Valor de la presión intrabdominal elevada como predictor de mortalidad en pacientes con pancreatitis aguda severa en el Hospital Belén de Trujillo, enero 2010 - diciembre 2020

La pancreatitis aguda es una enfermedad frecuente del mundo y nuestro país no es la excepción estando asociado a diferentes factores de riesgo que incrementan la morbimortalidad, por lo que se realizará un estudio para determinar o conocer si la presión intrabdominal elevada es factor de riesgo para mortalidad en pacientes con pancreatitis aguda severa en el Hospital Belén de Trujillo; en una población de pacientes con pancreatitis aguda severa atendidos en el Hospital Belén de Trujillo durante el periodo entre enero y diciembre del 2010 al 2020 y que cumplan con los criterios de selección; el estudio será analítico, observacional, retrospectivo, cohortes. En el análisis estadístico utilizaremos prueba Chi cuadrado para variables cualitativas y poder verificar la significancia estadística de las asociaciones encontradas. Calcularemos las variables cualitativas el riesgo relativo (RR) respecto a la presión intrabdominal elevada y el desenlace mortalidad intrahospitalaria evidenciada en historias clínicas. Se determinará el intervalo de confianza al 95% del estadígrafo correspondiente, se pretende su sustentar la identificación si la presión intraabdominal elevada es factores de riesgo de mortalidad comparado con los que no presentan elevación de presión intraabdominal así poder sustentar la importancia de la incorporación de ésta variable fisiológica en la práctica clínica y en protocolos actuales.Tesis de segunda especialida

El salario como crédito privilegiado

La presente tesis contiene la resolución de un supuesto problema, cual es el salario y las prestaciones sociales como créditos privilegiados. Manifestando supuesto problema porque el texto de nuestra Constitución Política, al respecto con claridad meridiana expresa; Art. 182 Nº.4. ' "El salario y las prestaciones sociales constituyen créditos privilegiados en relación a los demás créditos que puedan existir contra el patrono. Al emplear el término "demás créditos hicieron uso de un término genérico que comprende no sólo a los créditos privilegiados civiles, sino también a créditos preferentes como la hipoteca. Por otra parte, el Art. 220 Inc2 parte segunda del mismo ordenamiento jurídico expresa: “El interés público primará, sobre el interés privado" y el salario y las prestaciones sociales a nuestro entender contiene un interés general; no obstante, él interés individual, egoísta ha prevalecido en toda la historia de la humanidad, con excepción de la comunidad primitiva y actualmente en el socialismo, en donde prevaleció y prevalece el interés general

Agresividad y estrategias de afrontamiento en estudiantes adolescentes de una Universidad de Chanchamayo - 2021

El propósito de este estudio fue determinar la conexión entre la agresividad y las estrategias de afrontamiento en estudiantes de la Universidad Peruana Los Andes en la Provincia de Chanchamayo, en el año 2021. Se siguió un enfoque cuantitativo, utilizando un método descriptivo, tipo básico, nivel correlacional y diseño no experimental. Se aplicaron el Cuestionario de Agresividad y la Escala de Estrategias de Afrontamiento en Adolescentes a 159 estudiantes. Los resultados revelaron que el 14% de los estudiantes mostraron estrategias de afrontamiento regulares, mientras que el 86% presentaron estrategias favorables. En cuanto a la agresividad, el 80% de los estudiantes obtuvieron puntajes bajos y el 30% puntajes medios. Se utilizó el coeficiente de correlación de Spearman (rho), que mostró un valor de -,596 con un p-valor de ,000 indicando una relación inversa significativa entre las variables, con un nivel moderado de correlación. Esto sugiere que a medida que las estrategias de afrontamiento son más adecuadas, los niveles de agresividad tienden a disminuir. Se concluye que es vital publicar estos resultados y continuar investigando para mejorar aún más las estrategias de afrontamiento y reducir la agresividad en el entorno universitario

A review of community-based solar home system projects in the Philippines

Solar Home Systems (SHS) are easy to deploy in island and in remote communities where grid connection is costly. However, issues related to maintenance of these systems emerge after they are deployed because of the remoteness and inaccessibility of the communities. This study looked into community-based programs in the Philippines and investigated the following: (1) social preparation, (2) role of the community in the project, and (3) sustainability of the program. In this paper, three communities under two government programs offering SHS are presented. These programs are the Solar Power Technology Support (SPOTS) program of the Department of Agrarian Reform (DAR) and the Household Electrification Program (HEP) of the Department of Energy (DOE). A focused group discussion and key informant interviews were conducted in two communities in Bukidnon province and in a community in Kalinga to obtain information from the project beneficiaries and SHS users on the preparation, implementation and maintenance of the projects. The results revealed that emphasis on the economic value of the technology, proper training of the locals on the technical and management aspects of the project, as well as the establishment of a supply chain for replacement parts are crucial factors for the sustainability of the programs

A New Tool for Heart Disease Prognosis in the Community

Abstract The aim of this paper is to discuss the main characteristics of a system created to study, in a community, the evolution of people suffering cardiac disease or people prone to suffer it. The system has two main components: a portable device for ECG acquisition, henceforth Recorder, and Windows-compatibl

Una estética de la vivienda de interés social: desarrollos progresivos en Palmira, Colombia (2000-2017)

This case study explores the progressive development of social housing projects in the city of Palmira (Colombia) between 2000 and 2017. Here particular attention is paid to aesthetic parameters through three main concepts: perception, form and function. The methodological approach brought together four qualitative tools for data gathering and analysis: document review, field observations (field diaries, notes and photographic record); interviews (with users representatives of constructors and public servants), and; the development of urban profiles. The findings suggest that social housing units constitute an unfinished project, that, shaped by the subjectivity of their inhabitants’, generates conflict with public spaces. Despite their diversity, the interventions follow identifiable patterns, commonly linked to inadequacies in the original designs.Este estudio de caso explora los desarrollos progresivos de la vivienda de interés social (VIS) en la ciudad de Palmira (Colombia) entre los años 2000 y 2017, prestando particular atención a su dimensión estética, a partir de tres ejes fundamentales: percepción, forma y función. La aproximación metodológica agrupó cuatro herramientas cualitativas de recolección y análisis de datos: revisión documental, observación in situ (diarios de campo, levantamientos y registro fotográfico), entrevistas (a usuarios, representantes de constructoras y servidores públicos) y desarrollo de perfiles urbanos. Los hallazgos sugieren que la VIS constituye un proyecto inacabado, que, determinado por la subjetividad de los habitantes, genera relaciones conflictivas con el espacio público. Pesa a su diversidad, las intervenciones siguen patrones asociados a la solución de carencias en los diseños originales

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance