La gestión tributaria y la recaudación del impuesto predial en la Municipalidad Provincial de Cusco - 2022

La presente tesis se titula: “La Gestión Tributaria y la Recaudación del Impuesto Predial en la Municipalidad Provincial de Cusco”. El objetivo principal es Determinar la relación que existe entre la gestión tributaria y recaudación del impuesto predial en la Municipalidad Provincial de Cusco – 2022. Para alcanzar y lograr el objetivo de investigación se emplea la siguiente metodología: estudio con enfoque cuantitativo, aplicada, de nivel descriptivo correlacional, de diseño no experimental y de corte transversal. La población muestra es de 27 servidores públicos de la Oficina General de Tributación de la Municipalidad Provincial de Cusco. La técnica de recolección de datos aplicada es la encuesta con su respectivo instrumento del cuestionario. El principal resultado a la que concluye la investigación es que se determina la relación entre la gestión tributaria y la recaudación del impuesto predial, comprobado por un valor de Rho Spearman (0.709) y una significancia (0,000 ≤ 0,005), infiriendo que existe correlación directa y significativa de grado alta, es decir que si la gestión tributaria se desarrolla adecuadamente habrá repercusión, obteniendo una adecuada recaudación del impuesto predial en la Municipalidad

Reactor de flujo de vórtices para la adsorción y purificación de biomoléculas

Número de publicación: ES2536461 A1 (25.05.2015) También publicado como: ES2536461 B2 (01.12.2015) Número de Solicitud: Consulta de Expedientes OEPM (C.E.O.) P201301126 (22.11.2013)La invención consiste en la construcción de un reactor de flujo de vórtices para ser utilizado en la cromatografía de adsorción de biomoléculas en lecho expandido y elución de las mismas, partiendo de un alimento, caldo de cultivo o extracto biológico sin clarificar.Universidad de Almerí

Zinco sérico e perfil hormonal de pacientes do sexo masculino submetidos à hemodiálise em uso de eritropoetina humana recombinante

INTRODUÇÃO: Em pacientes submetidos à hemodiálise crônica (HD), o tratamento com eritropoetina humana recombinante (rHuEpo) está associado a melhora no bem-estar geral e na qualidade de vida. OBJETIVOS: O objetivo do presente trabalho foi avaliar os níveis dos hormônios sexuais e do zinco em pacientes sob HD e em uso de rHuEpo em comparação com pacientes sem tratamento com essa droga. MATERIAL E MÉTODOS: Dois grupos de doze pacientes do sexo masculino cada um, submetidos à HD, sendo um deles sem uso de rHuEpo (grupo 1) e o outro utilizando a droga (grupo 2), foram selecionados para um estudo transversal, comparando-se os níveis séricos do zinco, da albumina, dos hormônios FSH, LH, prolactina, testosterona e do hematócrito. RESULTADOS: No grupo 2, os valores de testosterona (4,65 vs. 3,5ng/ml), hematócrito (30,5 vs. 22%), albumina (3,9 vs. 3,7g/dl) e zinco (62,5 vs. 50,5microg/dl) foram significativamente maiores do que no grupo 1 (p < 0,05). DISCUSSÃO: Sugere-se que, em pacientes recipientes da rHuEpo, os níveis mais altos de hematócrito, zinco, albumina e testosterona possam ser fatores que contribuam para melhorar a disfunção sexual e a qualidade de vida dos pacientes hemodialisados. CONCLUSÃO: Os pacientes em HD em uso da rHuEpo apresentaram níveis mais elevados de testosterona, zinco e hematócrito quando comparados com os pacientes sem a terapia hormonal. __________________________________________________________________________________________________________________ ABSTRACTINTRODUCTION: Treatment with recombinant human erythropoietin (rHuEpo) is associated with an improvement in well-being and quality of life in patients submitted to maintenance hemodialysis (HD). OBJECTIVES: The goal of this work was to evaluate the levels of sex hormones, hematocrit, albumin and zinc in HD patients with rHuEpo therapy and compare them with those observed in patients without rHuEpo treatment. MATERIAL AND METHODS: Two groups of twelve male HD patients each were selected for a transversal study; one did not receive rHuEpo (group 1) whereas the other one did (group 2). Levels of hematocrit, albumin, zinc, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and testosterone were determined. RESULTS: Group 2 patients showed significantly higher medians (p < 0.05) of testosterone (4.65 vs. 3.5ng/mL), hematocrit (30.5 vs. 22%), albumin (3,9 vs. 3,7g/dL) and zinc (62.5 vs. 50.5microg/dL) than group 1 patients. DISCUSSION: In this study rHuEpo treatment resulted in higher hematocrit, testosterone, zinc and albumin. It is suggested that, in patients recipients of rHuEpo, higher levels of zinc and testosterone may be factors that contribute to relieve sexual dysfunction and improve quality of life. CONCLUSIONS: In HD patients, hematocrit, albumin, serum zinc and testosterone levels were higher in rHuEpo recipients when compared with patients not receiving this hormone therapy

Esclera azul e hipermobilidade ligamentar. Doença do tecido conjuntivo?

