Conocimientos y actitudes ante la Voluntad Anticipada en profesionales de la salud del Centro Médico “Lic. Adolfo López Mateos”, Toluca, México

Introducción: La Voluntad Anticipada es una declaración mediante la cual una persona mayor de edad, con capacidad mental suficiente y libremente, expone las instrucciones que se deben tener en cuenta respecto a la atención sanitaria que desea recibir en situaciones en las cuales no pueda ya expresar personalmente su voluntad. Objetivo: Determinar el nivel de conocimientos y actitudes que tienen los profesionales de la salud de Centro Médico “Lic. Adolfo López Mateos” con respecto a la Ley de Voluntad Anticipada del Estado de México. Método y materiales: Se aplicaron 265 encuestas que incluían el conocimiento y la actitud que tienen los profesionales de la salud sobre la Ley de Voluntad Anticipada del Estado de México. Resultados: El grupo mayoritario abarcó de 25-29 años con el 31%, el turno mayoritario fue el de la Jornada Especial con 34%, el 60% de los encuestados fueron mujeres y 40% hombres, el 94% no había leído la Ley de Voluntad Anticipada inscrita en la gaceta oficial del Gobierno del Estado de México y el 6% restante respondió afirmativamente. Conclusiones: La mayoría de los y las profesionales de salud refirieron no conocer la Ley inscrita en la gaceta oficial, lo que significa que hace falta difusión y promoción del tema; a pesar de eso, tuvieron una posición favorable hacia la voluntad anticipada y demostraron tener noción sobre lo tratad

Unlocking SARS-CoV-2 detection in low- and middle-income countries

Low- and middle-income countries (LMICs) are significantly affected by SARS-CoV-2, partially due to their limited capacity for local production and implementation of molecular testing. Here, we provide detailed methods and validation of a molecular toolkit that can be readily produced and deployed using laboratory equipment available in LMICs. Our results show that lab-scale production of enzymes and nucleic acids can supply over 50,000 tests per production batch. The optimized one-step RT-PCR coupled to CRISPR-Cas12a-mediated detection showed a limit of detection of 102 ge/μL in a turnaround time of 2 h. The clinical validation indicated an overall sensitivity of 80%–88%, while for middle and high viral load samples (Cq ≤ 31) the sensitivity was 92%–100%. The specificity was 96%–100% regardless of viral load. Furthermore, we show that the toolkit can be used with the mobile laboratory Bento Lab, potentially enabling LMICs to implement detection services in unattended remote regions.Fondo Nacional de Desarrollo Científico, Tecnológico y de Innovación TecnológicaRevisión por pare

Faint recombination lines in Galactic PNe with [WC] nucleus

We present spatially resolved high-resolution spectrophotometric data for the planetary nebulae PB8, NGC2867, and PB6. We have analyzed two knots in NGC2867 and PB6 and one in PB8. The three nebulae are ionized by [WC] type nuclei: early [WO] for PB6 and NGC2867 and [WC 5-6] in the case of PB8. Our aim is to study the behavior of the abundance discrepancy problem (ADF) in this type of PNe. We measured a large number of optical recombination (ORL) and collisionally excited lines (CEL), from different ionization stages (many more than in any previous work), thus, we were able to derive physical conditions from many different diagnostic procedures. We determined ionic abundances from the available collisionally excited lines and recombination lines. Based on both sets of ionic abundances, we derived total chemical abundances in the nebulae using suitable ionization correction factors. From CELs, we have found abundances typical of Galactic disk planetary nebulae. Moderate ADF(O++) were found for PB8 (2.57) and NGC2867 (1.63). For NGC2867, abundances from ORLs are higher but still consistent with Galactic disk planetary nebulae. On the contrary, PB8 presents a very high O/H ratio from ORLs. A high C/O was obtained from ORLs for NGC2867; this ratio is similar to C/O obtained from CELs and with the chemical composition of the wind of the central star, indicating that there was no further C-enrichment in the star, relative to O, after the nebular material ejection. On the contrary, we found C/O<1 in PB8. Interestingly, we obtain (C/O)ORLs/(C/O)CELs < 1 in PB8 and NGC2867; this added to the similarity between the heliocentric velocities measured in [OIII] and OII lines for our three objects, argue against the presence of H-deficient metal-rich knots coming from a late thermal pulse event.Comment: 25 pages, 13 Tables, 4 Figures Accepted for publication in A&A. First page is blank for obscure latex reason

Short stature, primary care approach and diagnosis

The following review article main objective seeks to provide an approach from a health care first level institution, of one of the mostfrequent queries in pediatrics and general medicine, stunted growth. The relation of consults for short stature in children is higher in boysrather than girls, but most of the times girls have more prevalence of organic diseases and growth disturbances than boys. When wereceive a patient who complains of short stature, we should ask a series of questions and take some anthropometric measures to classifythe child and determine the diagnosis. The first level doctor has to understand the meaning of these measures and determine if the child’sshort stature is whether pathological or physiological. Then the child has to be classified again, if it is a physiological short stature, heneeds to be group into genetic short stature or constitutional delay of growth and development, which constitutes by far the 80% of thecases. MÉD.UIS. 2016;29(3):73-8.Keywords: Growth Disorders. Growth and Development. Stature by Age

Factores que influyen en el control integral de las enfermedades cardiovasculares

Introducción. El objetivo de la presente investigación fue identiicar los factores que inluyen en el control integral de las enfermedades cardiovasculares en las personas pertenecientes al programa de salud cardiovascular de atención primaria de la comuna de San Pedro de la Paz, Chile. Material y Método. Estudio cuantitativo, transversal, correlacionaly explicativo (n=257), los instrumentos utilizados fueron un cuestionario elaborado para este estudio, Escala de Conductas en Salud de Miller y revisión de la icha clínica. Los datos fueron procesados en SPSS versión 15.0. Se utilizaron estadísticos univariados, pruebas paramétricas y no paramétricas, y análisis de regresión logística binaria. Resultados. Cinco variables fueron predictores del control integral de las enfermedades cardiovasculares: adherencia terapéutica (p=0,00), edad (p=0,00), automedicación con plantas medicinales para controlar la enfermedad (p=0,02), trabajo remunerado (p=0,00) y el número de enfermedades cardiovasculares (p=0,00). Conclusión. Estos resultados ilustran como valorar las prácticas y conductas en salud, tal como la adherencia terapéutica, la automedicación y los determinantes sociales de la salud como el trabajo remunerado, utilizándolos para el diseño de estrategias y tratamientos más integrales para el control de las enfermedades cardiovasculares

Organizational indicators for CASE tools selection: a case study

It is known that the selection, acquisition and implementation process of a CASE (Computer Aided Software Engineering) tool in an organization is a complex process. Fundamentally the impact of a tool is not simply the product of its inherent properties but also depends on the nature of the Information Systems (IS) development process and the organization thereof.Keywords: CASE tools, development process improvement, selection, evaluation, organizational indicators, Information System

The Iron abundance in Galactic Planetary Nebulae

We constrain the iron abundance in a sample of 33 low-ionization Galactic planetary nebulae (PNe) using [Fe III] lines and correcting for the contribution of higher ionization states with ionization correction factors (ICFs) that take into account uncertainties in the atomic data. We find very low iron abundances in all the objects, suggesting that more than 90% of their iron atoms are condensed onto dust grains. This number is based on the solar iron abundance and implies a lower limit on the dust-to-gas mass ratio, due solely to iron, of M_dust/M_gas>1.3x10^{-3} for our sample. The depletion factors of different PNe cover about two orders of magnitude, probably reflecting differences in the formation, growth, or destruction of their dust grains. However, we do not find any systematic difference between the gaseous iron abundances calculated for C-rich and O-rich PNe, suggesting similar iron depletion efficiencies in both environments. The iron abundances of our sample PNe are similar to those derived following the same procedure for a group of 10 Galactic H II regions. These high depletion factors argue for high depletion efficiencies of refractory elements onto dust grains both in molecular clouds and AGB stars, and low dust destruction efficiencies both in interstellar and circumstellar ionized gas.Comment: Accepted for publication in ApJ. 15 pages, 4 Postscript figures, corrected typos, Tables 2 and 3 correcte