Projeto de intervenção educacional para os Agentes Comunitários de Saúde a fim de melhorar o cadastro de pacientes no e-SUS - Unidade de saúde Abrahao Federman, Ponta Grossa.

Introdução: Cadastro em saúde se refere aos dados que apoiam as equipes de Atenção Básica a mapear as características de saúde, sociais e econômicas da população adscrita ao território sob sua responsabilidade. Este cadastro está organizado em duas dimensões: domiciliar e individual. A necesidade de cadastrar ou registrar a informação dos pacientes é considerado um problema antigo e importante,nesta direção depende da possibilidade de ter o suporte técnico adequado. Objetivo: melhorar o registro ou cadastro dos usuarios no e-SUS, a partir do preenchimento pelos Agentes comunitarios de saude . Metodologia: foi realizado um estudo de intervenção educacional entre que trabalham na unidade de saúde Abrahao Federman do Bairro Uvaranas, localizada no município de Ponta Grossa, PR , no período incluído de junho a agosto de 2017. A população do presente estudo consistiu na participação de 12 agentes comunitarios de saúde que trabalham na unidade de saúde. A coleta de dados foi feita através de uma pesquisa que constituiu o registro definitivo dos dados, foi aplicada antes e depois do programa de intervenção educacional. Resultados: Como resultados, houve uma participaçao de 12 agentes comunitarios de saúde e no que se refere ao conhecimento sobre cadastro de ususarios, a maior parte da amostra demonstrou possuir conhecimento inadequado sobre a temática. Os principais fatores que dificultaram o proceso adequado do cadastro de usuario no e-sus foram a disponibilidade de pouco tempo para desenvolver o trabalho, a população com a documentação desatualizada , e a rede de internet de qualidade ruim. Após a realização da intervenção educativa, observou-se uma importante modificação no nível de conhecimento dos participantes quanto ao cadastro de usuarios no e-sus. Do total da amostra, 92,6% assimiliram os conhecimentos repassados. Além disso foram tomadas algumas medidas como: pedir aos pacientes que atualizem sua documentação, para melhor atualizaçao do cartão do e-sus, foi tomado como um acordo, ter disponivel uma tarde semanal para os agentes comunitários dedicar-se apenas ao cadastro de pacientes no e-sus, outro acordo foi realizar uma reunião mensal para avaliar o processo de registro dos usuários no e-sus. Houve uma redução nas queixas na prefeitura de 5%, e as agendas de consulta foram feitas com melhor qualidade. As diferenças estatísticas, obtidas antes e após a intervenção educacional, foram significativas , o que evidencia os efeitos positivos do programa de intervenção educacional

Reversion of epigenetically mediated BIM silencing overcomes chemoresistance in Burkitt lymphoma

In Burkitt lymphoma/leukemia (BL), achievement of complete remission with first-line chemotherapy remains a challenging issue, as most patients who respond remain disease-free, whereas those refractory have few options of being rescued with salvage therapies. The mechanisms underlying BL chemoresistance and how it can be circumvented remain undetermined. We previously reported the frequent inactivation of the proapoptotic BIM gene in B-cell lymphomas. Here we show that BIM epigenetic silencing by concurrent promoter hypermethylation and deacetylation occurs frequently in primary BL samples and BL-derived cell lines. Remarkably, patients with BL with hypermethylated BIM presented lower complete remission rate (24% vs 79%; P = .002) and shorter overall survival (P = .007) than those with BIM-expressing lymphomas, indicating that BIM transcriptional repression may mediate tumor chemoresistance. Accordingly, by combining in vitro and in vivo studies of human BL-xenografts grown in immunodeficient RAG2(-/-)γc(-/-) mice and of murine B220(+)IgM(+) B-cell lymphomas generated in Eμ-MYC and Eμ-MYC-BIM(+/-) transgenes, we demonstrate that lymphoma chemoresistance is dictated by BIM gene dosage and is reversible on BIM reactivation by genetic manipulation or after treatment with histone-deacetylase inhibitors. We suggest that the combination of histone-deacetylase inhibitors and high-dose chemotherapy may overcome chemoresistance, achieve durable remission, and improve survival of patients with BL

Aplicación de la NIC 2 para la expresión razonable del valor de las existencias en los estados financieros de la empresa Inversiones y Servicios Generales Bazan S.A.C., Trujillo, 2017

