MANUAL PARA LA GESTIÓN DEL MANTENIMIENTO CORRECTIVO DE EQUIPOS BIOMÉDICOS EN LA FUNDACIÓN VALLE DEL LILI / MANUAL FOR THE MANAGEMENT OF CORRECTIVE MAINTENANCE OF BIOMEDICAL EQUIPMENT IN FUNDACIÓN VALLE DEL LILI / MANUAL DE GESTÃO DA MANUTENÇÃO CORRETIVA DE EQUIPAMENTOS BIOMÉDICOS NA FUNDAÇÃO VALLE DEL LILI

El mantenimiento correctivo está orientado a corregir los defectos observados en los equipamientos o instalaciones, localizando las averías y reparándolas. Los costos de reparación de un equipo suelen ser mucho mayores en la etapa correctiva que en la etapa preventiva, y la literatura existente está orientada más hacia la prevención que hacia la corrección. Sin embargo, es inevitable que en una institución hospitalaria, como en cualquier otra, se presenten frecuentemente problemas en los equipos que no pudieron ser previstos o evitados mediante el mantenimiento preventivo o correctivo. Por esta razón, se hace necesario contar con protocolos para el mantenimiento correctivo que contengan criterios y procesos claramente definidos para mejorar la eficiencia y la eficacia en la solución de los problemas y que permitan la máxima disponibilidad en la prestación de los servicios. En este trabajo se presenta, como caso de estudio, el desarrollo e implementación de un Manual para la Gestión del Mantenimiento Correctivo en una de las clínicas de más alto nivel en la ciudad de Cali: La Fundación Valle del Lili.

The corrective maintenance is aimed at correcting the shortcomings in the equipment or facilities, locating faults and repairing them. Repair costs of equipment are usually much higher in the corrective stage than in the preventive stage, and the existing literature is oriented more towards prevention than correction. However, it is inevitable that in a hospital, as elsewhere, problems are often present on computers that could not be foreseen or avoided through preventive or corrective maintenance. For this reason corrective maintenance protocols containing clearly defined criteria and processes to improve efficiency and effectiveness in solving problems and ensuring maximum availability in the provision of services, are needed. This paper presents a case study, development and implementation of a Management Manual for corrective maintenance of the highest level clinics in the city of Cali: The Fundación Valle del Lili.

A Manutenção corretiva visa corrigir as deficiências do equipamento ou instalações, localizando falhas e reparálas. Os Custos de reparação de equipamento são geralmente muito maior na fase corretiva que na fase preventiva, e a literatura existente é mais orientada para a prevenção que para a correção. No entanto, é inevitável que em um hospital, como em outros lugares, muitas vezes se apresentam problemas nos equipamentos que não podiam ser previstos ou evitados através da manutenção preventiva ou corretiva. Por esta razão, é necessário ter protocolos de manutenção corretiva que contenham critérios e processos claramente definidos para melhorar a eficiência e eficácia na resolução de problemas e para assegurar a máxima disponibilidade na prestação de serviços. Este trabalho se apresenta como um caso de estudo, o desenvolvimento e a implementação de um Manual de Gestão para manutenção corretiva das clínicas de maior nível na cidade de Cali: a Fundação Valle del Lili.

Oocyte structure and ultrastructure in the Mexican silverside fish Chirostoma humboldtianum (Atheriniforme: Atherinopsidae)

The structural and ultrastructural features of gonads from endemic Mexican fish have received scarce attention. This study describes the histological and ultrastructural characteristics of oocyte from Chirostoma humboldtianum. The ovary is asynchronic, and as such, most phases of oocyte development are found in the same ovary. The complete process of oogenesis was divided in five stages: oogonium and folliculogenesis, primary growth, cortical alveoli and lipid inclusions, vitellogenesis, and maturation. The presence of big filaments, which appear at the end of primary growth, induces some common follicular adaptation. During primary growth, abundant ribosomes, the rough endoplasmic reticulum, and mitochondria are grouped in the cytoplasm. At the end of this stage, the Z1 layer of the chorion is developed, while microvilli start to be evident. In the cortical alveoli and lipid droplets phase, intense PAS positive vesicles, some of them containing nucleoid material, are observed in the peripheral cytoplasm and the lipid droplets take a more central position. In vitellogenesis, the proteic yolk accumulates in a centripetal way while the chorion is completely formed. During maturation, the germinal vesicle migrates to the animal pole, meiosis is restored, and there is nuclear breakdown. The oocyte increases its size and holds some oil droplets and a big fluid mass of yolk. On the outside, filaments completely surround the oocyte. Rev. Biol. Trop. 56 (3): 1371-1380. Epub 2008 September 30.

