82 research outputs found
Observaciones etnobotánicas sobre algunas especies utilizadas por la comunidad indígena Andoque (Amazonas Colombia).
No full textObservaciones etnobotánicas sobre algunas especies utilizadas por la comunidad indígena andoque (Amazonas Colombia). Constanza La Rotta Cuéllar. Corporación Araracuara. Bogotá 1983
Esta publicación corresponde a la investigación presentada como tesis de grado por la Bióloga Constanza La Rotta C. a la Universidad Nacional de Colombia. Se aborda como cometido la comprensión de las mutuas relaciones entre cultura y vegetación, a partir de la experiencia de los Andoque de la Amazonía Colombiana.
 
La natura della responsabilità medica: il cambio di rotta
No full textABSTRACT
A tre anni di distanza dall’ approvazione della riforma il saggio propone una riflessione sulla natura della responsabilità medica ed, in particolare, sulla tenuta del presunto cambio di rotta rispetto alla teoria del contatto sociale, alla luce di un diritto vivente divenuto ius receptum e delle sollecitazioni alternative che l’autore individua in una differente lettura della nuova normativa.Three years after the approval of the reform, the essay proposes a reflection on the nature of medical liability and, in particular, on the keeping of the presumed change of course with respect to the theory of social contact, in the light of a case law that has become ius receptum and the alternative solicitations that the author identifies, in an a different construction of the new statutory rules
Left appendage emptying rate by transesophageal echocardiography in patients with cardiovascular diseases in a level III hospital in Lima, Peru (2018-2023)
No full textObjetivo: Evaluar la velocidad de la orejuela izquierda, la presencia de trombos y contraste espontáneo por ecocardiografía transesofágica en pacientes con diversas patologías cardiovasculares. Materiales y Métodos: Se revisarán retrospectivamente expedientes y reportes de ecocardiografía transesofágica almacenados en la institución entre enero 2018 y diciembre 2023. Se consignará edad, género, frecuencia cardiaca, fracción de eyección, tamaño de aurícula izquierda, estenosis mitral, hipertensión arterial, velocidad de vaciamiento, presencia de contraste ecogénico espontáneo y trombos. Resultados esperados: Se espera identificar relación entre velocidades bajas de vaciamiento de la orejuela izquierda y patologías cardiovasculares, especialmente fibrilación auricular y estenosis mitral, ya que tiene un mayor riesgo tromboembólico. Conclusiones: La medición de la velocidad de vaciamiento de la orejuela izquierda mediante ecocardiografía transesofágica es una herramienta útil en la evaluación de pacientes con patologías cardiovasculares. Este estudio busca reforzar el valor de la ecocardiografía transesofágica en la estratificación de riesgo y la toma de decisiones clínicas.Objective: To evaluate left atrial appendage velocity, presence of thrombi, and spontaneous contrast by transesophageal echocardiography in patients with various cardiovascular pathologies. Materials and Methods: We will retrospectively review records and transesophageal echocardiography reports stored at the institution between January 2018 and December 2023. Age, sex, heart rate, ejection fraction, left atrial size, mitral stenosis, arterial hypertension, emptying velocity, presence of spontaneous echogenic contrast, and thrombi will be recorded. Expected results: It is expected to identify a relationship between low left atrial appendage emptying velocities and cardiovascular pathologies, especially atrial fibrillation and mitral stenosis, since they have a higher thromboembolic risk. Conclusions: Measuring left atrial appendage emptying velocity by transesophageal echocardiography is a useful tool in the evaluation of patients with cardiovascular pathologies. This study seeks to reinforce the value of transesophageal echocardiography in risk stratification and clinical decision-making
Prevalence of resistant arterial hypertension and associated factors in people over 60 years of age in a hospital in Lima, Peru, in the years 2018 until 2023
