Qualidade na administração de medicamentos inotrópicos em profissionais de enfermagem de um hospital de Tabasco, México

The aim was to evaluate the quality in the administration of inotropic medications in the nursing staff of a high specialty hospital in Tabasco, Mexico. It is an observational, cross-sectional, analytical study. A sample was obtained for the convenience of 80 nursing professionals. To assess the knowledge, the quality and safety questionnaire of the administration of inotropic medications from Ipanaque and Pérez was used. Compliance with quality standards was evaluated with the official drug administration card of the National System of Health Quality Indicators in Mexico. For data analysis, descriptive and analytical statistics were used, SPSS Version 22.0 was used. The level of quality in the administration of inotropics in the hospital evaluated was insufficient in 73.8% (59). The nurses in the intensive care service were the best evaluated in 66% with an X2 of 20,622 and a statistically significant value of p = .002. Unlike nurses in the emergency department who reached the lowest level of quality in 27.1% of them. Conclusions: the level of quality and safety in the administration of inotropics was insufficient. Constant supervision and training is suggested at the critical points found to avoid adverse events and ensure patient safety.El objetivo de este estudio fue evaluar la calidad en la administración de medicamentos inotrópicos por parte del personal de enfermería de un hospital de alta especialidad en Tabasco, México. Es un estudio observacional, transversal, analítico. Se obtuvo una muestra por conveniencia de 80 profesionales de enfermería. Para evaluar el conocimiento se utilizó el cuestionario de calidad y seguridad de la administración de medicamentos inotrópicos de Ipanaque y Pérez. El cumplimiento de los estándares de calidad, se evaluó con la cédula oficial de administración de medicamentos del Sistema Nacional de Indicadores de Calidad en Salud en México. Para el análisis de los datos, se empleó estadística descriptiva y analítica, además, se utilizó el SPSS Versión 22.0. El nivel de calidad en la administración de inotrópicos en el hospital evaluado fue insuficiente en un 73.8% (59).  Las enfermeras del servicio de cuidados intensivos fueron las mejor evaluadas en el 66% con una X2 de 20.622 y un valor de p=.002, el cual es estadísticamente significativo. A diferencia de las enfermeras del área de urgencias que alcanzaron el nivel más bajo de calidad en el 27.1% de ellas. Se concluye que el nivel de calidad y seguridad en la administración de inotrópicos fue insuficiente. Por lo tanto, se sugiere supervisión y capacitación constante en los puntos críticos encontrados para evitar eventos adversos y garantizar la seguridad del paciente.   Objetivo: Avaliar a qualidade na administração de medicamentos inotrópicos na equipe de enfermagem de um hospital de alta especialidade em Tabasco, México. Estudo observacional, transversal, analítico. Uma amostra a conveniência foi obtida de 80 profissionais de enfermagem. Para avaliar o conhecimento, foi utilizado o questionário de qualidade e segurança da administração de medicamentos inotrópicos de Ipanaque e Pérez. A conformidade com os padrões de qualidade foi avaliada com o cartão oficial de administração de medicamentos do Sistema Nacional de Indicadores de Qualidade em Saúde no México. Para análise dos dados, utilizou-se estatística descritiva e analítica, SPSS Versão 22.0. O nível de qualidade na administração de inotrópicos no hospital avaliado foi insuficiente em 73,8% (59). Os enfermeiros do serviço de terapia intensiva foram os melhores avaliados em 66% com um X2 de 20.622 e um valor estatisticamente significante de p = 0,002. Diferentemente dos enfermeiros do pronto-socorro, que atingiram o nível mais baixo de qualidade em 27,1% deles. Conclusões: o nível de qualidade e segurança na administração de inotrópicos foi insuficiente. Supervisão e treinamento constantes são sugeridos nos pontos críticos encontrados para evitar eventos adversos e garantir a segurança do paciente

Inclusión de harina de cangrejo rojo americano (Procambarus clarkii) en alimentación de alevinos de trucha arco iris (Oncorhynchus mykiss)

