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O Prolongamento do Intervalo QTc na Admissão está Associado ao Aumento da Mortalidade em Pacientes com SARS-COV-2 durante a Hospitalização
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Barbosa, Stephany

; Muñoz, Oscar Mauricio

; Cañas, Alejandra

; Garcia, Angel Alberto

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 1 elocation e20220155

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background Cardiovascular involvement associated with SARS-COV-2 infection is related to unfavorable outcomes during hospitalization. Therefore, the measurement at the admission of the QTc interval on the 12-lead electrocardiogram may be a prognostic marker. Objective To identify the relationship between QTc prolongation at admission during hospitalization and mortality from SARS-COV-2. Method Observational study based on a retrospective cohort of patients with confirmed SARS-COV-2 infection from San Ignacio University Hospital, Bogotá (Colombia), between March 19, 2020, and July 31, 2021. Mortality was compared in patients with prolonged and normal QTc at admission after controlling by clinical variables and comorbidities using bivariate and multivariate logistic regression models. A p-value <0.05 was considered statistically significant. Results 1296 patients were analyzed, and 127 (9.8%) had prolonged QTc. Mortality was higher in patients with prolonged QTc (39.4% vs 25.3%, p=0.001), as was hospital stay (median 11vs.8 days; p=0.002). In the multivariate analysis, mortality was associated with prolonged QTc (OR 1.61, 95% CI: 1.02; 2.54, p=0.038), age (OR 1.03, 95% CI 1.02; 1.05, p<0.001), male sex (OR 2.15, 95% CI 1.60; 2.90, p <0.001), kidney disease (OR 1.32, 95% CI 1.05; 1.66, p =0.018) and Charlson comorbidity index > 3 (OR 1.49, 95% CI 1.03; 2.17, p=0.035). Conclusions Hospital mortality due to SARS-COV-2 is associated with prolonging the QTc interval at the time of admission, even after adjusting for age, sex, comorbidities, and basal severity of infection. Additional research is needed to establish whether these findings are related to cardiac involvement by the virus, hypoxia, and systemic inflammation.

Resumo Fundamento O envolvimento cardiovascular associado à infecção por SARS-COV-2 está relacionado a desfechos desfavoráveis durante a internação. Portanto, a medida na admissão do intervalo QTc no eletrocardiograma de 12 derivações pode ser um marcador prognóstico. Objetivo Identificar a relação entre o prolongamento do QTc na admissão durante a hospitalização e a mortalidade por SARS-COV-2. Método Estudo observacional baseado em uma coorte retrospectiva de pacientes com infecção confirmada por SARS-COV-2 do Hospital Universitário San Ignacio, Bogotá (Colômbia), entre 19 de março de 2020 e 31 de julho de 2021. A mortalidade foi comparada em pacientes com QTc prolongado e normal na admissão e controle das variáveis clínicas e comorbidades por meio de modelos de regressão logística bivariada e multivariada. Um valor de p <0,05 foi considerado estatisticamente significativo Resultados Foram analisados 1.296 pacientes e 127 (9,8%) apresentaram QTc prolongado. A mortalidade foi maior em pacientes com QTc prolongado (39,4% vs. 25,3%, p=0,001), assim como o tempo de internação (mediana 11 vs. 8 dias; p=0,002). Na análise multivariada, a mortalidade foi associada a QTc prolongado (OR 1,61, IC 95%: 1,02; 2,54, p=0,038), idade (OR 1,03, IC 95% 1,02; 1,05, p<0,001), sexo masculino (OR 2,15, IC 95% 1,60; 2,90, p<0,001), doença renal (OR 1,32, IC 95% 1,05; 1,66, p=0,018) e índice de comorbidade de Charlson > 3 (OR 1,49, IC 95% 1,03; 2,17, p=0,035). Conclusões A mortalidade hospitalar por SARS-COV-2 está associada ao prolongamento do intervalo QTc no momento da admissão, mesmo após ajuste para idade, sexo, comorbidades e gravidade basal da infecção. Pesquisas adicionais são necessárias para estabelecer se esses achados estão relacionados ao envolvimento cardíaco pelo vírus, hipóxia e inflamação sistêmica.

https://doi.org/10.36660/abc.20220155

Coronary Artery Disease in Women: Getting to Know Gender Related Disparities Women
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Gilabert-Garcia, Ana