No full textIntroducción: La hipertensión arterial resistente es la condición en la cual el paciente con diagnóstico definitivo de hipertensión arterial persiste con presiones arteriales superiores a 140/90 mmHg a pesar de llevar tratamiento con un mínimo de 3 fármacos antihipertensivos diferentes a dosis máxima, incluyendo un diurético. Esta es una enfermedad poco investigada en latinoamérica, los estudios de prevalencia a nivel mundial sólo han sido realizados en países de Europa, América del Norte y Oceanía, mas no se cuenta con data sobre la prevalencia de hipertensión resistente en nuestro país. Objetivos: Estimar la prevalencia de hipertensión arterial resistente en un hospital de tercer nivel de atención ubicado en Lima, Perú. Materiales y Métodos: Se realizará un estudio descriptivo, observacional, transversal y retrospectivo. Para ello, se revisarán las historias clínicas de pacientes hipertensos mayores de 60 años tratados entre el periodo de 1 de enero del 2018 al 31 de diciembre del 2023 según la base de datos de estadística de un Hospital de tercer nivel de atención. Conclusión: Se espera que la hipertensión arterial resistente en Lima-Perú sea prevalente, así como se identifique los principales factores de riesgo asociados.Introduction: Resistant hypertension is the condition in which a patient with a definitive diagnosis of hypertension continues to have blood pressures above 140/90 mmHg despite being treated with a minimum of 3 different antihypertensive drugs at maximum doses, including a diuretic. This is a disease that has been little researched in Latin America; worldwide prevalence studies have only been conducted in countries in Europe, North America, and Oceania. There is no data on the prevalence of resistant hypertension in our country. Objective: To estimate the prevalence of resistant arterial hypertension in a tertiary care hospital located in Lima, Peru. Materials and Methods: A descriptive, observational, cross-sectional and retrospective study will be carried out. To do this, the medical records of hypertensive patients over 60 years of age treated between the period from January 1, 2018 to December 31, 2023 will be reviewed according to the statistical database of a tertiary care Hospital. Conclusion: It is expected that resistant arterial hypertension in Lima-Peru is prevalent and the main associated risk factors are identified
Subclinical atherosclerosis according to carotid and femoral intima media measurement in HIV+ and antiretroviral patients with low or intermediate cardiovascular risk
No full textIntroducción: Diversos estudios actuales han buscado hallar una relación entre el desarrollo de enfermedad aterosclerótica y las complicaciones cardiovasculares que conlleva, con el uso de terapia antirretroviral en pacientes con el virus de la inmunodeficiencia humana (VIH). Sin embargo, no hay estudios previos en la población peruana y en todo Latinoamérica, siendo la información muy limitada. Aún no se ha establecido un mecanismo específico sobre la relación entre estos dos factores, sin embargo, la evidencia va en aumento de la relación entre ellos. Por ello mismo, planteamos generar información en un nuevo escenario, el Perú, más específicamente, un hospital de tercer nivel de Lima. Objetivos: Determinar la frecuencia con que se presenta la enfermedad aterosclerótica subclínica en pacientes con riesgo cardiovascular bajo e intermedio; y con ello, poder determinar también si la frecuencia varía según el esquema de tratamiento antirretroviral brindado a estos pacientes. Además, se buscará determinar la frecuencia de pacientes VIH positivos que han desarrollado enfermedad subclínica. Materiales y métodos: La enfermedad subclínica se evaluará a través de la medición ecográfica del grosor de la íntima media carotídea y femoral, mientras que el riesgo cardiovascular será calculado a través de una calculadora de riesgo según la escala de Framingham. Conclusiones: A pesar de que esta información no determine relación de causalidad, podrá establecer un patrón de correlación entre estos dos factores y poder de esta manera dar apertura a futuras investigaciones e incluso tomar en cuenta medidas preventivas en esta población.Introduction: Multiple studies have recently attempted to source a relation between the development of atherosclerotic disease and its cardiovascular, with the use of antiretroviral therapy in patients with Human Immunodeficiency virus (HIV). Nevertheless, there is no previous studies on Peruvian population and in general Latin American region, which makes the information very limited. The specific mechanism that explains the relation between these two factors is yet to be described, however, evidence on these two being tightly related is increasing. For that same reason, we are proposing to find information in a scenario yet to be studied, Peruvian population, more specifically, a level three hospital in Lima. Objectives: Determine the frequency in which subclinical atherosclerotic disease is presented in patients with low or intermediate cardiovascular risk, and with that, be able to also determine if its frequency varies according to the line of treatment given to these patients. Also, to determine the frequency in which HIV+ patients have developed subclinical disease. Materials and methods: Subclinical disease will be evaluated through ultrasound measurement of carotid and femoral intima media thickness, while cardiovascular risk will be determined with Framingham risk calculator. Conclusions: Although this information will not determine causality, it will be able to establish a pattern of correlation between these two factors and give opening to future investigations and even take into consideration preventive actions in this population
