RIESGO CARDIOVASCULAR DEL PERSONAL DE ENFERMERÍA EN EL ÁREA QUIRÚRGICA

The aim of the present investigation was to determine cardiovascular risk factors, through the Framingham model, in the Infirmary Personnel in the surgical area of the Instituto Autónomo Hospital Universitario de Los Andes Merida-Venezuela. A descriptive, field, and cross section study was made, with a population of 43 nurses. The analysis and interpretation of the results were made by descriptive statistics. Test results and the laboratory analysis proved that since age was a non modifiable factor, most of them were in the young adulthood and mature adulthood periods with low cardiovascular risk. As regards modifiable factors, it was determined that more than half had Total Cholesterol at normal levels. In relation to HDL Cholesterol, according to laboratory tests the results showed a high percentage of low values such as <40 mg/dl, which translates as a possible increase of cardiovascular disease risk. As for smoking, more than half of the Infirmary Personnel declared not to have smoking habits. As for Arterial Pressure levels, it was determined that more than half of the professionals were within the normal parameters. When calculating the cardiovascular risk at 10 years, according to the Framingham Model, most of the nurses were located as “Very Low” and “Low” risk of suffering cardiovascular disease in 10 years. Nevertheless, 18.61% had a “Moderate” “High” and “Very High” risk of suffering cardiovascular diseases in the future, which requires proposing promotion and prevention activities aimed at improving the working and health conditions of the Infirmary Personnel and at diminishing cardiovascular risks that can affect their individual, family and community health.La presente investigación tuvo como objetivo determinar los factores de riesgo cardiovascular, a través del modelo de Framingham, en el Personal de Enfermería que labora en el área quirúrgica, Instituto Autónomo Hospital Universitario de Los Andes Mérida-Venezuela. Se realizó un estudio de tipo descriptivo, de campo y de corte transversal, con una población determinada por 43 enfermeras. El análisis e interpretación de los resultados se realizó con estadística descriptiva. Los resultados del test y los exámenes de laboratorio evidenciaron que siendo la edad un factor no modificable, la mayoría se encuentran en el periodo adultez joven y adultez madura con bajo riesgo cardiovascular. Con respecto a los factores modificables, se determinó que del Colesterol Total más de la mitad presentó niveles normales. En relación al Colesterol HDL, según los exámenes de laboratorio los resultados reflejaron: un alto porcentaje mostró cifras bajas, es decir <40 mg/dl, lo cual se traduce en un posible aumento del riesgo a enfermedad cardiovascular. En cuanto al tabaquismo, más de la mitad del Personal de Enfermería manifestó no poseer hábitos tabáquicos. En lo referente a la medición de la Presión Arterial, se encontró que más de la mitad de los profesionales se encuentran en parámetros normales. Al calcular el riesgo cardiovascular a 10 años, según el Modelo de Framingham, la mayoría de las enfermeras, se ubicaron en “Muy Bajo” y “Bajo” riesgo de padecer enfermedad cardiovascular a 10 años. Sin embargo, el 18,61 % tienen un riesgo “Moderado”, “Alto” y “Muy Alto” de padecer en el futuro enfermedades cardiovasculares, lo que requiere de la propuesta de actividades de promoción y prevención, tendientes a mejorar las condiciones de trabajo y salud del Personal de Enfermería, orientadas a disminuir los riesgos cardiovasculares que puedan afectar su salud individual, familiar y en la comunidad

Two-particle BoseEinstein correlations in pp collisions at √s = 0.9 and 7 TeV measured with the ATLAS detector

