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The set of singular values of a digraph with respect to a vertex-degree based topological index is the set of all singular values of its general adjacency matrix. The spectral norm is the largest singular value and the energy the sum of the singular values. In this paper we characterize the digraphs which have exactly one singular value different from zero and the digraphs for which all singular values are equal. As a consequence, we deduce sharp upper and lower bounds for the spectral norm and energy of digraphs. In addition to being a natural generalization, proving the results in the general setting of digraphs allows us to deduce new results on graph energy.
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Background: Staphylococcus aureus infections are a significant cause of morbidity and mortality in pediatric populations worldwide. The Staphylo Research Network conducted an extensive study on pediatric patients across Colombia from 2018 to 2021. The aim of this study was to describe the epidemiological and microbiological characteristics of S. aureus in this patient group. Methods: We analyzed S. aureus isolates from WHONET-reporting centers. An "event" was a positive culture isolation in a previously negative individual after 2 weeks. We studied center characteristics, age distribution, infection type, and antibiotic susceptibilities, comparing methicillin sensitive (MSSA) and resistant S. aureus (MRSA) isolates. Results: Isolates from 20 centers across 7 Colombian cities were included. Most centers (80%) served both adults and children, with 55% offering oncology services and 85% having a PICU. We registered 8,157 S. aureus culture isolations from 5,384 events (3,345 MSSA and 1,961 MRSA) in 4,821 patients, with a median age of 5 years. Blood (26.2%) and skin/soft tissue (18.6%) were the most common infection sources. Most isolates per event remained susceptible to oxacillin (63.2%), clindamycin (94.3%), and TMP-SMX (98.3%). MRSA prevalence varied by city (<0.001), with slightly higher rates observed in exclusively pediatric hospitals. In contrast, the MRSA rate was somewhat lower in centers with Antimicrobial Stewardship Program (ASP). MRSA was predominantly isolated from osteoarticular infections and multiple foci, while MSSA was more frequently associated with recurrent infections compared to MRSA. Conclusions: This is the largest study of pediatric S. aureus infections in Colombia. We found MSSA predominance, but resistance have important regional variations. S. aureus remains susceptible to other commonly used antibiotics such as TMP-SMX and clindamycin. Ongoing monitoring of S. aureus infections is vital for understanding their behavior in children. Prospective studies within the Staphylored LATAM are underway for a more comprehensive clinical and genetic characterization.
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We assume that D is a directed graph with vertex set V ( D ) = { v 1 , v n } and arc set E ( D ) . A VDB topological index φ of D is defined as φ ( D ) = 1 2 ∑ u v ∈ E ( D ) φ d u + , d v - , where d u + and d v - denote the outdegree and indegree of vertices u and v, respectively, and φ i , j is a bivariate symmetric function defined on nonnegative real numbers. Let A φ = A φ ( D ) be the n × n general adjacency matrix defined as [ A φ ] i j = φ d v i + , d v j - if v i v j ∈ E ( D ) , and 0 otherwise. The energy of D with respect to a VDB index φ is defined as E φ ( D ) = ∑ i = 1 n σ i ( A φ ) , where σ 1 ( A φ ) ≥ σ 2 ( A φ ) ≥ ⯠≥ σ n ( A φ ) ≥ 0 are the singular values of the matrix A φ . We will show that in case φ = R is the Randic index, the spectral norm of A R is equal to 1, and rank of A R is equal to rank of the adjacency matrix of D. Immediately after, we illustrate by means of examples, that these properties do not hold for most well-known VDB topological indices. Taking advantage of nice properties the Randic matrix has, we derive new upper and lower bounds for the Randic energy E R in digraphs. Some of these generalize known results for the Randic energy of graphs. Also, we deduce a new upper bound for the Randic energy of graphs in terms of rank, concretely, we show that E R ( G ) ≤ r a n k ( G ) for all graphs G, and equality holds if and only if G is a disjoint union of complete bipartite graphs.
