RESUMO
The evergreen forests of the Ecuadorian Amazon Region are altered by anthropogenic and natural factors. This provokes the need to look for tools that facilitate decision-making in support of restoration. We characterized the ecological structure and distribution of an evergreen Amazonian-Andean forest in the upper Puyo River micro-basin as a base for establishing an ecological quality index. The inventory was assessed using transects 0.1 ha (10 m × 100 m), registering the species with diameters at 1.30 m height ≥10 cm. We encountered a high degree of richness (30 families, 65 species and 322 individuals). The structural parameters indicated the predominance of a heterogeneous forest, with characteristics belonging to disturbed forests. A non-continuous vertical distribution pattern was found, determined by 78% of the species in a single stratum. The mixing ratio resulted in a higher proportion (1:5) for the lower class. The species Wettinia maynensis, Alchornea glandulosa, Miconia splendens, Piptocoma discolor and Inga velutina had the highest ecological value. The principal components analysis distinguished the abundance of species that had a high correlation with the sites and a distinct pattern was found in transect three. We developed the Structural Ecological Quality Index, which considers the social position of various species as well as their ecological importance, to reflect alterations in structural parameters. Abundance was concentrated in the 10-20 m strata (10-20 cm diameter class), which showed the presence of disturbance indicator species and a low ecological value. This indicated the real value of the historical succession of the forest, thus we recommend carrying out a restoration of this important reservoir.
RESUMO
El traumatismo raquimedular se define como el trauma que afecta cualquier nivel de las estructuras de la columna vertebral (osteoligamentosas, cartilaginosas, musculares, vasculares, meníngeas, radiculares y medulares). Los pacientes son en su mayoría jóvenes, víctimas de accidentes o violencia. Los costos de su tratamiento inmediato y a largo plazo son elevados. Se reporta un caso de trauma raquimedular en un adolescente, cuyo examen físico demostró normalidad neurológica; sin embargo, en los exámenes de imagen se evidenció triple fractura vertebral toráxica (T6, T7 y T8), que fue corregida mediante cirugía, seguida de rehabilitación física; la recuperación fue completa y no quedaron secuelas. La normalidad neurológica luego de injuria espinal no descarta un daño medular, por lo que el cuidado inmediato y la evaluación completa de estos pacientes son parte fundamental del protocolo de su atención.
Spinal cord trauma is defined as the trauma that affects all levels of the structures of the spine (osteo, ligament, cartilaginous, muscle, vascular, meningeal, root and spinal cord). The patients are mostly young people, victims of accidents or violence. Immediate treatment and long-term costs are high. We report a case of spinal cord trauma in a teenager, whose physical exam was neurologically normal. However, the image exams showed triple spinal thoracic fracture (T6, T7 and T8), which was corrected by surgery, followed by physical rehabilitation; the recovery was complete and the patient had not sequelae. Neurological normality after spinal injury does not rule out a spinal cord damage; that is why immediate care and complete evaluation of these patients are an essential part of the protocol of their health attention.
Assuntos
Humanos , Adolescente , Traumatismos da Medula Espinal , Coluna Vertebral , Ferimentos e LesõesRESUMO
La presente investigación se centra en el manejo de medicamentos en el Centro de Salud 2 de Quito, unidad de atención primaria del Ministerio de Salud y tiene tres momentos: un diagnóstico de base, un proceso de implementación del Sistema integrado de manejo de medicamentos y una evaluación final.La investigación inicial reveló que el manejo de medicamentos en el Centro de Salud era ineficiente, no satisfacía a los clientes externos, y no propiciaba las buenas prácticas de prescripción ni el uso racional de los medicamentos.En la fase de intervención, que duró diecisiete meses, se implementó y monitorizó cada componente del Sistema integrado de manejo de medicamentos se planificó y ejecutó un proceso de educación continua dirigido a prescriptores
Assuntos
Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Atenção Primária à Saúde , Sistemas de Saúde , Medicamentos sem Prescrição/administração & dosagem , Medicamentos sem Prescrição , Medicamentos sem Prescrição/normas , Medicamentos sem Prescrição/provisão & distribuição , Medicamentos sem Prescrição/uso terapêutico , Organização e AdministraçãoRESUMO
Se presentan dos casos de niños varones XX, tratados en el Hospital de Niños Baca Ortíz de Quito. Los niños fenotípicamente masculinos, presentaron anomalías genitales (hipospadias y criptorquidea unilateral); la investigación complementaria reveló cariotipo 46 XX. el hallazgo de genitales ambiguos obliga a realizar un trabajo diagnóstico complejo con la intervención de un equipo multidisciplinario. Se revisa el proceso de la diferenciación sexual y sus anomalías, con énfasis en las posibles explicaciones para la condición de varón XX.