7 research outputs found
Agronomic, economic and ecological aspects of the papaya (Carica papaya) production in Tabasco, Mexico
No full textThe cultivation of papaya is important in the tropic because it provides source of income to the farmer within a short time. Statistical data were obtained from farmers located in the Chontalpa, Rios and Centro-Sierra regions; the size of the survey was 67 farmers. The study shows the results of the farmers’ problem in a drastic reduction of their productivity because of the virosis and low prices in commercialization. The farmers were classified into three levels of technology, “low”, “middle” and “high”. The first one covers 88% of the farmers in seasonal conditions in contrast with the high technology that concentrates 4.5% in irrigation conditions. According to the technology used, the fertilizer shows more yields. Economically, the high technology had an internal tax return of 0.43 in comparison with the low technology of 0.25, which means that the investment is recovered with different yields. However, the use of high technology makes the system more competitive. Key words
Characterization of dermatoses in neonates hospitalized in pediatric critical care units of the Foscal Clinic
No full textHistóricamente se ha considerado la dermatología como una especialidad de manejo ambulatorio con bajas tasas de mortalidad. Sin embargo hoy en día se conocen diversos procesos dermatológicos que conllevan a una elevada morbi-mortalidad y quienes las padecen pueden requerir ingreso en una unidad de cuidados intensivos (UCI); asimismo los pacientes hospitalizados en estas unidades pueden presentar lesiones dermatológicas no críticas, que pueden deteriorar el pronóstico y evolución de los pacientes las cuales requerirán de la colaboración de los dermatólogos para su abordaje diagnóstico y terapéutico. La piel neonatal está expuesta a múltiples desafíos extrínsecos e intrínsecos propios de la edad, que puede llevar a generar lesiones en la piel. Sumado a esto, los pacientes en UCIs cursan diferentes patologías, condiciones de base y diversas agresiones físicas y/o químicas que predisponen a patologías infecciosas locales y/o sistémicas, e inflamatorias como las dermatitis, alergias u otras reacciones cutáneas severas adversas a medicamentos, que complican el manejo de la enfermedad y requieren un abordaje integral y multidisciplinario. Así mismo, la morfología y evolución natural de las dermatosis dependen de otro factores como la prematurez, el estado inmunológico, nutricional y metabólico; lo cuales suelen estar alterados en las UCIs debido a la polifarmacia, pérdida prematura del colecho, y a las múltiples prácticas médicas requeridas para mantener la estabilidad hemodinámica del paciente. Existen pocos estudios prospectivos descriptivos en la literatura que caractericen las dermatosis observadas en las UCIs neonatales a pesar de que se establece una alta prevalencia de dermatosis (40,4%) en este grupo poblacional. Los pocos estudios constan con una muestra poblacional pequeña que puede conducir a resultados poco fiables y contradictorios e incluso subvalorados. No existen datos loco-regionales que nos permitan realizar cuadros comparativos, ni se han realizado hasta la fecha estudios en la UCI pediátrica/neonatal de la FOSCAL que caracterice las dermatosis más frecuentemente encontradas, ni los factores asociados con el deterioro clínico de estos pacientes. La identificación temprana y caracterización de las dermatosis en neonatos hospitalizados en la UCI Pediátrica/neonatal es de suma importancia y su abordaje multidisciplinario es fundamental para reducir la morbimortalidad y asegurar un mejor pronóstico funcional y vital de estos pacientes. El objetivo del estudio es establecer la incidencia y factores asociados a las dermatosis en población neonatal de las Unidades de Cuidado Intensivo Pediátrica de la FOSCAL, la cual se llevara mediante una búsqueda activa durante un periodo de 5 meses.Agradecimientos......................................................................................................................................................... 6 Resumen del proyecto ............................................................................................................................................. 7 1. Justificación ......................................................................................................................................................... 9 2. Marco teórico ................................................................................................................................................... 10 2.1 Estructura y función de la piel del recién nacido ..................................................................... 10 2.2 Clasificación de los niños recién nacidos ...................................................................................... 10 2.3 UCI neonatal y dermatosis .................................................................................................................... 11 2.3 Clasificación de las dermatosis en UCI ........................................................................................... 16 2. 4 Principales patologías de piel en las UCIs. .................................................................................. 17 2.4.1 Trastornos hereditarios ..................................................................................................................... 17 2.4.2 Trastornos transitorios benignos del recién nacido ............................................................. 19 2.4.3 Trastornos congénitos/Manchas del RN .................................................................................... 21 2.4.4 Cambios fisiológicos del RN ............................................................................................................. 