RESUMEN La presente investigación tiene como objetivo la aplicación de la NIC 2 para la expresión razonable del valor de las existencias en los Estados Financieros, incluyendo en su determinación los costos vinculados de las compras para darles su condición y ubicación actual, realizando una comparación de los importes del valor de las existencias antes y después de la aplicación de la NIC 2 del año 2017. Este estudio se enmarca dentro de una investigación no experimental y de corte transversal recogiendo datos del periodo 2017. Los resultados obtenidos nos muestran que la empresa no ha aplicado un correcto análisis y proceso contable de las existencias, de los productos obsoletos y deteriorados (mermas y/o desmedros), y el reconocimiento apropiadamente el valor neto realizable de los productos. Por consiguiente la investigación esta direccionada a poder presentar los Estados Financieros reales demostrando el valor de las existencias bajo el enfoque de la NIC 2, al ser esta partida un porcentaje importante de los activos que posee la empresa. Finalmente se emiten conclusiones y recomendaciones que permiten tener un correcto tratamiento contable de las existencias con información real.ABSTRACT The objective of this research is to apply IAS 2 for the reasonable expression of the value of inventories in the Financial Statements, including in its determination the related costs of purchases to give them their current condition and location, making a comparison of the amounts of the value of inventories before and after the application of IAS 2 of 2017. This study is part of a non-experimental and cross-sectional investigation collecting data from the 2017 period. The results obtained show us that the company has not applied a correct analysis and accounti ng process of the stock, obsolete and deteriorated products (losses and / or demerits), and the appropriate recognition of the net realizable value of the products Therefore, the investigation is directed to be able to present the actual Financial Statements demonstrating the value of inventories under the approach of IAS 2, since this item is an important percentage of the assets owned by the company. Finally, conclusions and recommendations are issued that allow having a correct accounting treatment of the stocks with real information

Efecto de la ceniza del bagazo de la caña de azúcar en la remoción de plomo, Aija, 2022

El objetivo del presente estudio fue la verificación de la variación de concentración de plomo en agua del río Llactún-Aija, se utilizó como absorbente la ceniza de bagazo de caña de azúcar preparada mediante una modificación física y química. El trabajo consistió en evaluar muestra del Rio Llactún en un punto crítico previamente analizado por la Autoridad Nacional del Agua, dándose a conocer la cantidad contaminado con plomo y filtrarla por medio de una dosis de ceniza de bagazo de caña de azúcar, que fue calcinada a 400°C para que pueda activarse, durante el proceso se tomaron muestras en un determinado tiempo. El proceso de absorción se realizó por medio de un biofiltro que consistió de piedras de distintos tamaños, ordenados granulométricamente y de la ceniza de bagazo de caña de azúcar, donde se estudió las variables independientes: la cantidad de biomasa absorbente, y como variable respuesta la capacidad de absorción. La dosis que se usaron en la remoción de plomo es de 1 g/L, 1.5 g/L y 2 g/L, el tiempo de contacto para cada dosis de bioadsorbente será de 30 minutos

Estimating, and setting targets for, the resilience of transport infrastructure

To ensure that transport infrastructure provides acceptable levels of service with respect to extreme events, the resilience of the infrastructure needs to be estimated and targets for it need to be set. In this paper, the methodology proposed in the Foresee EU research project is presented. The methodology allows managers to measure, and set targets for, the resilience of transport systems in all situations. It requires clear definition of the transport system and how the service provided and the resilience are to be measured. The methodology allows consideration of the fact that transport infrastructure managers need to estimate resilience with various degrees of accuracy depending on the specific problem to be addressed, the time frame at disposition and the expertise available. These various levels of accuracy are covered by proposing the use of (a) simulations, (b) indicators whose values are directly related to increases in expected restoration intervention costs and reductions in service, and (c) the percentage of fulfilment of indicators. Once resilience has been estimated, the methodology provides guidance on how to set resilience targets with or without cost-benefit analysis. For demonstration, the explanation of the steps of the guideline is supported by their use for a simple transport system.This work has received funding from the EU Horizon 2020 research and innovation programme under the grant agreement 769373 (Foresee project)

Estimating the resilience of, and targets for, a transport system using expert opinion

To ensure that transport infrastructure provides acceptable levels of service with respect to extreme events, the resilience of the infrastructure needs to be estimated and targets for it need to be set. Recent work in the European research project Future Proofing Strategies for Resilient Transport Networks against Extreme Events (Foresee) has shown how this can be done in situations with a wide range of available data, time frames for the estimation and expertise. This paper provides an example of how an infrastructure manager can use the guideline to estimate the resilience of, and set resilience targets for, an example transport system in a relatively short period of time, even in the case of limited expertise in all the relevant areas and limited knowledge and information on all the basic input variables. The example is fictive but realistic. It is based on a transport system consisting of a section of the A16 highway, in Italy, where a potential landslide could discharge enough material to damage road sections and bridges. The resilience is estimated using resilience indicators with differentiated weights, and the resilience targets are set using cost–benefit analysis, to identify the indicators to be improved first.This work has received funding from the EU Horizon 2020 research and innovation programme under grant agreement number 769373 (Foresee project). This paper reflects only the authors’ views. The European Commission and Innovation and Networks Executive Agency are not responsible for any use that may be made of the information contained therein

Importancia de la farmacovigilancia y acciones de mitigación frente a reacciones adversas por medicamentos homeopáticos y medicamentos tradicionales a base de plantas naturales en el municipio de Curumaní – Cesar

