Obtención de un plan motivacional para las jefaturas intermedias del Hospital de Linares

99 p.Los sistemas de salud en Chile están requiriendo cada vez mas de profesionales y trabajadores con mejores calificaciones, mejores desempeños y por sobre todo, a personas altamente motivadas en su puesto de trabajo, ya que la calidad de atencion a los usuarios, sobretodo de los sectores publicos, es un tema que esta en deuda y debe ir mejorando en el actual día a día. El presente estudio tiene como objetivo principal, obtener las variables motivacionales y desmotivacionales para establecer un Plan Motivacional para las Jefaturas Intermedias del Hospital de Linares. Para dar inicio a nuestro proyecto, desarrollamos en forma completa y minuciosa, las teorias y terminos conceptuales relevantes, de modo de estar fuertemente respaldados a lo largo de toda la investigacion. Luego de la revision bibliografica, consideramos que la Teoria de los Dos Factores, de Herzberg, junto con la Teorias del Reforzamiento, la Teoría de la Equidad y la Teoria de las Metas, serian las teorias que nos serviran de apoyo para el planteamiento y elaboracion de nuestros instrumentos de trabajo y nuestro Plan Motivacional. El estudio se definio como un estudio de tipo cualitativo, ya que se dan a conocer valores y actitudes de las personas en el trabajo, y la herramienta cuantitativa que se utilizo, fue el cuestionario, el cual ya estaba diseñado con una escala tipo Likert. Nuestra poblacion objetivo, fueron las Jefaturas Intermedias y Subrogantes del Hospital Base de Linares, ya que ellas son las encargadas de transmitir los objetivos y metas organizacionales a todo el personal del Hospital. Estas Jefaturas fueron las receptoras de nuestro estudio y las posteriores inductoras de motivacion en sus respectivas Unidades de trabajo. 2 Para el logro de nuestros objetivos especificos, se desarrollaron principalmente dos actividades. La primera, fue la aplicacion del cuestionario, ya mencionado, con la cual pudimos determinar en nivel actual de motivacion y jerarquizar las variables motivacionales y desmotivacionales (primer y segundo objetivo respectivamente). La segunda y última actividad consistio en una reunion de retroalimentacion, en la cual las mismas Jefaturas Intermedias y Subrogantes nos proporcionaron alternativas de solucion para mejorar su nivel de motivacion, las cuales consideramos para cumplir nuestro tercer y último objetivo especifico, la elaboracion de un Plan Motivacional. En este Plan se incluyeron alternativas de solucion sugeridas por las Teorías Motivacionales, textos de estudio y aportes personales, los cuales estuvieron asesorados y respaldados por profesores expertos en la materia. Los factores motivacionales mas relevantes y significativos para estas Jefaturas resultaron ser: El Compromiso, Crecimiento Personal, Vocación de Servicio, Retribucion al Trabajo, Estilo de Administración, Crecimiento Profesional y Equidad. Para efectos del diseño del Plan Motivacional, nos concentramos en los 5 primeros factores, estos constituyeron los puntos criticos de nuestro Plan, los cuales fueron atacados más profundamente a traves de una serie de acciones o alternativas de solucion, cuyo plazo de ejecucion dependio de la naturaleza de las variables que conformaron al factor. De esta forma, el Hospital de Linares contara con un personal altamente motivado en su lugar de trabajo, lo que se traducira en una mejor calidad de atencion para los usuarios de la salud en el sector publico, el cual constituye el fin social más importante de esta tesis.

Antimicrobial and Antioxidant Potential of Wild Edible Mushrooms

Wild edible mushrooms have a high nutritional property that has been consumed by people from different parts of the world, producing a wide variety of bioactive compounds such as polysaccharides, peptides, glycoproteins, triterpenoids, lipids, and their derivatives. In the world, multidrug-resistant pathogens have been increasing drastically, and it is very urgent to search for alternative solutions to fight against multidrug-resistant pathogens. Moreover, unhealthy foods, ultraviolet radiation, as well as other environmental effects, are responsible for generating free radicals, oxidative stress, and numerous health diseases. Hence, the wild edible mushroom could be an alternative source of new antimicrobial potential and possesses antioxidant properties that can play significant roles in preventing various health diseases. In this book chapter, we focus on investigating the antimicrobial and antioxidant potential of wild edible mushrooms and their bioactive compound production