The paper presents studies of Bose–Einstein Correlations (BEC) for pairs of like-sign charged particles measured in the kinematic range pT > 100 MeV and |η| <2.5 in proton–proton collisions at centre-of-mass energies of 0.9 and 7 TeV with the ATLAS detector at the CERN Large Hadron Collider. The integrated luminosities are approximately 7 μb−1, 190 μb−1 and 12.4 nb-1 for 0.9 TeV,7 TeV minimum-bias and 7 TeV high-multiplicity data samples, respectively. The multiplicity dependence of the BEC parameters characterizing the correlation strength and the correlation source size are investigated for charged-particle multiplicities of up to 240. A saturation effect in the multiplicity dependence of the correlation source size parameter is observed using the high-multiplicity 7 TeV data sample. The dependence of the BEC parameters on the average transverse momentum of the particle pair is also investigated

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Rotavirus A genotype G1P[8]: a novel method to distinguish wild-type strains from the Rotarix® vaccine strain

Rotaviruses are important enteric pathogens for humans and animals. Group A rotaviruses (RV-A) are the most common agents of severe gastroenteritis in infants and young children and vaccination is the most effective method to reduce RV-A-associated diseases. G1P[8], the most prevalent RV-A genotype worldwide, is included in the RV-A vaccine Rotarix®. The discrimination between wild-type G1P[8] and vaccine G1P[8] strains is an important topic in the study of RV-A epidemiology to manage outbreaks and to define control measures for vaccinated children. In this study, we developed a novel method to segregate the wild-type and vaccine strains using restriction endonucleases. The dsRNA from the Rotarix® vaccine was sequenced and the NSP3 gene was selected as the target gene. The vaccine strain has a restriction pattern that is different than that of wild-type RV-A G1P[8] isolates after digestion with the restriction endonuclease BspHI. This pattern could be used as a marker for the differentiation of wild-type G1P[8] strains from the vaccine strain

Distinctive expansion of gene families associated with plant cell wall degradation, secondary metabolism, and nutrient uptake in the genomes of grapevine trunk pathogens

BackgroundTrunk diseases threaten the longevity and productivity of grapevines in all viticulture production systems. They are caused by distantly-related fungi that form chronic wood infections. Variation in wood-decay abilities and production of phytotoxic compounds are thought to contribute to their unique disease symptoms. We recently released the draft sequences of Eutypa lata, Neofusicoccum parvum and Togninia minima, causal agents of Eutypa dieback, Botryosphaeria dieback and Esca, respectively. In this work, we first expanded genomic resources to three important trunk pathogens, Diaporthe ampelina, Diplodia seriata, and Phaeomoniella chlamydospora, causal agents of Phomopsis dieback, Botryosphaeria dieback, and Esca, respectively. Then we integrated all currently-available information into a genome-wide comparative study to identify gene families potentially associated with host colonization and disease development.ResultsThe integration of RNA-seq, comparative and ab initio approaches improved the protein-coding gene prediction in T. minima, whereas shotgun sequencing yielded nearly complete genome drafts of Dia. ampelina, Dip. seriata, and P. chlamydospora. The predicted proteomes of all sequenced trunk pathogens were annotated with a focus on functions likely associated with pathogenesis and virulence, namely (i) wood degradation, (ii) nutrient uptake, and (iii) toxin production. Specific patterns of gene family expansion were described using Computational Analysis of gene Family Evolution, which revealed lineage-specific evolution of distinct mechanisms of virulence, such as specific cell wall oxidative functions and secondary metabolic pathways in N. parvum, Dia. ampelina, and E. lata. Phylogenetically-informed principal component analysis revealed more similar repertoires of expanded functions among species that cause similar symptoms, which in some cases did not reflect phylogenetic relationships, thereby suggesting patterns of convergent evolution.ConclusionsThis study describes the repertoires of putative virulence functions in the genomes of ubiquitous grapevine trunk pathogens. Gene families with significantly faster rates of gene gain can now provide a basis for further studies of in planta gene expression, diversity by genome re-sequencing, and targeted reverse genetic approaches. The functional validation of potential virulence factors will lead to a more comprehensive understanding of the mechanisms of pathogenesis and virulence, which ultimately will enable the development of accurate diagnostic tools and effective disease management

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified