Análisis comparativo de las condiciones de habitabilidad de los programas de vivienda de Nuevo Chimbote 1975 – 2015 Casos: Urbanización Sector 1A-1B (Bruces) y Urbanización Paseo del Mar

El presente trabajo de investigación se realiza tomando un rango de tiempo de análisis 1975- 2015, se realizó con el objetivo de comparar las condiciones de habitabilidad en los programas de vivienda, para ello de eligió dos casos en el distrito de Nuevo Chimbote, los cuales se encuentran en dos etapas cronológicas distintas, uno es la Urb. De Bruces de 1975 y la siguiente es la Urb. Paseo del Mar 2011, ambas urbanizaciones cuentas con un área de terreno similar, pero al haber sido edificadas en dos etapas distintas presentan diferencias tanto en el diseño urbano como arquitectónico. La investigación se sustentan con teorías que fundamenten la importancia del estudio de las condiciones de habitabilidad en los programas de vivienda actuales, aplicando diferentes métodos como encuestas, fichas de observación para encontrar resultados óptimos; se encontró que las condiciones de habitabilidad se encuentra con deficiencias y falta de estudio en este ámbito, espacios públicos no consolidados, sin un diseño interior, carencia de un diseño de estacionamientos, entre otros factores que están provocando múltiples problemas en el interior de las habilitaciones, que ha ocasionado que estas habilitaciones se vuelvan lugares de paso y no cumpla la función de realizar diferentes actividades básicas y necesarias para la población

Work stress and quality of life of health personnel during the Covid-19 pandemic in the III el Agustino primary care center, Lima - Peru 2020

El estrés laboral y la calidad de vida del personal de salud durante la pandemia COVID-19 en el Centro de Atención Primaria III El Agustino 2020 ha tomado importancia en estos últimos 3 años, por la repercusión que ello implica el sufrimiento, el desgaste laboral en el ámbito profesional y personal. El presente trabajo de investigación tuvo como como objetivo general Determinar cómo el estrés laboral se relaciona con la calidad de vida en el personal de salud durante la pandemia del COVID 19 en el Centro de Atención Primaria III El Agustino durante la pandemia COVID-19 2020. El método de investigación fue hipotético deductivo con enfoque cuantitativo, descriptivo correlacional y el diseño de la investigación será observacional y transversal. La población de estudio estuvo conformada por 140 profesionales de salud y técnicos de la salud que laboran en Centro de Atención Primaria III El Agustino. Para la recolección de información se utilizó la técnica de la encuesta haciendo uso de dos variables: estrés laboral y calidad de vida. Resultados: respecto a los niveles de estrés se evidencia que el 47.8% de los participantes que presentaban una calidad de vida mala, tenían un nivel intermedio-alto de Estrés laboral. El 26.4% de los que presentaban una calidad de vida laboral buena presentaban un nivel bajo de Estrés laboral durante la pandemia COVID-19. Conclusiones: existe una relación significativa entre el estrés laboral y la calidad de vida en los profesionales y técnicos de la salud que laboran en el Centro de Atención Primaria III El Agustino

Climate change and the kidney

The worldwide increase in temperature has resulted in a marked increase in heat waves (heat extremes) that carries a markedly increased risk for morbidity and mortality. The kidney has a unique role not only in protecting the host from heat and dehydration but also is an important site of heat-associated disease. Here we review the potential impact of global warming and heat extremes on kidney diseases. High temperatures can result in increased core temperatures, dehydration, and blood hyperosmolality. Heatstroke (both clinical and subclinical whole-body hyperthermia) may have a major role in causing both acute kidney disease, leading to increased risk of acute kidney injury from rhabdomyolysis, or heat-induced inflammatory injury to the kidney. Recurrent heat and dehydration can result in chronic kidney disease (CKD) in animals and theoretically plays a role in epidemics of CKD developing in hot regions of the world where workers are exposed to extreme heat. Heat stress and dehydration also has a role in kidney stone formation, and poor hydration habits may increase the risk for recurrent urinary tract infections. The resultant social and economic consequences include disability and loss of productivity and employment. Given the rise in world temperatures, there is a major need to better understand how heat stress can induce kidney disease, how best to provide adequate hydration, and ways to reduce the negative effects of chronic heat exposure.Published versio

