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Adsorptive-photocatalytic composites based on activated carbon (AC) and α-ferrous oxalate dihydrate (α-FOD) were synthesized by an original two-step method and subsequently used for the removal of phenol from aqueous solutions. To obtain the composites, ferrotitaniferous black mineral sands (0.6FeTiO3·0.4Fe2O3) were first dissolved in an oxalic acid solution at ambient pressure, and further treated under hydrothermal conditions to precipitate α-FOD on the AC surface. The ratio of oxalic acid to the mineral sand precursor was tuned to obtain composites with 8.3 and 42.7 wt.% of α-FOD on the AC surface. These materials were characterized by X-ray powder diffraction, scanning electron microscopy, and the nitrogen adsorption-desorption method. The phenol removal efficiency of the composites was determined during 24 h of adsorption under dark conditions, followed by 24 h of adsorption-photocatalysis under visible light irradiation. AC/α-FOD composites with 8.3 and 42.7 wt.% of α-FOD adsorbed 60% and 51% of phenol in 24 h and reached a 90% and 96% removal efficiency after 12 h of irradiation, respectively. Given its higher photocatalytic response, the 42.7 wt.% α-FOD composite was also tested during successive cycles of adsorption and adsorption-photocatalysis. This composite exhibited a reasonable level of cyclability (~99% removal after four alternated dark/irradiated cycles of 24 h and ~68% removal after three simultaneous adsorption-photocatalysis cycles of 24 h). The promising performance of the as-prepared composites opens several opportunities for their application in the effective removal of organic micropollutants from water.
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Children's oral health depends on parents' knowledge and attitudes. The primary dentition stage, in particular, plays a crucial role in the comprehensive development of children. Therefore, the objective was to evaluate parents' knowledge and attitudes about oral health in the primary dentition stage in Chachapoyas (Amazonas, NW Peru). A questionnaire was administered to 409 parents from 15 educational institutions, and the data were analyzed using multinomial logistic regression. Among the surveyed parents, 75.3% could identify at least one habit harmful to their children's teeth (such as excessive sugar consumption) and one of its effects (such as dental caries). Additionally, 77.5% reported that their children presented some dental problem, more frequent in the peripheral areas than in the city's center. Gender (odd ratio, OR = 0.484; p = 0.037), educational level (OR = 2.144; p = 0.043), and type of health insurance (OR = 2.627; p = 0.044) of the parents influenced awareness of taking care of their children's primary dental health. The geographic location of the school (1.729 < OR < 2.079; p ≤ 0.011) and family income (OR = 3.504; p = 0.028) influenced parents' identification of the different harmful effects of children's habits. Factors such as low socioeconomic status and never taking the child to the dentist increased the risk of dental problems (p < 0.05). It is suggested that peripheral areas, like rural areas, lack the same oral health programs and access to treatment as central urban areas, leading to disparities in parental knowledge and attitudes.
Sujet(s)
Caries dentaires , Santé buccodentaire , Enfant , Humains , Pérou/épidémiologie , Caries dentaires/épidémiologie , Connaissances, attitudes et pratiques en santé , Dent de laitRÉSUMÉ
Bacterial communities in the mammalian reproductive system can be rich and diverse, differing in structure and quantity depending on location. In addition, its microbiome is associated with the state of health of this tract and reproductive success. This study evaluated the microbiome composition of the uterine body (UB) and uterine horn mucosa (UH) samples using 16S rRNA sequencing of samples extracted from cows in the Amazon region. It was observed that four main phyla were shared between the uterine sites: Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria. Linear discriminant analysis effect size and heat tree analysis showed that members of Lachnospiraceae (NK3A20 group) and Oscillospiraceae were significantly more abundant in the UB than in UH. In addition, there are more unique genera in the UB than in the UH. A higher bacterial load in UB than in UH is expected because of the exposure to external factors of UB. However, comparing the site's communities through beta diversity did not generate well-defined clustering. Thus, it can be attributed to the closeness of the sites, which would make the niches similar ecologically and microbiologically. Therefore, this research provides knowledge to understand biomarkers in the prior reproduction period.