Tuberculin skin test and CD+4/CD8+ T cell counts in adults infected with the human immunodeficiency virus in Medellin, Colombia

To evaluate the effect of BCG vaccination and T lymphocyte subpopulations on the reactivity to the tuberculin skin test, 113 asymtomatic HIV+ individuals were tuberculin tested by intradermal injection of 5TU of purified protein derivate and the levels of circulating lymphocyte (CD3, CD4 and CD8) subpopulations determined by indirect immunoflurescence. Ninety-two per cent of the subjects included in the study, were males. The mean age of the group was 32.1ñ7.4 years. Sixty-two percent presented a BCG scar. However, only 22 per cent exhibited positive tuberculin reations (ò5mm) irrespective of the presence of the BCG scar. Tuberculin positive individuals exhibited higher CD4+ cell counts (p=0.004) and CD4+/CD8+ ratios (p=0.006) than tuberculin negative (<5mm) HIV+ individuals. The number of individuals with positive tuberculin reactions was significantly higher in subjects with more than 500 CD4+ lymphocytes/µl (p=0.02) or CD4+/CD8+ ratios ò1.12 (p=0.002). These results suggest that a prior BCG vaccination does not influence the reactivity to the tuberculin skin test in HIV+ asymptomatic individuals and that the number of CD4+ lymphocytes and the CD4+ lymphocytes and the CD4+/CD8+ ratio positively correlate with the tuberculin reactivity.

Promoción del envejecimiento activo: efectos del programa «Vivir con vitalidad»® / Promoting active ageing: effects of the «Vital living» programme

Introducción: en las últimas décadas, el envejecimiento activo ha emergido como un nuevo paradigma en la Gerontología. El II Plan Internacional sobre Envejecimiento de Naciones Unidas y la Organización Mundial de la Salud enfatiza el envejecimiento activo como un concepto clave que ha de promocionarse mediante políticas adecuadas. El curso presencial «Vivir con vitalidad»® y la versión multimedia «Vital ageing»® se han desarrollado con el fin de promocionar el envejecimiento óptimo. Ambos programas se han valorado a través de un diseño experimental por el que se han comparado algunos de sus efectos. Método: participaron en el estudio 107 personas mayores de 60 años voluntarias: de ellas 44 recibieron el curso multimedia, 32 participaron en «Vivir con vitalidad»® presencial y 31 formaron parte del grupo de control. A todos los participantes se les administraron los mismos instrumentos antes y después (fases pre y post, respectivamente) de la implementación del programa y, tras el mismo intervalo, al grupo de control. Resultados: ambos programas producen cambios positivos y significativos en diversos indicadores conductuales. Se han observado cambios en el sentido esperado en los grupos experimentales (en comparación con el control) en la frecuencia de actividades, así como en las opiniones sobre el envejecimiento y la vejez. También se encontraron cambios significativos en la satisfacción con la vida, los hábitos nutricionales y de ejercicio físico regular en el grupo multimedia. No se encontraron cambios significativos en relaciones sociales y salud en ninguno de los 2 grupos experimentales. Los resultados se discuten a la luz de la investigación sobre envejecimiento saludable y activo

Introduction: during the last two decades, active ageing has emerged as a new paradigm in Gerontology. The II International Plan of Action on Ageing of the United Nations and the World Health Organisation emphasises active ageing as a key concept that should be promoted by suitable policies. The «Vivir con vitalidad»® (Vital Living) programme and its multimedia version «Vital ageing»®, constitute a program for optimal ageing. The present article reports an experimental evaluation of both programmes conducted to compare some of their effects. Method: a total of 107 volunteers aged more than 60 years old participated in this study: 44 received the multimedia course, 32 attended a «Vivir con vitalidad»® course taught by teachers, and 31 acted as control subjects. The same battery of tests was administered to all participants before and after receiving the course and to the control group at an identical interval. Results: both programmes produced positive and significant changes in several behavioural indicators. Changes in the expected direction were observed in the experimental groups (in comparison with the control group) in the frequency of activities, as well as in opinions on ageing and old age. Significant differences were found in life satisfaction, nutrition and regular physical exercise in the multimedia group. No significant changes were found in social relationships or in health in either of the experimental groups. The results of this study are discussed in light of research on active and healthy ageing published in the literature