Aging-associated renal disease in mice is fructokinase dependent

Aging-associated kidney disease is usually considered a degenerative process associated with aging. Recently, it has been shown that animals can produce fructose endogenously, and that this can be a mechanism for causing kidney damage in diabetic nephropathy and in association with recurrent dehydration. We therefore hypothesized that low-level metabolism of endogenous fructose might play a role in aging-associated kidney disease. Wild-type and fructokinase knockout mice were fed a normal diet for 2 yr that had minimal (<5%) fructose content. At the end of 2 yr, wild-type mice showed elevations in systolic blood pressure, mild albuminuria, and glomerular changes with mesangial matrix expansion, variable mesangiolysis, and segmental thrombi. The renal injury was amplified by provision of high-salt diet for 3 wk, as noted by the presence of glomerular hypertrophy, mesangial matrix expansion, and alpha smooth muscle actin expression, and with segmental thrombi. Fructokinase knockout mice were protected from renal injury both at baseline and after high salt intake (3 wk) compared with wild-type mice. This was associated with higher levels of active (phosphorylated serine 1177) endothelial nitric oxide synthase in their kidneys. These studies suggest that aging-associated renal disease might be due to activation of specific metabolic pathways that could theoretically be targeted therapeutically, and raise the hypothesis that aging-associated renal injury may represent a disease process as opposed to normal age-related degeneration. aging is associated with the development of glomerulosclerosis and tubulointerstitial disease in humans and rodents (12, 23, 35). Interestingly, aging-associated renal injury can vary greatly, and some individuals may show minimal reduction in kidney function and relatively preserved kidney histology with age. This raises the possibility that some of the “normal” deterioration in renal function during the aging process observed in Western cultures may be subtle renal injury driven by diet or other mechanisms. The ingestion of sugar has been associated with albuminuria in humans (3, 4, 31). Sugar contains fructose and glucose, and evidence suggests that the fructose component may be responsible for the renal injury. Specifically, fructose is metabolized in the proximal tubule by fructokinase, and this results in transient ATP depletion with the generation of oxidative stress and inflammatory mediators such as monocyte chemoattractant protein-1 (MCP-1) (5). The administration of fructose to rats results in modest proximal tubular injury, and has also been shown to accelerate preexistent kidney disease (9, 26). Fructose metabolism also results in the generation of uric acid, and this is associated with the development of afferent arteriolar disease with loss of autoregulation, resulting in glomerular hypertension (29, 30). While most studies have focused on dietary fructose, fructose can also be generated in the kidney and liver by the aldose reductase-sorbitol dehydrogenase polyol pathway, and modest fructose levels can be detected even in fasting animals (13, 21). Indeed, fructose can be generated in the kidney in diabetes or with dehydration, and in both situations may lead to local renal damage (20, 28). We hypothesized that some of the renal damage associated with aging could be due to fructose-dependent renal injury, even in the absence of dietary fructose. To investigate this hypothesis, we studied aging wild-type mice and aging mice that could not metabolize fructose via the fructokinase-dependent pathway [fructokinase knockout, also known as ketohexokinase knockout (KHK-A/C KO mice)]. KHK-A/C KO mice have a normal phenotype when young (6), but have not been examined in the aging state

Minimal Change Disease Is Associated With Endothelial Glycocalyx Degradation and Endothelial Activation

Minimal change disease (MCD) is considered a podocyte disorder triggered by unknown circulating factors. Here, we hypothesized that the endothelial cell (EC) is also involved in MCD

Hyperuricemia and chronic kidney disease: to treat or not to treat

Hyperuricemia is common in chronic kidney disease (CKD) and may be present in 50% of patients presenting for dialysis. Hyperuricemia can be secondary to impaired glomerular filtration rate (GFR) that occurs in CKD. However, hyperuricemia can also precede the development of kidney disease and predict incident CKD. Experimental studies of hyperuricemic models have found that both soluble and crystalline uric acid can cause significant kidney damage, characterized by ischemia, tubulointerstitial fibrosis, and inflammation. However, most Mendelian randomization studies failed to demonstrate a causal relationship between uric acid and CKD, and clinical trials have had variable results. Here we suggest potential explanations for the negative clinical and genetic findings, including the role of crystalline uric acid, intracellular uric acid, and xanthine oxidase activity in uric acid-mediated kidney injury. We propose future clinical trials as well as an algorithm for treatment of hyperuricemia in patients with CKD

Endemic Nephropathy Across the World

There have been several global epidemics of chronic kidney disease of unknown etiology (CKDu). Some, such as Itai-Itai disease in Japan and Balkan endemic nephropathy, have been explained, whereas the etiology of others remains unclear. In countries such as Sri Lanka, El Salvador, Nicaragua, and India, CKDu is a major public health problem and causes significant morbidity and mortality. Despite their geographical separation, however, there are striking similarities between these endemic nephropathies. Young male agricultural workers who perform strenuous labor in extreme conditions are the worst affected. Patients remain asymptomatic until end-stage renal failure. Biomarkers of tubular injury are raised, and kidney biopsy shows chronic interstitial nephritis with associated tubular atrophy. In many of these places access to dialysis and transplantation is limited, leaving few treatment options. In this review we briefly describe the major historic endemic nephropathies. We then summarize the epidemiology, clinical features, histology and clinical course of CKDu in Mesoamerica, Sri Lanka, India, Egypt, and Tunisia. We draw comparisons between the proposed etiologies and supporting research. Recognition of the similarities may reinforce the international drive to establish causality and to effect prevention

Copeptin reflects physiological strain during thermal stress.

PURPOSE: To prevent heat-related illnesses, guidelines recommend limiting core body temperature (T c) ≤ 38 °C during thermal stress. Copeptin, a surrogate for arginine vasopressin secretion, could provide useful information about fluid balance, thermal strain and health risks. It was hypothesised that plasma copeptin would rise with dehydration from occupational heat stress, concurrent with sympathoadrenal activation and reduced glomerular filtration, and that these changes would reflect T c responses. METHODS: Volunteers (n = 15) were recruited from a British Army unit deployed to East Africa. During a simulated combat assault (3.5 h, final ambient temperature 27 °C), T c was recorded by radiotelemetry to differentiate volunteers with maximum T c > 38 °C versus ≤ 38 °C. Blood was sampled beforehand and afterwards, for measurement of copeptin, cortisol, free normetanephrine, osmolality and creatinine. RESULTS: There was a significant (P  38 °C (n = 8) vs ≤ 38 °C (n = 7) there were significantly greater elevations in copeptin (10.4 vs. 2.4 pmol L(-1)) and creatinine (10 vs. 2 μmol L(-1)), but no differences in cortisol, free normetanephrine or osmolality. CONCLUSIONS: Changes in copeptin reflected T c response more closely than sympathoadrenal markers or osmolality. Dynamic relationships with tonicity and kidney function may help to explain this finding. As a surrogate for integrated physiological strain during work in a field environment, copeptin assay could inform future measures to prevent heat-related illnesses