Docencia universitaria en salud: análisis de la distribución entre tipos de cargo y género / University teaching in health: analysis of the distribution between job types and gender

Introduction: Despite the great contribution of women to health systems, men still occupy most leadership positions. The gender gap in leadership roles in healthcare is prevalent worldwide. Methods: This is a cross-sectional study that analyses the distribution of the types of appointments defined by hierarchy, duration of employment, and percentage of FTE and the positions occupied by women faculty compared with male counterparts. The unit of analysis corresponds to faculty positions in 2018 since each faculty can have more than one position with different hierarchy, duration, and percentage of FTE. We used logistic multivariate analysis to assess associations, considering the model with the lowest AIC. Results: Age group 31 to 50 years (AOR: 0.66; IC 95%: 0.50-0.87) and FTE appointments (AOR: 0.43; IC 95%: 0.29- 0.64) are significantly associated with positions assigned to women. For appointment type defined by hierarchy TA, is significantly occupied by a female when compared to each group of increased hierarchy, Assistant professor (AOR: 1.39; IC 95%: 1.14-1.70), Associate professor (AOR: 2.67: IC 95%: 1.95- 3.67), Full professor (AOR: 3.47; IC 95%: 2.27-5.30) and authorities (AOR: 5.57; IC 95%: 3.53-8.79). Conclusions: There is almost no representation of women in the highest-ranking positions, which are associated with academic recognition, decision-making, and higher pay. The higher prevalence of full-time positions occupied by women could be linked to women still being responsible for household and family tasks

Introducción: A pesar de la gran contribución de las mujeres a los sistemas de salud, a nivel mundial los hombres son mayoría en los puestos de liderazgo. A nivel mundial, la brecha de género en los cargos de liderazgo en atención médica es persistente. Métodos: Estudio de corte transversal que analiza la distribución de los tipos de cargos docentes ocupados por mujeres de la Facultad de Medicina de la Universidad de Buenos Aires según jerarquía, dedicación y regularidad, comparados con su contraparte masculina. La unidad de análisis corresponde a las posiciones, ya que cada docente puede tener más de un cargo. Usamos regresión logística considerando el modelo con el AIC más bajo. Resultados: Grupo de edad de 31 a 50 años (ORA: 0.66; IC 95%: 0.50 a 0.87) y la dedicación exclusiva (ORA: 0.43; IC 95%: 0.29 a 0.64) están significativamente asociados con posiciones ocupadas por mujeres. Para el tipo de cargos definidos por jerarquía, "ayudante de cátedra" está ocupado significativamente por mujeres, en comparación con cada grupo de jerarquía creciente, Jefe de Trabajos Prácticos (ORA: 1.39; IC 95%: 1.14 a 1.70), Profesor Adjunto (ORA: 2.67; IC 95%: 1.95 a 3.67), Profesor Titular (ORA: 3.47; IC 95%: 2.27 a 5.30) y autoridades (ORA: 5.57; IC 95%: 3.53 a 8.79). Conclusiones: Escasa representación femenina en los puestos de mayor rango asociados con reconocimiento académico, toma de decisiones y mejor salario. La dedicación exclusiva en las mujeres podría estar relacionada con que ellas que siguen siendo responsables de las tareas domésticas y familiares

First report of Leishmania infantum infection in the endangered orangutan (Pongo pygmaeus pygmaeus) in Madrid, Spain.

BACKGROUND: Some wild animals have been recognized as potential reservoirs of Leishmania infantum infection (e.g. carnivores, lagomorphs, rodents, etc.). Leishmania infantum was also identified infecting humans and lagomorphs (i.e. hares and rabbits) over the period of 2009-2016, with the latter acting as the main reservoirs involved in the human leishmaniosis outbreak in Madrid. RESULTS: Two cases of clinical leishmaniosis are reported in orangutans (Pongo pygmaeus pygmaeus) housed at two different centres in Madrid. The first is the case of a 36-year-old male orangutan with severe weight loss and apathy. A complete blood count and biochemical profile revealed anaemia, neutropenia, hypoalbuminaemia and elevated transaminases. Hepato-splenomegaly was also observed. Four months later, due to worsening of clinical signs (mainly bilateral epistaxis), blood and bone marrow samples were collected. Amastigotes of L. infantum were detected in macrophages from a bone marrow aspirate and by specific polymerase chain reaction. The second case was a 34-year-old female orangutan with severe weight loss and apathy and no other apparent clinical signs. A complete blood count and biochemical profile revealed anaemia, pancytopenia and hypoalbuminaemia. Splenomegaly and pericardial effusion were also observed. As leishmaniosis was included in the differential diagnosis, both blood and bone marrow samples were collected. Leishmania infantum infection was confirmed by microscopy, molecular diagnosis and serology (immunofluorescence antibody test). Both animals were treated daily with oral miltefosine for 28 days; allopurinol was also given uninterruptedly in Case 2 for at least 6 months. During follow-up, though good clinical recovery was clear, a lack of parasitological cure was confirmed molecularly in both blood and bone marrow samples from the two orangutans. In both habitats, the presence of the sand fly vector identified as Phlebotomus perniciosus was confirmed. CONCLUSIONS: To our knowledge, this is the first report of L. infantum infection in great apes and in the endangered species P. p. pygmaeus. We are presently looking for L. infantum in other non-human primates living in the same peri-urban areas. If detected, we will examine the impacts of this serious disease on these critically endangered species.

