Informe de experiencia profesional del consultorio de crecimiento y desarrollo del área de inmunización en el puesto de salud Yanamilla Microred Santa Elena Red de Salud Huamanga Ayacucho 2013 - 2016

El presente informe denominado " EXPERIENCIA PROFESIONAL DEL CONSULTORIO DE CRECIMIENTO Y DESARROLLO DEL ÁREA DE INMUNIZACIÓN DEL PUESTO DE SALUD YANAMILLA MICRORED SANTA ELENA RED DE SALUD HUAMANGA 2013-2016" tiene como objetivo dar a conocer el trabajo profesional que realiza la enfermera en el consultorio de Crecimiento y Desarrollo en el área de inmunización a través de actividades preventivas promocional que se realiza a diario consideradas en la atención integral del niño y niña para garantizar la protección de enfermedades prevenibles por vacunas contribuyendo a mejorar la calidad de vida del niño, familia y entorno. La metodología que se aplicó es descriptiva porque se menciona el conjunto de actividades que realiza la enfermera en el área de inmunización a través de la utilización de las técnicas como la observación, la entrevista, y el análisis documentado. Se recomienda involucrar a toda la población para el trabajo preventivo promocional y de esta manera mejorar la calidad de vida de la población, en el cuidado de su salud para disminuir los efectos en términos de desarrollo social, económico relacionado con la productividad y el desempeño en la actualidad y el futuro.Trabajo academic

Neonatal outcomes following early fetal growth restriction: a subgroup analysis of the EVERREST study

OBJECTIVE: To quantify the risks of mortality, morbidity and postnatal characteristics associated with extreme preterm fetal growth restriction (EP-FGR). DESIGN: The EVERREST (Do e s v ascular endothelial growth factor gene therapy saf e ly imp r ove outcome in seve r e e arly-onset fetal growth re st riction?) prospective multicentre study of women diagnosed with EP-FGR (singleton, estimated fetal weight (EFW) <3rd percentile, <600 g, 20+0-26+6 weeks of gestation). The UK subgroup of EP-FGR infants (<36 weeks) were sex-matched and gestation-matched to appropriate for age (AGA) infants born in University College London Hospital (1:2 design, EFW 25th-75th percentile). SETTING: Four tertiary perinatal units (UK, Germany, Spain, Sweden). MAIN OUTCOMES: Antenatal and postnatal mortality, bronchopulmonary dysplasia (BPD), sepsis, surgically treated necrotising enterocolitis (NEC), treated retinopathy of prematurity (ROP). RESULTS: Of 135 mothers recruited with EP-FGR, 42 had a stillbirth or termination of pregnancy (31%) and 93 had live births (69%). Postnatal genetic abnormalities were identified in 7/93 (8%) live births. Mean gestational age at birth was 31.4 weeks (SD 4.6). 54 UK-born preterm EP-FGR infants (<36 weeks) were matched to AGA controls. EP-FGR was associated with increased BPD (43% vs 26%, OR 3.6, 95% CI 1.4 to 9.4, p=0.01), surgical NEC (6% vs 0%, p=0.036) and ROP treatment (11% vs 0%, p=0.001). Mortality was probably higher among FGR infants (9% vs 2%, OR 5.0, 95% CI 1.0 to 25.8, p=0.054). FGR infants more frequently received invasive ventilation (65% vs 50%, OR 2.6, 95% CI 1.1 to 6.1, p=0.03), took longer to achieve full feeds and had longer neonatal stays (median difference 6.1 days, 95% CI 3.8 to 8.9 and 19 days, 95% CI 9 to 30 days, respectively, p<0.0001). CONCLUSIONS: Mortality following diagnosis of EP-FGR is high. Survivors experience increased neonatal morbidity compared with AGA preterm infants. TRIAL REGISTRATION NUMBER: NCT02097667

Measuring intellectual ability in cerebral palsy: The comparison of three tests and their neuroimaging correlates

Standard intelligence scales require both verbal and manipulative responses, making it difficult to use in cerebral palsy and leading to underestimate their actual performance. This study aims to compare three intelligence tests suitable for the heterogeneity of cerebral palsy in order to identify which one(s) could be more appropriate to use. Forty-four subjects with bilateral dyskinetic cerebral palsy (26 male, mean age 23 years) conducted the Raven's Coloured Progressive Matrices (RCPM), the Peabody Picture Vocabulary Test -3rd (PPVT-III) and the Wechsler Nonverbal Scale of Ability (WNV). Furthermore, a comprehensive neuropsychological battery and magnetic resonance imaging were assessed. The results show that PPVT-III gives limited information on cognitive performance and brain correlates, getting lower intelligence quotient scores. The WNV provides similar outcomes as RCPM, but cases with severe motor impairment were unable to perform it. Finally, the RCPM gives more comprehensive information on cognitive performance, comprising not only visual but also verbal functions. It is also sensitive to the structural state of the brain, being related to basal ganglia, thalamus and white matter areas such as superior longitudinal fasciculus. So, the RCPM may be considered a standardized easy-to-administer tool with great potential in both clinical and research fields of bilateral cerebral palsy

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Actividades lúdicas para el desarrollo de la noción del número y cantidad del área de matemática en los Niños y Niñas de 5 años de la I.E.I N° 1435 Nueva Esperanza, Santa Cruz - Cajamarca