Contextualization: The American red crayfish, Procambarus clarkii, is an invasive species whose presence has been confirmed in central Colombia. In the southern United States, where it is naturally distributed, it is an important aquaculture resource; however, high environmental impacts have been documented in areas where it has been introduced, precisely because of its high colonization capacity and the consequent impact on native species. The growing record of its presence in different systems in the center of the country, suggests an accelerated expansion pattern and implies that, as has occurred in other countries, negative effects may occur on the general structure of these highland ecosystems if mechanisms are not applied that allow some level of control. Knowledge gap: The possibility of controlling its expansion through manual eradication is a viable alternative, as long as some type of use is validated; this should include an economic incentive to motivate people to fish for it. The process to obtain meal that serves as a protein source for aquaculture concentrates is an option that should be evaluated. Purpose: Three percentages of inclusion of crayfish meal, in partial replacement of fish meal, were evaluated in a concentrate formulated for rainbow trout fingerling stage.Methodology: Specimens of P. clarkii were captured in the environment, using traps with animal bait. The crayfish were processed whole to obtain meal. The experimental feed was elaborated from the evaluation of meal composition; four treatments were applied in triplicate, with three levels of crayfish meal inclusion (T1: 2 %, T2: 4 % and T3: 6 %) and a control without meal. These were fed to trout fry from the start of feeding until they reached 6 cm total length. Total length (cm) and weight (g) were sampled every ten days for a period of 60 days. Through analysis of variance (ANOVA), the following variables of the fry were compared at the end of the period: final weight (Pf, g), total length gains (GLT, cm), weight (GP, g), feed conversion factor (FCA), specific growth rate (TCE, %), condition factor (K) and mortality (%). Results and conclusions: Among treatments and for the variables evaluated were no statistically significant differences among treatments. It is concluded that, up to the size worked, the inclusion at a level of 6% of crayfish meal is feasible as a partial replacement of fish meal. Obtaining the meal from whole specimens makes it difficult to balance diets with higher replacement percentages.Contextualización. El cangrejo rojo americano, Procambarus clarkii, es una especie invasora cuya presencia está confirmada en la zona central de Colombia. En el sur de Estados Unidos, área de distribución natural, es un importante recurso acuícola; sin embargo, se han documentado altos impactos ambientales en zonas donde ha sido introducido, precisamente por su elevada capacidad de colonización y la consecuente afectación a especies nativas. El creciente registro de su presencia en diferentes sistemas del centro del país, sugiere un acelerado patrón de expansión y supone que, tal como se ha presentado en otros países, podrán ocurrir efectos negativos sobre la estructura general de estos ecosistemas de altiplano de no aplicarse mecanismos que permitan algún nivel de control. Vacío de conocimiento. La posibilidad de controlar su expansión mediante erradicación manual es una alternativa viable, siempre que se valide algún tipo de uso; este debe contemplar un estímulo económico para motivar pobladores que se dediquen a su extracción por pesca. El proceso para obtener harina que sirva como fuente proteica para concentrados en acuicultura es una opción que debe ser valorada. Propósito. Se evaluaron tres porcentajes de inclusión de harina de cangrejo, en reemplazo parcial de harina de pescado, en un concentrado formulado para la etapa de alevinaje en trucha arco iris. Metodología. Ejemplares de P. clarkii fueron capturados en el medio, utilizando trampas con carnada animal. Los cangrejos fueron procesados completos hasta obtener harina. El alimento experimental, se elaboró a partir de la valoración en composición de harina; se aplicaron cuatro tratamientos por triplicado, con tres niveles de inclusión de harina de cangrejo (T1: 2 %, T2: 4 % y T3: 6 %) y un control sin harina. Estos fueron suministrados a alevinos de trucha desde el inicio de la alimentación hasta alcanzar 6cm de longitud total. Se realizaron muestreos de longitud total (cm) y peso (g) cada diez días, durante un periodo de 60 días. Mediante análisis de varianza (ANOVA), fueron comparadas las siguientes variables de los alevines al final del periodo: peso final (Pf, g), ganancias en longitud total (GLT, cm), peso (GP, g), factor de conversión alimenticia (FCA), tasa de crecimiento específico (TCE, %), factor de condición (K) y mortalidad (%). Resultados y conclusiones. Entre los tratamientos y para las variables evaluadas, no se presentaron diferencias estadísticamente significativas entre tratamientos. Se concluye que, hasta la talla trabajada, la inclusión a un nivel del 6 % de harina de cangrejo es factible como reemplazo parcial de harina de pescado. La obtención de la harina a partir de ejemplares completos dificulta el balanceo de las dietas con mayores porcentajes de reemplazo

