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Introducción: Las infecciones de sitio quirúrgico (ISQ), se encuentran entre las infecciones asociadas al cuidado de la salud (IACS) más frecuentes, la profilaxis antibiótica administrada en el período preoperatorio contribuye a prevenir las ISQ. Objetivo: determinar si los esquemas antimicrobianos utilizados para profilaxis en cirugía corresponden a recomendados por Guías Internacionales de Tratamiento de Enfermedades Infecciosas; así como conocer los esquemas antimicrobianos utilizados, estimar el costo de la quimioprofilaxis y comparar con los resultados obtenidos en un estudio similar realizado en el mismo servicio en el año 2005. Materiales y métodos: Estudio descriptivo, observacional, retrospectivo donde se seleccionaron todas las historias clínicas de pacientes de ≤15 años de edad sometidos a apendicectomía, con diagnóstico posquirúrgico de apendicitis congestiva o flegmonosa, desde enero a diciembre del 2022. Se elaboró una planilla electrónica donde se cargaron los siguientes datos: antibiótico utilizado, dosis, número de dosis y momento de la administración. Resultados: 53 pacientes ≤ de 15 años fueron sometidos a apendicectomía, de los cuales 21 llenaban los criterios de inclusión. Fue utilizado Amoxicilina/Sulbactam en 19/21. El número total de dosis administradas fue de 68 dosis y la media de 3,3±1,9 dosis; solo en 8 de los pacientes se administró el antimicrobiano profiláctico en el tiempo correcto; solo 1 paciente recibió el esquema correcto, 1 sola dosis, 1 hora antes del inicio de la cirugía. El costo de la profilaxis antimicrobiana por paciente fue de 15,7 USD. Conclusión: Este trabajo nos permitió verificar la falta de aplicación de guías en el uso de antimicrobianos en la profilaxis quirúrgica, lo cual demuestra: i) la necesidad de revisar y estandarizar la conducta de prescripción relacionada en profilaxis quirúrgica, ii) la importancia de elaborar y socializar una guía de manejo de antimicrobianos y iii) el monitoreo de su implementación.
Introduction: Surgical site infections (SSIs) are among the most frequent healthcare-associated infections (HCIs). Antibiotic prophylaxis administered during the preoperative period contributes to preventing SSIs. Objective: to determine if the antimicrobial regimens used for prophylaxis in surgery correspond to those recommended by International Guidelines for the Treatment of Infectious Diseases; as well as knowing the antimicrobial regimens used, estimating the cost of chemoprophylaxis and comparing the current results with those obtained in a similar study carried out in the same service in 2005. Materials and methods: This was a descriptive, observational and retrospective study where we reviewed all medical records of patients ≤15 years of age undergoing appendectomy, with a post-surgical diagnosis of congestive or phlegmonous appendicitis, from January to December 2022. An electronic spreadsheet was prepared where the following data were uploaded: antibiotic used, dose, number of doses and time of administration. Results: 53 patients ≤ 15 years of age underwent appendectomy, of which 21 met the inclusion criteria. Amoxicillin/Sulbactam was used in 19/21. The total number of doses administered was 68 doses and the average was 3.3±1.9 doses; only in 8 of the patients was the prophylactic antimicrobial administered at the correct time; only 1 patient received the correct regimen, 1 single dose, 1 hour before the start of surgery. The cost of antimicrobial prophylaxis per patient was 15.7 USD. Conclusions: This study allowed us to verify the lack of application of existing guidelines in the use of antimicrobials in surgical prophylaxis, which demonstrates: i) the need to review and standardize prescription behavior related to surgical prophylaxis, ii) the importance of developing and disseminating an antimicrobial management guide and iii) the need to monitor its implementation.