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OBJECTIVE: To describe a cohort of pediatric patients with encephalitis and their risk factors for admission to the pediatric intensive care unit (PICU). STUDY DESIGN: Children (<18 years old), with encephalitis evaluated by conventional microbiology and syndromic, multiplex test in cerebrospinal fluid (CSF) between July 2017 and July 2020, were recruited from 14 hospitals that comprise the Colombian Network of Encephalitis in Pediatrics. Multivariate analyses were used to evaluate risk factors associated with the need for PICU admission. RESULTS: Two hundred two children were included, of which 134 (66.3%) were male. The median age was 23 months (IQR 5.7-73.2). The main etiologies were bacteria (n = 55, 27%), unspecified viral encephalitis (n = 44, 22%) and enteroviruses (n = 27, 13%), with variations according to age group. Seventy-eight patients (38.6%) required management in the PICU. In multivariate analysis, factors associated with admission to the PICU were the presence of generalized seizures (OR 2.73; 95% CI: 1.82-4.11), status epilepticus (OR 3.28; 95% CI: 2.32-4.62) and low leukocyte counts in the CSF (OR 2.86; 95% CI: 1.47-5.57). Compared with enterovirus, bacterial etiology (OR 7.50; 95% CI: 1.0-56.72), herpes simplex encephalitis (OR 11.81; 95% CI: 1.44-96.64), autoimmune encephalitis (OR 22.55; 95% CI: 3.68-138.16) and other viral infections (OR 5.83; 95% CI: 1.09-31.20) increased the risk of PICU admission. CONCLUSIONS: Data from this national collaborative network of pediatric patients with encephalitis allow early identification of children at risk of needing advanced care and can guide the risk stratification of admission to the PICU.
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Países em Desenvolvimento , Encefalite , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Masculino , Estudos Retrospectivos , Fatores de RiscoRESUMO
Background: Children with cancer are at risk of critical disease and mortality from COVID-19 infection. In this study, we describe the clinical characteristics of pediatric patients with cancer and COVID-19 from multiple Latin American centers and risk factors associated with mortality in this population. Methods: This study is a multicenter, prospective cohort study conducted at 12 hospitals from 6 Latin American countries (Argentina, Bolivia, Colombia, Ecuador, Honduras and Peru) from April to November 2021. Patients younger than 14 years of age that had an oncological diagnosis and COVID-19 or multisystemic inflammatory syndrome in children (MIS-C) who were treated in the inpatient setting were included. The primary exposure was the diagnosis and treatment status, and the primary outcome was mortality. We defined "new diagnosis" as patients with no previous diagnosis of cancer, "established diagnosis" as patients with cancer and ongoing treatment and "relapse" as patients with cancer and ongoing treatment that had a prior cancer-free period. A frequentist analysis was performed including a multivariate logistic regression for mortality. Results: Two hundred and ten patients were included in the study; 30 (14%) died during the study period and 67% of patients who died were admitted to critical care. Demographics were similar in survivors and non-survivors. Patients with low weight for age (<-2SD) had higher mortality (28 vs. 3%, p = 0.019). There was statistically significant difference of mortality between patients with new diagnosis (36.7%), established diagnosis (1.4%) and relapse (60%), (p <0.001). Most patients had hematological cancers (69%) and they had higher mortality (18%) compared to solid tumors (6%, p= 0.032). Patients with concomitant bacterial infections had higher mortality (40%, p = 0.001). MIS-C, respiratory distress, cardiovascular symptoms, altered mental status and acute kidney injury on admission were associated with higher mortality. Acidosis, hypoxemia, lymphocytosis, severe neutropenia, anemia and thrombocytopenia on admission were also associated with mortality. A multivariate logistic regression showed risk factors associated with mortality: concomitant bacterial infection OR 3 95%CI (1.1-8.5), respiratory symptoms OR 5.7 95%CI (1.7-19.4), cardiovascular OR 5.2 95%CI (1.2-14.2), new cancer diagnosis OR 12 95%CI (1.3-102) and relapse OR 25 95%CI (2.9-214). Conclusion: Our study shows that pediatric patients with new onset diagnosis of cancer and patients with relapse have higher odds of all-cause mortality in the setting of COVID-19. This information would help develop an early identification of patients with cancer and COVID-19 with higher risk of mortality.
