Limitaciones de la Implementación de la Simulación Clínica como Estrategia Pedagógica en la Enseñanza de la Enfermería

Objective. To identify aspects that prevent clinical simulation from being a satisfying pedagogical tool for the learning of nursing undergraduate students from a Public University of the Oaxacan Mixteca in Mexico.Method. A study with a quantitative, descriptive, non-experimental and cross-sectional approach was carried out in students of the Degree in Nursing (n=94) in the state of Oaxaca in Mexico. A survey was implemented "Clinical Simulation Quality and Satisfaction Survey", which contained items on a Likert scale (1-5), and was analyzed with descriptive statistics. Results. 74.47% were students from rural locations and the majority are Mixtecs (80.85%). The level of satisfaction towards the use of clinical simulation was perceived as "Good" in 54.54% of the students, while the criteria of "regular", "bad" and "very bad" were for the following aspects: realistic scenarios (32%), case duration (30%), satisfactory experience with clinical simulation (20%), usefulness of viewing recorded proceedings (19%), and communication between team members (19%). Conclusions. It is suggested to pay attention to the theoretical-methodological aspects of realism and duration of the case, improve the communication of the actors involved and give feedback with video recordings, and thus achieve greater satisfaction in the use of this learning tool at the higher level.Objetivo. Identificar aspectos que impiden a la simulación clínica ser una herramienta pedagógica de satisfacción para el aprendizaje de alumnos de pregrado en enfermería de una Universidad Pública de la mixteca oaxaqueña en México. Método. Se realizó un estudio con enfoque cuantitativo, descriptivo, no experimental y transversal, en estudiantes de la Licenciatura en Enfermería (n=94) en el estado de Oaxaca en México. Se implementó la “Encuesta de Calidad y Satisfacción de Simulación Clínica”, la cual contenía reactivos en escala de Likert (1-5), y se analizó con estadística descriptiva. Resultados. El 74.47% fueron alumnos provienen de localidades rurales y la mayoría son mixtecos (80.85%). El nivel de satisfacción hacia el uso de la simulación clínica fue percibido como “Bueno” en el 54.54% de los estudiantes, mientras que los criterios de “regular”, “malo” y “muy malo” fueron para los siguientes aspectos: escenarios realistas (32%), duración del caso (30%), experiencia satisfactoria con la simulación clínica (20%), utilidad  de ver las actuaciones grabadas (19%), y la comunicación entre los miembros del equipo (19%). Conclusiones. Se sugiere poner atención en los aspectos teóricos metodológicos del realismo y duración del caso, mejorar la comunicación de los actores implicados y dar retroalimentación con videograbaciones, y así lograr una mayor satisfacción en el uso de esta herramienta de aprendizaje en el nivel superior

Cane toad Rhinella Marina Venom Causes Small Intestine Damage in CD1 Mice

Objetivo. Describir el daño celular que provoca el veneno de Rhinella marina en el intestino delgado en un modelo murino. Métodos. Se realizó un ensayo para determinación de la LD50, y posteriormente 16 ratones machos CD1 con un peso aproximado entre 20 y 25 gramos.  se dividieron aleatoriamente en dos grupos de 8 ratones cada uno. a) Control que recibió aceite de maíz (vehículo) vía intragástrica b) Intoxicado con 250 mg/Kg del veneno vía intragástrica, a las 74 horas se sacrificaron los animales y se obtuvo la primera parte del intestino delgado para su análisis histológico y evaluación de la lipoperoxidación. Resultados. Se observó en el grupo intoxicado a diferencia del control, un aumento de la lipoperoxidación, atrofia de las microvellosidades y leucocitosis de la submucosa. Conclusión. El veneno de sapo Rhinella marina, produce daño, inflamación y peroxidación del intestino delgado, lo cuál está relacionado con las alteraciones digestivas que se ha observado cuando algunos animales sobre todo perros y gatos lo ingieren por accidente.Objective. Describe cellular damage caused by Rhinella marina venom in the small intestine in a murine model. Methods. A test was carried out to determine the LD50, and subsequently 16 male CD1 mice weighing approximately between 20 and 25 grams were randomly divided into two groups of 8 mice each. a) Control that received corn oil (vehicle) Ig. b) Intoxicated with 250 mg/Kg of the poison ig. After 74 hours, the animals were sacrificed and the first part of the small intestine was obtained for histological analysis and evaluation of lipoperoxidation. Results. An increase in lipoperoxidation, microvilli atrophy and submucosal leukocytosis was observed in the intoxicated group, unlike the control group. Conclusion. Rhinella marina toad venom causes damage, inflammation and peroxidation of the small intestine. This is related to the digestive alterations that have been observed when some animals, especially dogs and cats, ingest it by accident

