Introducción: la ausencia de tratamientos específicos para COVID-19 ha promovido el diseño de estrategias en salud pública para reducir tasas de contagio y disminuir la mortalidad por el virus. En ...Colombia se decretó una cuarentena obligatoria a partir del 24 de marzo de 2020. Esta medida se convirtió en una oportunidad para la implementación de programas de consulta mediante telesalud, con el fin de continuar la prestación de servicios de salud. La Unidad de Neuropsicología del Instituto Neurológico de Colombia (INDEC) decidió instaurar un modelo de atención en neuropsicología mediante la metodología de telesalud. Métodos: en el presente artículo se exponen los detalles de esta experiencia, considerando y describiendo los aspectos administrativos, informáticos, clínicos, logísticos, éticos y legales. Resultados y conclusiones: esta modalidad de trabajo de una unidad de neuropsicología, revela que es posible capitalizar la madurez que se ha alcanzado en el campo clínico, tecnológico y administrativo, para generar transformaciones de forma rápida y que respondan de manera oportuna a las necesidades del medio.
Os analgésicos orais à base de opioides têm sido usados para o manejo da analgesia nos períodos peri e pós‐operatório de pacientes submetidos à linfadenectomia axilar. A região axilar é uma zona ...difícil de bloquear e não há registro de uma técnica de anestesia regional específica que ofereça o seu bloqueio adequado.
Após a aprovação do Conselho de Ética institucional, estudos anatômicos e radiológicos foram feitos para determinar a deposição e disseminação de azul de metileno e anestésico local, respectivamente injetados na axila via plano interfascial torácico. Exames de ressonância magnética foram então feitos em 15 de 34 pacientes programados para cirurgia de mama unilateral que envolveria qualquer um dos seguintes procedimentos: esvaziamento axilar, biópsia de linfonodo sentinela, biópsia de linfonodo axilar ou mamas supranumerárias, para verificar a deposição e o tempo de propagação da solução dentro do plano interfascial torácico in vivo.
Estudos radiológicos e em cadáveres mostraram que a injeção de anestésico local e azul de metileno via plano interfascial torácico com a técnica guiada por ultrassom resulta em deposição confiável na axila. Nos pacientes, a injeção de anestésico local produziu um bloqueio sensitivo axilar confiável. Esse achado foi corroborado por estudos de ressonância magnética que mostraram sinais hiperintensos na região axilar.
Esses achados definem as características anatômicas do bloqueio da região axilar e destacam o potencial clínico desses novos bloqueios.
Oral opioid analgesics have been used for management of peri‐ and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade.
After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter‐fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo.
Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter‐fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper‐intense signals in the axillary region.
These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block.
El proyecto por presentar consiste en la ampliación de la capacidad de producción para la fábrica de Huachipa de la empresa CBC Peruana S.A.C., la cual se dedica a la producción y distribución de los ...productos de PepsiCo.La propuesta consiste en ofrecer un servicio de consultoría donde se levante información, se analice y en conjunto con algunos responsables directos de la empresa se puedan ejecutar actividades e implementar proyectos de mejora para solventar el problema de falta de capacidad. Haciendo una proyección del volumen de ventas del año 2020 al 2025 se encontró que a partir de finales del 2022 existirá un déficit de capacidad para poder entregar el volumen solicitado por el área comercial, lo que traería consigo un desabastecimiento del mercado y una pérdida del 15% del crecimiento de la venta anual.La inversión requerida irá en base a las etapas en cuanto al corto, mediano y largo plazo. Para el corto plazo, la inversión estará basada en recursos como horas hombre adicionales tanto de los trabajadores de CBC Peruana como de los consultores, así como de modificaciones iniciales que se estarían ejecutando en el mediano plazo que oscila los $1,500,000 y en el largo plazo se estima que superaría los $3 millones, con rápido retorno.
A high throughput screening campaign identified nine β,γ-diamino ester derivatives as TRP modulators. A discrete library of new derivatives (23 components) was prepared in a one-pot two step ...reductive amination reaction, and evaluated for their ability to block the agonist-induced calcium influx in cells expressing human TRPV1, TRPM8 and TRPA1 channels. Selective antagonists for each channel, as well as dual TRPV1/TRPM8 and TRPM8/TRPA1 ligands, were obtained after subtle modification of this linear scaffold. SAR studies revealed the preferred substituents for the selective blockade of the three TRP channels under study. The most potent TRPV1 antagonists displayed submicromolar IC
50
values.
Incorporation of minor changes in the structure of a single β,γ-diaminoester linear scaffold resulted in selective hits for TRPV1, TRPM8 and TRPA1 blockade, as well as some dual antagonists.