23 2.4.5 Secundarias a injuria medica/Iatrogénica ................................................................................. 24 2.4.6 Secundarias a proceso infeccioso .................................................................................................. 26 2.4.7 Secundarias a proceso inflamatorio ............................................................................................. 28 3. Estado del Arte ................................................................................................................................................ 29 4. Pregunta de investigación ........................................................................................................................ 31 5. Hipótesis ............................................................................................................................................................. 31 6. Objetivos............................................................................................................................................................. 32 6.1. Objetivo General ................................................................................................................................... 32 6.2. Objetivos específicos.......................................................................................................................... 32 7. Metodología ...................................................................................................................................................... 33 7.1. Tipo de estudio: .................................................................................................................................... 33 7.2. Población: ................................................................................................................................................ 33 7.3. Criterios de inclusión: ....................................................................................................................... 33 7.4. Criterios de exclusión ........................................................................................................................ 33 7.5. Calculo de tamaño de muestra: .................................................................................................... 33 7.6. Muestreo ................................................................................................................................................... 33 7.7. Recolección de la información: .................................................................................................... 33 7.8. Plan de análisis de datos .................................................................................................................. 34
Versión 1.2. Fecha 12-07-2021
7.9. Variables ................................................................................................................................................... 34 7.10. Consideraciones éticas. ............................................................................................................... 51 8. Resultados ......................................................................................................................................................... 52 8.1 Datos sociodemográficos neonatales .............................................................................................. 52 8.2 Datos sociodemográficos maternos ................................................................................................. 52 8.3 Antecedentes maternos .......................................................................................................................... 54 8.4 Antecedentes neonatales ....................................................................................................................... 57 8.5 Hospitalización actual ............................................................................................................................. 59 8.5.1 Diagnóstico principal de la hospitalización ........................................................................ 59 8.5.3 Laboratorios .......................................................................................................................................... 62 8.5.4 Examen físico y diagnostico dermatológico ........................................................................ 62 8.6. Factores relacionados con las dermatosis incidentes .......................................................... 71 8.6.1 Factores sociodemográficos ......................................................................................................... 71 8.6.2 Antecedentes ........................................................................................................................................ 74 8.6.3 Laboratorios intrahospitalarios ................................................................................................ 78 8.6.5 Estancia hospitalaria ........................................................................................................................ 79 8.6.6 Diagnósticos principales de hospitalización ....................................................................... 80 8.6.7 Diagnósticos dermatológicos....................................................................................................... 82 8.6.7 Procedimientos médicos y terapias médicas ..................................................................... 86 9. Discusión ............................................................................................................................................................ 89 10. Conclusiones................................................................................................................................................ 