5to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

El V Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2019, realizado del 6 al 8 de febrero de 2019 y organizado por la Universidad Politécnica Salesiana, ofreció a la comunidad académica nacional e internacional una plataforma de comunicación unificada, dirigida a cubrir los problemas teóricos y prácticos de mayor impacto en la sociedad moderna desde la ingeniería. En esta edición, dedicada a los 25 años de vida de la UPS, los ejes temáticos estuvieron relacionados con la aplicación de la ciencia, el desarrollo tecnológico y la innovación en cinco pilares fundamentales de nuestra sociedad: la industria, la movilidad, la sostenibilidad ambiental, la información y las telecomunicaciones. El comité científico estuvo conformado formado por 48 investigadores procedentes de diez países: España, Reino Unido, Italia, Bélgica, México, Venezuela, Colombia, Brasil, Estados Unidos y Ecuador. Fueron recibidas un centenar de contribuciones, de las cuales 39 fueron aprobadas en forma de ponencias y 15 en formato poster. Estas contribuciones fueron presentadas de forma oral ante toda la comunidad académica que se dio cita en el Congreso, quienes desde el aula magna, el auditorio y la sala de usos múltiples de la Universidad Politécnica Salesiana, cumplieron respetuosamente la responsabilidad de representar a toda la sociedad en la revisión, aceptación y validación del conocimiento nuevo que fue presentado en cada exposición por los investigadores. Paralelo a las sesiones técnicas, el Congreso contó con espacios de presentación de posters científicos y cinco workshops en temáticas de vanguardia que cautivaron la atención de nuestros docentes y estudiantes. También en el marco del evento se impartieron un total de ocho conferencias magistrales en temas tan actuales como la gestión del conocimiento en la universidad-ecosistema, los retos y oportunidades de la industria 4.0, los avances de la investigación básica y aplicada en mecatrónica para el estudio de robots de nueva generación, la optimización en ingeniería con técnicas multi-objetivo, el desarrollo de las redes avanzadas en Latinoamérica y los mundos, la contaminación del aire debido al tránsito vehicular, el radón y los riesgos que representa este gas radiactivo para la salud humana, entre otros

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad

Acta de congresoLa conmemoración de los cien años de la Reforma Universitaria de 1918 se presentó como una ocasión propicia para debatir el rol de la historia, la teoría y la crítica en la formación y en la práctica profesional de diseñadores, arquitectos y urbanistas. En ese marco el VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad constituyó un espacio de intercambio y reflexión cuya realización ha sido posible gracias a la colaboración entre Facultades de Arquitectura, Urbanismo y Diseño de la Universidad Nacional y la Facultad de Arquitectura de la Universidad Católica de Córdoba, contando además con la activa participación de mayoría de las Facultades, Centros e Institutos de Historia de la Arquitectura del país y la región. Orientado en su convocatoria tanto a docentes como a estudiantes de Arquitectura y Diseño Industrial de todos los niveles de la FAUD-UNC promovió el debate de ideas a partir de experiencias concretas en instancias tales como mesas temáticas de carácter interdisciplinario, que adoptaron la modalidad de presentación de ponencias, entre otras actividades. En el ámbito de VIII Encuentro, desarrollado en la sede Ciudad Universitaria de Córdoba, se desplegaron numerosas posiciones sobre la enseñanza, la investigación y la formación en historia, teoría y crítica del diseño, la arquitectura y la ciudad; sumándose el aporte realizado a través de sus respectivas conferencias de Ana Clarisa Agüero, Bibiana Cicutti, Fernando Aliata y Alberto Petrina. El conjunto de ponencias que se publican en este Repositorio de la UNC son el resultado de dos intensas jornadas de exposiciones, cuyos contenidos han posibilitado actualizar viejos dilemas y promover nuevos debates. El evento recibió el apoyo de las autoridades de la FAUD-UNC, en especial de la Secretaría de Investigación y de la Biblioteca de nuestra casa, como así también de la Facultad de Arquitectura de la UCC; va para todos ellos un especial agradecimiento

