Gestión de recursos humanos y ética en servidores municipales

El estudio planteó diseñar una propuesta de gestión de recursos humanos que contribuya éticamente a la prestación de servicios en la Municipalidad Provincial de Rioja. Investigación básica, de diseño descriptivo propositivo. Cabe precisar que el estudio tiene como finalidad generar una propuesta, iniciando coordinaciones con la municipalidad, adicionando un vínculo con los ciudadanos. Posterior a ello, aplicación de instrumentos de recojo de datos. Asimismo, se podrá interactuar con el entrevistado por medio telefónico y recabar los elementos necesarios para el estudio. Se revisaron (20) artículos relevantes y de gran impacto. Concluyendo que la prestación de servicios debe tener características fiables para los ciudadanos, donde primero debe cerrar brechas, ampliando la cobertura de servicios, agregando calidad y cantidad de servicio; en busca de generar valor público que sea capaz de satisfacer las necesidades y expectativas de los ciudadanos.  De la misma manera, los investigadores precisan que es pertinente mejorar las condiciones institucionales, principalmente la estructura y funcionalidad, que son elementos fundamentales para la reestructuración organizacional, donde facilitara el acercamiento a la ciudadanía

Neurointensive of post-anoxic encephalopathy after heart arrest

Se presenta un caso atendido en el Servicio de Anestesiología y Reanimación del Hospital General Docente “Dr. Agostinho Neto” de Guantánamo, el cual presenta criterios de paro cardíaco tras herida exanguinante a nivel de músculo derecho que interesa arteria y vena femoral. Luego de 54 minutos de resucitación orientada al cerebro se logran parámetros vitales estables, se ingresó al salón de operaciones y se repararon las lesiones. Se comparten detalles de la neuroprotección intensiva perioperatoria aplicada así como las consideraciones existentes en la literatura respecto a la hipotermia terapéutica luego de paro cardíaco y el pronóstico de estos enfermos, que resultan singulares por tratarse de pacientes con baja supervivencia, lo cual puede revertirse con la concientización del personal de asistencia en función de que el rescate de estas víctimas es posible unido a la profesionalidad del trabajo en equipo.The event occurs in the Anesthesiology Service at the General Teaching Hospital "Dr. Agostinho Neto "Guantanamo, the patient presents criteria for heart arrest with severe wound in the right muscle close to the right femoral artery and vein. After 54 minutes of resuscitation oriented to brain, stable vital parameters are achieved. The patient entered to the operating room and the lesions were repaired. Details of per operative and intensive neuroprotection were shared as well as considerations in existing bibliographies regarding therapeutic hypothermia after heart arrest and the prognosis of this patient, which is unique for treating a patient with low survival, which can be reversed with the shared staff awareness of assistance based on the rescue of the victims that is possible together with the professionalism of teamwork

Marfan syndrome. A case

Se realiza la presentación de un caso atendido en el Servicio de Anestesiología y Reanimación del Hospital General Docente “Dr. Agostinho Neto” de Guantánamo, de una paciente femenina de 46 años con síndrome de Marfán y oclusión intestinal por bridas y adherencias, acompañado de prolapso en válvula mitral diagnosticado hace un año sin tratamiento medicamentoso, fumadora y con asma bronquial. Después de una valoración preoperatoria se realiza anestesia general endotraqueal. La paciente no presentó complicaciones quirúrgicas ni anestésicas. Se obtuvieron buenas condiciones de analgesia durante el postoperatorio. A presentation of a case that was performed and treated at the Anesthesiology Service, General Teaching Hospital "Dr. Agostinho Neto "Guantanamo. A female patient of 46 years with Marfan syndrome and intestinal obstruction due to adhesions and flanges, accompanied by mitral valve prolapsed diagnosed one year ago with no medication, smoking with bronchial  asthma. After preoperative evaluation is applied an endotracheal general anesthesia. The patient had no surgical or anesthetic complications. Good analgesia conditions were obtained postoperatively

Physical exercise, fitness and dietary pattern and their relationship with circadian blood pressure pattern, augmentation index and endothelial dysfunction biological markers: EVIDENT study protocol