Effectiveness of the Family and Friends CPR course in learning cardiopulmonary resuscitation in relatives of patients with high cardiovascular risk or who have suffered a cardiovascular event
No full textAntecedentes: La reanimación cardiopulmonar (RCP) temprana y de alta calidad aumenta la supervivencia en el paro cardíaco. Si bien la mayoría de casos ocurre en el hogar y son presenciados por testigos, en pocos casos se inicia RCP. Por ello, resulta importante su enseñanza y especialmente en familiares de pacientes con alto riesgo cardiovascular. Objetivo: Demostrar la efectividad de la enseñanza del curso Familiares y Amigos RCP en el aprendizaje teórico y práctico de la reanimación cardiopulmonar en familiares de pacientes con alto riesgo cardiovascular o que han presentado un evento cardiovascular. Materiales y métodos: Estudio de tipo analítico, cuasi experimental, prospectivo, de intervención antes y después. Se utilizó un cuestionario de conocimientos teóricos y una lista de cotejo sobre RCP en adultos para evaluar el nivel de conocimiento teórico y práctico, respectivamente. La parte teórica fue medida en tres momentos (antes, inmediatamente después y un mes después) y la parte práctica en dos momentos (inmediatamente después y un mes después). Resultados: El nivel de conocimiento teórico fue malo (8.64 +/- 2.47) antes de la intervención, logrando un nivel de conocimiento bueno inmediatamente después (17.33 +/- 2.02) y un mes después (16.5 +/- 1.91). Además, las medianas del nivel de conocimiento práctico fueron de 15 inmediatamente después y un mes después, mostrando que mantuvieron un nivel de conocimiento práctico bueno. Conclusiones: El curso Familiares y Amigos RCP fue efectivo en el aprendizaje teórico y práctico sobre RCP en la población estudiada, y se mantuvo un mes posterior a la intervención.Background: Early, high-quality cardiopulmonary resuscitation (CPR) increases survival in cardiac arrest. Although most cases occur at home and are witnessed, CPR is performed in few cases. For this reason, teaching CPR is important and especially in relatives of patients with high cardiovascular risk. Objective: To demonstrate the effectiveness of the Family and Friends CPR course in the theoretical and practical learning of cardiopulmonary resuscitation in relatives of patients with high cardiovascular risk or who have suffered a cardiovascular event. Methods: We carried out an analytical, quasi-experimental, prospective, before-and-after study. A theoretical knowledge questionnaire and an adult CPR checklist were used to assess the level of theoretical and practical knowledge, respectively. The theoretical knowledge was measured in three moments (before, immediately after and one month later) and the practical skills in two moments (immediately after and a month later). Results: The level of theoretical knowledge was low (8.64 +/- 2.47) before the intervention, achieving a good level of knowledge immediately after (17.33 +/- 2.02) and one month later (16.5 +/- 1.91). Furthermore, the medians of the level of practical knowledge were 15 immediately after and one month later, showing that they maintained a good level of practical knowledge. Conclusions: The Family and Friends CPR course was effective in the theoretical and practical learning of CPR in the studied population, and was maintained one month after the intervention
Clinical and epidemiological characteristics of patients with peripheral arterial disease that underwent angiographic study in a third level health center in Lima, Peru
No full textAntecedentes: La enfermedad arterial periférica presenta un curso subclínico considerable y la identificación de pacientes en riesgo de la enfermedad es importante para el diagnóstico oportuno. Objetivo: Describir las características clínicas y epidemiológicas de pacientes con el diagnóstico de enfermedad arterial periférica a quienes se realizó angiografía en el Hospital Cayetano Heredia. Materiales y métodos: Estudio retrospectivo tipo serie de casos que incluyó 41 pacientes con estudio angiográfico por enfermedad arterial periférica en el Hospital Cayetano Heredia. Se evaluaron las características clínicas y epidemiológicas, los factores de riesgo presentes, el antecedente de enfermedad cardiovascular, la indicación de la arteriografía, el estadio GLASS, las recomendaciones de manejo y el manejo definitivo de cada paciente. Resultados: La edad promedio de los participantes fue 65 (DE ± 11) años, 68.29% fueron hombres. El factor de riesgo más común fue la diabetes mellitus, se reportó en 87.80% pacientes. La presencia de al menos dos factores de riesgo se presentó en el 73.17% de los pacientes. El antecedente de enfermedad cardiovascular se presentó en el 14.63% de los pacientes, siendo el accidente cerebrovascular el más común. La indicación de angiografía más frecuente fue la isquemia crítica de extremidad con una frecuencia de 75.61%. El lecho vascular más afectado fue el infrapoplíteo con 53.66% de los pacientes presentando GLASS estadio 4, mientras que el lecho femoropoplíteo presentó GLASS estadio 0 en el 60.98% de los pacientes. La recomendación tras angiografía más común fue el manejo médico + angioplastia con una frecuencia de 43.90%, mientras que el manejo definitivo más común fue el manejo médico + amputación con 46.34% de frecuencia. Conclusión: El factor de riesgo más frecuente en el presente estudio fue la diabetes mellitus, la indicación más frecuente fue la isquemia crítica de extremidad y el manejo definitivo más común fue el manejo médico + amputación.Background: Peripheral arterial disease has a considerable subclinical course and the identification of patients at risk of the disease is important for an early diagnosis. Objective: Describe the clinical and epidemiological characteristics of patients with diagnosis of peripheral arterial disease in which an angiography procedure was conducted in the Hospital Cayetano Heredia. Materials and Methods: Retrospective case series study in which forty-one patients were included that counted with angiography procedure and diagnosis of peripheral arterial disease in the Hospital Cayetano Heredia. Clinical and epidemiological characteristics were evaluated along with frequency of risk factors, past medical history of any other cardiovascular disease, indication of the angiography, GLASS stage, recommendations for the management and the definitive management of each patient. Results: The mean age of the participants was 65 (DE ± 11) years, 26 (68.29%) were men. The most frequent risk factor was diabetes mellitus, it was reported on 36 (87.80%) patients. 73.17% of the patients reported to have as past medical history at least 2 risk factors. Past medical history of cardiovascular disease was not common, 6 (14.63%), cerebrovascular disease was the most common one. Chronic limb threatening ischemia, 31 (75.61%), was the most frequent reason to do the angiography. The infrapopliteal vascular bed was the most affected with 22 (53.66%) patients presenting a GLASS stage of four, meanwhile, the femoropopliteal vascular bed presented a GLASS stage of 0 in 25 (60.98%) patients. The most common recommendation of management was medical treatment + angioplasty, 18 (43.90%), while the definitive management was medical treatment + limb amputation, 19 (46.34%). Conclusion: The most common risk factor in the present study was diabetes mellitus, the most common indication for doing the angiography was chronic limb threatening ischemia and the definitive treatment more frequent was medical treatment + limb amputation
Compatibility of Trichoderma spp. to active ingredients of commercial fungicides applied in bean culture
No full textO uso de fungicidas representa um dos principais métodos de controle de doenças em plantas, entretanto, o uso de produtos químicos causa impactos no meio ambiente e na saúde humana. O uso do controle integrado é uma alternativa ao uso desses produtos. A implementação dessa prática requer cuidado, já que os agentes de controle biológico podem ser afetados pelos produtos químicos. O trabalho foi desenvolvido com o objetivo de avaliar o efeito de princípios ativos captana, carbendazim, fluazinam, iprodiona e tiofanato metílico sobre o fungo antagonista, Trichoderma spp. (Trichoderma harzianum TH11, Trichoderma viride TV21 e Trichoderma sp. T04, T16 e T20). Foram analisados os parâmetros crescimento vegetativo, esporulação, confronto direto, produção de metabólitos voláteis, produção de enzimas e sideróforos em meio de cultura suplementado com cada princípio ativo. Os princípios ativos carbendazim, fluazinam e iprodione mostraramse muito tóxicos aos isolados testados, em todas as concentrações. O princípio ativo captana mostrou-se moderadamente tóxico ao isolado T04 e tóxico ao isolado TV21 na concentração 120 g/L. Para os demais isolados e concentrações captana foi compatível. O princípio ativo tiofanato metílico também foi compatível em todas as concentrações para os isolados T04, T16, T20 e TV21. A concentração de 2800 g/kg desse princípio ativo foi moderadamente tóxica ao isolado TH11. As demais concentrações de tiofanato metílico foram compatíveis com esse isolado. Não