NIVEL DE CONOCIMIENTO DE LOS PACIENTES SOBRE PLANTAS ANTINEOPLÁSICAS EN EL INSTITUTO NACIONAL DE ENFERMEDADES NEOPLÁSICAS

El objetivo del estudio fue determinar el nivel de conocimiento de los pacientes sobre plantas antineoplásicas en el Instituto Nacional de Enfermedades Neoplásicas (INEN)en el mes de Mayo 2015. Ochenta personas fueron entrevistadas en total. Los encuestados fueron pacientes con diagnóstico de alguna neoplasia que se atiendan en el INEN de los cuales el 85% (n=80) utilizan plantas medicinales, el  64% (n=80)   lo utiliza por razones económicas, se observa que el  36% prefiere tratarse con medicina tradicional que con medicina científica y el 52% (n=80) de los pacientes utilizan complementariamente a su tratamiento plantas medicinales para prevenir el cáncer siendo la más utilizada la Annona muricata en un 40 %. Encontramos que el 58% (n=80) de los pacientes desconocen los efectos adversos de las plantas medicinales. El 79% (n=80) de los pacientes entrevistados manifestaron que el conocimiento sobre  plantas medicinales lo obtuvieron de sus padres o familiares y los fitofármacos más utilizados para  los efectos adversos producidos por la quimioterapia fueron el  Panax ginseng, Camellia sinensis y matricaria chamomilla

Rotación de cultivos en la producción de tabaco: Efecto sobre algunas propiedades edáficas

El cultivo de tabaco requiere numerosas labores, lo que sumado al escaso volumen de rastrojos que deja este cultivo, se favorece el deterioro físico, químico y biológico del suelo. El objetivo fue evaluar en un suelo del Valle los Pericos (Provincia de Jujuy), el efecto que ejercen sobre la calidad edáfica diferentes prácticas de manejo realizadas en el cultivo de tabaco: monocultivo (TM), rotación con gramíneas (TG) e incorporación de abonos verdes (TV), contrastando a su vez los resultados con los de una situación con bajo disturbio (T). Se estudió la respuesta de distintas variables edáficas determinadas a dos profundidades (0-20 cm y 20-40 cm), en lotes de producción de tabaco con diferentes rotaciones y más de 30 años bajo labranza convencional y riego. La agricultura provocó una merma del 44 % y 57 % en la estabilidad estructural promedio de los estratos superficial y profundo, respectivamente. La tasa de infiltración fue cinco veces superior en T. En los lotes agrícolas se observó un descenso marcado en todas las fracciones del carbono y entre un 8 % y 11% en el pH. La producción de tabaco bajo riego y fertilización mostró un aumento del 67 % al 100 % en la conductividad eléctrica del suelo y de más del 300 % en el fósforo extractable. La diversificación de cultivos generó en superficie, incrementos significativos del 54 % y 41 % del carbono orgánico total y asociado a la fracción mineral, respectivamente, mientras que el carbono particulado no varió según las distintas rotaciones agrícolas. El carbono de la biomasa microbiana superficial y profunda fue un 118 % y 159 % superior, respectivamente, en TG en relación al promedio de TV y TM, mientras que la respiración basal superficial fue un 83 % mayor en TG y TV respecto a TM.Tobacco cultivation requires numerous agricultural practices, which along with the low volume of stubble that it leaves, it favors soil physical, chemical and biological deterioration. The aim of this work was to evaluate, in a soil of Valle los Pericos (Jujuy Province), the effect on edaphic quality of crop rotations carried out in the tobacco cultivation: monoculture (TM), rotation with grasses (TG), incorporation of green manures (TV), and also compared these results with those of a low soil disturbance situation (T). The response of different edaphic variables was studied at two soil depths (0-20 cm and 20-40 cm), in tobacco production plots with different rotations and more than 30 years under conventional tillage and irrigation. Agriculture caused a decrease of 44 % and 57 % in the average structural stability at the superficial and deep layer, respectively. Infiltration rate was five times higher in T. A decrease in all carbon fractions and between 8 % and 11 % of soil pH was observed in cultivated plots. Tobacco production under irrigation and fertilization showed an increase from 67 % to 100 % in soil electrical conductivity and more than 300 % in the extractable phosphorus. Crop diversification generated in superficial layer significant increases of 54 % and 41 % of total and mineral associated organic carbon content, respectively, while particulate carbon did not change according to the different agricultural rotations. The superficial and deep carbon of the microbial biomass was 118 % and 159 % higher, respectively, in TG in relation to the TV and TM average, while superficial basal respiration was 83 % higher in TG and TV with respect to TM.Fil: Colque, Raúl A. Universidad Nacional de Jujuy. Facultad de Ciencias Agrarias; ArgentinaFil: Romaniuk, Romina Ingrid. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Suelos; ArgentinaFil: Arias, Patricia. Universidad Nacional de Jujuy. Facultad de Ciencias Agrarias; ArgentinaFil: Castiglioni, Mario Guillermo. Universidad de Buenos Aires. Facultad de Agronomía. Cátedra de Conservación y Manejo de Suelos; Argentin

Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America : an analysis within the ESTAMPA study

Corresponding author. E-mail address: [email protected] (A.T. Ramírez).Background. Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30–64 years participating in the ESTAMPA study. Methods. Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated. Findings. 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0–53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3–96.7). Specificity was 96.5% (95% CI: 96.3–96.7) using cytology and 88.7% (95% CI: 88.3–89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%–100% and 83.6–90.8%, respectively). Interpretation. The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America.Consejo Nacional de Ciencia y TecnologíaPrograma Paraguayo para el Desarrollo de la Ciencia y Tecnología. Proyectos de investigación y desarroll

Implementing HPV testing in 9 Latin American countries : the laboratory perspective as observed in the ESTAMPA study

Correspondence: Maribel Almonte [email protected] article was submitted to Infectious Diseases - Surveillance, Prevention and Treatment, a section of the journal Frontiers in Medicine.Background: Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings. Methods: We describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described. Results: Seven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs. Conclusion: High readiness of laboratories is an essential part of effective implementation of HPV testing. However, high readiness is insufficient to guarantee HPV testing high continuity capacity, for which a "culture of quality" should be established with regular training, robust monitoring and quality assurance systems tailored to local context. All efforts to strengthen HPV laboratories are valuable and crucial to guarantee effective implementation of HPV-based cervical screening.Consejo Nacional de Ciencia y TecnologíaPrograma Paraguayo para el Desarrollo de la Ciencia y Tecnología. Proyectos de investigación y desarroll

PENSAMIENTO CRÍTICO EN LA INVESTIGACIÓN CIENTÍFICA Y ACADÉMICA COLECCIÓN CIENTÍFICA EDUCACIÓN, EMPRESA Y SOCIEDAD

PENSAMIENTO CRÍTICO EN LA INVESTIGACIÓN CIENTÍFICA Y ACADÉMICA COLECCIÓN CIENTÍFICA EDUCACIÓN, EMPRESA Y SOCIEDAD Primera Edición 2023 Vol. 21 Editorial EIDEC Sello Editorial EIDEC (978-958-53018) NIT 900583173-1 ISBN: 978-628-95884-1-5 Formato: Digital PDF (Portable Document Format) DOI: https://doi.org/10.34893/e1150-3660-8721-s Publicación: Colombia Fecha Publicación: 13/09/2023 Coordinación Editorial Escuela Internacional de Negocios y Desarrollo Empresarial de Colombia – EIDEC Centro de Investigación Científica, Empresarial y Tecnológica de Colombia – CEINCET Red de Investigación en Educación, Empresa y Sociedad – REDIEES Revisión y pares evaluadores Centro de Investigación Científica, Empresarial y Tecnológica de Colombia – CEINCET Red de Investigación en Educación, Empresa y Sociedad – REDIEE

La calidad del servicio basado en las percepciones y expectativas de los asegurados de la Red Asistencial Puno - Essalud - Puno 2008