El presente estudio de investigación, Actividades lúdicas para el desarrollo de la noción del número y cantidad del área de matemática en los Niños y Niñas de 5 años de la I.E.I N° 1435 Nueva Esperanza, Santa Cruz- Cajamarca, tuvo como propósito: Determinar en qué medida un programa de actividades lúdicas influye en el aprendizaje de la noción del número y cantidad del área de Matemática de los niños y niñas de 5 años de la I.E.I N° 1435 Nueva Esperanza, Santa Cruz- Cajamarca. Este estudio se justifica porque observamos que los niños y niñas de la I.E.I N° 1435 Nueva Esperanza, Santa Cruz - Cajamarca, tienen dificultades para el aprendizaje de la noción del número y cantidad en el área de matemática por eso consideramos difundir el uso de las actividades lúdicas en los docentes, para la enseñanza de la matemática y de esta forma los niños y niñas logren aprender y puedan desarrollar su instinto científico. La investigación es de tipo Pre – experimental con un solo grupo pre y post test, la muestra estuvo conformada por la misma población; 13 estudiantes de 5 años de edad al cual se le aplicó un pre test para comprobar sus saberes referentes al aprendizaje de la noción del número y cantidad en el área de matemática. Posteriormente se aplicó el programa basado en actividades lúdicas, al término de éste se aplicó el post test, cuyos resultados obtenidos nos demuestra que las actividades lúdicas influyen significativamente en el aprendizaje en la noción del número y cantidad en el área de matemática

Propuesta de mejora de procesos aplicando herramientas de Lean Manufacturing en una empresa del sector de producción del pisco en Ica: Caso aplicado a La Piskera

El presente estudio tiene como objetivo principal, el presentar propuestas de mejoras en base a ciertas herramientas de Lean Manufacturing para una empresa de producción artesanal y comercialización de pisco, La Piskera. Es por ello que previamente se realiza un análisis y diagnóstico de los procesos ejecutados por la empresa. A partir de ello, se identificaron los principales problemas que presenta con la ayuda de herramientas de diagnóstico tales como el Brainstorming, la matriz de enfrentamiento y el diagrama de Ishikawa. Los principales problemas hallados fueron que no hay una correcta gestión de la información, no se tienen definidos los espacios de trabajo y no hay estandarización de sus procesos. Posteriormente, se plantean las propuestas de mejora, tomando en cuenta el marco dado por las herramientas de la filosofía de manufactura esbelta o Lean Manufacturing de las 5S, así como la implementación de herramientas de gestión como el cuadro de mando integral o Balanced Scorecard con la finalidad de monitorear el cumplimiento de las medidas y objetivos establecidos. Además, se empleó el marco brindado por el Hoshin Kanri para la estructuración de los proyectos propuestos en la presente investigación

Spreading Topsoil Encourages Ecological Restoration on Embankments: Soil Fertility, Microbial Activity and Vegetation Cover

<div><p>The construction of linear transport infrastructure has severe effects on ecosystem functions and properties, and the restoration of the associated roadslopes contributes to reduce its impact. This restoration is usually approached from the perspective of plant cover regeneration, ignoring plant-soil interactions and the consequences for plant growth. The addition of a 30 cm layer of topsoil is a common practice in roadslope restoration projects to increase vegetation recovery. However topsoil is a scarce resource. This study assesses the effects of topsoil spreading and its depth (10 to 30 cm) on two surrogates of microbial activity (β-glucosidase and phosphatase enzymes activity and soil respiration), and on plant cover, plant species richness and floristic composition of embankment vegetation. The study also evaluates the differences in selected physic-chemical properties related to soil fertility between topsoil and the original embankment substrate. Topsoil was found to have higher values of organic matter (11%), nitrogen (44%), assimilable phosphorous (50%) and silt content (54%) than the original embankment substrate. The topsoil spreading treatment increased microbial activity, and its application increased β-glucosidase activity (45%), phosphatase activity (57%) and soil respiration (60%)<b>.</b> Depth seemed to affect soil respiration, β-glucosidase and phosphatase activity. Topsoil application also enhanced the species richness of restored embankments in relation to controls. Nevertheless, the depth of the spread topsoil did not significantly affect the resulting plant cover, species richness or floristic composition, suggesting that both depths could have similar effects on short-term recovery of the vegetation cover. A significant implication of these results is that it permits the application of thinner topsoil layers, with major savings in this scarce resource during the subsequent slope restoration work, but the quality of topsoil relative to the original substrate should be previously assessed on a site by site basis.</p></div

In Silico Genomic Fingerprints of the Bacillus anthracis Group Obtained by Virtual Hybridization

In this study we evaluate the capacity of Virtual Hybridization to identify between highly related bacterial strains. Eight genomic fingerprints were obtained by virtual hybridization for the Bacillus anthracis genome set, and a set of 15,264 13-nucleotide short probes designed to produce genomic fingerprints unique for each organism. The data obtained from each genomic fingerprint were used to obtain hybridization patterns simulating a DNA microarray. Two virtual hybridization methods were used: the Direct and the Extended method to identify the number of potential hybridization sites and thus determine the minimum sensitivity value to discriminate between genomes with 99.9% similarity. Genomic fingerprints were compared using both methods and phylogenomic trees were constructed to verify that the minimum detection value is 0.000017. Results obtained from the genomic fingerprints suggest that the distribution in the trees is correct, as compared to other taxonomic methods. Specific virtual hybridization sites for each of the genomes studied were also identified