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Microbiote , Femelle , Animaux , Bovins , ARN ribosomique 16S/génétique , ARN ribosomique 16S/analyse , Microbiote/génétique , Utérus/microbiologie , Bactéries/génétique , Firmicutes/génétique , Mammifères/génétiqueRÉSUMÉ
INTRODUCTION: Twitter data has been used to surveil public sentiment about tobacco products, however, most tobacco-related Twitter research has been conducted with English-language posts. There is a gap in the literature on tobacco-related discussions on Twitter in languages other than English. This study summarized tobacco-related discussions in Spanish on Twitter. METHODS: A set of Spanish terms reflecting electronic cigarettes (e.g., cigarillos electrónicos), cigarettes (e.g., "pitillo"), and cigars (e.g., "cigaro") were identified. A content analysis of tweets (n=1,352) drawn from 2021 was performed to examine themes and sentiment. An initial codebook was developed in English then translated to Spanish and then translated back to English by a bilingual (Spanish and English) member of the research team. Two bilingual members of the research team coded the tweets into themes and sentiment. RESULTS: Themes in the tweets included 1) product promotion (n=168, 12.4%), 2) health warnings (n=161, 11.9%), 3) tobacco use (n=136, 10.1%), 4) health benefits of vaping (n=58, 4.3%), 5) cannabis use (n=50, 3.7%), 6) cessation (n=47, 3.5%), 7) addiction (n=33, 2.4%), 8) policy (n=27, 2.0%), and 9) polysubstance use (n=12, 0.9%). Neutral (n=955, 70.6%) was the most common category of sentiment observed in the data. CONCLUSIONS: Tobacco products are discussed in multiple languages on Twitter and can be summarized by bilingual research teams. Future research should determine if Spanish-speaking individuals are frequently exposed to pro-tobacco content on social media and if such exposure increases susceptibility to use tobacco among never users or sustained use among current users. IMPLICATIONS: Spanish-language pro-tobacco content exists on Twitter, which has implications for Spanish-speaking individuals who may be exposed to this content. Spanish-language pro-tobacco-related posts may help normalize tobacco use among Spanish-speaking populations. As a result, anti-tobacco tweets in Spanish may be necessary to counter areas of the online environment that can be considered pro-tobacco.
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The effects of salinity on the accumulation and toxicity of microplastics (MPs) in mangrove invertebrates are still scarcely described. We assessed the accumulation and osmoregulatory toxicity of the estuarine fiddler crab Minuca rapax, exposed to 25 mg L-1 of high-density polyethylene MPs at three combinations of osmotic media (hypo- 6, iso- 25, or hyper-35 psu), in 1, 3 and 5 days of exposure. Gills accumulated more MPs than the digestive tract (DT) and muscle. MP accumulation in the gills and DT was enhanced at 6 psu and reduced at 21 and 35 psu after 1 day of exposure. Muscle MP accumulation was not affected by salinity or exposure time. Osmotic regulation was unaffected by MP exposure in any exposure time. Our findings demonstrate that M. rapax accumulates MPs in gills and DT depending on the salinity and that MPs are not osmoregulatory toxicant for this species.
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Brachyura , Animaux , Brachyura/physiologie , Salinité , Matières plastiques/métabolisme , Microplastiques , Osmorégulation , BranchiesRÉSUMÉ
INTRODUCTION: Appendectomy has traditionally been considered as a training operation for junior pediatric surgeons during their training period. However, with the increase of laparoscopic appendectomy, there has been a growing concern about the performance of this procedure by junior trainees. Our aim is to analyze intra-/postoperative appendectomy outcomes according to the number of training years during Pediatric Surgical residency training program. METHODS: A retrospective study was performed in patients who underwent appendectomy between 2018 and 2021 in our institution, who were divided into 5 groups according to the number of training years of the junior surgeon who performed the intervention (Y1-Y5). Demographics, complicated appendicitis rate, operation time, and postoperative complications were compared. A stratified analysis according to the technique performed (open/laparoscopic) was performed. RESULTS: A total of 1274 appendectomized patients were analyzed, of which 1257 (98.7%) were operated on by junior trainees (81 in Y1; 407 in Y2; 337 in Y3; 261 in Y4; and 171 in Y5) without demographic differences between groups. As the year of training increased, an elevation in complicated appendicitis rate was observed, although without statistically significant differences. However, laparoscopic/open appendectomies ratio increased with increasing year of training (p < 0.001). Operative time decreased significantly with increasing year of training (p < 0.001), both in open and laparoscopic appendectomies. There were no significant differences in postoperative complications, nor in the stratified analysis according to surgical technique. CONCLUSION: Appendectomy performed by junior pediatric surgery trainees can be considered a safe procedure from the first year of training, regardless of the technique used.