; Guerrero, Cristina Cristina Villarreal

; Dagio-Cuéllar, Rodrigo

; Bermudez-Gonzalez, Jorge Luis

; Perez-Partida, Arantza Marie

; Berarducci, Joaquin

; Armenta-Moreno, Javier Ivan

; Luna-Alvarez-Amezquita, Jose

; Straface, Juan Ignacio

; Espinola-Zavaleta, Nilda

; Alexanderson, Erick

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220022

Abstract: En | Text: En | PDF: En

Abstract Coronary artery disease (CAD) and ischemic heart disease (IHD) are often indistinctly used terms. Both combined have generated, over the past years, concerns about sex disparities in their presentation. From an epidemiological perspective, females have several disadvantages regarding the prevention, diagnosis, and treatment of CAD. Most of the general cardiovascular risk factors affect women more frequently, or with a higher morbidity and mortality association. Besides, atypical manifestations of the disease and uncommon forms of CAD represent a diagnostic challenge for clinicians. Even if current treatments for CAD have no apparent sex bias, women representation in clinical trials and treatment patterns analyzed in clinical practice refuse this statement. Several disparities are caused by inevitable sex-particularities, but many of them are more social, cultural, and dogmatic beliefs that have to be addressed and overhaul. (CAD IHD (IHD terms generated years presentation perspective prevention diagnosis frequently association Besides clinicians bias statement sexparticularities, sexparticularities particularities, particularities sex-particularities social cultural overhaul

https://doi.org/10.36660/ijcs.20220022

SOBRE POLÍTICA E JUSTIÇA - OS RUMORES DA ANTIDEMOCRACIA
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Grecco, Leonardo

; Vitoria, Ignacio Garcia

Revista Internacional CONSINTER de Direito - Publicação Oficial do Conselho Internacional de Estudos Contemporâneos em Pós-Graduação

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dec 2022, N. 15 Pages 247 - 263

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract: In the modern democratic scenario, there is a great polarization between Politics and Justice, as if they were absolute rivals, simply due to the natural interaction of the Powers. However, it is characteristic of the Democratic system that a Power has the others always in view to stop and counterbalance the exaggerated conduct of its representatives. This is why the present study, bypassing Machiavellian teachings, does not propose a liturgy or catechism for politicians, but rather that they require a behavior of minimum value characterized by a commitment to legality, honesty and the unrestricted pursuit of the interests of the people, in order to unmask the current antagonistic idea of Politics and Justice. Thus, in an exploratory research of a reflective nature, this article aims to demonstrate that Justice and Politics coexist very well in a democratic system, provided that their representatives act in a minimally ethical way.

Resumo: Há, no cenário democrático moderno, grande polarização entre Política e Justiça, como se estas fossem rivais absolutas, simplesmente pela interação natural dos Poderes. No entanto, é característico do sistema Democrático que um Poder tenha os ínim sempre em vista para frear e contrapesar condutas exageradas de seus representantes. Assim é que o presente estudo, contornando os ensinamentos maquiavélicos, não propõe uma liturgia ou catecismo para políticos, mas sim que deles se exija uma conduta de mínimo valor caracterizada por um ínimament com a legalidade, a honestidade e a busca irrestrita dos ínimamen do povo, a fim de desmascarar a ideia ínimament que atualmente se tem da Política e da Justiça. Assim, em uma pesquisa ínimamente de caráter reflexivo, tem este artigo o objetivo de demonstrar que a Justiça e Política convivem muito bem num sistema democrático, desde que seus representantes ajam de forma ínimamente ética.

https://doi.org/10.19135/revista.consinter.00015.11

La resignificación de los discursos sobre el trabajo
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Bernad i Garcia, Joan Carles

; Molpeceres Pastor, Mariángeles

; Martínez Morales, Ignacio

Andamios

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dec 2022, Volume 19 N. 50 Pages 367 - 388

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen En este artículo analizamos los discursos laborales de docentes de la inserción sociolaboral, enmarcando el campo en las transformaciones de las políticas activas de prevención y lucha contra el desempleo. El material, obtenido a partir de 50 entrevistas a 25 sujetos, se analiza desde el prisma de los cambios que las normatividades emergentes en el mundo del trabajo están induciendo en los discursos tradicionales sobre el mismo. Se identifican tres tipos de discurso sobre el trabajo, que lo entienden como entrega, como empleo y como oficio. Sin embargo, se observa cómo estos modos de comprensión del trabajo, muy arraigados tradicionalmente en las sociedades industriales, están sufriendo mutaciones significativas en el marco de las lógicas de funcionamiento del capitalismo flexible.

Abstract In this paper, we discuss discourses about work in teachers of basic vocational education, framing this field within current transformations of active policies to prevent and fight unemployment. The empirical material, obtained through 50 interviews with 25 subjects, is analyzed from the viewpoint of transformations that emergent normativity in the labor market is inducing in traditional discourses about work. Three different kinds of classical discourse are identified, the first conceiving work as dedication, the second conceiving work as employment, and as the third conceiving work as trade. However, each of them is found to show significant mutations linked to emergent rationales in flexible capitalism.

https://doi.org/10.29092/uacm.v19i50.985

Avaliação Ecocardiográfica Transesofágica Bi e Tridimensional de Dissecção Espontânea do Átrio Esquerdo
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Armenta-Moreno, Javier Ivan

; Berarducci, Joaquin

; Garcia-Cardenas, Abel Mauricio

; Armendariz-Ferrari, José Carlos

; Bermudez-Gonzalez, Jorge Luis

; Straface, Juan Ignacio

; Luna-Alvarez-Amezquita, Jose Antonio

; Espinola-Zavaleta, Nilda

Arquivos Brasileiros de Cardiologia

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sep 2022, Volume 119 N. 3 Pages 499 - 501

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210740

Low molecular weight heparin is useful in adult COVID-19 inpatients. Experience during the first Spanish wave: observational study
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Gonzalez-Porras, Jose Ramon

; Belhassen-Garcia, Moncef

; Lopez-Bernus, Amparo

; Vaquero-Roncero, Luis Mario

; Rodriguez, Beatriz

; Carbonell, Cristina

; Azibeiro, Raul

; Hernandez-Sanchez, Alberto

; Martin-Gonzalez, Jose Ignacio

; Manrique, Juan Miguel

; Alonso-Claudio, Gloria

; Alvarez-Navia, Felipe

; Madruga-Martin, Jose Ignacio

; Macias-Casanova, Ronald Paul

; García-Criado, Jorge

; Lozano, Francisco

; Moyano, Jose Carlos

; Sanchez-Hernandez, Miguel Vicente

; Sagredo-Meneses, Víctor

; Borras, Rafael

; Bastida, Jose María

; Hernández-Pérez, Guillermo

; Chamorro, Antonio Javier

; Marcos, Miguel

; Martin-Oterino, Jose Angel

Sao Paulo Medical Journal

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feb 2022, Volume 140 N. 1 Pages 123 - 133

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: The intensity of the thromboprophylaxis needed as a potential factor for preventing inpatient mortality due to coronavirus disease-19 (COVID-19) remains unclear. OBJECTIVE: To explore the association between anticoagulation intensity and COVID-19 survival. DESIGN AND SETTING: Retrospective observational study in a tertiary-level hospital in Spain. METHODS: Low-molecular-weight heparin (LMWH) status was ascertained based on prescription at admission. To control for immortal time bias, anticoagulant use was analyzed as a time-dependent variable. RESULTS: 690 patients were included (median age, 72 years). LMWH was administered to 615 patients, starting from hospital admission (89.1%). 410 (66.7%) received prophylactic-dose LMWH; 120 (19.5%), therapeutic-dose LMWH; and another 85 (13.8%) who presented respiratory failure, high D-dimer levels (> 3 mg/l) and non-worsening of inflammation markers received prophylaxis of intermediate-dose LMWH. The overall inpatient-mortality rate was 38.5%. The anticoagulant nonuser group presented higher mortality risk than each of the following groups: any LMWH users (HR 2.1; 95% CI: 1.40-3.15); the prophylactic-dose heparin group (HR 2.39; 95% CI, 1.57-3.64); and the users of heparin dose according to biomarkers (HR 6.52; 95% CI, 2.95-14.41). 3.4% of the patients experienced major hemorrhage. 2.8% of the patients developed an episode of thromboembolism. CONCLUSIONS: This observational study showed that LMWH administered at the time of admission was associated with lower mortality among unselected adult COVID-19 inpatients. The magnitude of the benefit may have been greatest for the intermediate-dose subgroup. Randomized controlled trials to assess the benefit of heparin within different therapeutic regimes for COVID-19 patients are required.

https://doi.org/10.1590/1516-3180.2021.0098.r1.08062021

Reconstrucción mandibular mediante colgajo miocutáneo de pectoral mayor en carcinoma epidermoide, reporte de caso clínico y revisión de la literatura.
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Gallardo Caudillo, Josué

; Miranda Villasana, José Ernesto

; Plaza Garcia, Eduardo

Revista Estomatológica Herediana

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jan 2022, Volume 32 N. 1 Pages 79 - 86

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN El carcinoma epidermoide surge del epitelio de la mucosa oral, es frecuente en la quinta y sexta décadas de la vida y está típicamente asociado con factores de riesgo como tabaquismo y el consumo de alcohol. En todo el mundo, la incidencia de cáncer oral es más alta en hombres que en mujeres. El incremento en la incidencia del cáncer en México requiere de un manejo adecuado, como colgajos vascularizados para reparar defectos generados por una hemimandibulectomía con márgenes de seguridad. A pesar de la llegada de injertos de tejido libres vascularizados, el colgajo pectoral mayor miocutáneo sigue siendo un colgajo pediculado ampliamente utilizado para la reconstrucción de defectos de tejidos blandos en la región oral y maxilofacial. Se muestra el protocolo quirúrgico realizado en el Hospital Regional “General Ignacio Zaragoza” ISSSTE para el tratamiento de un carcinoma epidermoide mandibular.

ABSTRACT Squamous cell carcinoma arises from the epithelium of the oral mucosa, common in the fifth and sixth decades of life and is typically associated with risk factors such as smoking and alcohol consumption. Worldwide, the incidence of oral cancer is higher among men than women. The increase in the incidence of cancer in Mexico requires proper management and the use of vascularized flaps to repair defects generated by a hemimandibulectomy with safety margins. Despite the advent of vascularized free tissue grafts, the myocutaneous pectoralis major flap remains a pedunculated flap widely used for the reconstruction of soft tissue defects in the oral and maxillofacial region. The surgical protocol carried out at the ISSSTE “General Ignacio Zaragoza” Regional Hospital for the treatment of mandibular squamous cell carcinoma is shown.

https://doi.org/10.20453/reh.v32i1.4187

THE APPENDICITIS INFLAMMATORY RESPONSE SCORE FOR ACUTE APPENDICITIS: IS IT IMPORTANT FOR EARLY DIAGNOSIS?
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DEBONI, Vitor Steil

; ROSA, Matheus Ignácio

; LIMA, André Carminati

; GRACIANO, Agnaldo José

; GARCIA, Christian Evangelista

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2022, Volume 35 elocation e1686

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO - RACIONAL: A utilização do escore clínico Appendicitis Inflammatory Response em pacientes com suspeita de apendicite aguda torna o diagnóstico mais objetivo e preciso. OBJETIVOS: Comparar prospectivamente dois grupos com suspeita de apendicite aguda, analisando o número de exames de imagem solicitados, o tempo de espera no Pronto-Socorro, até a definição da conduta, bem como a sensibilidade e especificidade desse método diagnóstico. MÉTODOS: Estudo prospectivo randomizado comparando 55 pacientes submetidos ao diagnóstico clínico-radiológico de acordo com a rotina do Serviço (grupo controle), com outros 55 pacientes submetidos ao fluxograma do escore Appendicitis Inflammatory Response (grupo intervenção). RESULTADOS: O tempo de espera para definir a conduta do grupo intervenção foi 1,5 hora menor do que o grupo controle (p=0,02). A tomografia computadorizada foi realizada em 42 pacientes do grupo controle, em comparação com 25 do grupo intervenção (p=0,001). O impacto do fluxograma baseado no escore Appendicitis Inflammatory Response dos casos em relação ao grupo controle foi a redução de apendicectomias com apêndice de aparência normal de 5 para 1 e um aumento na exclusão de diagnósticos de apendicite. O uso do escore Appendicitis Inflammatory Response resultou em especificidade diagnóstica de 92%, comparado a 29% no grupo controle. CONCLUSÕES: A utilização do escore Appendicitis Inflammatory Response reduziu o tempo de espera para o diagnóstico de apendicite aguda, diminuiu o número de exames de imagem e aumentou a especificidade diagnóstica da doença.

ABSTRACT - BACKGROUND: The use of Appendicitis Inflammatory Response clinical score in patients with suspected acute appendicitis makes the diagnosis more objective and accurate. AIMS: The aim of this study was to prospectively compare two groups with suspected acute appendicitis, analyzing the number of imaging tests requested, waiting time in the emergency department, until definition of conduct, as well as the sensitivity and specificity of this diagnostic method. METHODS: This is a prospective randomized study comparing 55 patients submitted to clinical-radiological diagnosis according to the routine of the service (control group), with another 55 patients submitted to the Appendicitis Inflammatory Response score flowchart (intervention group). RESULTS: Waiting time for defining the intervention group’s conduct was 1.5 h shorter than the control group (p=0.02). Computed tomography was performed in 42 patients in the control group, compared with 25 in the intervention group (p=0.001). The impact of the flowchart based on the Appendicitis Inflammatory Response score of the cases compared to the control group was the reduction of appendectomies with a normal-appearing appendix from 5 to 1 and an increase in the exclusion of appendicitis diagnoses. The use of the Appendicitis Inflammatory Response score resulted in a diagnostic specificity of 92%, compared to 29% in the control group. CONCLUSIONS: The use of the Appendicitis Inflammatory Response score reduced the waiting time for the diagnosis of acute appendicitis, decreased the number of imaging tests, and increased diagnostic specificity of the disease.

https://doi.org/10.1590/0102-672020220002e1686

Enfermedad de whipple e hipertensión pulmonar reversible
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Pankl, Sonia

; Báez, Milagros

; Young, Pablo

; Bruetman, Julio E.

; Rausch, Astrid

; Zubiaurre, Ignacio

; Bosio, Martín

; Finn, Bárbara C.

; Vigovich, Felix

; Speisky, Daniela

; Verdaguer, Fernanda

; Garcia De Dávila, María T.

Medicina (Buenos Aires)

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mar 2021, Volume 81 N. 1 Pages 91 - 95

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Whipple’s disease is a chronic mutisystem disease caused by the bacteria Tropherima whipplei. Approximately 1200 cases have been described in the literature. The worldwide incidence is estimated at 9.8 cases per million people. Data from South America and Europe show that it affects middle-aged males. It is believed that host immunological factors rather than agent genotypic traits influence the course of the infection. Since the clinical characteristics are usually nonspecific and the wide spectrum of manifestations in individual organs may be underestimated, the diagnosis remains challenging. We present a case with multisystem compromise confirmed by histopathology. We consider its publication important given the few cases documented in South America and the relevance of bearing in mind the importance of an early diagnosis for a prompt treatment that improves the prognosis of this rare disease.

Resumen La enfermedad de Whipple es una enfermedad multisistémica crónica, causada por la bacteria Tropherima whipplei. Se han descripto aproximadamente 1200 casos en la literatura. La incidencia mundial se estima en 9.8 casos por millón de personas. Los datos provenientes de Sudamérica y Europa muestran que afecta a varones de mediana edad. Se cree que los factores inmunológicos del huésped son los que influyen en el curso de la infección y no el genotipo del agente. Dado que las características clínicas no suelen ser específicas y el espectro de manifestaciones en órganos individuales puede ser subestimado, el diagnóstico sigue siendo muy difícil. Presentamos un caso confirmado por histopatología con compromiso multisistémico. Consideramos importante su difusión dados los escasos casos documentados en Sudamérica y la relevancia de tener presente la sospecha diagnóstica para el abordaje terapéutico precoz que mejora el pronóstico de esta rara enfermedad.

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Uso potencial de las aguas residuales en la agricultura
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Mendoza-Retana, Sarai Shesareli

; Cervantes-Vázquez, María Gabriela

; Valenzuela-Garcia, Ana Alejandra

; Guzmán-Silos, Tania Lizzeth

; Orona-Castillo, Ignacio

; Cervantes-Vázquez, Tomás Juan Álvaro

Revista mexicana de ciencias agrícolas

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feb 2021, Volume 12 N. 1 Pages 115 - 126

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract The contamination of water, air, soil and food is a collateral consequence of the activities that man has developed to live and improve his quality of life. The development of the human being, its continuous growth since the time of the industrial revolution has left damage and degradation in natural resources. In its demographic, scientific and technological growth, human beings have not made sufficient efforts to sustainably preserve natural resources. Among these resources, water is one of the most essential and vital for all forms of life, but every day the resource is scarcer in a healthy way. Due to multiple factors associated with population growth, urbanization and industrialization, all equally direct and indirect causes of climate change. Treating and using wastewater is challenging because that is often the only option farmers have. Thus, these waters represent a valuable resource, both from an economic and environmental point of view (conservation of water resources, recycling of nutrients). Currently, about 80% of wastewater is disposed of without treatment and is used for agricultural irrigation, representing a significant sanitary problem (due to the presence of pathogenic and toxic elements).

Resumen La contaminación del agua, aire, suelo y alimentos es una consecuencia colateral de las actividades que el hombre ha desarrollado para vivir y mejorar su calidad de vida. El desarrollo del ser humano, su crecimiento continuo desde la época de la revolución industrial ha dejado daños y degradación en los recursos naturales. En su crecimiento demográfico, científico y tecnológico el ser humano no ha realizado los esfuerzos suficientes para preservar sustentablemente los recursos naturales. Dentro de tales recursos, el agua es uno de los primordiales y vital para todas las formas de vida, pero cada día está más escaso el recurso en forma saludable. Debido a múltiples factores asociados al crecimiento demográfico, la urbanización y la industrialización, todas igualmente causas directas e indirectas del cambio climático. El tratamiento y uso de aguas residuales constituye un reto, porque con frecuencia esa es la única opción con la que cuentan los agricultores. Así, estas aguas representan un recurso valioso, tanto desde el punto de vista económico como ambiental (conservación de recursos hídricos, reciclaje de nutrientes). En la actualidad, cerca de 80% de las aguas residuales son dispuestas sin tratamiento son usadas para riego agrícola, representando un problema sanitario significativo (por la presencia de elementos patógenos y tóxicos).

https://doi.org/10.29312/remexca.v12i1.2789 155 downloads

11.

Long-term effectiveness of a mindfulness based intervention (MBI) program for stuttering: a case study
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Moreno-Jiménez, Jennifer E

; Rodríguez-Carvajal, Raquel

; Garcia-Rubio, Carlos

; Castillo-Gualda, Ruth

; Montero, Ignacio

Clínica y Salud

Journal Metrics
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2021, Volume 32 N. 2 Pages 55 - 63

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT A mindfulness-based intervention (MBI) to address emotional factors that may negatively impact the fluency of the subjects was implemented. A MBI consisting of 5 weekly 2-h sessions was designed and applied to two stuttering cases. The goals were to lower stuttering and to reduce anxiety through the acquisition of mindfulness skills. Participants were asked to video-record a speaking task and to fill out anxiety and mindfulness skills self-reports pre and post-intervention. Both participants diminished stuttering error rates from severe (participant 1) and moderate (participant 2) to mild. Participant 2, who showed high pre-treatment anxiety, showed a significant reduction. A year-follow-up revealed that therapeutic gains in anxiety, mindfulness skills, and stuttering were successfully maintained in both participants. This is the first study focused on emotional aspects of stuttering showing long-term improvements through a MBI. MBI programs could serve as a promising complement for stuttering treatments.

RESUMEN Se utilizó una intervención basada en mindfulness (MBI) para abordar los factores emocionales que pueden afectar negativamente a la fluidez de los sujetos a través de un estudio de caso. Se diseñó un MBI que constaba de 5 sesiones semanales de 2 horas y se aplicó a dos casos de tartamudez. Los objetivos eran dismunuir la tartamudez y reducir los síntomas de ansiedad mediante la adquisición de habilidades de atención plena. Se pidió a los participantes que grabaran en video una tarea oral y que cumplimentaran los autoinformes de ansiedad y de habilidades de atención plena antes y después de la intervención. En ambos participantes disminuyó el índice de errores de tartamudeo de grave (participante 1) y moderado (participante 2) a leve. El participante 2, que mostró una elevada ansiedad previa al tratamiento, mostró una reducción significativa. Al año de seguimiento los beneficios terapéuticos en ansiedad, habilidades de atención plena y tartamudeo se mantuvieron con éxito en ambos participantes. Se trata del primer estudio centrado en los aspectos emocionales de la tartamudez que muestra mejoras a largo plazo a través de un MBI. Por lo tanto, los programas MBI podrían servir como complemento prometedor a los tratamientos de tartamudez.

https://doi.org/10.5093/clysa2021a1

12.

[SciELO Preprints] - Limiting the exposure of the most vulnerable people as a strategy to minimize deaths from COVID-19
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Buján Pérez, Alejandro Domínguez, Ignacio López Garcia, Pablo Mallaina Fresneda, Ramiro Romero

Journal Metrics
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Publication date: 2020-05-06

Abstract: En Es

The foreseeable lifting of the containment measures that were taken in Spain to reduce the rate of contagion and avoid saturation of the health system caused by the COVID-19 pandemia, suggests making approaches to how to deal with it. Strategies are proposed until the infected population exceeds the herd immunity threshold: an initial unfiltered proportional reopening, an age-limiting one (first strategy), and a more selective one, restricting mobility by age and only to people without chronic diseases (second strategy). The results obtained show reductions in the potential number of deaths of 82.56 %, if it were limited only by age. If it were restricted by age and without chronic diseases the reduction grows up to 95.34 %. Therefore, the fatality rate would be reduced from 1.04 % to 0.18 % and 0.05 % respectively.

Cercanos al levantamiento de las medidas de confinamiento que se tomaron para reducir la velocidad de contagio y evitar la saturación del sistema sanitario provocado por la pandemia de COVID-19, sugiere hacer planteamientos de cómo afrontarlo, aplicado en este caso concreto a España. Se plantean estrategias hasta que la población contagiada supere el umbral de la inmunidad de grupo: una salida proporcional sin filtrar, una reapertura limitando por edad (primera estrategia) y un desconfinamiento más selectivo restringiendo salidas por edad a personas sin enfermedades crónicas (segunda estrategia). Los resultados obtenidos muestran reducciones en el número potencial de fallecidos del 82.56 % si se limitase la reapertura por edad y del 95.34 % si se restringiese por edad y sin enfermedades crónicas. Así, se reduciría la letalidad del 1.04 %, al 0.18 % y 0.05 % respectivamente.

https://doi.org/10.1590/SciELOPreprints.354

13.

Oropharyngeal Squamous Cell Carcinoma: Human Papilloma Virus Coinfection with Streptococcus anginosus
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Robayo, Dabeiba Adriana Garcia

; Erira, Herlinto Alveiro Tupaz

; Jaimes, Fredy Omar Gamboa

; Torres, Andrey Moreno

; Galindo, Andres Ignacio Chala

Brazilian Dental Journal

Journal Metrics
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nov 2019, Volume 30 N. 6 Pages 626 - 633

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O vírus do papiloma humano (VPH) e bactérias orais capacidade de produção acetaldeído a partir do etanol, tais como Streptococcus anginosus, Prevotella melaninogenica e Fusobacterium naviforme, estão entre os fatores de risco infecciosos do carcinoma de células escamosas de orofaringe (CCEO). Determinar associações o VPH e S. anginosus, P. melaninogenica, e F. naviforme em pacientes com e sem o CCEO. A presença de VPH e VPH-16 foi determinada em 26 pacientes com CCEO e 26 sem CCEO por PCR convencional e presença simultânea de quantificação de S. anginosus, P. melaninogenica e F. naviforme por meio de q-PCR. Uma análise estatística foi realizada por meio do t-Student e χ² de Pearson. Os pacientes com CCEO apresentaram frequências de VPH e VPH-16 de 84% e 61,5%, respectivamente, em contraste, para os pacientes sem CCEO frequências de 34,6 e 30,7%. Os microorganismos P. melaninogenica e F. naviforme não estavam presentes em nenhum dos participantes deste estudo. A freqüência de S. anginosus em pacientes com CCEO foi de 38,4% e em pacientes sem CCEO foi de 30,7%. Os pacientes com CECO apresentaram coinfecção com S. anginosus + VPH em uma freqüência de 38,4% e S. anginosus + VPH-16 com freqüência de 23,1%. Para os indivíduos sem CCEO, co-infecção com S. anginosus + VPH foi de 3,8% e S. anginosus + VPH-16 foi de 3,8%. A Maior frequência de co-infecção com S. anginosus + VPH e S. anginosus + VPH-16 foi observada em pacientes com CCEO em comparação com indivíduos sem CCEO, sugerindo a importância da detecção de VPH / VPH-16 e S. anginosus simultaneamente em indivíduos em risco de desenvolver CCEO.

Abstract Introduction: Human papilloma virus (HPV) and oral bacteria capable of acetaldehyde production from ethanol, such as Streptococcus anginosus, Prevotella melaninogenica, and Fusobacterium naviforme are among oropharyngeal squamous cell carcinoma (OSCC) infectious risk factors. Objective: Determine associations with HPV and S. anginosus, P. melaninogenica, and F. naviforme in patients with and without OSCC. Methods: Presence of HPV and HPV-16 was determined in 26 patients with OSCC and 26 without OSCC by conventional PCR and simultaneous presence of S. anginosus, P. melaninogenica, and F. naviforme quantification through q-PCR. Statistical analysis was carried out using Pearson’s X² and Student’s-t test. Results: Patients with OSCC had HPV and HPV-16 frequencies of 84% and 61.5%, respectively, in contrast for patients without OSCC frequencies were 34.6 and 30.7%. P. melaninogenica, and F. naviforme microorganisms were not present in any participant in this study. S. anginosus frequency in patients with OSC was 38.4% and in patients without OSCC was 30.7%. Patients with OSCC had S. anginosus + HPV co-infection at a 38.4% frequency and S. anginosus + HPV-16 at a 23.1% frequency. For individuals without OSCC S. anginosus + HPV co-infection was 3.8% and S. anginosus + HPV-16 3.8%. A greater frequency of S. anginosus + HPV co-infection and S. anginosus + HPV-16 was observed in patients with OSCC in comparison with individuals without OSCC, suggesting the importance of detecting HPV/HPV-16 and S. anginosus simultaneously in individuals at risk of developing OSCC

https://doi.org/10.1590/0103-6440201902805 1337 downloads

14.

Iniciativa Stent-Save a Life! Argentina
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CANDIELLO, ALFONSINA

; CIGALINI, IGNACIO M.

; ZANGRONIZ, PEDRO

; GARCIA ESCUDERO, ALEJANDRO

; RIPA, LEONARDO

; LASAVE, LEANDRO

; COHEN, FERNANDO

; PASCUA, ANDRÉS

; COROLEU, SANTIAGO

; BELARDI, JORGE

Revista argentina de cardiología

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may 2019, Volume 87 N. 3 Pages 210 - 216

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT 39. Introduction: The Stent-Save a Life! (SSL) initiative is a European program that seeks to improve the access of patients with ST-segment elevation acute myocardial infarction (STEMI) to reperfusion therapies based on clinical guideline recommendations, thus reducing morbidity and mortality. Objective: The aim of this study was to describe the results of the first three years of the SSL Argentina initiative. Methods: Initially, a mapping was carried out to analyze the local situation and then the Door-to- Balloon Program (DBP) was developed as a continuous improvement process for centers with primary percutaneous coronary intervention (pPCI) capability. Results: From March 2016 to March 2018, 3,041 patients with STEMI were treated in 38 centers participating in this program. In 20% of cases (n=610) patients had their first medical contact with the emergency medical services. After excluding 184 patients (6%) without coronary lesions, reperfusion therapy was performed in 93% of cases, mainly by pPCI (95%). Total ischemic time was 117 minutes, with differences according to the time of first medical contact. Overall in-hospital mortality was 7%. Conclusions: The lack of a “reperfusion culture” was the common barrier of public and private centers that motivated the development of the DBP. The identification of critical points that prevent treatment on time, together with enhancement of in-hospital organization, represent the first step to improve the care of these patients. The integrated work of all the involved parties is necessary to develop care networks adapted to the local reality of each center and region.

RESUMEN 31. Introducción: La iniciativa Stent-Save a Life! (SSL) es un programa europeo que busca mejorar el acceso de pacientes con infarto agudo de miocardio con elevación del ST (IAMCEST) a un tratamiento de reperfusión basado en las recomendaciones de las guías clínicas, reduciendo así su morbimortalidad. Objetivo: Describir los resultados de los primeros tres años de la iniciativa SSL Argentina Material y métodos: Se realizó inicialmente un mapeo para analizar la situación local y luego se desarrolló el Programa Puerta-Balón (PPB) como un proceso de mejora continua para centros con capacidad de realizar angioplastia primaria (ATCp). Resultados: Desde marzo de 2016 hasta marzo de 2018 se trataron 3041 pacientes con IAMCEST en 38 centros participantes del citado programa. El 20% (n = 610) de esos pacientes tuvo su primer contacto médico (PCM) con el servicio de emergencias médicas. Excluyendo los 184 pacientes sin lesiones coronarias (6% del total), el 93% fue reperfundido, principalmente con ATCp (95%). El tiempo global de isquemia fue de 117 minutos, variando según el momento del PCM. La mortalidad global intrahospitalaria fue del 7%. Conclusiones: La falta de una “cultura de reperfusión” fue la barrera en común de centros públicos y privados que motivó el desarrollo del PPB. La identificación de los puntos críticos que impiden un tratamiento a tiempo, junto con la organización de los centros puertas adentro, representan el primer paso para mejorar la atención de estos pacientes. Es necesario el trabajo integrado de todos los actores involucrados a partir de la organización de redes de atención, adaptadas a la realidad local de cada centro y región.

https://doi.org/10.7775/rac.es.v87.i3.15158 212 downloads

15.

