Gestión directiva y la relación con el error médico de un hospital en Lima, 2022

Un mundo de cambios paga el precio de los conocimientos en base a “ensayo y error” y la salud no es ajeno a ello.El incremento de las denuncias por el “error médico”, nos lleva a analizar y conocer sobre el tema, es labor imperiosa de los gestores directivos de cambiar el paradigma deletereo de su significado. El objetivo del estudio fue determinar la relación entre la gestión directiva y el error médico de un hospital en Lima, 2022. Es una investigación del tipo básica con diseño no experimental y correlacional.Se utilizó un instrumento de 44 ítems para efectos de la investigación .Se validó con la participación de 3 jueces como expertos; se conto con 70 trabajadores sanitarios como muestra y se realizo el muestreo por conveniencia. La recolección de la data se realizo en el programa Excel, luego se procesó en el programa SPSS versión 25 para el análisis. Se realizaron estadísticas descriptivas y pruebas de hipótesis para ambas variables. Como resultado se comprobó que existe relación significativa entre la gestión directiva y el error médico (p<0,001). Asu vez con una correlacion positiva de r = 0,393 .Es decir una buena gestión directiva conllevaría a disminuir los errores médicos. Por lo cual se concluye que existe relación significativa entre la gestión directiva y el error médico de un hospital en lima, 2022

Pelvic inflammatory disease by actinomyces: report of 1 case and review of the literature

Actinomycosis is a chronic disease that is characterized by the formation of abscesses, fistulas and dense fibrous tissue at the site of involvement. Its distribution is worldwide. However, pelvic actinomycosis has increased in frequency and has been associated with abdominal surgery, intestinal perforation or trauma, due to the destruction of the muscular barrier. The clinical elements of suspicion are the latency of months and even years of symptoms and the history of being a carrier of an intrauterine device. Actinomyces israelli is a rare etiological agent of pelvic inflammatory disease, so it is difficult to reach the diagnosis. A case report is made of a 48-year-old patient with an intrauterine device older than 5 years, who entered the emergency department with abdominal pain syndrome and 7-day evolutionary fever accompanied by dyspareunia. She was hospitalized for antibiotic treatment, presenting an unsatisfactory evolution, with increased leukocytosis and persistent abdominal pain. An exploratory laparotomy with abdominal hysterectomy was performed. The histopathological diagnosis was pelvic inflammatory disease due to actinomyces. We must always suspect in the presence of a pelvic inflammatory disease in any of its clinical forms, the presence of actinomyces as one of the possible causative germs, especially in patients with intrauterine device for more than 5 years

The challenge of achieving basal energy, iron and zinc provision for home consumption through family farming in the Andes: a comparison of coverage through contemporary production systems and selected agricultural interventions

Background Child undernutrition is persistently high in the central Andes of Peru, and numerous smallholder households fail to meet their basic needs of energy, iron and zinc. Food-based approaches assume household-level nutrition can be improved following agricultural interventions. This study assesses for the first time whether current Andean production systems provide sufficient energy, iron and zinc output to meet household-level requirements and explores the likely effect of commonly promoted food-based approaches. Across four communities, we determined the crop and livestock production output for each household (n = 165) during one growing season. The household-level nutritional demand or input was calculated as a function of household composition and daily requirements of energy, iron and zinc as established by FAO/WHO. We examined five scenarios, current practice or status quo and four food-based interventions: (1) increased potato yield, (2) introduced biofortified potatoes, (3) promotion of guinea pigs and (4) a mixed strategy combining all of the above. Results Under status quo, 86, 62 and 76 % of households obtained sufficient production output to meet energy, iron and zinc requirements, respectively. Considering the three parameters simultaneously, 59 % of households were able to meet their energy, iron and zinc requirements. The total crop production among households provided more than the necessary energy, iron and zinc output to meet the demand of all 165 households. Yet, significant differences between households account for individual deficits or surpluses in household-level output–input balances. Potato (Solanum spp.), barley (Hordeum vulgare) and faba (Vicia faba) production was particularly significant in determining the energy, iron and zinc output. Livestock did not make a substantial contribution. The main difference between households with negative versus positive coverage, in terms of household-level production output from agriculture meeting demand (=input), was available cropping area given household size. None of the explored food-based interventions closed the energy, iron and zinc deficit from production among households with negative coverage. Conclusions The smallholder production systems analyzed are only partially capable of providing sufficient production output to cover household-level energy, iron and zinc demands. Of the four interventions examined, a mixed strategy holds most potential for reducing nutrition gaps. Particularly potato yield increases had a positive effect. The carrying capacity of high-altitude Andean farming systems is strained for households with limited land. Food-based approaches to nutrition under scenarios similar to those reported in this study are advised to balance agricultural interventions with options to enhance off-farm access to food

