Characteristics and Management of Community-Acquired Pneumonia in the Era of Global Aging

Community-acquired pneumonia (CAP) can occur at any time of life, but its incidence and risk of death are linked to increasing age. CAP in the elderly is a major health problem associated with high rates of readmission, morbidity, and mortality. Since the clinical presentation of pneumonia in the elderly may be atypical, clinicians should suspect pneumonia in older patients presenting symptoms such as falls and altered mental status, fatigue, lethargy, delirium, anorexia, in order to avoid the complications associated with delayed diagnosis and therapy. Streptococcus pneumoniae remains the most frequently reported pathogen in this population. However, particular attention should be paid to patients with risk factors for multidrug resistant pathogens, because a large proportion of elderly persons present multimorbidity. Vaccination is one of the most important preventive approaches for CAP in the elderly. In addition, lifestyle-tailored interventions for different modifiable risk factors will help to reduce the risk of pneumonia in elderly persons. Surveillance of etiological pathogens may improve vaccination policies in this population

Algoritmo internacional de cifrado de datos (IDEA) que utiliza la variante de cifrado SHA-256

The international data encryption algorithm was described in 1991, it came to replace the DES algorithm, this algorithm has a much more adaptable security and consuming less technological resources than DES, it should be noted that for the development of this algorithm cryptography went through a fairly extensive development path, it should be noted that cryptography is based on mathematics and how this protects the information, besides this is always intended to improve existing protections or mix encryption technologies in this way to protect the data efficiently.El algoritmo internacional de cifrado de datos fue descrito en 1991, llego para el remplazo de algoritmo DES, este algoritmo cuenta con una seguridad mucho más adaptable y consumiendo menos recursos tecnológicos que el DES, cabe aclarar que para el desarrollo de este algoritmo la criptografía paso por un camino de desarrollo bastante extenso, cabe aclarar que la criptografía se basa en las matemáticas y como mediante esta se protege la información, además de esto siempre se pretende mejorar las protecciones existentes o mezclar tecnologías de encriptación de esta manera resguardar los datos de manera eficiente

Toma de decisiones, inteligencia contextual, consumo máximo de oxígeno y fuerza explosiva en deportistas de futsal durante el covid-19

The present study search to determine the relationship between maximum oxygen consumption, explosive force, decision-making and contextual intelligence in futsal athletes during isolation by Covid-19. Descriptive study, carried out with 30 indoor soccer athletes from the city of Popayan during the confinement by Covid-19, where training characteristics, body mass index, aerobic capacity, explosive strength of lower limbs, contextual intelligence and decision making. The average VO2max of the athletes was 43.60 ml/kg/min, the average jump height was 38.22 cm; the average reaction time for the Stroop test was 1.41 s. In addition, a statistical relationship was found between VO2max, the intuition to detect the actions of my opponent (p= 0.016), the quick reaction to changes in the competition (p= 0.012) and taking the initiative (p= 0.017). During the lockdown, the athletes presented levels of overweight, slow reaction times for decision making and low values in Vo2 max. and explosive force. The VO2 max. is related to a better cognitive response and decision making.La presente investigación buscó determinar la relación entre el consumo máximo de oxígeno, la fuerza explosiva, la toma de decisiones y la inteligencia contextual en deportistas de fútbol sala durante el aislamiento por Covid-19. Estudio descriptivo, realizado con 30 deportistas de futbol sala de la ciudad de Popayán durante el confinamiento por Covid-19, en donde se evaluó las características de entrenamiento, el índice de masa corporal, la capacidad aeróbica, la fuerza explosiva de miembros inferiores, la inteligencia contextual y la toma de decisiones. El promedio de VO2máx de los deportistas fue de 43,60 ml/kg/min, la media en la altura de salto fue de 38,22 cm; el tiempo de reacción promedio para la prueba de Stroop fue de 1,41 s. Además, se encontró relación estadística entre el VO2máx, la intuición para detectar las acciones de mi oponente (p= 0,016), la reacción rápida a los cambios en la competición (p= 0,012) y tomar la iniciativa (p= 0,017). Durante el aislamiento, los deportistas presentaron niveles de sobrepeso, tiempos de reacción lentos para la toma de decisiones, y valores bajos en Vo2 máx. y fuerza explosiva. El VO2 máx. está relacionado con una mejor respuesta cognitiva y toma de decisiones.Actividad Física y Deport

Modulation of the lipolysis and subsequent antibacterial activity of the fat from black soldier fly (Hermetia illucens) by the combined selection of slaughtering, drying and defatting methods of the larvae

