International lower limb collaborative (INTELLECT) study: a multicentre, international retrospective audit of lower extremity open fractures

Trauma remains a major cause of mortality and disability across the world1, with a higher burden in developing nations2. Open lower extremity injuries are devastating events from a physical3, mental health4, and socioeconomic5 standpoint. The potential sequelae, including risk of chronic infection and amputation, can lead to delayed recovery and major disability6. This international study aimed to describe global disparities, timely intervention, guideline-directed care, and economic aspects of open lower limb injuries

Conferencia internacional. Desafíos de la Investigación e innovación en tiempos de Covid-19

En 2018, Treinta y nueve estudiantes femeninas del X ciclo del periodo 2018-1 de la escuela de Psicología de una universidad particular del cono norte de Lima, ellas han descrito el romance de su personas cercanas a ellas. Se analizaron los 266 casos de parejas de enamorados estaban el rango de 17 a 25 años. El instrumento que se usó fue una CUESTIONARIO CUPIDO que es una escala nominal de conductas donde las estudiantes de psicología clasificaban los comportamientos en categorías preestablecidas, claramente definidas y mutuamente excluyentes. La conclusión más importante del estudio observacional fue que las parejas analizadas en un 64.4 % la mujer ero atrajo al varón y después el varón emo conectó con la mujer. También han observado otro estilo de romance cuando el varón ero atrajo a la mujer por su cuerpo atracción y después la mujer fue la que emo conectó con el varón y observaron este hecho en un 35.6 % de los casos

Otra visión de la aplicación didáctica del programa de matemáticas I en el colegio de bachilleres en el D. F.

Maestría en Educación con Campo en Planeación Educativ

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease