Cuidado de las lesiones posparto en la consulta perineal

El objetivo de este artículo fue revisar bibliográficamente los principales problemas que se derivan de las lesiones perineales, así como dar a conocer el trabajo de la matrona en una consulta perineal y el modo en que se está implementando esta consulta en el Hospital General de Granollers. Para cumplir con la primera parte del objetivo, se realizó una revisión bibliográfica sobre las complicaciones derivadas de las lesiones perineales que ocurren durante el parto. Los resultados obtenidos se han estructurado en los siguientes apartados: dolor perineal y dispareunia, infección y dehiscencia, incontinencia urinaria y prolapso genital (lesión del músculo elevador del ano) e incontinencia fecal y de gases (lesión del esfínter anal). En la segunda parte del artículo se explica la experiencia que se realizó en el Servicio de Obstetricia del Hospital de Granollers para disminuir la morbilidad posparto derivada de las lesiones perineales. Se implementaron diversas medidas de prevención, y se creó una consulta perineal para dar continuidad a los cuidados especializados para las mujeres que han sufrido alguna complicación perineal tras el parto vaginal. La matrona, integrada en el equipo multidisciplinario especialista en suelo pélvico, es la profesional que realiza este seguimiento y proporciona apoyo a la mujer

Quid: observatorio de medios

El informe está dividido en cuatro apartados: “Derecho a la información y transparencia”, “La televisión mexicana”, “Empresas y prácticas periodísticas” y “Los que se fueron”. En el primero de ellos se presenta un texto que ayuda a entender cuál es el momento en el que se encuentran las propuestas legislativas para regular a los medios y las telecomunicaciones en México, y una evaluación de los primeros cinco años del Instituto de Transparencia e Información Pública de Jalisco. El segundo apartado del informe es ecléctico, pues se compone de artículos que trabajan distintas temáticas de la televisión:la estructura y oferta de la televisión en nuestro país (en particular en la ciudad de Guadalajara), la televisión por cable (enfatizando el caso de Megacable), un recuento de cómo se gestó el Canal 44 y de sus prospectivas en 2011, y los mundiales de futbol. La tercera parte del informe documenta algunas de las situaciones más importantes que se viven en el periodismo local: estos trabajos presentan sistemas en crisis (alta vulnerabilidad de los periodistas mexicanos ante un clima de violencia que lejos de disminuir va en aumento, y la participación, por acción u omisión, del Estado mexicano en la sistemática violación de los derechos de quienes dedican su vida al trabajo periodístico. Los siguientes artículos tratan sobre las transformaciones de las empresas periodísticas, particularmente las del sector de la prensa escrita: la rápida e inexorable desaparición de los suplementos culturales, y una radiografía sobre las formas de producción de algunas secciones internacionales de los periódicos tapatíos. Al final se presentan las semblanzas de José Galindo, Raúl Mora Lomelí, S.J., Tomás Eloy Martínez y Juan Pablo Rosell.ITESO, A.C

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Use of PTC3 as a pathogen-growth inhibitor: comparative study with silver nanoparticles in in vitro propagation of Tropaeolum tuberosum Ruiz & Pavón “Mashua”

In vitro culture of any plant tissue requires stringent aseptic conditions to thrive within a microorganism-free environment. This is particularly difficult since culture media inherently contain an optimal and sufficient nutrient concentration for numerous microorganisms, thereby impeding the correct development of the explants. In this study, we assessed the antimicrobial and antifungal efficacy of silver nanoparticles (AgNPs) and the chemical inhibitor of contamination, 1-phenyl-1- (N-phenyl-N’-ethyl-guanil)-3-ethyl-thiocarbamide (Plant Tissue Culture Contamination Control, PTC3) during the propagation of “mashua” MAC003 morphotype (Tropaeolum tuberosum Ruiz & Pavón). We successfully demonstrated the use of these compounds in the medium obviating the need for an autoclaving procedure. To achieve this, we employed a gradient of concentrations of both agents. Murashige and Skoog (MS) culture medium with 3% sucrose and 0.7% agar at pH 5.6 was supplemented with AgNPs nanoparticles at 20, 50, and 100 ppm, alongside PTC3 at 0.2, 2 and 3 ppm concentrations. Both AgNPs and PTC3 exhibited inhibitory effects on microbial and fungal growth across all tested concentrations. Statistical analysis of the biometric parameters measured in explants over 4 week period indicated that the optimal AgNPs concentration was 20 ppm. Additionally, the growth and development outcome of Tropaeolum tuberosum explants were most favorable with PTC3 concentration of 0.2 ppm, as discerned through a comparative analysis of the two compounds. This study proposes the use of PTC3 as a novel compound of choice for avoiding the autoclaving process within in vitro plant tissue culture techniques

Desafíos del diseño social en condiciones de contingencia

Esta obra aborda al enfoque social del diseño como un desafío para definir propuestas que coadyuven al mejoramiento de diversos sectores de la sociedad, entendido como un esfuerzo conjunto para encontrar soluciones pertinentes y adecuadas basadas en la cultura y los valores de los pueblos. Condiciones que demandan una gran responsabilidad social y moral del diseñador. Se destacan diversas aportaciones de investigaciones que destacan esta visión a través de diversas reflexiones y aportaciones al campo del diseño y la cultura, desde enfoques del respeto a los derechos humanos, a la diversidad y la equidad

Bases para un diseño social, innovador e incluyente

El diseño social es un concepto vivo, incluye una serie de elementos alrededor de él que le hacen trascender como una disciplina que genera valor en los grupos a partir de su praxis. En este sentido, se reconoce una serie de planteamientos en torno a los aspectos sociales del diseño, mismos que están vinculados con necesidades y fenómenos contemporáneos que han sido poco abordados o atendidos, dado que implican una postura del profesional del diseño, quien requiere de una sensibilidad a priori para dirigir su atención a grupos pequeños y/o minoritarios, lo que involucra también, una mirada distinta, que deja de lado la dinámica de mercado como única posibilidad del ejercicio de la disciplin

Role of age and comorbidities in mortality of patients with infective endocarditis.

The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups: A total of 3120 patients with IE (1327  There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in th

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective