Aplicación de dispositivos móviles para la monitorización y seguimiento de pacientes con hipertensión arterial polimedicados y diabetes mellitus insulinodependiente con factores de riesgo

Las enfermedades cardiovasculares son la primera causa de muerte en personas mayores de 45 años en el mundo, por lo que es necesaria la implementación de actividades e intervenciones que contribuyan a la detección, diagnóstico temprano y seguimiento ambulatorio adecuado de estos padecimientos.Dentro del propósito más importante de este trabajo, es detectar y realizar un seguimiento adecuado a estos usuarios diagnosticados, a través de diferentes vías y estrategias de captación y control, con el objetivo de realizar un plan terapeútico adecuado de acuerdo a los factores de riesgo identificados

Prevalencia de anemia infecciosa equina en caballos de tracción en el municipio de Florencia (Caquetá)

In the study, was evaluated the prevalence of equine infectious anemia (EIA) in traction horses in the municipality of Florencia, looking for relationship by sex, age, body condition and racial communes. 128 blood samples were collected from horses (103 males and 25 females) who attended four animal health brigades carried out by the hotbed research in horses ”S|EQLIUS" of the University of Amazonia, during the period between May 2014 and December 2015. The samples were analyzed in laboratory with agar gel immunodiffusion test. Descriptive statistical analysis and chi—square test (P <0.05) was performed. The data show the prevalence found IEA, determining that 26 % of the animals were positive to the disease (31.1 % of males and 4% of females). Regarding body condition, 21 horses classified in grade 2, and 47.62 % of them tested positive for EIA; in grade 3 were found the largest population (82 horses), with positive 18.29 %, and grade 4, 25 animals with positive 17.97 %; significant relationship between body condition and the prevalence of IEA was found. The prevalence in animals under 5 years (< 5) was 5%; in over 10 years (> 10) was 14.29 %, and animals between 5 and 10 years was considerably higher, 33.33 %. Environmental and socio-economic conditions facilitate transmission of the virus between horses of the same trade and any equine management system and production in the area, which would generate economic and livestock of importance to the equine industry losses.En el estudio se evaluó la prevalecía de anemia infecciosa equina (AIE) en los caballos de tracción en el municipio de Florencia, buscando relación por sexo, edad, condición corporal y distribución por comunas. Para ello se recolectaron 128 muestras de sangre de equinos (103 machos y 25 hembras) que asistieron a 4 brigadas de salud animal realizadas por el semillero de investigación en equinos “SIEQUUS”, de la Universidad de la Amazonia, durante el periodo comprendido entre mayo de 2014 y diciembre de 2015. Las muestras fueron analizadas en laboratorio con la prueba de inmunodifusión en agar gel. Se realizó análisis estadístico descriptivo y una prueba Chí cuadrado (P<0.05). Los datos muestran la prevalencia encontrada de AIE, determinando que el 26 % de los animales eran positivos a la enfermedad (el 31.07 % de los machos y el 4 % de las hembras). Referente a la condición corporal, 21 equinos fueron clasificados en el grado 2, y el 47.62 % de ellos resultaron positivos a AIE; en el grado 3 se encontró la mayor población (82 equinos), con el 18.29 % positivos, y en el grado 4, 25 animales, con el 17.97 % positivos; se encontró relación significativa entre la condición corporal y la prevalencia de AIE. La prevalencia en los animales menores de 5 años (<5) fue del 5 %; en los mayores de 10 años (>10) fue del 14.29 %, y en los animales entre 5 y 10 años fue considerablemente mayor, el 33.33 %. Las condiciones ambientales y socioeconómicas facilitan la transmisión del virus entre los caballos del mismo gremio y con cualquier sistema de manejo y producción equina de la zona, lo que generaría pérdidas económicas y de semovientes de importancia para el sector equino

Knowledge society, ICT and its influence on education

El propósito de la investigación es realizar una revisión documental donde se analiza en primera medida la globalización, su relación con la sociedad del conocimiento, posteriormente se analiza específicamente los estudios realizados de las TIC en la educación, a través de un enfoque cualitativo de corte comprensivo, a través de una método Hermenéutico, utilizando la técnica análisis documental relacionando las categorías de la globalización y las tic en la educación, en esta investigación se llega a la conclusión de propender por una sociedad que genere nuevas formas de ver el mundo a través de la ciencia, la innovación y la tecnología.The purpose of the research is to carry out a documentary review in which globalization is analyzed first, its relation with the knowledge society, and then specifically analyzes the studies of ICT in education, through a qualitative approach of comprehensive cut , Through a Hermeneutic method, using the documentary analysis technique relating the categories of globalization and ICT in education, this research concludes that a society that generates new ways of seeing the world through Science, innovation and technolog

Afinidad Entre Intereses Profesionales Y Carrera Elegida: Un Análisis De Su Relación Con La Deserción Universitaria Temprana

La compatibilidad entre los intereses profesionales de los estudiantes y su elección de carrera constituye un factor explicativo de creciente interés para el entendimiento de la problemática del abandono en la educación superior. En el marco de los esfuerzos de la Universidad Politécnica Salesiana (UPS-Ecuador) encaminados hacia el desarrollo de estrategias para el aumento de la permanencia estudiantil, este trabajo se propone indagar en el efecto que sobre la deserción temprana ejerce la afinidad entre los intereses profesionales y la carrera elegida por los estudiantes. La medición de los intereses profesionales se realizó a través de un instrumento propio desarrollado por la UPS, el Cuestionario de Intereses Profesionales (CIPRO-UPS) fundamentado en el enfoque teórico del aprendizaje social para la toma de decisiones de John Krumboltz. Los datos empleados corresponden a los estudiantes que participaron en el programa de nivelación y admisiones de la UPS para ingresar en las carreras del nivel de grado ofertadas para el periodo académico 2017 – 2018 en la Sede Quito. Como parte del programa señalado, las y los aspirantes universitarios completaron el CIPRO-UPS. La deserción temprana se determinó a partir de los estudiantes que habiéndose matriculado en primer nivel durante el periodo 2017 – 2018 no permanecieron en la carrera seleccionada hasta el periodo 2018 – 2018. Para evaluar la relación entre deserción temprana y la afinidad profesional-vocacional de la carrera elegida se formuló un modelo de regresión logística incluyendo una serie de variables de control conceptualmente asociadas con el abandono universitario: edad, género, lugar de origen (provincia o no), ingresos familiares, tipo de colegio (público, cofinanciado o privado) y tipo de bachillerato obtenido por los estudiantes. Complementariamente, se efectuó un análisis desagregado para el caso de las carreras de ciencias exactas y aquellas pertenecientes al área de humanidades y ciencias sociales, con el objetivo de detectar efectos diferenciados de la compatibilidad entre carrera elegida e intereses profesionales sobre la deserción temprana. Los hallazgos de este estudio permiten mejorar la comprensión del modo en que la selección de una carrera no afín a las preferencias profesionales del estudiante afecta sus probabilidades de permanencia en el proceso de formación universitaria a corto plazo. Asimismo, se explora el efecto que otros factores ejercen sobre esta problemática

Colorectal cancer: a review

Colorectal cancer (CCR) is the third most common cancer worldwide in men and women, the second largest cause of death related to cancer, and the main cause of death in gastrointestinal cancer. The risk of developing this cancer is related to bad alimentary habits, smoking, intestinal inflammatory disease, polyps, genetic factors, and aging. Of the patients that are diagnosed with colorectal cancer 90% are older than 50, with a median age of 64 years; however, the disease is more aggressive in patients that are diagnosed at younger ages. According to the American Cancer Association, it was accounted for more than 49,700 deaths in 2015. The goal is to reduce the mortality rate with early diagnosis and treatment. Currently, the survival rate is used to predict a patient’s prognosis. The patient is considered to have a positive familial history if a first-degree relative has been diagnosed with colorectal cancer or colonic polyps before the age of 60, or also if two or more first-degree relatives have been diagnosed with cancer or polyps at any age. There are several methods for detecting colorectal cancer, such as the guaiac test, immunochemical test of stool, DNA stool test, sigmoidoscopy, colonoscopy, and barium enema. The stage in which the cancer is detected determines the prognosis, survival, and treatment of the patient. Provide a review about generalities, genetic basis, risk factors, protective factors, clinical course, diagnostic methods, therapy and survival in colorectal cancer. Conducted research from different databases such as PubMed, Medline, MedScape, on the definition, genetic factors, classification, risk factors, protective factors, diagnostic methods, epidemiology, survival and treatment of colorectal cancer. Articles from 2000 to 2017 were included using the following keywords

Incremento de peso en pacientes con fibrosis quística: ¿es siempre beneficioso?

