Enuresis no orgánica tratada con medicamentos homeopáticos

Introduction: nocturnal enuresis in children is a frequent reason for attending the doctor’s office.Objective: to evaluate the clinical evolution in pediatric patients from 5 to 18 years old with non-organic nocturnal enuresis treated with homeopathic drugs.Methods: a quasi-experimental intervention study was conducted. The sample intentionally comprised 327 patients with nocturnal enuresis from the Homeopathy Clinic at Pepe Portilla Provincial Pediatric Teaching Hospital, from January 2015 to January 2018. Descriptive tools such as frequency tables and percentage calculation were applied to process the data. In addition to the Kolmogorov Smirnov test to compare the trend of the variables between two independent groups.Results: male children between 5 and 11 years old predominated. In both groups, primary enuresis, the characteristic inability to wake up and family history of enuresis prevailed. In the study group, 76.1% had complete response to treatment, only one case had no response, in the control group only 8.3% of patients had complete response.Conclusions: homeopathy is a useful therapeutic modality in the treatment of non-organic nocturnal enuresis in children.Introducción: la enuresis nocturna en niños es motivo de consulta frecuente.Objetivo: evaluar la evolución clínica en pacientes pediátricos de cinco a 18 años, con enuresis nocturna no orgánica, tratados con medicamentos homeopáticos.Métodos: se realizó un estudio cuasi-experimental de intervención. La muestra se conformó de forma intencional por 327 pacientes con enuresis de la consulta de Homeopatía del Hospital Provincial Pediátrico Docente, “Pepe Portilla”, de enero del 2015 a enero 2018. En el procesamiento se utilizaron herramientas descriptivas como tablas de frecuencias y cálculo porcentual. Además de la prueba Kolmogorov Smirnov para comparar tendencia de variables entre dos grupos independientes.Resultados: predominaron los niños entre cinco a 11 años del sexo masculino. En ambos grupos prevaleció la enuresis primaria, la incapacidad para despertar y los antecedentes familiares de enuresis. En el grupo estudio, 76,1 % tuvo respuesta completa al tratamiento, solo un caso no tuvo respuesta; en el grupo control solo 8,3 % de los pacientes obtuvo respuesta completa.Conclusiones: la Homeopatía es una modalidad terapéutica útil en el tratamiento de la enuresis no orgánica en niños

Enuresis no orgánica tratada con medicamentos homeopáticos

Introduction: nocturnal enuresis in children is a frequent reason for attending the doctor’s office.Objective: to evaluate the clinical evolution in pediatric patients from 5 to 18 years old with non-organic nocturnal enuresis treated with homeopathic drugs.Methods: a quasi-experimental intervention study was conducted. The sample intentionally comprised 327 patients with nocturnal enuresis from the Homeopathy Clinic at Pepe Portilla Provincial Pediatric Teaching Hospital, from January 2015 to January 2018. Descriptive tools such as frequency tables and percentage calculation were applied to process the data. In addition to the Kolmogorov Smirnov test to compare the trend of the variables between two independent groups.Results: male children between 5 and 11 years old predominated. In both groups, primary enuresis, the characteristic inability to wake up and family history of enuresis prevailed. In the study group, 76.1% had complete response to treatment, only one case had no response, in the control group only 8.3% of patients had complete response.Conclusions: homeopathy is a useful therapeutic modality in the treatment of non-organic nocturnal enuresis in children.Introducción: la enuresis nocturna en niños es motivo de consulta frecuente.Objetivo: evaluar la evolución clínica en pacientes pediátricos de cinco a 18 años, con enuresis nocturna no orgánica, tratados con medicamentos homeopáticos.Métodos: se realizó un estudio cuasi-experimental de intervención. La muestra se conformó de forma intencional por 327 pacientes con enuresis de la consulta de Homeopatía del Hospital Provincial Pediátrico Docente, “Pepe Portilla”, de enero del 2015 a enero 2018. En el procesamiento se utilizaron herramientas descriptivas como tablas de frecuencias y cálculo porcentual. Además de la prueba Kolmogorov Smirnov para comparar tendencia de variables entre dos grupos independientes.Resultados: predominaron los niños entre cinco a 11 años del sexo masculino. En ambos grupos prevaleció la enuresis primaria, la incapacidad para despertar y los antecedentes familiares de enuresis. En el grupo estudio, 76,1 % tuvo respuesta completa al tratamiento, solo un caso no tuvo respuesta; en el grupo control solo 8,3 % de los pacientes obtuvo respuesta completa.Conclusiones: la Homeopatía es una modalidad terapéutica útil en el tratamiento de la enuresis no orgánica en niños

