Lumbar estrecho: experiencia de 10 años en la fundación santa fé de Bogotá

El canal lumbar estrecho de tipo degenerativo, es una enfermedad que se presenta en pacientes entre la quinta y la sexta década de vida; es la causa más común de cirugía lumbar después de los 65 años. Este trabajo busca determinar cuáles son los factores asociados a la presentación de eventos adversos o re-intervención en cirugía de canal lumbar estrecho en la Fundación Santa Fe de Bogotá en los años comprendidos entre 2003 y 2013. Métodos: se realizó un estudio de prevalencia de tipo analítico, en donde se analizaron 249 pacientes sometidos a intervención quirúrgica por cirugía de canal lumbar estrecho.

Descripción de los casos de accidentes laborales ocurridos en una empresa manufacturera, 2010 al 2014

Introducción Debido a que los accidentes de origen ocupacional ocupan un lugar importante dentro de las causas de ausentismo, discapacidades y hasta las muertes se realizó la descripción de la accidentalidad, teniendo en cuenta factores como la severidad y tipo de lesión, el tipo de actividad laboral y re accidentalidad ocurrida en una empresa manufacturera en un periodo de 2010 al 2014. Objetivos Establecer la distribución de los accidentes laborales ocurridos en una empresa manufacturera en el periodo de 2010 al 2014 según edad, género, área laboral y tipo de lesión. Materiales y métodos Se realizó un estudio de corte transversal en donde se analizaron las características según los trabajadores y la empresa y se realizaron asociaciones para establecer cuáles eran los factores de riesgo para presentar re accidentalidad. Se tomó una empresa manufacturera del sector de producción de alimentos que cuenta con un total de 950 empleados, en riesgo de presentar accidentes laborales. Se seleccionaron 338 accidentes ocurridos en el periodo de 2010 y 2014.Se realizaron análisis de los accidentes según las variables de: género, área de trabajo y tipo de herida para determinar su distribución según dichos factores. Posteriormente se realizaron análisis bivariado por medio de asociaciones estadísticas usando el estadístico Chi cuadrado y pruebas no paramétricas o paramétricas según la distribución de normalidad de las variables cuantitativas. El programa que se usó para el análisis fue el de SPSS versión 22. Resultados El estudio identificó que la proporción de accidentes durante el periodo estudiado con respecto al número de trabajadores fue de 35,6% y de los 950 trabajadores el 28,8% presentaron accidentes que corresponde a los 274 trabajadores. La mediana de edad fue de 35 años y se presentó más frecuente en mujeres (55,6%). El área laboral en la que se presentaron mayor número de accidentes fue el área de manufactura (75,7%). La proporción de mujeres que presentaban mayor accidentes en el área de manufactura si representó una diferencia de 23,4% con respecto a la proporción de hombres que presentaron mayor accidentes en la misma área. Con respecto al tipo de lesión, se presentaron accidentes frecuentemente en miembros superiores y según el género, las mujeres presentaron 2,02% más accidentes en miembros superiores comparado con los hombres. Los análisis en cuanto a re accidentalidad determinaron que el 16,8% de los trabajadores presentaron más de un accidente y un trabajador presentó 5 accidentes en el periodo de tiempo estudiado en la empresa, la edad se relacionó significativamente con el hecho de presentar re accidentalidad.

Caracterización del ausentismo laboral de una IPS que presta servicios de consulta externa de medicina general, 2014