Introduction: The primary objective of this study was to find out the prevalence of overweight and obese status, as well as their association to pulmonary function, total cholesterol and vitamin D in patients with cystic fibrosis (CF). Materials and methods: This is a multicenter descriptive and cross-sectional study. Twelve Spanish hospitals participated. 451 patients with CF were included. Adults were classified according to body mass index (BMI) and children were classified according to BMI percentiles (WHO tables). Pearson’s correlation, Anova, Student’s t-test and multiple linear regression were conducted. Results: Mean age was 12.3 (range 4-57) years old, 51% were male and 18% had pancreatic sufficiency. Participants were classified in five nutritional status categories: 12% were malnourished; 57%, at nutritional risk; 24%, normally nourished; 6%, overweight; and 1%, obese. Pulmonary function in overweight or obese patients (91 ± 19%) was better than in malnourished patients (77 ± 24%) (p = 0.017). However, no difference was observed between those at nutritional risk (86 ± 19%) or normally nourished (90 ± 22%) groups. Overweight and obese patients had higher levels of total cholesterol (p = 0.0049), a greater proportion of hypercholesterolemia (p = 0.001), as well as lower levels of 25 OH vitamin D (p = 0.058). Conclusions: Prevalence of overweight and obese was 6 and 1%. Excess weight status does not offer any benefit in pulmonary function in comparison to normally nourished patientsIntroducción y objetivos: conocer la prevalencia de sobrepeso y obesidad, así como su asociación con la función pulmonar, el colesterol total y la vitamina D en pacientes con fi brosis quística (FQ). Material y métodos: estudio multicéntrico descriptivo y transversal. Participaron 12 hospitales españoles. Fueron incluidos 451 pacientes con FQ, clasifi cados según el índice de masa corporal (IMC) en adultos y el IMC percentilado (tablas OMS) en niños. Análisis estadístico: C.Pearson, Anova, t de Student y regresión lineal múltiple. Resultados: la mediana de edad fue 12,3 (rango 4-57) años. Un 51% eran varones y el 18%, sufi cientes pancreáticos (SP). El 12% estaba desnutrido; el 57%, en riesgo nutricional; el 24%, normonutrido; el 6% presentaba sobrepeso; y un 1%, obesidad. La función pulmonar en los pacientes con sobrepeso (91 ± 19%) era mejor que en los desnutridos (77 ± 24%) (p = 0,017), sin embargo, no se observaron diferencias con respecto a los que estaban en riesgo nutricional (86 ± 19%) o normonutridos (90 ± 22%). Los pacientes con sobrepeso tenían más elevado el colesterol total (p = 0,0049), mayor proporción de hipercolesterolemia (p = 0,001), así como niveles más bajos de 25 OH vitamina D (p = 0,058). Conclusiones: la prevalencia de sobrepeso y obesidad fue del 6 y el 1%. El sobrepeso y la obesidad no ofrecen benefi cio sobre la función pulmonar en comparación con los normonutrido

Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain

Background Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5-11.8) vs 3.4 years (IQR 0.4-9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5-8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. Conclusions MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients

Temas Socio-Jurídicos. Volumen 23 No. 49 Diciembre 2005

El texto que se ofrece a continuación se ha estructurado en función del estudio de dos momentos claves en la configuración del institucionalismo. En un primer momento se retoman las iniciales ideas de Veblen, Commons y Mitchell, buscando identificar en ellas el tópico que las conecta con el proceso de construcción de este marco analítico. En un segundo momento, se examina cómo la ideas de los protoinstitucionalistas mencionados, son retomadas por Coase, Williamson y North en tiempos y contextos relativamente lejanos a los que se plantearon los primeros enfoques, dándole forma a un enfoque analítico concebido para afianzar el rol de las organizaciones y promover la eficiencia en las transacciones sobre las que descansan el bienestar social, la transparencia política y el desarrollo económico.The text offered below has been structured based on the study of two key moments in the configuration of institutionalism. At first, the initial ideas of Veblen, Commons and Mitchell are taken up, seeking to identify in them the topic that connects them with the construction process of this analytical framework. In a second moment, it is examined how the ideas of the aforementioned proto-institutionalists are taken up by Coase, Williamson and North in times and contexts relatively distant from those of the first approaches, giving shape to an analytical approach designed to strengthen the role of organizations and promote efficiency in the transactions on which social welfare, political transparency rest and economic development

Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review

Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5-50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0-31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5-50.0) to 5.0 (0.0-5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0-14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0-46.0) versus 45.0 (38.0-57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0-38.0) versus 6.0 (1.0-23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7-5.6) versus 1.3 (0.3-3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.Funding: This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from “Instituto de Salud Carlos III” (ISCIII) (Spain)

Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain

Background Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5–11.8) vs 3.4 years (IQR 0.4–9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5–8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. Conclusions MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients