Clinical, microbiological, and imaging characteristics of infective endocarditis in Latin America: a systematic review

Objectives: We aimed to describe the clinical, microbiological, and imaging characteristics of patients with infective endocarditis (IE) in studies from Latin America (LATAM). Methods: A systematic search through PubMed, EMBASE, LILACS, and SciELO from inception until Febru ary 2021 was conducted. We included observational studies that assessed adults with IE from LATAM and reported data on clinical, microbiological, or imaging characteristics. Data were independently extracted by 2 authors and the risk of bias was evaluated by study design with its respective tool. Findings were summarized using descriptive statistics. Results: Forty-four studies were included. Most cases were male (68.5%), had a predisposing condition including valve disease (24.3%), or had a prosthetic valve (23.4%). Clinical manifestations included fever (83.9%), malaise (63.2%), or heart murmur (57.7%). A total of 36.4% and 27.1% developed heart failure or embolism, respectively. Blood cultures were negative in 23.9% and S. aureus (18.6%) and the viridans group streptococci (17.8%) were the most common isolates. Most cases were native valve IE (67.3%) affecting mainly left-sided valves. Echocardiographic findings included vegetations (84.3%) and regurgitation (75.9%). In-hospital mortality was 25.1%. Conclusions: This is the first systematic review that evaluated the characteristics of IE in LATAM patients. A lack of multicenter studies reflects the need for these studies in LATAM

Afrontamiento Psicosocial en el desarrollo sexual de los adolescentes de los grados séptimo y octavo de la institución educativa José María Córdoba Mondomo - Cauca

El estudio de investigación tuvo como objetivo principal, Contribuir al afrontamiento sexual del adolescente mediante el desarrollo de estrategias psicosociales con el fin de rescatar el valor sexual de sí mismo, desarrollo de su asertividad y capacidad crítica. El soporte teórico fundamental se basó en el Enfoque Humanista, enfatizando en los aportes de Abraham Maslow, Kart Roger y Erick Ericsson. Metodológicamente es un estudio de carácter cualitativo, y corresponde al tipo de investigación exploratorio y descriptivo. para la recolección de datos se recurrió a estrategias como la Entrevista, la aplicación de la Escala de Afrontamiento, talleres lúdicos con padres, adolescentes y docentes. Los resultados permitieron identificar las estrategias de afrontamiento que utilizan los adolescentes, como están en cuanto a conocimientos sobre sexualidad para diseñar estrategias Psicosociales como el Proyecto transversal pedagógico de sexualidad que a su vez involucra Escuela para padres, Estrategias para docentes y estudiantes. PALABRAS CLAVES Adolescencia, Afrontamiento, Desarrollo Psicosexual, Desarrollo Psicosocial, Humanismo, comunidad educativaThe research study had as main objective, contribute to adolescent sexual coping through the development of psychosocial strategies in order to recover the value of sex itself, the development of their assertiveness and critical capacity. The theoretical support was based on the fundamental human approach, emphasizing the contributions of Abraham Maslow, Kurt and Roger Erick Ericsson. Methodologically a qualitative study, and corresponds to the type of exploratory and descriptive research. for data collection strategies were used as the interview, the application of the Coping Scale, fun workshops with parents, teens and teachers. The results identify the coping strategies used by adolescents, as they are in terms of knowledge about sexuality to design strategies such as Project Psychosocial cross sexuality education, which in turn involves School for parents, strategies for teachers and students

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Ciudad de Bogotá.

En este trabajo se muestran actividades de reflexión viendo la narrativa como un mecanismo de abordaje psicosocial en los escenarios de conflicto armado, inicialmente se realizó un análisis de la historia de la señora Amparo del capítulo 3 de la Comisión de la verdad. Desde este relato se plantean una serie de preguntas circulares, reflexivas y estratégicas para profundizar en el acercamiento psicosocial en la superación del conflicto armado, convirtiéndose en soporte hacia la resignificación cultural y social. Posteriormente se procedió a realizar un análisis de los hechos ocurridos durante la masacre del municipio de El Salado, (Departamento de Bolívar). Presuntamente por parte de un grupo de paramilitares del Bloque Norte de las Autodefensas Unidas de Colombia (AUC). Teniendo en cuenta los emergentes psicosociales, el impacto del trauma colectivo en la salud mental de los sobrevivientes y los elementos simbólicos. Con base a las respuestas de los ítems orientadores se proponen estrategias de acompañamiento psicosocial a fin de mejorar la calidad de vida de sus pobladores debido a los hechos de violencia vividos. Las experiencias de transformación se reflejan en el proceso de sanación emocional y en la resistencia ante la adversidad. Por último, se desarrolló un informe analítico y reflexivo desde la experiencia de foto voz esta estrategia relaciona los diferentes escenarios de violencia, utilizando como herramientas la imagen y la narrativa siendo la clave para la identificación de los problemas sociales, estos ejercicios generan reflexiones y conclusiones sobre la experiencia, para lograr una recuperación integral de las víctimas.This work shows reflection activities using narrative as a mechanism of psychosocial approach in armed conflict scenarios. Initially, an analysis of Mrs. Amparo's story from chapter 3 of the Truth Commission was carried out. From this story, a series of circular, reflexive and strategic questions are posed to deepen the psychosocial approach in overcoming the armed conflict, becoming a support for cultural and social resignification. Subsequently, an analysis was made of the events that occurred during the massacre in the municipality of El Salado (Department of Bolivar). Allegedly by a group of paramilitaries of the Northern Block of the United Self-Defense Forces of Colombia (AUC). Taking into account the psychosocial emergent, the impact of the collective trauma on the mental health of the survivors and the symbolic elements. Based on the answers to the guiding items, psychosocial accompaniment strategies are proposed in order to improve the quality of life of its inhabitants due to the violence experienced. Finally, an analytical and reflective report was developed from the experience of photovoice, this strategy relates the different scenarios of violence, using as tools the image and the narrative being the key to the identification of social problems, these exercises generate reflections and conclusions about the experience, to achieve a comprehensive recovery of the victims

Epidemiology of Immune-Mediated Glomerulopathies before and after SARS-CoV-2 Vaccination: A Tertiary Referral Hospital Experience

SARS-CoV-2; Immune-mediated glomerulopathy; VaccineSARS-CoV-2; Glomerulopatía inmunomediada; VacunaSARS-CoV-2; Glomerulopatia immunomediada; VacunaBackground: Vaccination is a known trigger for the appearance of immune-mediated glomerulopathies (IMG). The appearance of IMG after SARS-CoV-2 vaccination with suspected causality has been described. Our aim is to analyze the incidence of IMG flares before and after SARS-CoV-2 vaccination in our center. Methods: All persons with native kidney biopsy (KB) from January 2019 to March 2022 in our center were included in the study. We compared the incidence of IMG before and after the start of vaccination. We also collected information about whether the patients had received a SARS-CoV-2 vaccine or have suffered from COVID in the six weeks before the IMG. We also evaluated the analytical characteristics of the outbreaks. Results: A total of 386 KB were studied. Of them, 86/218 (39.4%) were IMG performed pre- and 85/168 (50.6%) post-SV (029). The incidence of idiopathic nephrotic syndrome (INS), studied separately, was also significantly increased post-vaccination (n = 18 (10.7%)) compared to pre-vaccination (n = 11 (5%)) (p = 0.036). There were no differences in the incidence of vasculitis or IgA nephropathy. Up to 17 (20%) flares occurred 6 weeks before SARS-CoV-2 vaccination and only 2 (2.4%) within the first 6 weeks after SARS-CoV-2 infection. Within those 17 flares, the most common diagnosis was IgAN (n = 5 (29.4%)); a total of 14 (82.4%) received an mRNA vaccine and 9 (52.9%) took place after the 1st vaccine dose. There were 13 cases of minimal change disease (MCD) with debut/recurrence pre-SV and 20 MCD with debut/recurrence post-SV (p = 0.002). Conclusions: The incidence of IMG, INS and MCD flares in our center increased significantly after SARS-CoV-2 vaccination. Importantly, 20% of IMG flares took place within the first 6 weeks after receiving a vaccine dose, with the first dose being the riskiest one and IgAN the most frequent diagnosis.This research was funded by ISCIIII-FEDER and ISCIII-RETICS REDinREN, grant numbers PI17/00257, PI21/01292, RICORS RD21/0005/0016, Marató TV3 2020 421/C/2020, Marató TV3 2021 215/C/2021, and ERA-PerMed-JTC 2022 (ONAKI-ICI AC22/00029)

Enteric Budesonide in Transplant and Native IgA Nephropathy: Real-World Clinical Practice

Budesonide; Transplant; NephropathyBudesonida; Trasplante; NefropatíaBudesonida; Trasplantament; Nefropati

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

Multiple Scenario Generation of Subsurface Models:Consistent Integration of Information from Geophysical and Geological Data throuh Combination of Probabilistic Inverse Problem Theory and Geostatistics

Neutrinos with energies above 1017 eV are detectable with the Surface Detector Array of the Pierre Auger Observatory. The identification is efficiently performed for neutrinos of all flavors interacting in the atmosphere at large zenith angles, as well as for Earth-skimming \u3c4 neutrinos with nearly tangential trajectories relative to the Earth. No neutrino candidates were found in 3c 14.7 years of data taken up to 31 August 2018. This leads to restrictive upper bounds on their flux. The 90% C.L. single-flavor limit to the diffuse flux of ultra-high-energy neutrinos with an E\u3bd-2 spectrum in the energy range 1.0 7 1017 eV -2.5 7 1019 eV is E2 dN\u3bd/dE\u3bd < 4.4 7 10-9 GeV cm-2 s-1 sr-1, placing strong constraints on several models of neutrino production at EeV energies and on the properties of the sources of ultra-high-energy cosmic rays