Introduction: the bluish coloration of sclera, frequently, can be associated with multiple systemic syndromes like the ligamentous hyperlaxity, which is a connective tissue disease currentely affecting population, joints, tendons and also some organs, all due to tegumentary weaknesses.Objective: to describe all epidemiologic and clinical characteristics of joint hypermobility syndrome associated with blue sclera in pediatric patients. Method: a review of the literature was conducted on published articles from May 2002 up to August 2020. Databases checked were Scopus, Wiley Online Library, SciELO, Dialnet, EBSCO, PubMed/Medline. Keywords used were: “blue scleras”, “joints”, “joint hypermobility syndrome”, “connective tissue”, all in spanish and english language. A total of 21 bibliographic references were selected.Results: the uvea is a highly pigmented tissue, and when this pigmented layer increase or when the sclera decrease, allows the uvea to show through the sclera, giving rise to blue sclera. If extraocular manifestations are obvious, so blue sclera becomes an additional data supporting the diagnosis of joint hypermobility syndrome, may even be the only guide to an accurate diagnosis.Conclusions: it becomes necessary, from an ophthalmologic point of view, consider blue sclera a possible sign of onset acute diseases, cause of severe visual loss and systemic syndromes like joint hypermobility syndrome.Introducción: la coloración azul en la esclerótica se puede asociar con frecuencia a múltiples síndromes sistémicos como la hiperlaxitud ligamentaria, la cual es una enfermedad del tejido conectivo que actualmente azota a la población, afecta articulaciones, tendones y también algunos órganos, debido a la debilidad tegumentaria. Objetivo: describir las características clínicas y epidemiológicas del síndrome de hiperlaxitud articular asociado a escleras azules en el paciente pediátrico. Método: se realizó una revisión de la literatura en artículos publicados desde mayo de 2002 hasta agosto de 2020. Se consultaron las bases de datos Scopus, Wiley Online Library, SciELO, Dialnet, EBSCO, PubMed/Medline, usando los términos “escleras azules”, “articulación”, “síndrome de Hiperlaxitud Articular”, “tejido conectivo”, para español e inglés. Se seleccionaron 21 referencias. Resultados: la úvea es un tejido intensamente pigmentado, es posible que esta se haga visible a través de la esclerótica si la pigmentación aumenta o si el espesor escleral disminuye, dando origen a la esclerótica azul. Si las manifestaciones extraoculares son evidentes, la esclerótica azul se convierte en un dato más que apoya el diagnóstico del síndrome de hiperlaxitud articular, incluso puede ser la única guía hacia un diagnóstico acertado. Conclusiones: es necesario considerar desde el punto de vista oftalmológico que la esclerótica azul puede indicar la presencia de enfermedades serias, capaces de inducir pérdida visual severa si no se diagnostican y tratan a tiempo, además, de síndromes sistémicos como el síndrome de hiperlaxitud articular.Introdução: a coloração azulada da esclera pode estar frequentemente associada a múltiplas síndromes sistêmicas como a hipermobilidade ligamentar, doença do tecido conjuntivo que atualmente assola a população, afetando articulações, tendões e também alguns órgãos, devido à fraqueza tegumentar. Objetivo: descrever as características clínicas e epidemiológicas da síndrome de hipermobilidade articular associada às escleras azuis em pacientes pediátricos. Método: foi realizada revisão de literatura dos artigos publicados no período de maio de 2002 a agosto de 2020. Foram consultadas as bases de dados Scopus, Wiley Online Library, SciELO, Dialnet, EBSCO, PubMed/Medline, utilizando os termos "escleras azuis", "articulação", "síndrome de hipermobilidade articular", "tecido conjuntivo", para espanhol e inglês. 21 referências foram selecionadas. Resultados: a úvea é um tecido intensamente pigmentado, sendo possível que se torne visível através da esclera se a pigmentação aumentar ou se a espessura escleral diminuir, dando origem ao azul da esclera. Se as manifestações extraoculares são evidentes, a esclera azulada torna-se mais um achado que dá suporte ao diagnóstico da síndrome da hipermobilidade articular, podendo até ser o único guia para um diagnóstico correto.Conclusões: é preciso considerar do ponto de vista oftalmológico que a esclera azulada pode indicar a presença de doenças graves, capazes de induzir grave perda visual se não diagnosticadas e tratadas a tempo, além de síndromes sistêmicas como a síndrome da hipermobilidade articular

Blue sclera and ligamentous hyperlaxity - Connective tissue disease?

Introduction: the bluish coloration of sclera, frequently, can be associated with multiple systemic syndromes like the ligamentous hyperlaxity, which is a connective tissue disease currentely affecting population, joints, tendons and also some organs, all due to tegumentary weaknesses. Objective: to describe all epidemiologic and clinical characteristics of joint hypermobility syndrome associated with blue sclera in pediatric patients. Method: a review of the literature was conducted on published articles from May 2002 up to August 2020. Databases checked were Scopus, Wiley Online Library, SciELO, Dialnet, EBSCO, PubMed/Medline. Keywords used were: “blue scleras”, “joints”, “joint hypermobility syndrome”, “connective tissue”, all in spanish and english language. A total of 21 bibliographic references were selected. Results: the uvea is a highly pigmented tissue, and when this pigmented layer increase or when the sclera decrease, allows the uvea to show through the sclera, giving rise to blue sclera. If extraocular manifestations are obvious, so blue sclera becomes an additional data supporting the diagnosis of joint hypermobility syndrome, may even be the only guide to an accurate diagnosis. Conclusions: it becomes necessary, from an ophthalmologic point of view, consider blue sclera a possible sign of onset acute diseases, cause of severe visual loss and systemic syndromes like joint hypermobility syndrome

Pharmaceutical and Botanical Management of Pain Associated with Psychopathology: A Narrative Review

Generally, pain can be described as an unpleasant sensory or emotional experience associated with tissue damage. Chronic pain has become a public health problem because among 35 and 75% of the world population has shown the symptom. In particular, neuropathic pain has shown high comorbidity disorders such as anxiety and depression. Conventional therapies for treating pain include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, tricyclic antidepressants, anticonvulsants, and opioids, which usually cause some side effects such as gastritis, headache, liver and kidney toxicity, and drug dependence. Conventional pharmaceuticals also tend to be expensive, and they cannot be easily afforded in developing countries, which have led to the use of natural products as an alternative treatment. In this chapter, we reviewed the current research of natural products for pain treatment. We also describe preclinical studies that assess the effect of some natural products on pain therapy, phytochemistry research, toxicity, adverse effects, and biosecurity. We also describe how conventional pain is managed and the possible use of compounds obtained from vegetable species for pain treatment

Cystatin C, CRP, log TG / HDLc and metabolic syndrome are associated with microalbuminuria in hypertension

Fundamento: Em pacientes com hipertensão arterial sistêmica, a microalbuminúria é um marcador de lesão endotelial e está associada a um risco aumentado de doença cardiovascular. Objetivo: O objetivo do presente estudo foi determinar os fatores que influenciam a ocorrência de microalbumiúria em pacientes hipertensos com creatinina sérica menor que 1,5 mg/dL. Métodos: Foram incluídos no estudo 133 pacientes brasileiros atendidos em um ambulatório multidisciplinar para hipertensos. Pacientes com creatinina sérica maior do que 1,5 mg/dL e aqueles com diabete mellitus foram excluídos do estudo. A pressão arterial sistólica e diastólica foi aferida. O índice de massa corporal (IMC) e a taxa de filtração glomerular estimada pela fórmula CKD-EPI foram calculados. Em um estudo transversal, creatinina, cistatina C, colesterol total, HDL colesterol, LDL colesterol, triglicerídeos, proteína C-reativa (PCR) e glicose foram mensurados em amostra de sangue. A microalbuminúria foi determinada na urina colhida em 24 horas. Os hipertensos foram classificados pela presença de um ou mais critérios para síndrome metabólica. Resultados: Em análise de regressão múltipla, os níveis séricos de cistatina C, PCR, o índice aterogênico log TG/HDLc e a presença de três ou mais critérios para síndrome metabólica foram positivamente correlacionados com a microalbuminuria (r2: 0,277; p < 0,05). Conclusão: Cistatina C, PCR, log TG/HDLc e presença de três ou mais critérios para síndrome metabólica, independentemente da creatinina sérica, foram associados com a microalbuminúria, um marcador precoce de lesão renal e de risco cardiovascular em pacientes com hipertensão arterial essencial.Background: In patients with systemic hypertension, microalbuminuria is a marker of endothelial damage and is associated with an increased risk for cardiovascular disease. Objective: To determine the factors that may lead to the occurrence of microalbuminuria in hypertensive patients with serum creatinine lower than 1.5 mg/dL. Methods: This cross-sectional study included 133 Brazilians with essential hypertension followed up at a hypertension outpatient clinic. Those with serum creatinine higher than 1.5 mg/dL, as well as those with diabetes mellitus, were excluded. Systolic and diastolic blood pressures were measured, and body mass index (BMI) and GFR estimated by using the CKD-EPI formula were calculated. The serum levels of the following were assessed: CysC, creatinine, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, C-reactive protein (CRP) and fasting glucose. Microalbuminuria was determined in 24-hour urine. Hypertensive patients were classified according to the presence of one or more criteria for metabolic syndrome. Results: In a multiple regression analysis, the serum levels of CysC and CRP, the atherogenic index log TG/HDLc and the presence of three or more criteria for metabolic syndrome were positively correlated with microalbuminuria (r2: 0.277, p < 0.05). Conclusion: CysC, CRP, log TG/HDLc, and the presence of three or more criteria for metabolic syndrome, regardless of serum creatinine, were associated with microalbuminuria, an early marker of kidney damage and cardiovascular risk in patients with essential hypertension

Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country : a case series analysis

Disseminated tuberculosis is frequently associated with delayed diagnosis and a poorer prognosis. To describe case series of disseminated TB and diagnosis delay in a low TB burden country during the COVID-19 period. We consecutively included all patients with of disseminated TB reported from 2019 to 2021 in the reference hospital of the Northern Crown of the Metropolitan Area of Barcelona. We collected socio-demographic information, clinical, laboratory and radiological findings. We included all 30 patients reported during the study period-5, 9, and 16 in 2019, 2020, and 2021 respectively-20 (66.7%) of whom were male and whose mean age was 41 years. Twenty-five (83.3%) were of non-EU origin. The most frequent system involvement was central nervous system (N = 8; 26.7%) followed by visceral (N = 7; 23.3%), gastro-intestinal (N = 6, 20.0%), musculoskeletal (N = 5; 16.7%), and pulmonary (N = 4; 13.3%). Hypoalbuminemia and anemia were highly prevalent (72 and 77%). The median of diagnostic delay was 6.5 months (IQR 1.8-30), which was higher among women (36.0 vs. 3.5 months; p = 0.002). Central nervous system involvement and pulmonary involvement were associated with diagnostic delay among women. We recorded 24 cured patients, two deaths, three patients with post-treatment sequelae, and one lost-to-follow up. We observed a clustering effect of patients in low-income neighborhoods (p < 0.001). There was a substantial delay in the diagnosis of disseminated TB in our study region, which might impacted the prognosis with women affected more negatively. Our results suggest that an increase in the occurrence of disseminated TB set in motion by diagnosis delay may have been a secondary effect of the COVID-19 pandemic

Corrigendum : Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis

Disseminated tuberculosis is frequently associated with delayed diagnosis and a poorer prognosis. To describe case series of disseminated TB and diagnosis delay in a low TB burden country during the COVID-19 period. We consecutively included all patients with of disseminated TB reported from 2019 to 2021 in the reference hospital of the Northern Crown of the Metropolitan Area of Barcelona. We collected socio-demographic information, clinical, laboratory and radiological findings. We included all 30 patients reported during the study period-5, 9, and 16 in 2019, 2020, and 2021 respectively-20 (66.7%) of whom were male and whose mean age was 41 years. Twenty-five (83.3%) were of non-EU origin. The most frequent system involvement was central nervous system (N = 8; 26.7%) followed by visceral (N = 7; 23.3%), gastro-intestinal (N = 6, 20.0%), musculoskeletal (N = 5; 16.7%), and pulmonary (N = 4; 13.3%). Hypoalbuminemia and anemia were highly prevalent (72 and 77%). The median of diagnostic delay was 6.5 months (IQR 1.8-30), which was higher among women (36.0 vs. 3.5 months; p = 0.002). Central nervous system involvement and pulmonary involvement were associated with diagnostic delay among women. We recorded 24 cured patients, two deaths, three patients with post-treatment sequelae, and one lost-to-follow up. We observed a clustering effect of patients in low-income neighborhoods (p < 0.001). There was a substantial delay in the diagnosis of disseminated TB in our study region, which might impacted the prognosis with women affected more negatively. Our results suggest that an increase in the occurrence of disseminated TB set in motion by diagnosis delay may have been a secondary effect of the COVID-19 pandemic