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Let D be a digraph with set of arcs A. The Sombor index of D is defined as SO ( D ) = 1 2 ∑ u v ∈ A ( d u + ) 2 + ( d v - ) 2 , where d u + and d v - are the out-degree and in-degree of the vertices u and v of D. When D is a graph, we recover the Sombor index of graphs, a molecular descriptor recently introduced with a good predictive potential and a great research activity this year. In this paper we initiate the study of the Sombor index of digraphs. Specifically, we find sharp upper and lower bounds for SO over the class D n of digraphs with n non-isolated vertices, the classes C n and S n of connected and strongly connected digraphs on n vertices, respectively, the class of oriented trees OT ( n ) with n vertices, and the class O ( G ) of orientations of a fixed graph G.
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Introducción:el síndrome de Guillain-Barré (SGB) es una polineurorradiculopatía desmielinizante aguda inmunomediada. El síntoma principal es la debilidad muscular. El objetivo del presente estudio es describir las características del episodio agudo, las secuelas neurológicas a largo plazo y cómo estas afectan la situación laboral y las actividades de tiempo libre. Materiales y métodos: estudio realizado en dos fases: primera, descripción retrospectiva de casos; segunda, corte transversal donde se interrogaron las secuelas neurológicas y sus implicaciones. Resultados: se identificaron 63 casos de SGB con edad promedio de 50,79 años (DE 17.8), más frecuente en hombres (61,9%) y cuyo promedio de la escala Hughes en el episodio agudo fue 3,2 (DE ± 10,1). Las principales complicaciones durante la fase aguda fueron neumonía (7,94 %) y úlceras por presión (3,17 %). Se logró contactar vía telefónica a 28 pacientes, 82,1% presentó al menos un síntoma como secuela, 60,7% parestesias, 57,1% fatiga, 50% calambres y 46,4% dolor de características neuropáticas. El 32,1% tuvo cambios o retiro de su trabajo por las secuelas; 21,43% debió modificar sus actividades de tiempo libre. Conclusión: existe alta prevalencia de síntomas residuales discapacitantes después del episodio agudo de SGB con predominio de síntomas sensitivos, coincidiendo con estudios realizados en países desarrollados. Estas alteraciones ocasionan un impacto negativo en la actividad laboral y en la de tiempo libre de los pacientes.
Introduction: Guillain-Barré syndrome (GBS) is an acute immune-mediated demyelinating polyneuropathy. The main symptom encountered is muscle weakness. This study seeks to describe the characteristics of an acute episode, the long-term neurologic sequelae and how they affect patients Ì work and leisure activities. Materials and Methods: a two-phase study comprising a retrospective case description in the first phase followed by a cross sectional study during the second phase in which patients were asked to describe their neurologic sequelae and how they affected them Results: we identified 63 cases of GBS, mean age was 50.79 years (SD 17.8), there was a male preponderance (61.9%) with a 3.2 (SD ± 10.1) average score on the Hughes scale during the acute episode. Major complications during the acute phase were pneumonia (7.94 %) and pressure sores (3.17 %). Phone contact was achieved with 28 patients, 82.1% presented at least one sequelae 60.7% paresthesia, 57.1% fatigue, 50% cramps and 46.4% neuropathic pain. In 32.1% of cases patients Ì work was adjusted or they were removed from work because of their sequelae; 21.43% had to modify their free-time activities. Conclusion: there is a high prevalence of disabling residual symptoms after a GBS acute episode predominantly sensory signs, which coincide with the results of studies conducted in developed countries. Said alterations negatively impact patients Ì work and leisure activities
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Humanos , Animais , Masculino , Pessoa de Meia-Idade , Idoso , Síndrome de Guillain-Barré , Dor , Polineuropatias , Sinais e Sintomas , FadigaRESUMO
