Incapacidad laboral por Infarto Agudo de Miocardio (IAM). ¿Podrían cambiar nuestros criterios de valoración médica de la incapacidad laboral en la era de la reperfusión miocárdica?

Posters galardonados[ES] Actualmente, el infarto agudo de miocardio (IAM) es una enfermedad con un alto grado de morbilidad y mortalidad, y es responsable de un gran porcentaje de incapacidades laborales. Se constituyó un equipo de investigación formado por la Unidad Médica de Evaluación de las Incapacidades Laborales del Instituto Nacional de la Seguridad Social (INSS) y de la Unidad de Gestión Clínica del área de salud del Hospital “Virgen Macarena” de Sevilla. Con el objetivo de analizar el impacto en la salud y en la capacidad laboral del proyecto común para la atención del IAM con elevación del ST en Sevilla implantado desde enero de 2011. Este proyecto tenía los siguientes objetivos: analizar el aumento de la tasa global de reperfusión y el porcentaje de angioplastias primarias realizadas, la disminución de la mortalidad general y la mejoría significativa en la función ventricular izquierda en pacientes que han sufrido un IAM. Basado en estos datos, se puede concluir que la mayoría de los pacientes que en la actualidad han sufrido un IAM en Sevilla van a estar en un grupo funcional 1 del manual de actuación de los médicos evaluadores del INSS, con buena función ventricular, buen pronóstico y bajo riesgo cardiovascular, y podrían reincorporarse a la vida laboral activa salvo determinadas y circunstancia de comorbilidad.[EN] At present, acute myocardial infarction (AMI) is a disease with a high degree of morbidity and mortality and it is responsible of a high percentage of work disability. We form a joint team from the medical staff of the Seville Evaluation Unit of the Department of Social Security (INSS) and the clinical management unit from “Virgen Macarena” Health area in Seville. We have analyzed the health and working capacity impact of the Joint Project for the Care of AMI with ST elevation in Seville since January 2011. This project has the following aims: checking the rising reperfusion and primary angioplasties rates, the decline in overall mortality and a significant improvement in left ventricular function in patients who have suffered an AMI. Based on these dates, the majority of the patients who fulfill the project criteria are in a functional group 1 of the INSS medical disability handbook, with normal left ventricular function, good prognosis and low cardiovascular risk. These patients can be able to reinstate their usual working activities, except when certain comorbidity diseases are present.N

La nueva formación profesional en Córdoba

Se plantean los siguientes objetivos: analizar cuantitativamente la situación de la Formación Profesional en la provincia de Córdoba; valorar la formación en centros de trabajo desde la triple vertiente alumnos, docentes y empresas; detectar las posibles deficiencias formativas con que los alumnos concluyen sus estudios, de los distintos módulos profesionales de cara al desempeño de los puestos de trabajo para los que deberían estar capacitados; identificar las repercusiones de la implantación de la LOGSE en el profesorado de Formación Profesional; disponer de un marco de referencia desde el que organizar y dinamizar la actualización y formación del profesorado; analizar las diferencias en la implantación de los Ciclos Formativos en función del ámbito geográfico y las familias profesionales; aportar soluciones que contribuyan a mejorar la Formación Profesional. Se elaboraron tres tipos de cuestionarios destinados a profesores, alumnos y empresas en los cuales se contemplaban cuatro bloques temáticos: los cambios en la docencia de Formación Profesional, valoración del aprendizaje de los alumnos, la formación en centros de trabajo y adecuación de los planes de formación del profesorado. Estos cuestionarios se han distribuido personalmente por los centros entre el mes de diciembre del año 2000 y el mes marzo del año 2001 a la vez que se explicaban los objetivos del estudio. El grado de respuesta de los centros fue muy variado. Falta adecuación entre la oferta de ciclos y el entorno socioeconómico. Se observa una oferta de Ciclos similar en todas en las mancomunidades de Córdoba, centrada básicamente en tres familias profesionales: Administración, Electricidad y Electrónica, y Mantenimiento de Vehículos Autopropulsados, lo que induce a pensar que a la hora de implantar los Ciclos Formativos se ha obedecido más a las necesidades de utilizar las infraestructuras existentes de profesores y materiales que al entorno socioeconómico. Pero cuando se ha intentado implantar un Ciclo que supone una novedad en la oferta educativa de la provincia el alumnado no responde, por lo que resulta complejo explicar lo que está ocurriendo con la Formación Profesional Específica.AndalucíaInstituto de Educación Secundaria Gran Capitán; Calle Arcos de la Frontera, s. n.; 14014 Córdoba; +34957440770; +34957436311; [email protected]

