Complicaciones Cardiovasculares asociadas a infección por SARS-CoV-2. Revisión Sistemática

El COVID-19 es una enfermedad que ha afectado a la población mundial, convirtiéndose en una de las peores pandemias de nuestra generación, representando un reto social y sanitario sin precedentes; afecta principalmente el sistema respiratorio, sin embargo, diversos estudios han demostrado el compromiso cardiovascular, generando preocupación, que se traduce en una mayor vulnerabilidad en los pacientes con patologías cardiovasculares subyacentes. Se ha establecido que la presencia de comorbilidades, como hipertensión, diabetes y enfermedad arterial coronaria, se asocian con tasas de mortalidad elevadas, afectando a pacientes cardiovasculares crónicos y causando alteraciones cardiovasculares en pacientes sin antecedentes, por lo cual es necesario el monitoreo de biomarcadores cardíacos para un mejor abordaje de la enfermedad. Estudios clínicos han evidenciado que la patología cardiovascular que principalmente se asocia al COVID-19 es la insuficiencia cardíaca (IC), que se manifiesta con un aumento en los niveles de troponina, miopericarditis, shock cardiogénico, lesión cardíaca aguda, trastornos de coagulación y trombosis, arritmias, además del síndrome coronario agudo y la enfermedad de Kawasaki. Este artículo es una revisión de las complicaciones cardíacas asociadas al COVID-19 y sus posibles mecanismos de acción, que permitan un mejor entendimiento por parte del personal médico y de salud (PROSPERO ID 316364

COMPLICACIONES DE COVID-19 ASOCIADAS A LA OBESIDAD: REVISIÓN

Introducción: La interacción del hombre con los virus sigue siendo un amplio campo de estudio donde cada día hay novedades; en este sentido, con el reciente SARS-CoV-2 agente causal de la pandemia de COVID-19 se ha demostrado que determinadas condiciones inmunogenéticas, inflamatorias y cardio-metabólicas constituyen factores de riesgo para la forma de presentación complicada de la enfermedad, como se documentó en pacientes obesos. Objetivo: analizar y relacionar las complicaciones del COVID-19 asociadas a la obesidad y receptores inmunológicos. Métodos: Se llevó a cabo una búsqueda sistemática en las bases de datos PubMed, Embase, Redalyc, Springer y LILACS, tomando en cuenta artículos de revisión, artículos originales y revisiones sistemáticas publicadas en el contexto internacional; en el periodo febrero 2020 -febrero 2022. Se incluyó la revisión de 75 artículos en total: de los cuales se rechazaron 34 artículos por no contener la información a razón de búsqueda, resultando elegidos 41 artículos al cumplir con los criterios de elegibilidad. Resultados: La revisión bibliográfica sugiere la relación del estado inflamatorio crónico de bajo grado inducido por la obesidad y la infección por SARS-CoV-2. Conclusion: Es de suma importancia incrementar el número de investigaciones y/o reporte de casos en los cuales se incluyan pacientes con síndrome metabólico y obesidad resaltando además el amplio rango de receptores inmunes que se han descrito, sobre los cuales podrían diseñarse blancos terapéuticos aunado a la compresión fisiopatológica que cada día demuestra ser una red compleja con fuerte base inmunopatológica.    Palabras clave: Síndrome Respiratorio Agudo Severo, COVID-19, inflamación, obesidad.   ABSTRACT Introduction: The interaction of man with viruses continues to be a broad field of study where there are new developments every day; In this sense, with the recent SARS-CoV-2 causal agent of the COVID-19 pandemic, it has been shown that certain immunogenic, inflammatory and cardio-metabolic conditions constitute risk factors for the complicated form of presentation of the disease, as shown documented in obese patients. Objective: to analyze and relate the complications of COVID-19 associated with obesity and immune receptors. Methods: A systematic search was carried out in the PubMed, Embase, Redalyc, Springer and LILACS databases, taking into account review articles, original articles and systematic reviews published in the international context; in the period February 2020-February 2022. A total of 75 articles were reviewed: of which 34 articles were rejected for not containing the information due to the search, resulting in 41 articles being chosen as they met the eligibility criteria. Results: The literature review suggests the relationship between the low-grade chronic inflammatory state induced by obesity and SARS-CoV-2 infection. Conclusion: It is extremely important to increase the number of investigations and/or case reports in which patients with metabolic syndrome and obesity are included, also highlighting the wide range of immune receptors that have been described, on which therapeutic targets could be designed together with the pathophysiological understanding that each day proves to be a complex network with a strong immunopathological basis. Keywords: Severe Acute Respiratory Syndrome, COVID-19, inflammation, obesity