Anti-fibrillarin antibody in African American patients with systemic sclerosis: immunogenetics, clinical features, and survival analysis.

OBJECTIVE: Anti-U3-RNP, or anti-fibrillarin antibodies (AFA), are detected more frequently among African American (AA) patients with systemic sclerosis (SSc) compared to other ethnic groups and are associated with distinct clinical features. We examined the immunogenetic, clinical, and survival correlates of AFA in a large group of AA patients with SSc. METHODS: Overall, 278 AA patients with SSc and 328 unaffected AA controls were enrolled from 3 North American cohorts. Clinical features, autoantibody profile, and HLA class II genotyping were determined. To compare clinical manifestations, relevant clinical features were adjusted for disease duration. Cox proportional hazards regression was used to determine the effect of AFA on survival. RESULTS: Fifty (18.5%) AA patients had AFA. After Bonferroni correction, HLA-DRB1*08:04 was associated with AFA, compared to unaffected AA controls (OR 11.5, p < 0.0001) and AFA-negative SSc patients (OR 5.2, p = 0.0002). AFA-positive AA patients had younger age of disease onset, higher frequency of digital ulcers, diarrhea, pericarditis, higher Medsger perivascular and lower Medsger lung severity indices (p = 0.004, p = 0.014, p = 0.019, p = 0.092, p = 0.006, and p = 0.016, respectively). After adjustment for age at enrollment, AFA-positive patients did not have different survival compared to patients without AFA (p = 0.493). CONCLUSION: Our findings demonstrate strong association between AFA and HLA-DRB1*08:04 allele in AA patients with SSc. AA SSc patients with AFA had younger age of onset, higher frequency of digital ulcers, pericarditis and severe lower gastrointestinal involvement, but less severe lung involvement compared to AA patients without AFA. Presence of AFA did not change survival.

[Application of amniotic membrane dressings in patients with skin damage]. / Aplicación de apósitos de membrana amniótica en pacientes con deterioro de la integridad cutánea.

The application of amniotic membranes in patients diagnosed with skin damage is a valid treatment option. A care plan following the Virginia Henderson model and NANDA, NOC and NIC taxonomy was applied to 36 patients admitted to the Dr. Miguel Enríquez hospital with different cutaneous lesions. This membrane has already been used for years due to its healing properties. These are attributed to antimicrobial properties reducing infection risk and promoting epithelial activity. They can decrease the need for the use of antibiotics, expendable materials, and can be applied during long periods of healing. This decreases the cost of wide spectrum antibiotic treatments, as well as the time patients spend in hospital. We present the results of this application in cases with several types of skin lesions.

Aplicación de apósitos de membrana amniótica en pacientes con deterioro de la integridad cutánea / Application of amniotic membrane dressings in patients with skin damage

La aplicación de membrana amniótica en pacientes con diagnóstico enfermero de deterioro de la integridad cutánea es una alternativa válida. Se aplicó el plan de cuidaos según el modelo de Virginia Henderson y la taxonomía NANDA, NOC y NIC a 36 pacientes ingresados en el hospital Dr. Miguel Enríquez con diferentes lesiones cutáneas. Esta membrana se ha utilizado hace ya algunos años por sus propiedades curativas. Se le atribuyen propiedades antimicrobianas reduciendo el riesgo de infección y actividad promotora de epitelización. Permiten disminuir el uso de antibióticos, materiales gastables y aplicación entre curas de periodos prolongados; lo que permite disminuir los costos por tratamientos de antibióticos de amplio espectro, así como el tiempo de hospitalización de los pacientes. Por sus resultados presentamos estos casos de aplicación en varios tipos de lesiones de la piel (AU)

The application of amniotic membranes in patients diagnosed with skin damage is a valid treatment option. A care plan following the Virginia Henderson model and NANDA, NOC and NIC taxonomy was applied to 36 patients admitted to the Dr. Miguel Enríquez hospital with different cutaneous lesions. This membrane has already been used for years due to its healing properties. These are attributed to antimicrobial properties reducing infection risk and promoting epithelial activity. They can decrease the need for the use of antibiotics, expendable materials, and can be applied during long periods of healing. This decreases the cost of wide spectrum antibiotic treatments, as well as the time patients spend in hospital. We present the results of this application in cases with several types of skin lesions (AU)