RESUMEN
INTRODUCTION: Patient Safety is a major public health problem worldwide and is responsibility of all those involved in health care. Establishing a Safety Culture has proved to be a factor that favors the integration of work teams, communication and construction of clear procedures in various organizations. Promote a culture of safety depends on several factors, such as organization, work unit and staff. Objective assessment of these factors will help to identify areas for improvement and establish strategic lines of action. OBJECTIVE: [corrected] To adapt, validate and calibrate the questionnaire Culture of Quality in Health Services (CQHS) in Mexican population. MATERIAL AND METHODS: A cross with a stratified representative sample of 522 health workers. The questionnaire was translated and adapted from Singer's. Content was validated by experts, internal consistency, confirmatory factorial validity and item calibration with Samejima's Graded Response Model. RESULTS: Convergent and divergent construct validity was confirmed from the CQHS, item calibration showed that the questionnaire is able to discriminate between patients and represent different levels of the hypothesized dimensions with greater accuracy and lower standard error. CONCLUSIONS: The CQHS is a valid and reliable instrument to assess patient safety culture in hospitals in Mexico.
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Cultura Organizacional , Seguridad del Paciente , Calidad de la Atención de Salud , Encuestas y Cuestionarios , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
OBJECTIVES: To determine the lymphoproliferative response to the 30-kDa protein (p30) of Salmonella typhimurium in patients with ankylosing spondylitis (AS). METHOD: Lymphoproliferative response was determined in peripheral blood mononuclear cells (PBMCs) from 30 patients with AS and 40 healthy subjects. Cells were cultured with concanavalin A (Con A), a crude lysate of S. typhimurium (StCL), or p30. Lymphoproliferation was measured by the MTT assay. RESULTS: Our data show that the mitogenic response to Con A was similar in both groups studied; however, the lymphoproliferative response to StCL and p30 was statistically higher in AS patients than in healthy subjects. CONCLUSIONS: Our data strongly suggest that S. typhimurium, and particularly p30, are associated with AS.
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Proteínas Bacterianas/inmunología , Infecciones por Salmonella/complicaciones , Salmonella typhimurium/inmunología , Espondilitis Anquilosante/inmunología , Espondilitis Anquilosante/microbiología , Adulto , Concanavalina A/inmunología , Femenino , Humanos , Inmunidad Celular , Linfocitos/fisiología , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To compare the bleeding patterns, satisfaction and tolerability of 3 different contraceptive in an extended regimens in the service of Family Planning of the North Central Hospital of PEMEX. MATERIAL AND METHODS: Healthy, adult women with desire of contraception for one year (N 120) were randomly assigned to receive oral contraceptive drospirenone/ethinyl E2 (group1), the norelgestromin/ethinyl E2 transdermal patch (group 2) and vaginal ring etonogestrel/ ethinyl E2 (group 3) in an extended regimen (42 consecutive days, 1 hormone-free week). Study assessments were conducted at scheduled visits at the time of initial screening, at baseline after 1, 3, 6, and 12 months. Subjects recorded menstrual associated symptoms bleeding data and completed satisfaction questionnaires. Subjects and investigators provided overall assessments of the regimens. RESULTS: Extended use of 3 different contraceptive resulted in fewer bleeding days in every group (66.6%, 55% and 58.3% P 0.0024), and less mastalgia and menstrual pain. Subjects were highly satisfied with three regimens (93.3%, 96.6% and 91.6% P 0.00421). Although not mayor adverse events were reported with this regimen, there was an increase in spotting days; it decreased with each successive cycle of therapy. Efficacy and safety were similar to those reported for traditional cycle. CONCLUSION: Extended-contraceptive regimen delays menses and reduces bleeding, a profile that may be preferred by women who seek flexibility with their contraceptive method.
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Androstenos/farmacología , Anticonceptivos Orales Combinados/farmacología , Anticonceptivos Hormonales Orales/farmacología , Desogestrel/farmacología , Etinilestradiol/farmacología , Ciclo Menstrual/efectos de los fármacos , Norgestrel/análogos & derivados , Administración Cutánea , Adolescente , Adulto , Androstenos/administración & dosificación , Androstenos/efectos adversos , Enfermedades de la Mama/inducido químicamente , Dispositivos Anticonceptivos Femeninos , Anticonceptivos Orales Combinados/administración & dosificación , Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Hormonales Orales/administración & dosificación , Anticonceptivos Hormonales Orales/efectos adversos , Desogestrel/administración & dosificación , Desogestrel/efectos adversos , Combinación de Medicamentos , Dismenorrea/prevención & control , Etinilestradiol/administración & dosificación , Etinilestradiol/efectos adversos , Femenino , Cefalea/inducido químicamente , Humanos , Norgestrel/administración & dosificación , Norgestrel/efectos adversos , Norgestrel/farmacología , Aceptación de la Atención de Salud , Estudios Prospectivos , Factores de Tiempo , Hemorragia Uterina/inducido químicamente , Adulto JovenRESUMEN
BACKGROUND: Psoriasis is a chronic disease of the skin that appears to be of autoimmune nature. It has a strong association with throat streptococcal infections, as well as with stressful events. Although many groups consider psoriasis to be a T-cell-mediated autoimmune disease, autoantibodies could also play a role in the development of this process. METHODS: In this work, we looked for autoantibodies to psoriatic skin in 21 psoriatic patients and four healthy donors (controls). The immunoperoxidase technique was used to look for autoantibodies in autologous sera in skin sections obtained from lesions or from healthy areas of the same patient, before and after immunoadsorption with a Streptococcus pyogenes extract. The skin biopsies were also analyzed with a pool of sera from mice immunized with the streptococcal extract. RESULTS: We found that all psoriatic patients had autoantibodies to antigens present in keratinocytes, whereas healthy subjects did not. These antibodies did not recognize epitopes on healthy skin from the same psoriatic patients or controls. Immunoadsorption of autologous sera removed the reactivity to antigens in skin lesions in all cases. Mouse anti-streptococcal sera recognized epidermal antigens present in lesional psoriatic skin, but not in healthy skin from psoriatic patients or controls. Deposits of immunoglobulin G (IgG) were not detected in the lesions. CONCLUSIONS: It seems that autoantibodies, although they do not appear to participate in the pathogenesis of psoriasis, are an important feature, and that skin antigens, which appear in lesional immature keratinocytes, cross-react with S. pyogenes and contribute to the autoimmune process in psoriasis.