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Appendicite , Internat et résidence , Laparoscopie , Enfant , Humains , Appendicectomie/méthodes , Appendicite/chirurgie , Études rétrospectives , Laparoscopie/méthodes , Complications postopératoires/épidémiologie , Complications postopératoires/chirurgie , Durée du séjour , Résultat thérapeutiqueRÉSUMÉ
BACKGROUND: The COVID-19 pandemic required the public to alter their daily lives drastically. For adolescents, school closures and social isolation added further challenges to a stressful stage of life, potentially increasing the likelihood of substance use initiation. This study explored the relationship between adolescent substance use initiation and negative life changes due to COVID-19. METHODS: Students from 9 high schools (N = 2478) in Los Angeles County were surveyed as 9th graders in the 2019-2020 school year and re-surveyed in 10th and 11th grades as part of an ongoing longitudinal study. Two logistic regression models were conducted to test hypotheses that negative life changes due to the COVID-19 pandemic increases the odds of initiation of both tobacco/nicotine products and cannabis products, controlling for sex, age, and race/ethnicity. RESULTS: The final analytic sample included adolescents in 10th grade who were never-users of tobacco/nicotine (N = 809) and cannabis (N = 837). The odds of initiating cannabis use increased by 6.42% for every 1 standard deviation increase in the COVID-19 negative daily life changes index [AOR: 1.063; 95% CI: 1.010, 1.121]. The association between the COVID-19 negative daily life changes index and tobacco/nicotine use initiation was not significant. DISCUSSION: Adolescents who experienced life changes due to COVID-19 were more likely to initiate cannabis use, but not tobacco/nicotine use. Results identify a need for early intervention efforts to promote effective coping skills and prevent cannabis initiation among adolescents during a wide-scale stressor, such as COVID-19.
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COVID-19 , Cannabis , Dispositifs électroniques d'administration de nicotine , Hallucinogènes , Trouble lié au tabagisme , Humains , Adolescent , Nicotine , Pandémies , Études longitudinales , COVID-19/épidémiologie , Trouble lié au tabagisme/épidémiologie , Enquêtes et questionnaires , Qualité de vieRÉSUMÉ
INTRODUCTION: Postoperative rhabdomyolysis (RML) has been documented after several surgical procedures in adults. Musculoskeletal remodeling after Nuss procedure for pectus excavatum (PE) could cause RML. We evaluated the incidence of RML after Nuss procedure in children. METHODS: This study was a prospective study from 2018 to 2021. We enrolled all otherwise healthy patients who underwent PE correction with only one bar. Studied variables included demographic and clinical data, duration of surgery, complications, and length of hospitalization. The patients included underwent serial measurements of serum creatine kinase (CK), troponin I, N terminal pro B-type natriuretic peptide (NT-proBNP), serum creatinine, urea, and glomerular filtration rate at 6 and 48 hours postoperatively, and hospital discharge. RESULTS: Forty-six patients met criteria (40 males/6 females), with a mean age of 15.1 ± 1.4 years. Mean duration of surgery was 74 ± 28 minutes, and length of hospitalization was 4.6 ± 1.6 days. RML was diagnosed in 30.4% of patients at 6 hours, 91.3% at 48 hours, and 21.7% at hospital discharge. Mean preoperative CK value was 181.1 ± 141.6 IU/L, and postoperative values were 863.3 ± 302.6 IU/L at 6 hours, 1,675.2 ± 561 IU/L at 48 hours, and 850 ± 683.7 IU/L at hospital discharge, with statistically significant differences (p = 0.001). High-sensitivity troponin I and NT-proBNP levels increased significantly during the postoperative time (p = 0.001). Renal function remained stable (p = 0.55). CONCLUSION: Nuss technique produces RML without kidney injury in healthy patients. This knowledge should be considered for patients at increased risk of developing acute kidney injury and other complications.
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Thorax en entonnoir , Rhabdomyolyse , Adolescent , Femelle , Humains , Mâle , Thorax en entonnoir/chirurgie , Hospitalisation , Études prospectives , Rhabdomyolyse/épidémiologie , Rhabdomyolyse/étiologie , Troponine IRÉSUMÉ
This study aimed to evaluate the efficacy of a new trivalent vaccine containing inactivated Porcine Circovirus 1-2a and 1-2b chimeras and a Mycoplasma hyopneumoniae bacterin administered to pigs around 3 weeks of age. This trivalent vaccine has already been proved as efficacious in a split-dose regimen but has not been tested in a single-dose scenario. For this purpose, a total of four studies including two pre-clinical and two clinical studies were performed. Globally, a significant reduction in PCV-2 viraemia and faecal excretion was detected in vaccinated pigs compared to non-vaccinated animals, as well as lower histopathological lymphoid lesion plus PCV-2 immunohistochemistry scorings, and incidence of PCV-2-subclinical infection. Moreover, in field trial B, a significant increase in body weight and in average daily weight gain were detected in vaccinated animals compared to the non-vaccinated ones. Circulation of PCV-2b in field trial A and PCV-2a plus PCV-2d in field trial B was confirmed by virus sequencing. Hence, the efficacy of this new trivalent vaccine against a natural PCV-2a, PCV-2b or PCV-2d challenge was demonstrated in terms of reduction of histopathological lymphoid lesions and PCV-2 detection in tissues, serum and faeces, as well as improvement of production parameters.
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Study Design: Retrospective case-control study. Objective: Identify risk factors among sociodemographic, nutritional, and health characteristics associated with iron deficiency anemia in children under five years of age attending the growth and development clinic of the Nueve de Enero de Chachapoyas Health Center in 2019. Methods: Two groups were formed, each consisting of 50 children. Group 1 (G1, cases) were children diagnosed with iron deficiency anemia and a control group (CG) of age-matched healthy children residing in the same jurisdiction. Data were collected from the medical records of the health center in a structured record card based on the study variables: age, birth weight, parasitic diseases, or associated symptomatologies such as diarrhea, frequency, and type of feeding before and after six months of age. Data were grouped in contingency tables to calculate Odds Ratio (OR), and statistical significance was estimated by analysis of variance (ANOVA) with 95% confidence. Results: All the factors considered presented significant association p<0.05, except for sex, concerning the presence of anemia in children. With OR values of: under 32 months of age (OR=2.26, 95% CI 0.59-2.79), under 2900 g birth weight (OR=2.98, 95% CI 0.43-2.99), prolonged exclusive breastfeeding (OR=3.14, 95% CI 1. 55-3.88), early ablactation (OR=4.96, 95% CI 1.27-5.07), low consumption of foods of animal origin (3.5, 95% CI 1.18-3.61), low consumption of fruits and vegetables (2.33, 95% CI 0.86-2.63), among others. Conclusions: In the population of Chachapoyas, the factors considered in the study increase the risk of developing anemia in children under five years of age by more than 93%. Its probability of occurrence warrants a reevaluation of the strategies applied in the different programs or interventions carried out in the area for the control and prevention of anemia. (AU)
Desenho do estudo: Estudo retrospectivo de casos-controle. Objetivo: Identificar fatores de risco entre as ca-racterísticas sociodemográficas, nutricionais e de saúde associados à anemia por deficiência de ferro em crianças menores de cinco anos, atendendo à clínica de crescimento e desenvolvimento do Centro de Saúde Nueve de Enero de Chachapoyas em 2019. Método: Foram formados dois grupos, cada um formado por 50 crianças. O grupo 1 (G1, casos) eram crianças diagnosticadas com anemia por deficiência de ferro e um grupo controle (GC) de crianças saudá-veis, com idade compatível, residentes na mesma jurisdição. Os dados foram coletados dos registros médicos do cen-tro de saúde, em uma ficha de registro estruturada com base nas variáveis do estudo: idade, peso ao nascer, doenças parasitárias ou sintomas associados, como diarreia, frequência e tipo de alimentação antes e depois dos seis meses de idade. Os dados foram agrupados em tabelas de contingência para o cálculo do Odds Ratio (OR), e a significância esta-tística foi estimada pela análise de variância (ANOVA) com 95% de confiança. Resultados: Todos os fatores conside-rados apresentaram associação significativa p<0,05, com exceção do sexo, no que diz respeito à presença de anemia em crianças. Com valores OR de: menos de 32 meses de idade (OR=2,26, 95% CI 0,59-2,79), menos de 2900 g de peso ao nascer (OR=2,98, 95% CI 0,43-2,99), amamentação exclusiva prolongada (OR=3,14, 95% CI 1. 55-3. 88), ablactação precoce (OR=4,96, 95% CI 1,27-5,07), baixo consumo de alimentos de origem animal (3,5, 95% CI 1,18-3,61), baixo consumo de frutas e vegetais (2,33, 95% CI 0,86-2,63), entre outros. Conclusão: Na população de Chachapoyas, os fatores considerados no estudo aumentam em mais de 93% o risco de desenvolver anemia em crianças com menos de cinco anos. Sua probabilidade de ocorrência justifica uma reavaliação das estratégias aplicadas nos diferentes programas ou intervenções realizadas na área para o controle e prevenção da anemia.Palavras-chave: Fatores de risco, Anemia ferropriva, Anemia; Criança. (AU)
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Humains , Mâle , Femelle , Nourrisson , Enfant d'âge préscolaire , Groupes témoins , Études rétrospectives , Facteurs de risque , Anémie par carence en ferRÉSUMÉ
Staphylococcus aureus mastitis constitutes a serious threat to dairy cows. The reasons why available vaccines are not fully effective remain poorly understood; thus, in the present study, we investigated CD4+ and CD8+ T lymphocyte proliferation in dairy cows vaccinated with a polyvalent mastitis vaccine that had distinct precedent Staphylococcus aureus mastitis. We studied 17 S. aureus-infected dairy cows (11 vaccinated and six unvaccinated) and eight vaccinated healthy dairy cows with no previous S. aureus mastitis infections. Flow cytometry was used to assess lymphocyte proliferation using an anti-Ki67 antibody, and monoclonal antibodies were used to identify T cell subsets. S. aureus-infected cows exhibited reduced overall lymphocyte proliferation, including CD4+ T lymphocyte proliferation, and memory lymphocyte proliferation in response to S. aureus isolate stimulus. Immunization did not influence the expansion of blood lymphocyte populations. Furthermore, CD8+ T cells, memory CD8+ T lymphocytes, and effector memory CD8+ T lymphocytes displayed reduced proliferation 21 days after the third vaccine dose compared with before vaccination at time zero. The present data demonstrates an overall negative regulation of the T-cell response suggesting its detrimental impact leading to the persistence of S. aureus intramammary infections. Furthermore, the lack of vaccination effect on T-cell mediated immunity (e.g., proliferation) may be related to poor vaccine efficacy.
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Mammite bovine , Infections à staphylocoques , Vaccination , Animaux , Bovins , Femelle , Lymphocytes T CD4+/cytologie , Lymphocytes T CD4+/immunologie , Lymphocytes T CD8+/cytologie , Lymphocytes T CD8+/immunologie , Prolifération cellulaire , Mammite bovine/immunologie , Mammite bovine/prévention et contrôle , Lait , Infections à staphylocoques/prévention et contrôle , Infections à staphylocoques/médecine vétérinaire , Staphylococcus aureus , Vaccins antibactériens/immunologie , Vaccination/médecine vétérinaireRÉSUMÉ
Clostridium perfringens is a dangerous bacterium and known biological warfare weapon associated with several diseases, whose lethal toxins can produce necrosis in humans. However, there is no safe and fully effective vaccine against C. perfringens for humans yet. To address this problem, we computationally screened its whole proteome, identifying highly immunogenic proteins, domains, and epitopes. First, we identified that the proteins with the highest epitope density are Collagenase A, Exo-alpha-sialidase, alpha n-acetylglucosaminidase and hyaluronoglucosaminidase, representing potential recombinant vaccine candidates. Second, we further explored the toxins, finding that the non-toxic domain of Perfringolysin O is enriched in CTL and HTL epitopes. This domain could be used as a potential sub-unit vaccine to combat gas gangrene. And third, we designed a multi-epitope protein containing 24 HTL-epitopes and 34 CTL-epitopes from extracellular regions of transmembrane proteins. Also, we analyzed the structural properties of this novel protein using molecular dynamics. Altogether, we are presenting a thorough immunoinformatic exploration of the whole proteome of C. perfringens, as well as promising whole-protein, domain-based and multi-epitope vaccine candidates. These can be evaluated in preclinical trials to assess their immunogenicity and protection against C. perfringens infection.
