This paper covers the problem of corruption in Peru, with an emphasis on regional governments, and presents a proposal for an anti-corruption software application architecture for those levels of ...government. The design of the proposal starts from the analysis of corruption encompassing statistical studies, trust evolution, government management, legal situation and incidents in information technology. Also, aspects of the budget allocation, crime data, political party financing data, management resources, contracting processes, integration systems and citizen participation are presented, for the subsequent presentation of the data structure and resources for the software application architecture. The methodology used is of an exploratory documentary type. In addition, a systemic approach and development are considered in three layers: data persistence, logical process, and presentation; considering the interrelationships that must exist between them for the development of the proposed architecture.
Antimicrobial resistance is a global concern. Analysis of sterile fluids is essential because microorganisms are defined as significant in most cases. Blood, cerebrospinal, and pleural fluids are ...frequently received in the microbiology lab because they are associated with considerable rates of morbi-mortality. Knowledge of epidemiology in these samples is needed to choose proper empirical treatments due to the importance of reducing selection pressure.
We used retrospective laboratory data of blood, CSF, and pleural fluid collected from patients in Mexico between 2019 and 2020. Each laboratory identified the strains and tested susceptibility using its routine methods. For
, a comparative analysis was performed with data from the broth microdilution method.
Forty-five centers participated in the study, with 30,746 clinical isolates from blood, 2,429 from pleural fluid, and 2,275 from CSF. For blood and CSF,
was the most frequent. For blood, among gram negatives, the most frequent was
. Among
, 9.8% of
were carbapenem-resistant
For
, similar resistance percentages were observed for levofloxacin, cefotaxime, and vancomycin. For CSF, the most frequent gram-negative was
In
, carbapenem resistance was 71.4%. The most frequent species detected for pleural fluid was
; in
, carbapenem resistance was 96.3%.
Gram-negative bacteria, with
most prevalent, are frequently recovered from CSF, blood, and pleural fluid. In
, the routine, conventional methods showed good agreement in detecting resistance percentages for erythromycin, levofloxacin, and vancomycin.
The administration of parenteral infusates is a frequent intervention that is considered innocuous; moreover, the risk of this procedure which offers a direct access to the bloodstream is minimized.
...To evaluate the epidemiology of nosocomial pediatric bacteremias after implementing a control program.
Analysis of pediatric bacteremias was made in 3 periods: 1) 1990-1992, prior to establishing strategies to avoid contamination of parenteral infusions; 2) 1996, the phase after establishing these strategies; and 3) 2005-2006, the recent situation in the hospital.
The proportion of gram-negative rods isolated in blood cultures dropped from 82.9 to 35.1% (p = 0.004) during the 17-year study period. There was no significant difference in the proportion of gram-negative rods isolated from intravascular catheters. The proportion of contaminated parenteral infusions dropped from 22.2% to 0.4% (p < 0.001).
The strategies established to avoid the contamination of parenteral infusions were associated with a reduction in the proportion of gram-negative rods in blood cultures, although the proportion is still higher than that in developed countries, probably related to catheter contamination. We suggest establishing similar strategies in other hospitals from developing countries.
Giant cell ependymoma of the filum terminale is a rare variant, generally manifested as a well-circunscribed intradural mass with an indolent biological behavior.
We describe the case of a ...48-year-old Mexican female who non-relevant past medical history, that developed a GCE of the filum terminale. Magnetic resonance imaging and computed tomography revealed the presence of an intra-axial tumor extending from L3 to L5 with extra-medullary invasion. Therefore the tumor was considered unresectable and only incisional biopsy was obtained, establishing the tentative diagnosis of a poorly differentiated neoplasia. A second evaluation of the case revealed the presence of numerous non-cohesive pleomorphic giant cells with intranuclear inclusions and broad eosinophilic cytoplasm, alternating with intermediate size cells with round, hyperchromatic nuclei and forming a perivascular pseudo-rosettes pattern. The ependymal phenotype was supported by light microscopy and corroborated by immunohistochemistry analysis. The patient was subsequently treated with radiotherapy 54Gy. She is alive after a 27-month follow-up, with residual disease, difficulty ambulating and pain.
GCE of filum terminale may have an atypical clinical and radiological presentation, albeit with invasive characteristics and anaplasia on histologic analysis. However, its biological behavior is indolent and associated to longer survival. Due to the presence of giant cells, the differential diagnosis of other primary neoplasias at that site were considered, including paraganglioma, malignant peripheral nerve sheath tumors as well as metastatic malignant melanoma, adrenal carcinoma, thyroid gland carcinoma and urothelial carcinoma, that may all harbor giant cells.
