Propuesta Estratégica de Mejora en la Implementación de los estándares mínimos del Sistema de Gestión de la Seguridad y Salud en el Trabajo (SG-SST) en la Empresa Evolution Consulting S.AS para el Año 2020

El presente documento contiene la investigación rigurosa de la implementación del Sistema de Gestión y Seguridad y Salud en el Trabajo de acuerdo a la normatividad legal vigente, de esta manera establecer un Plan de Mejoramiento el cual se lleve a cabo en las empresas y permita a cabalidad su cumplimiento.This document contains rigorous research into the implementation of the Occupational Health and Management System in accordance with current legal regulations, thus establishing an Improvement Plan which is carried out in companies and fully allows compliance

Estudio de candidiasis oral en pacientes VIH(+)/SIDA del Hospital Regional de Talca

97 p.Introducción: La candidiasis oral se ha convertido en la infección oportunista más frecuente tanto en los pacientes VIH y SIDA. Candida Albicans es la especie que más comúnmente se aísla, apareciendo en más del 70% de los aislamientos. Objetivos: Determinar la frecuencia de los tipos clínicos de candidiasis oral y de Candida albicans en los pacientes controlados por VIH/SIDA en el Servicio de Dermatología del Hospital Regional de Talca. Método: Se seleccionó a pacientes con candidiasis oral diagnosticados y controlados por VIH/SIDA en el Servicio de Dermatología del Hospital Regional de Talca entre los meses de junio a septiembre del 2004. Se obtuvieron muestras microbiológicas de las lesiones de candidiasis oral y posteriormente se determinó la presencia de Candida albicans. A través de la revisión de fichas clínicas de los pacientes se identificaron las características propias de cada paciente como: edad, sexo, carga viral , linfocitos T-CD4 , factores de riesgo asociados a la infección por Candida y vía de contagio. Resultados: Fueron diagnosticados 29 pacientes con candidiasis oral. El tipo de candidiasis predominante correspondió a la variante pseudomembranosa, seguida por la eritematosa y por último la queilitis angular. Candida albicans fue aislada en el 84,3% de los aislamientos. Conclusiones: La candidiasis es una enfermedad frecuente asociada a pacientes portadores del VIH. Candida albicans es la especie que se aísla con mayor frecuencia. La candidiasis pseudomembranosa es igual o incluso más frecuente que la variante eritematosa, la queilitis angular es la variante menos común y la variante hiperplásica no se encontró en este estudio. La Anfotericina B mostró ser el antifungico más eficaz sobre las 24 cepas de Candida albicans, siendo el 100% de las cepas sensibles a éste

Mesa Redonda Online

Nuestro proyecto, Mesa Redonda Online, se presenta como una alternativa de negocio y tiene como finalidad colaborar con el intercambio de compra y venta de diversos productos que se comercializan en el conglomerado comercial de Mesa Redonda. Buscamos satisfacer la necesidad que hoy existe en las personas que no cuentan con tiempo suficiente para realizar sus compras de forma presencial y prefieren hacerlas de manera online desde la comodidad de su casa u oficina. Es por ello que proponemos implementar una plataforma de negocio electrónico con el nombre de Mesa Redonda Online. Nuestra propuesta busca intermediar entre los comerciantes del conglomerado y clientes usuarios que necesiten adquirir productos a través de nuestro aplicativo móvil. Para la puesta en marcha, se desarrolló una investigación de mercado, en la cual identificamos el problema y también su posible solución, los cuales fueron validados y comprobados mediante entrevistas e implementación de un producto mínimo viable, cuyos resultados nos permitieron concretar el desarrollo del proyecto. De igual manera, se desarrolló un plan de marketing orientado a ser competitivos. Implementamos una estructura organizacional propia según el modelo de gestión interna y diseñamos un plan de operaciones, aplicando indicadores de gestión, métodos técnicos y organizativos necesarios para llevar a cabo el desarrollo de nuestro servicio, considerado en 5 años. Finalmente, aplicamos el plan económico financiero para demostrar mediante indicadores económicos y financieros la viabilidad del proyecto, a corto, mediano, y largo plazo. De esta forma, llegamos a la conclusión de que nuestro modelo de negocio es rentable.He objective of the Mesa Redonda Online business project is to be a viable alternative for the commercialization of various products that trade hands in the commercial quarter known as Mesa Redonda. We aim to satisfy the existing need of people who lack the time to do their shopping in person and prefer to shop online from the comfort of their home or office. That is why we propose the Mesa Redonda Online e-commerce platform, which will allow the commercial quarter’s customers and merchants to buy and sell through our mobile application. The first step involved market research, through which we identified the problem as well as its possible solution, which we then validated and verified through interviews and the implementation of a minimum viable product, whose results allowed us to define the development of the project. Furthermore, we developed a marketing plan aimed at being competitive. We implemented our own organizational structure according to the internal management model and designed an operations plan, applying management indicators, technical and organizational methods in order to carry out the development of our service, considering a five-year planning horizon. Finally, we applied the economic-financial plan to demonstrate through economic and financial indicators the feasibility of the project, in the short, medium, and long term. That led us to the conclusion that our business model is profitable.Trabajo de investigació

Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Common variants in Alzheimer's disease and risk stratification by polygenic risk scores.

Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

EFFECTIVENESS OF THE TREATMENT WITH THE HIGH-FLOW NASAL CANNULA VERSUS CONTINUOUS POSITIVE PRESSURE DEVICE ON THE AIRPLANE IN THE NEWBORN WITH RESPIRATORY DIFFICULTY

Trabajo AcadémicoObjetivo: Sistematizar la Eficacia del tratamiento de la cánula nasal de alto flujo (CNAF) versus CPAP en la vía aérea en el recién nacido con dificultad respiratoria. Materiales y Métodos: Es cuantitativo y de diseño Revisión Sistemática de tipo retrospectivo y transversal. La población estuvo constituida por 18 artículos, con una selección definitiva de 10 artículos, los cuales se encuentran publicados en idioma inglés y español con una antigüedad no mayor de 10 años en los siguientes buscadores científicos: Scielo, Cochrane plus, Dialnet, Pubmed, Ebsco. Resultados: El 70% concluyen que la CNAF comparado con el dispositivo CPAP de las vías aéreas proporciona igual eficacia en el tratamiento del recién nacido con dificultad respiratoria, el 20% señala que no se puede determinar su efectividad en comparación al otro dispositivo debido a la falta de investigaciones con una mayor muestra de tipo ensayo aleatorio, y por otro lado el 10% concluye que la CNAF es menos eficaz que el sistema de CPAP. Conclusiones: Se concluye que 7 artículos de ellos demuestran la similitud en cuanto a la eficacia en el tratamiento del recién nacido con algún tipo de dificultad respiratoria, resaltando la menor producción de lesión a nivel nasal

Pain Analysis in Patients with Hepatocellular Carcinoma: Irreversible Electroporation versus Radiofrequency Ablation—Initial Observations

To retrospectively compare the postprocedure pain of hepatocellular carcinoma treated with irreversible electroporation (IRE) with radiofrequency ablation (RFA).This Health Insurance Portability and Accountability Act–compliant, institutional review board–approved study compared postprocedure pain in 21 patients (15 men, six women; mean age 61.5 years) who underwent IRE of 29 intrahepatic lesions (mean size 2.20 cm) in 28 IRE sessions with 22 patients (16 men, six women; mean age 60.2 years) who underwent RFA of 27 lesions (mean size 3.38 cm) in 25 RFA sessions. Pain was determined by patient-disclosed scores with an 11-point numerical rating scale and 24 h cumulative hydromorphone use from patient-controlled analgesia pump. Complications were noted. Statistical significance was evaluated by Fisher’s exact test, the Chi-square test, and Student’s t test.There was no significant difference in the cumulative hydromorphone dose (1.54 mg (IRE) vs. 1.24 mg (RFA); P = 0.52) and in the mean pain score (1.96 (IRE) vs. 2.25 (RFA); P = 0.70). In nine (32.14 %) of 28 IRE sessions and 11 (44.0 %) of 25 RFA sessions, patients reported no pain. Complications occurred in three (10.7 %) of 28 IRE treatments and included pneumothorax (n = 1), pleural effusion (n = 1), and bleeding in the form of hemothorax (n = 1); one (4 %) of 25 RFA treatments included burn.IRE is comparable to RFA in the amount of pain that patients experience and the amount of pain medication self-administered. Both modalities were well tolerated by patients. Prospective, randomized trials are necessary to further evaluate these findings