RESUMEN
La pérdida de superficie dental se define como una condición en la que el desgaste de la estructura dental es excesivo según la edad. Esta pérdida patológica se relaciona comúnmente con una combinación de factores como erosión, abrasión, atricción o parafunción. La técnica de Dahl es una alternativa válida que resuelve los inconvenientes surgidos en este tipo de situaciones como ser la compensación dentoalveolar. Este caso corresponde a un paciente de 63 años que acudió al Hospital Dental de la Universidad de Manchester, derivado por su odontólogo particular. Al momento del examen clínico se constató pérdida moderada a severa de la superficie dental palatina e incisal localizada en el sector anterior de los dientes, sobremordida profunda y compensación alveolar dental. Fueron realizadas restauraciones directas a mano alzada de canino a canino. Luego del relleno incisal se constató una mordida abierta posterior de aproximadamente 1 a 1,5 mm. El contacto oclusal posterior fue restablecido totalmente en 3 meses.
A perda da superfície dentária é definida como uma condição em que o desgaste da estrutura dentária é excessivo de acordo com a idade, essa perda patológica está comumente relacionada a uma combinação de fatores, sendo eles: erosão, abrasão, atrito ou parafunção. Uma abordagem restauradora nestas situações representa um desafio para a reabilitação oral principalmente pela Compensação dentoalveolar. A técnica de Dahl é uma alternativa válida para resolver este problema. Este caso corresponde a um paciente de 63 anos que procurou o Hospital Odontológico da Universidade de Manchester, encaminhado por seu dentista particular. No momento do exame clínico, observou-se perda moderada da superfície dentária no setor anterior, sobremordida profunda e compensação alveolar dentária. Foram realizadas restaurações diretas da mão livre do canino para o canino. Após o enchimento incisal, observou-se mordida aberta posterior de aproximadamente 1 a 1,5 mm. O contato oclusal total foi restabelecido em 3 meses.
Tooth Surface Loss (TSL) is defined as a condition in which the wear of the tooth structure is excessive according to age. This pathological loss is commonly related to a combination of factors such as erosion, abrasion, attrition, or parafunction. The Dahl technique is a valid alternative that solves the problems that arise in this type of situation, such as dentoalveolar compensation. This case describes a 63-year-old patient who attended the Dental Hospital of the University of Manchester, referred by his private dentist. At the time of the clinical examination, moderate to severe loss of the palatal and incisal tooth surface located in the anterior sector of the teeth, deep overbite and dental alveolar compensation were found. Direct free-hand restorations were performed from canine to canine. After incisal filling, a posterior open bite of approximately 1 to 1.5 mm was observed. Posterior occlusal contact was completely restored in 3 months.
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A mixture design (MD) was used to evaluate the effect of replacing wheat flour (WF) with sprouted cañihua (Chenopodium pallidicaule Aellen), kiwicha (Amarathus caudatus L.), and quinoa (Chenopodium quinoa Willd.) flours (SCF, SKF, and SQF, respectively) on the content of phytic acid (PA), γ-aminobutyric acid (GABA), total soluble phenolic compounds (TSPC), and antioxidant activity (AA) in biscuits. Generally, sprouted pseudocereal flours contained lower amounts of starch and protein, comparable fat, ash, PA content, and increased levels of bioactive compounds (GABA and TSPC) and AA compared with wholegrain flours. Moreover, it was confirmed that sprouted pseudocereal flours were nutritionally superior to refined WF. MD allowed the modeling of target parameters showing that PA, GABA, TSPC, and AA were positively influenced by the proportion of flours in the biscuit. The models that better described the variation in nutritional parameters as a function of the formulation displayed typically linear and binary interactions terms. SKF exerted the highest influence on the increased content of PA. Therefore, to increase mineral bioavailability, the use of SCF and SQF in the formulation of biscuits was suggested. SCF and SQF positively influenced in GABA, TSPC, and AA in biscuits. The optimal ternary blends of flours that maximize the content of bioactive compounds and AA of biscuits and simultaneously minimize PA content were identified. To study the fate of biscuits in digestion, the optimal formulation for biscuits containing SQF/SCF was selected. For this type of baked product, reduced starch digestibility and glycemic index was observed compared with the control (100% WF). Moreover, the amounts of bioaccessible GABA, TSPC, and AA were higher in gastric and intestinal digests compared with control biscuit. Overall, these results highlighted the nutritional and health benefits of incorporation of flours from sprouted Andean grains in the production of biscuits.