The aim of this study was to evaluate the modulating effect of the processing of Hermetia illucens larvae on the antibacterial activity of the fat related to lipolysis to free fatty acids (FFAs), mainly as lauric acid. Blanching and freezing were compared for slaughtering, oven or freeze-drying for drying, and mechanical pressing or supercritical fluid for defatting. Freezing plus freeze-drying produced the highest FFAs content (21%), mainly as lauric acid (11%). In agreement, freezing plus freeze-drying was also the most effective method to obtain fats with higher antibacterial activity, regardless of the defatting method. The antibacterial activity was significantly more relevant for gram-positive bacteria, having a strain-dependent character. The most effective fat was bactericidal for Listeria monocytogenes and Bacillus subtilis and reduced Staphylococcus aureus growth. Therefore, it is possible to selectively modulate the antibacterial activity of the H. illucens fat due to lipolysis by the processing methods of larvae. Industrial relevance: This study provides guidance to choose the best mode of processing of H. illucens larvae to selectively modulate the potential use of the lipid coproduct of this edible insect, either from the point of view of food use, which requires methods of processing to yield a high quality (low acidity), or from the point of view of antimicrobial applications, using methods of processing that selectively produce an antibacterial fat (high acidity). Furthermore, the best antibacterial activity demonstrated for fats of H. illucens of poor acid quality is an innovative approach for revalorization of such fats that would fail to meet the quality standard required for food applicationsAGL2017-89566-

Beliefs, attitudes and practices of physicians in patient situations: Online survey conducted in Latin American countries

 La invulnerabilidad del médico como mito social, miedo de afrontar y subestimar sus dolencias físicas y mentales, dificultan el manejo de su enfermedad. Objetivo: determinar las creencias, actitudes y prácticas del médico en situación de paciente en los países latinoamericanos. Material y Métodos: se realizó un estudio descriptivo, de corte transversal, empleando una encuesta en línea que generó un total de 533 respuestas efectivas procedentes 21 países de la región. Resultados. La mayoría fue de sexo femenino 57,6%, La media de edad de los participantes fue de 46,5 años y la especialidad con mayor participación fue medicina interna 48,4%. El 47,3% no tenía médico de cabecera y 7,5 % respondieron que no contaban con un seguro de salud. En el renglón de creencia, la mayoría de los encuestados 61,5% consideró que es más difícil tratar a un colega como paciente, y el 67,9% admitió la importancia de las acciones espirituales y religiosas en caso de enfermedad. En cuanto a la vulnerabilidad de los médicos frente las enfermedades, el miedo de cambiar su estado a paciente y pérdida de autonomía respondieron afirmativamente 95,5%. En relación a la actitud, el 79% respondió que buscaría a un médico de su misma especialidad, el 93,8% obedecería íntegramente las órdenes médicas y el 98,8% no pediría cambio de protocolo o de procedimiento. Así mismo, el 59,9% reportaría a un colega que no está en su plena facultad y el 75% divulgaría el estado de salud de otro colega si pone en peligro su vida o la de su paciente. En relación a la práctica, el 43,7% trataría a sus familiares de primer grado; el 21,5% seguiría laborando aun con una dolencia; el 37% haría su propia indicación de pruebas diagnósticas; el 21,4% se automedicaría; y el 4,3% y 7,7%, respectivamente, cambiaría las prescripciones y haría caso omiso a las recomendaciones de su médico tratante. Conclusión: los médicos en situación de pacientes temen estar enfermos y perder su autonomía, muchos no tienen médico de cabecera ni seguro de salud, le dan importancia a las acciones espirituales y religiosas, tienden a buscar a un médico de su propia especialidad y están llanos a aceptar las órdenes médicas, aun cuando también pueden decidir por la automedicación e indicar sus propias pruebas diagnósticas.The invulnerability of the physician as a social myth, fear of facing and underestimation of his physical and mental ailments, hinder the management of his disease. Objective: to determine the beliefs, attitudes and practices of the physician as a patient in Latin American countries. Material and Methods: a descriptive, cross-sectional study was carried out using an online survey that generated a total of 533 effective responses from 21 countries in the region. Results. The majority was female 57,6%, the mean age of the participants was 46,5 years and the specialty with the highest participation was internal medicine 48,4%. The mean age of the participants was 46,5 years and the specialty with the highest participation was internal medicine (48,4%), and 47,3% did not have a family doctor and 7,5% responded that they did not have health insurance. In the line of belief, the majority of the respondents 61,5% considered that it is more difficult to treat a colleague as a patient, and 67,9% admitted the importance of spiritual and religious actions in case of illness. As for the vulnerability of physicians to illness, fear of changing their status to patient and loss of autonomy, 95,5% responded affirmatively. In relation to attitude, 79% responded that they would look for a physician of their own specialty, 93,8% would obey medical orders in their entirety and 98,8% would not ask for a change of protocol or procedure. Likewise, 59,9% would report a colleague who is not in their full capacity and 75% would disclose the health status of another colleague if it endangered their life or that of their patient. In relation to practice, 43,7% would treat their first-degree relatives; 21,5% would continue to work even with an ailment; 37% would make their own indication for diagnostic tests; 21,4% would self-medicate; and 4,3% and 7,7%, respectively, would change prescriptions and disregard the recommendations of their treating physician. Conclusion: physicians as patients are afraid of being sick and losing their autonomy, many do not have a general practitioner or health insurance, give importance to spiritual and religious actions, tend to look for a physician of their own specialty and are willing to accept medical orders, even though they can also decide to self-medicate and indicate their own diagnostic tests

Evaluation of the interrelated effects of slaughtering, drying, and defatting methods on the composition and properties of black soldier fly (Hermetia illucens) larvae fat

The interrelated effect of different slaughtering, drying and defatting methods of black soldier fly larvae (BSFL) on the lipid composition and properties of the fat was studied. Blanching and freezing were compared as slaughtering methods, oven or freeze-drying as drying methods, and mechanical pressing or supercritical fluid extraction (SFE) as defatting methods. The different modes of slaughtering, drying, and defatting, along with both binary and ternary interactions caused significant effects on processes yields, lipid composition, moisture content and thermal properties. Thus, considering the defatting degree and the yield in total valued products (defatted meal plus fat), the combination of blanching, freeze-drying plus mechanical pressing was the worst option (51.2% and 87.5%, respectively). In contrast, the other combinations demonstrated better and comparable efficiency, although SFE is preferable for defatting (83.2% and 96.9%, respectively). The content of major fatty acids (lauric, palmitic and myristic acids) was significantly affected by the BSFL treatments, although with unsignificant impact on the total saturated fatty acids content. To preserve the integrity of the fat, the combination of blanching and oven-drying was preferred, as non-thermal methods of slaughtering and drying caused intense lipolysis, releasing free fatty acids (FFA) in the range of 18.6–23.5%. To achieve the lowest moisture content in the fats (≤0.1%), oven-drying with mechanical pressing were desired, regardless of the slaughtering method; while values > 1% were reached for freezing, freeze-drying and SFE. Both differences in FFA and moisture contents caused different thermal behaviors in the samples. Specially, the melting temperature was lower for samples with higher FFA and moisture contents, with a notable difference when freezing, freeze-drying and SFE were combined (14.5 ◦C vs 30.6 ◦C, as the mean value for the rest of samples). The different modes of processing did not affect the minor lipid compounds. Therefore, the modes employed for slaughtering, drying, and defatting of BSFL determine, either individually or in combination, the process yields, composition, and properties of the fatThis research was funded by the Spanish National Plans of Aquaculture of the Ministry of Agriculture, Fisheries and Food, project ACUINSECT (Optimization of insect flours as sustainable ingredient for aquaculture feed) with the support of the European Maritime and Fisheries Fund (FEMP

The interaction of slaughtering, drying, and defatting methods differently affects oxidative quality of the fat from black soldier fly (Hermetia illucens) larvae

The interrelation effect of slaughtering, drying, and defatting methods of BSFL on the oxidative quality of the derived fat was studied. Blanching and freezing were compared as slaughtering methods, followed by oven or freeze-drying for drying and mechanical pressing or SFE for defatting. The oxidative state and stability of the extracted fat and defatted meals were monitored immediately after their production, using peroxide value (PV) and Rancimat test, and over 24 weeks of storage. Slaughtering and drying methods had an independent effect on PV, with freezing and freeze-drying being the best methods. Mechanical pressing and SFE were comparable and superior to conventional hexane defatting. Interactions were observed between slaughtering and defatting, drying and defatting, and between all three factors. Generally, freeze-drying combined with any of the slaughtering and defatting methods resulted in the lowest PVs, with mechanical pressing being preferred. Freeze-drying plus mechanical pressing also produced the most stable fats during storage according to the evolution of PV, while the combination of blanching and SFE produced the least stable. A significant correlation was found between the PV at 24 weeks and the antioxidant activity of the fats. Contrary to storage assays, in accelerated Rancimat assays, freeze-dried samples were the least stable, which was partially attributed to the significant correlation with the acid values of the samples. Defatted meals followed a similar pattern to the extracted fat, except for worse oxidation for SFE defatting. Therefore, the different processing methods of slaughtering, drying, and defatting of BSFL differently affect lipid oxidation, with interactions between such successive stepsThis research was funded by the Spanish National Plans of Aquaculture of the Ministry of Agriculture, Fisheries and Food, project ACUINSECT (Optimization of insect flours as sustainable ingredient for aquaculture fee