NKG2D-CAR-transduced natural killer cells efficiently target multiple myeloma

CAR-T-cell therapy against MM currently shows promising results, but usually with serious toxicities. CAR-NK cells may exert less toxicity when redirected against resistant myeloma cells. CARs can be designed through the use of receptors, such as NKG2D, which recognizes a wide range of ligands to provide broad target specificity. Here, we test this approach by analyzing the antitumor activity of activated and expanded NK cells (NKAE) and CD45RA− T cells from MM patients that were engineered to express an NKG2D-based CAR. NKAE cells were cultured with irradiated Clone9.mbIL21 cells. Then, cells were transduced with an NKG2D-4-1BB-CD3z-CAR. CAR-NKAE cells exhibited no evidence of genetic abnormalities. Although memory T cells were more stably transduced, CAR-NKAE cells exhibited greater in vitro cytotoxicity against MM cells, while showing minimal activity against healthy cells. In vivo, CAR-NKAE cells mediated highly efficient abrogation of MM growth, and 25% of the treated mice remained disease free. Overall, these results demonstrate that it is feasible to modify autologous NKAE cells from MM patients to safely express a NKG2D-CAR. Additionally, autologous CAR-NKAE cells display enhanced antimyeloma activity demonstrating that they could be an effective strategy against MM supporting the development of NKG2D-CAR-NK-cell therapy for MM.This study was supported by a grant from the Spanish Society for Hematology and Hemotherapy to Alejandra Leivas, the CRIS Foundation to Beat Cancer and the Instituto de Salud Carlos III (PI18/01519)

Scar channels in cardiac magnetic resonance to predict appropriate therapies in primary prevention.

Background Scar characteristics analyzed by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) are related with ventricular arrhythmias. Current guidelines are based only on the left ventricular ejection fraction to recommend an implantable cardioverter-defibrillator (ICD) in primary prevention. Objectives Our study aims to analyze the role of imaging to stratify arrhythmogenic risk in patients with ICD for primary prevention. Methods From 2006 to 2017, we included 200 patients with LGE-CMR before ICD implantation for primary prevention. The scar, border zone, core, and conducting channels (CCs) were automatically measured by a dedicated software. Results The mean age was 60.9 ± 10.9 years; 81.5% (163) were men; 52% (104) had ischemic cardiomyopathy. The mean left ventricular ejection fraction was 29% ± 10.1%. After a follow-up of 4.6 ± 2 years, 46 patients (22%) reached the primary end point (appropriate ICD therapy). Scar mass (36.2 ± 19 g vs 21.7 ± 10 g; P 10 g (25.31% vs 5.26%; hazard ratio 4.74; P = .034) and the presence of CCs (34.75% vs 8.93%; hazard ratio 4.07; P = .003) were also strongly associated with the primary end point. However, patients without channels and with scar mass < 10 g had a very low rate of appropriate therapies (2.8%). Conclusion Scar characteristics analyzed by LGE-CMR are strong predictors of appropriate therapies in patients with ICD in primary prevention. The absence of channels and scar mass < 10 g can identify patients at a very low risk of ventricular arrhythmias in this population

Detection of kinase domain mutations in BCR::ABL1 leukemia by ultra-deep sequencing of genomic DNA

The screening of the BCR::ABL1 kinase domain (KD) mutation has become a routine analysis in case of warning/failure for chronic myeloid leukemia (CML) and B-cell precursor acute lymphoblastic leukemia (ALL) Philadelphia (Ph)-positive patients. In this study, we present a novel DNA-based next-generation sequencing (NGS) methodology for KD ABL1 mutation detection and monitoring with a 1.0E-4 sensitivity. This approach was validated with a well-stablished RNA-based nested NGS method. The correlation of both techniques for the quantification of ABL1 mutations was high (Pearson r = 0.858, p < 0.001), offering DNA-DeepNGS a sensitivity of 92% and specificity of 82%. The clinical impact was studied in a cohort of 129 patients (n = 67 for CML and n = 62 for B-ALL patients). A total of 162 samples (n = 86 CML and n = 76 B-ALL) were studied. Of them, 27 out of 86 harbored mutations (6 in warning and 21 in failure) for CML, and 13 out of 76 (2 diagnostic and 11 relapse samples) did in B-ALL patients. In addition, in four cases were detected mutation despite BCR::ABL1 < 1%. In conclusion, we were able to detect KD ABL1 mutations with a 1.0E-4 sensitivity by NGS using DNA as starting material even in patients with low levels of disease