é possível definir o efeito de captana, carbendazim, fluazinam e iprodiona sobre o confronto direto dos isolados testados e o patógeno, já tiofanato metílico não interfere na ação dos isolados. A produção de metabólitos voláteis é afetada pelos princípios ativos captana, carbendazim, iprodiona e tiofanato metílico. Com fluazinam, o desenvolvimento do patógeno foi menor devido a ação dos metabólitos voláteis, entretanto não é possível definir se a ação é sinérgica ou apenas provocada pelo produto químico. Todos os isolados produziram enzimas e sideróforos. Os princípios ativos impediram a detecção da produção de enzimas. Captana inibiu a produção de sideróforos. Dessa forma, é necessária a realização de testes de compatibilidade entre princípios ativos e agentes de controle biológico antes de sua aplicação no campo para controle integrado de doenças de plantas.The use of fungicides is one of the main methods of plant disease control, however, these chemicals cause impacts on the environment and on human health. The use of integrated control is an alternative to the use of these products. The implementation of this practice requires caution as the biological control agents can be affected by the chemical products. The aim of this work was to evaluate the effects of active ingredients captan, carbendazim, fluazinam, iprodione and thiophanate-methyl on Trichoderma spp. isolates (Trichoderma harzianum TH11, Trichoderma viride TV21 and Trichoderma sp. T04, T16 and T20). Samples were analyzed for vegetative growth, sporulation, direct confrontation, volatiles metabolites production, enzymes and siderophores production in culture medium supplemented with each active ingredient. The active ingredients carbendazim, fluazinam and iprodione were very toxic to isolates at all concentrations. The active ingredient captan was moderately toxic to T04 and toxic to TV21 isolates in 120 g/L of concentration. For other isolates and captan concentrations was compatible. The active ingredient thiophanate-methyl was also compatible at all concentrations for isolates T04, T16, T20 and TV21. The concentration of 2800 g/kg of this active ingredientc was moderately toxic to TH11. The remaining concentrations of thiophanate-methyl was compatible with this isolate. Can not define the effect of captan, carbendazim, iprodione and fluazinam in direct confrontation of the isolates and pathogens, just tiophanate-methyl does not affect the action of isolates. The prodution of volatiles metabolites is affected by the active ingredients captan, carbendazim, iprodione and thiophanate-methyl. With fluazinam, the development of the pathogen was reduced by the action of volatiles metabolites, however is not possible to define if the action is synergistic or merely caused by the chemical product. All isolates produced enzymes and siderophores. The ingredient actives prevented the enzyme production detection. Captan inhibited the siderophores production. Thus, with this work it was possible to verify the need of compatibility tests between active ingredients and biological control agents before their implementation at the field level for the integrated control of plant diseases
A spatially explicit risk assessment approach: Cetaceans and marine traffic in the Pelagos Sanctuary (Mediterranean Sea)
No full text15 páginas, 5 figuras, 2 tablas.-- This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedSpatially explicit risk assessment is an essential component of Marine Spatial Planning (MSP), which provides a comprehensive framework for managing multiple uses of the marine environment, minimizing environmental impacts and conflicts among users. In this study, we assessed the risk of the exposure to high intensity vessel traffic areas for the three most abundant cetacean species (Stenella coeruleoalba, Tursiops truncatus and Balaenoptera physalus) in the southern area of the Pelagos Sanctuary, which is the only pelagic Marine Protected Area (MPA) for marine mammals in the Mediterranean Sea. In particular, we modeled the occurrence of the three cetacean species as a function of habitat variables in June by using hierarchical Bayesian spatial-temporal models. Similarly, we modelled the marine traffic intensity in order to find high risk areas and estimated the potential conflict due to the overlap with the cetacean home ranges. Results identified two main hot-spots of high intensity marine traffic in the area, which partially overlap with the area of presence of the studied species. Our findings emphasize the need for nationally relevant and transboundary planning and management measures for these marine speciesThis work was supported by the “Banco di Sardegna” Foundation (BAN6077)Peer reviewe
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