RESUMEN El ausentismo laboral genera un gran impacto económico en las empresas y a la sociedad en general. Es un problema difícil de manejar ya que es multifactorial, porque a pesar de que en su gran mayoría es generado por enfermedad general, al analizarlo se puede encontrar otros factores que conlleven a la ausencia del trabajador y con ello producir alteración al normal funcionamiento de la empresa, por lo que resulta indispensable estudiar este tema. Objetivo Caracterizar las principales causas de ausentismo laboral en los médicos generales de una IPS que presta servicios de consulta externa de medicina general a nivel nacional durante el año 2014. Materiales y Métodos: es un estudio de corte transversal sobre datos secundarios correspondientes al registro de incapacidades que presento la IPS durante el año 2014. Los criterios de inclusión fueron los médicos generales con los que contaba la IPS que presta servicios de salud a nivel nacional durante el año 2014 y los criterios de exclusión fueron las licencias de maternidad y paternidad. El tamaño de la muestra final fue de 202 médicos y el número de incapacidades que se presentó durante el año 2014 fue 313. Se realizó análisis de distribución de frecuencias, porcentaje y prevalencia de las incapacidades. Resultados: durante el año 2014 se presentaron 313 incapacidades, en una población de 202 médicos generales con prevalencia en las mujeres. El diagnóstico más frecuente de las incapacidades fue la categoría diagnostica “otros” en el cual se encuentra migraña, vértigo, alteraciones de la mama con 59 incapacidades, seguida por enfermedades gastrointestinales con 25 incapacidades. Conclusiones y recomendaciones: Las incapacidades fueron más frecuentes en mujeres que en hombres. El diagnóstico de las incapacidades más frecuente fue “enfermedad genérica o ausencia de diagnóstico”. La incapacidad más frecuente de un día que se presentaron 46 registros. El médico que mayor número de incapacidades presento fue de 18 para el año 2014. Se recomienda a la empresa tener un seguimiento de las incapacidades repetitivas, ya que estas podrían tener relación con enfermedad laboral que aún no ha sido calificada. Se recomienda complementar la base de datos con información como el antecedente de enfermedad crónica y el sedentarismo, lo que puede permitir realizar nuevos estudios respecto al riesgo cardiovascular de esta población.

Entrevista a Roberto Fernández Retamar: la poesía, la Piadosa, me dio una razón para vivir (De la Escena Contemporánea. Entrevista)

El poeta y ensayista cubano confiesa que la poesía le dio una razón para vivir, y que sigue siendo su gran amor. Aunque difícil de definir, plantea que al ser humano le resulta imposible resistir sin ella: en toda crisis (la enfermedad, la muerte o la guerra), se recurre a la poesía. Las influencias literarias le llegaron de escritores alemanes, franceses y latinoamericanos (sobre todo, de Jorge Luis Borges, José Lezama Lima, Octavio Paz y Alfonso Reyes). El autor cubano destaca los méritos de varios poetas ecuatorianos y latinoamericanos. De Lezama Lima, quien “vivía para la poesía y el espíritu, con apenas unos pesitos”, resalta su sentido coral de la cultura (como construcción colectiva) y de la literatura. Respecto de la Revolución, aun reconociendo que hubo errores, está convencido de que es lo mejor que pudo pasarle a Cuba, no solo porque es la que buscó con insistencia, de Martí a Lezama, sino porque es la que triunfó y sigue adelante, pese al bloqueo económico de medio siglo por parte de la mayor potencia mundial, y de todas las dificultades.

Environmental quality and the productive workplace

A good working environment will help to provide the user with a good sense of wellbeing, inspiration and comfort. The main advantages of good environments is in terms of reduced upgrading investment, reduced sickness absence, an optimum level of productivity and improved overall satisfaction. Individuals respond very differently to their environments and research suggests a correlation between worker productivity and well-being, environmental, social and organisational factors. Research shows the occupants who report a high level of dissatisfaction about their job are usually the people who suffer more work and office environment related illnesses which affect their wellbeing, but not always so. Well-being expresses overall satisfaction. There is a connection between dissatisfied staff and low productivity; and a good sense of well-being is very important as it can lead to substantial productivity gain. If the environment is particularly bad people will be dissatisfied irrespective of job satisfaction. This paper describes research showing how environment affects productivity.

Health-related quality of life in Huntington's disease: a comparison of two generic instruments, SF-36 and SIP

Whereas several clinical endpoints in monitoring the response to treatment in patients with Huntington's disease (HD) have been explored, there has been a paucity of research in the quality of life in such patients. The aim of this study was to validate the use of two generic health-related quality of life instruments (the Short Form 36 health survey questionnaire [SF-36] and the Sickness Impact Profile [SIP]) and to evaluate their psychometric properties. We found that both instruments demonstrated acceptable convergent validity and reliability for patients and carers. However, there was an advantage in using the SF-36 because of its more robust construct validity and test-retest reliability; furthermore, motor symptoms appeared to influence some strictly nonmotor dimensions of the SIP. On a pragmatic level, the SF-36 is shorter and quicker to administer and, therefore, easier for patients at various stages of the disease to complete. Thus, the SF-36 would appear to be the recommended instrument of choice for patients with HD and their carers, although further work needs to be done to investigate the sensitivity of this instrument longitudinally. (C) 2004 Movement Disorder Society.