Resumen Introducción. La gestión del conocimiento como proceso innovador y clave para organizaciones inteligentes permitió llevar su aplicación a centros de investigación de educación superior, basados en el capital intelectual (CI), como eje fundamental en la creación de activos intangibles, haciendo uso del modelo Intellectus, el cual enfatiza como componentes del CI: el Capital Humano (CH), Estructural (CE) y Relacional (CR). Objetivo. Desarrollar una metodología en la medición del CH y CE para centros de investigación. Materiales y métodos. Haciendo uso de la técnica de lógica difusa 2 y el toolbox Matlab®, se generaron algoritmos para obtener una herramienta inteligente. Para su validación, el modelo se aplicó al grupo de investigaciones de Ciencias Administrativas del Instituto Tecnológico Metropolitano de Medellín. Mediante la técnica Delfi, seis expertos dictaminaron que las variables decisivas a evaluar son, del CH: valores y aptitudes, actitudes, y conocimiento; del CE organizativo: aprendizaje organizativo y del CE tecnológico: I+D. La información se obtuvo de la aplicación en 16 investigadores en un formato con 54 preguntas, medidas en escala de Likert. Resultados. Con lógica difusa 2 se logró una base de reglas que, junto al tipo de reducción Karnik-Mendel, permitieron la toma de decisiones sobre las variables, a través de la superficie de control. Conclusión. La combinación entre capacidades y esfuerzo, I+D aporta mayor valor. La relación actitudes con aprendizaje organizativo es significativa, aunque no prioritaria en la generación de valor y la generación de valor, entre las variables valores y aptitudes, con aprendizaje organizativo, no es significativa.
Abstract Introduction: Knowledge management as an innovative and key process for smart organizations allowed its application in higher education research centers, based on intellectual capital (IC), as a fundamental axis in the creation of intangible assets, using the Intellectus model, which emphasizes as components of the IC: Human Capital (HC), Structural Capital (SC) and Relational Capital(RC). Objective: The work seeks to develop a measurement methodology for HC and SC for research centers. Materials and methods: Using the fuzzy logic technique 2 and the Matlab® toolbox, algorithms were generated to obtain an intelligent tool. The model validation was applied to the Administrative Sciences research group of the Metropolitan Technological Institute of Medellin. Through the Delphi technique, six experts determined that the decisive variables to be evaluated, according to the model, were from the HC: values and aptitudes, attitudes, and knowledge; from organizational SC: organizational learning; and from technological SC: R&D. The information was obtained from the application of a questionnaire with 54 questions to 16 researchers, measured with a Likert scale. Results: With fuzzy logic 2, a base of rules was achieved that, together with the Karnik-Mendel type of reduction, allowed decision making on the variables through the control surface. Conclusion: The combination of capabilities and effort and R&D brings greater value. The relationship between attitudes and organizational learning is significant, although not a priority in the generation of value; and the generation of value, between the values and skills variables, with organizational learning, is not significant.
Resumo Introdução. A gestão do conhecimento como processo inovador e chave para organizações inteligentes permitiu levar sua aplicação à centros de pesquisa de educação superior, baseados no capital intelectual (CI), como eixo fundamental na criação de ativos intangíveis, fazendo uso do modelo Intellectus, o qual enfatiza como componentes do CI: o Capital Humano (CH), Estrutural (CE) e Relacional (CR). Objetivo. Desenvolver uma metodologia na medição do CH e CE para centros de pesquisa. Materiais e métodos. Fazendo o uso da técnica de lógica difusa 2 e o toolbox Matlab®, se geraram algoritmos para obter uma ferramenta inteligente. Para a sua validação, o modelo se aplicou ao grupo de pesquisas de Ciências Administrativas do Instituto Tecnológico Metropolitano de Medellín. Mediante a técnica Delfi, seis expertos ditaram que as variáveis decisivas à avaliar são, do CH: valores e aptidões, atitudes e conhecimento; do CE organizativo: aprendizagem organizativo e do CE tecnológico: P&D. A informação se obteve da aplicação em 16 pesquisadores em um formato com 54 perguntas, medidas em escala de Likert. Resultados. Com lógica difusa 2 se conseguiu uma base de regras que, junto ao tipo de redução Karnik-Mendel, permitiram a tomada de decisões sob as variáveis, através da superfície de controle. Conclusão. A combinação entre as capacidades e o esforço, P&D aporta maior valor. A relação atitudes com aprendizagem organizativo é significativa, embora não seja prioritária na geração de valor, e a geração de valor entre as variáveis valores e aptidões, com aprendizagem organizativo, não é significativa.