Traditional soil fertility management ameliorates climate change impacts on traditional Andean crops within smallholder farming systems

Global changes, particularly rising temperatures, threaten food security in smallholder mountain communities by impacting the suitability of cultivation areas for many crops. Land-use intensification, associated with agrochemical use and tillage threaten soil health and overall agroecosystem resilience. In the Andean region, farmers often cultivate crops at multiple elevations. Warming climates have led to a shift in cultivation upslope, but this is not feasible in many areas. Traditional soil fertility management practices together with a focus on traditional (orphan) crops offers promise to cope with rapid climate warming in the region. To understand the impacts of warming and changing nutrient management, we established two side-by-side experiments using the traditional Andean crops Oxalis tuberosa (Oca) and Lupinus mutabilis (Tarwi) at three elevations, each with two fertility treatments (organic and synthetic). Soil and climate data (i.e., temperature and precipitation) were collected throughout the growing season, and crop performance was evaluated through impacts on yield and other growth metrics (e.g., biomass, pest incidence). We used two-way ANOVA to assess the influence of site (elevation) and management type (organic vs. synthetic) on crop performance. Results indicated that warmer climates (i.e., lowest elevation) negatively impact the production and performance of O. tuberosa, but that organic fertilization (sheep manure) can help maintain crop yield and biomass production in warmer conditions relatively to synthetic nutrient inputs. In contrast, L. mutabilis showed accelerated growth in warmer conditions, but grain yield and biomass production were not significantly affected by site and showed no interaction with nutrient management. Our findings highlight that climate warming represents a serious threat to small-scale crop production in the Peruvian Andes and could cause severe declines in the production of locally important crops. Additionally, the continued reliance traditional crops with organic inputs, instead of synthetic fertilizers, may help support agricultural productivity and resilience under climate change

Plataforma digital de intermediación para el talento flexible

El trabajo remoto en el Perú fue acelerado por la pandemia de la COVID-19 y se convirtió en la nueva realidad. En este escenario, herramientas y plataformas que conectan el talento con oportunidades, ahorren tiempo a los usuarios y den un servicio de calidad, tienen la posibilidad de ser los primeros en un mercado que aún sigue siendo explorado. La consultora McKinsey & Company (2015) proyectó que al año 2025 las plataformas de talento online tendrán un impacto potencial de 2.3% del PBI del Perú, originando por lo menos 320,000 empleos. Zenit es una empresa socialmente responsable y sostenible que busca diversificar la fuente de ingresos del talento independiente conectándolo con clientes a través de una plataforma web tipo marketplace; además de alinearse al Objetivo de Desarrollo Sostenible 8 mediante su contribución a la mejora del PBI y así al crecimiento sostenido de la economía nacional; siendo una alternativa de trabajo segura, formal e independiente; y con su contribución a la reducción de emisiones de GEI al eliminar la necesidad de trasladarse a un centro de trabajo tradicional. Para el presente proyecto se usó la combinación de las metodologías Design Thinking y Lean StartUp; esto permitió crear una plataforma con una propuesta de valor innovadora para el Perú centrada en el cliente. Por último, los resultados de los indicadores financieros de una proyección a cinco años del proyecto prueban la sostenibilidad económica del proyecto. La inversión inicial asciende a S/321,465 y considerando un costo promedio de capital del 12% se obtiene un valor actual neto económico (VAN) de S/1’745,567 en los cinco primeros años de operación y una tasa interna de retorno (TIR) de 54% con un periodo de recuperación de inversión equivalente a dos años

