estudio prospectivo en Uruguay

La investigación tiene como objetivo determinar y analizar el costo en la pandemia del Sars-cov2 en una Unidad de Cuidados Intensivos (en adelante UCI). En forma conjunta, determinar el costo por paciente, por día y por cama en casos de obesidad para Uruguay en la misma Unidad de Cuidados Intensivos. Especialmente, identificar el desvío entre el costo de pacientes internados en UCI con obesidad y sin obesidad. Esto implica la definición operacional de los componentes y de las variables, que incluye la metodología, y establecer la forma en que éstas son incorporadas para el cálculo de costos y resultados en salud. Se trata de una metodología prospectiva, con uso de estadísticos descriptivos. Los datos muestran que el 80% de los pacientes en UCI tenían un Índice de Masa Corporal superior a 30. Los costos considerados directos implican tratamientos médicos, recursos fungibles y fármacos, camillas, tomógrafos con ventilación especial para traslados que no suelen estar diseñados para pesos superiores a 150 kgs del paciente. Como resultado, se abren alternativas de acciones en la sociedad, dirigidas al tratamiento preventivo y la medición de potenciales ahorros en recursos públicos y del Sistema Nacional de Salud. Metodología: Se realizó un estudio descriptivo y prospectivo en 261 pacientes, entre los meses de mayo y julio de 2021. Las variables estudiadas de costo responden a día paciente, día cama, fármacos, insumos médicos fungibles, alimentación, costo por recursos humanos médicos y no médicos, y equipamiento de largo plazo específico para la atención hospitalaria en UCI. Para la obtención del costo total de un día paciente y de un día cama, se sumaron los costos directos e indirectos, expresados en dólares estadounidenses a la fecha de utilización del recurso. El costo para pacientes con obesidad y sin obesidad se calcula enfatizando el tiempo medio de internación en UCI (estancia en días). Resultados: Se observó una mayor estancia en UCI para pacientes obesos, en algunos meses observados duplicando los días promedio que para los no obesos. El costo diario por cama ocupada en UCI resulta en $1.585 dólares estadounidenses, resultado alineado a los reportados por UCI de otros países en la región. [Resumen de los autores

Self-piercing riveting-a review

© The Author(s) 2017. This article is published with open access at Springerlink.com.Self-piercing riveting (SPR) is a cold mechanical joining process used to join two or more sheets of materials by driving a rivet piercing through the top sheet or the top and middle sheets and subsequently lock into the bottom sheet under the guidance of a suitable die. SPR is currently the main joining method for aluminium and mixed-material lightweight automotive structures. SPR was originated half century ago, but it only had significant progress in the last 25 years due to the requirement of joining lightweight materials, such as aluminium alloy structures, aluminium-steel structures and other mixed-material structures, from the automotive industry. Compared with other conventional joining methods, SPR has many advantages including no pre-drilled holes required, no fume, no spark and low noise, no surface treatment required, ability to join multi-layer materials and mixed materials and ability to produce joints with high static and fatigue strengths. In this paper, research investigations that have been conducted on self-piercing riveting will be extensively reviewed. The current state and development of SPR process is reviewed and the influence of the key process parameters on joint quality is discussed. The mechanical properties of SPR joints, the corrosion behaviour of SPR joints, the distortion of SPR joints and the simulation of SPR process and joint performance are reviewed. Developing reliable simulation methods for SPR process and joint performance to reduce the need of physical testing has been identified as one of the main challenges.Peer reviewe

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

Background: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care