Aspectos genéticos del virus del dengue

El dengue es un virus endémico en regiones tropicales, que está asociado a las precipitaciones, temperatura, urbanización y distribución de su principal vector, Aedes aegypti. La carga mundial de esta enfermedad no es bien conocida, pero sus patrones epidemiológicos son alarmantes tanto para los seres humanos, la salud y economía global. El dengue se ha identificado como una enfermedad del futuro debido a las tendencias hacia el aumento de la urbanización, la escasez de agua y, posiblemente, el cambio ambiental. La transmisión de este virus se reporta principalmente en las regiones del Mediterráneo Oriental, América, Asia Sudoriental, Pacífico Occidental y África. A partir del conocimiento del genoma del dengue se puede conocer más a detalles el posible comportamiento de esta enfermedad incidente. La creación de moléculas terapéuticas y la toma de decisiones en la clínica se basan en el conocimiento acerca de los aspectos genéticos del virus, pues a este nivel se puede medir la virulencia y patogenicidad del mismo. En este sentido, el objetivo de este trabajo fue describir los elementos más importantes del virus, su distribución génica, los elementos de resistencia conferido por su estructura a nivel intracelular y el ciclo replicativo respectivo de esta familia viral. Palabras clave: Virus, dengue, regiones no codificantes, virus ARN, genes virales

Human subcortical brain asymmetries in 15,847 people worldwide reveal effects of age and sex

The two hemispheres of the human brain differ functionally and structurally. Despite over a century of research, the extent to which brain asymmetry is influenced by sex, handedness, age, and genetic factors is still controversial. Here we present the largest ever analysis of subcortical brain asymmetries, in a harmonized multi-site study using meta-analysis methods. Volumetric asymmetry of seven subcortical structures was assessed in 15,847 MRI scans from 52 datasets worldwide. There were sex differences in the asymmetry of the globus pallidus and putamen. Heritability estimates, derived from 1170 subjects belonging to 71 extended pedigrees, revealed that additive genetic factors influenced the asymmetry of these two structures and that of the hippocampus and thalamus. Handedness had no detectable effect on subcortical asymmetries, even in this unprecedented sample size, but the asymmetry of the putamen varied with age. Genetic drivers of asymmetry in the hippocampus, thalamus and basal ganglia may affect variability in human cognition, including susceptibility to psychiatric disorders