Despite administration of annual influenza vaccination, influenza-associated complications in transplant recipients continue to be an important cause of hospitalization and death. Although influenza ...vaccination has been proven to be the most effective measure to reduce influenza infection after transplantation, transplant recipients are still vulnerable to influenza infections, with lower serological responses to vaccination compared to the general population. In order to assess the efficacy and safety of an alternative immunization scheme for solid organ transplant recipients, the TRANSGRIPE1-2 Study Group aimed to test a booster dose administration 5 weeks after the standard vaccination. The primary objective of this trial was to compare short-term and long-term neutralizing antibody immunogenicity of a booster dose of influenza vaccination to the standard single-dose immunization scheme. Secondary objectives included the evaluation of the efficacy and/or safety, cellular immune response, incidence of influenza infection, graft rejection, retransplant and mortality rates.
This phase III, randomized, controlled, open-label clinical trial was conducted between October 2012 and December 2013 in 12 Spanish public referral hospitals. Solid organ transplant recipients (liver, kidney, heart or lung), older than 16 years of age more than 30 days after transplantation were eligible to participate. Patients (N = 514) were stratified 1:1 by center, type of organ and time after transplantation and who either received the standard single dose (n = 257) or were treated according to a novel influenza vaccination schedule comprising the administration of a booster dose 5 weeks after standard vaccination (n = 254). Seroconversion rates were measured as a determinant of protection against influenza (main outcome). Efficacy and safety outcomes were followed until 1 year after influenza vaccination with assessment of short-term (0, 5, 10 and 15 weeks) and long-term (12 months) results. Intention-to-treat, per-protocol and safety analyses will be performed.
This trial will increase knowledge about the safety and efficacy of a booster dose of influenza vaccine in solid organ transplant recipients. At the time the manuscript was submitted for publication, trial recruitment was closed with a total of 499 participants included during a 2-month period (within the seasonal influenza vaccination campaign).
ClinicalTrials.gov Identifier: NCT01761435 (registered 13 December 2012). EudraCT Identifier: 2011-003243-21 (registered 4 July 2011).
Newborn Screening Programs (NSP) in Spain were born in the city of Granada in 1968. Till the 1980s, they were developed around the so-called "National Plan for Preventing Subnormality", covering up ...to 30% of the Spanish newborns. From 1982, when the health system management was transferred to the different autonomous regions, the NSP began to expand, and the bases to transform them into an organized and multidisciplinary activity, integrated and coordinated from the National Health System were settled. Despite this expansion, it is not until the 1990s when their coverage reaches almost 100% newborns in Spain. NSP grew up asymmetrically across the different autonomous regions. In 2005 and 2006 the scientific societies SEQC (Spanish Society of Clinical Chemistry) and AECNE (Spanish Society of Newborn Screening), coordinated by the Health Promotion Area of the General Directorate of Public Health, gathered together the necessary information to elaborate a report on the NSP in Spain addressed to the Interterritorial Council of the National Health System. In July 2013, that Council approved the seven diseases that should be part of each region newborn screening panel, being the first step towards the NSP harmonization in Spain. Currently, the NSP include between 8 and 29 diseases in their panels, thus more still more efforts are needed in order to achieve a higher uniformity.
El proyecto por presentar consiste en la ampliación de la capacidad de producción para la;
fábrica de Huachipa de la empresa CBC Peruana S.A.C., la cual se dedica a la producción y;
distribución de ...los productos de PepsiCo.;
La propuesta consiste en ofrecer un servicio de consultoría donde se levante información,;
se analice y en conjunto con algunos responsables directos de la empresa se puedan ejecutar;
actividades e implementar proyectos de mejora para solventar el problema de falta de capacidad.;
Haciendo una proyección del volumen de ventas del año 2020 al 2025 se encontró que a partir de;
finales del 2022 existirá un déficit de capacidad para poder entregar el volumen solicitado por el;
área comercial, lo que traería consigo un desabastecimiento del mercado y una pérdida del 15%;
del crecimiento de la venta anual.;
La inversión requerida irá en base a las etapas en cuanto al corto, mediano y largo plazo.;
Para el corto plazo, la inversión estará basada en recursos como horas hombre adicionales tanto de;
los trabajadores de CBC Peruana como de los consultores, así como de modificaciones iniciales;
que se estarían ejecutando en el mediano plazo que oscila los $1,500,000 y en el largo plazo se;
estima que superaría los $3 millones, con rápido retorno.
The project to be presented consists of expanding the production capacity for the Huachipa;
factory of CBC Peruana S.A.C., which is engaged in the production and distribution of PepsiCo;
products.;
The proposal involves offering a consultancy service where information will be gathered,;
analyzed, and in conjunction with key stakeholders of the company, activities will be executed and;
improvement projects will be implemented to address the capacity shortage issue. By projecting;
the sales volume from 2020 to 2025, it was found that starting from late 2022, there will be a;
capacity deficit to meet the volume requested by the commercial area, which would result in;
market shortages and a 15% loss in annual sales growth.;
The required investment will be based on short, medium, and long-term stages. For the;
short term, the investment will be based on additional manpower resources, including both CBC;
Peruana employees and consultants' working hours. Initial modifications that would be;
implemented in the medium term would amount to approximately $1,500,000, while in the long;
term, it is estimated to exceed $3 million, with a fast return on investment.
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