RESUMEN

Gold nanostructures (AuNSs) were used to fabricate surface-enhanced Raman spectroscopy (SERS) substrates. These AuNSs were produced using the solid-state dewetting method from thin films. The fragmentation process was studied at 300 °C, with durations of thermal treatment of 1, 3, 6, and 12 h. These SERS substrates were then employed to detect Rhodamine B (RhB) as the model analyte, simulating a contaminant in the water at a concentration of 5 ppm. The morphology of the AuNSs was examined using SEM, which revealed a spheroidal shape that began to coalesce at 12 h. The size of the AuNSs was estimated to range from 22 ± 7 to 24 ± 6 nm, depending on the annealing time. The localized surface plasmon resonance of the AuNSs was determined using absorption spectroscopy, showing a shift as the annealing time increased. The SERS signals of RhB adsorbed on the AuNS substrates were validated by performing a 10 × 10 point map scan over each sample surface (1, 3, 6, and 12 h), and a comparative analysis showed no significant differences in the positions of the bands; however, variations in intensity enhancement ranged from 5 to 123 times at 6 and 1 h, respectively.

RESUMEN

Tin (Sn) metal has emerged as a promising anode for aqueous batteries, due to its high capacity, non-toxicity, and cost-effectiveness. However, Sn metal has often been coupled with strong and corrosive sulfuric acids (2-3 M), leading to severe electrode corrosion and hydrogen evolution issues. Although high efficiency and long cycling were reported, the results were achieved using high currents to kinetically mask electrode-electrolyte side reactions. Herein, we introduce a low-acidity tin chloride electrolyte (pH=1.09) as a more viable option, which eliminates the need of strong acids and enables a reversible dendrite-free Sn plating chemistry. Remarkably, the plating efficiency approaches unity (99.97 %) under standard testing conditions (1 mA cm-2 for 1 mAh cm-2), which maintains high at 99.23-99.93 % across various aggressive conditions, including low current (0.1-0.25 mA cm-2), high capacity (5-10 mAh cm-2), and extended resting time (24-72 hours). The battery calendar life is further prolonged to 3064 hours, significantly surpassing literature reports. Additionally, we presented an effective method to mitigate the potential Sn2+ oxidization issue on the cathode, demonstrating long-cycling Sn||LiMn2O4 hybrid batteries. This work offers critical insights for developing highly reversible Sn metal batteries.

RESUMEN

The von Willebrand disease (vWD) is the most common hereditary bleeding disorder caused by defects of the von Willebrand Factor (vWF), a large extracellular protein in charge of adhering platelets to sites of vascular lesions. vWF performs this essential homeostatic task via specific protein-protein interactions between the vWF A1 domain and the platelet receptor, the glycoprotein Ib alpha (GPIBα). The two naturally occurring vWF A1 domain mutations G1324A and G1324S, near the GPIBα binding site, induce a dramatic decrease in platelet adhesion, resulting in a bleeding disorder classified as type 2M vWD. However, the reason for the drastic phenotypic response induced by these two supposedly minor modifications remains unclear. We addressed this question using a combination of equilibrium-molecular dynamics (MD) and nonequilibrium MD-based free energy simulations. Our data confirms that both mutations maintain the highly stable Rossmann fold of the vWF A1 domain. G1324A and G1324S mutations hardly changed the per-residue flexibility of the A1 domain but induced a global conformational change affecting the region near the binding site to GPIBα. Furthermore, we observed two significant changes in the vWF A1 domain upon mutation, the global redistribution of the internal mechanical stress and the increased thermodynamic stability of the A1 domain. These observations are consistent with previously reported mutations increasing the melting temperature. Overall, our results support the idea of thermodynamic conformational restriction of A1-before the binding to GPIBα-as a crucial factor determining the loss-of-function of the G1324A(S) vWD mutants.

Asunto(s)

Enfermedades de von Willebrand , Factor de von Willebrand , Humanos , Sitios de Unión , Plaquetas/metabolismo , Unión Proteica , Termodinámica , Enfermedades de von Willebrand/genética , Factor de von Willebrand/química , Factor de von Willebrand/genética

RESUMEN

Background: Cataract surgery with intraocular lens implant is, nowadays, the most frequent surgical procedure in all the world. Its success depends on a lot of factors, one of the most important is the calculation of the exact dioptric power of intraocular lens. Objective: To compare the calculation of dioptric power of intraocular lens with and without dilatation in patients with cataract. Material and methods: Longitudinal study, the calculation of the dioptric power of the intraocular lens was determined in patients without and with pupillary dilation. The variables were age, gender, eye to study, keratometry, axial length, anterior chamber depth and dioptric power of the intraocular lens. Descriptive statistics and Student t test were performed. Results: There were 37 patients, 23 females and 14 males. The average age was 68 + 7.87 years. Sixty-four eyes were studied, 30 were right and 34 left. Statistically, there was only significant difference in K2 of the ocular biometry between patients without and with pupillary dilation when obtaining a value of p < 0.05. Conclusion: There are no changes in the calculation of the dioptric power of the Intraocular lens without and with pupillary dilation.

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Introducción: la cirugía de catarata con implante de un lente intraocular es, hoy en día, el procedimiento quirúrgico más frecuente en todo el mundo. Su éxito depende de muchos factores, uno de los más importantes es el cálculo exacto del poder dióptrico del lente intraocular. Objetivo: comparar el cálculo del poder dióptrico del lente intraocular en los pacientes sin y con dilatación pupilar. Material y métodos: estudio longitudinal, en el que se determinó el cálculo del poder dióptrico del lente intraocular en pacientes con y sin dilatación pupilar. Las variables de estudio fueron: edad, género, ojo a estudiar, queratometría, longitud axial, profundidad de cámara anterior y poder dióptrico del lente intraocular. Se realizó estadística descriptiva y t de Student. Resultados: se estudiaron 37 pacientes, 23 mujeres y 14 hombres. La edad promedio fue de 68 ± 7.87 años. Se estudiaron 64 ojos, 30 fueron derechos y 34 izquierdos. Estadísticamente solo hubo diferencia significativa en K2 de la biometría ocular entre pacientes sin y con dilatación pupilar al obtenerse un valor de p ≤ 0.05. Conclusión: no existen cambios en el cálculo del poder dióptrico del LIO sin y con dilatación pupilar.

Asunto(s)

Catarata , Lentes Intraoculares , Anciano , Biometría/métodos , Catarata/etiología , Dilatación , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad

RESUMEN

Vitamin D (VD) is essential for calcium and phosphorus metabolism. Its deficiency can cause rickets. In Chile, newborns receive 400UI/day supplementation from the first day of age until the first year. OBJECTIVE: To describe the VD plasma levels in healthy infants who received supplementation and secondarily to correlate this with seasonality and nutritional status. SUBJECTS AND METHOD: Cross sectional study. Infants on exclusive or mixed breastfeeding, with monthly pediatric checkups recei ving 400 UI VD supplementation were evaluated, measuring VD plasma levels at 6 months of age, weight, and length, and their nutritional status was classified according to the WHO growth referen ces (weight/age and weight/length). The VD cut-off concentration values were < 20 ng/ml, 21- 29 ng/ ml, and ≥ 30 ng/ml considered as deficiency, insufficiency, and sufficiency, respectively. RESULTS: 40 infants were studied, 40% had insufficient levels and 40% presented deficiency. Season and nutritio nal status were variables significantly related to lower VD values (Winter-Spring p = 0.007; at risk of malnutrition p = 0.038). CONCLUSIONS: The population who received supplementation presented a high frequency of VD deficiency and insufficiency which increases during winter and spring and in subjects at risk of malnutrition.

Asunto(s)

Suplementos Dietéticos , Deficiencia de Vitamina D , Niño , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Vitamina D , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico , Vitaminas

RESUMEN

ntroducción: la cirugía de catarata con implante de un lente intraocular es, hoy en día, el procedimiento quirúrgico más frecuente en todo el mundo. Su éxito depende de muchos factores, uno de los más importantes es el cálculo exacto del poder dióptrico del lente intraocular. Objetivo: comparar el cálculo del poder dióptrico del lente intraocular en los pacientes sin y con dilatación pupilar. Material y métodos: estudio longitudinal, en el que se determinó el cálculo del poder dióptrico del lente intraocular en pacientes con y sin dilatación pupilar. Las variables de estudio fueron: edad, género, ojo a estudiar, queratometría, longitud axial, profundidad de cámara anterior y poder dióptrico del lente intraocular. Se realizó estadística descriptiva y t de Student. Resultados: se estudiaron 37 pacientes, 23 mujeres y 14 hombres. La edad promedio fue de 68 ± 7.87 años. Se estudiaron 64 ojos, 30 fueron derechos y 34 izquierdos. Estadísticamente solo hubo diferencia significativa en K2 de la biometría ocular entre pacientes sin y con dilatación pupilar al obtenerse un valor de p ≤ 0.05. Conclusión: no existen cambios en el cálculo del poder dióptrico del LIO sin y con dilatación pupilar.

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Background: Cataract surgery with intraocular lens implant is, nowadays, the most frequent surgical procedure in all the world. Its success depends on a lot of factors, one of the most important is the calculation of the exact dioptric power of intraocular lens. Objective: To compare the calculation of dioptric power of intraocular lens with and without dilatation in patients with cataract. Material and methods: Longitudinal study, the calculation of the dioptric power of the intraocular lens was determined in patients without and with pupillary dilation. The variables were age, gender, eye to study, keratometry, axial length, anterior chamber depth and dioptric power of the intraocular lens. Descriptive statistics and Student t test were performed. Results: There were 37 patients, 23 females and 14 males. The average age was 68 + 7.87 years. Sixty-four eyes were studied, 30 were right and 34 left. Statistically, there was only significant difference in K2 of the ocular biometry between patients without and with pupillary dilation when obtaining a value of p < 0.05. Conclusion: There are no changes in the calculation of the dioptric power of the Intraocular lens without and with pupillary dilation

Asunto(s)

Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Catarata , Pupila , Dilatación , Lentes Intraoculares , Estudios Longitudinales , Biometría/métodos , Octogenarios

RESUMEN

BACKGROUND: Monitoring of adequate food intake is not a priority in hospital patients' care. The present study aimed to examine selective data from the nutritionDay survey to determine the impact of food intake during hospitalization on outcomes according to the nutrition risk status. METHODS: We conducted a descriptive analysis of selected data from 7 consecutive, annual, and cross-sectional nutritionDay samples from 2009 to 2015. The impact of food intake on outcomes was assessed by univariate and multivariate Cox models controlling for PANDORA scores. RESULTS: A total of 7994 adult patients from Colombia, 7243 patients from 9 Latin American countries, and 155,524 patients worldwid were included. Less than half of the patients worldwide consumed their entire meal on nutritionDay (41%). The number of reduced eaters is larger in the "no nutrition risk group" than in the "nutrition risk group" (30% vs 25%). Reduced eating is associated with higher mortality and delayed discharge in patients, regardless of the nutrition risk status. Patients without nutrition risk at the screening who ate "nothing, but were allowed to eat" had 6 times more risk of mortality (hazard ratio, 6.48; 95% CI, 3.5311.87). CONCLUSIONS: This is the first large-scale study evaluating the relationship of food intake on clinical outcomes showing an increase of in-hospital mortality rates and a reduction in the probability of being discharged home regardless of the nutrition risk status. Traditional screening tools may not identify a group of patients who will become at risk because of reduced intake while in the hospital.

Asunto(s)

Desnutrición , Adulto , Estudios Transversales , Ingestión de Alimentos , Hospitales , Humanos , Desnutrición/diagnóstico , Estado Nutricional

RESUMEN

RESUMEN INTRODUCCIÓN: El ochenta por ciento de los ataques cerebrovasculares son isquémicos, y uno de cada cinco afecta la circulación posterior. Su diagnóstico es difícil y los datos disponibles sobre el pronóstico y la mortalidad son discordantes. OBJETIVO: Evaluar el desenlace funcional a 180 días de los pacientes con ataque cerebrovascular (ACV) isquémico de circulación posterior (CP). MATERIALES Y MÉTODOS: Seguimiento prospectivo a pacientes con ACV de CP que ingresaron al Instituto Neurológico de Colombia entre septiembre del 2017 y septiembre del 2018. El desenlace clínico fue determinado mediante la escala Rankin modificada (mRS) al mes, a los seis meses y al año. RESULTADOS: Fueron incluidos 68 pacientes. La edad promedio fue 61 ±17 años y 60,3 % fueron hombres. El 85% tenía un mRS previo al ACV ≤ 1 y el 63 % un NIHSS basal ≤ 4. Nueve pacientes (13,2 %) recibieron terapia de reperfusión aguda (rtPA, TEV o ambas) y siete (10,3 %) adicionales arteriografía diferida. Dieciséis pacientes (23,5 %) presentaron una mejoría del NIHSS basal ≥ 4 puntos. Cuarenta y seis pacientes (74,2 %) presentaron un desenlace excelente mRS 0-1 a los seis meses y 87,1 % fueron categorizados mRS favorable (mRS 0-2). En el análisis ajustado, el NIHSS ≥ 4 fue un predictor de desenlace desfavorable a seis meses (RR 6,4; IC95 % 2,9-14,2). Seis pacientes (9,0 %) fallecieron, cuatro relacionados con el episodio actual o su recurencia. CONCLUSIONES: La mayoría de los pacientes con ACV de CP tienen desdenlaces favorables y una baja mor%talidad. La escala de NIHSS basal es un factor pronóstico independiente.

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SUMMARY BACKGROUND: Ischemic strokes account for 80 % of all strokes, and one of every five compromises the posterior circulation. The diagnosis is difficult, and the data available about the outcome and mortality are discordant in the literature. OBJECTIVE: To investigate the clinicai outcome of patients at 180 days after posterior circulation ischemic stroke METHODS: Patients with diagnosis of posterior circulation stroke admitted to Instituto Neurológico de Colombia between September 2017 to 2018 were prospective included. The functional outcome by modified Rankin scale score (mRS) was determined at 1-month, 6-month, and 12-month after disease onset. RESULTS: 68 patients were included. The median age was 61 years ± 17 and 60.3 % were male. 85 % had a baseline mRS ≤ 1, and 63 % had a baseline National Institute Stroke Scale (NIHSS) ≤ 4. Nine patients were taken to acute recanalization therapies (rtPA, endovascular therapy or both) and seven more delayed arteriography. Sixteen patients (23.5 %) demonstrated an improvement of four or more points over the baseline NIHSS. Forty-six patients (74.2 %) had an excellent outcome 0-1 at six months and 87,1 % were categorized favorable mRS (mRS 0-2). In the adjusted analysis an NIHSS > 4 was a predictor of an unfavorable outcome at 6-month (RR 6.4; IC95 % 2.9-14.2). Six patients died (9 %); four of them in relation to the current event or an ischemic stroke recurrence. CONCLUSION: Most of the patients with posterior ischemic stroke have favorable outcomes and a low mortality. The baseline NIHSS is an independent prognostic risk factor.

Asunto(s)

Infarto Cerebral , Accidente Cerebrovascular , Diagnóstico , Evaluación de la Discapacidad

RESUMEN

Neutrophils release their intracellular content, DNA included, into the bloodstream to form neutrophil extracellular traps (NETs) that confine and kill circulating pathogens. The mechanosensitive adhesive blood protein, von Willebrand Factor (vWF), interacts with the extracellular DNA of NETs to potentially immobilize them during inflammatory and coagulatory conditions. Here, we elucidate the previously unknown molecular mechanism governing the DNA-vWF interaction by integrating atomistic, coarse-grained, and Brownian dynamics simulations, with thermophoresis, gel electrophoresis, fluorescence correlation spectroscopy (FCS), and microfluidic experiments. We demonstrate that, independently of its nucleotide sequence, double-stranded DNA binds to a specific helix of the vWF A1 domain, via three arginines. This interaction is attenuated by increasing the ionic strength. Our FCS and microfluidic measurements also highlight the key role shear-stress has in enabling this interaction. Our simulations attribute the previously-observed platelet-recruitment reduction and heparin-size modulation, upon establishment of DNA-vWF interactions, to indirect steric hindrance and partial overlap of the binding sites, respectively. Overall, we suggest electrostatics-guiding DNA to a specific protein binding site-as the main driving force defining DNA-vWF recognition. The molecular picture of a key shear-mediated DNA-protein interaction is provided here and it constitutes the basis for understanding NETs-mediated immune and hemostatic responses.

Asunto(s)

ADN/química , Simulación del Acoplamiento Molecular , Factor de von Willebrand/química , Sitios de Unión , ADN/metabolismo , Humanos , Simulación de Dinámica Molecular , Concentración Osmolar , Unión Proteica , Electricidad Estática , Factor de von Willebrand/metabolismo

RESUMEN

BACKGROUND: Compared to non-Hispanic white individuals, assistive technology (AT) utilization is lower among Hispanic individuals.1-7 In the US, Spanish is the 2nd most frequently spoken language. Greater than one-fifth of Spanish-speaking households are limited English proficiencty (LEP) households (i.e., all individuals over age 14 in the household speak English less than "very well").8 Availability of AT materials in Spanish is one factor influencing knowledge about and utilization of AT among Spanish-speakers. OBJECTIVE: To examine the availability of Spanish-language AT information on state AT program websites and to assess the relationship between availability and state demographic and linguistic characteristics. METHODS: In 2018, we evaluated 56 state and territory AT program websites for the availability of AT information in Spanish. We calculated 4 measures (US Hispanic population in the state/territory; Hispanic individuals as a proportion of state population; overall Spanish-speaking households, and Spanish-speaking, limited English proficient households) from the 2016 American Community Survey and created ranked lists for each measure. Point biserial (rpb) correlations were calculated to test associations between each measure and availability of AT information in Spanish on each program's website. RESULTS: Sixteen program websites (15 states, 1 territory) provided access to Spanish-language AT information. None of the 4 measures were strongly associated with this outcome (rpb ranged from 0.30 to 0.42). For any of the 4 measures, no more than half of states in the top 10 ranks offered online access to AT information in Spanish. CONCLUSIONS: Improving the online availability of AT information in Spanish is necessary to increase equity in AT utilization among Spanish-speaking people with disabilities.

Asunto(s)

Informática Aplicada a la Salud de los Consumidores/métodos , Bases de Datos Factuales , Personas con Discapacidad/educación , Hispánicos o Latinos/educación , Dispositivos de Autoayuda , Traducciones , Población Blanca/educación , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Puerto Rico , Estados Unidos , Población Blanca/estadística & datos numéricos

RESUMEN

RESUMEN Introducción: A mediados de 2017, 20,9 millones de personas estaban recibiendo terapia antirretrovírica en todo el mundo. Sin embargo, solo 53 % de los 36,7 millones de personas que vivían con el VIH estaba recibiendo el tratamiento en 2016 a nivel mundial. Objetivo: Determinar adherencia al tratamiento antirretroviral de personas que conviven con VIH/sida. Métodos: Estudio cuantitativo, correlacional de corte transversal, en los meses de julio a octubre del 2019 en una muestra intencional de 166 personas con VIH/sida atendidas en institución de salud Santa Marta, Colombia. Para determinar adherencia se adaptó el instrumento Morisky-Green. Investigación sin riesgo según resolución 84 30 de 1993 del Ministerio de Salud y Protección Social de Colombia. Resultados: De 166 personas que conviven con VIH/sida, 74,7 % son hombres y 25,3 % son mujeres; la edad fluctúa entre una mínima 16 años y máxima73 años, con media de 39,3 años. El tiempo del tratamiento antirretroviral fue 6 años en promedio; 51,2 % utiliza alguna estrategia para acordarse de tomar los medicamentos; 68,1 % no fueron adherentes al tratamiento antirretroviral, 49,4 % hombres y 18,7 % mujeres. Se identificó que la relación médico-paciente es negativa (-0,005) y no está relacionada con la no adherencia. Conclusiones: La no adherencia al tratamiento antirretroviral estuvo representada por el 68,1 % de la población en estudio y es mayor en los hombres.

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ABSTRACT Introduction: By mid-2017, 20.9 million people were under antiretroviral therapy worldwide. In 2016, only 53% of the 36.7 million people living with HIV worldwide were under treatment. Objective: Determine adherence to antiretroviral treatment among people living with HIV/AIDS. Methods: A quantitative cross-sectional correlational study was conducted from July to October 2019 of an intentional sample of 166 people with HIV/AIDS attending Santa Marta health center in Colombia. The Morisky-Green tool was adapted to determine adherence. The study was non-risk according to Resolution 84 30 / 1993 of the Ministry of Health and Social Protection of Colombia. Results: Of the total 166 people living with HIV/AIDS, 74.7% are men and 25.3% are women; mean age is 39.3 years (range 16-73). Average antiretroviral treatment duration is 6 years. 51.2% make use of some strategy to remember taking their medication; 68.1% are not adherent to antiretroviral treatment, 49.4% are men and 18.7% are women. The doctor-patient relationship was found to be negative (p = -0.005) and not related to non-adherence. Conclusions: Non-adherence to antiretroviral treatment was represented by 68.1% of the study population and is higher in men.

RESUMEN

INTRODUCTION: The need to promote the right to nutritional care, to fight against malnutrition and to advance in education and research in clinical nutrition has led all the FELANPE's societies to sign on May 3rd, during the 33rd Congress of the Colombian Clinical Nutrition Association (ACNC) in the city of Cartagena, the International Declaration on the Right to Nutritional Care and the Fight against Malnutrition, "Declaration of Cartagena". The Declaration provides a coherent framework of 13 principles which can serve as a guide for societies, schools and associations affiliated to FELANPE in the development of action plans. In addition, it will serve as an instrument to promote, through governments, the formulation of policies and legislation in the field of clinical nutrition. We believe that the general framework of principles proposed by the Declaration can contribute to raise awareness about the magnitude of this problem and to promote cooperation networks among Latin-American countries. Although this Declaration does not have a binding legal effect, it has an undeniable moral strength and it can provide practical guidance to States. An implementation program will allow developing a toolkit to transform principles into actions.

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INTRODUCCIÓN: Frente a la necesidad de promover el derecho al cuidado nutricional, de luchar contra la malnutrición y de avanzar en temas de educación e investigación en nutrición clínica, las sociedades que constituyen la FELANPE firmaron la Declaración Internacional sobre el Derecho al Cuidado Nutricional y la Lucha contra la Malnutrición, "Declaración de Cartagena", el 3 de mayo del presente año en la ciudad de Cartagena, en el marco del 33º Congreso de la Asociación Colombiana de Nutrición Clínica. La Declaración proporciona un marco coherente de 13 principios, los cuales podrán servir de guía a las sociedades afiliadas a la FELANPE en el desarrollo de los planes de acción. Además, servirá como un instrumento para que promuevan, a través de los gobiernos, la formulación de políticas y legislaciones en el campo de la nutrición clínica. Consideramos que el marco general de principios propuesto por la Declaración puede contribuir a crear conciencia acerca de la magnitud de este problema y a forjar redes de cooperación entre los países de la región. Aunque esta Declaración no tiene un efecto jurídico vinculante (obligatorio), tiene una fuerza moral innegable y puede proporcionar orientación práctica a los estados. Un plan de implementación permitirá desarrollar la caja de herramientas necesaria para transformar los principios en acciones.

Asunto(s)

Derechos Humanos , Cooperación Internacional , Desnutrición/prevención & control , Política Nutricional , Discusiones Bioéticas , Colombia , Prestación Integrada de Atención de Salud , Industria Farmacéutica/ética , Industria de Alimentos/ética , Abastecimiento de Alimentos , Guías como Asunto , Humanos , Cooperación Internacional/legislación & jurisprudencia , América Latina , Desnutrición/diagnóstico , Política Nutricional/legislación & jurisprudencia , Política Nutricional/tendencias , Ciencias de la Nutrición/educación , Apoyo Nutricional , Cultura Organizacional , Grupo de Atención al Paciente/organización & administración , Participación del Paciente , Investigación

RESUMEN

Introducción: La formación de profesionales de la salud en Cuba concibe la educación de estos, en valores éticos y morales. Los errores en los que incurren los profesionales de la salud en sus prácticas profesionales aumentan el riesgo de eventos adversos que atentan contra la seguridad del paciente. Los valores profesionales contribuyen a minimizar los errores y sus efectos. Los errores de medicación son unos de los más frecuentes. Objetivo: Exponer aspectos generales de los errores de medicación, los valores de los profesionales de la salud relacionados con esta temática y el papel de la formación de los profesionales en la cultura de la seguridad al paciente en Cuba. Desarrollo: Se presentan los conceptos de seguridad del paciente y de errores de medicación, vinculados con los valores de los profesionales de la salud y el proceso de formación profesional. El papel de los valores en la prevención y evaluación de los errores de medicación, así como los métodos más usados en su detección. Conclusiones: La academia y las unidades del sistema de salud cubano juegan un papel esencial en la formación en valores de los profesionales de la salud, para que ejerzan sus funciones en una cultura de la seguridad del paciente, donde los errores de medicación estén adecuadamente gestionados(AU)

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Introduction: The training of health professionals in Cuba conceives their education in ethical and moral values. The errors by health professionals in their professional practices increase the risk of adverse events that threaten patient safety. Professional values ​​help minimize errors and their effects. Medication errors are one of the most frequent. Objective: To present general aspects of medication errors, the values ​​of health professionals related to this topic, and the role of professional training in the culture of patient safety in Cuba. Development: The concepts of patient safety and medication errors are presented, associated with the values ​​of health professionals and the professional training process. The role of values ​​in the prevention and evaluation of medication errors, as well as the methods most used in their detection. Conclusions: The academy and the units of the Cuban health system play an essential role in the training in values ​​of health professionals, so that they perform their functions in a culture of patient safety, where medication errors are adequately managed(AU)

Asunto(s)

Humanos , Valores Sociales , Personal de Salud/educación , Capacitación Profesional , Errores de Medicación , Atención al Paciente

RESUMEN

BACKGROUND: Metabolic syndrome is a condition that predisposes to cardiovascular disease and diabetes mellitus. In addition, it can have effects over neoplastic pathologies, liver and pulmonary function. Our objective is to analyze the effect of the metabolic syndrome and its components on pulmonary function. METHOD: 110 subjects from Mexico City were evaluated and anthropometric measurements, glucose determination, triglycerides and high-density lipoprotein (HDL) cholesterol were made. They underwent a simple spirometry. Diagnosis of metabolic syndrome was made following the NCEP-ATPIII criteria. RESULTS: Of 110 individuals, 90 (82%) were women and 20 men (18%); 71 subjects (65%) presented metabolic syndrome. Subjects with central obesity had a forced vital capacity (FVC) lower than subjects without central obesity (2.72 vs. 3.11 liters; p < 0.05). Those with low HDL had better spirometric results than subjects with normal HDL (FEV1 2.36 vs. 1.85 liters; p < 0.05), FVC (2.95 vs. 2.45 liters; p < 0.05) and FEV1/FVC ratio (0.78 vs.74; p < 0.05). Hypertensive subjects presented lower volumes in FEV1 (1.91 vs. 2.38; p < 0.05) and FVC (2.49 vs. 2.99; p < 0.05). CONCLUSION: There is no difference between the spirometry volumes of patients with metabolic syndrome versus the metabolically healthy subjects. The only factors associated with a decrease in FEV1 and FVC are central obesity and arterial hypertension. An unexpected finding was the negative correlation between HDL levels and lung function.

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ANTECEDENTES: El síndrome metabólico es un estado que predispone a enfermedad cardiovascular y diabetes mellitus. Además, puede repercutir en la función hepática, en patologías neoplásicas y en la función pulmonar. Nuestro objetivo es analizar el efecto del síndrome metabólico y sus componentes sobre la función pulmonar. MÉTODO: Se evaluaron 110 sujetos de la Ciudad de México a quienes se realizaron mediciones antropométricas, determinación de glucosa, triglicéridos y colesterol ligado a lipoproteínas de alta densidad (HDL). Se les practicó una espirometría simple. Se realizó el diagnóstico de síndrome metabólico siguiendo los criterios NCEP-ATPIII. RESULTADOS: De 110 individuos, 90 (82%) fueron mujeres y 20 hombres (18%), y 71 (65%) presentaron síndrome metabólico. Los sujetos con obesidad central tuvieron una capacidad vital forzada (CVF) menor que aquellos sin obesidad central (2.72 vs. 3.11 l; p < 0.05). Los que presentaron colesterol HDL bajo tuvieron mejores resultados espirométricos que los sujetos con colesterol HDL normal (volumen espiratorio forzado en el primer segundo [VEF1] 2.36 vs. 1.85 l; p < 0.05), mejor CVF (2.95 vs. 2.45 l; p < 0.05) y mejor relación VEF1/CVF (78 vs. 74; p < 0.05). Los sujetos hipertensos presentaron menores volúmenes en VEF1 (1.91 vs. 2.38; p < 0.05) y CVF (2.49 vs. 2.99; p < 0.05). CONCLUSIÓN: No existe diferencia en los volúmenes espirométricos de pacientes con síndrome metabólico al compararlos con sujetos metabólicamente sanos. Solo la obesidad central y la hipertensión arterial se asocian con disminución del VEF1 y la CVF. Un hallazgo inesperado es la correlación negativa entre los valores de colesterol HDL y la función pulmonar.

Asunto(s)

HDL-Colesterol/sangre , Pulmón/fisiopatología , Síndrome Metabólico/sangre , Síndrome Metabólico/fisiopatología , Espirometría , Estudios Transversales , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Salud Urbana

RESUMEN

El islam surgió a principios del siglo VII, al este de la península arábiga, cuando Mahoma, el profeta, tuvo revelaciones del arcángel Gabriel y, consecuentemente, propuso el nacimiento de este modo de vida basado en el sometimiento a la voluntad de Alá. Las creencias alrededor de esta religión han cruzado fronteras, debido a la migración voluntaria o forzosa de su comunidad, hecho que ha marcado una influencia sociocultural de gran magnitud en sus creyentes respecto a la muerte y, por ende, a la donación humana de órganos y tejidos para trasplante. Por este motivo, su estudio constituye un tema de gran interés para los profesionales de la salud, dado que hay percepciones que influyen directamente en la concepción de sus fieles. Se tiene en cuenta el cuerpo como un ente sagrado, símbolo de la integración del alma, materia, ego e intelecto con una resurrección que podría comprometer su integridad en el proceso de donación. Sin embargo, las grandes instituciones en materia de bioética islámica respaldan que prima la obligación moral de solidaridad universal que conlleva hacerle el bien al prójimo, siempre y cuando no se infrinja un daño al ser propio.

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Islam is a religion that emerged in the seventh century in the east of the Arabian Peninsula when Mahoma, the prophet, had revelations of angel Gabriel and consecutively proposed the birth of this form of life that is based on submission before the will of Allah. Beliefs around this religion have crossed borders due to the voluntary or forced migration of their community, exercising a major socio-cultural influence on its believers regarding death and, therefore, human organ donation and tissues for transplantation. For this reason, its study is an issue of great interest to health professionals, since there are perceptions that have a direct impact on the conception of their faithful. The body is considered as a sacred entity, symbol of the integration of the soul, matter, ego and intellect with a resurrection that could jeopardize its integrity when donation is carried out. However, major institutions in Islamic Bioethics support that moral obligation of universal solidarity is more important, leading to do good to the neighbor, as long as it does not infringe any damage to one's own.

Asunto(s)

Humanos , Obtención de Tejidos y Órganos , Muerte , Islamismo

RESUMEN

Objetivo. Identificar elementos metodológicos clave para la priorización en investigación en salud, a partir de las metodologías reportadas en la literatura científica. Métodos. Se realizó una búsqueda sistemática en Medline, Embase, LILACS, y fuentes complementarias de literatura gris. Se utilizaron las palabras clave: research, methods y Health priorities, en combinación con términos libres. Dos revisores independientes, de acuerdo con criterios previamente definidos, seleccionaron revisiones de la literatura o documentos metodológicos que presentaran metodologías para priorización en investigación en salud. Se extrajeron las principales características de las metodologías reportadas y se identificaron elementos comunes. Resultados. Se incluyeron siete revisiones y cinco documentos metodológicos, que reportaron cuatro metodologías estructuradas específicas y múltiples aproximaciones metodológicas que combinan elementos diversos. En general, estas metodologías integran la perspectiva de actores clave con información objetiva, mediante la aplicación de técnicas estandarizadas de participación, para establecer un ranking de prioridades, con base en criterios previamente definidos. Se identificaron elementos metodológicos comunes relacionados con pasos del proceso, mecanismos de participación, criterios para priorizar y análisis de resultados. Conclusión. La priorización en investigación en salud requiere el empleo de una metodología definida a priori, que debe contener como mínimo cuatro elementos clave: pasos claros del proceso, criterios para priorizar, técnicas formales de participación y métodos de análisis de resultados. Estos elementos deben ajustarse a las condiciones y necesidades del contexto de aplicación.

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Objective. To identify key methodological elements for prioritization in health research, based on the methodologies reported in the scientific literature. Methods. A systematic search was conducted in Medline, Embase, LILACS, and complementary sources of gray literature. Keywords research, methods and health priorities were used in combination with free terms. Two independent reviewers, according to previously defined criteria, selected literature reviews or methodological documents that presented methodologies for prioritization in health research. The main characteristics of the reported methodologies were extracted and common elements were identified. Results. Seven revisions and five methodological documents were included, reporting four specific structured methodologies and multiple methodological approaches combining diverse elements. In general, these methodologies integrate the perspective of key stakeholders with objective information, through the application of standardized participation techniques, to establish a ranking of priorities based on previously defined criteria. Common methodological elements related to process steps, participation mechanisms, criteria for prioritizing and analysis of results were identified. Conclusion. The prioritization in health research requires the use of a methodology defined a priori, which must contain at least four key elements: clear steps of the process, criteria to prioritize, formal techniques of participation and methods for analysis of results. These elements should be tailored to the conditions and needs of the application context.

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Objetivo. Identificar os principais aspectos metodológicos para a priorização em pesquisa em saúde segundo metodologias descritas na literatura científica. Métodos. Foi realizada uma busca sistemática nas bases de dados MEDLINE, Embase, LILACS e fontes complementares da literatura cinzenta. Foram usadas as palavras-chave research, methods e health priorities, em combinação com termos livres. Dois revisores independentes selecionaram, com base em critérios predefinidos, estudos de revisão da literatura ou textos metodológicos que descreviam metodologias para a priorização em pesquisa em saúde. Foram extraídas as principais características das metodologias descritas e identificados os aspectos comuns. Resultados. Foram incluídos sete estudos de revisão e cinco textos metodológicos, que descreviam quatro metodologias estruturadas específicas e vários enfoques metodológicos que combinavam diversos aspectos. As metodologias em geral integram a perspectiva de atores-chave com informação objetiva, com a aplicação de técnicas padronizadas de participação, a fim de determinar a ordem de prioridade segundo critérios predefinidos. Foram identificados aspectos metodológicos comuns relacionados às etapas do processo, mecanismos de participação, critérios para priorização e análise de resultados. Conclusão. A priorização em pesquisa em saúde requer o uso de uma metodologia definida a priori, que no mínimo deve englobar quatro aspectos principais: etapas distintas do processo, critérios para priorização, técnicas formais de participação e métodos de análise de resultados. Estes aspectos devem ser adaptados às condições e necessidades do contexto de aplicação.

Asunto(s)

Investigación , Prioridades en Salud , Métodos , Revisión , Investigación , Prioridades en Salud , Métodos , Revisión , Investigación , Prioridades en Salud , Revisión

RESUMEN

La infección por VIH confiere al portador la susceptibilidad para desarrollar un conjunto de infecciones que normalmente no serían encontradas en un paciente inmunocompetente. En Colombia, en el año 2015, se reportaron 11.606 casos de infección por VIH. En este escrito documentamos el caso de un paciente con diagnóstico de infección por VIH, el cual desarrolló lesiones típicas de infección por el virus Varicela Zoster, y se documentó la evolución de las lesiones vesiculares hacia flictenas con necrosis local. Dada la presentación del caso, el diagnóstico de lesiones en piel en pacientes inmunocomprometidos o con infección por VIH se convierte en un reto para el profesional de la salud a la hora de establecer un diagnóstico etiológico, a fin de establecer un adecuado tratamiento de acuerdo a este.

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HIV infection makes HIV carriers susceptible to develop a group of infections that would not normally be found in an immunocompetent patient. In Colombia, a total of 11,606 cases of HIV infection were reported in 2015. This paper documents the case of a patient diagnosed with HIV infection, who developed lesions typically caused by the varicellazoster virus. These vesicular lesions evolved into phlyctenas with local necrosis. Given the case presentation, the diagnosis of skin lesions in immunocompromised or HIV-infected patients becomes a challenge for health professionals when determining an etiological diagnosis, in order to establish an appropriate treatment.