The Caldera. No. 26

“La PALABRA tiene PODER”, más allá del lema que nos convocó en la décima versión del Concurso Inter colegiado de Oratoria, que en el marco de ULIBRO 2023, se llevó a cabo en NEOMUNDO, el 1 de septiembre pasado, esta frase es una profunda convicción que ha movido al Área de Lengua Castellana del Instituto Caldas, a propiciar y mantener este espacio en el que nuestros estudiantes son los protagonistas. Este año, al tratarse de una celebración especial, quisimos que el tema fundamental fuera el inmenso PODER que tiene la PALABRA; la palabra que construye, que transforma, que edifica, que fortalece, que acompaña, que “abriga”, a diario, al ser humano; en un mundo en el que se debe volver a entender y vivenciar, en el hogar, en la escuela, en la sociedad, el poder transformador de vocablos tan importantes como lo son: “Familia, Educación, Vida, Diversidad, Respeto, Literatura, Escritura, Creatividad, Lectura, Inclusión, Paz, Igualdad Social, Democracia, Ciudadanía y Diálogo”, la palabra cobró fuerza en las voces de nuestros educandos; de esta manera, analizar estos temas tiene que ver necesariamente con los “Futuros posibles”, que planteó la Gran Feria del Libro, ULIBRO, en su vigésima primera versión, para que sigamos trabajando por una sociedad mejor, razón de ser de todas las instituciones educativas del mundo entero.“The WORD has POWER”, beyond the motto that summoned us in the tenth version of the Intercollegiate Oratory Contest, which within the framework of ULIBRO 2023, was held in NEOMUNDO, last September 1, this phrase is a deep conviction that has moved the Spanish Language Area of ​​the Caldas Institute to promote and maintain this space in which our students are the protagonists. This year, as it is a special celebration, we wanted the fundamental theme to be the immense POWER that the WORD has; the word that builds, that transforms, that edifies, that strengthens, that accompanies, that “shelters”, daily, the human being; in a world in which we must understand and experience again, at home, at school, in society, the transformative power of words as important as: “Family, Education, Life, Diversity, Respect, Literature, Writing, Creativity, Reading, Inclusion, Peace, Social Equality, Democracy, Citizenship and Dialogue”, the word gained strength in the voices of our students; In this way, analyzing these issues necessarily has to do with the “Possible Futures”, which the Great Book Fair, ULIBRO, proposed in its twenty-first version, so that we continue working for a better society, the reason for being of all institutions. . educational institutions around the world.Modalidad Presencia

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Role of peroxynitrite in sepsis-induced acute kidney injury in an experimental model of sepsis in rats

The mechanisms involved in sepsis-induced acute kidney injury (AKI) are unknown. We investigated the role of nitrosative stress in sepsis-induced AKI by studying the effects of manganese (III) tetrakis-(1-methyl-4-pyridyl) porphyrin pentachloride (MnTMPyP), a peroxynitrite decomposition catalyst, and aminoguanidine (AG), a selective nitric oxide synthase 2 (NOS2) inhibitor and peroxynitrite scavenger, on kidney function of rats subjected to cecal ligation and puncture (CLP). Sprague-Dawley rats (weighing 350 [SD, 50] g) were treated with MnTMPyP (6 mg/kg i.p.) or AG (50 mg/kg i.p.) at t = 12 and 24 h after CLP or sham procedure. At t = 36 h, mean arterial pressure and aortic blood flow were measured, and blood and urine samples were obtained for biochemical determinations, including creatinine clearance, fractional excretion of sodium, and neutrophil gelatinase-associated lipocalin concentration in the urine. Kidney tissue samples were obtained for (i) light microscopy, (ii) immunofluorescence and Western blot for 3-nitrotyrosine and NOS2, (iii) gene expression (quantitative real-time polymerase chain reaction) studies (NOS1, NOS2, NOS3, and superoxide dismutase 1), and (iv) matrix-assisted laser desorption ionization time-of-flight mass spectrometry.3.045 JCR (2014) Q1, 32/198 Surgery; Q2, 20/60 Peripheral vascular disease, 25/68 Hematology, 9/27 Critical care medicineUE