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We report the measurement of the entangled two-photon absorption (ETPA) cross section, σE, at 808 nm on organic chromophores in solution in a low photon flux regime. We performed measurements on zinc tetraphenylporphyrin (ZnTPP) in toluene and rhodamine B (RhB) in methanol. This is, to the best of our knowledge, the first time that σE is measured for RhB. Additionally, we report a study of the dependence of σE on the molecular concentration for both molecular systems. In contrast to previous experiments, our measurements are based on detecting the pairs of photons that are transmitted by the molecular system. By using a coincidence count circuit it was possible to improve the signal-to-noise ratio. This type of work is important for the development of spectroscopic and microscopic techniques using entangled photons.
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El síndrome de Melas es una enfermedad de herencia mitocondrial caracterizada por encefalopatía mitocondrial, acidosis láctica y eventos similares a ataque cerebrovascular, secundaria a una mutación en los genes que codifican las proteínas transportadoras de electrones, limitando la producción energética y generando disfunción multiorgánica, que afecta principalmente el sistema músculo esquelético y el sistema nervioso, lo que está en correlación con las características clínicas que presentan los pacientes. El diagnostico se basa en la sospecha clínica, los hallazgos paraclínicos e imagenológicos y la confirmación de la mutación a través del estudio genético. No existe tratamiento específico, se basa únicamente en el manejo sintomático y requiere apoyo multidisciplinario. Presentamos el caso de un paciente con antecedente de Melas, que ingresó por evento cerebrovascular isquémico bioccipital y correlación con hallazgos en neuroimágenes (espectroscopia y tractografía).
Melas syndrome is a disease characterized by mitochondrial inheritance of mitochondrial encephalopathy, lactic acidosis and events like stroke secondary to a mutation in the gene encoding the electron transport proteins limiting energy production and generating multiorgan dysfunction being affected mainly musculoskeletal system and the nervous system which correlates with the clinical characteristics presented by patients. The diagnosis is based on clinical suspicion, laboratory, and imaging findings and confirmation of the mutation through genetic study. No specific treatment is Is available, but symptomatic treatment is needed and requires multidisciplinary support. We report a patient with a history of Melas who who had bioccipital cerebral ischemic event and correlation with findings in neuroimaging (spectroscopy and tractography).
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BACKGROUND: Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) reduces disability in patients with ischemic stroke. However, its implementation in Chilean public general hospitals has been slow and faces some difficulties. AIM: To analyze the results of an intravenous thrombolysis protocol implementation in a public general hospital. MATERIAL AND METHODS: During a lapse of 28 months a standardized protocol for intravenous thrombolysis implemented in the emergency room of a public hospital, was prospectively evaluated. Fifty four patients with ischemic stroke were treated and assessed three months later as outpatients. RESULTS: At three months of follow-up, 66.4% of patients subjected to thrombolysis had a favorable evolution, defined as having 0 to 1 points in the modified Rankin scale. Intracerebral hemorrhage rate was 11.1%, including 5.5% of symptomatic intracerebral hemorrhage. Four percent of patients had systemic bleeding complications after thrombolysis. The mortality rate was 14.8%. CONCLUSIONS: The success rates, mortality, and complications rate were comparable to the results obtained in international studies, despite of the absence of a stroke unit to manage stroke and its complications.