Drivers of growth and establishment of the invasive plant Rumex acetosella within Andean fallow systems

Intensification of crop rotations and associated agricultural practices are reducing the capacity of traditional fallows to restore soil fertility and provide forage in Andean cropping systems. While the implementation of improved fallows offers great promise to enhance forage provision and maintain soil productivity, effects of these practices on the establishment of problematic weeds, including non-native plant species, remain poorly understood. To address this knowledge gap, we studied: i) how biotic and abiotic environmental factors influence the establishment and productivity of weeds in traditional fallows; and ii) to what extent improved fallows can help control weedy vegetation in smallholder rotations of the high Andes. Specifically, in this research, we focused on the invasive plant species Rumex acetosella L., which is a common concern of farmers throughout the central Peruvian Andes. We leveraged a multi-site, participatory research trial established in 2017 across eight communities in the region to understand the main drivers of R. acetosella presence and productivity. We used a total of 82 sites, each with paired treatments of traditional fallow (control with natural revegetation) and improved fallow (seeded with Vicia sativa L. and Avena sativa L.). Prior to treatment establishment we measured soil texture, pH, soil organic matter content as well as exchangeable macro-nutrients. Vegetation data was recorded in each treatment and divided into four categories: 1) A. sativa, 2) V. sativa, 3) R. acetosella, and 4) other weeds, and weighed to determine the relative biomass contribution of each. From these data, we calculated an index for R. acetosella pressure, weed pressure, and forage productivity. Our findings indicate that improved fallows greatly suppress weedy vegetation relative to unmanaged controls, including the invasive R. acetosella. Multivariate analyses suggested that R. acetosella abundance was associated with the presence of other non-planted weeds and predictors of soil fertility. The mean R. acetosella index in improved fallows was significantly lower compared to traditional fallows. We found R. acetosella biomass to be greater at lower productivity sites, i.e., those at higher elevations with cooler climates and sites with less fertile soils. Our findings indicate that if the fallow portion of a rotation is kept productive via adequate soil fertility inputs, the biomass of weeds, including the alien R. acetosella, is dramatically reduced

Prevalencia de presentación de algunos agentes zoonóticos transmitidos por caninos y felinos en Medellín, Colombia

Objetivo. Determinar la prevalencia de agentes zoonóticos en caninos y felinos en Medellín, Colombia. Materiales y métodos. Se muestrearon 1501 individuos para el análisis de parásitos gastrointestinales zoonóticos por medio de coprología directa y flotación. Se examinaron 500 sueros caninos por medio de PARP-2ME y MAT para el diagnóstico de Brucella canis y Leptospira sp, respectivamente. Se procesaron 500 sueros felinos por medio de IFI para el diagnóstico de Toxoplasma gondii. Se estableció la frecuencia para cada zoonosis y la significancia estadística para las diferentes variables (p≤0.05; OR≥1; IC 95%). Resultados. El 23.6% de los caninos y 16.3% de los felinos fueron positivos a parásitos gastrointestinales, siendo los Ancylostomideos y D. caninum los más prevalente, respectivamente; la especie, edad, sexo, sector, estrato socioeconómico y el mes de muestreo presentaron asociaciones con el parasitismo gastrointestinal en mascotas. En caninos se evidenció una seroprevalencia del 6.6% para B. canis y 8.4% para Leptospira sp; en felinos del 56.2% para T. gondii. Todas las anteriores asociadas con la zona de muestreo, mes, edad y estrato. Conclusiones. Las mascotas ubicadas en diferentes comunas y estratos socioeconómicos con condiciones de calidad de vida menores representan un riesgo de transmisión zoonótica

Clinical veterinary boron neutron capture therapy (BNCT) studies in dogs with head and neck cancer: Bridging the gap between translational and clinical studies