El siguiente proyecto tiene como fin identificar las reacciones adversas de los medicamentos tradicionales y homeopáticos en el municipio de Curumaní y los mecanismos de control y farmacovigilancia que rigen a esta práctica. La realización de esta investigación nos permite hacer uso de diferentes herramientas para obtener información veraz que nos permita identificar esas reacciones y que efectos causan en la salud de las personas, cual es el comportamiento de los habitantes ante la forma correcta de la medicación para su tratamiento. Con el apoyo de un cuestionario aplicado con escala tipo Likert y una muestra de 50 personas se aplica el cuestionario, se realiza posteriormente el análisis descriptivo de los resultados encontrados.The following project aims to identify the adverse reactions of traditional and homeopathic medicines in the municipality of Curumaní and the control and pharmacovigilance mechanisms that govern this practice. The realization of this research allows us to make use of different tools to obtain truthful information that allows us to identify these reactions and what effects they cause in the health of people, what is the behavior of the inhabitants before the correct form of medication for their treatment. With the support of a questionnaire applied with a Likert scale and a sample of 50 people, the questionnaire is applied, and the descriptive analysis of the result

Ventajas del uso de la telemedicina en pacientes oncológicos desde la perspectiva médica y la de los pacientes

Introduction: telemedicine, driven by the COVID-19 pandemic, has become an essential component of global healthcare offering improved access and quality of care, especially for oncology patients.Objective: to identify the advantages of the use of telemedicine in oncology patients from a medical and patient perspective.Methods: a systematic review was carried out in the following databases: PubMed, ClinicalKey, Scopus, Scielo and Google Scholar. Articles published from January 2019 to March 2024 were selected, and the search strategy included the keywords “telemedicine”, “oncology”, “cancer” and their English equivalents.Development: the main advantages found from the perspective of oncology patients with respect to telemedicine are that it helps them to overcome geographical limits and contributes to a better quality and better accessibility of medical care; in addition, it is beneficial to them as a strategy for the prevention of infections originated by the immunosuppression to which they are exposed. From the medical perspective, the advantages mentioned are that it has become a useful tool in the follow-up and control of treatments and symptoms of oncology patients, it helps to offer greater coverage in terms of the number of treatments and all this without altering the doctor-patient relationship.Conclusions: telemedicine is a tool that offers significant benefits for both oncology patients and their oncology physicians. Introducción: la telemedicina, impulsada por la pandemia de COVID-19, se ha convertido en un componente esencial de la atención médica global ofreciendo una mejora en el acceso y la calidad de la atención, especialmente para pacientes oncológicos.Objetivo: identificar las ventajas del uso de la telemedicina en pacientes oncológicos desde la perspectiva médica y la de los pacientes.Métodos: se realizó una revisión sistemática en las siguientes bases de datos PubMed, ClinicalKey, Scopus, Scielo y Google Scholar. Se seleccionaron artículos publicados desde enero del 2019 a marzo del 2024, y la estrategia de búsqueda incluyó las palabras clave "telemedicina", "oncología", "cáncer" y sus equivalentes en inglés. Desarrollo: las principales ventajas encontradas desde la perspectiva de los pacientes oncológicos con respecto a la telemedicina son que les ayuda a superar los límites geográficos y contribuye a una mejor calidad y mejor accesibilidad de la atención médica; además, les es beneficiosa como estrategia para la prevención de infecciones originadas por la inmunodepresión a la que están expuestos. Desde la perspectiva médica, las ventajas mencionadas son que se ha convertido en una herramienta útil en el seguimiento y control de tratamientos y síntomas de los pacientes oncológicos, ayuda a ofrecer una mayor cobertura en cuanto número de atenciones y todo esto sin alterar la relación médico-paciente. Conclusiones: la telemedicina es una herramienta que ofrece beneficios significativos tanto para los pacientes oncológicos y sus médicos oncólogos

Current clinical spectrum of common variable immunodeficiency in Spain: The multicentric nationwide GTEM-SEMI-CVID registry

Common variable immunodeficiency (CVID) constitutes a heterogenic group of primary immunodeficiency disorders with a wide-ranging clinical spectrum. CVID-associated non-infectious morbidity constitutes a major challenge requiring a full understanding of its pathophysiology and its clinical importance and global variability, especially considering the broad clinical, genetic, and regional heterogeneity of CVID disorders. This work aimed to develop a nationwide, multicenter, retrospective study over a 3-year period describing epidemiological, clinical, laboratory, therapeutic, and prognostic features of 250 CVID patients in Spain. The mean diagnostic delay was around 10 years and most patients initially presented with infectious complications followed by non-infectious immune disorders. However, infectious diseases were not the main cause of morbimortality. Non-infectious lung disease was extraordinarily frequent in our registry affecting approximately 60% of the patients. More than one-third of the patients in our cohort showed lymphadenopathies and splenomegaly in their follow-up, and more than 33% presented immune cytopenias, especially Evans' syndrome. Gastrointestinal disease was observed in more than 40% of the patients. Among biopsied organs in our cohort, benign lymphoproliferation was the principal histopathological alteration. Reaching 15.26%, the global prevalence of cancer in our registry was one of the highest reported to date, with non-Hodgkin B lymphoma being the most frequent. These data emphasize the importance of basic and translational research delving into the pathophysiological pathways involved in immune dysregulation and diffuse lymphocytic infiltration. This would reveal new tailored strategies to reduce immune complications, and the associated healthcare burden, and ensure a better quality of life for CVID patients