The relationship between membrane damage, release of protein and loss of viability in Escherichia coli exposed to high hydrostatic pressure

The aim of this work was to examine a possible association between resistance of two Escherichia coli strains to high hydrostatic pressure and the susceptibility of their cell membranes to pressure-induced damage. Cells were exposed to pressures between 100 and 700 MPa at room temperature (~20C) in phosphate-buffered-saline. In the more pressure-sensitive strain E. coli 8164, loss of viability occurred at pressures between 100 MPa and 300 MPa and coincided with irreversible loss of membrane integrity as indicated by uptake of propidium iodide (PI) and leakage of protein of molecular mass between 9 and 78 kDa from the cells. Protein release increased to a maximum at 400 MPa then decreased, possibly due to intracellular aggregation at the higher pressures. In the pressure-resistant strain E. coli J1, PI was taken up during pressure treatment but not after decompression indicating that cells were able to reseal their membranes. Loss of viability in strain J1 coincided with the transient loss of membrane integrity between approximately 200 MPa and 600 MPa. In E. coli J1 leakage of protein occurred before loss of viability and the released protein was of low molecular mass, between 8 and 11 kDa and may have been of periplasmic origin. In these two strains differences in pressure resistance appeared to be related to differences in the ability of their membranes to withstand disruption by pressure. However it appears that transient loss of membrane integrity during pressure can lead to cell death irrespective of whether cells can reseal their membranes afterwards.

Terminal: a miracle play with popular music from the end of the world

Terminal: A Miracle Play with Popular Music from the End of the World is a film and live performance project exploring the politics of post-apocalyptic fiction. A theatrical staging of a morality play for end times and future folk music, it recasts eschatology, as a foundational myth for a future society. Post-apocalyptic writing and cinema are grounded in an ethos of survivalism. Invoking Rousseau’s state of nature, or time before government, these fictions propose violent scenarios in which nuclear holocaust, environmental catastrophe and other disasters generate an individualistic politics of pure pragmatism, negating the possibility of democratic deliberation. Terminal narrates this familiar scenario, but at the same time questions its validity. The film, shot on black and white VHS at Kurt Schwitters’ Merzbarn in Cumbria, dramatises a series of conversations between future-historical archetypes about the needs and pressures of the situation in which they find themselves at the end of the world. The performers then gather to play worshipful songs about acid rain, radiation sickness and eating the dog, using a mix of conventional, obscure and makeshift instruments In the tradition of books such as Russell Hoban’s Riddley Walker and Arthur M. Miller Jr.’s A Canticle for Liebowitz, Terminal imagines artistic expression and new folk traditions for a world to come after the apocalypse. If, as Slavoj Žižek would have it, it is easier to imagine the end of the world than to think of the end of capitalism, the project juxtaposes these two endpoints to test out how alternative scenarios might emerge from the collaborative practice of making theatre and music against a setting of social collapse.

The spectacle of modernity: blood, microscopes and mirrors in Colonial Tanganyika

The chapter focuses on attempts to change and improve the subjects of the colonial regime in what was the British Protectorate of Tanganyika, contemporary Tanzania. The colonial project in Africa was surrounded by technology, ideology, and representations of modernity based on the application of instrumental rationality. Through the example of colonial practices to control sleeping sickness, it examines how local forms of knowledge and livelihoods were negated and counter-tendencies people generated, offering explanations for the predicament of the human condition consequent upon the colonial experience.

The Sick Child in Early Modern England, 1580-1720

The Sick Child in Early Modern England is a powerful exploration of the treatment, perception, and experience of illness in childhood, from the late sixteenth to the early eighteenth centuries. At this time, the sickness or death of a child was a common occurrence - over a quarter of young people died before the age of fifteen - and yet this subject has received little scholarly attention. Hannah Newton takes three perspectives: first, she investigates medical understandings and treatments of children. She argues that a concept of 'children's physic' existed amongst doctors and laypeople: the young were thought to be physiologically distinct, and in need of special medicines. Secondly, she examines the family's' experience, demonstrating that parents devoted considerable time and effort to the care of their sick offspring, and experienced feelings of devastating grief upon their illnesses and deaths. Thirdly, she takes the strikingly original viewpoint of sick children themselves, offering rare and intimate insights into the emotional, spiritual, physical, and social dimensions of sickness, pain, and death. Newton asserts that children's experiences were characterised by profound ambivalence: whilst young patients were often tormented by feelings of guilt, fears of hell, and physical pain, sickness could also be emotionally and spiritually uplifting, and invited much attention and love from parents. Drawing on a wide array of printed and archival sources, The Sick Child is of vital interest to scholars working in the interconnected fields of the history of medicine, childhood, parenthood, bodies, emotion, pain, death, religion, and gender.