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Efecto de las sensaciones térmicas en la enfermedad cerebrovascular en la región Occidental de Cuba. 2001-2012

El accidente cerebrovascular ha emergido como un importante problema de salud en el mundo. En Cuba constituye desde hace más de 30 años una de las principales causas de muerte. El objetivo del estudio fue determinar la relación entre el comportamiento de las sensaciones térmicas y la mortalidad por Accidentes vasculares encefálicos. Se realizó un estudio ecológico de series de tiempo retrospectivo del total de 36 106 fallecidos por Accidentes vasculares encefálicos en la región Occidental de Cuba durante el período 2001-2012. Para describir el espectro de sensaciones térmicas fueron calculados los índices bioclimáticos Temperatura Efectiva y Temperatura Efectiva Equivalente. Los datos de mortalidad por Accidentes vasculares encefálicos fueron obtenidos de la Dirección Nacional de Registros Médicos y Estadísticas de Salud. El comportamiento de estos índices bioclimáticos muestra una relación con la mortalidad por Accidentes vasculares encefálicos en diferentes meses del año, además se constató que en el periodo poco lluvioso (noviembre-abril) se reporta el mayor número de defunciones bajo la sensación térmica fresca. Sin embargo la zona del interior de la región Occidental de Cuba mostró los mayores por ciento de sensaciones térmicas fría y muy fría. Las mayores tasas de defunciones por municipios se reportan en los meses de invierno, con mayor frecuencia en las sensaciones fría, fresca y confortable. Los resultados obtenidos sirven de base para la planificación de intervenciones de salud pública con el fin de minimizar las consecuencias de las temperaturas adversas para la salud así como establecer medidas preventivas encaminadas a disminuir los riesgos de mortalidad y morbilidad Accidentes vasculares encefálicos

Coping with poachers in European stalked barnacle fisheries: Insights from a stakeholder workshop

In January 2020, a stakeholder workshop was organized as a knowledge sharing strategy among European stalked barnacle fisheries. Management of this fishery differs greatly among regions and ranges from less organized and governed at large scales (>100 km, coasts of SW Portugal and Brittany in France) to highly participatory systems which are co-managed at small spatial scales (10′s km and less, Galicia and Asturias). Discussions revealed that poaching is ubiquitous, hard to eradicate, and adapts to all types of management. The stakeholders identified some key management initiatives in the fight against poaching: granting professional harvesters with exclusive access to the resource, increasing social capital among harvesters through tenure systems (e.g. Territorial Use Rights in Fisheries) that empower them as stewards of their resource and intensification of surveillance with the active participation of the harvesters. Furthermore, increased cooperation between fishers associations and regional fisheries authorities, improved legal frameworks, adoption of new technologies and the implementation of market-based solutions can also help coping with this systemic problemAgencia Estatal de Investigación | Ref. PCIN-2016-120Agencia Estatal de Investigación | Ref. PCIN-2016-063Fundação para a Ciência e a Tecnologia | Ref. BIODIVERSA / 0005/2015Fundação para a Ciência e a Tecnologia | Ref. BIODIVERSA / 0006/2015Agence Nationale de la Recherche | Ref. ANR-16-EBI3-0006-01Agence Nationale de la Recherche | Ref. ANR-16-EBI3-0006-02 a ANFundação para a Ciência e a Tecnologia | Ref. UIDB / 04292/2020Fundação para a Ciência e a Tecnologia | Ref. UIDP / 50017 / 2020Fundação para a Ciência e a Tecnologia | Ref. UIDB / 50017/2020Principado de Asturias | Ref. PA-18-PF-BP17-184Ministerio de Ciencia, Innovación y Universidades | Ref. FPU2016- 04258Principado de Asturias | Ref. FC-Grupin-IDI-2018- 000201Xunta de Galicia | Ref. ED481A-2020/199Fundação para a Ciência e a Tecnologia | Ref. SFRH / BD / 135872/2018Ministerio de Economía y Competitividad |Ref. CTM2014-51935-

(Des)iguales y (des)conectados : políticas, actores y dilemas info-comunicacionales en América Latina

En este libro nos proponemos trabajar sobre uno de los problemas contemporáneos del campo, que quedó expuesto con crudeza a partir de la catástrofe planetaria que ha significado la pandemia "COVID 19: la desigualdad info-comunicacional, que tiene a la conectividad y a su reverso, la desconexión, como algunos de sus puntos medulares.

Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure

BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research