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Satisfacción de la simulación clínica como herramienta pedagógica para el aprendizaje en estudiantes de pregrado en Enfermería

El objetivo del trabajo fue medir el nivel de satisfacción en el uso de simulación clínica como herramienta pedagógica para el aprendizaje de estudiantes de pregrado en Enfermería de una universidad pública de la región de la Mixteca Oaxaqueña.El estudio fue con un enfoque cuantitativo, descriptivo no experimental, transversal, realizado entre marzo-julio de 2021. Un universo de estudio constituido por estudiantes de pregrado en Enfermería. La muestra fue de 94 estudiantes. Se utilizó la “Encuesta de Calidad y Satisfacción de Simulación Clínica”. Se realizaron estadísticas descriptivas.Resultados: el nivel de satisfacción general fue “bueno” 54.54% (n= 51). Los reactivos con mayor porcentaje de respuesta “excelente” fueron: “la simulación ayuda a desarrollar el razonamiento crítico y la toma de decisiones” y “la simulación me ha ayudado a integrar teoría y práctica, con 38.29% (n= 36), por otra parte, con menor puntuación, “la duración del caso es adecuada” 7.44% (n= 7) y “los escenarios donde se desarrolla la simulación son realistas” 10.64% (n= 10).Conclusión: existe un “buen” nivel de satisfacción de la simulación clínica como herramienta pedagógica para el aprendizaje en estudiante de pregrado en Enfermería en la población Mixteca Oaxaqueña

Effect of the ethanolic extract of Randia aculeata’s fruit in heart and skeletal muscle oxidative stress caused by snake venom

The purpose of this investigation was to prove if Randia aculeata is able to protect against oxidative stress generated by snake’s venom. Forty-eight male CD1 mice were used divided in groups of 8. 1) control group, 2) Randia aculeata, 3) Bothrops asper venom, 4) Randia aculeata and Bothrops asper, 5) Crotalus simus venom and 6) Randia aculeata and Crotalus simus. Blood was obtained and then fibrinogen, Lactate Dehydrogenase (ldh) and Creatin kinase (ck) were quantified. Muscle and hearts from animals were obtained in order to analyse Lipid-peroxidation (lpx), and antioxidant enzymes (catalase, super oxide dismutase [sod], and glutathione peroxidase, [gpx]). Mice treated with the venom had an increase in ck and ldh enzyme activity. Fibrinogen decreased. These disturbances were prevented with the administration of extract. It also prevented increasing levels of lipoperoxidation in both organs. It was found that sod, catalase and gpx enzyme activity in skeletal muscle, were not altered. In heart tissue, sod and gpx decreased levels were found in groups that received the venom, but ethanol extract prevented this decrease. Catalase activity increased in groups treated with snake venom, and the one that received venom from C. simus and ethanol extract. The plant minimizes significantly

The Protective Role of Cranberries and Blueberries in Oral Cancer

Background: Oral cancer has a high prevalence worldwide, and this disease is caused by genetic, immunological, and environmental factors. The main risk factors associated with oral cancer are smoking and alcohol. Results: There are various strategies to reduce risk factors, including prevention programs as well as the consumption of an adequate diet that includes phytochemical compounds derived from cranberries (Vaccinium macrocarpon A.) and blueberries (Vaccinium corymbosum L.); these compounds exhibit antitumor properties. Results: The main outcome of this review is as follows: the properties of phytochemicals derived from cranberries were evaluated for protection against risk factors associated with oral cancer. Conclusions: The secondary metabolites of cranberries promote biological effects that provide protection against smoking and alcoholism. An alternative for the prevention of oral cancer can be the consumption of these cranberries and blueberries