Translational Boron Neutron Capture Therapy (BNCT) studies performed by our group and clinical BNCT studies worldwide have shown the therapeutic efficacy of BNCT for head and neck cancer. The present BNCT studies in veterinary patients with head and neck cancer were performed to optimize the therapeutic efficacy of BNCT, contribute towards exploring the role of BNCT in veterinary medicine, put in place technical aspects for an upcoming clinical trial of BNCT for head and neck cancer at the RA-6 Nuclear Reactor, and assess the feasibility of employing the existing B2 beam to treat large, deep-seated tumors. Five dogs with head and neck cancer with no other therapeutic option were treated with two applications of BNCT mediated by boronophenyl-alanine (BPA) separated by 3–5 weeks. Two to three portals per BNCT application were used to achieve a potentially therapeutic dose over the tumor without exceeding normal tissue tolerance. Clinical and Computed Tomography results evidenced partial tumor control in all cases, with slight-moderate mucositis, excellent life quality, and prolongation in the survival time estimated at recruitment. These exploratory studies show the potential value of BNCT in veterinary medicine and contribute towards initiating a clinical BNCT trial for head and neck cancer at the RA-6 clinical facility.Fil: Schwint, Amanda Elena. Comisión Nacional de Energía Atómica. Gerencia de Área de Aplicaciones de la Tecnología Nuclear. Departamento de Radiobiología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Monti Hughes, Andrea. Comisión Nacional de Energía Atómica. Gerencia de Área de Aplicaciones de la Tecnología Nuclear. Departamento de Radiobiología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Garabalino, Marcela Alejandra. Comisión Nacional de Energía Atómica; ArgentinaFil: Santa Cruz, Gustavo Alberto. Comisión Nacional de Energía Atómica; ArgentinaFil: González, Sara Josefina. Comisión Nacional de Energía Atómica. Gerencia del Área de Investigación y Aplicaciones No Nucleares. Gerencia Física (Centro Atómico Constituyentes). Proyecto Tandar; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Longhino, Juan Manuel. Comisión Nacional de Energía Atómica; ArgentinaFil: Provenzano, Lucas. Comisión Nacional de Energía Atómica. Gerencia del Área de Investigación y Aplicaciones No Nucleares. Gerencia Física (Centro Atómico Constituyentes). Proyecto Tandar; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Oña, Paulina. Comisión Nacional de Energía Atómica. Gerencia de Área de Aplicaciones de la Tecnología Nuclear. Instituto de Tecnologías Nucleares para la Salud; ArgentinaFil: Rao, Monica. Hospital Veterinario; ArgentinaFil: Cantarelli, María de los Ángeles. Hospital Veterinario; ArgentinaFil: Leiras, Andrea. No especifíca;Fil: Olivera, María Silvina. Comisión Nacional de Energía Atómica; ArgentinaFil: Trivillin, Verónica Andrea. Comisión Nacional de Energía Atómica. Gerencia de Área de Aplicaciones de la Tecnología Nuclear. Departamento de Radiobiología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Alessandrini, Paula. No especifíca;Fil: Brollo, Fabricio Raul. Comisión Nacional de Energía Atómica; ArgentinaFil: Boggio, Esteban Fabián. Comisión Nacional de Energía Atómica; ArgentinaFil: Costa, Hernan. Comisión Nacional de Energía Atómica. Gerencia de Área de Aplicaciones de la Tecnología Nuclear. Instituto de Tecnologías Nucleares para la Salud; ArgentinaFil: Ventimiglia, Romina. Comisión Nacional de Energía Atómica. Gerencia de Área de Aplicaciones de la Tecnología Nuclear. Instituto de Tecnologías Nucleares para la Salud; ArgentinaFil: Binia, Sergio. Comisión Nacional de Energía Atómica. Gerencia de Área de Aplicaciones de la Tecnología Nuclear. Instituto de Tecnologías Nucleares para la Salud; ArgentinaFil: Pozzi, Emiliano César Cayetano. Comisión Nacional de Energía Atómica; ArgentinaFil: Nievas, Susana Isabel. Comisión Nacional de Energía Atómica; ArgentinaFil: Santa Cruz, Iara S.. Comisión Nacional de Energía Atómica; Argentin