemplares de los tratados de Lógica y Psicología. Noticia publicada en Gaceta de Cundinamarca No. 74, Junio 7-1887.The image contains news about Law 82 of 1886, which approves a contract signed between the Minister of Public Instruction and Mr. Gabriel Rosas, for the purchase of 500 copies of the Logic and Psychology treatises. News published in Gaceta de Cundinamarca No. 74, June 7-1887

Chandra High Energy Transmission Gratings Spectra of V3890 Sgr

The recurrent nova (RN) V3890 Sgr was observed during the seventh day after the onset of its most recent outburst, with the Chandra ACIS-S camera and High Energy Transmission Gratings. A rich emission line spectrum was detected, due to transitions of Fe-L and K-shell ions ranging from neon to iron. The measured absorbed flux is ≈10−10 erg cm−2 s −1 in the 1.4–15 Å range (0.77–8.86 keV). The line profiles are asymmetric, blueshifted, and skewed toward the blue side, as if the ejecta moving toward us are less absorbed than the receding ejecta. The full width at half-maximum of most emission lines is 1000–1200 km s−1 , with some extended blue wings. The spectrum is thermal and consistent with a plasma in collisional ionization equilibrium with column density 1.3 × 1022 cm−2 and at least two components at temperatures of about 1 and 4 keV, possibly a forward and a reverse shock, or regions with differently mixed ejecta and a red giant wind. The spectrum is remarkably similar to the symbiotic RNe V745 Sco and RS Oph, but we cannot distinguish whether the shocks occurred at a distance of a few au from the red giant, or near the giant’s photosphere, in a high-density medium containing only a low mass. The ratios of the flux in lines of aluminum, magnesium, and neon relative to the flux in lines of silicon and iron probably indicate a carbon–oxygen white dwarf.Fil: Orio, M.. Istituto Nazionale di Astrofisica; ItaliaFil: Drake, J. J.. Harvard-Smithsonian Center for Astrophysics; Estados UnidosFil: Ness, J. U.. Agencia Espacial Europea. XMM-Newton Science Operations Centre; EspañaFil: Behar, E.. Technion - Israel Institute of Technology; IsraelFil: Luna, Gerardo Juan Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Astronomía y Física del Espacio. - Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Astronomía y Física del Espacio; ArgentinaFil: Darnley, M. J.. University of Liverpool; Reino UnidoFil: Gallagher, J.. Istituto Nazionale di Astrofisica; ItaliaFil: Gehrz, R. D.. University of Minnesota; Estados UnidosFil: Kuin, N. P. M.. University College London; Estados UnidosFil: Mikolajewska, J.. Polish Academy of Sciences; ArgentinaFil: Ospina, N.. Istituto Nazionale di Astrofisica; ItaliaFil: Page, K. L.. University of Leicester; Reino UnidoFil: Poggiani, R.. Istituto Nazionale di Astrofisica; ItaliaFil: Starrfield, S.. Arizona State University; Estados UnidosFil: Williams, R.. Space Telescope Science Institute; Estados UnidosFil: Woodward, C. E.. University of Minnesota; Estados Unido

Haematological Alterations Associated with Selected Vector-Borne Infections and Exposure in Dogs from Pereira, Risaralda, Colombia

Infections due to Ehrlichia, Anaplasma, Dirofilaria, Mycoplasma, Babesia and Hepatozoon continue to be highly prevalent in dogs, especially in tropical and subtropical areas, where vectors of many of them are present. However, many clinical aspects of dogs have not been characterized in detail, including assessing the haematological alterations associated with them, particularly in Colombia and Latin America. A group of 100 dogs with Ehrlichia, Anaplasma, Dirofilaria, Mycoplasma, Babesia and Hepatozoon infections/exposure were assessed by blood smear serology (SNAP4DX) and PCR in Pereira, Colombia. We performed blood counts to evaluate anaemia, leukopenia/leukocytosis, neutropenia, neutrophilia, lymphopenia/lymphocytosis, monocytosis, eosinophilia, and thrombocytopenia, among other alterations. Bivariate analyses were performed on Stata®14, with significant p Ehrlichia 75%), and 89% presented clinical alterations. A total of 100% showed anaemia, 70% thrombocytopenia, 61% monocytosis, and 47% neutropenia, among other alterations. Additionally, 11% presented pancytopenia and 59% bicytopenia. The median platelet count was lower in infected dogs (126,000 cells/μL) versus non-infected (221,000 cells/μL) (p = 0.003). Thrombocytopenia was higher among infected dogs (75%) versus non-infected (40%) (p = 0.006), with a 91% positive predictive value for infection. Median neutrophil count was lower in infected dogs (6591 cells/μL) versus non-infected (8804 cells/μL) (p = 0.013). Lymphocytosis occurred only among those infected (27%) (p = 0.022). Leukopenia was only observed among infected dogs (13%). Pancytopenia was only observed among infected dogs. Ehrlichiosis and other hematic infections have led to a significant burden of haematological alterations on infected dogs, including pancytopenia in a tenth of them, most with thrombocytopenia and all anemic