92 11. Referencias bibliográficas ................................................................................................................... 93 Anexos ........................................................................................................................................................................... 97EspecializaciónHistorically, dermatology has been considered an outpatient management specialty with low mortality rates. However, today various dermatological processes are known that lead to high morbidity and mortality and those who suffer from them may require admission to an intensive care unit (ICU); Likewise, patients hospitalized in these units may present non-critical dermatological lesions, which can deteriorate the prognosis and evolution of the patients, which will require the collaboration of dermatologists for their diagnostic and therapeutic approach. Neonatal skin is exposed to multiple intrinsic and extrinsic challenges of age, which can lead to skin lesions. In addition to this, patients in ICUs experience different pathologies, basic conditions and various physical and / or chemical aggressions that predispose to local and / or systemic infectious pathologies, and inflammatory diseases such as dermatitis, allergies or other severe adverse skin reactions to medications, that complicate the management of the disease and require a comprehensive and multidisciplinary approach. Likewise, the morphology and natural evolution of dermatoses depend on other factors such as prematurity, immunological, nutritional and metabolic status; which are usually altered in ICUs due to polypharmacy, premature loss of co-sleeping, and the multiple medical practices required to maintain the patient's hemodynamic stability. There are few descriptive prospective studies in the literature that characterize the dermatoses observed in neonatal ICUs despite the fact that a high prevalence of dermatosis (40.4%) is established in this population group. The few studies have a small population sample that can lead to unreliable, contradictory, and even undervalued results. There are no locoregional data that allow us to make comparative tables, nor have studies been carried out to date in the pediatric / neonatal ICU of FOSCAL that characterize the most frequently encountered dermatoses, nor the factors associated with the clinical deterioration of these patients. The early identification and characterization of dermatoses in neonates hospitalized in the Pediatric / neonatal ICU is of utmost importance and its multidisciplinary approach is essential to reduce morbidity and mortality and ensure a better functional and vital prognosis of these patients. The objective of the study is to establish the incidence and factors associated with dermatoses in the neonatal population of the Pediatric Intensive Care Units of FOSCAL, which will be carried out through an active search during a period of 5 months
Candida bloodstream infections in intensive care units: analysis of the extended prevalence of infection in intensive care unit study
No full textTo provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection.
DESIGN:
A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge.
SETTING:
EPIC II included 1265 intensive care units in 76 countries.
PATIENTS:
Patients in participating intensive care units on study day.
INTERVENTIONS:
None.
MEASUREMENT AND MAIN RESULTS:
Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant.
CONCLUSION:
Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use
Terrestrial very-long-baseline atom interferometry: Workshop summary
No full textThis document presents a summary of the 2023 Terrestrial Very-Long-Baseline Atom Interferometry Workshop hosted by CERN. The workshop brought together experts from around the world to discuss the exciting developments in large-scale atom interferometer (AI) prototypes and their potential for detecting ultralight dark matter and gravitational waves. The primary objective of the workshop was to lay the groundwork for an international TVLBAI proto-collaboration. This collaboration aims to unite researchers from different institutions to strategize and secure funding for terrestrial large-scale AI projects. The ultimate goal is to create a roadmap detailing the design and technology choices for one or more kilometer--scale detectors, which will be operational in the mid-2030s. The key sections of this report present the physics case and technical challenges, together with a comprehensive overview of the discussions at the workshop together with the main conclusions.</p
Spontaneous motility patterns as an indicator of progression of muscle tone in infants served at the San Rafael Hospital, Bogotá
No full textilustraciones, graficasDesde una perspectiva fisiológica, esta investigación presenta un acercamiento a la evaluación de la motilidad espontánea basada en la observación, caracterizando los patrones de movimiento de 9 lactantes con el objetivo establecer si existe relación con la progresión del tono muscular en esta población.
Partiendo de una revisión multinivel, se documentó la evolución conceptual de lo que han sido las escalas de evaluación del recién nacido, encontrando la falta de un elemento integrador que dé cuentas de la función más allá de lo topográfico y/o anatómico en el desarrollo motor. De ahí, que se definiera el tono muscular activo como componente de la evaluación neurológica tradicional, develando una condición de procesamiento mucho más compleja que lo que se conoce como respuesta refleja; para la evaluación del movimiento espontáneo se estableció un modelo de análisis de los resultados en tres categorías propuestas por los investigadores: calidad, armonía, y simetría del movimiento.