In vivo cholinergic basal forebrain degeneration and cognition in Parkinson's disease: Imaging results from the COPPADIS study

Introduction: We aimed to assess associations between multimodal neuroimaging measures of cholinergic basal forebrain (CBF) integrity and cognition in Parkinson’s disease (PD) without dementia. Methods: The study included a total of 180 non-demented PD patients and 45 healthy controls, who underwent structural MRI acquisitions and standardized neurocognitive assessment through the PD-Cognitive Rating Scale (PD-CRS) within the multicentric COPPADIS-2015 study. A subset of 73 patients also had Diffusion Tensor Imaging (DTI) acquisitions. Volumetric and microstructural (mean diffusivity, MD) indices of CBF degeneration were automatically extracted using a stereotactic CBF atlas. For comparison, we also assessed multimodal indices of hippocampal degeneration. Associations between imaging measures and cognitive performance were assessed using linear models. Results: Compared to controls, CBF volume was not significantly reduced in PD patients as a group. However, across PD patients lower CBF volume was significantly associated with lower global cognition (PD-CRStotal: r =0.37, p <0.001), and this association remained significant after controlling for several potential confounding variables (p =0.004). Analysis of individual item scores showed that this association spanned executive and memory domains. No analogue cognition associations were observed for CBF MD. In covariate-controlled models, hippocampal volume was not associated with cognition in PD, but there was a significant association for hippocampal MD (p =0.02). Conclusions: Early cognitive deficits in PD without dementia are more closely related to structural MRI measures of CBF degeneration than hippocampal degeneration. In our multicentric imaging acquisitions, DTI-based diffusion measures in the CBF were inferior to standard volumetric assessments for capturing cognition- relevant changes in non-demented PD

Mis casos clínicos de especialidades odontológicas

Libro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasLibro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasUniversidad Autónoma de Campeche Universidad Autónoma del Estado de Hidalgo Universidad Autónoma del Estado de Méxic

Taenia crassiceps-Excreted/Secreted Products Induce a Defined MicroRNA Profile that Modulates Inflammatory Properties of Macrophages

Helminth parasites modulate immune responses in their host to prevent their elimination and to establish chronic infections. Our previous studies indicate that Taenia crassiceps-excreted/secreted antigens (TcES) downregulate inflammatory responses in rodent models of autoimmune diseases, by promoting the generation of alternatively activated-like macrophages (M2) in vivo. However, the molecular mechanisms triggered by TcES that modulate macrophage polarization and inflammatory response remain unclear. Here, we found that, while TcES reduced the production of inflammatory cytokines (IL-6, IL-12, and TNFα), they increased the release of IL-10 in LPS-induced bone marrow-derived macrophages (BMDM). However, TcES alone or in combination with LPS or IL-4 failed to increase the production of the canonical M1 or M2 markers in BMDM. To further define the anti-inflammatory effect of TcES in the response of LPS-stimulated macrophages, we performed transcriptomic array analyses of mRNA and microRNA to evaluate their levels. Although the addition of TcES to LPS-stimulated BMDM induced modest changes in the inflammatory mRNA profile, it induced the production of mRNAs associated with the activation of different receptors, phagocytosis, and M2-like phenotype. Moreover, we found that TcES induced upregulation of specific microRNAs, including miR-125a-5p, miR-762, and miR-484, which are predicted to target canonical inflammatory molecules and pathways in LPS-induced BMDM. These results suggest that TcES can modulate proinflammatory responses in macrophages by inducing regulatory posttranscriptional mechanisms and hence reduce detrimental outcomes in hosts running with inflammatory diseases

Prácticas de Agricultura de Conservación para la producción de maíz (Zea mays Lin.) ecológico