RESUMEN
Sprouting is an effective treatment for improving nutritional and bioactive properties as well as lowering the anti-nutritional compounds in pseudo-cereals. Enhancing nutritional properties when using sprouted pseudo-cereals flours as a baking ingredient requires tailored formulation. Simplex centroid designs and response surface methodology has been applied in the present study to define the ideal proportions of ternary blends of sprouted kiwicha (SKF), cañihua (SCF) and wheat flours (WF) to simultaneously enhance the content in bioactive compounds (γ-aminobutyric acid, GABA, total soluble phenolic compounds and TSPC), as well as sensory (odor, color, taste and texture) and functional attributes (antioxidant activity, AA) while reducing phytic acid (PA) content of bread. The effect of gastric and intestinal digestion on bioactive compounds, AA, PA and starch hydrolysis was also evaluated. Mixture design allowed for the identification of optimal formulation (5% SKF, 23.1% SCF, 71.9% WF) that can be used to obtain breads with higher content of GABA, TSPC, AA, overall sensorial acceptability (scores > 7) and reduced PA content and glycemic index. Moreover, this study demonstrated that these nutritional and health benefits provided by the replacement of WF by sprouted pseudo-cereal flours remained upon digestion. The results of this study indicated that WF replacement with SKF and SCF is sensory acceptable and improved the nutritional quality of bread.
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El estudio se propuso determinar el bienestar psicológico de estudiantes de dos instituciones educativas (pública y privada) de Gran Asunción. Se empleó un diseño descriptivo, comparativo y de corte transversal. La muestra estuvo compuesta por 189 estudiantes secundarios de dos instituciones educativas de la ciudad de Asunción, seleccionados a través de una técnica no probabilística de muestreo intencional y de participación voluntaria. El instrumento empleado fue la Escala de Bienestar Psicológico de José Sánchez-Cánovas (2007). Los datos fueron analizados a través de estadísticos descriptivos y la aplicación de la prueba t de Student de comparación de medias para muestras independientes. Se utilizó el programa estadístico SPSS versión 20, para Windows. Se hallo en el nivel alto de bienestar subjetivo el mayor porcentaje de estudiantes de colegio público, y en bienestar material a participantes del colegio privado.
This study was aimed to determine the psychological well-being in students from two educational institutions in Asuncion (public and private). It was used a descriptive, comparative and transversal design. The sample consisted of 189 high school students from two educational institutions in the city of Asuncion, selected through a probability sampling technique using a not intentional technique based on voluntary participation. The instrument used was the Psychological Well-being Scale of José Sánchez-Canova (2007). Data were analyzed using descriptive statistics and the application of the Student t test for comparison of means for independent samples. the statistical program SPSS version 20 for Windows was used. It was found in the high level of subjective well-highest percentage of public school students in material welfare to private school participants.
RESUMEN
Las neumonías nosocomiales, son la principal causa de mortalidad y están dentro de las tre primeras causas de morbilidad de las infecciones nosocomiales, por lo tanto la importancia de las medidias de prevención es vital. Estas medidas involucran al personal médico y paramédico que intervienen en el manejo, diagnóstico y terapéutica que pueden alterar los mecanismos de defensa respiratoria del paciente. El conocimiento y aplicación de las medidias de prevención de la Neumonía Nosocomial harán disminuir la tasa de morbilidad producida por estas. El método empleado para el estudio fue de tipo descriptivo, retrospectivo, transversal y no experimental. Con los resultados obtenidos, se observa que existe una baja prevalencia de Neumonías nosocomiales, encontrándose en el Hospital Obrero N° 1 con el 1,1 por ciento, luego la Caja Petrolera de Salud con 1,2 por ciento y por último el Intituto Nacional del Tórax con una prevalencia del 2,1 por ciento de casos de Neumonía Nosocomial en las Unidades de Terapia Intensiva, durante la gestión 2003. En conclusiones los resultados obtenidos nos demuestran que no difieren mucho en relación a otros países, lo que demuestra que nuestros Centros Hospitalarios están capacitados para brindar una atención de calidad, con personal eficiente con permanente actualización.