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Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tecidual/uso terapêutico , Adulto , Idoso , Encéfalo/diagnóstico por imagem , Isquemia Encefálica/complicações , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/prevenção & controle , Progressão da Doença , Feminino , Hospitais Públicos , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Acidente Vascular Cerebral/complicações , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Background: Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) reduces disability in patients with ischemic stroke. However, its implementation in Chilean public general hospitals has been slow and faces some difficulties. Aim: To analyze the results of an intravenous thrombolysis protocol implementation in a public general hospital. Material and Methods: During a lapse of 28 months a standardized protocol for intravenous thrombolysis implemented in the emergency room of a public hospital, was prospectively evaluated. Fifty four patients with ischemic stroke were treated and assessed three months later as outpatients. Results: At three months of follow-up, 66.4% of patients subjected to thrombolysis had a favorable evolution, defined as having 0 to 1 points in the modified Rankin scale. Intracerebral hemorrhage rate was 11.1%, including 5.5% of symptomatic intracerebral hemorrhage. Four percent of patients had systemic bleeding complications after thrombolysis. The mortality rate was 14.8%. Conclusions: The success rates, mortality, and complications rate were comparable to the results obtained in international studies, despite of the absence of a stroke unit to manage stroke and its complications.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Ativadores de Plasminogênio/uso terapêutico , Terapia Trombolítica/métodos , Isquemia Encefálica/tratamento farmacológico , Acidente Vascular Cerebral/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Fatores de Tempo , Índice de Gravidade de Doença , Infusões Intravenosas , Encéfalo/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/prevenção & controle , Isquemia Encefálica/complicações , Estudos Prospectivos , Reprodutibilidade dos Testes , Resultado do Tratamento , Progressão da Doença , Acidente Vascular Cerebral/complicações , Hospitais PúblicosRESUMO
La tuberculosis es una de las enfermedades infecciosas más importantes en el mundo. Las manifestaciones extrapulmonares se presentan en el 10 al 15 % de los pacientes con la enfermedad y el compromiso músculo esquelético en el 1 al 2 %. Hasta la mitad de estos pacientes pueden tener tuberculosis en columna vertebral, también llamada mal de Pott, siendo mas frecuente la afectación de la columna lumbar y los segmentos inferiores de la columna dorsal. Los síntomas más comunes de la enfermedad de Pott son el dolor de espalda progresivo y de larga duración, acompañado de síntomas constitucionales. El tratamiento antituberculoso tetraconjugado ha mostrado unas elevadas tasas de éxito, evitando así la necesidad de cirugía. Se presenta el caso de un paciente pediátrico con enfermedad de Pott, que inició con un cuadro de dolor lumbar crónico, fiebre y síntomas constitucionales; por imágenes diagnósticas se comprobó el compromiso lumbar, fue llevado a cirugía y en la tinción de Zielh Nielsen del líquido obtenido se encontraron bacilos acido alcohol resistentes, además se demostró compromiso pulmonar primario. Debido al subdiagnóstico de tuberculosis en nuestro medio, se realizó este reporte para llamar la atención de la necesidad de una alta sospecha, lograr una detección y tratamiento oportunos, y el consiguiente impacto sobre la morbilidad y complicaciones de esta enfermedad.
Tuberculosis is one of the most important infectious diseases in the world; extrapulmonary manifestations occur in 10 to 15% and skeletal compromise in 1 to 2% of the total cases, up to half of these patients may have tuberculosis of the spine or Pott's disease, being most frequently affecting the lumbar and the lower segments of the spine. The most common symptom is a progressive and long lasting back pain, accompanied by constitutional symptoms. Antituberculous treatment using four drug regimens has shown high rates of success, avoiding the need for surgery. We present the following case of a pediatric patient whit Pott's disease, which began with a chronic lumbar pain, fever and constitutional symptoms, lumbar compromise was confirmed by diagnostic imaging, he was taken to surgery and staining of the fluid was positive for acid fast bacilli, primary pulmonary involvement was also showed. Due to the underestimation of tuberculosis in our country, we present this report to bring our attention to the need of a high index of suspicion in order to have a prompt diagnosis and treatment to avoid long term morbidity of this disease.
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Objetivo: describir las apreciaciones que tiene la población en condición de desplazamiento forzado sobre los tributos de accesibilidad, oportunidad, continuidad, integridad y calidez de las instituciones prestadoras de servicios de salud. Metodología: a una muestra de afijación proporcional según la cantidad de poblaciones desplazada, asentada en los municipios de Soacha, Cali y Pereira, se administró un instrumento con escalas tipo Likert. Se obtuvieron medianas para calificar los atributos del servicio recibidos por la población. Resultados: el aseguramiento al régimen subsidiado de 38 a 69,4% después del desplazamiento. Se dectetaron limitaciones en la accesibilidad por cobro de los servicos de salud (26,7%) y negación del servicio por la ausencia de contratos (14,4%). El 75,1% de los usuarios declararon que no se dio solución a sus necesidades de salud. La menor calificación la obtuvo la oportunidad, reflejada en el tiempo para la búsqueda de la cita para la consulta especializada y el tiempo de espera en urgencias, percibidos como muy largos. Conclusiones: las apreciaciones de los desplazados sobre los servicios de salud fueron parcialmente satisfactorias, salvo en la oportunidad. Se evidencia un esfuerzo del sistema de salud por garantizar la afiliación de esta población al régimen subsidiado.