Considerando que la seguridad social de la población es de gran importancia para el desarrollo de las sociedades se ha planteado la investigación LA CALIDAD DEL SERVICIO BASADO EN LAS PERCEPCIONES Y EXPECTATIVAS DE LOS ASEGURADOS DE LA RED ASISTENCIAL PUNO- ESSALUD- PUNO 2008". Los objetivos de esta investigación fueron: Primero, determinar las deficiencias del servicio de salud ofrecido por el Hospital 111 EsSalud-Puno, según la percepción y expectativa de los asegurados. Segundo, analizar la calidad del servicio de salud ofrecido en el Hospital 111 EsSalud Puno, según la percepción y expectativa de los asegurados. Tercero, Proponer lineamientos para mejorar el servicio de salud ofrecido a los asegurados del Hospital 111 EsSalud. Puno. En la presente investigación se aplicó el diseño no experimental transeccional - descriptivo. Se usó el método deductivo para estudiar formalmente el marco conceptual referente a calidad de servicio así como la percepción y expectativa de los clientes. Los resultados muestran que la calidad de servicio ofrecido en el Red Asistencial Puno - EsSalud según los encuestados lo consideran REGULAR 38.5%. Así mismo, se encontró que el servicio de salud que se recibe en el Red Asistencial Puno - EsSalud hace presumir que la organización no conoce, no entiende las necesidades y no ofrece una solución personalizada que vaya más allá de la necesidad de los asegurados que es una urgencia médica. Con respecto a las expectativas del usuario encontramos que las dimensiones más significativas de esta evaluación son la dimensión SENSIBILIDAD y EMPATÍA las mismos que estuvieron cerca del ideal en calidad de servicio 3.7 y 4,2 puntos (percibido) de 7 puntos (expectativa) respectivamente; sin embargo es importante considerar las dimensiones ASPECTOS TANGIBLES, FIABILIDAD y SEGURIDAD que estuvieron debajo del ideal en calidad de servicios 2.2, 3.1, 3.3 puntos (percibido).Tesi

La calidad del servicio basado en las percepciones y expectativas de los asegurados de la Red Asistencial Puno - Essalud - Puno 2008

TesisConsiderando que la seguridad social de la población es de gran importancia para el desarrollo de las sociedades se ha planteado la investigación LA CALIDAD DEL SERVICIO BASADO EN LAS PERCEPCIONES Y EXPECTATIVAS DE LOS ASEGURADOS DE LA RED ASISTENCIAL PUNO- ESSALUD- PUNO 2008". Los objetivos de esta investigación fueron: Primero, determinar las deficiencias del servicio de salud ofrecido por el Hospital 111 EsSalud-Puno, según la percepción y expectativa de los asegurados. Segundo, analizar la calidad del servicio de salud ofrecido en el Hospital 111 EsSalud Puno, según la percepción y expectativa de los asegurados. Tercero, Proponer lineamientos para mejorar el servicio de salud ofrecido a los asegurados del Hospital 111 EsSalud. Puno. En la presente investigación se aplicó el diseño no experimental transeccional - descriptivo. Se usó el método deductivo para estudiar formalmente el marco conceptual referente a calidad de servicio así como la percepción y expectativa de los clientes. Los resultados muestran que la calidad de servicio ofrecido en el Red Asistencial Puno - EsSalud según los encuestados lo consideran REGULAR 38.5%. Así mismo, se encontró que el servicio de salud que se recibe en el Red Asistencial Puno - EsSalud hace presumir que la organización no conoce, no entiende las necesidades y no ofrece una solución personalizada que vaya más allá de la necesidad de los asegurados que es una urgencia médica. Con respecto a las expectativas del usuario encontramos que las dimensiones más significativas de esta evaluación son la dimensión SENSIBILIDAD y EMPATÍA las mismos que estuvieron cerca del ideal en calidad de servicio 3.7 y 4,2 puntos (percibido) de 7 puntos (expectativa) respectivamente; sin embargo es importante considerar las dimensiones ASPECTOS TANGIBLES, FIABILIDAD y SEGURIDAD que estuvieron debajo del ideal en calidad de servicios 2.2, 3.1, 3.3 puntos (percibido)

Serum antibodies against Staphylococcus aureus antigens in healthy individuals and patients with invasive infections