Background: Healthy lifestyles may help to delay arterial aging. The purpose of this study is to analyze the relationship of physical activity and dietary pattern to the circadian pattern of blood pressure, central and peripheral blood pressure, pulse wave velocity, carotid intima-media thickness and biological markers of endothelial dysfunction in active and sedentary individuals without arteriosclerotic disease. Methods/Design Design: A cross-sectional multicenter study with six research groups. Subjects: From subjects of the PEPAF project cohort, in which 1,163 who were sedentary became active, 1,942 were sedentary and 2,346 were active. By stratified random sampling, 1,500 subjects will be included, 250 in each group. Primary measurements: We will evaluate height, weight, abdominal circumference, clinical and ambulatory blood pressure with the Radial Pulse Wave Acquisition Device (BPro), central blood pressure and augmentation index with Pulse Wave Application Software (A-Pulse) and SphymgoCor System Px (Pulse Wave Analysis), pulse wave velocity (PWV) with SphymgoCor System Px (Pulse Wave Velocity), nutritional pattern with a food intake frequency questionnaire, physical activity with the 7-day PAR questionnaire and accelerometer (Actigraph GT3X), physical fitness with the cycle ergometer (PWC-170), carotid intima-media thickness by ultrasound (Micromax), and endothelial dysfunction biological markers (endoglin and osteoprotegerin). Discussion: Determining that sustained physical activity and the change from sedentary to active as well as a healthy diet improve circadian pattern, arterial elasticity and carotid intima-media thickness may help to propose lifestyle intervention programs. These interventions could improve the cardiovascular risk profile in some parameters not routinely assessed with traditional risk scales. From the results of this study, interventional approaches could be obtained to delay vascular aging that combine physical exercise and diet

Marine Biodiversity in the Caribbean: Regional Estimates and Distribution Patterns

This paper provides an analysis of the distribution patterns of marine biodiversity and summarizes the major activities of the Census of Marine Life program in the Caribbean region. The coastal Caribbean region is a large marine ecosystem (LME) characterized by coral reefs, mangroves, and seagrasses, but including other environments, such as sandy beaches and rocky shores. These tropical ecosystems incorporate a high diversity of associated flora and fauna, and the nations that border the Caribbean collectively encompass a major global marine biodiversity hot spot. We analyze the state of knowledge of marine biodiversity based on the geographic distribution of georeferenced species records and regional taxonomic lists. A total of 12,046 marine species are reported in this paper for the Caribbean region. These include representatives from 31 animal phyla, two plant phyla, one group of Chromista, and three groups of Protoctista. Sampling effort has been greatest in shallow, nearshore waters, where there is relatively good coverage of species records; offshore and deep environments have been less studied. Additionally, we found that the currently accepted classification of marine ecoregions of the Caribbean did not apply for the benthic distributions of five relatively well known taxonomic groups. Coastal species richness tends to concentrate along the Antillean arc (Cuba to the southernmost Antilles) and the northern coast of South America (Venezuela – Colombia), while no pattern can be observed in the deep sea with the available data. Several factors make it impossible to determine the extent to which these distribution patterns accurately reflect the true situation for marine biodiversity in general: (1) highly localized concentrations of collecting effort and a lack of collecting in many areas and ecosystems, (2) high variability among collecting methods, (3) limited taxonomic expertise for many groups, and (4) differing levels of activity in the study of different taxa

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Identification of 12 new susceptibility loci for different histotypes of epithelial ovarian cancer.

To identify common alleles associated with different histotypes of epithelial ovarian cancer (EOC), we pooled data from multiple genome-wide genotyping projects totaling 25,509 EOC cases and 40,941 controls. We identified nine new susceptibility loci for different EOC histotypes: six for serous EOC histotypes (3q28, 4q32.3, 8q21.11, 10q24.33, 18q11.2 and 22q12.1), two for mucinous EOC (3q22.3 and 9q31.1) and one for endometrioid EOC (5q12.3). We then performed meta-analysis on the results for high-grade serous ovarian cancer with the results from analysis of 31,448 BRCA1 and BRCA2 mutation carriers, including 3,887 mutation carriers with EOC. This identified three additional susceptibility loci at 2q13, 8q24.1 and 12q24.31. Integrated analyses of genes and regulatory biofeatures at each locus predicted candidate susceptibility genes, including OBFC1, a new candidate susceptibility gene for low-grade and borderline serous EOC

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Manejo anestésico de un paciente con distrofia muscular de Duchenne. A propósito de un caso

The presentation of a case with Duchenne muscular dystrophy was performed at the Anesthesiology and Resuscitation Service of the General Teaching Hospital "Dr. Agostinho Neto "of Guantanamo, which is something unique because there is no precedent in this environment and therefore of great interest because this is a genetic disease that is transmitted in a recessive and sex-linked way in a way that affects men And is transmitted from female carriers. Her presentation in women is exceptional. It presents its preoperative evaluation and the anesthetic follow-up applied as well as the existing considerations in the literature regarding the anesthetic management of these patients.Se realiza la presentación de un caso con distrofia muscular de Duchenne atendida en el Servicio de Anestesiología y Reanimación del Hospital General Docente “Dr. Agostinho Neto” de Guantánamo, lo cual constituye algo singular por no existir antecedentes de realización en este medio y, por tanto, de elevado interés por ser esto una enfermedad genética que se transmite de forma recesiva y ligada al sexo de forma que afecta a varones y es transmitida de mujeres portadoras. Su presentación en mujeres es excepcional. Se presenta su evaluación preoperatoria y el seguimiento anestésico aplicado así como las consideraciones existentes en la literatura respecto al manejo anestésico de estos pacientes