The lipid composition of a cell membrane modulates the interaction of an antiparasitic peptide at the air-water interface

The antiparasitic property of peptides is believed to be associated with their interactions with the protozoan membrane, which calls for research on the identification of membrane sites capable of peptide binding. In this study we investigated the interaction of a lipophilicglutathioine peptide known to be effective against the African Sleeping Sickness (ASS - African Trypanosomiasis) and cell membrane models represented by Langmuir monolayers. It is shown that even small amounts of the peptide affect the monolayers of some phospholipids and other lipids, which points to a significant interaction. The latter did not depend on the electrical charge of the monolayer-forming molecules but the peptide action was particularly distinctive for cholesterol + sphingomyelin monolayers that roughly resemble rafts on a cell membrane. Using in situ polarization-modulated infrared reflection absorption spectroscopy (PM-IRRAS), we found that the orientation of the peptide is affected by the phospholipids and dioctadecyldimethylammonium bromide (DODAB), but not in monolayers comprising cholesterol + sphingomyelin. In this mixed monolayer resembling rafts, the peptide still interacts and has some induced order, probably because the peptide molecules are fitted together into a compact monolayer. Therefore, the lipid composition of the monolayer modulates the interaction with the lipophilic glutathioine peptide, and this may have important implications in understanding how the peptide acts on specific sites of the protozoan membrane. (C) 2011 Elsevier B.V. All rights reserved.

Systematic structural studies of iron superoxide dismutases from human parasites and a statistical coupling analysis of metal binding specificity

Superoxide dismutases (SODs) are a crucial class of enzymes in the combat against intracellular free radical damage. They eliminate superoxide radicals by converting them into hydrogen peroxide and oxygen. In spite of their very different life cycles and infection strategies, the human parasites Plasmodium falciparum, Trypanosoma cruzi and Trypanosoma brucei are known to be sensitive to oxidative stress. Thus the parasite Fe-SODs have become attractive targets for novel drug development. Here we report the crystal structures of FeSODs from the trypanosomes T. brucei at 2.0 angstrom and T. cruzi at 1.9 angstrom resolution, and that from P. falciparum at a higher resolution (2.0 angstrom) to that previously reported. The homodimeric enzymes are compared to the related human MnSOD with particular attention to structural aspects which are relevant for drug design. Although the structures possess a very similar overall fold, differences between the enzymes at the entrance to the channel which leads to the active site could be identified. These lead to a slightly broader and more positively charged cavity in the parasite enzymes. Furthermore, a statistical coupling analysis (SCA) for the whole Fe/MnSOD family reveals different patterns of residue coupling for Mn and Fe SODs, as well as for the dimeric and tetrameric states. In both cases, the statistically coupled residues lie adjacent to the conserved core surrounding the metal center and may be expected to be responsible for its fine tuning, leading to metal ion specificity.

Quartz recrystallization regimes, c-axis texture transitions and fluid inclusion reequilibration in a prograde greenschist to amphibolite facies mylonite zone (Ribeira Shear Zone, SE Brazil)

The crystal-plastic behavior of quartz mylonites from the Ribeira Shear Zone (SE Brazil), a major strike-slip structure that was active during a prograde metamorphic phase related to the Neoproterozoic Brasiliano-Pan African Orogeny, was investigated using a multi-method approach. Geothermobarometry results indicate deformational conditions ranging from similar to 300 to similar to 630 degrees C and 500-700 MPa. A strong correlation between mapped metamorphic zones and a dominance of different dynamic recrystallization mechanisms of quartz occurs within the mylonite zone. Bulging recrystallization (BLG) dominates within the chlorite zone between 300 and 410 degrees C, subgrain rotation recrystallization (SGR) operates within the biotite zone from 410 to 520 degrees C, and grain boundary migration recrystallization (GBM) dominates in the garnet zone above 520 degrees C. The development of quartz c-axis textures is mainly governed by temperature and dynamic recrystallization mechanisms. Textures from BLG zone mylonites are characterized by maxima around Z; SGR zone mylonites display single girdles or asymmetric type I crossed girdles; and GBM zone mylonites comprise maxima around Y and intermediate between X and Z. The scarcity or absence of water-bearing fluid inclusions in quartz mylonites from the SGR and GBM zones, which are dominated by carbonic inclusions, suggests water-deficient conditions, whereas BLG zone mylonites are dominated by water-bearing inclusions. This evidence indicates that water was available in the protoliths but has been eliminated with increasing deformation and deformation temperature. No effect of the water content variation on the quartz microstructural and recrystallized grain size evolution was detected, and little influence on c-axis texture development was observed. Most of the fluid inclusion densities were reequilibrated during the shear zone exhumation history, recording a decompression in the range of 300-500 MPa, while microstructural reequilibration effects related to the prograde metamorphism are largely preserved. Fluid inclusion microstructures and densities from two SGR zone samples preserved evidence for a near isothermal compression within the interior of the Ribeira Shear Zone during the prograde metamorphism. (C) 2009 Elsevier B.V. All rights reserved.