Actually research as direct seed has not advanced at the desired pace, and in the case of corn production. This research had the results of two management practices campaigns for the cultivation of corn, established in Brown soils without Carbonates in the Credit and Services Cooperative (CCS) Camilo Cienfuegos of the municipality of La Palma, Pinar del Río province. The effects of tillage bring with it the lack of soil fertility due to erosion and degradation processes, as well as the incidence of climatic factors that limit the resilience of crops and at the same time have a great influence in the yields. Based on these elements, it was intended to contribute with Conservation Agriculture to the stability of the agromorphological and yield descriptors of corn, with the aim of implementing agricultural practices that improve these descriptors in a more beneficial way for the environment. The yield descriptors and their components were evaluated, as well as the agromorphological descriptors of the crop. The results showed that the applied conservation agriculture technology manages to maintain the agromorphological and yield characteristics; it brings benefits to the conservation of the properties of the soils and reduces erosion. It was proved that the use of good agricultural practices for the production of corn favors the quality of the products by not using chemicals, giving the population healthier productsEn la actualidad los estudios relacionados a prácticas agrícolas como el caso de la siembra directa para el cultivo del maíz son muy escasos en nuestro país. La presente investigación contó con los resultados de dos campañas de manejo (siembra tradicional y siembra directa) de prácticas de manejo para el cultivo del maíz, establecidos en suelos Pardo sin Carbonatos en la Cooperativa de Créditos y Servicios (CCS) Camilo Cienfuegos del municipio La Palma, provincia de Pinar del Río. El laboreo continuo del suelo trae consigo su baja fertilidad; debido a los procesos de erosión y degradación, así como a la incidencia de factores climáticos que limitan la resilencia de los cultivos y que a su vez influyen significativamente en los rendimientos. Basado en esos elementos se pretendió contribuir mediante el empleo de la Agricultura de Conservación a la estabilidad de los descriptores agromorfológicos y de rendimiento del maíz, con el objetivo de implementar prácticas agrícolas que mejoren estos descriptores que contribuyan a mejorar el proceso productivo del cultivo y a su vez de una manera más beneficiosa para el medio ambiente. Se evaluaron los descriptores de rendimiento y sus componentes, así como los descriptores agromorfológicos del cultivo. Los resultados demostraron que la práctica de la siembra directa logra mantener las características agromorfológicas y de rendimiento, asimismo aporta beneficios a la conservación de las propiedades de los suelos y disminución de la erosión. Se pudo comprobar que el empleo de buenas prácticas agrícolas como la siembra directa para la producción de maíz logra mantener las propiedades agromorfológicas del cultivo con una tecnología muy amigable con el medio ambiente

Privatisation and quasi-markets

Paper presented at the EACES First Trento Workshop, University of Trento (IT), 1-2 Mar 1991Available from British Library Document Supply Centre- DSC:8490.3304(7) / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Identification of a threshold to discriminate fasting hypertriglyceridemia with postprandial values

Abstract Background Postprandial lipemia is an important cardiovascular risk factor. The assessment of postprandial lipid metabolism is a newly trend that several consortiums and countries have adopted. The aim of the study is to determine a postprandial triglyceride concentration cut-off point that accurately discriminate individuals with fasting normal triglyceride concentrations from those with fasting hypertriglyceridemia. Methods Cross sectional population-based study. A total of 212 subjects underwent an eight hours’ oral fat tolerance test. Samples were taken fasting, three, four, five, six and eight hours after the meal. The area under the receiver operating characteristic curve (c-statistic) was computed using postprandial triglycerides concentrations as independent predictor, and fasting hypertriglyceridemia as dependent variable. Results The best threshold of postprandial lipemia to discriminate fasting hypertriglyceridemia was 280 mg/dL at any hour area under the curve 0.816 (95% confidence interval 0.753–0.866), bootstrap-corrected c-statistic = 0.733 (95% confidence interval 0.68–0.86). The same value was compared with apolipoprotein B concentrations (>90th percentile) having a good performance: area under the curve 0.687 95% confidence interval 0.624–0.751). Likewise, subjects with high postprandial lipemia have higher Globo risk scores. Conclusion The 280 mg/dL cut-off point value of postprandial triglycerides concentration any time after a test meal discriminate subjects with fasting hypertriglyceridemia. This threshold has a good performance in a heterogeneous population and has a good concordance with cardiovascular risk surrogates