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Clostridium perfringens , Protéome , Acetylglucosaminidase , Épitopes/métabolisme , Humains , Hyaluronoglucosaminidase/métabolisme , Sialidase/métabolisme , Protéome/métabolisme , Vaccins synthétiquesRÉSUMÉ
National forest inventories (NFIs) are a reliable source for national forest measurements. However, they are usually not developed for linking with remotely sensed (RS) biomass information. There are increasing needs and opportunities to facilitate this link towards better global and national biomass estimation. Thus, it is important to study and understand NFI characteristics relating to their integration with space-based products; in particular for the tropics where NFIs are quite recent, less frequent, and partially incomplete in several countries. Here, we (1) assessed NFIs in terms of their availability, temporal distribution, and extent in 236 countries from FAO's Global Forest Resources Assessment (FRA) 2020; (2) compared national forest biomass estimates in 2018 from FRA and global space-based Climate Change Initiative (CCI) product in 182 countries considering NFI availability and temporality; and (3) analyzed the latest NFI design characteristics in 46 tropical countries relating to their integration with space-based biomass datasets. We observed significant NFI availability globally and multiple NFIs were mostly found in temperate and boreal countries while most of the single NFI countries (94 %) were in the tropics. The latest NFIs were more recent in the tropics and many countries (35) implemented NFIs from 2016 onwards. The increasing availability and update of NFIs create new opportunities for integration with space-based data at the national level. This is supported by the agreement we found between country biomass estimates for 2018 from FRA and CCI product, with a significantly higher correlation in countries with recent NFIs. We observed that NFI designs varied greatly in tropical countries. For example, the size of the plots ranged from 0.01 to 1 ha and more than three-quarters of the countries had smaller plots of ≤0.25 ha. The existing NFI designs could pose specific challenges for statistical integration with RS data in the tropics. Future NFI and space-based efforts should aim towards a more integrated approach taking advantage of both data streams to improve national estimates and help future data harmonization efforts. Regular NFI efforts can be expanded with the inclusion of some super-site plots to enhance data integration with currently available space-based applications. Issues related to cost implications versus improvements in the accuracy, timeliness, and sustainability of national forest biomass estimation should be further explored.
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Surveillance de l'environnement , Arbres , Biomasse , Changement climatique , ForêtsRÉSUMÉ
Congenital infantile fibrosarcoma (CIF) is a rare tumor in children that occurs in the first years of life. It usually arises in the extremities but some cases affect the trunk, neck, abdomen, or retroperitoneum. Surgical resection has been traditionally the treatment of choice but the development of genomic analysis and targeted therapies has shed light on new therapeutic options. We present two patients with a congenital mass, one in the abdominal cavity (1-month-old) and the second in the left lower extremity respectively (2-months-old). In both cases, the clinical and radiological findings showed heterogeneous masses with rapidly progressive growth. MRI in the first patient exhibited an abdominal mass surrounding the aorta and inferior vena cava associated with a giant infrarenal aortic aneurysm. CT-guided biopsy was performed with pathological findings of fibrosarcoma and ETV6-NTRK3 gene fusion. The second patient underwent open biopsy also with histopathological diagnosis of fibrosarcoma and the same mutation in the TRK gene ( NTRK3 ). Targeted therapy with a specific TRK inhibitor, larotrectinib, was started in both patients. Periodical controls were made by ultrasound or MRI, and after a few weeks of treatment, both children showed significant decrease in the mass. By the second and third months after starting the treatment, both tumors disappeared. The first patient is now 15-months-old and the second one is 8-months-old. Larotrectinib is a novel targeted therapy with excellent results in CIF but long-term outcomes are limited to establish it as a gold standard treatment.
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BACKGROUND: Little is known about factors affecting implementation of patient safety programmes in low and middle-income countries. The goal of our study was to evaluate the implementation of a patient safety programme for paediatric care in Guatemala. METHODS: We used a mixed methods design to examine the implementation of a patient safety programme across 11 paediatric units at the Roosevelt Hospital in Guatemala. The safety programme included: (1) tools to measure and foster safety culture, (2) education of patient safety, (3) local leadership engagement, (4) safety event reporting systems, and (5) quality improvement interventions. Key informant staff (n=82) participated in qualitative interviews and quantitative surveys to identify implementation challenges early during programme deployment from May to July 2018, with follow-up focus group discussions in two units 1 year later to identify opportunities for programme modification. Data were analysed using thematic analysis, and integrated using triangulation, complementarity and expansion to identify emerging themes using the Consolidated Framework for Implementation Research. Salience levels were reported according to coding frequency, with valence levels measured to characterise the degree to which each construct impacted implementation. RESULTS: We found several facilitators to safety programme implementation, including high staff receptivity, orientation towards patient-centredness and a desire for protocols. Key barriers included competing clinical demands, lack of knowledge about patient safety, limited governance, human factors and poor organisational incentives. Modifications included use of tools for staff recognition, integration of education into error reporting mechanisms and designation of trained champions to lead unit-based safety interventions. CONCLUSION: Implementation of safety programmes in low-resource settings requires recognition of facilitators such as staff receptivity and patient-centredness as well as barriers such as lack of training in patient safety and poor organisational incentives. Embedding an implementation analysis during programme deployment allows for programme modification to enhance successful implementation.