Como resultado se hace manifiesta la necesidad, de ponderar las condiciones particulares del momento de la evaluación y el seguimiento de cada niño(a) en la evaluación del desarrollo motor, más allá de la búsqueda de hitos del desarrollo, como elemento diferenciador de lo que se espera sea ideal y que responda a las necesidades de condiciones que pueden o no implicar alteraciones, dando lugar a intervenciones tempranas y pronósticos pertinentes en una población de riesgo, impactando a largo plazo en su calidad de vida, retrasando o reduciendo complicaciones, también mejorar el pronóstico de aquellos que presentan alteraciones evidentes. (Texto tomado de la fuente)From a physiological perspective, this research presents an approach to the evaluation of spontaneous motility based on observation, characterizing the movement patterns of 9 infants in order to establish whether there is a relationship with the progression of muscle tone in this population.
Starting from a multilevel review, the conceptual evolution of what have been the newborn assessment scales was documented, finding the lack of an integrating element that accounts for the function beyond the topographical and/or anatomical in motor development. . Hence, active muscle tone was defined as a component of the traditional neurological evaluation, revealing a much more complex processing condition than what is known as a reflex response; For the evaluation of the spontaneous movement, a model was established to analyze the results in three categories proposed by the researchers: quality, harmony, and symmetry of the movement.
As a result, the need to weigh the particular conditions at the time of evaluation and monitoring of each child in the evaluation of motor development, beyond the search for developmental milestones, as a differentiating element of what it is expected to be ideal and to respond to the needs of conditions that may or may not involve alterations, leading to early interventions and relevant prognoses in a population at risk, impacting long-term quality of life, delaying or reducing complications, also improving the prognosis of those who present evident alterations.MaestríaMagíster en Fisiologí
Factores psicosociales relacionados con Síndrome de Burnout en médicos especialistas en cirugía general de Cartagena de Indias
No full textEl objetivo de este estudio fue relacionar el síndrome de Burnout con los factores psicosociales presentes en cirujanos generales de la ciudad de Cartagena, la investigación tiene un diseño de corte correlacional y se utilizó el método de muestreo no probabilístico. Por lo que resultaría oportuno y pertinente que, por medio de investigaciones como esta, se permita diagnosticar situaciones que pueden ser intervenidas a tiempo y prevenir la presencia de este síndrome en cirujanos generales y en consecuencia ayudar no sólo a esta población, sino también para la estructuración de estrategias y pautas que hagan más fácil contribuir a la calidad de la salud mental y física en el personal sanitario. Los resultados obtenidos demostraron que el 85.2% de los sujetos padecen el síndrome de burnout y el 54,6% y el 24% resultó estar expuestos a riesgo psicosocial intralaboral y extralaboral muy alto, respectivamente. En cuanto a la relación entre los factores de riesgos psicosociales y el síndrome de burnout los niveles de riesgo mostraron una asociación positiva entre las dimensiones intralaborales de influencia del trabajo sobre el entorno, demandas de la jornada de trabajo, demandas de carga mental y demandas de la jornada del trabajo al igual que en todas las dimensiones extralaborales en relación con el síndrome de Burnout en los cirujanos generales de la ciudad de Cartagena-Colombia.The objective of this study was to relate burnout syndrome with psychosocial factors present in general surgeons in the city of Cartagena, the research has a correlational cut design, and the non-probabilistic sampling method was used. Therefore, it would be opportune and pertinent that through research such as this, it is possible to diagnose situations that can be intervened in time and prevent the presence of this syndrome in general surgeons and consequently help not only this population, but also for the structuring of strategies and guidelines that make it easier to contribute to the quality of mental and physical health in health personnel. The results showed that 85.2% of the subjects suffer from burnout syndrome and 54.6% and 24% were exposed to very high intra work and extra-work psychosocial risk, respectively. As for the relationship between psychosocial risk factors and burnout syndrome, risk levels showed a positive association between the intra occupational dimensions of influence of work on the environment, demands of the working day, demands of mental load and demands of the workday as in all extra-occupational dimensions in relation to Burnout syndrome in general surgeons of the city of Cartagena-Colombia.MaestríaMagíster en Seguridad Y Salud En El Trabaj