Caracterización de pacientes con demencia avanzada hospitalizados por el servicio de geriatría en un hospital de alta complejidad
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Martínez-Velásquez, Daniel Andrés

; Chavarro-Carvajal, Diego Andrés

; Garcia-Cifuentes, Elkin

; Venegas-Sanabria, Luis Carlos

; Cano-Gutiérrez, Carlos Alberto

Acta Neurológica Colombiana

Journal Metrics
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mar 2019, Volume 35 N. 1 Pages 15 - 21

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN OBJETIVO: Describir y analizar las características clínicas, funcionales, nutricionales y sociales de pacientes con demencia avanzada (DA), hospitalizados a cargo del servicio de geriatría del Hospital Universitario San Ignacio (HUSI) y su relación con desenlaces hospitalarios, comparando con demencia no avanzada. MÉTODOS: Se realizó un estudio observacional, descriptivo en pacientes ancianos hospitalizados por el servicio de geriatría del HUSI, con revisión retrospectiva de historias clínicas en el perioro de tiempo entre enero del 2016 y diciembre del 2017. La variable dependiente fue DA. Se realizó análisis univariado, bivariado y multivariado. RESULTADOS: De 1091 pacientes con demencia, 606 tenían diagnóstico de DA. La mediana de edad fue de 86 años y la prevalencia de mujeres fue mayor (57,3 %). En los sujetos con DA, comparados con el grupo de demencia, se encontró mayor porcentaje de malnutrición (91,1 %), úlceras por presión (26,2 %), delirium (67,2 %%), polifarmacia (68,3 %%), estancia hospitalaria (5 días), complicaciones (10,6 %%) y mortalidad (16,9 %%). Se encontró una mayor asociación de malnutrición con DA (OR = 2,80, IC = 1,94-4,06, p < 0,00), así mismo con polifarmacia (OR = 1,41, IC = 1,07-1,86, p = 0,012), delirium (OR = 2,24, IC = 1,72-2,92, p < 0,00), úlceras por presión (OR = 3,75, IC = 2,45-5,73, p < 0,00) y mortalidad (OR = 2,21, IC = 1,42-3,44, p < 0,00). DISCUSIÓN: La avanzada edad de nuestros pacientes puede ser determinante en el alto porcentaje de demencia encontrada. La DA condiciona a mayor compromiso en el curso de diferentes desenlaces hospitalarios como malnutrición, polifarmacia, delirium, úlceras y mortalidad. Lo anterior hace necesaria una valoración geriátrica integral del paciente anciano con demencia para mejorar el curso clínico de la hospitalización.

SUMMARY OBJECTIVE: To describe and analyze the clinical characteristics, functionality, nutritional, and social aspects in patients with Advance Dementia (AD), and to hospitalized in the geriatric unit in the Hospital Universitario San Ignacio (HUSI) and it how it is related with hospital outcomes, compare with no advanced dementia. METHODS: A cross-sectional study was conduct, in patient hospitalized in the geriatric unit in the HUSI, with a retrospective review of electronic medical charts from January of 2016 to December 2017. The dependent variable was AD, a univariate, bivariate and multivariate analysis was made. RESULTS: 1091 patients had dementia, 606 with AD, the median age was 86 years and the women prevalence were (57.3 %) higher than men. In the AD group, compared with those with dementia, had high percentage of malnutrition (91.1 %%), pressure ulcers (26.2 %%), delirium (67.2 %%), polypharmacy (68.3 %%), longer hospital admission (median of 5 days vs 4 days), medical complication (10.6 %%), and mortality (16.9 %%). We found a higher association with malnutrition with AD (OR = 2.80, CI = 1.94-4.06, p < 0.00), polypharmacy (OR = 1.41, CI = 1.07-1.86, p = 0.012), delirium (OR = 2.24, CI = 1.72-2.92, p < 0.00), pressure ulcers (OR = 3.75, CI = 2.455.73, p < 0.00) and mortality (OR = 2.21,CI = 1.42-3.44, p < 0.00). DISCUSSION: The advance aged in our patients, might be a determinant in the high percentage of dementia that we found. AD is an entity that predispose to higher clinical outcomes as malnutrition, polypharmacy, delirium, pressure ulcers and mortality. As previously shown there is a need for a comprenhensive geriatric assessment in elderly with dementia, to improve hospital outcomes.

https://doi.org/10.22379/24224022228 665 downloads

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