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Sécurité des patients , Amélioration de la qualité , Enfant , Groupes de discussion , Guatemala , Humains , Recherche qualitativeRÉSUMÉ
Los recientes avances en los equipos de ultrasonido y de sus transductores han permitido la mayor competitividad del método, posicionándose como la primera opción sobre otras modalidades de imagen en la valoración de las enfermedades de los tendones y nervios, gracias al incremento en la resolución para visualizar y explorar los tendones y los nervios periféricos. El ultrasonido (US) se consideraba un complemento de la resonancia magnética (RM); sin embargo, con los equipos modernos, se ha convertido en la mejor modalidad diagnóstica para la revisión de los nervios periféricos, aceptada cada día más, debido a la rapidez, disponibilidad y la característica dinámica del método ecográfico. La desventaja principal es que depende del operador y que la experiencia de quien lo realiza es fundamental para su adquisición e interpretación. Este trabajo muestra una breve revisión de la técnica y de los marcadores anatómicos en la valoración de los nervios periféricos más comunes de la extremidad inferior.
Recent advances in ultrasound technology and the development of high-resolution ultrasound transducers have enabled detailed depiction of superficial musculoskeletal structures, tendons and nerves, allowing the method to become more competitive, positioning it as the first choice over other imaging modalities in the assessment of tendon and nerve diseases. While in the past considered as complementary to magnetic resonance (MR) imaging, modern ultrasound has clearly become competitive. It is now the imaging modality of choice for evaluating tendon and neural pathology. The major advantages of ultrasound include dynamic evaluation of structures, low cost and wide availability. The main disadvantage is a high degree of operator dependency and the experience of the operator is essential for its acquisition and interpretation. This article reviews the technique and anatomical markers in the ultrasound appearance of the most common peripheral nerves of the lower limb.
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Science des ultrasons , Membre inférieur , NeurofibresRÉSUMÉ
El síndrome de ovario poliquístico (SOP) es una anormalidad endocrino - metabólica común con una prevalencia a nivel mundial equivalente al 4% siendo una patología de interés que afecta la salud de las mujeres. OBJETIVO: determinar la prevalencia del síndrome de ovario poliquístico por Ecografía en el Hospital Virgen de Fátima, Chachapoyas. MATERIALES Y MÉTODOS: el estudio fue de enfoque cuantitativo, descriptivo de prevalencia, retrospectivo, trasversal, la muestra lo formaron 300 historias clínicas. RESULTADOS: del 100% historias clínicas, la tasa de prevalencia del SOP por ecografía fue del 56.3 x 100. Así mismo existe una Tasa de Prevalencia (TP) del SOP bilateral es de 52.6 x 100 historias clínicas; la TP del SOP derecho es de 2 x 100 y del SOP Izquierdo es de 1.6 x 100. CONCLUSIONES: la TP del SOP por ecografía es muy alta, ya que más de la mitad de la población sufre esta patología. Así mismo el SOP de tipo bilateral es el más predominante en un 52.6 x cada 100.
Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic abnormality with a worldwide prevalence equivalent to 4% being a pathology of interest that affects women's health. OBJECTIVE: to determine the prevalence of polycystic ovary syndrome by ultrasound at the Hospital Virgen de Fatima, Chachapoyas. MATERIALS AND METHODS: the study was a quantitative, descriptive, retrospective, cross-sectional, retrospective, prevalence study, the sample consisted of 300 medical records. RESULTS: of the 100% medical records, the prevalence rate of PCOS by ultrasound was 56.3 x 100. Likewise, there is a Prevalence Rate (PT) of bilateral PCOS of 52.6 x 100 medical records; the PT of right PCOS is 2 x 100 and of left PCOS is 1.6 x 100. CONCLUSIONS: the PT of PCOS by ultrasound is very high, since more than half of the population suffers from this pathology. Likewise, bilateral PCOS is the most predominant at 52.6 per 100.
A síndrome do ovário policístico (PCOS) é uma anormalidade endócrina metabólica comum com uma prevalência mundial de 4% e é uma patologia de interesse que afeta a saúde da mulher. OBJETIVO: para determinar a prevalência da síndrome dos ovários policísticos por ultra-som no Hospital Virgen de Fátima, Chachapoyas. MATERIAIS E MÉTODOS: o estudo foi um estudo quantitativo, descritivo, retrospectivo, transversal, de prevalência retrospectiva, com uma amostra de 300 prontuários médicos. RESULTADOS: dos 100% dos registros médicos, a taxa de prevalência de PCOS por ultra-som foi 56,3 x 100. CONCLUSÕES: da mesma forma, a Taxa de Prevalência (TP) de PCOS bilateral é 52,6 x 100 registros médicos; o TP de PCOS direito é 2 x 100 e o de PCOS esquerdo é 1,6 x 100. O PT do PCOS por ultra-som é muito alto, pois mais da metade da população sofre desta patologia. O PCOS bilateral é o tipo mais predominante a 52,6 por 100.