Relics of eclogite facies assemblages in the Ceara Central Domain, NW Borborema Province, NE Brazil: Implications for the assembly of West Gondwana

The Borborema Province, in the NE of Brazil, is a rather complex piece in the Brazil-Africa puzzle as it represents the junction of the Dahomeyide/Pharusian, Central African, Aracuai and Brasilia fold belts located between the West-African/Sao Luis, Congo/Sao Francisco and Amazonas craton. The correlation between the Dahomeyides from W-Africa (Ghana, Benin, Togo, and Mali) and the Borborema Province involves the Medio Coreau and Central Ceara domains. The inferred continuation of the main oceanic suture zone exposed in the Dahomeyides of W Africa is buried beneath the Phanerozoic Parnaiba Basin in Brazil (northwest of the Medio Coreau domain) where some high density gravity anomalies may represent hidden remnants of an oceanic suture. In addition to this major suture a narrow, nearly continuous strip composed of mainly mafic pods containing relics of eclogite-facies assemblages associated with partially migmatized granulite-facies metapelitic gneisses has been found further east in the NW Borborema Province. These high pressure mafic rocks, interpreted as retrograded eclogites, are located between the Transbrasiliano Lineament and the Santa Quiteria continental arc and comprise primitive to evolved arc-related rocks with either arc- or MORB-type imprints that can indicate either deep subduction of oceanic lithosphere or roots of continental and oceanic magmatic arcs. Average peak P-T conditions under eclogite-facies metamorphism (T=770 degrees C and P = 17.3 kbar) were estimated using garnet-clinopyroxene thermometry and Jd content in clinopyroxene. Transition to granulite-facies conditions, as well as later widespread re-equilibration under amphibolite facies, were registered both in the basic and the metapelitic rocks and suggest a clockwise P-T path characterized by an increase in temperature followed by strong decompression. A phenomenon possibly related to the exhumation of a highly thickened crust associated with the suturing of the Medio Coreau and Central Ceara domains, two distinct crustal blocks separated by the Transbrasiliano Lineament. (C) 2009 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.

Metamorphic P-T evolution of granulites in the central Ribeira Fold Belt, SE Brazil

Pseudosections, geothermobarometric estimates and careful petrographic observations of gneissic migmatites and granulites from Neoproterozoic central Ribeira Fold Belt (SE Brazil) were performed in order to quantify the metamorphic P-T conditions during prograde and retrograde evolution of the Brasiliano Orogeny. Results establish a prograde metamorphic trajectory from amphibolite facies conditions to metamorphic peak (T = 850 +/- 50 A degrees C; P = 8 +/- 1 kbar) that promoted widespread dehydrationmelting of 30 to 40% of the gneisses and high-grade granitization. After the metamorphic peak, migmatites evolved with cooling and decompression to T a parts per thousand 500 A degrees C and P a parts per thousand 5 kbar coupled with aH2O increase, replacing the high-grade paragenesis plagioclase-quartz-K-feldspar-garnet by quartz-biotite-sillimanite-(muscovite). Cordierite absence, microtextural observations and P-T results constrain the migmatite metamorphic evolution in the pseudosections as a clockwise P-T path with retrograde cooling and decompression. High-temperature conditions further dehydrated the lower crust with biotite and amphibole-dehydration melting and granulite formation coupled with 10% melt generation. Granulites can thus be envisaged as middle to lower crust dehydrated restites. Granulites were slowly (nearly isobarically) cooled, followed by late exhumation/retrograde rapid decompression and cooling, reflecting a two step P-T path. This retrograde evolution, coupled with water influx, chemically reequilibrated the rocks from granulite to amphibolite/greenschist facies, promoting the replacement of the plagioclase-quartz-garnet-hypersthene peak assemblage by quartz-biotite- K-feldspar symplectites.