The present work aims to study the antibody responses against Staphylococcus aureus in health and in deep infections and is composed of six papers. We developed a sandwich enzyme immuno assay (EIA) with a detection limit for alpha-toxin at nanograms levels. This method is applicable to measure alpha-toxin in culture supernatants and in human fluids. The assay is simple, reproducible and performed within 6 hours. We determined the presence of alpha-toxin in serum samples and homologous strains from 41 patients with septicaemia due to Staphylococcus aureus. We detected alpha-toxin in 22% (6/27) of the sera taken on admission from patients whith symptoms presented for ~7 days. In all, alpha-toxin was found in 20 % (8/41) serum samples taken on admission. In seven of these eight samples low antibody titres were also noted. 57 % of the patients ( 20/35) showed a positive antibody antibody detection increased the diagnostic sensitivity to 52 % in early serum samples. The subsequent studies are based on 2 prospective studies performed in Sweden with aproximately 10 years in between. We use EIA method to measure the antibody response. The clinical material for the first prospective study was collected during 1988-1991 at the Department of Infectious Diseases, Örebro University Hospital. 240 consecutive samples from 63 patients suffering S. aureus septicaemia were collected. We studied the antibody response during disease against three antigens: alpha-toxin, teichoic acid, and lipase. A considerable individual variation in the response to the different antigens was noted, as was a good correlation between clinical course of the disease and the antibody response, indicating the possible use of serology for monitoring disease and recovery. Antibody levels against alpha-toxin measured in the EIA correlated with the alpha-toxin neutralizing activity of the patient sera. Patients with initially low antibody levels displayed a poorer antibody response during the disease than those with higher antibody levels; this phenomenon was observed with the three antigens alpha-toxin, teichoic acid, and lipase, but was most pronounced with alpha-toxin (p < 0.001). Furthermore, initially low antibody levels were associated with the development of complicated septicaemia (11 out of 13 patients). These latter observations point at the significance of low antibody levels in staphylococcal disease. We also analyzed levels of antibodies against clumping factor A (Clf-A) and extracellular fibrinogen binding protein (Efb), antigens belonging to the group of fibrinogen binding proteins. No correlation was seen between levels against these antigens indicating that measured antibodies were produced independently. Antibody levels against Efb were significantly lower in the acute sera than in sera from healthy individuals (p = 0.002). This difference may reflect that individuals with lower antibody levels against Efb are more prone to develop deep staphylococcal infections. Sample collection for the second prospective study was performed from 2003 to 2005 at the Clinic of Infectious Diseases in Skövde, comprised 218 samples from 96 patients, collected at the time of diagnosis, after completed antibiotic treatment and one month after the end of treatment. We investigated the antibody response against the five previously described antigens and furthermore included three more antigens, enterotoxin A (SEA), Toxic Shock Syndrome Toxin 1(TSST), and Scalded Skin Syndrome toxin (SSS). We found a correlation between patient strains agr-group, PFGE-group, alpha-toxin production and patient initial antibody levels. Patients with fatal outcome displayed lower initial antibody levels to all antigens and significantly to teichoic acid, lipase, SEA, and SSS. In episodes with complicated bacteraemia, significantly lower levels to teichoic acid and lipase were registered in the initial sample. We analysed the antibody levels in 151 healthy individuals with matched ages as to give reference values to sepsis patients. Eleven antigens were analysed including three new antigens: Clumping factor B (Clf-B), bone sialoprotein-binding (Bsp) protein and Extracellular adherence protein (Eap). We found great individual variations in antibody levels, both in young and elder individuals. Occurrence of S. aureus in the nares at time of sampling was correlated to higher antibody levels, specially against the extracellular proteins alpha-toxin, lipase, SEA, TSS-1, and SSS . Elderly individuals over 65 y showed slightly lower antibody levels. Certain individuals were more prone to produce or not to produce antibodies than others, and certain extracellular proteins were more often inducing high IgG levels. Conclusions. Analysis of the antibody levels in S. aureus septicaemia showed a variation between patients and between different antigens both in disease and in health. Low antibody levels may have a prognostic value. Healthy colonized individuals show higher antibody levels against extracellular proteins, alpha-toxin, lipase, SEA, TSS-1, SSS. The serological diagnosis can be improved through the use of more than one antigen in a combinatory analysis and serological analysis in the future may be important for monitoring the diseases. It may also be crucial for monitoring the use of passive and active immune therapy against S. aureus invasive disease