Sujet(s)
Dossiers médicaux , Syndrome des ovaires polykystiques , Études transversalesRÉSUMÉ
BACKGROUNDS: The present study explored the viability of bovine milk macrophages, their intracellular production of reactive oxygen and nitrogen species (RONS), and their phagocytosis of Staphylococcus aureus, as well as the profile of lymphocytes, from healthy udder quarters and udder quarters infected by Corynebacterium bovis. The study included 28 healthy udder quarters from 12 dairy cows and 20 udder quarters infected by C. bovis from 10 dairy cows. The percentages of macrophages and lymphocytes were identified by flow cytometry using monoclonal antibodies. Macrophage viability, RONS production, and S. aureus phagocytosis were evaluated by flow cytometry. RESULTS: Milk samples from quarters infected with C. bovis showed a lower percentage of macrophages but an increased number of milk macrophages per mL and a higher percentage of macrophages that produced intracellular RONS and phagocytosed S. aureus. No effect of C. bovis infection on macrophage viability was found. Udder quarters infected by C. bovis showed a higher percentage of T cells and CD4+ T lymphocytes, but no effect was found on the percentage of CD8+ CD4- T, CD8- CD4- T, or B lymphocytes. CONCLUSIONS: Thus, our results corroborate, at least in part, the finding that intramammary infections by C. bovis may offer protection against intramammary infections by major pathogens.
Sujet(s)
Macrophages/physiologie , Mammite bovine/microbiologie , Lait/cytologie , Animaux , Bovins , Corynebacterium , Femelle , Lymphocytes , Mammite bovine/anatomopathologie , Phagocytose , Espèces réactives de l'azote , Espèces réactives de l'oxygène , Staphylococcus aureusRÉSUMÉ
Existen múltiples patologías del tracto urinario, ya sea congénitas o adquiridas, que requieren de tratamiento quirúrgico de Nefrectomía total o parcial. En el siguiente estudio longitudinal prospectivo se incluyen 21 nefroureterectomías en pacientes pediátricos con patología del tracto urinario con o sin enfermedad renal crónica y algún tipo de terapia de reemplazo renal, realizados con la técnica de Cirugía Minimamente Invasiva (CMI) abordaje retroperitoneal o retroperitoneoscopía. (AU)
There are several urinary tract diseases, such as congenital or adquired, that require total or partial nephrectomy. This prospective longitudinal study included 21 total nephrectomies in pediatric patients with or without end stage renal disease and some kind of renal replacement therapy. All surgeries were done with retroperitoneal approach using minimally invasive surgery (MIS), retroperitoneoscopy. (AU)
Sujet(s)
Humains , Mâle , Femelle , Nourrisson , Enfant d'âge préscolaire , Enfant , Adolescent , Insuffisance rénale chronique/chirurgie , Maladies du rein/chirurgie , Néphrectomie/méthodes , Espace rétropéritonéal , Malformations urogénitales/chirurgie , Études prospectives , Études longitudinales , Interventions chirurgicales mini-invasives/méthodesRÉSUMÉ
BACKGROUND: The implementation of programs to improve patient safety remains challenging in low- and middle-income countries. The goal of our study was to define the barriers and facilitators to implementation of a perioperative patient safety program in Guatemala. MATERIAL AND METHODS: We conducted semi-structured interviews with 16 staff pre-intervention and a follow-up focus group discussion 1 year later in the perioperative department at the Roosevelt Hospital in Guatemala. We performed qualitative thematic analysis to identify barriers and facilitators to the implementation process, with analysis guided by the Consolidated Framework for Implementation Research. RESULTS: We found several dominant themes affecting implementation of a patient safety program. Implementation facilitators included strong prioritization of patient needs, program compatibility with existing workflow, and staff attributes. Barriers included a lack of knowledge about patient safety, limited resources, limited leadership engagement, and lack of formal implementation leaders. Several program modifications were made to enhance successful implementation iteratively during the implementation process. DISCUSSION: Our analysis highlights several dominant themes which affect the implementation of a perioperative safety program in Guatemala. Understanding the barriers and facilitators to implementation during program deployment allows for program modification and improvement of the implementation process itself.