Introducción. La línea de trabajo sobre las emociones en el aprendizaje y su relación con el logro académico considera las emociones como motivadoras o residuales del aprendizaje ...intelectual-cognitivo y busca determinar el papel o la función de las emociones como formadoras del aprendizaje. Objetivo. Evaluar las diferencias de la emoción del logro académico frente a distintos momentos evaluativos en estudiantes de kinesiología. Sujetos y métodos. El estudio tuvo un enfoque cuantitativo, con diseño observacional, temporalidad transversal y alcance correlacional. Se incluyó a 238 estudiantes regulares de primer a quinto año pertenecientes a la carrera de kinesiología de una universidad privada de la provincia de Concepción. A todos ellos se les aplicó el cuestionario de emociones de prueba. Resultados. Se hallaron puntuaciones más altas para las emociones positivas y más bajas para las emociones negativas. Los estudiantes muestran un promedio estadísticamente significativo más elevado en la emoción de disfrute y esperanza antes de la evaluación. Emociones como el orgullo, la vergüenza y el enojo muestran variabilidad en el eje temporal que rodea al hito evaluativo y muestran una disminución significativa posterior a la rendición de una evaluación. No se encontraron diferencias de las emociones entre hombres o mujeres, grupos etarios o el curso de los estudiantes. Conclusión. Es imperativo que los educadores en kinesiología consideren el aprendizaje emocional que emana junto con el proceso de enseñanza-aprendizaje y se transformen en facilitadores del entorno educativo, para que sus estudiantes puedan identificar de forma precisa sus emociones, las definan y puedan regularlas en los distintos momentos evaluativos.
La gangrena de Fournier (GF) es una fascitis necrotizante que pone en peligro la vida del paciente. El objetivo de este trabajo fue determinar la etiología y el impacto del agente aislado en el ...cultivo de la herida y de orina.
Se llevó a cabo un análisis retrospectivo de una cohorte de 66 pacientes con GF de origen urogenital. Los valores cualitativos medidos se expresaron como frecuencia y porcentaje, y se compararon con la prueba de ji al cuadrado y la prueba de Fisher. La diferencia se consideró estadísticamente significativa con p < 0.05.
Los pacientes que murieron presentaban con mayor frecuencia cultivos de orina y herida positivos para Escherichia coli productora de betalactamasas de espectro extendido (BLEE): orina, sobrevivientes 14.5% vs. muertes 44.4%; herida, sobrevivientes 20.8% vs. muertes 66.6% (p < 0.001).
Durante la valoración integral del paciente con GF es fundamental realizar cultivos de orina y de herida con el fin de iniciar el manejo antibiótico dirigido de manera temprana. Los pacientes con GF que mueren presentan mayor número de cultivos positivos para E. coli BLEE.
Fournier gangrene (FG) is a necrotizing fasciitis that endangers the patient’s life. The objective of this study was to determine the etiology and impact of the agent isolated on wound and urine culture.
We performed a retrospective analysis within a cohort of 66 patients with FG of urogenital origin. The measured qualitative values were expressed as frequency and Percentage and compared with the chi square test and Fisher’s test. The difference was considered statistically significant at p < 0.05.
Patients who died had more frequent cultures of urine and wound positive for extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli: urine, survivors 14.5% vs. deaths 44.4%; wound, 20.8% vs. 66.6% (p < 0.001).
During the integral evaluation of the patient with FG it is essential to perform the urine and surgical wound cultures in order to initiate the antibiotic management directed at an early stage. Patients with GF who die present a greater number of cultures positive for E. coli ESBL.
The plasma membrane in plant cells is energized with an electrical potential and proton gradient generated through the action of H super(+) pumps belonging to the P-type ATPase superfamily. The ...Arabidopsis genome encodes 11 plasma membrane H super(+) pumps. Auto-inhibited H super(+)-ATPase isoform 10 (AHA10) is expressed primarily in developing seeds. Here we show that four independent gene disruptions of AHA10 result in seed coats with a transparent testa (tt) phenotype (light-colored seeds). A quantitative analysis of extractable flavonoids in aha10 seeds revealed an similar to 100-fold reduction of proanthocyanidin (PA), one of the two major end-product pigments in the flavonoid biosynthetic pathway. In wild-type seed coat endothelial cells, PA accumulates in a large central vacuole. In aha10 mutants, the formation of this vacuole is impaired, as indicated by the predominance of multiple small vacuoles observed by fluorescence microscopy using a vacuole-specific dye, 5-(and -6)- carboxy 2',7'-dichlorofluorescein diacetate. A similar vacuolar defect was also observed for another tt mutant, tt12, a proton-coupled multidrug and toxic compound extrusion transporter potentially involved in loading provacuoles with a flavonoid intermediate required for PA production. The endothelial cells in aha10 mutants are otherwise healthy, as indicated by the lack of a significant decrease in (i) the accumulation of other flavonoid pathway end products, such as anthocyanins, and (ii) mRNA levels for two endothelium-specific transcripts (TT12 and BAN). Thus, the specific effect of aha10 on vacuolar and PA biogenesis provides genetic evidence to support an unexpected endomembrane function for a member of the plasma membrane H super(+)-ATPase family.
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