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Contabilidad - CP38 201801

Descripción: El curso Contabilidad brinda al estudiante los aspectos básicos contables; así como, sus principales fundamentos y técnicas, que les permita estar en capacidad de comprender el alcance de la información financiera de las empresas, que es considerada como uno de los principales recursos de las empresas para la toma de decisiones. Propósito: El curso Contabilidad es un curso obligatorio, de la especialidad de Contabilidad y en general, de las carreras de la Facultad de Negocios. Es un curso teórico-práctico dirigido a los estudiantes de segundo ciclo, que brinda las herramientas necesarias que ayudarán al mejor entendimiento de cursos subsiguientes y desarrolla la I. INFORMACIÓN GENERAL CURSO : Contabilidad CÓDIGO : CP38 CICLO : 201801 CUERPO ACADÉMICO : Avilés Valdez, José Roberto Cabana Huamani, Henry Canelo Vásquez, Sabino Pablo Cruzado Ribeyro, Anita Justina Diaz Cubas, Zaira Andrea Escriba Marcelo, Yessela Victoria Lau Rebolledo, Juan Eduardo Laynes López, José José Lockuan Silva, Héctor Alfonso Marañón Winder, Domingo Leonardo Mendoza Ibarra, Veronica Oviedo Álvarez, Gustavo Adolfo Paiva Cruz, Rosaura Venecia Torres Guillén, Fany Patricia Valdivieso Virhuez, Luis Guillermo Zuazo Valenzuela, Vanessa CRÉDITOS : 5 SEMANAS : 10 HORAS : 10 H (Teoría) Semanal ÁREA O CARRERA : Contabilidad II. MISIÓN Y VISIÓN DE LA UPC Misión: Formar líderes íntegros e innovadores con visión global para que transformen el Perú. Visión: Ser líder en la educación superior por su excelencia académica y su capacidad de innovación. 2 competencia general de Razonamiento Cuantitativo; y la competencia específica de Gestión Comercial, ambas a nivel 1

Taller de aptitud vocacional para arquitectura - AR206 201801

El Taller de Aptitud Vocacional para Arquitectura es un curso de especialidad en la carrera de Arquitectura, de carácter teórico-práctico dirigido a los estudiantes del ciclo 0 que no aprobaron la "Prueba de aptitud Vocacional para Arquitectura"; el curso permite verificar si el perfil de los estudiantes coincide con el necesario para el seguimiento de la Carrera de Arquitectura y busca desarrollar la competencia general de Manejo de la información y la competencia específica de Proyecto Arquitectónico. En este sentido, el curso brinda el primer acercamiento a los conceptos arquitectónicos básicos y a la historia del arte y arquitectura, con el fin de corroborar y/o reforzar las aptitudes vocacionales para la carrera de Arquitectura y así el estudiante, aumente sus probabilidades de un buen desempeño académico y la exitosa culminación de la carrera

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

Human subcortical brain asymmetries in 15,847 people worldwide reveal effects of age and sex.

The two hemispheres of the human brain differ functionally and structurally. Despite over a century of research, the extent to which brain asymmetry is influenced by sex, handedness, age, and genetic factors is still controversial. Here we present the largest ever analysis of subcortical brain asymmetries, in a harmonized multi-site study using meta-analysis methods. Volumetric asymmetry of seven subcortical structures was assessed in 15,847 MRI scans from 52 datasets worldwide. There were sex differences in the asymmetry of the globus pallidus and putamen. Heritability estimates, derived from 1170 subjects belonging to 71 extended pedigrees, revealed that additive genetic factors influenced the asymmetry of these two structures and that of the hippocampus and thalamus. Handedness had no detectable effect on subcortical asymmetries, even in this unprecedented sample size, but the asymmetry of the putamen varied with age. Genetic drivers of asymmetry in the hippocampus, thalamus and basal ganglia may affect variability in human cognition, including susceptibility to psychiatric disorders

Human subcortical brain asymmetries in 15,847 people worldwide reveal effects of age and sex

The two hemispheres of the human brain differ functionally and structurally. Despite over a century of research, the extent to which brain asymmetry is influenced by sex, handedness, age, and genetic factors is still controversial. Here we present the largest ever analysis of subcortical brain asymmetries, in a harmonized multi-site study using meta-analysis methods. Volumetric asymmetry of seven subcortical structures was assessed in 15,847 MRI scans from 52 dataset worldwide. There were sex differences in the asymmetry of the globus pallidus and putamen. Heritability estimates, derived from 1170 subjects belonging to 71 extended pedigrees, revealed that additive genetic factors influenced the asymmetry of these two structures and that of the hippocampus and thalamus. Handedness had no detectable effect on subcortical asymmetries, even in this unprecedented sample size, but the asymmetry of the putamen varied with age. Genetic drivers of asymmetry in the hippocampus, thalamus and basal ganglia may affect variability in human cognition, including susceptibility to psychiatric disorders