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

Design of an application based on machine learning- computer vision techniques for the physiological workload assessment in dynamics manual task

Hoy en día, la ergonomía ha ido asumiendo un papel muy importante dentro de las organizaciones, ya que éstas imponen mayores exigencias a los empleados para seguir siendo competitivas en el mercado. Esta disciplina hace hincapié en el cuidado de las personas que trabajan en las organizaciones, proporcionando a los empleados un entorno de desarrollo más productivo y reduciendo el riesgo de obtener trastornos musculoesqueléticos en los empleados que realizan actividades manuales dinámicas como el levantamiento y transporte de cargas. Este proyecto de grado desarrolla mejoras en el método de evaluación ergonómica de observación directa, a través de la modificación de algoritmos donde se desarrolló una aplicación no invasiva que permite la visión por ordenador, para obtener y medir parámetros fisiológicos como la frecuencia cardiaca para realizar una evaluación ergonómica bajo los criterios de Frimat. La evaluación que ofrece la aplicación reducirá drásticamente la subjetividad de la evaluación del profesional y apoyará la transformación tecnológica integrada con la Industria 4.0, dando la posibilidad de que cualquier tipo de empresa pueda hacer uso de este tipo de tecnología sin aumentar drásticamente sus costes. Este proyecto de grado se desarrolló principalmente bajo la metodología Design Thinking, desarrollando dentro de esta, otras metodologías o herramientas como el mapa de empatía, los cinco sombreros y SCRUM donde se realizó inicialmente la recolección de datos actuales y el análisis del centro, finalizando en el diseño completo de la aplicación y su correcto funcionamiento. La aplicación cumple con la medición de la frecuencia cardiaca del sujeto mientras realiza tareas de carga dinámica y a su vez con la medición del riesgo ergonómico que presenta. Los datos reportados por la aplicación fueron respaldados, por un lado, al realizar un análisis estadístico a través de un ANOVA de medidas repetidas donde se obtuvo un resultado favorable mostrando que la combinación Altura-Repeticiones es la que presenta mayor efecto sobre la variable respuesta (FC). Por otro lado, la validación de su funcionamiento con un pulsómetro se realizó con una prueba estadística T emparejada, concluyendo que la aplicación tiene una eficacia del 97,5% respecto al equipo de medición directa.Nowadays, ergonomics has been assuming a very important role within organizations, as they impose higher demands on employees to remain competitive in the market. This discipline emphasizes the care of the people who work in organizations, providing employees with a more productive development environment and reducing the risk of obtaining musculoskeletal disorders in employees who perform dynamic manual activities such as lifting and carrying loads. This degree project develops improvements in the ergonomic evaluation method of direct observation, through the modification of algorithms where a non-invasive application was developed that allows computer vision, to obtain and measure physiological parameters such as heart rate to perform an ergonomic evaluation under the criteria of Frimat. The evaluation offered by the application will drastically reduce the subjectivity of the evaluation of the professional and will support the technological transformation integrated with Industry 4.0, giving the possibility that any type of company can make use of this type of technology without drastically increasing its costs. This degree project was developed mainly under the Design Thinking methodology, developing within this, other methodologies or tools such as the empathy map, the five hats, and SCRUM where the collection of current data and the analysis of the center was initially performed, ending in the complete design of the application and its proper functioning. The application complies with the measurement of the heart rate of the subject while performing dynamic load tasks and in turn with the measurement of the ergonomic risk presented. The data reported by the application were supported, on the one hand, by performing a statistical analysis through a repeated- measures ANOVA where a favorable result was obtained showing that the combination Height-Repetitions is the one that presents the greatest effect on the response variable (HR). On the other hand, the validation of its functioning with a pulsometer was carried out with a paired statistical T-test, concluding that the application has a 97.5% efficiency concerning the direct measurement equipment.Ingeniero (a) IndustrialPregrad

Distinctive prokaryotic microbiomes in sympatric plant roots from a Yucatan cenote

Objective!#!Cenotes are flooded caves in Mexico's Yucatan peninsula. Many cenotes are interconnected in an underground network of pools and streams forming a vast belowground aquifer across most of the peninsula. Many plants in the peninsula grow roots that reach the cenotes water and live submerged in conditions similar to hydroponics. Our objective was to study the microbial community associated with these submerged roots of the Sac Actun cenote. We accomplished this objective by profiling the root prokaryotic community using 16S rRNA gene amplification and sequencing.!##!Results!#!We identified plant species by DNA barcoding the total genomic DNA of each root. We found a distinctive composition of the root and water bacterial and archaeal communities. Prokaryotic diversity was higher in all plant roots than in the surrounding freshwater, suggesting that plants in the cenotes may attract and select microorganisms from soil and freshwater, and may also harbor vertically transmitted lineages. The reported data are of interest for studies targeting biodiversity in general and root-microbial ecological interactions specifically