Aldol Condensation of Furfural with Acetone Over Mg/Al Mixed Oxides. Influence of Water and Synthesis Method

Aldol condensation of furfural and acetone (an important initial step to obtain diesel from biomass) was studied over MgAl mixed oxides. The influence of the utilization of microwaves and/or a surfactant (Pluronic 123) during the synthesis as well as the use of water (either pre-hydrating the solids before catalytic studies or in water/toluene mixtures as the reaction medium) is discussed. The combined use of Pluronic 123 and microwaves led to solids with bigger pore sizes, exhibiting lower basicity and higher acidity than the conventional synthetic method, thus resulting in an increase in the yield of the desired product of condensation, comprising two molecules of furfural and one of acetone (F2Ac). As for the influence of water, re-hydration of the mixed oxides was detrimental to activity, probably as a result of the partial blocking (solvation) of active sites. On the contrary, the increase in water percentage in the reaction medium resulted in higher conversions, though selectivity to F2Ac decreased. The weakening of the C=O bond of furfural in the presence of water as well as the higher solubility of the first condensation product (FAc) in toluene, as compared to water, could account for that. A 44.5% yield of F2Ac (66% conversion) after 16 h was obtained with the most active solid, which maintained the activity for three consecutive reactions

Biochars from Olive Stones as Carbonaceous Support in Pt/TiO₂-Carbon Photocatalysts and Application in Hydrogen Production from Aqueous Glycerol Photoreforming

Several biochars were synthesized from olive stones and used as supports for TiO2, as an active semiconductor, and Pt as a co-catalyst (Pt/TiO2-PyCF and Pt/TiO2-AC). A third carbon-supported photocatalyst was prepared from commercial mesoporous carbon (Pt/TiO2-MCF). Moreover, a Pt/TiO2 solid based on Evonik P25 was used as a reference. The biochars used as supports transferred, to a large extent, their physical and chemical properties to the final photocatalysts. The synthesized catalysts were tested for hydrogen production from aqueous glycerol photoreforming. The results indicated that a mesoporous nature and small particle size of the photocatalyst lead to better H2 production. The analysis of the operational reaction conditions revealed that the H2 evolution rate was not proportional to the mass of the photocatalyst used, since, at high photocatalyst loading, the hydrogen production decreased because of the light scattering and reflection phenomena that caused a reduction in the light penetration depth. When expressed per gram of TiO2, the activity of Pt/TiO2-PyCF is almost 4-times higher than that of Pt/TiO2 (1079 and 273 mmol H2/gTiO2, respectively), which points to the positive effect of an adequate dispersion of a TiO2 phase on a carbonaceous support, forming a highly dispersed and homogeneously distributed titanium dioxide phase. Throughout a 12 h reaction period, the H2 production rate progressively decreases, while the CO2 production rate increases continuously. This behavior is compatible with an initial period when glycerol dehydrogenation to glyceraldehyde and/or dihydroxyacetone and hydrogen predominates, followed by a period in which comparatively slower C-C cleavage reactions begin to occur, thus generating both H2 and CO2

Feasibility and results of an intensive cardiac rehabilitation program. Insights from the MxM (Más por Menos) randomized trial.

Cardiac rehabilitation programs (CRP) are a set of interventions to improve the prognosis of cardiovascular disease by influencing patients' physical, mental, and social conditions. However, there are no studies evaluating the optimal duration of these programs. We aimed to compare the results of a standard vs a brief intensive CRP in patients after ST-segment elevation and non-ST-segment elevation acute coronary syndrome through the Más por Menos study (More Intensive Cardiac Rehabilitation Programs in Less Time). In this prospective, randomized, open, evaluator-blind for end-point, and multicenter trial (PROBE design), patients were randomly allocated to either standard 8-week CRP or intensive 2-week CRP with booster sessions. A final visit was performed 12 months later, after completion of the program. We assessed adherence to the Mediterranean diet, psychological status, smoking, drug therapy, functional capacity, quality of life, cardiometabolic and anthropometric parameters, cardiovascular events, and all-cause mortality during follow-up. A total of 497 patients (mean age, 57.8±10.0 years; 87.3% men) were finally assessed (intensive: n=262; standard: n=235). Baseline characteristics were similar between the 2 groups. At 12 months, the results of treadmill ergometry improved by ≥ 1 MET in ≥ 93% of the patients. In addition, adherence to the Mediterranean diet and quality of life were significantly improved by CRP, with no significant differences between the groups. The occurrence of cardiovascular events was similar in the 2 groups. Intensive CRP could be as effective as standard CRP in achieving adherence to recommended secondary prevention measures after acute coronary syndrome and could be an alternative for some patients and centers. Registered at ClinicalTrials.gov (Identifier: NCT02619422)