Intervenções na comunidade com abordagens à construção da paz, a partir do desenvolvimento social e humano

This article aims to present the work carried out by some researchers who proposed research projects with the participation of different communities from theunderstanding of their perceptions of peace, with the intervention guided towards its constituent elements and converging towards the same objective, focusedon peacebuilding. The communities involved range from children from Pirgua, a village near Tunja, university students from the University of Santo Tomás and,finally, inmates from the maximum security prison in Combita. Three types of population with different characteristics that, through the activities of the proposed projects, carried out actions to improve their environmentand build peace from their territory, based on a model of social and, above all, human development.El presente artículo pretende exponer el trabajo realizado por algunos investigadores que plantearon proyectos de investigación con participación de diferentescomunidades desde la comprensión de sus percepciones sobre paz, con la intervención guiada hacia elementos constitutivos de la misma y que convergenen un mismo objetivo, enfocado en la construcción de paz. Las comunidades intervenidas van desde los niños y niñas de Pirgua, una vereda cercana a Tunja,estudiantes universitarios de la Universidad Santo Tomás y por último, internos de la cárcel de máxima seguridad de Cómbita.Tres tipos de población con distintas características que, por medio de las actividades de los proyectos planteados, realizaron acciones para mejorar su entornoy desde su territorio construir paz, basados en un modelo de desarrollo social y sobre todo humano.Cet article vise à exposer le travail effectué par certains chercheurs qui ont proposé des projets de recherche avec la participation de différentes communautésà partir de la compréhension de leurs perceptions de la paix, avec l’intervention guidée vers les éléments constitutifs de la même et convergent dans le mêmeobjectif, axé sur la consolidation de la paix. Les communautés concernées vont des enfants de Pirgua, un village proche de Tunja, aux étudiants de l’université deSanto Tomás, en passant par les détenus de la prison de haute sécurité de Combita. Trois types de population aux caractéristiques différentes qui, à travers les activités des projets proposés, ont mené des actions pour améliorer leur environnementet depuis leur territoire pour construire la paix, sur la base d’un modèle de développ ementsocial et surtout humain.Este artigo visa expor o trabalho realizado por alguns investigadores que propuseram projectos de investigação com a participação de diferentes comunidades apartir da compreensão das suas percepções de paz, com a intervenção orientada para os elementos constituintes do mesmo e convergindo no mesmo objectivo,centrada na construção da paz. As comunidades envolvidas vão desde crianças de Pirgua, uma aldeia perto de Tunja, estudantes universitários da Universidade deSanto Tomás e finalmente, reclusos da prisão de segurança máxima em Combita. Três tipos de população com características diferentes que, através das actividades dos projectos propostos, realizaram acções para melhorar o seu ambiente e doseu território para construir a paz, com base num modelo de desenvolvimento social e especialmente humano

Tuberculosis pericárdica en paciente inmunocompetente: a propósito de un caso

La tuberculosis pericárdica es una forma de infección extrapulmonar causada por Mycobacterium tuberculosis, que se da de manera infrecuente y posee alta tasa de morbilidad y mortalidad. Se reporta el caso de un paciente de 65 años de edad, inmunocompetente, que presentó disnea y dolor precordial de siete días de evolución. Se confirmó derrame pericárdico y pleural a gran volumen por ecocardiograma y tomografía, respectivamente. El derrame pericárdico fue manejado por punción y ventana pericárdica. El diagnóstico de tuberculosis pericárdica se confirmó mediante biopsia. Discutimos el cuadro clínico, diagnóstico y tratamiento oportuno de esta patología, sobre todo en países endémicos de tuberculosis como el nuestro.Palabras claves: Tuberculosis, tuberculosis pericárdica, derrame pericárdico.DOI: http://dx.doi.org/10.17268/rmt.2020.v15i01.0