Objective: To describe the findings that the population has in condition of forced displacement on the attributes of accessibility, timeliness, continuity, integrity and warmth of the institutions providing health services. Methodology: the proportional sample was calculated and the questionnaire was applied to displaced population living in three Colombian cities: Soacha, Cali and Pereira. A Likert scales questionnaire was designed. Medians were calculated to rate the health care attributes of the service provided. Results: subsidized insurance scheme rose from 38 to 69.4% after displacement. Limitations were found in the collection accessibility of health services (26.7%) and denial of service by the lack of contracts (14.4%). 75.1% of users stated that there was a solution to their health needs. The lower the grade got the opportunity, as reflected in the time for seeking an appointment for specialist consultation and waiting times in emergency care are perceived as too long. Conclusions: The findings of the displaced on the health services were partially satisfactory, except in the health of this population affiliation to the subsidized regime.
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Acessibilidade aos Serviços de Saúde , Qualidade da Assistência à SaúdeRESUMO
14-Deoxyandrographolide (14-DAP) is a labdane diterpene isolated from Andrographis paniculata with previously reported calcium channel blocking activity. Its potential platelet activating factor (PAF) antagonistic activity in bovine neutrophils was assessed. 14-DAP, in concentrations between 10-100 microM, reduced the extracellular acidification rate and the intracellular alkalinization in a dose-dependent manner. In addition, 14-DAP reduced PAF-induced calcium flux in the presence of extracellular calcium, and tyrosine phosphorylation of a 44 kDa protein corresponding to the MAPK(ERK1). However, 14-DAP reduced the 3H-PAF binding with a Ki of 7.8 x 10 (- 9)M, and a Hill slope of 0.63, suggesting that there is more than one binding site for 14-DAP. We concluded that 14-DAP is an effective antagonist of PAF-mediated processes in bovine neutrophils, probably by virtue of its calcium channel blocking property.
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Andrographis , Diterpenos/farmacologia , Neutrófilos/efeitos dos fármacos , Fitoterapia , Fator de Ativação de Plaquetas/antagonistas & inibidores , Animais , Bloqueadores dos Canais de Cálcio/administração & dosagem , Bloqueadores dos Canais de Cálcio/farmacologia , Bloqueadores dos Canais de Cálcio/uso terapêutico , Bovinos , Diterpenos/administração & dosagem , Diterpenos/uso terapêutico , Relação Dose-Resposta a Droga , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Fosforilação/efeitos dos fármacosRESUMO
Antecedentes: El 95 por ciento de los trastornos de la alimentación se presenta en mujeres, siendo más frecuente en estudiantes de secundaria y universitarias, Su prevalencia en el mundo es el 0.5 al 1 por cinto para anorexia nerviosa y del 1 al 10 por ciento para bulimia. En Colombia es del 2.3 por ciento y 0.1 por ciento respectivamente, y no se conoce la prevalencia real para el trastorno de alimentación compulsiva. Dentro de la etiología, factores culturales como los medios de comunicación, presión social, estrés académico y otros desordenes mentales como depresión y ansiedad están fuertemente asociados."Objetivo": Calcular la prevalencia de los trastornos de alimentación y estimar su asociación con presión familiar, influencia de los medios de comunicación, estrés académico, depresión y ansiedad. Materiales y métodos: Estudio descriptivo realizado en 196 estudiantes universitarias de primer y segundo año en cuatro programas de pregrado del CES. Se aplicó un cuestionario con preguntas dirigidas a evaluar cada trastorno y factor de riesgo mencionado...