Relación proteína C reactiva/albumina como factor pronóstico de severidad en pacientes con pancreatitis aguda

Objetivo: El propósito del estudio fue determinar que la relación proteína C reactiva/albumina es un factor pronóstico de severidad en pacientes con pancreatitis aguda. Material y Métodos: Se realizó un estudio de casos y controles, con un tamaño de muestra de 148 pacientes, que cumplieron con los criterios de selección, que fueron distribuidos en los grupos, 37 pacientes con pancreatitis aguda grave (casos) y 111 con pancreatitis aguda no grave (controles), se evaluó que el valor de la relación PCR/albúmina > 16.3 como factor de severidad en el Hospital Víctor Lazarte Echegaray, periodo 2014 – 2018, la diferencia de ambos grupos se realizó con la prueba de Chi cuadrado, T- student, Odds ratio. Resultados: De los 37 pacientes con pancreatitis aguda grave el 54.1% son mujeres y el 45.9% son varones, con p > 0.05 que nos dice que el sexo no influyó significativamente con esta entidad. Las edades que más presentaron una relación PCR/albúmina >16.3 y pancreatitis aguda grave fueron los pacientes entre 18 - 35 años. Por otra parte dentro de las comorbilidades (obesidad, la hipertensión arterial, diabetes mellitus tipo II) y las infecciones intrahospitalarias (p = 0,97) no tuvieron significancia estadística asociada a la pancreatitis aguda grave. La relación PCR/albúmina >16.3 se presentó en el 80% (30 casos) de los pacientes con pancreatitis aguda grave y el 61.3% (68 controles) de los pacientes con pancreatitis aguda no grave, OR: 2.7 (IC=1,094 - 6,713), X = 4.87 y un p<0.05. Conclusiones: En los pacientes con cuadro clínico de pancreatitis aguda con una relación PCR/albúmina >16.3 tiene 2.7 veces más probabilidad de presentar su forma grave. La estancia hospitalaria prolongada y las infecciones intrahospitalarias no están asociadas a la pancreatitis aguda grave.Objective: The purpose of the study was to determine that the C-reactive protein/albumin ratio is a predictive factor of severity in patients with acute pancreatitis. Material and methods: A case-control study was conducted, with a sample size of 148 patients, who met the selection criteria, which were distributed in the groups, 37 patients with severe acute pancreatitis (cases) and 111 with acute non-severe pancreatitis (controls), It was evaluated that the value of the CRP/albumin ratio> 16.3 as a severity factor in the Víctor Lazarte Echegaray Hospital, period 2014-2018, the difference of both groups was made with the Chi square test, T-student, Odds ratio. Results: The 37 patients with severe acute pancreatitis, 54.1% are women and 45.9% are men, with p> 0.05 telling us that sex did not significantly influence this entity. The ages with the highest CRP/albumin ratio> 16.3 and severe acute pancreatitis were patients between 18-35 years. On the other hand, within comorbidities (obesity, blood hypertension, diabetes mellitus type II) and nosocomial infections (p = 0.97) had not statistical significance associated with severe acute pancreatitis. The CRP/albumin ratio> 16.3 occurred in 80% (30 cases) of patients with severe acute pancreatitis and 61.3% (68 controls) of patients with acute non-severe pancreatitis, OR: 2.7 (CI = 1.094 - 6.713), X = 4.87 and a p <0.05. Conclusions: In patients with clinical symptoms of acute pancreatitis with a CRP/albumin ratio> 16.3, it is 2.7 times more likely to present its severe form. Prolonged hospital stay and nosocomial infections aren’t associated with severe acute pancreatitis.Tesi

Experiencias de aprendizaje

Libro de experiencias de aprendizaje del grupo de investigación Giteca y de los semilleros de investigación en la que se visualizan las diferentes experiencias lideradas por instructores y aprendices en las diferentes áreas y líneas de formación.Book of learning experiences of the Giteca research group and the research hotbeds in which the different experiences led by instructors and apprentices in the different areas and lines of training are visualized.Propagación in vitro como un camino de aprendizaje para la formación profesional integral -- Experiencias significativas de aprendizaje, laboratorio de hematología y parasitología animal del Complejo Tecnológico para la Gestión Agroempresarial CTPGA-SENA -- Experiencias significativas adquiridas por aprendices en el área de SENNOVA, Complejo Tecnológico para la Gestión Agroempresarial. Regional – Antioquia -- El papel de la prensa escrita en el desarrollo de la competencia textual -- Aprendiendo a Emprender con un emprendedor -- Ven y te cuento sobre ADSI -- Observaciones fenológicas del cultivo de cacao (Theobroma cacao) en los municipios de Tarazá, El Bagre y Caucasia dentro de la formación del programa SENA emprende rural -- Tejiendo sueños desde la formación -- Forraje verde hidropónico como alternativa para disminuir la expansión de la frontera agrícola en el Putumayo -- La importancia del saber hacer para ser competente en el sector agrícola -- Experiencia significativa de aprendizaje semilleros de investigación -- La investigación como ente transformador de pensamientos -- Piscícola Paraguay; Mi Sueño, Mi Proyecto de Vida! -- Estrategia de aprendizaje a través de la investigación y la empresa aplicando un programa de Responsabilidad Social Empresarial –RSE -- Matemática aplicada para procesos agroindustriales de panificaciónna85 página

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

I simposio Internacional sobre Investigación en la enseñanza de las ciencias

Edición 202

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P&lt;0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P&lt;0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally